Objective: This study aimed at providing a critical review of the overall benefits of the chin-tuck maneuver through a systematic review of its effects when used in the treatment of dysphagia, as well as to provide basic data for a comparative analysis in future studies. Methods: To identify academic papers on the chin-tuck maneuver published from January 2000 to January 2021, a literature search on three databases was performed using keywords, including chin-tuck, dysphagia, and head flexion. Out of the 712 related papers identified, the methodological characteristics and results of 12 selected studies were reviewed. Results: Nine of the 12 studies found that the chin-tuck position not only helped in the opening of the upper esophageal sphincter (UES) but also reduced pharyngeal residues and prevented aspiration and penetration. In addition, three studies analyzed the position of the neck flexion angle and the changing angle when performing the chin-tuck maneuver. Conclusion This shows that the chin-tuck maneuver is an effective strategy in the treatment of dysphagia. In future studies, further investigation of the posture, angles, and effects of the chin-tuck maneuver, could help identify additional benefits of this treatment.

Tailgut cysts are known to originate from the remnants of the embryonic hindgut. They occur exclusively in the retrorectal and presacral spaces. There have been limited reports of tailgut cysts occurring in the left perirenal space. The present case features a huge tailgut cyst extending from the right perirenal to the perivesical space. We believe that this case report will help to further elucidate the characteristics of perirenal and perivesical tailgut cysts.

PURPOSE: Human saliva, as a vital part of the immune defense system, contains a number of distinct proteins and peptides. Recently human common salivary protein 1 (CSP1) has been identified as an abundant salivary protein and may play a role in promoting the binding of cariogenic bacteria to salivary pellicles. However, nothing else is known regarding the role of CSP1 in periodontology. The aim of this study was to quantify and compare CSP1 levels between healthy subjects and periodontal patients. METHODS: This controlled clinical study was conducted in periodontally healthy individuals and patients with chronic periodontitis Chonbuk National University Hospital, with Institutional Review Board approval. Whole saliva samples were collected from 36 healthy subjects and 33 chronic periodontitis patients and analyzed. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immune blotting were conducted to ensure that anti-CSP1 monoclonal antibody (mAb) binds to CSP1 in human saliva. A sandwich enzyme-linked immunosorbent assay (ELISA) system was house-fabricated using mAb-hCSP1#14 and mAb-hCSP1#4 as a capture and a detector mAb, respectively. The CSP1 concentrations in saliva from 36 healthy subjects and 33 periodontal patients were quantified using the CSP1 sandwich ELISA system, and the results were analyzed using the Student’s t-test. RESULTS: Immunoblot analysis using mAb-hCSP1 as a probe confirmed that CSP1 in human saliva existed as a single band with a molecular weight of approximately 27-kDa. The quantification of CSP1 concentrations by CSP1 ELISA showed that the median values (25th to 75th percentiles) of periodontal patients and healthy subjects were 9,474 ng/mL (range, 8,434–10,139 ng/mL) and 8,598 ng/mL (range, 7,421–9,877 ng/mL), respectively. The Student's t-test indicated the presence of a statistically significant difference between the 2 groups (P=0.024). CONCLUSIONS: The presence of a significant difference in CSP1 levels between healthy subjects and periodontal patients suggests that CSP1 may be a potential biomarker for the detection or screening of periodontitis patients.
Bacteria ; Chronic Periodontitis ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Ethics Committees, Research ; Healthy Volunteers* ; Humans ; Jeollabuk-do ; Mass Screening ; Molecular Weight ; Peptides ; Periodontitis ; Saliva ; Sodium

Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.
Adolescent ; Antibodies, Antinuclear ; Arthritis ; Autistic Disorder ; Epilepsy ; Exanthema ; Female ; Fever ; Humans ; Liver ; Liver Function Tests ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphatic Diseases ; Pharyngitis ; Prednisolone ; Rheumatoid Factor ; Spleen ; Still's Disease, Adult-Onset

Association between postoperative nausea and vomiting (PONV) and micro-opioid receptor A118G single nucleotide polymorphism (SNP) is undefined and might underlie inconsistent results of studies on PONV occurrence in patients undergoing general anesthesia with the opioid, remifentanil. Four hundred and sixteen Korean women undergoing breast surgery with general anesthesia were randomized to receive remifentanil 10 ng/mL (plasma-site, Minto model) using a target-controlled infusion device and either propofol for total intravenous anesthesia (T group) or sevoflurane for inhalation anesthesia (I group) with bispectral index values maintained between 40 and 60. Blood specimens were collected after anesthesia induction for A118G SNP analysis. PONV and postoperative pain were evaluated. A118G SNP type distribution among Korean female adults studied was AG (n=195)>AA (n=158)>GG (n=63). Regardless of anesthetic technique, patients with GG types had lower PONV scale on arrival at postoperative care unit (PACU) (P=0.002), while T group showed lower PONV scale than I group up to 6 hr after PACU discharge in AA and AG types. No differences were apparent for postoperative pain among opioid receptor polymorphism. PONV occurrence differs according to opioid receptor polymorphism and anesthetic technique in patients undergoing general anesthesia with remifentanil.
Adult ; Analgesics, Opioid/*adverse effects ; Anesthesia, General/*adverse effects ; Breast Diseases/surgery ; Demography ; Double-Blind Method ; Female ; Humans ; Methyl Ethers/adverse effects/therapeutic use ; Pain, Postoperative/drug therapy ; Piperidines/*adverse effects/therapeutic use ; *Polymorphism, Single Nucleotide ; Postoperative Nausea and Vomiting/*etiology ; Receptors, Opioid, mu/*genetics

OBJECTIVES: The purpose of this study was to assess the long-term results of endoscopic dilatation of airway stenosis and to evaluate predictive factors for favorable results. METHODS: Fifty-four patients with tracheal and subglottic stenosis who underwent endoscopic dilatation with at least 12 months follow-up were enrolled in this study. We evaluated predictive factors for final treatment outcome such as stenosis length, location, characteristics, procedure type, and the severity of stenosis. RESULTS: The final outcome of endoscopic dilatation showed a cure rate of 40.7%, improvement rate of 46.3%, and failure rate of 13.0%. Patients with mild stenosis or a shorter stenotic segment and those who underwent a touch-up procedure following tracheal resection with end-to-end anastomosis showed better outcomes. The cure rate of endoscopic dilatation for patients with shorter mild stenosis was 72.2%. CONCLUSION: Endoscopic dilatation may be a primary treatment modality for patients with airway stenosis characterized by mild severity and a short stenotic segment.
Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Humans ; Tracheal Stenosis ; Treatment Outcome

Schwannoma is benign tumor that is originated from the schwann cell. It rarely occurs in the middle ear. Schwannomas of the middle ear may originate from the nerves of the middle ear cavity or by extensions from its neighboring structures. Most schwannomas arising from the middle ear are facial nerve schwannomas. We present a case of a 16-year-old male patient with primary middle ear schwannoma believed to arise from Jacobson's nerves. The tumor was easily dissected from the facial nerve and the chorda tympani nerve. The mass was successfully removed by canal down mastoidectomy, while preserving the hearing and facial nerve functions of the patient.
Adolescent ; Chorda Tympani Nerve ; Ear, Middle ; Facial Nerve ; Hearing ; Humans ; Male ; Neurilemmoma

Posterior fossa meningioma constitute approximately 10% of meningiomas. It can rarely involve the endolymphatic sac and produce symptoms of Meniere's disease. We present the case of a 41-year-old male patient who was suffering from recurrent vertigo. The pure tone audiogram revealed low tone hearing loss on right side and temporal magnetic resonance image revealed a meningioma in posterior fossa. Posterior fossa meningioma should be considered in the differential diagnosis of patients with signs and symptoms of Meniere's disease.
Adult ; Diagnosis, Differential ; Endolymphatic Hydrops ; Endolymphatic Sac ; Hearing Loss ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Meniere Disease ; Meningioma ; Stress, Psychological ; Vertigo

BACKGROUND: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) and fracture risk are both closely related to declining renal function. Controlling hyperphosphatemia with phosphate binders is a basic principle of CKD-MBD treatment. The aim of this study was to identify differences in fracture risk between pre-dialysis CKD patients and end-stage renal disease (ESRD) on dialysis, and to evaluate the effects of phosphate binders on fracture risk in ESRD patients. METHODS: Data from a total of 89,533 CKD patients comprising CKD diagnosis, dialysis, fracture history, and phosphate binder prescription history from 2012 to 2016 were retrieved from the Health Insurance Review and Assessment Service Database. Multivariate Cox regression analyses were performed to identify whether dialysis or phosphate binders were associated with an increased fracture risk. RESULTS: Overall, the rate of fractures in pre-dialysis CKD patients was 74 per 1,000 patient-years, while that in dialysis patients was 84 per 1,000 patient-years. The risk of fracture in ESRD patients was higher than pre-dialysis CKD patients (hazard ratio, 1.16; 95% confidence interval, 1.12–1.21; P < 0.001) after adjusting for confounding variables. In addition, the fracture risk in patients who were not taking phosphate binders was 20.0% higher compared to ESRD patients taking phosphate binders. CONCLUSION: Fractures were more prevalent in ESRD patients on dialysis than pre-dialysis CKD patients. Use of phosphate binders was associated with a lower fracture risk in ESRD patients.
Cohort Studies ; Confounding Factors (Epidemiology) ; Diagnosis ; Dialysis ; Humans ; Hyperphosphatemia ; Insurance, Health ; Kidney Failure, Chronic ; Prescriptions ; Renal Insufficiency, Chronic

Nasal dermoid cysts are rare neoplasms, which are diagnosed frequently in childhood. These lesions are derived from both ectoderm and mesoderm, and have keratinizing epithelium with skin appendages. A fistula, pit, or mass is the common clinical presentation. The diagnosis is primarily based on the medical history, physical examination, clinical symptoms, and radiologic findings. Complete surgical excision is the treatment of choice. A 15-year-old boy presented with a fistula on the nasal vestibule, which existed from birth. Fistulography revealed a contrast-filling fistulous tract and cyst in the caudal portion of the nasal septum. The lesion was removed surgically and pathology confirmed the diagnosis of dermoid cyst. We report, with a review of the literature, a rare case of dermoid cyst that occurred from the nasal septum.
Adolescent ; Dermoid Cyst ; Ectoderm ; Epithelium ; Fistula ; Humans ; Keratins ; Mesoderm ; Nasal Septum ; Parturition ; Physical Examination ; Skin