This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression anaylsis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.
Adult ; Affective Symptoms/*epidemiology ; Aged ; *Anger ; Coronary Stenosis/*epidemiology/*psychology ; Female ; Human ; Male ; Middle Aged ; Risk Factors ; Severity of Illness Index

BACKGROUND AND OBJECTIVES: Although there have been various methods to remove adenoid, it is still difficult to achieve complete adenoidectomy due to its unfavorable anatomic structure. The aim of this study was to introduce transoral adenoidectomy using a microdebrider under transnasal endoscopy and to evaluate its efficacy. MATERIALS AND METHOD: The subjects consisted of 80 patients with adenoid vegetation. Among them, 40 patients underwent adenoidectomy using the microdebrider and other 40 cases were performed using the adenoid curette via transoral approach. Preoperative and postoperative lateral skull radiographs were obtained and compared. Also, the amount of intraoperative bleeding, complications, postoperative symptom score, and the duration of operation were compared. RESULTS: There were no statistical differences in the intraoperative bleeding, subjective symptoms after surgery and postoperative complications. But, patients, who had been performed adenoidectomy using the transoral debrider under transnasal endoscopy, had better outcomes in the nasopharyngeal ratio and the shortest nasopharyngeal diameter in lateral skull radiographs. CONCLUSION: Transoral adenoidectomy using the microdebrider under transnasal endoscopy is an effective method for more complete adenoidectomy.
Adenoidectomy* ; Adenoids ; Endoscopy* ; Hemorrhage ; Humans ; Postoperative Complications ; Skull

Immunosuppressive medications after renal allograft transplantation have impacted the course of acute and chronic rejection: however, they have no defined effects on the prevention of recurrent and Glomerulonephritis (GN) in an allograft kidney. Authors experienced a case of rapidly progressive glomerulonephritis (RPGN). The 35-year-old female patient developed a rapid deterioration of renal function 4 years after renal transplantation. The allograft biopsy showed crescentic glomerulonephritis evolving from membranoproliferative glomerulonephritis (MPGN) type I. She was given pulse steroid and oral cyclophosphamide therapy immediately after the renal biopsy. Graft function stabilized and proteinuria decreased even though graft function did not recover to pre-treatment level and low grade proteinuria persisted.
Adult ; Allografts ; Biopsy ; Cyclophosphamide ; Female ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney Transplantation* ; Kidney* ; Proteinuria ; Transplants

Background & Objectives: Vasomotor rhinitis (VMR) is a chronic non-allergic rhinitis without the increased Ig E level and eosinophilia. Azelastine hydrochloride is a second generation anti-histamine medication with anti-inflammatory properties that inhibits the synthesis of inflammatory materials. There are reports that azelastine hydrochloride can be effective in the treatment of VMR. Therefore, this study examined the clinical efficacy of intranasal azelastine hydrochloride spray in comparison with placebo for the treatment of VMR. MATERIALS AND METHOD: This study was a prospective double blind randomized test. The subjects consisted of 84 VMR patients. Among them, 54 patients were treated with intranasal azelastine hydrochloride for 4 weeks and 30 patients with intranasal normal saline. Following the treatment, an analysis of the symptom score was performed in order to compare the treatment effects between the study group and the control group. RESULTS: In the study group, the symptom score was significantly improved in the areas of sneezing (1.38 to 0.72), rhinorrhea (1.57 to 0.76), nasal obstruction (1.76 to 1.01) and postnasal drip (1.43 to 0.65). In the control group, however, the symptom score was significantly improved in a single area of rhinorrhea (1.73 to 0.65). Patients in the study group, thus, displayed greater improvements in the areas of sneezing, rhinorrhea, nasal obasturction and postnasal drip comparative to the control group. Consequently, the study group patients were more satisfied with their quality of life than those of the control group. CONCLUSION: Azelastine chloride is a useful medicine for the treatment of VMR, especially in controlling sneezing, rhinorrhea, nasal obstruction and postnasal drip.
Eosinophilia ; Humans ; Nasal Obstruction ; Prospective Studies ; Quality of Life ; Rhinitis ; Rhinitis, Vasomotor* ; Sneezing

BACKGROUND: This study was performed to determine the effects of a humidifier with heated wire circuits on the incidence and severity of postoperative sore throat (POST) and cough after thyroidectomy. METHODS: A total of 61 patients scheduled for elective thyroid surgery under general anesthesia were included in this prospective study. We randomized the patients in to two groups, "without active warming and humidification" (Group C) and "using a heated humidifier" (Group H). The patients were interviewed to obtain the POST and cough scores at 1, 6, 24 and 48 hours after thyroidectomy. RESULTS: The incidence of POST was significantly lower in Group H compared to Group C at 6 hours (57% vs 84%, P = 0.041), 24 hours (37% vs 65%, P = 0.045), and 48 hours (10% vs 52%, P = 0.001). Also the incidence of cough was significantly lower in Group H at 6 hours (27% vs 71%, P = 0.001), 24 hours (13% vs 45%, P = 0.015), and 48 hours (7% vs 32%, P = 0.028). The severity of POST was significantly lower in Group H at all times. In addition, the severity of cough was lower in Group H at other times except at 1 hour. CONCLUSIONS: This result suggests that an active humidification of inspired gases may have the appreciable effect on reducing the incidence and severity of sore throat and cough after thyroid surgery using the endotracheal tube.
Anesthesia, General ; Cough ; Gases ; Hot Temperature ; Humans ; Incidence ; Intubation, Intratracheal ; Pharyngitis ; Prospective Studies ; Thyroid Gland ; Thyroidectomy

BACKGROUND AND OBJECTIVES: Papillary microcarcinoma of the thyroid gland (PMC) is defined as a papillary thyroid cancer (PTC) measuring less than 1 cm in its diameter. PMC is frequently diagnosed today, mainly as a result of the wide use of neck ultrasonography and fine needle aspiration biopsy. Despite the overall excellent prognosis for patients with PMC, the extent of thyroid resection and the necessity of lymph node dissection have become the issues of controversy. The rising incidence of the PMC among PTC necessitates the identification of prognostic factors and standardization of treatment protocols. Therefore, to evaluate the characteristics of PMC, we reviewed our experiences. SUBJECTS AND METHOD: Between 2000 and 2005, 265 patients underwent thyroid surgery and 194 patients showed PTC. Of these patients, 53 patients (27.3%) had PMC (9 male, 44 female, mean age 50.1 years). The data from these patients were retrospectively analyzed. RESULTS: The mean tumor size was 7.19 mm. The most frequently presenting symptom was thyroid mass only (77%) and the combined thyroid diseases were found in 35 patients (66%). Twelve patients (27.9%) had multifocal microcarcinomas and in 11 patients (20.8%) had extrathyroidal invasion. Lymph node metastasis was found in 18 patients (33.9%). Lymph node metastasis was significantly associated with the presence of extrathyroidal invasion (p=0.031), lymph node metastasis (p=0.008) and extrathyroidal invasion are more frequently observed in PMCs over 5 mm in size. CONCLUSION: These clinical characteristics may be considered as prognostic factors of the PMC. So the treatment modalities should be chosen taking into consideration of the various clinical factors.
Biopsy ; Biopsy, Fine-Needle ; Clinical Protocols ; Female ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Ultrasonography

PURPOSE: The aim of this study was to assess the feasibility and safety of laparoscopic resection following the insertion of self-expanding metallic stents (SEMS) for the treatment of obstructing left-sided colon cancer. METHODS: Between October 2006 and December 2012, laparoscopic resection following SEMS insertion was performed in 54 patients with obstructing left-sided colon cancer. RESULTS: All 54 procedures were technically successful without the need for conversion to open surgery. The median interval from SEMS insertion to laparoscopic surgery was 9 days (range, 3-41 days). The median surgery time was 200 minutes (range, 57-444 minutes), and estimated blood loss was 50 mL (range, 10-3,500 mL). The median time to soft diet was 4 days (range, 2-8 days) and possible length of stay (hypothetical length of stay according to the discharge criteria) was 7 days (range, 4-22 days). The median total number of lymph nodes harvested was 23 (range, 8-71) and loop ileostomy was performed in 2 patients (4%). Six patients (11%) developed postoperative complications: 2 patients with anastomotic leakages, 1 with bladder leakage, and 3 with ileus. There was no mortality within 30 days. CONCLUSION: The present study shows that the presence of a SEMS does not compromise the laparoscopic approach. Laparoscopic resection following stent insertion for obstructing left-sided colon cancer could be performed with a favorable safety profile and short-term outcome. Large-scale comparative studies with long-term follow-up are needed to demonstrate a significant benefit of this approach.
Anastomotic Leak ; Colon* ; Colonic Neoplasms* ; Conversion to Open Surgery ; Diet ; Humans ; Ileostomy ; Ileus ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Mortality ; Postoperative Complications ; Stents* ; Urinary Bladder

Hyponatremia in patients with central nervous system disorders is suggestive of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and volume restriction is recommended for its correction. However, if volume depletion is present in a situation otherwise compatible with SIADH, cerebral salt wasting syndrome (CSWS) should be considered as the cause of the hyponatremia to avoid hypovolemic shock that may be induced by the standard management of SIADH, i.e. volume restriction. We present a case of a 17-year-old male patient with CSWS associated with tuberculous meningitis. The clinical feature of the patient comprised hyponatremia, excessive natriuresis, polyuria, and hypovolemia. Following the administration of saline and fludrocortisone, natriuresis and polyuria were decreased, and the hyponatremia improved
Adolescent ; Central Nervous System Diseases ; Fludrocortisone ; Humans ; Hyponatremia ; Hypovolemia ; Inappropriate ADH Syndrome ; Male ; Natriuresis ; Polyuria ; Shock ; Tuberculosis, Meningeal* ; Wasting Syndrome*

BACKGROUND AND OBJECTIVES: An increased pulse wave velocity (PWV) and a non-dipping pattern in hypertensive patients have been shown to be associated with an excess of target organ damage. The relationship between the PWV and circadian variation of blood pressure (BP) (dipper or nondipper) were sought, and also the LV diastolic function between dipper and nondipper patients compared. SUBJECTS AND METHODS: 44 hypertensive subjects, who had never been treated, were enrolled (mean age: 48+/-12 yrs, men: 29). The following procedures were undertaken. 1) 24 hour ambulatory BP monitoring; 2) echocardiography for LV geometry, LV mass index (LVMI), LV systolic and diastolic functions, including tissue Doppler and aortic PWV. The patients were divided into two groups with respect to their ambulatory BP profiles, i.e., dipper and nondipper. The PWV, LV geometry and diastolic functions were compared between dipper and nondipper patients, and the relationship between the PWV and diastolic function analyzed in all patients. RESULTS: Twenty (45%) were nondipper patients. There were no significant differences in the LV geometry, LVMI and PWV between dipper and nondipper patients (PWV; 8.8+/-3.1 vs. 8.6+/-3.3 m/sec, p>0.05). In all patients, the PWV was related to the deceleration time (r=0.34, p=0.03) and the mitral E/A (r=-0.31, p=0.02) and mitral Em/Am ratios obtained by the tissue Doppler echocardiography (r=-0.31, p=0.03). The proportion with diastolic dysfunction was higher in the nondipper than the dipper patients (21 vs. 50%, p<0.01). There was a significant relation between the PWV and Em (r=-0.45, p=0.047) in the nondipper, but not in the dipper. CONCLUSION: Prolonged exposure to high BP (nondipper) was not related with increased aortic stiffness in never treated hypertensive patients. The PWV was closely related with LV diastolic dysfunction in nondipper patients.
Blood Pressure* ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Heart Function Tests ; Humans ; Hypertension* ; Male ; Pulse Wave Analysis* ; Vascular Stiffness

Purpose : The clinical features and microbiologic characteristics of acute pyelonephritis (APN) have been changing due to an increased prevalence of chronic disease, overuse and/or misuse of antibiotics and so on. We investigated the causative organisms and their antibiotic sensitivity profile and clinical manifestation with the purpose to suggest a proper empirical therapy of the disease. METHODS: We analysed the medical records of 246 APN patients older than 15 years who were admitted at Hallym University, Kandong Sacred Heart Hospital from January 1997 to December 2001, excluding hospital-acquired infections. RESULTS: Patients were 46.2+/-19.0 years old with male : female ratio of 1 : 10.2. The severity score was 4.43+/-1.63 out of 8. The average duration of hospital admission was 6.1+/-2.8 days and all of the cases were cured without a complication such as septic shock or renal abscess. In 133 cases, their etiologic microorganisms were identified, among which E. coli was the most common (91.7%). Antibiotic sensitivity of the isolated E. coli strains were as follows; 29.8% to ampicillin, 44.2% to trimethoprim/sulfamethoxazol, 75% to ciprofloxacin, 86.8% to cefazolin and 99.2% to amikacin. CONCLUSION: E. coli was the most common pathogen of community-acquired APN. Ampicillin, trimethoprim/sulfamethoxazol and cephalothin are inappropriate for its empirical therapy. Ciprofloxacin, 3rd generation cephalosporins and aminoglycosides are effective as the first-line empirical agent.
Abscess ; Amikacin ; Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; Cefazolin ; Cephalosporins ; Cephalothin ; Chronic Disease ; Ciprofloxacin ; Female ; Heart ; Humans ; Male ; Medical Records ; Prevalence ; Pyelonephritis* ; Shock, Septic