BACKGROUND: Lidocaine administered intravenously (IV lidocaine) is efficacious in the treatment of thic pain. There are many differences in doses and methods of IV lidocaine therapy. We have made a ous clinical report of IV lidocaine infusion for chronic pain patients. The aims of this study were to evaluate the plasma concentration of lidocaine, and the analgesic effect and safety of our method of IV idocaine infusion. METHODS: Sixteen neuropathic pain patients received IV lidocaine infusion. Lidocaine of 5 mg/kg ixed in 150 ml of normal saline was infused over 40 min at a rate with 300 ml/h for the initial 10 min, and the remaining at 200 ml/h. Blood sampling, for the analysis of plasma lidocaine concentration, pain score by numerical rating scale, blood pressure and heart rate were obtained before the infusion and at 20, 40, 60, 90 and 120 min following the start of infusion. RESULTS: Thirteen patients (81.3%) had analgesic effects in IV lidocaine infusion. Mean plasma caine concentrations were 0, 2.0, 2.7, 2.2, 1.5, 1.1 ug/ml, and mean pain scores were 7.6, 5.6, 3.7, 3.1, 3.0, and 3.1 before the infusion and at 20, 40, 60, 90 and 120 min following the start of infusion. Plasma aine over 2 microgram/ml revealed an analgesic effect, and pain scores precipitously dropped around 40 min following the start of infusion. There were no significant changes of blood pressure and heart rate. Side effects were mild in terms of sedation, dizziness, light-headedness, nausea and metallic taste. CONCLUSIONS: These results suggest that our method of IV lidocaine infusion -within therapeutic nge of lidocaine not to allow toxic plasma concentration, and with any effective analgesia, little modynamic change and minimal side effects- is a useful and a safe diagnostic and therapeutic modality for hronic neuropathic pain.
Analgesia ; Blood Pressure ; Chronic Pain ; Dizziness ; Heart Rate ; Humans ; Lidocaine* ; Nausea ; Neuralgia ; Plasma* ; Taste Disorders

Kasabach-Merritt phenomenon does not occur with common hemangioma, rather it is associated with the more aggressive Kaposiform hemangioendothelioma and rarely with other vascular neoplasm. We report the case of an adult who was diagnosed as Kaposiform hemangioendothelioma complicated by Kasabach-Memtt phenomenon. This is the first report in Korea of an adult with Kasabach-Merritt phenomenon who has osteolytic changes of femur, pelvic bone, and lumbar spine.
Adult* ; Femur ; Hemangioendothelioma* ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome ; Korea ; Pelvic Bones ; Spine ; Vascular Neoplasms

PURPOSE: The purpose of this study was to investigate the risk factors related to prehypertension in Korean adults. METHODS: The data were obtained from the Korean National Health and Nutrition Examination Survey 2005. The ubjects of this study were 3,981 adults aged over 20 years of age. Demographic characteristics, alcohol drinking, smoking, physical activity, stress, BMI, serum lipid profiles and blood pressure were analyzed in this study. RESULTS: Prevalence of prehypertension was 38.9% in this study. As the result of multiple logistic regression, the risk of prehypertension in male, elderly and low income persons was increased. And the risk of prehypertension was increased in the case of problem drinking, alcohol abuse, formal smoker, overweight, obesity and hyperlipidemia in triglyceride. CONCLUSION: To decrease prehypertension prevalence, it is necessary to detect and manage the influencing risk factors of prehypertension such as alcohol drinking, smoking, obesity, physical activity, stress and serum lipid profiles.
Adult ; Aged ; Alcohol Drinking ; Asian Continental Ancestry Group ; Blood Pressure ; Humans ; Hyperlipidemias ; Hypertension ; Logistic Models ; Male ; Motor Activity ; Nutrition Surveys ; Obesity ; Overweight ; Prehypertension ; Prevalence ; Risk Factors ; Smoke ; Smoking

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Xanthogranulomatous cholecystitis (XGC) is a rare type of chronic inflammation of the gallbladder characterized by focal or diffuse destructive inflammatory responses. Although it is a benign condition, its destructive course may lead to more aggressive outcomes of the gallbladder, such as local infiltration, fistula, stricture, and perforation as compared with other gallbladder inflammations. There are reports about XGC accompanied by cholecystoenteric fistula. However, XGC accompanied by more than one cholecystoenteric fistula is rare. We report a case of a 54-year-old man with gastric outlet obstruction arising from XGC, accompanied by cholecystoduodenal fisula and cholecystocolonic fistula, but without impacted gallstones.
Cholecystitis* ; Constriction, Pathologic ; Fistula* ; Gallbladder ; Gallstones ; Gastric Outlet Obstruction* ; Humans ; Inflammation ; Intestinal Fistula ; Middle Aged

No abstract available.

Inferior mesenteric arteriovenous fistula is rare and may be congenital or acquired. Affected patients present with abdominal pain, mass, or manifestations of portal hypertension and bowel ischemia. Until now, inferior mesenteric arteriovenous fistula due to trauma has not been reported. Herein, we report a case of a 53-year-old woman who had inferior mesenteric arteriovenous fistula considered to have originated from remote blunt trauma that was successfully treated by surgical resection of only the arteriovenous fistula without colectomy. To our knowledge, this is the first case of traumatic inferior mesenteric arteriovenous fistula.
Arteriovenous Fistula/*diagnosis/pathology/surgery ; Colonoscopy ; Female ; Humans ; Mesenteric Artery, Inferior/radiography ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

Internal jugular phlebectasia (IJP) is a fusiform dilatation of the internal jugular vein (IJV), usually presented as a neck mass in children. Accurate diagnosis from carefully directed history, physical examination, and radiological study could result in lifesaving therapy. We performed our study to suggest possible clinical diagnostic criteria for IJP in Korean children. We reviewed three cases of IJP (patients group) and compared the diameter of the internal jugular phlebectasias with diameters of IJVs in ten normal children (control group) using ultrasonography (USG). There were no significant differences in the range of diameters in the resting state between the two groups. The diameters on the right side, compared with those on the left side, showed no statistical significance (p < 0.05). Te range of expanding diameter and average expanding ratios (resting state to Valsalva maneuver X 100%) showed a statistical difference between the two groups (p < 0.05).
Child ; Child, Preschool ; Dilatation, Pathologic/*ultrasonography ; Female ; Human ; Jugular Veins/*ultrasonography ; Korea ; Male ; Valsalva's Maneuver

BACKGROUND: Esophageal perforation is an extremely lethal injury that requires careful management for survival. MATERIAL AND METHOD: We performed a retrospective clinical review of 14 patients treated for esophageal perforation at the Department of Thoracic and Cardiovascular Surgery hanyang University Hospital between July 1986 and August 1998. Cardiovascular Surgery Hanyang University Hospital between July 1986 and August 1998. RESULT: The ration between male and female patients was 12:2 and their ages ranged from 9 to 68 years( average: 446 years). Iatrogenic perforations were found in 6 patients(42.9%) spontaneous perforations in 3 patients(21.4%) traumatic perforations in 2 patients(14.3%) and caustic perforations foreign body origin and esophagel cancer in 1 patient (7.1%) each. Four of the patients(28.6%) had esophageal ruptures located cancer in 1 patient (7.1%) each. Four of the patients (28.6%) had esophageal ruptures located in the cervical esophagus and 10 patients (71.4%) in the thoracic esophagus, The most frequent location was in the mid third portion of the esophagus (35.7%) there were also 2 patients(14.3%) in the upper third portion and 3 patients(21.4%) in the lower third portion. Complications encountered included mediastinitis empyema or pleural effusion mediastinal or lung abscess sepsis and aspiration pneumonia. The most frequent complication that occurred was mediastinitis in 9 cases (57%) Three patients underwent conservative treatment. Among the patients who underwent surgical treatment 5 patients underwent primary closure 6 patients underwent open drainage and 2 patients underwent reconstrumction (1 patients had an initial primary closure and 1 patient had an initial open drainage procedure). The mortality rates for those with conservative and surgical treatment were 66.7% (2cases) and 9.1% (1 cases) respectively. CONCLUSIONS: Perforation of the esophagus although very rare has a high mortality rate and thus aggressive operative therapy is necessary.
Drainage ; Empyema ; Esophageal Perforation* ; Esophagus ; Female ; Foreign Bodies ; Humans ; Lung Abscess ; Male ; Mediastinitis ; Mortality ; Pleural Effusion ; Pneumonia, Aspiration ; Retrospective Studies ; Rupture ; Sepsis

BACKGROUND: We have allocated liver according to the Korean Network Organ Sharing (KONOS) status. However, it was necessary to change the system to a more adequate and objective system. We analyzed the correlation between KONOS status and MELD score under the current status of organ allocation. METHODS: We reviewed medical records of 70 liver recipients as KONOS status 2A and 2B between September 2005 and December 2010. We analyzed their KONOS status, MELD score, clinical characteristics, waiting time, Child-Turcotte-Pugh (CTP) score and clinical symptoms accorded to KONOS status 2A. RESULTS: Mean MELD and CTP score of the 2A group was significantly higher than the 2B group (P<0.001). In the 2B group, the blood types of all recipients were identical to those of the donors. However, 2A group included 7 cases (23.3%) of non-identical blood types. The MELD score of all recipients were correlated with CTP score (R=0.798, P<0.001). However, there was an overlapping area between the 2B group and the 2A group that was registered by the condition of intractable ascites. Those who had hepatorenal syndrome and hepatic encephalopathy showed high MELD score over 20. However, 36.4% of the patients who had only intractable ascites showed a MELD score of less than 20. CONCLUSIONS: CTP score was highly correlated with MELD score. However, KONOS status showed some overlapping area of the MELD score between 2A and 2B groups. We should make an effort to improve KONOS allocation system to meet the Korean situation.
Ascites ; Cytidine Triphosphate ; Hepatic Encephalopathy ; Hepatorenal Syndrome ; Humans ; Liver ; Liver Diseases ; Liver Transplantation ; Medical Records ; Resource Allocation ; Severity of Illness Index ; Tissue and Organ Procurement ; Tissue Donors ; Transplants