Removal of blunt esophageal foreign bodies using Foley catheter under a fluoroscopic guidance is a well-recognized procedure. However, since this procedure is rather cumbersome and uncomfortable to the patient, the authors tried to find an easier and more convenient modified technique. For 10 patients with esophageal foreign body, we tried the method to the patients who is lying in the right lateral decubitus position and 3 assistants hold head. arms, trunk and legs of the patients without tilting the table and without using immobilizer. Foley catheter is inserted through nostril, nasal cavity and pharynx to esophagus. In order to identify the Foley catheter in esophagus, 0.025 inch short wire was inserted in the Foley catheter. The balloon of a Foley catheter was inflated by 10cc of air, and the syringe was kept attached to the Foley catheter during the procedure. After passage of the foreign body through the upper esophageal sphincter, the balloon was deflated immediately and the foreign body was removed through the mouth. We successfully removed in removing all the blunt esophageal foreign body with ease. This modified method is also fast, safe and efficient.
Arm ; Catheters* ; Deception ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies* ; Head ; Humans ; Leg ; Methods* ; Mouth ; Nasal Cavity ; Pharynx ; Syringes

The Mayer-Rokitanski-Kuster-Hauser Syndrome refers to the clinical entity consistingof primary amenorrhea associated with congenital absence of the vagina, 46XX Karyotype,a rudimentary uterus in the form of bilateral noncanaliculated muscular band or completeabsence, normal ovarian function and normal ovulation, normal breast development, bodyproportion and body hair, frequent associated of renal, skeletal and other congenitalanomalies. A case of Mayer-Rokitanski-Kuster-Hauser syndrome was presented and the literatureswere reviewed briefly.
Amenorrhea ; Breast ; Female ; Hair ; Ovulation ; Uterus ; Vagina*

Cervical pregnancy is one of most rare form of ectopic pregancy in which the blastocyst implants within the cervical canal below the internal os of uterine cervix. Most cervical pregnancy result in early spontaneous abortion, complicated by severe hemorrhage frm the eroded blood vessels within the cervix. Because of fear of rofuse hemorrhage, abdominal hysterectomy has been historically considered the standard therapy. However, a number of new therapies have been aimed at uterine preservation, conservative treatment is highly desirable for young women who want to be pregnancy in the future. Methotrexate has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of a cervical preganncy that was successfully managed with methotrexate and leucovorine.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Cytochrome P-450 CYP1A1 ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Methotrexate* ; Pregnancy*

Spontaneous cervical epidural hematoma is an infrequent entity that usually requires emergency decompression on account of impending neurologic deficit. We present a case of a 36-year-old man who visited our emergency room complainng of severe neck pain with progressive weakness of both upper extrmities. On cervical MRI, fusiform epidural hematoma was found extending from the fifth to the seventh cervical vertebrae. Emergency surgical evacuation was performed. The patient was fully recovered and discharged uneventfully.
Adult ; Cervical Vertebrae ; Decompression ; Emergencies ; Emergency Service, Hospital ; Female ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Neck Pain ; Neurologic Manifestations

CSF shunting procedures are widely employed in the treatment of hydrocephalus and other disturbances of the dynamics of CSF such as a rachnoid cyst and syrinx. The relative simplicity of this operation with respect to other neurosurgical procedures is matched by a high incidence of complications. Many kinds of shunt devices have been developed to reduce complications. Yet, this operation frequently requires surgical revision. Traditional shunts were primarily designed to manage hydrocephalus by regulating intracranial pressure. Those devices, in some circumstances, can cause to underdrain or overdrain CSF and may need a surgical revision to adjust the pressure Authors have treated 28 patients with the disturbaces of CSF dynamics using pressuread justable valve system (Codman-Medos p rogrammable Hakim valve system). Two patients had arachnoid cysts and the others had hydrocephalus with various etiologies. Subdural hygroma was developed in 5 patients and underdrainage was observed in 9 patients on CT scan. By adjusting the pressure, Authors achieved clinical improvements without a need for surgical revision. The optimum pressure was 97.4+17.4mmHO for the patients with hydrocephalus with various etiologies in adults. In conclusion, the incidence of shunt revision by using this shunt device for the treatment of hydrocephalus and arachnoid cysts was decreased.
Adult ; Arachnoid Cysts ; Humans ; Hydrocephalus ; Incidence ; Intracranial Pressure ; Lymphangioma, Cystic ; Neurosurgical Procedures ; Reoperation ; Subdural Effusion ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt*

The vectorcardiography was performed on 34 cases with PRWP of precordial leads. We have studied the vectorcardiographic finding for the differential diagnosis of disease entities were obtrained; 1) Poor R-Wave progression of precordial leads has simply considered as suggestion of anterior myocardial infarction, ischemic heart disease, chronic lung disease and normal variant. 2) The sensitivity and specificity of myocardial infarction criteria were 85.8% and 63.0% respectively in left sagittal plane and 85.8% and 66.7% respectively in horizontal plane. 3) The seneitively and specificity of more than 90 QRS-T vector angle in left sagittal plane were 100.0% and 62.5% respectively in ischemic heart disease and myocardial infarction. 4) The sensitively and specificity of chronic lung disease criteria were 85.7% and 51.9% respectively. 5) Vectorcardiographic study was considered as effective differentiating method for patients with PRWP in EKG.
Diagnosis, Differential* ; Electrocardiography* ; Humans ; Lung Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Sensitivity and Specificity ; Vectorcardiography*

No abstract available.
Humans ; Hypersensitivity* ; Phenytoin*

BACKGROUND: Rocuronium produce intense discomfort on IV injection in conscious patients. The purpose of this study was to evaluate the incidence and severity of pain associated with IV injection of rocuronium in conscious patients and to determine the efficacy of different doses of IV lidocaine at minimizing injection pain. METHODS: The author evaluated 120 in-patients undergoing various elective surgeries. Patients were randomized into four groups of 30 patients for this blind, prospective study. After tourniquet application on the forearm, the patients were given saline (3 ml) (Group I, n = 30), lidocaine 20 mg (Group II, n = 30), lidocaine 40 mg (Group III, n = 30), or lidocaine 60 mg (Group IV, n = 30) diluted in a 3 ml solution. The occlusion was released after 20 seconds and rocuronium 0.6 mg/kg was injected over 10 seconds. The patients were observed and asked immediately if they had pain in the arm; responses were assessed. Five mg/kg of thiopental sodium was injected intravenously, 30 seconds after the administration of rocuronium. RESULTS: The incidence of pain was 86.7% in group I and was significantly lower group II (60.0%), group III (36.3%), and in IV (P <0.05). In addition, patients pretreated with lidocaine were less likely to suffer moderate to severe pain. But, pain incidences and severities were similar in those that received 40 mg or 60 mg of lidocaine. CONCLUSIONS: Lidocaine was effective at relieving rocuronium-induced and doses of 40 mg and 60 mg of lidocaine were most effective.
Arm ; Forearm ; Humans ; Incidence ; Lidocaine* ; Prospective Studies ; Thiopental ; Tourniquets

A food exchange system for diabetes is a useful tool for meal planning and nutritional education. The first edition of the Korean food exchange lists was developed in 1988 and the second edition was revised in 1995. With recent changes in the food marketplace and eating patterns of Koreans, the third edition of food exchange lists was revised in 2010 by the Korean Diabetes Association, the Korean Nutrition Society, the Korean Society of Community Nutrition, the Korean Dietetic Association and the Korean Association of Diabetes Dietetic Educators through a joint research effort. The third edition is based on nutritional recommendations for people with diabetes and focuses in adding foods to implement personalized nutrition therapy considering individual preferences in diverse dietary environment. Foods were selected based on scientific evidence including the 2007 Korea National Health and Nutrition Examination Survey data analysis and survey responses from 53 diabetes dietetic educators. While a few foods were deleted, a number of foods were added, with 313 food items in food group lists and 339 food items in the appendix. Consistent with previous editions, the third edition of the food exchange lists included six food categories (grains, meat, vegetables, fats and oils, milk, and fruits). The milk group was subdivided into whole milk group and low fat milk. The standard nutrient content in one exchange from each food group was almost the same as the previous edition. Korea Food & Drug Administration's FANTASY(Food And Nutrient daTA SYstem) database was used to obtain nutrient values for each individual food and to determine the serving size most appropriate for matching reference nutrients values by each food group. The revised food exchange lists were subjected to a public hearing by experts. The third edition of the food exchange lists will be a helpful tool for educating people with diabetes to select the kinds and amounts of foods for glycemic control, which will eventually lead to preventing complications while maintaining the pleasure of eating.
Appendix ; Diabetes Mellitus ; Eating ; Fats ; Hearing ; Humans ; Joints ; Korea ; Meals ; Meat ; Milk ; Nutrition Surveys ; Nutrition Therapy ; Oils ; Pleasure ; Statistics as Topic ; Vegetables

BACKGROUND: This study is aimed to investigate the effect of tramadol on the bispectral index (BIS) during anesthesia with desflurane. METHODS: One hundred fifty adults, ASA class 1 and 2 patients, scheduled for general anesthesia for elective surgical procedures were included in this study. None of the patients were premedicated and anesthesia was induced with propofol 2 mg/kg and maintained with air-oxygen (FiO2 0.5) and desflurane, adjusted to keep the BIS between from 50 and 60. Forty minutes before completing surgery, the subjects were randomly allocated into 3 groups to receive saline (control group), tramadol 1.5 mg/kg (T1 group) or 3.0 mg/kg (T2 group) intravenously. Hemodynamics and BIS values were then recorded every 5 minutes until completion of the operation, during which time the concentrations of desflurane were not modified. RESULTS: The mean BIS values after tramadol administration weren't significantly different from the control group throughout the period of observation. No significant changes in the hemodynamics were noted, except systolic and diastolic arterial blood pressure in the T1 and T2 groups significantly increased in the first 5 minutes after the tramadol injection. CONCLUSIONS: The results indicate that the administration of tramadol while maintaining anesthesia with desflurane, adjusted to keep the BIS between 50 and 60, does not modified BIS values. So, we propose that tramadol can be safely administered as an immediate postoperative analgesia without concern about intra-operative awareness.
Adult ; Analgesia ; Anesthesia ; Anesthesia, General ; Arterial Pressure ; Hemodynamics ; Humans ; Isoflurane ; Propofol ; Surgical Procedures, Elective ; Tramadol