Effectiveness of a Rectal Tube for Relief of Pain after Colonoscopy / 대한소화기내시경학회지

BACKGROUND AND AIMS: Abdominal distension from the insufflation of air can create more troublesome discomfort after colonoscopy (CFS) than after upper endoscopy. Many patients report difficulty in expelling insufflated air after CFS. One previous study demonstrated that insertion of rectal tube at the conclusion of CFS significantly improves patient satisfaction with the procedure. The aim of this study was to compare the effectiveness of rectal tube placement for abdominal decompression after CFS in an effort to limit patient discomfort by carefully applying air suction during CFS. METHODS: We conducted a prospective trial in 103 consecutive patients undergoing elective CFS. Patients were randomized to receive rectal tube placement at the end of the procedure or simple air suction during the procedure. Patients were evaluated by clinical symptoms and signs 10 minutes after completion of CFS. RESULTS: All 103 patients had a complete examination of the colon to the cecum. No specific complications occurred during and a day after examination. The two groups were well matched with respect to age, sex, height, weight, chief complaints. There were no significant differences between the two groups for bowel preparation, duration of examination, abdominal pain during procedure, abdominal disten-sion 10 minutes after CFS, and abdominal pain 10 minutes after CFS (p >0.05). CONCLUSIONS: Meticulous air suction during CFS reduces abdominal discomfort and distension after CFS and is as effectively as the placement of a rectal tube at the con-clusion of CFS.

Effect of Hemodialysis on Taste Acuity in Patient with End-Stage Renal Disease / 대한신장학회잡지

In patients with end-stage renal disease, depressed taste acuity may often affect their food intake and causes malnutrition. We measured mean recognition thresholds for the four primary tastes before and after hemodialysis to evaluate the efficacy of hemodialysis on taste acuity and measured serum zinc concentrations to determine the relationship between taste acuity and zinc status in 21 patients undergoing hemodialysis. The results were as follows : 1) Mean taste recognition thresholds of sour(0.0034+/-0.0021 N), sweet(0.027+/-0.012 M), and salty(0.027+/-0.014 M) were significantly higher than those of controls(0.0012+/-0.0007 N, 0.016+/-0.008 M, and 0.015+/-0.008 M, respectively)(P<0.05). 2)After hemodialysis, mean taste recognition thresholds of sour(0.0014+/-0.0011 N), sweet(0.015+/-0.011 M), and salty(0.020+/-0.011 M) were significantly decreased(P<0.05) but were not different from those of controls. 3) The mean recognition threshold for bitter was not improved after hemodialysis and was not different from that of controls. 4) The serum zinc concentration of patients with chronic renal failure was not different from that of controls. Finally, the mean taste recognition thresholds for sour, sweet, and salty were decreased in patients with end-stage renal disease and were improved after hemodialysis. The mean taste recognition threshold for bitter was not improved after hemodialysis and was not different from that of controls.

A Case of Rhino-orbital Mucormycoses with Orbital Apex Syndrome in Diabetic Patient / 대한내분비학회지

Rhino-orbital mucormycosis is a rare fungal infection that involves paranasal sinus and orbits and usually presented as acute invasive fungal sinusitis or orbital apex syndrome. It often occurs in patients with poorly controlled diabetes mellitus especially during or following episode of diabetic ketoacidosis. If the condition is not treated, the fungal infection may disseminated into the brain and death usually occurs in a day to week. Exenteration is often needed as a therapy. We have experienced a case of rhino-orbital mucormycosis that presented as a orbital apex syndrome and confirmed by maxillary and periorbital soft tissue biopsy. A 56-year-old female suffered from diabetes mellitus for 3 years was admitted with rapidly progressive visual acuity loss and left hemi-facial numbness. She was treated with daily intravenous amphotericin B and intraconal amphotericin B irrigation and packing. Exenteration was not neccisated.