Laparoscopic radiofrequency thermal ablation is a promising new approach for the conservative treatment of a uterine myoma. I report a pad burn in a patient undergoing laparoscopic radiofrequency thermal ablation for a uterine myoma. The burn occurred at the leading edge of the pad attached to the patient's thigh. The burn was treated successfully with dressings.
Bandages ; Burns* ; Humans ; Leiomyoma* ; Myoma ; Skin* ; Thigh

Myotonia dystrophica(Synonym: Myotonia atrophica, Dystrophia myotonia, Steinert's disease) is a autosomal dominant hereditary multisystemic disorder involving several organs besides skeletal muscle, and commonly called with myotonia congenita, paramyotonia congenita as myotonia. Although most cases are of adult onset, where a mother has the disease, neonatal dystrophia myotonia can occur in her offspring. The main feature is a steadily progressive muscle dystrophy, complicated by myotonia, which is a failure of muscles to relax normally after a forceful contraction. Steinert in 1909 was the first to report the finding of atrophic testes and baldness in patients with myotonia dystrophica, and the other clinical feature of myotonia dystrophica were reported by many authors after that time. We are reporting a case of myotonia dystrophica, which showing familial history with brief review of literature.
Adult ; Alopecia ; Humans ; Mothers ; Muscle, Skeletal ; Muscles ; Myotonia Congenita ; Myotonia ; Myotonic Disorders ; Myotonic Dystrophy ; Testis

Lingual nerve palsy is a rare multi-etiological disease.Almost all devices used for airway manipulation can cause this complication, including laryngoscopes, laryngeal masks, cuffed oropharyngeal airways, tongue retractors, and suspension laryngoscopes.We report a case of transient lingual nerve palsy after general anesthesia, using orotracheal intubation, for surgery of a humerus fracture in the prone position.
Anesthesia, General ; Humerus ; Hypesthesia ; Intubation ; Laryngeal Masks ; Laryngoscopes ; Lingual Nerve ; Paralysis ; Tongue

BACKGROUND: The objective of this study was to describe the extent of pain relief after an epidural steroid injection in the patients suffering from chronic low back pain from herniated disks or lumbar spinal stenosis. METHODS: The study was prospectively designed for patients suffering with lumbar spinal stenosis (LSS) and herniated disks (HD) who were referred to a hospital-based pain clinic for epidural steroid injections (ESI). The pain was assessed with using a visual analog scale at baseline, two weeks after the first ESI and two weeks after the third ESI. RESULTS: Eighty patients were enrolled, and all of them provided pain ratings before and after the injections. The LSS patients seemed to improve less than did the HD patients. The results showed no significant differences in the triamcinolone dosage and the frequency of injections for determining the efficacy of ESI. CONCLUSIONS: The LSS patients tended to have a less effective respond to ESIs than did the HD patients. The unsatisfactory response to ESI by the LSS patients underscores the need for randomized controlled trials of performing ESI in this population.
Humans ; Intervertebral Disc Displacement* ; Low Back Pain ; Pain Clinics ; Prospective Studies ; Spinal Stenosis* ; Triamcinolone ; Visual Analog Scale

Eisenmenger's syndrome is defined as pulmonary hypertension with right-to-left or bidirectional shunting of blood through an intracardiac or aorto-pulmonary commumication. It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. Parturients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. We experienced a case of parturient for cesarean section with Eisenmenger's syndrome and performed epidural anesthesia with fractionated doses of 2% lidocaine and fentanyl. The sensory block reached to T10 level and blood pressure was maintained with intravenous phenylephrine. After baby out, sudden hypotension with severe bradycardia developed and arterial oxygen saturation dropped. Immediate intubation and resuscitation was done, but cardiac rhythm disturbance, hypoxemia, and acidosis did not corrected. Cardiac standstill developed and stopped resuscitation. The neonate's Apgar score was 7 and he was transferred to pediatric ICU.
Acidosis ; Anesthesia, Epidural* ; Anoxia ; Apgar Score ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Ductus Arteriosus, Patent ; Eisenmenger Complex* ; Female ; Fentanyl ; Hypertension, Pulmonary ; Hypotension ; Intubation ; Lidocaine ; Mortality ; Oxygen ; Peripartum Period ; Phenylephrine ; Pregnancy ; Resuscitation

We recently observed an unusual case of visual loss after periocular injection of silicone oil. A 31-year-old woman immediately experienced total loss of vision in the left eye with ipsilateral headache and ocular pain, dyspnea, abdominal pain, general weakness, and transient coma after subcutaneous injection of silicone oil on the glabellar area to reduce the facial wrinkles. We believe that the cause of blindness was multiple embolization in the central retinal artery and posterior ciliary branches of the ophthalmic artery.
Abdominal Pain ; Adult ; Blindness* ; Coma ; Dyspnea ; Female ; Headache ; Humans ; Injections, Intraocular ; Injections, Subcutaneous* ; Ophthalmic Artery ; Retinal Artery ; Silicone Oils*

BACKGROUND AND OBJECTIVES: An increase in intracellular calcium concentration due to loss of Ca2+ homeostasis triggers arrhythmia or cardiac cell death in the heart. Paracrine factors released from stem cells have beneficial cardioprotective effects. However, the mechanism of modulation of Ca2+ homeostasis by paracrine factors in ischemic myocardium remains unclear. MATERIALS AND METHODS: We isolated rat bone marrow-derived mesenchymal stem cells (MSCs), and prepared paracrine media (PM) from MSCs under hypoxic or normoxic conditions (hypoxic PM and normoxic PM). We induced rat myocardial infarction by left anterior descending ligation for 1 hour, and treated PM into the border region of infarcted myocardium (n=6/group) to identify the alteration in calcium-regulated proteins. We isolated and stained the heart tissue with specific calcium-related antibodies after 11 days. RESULTS: The hypoxic PM treatment increased Ca2+-related proteins such as L-type Ca2+ channel, sarcoplasmic reticulum Ca2+ ATPase, Na+/K+ ATPase, and calmodulin, whereas the normoxic PM treatment increased those proteins only slightly. The sodium-calcium exchanger was significantly reduced by hypoxic PM treatment, compared to moderate suppression by the normoxic PM treatment. CONCLUSION: Our results suggest that hypoxic PM was significantly associated with the positive regulation of Ca2+ homeostasis in infarcted myocardium.
Adenosine Triphosphatases ; Animals ; Antibodies ; Arrhythmias, Cardiac ; Calcium ; Calcium-Transporting ATPases ; Calmodulin ; Cell Death ; Heart ; Homeostasis ; Ligation ; Mesenchymal Stromal Cells ; Myocardial Infarction ; Myocardium* ; Paracrine Communication ; Rats* ; Sarcoplasmic Reticulum ; Sodium-Calcium Exchanger ; Stem Cells

In order that anesthesiologists may reduce the anesthetic and surgical stress on the heart, they frequently use regional anesthesia in patients with coronary artery disease, even though there is no evidence that it reduce the incidence of myocardial ischemia. We report a case of life-threatening cardiovascular collapse that occurred in a 47 years old male patient at the emergence from regional anesthesia. He underwent open reduction and internal fixation for femur fracture under combined spinal epidural anesthesia.The cause of serious hypotension is suspected of myocardial ischemia on the basis of ST segment elevation on EKG. We considered that these cardiovascular events were due to coronary spasm.The possible inducing factors of coronary spasm were altered autonomic balance and arteriosclerotic change related endothelial dysfunction.
Anesthesia, Conduction ; Coronary Artery Disease ; Electrocardiography ; Femur ; Heart ; Humans ; Hypotension ; Incidence ; Male ; Myocardial Ischemia ; Spasm

BACKGROUND: The purpose of this study was to investigate the prevalence of Stap hylococcus aureus with decreased susceptibility to glycopeptides in Korea and to evaluate the methods for detection. METHODS: From March to May 1998, 106 clinical isolates of S. aureus were collected from patients of the Kosin Medical Center . Antimicrobial susceptibilities for vancomycin and teicoplanin were determined by NCCLS disc diffusion method and the MICs were determined by agar dilution method. Correlation between both results was evaluated. RESULTS: MICs of vancomycin and teicoplanin against S. aureus isolates were 0.5 ~2 microgram/mL and 0.25 ~8 microgram/mL. Some S. aureus isolates showed decreased susceptibility to teicoplanin (MIC 4 microgram/mL, 33 strains; MIC 8 microgram/mL, 1 strain), but none showed decreased susceptibility to vancomycin. A positive correlation was observed between the inhibitory zone diameters of teicoplanin disc and the MICs of teicoplanin(P< 0.0 1). Inhibitory zone diameter differences between vancomycin and teicoplanin discs also showed a positive correlation with the MICs of teicoplanin (P< 0.01). Strains whose inhibitory zone diameters of teicoplanin disc were less than 16 mm, the sensitivity and positive predictive value for the detection of strains with MICs more than 4 microgram/mL were 100 % (34/ 34) and 43% (34/ 79), respectively. In strains with inhibitory zone diameter difference of more than 4 mm, the sensitivity and positive predictive value of detection in MICs of more than 4 microgram/mL were 94 % (32/ 34) and 70 % (32/46), respectively. CONCLUSION: Although S. aureus with intermediate or full resistance to glycopeptides was not isolated in this study, few strains had decreased susceptibility to teicoplanin. We conclude that when the inhibitory zone diameters of teicoplanin disc are less than 16 mm or inhibitory zone diameter difference between vancomycin and teicoplanin discs is more than 4 mm, the presence of S. aureus isolates with decreased susceptibility to teicoplanin should be suspected.
Agar ; Diffusion ; Glycopeptides ; Humans ; Korea ; Prevalence ; Staphylococcus aureus* ; Staphylococcus* ; Teicoplanin* ; Vancomycin

Severe symptomatic hyponatremia shows high mortality in association with cerebral edema and central nervous system dysfunction. Postoperative hyponatremia is usually attributed to administration of hypotonic fluids while antidiuretic hormone is acting. However, we experienced a severe symptomatic hyponatremia in spite of infusion of lactated Ringer's solution perioperatively in a case of 4-year-old girl's tonsillectomy. Inappropriate secretion of ADH caused by pain, stress, anxiety, nausea, vomiting. Paralytic ileus developed several hours after surgery, severe hyponatremia (Na 119 mmol/L) with convulsion notified. After prompt infusion of sodium supplement and fluid restriction, the patient recovered uneventfully.
Anxiety ; Brain Edema ; Central Nervous System ; Child, Preschool ; Humans ; Hyponatremia* ; Intestinal Pseudo-Obstruction* ; Mortality ; Nausea ; Seizures* ; Sodium ; Tonsillectomy* ; Vomiting