BACKGROUND: Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002. We checked the preoperative factors; sex, age, history of previous serum creatinine over 2.0 mg/dL, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors; IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/dL. RESULT: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/dL in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6.4%) in the patients whose creatinine level have not increased over 2.0 mg/dL. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/dL are diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. CONCLUSION: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. Postoperative ARF could be the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.
Acute Kidney Injury* ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Creatinine ; Dialysis ; Fluid Therapy ; Humans ; Hypertension ; Medical Records ; Mortality ; Postoperative Complications ; Pulmonary Edema ; Risk Factors ; Stroke Volume ; Thoracic Surgery

To achieve optimal decalcification in tissue and tissue preservation, we have tried magnetic field method and made some promising results. We used pulsed unipolar magnetic field obtained by rectification of 250 V-60 cycle, A.C. As a new method of bony decalcification, using 5% nitric acid, 10% formic acid and 10% formic acid+3% hydrochloric acid solutions, experimental groups were decalcified in the center of the magnetic field. The concentration of calcium ion in the decalcifying solution was measured by calcium-oxalate turbidity test by photometry method, and direct visualization of calcium radiopacity was obtained by soft X-ray view during the decalcification process. The pH change during decalcification was continuously checked and needle penetration method was also used. All the decalcification solution used in this study showed accelerated effect of bony decalcification in the strong magnetic field. Among them 5% nitric acid produced complete decalcification for the medium size bony specimen (less than 10x10x10 mm) within 24 hours, and the histologic feature was almost free of acid-chemical degeneration. The pH of all the decalcification solutions decreased in the strong magnetic field, maximum within 4~6 hours, and kept strong acidity throughout the decalcification procedure. After removal of the magnetic field the pH of all the decalcification solution returned to their original values after 24 hours. It was presumed that the cause of the accelerated decalcification in the magnetic field was due to combined effects of the rapid increase of acidity and the increased molecular resonance to stimulate the ionization of mineral elements.

Congenital cutis laxa is a rare inherited disorder of connective tissue manifested by loose and hanging skin, resulting in a prematurely-aged appearance. Cutis laxa may be inherited in an autosomal dominant, autosomal recessive and X-linked recessive pattern or an acquired form. In this report we describe a patient with congenital cutis laxa and growth retardation. The skin showed loose folds, wrinkling, and sagging of the face, abdomen, and both thighs. His weight and height were below the 3rd percentile. He had no family history for this skin disease.
Abdomen ; Connective Tissue ; Cutis Laxa* ; Elastic Tissue ; Humans ; Skin ; Skin Diseases ; Thigh

Congenital cutis laxa is a rare inherited disorder of connective tissue manifested by loose and hanging skin, resulting in a prematurely-aged appearance. Cutis laxa may be inherited in an autosomal dominant, autosomal recessive and X-linked recessive pattern or an acquired form. In this report we describe a patient with congenital cutis laxa and growth retardation. The skin showed loose folds, wrinkling, and sagging of the face, abdomen, and both thighs. His weight and height were below the 3rd percentile. He had no family history for this skin disease.
Abdomen ; Connective Tissue ; Cutis Laxa* ; Elastic Tissue ; Humans ; Skin ; Skin Diseases ; Thigh

Peripheral nervous system involvement is common in systemic vasculitis, occurring most frequently in the polyarteritis nodosa (PAN) group of disorders and in rheumatoid vasculitis. Within the polyarteritis nodosa group of systemic necrotizing vasculitides, three subgroups have been described: classic polyarteritis nodosa, Churg-Strauss syndrome, and an overlap syndrome. Three patients with evidence of systemic vasculitis and peripheral neuropathy were clinically and electrophysiologically investigated. All cases presented clinically with mononeuropathy multiples considered typical pattern of ischemic involvement of the peripheral nerve. The causes included polyarteritis nodosa, its Churg-strauss variant, and the overlap syndrome. Pain and weakness were frequent symptoms. Nerve conduction studies were abnormal In all cases. Necrotizing vasculitis was present as pathologic findings in two cases. All patients were treated with prednisolone alone or in combination with other immunosuppressive agents or with plasmapheresis.
Churg-Strauss Syndrome ; Humans ; Immunosuppressive Agents ; Mononeuropathies* ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Plasmapheresis ; Polyarteritis Nodosa ; Prednisolone ; Rheumatoid Vasculitis ; Systemic Vasculitis ; Vasculitis*

Although the incidence of extrapyramidal reactions associated with metoclopramide has been reported to be approximately 0.2%, such reactions are rare in the anesthetic field. Several anesthetic adjuvants, including ondansetron and pregabalin, have also been associated with extrapyramidal side effect. Here, the authors report the case of a 47-year-old patient, previously administered pregabalin and ondansetron, who developed extrapyramidal side effects after a single injection of metoclopramide (10 mg) in a post-anesthesia care unit.
Adjuvants, Anesthesia ; gamma-Aminobutyric Acid ; Humans ; Incidence ; Metoclopramide ; Middle Aged ; Ondansetron ; Pregabalin

PURPOSE: To determine the changes of location of intraocular lens (IOL) and refractive errors in the cases of vitrectomized eyes and non-vitrectomized eyes, we evaluated the anterior chamber depth and refractive errors after phacoemulsification and posterior chamber IOL implantation. METHODS: In 21 vitrectomized eyes of 21 patients (group 1) and 22 non-vitrecomized eyes of 22 patients (group 2), the anterior chamber depth was measured with Orbscan II (Bausch and Lomb Surgical, Germany) for the evaluation of changes of anterior chamber depth preoperatively, at 1 month and 3 months postoperatively. We compared the desired refraction by preoperative data, and postoperative manifest refraction of postoperative 1 month and 3 months. RESULTS: In group 1, the anterior chamber was deeper than that of group 2 postoperative 1 month but the result was not statistically significant. After 3 months the chamber depth was significantly deeper in group 1 than group 2, (P=0.047), and refractive errors were significantly more hyperopic in group 1 than group 2. CONCLUSIONS: The vitreous influenced the location of IOL after phacoemulsification and posterior chamber IOL implantation, so in the cases of vitrectomized eyes IOL was more posteriorly located, and thus hyperopic shift was noted.
Anterior Chamber* ; Cataract* ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Refractive Errors

In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients(89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A(95.7%), type B (89.%). There was significantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bed >45° and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors, Stenosis severity, thrombus, lesion location at a bend >45°, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.
American Heart Association ; Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Male ; Myocardial Infarction ; Phenobarbital ; Thrombosis

BACKGROUND/AIMS: Due to the recent increase in elderly population, laparoscopic surgery is more frequently performed in the elderly. This study aimed to compare the short-term outcomes of laparoscopic colorectal cancer surgery between the very elderly group (VEG), categorized as those with age over 80 years and the elderly group (EG), categorized as those with age 65 to 79 years. METHODS: We retrospectively compared 48 very elderly patients with 96 elderly patients (1:2 matched) who underwent laparoscopic resection for colorectal cancers at our institution between March 2010 and December 2014. The clinicopathologic parameters, surgical characteristics and short term outcomes were compared. RESULTS: There was no statistically significant difference in clinicopathologic characteristics between VEG and EG. Postoperative pain score (7 points vs. 6 points, p=0.264), time to first flatus (3 days vs. 3 days, p=0.335), hospital stay (15 days vs. 16.5 days, p=0.361), complication rates (47.9% vs. 26.0%, p=0.147) and major complication rate (25% vs. 20.8%, p=0.681) were not statistically different between the two groups. Before surgery, VEG had higher rate of neurologic underlying disease, such as dementia or cerebrovascular disease, than EG (25.0% vs. 7.3%, p=0.007). CONCLUSIONS: There was no significant difference in the clinicopathologic characteristics, short-term outcomes, and complication rates for laparoscopic colorectal resection between VEG and EG, except delirium. Age over 80 years may be relevant for the application of laparoscopic colorectal cancer resection.
Aged* ; Cerebrovascular Disorders ; Colorectal Neoplasms* ; Delirium ; Dementia ; Flatulence ; Humans ; Laparoscopy ; Length of Stay ; Pain, Postoperative ; Retrospective Studies

PURPOSE: As the Korean population ages, an increasing number of elderly patients with gastric cancer are undergoing surgical resection. The aim of this study was to analyze the surgical outcomes and prognostic factors after gastric cancer surgery for patients 80 years of age or older.METHODS: We analyzed the medical records of 720 patients with gastric cancer who underwent gastrectomy from March 2010 to December 2014 retrospectively. Patients were divided into two groups: octogenarians (age ≥80 years, n=46) and non-octogenarians (age <80 years, n=674). We evaluated clinicopathologic data including postoperative morbidity, mortality, and 5-year survival rate.RESULTS: The rate of curative resection was not different between the two groups. The American Society of Anesthesiology score was significantly higher in the octogenarians (P<0.05). Octogenarians exhibited poorer performance scale scores, higher comorbidities, and more advanced TNM stages than non-octogenarians. There was no difference in surgical resection margins between the two groups. In addition, octogenarians suffered from more postoperative morbidity and mortality than non-octogenarians. In the analysis of risk factors of survival after gastrectomy for octogenarians, advanced TNM stage and dose of transfusion were independent risk factors. Overall survival was significantly lower in octogenarians than non-octogenarians. There was no difference in the disease-specific survival for each stage of cancer after adjustment for tumor stage.CONCLUSION: Octogenarians had more preoperative risk factors and postoperative morbidity and mortality, but cancer-specific survival was comparable with non-octogenarians. Careful preoperative evaluation, thorough resection, and attentive postoperative care can improve the overall survival of octogenarians with gastric cancer.
Aged ; Aged, 80 and over ; Anesthesiology ; Comorbidity ; Gastrectomy ; Humans ; Medical Records ; Mortality ; Postoperative Care ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; Survival Rate ; Treatment Outcome