• Journal of Medicine and Life Science
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• v.20 no.4
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• pp.183-187
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• 2023

Empty nose syndrome is an uncommon complication of turbinoplasty and other nasal operations. It presents with various manifestations, with the most common symptom being paradoxical nasal obstruction. Here, we report the case of a 67-year-old male patient diagnosed with empty nose syndrome 20 years after turbinoplasty. Autologous auricular conchal cartilage was harvested and implanted into the lateral wall of the inferior turbinate to reduce nasal volume. The patient experienced significant relief from subjective nasal obstruction symptoms immediately after surgery. Over a 23-month follow-up period, no side effects or symptom recurrence was reported.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.130-135
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• 2024

The effectiveness of corticosteroids in preventing immune reconstitution inflammatory syndrome in non-human immunodeficiency viruses Pneumocystis carinii pneumonia (PCP) patients, such as severe combined immunodeficiency (SCID) patients, is controversial. We experienced a paradoxical reaction during severe PCP treatment in a SCID infant, which responded well to adjuvant corticosteroids.

• The Korean Journal of Physiology and Pharmacology
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• v.9 no.2
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• pp.77-86
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• 2005

In this study, we examined the morphine-induced modulation of the nociceptive spinal dorsal horn neuronal activities before and after formalin-induced inflammatory pain. Intradermal injection of formalin induced time-dependent changes in the spontaneous activity of nociceptive dorsal horn neurons. In naive cats before the injection of formalin, iontophoretically applied morphine attenuated the naturally and electrically evoked neuronal responses of dorsal horn neurons. However, neuronal responses after the formalin-induced inflammation were significantly increased by morphine. Bicuculline, $GABA_A$ antagonist, increased the naturally and electrically evoked neuronal responses of dorsal horn neurons. This increase in neuronal responses due to bicuculline after the formalin-induced inflammation was larger than that in the naive state, suggesting that basal $GABA_A$ tone increased after the formalin injection. Muscimol, $GABA_A$ agonist, reduced the neuronal responses before the treatment with formalin, but not after formalin treatment, again indicating an increase in the GABAergic basal tone after the formalin injection which saturated the neuronal responses to GABA agonist. Morphine-induced increase in the spinal nociceptive responses after formalin treatment was inhibited by co-application of muscimol. These data suggest that formalin-induced inflammation increases $GABA_A$ basal tone and the inhibition of this augmented $GABA_A$ basal tone by morphine results in a paradoxical morphineinduced increase in the spinal nociceptive neuronal responses after the formalin-induced inflammation.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.11 no.2
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• pp.76-80
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• 2015

Mental retardation is one of the major disorders covered in special care dentistry. Patients show poor oral health and are a challenge for the dentist due to lack of cooperation. Triazolam is a short-acting benzodiazepine and has been used in the dental office for many years because of its favorable properties. In this study, five patients with mental retardation were sedated with triazolam on a dental out-patient setting. Patients were administrated with 0.25 mg or 0.5 mg of triazolam on the first dose according to the patient's cooperation. Twenty minutes after the initial dose, patients received 0.25 mg of triazolam. Triazolam was administrated sublingually to one patient and orally to four patients. Hydroxyzine was also administrated to three patients in order to prevent nausea and vomiting. All patients were inhaled with 50% nitrous oxide during the sedation. Treatment time ranged from 20 minutes to 55 minutes. Two patients showed paradoxical reactions and were administrated with intramuscular injections of flumazenil. In result, depending on the range of dental treatment and level of intellectual disability, we can assume that triazolam may be beneficial for sedation in disabled patients.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.244-249
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• 1984

Surgical treatment of partial endocardial cushion defect was accomplished in Feb. 1984 in this department. The 5 year old male patient had history of frequent upper respiratory tract infection and since his age of 3 years dyspnea on exertion and palpitation were noted but there were no cyanosis and clubbing. A thrill was palpable on the apex and grade IV/IV harsh systolic ejection murmur and diastolic murmur was audible on it. Liver was palpable about 3 finger breadths and no ascites. Chest X-ray revealed increased pulmonary vascularity, moderate cardiomegaly [C-T ratio; 0.69], and enlarged left atrium. EKG showed first degree heart block, RVH, LVH, and LAD. Echocardiogram showed paradoxical ventricular septal movement and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted left to right shunt [Qp:Qs:2.1:1 ] and moderate pulmonary hypertension [60/40 mmHg]. Left ventriculogram showed mitral regurgitation [Grade III/IV] and filling of left atrium and right atrium nearly same time. Operative findings were: 1.Primum type atrial septal defect [3x2 cm] 2.Cleft on the anterior leaflet of mitral valve. 3.No interventricular communication and cleft of tricuspid valve leaflet. The mitral cleft was repaired with 4 interrupted sutures. The primum type atrial septal defect was closed with Dacron patch intermittently at endocardial cushion and continuously remainder. The post operative course was uneventful and discharged on 22nd postoperative day in good general conditions.

• The Journal of the Korean Society for Microbiology
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• v.16 no.1
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• pp.57-64
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• 1981

The clinical need for agents to modify immune response in the treatment of viral infection has lead to an increased interest in cellular and biochemical mechanisms regulating the immune response and to the development of a variety of biological and chemical substance with immunomodulatory activity. Inosiplex has shown antiviral activity in tissue culture, animal models and huamn studies through augmentation of immune response. However, the effect of inosiplex on immune response in animal has not been extensively analyzed, and the effect of inosiplex on immune response has been paradoxical depending on the time of administration of inosiplex in relation to that of antigen. Therefore, this study was undertaken to assess the effect of inosiplex on the immune response to sheep red blood cells(SRBC) in normal and viral infected mice. Inosiplex increased cellular immune response and plaque forming lymphocyte response to SRBC, decreased the recovery of S. typhimurium from infected mice spleen, and restored the depressed cellular immune response by measle and newcastle disease virus infections. All of the above results were observed only when inosiplex was given after immunization but did not when given before immunization. These results indicate that inosiplex stimulate the efferent are of immune response and may even block the afferent are, and suggest that inosiplex is a very promising drug in therapy of many viral infections.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.216-220
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• 2005

Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.175-183
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• 1983

Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

• The Journal of the Korean dental association
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• v.55 no.5
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• pp.365-369
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• 2017

In clinical dentistry, botulinum toxin is generally used to treat the square jaw, bruxism, and temporomandibular joint diseases. Recently, this procedure has been expanded and applied for cosmetic purposes, and it is becoming a key task to be aware of the precise anatomical structure of the target muscles to be cautious during treatment and how to prevent side effects. Therefore, the purpose of this study is to observe the anatomical structure of the superficial layer of masseter muscle and to provide a most effective botulinum toxin injection method through clinical anatomical consideration. It was observed that the muscle belly of superficial part of the superficial layer was originated from the deep to the aponeurosis of masseter muscle and descend, then changed gradually into the tendon structure attaching to the inferior border of the mandible. In this study, we named this structure deep inferior tendon. This structure was observed in all specimens. We conclude that the use of superficial layer and deep layer injection should be considered to prevent paradoxical masseteric bulging in consideration of the deep inferior tendon of superficial part of superficial layer of masseter muscle.

• Journal of Hospice and Palliative Care
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• v.26 no.1
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• pp.18-21
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• 2023

The combination of oxycodone and naloxone is useful for cancer pain management. Naloxone, as a pure opioid antagonist, cannot be used simultaneously with opioids. However, owing to its low bioavailability, it can be used in an oral composite formulation. We present the case of a 55-year-old man with gastric cancer who experienced severe opioid withdrawal syndrome (OWS) triggered by oxycodone/naloxone that was successfully managed with dexmedetomidine. He had been in a stable condition on intravenous morphine to alleviate cancer pain. Intravenous morphine was switched to oral oxycodone/naloxone for discharge from the hospital. The patient suddenly developed restlessness, heartburn, and violent behavior 30 minutes after taking oxycodone/naloxone. We attempted sedation with midazolam and propofol, but paradoxical agitation and desaturation occurred. Next, we tried dexmedetomidine and the patient showed a decreased heart rate and reduced agitation. The patient was eventually stabilized by increasing the dose of dexmedetomidine. This report informs clinicians of the possibility of OWS when switching from opioids to oxycodone/naloxone, which can be overcome with the appropriate use of sedatives and dexmedetomidine depending on the patient's condition.