This case was an acquired aplastic anemia patient who required a major operation for excision of a mediastinal mass. The authors previewed that the coagulation abnormalities would be developed due to major operation. Thus we decided to monitoring the coagulation function using the thromboelastography during the perioperative period and checked the complete blood count, concommitantly. The total blood volume lost during operation was 1800 ml, so we gave him a transfusion of 10 U's of platelet concentrate, 10 U's of pheretic platelet rich plasma and 5 U's of whole blood. The thromboelastography was a good guide that helped us to avoid excessive treatment of the coagulation abnormalities. We concluded that the thromboelastograhy was a reliable and effective monitoring system at the intraoperative coagulation management.
Anemia, Aplastic* ; Anesthesia, General ; Blood Cell Count ; Blood Platelets ; Blood Volume ; Humans ; Perioperative Period ; Platelet-Rich Plasma ; Thrombelastography

Several shorter-term alternatives for whole-day ambulatory monitoring of BP using Pressureometer III or standard sphygmomanometer were evaluated in 12 male hypertensive patients. Averages of BP reading at 8 AM once, consecutive 3 readings either by Pressurometer or manual, serial readings during 2-hr intervals of 8-10 AM and 2/4 PM were compared with that of 24-hr ambulatory, non-invasive BP readings. Both systolic and diastolic 2-hr Bp averages in the morning were correlated more strongly with 24-hour averages(r=0.91 and 0.91), than were those of the 3 readings(r=0.88 and 0.66) or single reading(r=0.49 and -0.35) alternatives. In conclusion, the average of serial readings obtained during 2-hr monitoring period from 8 to 10AM is a reliable predictor of 24-hr ambulatory BP and represents it more closely than the conventional single or multiple BP readings.
Blood Pressure Monitoring, Ambulatory* ; Humans ; Male ; Monitoring, Ambulatory ; Reading ; Sphygmomanometers

Squamous cell carcinoma is a malignant tumor arising from the epidermis or its appendages, Squamous cell carcinoma of extremity comprises approximately 1 to 2 percent of all squamous celi carcinoma and of these 0.2 to 1.7 percents are secondary to chronic osteomyelitis and 2 percents are secondary to the burn scar. We experienced 4 cases of squamous cell carcinoma invading bone directly, of these 2 cases are secondary to chronic osteomyelitis and 2 cases are secondary to the burn scar. With prompt and aggressive surgical treatment the prognosis is good. Routine regional lymphadenectomy is unnecessary because in most instances enlarged nodes are inflammatory and subside after amputation.
Amputation ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Epidermis ; Epithelial Cells ; Extremities ; Lymph Node Excision ; Osteomyelitis ; Prognosis

To evaluate the visual, astigmatic results and incidence of complications in cases of no-stich, small incision cataract surgery with a square sclerocorneal tunnel and silicone flexible intraocular lens we cornpared the resuite of catarct surgery in DM patients with those of non-DM patients. 305 eyes of 284 patients including 21 eyes of 20 patients of diabetes mellitus from October, 1994 to Decernber, 1996 who underwent cataract surgery with silicone foldable intraocular lens were enrolled in this retrospective study. During follow-up examination, the change of visual acuity, astigmatism, the incidence of postoperative complications was evaluated. Early visual rehabilitation because of small surgically induced refractive change during im.mediate postoperative period can be achieved. During 2 months follow-up, no against-the-rule shift of astigmatism detected. The incidence of postoperative complication were nearly the same as previous report : decentration 0.7%, hyphema 2%, uveitis 0.4%, posterior casular opacification 4.2%. In cases of posterior capsular opacification, Nd-YAG laser posterior capsulotomy showed significant increment of vision. The visual acuities in DM patients were comparably as good as those of non-DM patients. The incidence of posterior capsular opacification and corneal edema was relatively high in DM patients. In conclusion, no stitch snaall incision cataract, surgery through which silicone foldable intraocular lens im. planted showed good visual, astigmatic results in uncomplicated and selected cases of cornplicated with DM patients.
Astigmatism ; Cataract ; Corneal Edema ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Hyphema ; Incidence ; Lasers, Solid-State ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Plants ; Posterior Capsulotomy ; Postoperative Complications ; Postoperative Period ; Rehabilitation ; Retrospective Studies ; Silicones* ; Uveitis ; Visual Acuity

No Abstract Available.
Endothelium, Corneal* ; Lidocaine*

Keratoprosthesis implantation is the only alternative method to restore vision in patients who might invariably fail allograft coneal transplantation. Seoul type keratoprosthesis adapted 20 micrometer pore sized expanded polytetrafluoroethyl-ene[PTFE, Gore-Tex]as a skirt material in this study. To evaluate compatibility of this material as a skirt we performed in vitro cell culture experiment and animal experiment. For in vitro experiment, expanded PTFE membrane was cultured with rabbit keratocytes in 24-well culture plate for a week.For animal experiment Seoul type keratoprosthesis was implanted in the rabbit cornea. Two months after the operation specimens for pathologic examination were retrieved. In culture experiment no keratocyte invaded pores. In animal experiment no keratocyte but only many inflammatory cells mainly polymorphonuclear leukocytes infiltrated pores of skirt and surrounding cornea. In conclusion, 20 micrometer pore sized expanded PTFE is not good as a skirt material of keratoprosthesis.
Allografts ; Animal Experimentation ; Cell Culture Techniques ; Cornea* ; Humans ; Membranes ; Neutrophils ; Polytetrafluoroethylene ; Seoul*

No Abstract Available.
Arthroplasty* ; Congenital Abnormalities* ; Humans ; Knee*

No abstract available.
Foot ; Hand

Purpose: Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods: We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results: Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.