BACKGROUND AND OBJECTIVES: Post-tonsillectomy pain is unavoidable and related to the dysphagia, dehydration and loss of time in returning to normal activities. This study was performed to investigate whether fibrin glue (Tissucol(R) Duo Quick, Baxter AG, Wien, Austria) applied to tonsillar bed after the completion of tonsillectomy reduced pain. SUBJECTS AND METHOD: Twenty-five adults scheduled for an elective tonsillectomy were included in this prospective double-blind study. After removal of both tonsils electrocauterization was done on both tonsillar bed for adequate hemostasis. And then, one side of tonsillar bed randomly selected by operating surgeon was coated with the fibrin glue and the other side was left without coating. Pain scores were measured at the first (postoperative day, POD1), third (POD3) and tenth (POD10) day of the operation by using visual analogue scale (VAS). RESULTS: The VAS scores of the side treated with fibrin glue and the non-coated side were 3.67+/-1.16/3.14+/-0.96/1.52+/-0.81 (POD1/POD3/POD10) and 5.33+/-1.28/4.19+/-1.21/1.71+/- 0.96 (POD1/POD3/POD10), respectively. The VAS score difference between both sides were 1.67+/-0.58/1.05+/-0.59/0.19+/-0.40 (POD1/PO3/POD10). CONCLUSION: This study shows that the application of fibrin glue on tonsillectomy site was effective for postoperative pain control. Moreover, the efficacy was prominent at early postoperative days known as period of severe pain.
Adult ; Deglutition Disorders ; Dehydration ; Double-Blind Method ; Fibrin ; Fibrin Tissue Adhesive ; Hemostasis ; Humans ; Pain, Postoperative ; Palatine Tonsil ; Prospective Studies ; Tonsillectomy

Unilateral adrenal hyperplasia (UAH) is a rare, surgically correctable subset of primary aldosteronism. It has similar clinical features to aldosterone-producing adenoma (APA), but different pathologic finding. We report a case of UAH in a 51-year-old Korean man. The patient had hypertension. Hypokalemia and suppressed plasma renin activity (PRA) with elevated plasma aldosterone concentration (PAC) was observed. The 1.5 cm-sized nodule in left adrenal gland was scanned by abdominal computed tomography (CT). The selective adrenal venous sampling for determinations of PAC showed an overfunctioning left adrenal gland, and laparoscopic left adrenalectomy was performed. Pathologically, 1.3 cm-sized nodular hyperplasia lesion was observed. Hypokalemia, hypertension, and endocrine data were corrected after surgery, and there was no sign of recurrence for eight months after surgery. Clinical features of UAH are also reviewed.
Adenoma ; Adrenal Glands ; Adrenalectomy ; Aldosterone ; Humans ; Hyperaldosteronism* ; Hyperplasia* ; Hypertension ; Hypokalemia ; Middle Aged ; Plasma ; Recurrence ; Renin

The reVersible posterior leukoencephalopathy syndrome (RPLS) describes a syndrome of headaches, confusion, seizures, and visual disturbances associated with transient, predominantly posterior cerebral lesions revealed by neuroimaging. RPLS has been associated clinically with hypertension, immunosuppression, and known triggers include acute renal failure, eclampsia, cyclosporine, and lupus. We report a 45-year-old male with chronic renal failure showed RPLS following hemodialysis and review literatures.
Acute Kidney Injury ; Cyclosporine ; Eclampsia ; Female ; Headache ; Humans ; Hypertension ; Immunosuppression ; Kidney Failure, Chronic* ; Male ; Middle Aged ; Neuroimaging ; Posterior Leukoencephalopathy Syndrome* ; Pregnancy ; Renal Dialysis ; Seizures

BACKGROUND: Radiofrequency catheter ablation (RFCA) becomes an useful treatment for idiopathic ventricular tachycardia, especially right ventricular outflow tract ventricular tachycardia (RVOT VT) typically originates from "superior septal" aspect of right ventricular outflow tract. However, some of the right ventricular outflow tachycardias remain resistant despite repeated attempts of RFCA. This study was focused to search the electrocardiographic characteristics suggesting procedural success of radiofrequency ablation in RVOT VT and ventricular tachycardia that can not be ablated by conventional approach confined to right ventricular outflow tract even though to show similar electrocardiographic morphology. METHODS: The study subjects were 25 patients who underwent RFCA with the diagnosis of RVOT VT. We classified the study subjects into 2 groups and in group 1 (N=17, Age 47.5 +/- 16.8) in those successful RFCA was possible in RVOT. In group 2 (N=8, Age 54.8 +/- 8.0), the removal of VT was not possible with the RFCA confined in RVOT. We analyzed the morphologic characteristics of QRS complex of VT or ventricular premature beats in right precordial leads; V(1-3). The QRS and R wave duration, height of R wave, depth of S wave, R/S ratio and R wave duration index were measured. RESULTS: There was no difference of age and sex between group 1 and 2 (Group 1: N=17, Male 29.4%, Age 49.5 +/- 16.8 vs Group 2: N=8, Age 54.8 +/- 8.0, Male 37.5%). The maximal QRS duration in V(1-3) was 144.2 +/- 23.6 ms in group 1 and 136.3 +/- 25.1 ms in group 2. The R wave duration and R wave duration index were not different either between group 1 and 2. However, the R wave duration of lead V 3 in group 2 was 97.0 +/- 34.4 ms and significantly longer than 65.0 +/- 26.0 msec in Group 1 (p=0.04). R wave duration index also showed significant difference between two groups: 72.0 +/- 23.5% of group 2 vs 45.4 +/- 17.8% of group 1. In comparison of R wave height and depth of S wave in V(1-3) between two groups, the R/S ratio of lead V3 in group 2 showed the ratio of 343.4 +/- 227.7% which was significantly larger than 97.4 +/- 92.2% in group 1. CONCLUSION: For the practice of RFCA for RVOT VT, morphologic characterstics of VT or VPC showing wide R wave and high R/S wave ratio in precordial leads, especially in V3 could be an useful electrocardiographic indicator to suspect the unusual focus of idiopathic VT showing inferior axis and LBBB pattern.
Axis, Cervical Vertebra* ; Bundle-Branch Block* ; Cardiac Complexes, Premature ; Catheter Ablation* ; Diagnosis ; Electrocardiography ; Humans ; Male ; Tachycardia ; Tachycardia, Ventricular*

BACKGROUND: Bronchial anthracofibrosis, which is defined as bronchial narrowing with black pigmentation of the overlying bronchial mucosa, is frequently associated with tuberculosis. The aim of this study was to examine the relationship between bronchial anthrocofibrosis and to identify the clinical and radiological characteristics of non-tuberculous bronchial anthracofibrosis. METHODS: All patients who showed bronchial anthracofibrosis in more than one segment on a bronchoscopic examination from January 2003 to July 2006 at Kangnam St. Mary's hospital were enrolled in this study. The underlying diseases, baseline clinical characteristics, characteristic findings on a computed tomogram (CT) of the chest, pathologic findings of the bronchial mucosa, and the clinical response to steroid therapy were analyzed retrospectively. RESULTS: A total 54 patients (19 males, 35 females) were enrolled with a mean age of 75 years. The most common presenting symptoms were cough, sputum and dyspnea. The predominant X-ray findings were peribronchial soft tissue attenuation with or without calcification, mediastinal lymphadenopathy with or without calcification and atelectasis. Fourteen non-tuberculous anthracofibrosis patients were treated with steroid. Nine patients were improved clinically, and 6 patients were improved radiologically. CONCLUSION: Bronchial anthracofibrosis is frequently associated with various pulmonary diseases not only tuberculosis but also COPD pneumonia etc.
Cough ; Dyspnea ; Humans ; Lung Diseases ; Lymphatic Diseases ; Male ; Mucous Membrane ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis

BACKGROUND: Bronchial anthracofibrosis, which is defined as bronchial narrowing with black pigmentation of the overlying bronchial mucosa, is frequently associated with tuberculosis. The aim of this study was to examine the relationship between bronchial anthrocofibrosis and to identify the clinical and radiological characteristics of non-tuberculous bronchial anthracofibrosis. METHODS: All patients who showed bronchial anthracofibrosis in more than one segment on a bronchoscopic examination from January 2003 to July 2006 at Kangnam St. Mary's hospital were enrolled in this study. The underlying diseases, baseline clinical characteristics, characteristic findings on a computed tomogram (CT) of the chest, pathologic findings of the bronchial mucosa, and the clinical response to steroid therapy were analyzed retrospectively. RESULTS: A total 54 patients (19 males, 35 females) were enrolled with a mean age of 75 years. The most common presenting symptoms were cough, sputum and dyspnea. The predominant X-ray findings were peribronchial soft tissue attenuation with or without calcification, mediastinal lymphadenopathy with or without calcification and atelectasis. Fourteen non-tuberculous anthracofibrosis patients were treated with steroid. Nine patients were improved clinically, and 6 patients were improved radiologically. CONCLUSION: Bronchial anthracofibrosis is frequently associated with various pulmonary diseases not only tuberculosis but also COPD pneumonia etc.
Cough ; Dyspnea ; Humans ; Lung Diseases ; Lymphatic Diseases ; Male ; Mucous Membrane ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis

The follow-up of patients after performing potentially curative resection for colon cancer is important, yet the ideal surveillance strategy has not been defined. Periodic clinical examinations, laboratory tests, radiographic imaging, colonoscopy and carcinoembryonic antigen (CEA) testing have been utilized for surveillance, and the serial CEA measurement is the most cost-effective test for identifying the recurrence of disease. However, this test also indicates the development of secondary gastrointestinal malignancy such as gastric cancer or duodenal cancer. We report here on a case of metachronous duodenal adenocarcinoma that was revealed by the serial measurement of the serum CEA after we performed curative resection for colon cancer.
Adenocarcinoma* ; Carcinoembryonic Antigen ; Colon* ; Colonic Neoplasms* ; Colonoscopy ; Duodenal Neoplasms ; Follow-Up Studies ; Humans ; Recurrence ; Stomach Neoplasms

OBJECTIVE: To evaluate the effect of Korean Computer-Assisted Cognitive Rehabilitation Program (CogRehabK ) on cognitive function of the patients with brain injury. METHOD: Fifty subjects with brain injury were enrolled and classified into two groups, experimental (n=25) and control group (n=25). Control group received conventional rehabilitation therapy including physical and occupational therapy. Experimental group received additional computer-assisted cognitive training using CogRehabK software consisted of 10 level-completing programs, 3 times per week, 30 minutes per session, for 4 to 6 weeks. All patients were assessed their cognitive functions using Seoul Computerized Neuropsychological Test (SCNT , Maxmedica, 2001), minimental status examination (MMSE), digit span, and Wechslermemory scale before and after treatment. Functional independence measure and geriatric depression scale were also applied for evaluation of functional and mood status. RESULTS: Before the treatment, two groups showed no difference in their cognitive functions. After 4 to 6 weeks of treatment, the experimental group showed significantly higher performance in forward digit span, forward visual span, auditory continuous performance test, and visual continuous performance test in CNT and MMSE than control group (p<0.05). CONCLUSION: We conclude that the CogRehabK may be useful as an additional tool for the cognitive rehabilitation in patients with brain injury.
Brain Injuries* ; Brain* ; Depression ; Humans ; Neuropsychological Tests ; Occupational Therapy ; Rehabilitation* ; Seoul

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure