BACKGROUND: Epidural morphine is effective in the treatment of postoperative pain, but the incidence of associated side effects is high. To evaluate the reduction of opioid sideeffects by epidural use of droperidol mixture, this study was performed. METHODS: Randomly sampled sixty patients undergoing upper abdominal surgery were divided into two groups. To assess a reduction of opioid side effects by droperidol, group I (n=30) were received 3mg morphine and 0.15% bupivacaine 10ml through the indwelling epidural catheter before the conclusion of operation, followed by an infusion of 6 mg morphine plus 0.15% bupivacaine 100ml with the two day infusor. Group II (n=30) were treated with the same protocol as group I but 1.5 mg of droperidol was added to initial bolus and 5mg of droperidol to the two day infusor. Analgesic effect and side effect were 48 hours after operation. RESULTS: No significant differences in intensity of analgesiaand sedation were seen. The intensity of nausea and vomiting in the group II was significantly less than in the group I at 8, 12 hours after operation (p<0.05). The intensity of pruritus in group II was significantly less than in group I at 4, 8 hours of postoperative period (p<0.05). The frequency of nausea, vomiting, pruritus and urinary retention in group II were less than in group I. respiratory depression. Epidural injection of droperidol did not result in any local or systemic side effects. CONCLUSION: The addition of epidural droperidol significantly reduced the side effects of epidural morphine without altering the effect on analgesia.
Analgesia ; Bupivacaine ; Catheters ; Droperidol* ; Humans ; Incidence ; Infusion Pumps ; Injections, Epidural ; Morphine* ; Nausea ; Pain, Postoperative ; Postoperative Period ; Pruritus ; Respiratory Insufficiency ; Urinary Retention ; Vomiting

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion

Although nitric oxide (NO) plays an important role in the pathophysiological process of cerebral ischemia or severe traumatic brain injury, its contribution to the pathogenesis of moderate diffuse axonal injury (mDAI) remains to be clarified. The alterations in nitric oxide synthase (NOS) activity and the histopathological response after mDAI was investigated. Forty anesthetized Sprague-Dawley adult rats were injured with a Marmarou's weight-drop device through a Plexiglas guide tube. These rats were divided into 8 groups (control, 1 hr, 2 hr, 3 hr, 6 hr, 12 hr, 24 hr, 48 hr after trauma). The temporal pattern of apoptosis in the adult rat brain after mDAI was characterized using TUNEL histochemistry. In addition, the cDNA for NOS activity was amplified using RT-PCR. The PCR products were electrophoresed on a 2% agarose gel. eNOS activity was not detected, but nNOS activity was expressed after 3 hr and continuously 48 hr after impact, which was approximately double that of the control group at 12 and 24 hr. Subsequently, there was a decrease in activity after 48 hr. The iNOS activity increased dramatically after 12 hr and was constant for a further 12 hr followed by a dramatic decrease below the level of the control group. Significant apoptotic changes occurred 12 and 24 hr. after insult. nNOS and iNOS activity were affected after moderate diffuse axonal injury in a time-dependent manner and there was a close relation between the apoptotic changes and NOS activity. Although the nNOS activity was expressed early, its activity was not stronger th an iNOS, which was expressed later.
Animal ; *Apoptosis ; Craniocerebral Trauma/enzymology/*physiopathology ; Diffuse Axonal Injury/enzymology/*physiopathology ; Nitric-Oxide Synthase/*metabolism ; Rats ; Rats, Sprague-Dawley ; Wounds, Nonpenetrating/enzymology/*physiopathology

No abstract available.
Lymphangioma*

No abstract available.
Eosinophils* ; Gyeongsangbuk-do* ; Humans ; Immunoglobulin E* ; Skin*

Objectives: ：Depression is known to be very common for coexistence with physical diseases, but reports of this are not well known in Korea. The purpose of this study is to investigate demographic factors related to adult depression in Korea and the association between physical diseases and depression. Methods: ：This study used raw data from the 7th National Health and Nutrition Survey of the Korea Centers for Disease Control and Prevention in 2016 and 2018, and analyzed by integrating data from adults over the age of 19. Patient Health Questionnaire-9 was applied to the diagnosis of depression. Cross-analysis and logistic regression analysis were used for the association with depression according to socio-demographic characteristics and health-related characteristics. Results: ：The point-prevalence of depression in Korea using Patient Health Questionnaire-9 is 5.4%. Regarding sociodemographic characteristics, risks of depression were increased among the elderly, women, people with low household income, and people with low education levels. It was analyzed that the risk of coexistence of depression with physical diseases such as diabetes, stroke, myocardial infarction, arthritis, asthma, thyroid disease, renal failure, and cirrhosis was significantly high. Conclusions ：In this study, the presence of chronic diseases greatly increased the risk of depression, and it was confirmed that certain groups were at high risk for depression.

Purpose: To report the short-term clinical outcomes after intrascleral fixation of intraocular lenses (IOLs) using oblique intrascleral tunnels. Methods: We retrospectively studied 17 patients (18 eyes) who underwent flanged intrascleral IOL fixation from October 2019 to October 2021. The patients were divided into those who underwent fixation using horizontal (group A) and oblique (group B) intrascleral tunnels. We compared the best-corrected visual acuities (BCVAs), cylindrical powers, refractive errors (the differences between the targeted spherical equivalents [SEs] and postoperative SEs) before and 3 months after surgery, and operating times. Results: At 3 months vs. preoperatively, there were no significant differences in BCVA (-0.83 ± 0.43 vs. -0.48 ± 0.59), refractive error (-0.06 ± 0.97 diopter [D] vs. -0.05 ± 0.80 D), cylindrical power (-0.42 ± 3.81 D vs. -0.33 ± 1.20 D), or operating time (83.33 ± 28.05 minutes [min] vs. 66.33 ± 20.57 min) between groups A and B, respectively. Conclusions In terms of the short-term clinical outcomes after use of horizontal and oblique intrascleral tunnels, we found no significant differences in any parameters studied. However, use of an oblique intrascleral tunnel may shorten the operating time.

BACKGROUND: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. MATERIAL AND METHOD: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. RESULT: The proportion of the skin incision length to the sternal length was 63.1+/-3.9%(5.2~11cm, mean 7.3cm) in children, and 55.0+/-3.5%(10~13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. CONCLUSION: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.
Adult ; Aneurysm ; Cardiopulmonary Bypass ; Catheterization ; Child ; Cicatrix ; Heart Arrest, Induced ; Heart Defects, Congenital ; Heart Diseases ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Hematoma ; Hemorrhage ; Humans ; Manubrium ; Necrosis ; Skin* ; Sternotomy* ; Thoracic Surgery* ; Thorax ; Wound Infection

BACKGROUND: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. MATERIAL AND METHOD: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. RESULT: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. CONCLUSION: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atheroscleroti.
Aorta ; Aorta, Thoracic ; Atherosclerosis ; Brain Death ; Cardiopulmonary Bypass ; Carotid Stenosis ; Catheterization ; Cerebral Infarction ; Consciousness ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Incidence ; Intellectual Disability ; Ischemic Attack, Transient ; Multivariate Analysis ; Myocardial Infarction ; Neurologic Examination ; Paralysis ; Plaque, Atherosclerotic ; Postoperative Complications ; Retrospective Studies ; Risk Factors* ; Stroke

The patient is a 62-year-old man with known diabetes mellitus who presented with a two-weeks-history of dyspnea, cough, and fever. He was diagnosed with a lung abscess in the right upper lobe and was treated with intravenous antibiotics. The patient's clinical and radiological findings improved within seven days after medical treatment. However, newly developed ground-glass opacity and infiltrations were observed in the right lower lung. Fourteen days after admission, the patient's symptoms and imaging finding became aggravated despite trestment with susceptible antibiotics for lung abscess. Trans-bronchial lung biopsy (TBLB) was performed in the lateral basal segment of the right lower lobe of the lung. A histologic photomicrograph showed organizing pneumonia, also called bronchiolitis obliterans with organizing pneumonia(BOOP), that became more definite as the terminal bronchioles and alveoli became occluded with masses of inflammatory cells and fibrotic tissue. The clinical symptoms and radiograph findings resolved quickly with prednisone treatment. We report a case of secondary organizing pneumonia diagnosed after TBLB following lung abscess treatment and provide a review of the literature.
Anti-Bacterial Agents ; Biopsy ; Bronchioles ; Bronchiolitis Obliterans ; Cough ; Diabetes Mellitus ; Dyspnea ; Fever ; Humans ; Lung Abscess* ; Lung* ; Middle Aged ; Pneumonia* ; Prednisone