The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.
Child ; Deglutition ; Glossectomy* ; Humans ; Macroglossia* ; Malocclusion ; Mouth ; Respiration ; Sialorrhea ; Tongue*

BACKGROUND: Doxylamine succinate(DS) is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effect. Recently it was revealed that DS had a direct effect on muscle, while its exact mechanism is not clear yet. We evaluated the patients with rhabdomyolysis induced by DS overdose for patients disposition based upon clinical decision, especially by creatinine phosphokinase(CPK). METHODS: We reviewed retrospectively the medical records of patients admitted by DS overdose from Jan. 1998 to Oct. 1999. Seventy and nine cases of DS overdose were evaluated with respect to age and sex distribution, amount ingested, clinical symptomatology, time from ingestion to visit, pattern of CPK, amount of bicarbonate used as therapy, complication and prognosis, especially in patients complicated rhabdomyolysis. RESULTS: Rhabdomyolysis, diagnosed as more than 1,000I. U/L of CPK, has been noted in 25(31.6%) of 79 cases of DS overdose visited to our emergency department(ED). In patients diagnosed rhabdomyolysis, the number of man was 10 cases(40%) and the number aged between 20 and 40 years was 22 cases(88%). The average time from DS ingestion to ED visit was 459 minutes. The amount of DS ingested was 500-5,000mg(mean, 1,980mg). 13(52%) cases ingested less than 2,250mg of DS. The initial levels of CPK(range, 48-14900I. U/L; normal range, 26-200I. U/L) after admitting to our emergency department were normal in 15 cases(60%) of rhabdomyolysis patients. The range of peak CPK levels after ingestion was 607 to 412,500I. U/L(mean, 33,550I. U/L). Its peak time was 6 to 96 hours(mean, 28.96 hours). In 14 cases(67%) of 21 visiting within 24 hours after ingestion, peak time of CPK ranged 12 to 24 hours after ingestion. The amount of bicarbonate used as therapy of rhabdomyolysis ranged 100 to 2,740mEq(mean, 656mEq) and all patients was discharged after improvement without other complication including acute renal failure. CONCLUSIONS : Although patients ingested less than 2,250mg of DS, emergency physicians should observe them more than 24 hours after DS ingestion with CPK follow-up after gastric irrigation and charcoal administration.
Acute Kidney Injury ; Charcoal ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Emergency Service, Hospital ; Follow-Up Studies ; Gastric Lavage ; Humans ; Medical Records ; Prognosis ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Sex Distribution ; Sleep Initiation and Maintenance Disorders ; Succinic Acid*

A secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Skin ; Transplants

Hypertrophic scarring is common in burn patients. The treatment of such scarring is difficult, and recurrence of the hypertrophic change after scar revision is not uncommon. It has been done intramarginal excision to diminish the chances of recurrent hypertrophic scarring. Core scars in the auricle are easily separated from auricular cartilage and overlying soft tissue because there is loose areolar tissue between them. We therefore reviewed our experience with core extirpation of post-burn hypertrophic scars in the auricle. Between June 14, 1991, and August 6, 1994, we excised 10 hypertrophic scars in the auricle in 5 burn patients. Core extirpations of hypertrophic scars were performed under local anesthesia with longitudinal incision along long axis of scars. The wounds were closed directly in one layer after marginal trimming. We observed that core extirpation yielded good results in post-burn hypertrophic scars in the auricles.
Anesthesia, Local ; Axis, Cervical Vertebra ; Burns ; Cicatrix ; Cicatrix, Hypertrophic* ; Ear Cartilage ; Humans ; Recurrence ; Wounds and Injuries

BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

The rapid quantification of paraquat in body fluids is of undoubted value in both initial assesment as well as the immediate prognosis of acutely poisoned patients. A 20-year-old woman ingested a mouthful of paraquat. Serum and urine paraquat levels were measured colorimetrically for 48 hours after identifying the presence of paraquat in her urine by a Paraquat test kit. At that time her survivability was considerd to be over 50% according to Proudfoot's scale of time related measured serum paraquat levels. Five days after admission, she began to cough but her chest x-ray picture was normal. However, she persisted to cough and subsequent chest x-rays showed fine reticulonodular densities in both upper and lower lobes. Twenty days after admission, she .was clinically well, and not deteriorated radiologically. Therefore, respiratory function tests were under-taken. They showed reduced lung volume, moderate reduction in ventilatory capacity, and a diffusion defect (DLco: 27% predicted value). Twenty four days after admission, the patient was discharged in good condition except for the sequale of lung involvement. Six months later, she was re-examined and found to be healthy with a large regression of lung lesions on her chest x-ray.
Body Fluids ; Cough ; Diffusion ; Eating* ; Equidae ; Female ; Humans ; Lung ; Mouth ; Paraquat* ; Prognosis ; Respiratory Function Tests ; Thorax ; Young Adult

The rapid quantification of paraquat in body fluids is of undoubted value in both initial assesment as well as the immediate prognosis of acutely poisoned patients. A 20-year-old woman ingested a mouthful of paraquat. Serum and urine paraquat levels were measured colorimetrically for 48 hours after identifying the presence of paraquat in her urine by a Paraquat test kit. At that time her survivability was considerd to be over 50% according to Proudfoot's scale of time related measured serum paraquat levels. Five days after admission, she began to cough but her chest x-ray picture was normal. However, she persisted to cough and subsequent chest x-rays showed fine reticulonodular densities in both upper and lower lobes. Twenty days after admission, she .was clinically well, and not deteriorated radiologically. Therefore, respiratory function tests were under-taken. They showed reduced lung volume, moderate reduction in ventilatory capacity, and a diffusion defect (DLco: 27% predicted value). Twenty four days after admission, the patient was discharged in good condition except for the sequale of lung involvement. Six months later, she was re-examined and found to be healthy with a large regression of lung lesions on her chest x-ray.
Body Fluids ; Cough ; Diffusion ; Eating* ; Equidae ; Female ; Humans ; Lung ; Mouth ; Paraquat* ; Prognosis ; Respiratory Function Tests ; Thorax ; Young Adult

BACKGROUND: This study was designed to evaluate the antihypertensive efficacy and safety of nifedipine gastrointestinal system push-pull osmotic pump formulation in patients with mild to moderate essential hypertension. METHODS: After 2 weeks placebo run-in period, nifedipine 60 mg was administered once daily for 8 weeks in thirty-two patients with mild to moderate essential hypertension. RESULTS: At the end point of treatment, sitting blood pressure decreased as much as 33/16mmHg in average and rewarded 88% of efficacy and 69% of normalization. The ambulatoy blood pressure monitoring in 10 patients also revealed 11% decrease in 24 hr mean diastolic blood pressure and 32% decrease in % elevated blood pressure. The most frequent side reactions were constipation in 7 patients and polyuria in 6 patients which were tolerated during entire trial period. There were no significant changes in biochemical parameters and hematologic data, thus making the rate of safety 91% and overall rating of usefulness was 84%. CONCLUSION: Nifedipine GITS 60 mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Blood Pressure Monitors ; Constipation ; Humans ; Hypertension* ; Nifedipine* ; Polyuria ; Reward

Authors carried out an investigation of the helminthic parasites of the wild birds in Korea. Most wild birds were collected from Kyoung Sang Do, Kyoung Kee Do and Seoul area from September 1970 to March 1973. A total of 70 wild birds, 19 species were examined, which comprised as follows; 10 Anas platyrhynchus, 10 Anas fulicata, 4 Anas poeciolorhyncha zonorhyncha, 8 Anser albifrone albifrone, 5 Anser cygonopsis cygnoid, 10 Aythya fuligula, 6 Gallicrex cinerea, 2 Porgana fusca, 2 Phisianum calichius korponri, 4 Sterptopilla orientalis, Podiceps cristatus, Larus crasirotatus, Malantta fusca, Garis artcus, Buetes buteo, Egretta alba, Starmus philpiens, Bombycilla granulus. Trematode parasites found from six species of the wild birds. Echinostomatidae has been found from intestine of the Anas platyrhynchus platyrhynchus, Anas poeciolorhyncha zonorhyncha, Anas fulcata. Notocatylus attenuatis found from intestine of the Podiceps cristatus, Anas fulcata. Catylurus japonicus was found from rectum of the Anas platyrhynchus platyrhynchus, Anas poeciolorhyncha zonorhyncha.
parasitology-helminth-trematoda ; Notocatylus attenuatus ; Catylurus japonicus ; Echinostoma revolutum ; Echinostoma gotoi ; Echinostoma miyagawai ; Echinoparyphium koizumi ; bird

The objective of this study was to investigate the relationship between insomnia severity, depression, anxiety, and anxiety sensitivity and to find out the explanatory variables that account for the insomnia severity among depression, anxiety, and anxiety sensitivity in general population. 95 mentally healthy volunteers who visit health promotion center of Kangbuk Samsung hospital for their regular medical examination were requested to complete Athens Insomnia Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Anxiety Sensitivity Index. Association between total scores of Athens Insomnia scale and other variables (total scores of Beck Depression Inventory excluded item 16, total scores of State Anxiety, total scores of Trait Anxiety, and total scores of Anxiety Sensitivity Scale) was assessed individually with partial correlations adjusted by age and then together using multiple regression analysis. The total scores of Athens Insomnia Scale were significantly associated with total scores of Beck Depression Inventory excluded item 16(r = 0.541, p<0.001), total scores of Trait Anxiety(r = 0.642, p<0.001), total scores of State Anxiety(r = 0.267, p<0.05), and total scores of Anxiety Sensitivity Index(r = 0.312, p<0.01). Total scores of trait anxiety showed the highest correlation with the total scores of Athens Insomnia Scale and was the significant predictor to total scores of Athens Insomnia Scale among the other predictor variables (p<0.001). These results show that insomnia severity is positively correlated with depression, anxiety, and anxiety sensitivity. The correlation was strongest with trait anxiety. In addition, our results suggest that trait anxiety is associated with insomnia severity in general populations.
Anxiety* ; Depression* ; Health Promotion ; Healthy Volunteers ; Sleep Initiation and Maintenance Disorders*