No abstract available.
B-Lymphocytes* ; Humans*

No abstract available.

No abstract available.
Nasal Polyps*

PURPOSE: With an accumulation of surgical experience for endoscopic or video-assisted thyroidectomy and improvements in surgical techniques and endoscopic instruments, these procedures have become a valid option for patients with benign thyroid nodules. These applications are now being expanded even to selected patients with low risk thyroid carcinomas. This study was performed to suggest new modified methods of approach on the use of a gasless endoscopic thyroidectomy via an axillary approach and to evaluate the short-term outcomes. METHODS: Between May 2004 and March 2007, 66 female patients underwent a gasless endoscopic thyroidectomy via an axillary approach. Surgical outcomes were evaluated in terms of surgical time, length of hospital stay, the incidence of perioperative complications, and patient opinion at two and four months after surgery. RESULTS: No cases required conversion to open surgery. The mean surgical time was 136.5±31.8 minutes, and the mean length of hospital stay was 4.2±1.1 days. There were two transient recurrent laryngeal nerve palsies, two minor tracheal injuries without air leakage, and two postoperative hemorrhages that required a second surgery. Only one patient (1.9%) and five patients (9.4%) complained of slight hypesthesia or paresthesia in the neck and anterior chest wall, respectively, and only three patients (5.7%) complained of discomfort while swallowing 4 months after surgery. CONCLUSION: Gasless endoscopic thyroidectomy via an axillary approach is a feasible and safe procedure and providesa minimal degree of postoperative complaints. This procedure is now a valid option for the surgical treatment of benign thyroid disease and its applications will broaden in the near future.
Conversion to Open Surgery ; Deglutition ; Female ; Humans ; Hypesthesia ; Incidence ; Length of Stay ; Neck ; Operative Time ; Paralysis ; Paresthesia ; Postoperative Hemorrhage ; Recurrent Laryngeal Nerve ; Thoracic Wall ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy*

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

Noonan syndrome is characterized by short stature, mental retardation, typical facial morphology, webbed neck and congenital heart disease. Noonan syndrome can be inherited in an autosomal dominant manner but all Korean patients with Noonan syndrome have been reported as sporadic cases thus far. In approximately 50-60% of cases, the disease is caused by mutation in the PTPN11 (protein tyrosine phosphatase, nonreceptor type 11) gene on chromosome 12, encoding SHP-2 (Src homology protein-tyrosine phosphatase-2). We have experienced a boy and his father with typical clinical features of Noonan syndrome in whom Asn58Asp mutation of the PTPN11 gene were identified. To the best of our knowledge, this is the first report of genetically confirmed familial Noonan syndrome in Korea.
Chromosomes, Human, Pair 12 ; Fathers ; Heart Diseases ; Humans ; Intellectual Disability ; Neck ; Noonan Syndrome ; Tyrosine

BACKGROUND/AIMS: For decades, thiopurines have been the mainstay of inflammatory bowel disease (IBD) treatment and will play an important role in the future. However, complex metabolism and various side effects limit the use of these potent drugs in clinical practice. The Korean Association for the Study of Intestinal Diseases developed a set of consensus statements with the aim of guiding clinicians on the appropriate use of thiopurines in the management of IBD. METHODS: Sixteen statements were initially drafted by five committee members. The quality of evidence and classification of recommendation were assessed according to the Grading of Recommendations Assessment, Development and Evaluation system. The statements were then circulated to IBD experts in Korea for review, feedback, and then finalized and accepted by voting at the consensus meeting. RESULTS: The consensus statements comprised four parts: (1) pre-treatment evaluation and management strategy, including value of thiopurine S-methyltransferase screening, dosing schedule, and novel biomarkers for predicting thiopurine-induced leukopenia; (2) treatment with thiopurines with regards to optimal duration of thiopurine treatment and long-term outcomes of combination therapy with anti-tumor necrosis factors; (3) safety of thiopurines, especially during pregnancy and lactation; and (4) monitoring side effects or efficacy of therapy using biomarkers. CONCLUSIONS: Thiopurines are an effective treatment option for patients with IBD. Management decisions should be individualized according to the risk of relapse and adverse events.
Appointments and Schedules ; Biomarkers ; Classification ; Committee Membership ; Consensus* ; Female ; Humans ; Inflammatory Bowel Diseases* ; Intestinal Diseases* ; Korea ; Lactation ; Leukopenia ; Mass Screening ; Metabolism ; Necrosis ; Politics ; Pregnancy ; Recurrence

BACKGROUND: This bispectral index, which is used for intravenous anesthetics and inhalation anesthesia, is a scale of sedation and hypnotic effect, which is widely used in clinics. Atypical changes in BIS are expected due to increased cardiac output, decreased blood albumin concentrations and renal function in severe burn patients undergoing early escharectomy. The aim of this study was to compare BIS according to effected site concentrations of propofol during anesthetic induction using propofol TCI in severe burn and nonburn patients. METHODS: Forty patients were classified as twenty nonburn elective surgical patients (group 1) and twenty burn patients scheduled for escharectomy (group 2). For induction, a propofol TCI device incorporating a prefilled syringe was adjusted to a target concentration of 6mug/ml in flash mode. The bispectral index was checked before induction and at each effect site concentration of propofol (0.5mug/ml interval) until an effect site concentration of 4.5mug/ml. Other suspected contributory factors such as cardiac index, creatinine clearance and albumin were checked simultaneously. The unpaired t-test and repeated measures ANOVA were performed for the statistical analysis. RESULTS: Below an effect site concentration of propofol of 3mug/ml, no BIS difference was evident between group 1 and group 2. However, at 3.5mug/ml, group 1 was 41.1+/-13.5 and group 2 was 54.7+/-16.6 and at 4mug/ml, group 1 was 40.1+/-2.6 and group 2 was 50.1+/-13.1. Among the suspected contributing factors, cardiac index and albumin showed significant differences between groups 1 and 2 (cardiac index: 3.4+/-0.5 L/min/m2 vs 2.7+/-0.3 L/min/m2, albumin: 4.1+/-0.3 g/dl vs 2.6+/-0.3 g/dl, P<0.05). Creatinine clearance showed no significant difference between the groups. CONCLUSIONS: Severe burn patients who are expecting early escharectomy had higher BIS values than nonburn patients from an effect site concentration of propofol of 3.5mug/ml. This study suggest that cardiac index should be considered as a factor that influences propofol.
Anesthesia, Inhalation ; Anesthetics, Intravenous ; Burns* ; Cardiac Output ; Creatinine ; Humans ; Hypnotics and Sedatives ; Propofol* ; Syringes

PURPOSE: The purpose of this study was to calculate the size and CT number of both normal parotid and submandibular gland, and evaluate its relation to sex, age and obesity using computed tomography. MATERIALS AND METHODS: The computed tomography was performed parallel to the Frankfurt plane in 46 subjects with healthy salivary gland. The subjects were divided into the three groups(young, middle, old) according to their ages. The size of salivary gland was determined as maximum cross-sectional area and the CT number of salivary gland was determined as the mean CT number of three ROI's. The body mass index was calculated from weight and height. RESULTS: The mean maximum cross-sectional area was 7.79(+/-1.26) cm2 on parotid gland and 4.12(+/-0.83) cm2 on submandibular gland. The mean CT number was -4.43(+/-23.87) HU on parotid gland and 50.01(+/-15.63) HU on submandibular gland. There were decreasing pattern of the maximum cross-sectional area of submandibular gland and the CT number of both parotid and submandibular gland according to age(p<0.05). As the body mass index increased, the maximum cross-sectional area of parotid gland increased and CT number of both parotid and submandibular gland decreased(p<0.05). The maximum cross-sectional area of submandibular gland in male was larger than that in female(p<0.05). As the maximum cross-sectional area and CT number of left salivary gland increased, those of right gland increased(p<0.05). CONCLUSION: Intra-individual differences in salivary gland size and CT number is considered in the age and individual obesity.
Aging ; Body Mass Index ; Humans ; Male ; Obesity ; Parotid Gland ; Salivary Glands* ; Submandibular Gland

The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. MATERIALS AND METHODS: The oral squamous cell carcinoma patients(21 patients, 59 lymph nodes) who have visited SNU hospital and been taken by MRI, were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images, each lymph node were evaluated by using 6 MR imaging criteria(size, roundness, heterogeneity, rim enhancement, central necrosis, grouping) respectively. Positive predictive value, negative predictive value, and accuracy of each single MR imaging criteria were calculated. At neural network system, the layers of neural network system consisted of 10 input layer units, 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level 2, site II-other node level, shape I-oval, shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes, 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes, 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis from neural network was decided according to 4 different standard metastatic index-68, 78, 88, 98 respectively and positive predictive values, negative predictive values and accuracy of each standard metastatic index were calculated. RESULTS: In the diagnosis of using single MR imaging criteria, the rim enhancement criteria had the highest positive predictive value, 0.95 and the size criteria showed the highest at negative predictive value, 0.77. The highest accurate criteria was heterogeneity with the accuracy of 0.81 and the lowest one was central necrosis with accuracy of 0.59. In the diagnosis of using neural network systems, the highest accurate standard metastatic index was 78, and that time, the accuracy was 0.90. Neural network system was more accurate than any other single MR imaging criteria in evaluating cervical lymph node metastasis. CONCLUSION: Neural network system has been shown to be more useful than any other single MR imaging criteria. In future, Neural network system will be powerful aiding tool in evaluating cervical node metastasis.
Biopsy ; Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging ; Neck Dissection ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics