With remarkable progress in upper GI endoscopy; it has been applied to therapeutid purpose. ln this paper, we present one suceessful case of endoscopic extraction of BADUG STONE by biopsy forceps and contraceytive condom., Using a biopsy forceps and condom inserted through the fiberscope, BADUG STONE' was eaaily made to roll into the self-opening trawl net' and safly removed.
Biopsy ; Condoms* ; Endoscopy ; Surgical Instruments

The coronary vasospasm has usually been readily reversible by sublingual, intravenous or intracoronary nitroglycerin. Relief of spasm, either spontaneous or following nitrate therapy, results in reperfusion. Occurence of ventricular tachyarrhythmia during release of coronary spasm is attractive as a possible cause of sudden death because of significant proportion of sudden death victims do not have acute myocardial infarction. Recently, we experienced a 36 year old man who developed spontaneous coronary vasospasm, and the patients suffered from repetitive reperfusion ventricular tachyarrhythmia, and died suddenly in spite of administration of isosorbide dinitrate, lidocaine and several trials of cardioversion and cardiopulmonary resuscitation, and we report.
Adult ; Cardiopulmonary Resuscitation ; Coronary Vasospasm ; Death, Sudden* ; Electric Countershock ; Humans ; Isosorbide Dinitrate ; Lidocaine ; Myocardial Infarction ; Nitroglycerin ; Reperfusion* ; Spasm ; Tachycardia*

Intrathecal meperidine produces a profound analgesia, because meperidine has a high lipid solubility and a structure similar to local anesthetics. This study was undertaken to evaluate the anesthetic effect and complications of intrathecal meperidine anesthesia and the effect of added epinephrine. Two percent meperidine 30 mg (Group I) and 2% meperidine 30 mg with 0.3 mg epinephrine (Group II) in 20% D/W were injected intrathecally in each of 30 cases scheduled for simple and short surgical procedures. The results are as follows: 1) Systolic blood pressure and pulse rate decreased significantly from 10 minutes to 1 hour after intrathecal meperidine injection, compared with the value before anesthetic administration, but did not require special medical treatment. 2) The onset time of block of T, sensory dermatome in the meperidine injection group (Group 1) and the added epinephrine mixed injection group (Group II), were 5.3+/-1.4 minutes and 6.6+/-2.1 minutes, and duration were 58.5+/-10.5 minutes and 74.1+/-16.4 minutes respectively. Therefore, the onset time of motor nerve blok were 5.5+/-2.6 minutes and 8.9+/-1.6 minutes, and then their duration were 65.7+/-11.4 minutes and 79.7+/-13.4 minutes respectively. 3) PaO decreased and PaCO2 increased significantly 1 hour after meperidine injection without any serious problem. 4) Complications, such as nausea, pruritus and urinary retention, were observed in many patients without any serious problem.
Analgesia ; Anesthesia* ; Anesthetics ; Anesthetics, Local ; Blood Pressure ; Epinephrine* ; Heart Rate ; Humans ; Meperidine* ; Nausea ; Pruritus ; Solubility ; Urinary Retention

No abstract available.
Humans ; Staphylococcal Protein A*

Supravalvular aortic stenosis is an uncommon congenital narrowing of the ascending aorta that may be localized or diffuse, originating at the superior margin of the sinuses of Valsalva just above the level of the coronary arteries. The most common complication of supravalvular aortic stenosis is early onset of intimal hyperplasia and atherosclerosis of the coronary arteries. The coronary arterial lesions of supravalvular aortic stenosis are dilatation or coronary artery ostial obstruction. We experienced a case of supravalvular aortic stenosis combined with right coronary artery ostial obstruction. A 21 year-old female patient was admitted because of exertional dyspnea and chest pain for 2 months. Cardiac catheterization showed a narrowing of ascending aorta with prominent calcification in the lesion and moderate aortic valve insufficiency. The peak to peak left ventricular-supravalvular aortic pressure gradient was 54 mmHg. Selective coronary angiography revealed as a complete obstruction of the ostium of the right coronary artery. Surgical correction was performed successfully. Postoperative left ventricular-supravalvular aortic pressure gradient was decreased to 22 mmHg. Postoperative clinical course was favorable and she was discharged with good condition. We present a case of supravalvular aortic stenosis combined with right coronary artery ostial obstruction with a review of literatures.
Aorta ; Aortic Stenosis, Supravalvular* ; Aortic Valve Insufficiency ; Arterial Pressure ; Atherosclerosis ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels* ; Dilatation ; Dyspnea ; Female ; Humans ; Hyperplasia ; Young Adult

No abstract available.

BACKGROUND: The cross-matching test is regarded as an essential pre-transfusion test. It serves an important role in confirming the ABO/Rh compatibility of transfusion and screening for possible unexpected antibodies. We evaluated cross-matching tests in QWALYS-3 (DIAGAST, Loos Cedex, France), comparing the automated process to manual tube methods. METHODS: A total of 545 crossmatching tests from 169 patients, collected from RBC concentrate transfusion orders, were performed using both QWALYS-3 and manual tube methods. All patients were follow-up tested later on with antibody identification tests to confirm the presence of unexpected antibodies in plasma. RESULTS: None of the samples were ABO/Rh incompatible. The presence of unexpected antibodies was later confirmed in 277 tests in 56 patients. Out of those 277 tests, the concordance rate between two methods was 83.8% (232/277). In 268 tests which were later confirmed with no unexpected antibodies, manual tube methods did not show any positive results while five tests were false-positive (5/268, 1.9%) only in QWALYS-3. The overall concordance rate between two methods was 90.82%, and the kappa coefficient was 0.696 (P<0.05) (n=545). CONCLUSION: The QWALYS-3 system has its merits in accuracy, precision, and lack of possible human errors, however, the automated procedure showed some disadvantages, including relatively low cost-and-time-effectiveness, less effective cold antibody detection, and difficulties in handling small quantity samples. Thus, the QWALYS-3 system has meaningful, but only a limited value in the automation of routine cross-matching tests.
Antibodies ; Automation ; Blood Banks* ; Follow-Up Studies ; Humans ; Mass Screening ; Plasma

STUDY DESIGN: This is a mechanical study of polymethylmetacrylate(PMMA) mixed with blood as a filler. OBJECTIVE: We tried to change the properties of PMMA so that it is more suitable to use for percutaneous vertebroplasty (PVP). SUMMARY OF THE LITERATURE REVIEW: The mechanical changes by adding a filler into PMMA were expected to decrease the Young's modulus, the polymerization temperature and the setting time. These changes of PMMA were considered to be more suitable and adaptable conditions for PVP for treating osteoporotic vertebral compression fracture. MATERIALS AND METHODS: Porous PMMA was produced by mixing 2 ml (B2), 4 ml (B4) and 6 ml (B6)-blood as a filler, and the mechanical properties were investigated in comparison with regular PMMA(R) in view of Young's modulus, the polymerization temperature, the setting time and the optimal passing-time within the injectable viscosity (20~50N-needed) through a 2.8mm-diameter cement-filler tube. Porosity was inspected by performing microcomputated tomography (micro-CT). RESULTS: Young's modulus was decreased from 919.5 MPa (R) to 701 MPa (B2), 693.5 MPa (B4) and 545.6 MPa (B6) in each group. The polymerization temperature decreased from 74.2degrees C (R) to 59.8degrees C (B2), 54.2degrees C (B4) and 47.5degrees C(B6), respectively. The setting time decreased from 1065sec (R) to 624sec (B2), 678sec(B4) and 606sec (B6), respectively, and the optimal passing-time decreased from 75.6sec (R) to 46.6sec (B2), 65.0sec (B4) and 79.0sec(B6), respectively. The porosity increased from 4.2%(R) to 27.6%(B2), 27.5%(B4) and 29.5%(B6), respectively. A homogenous microstructure with very fine pores was seen on inspection of all the blood-mixed PMMAs. CONCLUSION: Blood mixed with PMMA was considered as an excellent filler that was easy to make and had good biocompatibility. The 6ml blood-mixed PMMA (B6) showed more suitable mechanical properties, including a decreased elastic modulus due to more porosity, less heating and a retarded optimal passing-time by the serum barrier, which diminished the friction between the PMMA and a cement-filler tube.
Elastic Modulus ; Fractures, Compression ; Friction ; Heating ; Hot Temperature ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Porosity ; Vertebroplasty ; Viscosity

STUDY DESIGN: Mechanical study of polymethylmetacrylate (PMMA) mixed with blood as a filler. PURPOSE: An attempt was made to modify the properties of PMMA to make it more suitable for percutaneous vertebroplasty (PVP). OVERVIEW OF LITERATURE: The expected mechanical changes by adding a filler into PMMA included decreasing the Young's modulus, polymerization temperature and setting time. These changes in PMMA were considered to be more suitable and adaptable conditions in PVP for an osteoporotic vertebral compression fracture. METHODS: Porous PMMA were produced by mixing 2 ml (B2), 4 ml (B4) and 6 ml (B6) of blood as a filler with 20 g of regular PMMA. The mechanical properties were examined and compared with regular PMMA(R) in view of the Young's modulus, polymerization temperature, setting time and optimal passing-time within an injectable viscosity (20-50 N-needed) through a 2.8 mm-diameter cement-filler tube. The porosity was examined using microcomputed tomography. RESULTS: The Young's modulus decreased from 919.5 MPa (R) to 701.0 MPa (B2), 693.5 Mpa (B4), and 545.6 MPa (B6). The polymerization temperature decreased from 74.2degrees C (R) to 59.8degrees C (B2), 54.2degrees C (B4) and 47.5degrees C (B6). The setting time decreased from 1,065 seconds (R) to 624 seconds (B2), 678 seconds (B4), and 606 seconds (B6), and the optimal passing-time decreased from 75.6 seconds (R) to 46.6 seconds (B2), 65.0 seconds (B4), and 79.0 seconds (B6). The porosity increased from 4.2% (R) to 27.6% (B2), 27.5% (B4) and 29.5% (B6). A homogenous microstructure with very fine pores was observed in all blood-mixed PMMAs. CONCLUSIONS: Blood is an excellent filler for PMMA. Group B6 showed more suitable mechanical properties, including a lower elastic modulus due to the higher porosity, less heating and retarded optimal passing-time by the serum barrier, which reduced the level of friction between PMMA and a cement-filler tube.
Elastic Modulus ; Fractures, Compression ; Friction ; Heating ; Hot Temperature ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Porosity ; Vertebroplasty ; Viscosity ; X-Ray Microtomography

Primary lymphoma of the thyroid is a relatively rare malignant tumor of the thyroid. It is known to be frequently associated with Hashimoto's thyroiditis. In Korea, a few cases of primary lymphoma of the thyroid have been reported and most of these cases were in the stage I E or II E. Recently, we experienced a case of the primary thyroid lymphoma, stage IV E associated with Hashimoto's thyroiditis in a 70-year-old woman who presented with dysphagia and dyspnea due to rapidly enlarging neck mass.She was treated with combination chemotherapy(cyclophosphamide, adriamycin, vincristine and methylprednisolone) and local radiotherapy and achieved partial response with resolution of dysphagia and dyspnea.
Aged ; Bone Marrow ; Deglutition Disorders ; Doxorubicin ; Dyspnea ; Female ; Humans ; Korea ; Lymphoma ; Neck ; Radiotherapy ; Thyroid Gland ; Thyroiditis ; Vincristine