BACKGROUND: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnoimal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management. METHODS: We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultrasound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was derivated from Food Composition Table, and we analyzed several biochemical variables. RESULTS: There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertriglyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8%, in patients, 7.4% in controls(p<0.05). There were no significant statistical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient gr oup or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patients, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0,05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and excercise between patients and controls. CONCLUSIONS: The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.
Adult ; Age Distribution ; Alcohol Drinking ; Chungcheongnam-do ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Hypertriglyceridemia ; Life Style ; Liver Function Tests ; Male ; Middle Aged ; Obesity ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

The goals of this study were 1) to present pre-surgical naso-alveolar molding(PNAM) appliance for bilateral cleft lip and palate treatment and 2) To evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and lateral segment was 8.09+/- 5.03mm and average duration of alveolar molding treatment was 8.8+/-3.1weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper. All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully. 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved posteriorly via alveolar molding. Conclusion : This appliance can be applied to bilateral cleft lip and palate infants with satisfactory result before cheiloplasty.
Cleft Lip* ; Female ; Fungi* ; Humans ; Infant* ; Male ; Orthodontics ; Palate* ; Photometry ; Seoul ; Vomer

BACKGROUND: Viral myocarditis is considered as a cause of dilated cardiomyopathy. At present, two pathogenic mechanisms may be involved in the pathogenesis of viral myocarditis and subsequent cardiomyopathy. First, the virus infection of myocyte may directly lead to either cell death or persistent metabolic dysfunction. Second, virus-induced immune or autoimmune mechanism may play a role. METHODS: To test the therapeutic efficacy of immunosuppression with cyclophophamide(CYP) on coxsackievirus B3(CB3) myocarditis, 10-14 week-old Balb/c mice were inoculated with 4000 plaque-forming units of CB3. In experiment 1, CYP (100mg/kg/day subcutaneous injection, s.c) was administrated daily on days 1-7(group 2, n=16). In experiment 2, CYP 30mg/kg/day s.c(group 3, n=32) or CYP 100mg/kg/day s.c(group 4, n=32) were administrated on days 8-14. The animals of infected controls(group 1, n=26) and group 2, 3, 4 were dissected at days 4, 7, 15, 22 and spleen, heart, thymus and body weights were measured. RESULTS: In experiment 1. survival rate in group 2 on day 7, 15 were low compared with group 1(85%, 0% vs 100%, p<0.05). and myocardial virus titers in group 2 on day 4 was 50 times, and on day 7, 1000 times higher compared with group 1, Histologically, on day 7, focal cellular infiltrations were prominent findings in group 1, but diffuse myocardial necrosis without cellular infiltration were observed in group 2. In experiment 2, survival rate, cardiac histopathology myocardial virus titer and serum neutralizing antibody titers did not differ among groups 1, 3 and 4. In experiment 1 and 2, the spleen-to-body-weight and thymus-to-body-weight ratios were significantly lower in CYP treated groups than those in controls and marked cellular depletions in spleens and thymus were observed in CYP treated groups. CONCLUSIONS: As the results of above, it can be concluded that the immunosuppression during viremic phase of murine viral myocarditis aggravated the myocardial necrosis, and during aviremic phase, the administration of CYP didnot affect the process of viral myocarditis. Thus, direct viral mechanisms in the production of cardiomyocyte injury in CB3-infected mice appear to bo more important than cell mediated immune mechanism. To understand relevant pathogenic mechanisms of clinical myocarditis and dilated cardiomyopathy resulting from viral infection, the experimental study expanding into nonmurine animals and into various models using other infectious agents may be required.
Animals ; Antibodies, Neutralizing ; Body Weight ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cell Death ; Cyclophosphamide* ; Heart ; Immunosuppression ; Injections, Subcutaneous ; Mice ; Muscle Cells ; Myocarditis* ; Myocytes, Cardiac ; Necrosis ; Spleen ; Survival Rate ; Thymus Gland ; Viral Load

BACKGROUND: Fiberoptic bronchoscope guided intubation is an important method of difficult airway management. The use of specific airways has been devised to assist the fiberoptic intubation. The authours compared effectiveness of separated airway with fiberoptic bronchoscope guided intubation and the hemodynamic responses. METHODS: 104 adult patients of American Society of Anesthesiologists grading (ASA) I-II who scheduled for surgery under general anesthesia were randomly divided into the Laryngoscope group (L group, n = 30) or the Fiberoptic bronchoscope group (F group, n = 36) or the Fiberoptic bronchoscope with separated airway (MF group, n = 38). A Fiberoptic bronchoscope guided intubation and a fiberoptic bronchoscope with separated airway and a direct laryngoscope was performed after inducing anesthesia. Intubation time, Jaw thrust incidence, mean blood pressure and heart rate after anaesthesia induction, at intubation and every two minute for a further 7 min were recorded. RESULTS: The intubation time was significantly shorter in the MF group (58.3 +/- 13.7 sec) than F group (71.9 +/- 22.1 sec). Jaw thrust incidence was lower in the MF group (60.5%) than F group (100%). The changes of MAPs and HRs during the observation were not significantly different in three group. CONCLUSIONS: Fiberoptic intubation using separated airway reduced intubation time and the incidence of jaw thrust.
Adult ; Airway Management ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Bronchoscopes ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Intubation ; Jaw ; Laryngoscopes

An appendico-sigmoid fistula is a rare entity that has seldom been reported in the literature. In review articles, there are only several reports of appendiceal fistulas, including two into the ileum, two into the ascending colon, two into the sigmoid colon, and one into the Meckel's diverticulum. Presumably, these cases were caused primarily by antecedent appendicitis and diverticulitis. We experienced a case of an appendico-sigmoid fistula due to appendicitis. A 42-year-old man was admitted with complaints of low abdominal pain, distension, and a chilling sense for 1 month. On physical examination, the patient had right low-quadrant abdominal tenderness and rebound tenderness. However, the patient had no fever, and the WBC count was 8,900/mm3. On colonoscopy and barium study, the patient was diagnosed as having an appendico-sigmoid fistula due to appendicitis. An appendectomy and segmental resection of the sigmoid colon was done.
Abdominal Pain ; Adult ; Appendectomy ; Appendicitis* ; Barium ; Colon, Ascending ; Colon, Sigmoid ; Colonoscopy ; Diverticulitis ; Fever ; Fistula* ; Humans ; Ileum ; Meckel Diverticulum ; Physical Examination

he conclusion should be corrected as The addition of aminoglycoside to dual antibiotic therapy, second cephalosporinmetronidazole showed no advantage in prevention of postoperative wound complications. Journal of The Korean Society of Coloproctology apologizes to the readers for this error.

Brugada syndrome describes a subgroup of patients at risk of ventricular fibrillation, but with no evidence of an underlying structural heart disease associated with an ECG pattern of right bundle branch block and a ST segment elevation in the right precordial leads (V1 to V3). This syndrome is familial with an autosomal dominant mode of transmission, and may be considerably more common in Southeast Asia. It is associated with a significant risk of ventricular tachyarrhythmias and sudden death, which is not effectively prevented by anti-arrhythmic drug therapy. We experienced such a case under general anesthesia for a hemi-colectomy, in a 32-year-old male patient diagnosed as having Brugada syndrome by characteristic ECG findings without untoward cardiovascular events.
Adult ; Anesthesia, General ; Asia, Southeastern ; Brugada Syndrome* ; Bundle-Branch Block ; Death, Sudden ; Drug Therapy ; Electrocardiography ; Heart Diseases ; Humans ; Male ; Tachycardia ; Ventricular Fibrillation

Brugada syndrome describes a subgroup of patients at risk of ventricular fibrillation, but with no evidence of an underlying structural heart disease associated with an ECG pattern of right bundle branch block and a ST segment elevation in the right precordial leads (V1 to V3). This syndrome is familial with an autosomal dominant mode of transmission, and may be considerably more common in Southeast Asia. It is associated with a significant risk of ventricular tachyarrhythmias and sudden death, which is not effectively prevented by anti-arrhythmic drug therapy. We experienced such a case under general anesthesia for a hemi-colectomy, in a 32-year-old male patient diagnosed as having Brugada syndrome by characteristic ECG findings without untoward cardiovascular events.
Adult ; Anesthesia, General ; Asia, Southeastern ; Brugada Syndrome* ; Bundle-Branch Block ; Death, Sudden ; Drug Therapy ; Electrocardiography ; Heart Diseases ; Humans ; Male ; Tachycardia ; Ventricular Fibrillation

PURPOSE: The use of prophylactic antibiotics is the current standard of care after elective colorectal surgery. The aim of this study was to compare the efficacy of antibiotic prophylaxis with dual antibiotic therapy and triple antibiotic therapy after elective colorectal surgery. METHODS: We studied consecutive patients underwent elective colorectal surgery from January to June, 2007. Patients of triple-therapy group were administered second cephalosporin, metronidazole, and aminoglycoside for early 3 mo and dual-therapy group were administered second cephalosporin and metronidazole for next 3 mo. The prophylactic antibiotics were administered 2-3 doses for 24 hr after surgery. The surgery for diverticulitis, inflammatory bowel disease, and colon obstruction were excluded. Wound conditions were checked on alternate days during the hospital stay and follow up at least for 30 days after discharge. RESULTS: Over 6 mo, 110 patients were enrolled (59 dual-therapy group, 51 triple-therapy group). In two group, sex, age, American Society of Anesthesiology score, body mass index, combined diseases, and location of disease were similar. Wound infection rate were 1.7% in dual-therapy group and 2.0% in triple-therapy group (P=1.0). Anastomotic leakage rate were 5.1% in dual-therapy group and 2.0% in triple-therapy group (P=0.622). CONCLUSION: The addition of aminoglycoside to dual antibiotic therapy, second cephalosporin-metronidazole showed on advantage in prevention of postoperative wound complications. Further studies are required to establish appropriate guideline of antibiotic prophylaxis after elective colorectal surgery.
Anastomotic Leak ; Anesthesiology ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Body Mass Index ; Colon ; Colorectal Surgery ; Diverticulitis ; Follow-Up Studies ; Humans ; Imidazoles ; Inflammatory Bowel Diseases ; Length of Stay ; Metronidazole ; Nitro Compounds ; Standard of Care ; Wound Infection

Subacute thyroiditis is a self-limiting inflammation of the thyroid, presenting with painful thyroid swelling, thyrotoxicosis and low radioactive iodine uptake. The characteristic US findings for this disease are focal ill-defined hypoechoic areas in one lobe or diffuse hypoechoic areas in both lobes. Thyroid carcinomas should be included in the differential diagnosis for a lesion with focal hypoechoic areas and have been rarely reported to coexist with subacute thyroiditis. Takayasu's arteritis is an autoimmune disease that affects the aorta and its branches as well as pulmonary arteries. Subacute thyroiditis associated with Takayasu's arteritis is extremely rare, with only three cases being reported. We report here on the first case with the simultaneous diagnosis of subacute thyroiditis, papillary thyroid carcinoma and Takayasu's arteritis.
Aorta ; Autoimmune Diseases ; Carcinoma ; Diagnosis, Differential ; Inflammation ; Iodine ; Pulmonary Artery ; Takayasu Arteritis ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis, Subacute ; Thyrotoxicosis