No abstract available.
Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

No abstract available.
Dislocations* ; Elbow*

Laparoscopic repair using mesh is a standard technique for ventral hernia repair. Complications of laparoscopic ventral hernia repair increase according to the increment of laparoscopic repair. Subcutaneous emphysema and mesh infection are major complications of laparoscopic repair of ventral hernia. The principle of management of infection is removal of a foreign body. However, in the case of repair with mesh, removal of infected mesh induces recurrence of hernia. Preservation of mesh is the best option for treatment of infected mesh. We have experienced treatment without removal of mesh in a case of infected subcutaneous emphysema after laparoscopic ventral hernia repair. The infection spread slowly to mesh and seroma. Drainage and debridement of infected tissue and evacuation of infected seroma resulted in healing of the infection without removal of mesh.
Debridement ; Drainage ; Foreign Bodies ; Hernia ; Hernia, Ventral ; Herniorrhaphy ; Laparoscopy ; Recurrence ; Seroma ; Subcutaneous Emphysema ; Surgical Mesh

OBJECTIVE: The aim of the study is to evaluate the changes of the respiratory patterns associated with swallowing in the brain-injured patients. METHOD: Twenty brain-injured patients(6 bulbar lesions, 14 pseudobulbar lesions) and fifteen normal subjects were selected for this study. Each subject swallowed 5cc of water for ten times in a upright sitting position and a submental electromyography recording and respirography by pneumobelt on mid-abdomen were recorded simultaneously. RESULTS: 1) Most swallows occured during the late expiratory phase in both brain-injured patients and controls. 2) In brain-injured patients, the incidence of swallowing during inspiration was significantly higher than the controls(p<0.05). 3) In brain-injured patients, the postdeglutitive inspiration was significantly higher than the controls(p<0.05). 4) In patients with a bulbar lesion, the postdeglutitive inspiration was significantly higher than patients with a pseudobulbar lesion(p<0.01). 5) Postdeglutitive swallowing relatively correlates with the abnormalities in clinical findings and Video Fluoroscopic Swallowing Study(VFSS) findings. CONCLUSION: The respiratory patterns associated with the swallowing in brain-injured patients were different from that of the normal adults and the postdeglutitive inspiration could be the most valuable predictor of the aspiration.
Adult ; Deglutition* ; Electromyography ; Humans ; Incidence ; Swallows ; Water

Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and incresed pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was assciated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered. reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather incresed than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Anesthetics ; Anesthetics, Local ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Cardiovascular System* ; Central Nervous System ; Central Venous Pressure ; Cough ; Diazepam* ; Dogs* ; Heart Rate ; Hemodynamics ; Intubation ; Laryngoscopy ; Lidocaine* ; Nerve Block ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reflex ; Stroke ; Vascular Resistance

Cutaneous focal mucinosis is a rare disease which usually manifests itself as a single asymptomatic papule or nodule, but vesicular presentati:on has only rarely been reported. This condition is one of many mucinoses, including localized lichen myxedematosus, acral persistent papular mucinosis, alopecia mucinosa, follieular mucinosis, and myxoid cysts which present with localized cutaneous lesions. We report a rare vesicular form of cutaneous focal mucinosis in a 42-year-old caucasian male who showed a slowly growing, 0.5 cm-sized, asymptomatic vesicle of one-week duration on his right knee. A histopathological examination revealed a localized accumulation of amorphous basophilic material which was positive on colloidal iron staining at pH 2.5. However, it was negative at pH 0.4 in an alcian blue stain, and negative on colloidal iron staining after treatment with hyaluronidase. The amorphous material was judged to be hyaluronic acid from the results of the above special stains. Proliferation of fibroblasts was also observed. Electron microscopy showed well-develuped endoplasmic reticulum and secretory vesicles in the fibroblasts. The lesion could not be completely removed even after two succesive wide excisions.
Adult ; Alcian Blue ; Basophils ; Colloids ; Coloring Agents ; Endoplasmic Reticulum ; Fibroblasts ; Ganglion Cysts ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Hydrogen-Ion Concentration ; Iron ; Knee ; Male ; Microscopy, Electron ; Mucinoses* ; Mucinosis, Follicular ; Rare Diseases ; Scleromyxedema ; Secretory Vesicles

To investigate the effects of prostaglandin E1(PGX1) in prevention of proliferative scar formation, we cultured fibroblasts of normal skin (NS), hypertrophic scar (HS) and keloid (KL) tissues obtained from patients. We have compared type I collagenase production of cultured fibroblasts from normal skin, hypertrophic scar, and keloid tissues under various concentrations of PGE1. Our results demonstrate that type I collagenase production was significantly increased after addition of PGE1 in HS and KL, but not NS. Type I collagenase production of HS and KL fibroblasts were increased similarly in 10M and 10M of PGE1 and maximally increased in the concentration of 10M. This promotive effects of PGE1 on the production of type I collagenase was larger in KL than in HS. These results also suggest that PGE1 may play the promotive effects on type I collagenase production in dose-dependent manner. PGE1 may have a role in the prevention of hypertrophic scar and keloid by enhancing the production of type I collagenase of HS and KL fibroblasts. The promotive effects of PGE1 on type I collagenase production was variable depending on its concentration, and its effects was maximum in certain optimal condition. The maximally effective concentration of PGE1 in the prevention of proliferative scar formation should be searched in further investigations for clinical use.
Alprostadil ; Cicatrix ; Cicatrix, Hypertrophic* ; Collagenases* ; Fibroblasts* ; Humans ; Keloid* ; RNA, Messenger* ; Skin

Research or therapy involving human fetal tissue has been subject of intense political and ethical debate in many country for almost two decades. Especially, Transplantation of cells or tissues from aborted fetuses to treat Parkinson's disease shows great clinical promise but it has some ethical or legal controversy. We can expect that demand of fetal brain tissue is increased explosively near future. So we have to establish our own eithical guidelines urgently. In this article authors report several basic medical or ethical issues which the fetal mesencephalic transplantation brings up inevitably and suggest our own ethical guidelines.
Aborted Fetus ; Brain ; Ethics ; Fetus ; Humans ; Parkinson Disease ; Transplantation

We diagnosed 48 babies as retinopathy of prematurity (ROP) among 438 premature infants from April 1995 to March 1996 in Gil General Hospital. Among 48 ROP babies, 16 (30 eyes) infants progressed to stage 3+ ROP. Mean birth weight was 1474.0 gm, mean gestational age was 29.7 weeks and mean oxygen inhalation duration was 471.2 hours. Among 30 eyes of stage 3+ ROP, 25 eyes progressed to threshold stage and 5 eyes regressed spontaneously. Ten eyes were treated with cryotherapy and 15 eyes with diode laser photocoagulation and the treatment depends on random selection. Four eyes progressed to stage 5 ROP in spite of photocoagulation and encircling scleral buckling. Favorable outcome was achieved in all eyes treated with cryotherapy, and in 73. 3% of eyes laser-treated.
Birth Weight ; Cryotherapy ; Gestational Age ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Inhalation ; Lasers, Semiconductor ; Light Coagulation ; Oxygen ; Retinopathy of Prematurity* ; Scleral Buckling

Medullary pyramid is the one place where corticospinal fibers are isolated as the pyramidal tract, and the result of such lesions has been a flaccid hemiplegia. Medial medullary syndrome may occur bilaterally, resulting in flaccid quadriplegia with facial sparing, bilateral lower motor neuron signs of the tongue, and complete loss of position and vibratory sensation affecting all for extremities. Occasionally, only the pyramid is damaged, resulting in a pure motor quadriplegia without other medullary signs. We report a 78-year-old man who suddenly developed flaccid quadriplegia without any other medullary signs. Brain MRI showed bilateral medial medullary infarctions that was probably due to anterior spinal artery occlusion.
Aged ; Arteries ; Brain ; Extremities ; Hemiplegia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Motor Neurons ; Pyramidal Tracts ; Quadriplegia* ; Sensation ; Tongue