BACKGROUND: In previous our retrospective study, we concluded that administered fluid volume, duration of operation, operative procedures and anesthetic techniques were the major factors of postoperative urinary retention. However, the administered fluid volume, age, types and duration of the operation confined to hemorrhoidectomy was questioned as a precipitating factor. The high retention rate in spinal anesthesia is also questioned. METHODS: We investigated these possible precipitating factors of urinary retention in healthy patients (n=154) undergoing hemorrhoidectomy. The patients were randomly divided into three different anesthetic techniques: caudal (2% lidocaine 300 mg with 1 : 200,000 epinephrine), spinal (0.5% tetracaine 5 mg with epinephrine 0.1 mg or 5% lidocaine 40 mg) and general (enflurane, N2O, vecuronium). Urinary retentin was searched according to above factors following surgery. RESULTS: The overall urinary retention rate was 46.1%. The retention rate in patients with spinal anesthesia was higher than that in those with other anesthetic techniques (p<0.05). There was no significant difference between patients with lidocaine and tetracaine spinal anesthesia in urinary retention rate. The administered fluid volume in patients with urinary retention was significantly higher than that of patients without retention (p<0.05). Age, duration and types of hemorrhoidectomy did not significantly affect urinary retention rate. CONCLUSIONS: Restriction of fluid administration and avoidance of spinal anesthesia are necessary in reducing postoperative urinary retention following hemorrhoidectomy.
Anesthesia, Spinal ; Epinephrine ; Hemorrhoidectomy* ; Humans ; Lidocaine ; Precipitating Factors ; Retrospective Studies ; Surgical Procedures, Operative ; Tetracaine ; Urinary Retention*

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No abstract available.
Heel* ; Molluscum Contagiosum* ; Weight-Bearing* ; Zea mays

BACKGROUND: Incidence of traumatic hip dislocation have ween increased with development of transportation. Traumatic hip dislocation demands early recognition as an emergency and prompt reduction. So we designed this study to determine what kinds of factors affect the prognosis of the patient. METHODS: Eighty five patients who admitted emergency department of our hospital with the traumatic hip dislocation were enrolled in this study. Cause of injury, type of dislocation, method of reduction, the time from dislocation to reduction, age, gender and associated patellar injury were evaluated by retrospective chart reviews. RESULTS: Average age of excellent and good group(E&G) is 28+/-17.8 and fair and poor group(F&P) is 39+/-18.6, so the older the age the more poor prognosis(P<0.05). The time to take reduction of E&G group is 18+/-8.2 hours and F&P group is 25+/-12.6 hours, so the faster the better prognosis(P<0.05). We classify the type of hip dislocation by Thompson and Epstein method, type I to type V. The prognosis of type I is better than type V(P<0.05). Fifty five case were associated with patellar injury and they had poor prognosis than the other cases that were not associated with knee joint injury. CONCLUSION: In traumatic dislocated hip patients, the prognosis was poor in old age, delay in reduction, higher type of dislocation and associated with knee joint injury.
Dislocations ; Emergencies ; Emergency Service, Hospital ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Knee Joint ; Prognosis* ; Retrospective Studies ; Transportation

The vasoactive effecs of ketamine on aortic and pulmonary arteries have not heen clearly characterized. Nevertheless, it has been recommended to avoid ketamine in systemic and pulmonary hypertension because of its tendency to increase systemic and pulmonary vascular resistance. This study was designed to investigate and compare the direct effects of ketamine on isolated rat aortic and pulmonary arteries, with or without intact endothelium. The optimal resting tension (Lmax) of each ring was searched hased on contractile responses to 3.7X10(6)M norepinephrine. Once the Lmax was Obtained, the peak developed tension was recorded as the control. Thereafter, in the second part of the experiments, prior to ketamine exposure, the endothelium was denuded which was confirmed pharmacologically using norepinephrine(3.7X10-6M) and acetylcholine(10(-6)M). In groups with intact endothelium, .3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -10.3+/-5.6%, -17.8+/-4.4%, respectively. In groups without intact endothelium, 3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -9.9+/-3.6%, -14.2+/-3.8%, respectively. It was statistically significant. In groups with or without intact endothelium, 0.1X10(3) M ketamine relaxed aortic and pulmonary artery ring. Hut it was statistically insignificant. We conclude that ketamine is a powerful aortic and pulmonary artery dilator in vitro and that is endothelium independent.
Animals ; Aorta* ; Endothelium ; Hypertension, Pulmonary ; Ketamine* ; Norepinephrine ; Pulmonary Artery* ; Rats* ; Vascular Resistance

A 41-year-old man was admitted due to altered mentality and confusion. He had showed progressive cerebellar ataxia, dysarthria, gait disturbance from his age of 33 years old. Brain MRI revealed high signal lesions in periaqueductal gray matter, mammillary bodies, median thalami and postcentral gyri bilaterally on T2-weighted images. Severe cerebellar atrophy was noted, too. We report a case of Wernicke's encephalopathy in a patient with probable multiple system atrophy. As far as we know, there have been no published report on this kind of case.
Adult ; Atrophy ; Brain ; Cerebellar Ataxia ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging ; Mamillary Bodies ; Multiple System Atrophy* ; Periaqueductal Gray ; Wernicke Encephalopathy*

Drug-induced thrombocytopenia and purpura have boon developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects art fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.
Ciprofloxacin* ; Female ; Humans ; Purpura* ; Pyrazinamide* ; Rifampin ; Thrombocytopenia* ; Young Adult

Adult-onset Still's disease (AOSD) is a rare systemic febrile disorder of unknown etiology. AOSD is characterized by spiking fever, arthralgia, sore throat, skin rash, and multi-organ involvement but is difficult to diagnose due to the lack of specific clinical features. AOSD is most frequently observed among young adults. We describe the case of an 18-year-old male patient with multiple cerebral infarction who was diagnosed with AOSD based on the clinical features observed during rehabilitation treatment after the diagnosis of ischemic stroke. Clinical symptoms of the patient was controlled with steroid therapy. If cerebral infarction is accompanied by unusual clinical features as non-infectious fever, rash, and arthralgia, AOSD should be considered in young stroke patient.
Adolescent ; Arthralgia ; Cerebral Infarction* ; Diagnosis ; Exanthema ; Fever ; Fever of Unknown Origin ; Humans ; Male ; Pharyngitis ; Rehabilitation ; Still's Disease, Adult-Onset* ; Stroke ; Young Adult

We present the case report of a 72-year-old female in whom diaphragmatic eventration and secondary gastric volvulus developed 10 years after a left partial pneumonectomy for a bronchiectasis. Eventration of the diaphragm is defined as an abnormal elevation of an intact diaphragm. The abnormally wide subdiaphragmatic space provides the potential for a gastric volvulus, which results from the strong negative intrathoracic pulling force created by the potential subphrenic space and paradoxical movement of the diaphragm. Unless this strong negative force is first eliminated, gastropexy alone will lead to recurrence. Obliteration of the subphrenic space by colonic displacement is a simple and effective way of abolishing this negative subdiaphragmatic pulling force. Treatment of gastric volvulus requires immediate surgical repair to prevent subsequent necrosis and perforation, with surgical correction of the underlying anatomic abnormality being the treatment of choice for gastric volvulus. We experienced a case of gastric volvulus due to diaphragmatic eventration who was treated with colonic displacement.
Aged ; Bronchiectasis ; Colon ; Diaphragm ; Diaphragmatic Eventration ; Displacement (Psychology) ; Female ; Gastropexy ; Humans ; Necrosis ; Pneumonectomy ; Recurrence ; Stomach Volvulus