No abstract available.
Complementary Therapies*

BACKGROUND: Propofol has a high incidence of pain with intravenous injection, and different methods have been used to minimize the incidence and severity of this pain. In this study, we have compared the effect of lidocaine pretreatment with that of ketamine pretreatment on propofol injection pain. METHODS: Ninety healthy female patients scheduled for general anesthesia were randomly divided into three groups; saline group (n=30), lidocaine group (n=30) and ketamine group (n=30). Each patient received 2 ml of pretreatment solution (normal saline, 1% lidocaine, 0.5% ketamine) via 18G angiocatheter inserted in the antecubital fossa after applying an arm tourniquet inflated to 50 mmHg. The tourniquet was released 1 minute later, followed by intravenous injection of 2.5 mg/kg of propofol. The assessment of pain was made at the induction of anesthesia and in the recovery room, and the severity of pain was classified as none, mild, moderate, severe by one observer. RESULTS: The severity and incidence of pain diminished significantly in the lidocaine group and the ketamine group compared with the saline group at the induction of anesthesia (p<0.05) and there was no significant difference between the lidocaine group and the ketamine group. We had similar results in the recovery room and one patient from the saline group and the ketamine group had no recall regarding injection pain. CONCLUSION: Intravenous ketamine pretreatment is as effective as intravenous lidocaine pretreatment in alleviating the propofol injection pain.
Anesthesia ; Anesthesia, General ; Arm ; Female ; Humans ; Incidence ; Injections, Intravenous ; Ketamine* ; Lidocaine* ; Propofol* ; Recovery Room ; Tourniquets

Bosworth fracture, fracture-dislocation of ankle with entrapment of fibula behind the tibia, is a rare condition. Diagnosis of this fracture-dislocation may not he easy, and closed reduction of this injury is difficult because of entrapment of fibula by the tieht interosseous membrane. We report a case of Bosworth fracture treated with the anti-glide plate technique.
Ankle ; Diagnosis ; Fibula ; Membranes ; Tibia

OBJECTIVE: The operative indications on cerebellar hemorrhage have been controversial especially when the patient condition is grave. Therefore we investigated whether it can be justifiable if we perform the surgery in poor clinical grade. METHODS: Clinical records and computerized tomography(CT) films of the 89 patients, who were undergone hospital treatment due to spontaneous cerebellar hemorrhage between May 1997 and May 2004, were retrospectively researched. RESULTS: The study population consisted of 36 males and 53 female patients. The mean age was 65years (range 23~89). As a result of treatment, the patients, whose Glasgow coma scale(GCS) score were higher, showed better outcomes (p=0.001). 13 patients (14.6%) were below 5 in GCS score and 10 patients of these were operated. Among 10 patients, 4 patients (40%) showed good outcome and 5 patients (50%) had been dead. 3 patients (60%) of these dead patients had the findings of intraventricular hemorrhage, fourth ventricular obliteration and hydrocephalus in CT scan. CONCLUSION: This study suggests that operation may be justifiable in clinically poor grade patient with spontaneous intra cerebellar hemorrhage.
Coma ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage* ; Humans ; Hydrocephalus ; Male ; Retrospective Studies ; Tomography, X-Ray Computed

Acute thyroid abscess is an uneommon type of neck infection. We experieneed a case of staphylococcal thyroid abscess in 29 year old man, diagnosed by needle aspira~tion and culture of the aspirate. The patient had complained fever and slowly growing anterior neck swelling. Needle aspiration of the cold nodule prior to broad spectrum antibiotics was performed. After Surgical excision combined with antibiotics, he was discharged with elinical improvement. The laboratory diagnosis and clinical course was summarized and is reported with relevent references.
Abscess ; Anti-Bacterial Agents ; Clinical Laboratory Techniques ; Fever ; Humans ; Neck ; Needles ; Staphylococcus aureus ; Staphylococcus ; Thyroid Gland

Lymphangioma is a benign tumor of lymphatic origin. Lymphangioma can occur anywhere in the body and only rarely affects the intestinal tract. Most intestinal lymphangiomas are asymptomatic and detected incidentally at autopsy or surgery. Occasionally, they may be large enough to present as a mass to cause obstruction or intussusception. Recently, we examined a case of a 27-year-old woman who complained right upper quadrant abdominal pain, increased bowel sound and weight loss. By surgical resection after the double contrast barium enema and colonoscopy, we could confirm cystic lymphangioma of the transverse colon. So we report this case with brief review of relevant literature.
Abdominal Pain ; Adult ; Autopsy ; Barium ; Colon* ; Colon, Transverse ; Colonoscopy ; Enema ; Female ; Humans ; Intussusception ; Lymphangioma ; Lymphangioma, Cystic* ; Weight Loss

No abstract available.
Carbapenems* ; Korea*

No abstract available.
Carbapenems* ; Korea*

Vitamin C, one of essential micronutrients, has been reported to modulate the humoral immune responses in some mammals. We investigated whether vitamin C might modulate this response in mice by directly affecting B cells. Splenic B cells were isolated and activated by CD40- and B cell receptor-ligation in vitro. The cells were cultured with a pretreatment of vitamin C from 0 to 1 mM of concentrations. Vitamin C slightly increased apoptosis of B cells dose-dependently and behaved as an antioxidant. We found that in vivo administration of vitamin C by intraperitoneal injection affected isotype switching as previously reported: the titer of antigen-specific IgG1 antibody was decreased, while that of IgG2a was unaffected. Somewhat different from those observed in vivo, in vitro exposure to vitamin C slightly decreased isotype switching to IgG1 and increased isotype switching to IgG2a. Pretreatment with vitamin C in the safe range did not affect either proliferation of cultured B cells or the expression of CD80 and CD86 in those cells. Taken together, in vivo results suggest that vitamin C acts to modulate isotype switching in the mouse. However, because of our in vitro results, we suggest that the modulation exerted by vitamin C in vivo is by indirectly affecting B cells, perhaps by directly influencing other immune cells such as dendritic cells.
Animals ; Apoptosis ; Ascorbic Acid ; B-Lymphocytes ; Dendritic Cells ; Immunity, Humoral ; Immunoglobulin Class Switching ; Immunoglobulin G ; Injections, Intraperitoneal ; Mammals ; Mice ; Micronutrients ; Reactive Oxygen Species ; Vitamins

Spontaneous coronary artery embolization is a known complication of infective endocarditis. However, a microembolism from the aortic valve into the left anterior descending artery resulting in an acute anterior myocardial infarction is very rare. A 44-year-old male patient suffered from chest pain and fever of seven days duration. The echocardiogram demonstrated severe aortic stenosis, aortic root abscess and mobile vegetation on bicuspid aortic valve near the left coronary artery ostium. The electrocardiogram revealed ST segment elevation in lead V1-3 and heart enzyme analysis showed LD 936 IU/L, CK 299 IU/L, CK-MB 7.2 U/L, Troponin I 9.94 ng/mL. Diagnostic coronary angiogram revealed insignificant coronary lesion. Emergent operation was required because of aortic root abscess formation and high risk of recurrent embolization. He underwent surgery for aortic valve replacement and conservative management for acute myocardial infarction. The purpose of this article is to report the successful emergent aortic valve replacement of a patient with myocardial infarction due to coronary microembolism in a case of bacterial endocarditis.
Abscess ; Adult ; Aortic Valve ; Aortic Valve Stenosis ; Arteries ; Bicuspid ; Chest Pain ; Coronary Vessels ; Electrocardiography ; Endocarditis ; Endocarditis, Bacterial* ; Fever ; Heart ; Humans ; Male ; Myocardial Infarction* ; Troponin I