No abstract available.
Aortic Coarctation*

Dislocation of the temporomandibular joint(TMJ) is fairly frequent but backward dislocation of TMJ during induction of anesthesia is rarely reported. The causes include congenital weakness of the capsule or malformation of the condyles of both. The physical causes are as follows ; The joint may be strained or injured during general anesthesia, 1) possible straing or injureyto the joint, 2) yawning, 3) attempts by children to insert large objects into the mouth, 4) and positional pressures during sleep. Acase of backward dislocation of TMJ occureed during induction of anesthesia and treated with nanual reduction and subsequent intermaxillary fixation.
Anesthesia* ; Anesthesia, General ; Child ; Dislocations* ; Humans ; Joints ; Mouth ; Temporomandibular Joint* ; Yawning

No abstract available.
Cervix Uteri* ; Female ; Pregnancy*

PURPOSE: The aim of this study was to evaluate the prevalence of Benign Vocal Fold Lesion (polyp, cysts, nodules) and Leukoplakia in Korea. MATERIALS AND METHODS: The data from the 2008 to 2011 Korea National Health and Nutrition Examination Surveys, which were cross-sectional survey of the civilian noninstitutionalized population of South Korea. A survey team that included an otolaryngology residents, nurses, and interviewers moved with a mobile examination unit and performed laryngologic interviews and examinations of vocal folds using rigid telescopic laryngoscopy on survey participants over 19 years old (n=19636). RESULTS: Laryngoscopic examination revealed normal results in 19251 (98.04%) of those included in the survey. Abnormal laryngoscopic findings were observed in 1.96% of the population examined, and vocal cord nodules were the most common abnormal finding. The prevalence of vocal cord nodules was 0.99-1.72%, the prevalence of vocal cord polyps was 0.31-0.55%, the prevalence of vocal cysts was 0.04-0.17%, and the prevalence of vocal cord leukoplakia was 0.07-0.21%. There was no significant correlation of linear trend of prevalence by year, and there were no significant differences in prevalence between males and females. CONCLUSION: This is the first nationwide epidemiologic study to assess the prevalence of Benign Vocal Fold Lesion (polyp, cysts, nodules) and Leukoplakia by both the Korean Otolaryngologic Society and the Ministry of Health and Welfare. The results of this large epidemiologic study provide valuable information regarding the prevalence of voice disorders and the management of laryngologic diseases.
Cross-Sectional Studies ; Epidemiologic Studies ; Epidemiology ; Female ; Humans ; Korea* ; Laryngeal Diseases* ; Laryngoscopy ; Leukoplakia ; Male ; Methods ; Nutrition Surveys* ; Otolaryngology ; Polyps ; Prevalence* ; Republic of Korea* ; Vocal Cords ; Voice Disorders

PURPOSE: The purpose of this study is to determine for upper abdominal pain, the accuracy of emergency abdominal ultrasonography (EAU) performed by emergency physicians with limited training. METHODS: Two PGY-3 emergency physicians, who had received 2 hours of hands-on training, including the normal anatomy of a biliary system, liver, kindney, spleen, and pancreas, and who had studied the pathologic findings for another month were the subjects of this study. They used a Sonosite 180 R to perform EAU on patients with upper abdominal pain within 2 months after training. We determined the agreement between the radiologist 's abdominal ultrasonography(RAU) and EAU by using Kappa statistics. RESULTS: A total of 59 patients were enrolled. The agreement between the EAU and the RAU findings was 0.97, 0.88, 0.79, 0.73, 0.62, and 0.57 for gall bladder (GB) distension, cholelithiasis, GB wall thickening, duct dilatation, choledocholithiasis, and pericholecystic fluid, respectively (p<0.05). CONCLUSION: The results of EAU, performed by emergency physician with limited training on patients suffering from upper abdominal pain had a significant agreement with the RAU. However, more educations and cautions are warranted for diagnosing pericholecystic fluid and choledocholithiasis.
Abdominal Pain ; Biliary Tract ; Choledocholithiasis ; Cholelithiasis ; Dilatation ; Emergencies* ; Humans ; Liver ; Pancreas ; Spleen ; Ultrasonography* ; Urinary Bladder

PURPOSE: Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. MATERIALS AND METHODS: We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. RESULTS: 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. CONCLUSION: We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.
Calcium/blood ; Humans ; Hypocalcemia/*diagnosis ; Magnesium/blood ; Odds Ratio ; Parathyroid Hormone/*blood ; Phosphates/blood ; Postoperative Complications/blood/*diagnosis ; Prospective Studies ; Serum Albumin ; Thyroidectomy/*adverse effects

PURPOSE: This study was designed to investigate the predictors of long-term admission in patients with acute diarrhea at an early stage of their emergency department (ED) visit. METHODS: We retrospectively analyzed clinical data of 125 patients who visited our ED with complaints of acute diarrhea and abdominal pain and underwent a stool test during one year (Jan. to Dec. 2001). We excluded patients who were transferred out or were self-discharged and those with another illness. We checked the numbers of cases of diarrhea, the presence of fever and abdominal pain, the stool cell counts, the blood cell counts, platelets, blood urea nitrogen, and creatinine on admission. We also counted the length of stay and defined a stay of over 4 days in the hospital as a long-term admission. We tried to find parameters that could predict long-term admission at an early stage. RESULTS: A total of 125 patients were enrolled (men : 56 ; women : 69), and their mean age was 44 +/- 0.25 years. The mean length of stay was 3.0 +/- 0.02 days. The length of stay had a statistically significant correlation with the stool WBC (p<0.01, R=0.361). Only the stool WBC a the discriminative variable for long-term admission (p<0.01). CONCLUSION: The stool WBC was a statistically significant predictive variable to determinate the long-term admission and the severity of acute diarrhea, and we think it could be used to make an early decision for the close medical attention.
Abdominal Pain ; Blood Cell Count ; Blood Platelets ; Cell Count ; Creatinine ; Diarrhea* ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Length of Stay ; Nitrogen ; Retrospective Studies ; Urea

PURPOSE: In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. MATERIALS AND METHODS: The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement. Monte Carlo simulations were performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. RESULTS: In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 2.0 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of 10cm in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated penumbra radii were 0.1 cm shorter than measured values. CONCLUSION: The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.
Radiosurgery ; Semiconductors ; Water

PURPOSE: The dose calculation program for the Buchler type remote afterloading system was developed. This program also can be used to calculate dose for various sealed sources. METHODS AND MATERIALS: We determined the source length and distribution by dividing the program disk to 72 points. The dose rate for the each program disk and source was calculated. The dose rate table for the xy coordinate was established. The dose rate for the interesting points of the patient were calculated by using this table. We also made isodose curve from this calculations. RESULTS: The storage size for the dose rate table were increased.But the calculation of the dose rate for the patient were carried out rapidly. So we could get real time calculation. CONCLUSION: By using this program, we could calculate the dose rate for the various oints of the patient quickly and accurately. This program will be useful for the treatment with various linear sources.
Brachytherapy ; Humans

Sodium nitroprusside is used to induce hypotension to decrease bleeding in operation site, Sodium nitroprusside decrease vascular resistance by directly relax arteriolar and venous smooth muscle, to a lesser extent. Hypotension stimulate baroreceptors and increase sympatho-adrenal activity. The function of sympatho-adrenal mdullary system may be monitored by the changes of plasma cancentrations of epinephrine and norepinephrine. To study the relationship between induced hypotension and the catecholamine release, the plasma epinephrine and norepinephrine concentration were measured before, during and after infusion of aodium nitropruaside to rabbits The results were as follows: 1) The mean arterial blood pressure decreased significantly after SNP infusion (5.0 ug/kg/minute) from the control value of 98.1+/-11.9 mmHg to 66.3+/-16.2, 57.9+/-17.9 mmHg in 10 and 20 minutes after SNP infusion (P<0.01) and 78.8+/-12.5 mmHg after discontinuation of SNP infusion. 2) The heart rate increased significantly after SNP infusion from the control value of 149.8+/-12.8 beat/minute to 166.5+/-10.8, 190.4+/-17.6 beats/minute in 10 and 20 minutes after SNP infusion (P<0.05, P<0.01) and the heart rate increased after discontinuation of SNP infusion. 3) The plasma epinephrine concentration increased significantly after SNP infusion from the control value of 181.2+/-91.9 pg/ml to 547.5+/-163.2, 837.5+/-253.6 pg/ml in 10 and 20 minutes after SNP infusion and continued to increase of epinephrine after discontinuation of SNP infusion. 4) The plasma norepinephrine concentration increased significantly after SNP infusion from the control value of 566.2+/-92.6 pg/ml to 1131.3+/-424.7, 1432.5+/-479.2 pg/ml 10 and 20 minutes after SNP infusion and continued to increase after discontinuation of SNP infusion. There was a highly significant correlation between decrease in mean arterial pressure and increase in plasma epinephrine and norepinephrine concentrations.
Arterial Pressure ; Epinephrine ; Heart Rate ; Hemorrhage ; Hypotension* ; Muscle, Smooth ; Nitroprusside ; Norepinephrine ; Plasma* ; Pressoreceptors ; Rabbits ; Sodium* ; Vascular Resistance