Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic procedure in many clinical situations and is relatively simple to perform with proper technique. Local anesthetic technique is often preferable to general anesthesia for bronchoscopies since these examinations are mostly undertaken as outpatient procedures. Inhaled topical lidocaine, used to produce anesthesia of the repiratory tract prior to bronchoscopy, may cause anaphylactoid reaction in patients. However lidocaine hypersensitivity reaction is uncommon. We report the case of death due to hypersensitivity to topical lidocaine spray given during routine premedication for this procedure. The possibility of bronchospasm secondary to an adverse reaction to premedication or anesthesia must also be considered.
Anaphylaxis* ; Anesthesia* ; Anesthesia, General ; Bronchial Spasm ; Bronchoscopy* ; Humans ; Hypersensitivity ; Lidocaine* ; Outpatients ; Premedication

Incidence of aseptic loosening of hip prostheses is increasing in recent years. Previous studies suggested the involvement of proteinases and cytokines in the accelerated bone lysis associated with loosening. To investigate the role of matrix metalloproteinases (MMPs) in the loosening, Gelatin/Type IV collagenases, namely, 72 KDa matrix metalloproteinase (MMP)-2 type and 92 KDa MMP-9 type were analyzed in 14 cases of the loosened endoprostheses of the hip. Zymographic and densitometric analyses revealed production of MMP-2 ancl elevated induction of MMP-9 in tissue extracts from both the interface hetween hone and implants and the capsular tissues when compared with those in synovium obtained from a patient with a t'ractured femoral neck. MMP-9 showed stronger activity than MMP-2. In the sample of a fractured femoral neck, MMP-2 was detected, but MMP-9 was not detected. In matched samples, the activity of MMP-2 and MMP-9 in the interface tissues showed stronger activity than those in the capsular tissues. There was no difference between cemented and uncemented femoral prostheses. The state of prostheses(loosening, osteolysis, and cup wear) did not influence on the activity of MMP-2 and MMP-9. Theses findings suggest a role for MMP-2 and MMP-9 type gelatinase/Type IV collagenases in the degradation of extracellular matrix of periprosthetic tissues, where they may cause weakening of the connective tissue hed and the loosening of total hip replacement endoprostheses. Consequently. we could confirm the role of MMP cascade in aseptic loosening of total hip prostheses. The further study ahout other types of MMP and the inhihitor of MMP will be needed.
Arthroplasty, Replacement, Hip ; Collagenases ; Connective Tissue ; Cytokines ; Extracellular Matrix ; Femur Neck ; Hip Prosthesis* ; Hip* ; Humans ; Incidence ; Matrix Metalloproteinases* ; Osteolysis ; Peptide Hydrolases ; Prostheses and Implants ; Synovial Membrane ; Tissue Extracts

The wrist, or carpus, is a deformable anatomic entity composed of 8 small carpal bones (scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezium and trapezoid) and the surrounding soft-tissue structures. We should get radiological knowledge of normal wrist in order to identify pathology of that. So we measured the several values on AP, PA and lateral roentgenograms of 228 normal wrist(male : 124 cases, femal: 104 cases). The following results were obtained: 1. Scapholunate gap : 1.4±0.5mm 2. Ulnar variance : 1.3 ±1.7mm, Positive variance … 59.7%, Neutral variance … 25.4% 3. Carpal height ratio : 0.543 ±0.078 4. Carpal ulner distance ratio : 0.32 ±0.04 5. Scapholunate angle : 45.8 ± 8.7° 6. Capitatolunate angle : 19.3 ± 8.2° 7. Radiolunate angle : 8.9 ± 4.7° 8. Ulnar tilt: 23.5 ± 3.3° 9. Volar tilt: 12.0 ± 4.7°
Carpal Bones ; Pathology ; Wrist

No abstract available.
Leukemia, Eosinophilic, Acute* ; Trisomy*

In correction of ptosis, symmetry of lid contour, lash position and lid height must be matched. Most of blepharoptosis patients want to perform both the double eyelid operation and ptosis repair at the same time to achieve the best cosmetic and functional result. Using a surgical technique directed at the levator aponeurosis or the frontalis muscle with double eyelid operation, we corrected 13 cases of unilateral and 10 cases of bilateral congenital blepharoptosis. In unilateral ptosis with good or fair levator function, levator resection was performed and the position of the lid margin was adjusted at 1~2 mm below the superior limbus. The height of the lid crease of the ptotic eye is determined 1~3 mm lower than that of normal side. The position of the lid margin is adjusted at the level of the superior limbus and the height of the lid crease of the ptotic eye is determined 2~4 mm lower than that of nonptotic side. The advantages of this approach are normal anatomic planes of the eyelid are maintained, to obtain symmetry of both eyelids relatively easily, entropion may be prevented, and to achieve aesthetically pleasing results.
Blepharoptosis* ; Entropion ; Eyelids* ; Humans

The purpose of this study was to explore the differentiation of common personality profiles and defense mechanisms between medicine and surgery resident groups. The authors evaluated the defense mechanisms of the residents by using Ewha Defense Mechanisms Test. The authors compared the defense mechanisms between two groups (medicine and surgery resident groups) who were training at SoonChunHyang University hospital in 1999. First, There were significant differences in mean scores of the defense mechanisms ratings. For the surgery group, identification and show-off were significantly higher than in the medicine group. Secondly, the differences of defense mechanism ratings, which were divided by maturity level between the two groups, were significantly higher using neurotic defense of the surgery group. Thirdly, the authors compared the frequency of major defense mechanisms of the two groups. The surgery group used identification, show-off and sublimation as major defense mechanisms in higher frequency than the medicine group. This result reflects on the fact that the surgery group has exact an apprentice discipline and dramatical therapeutic approach. The results seem to be useful in understanding the resident's optimal character for specific specialties that were selected by evaluating the differences of the common characteristics and coping mechanisms of each specialty group.
Classification* ; Defense Mechanisms* ; Sublimation

PURPOSE: Spiculation pathologically correlated with irregular fibrosis, localized lymphatic spread of tumor, or an infiltrative growth pattern of tumor, and the spiculation was Observed in malignant mass. But the spiculation was also observed in benign mass, particularly in tuberculoma. We retrospectively reviewed the length of spiculation under the hypothesis that the length of spiculation could be one of differential diagnostic points between lung cancer and tuberculoma. MATERIALS AND METHODS: We studied thirty seven patients (27 men and 10 women) ranging in age from 35 to 80 years (mean, 60 years). Analysis of spiculation included (a) the number of spicules (b) the mean length of spicules (c) the mean length of the longest spicule (d) the percentage of the mean length of spicules to the longest diameter of mass (e) the percentage of the mean length of spicules to the shortest dia, meter of mass. RESULTS: The mean length of spicules of tuberculoma was 13.8 mm (S. D. 6.7) and that of lung cancer was 5.7 mm (S. D. 3.5). The percentage of the mean length of spicules to the longest diameter of tuberculoma was 63.6% and that of lung cancer was 13.7%. The percentage of the mean length of spicules to the shortest diameter of tuberculoma was 90.4% and that of lung cancer w~s 18.3%. CONCLUSION: It is hard to differentiate lung cancer from tuberculoma on the basis of the spiculation being present or not, but we suggest that the longer spiculation be more highly suggestive of tuberculoma rather than lung cancer. The length of spiculation may help us differentiate lung cancer from tuberculoma.
Fibrosis ; Humans ; Lung Neoplasms ; Lung* ; Male ; Retrospective Studies ; Tuberculoma*

No abstract available.
Pulmonary Edema*

PURPOSE: Although the advent of orthotopic bladder substitution in women was a major achievement in the evolution of urinary diversion, the mechanism of voiding dysfunction remains to be fully understood. This is a report on the voiding function of the ileal neobladder, based on a questionnaire survey of 6 female patients. MATERIALS AND METHODS: Between 1995 and 2002, 7 of 10 women(mean age 56.1) that underwent an orthotopic bladder substitution were evaluated using uroflowmetry, bladder diary and voiding cystourethrography. Six patients completed the questionnaire. The mean follow-up period was 24.6 months(range 1 to 72 months). RESULTS: From the uroflowmetry, the mean maximum flow rate was 12.2ml/sec, with a low average flow rate(mean 6.2ml/sec), and the voiding time was considerably prolonged(mean 68.5sec). According to the bladder diary and questionnaire responses, although the frequency and tidal volume of micturition were normal, the majority of patients were conscious of retarded, intermittent, prolonged and weak streams, with straining during voiding. Of the 7 patients, 5(71.4%) achieved excellent daytime continence, but 6(85.7%) had nighttime incontinence. One patient was unable to void and required regular intermittent catheterization. Two patients sometimes, or often, performed self-catheterization due to residual urine. According to the questionnaire responses, 4(66.7%) of the 6 patients stated that their micturition status was better or the same compared with their preoperative status, and 4(66.7%) of the patients felt satisfied. The degree of inconvenience was low for every item and the limitation on daily life was considered minimal. Cystograms revealed a descent of the pouch and urethral angulation in the 3 patients with difficulty in urination or hypercontinence. CONCLUSIONS: Orthotopic bladder substitution after a radical cystectomy in women provides relatively satisfactory functional outcomes.
Catheterization ; Catheters ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Surveys and Questionnaires* ; Rivers ; Tidal Volume ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion ; Urination

The authors underwent the serum lipid study, involving the lipoprotein fraction, and the HDL-cholesterol mean values in normal Korean adults visited to Hanyang University Hospital, and also compared with the previously reported serum lipid studies. The results are as follows; 1) The mean values of triglyceride, total cholesterol, and phospholipid were 103.3+/-17.1mg%, 188.9+/-18.2mg%, and 196.7+/-19.8mg%, respectively. 2) Compared with the past 7 years triglyceride showed increasing tendency with significance, and cholesterol and phospholipid showed slightly increasing tendency. 3) In the serum lipoprotein fraction, the mean values of alpha-lipoprotein, pre-beta-lipoprotein, and beta-lipoprotein were 37.2+/-5.9%, 16.0+/-4.2%, and 48.6+/-5.2%, respectively. 4) Compared with the past 10 years, the alpha-, and pre-beta-lipoprotein showed increasing tendency, meanwhile, beta-lipoprotein revealed decreasing tendency. 5) The mean value of HDL-cholesterol was 52.3+/-14.6mg%, and the ratio of HDL-cholesterol to total cholesterol(HDL-cholesterol/total cholesterol) was 28.2+/-7.9. 6) Compared with the past 2 years, HDL-cholesterol level showed slightly increasing tendency.
Adult ; Cholesterol ; Humans ; Lipoproteins ; Triglycerides