We present a case of problematic tracheal intubation in an adult patient with an unrecognized tracheal bronchus. Immediately after tracheal intubation and position change to prone, bilateral breath sounds were almost absent, and there was a diminished tidal volume. In order to resolve the ventilatory difficulty, the wire-reinforced tube was replaced with a conventional tube, and proper positioning of the tube was completed under fiberoptic guidance. A tracheal bronchus (originating about 1.2 cm above the carina, and supplying the right upper lobe) was found on the postoperative chest CT. In the presence of tracheal bronchus, tracheal intubation may cause pulmonary complications. Anesthesiologists should keep in mind the anesthetic implications of tracheal bronchus, and must be familiar with the use of fiberoptic bronchoscopy for proper positioning of endotracheal tube.
Adult ; Bronchi ; Bronchoscopy ; Humans ; Intubation ; Intubation, Intratracheal ; Thorax ; Tidal Volume

BACKGROUND: To determine the prevalence of chronic fatigue syndrome and idiopathic chronic fatigue in Korea and to describe demographic, clinical, and psychological differences among those with chronic fatigue syndrome (CFS), those with idiopathic chronic fatigue, and healthy controls. METHODS: 1,526 persons aged 18-76 years who visited Korea university hospital health management center for general check-up between December 1998 and August 1999 were participated in the study. The questionnaire made according to the Centers for Disease Control and Prevention criteria was administered to the recruited persons and patients with chronic fatigue syndrome were diagnosed by questionnaire, physical examination and laboratory tests. The Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depression. RESULTS: Of the 1,526 persons studied, 433 (29.4 %) reported severe fatigue lasting at least 6 months. Of the 202 persons with unexplained chronic fatigue, 31 persons (2.0% of the study population) were classified as CFS cases. The prevalence of CFS was 2.81% in women, 1.49% in men respectively (p<0.05). When CES-D cut-off score of 25 was used, 30.43% of persons with CFS and 5.93% of persons without chronic fatigue had scores suggestive of depression. CFS patients had higher mean scores on CES-D than persons without chronic fatigue (p<0.05). CONCLUSION: Persons who met the criteria for chronic fatigue syndrome were found in 2.0%. The prevalence of chronic fatigue syndrome in our study were high, compared with previous studies in other countries. CFS patients had higher mean scores on CES-D than persons without chronic fatigue.
Centers for Disease Control and Prevention (U.S.) ; Depression ; Fatigue ; Fatigue Syndrome, Chronic* ; Female ; Humans ; Korea ; Male ; Physical Examination ; Prevalence* ; Surveys and Questionnaires

BACKGROUND/AIMS: As a result of the rapid development of medical diagnostic tools, physicians require concrete evidence to evaluate the effectiveness of the tools. We aimed to investigate the effectiveness and additional diagnostic benefits of capsule endoscopy (CE) in patients with small bowel Crohn’s disease (CD). METHODS: We performed a systematic search of databases, including MEDLINE, EMBASE, and the Cochrane Library, as well as eight domestic databases. Two reviewers independently screened all references. Diagnostic data from the studies were collected, and a meta-analysis was performed. RESULTS: Twenty-four studies were included. In cases of suspected CD, CE demonstrated a superior diagnostic yield compared with small bowel follow-through (SBFT) and enteroclysis (EC); however, there was no difference compared with computed tomography enterography or magnetic resonance enterography. In cases with established CD, CE demonstrated a higher diagnostic yield only compared with EC. In the detection of terminal ileum lesions, CE exhibited a significantly increased detection rate compared with ileoscopy. CONCLUSIONS: The findings of our meta-analysis indicate that CE is superior to SBFT and EC in the evaluation of suspected CD cases. CE is also a more effective diagnostic modality in patients with established CD compared with EC.
Capsule Endoscopy* ; Crohn Disease ; Humans ; Ileum ; Intestines

PURPOSE: Many burn patients have been suffered from sequelae of burn injury (itching, pain, heating sense, etc.). The treatment of those symptoms was not successful even though they are approached multiply. Some patients depend on folk remedies. We try to find the effectiveness of microneedling procedure (dermastamp(R)) which is used for esthetic purpose. METHODS: 25 patients were included who had been treated with the skin massage therapy from September 2008 to March 2009. They received the dermastamp(R) procedure once a week and surveyed from 2 months after procedure. The survey items were itching, pain, tightness, firmness, shape of scar, joint deformities. We divided the severity of symptoms into digit scale form 0 (no symptoms) to 10 (too severe to sleep) and the severity was estimated by patients. Statistical method was Wilcoxon signed rank test. RESULTS: The patient group consisted of 8 males and 17 females. The mean age was 22.2+/-13.8 years old. The average time that felt the effectiveness was 4.4+/-2.3 times. Statistically significant responses showed in itching, firmness (P<0.05), pain and tightness (P<0.01). Improvement of the shape of scar and joint deformities were not statistically significant. CONCLUSION: Even now, no definite treatment against the sequelae of burn injury. Multimodalities of treatment in sequelae of burn injury are using and dermastamp(R) can be an additional method for sequelae of burn injury.
Burns ; Cicatrix ; Congenital Abnormalities ; Female ; Heating ; Hot Temperature ; Humans ; Joints ; Male ; Massage ; Medicine, Traditional ; Pruritus ; Skin

Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.
Abdomen ; Aged ; Biopsy ; Brain ; Dysarthria ; Follow-Up Studies ; Humans ; Laminectomy ; Lung ; Magnetic Resonance Imaging ; Meningioma ; Neoplasm Metastasis ; Recurrence ; Reoperation ; Ribs ; Spine ; Thorax

BACKGROUND: Almost no study has been carried out to explore the cognitive characteristics of the oldest old population in Korea, even though Korean society is becoming very 'old'. The purpose of this study is to the examine basic cognitive functions of Korean elders over 100 years of age. METHODS: Data collection was completed with 87 elders, 12 males and 75 females. Their mean age was 103.2 for males and 102.3 for females. The average year of education for this population was less than 1 year(0.5 year). We evaluated cognitive functions by K-MMSE and the severity of dementia by CDR (Clinical Dementia Rating). RESULTS: Most of them were able to speak fluently(81.6%) and had reasonable vision(67.8%), but 55.2 % of subjects had full comprehension ability. There was no significant difference in results between elders from Seoul and from other country area. We have divided the sample population into 5 groups according to CDR score; 0(7.4%), 0.5(33.3%), 1(25.9%), 2(14.8%), 3(18.5%), to compare with K-MMSE score. There were significant differences in K-MMSE scores between CDR groups. DISCUSSION: About 7% of elders over 100 years of age are still maintaining normal cognitive function. Considering the physical handicaps of the subjects, probable dementia group(30%) can also be regarded as to possess near normal cognitive function. This study is the first study on Korean centenarians and will provide essential data for future studies on the oldest old.
Aged, 80 and over ; Comprehension ; Data Collection ; Dementia ; Education ; Female ; Humans ; Korea ; Male ; Seoul

Mesenchymal chondrosarcomas are rare malignant tumors of the bone and soft tissue. Spinal mesenchymal chondrosarcomas are even rarer and, to the best of our knowledge those that are concomitantly located in the intradural and extradural regions, have never been reported. We report a case of a 25-year-old man with back pain and bilateral progressive weakness of the lower extremities. Magnetic resonance imaging revealed a markedly enhanced dumbbell-shaped mass at the T7 level. The lesion was intradurally located at the left side of the spinal cord, and extended extradurally to the extraforminal space through the T7-8 intervertebral foramen. The tumor was completely excised through a posterior approach. Microscopic examination and immunohistochemical studies confirmed mesenchymal chondrosarcoma. Postoperative radiation therapy and chemotherapy were also performed to prevent local recurrence and metastasis. The patient has been symptom-free for two years after surgery. Herein, we reviewed and discussed the clinical characteristics, treatments, and outcomes of primary intraspinal mesenchymal chondrosarcomas in the literature.
Adult ; Back Pain ; Chondrosarcoma, Mesenchymal ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Recurrence ; Spinal Cord

PURPOSE: The optimal initial treatment for burn wound is generally applying cold running tap water of temperature 12~18degrees C for approximately 20 minutes. But most of the patients are not susceptible to this initial treatment because they are likely to get embarrassed in such situation. According to statistics of our hospital, 92.2% of patients who visited ER (emergency room) had less than 10 minutes of water cooling. In this study, our aim was to find out the clinical effect of biocellulose sheet (Bestian M(R) pack) as an emergent treatment. METHODS: Between November 2010 and October 2011, 93 patients with burn wound showing first or superficial second degree at first inspection were evaluated in our study. Biocellulose sheet (Bestian M(R) pack) was applied at the wound as soon as possible for 25 minutes and second inspection was done. Routine moisture dressing was done thereafter and patients were followed as outpatient. RESULTS: Among 93 patients, 28 were male and 65 were female. Scalding burn, contact burn, flame burn and other causes were 78, 6, 4 and 5 patients respectively. Average complete healing time was 7.99 days and average follow-up time was 5.49. CONCLUSION: Biocellulose sheet has the effect of cooling down the skin temperature up to 6~8degrees C after 10 minutes of its application. Recent studies reported that appropriate cooling in burn wound improves the zone of stasis and zone of erythema histologically eventually reducing the chance of skin graft. Therefore, biocellulose sheet has the effect of improving initial pain, histologic status, healing time and cost in patients with burn wound whose depth is not deep. Furthermore it reduces the risk of scar formation.
Bandages ; Burns ; Cicatrix ; Cold Temperature ; Erythema ; Female ; Follow-Up Studies ; Humans ; Male ; Running ; Skin ; Skin Temperature ; Transplants ; Water

OBJECTIVE: To investigate the cross-sectional association of the obesity with the knee osteoarthritis (OA) in a rural population. METHOD: We studied the cross-sectional asssociation between the obesity and the knee OA by analysis of data (Juam-Study based data) from an epidemiologic survey of a population of 1,100 adults who resided around the Juam lake in Chonnam. The recruited sampling were 475 adults above 40 years old. We diagnosed knee OA by typical clinical features such as bony swelling, crepitus and pain on movement and divided the subjects into non-OA group (143 males:148 females) and OA group (60 males:124 females). There is no difference in the mean ages of two groups. The body mass index (BMI) was calculated from a weight and height (kg/m2) and body fat percent (BFP) was measured by bioelectric impedance fatness analyzer (BIA). We defined obesity as a BMI over 30 kg/m2 in both sex or a BFP over 25% in male and over 30% in female. The BMI and BFP were 23.2 +/- 3.2 kg/m2, 24.0 +/- 7.5% in non-OA group and 23.5 +/- 3.4 kg/m2, 26.0 +/- 7.0% in OA group and were compared in two groups. RESULTS: 1) Prevalence odds ratio (POR) for risk factors of knee OA was high in seventh decade, female, a high cholesterol group, and a high BFP group, and was not high in BMI group. 2) There was no association between BMI and knee OA. 3) There was no association between BFP and knee OA. CONCLUSION: We were not able to prove the cross-sectional association between obesity and knee OA. The results suggested that knee OA was a heterogeneous disorder and more possibly influenced by multiple other factors, such as age, sex, and various metabolic abnormalities than obesity itself.
Adipose Tissue ; Adult ; Body Mass Index ; Cholesterol ; Electric Impedance ; Female ; Humans ; Jeollanam-do ; Knee* ; Lakes ; Male ; Obesity* ; Odds Ratio ; Osteoarthritis, Knee* ; Prevalence ; Risk Factors ; Rural Population*