No abstract available.
Humans ; Stroke*

No abstract available.
Anesthesia, Spinal* ; Dilatation, Pathologic* ; Marfan Syndrome*

PURPOSE: To estimate the age and spherical equivalent related changes in the wavefront aberrations. METHODS: The age related difference in the wavefront aberrations were measured using a WASCA aberrometer on 63 eyes from 38 persons ranging in age from 18 to 60 years with a mean spherical equivalent of -0.55 diopter. The total RMS (root mean square), the high order RMS, coma and spherical aberration were analyzed and compared according to age(second, third, fourth, fifth and sixth decade). The spherical equivalent related difference in the wavefront aberrations were also measured on 118 eyes from 62 persons with a spherical equivalent ranging from +0.5 D to -10.5 D (average -4.87 D). The total RMS, high order RMS and spherical aberration were analyzed and compared according to the spherical equivalent. RESULTS: With increasing age, the total RMS showed no statistically significant increase (p>0.05), but a high order RMS and spherical aberration showed a significant increase (p<0.05) and there was increase in the incidence of coma but without statistical significance (p>0.05). With the increasing amount of spherical equivalent, the total RMS increased significantly (p<0.05), but the incidence of coma and the spherical aberration did not (p>0.05). CONCLUSIONS: In emmetropia, the total RMS and high order aberration increased significantly with increasing age. With increasing amount of spherical equivalent, the total RMS increased significantly while coma and the spherical aberrations did not.
Coma ; Emmetropia ; Humans ; Incidence

Mucormycosis is an opportunistic fungal infection affecting patients with diabetes or immune-compromised status, caused by species of the Mucoraceae family. Rhinocerebral mucormycosis, the most frequent form of mucormycosis, is characterized by a rapidly progressive and usually fatal course. Common initial symptoms of rhinocerebral mucormycosis include facial pain, facial swelling, headache, fever and blood-tinged rhinorrhea, however, facial palsy is relatively rare. We describe a diabetic female considered rhinocerebral mucormycosis presenting with facial palsy.
Facial Pain ; Facial Paralysis* ; Female ; Fever ; Headache ; Humans ; Mucormycosis*

Oral phosphate binders and high calcium dialysate have been used as standard therapies for dialysis patients to prevent renal osteodystrophy. Calcium containing phosphate binders are used to prevent intestinal absorption of dietary phosphate and to avoid aluminum loading by using aluminum containing phosphate binders. The use of calcium products resulted in hypercalcemia in a substantial portion of dialysis population. Calcium carbonate as a phophate binder is widely used in Korea. However, the incidence of hypercalcemia in Korean dialysis patients has not been reported to date. In this study we evaluated the incidence of hypercalcemia in dialysis patients. Patients with associated diseases that may influence serum calcium level were excluded from the study. A total of 180dialysis patients (116 HD patients and 64 CAPD patients) maintained at Soon Chun Hyang University Hospital were included. Three consecutive 2 monthly measurements of serum calcium, phosphate, albumin, alkaline phosphatase, bicarbonate in HD and two consecutive measurements in 3 month interval in CAPD patients were retrospectively evaluated. Ionized calcium and intact parathyroid hormone (N-terminal) were measured every 6 months. Serum total calcium level was corrected by serum albumin level. Three HD patients(2.5%) were hypercalcemic pre-HD while 50(43.1%) hypercalcemic postdialysis. 5 CAPD patients(7.8%) were hypercalcemic. Pre-HD calcium level did not differ from the value in CAPD patients. An average value of pre-and post-HD calcium, and serum albumin levels were significantly higher in HD patients than those values in CAPD patients(p<0.01). Ionized calcium (p<0.01) and serum PTH(p<0.05) levels were significantly higher, while serum bicarbonate level (p<0.01) was significantly lower in HD patients than in CAPD patients. The amount of calcium carbonate used were 2.2g in HD and 2.8g in CAPD. In conclusion, the incidence of hypercalcemia is low in pre-HD (2.5%) and in CAPD patients(7.8%). However, the high incidence of post-HD hypercalcemia observed in this study advocates a future study to evaluate the effect of low calcium dialyste on calcium-phosphate metabolism.
Alkaline Phosphatase ; Aluminum ; Calcium ; Calcium Carbonate ; Dialysis* ; Humans ; Hypercalcemia* ; Incidence* ; Intestinal Absorption ; Korea ; Metabolism ; Parathyroid Hormone ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis ; Renal Osteodystrophy ; Retrospective Studies ; Serum Albumin

Remifentanil, an ultra-short acting opioid, exhibits at low doses distinct sedative properties that may be useful for supplementation of regional or local anesthesia. We described two patients suffered from serious underlying medical problems who underwent unilateral inguinal herniorrhaphy. One of them was 61 year-old male patient who had type B viral hepatitis, Child class B liver cirrhosis and rheumatoid arthritis with severe joint deformity including instability of cervical vertebrae. The other patient was 73 year-old man who had severe coronary artery occlusive disease which was recently managed with coronary stent and was underwent hemodialysis three times a week due to chronic renal failure. Monitored anesthesia care (MAC) with remifentanil through target controlled infusion (TCI) and local infiltration and ilioinguinal-hypogastric nerve block (IHNB) were done for herniorrhaphy. The operations were performed successfully without any complications such as respiratory depression or hypoxia and all patients and surgeon were very satisfied with MAC.
Anesthesia ; Anesthesia, Local ; Anoxia ; Arthritis, Rheumatoid ; Cervical Vertebrae ; Child ; Congenital Abnormalities ; Coronary Vessels ; Female ; Hepatitis ; Herniorrhaphy ; Humans ; Joints ; Kidney Failure, Chronic ; Liver Cirrhosis ; Male ; Nerve Block ; Piperidines ; Renal Dialysis ; Respiratory Insufficiency ; Stents

BACKGROUND: Subarachnoid block is widely used for cesarean section due to the rapid induction, the complete analgesia, the low failure rate and the prevention of aspiration pneumonia. The addition of intrathecal opioids to local anesthetics seems to improve the quality of analgesia & prolong the duration of analgesia. Therefore we compared the effects of fentanyl 20 microg and sufentanil 2.5 microg, which were added to intrathecal hyperbaric bupivacaine. METHODS: Seventy two healthy term parturients were randomly divided into three groups: Group C (control), Group F (fentanyl 20 microg) and Group S (sufentanil 2.5 microg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen by Harten et al. We observed the maximal level of the sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and the side effects. RESULTS: There were significant differences between the control and the fentanyl 20 microg and sufentanil 2.5 microg groups for the degree of muscle relaxation, the quality of intraoperative analgesia, the maximal sedation level and the duration of effective analgesia. The frequencies of side effects such as nausea and pruritis in the opioid groups were higher than those in the control group. But there were no differences between fentanyl 20 microg and sufentanil 2.5 microg for the frequencies of nausea and pruritis. CONCLUSIONS: The addition of fentanyl 20 microg or sufentanil 2.5 microg for spinal anesthesia provides adequate intraoperative analgesia without significant adverse effects on the mother and neonate.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Humans ; Infant, Newborn ; Mothers ; Muscle Relaxation ; Nausea ; Pneumonia, Aspiration ; Pregnancy ; Pruritus ; Sufentanil

BACKGROUND: A decreased lumbosacral subarachnoidal space volume is a major factor in the cephalad intrathecal spread of local anesthetics in term parturients and their subarachnoidal space is decreased due to the compressive effect of huge uteri. Therefore, they show a higher level of sensory block and hypotensive episodes. The purpose of this study is to investigate whether the symphysis-fundal height (SFH) correlates with the highest sensory level and the amount of ephedrine administered under spinal anesthesia. METHODS: Fifty-two uncomplicated parturients who consented to spinal anesthesia for elective cesarean section were studied. The SFH of all parturients had been measured just before the spinal anesthesia administered by one person. Hyperbaric bupivacaine with fentanyl 20 microgram, was administered for spinal anesthesia. The amount of 0.5% bupivacaine was adjusted according to the patient's height and weight. The level of sensory block and the amounts of ephedrine to treat hypotension, nausea and vomiting were assessed. Linear regression and correlation analysis were applied to analyze the data. RESULTS: According to the results of correlation analysis, there was no significant correlation between the level of sensory block and SFH. There were statistically significant positive correlations between the amount of ephedrine administered due to hypotension and SFH. CONCLUSIONS: In term parturients choosing elective cesarean section, the SFH is not correlated with the sensory level of spinal anesthesia, but is correlated with the amount of ephedrine administered during spinal anesthesia.
Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Cesarean Section ; Ephedrine ; Female ; Fentanyl ; Humans ; Hypotension ; Linear Models ; Nausea ; Pregnancy ; Uterus ; Vomiting

Meralgia paresthetica is commonly caused by a focal entrapment of lateral femoral cuteneous nerve while it passes the inguinal ligament. Common symptoms are paresthesias and numbness of the upper lateral thigh area. Pregnancy, tight cloths, obesity, position of surgery and the tumor in the retroperitoneal space could be causes of meralgia paresthetica. A 29-year-old female patient underwent an emergency cesarean section under spinal anesthesia without any problems. But two days after surgery, the patient complained numbness and paresthesia in anterolateral thigh area. Various neurological examinations and L-spine MRI images were all normal, but the symptoms persisted for a few days. Then, electromyogram and nerve conduction velocity test of the trunk and both legs were performed. Test results showed left lateral cutaneous nerve injury and meralgia paresthetica was diagnosed. Conservative treatment was implemented and the patient was free of symptoms after 1 month follow-up.
Adult ; Anesthesia, Spinal ; Cesarean Section ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Hypesthesia ; Leg ; Ligaments ; Nerve Compression Syndromes ; Neural Conduction ; Neurologic Examination ; Obesity ; Paresthesia ; Pregnancy ; Retroperitoneal Space ; Thigh

Budd-Chiari syndrome (BCS) represents a spectrum of disease states resulting in hepatic venous outflow occlusion. Prothrombotic disorders, such as protein S deficiency may cause thrombosis of the portal and hepatic veins. We report the management of a 30-year-old BCS primigravida with protein S deficiency and destroyed lung by the pulmonary tuberculosis scheduled for Cesarean section. Moreover, patient's lungs were destroyed by the pulmonary tuberculosis. Spinal anesthesia was selected for the anesthetic management. The patient recovered without any complication and discharged from hospital on the fifth postoperative day.
Adult ; Anesthesia, Spinal ; Budd-Chiari Syndrome ; Cesarean Section ; Female ; Hepatic Veins ; Humans ; Lung ; Pregnancy ; Protein S Deficiency ; Thrombosis ; Tuberculosis, Pulmonary