Background: The OptiscopeTM and the backward, upward, rightward pressure (BURP) maneuver are widely used in clinical practice because the BURP maneuver facilitates intubation by improving visualization of the larynx. However, the effect of the BURP maneuver is unclear when using the OptiscopeTM. Therefore, we retrospectively investigated the effect of the BURP maneuver on intubation using the OptiscopeTM. Methods: Sixty-eight patients intubated with the OptiscopeTM were enrolled. We used the BURP maneuver in Group A (n = 33) and the conventional maneuver (which does not use the BURP maneuver) in Group B (n = 35). BURP application status was a binary variable representing whether the BURP maneuver was used during the intubation. A multiple linear regression analysis was performed to assess the effects of the BURP application status on intubation time controlling for body mass index, preoperative dental injury status, obstructive sleep apnea history, thyromental distance, sternomental distance (SMD), interincisor distance, history of neck rotation restriction, and Mallampati classification. Results: There was no difference in the intubation time between the two groups. According to the regression model (R2 = 0.308, P = 0.007), the BURP maneuver (Group A) decreased the intubation time by 6.089 seconds (95% confidence interval 1.303–10.875, P = 0.014) compared to Group B. Conclusion The BURP maneuver reduced intubation time when using the OptiscopeTM.

Pasteurella multocida is a gram-negative coccobacillus that commonly inhabits the oropharynx of healthy domestic and wild animals, including cats and dogs. Although Pasteurella multocida infection is rare in human beings, in recent years an increasing number of infections have been reported in men, which have included a variety of illness from local infections to systemic illness. Among them, spontaneous bacterial peritonitis due to Pasteurella multocida is particularly rare all through the world. Recently, we have experienced a case of spontaneous bacterial peritonitis and sepsis due to Pasteurella multocida in a liver cirrhosis patient, successfully controlled by antibiotics. To our knowledge, this is the first case report of spontaneous bacterial peritonitis caused by Pasteurella multocida in Korea and provides another causative organism of spontaneous bacterial peritonitis.
Animals ; Animals, Wild ; Anti-Bacterial Agents ; Cats ; Dogs ; Fibrosis ; Humans ; Korea ; Liver Cirrhosis* ; Liver* ; Male ; Oropharynx ; Pasteurella multocida* ; Pasteurella* ; Peritonitis* ; Sepsis*

BACKGROUND/AIMS: With the development of self-expanding metallic stents, colonic obstruction can be relieved without the need for surgery. The results of preoperative placement of stents for malignant colorectal obstruction might be different according to the obstructing lesion. The objective of this study was to compare clinical improvement rates and operative results after preoperative placement of stents for malignant colorectal obstruction according to the location of the obstructing lesion. METHODS: This is a retrospective study including 57 patients who underwent self-expanding metallic stent insertion for obstructing resectable colorectal cancers. Patients were classified into three groups according to the location of the lesion as follows: proximal to the sigmoid colon (Group A), sigmoid colon (Group B), and rectum (Group C). RESULTS: The number of patients in A, B, and C groups was 13, 22, and 22, respectively. No significant differences in age, gender, stent type, and accompanying diseases among the three groups were observed. There were no significant differences in stent-related complications, clinical improvement rates, and one-stage resection rates among the three groups. The postoperative complications, the requirement rate of ICU care, the period of ICU stay, postoperative hospital stay, and hospital mortality did not significantly differ among the three groups. CONCLUSIONS: Clinical improvement rates and operative results after successful placement of stents for obstructing resectable colorectal cancers are not different according to the location of the obstructing lesion, suggesting that preoperative stenting for one-stage curative resection is useful, irrespective of the location of lesion.
Aged ; Aged, 80 and over ; Colorectal Neoplasms/*diagnosis/surgery ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Intestinal Obstruction/*surgery ; Length of Stay ; Male ; Middle Aged ; Preoperative Care ; Retrospective Studies ; *Stents

Fitz-Hugh-Curtis syndrome, a kind of perihepatitis, occurs approximately in 3 to 10 percent of patients with pelvic inflammatory disease. It is not easy to detect in clinical settings due to requirement of invasive methods for diagnosis, for example, like a laparoscopic examination. Now, it has become possible to recognize it easily with the aid of non-invasive methods including an abdominal dynamic CT scan and laboratory tests. Moreover, it can be improved after the oral administration of antibiotics. Therefore, noninvasive diagnosis is desirable. Herein, clinical characteristics of ten cases of Fitz-Hugh-Curtis syndrome are reported, with a review of the literature.
Adolescent ; Adult ; Chlamydia Infections/diagnosis ; Chlamydia trachomatis ; Diagnosis, Differential ; Female ; Humans ; Laparoscopy ; Liver/pathology/radiography ; Pelvic Inflammatory Disease/*diagnosis/drug therapy/etiology ; Peritonitis/*diagnosis/drug therapy ; Syndrome ; Tomography, X-Ray Computed

OBJECTIVES: Obstructive sleep apnea (OSA) is a disorder characterized by repetitive partial or complete occlusion of the upper airway during sleep that affects quality of life. The aim of this study was to develop the Korean version of the sleep apnea quality of life index (K-SAQLI) and apply it in Korean patients with OSA. METHODS: Ninety-three patients with OSA completed the K-SAQLI. Its construct validity and responsiveness were tested by comparing the baseline and change scores obtained in each domain (i.e., daily functioning, social interactions, emotional functioning, and symptoms) using the medical outcome survey-short form 36 (SF-36). RESULTS: The Cronbach alpha coefficients of internal reliability exceeded 0.60 in all the domains (daily functioning, 0.89; social interactions, 0.88; emotional functioning, 0.92; symptoms, 0.67; and total, 0.94). The K-SAQLI had a high test-retest correlation coefficient of 0.73 in the 20 randomized selected patients. The construct validity was confirmed by significant correlations with SF-36 subscale scores. CONCLUSION: The results of this study demonstrate that the K-SAQLI may be applicable for clinical purposes.
Humans ; Interpersonal Relations ; Quality of Life* ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Surveys and Questionnaires

PURPOSE: A conventional resuscitator is used as first-line equipment during cardiopulmonary resuscitation (CPR). However, resuscitation providers have difficulty in achieving adequate tidal volume during ventilation by conventional resuscitator (CR). This study was conducted to evaluate the usefulness of the newly-designed resuscitator (NR) during chest compression. METHODS: Fifty nine individuals participated in this study. NR was produced by insertion of a silicon implant in the CR. The NR was set at a tidal volume of 500 mL. Subjects completed four procedures: CR without compression, NR without compression, CR with compression, and NR with compression. Individual characteristics were obtained and the results were analyzed statistically. RESULTS: The mean volumes for the CR without compression were 482.03 mL, NR without compression 513.71 mL, CR with compression 461.93 mL, and NR with compression 496.12 mL. When the two types of resuscitators were used during chest compression, success rate of CR of 64.4% was observed, and success rate of NR was 94.9% (p<0.01). The physical aspects including hand size, volume, and grip power showed no correlation with the volume that we delivered. CONCLUSION: The NR can approximate the exact tidal volume and may be useful in preventing possible complications from inappropriately delivered tidal volumes.
Cardiopulmonary Resuscitation ; Hand ; Hand Strength ; Resuscitation ; Silicones ; Thorax* ; Tidal Volume* ; Ventilation

PURPOSE: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication impairments and repetitive behaviors or restricted interests. Impaired pragmatic language comprehension is a universal feature in individuals with ASD. However, the underlying neural basis of pragmatic language is poorly understood. In the present study, we examined neural activation patterns associated with impaired pragmatic language comprehension in ASD, compared to typically developing children (TDC). MATERIALS AND METHODS: Functional magnetic resonance imaging (fMRI) was applied to 15 children with ASD and 18 TDC using the Korean pragmatic language task. RESULTS: Children with ASD were less accurate than TDC at comprehending idioms, particularly when they were required to interpret idioms with mismatched images (mismatched condition). Children with ASD also showed different patterns of neural activity than TDC in all three conditions (neutral, matched, and mismatched). Specifically, children with ASD showed decreased activation in the right inferior frontal gyrus (IFG) (Brodmann area 47) in the mismatched condition, compared with TDC (IFG; t(31)=3.17, p < 0.001). CONCLUSION: These results suggest that children with ASD face difficulties in comprehending pragmatic expressions and apply different pragmatic language processes at the neural level.
Autism Spectrum Disorder* ; Autistic Disorder* ; Child* ; Comprehension* ; Humans ; Magnetic Resonance Imaging ; Neurodevelopmental Disorders ; Prefrontal Cortex

Fitz-Hugh-Curtis syndrome has been defined as perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhoeae and Chlamydia trachomatis. In the acute phase, patients usually complain of severe right upper quadrant pain of sudden onset. The pain is sharp, pleuritic and most intense at the level of the right lower rib margin and thus it is frequently confused with acute cholecystitis or pleurisy. Definitive diagnosis of Fitz-Hugh-Curtis syndrome needs invasive procedures such as laparoscopy or laparotomy, but considering that Fitz-Hugh-Curtis syndrome is a benign condition that can be cured by oral administration of appropriate antibiotics, noninvasive diagnosis is desirable. Recently, we have experienced two cases of Fitz-Hugh-Curtis syndrome in acute phase accompanied with sharp and pleuritic right upper quadrant pain. In one case, pelvic inflammatory disease was not definite, so at first we mistook it for acute cholecystitis and reactivation of chronic hepatitis B. In the other case, Fitz-Hugh-Curtis syndrome followed the preceding, typical pelvic inflammatory disease. Both cases were diagnosed noninvasively and treated successfully by oral administration of antibiotics.
Adult ; Chlamydia Infections/*diagnosis ; *Chlamydia trachomatis ; Diagnosis, Differential ; Female ; Gonorrhea/*diagnosis ; Hepatitis/*diagnosis ; Humans ; Pelvic Inflammatory Disease/*diagnosis ; Syndrome

This study was to clarify whether Behcet's disease (BD) could be classified into the spondyloarthropathy (SpA) complex. It was undertaken on 58 patients with BD (BD group), 56 patients with SpA (SpA group), and 3 patients who concurrently satisfied the criteria for BD and SpA (BDSpA group). The clinical parameters and known susceptible HLA antigens were compared between BD group and SpA group. In addition, 3 patients in BDSpA group were reviewed. The prevalence of definitive sacroiliitis (SI) in BD group and SpA group was 46.4% and 5.2%, respectively. However, none had a definitive SI in healthy controls. Enthesitis was observed in 3.4% of BD group and in 50% of SpA group. The patterns of eye involvement were different between these two groups. HLA-B27 was negative in all 49 patients of BD group, whereas it was positive in 67.9% of SpA group. The prevalence of HLA-B51 was 51.7% in BD group, and that in SpA group was 21.4%. One patient in BDSpA group was considered to have concurrent BD and ankylosing spondylitis (AS). Another patient was closer to AS, and the third to BD. Conclusively, it seems that BD could not be classified into the SpA complex.
Adult ; Behcet Syndrome/*classification/immunology/pathology ; Eye/pathology ; Female ; HLA-B Antigens/analysis/immunology ; HLA-B27 Antigen/analysis/immunology ; Humans ; Lumbar Vertebrae/pathology/radiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pelvis ; Radioactive Tracers ; Sacroiliac Joint/pathology/radiography ; *Spondylarthritis/immunology/pathology ; Tomography, Emission-Computed, Single-Photon

Objective: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. Methods: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. Results: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. Conclusion Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.