No abstract available.
Colon* ; Humans* ; Morphine* ; Naloxone* ; Perfusion*

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies

BACKGROUND: Perioperative hypothermia can develop easily during shoulder arthroscopy, because cold irrigation can directly influence core body temperature. The authors investigated whether active warming and humidification of inspired gases reduces falls in core body temperature and allows redistribution of body heat in patients undergoing arthroscopic shoulder surgery under general anesthesia. METHODS: Patients scheduled for arthroscopic shoulder surgery were randomly assigned to receive either room temperature inspired gases using a conventional respiratory circuit (the control group, n = 20) or inspired gases humidified and heated using a humidified and electrically heated circuit (HHC) (the heated group, n = 20). RESULTS: Core temperatures were significantly lower in both groups from 30 min after anesthesia induction, but were significantly higher in the heated group than in the control group from 75 to 120 min after anesthesia induction. CONCLUSIONS: In this study the use of a humidified and electrically heated circuit did not prevent core temperature falling during arthroscopic shoulder surgery, but it was found to decrease reductions in core temperature from 75 min after anesthesia induction.
Anesthesia ; Anesthesia, General ; Arthroscopy ; Body Temperature ; Cold Temperature ; Gases ; Hot Temperature ; Humans ; Hypothermia ; Shoulder

Poststernotomy mediastinitis is a rare but potentially life-threatening complication of cardiac surgery. Up to present, poststernotomy wound infection has been treated by closure of wound directly or by use of myocutaneous flaps after irrigation and debridement of wound. We describe a new treatment of poststernotomy wound infection by using the vacuum- assisted closure technique. This technique was successfully applied in 3 patients with poststernotomy wound infection and mediastinitis, and a healed sternotomy wound could be achieved using this new technique.
Debridement ; Humans ; Mediastinitis* ; Myocutaneous Flap ; Negative-Pressure Wound Therapy* ; Sternotomy ; Thoracic Surgery ; Wound Infection* ; Wounds and Injuries*

OBJECTIVE: Although alcohol dependence is associated with a wide range of cognitive impairment, working memory function of alcohol dependence has not been well studied. The aim of this study was the assessment of working memory in alcohol dependence, the comparison of verbal and visuo-spatial working memory, and the examination of the correlations between working memory and clinical parameters. METHODS: A sample of 18 sober alcohol-dependent participants was compared with a sample of 19 controls on verbal and visuo-spatial working memory test using "2-back" system. RESULTS: Alcohol dependent participants showed the increased errors of verbal working memory. The amount of alcohol consumption during problem alcohol drinking period was correlated significantly with false positive error of verbal working memory. CONCLUSION: These results demonstrated that alcohol dependence impairs verbal working memory despite no impairment of intelligence. This study suggested the relationship between verbal working memory impairment and the amount of alcohol consumption.
Alcohol Drinking ; Alcoholism* ; Humans ; Intelligence ; Memory, Short-Term*

Oligodendroglioma that occurs in the ventricle has been reported uncommonly. The case is reported of a 38-year-old man who presented with severe headache and vomiting and was discovered to have an oligodendroglioma in the lateral and third ventricles. The clinical presentation, radiological finding, pathology and response to radiation are described with brief review of general biology in oligodendroglioma.
Adult ; Biology ; Headache ; Humans ; Lateral Ventricles ; Oligodendroglioma* ; Pathology ; Third Ventricle* ; Vomiting

BACKGROUND: Left ventricular function and left ventricular hypertrophy often show weak correlation with the degree of blood pressure in hypertensive patients. So we assessed correlation of hemodynamic load to left ventricular hypertrophy and left ventricular performance, and whether left ventricular wall stress is the major factor on the regulation of left ventricular function. METHODS: Relationships between echocardiographic hemodynamic parameters and indices of left ventricular hypertrophy and left ventricular function were evaluated in 40 patients with essential hypertension who have not been previously treated. RESULTS: Left ventricular mass index correlated weakly with blood pressure, cardiac index, and stroke volume. End-diastolic left ventricular relative wall thickness, as an index that assess the severity of concentric hypertrophy showed significantly negative correlation with cardiac index (r=-0.49, p<0.001),stroke index(r=-0.46, p<0.001) and a positive correlation with total peripheral resistance (r=0.55, p<0.001). Furthermore, patient with cardiac indices tend to have higher end-diastolic wall thickness at any given level of blood pressure. Fractional shortening suggesting left ventricular systolic function was not related with blood pressure. stroke volume, cardiac index, left ventricular mass index, and peak systolic wall stress. In contrast there were significant negative correlations between fractional shortening with mean wall stress index (r=-0.42, p<0.005) and with end-systolic wall stress (r=-0.72, p<0.001). CONCLUSIONS: These results suggest that anatomic and hemodynamic changes may be pathophysiologically interdependent and left ventricular function was regulated by the level of left ventricular wall stresses reflecting afterload (blood pressure).
Blood Pressure ; Echocardiography ; Hemodynamics* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Stroke Volume ; Vascular Resistance ; Ventricular Function, Left

Venous air embolism (VAE) is a potentially fatal complication in patients with chronic liver disease during liver surgery, although VAE is unlikely to occur during laparotomy in a supine position. We report a case presenting unexpected cardiovascular collapse due to venous air embolism in a patient with liver cirrhosis during hepatic resection.
Embolism, Air ; Humans ; Laparotomy ; Liver ; Liver Cirrhosis ; Liver Diseases ; Shock ; Supine Position

This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers.
Guideline Adherence/*standards ; *Models, Organizational ; Practice Guidelines as Topic/*standards ; Quality Assurance, Health Care/*standards ; Republic of Korea

Secure fixation is essential for continous epidural catheterization on a long-term-basis. Adhesive tape or surgical knots were commonly used for those patients, but the surgical knot method has a tendency to cause strangulation of catheter. Another invasive technique, subcutaneous tissue tunnelling is more safe than other methods but requires sophisticated technique and time. We employed a simple device using a blood transfusion set for patients who have epidural catheters placed safely on their backs. In 120 patients treated for postoperative and chronic pain by means of this technique, the results were as follows: 1) Five of 120 patients (4.2%) developed backache and pruritus, but there were no instances of respiratory depression, local infection and headache. 2) Nine of 120 patients (7.5%) failed booster-injections, but two cases were due to be non-technical errors. 3) The duration of fixation was 1-3 days in most cases (85%), the longest being for 21 days.
Adhesives ; Back Pain ; Blood Transfusion ; Catheterization ; Catheters* ; Chronic Pain ; Headache ; Humans ; Pruritus ; Respiratory Insufficiency ; Subcutaneous Tissue