No abstract available.
Fetus* ; Humans ; Infant*

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

The purposes of this case report(8 case) were to investigate the oral health periodontal conditions (CPITN 1 : 3, CPITN 2 : 182, CPITN 3 : 528) and prevent natural teeth through periodontal treatment(non-surgical periodontal treatment and surgical periodontal treatment) of patients who have Hansen's disease, which is an infectious periodontitis. Operative method of periodontal treatment are scaling, root planning, gingivectomy, partial flap, full flap.
Dental Scaling ; Gingivectomy ; Humans ; Leprosy ; Oral Health ; Periodontal Index ; Periodontitis ; Tooth

No abstract available.
Laryngectomy*

Diffuse tremendous thickening of gastric wall caused by excessive proliferation of the mucosa of unknown causewas first decribed by Menetrier in 1888. The disease is highly uncommon, but the exact preoperative diagnosis iscrucial because of the more excellent prognosis than other malignant lesions including gastric lymphoma andinfiltrative gastric carcinoma. The authors recently experienced a case of Menetrier's disease which had beendiagnosed as gastric lymphoma preoperatively. Radiologic differentiation is not impossible between this extermelyrare disease and other mimicking malignant lesions, that is the reason why we introduce radiographic findings ofthe case by comparison with gastric lymphoma of giant rugal type and infiltrative gastric carcinoma. Typical upperG-I series findings of the case are: 1) Enlarged tortuous proximal gastric rugal folds only along the greatercurvature, 2) Perpendicular lines of barium spicules trapped by apposed folds with clubbed or forked appearance,3) Abrupt transition of transion to normal stomach, 4) No luminal narrowing and retained but sluggish peristalsis.Thus radiologists can diagnose Menetrier's disease scrupulously based on critical application of enlarged foldspattern and extent of the lesion in association with other radiologic features and clinial history of fairly longduration. Brief review of clinical and pathologic features about Menetrier's disease is included.
Barium ; Diagnosis ; Diagnosis, Differential ; Gastritis, Hypertrophic ; Hypertrophy ; Lymphoma ; Mucous Membrane ; Phenobarbital ; Prognosis ; Stomach

BACKGROUND: Current guidelines of advanced trauma life support recommend open thoracotomy when pericardiocentesis reveals bloody pericardial effusion in patients with blunt chest trauma. However, open thoracotomy may not be always required for treating patients alive until arriving emergency department, because rapid accumulation of the blood into pericardial space results in immediate death at scene. We report our experiences of treating traumatic pericardial effusion, and discuss the therapeutic modality in patients with traumatic pericardial effusion. METHODS: The study consisted of 37 patients(20 males and 17 females with the mean age 42) sustaining traumatic pericardial effusion. The patients were divided according to treatment modality into 3 groups(group I : patients receiving conservative management, group II : patients treated with pericardiocentesis, group III : patients required emergency thoracotomy). We compared clinical presentations, hemodynamic profiles and echocardiographic findings among three groups. RESULTS: Cardiac tamponade was present in 14 of 37 patients. Pericardiocentesis was performed in 13 patients, and open thoracotomy in 4 patients. Pericardiocentesis was curative in 9 patients. Thoracotomy was performed in only 3(24%) of 13 patients required pericardiocentesis. 3(75%) of 4 patients having moderate or severe pericardial effusion from penetrating injury were required open thoracotomy. CONCLUSION: In selected patients who have traumatic pericardial effusion by blunt chest injury, pericardiocentesis may be curative, and thoracotomy may not be inquired as long as bleeding via indwelling pericardial catheter is not sustained after pericardiocentesis.
Advanced Trauma Life Support Care ; Cardiac Tamponade ; Catheters ; Echocardiography ; Emergencies ; Emergency Service, Hospital ; Female ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Pericardial Effusion* ; Pericardiocentesis ; Thoracic Injuries ; Thoracotomy ; Thorax

BACKGROUND AND OBJECTIVES: Surgical treatment is considered as a secondary treatment option for obstructive sleep apnea (OSA). This study was performed to determine whether surgical treatment can be considered in patients with moderate-severe OSA as a treatment modality. MATERIALS AND METHODS: A total of 127 patients with moderate-severe OSA were retrospectively enrolled. The anatomic narrowing sites were mainly evaluated using cephalometry and drug induced sleep endoscopy (DISE), and then multi-level surgeries were performed. RESULTS: Both uvula and soft palate were the most frequent narrowing sites and a total of 110 patients showed upper airway narrowing more than two anatomic structures. A total of 79 patients (62.1%) were categorized as responders and 48 patients (39.1%) were non-responders. After multi-level sleep surgeries, patients' subjective symptoms and sleep parameters were significantly improved. However, AHI was not considerably decreased. Non-responders to sleep surgeries showed relatively higher rates of severe OSA and body mass index. Tongue base narrowing, incomplete corrections of nasal pathologies and soft palate were significant factors for lower success rates. CONCLUSION: We estimate that sleep surgery might be a therapeutic option for moderate to severe patients with OSA. A delicate pre-operative evaluation for upper airway narrowing is necessary to adapt sleep surgery to these patients.
Body Mass Index ; Cephalometry ; Endoscopy ; Humans ; Palate, Soft ; Pathology ; Retrospective Studies ; Sleep Apnea, Obstructive* ; Tongue ; Treatment Outcome* ; Uvula

The purpose of this study was to investigate the oral health periodontal conditions (CPITN(0), CPITN(1) CPITN(2) CPITN(3)) and periodontal treatment (non-surgical periodontal treatment and surgical periodontal treatment) of patients who have leprous disease. The objects for this study were 754patients (male: 453, female: 301, 60-69ages: 340, 70-79ages: 414) treated in the oral health center among Leprous disease patients with gingivitis and periodontal disease, residents in the Sirocco from 2003, May 1st to 2005, April 30th. The subdivided result carrying out periodontal conditions and treatment were as follows: 1. The results of periodontal conditions investigated that the number of 60-69year-old patients group were Community Periodontal treatment need index (CPITN)0: 15, CPITN1: 2, CPITN2: 66, CPITN3: 257, and 70-79year-old patients group were CPITN0: 27, CPITN1: 1, CPITN2: 116, CPITN3: 271 (Community Periodontal treatment need index(CPITN)0 of patients who have Leprous disease means exodontias states) 2. The results of periodontal treatment investigated that Non surgical periodontal treatment 25%, Surgical periodontal treatment 70%
Female ; Gingivitis ; Humans ; Leprosy ; Oral Health ; Periodontal Diseases ; Periodontal Index

The authors retrospectively analysed the ultrasonographic findings of 43 cases of surgically confirmed hypertrophic pyloric stenosis and their postoperative findings of sonograms taken at 1 month(n=40) or 3 months( n=5) after pyloromyotomy. In preoperative study, the thickened pyloric muscle was isoechoic or slight hypoechoic relative to liver on the midline longitudinal view and appeared as a "nonuniform acoustic ring" on the transverse view. The results of measurement in the all cases with hypertrophic pyloric stenosis were the pyloric thickness ≥3.8mm, the pyloric diameter ≥14mm, the pyloric channel length ≥16mm, the pyloric muscle volume ≥2.21Cm
Acoustics ; Follow-Up Studies ; Humans ; Liver ; Methods ; Pyloric Stenosis, Hypertrophic ; Reference Values ; Retrospective Studies ; Ultrasonography*

Little is known about the benefits of statin use on liver cancer mortality among patients with chronic hepatitis B (CHB) considering hypercholesterolemia and obesity. A nationwide retrospective cohort study was conducted using data from a Health Examination Cohort of the National Health Insurance Service of Korea. Data on CHB patients with no other concurrent liver disease were acquired, and statin use was defined as a cumulative daily dose ≥28. A 3-year landmark analysis was performed to avoid immortal time bias. Patients who started statin therapy within the landmark date were considered statin users. A Cox regression analysis was applied to assess associations between statin use and liver cancer mortality considering hypercholesterolemia and obesity. Among 13063 patients, 193 (1.5%) died of liver cancer during the mean follow-up period of 10.6 years. After adjusting for demographic and metabolic factors, statin use [hazard ratio (HR), 0.17; 95% confidence interval (CI), 0.04–0.70] and hypercholesterolemia (HR, 0.46; 95% CI, 0.24–0.88 for total cholesterol ≥240 mg/dL) were associated with a decreased risk of liver cancer mortality, whereas body mass index (BMI) ≥30 kg/m² was associated with an increased risk of liver cancer mortality (HR, 2.46; 95% CI, 1.20–5.06). This study showed that statin use was associated with decreased liver cancer mortality when adjusting for cholesterol levels and BMI. This study found that hypercholesterolemia was independently associated with decreased liver cancer mortality regardless of statin use.
Bias (Epidemiology) ; Body Mass Index ; Carcinoma, Hepatocellular ; Cholesterol ; Cohort Studies ; Follow-Up Studies ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Korea ; Liver Diseases ; Liver Neoplasms ; Liver ; Mortality ; National Health Programs ; Obesity ; Retrospective Studies