Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer

For the evaluation of the 51Cr labelled in-vivo crossmatching test as a transfusion safety test, We examined the viability of the thransfused autologous and heterologous 51Cr labelled red cell at 1 hour and 24 hour in 6 normal volunteers and 4 patients whose RBC had been stored in CPDA-1 media from 1 day to 30 day. In both autologous transfusion control group(n=3) and allogeneic transfusion control group(n=3), the in-vivo RBC survival rate were more than 70% at 1 hour and 24 hour compared to that of basal 3 minute result(percent counted as 100%), and the eluted free radioisotope activity was less than 5% compared to that of whole blood. The crossmatch incompatible patient group also satisfied the safe transfusion criteria. The mean labelling efficiency which was tested in three patients was more than 95% and also satisfactory to reliable test. We concluded that in-vivo crossmatching test using 51Cr radioisotope would give us valuable informations about transfusion safety, especially in serologically incompatible patients.
Healthy Volunteers ; Humans ; Survival Rate

No abstract available.
Barium* ; Intussusception*

No abstract available.
Anemia, Aplastic* ; Child* ; Humans ; Immunomodulation*

No abstract available.
Leukemia*

No abstract available.
Dermatitis, Atopic ; Pyroglyphidae

No abstract available.
Dyskeratosis Congenita*

OBJECTIVE: To evaluate the effects of strengthening exercise for isolated lumbar extensor muscles on chronic low back pain patients. METHOD: 28 patients with chronic low back pain in back school program participated in this study. Initially, isometric lumbar extensor strength, 10 point of Visual analog scale (VAS) and questionnaires related to self-experienced symptoms and daily activity (ADL) were checked. Isometric lumbar extensor strength test and strengthening exercise were performed with MedXTM lumbar extensor machine, which was designed to stabilize the pelvis. After 8 weeks of training program, isometric lumbar extensor strength & other pain related variables were checked again in the same way. RESULTS: The results were as follows: 1) After 8 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased at all the measured points significantly (p<0.01). 2) VAS and ADL were improved from 6.7 to 3.7, and from 6.9 to 9.1 respectively (p<0.05). CONCLUSION: 8 weeks of lumbar extensor strengthening program with pelvic stabilization was effective therapeutic tools for patients with chronic low back pain.
Activities of Daily Living ; Education ; Humans ; Low Back Pain* ; Muscles ; Pelvis ; Surveys and Questionnaires ; Visual Analog Scale

Varying types of polyps could occur in the vermiform appendix. However, it is very unusual. Collins found 57 cases (0.08%) of benign mucosal polyps in the 71,000 cases of appendectomy specimens. There has been no reported case of appendiceal polyp in the literature in Korea. The authors experienced two cases of polyp in the vermiform appendix. The first case was a 51 year-old male patient who received a left hemicolectomy due to colonic polyposis. The second case was a 71 year-old male patient who was treated by appendectomy under the clinical diagnosis of acute appendicitis. The microscopic type of both cases were hyperplastic polyp.
Male ; Humans

OBJECTIVE: It has been suggested that hysterectomy has a disturbing influence on bowel function, mainly constipation. We performed a prospective study to assess the changes of ano-rectal physiology after hysterectomy. METHODS: Fourteen consecutive patients were assessed before and two months after hysterectomy. A detail questionnaire was devised to allow assessment of bowel function and ano-rectal pressure test and balloon expulsion test were performed before and after hysterectomy. The parameters measured in ano-rectal pressure test included the minimal sensible volume, ano-rectal resting pressure, maximal squeezing pressure, recto-anal inhibitory reflex and balloon expulsion test. Data analysis was carried out by paired t-test. Statistical significance was inferred when the p value was<0.05. RESULTS: Among the fourteen patients, the straining in defecation was found in three patients after operation, other defication habits were not significantly changed after hysterectomy(P>0.05). There were no significant changes in ano-rectal pressure test after hysterectomy. The disturbance of balloon expulsion capacity was increased in four patients after hysterectomy(29%). CONCLUSION: Our results demonstrate that hysterectomy does not cause a decrease in ano-rectal pressure and rectal sensitivity, but has an adverse effect on rectal expulsion capacity in a some of patients.
Constipation ; Defecation ; Humans ; Hysterectomy* ; Physiology ; Prospective Studies ; Surveys and Questionnaire ; Reflex ; Statistics as Topic