Complications of penile prosthesis include malfunction, infection and patient dissatisfaction. Herein, a rare complication of a retained reservoir having eroded into the bladder after the removal of the penile components of a three-piece penile prosthesis, is reported. A 39-year-old man complained of irritative voiding symptoms. The symptoms had developed 4 years after the removal of the penile components of the prosthesis. The erosion of the reservoir into the bladder was discovered incidentally during the treatment of bladder calculi. The reservoir was removed by an open vesicolithotomy.
Adult ; Calculi ; Cytochrome P-450 CYP1A1 ; Humans ; Penile Prosthesis* ; Prostheses and Implants ; Urinary Bladder Calculi* ; Urinary Bladder*

Hemintaxia-hypesthesia in thalamic stroke has been rarely reported. We experienced six patients who has hemiataxia-hypesthesia with or without transientweakness due to thalamic stroke. Upon reviewing the pattern of sensory deficits and the presence of weakness m our cases and those in previously reported thalamic stroke patients with hemiataxiahypesthesia with or without transient weakness, hemiataxia-hypesthesia has a localizing value of the thalamic lesion, particularly in case of presenting with pain sensory loss and of no weakness.
Humans ; Stroke*

There have been accumulating evidences that dyslipidemia is a major risk factor of cardiovascular disease (CVD) and improvement in lipid profile can reduce the incidence of CVD. Guidelines for management of dyslipidemia have been developed by major organizations in several contries including the United States. In Korea, a guideline was also published by the Korean Society of Lipidology and Atherosclerosis. However, This guideline was not based on evidences in Korea, but was made by a consensus of experts using a pre-developed guideline as a reference. For clinical application for Korean of guidelines developed in different nations, the disease epidemiology and medical environment in Korea should be considered. In this article, we reviewed whether guidelines for management of dyslipidemia are applicable in Korean context.
Atherosclerosis ; Cardiovascular Diseases ; Consensus ; Dyslipidemias ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Korea ; Risk Factors ; United States

Anterior approaches to the cervical spine for performing decompression, fusion and/or instrumentation are common and useful methods for treating many conditions, including degenerative diseases. One of the rare, but serious complications of an anterior cervical approach is respiratory insufficiency as a result of upper airway obstruction, which is due to airway narrowing and prevertebral soft tissue swelling. We experienced a case of serious airway obstruction that was caused by soft tissue edema combined with postoperative hematoma after an anterior cervical spine approach. We report here on this case and include a review of the relevant literature.
Airway Obstruction ; Decompression ; Edema ; Hematoma ; Respiratory Insufficiency ; Spine

Pulmonary alveolar proteinosis (PAP) is characterized by the progressive accumulation of phospholipids and proteins within the alveolar sacs without producing an inflammatory response. Whole-lung lavage (WLL) is performed as the standard therapy for this disease because it serves to wash out the proteinaceous material from the alveoli. In this case, we performed sequential WLL using propofol-remifentanil, which is not related to hypoxic pulmonary vasoconstriction during one-lung ventilation. The patient's symptoms and radiologic findings showed improvement without the occurrence of any specific complications. Therefore, we report a case of anesthetic management of WLL performed repeatedly for a patient with recurrent PAP.
Humans ; One-Lung Ventilation ; Phospholipids ; Proteins ; Pulmonary Alveolar Proteinosis ; Therapeutic Irrigation ; Vasoconstriction

PURPOSE: We analyzed the survival and failure patterns of cervix cancer patients treated with irradiation alone to evaluate our treatment method and to compare with the others. METHODS AND MATERIALS: Two hundred and twenty cervical cancer patients, Stage IB, IIA, and IIB who completed the planned treatment between May 1987 and December 1991 were analyzed retrospectively. The Stage IB patients were restaged to the Stage IB1 and IB2 by the recently revised FIGO classification. Patients were treated with a combination of external irradiation and the intracavitary brachytherapy. Determination of the tumor control was done at the time of 6 months postirradiation. The follow-up time was ranged from 3 to 115 months and the mean was 62 months and the follow-up rate was 93.6%(206/220). RESULTS: The overall 5-year survival rate of Stage IB1(N=50), IB2(N=15), IIA(N=58), and IIB(N=97) was 94%, 87%, 69%, and 56%, respectively. In the univariate analysis of prognostic factors,stage(0.00), initial Hg level (p=0.00), initial TA-4(tumor-associated) antigen level(p=0.02), initial CEA level(p=0.02), barrel-shaped tumor(p=0.02), whole cervical involvement (0.00), pelvic lymphadenopathy(LAP) in CT(p=0.04), and post-irradiation adjuvant chemotherapy(p=0.00) were statistically significant in survival analysis. In a while, multivariate analysis showed that the stage was the most powerful prognostic indicator and the post-irradiation chemotherapy factor also showed the statistical significance. The overall local control rate was 81% and by the stage, 100% in Stage IB1, 86.7% in Stage IB2, 84.5% in Stage IIA, and 68.1% in Stage IIB, respectively. The overall tumor recurrence rate was 15.5%(27/174) and by the stage, 8%(4/50) in Stage IB1, 0%(0/13) in Stage IB2, 22.4%(11/49) in Stage IIA, and 19.4%(12/62) in Stage IIB, respectively. CONCLUSIONS: We obtained the similar treatment results to the other's ones in early stage cervical cancer patients. But in Stage IIB, the local control rate was lower than that of the other institutes and also the survival was poorer. So it seems to be necessary to reevaluate the treatment method in advanced cervical cancer patients.
Academies and Institutes ; Brachytherapy ; Cervix Uteri* ; Classification ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms

Gastric volvulus is a rare condition, and it is classified as the organoaxial or mesentericaxial type according to the axis of rotation. We experienced 1 case of pediatric recurrent mesenteroaxial gastric volvulus and we report here the ultrasonographic and CT findings.
Axis, Cervical Vertebra ; Stomach Volvulus*

BACKGROUD: Ephedrine has been most commonly used for the prevention and treatment of hypotension occurring frequently during spinal anesthesia for cesarean section. But recent studies reported that phenylephrine was more effective for treatment of maternal hypotension and for prevention of fetal acidosis than ephedrine. We compared effect of phenylephrine, ephedrine, and ephedrine combined with phenylephrine to maternal hypotension and fetal acidosis. METHODS: This study compared ephedrine 2 mg/min infusion with 6 mg bolus (n = 30), phenylephrine 33.3microgram/min infusion with 50microgram bolus (n = 30), and ephedrine combined phenylephrine with half the dose infusion rate & bolus (n = 30). Hypotension, defined as systolic blood pressure less than 100 mmHg and less than 80% of baseline, was treated with additional bolus injection. RESULTS: In ephedrine group, the number of bolus given for hypotension was larger than other groups (P < 0.001), the incidence of hypotension was also higher than other groups (P = 0.02). The heart rate was lower in phenylephrine group than other groups, but bradycardia which needs to be treated didn't occur. Umbilical blood gas analysis and Apgar score were similar for three groups, but only one patient in ephedrine group had fetal acidosis (pH = 7.130). Nausea and vomiting were more frequent in ephedrine group than other groups. CONCLUSIONS: In our study, giving phenylephrine alone was more effective in the prevention and treatment of maternal hypotension and nausea & vomiting than giving ephedrine alone or combined phenylephrine.
Acidosis ; Anesthesia, Spinal* ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Ephedrine* ; Female ; Heart Rate ; Humans ; Hypotension ; Incidence ; Nausea ; Phenylephrine* ; Pregnancy ; Vomiting

BACKGROUND: Spinal anesthesia for cesarean section is regaining popularity. The effects of patient variables on the spread of sensory blockade have been reported to vary widely. We evaluated the effects of abdominal circumference, fundus height and cerebrospinal fluid pressure on the spread of sensory blockade following subarachnoid hyperbaric bupivacaine with fentanyl in term parturients. We also evaluated the effects of age, height, weight, body mass index on the spread of sensory blockade. METHODS: Sixty healthy term parturients scheduled for elective cesarean section, were measured for, abdominal circumference, fundus height, cerebrospinal fluid pressure, and received 8 mg of 0.5% hyperbaric bupivacaine with fentanyl 20microgram intrathecally. Maximal sensory block height and blood pressure were assessed. Intraoperative visceral pain was checked as discribed using four grades. RESULTS: Age, weight, abdominal circumference, fundus height and cerebrospinal fluid pressure were not found to be correlated with the spread of sensory blockade. However, height and body mass index correlated with the spread of sensory blockade (P<0.05). CONCLUSIONS: It is necessary to vary the dose of injected hyperbaric bupivacaine according to changes in height and body mass index.
Anesthesia, Spinal* ; Blood Pressure ; Body Mass Index ; Body Weight ; Bupivacaine* ; Cerebrospinal Fluid Pressure ; Cesarean Section ; Female ; Fentanyl ; Humans ; Pregnancy ; Visceral Pain

Herpes zoster is viral infection that presents unilateral skin rash or vesicle along the sensory nerve. It is known that pediatric herpes zoster rarely occurs and usually not so severe when it developed, except in immunocompromised children. We report an uncommon case of herpes zoster ophthalmicus in a 9-year-old boy. He presented with acute onset of vesiculopapular rash covering his left forehead, upper eyelid. He was treated with oral acyclovir and stellate ganglion block, with complete resolution without sequelae. In addition, we also review the literature on herpes zoster in childhoods.
Acyclovir ; Child ; Exanthema ; Eyelids ; Forehead ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Stellate Ganglion