No abstract available.
Child* ; Humans ; Interleukin-6* ; Nephritis* ; Purpura, Schoenlein-Henoch*

Purpose: This study was performed to analyze the predictors that might contribute to urinary retention following semiclosed hemorrhoidectomy under spinal anesthesia. Methods: This retrospective study enrolled 2,176 consecutive patients with symptomatic grade III to IV hemorrhoids who underwent semiclosed hemorrhoidectomy between September 2018 and September 2019. Results: Among the 2,176 patients, 1,878 (86.3%) had no postoperative urinary retention, whereas 298 (13.7%) developed urinary retention after hemorrhoidectomy. The percentage of males was significantly higher in the retention group than in the non-retention group (60.4% vs. 48.1%; P=0.001). The risk of urinary retention was 1.52-fold higher in males than in females (95% confidence interval [CI], 1.13–2.04; P=0.005), 1.62-fold higher in old age (95% CI, 1.14–2.28; P=0.006), and 1.37-fold higher with high body mass index (BMI) (95% CI, 1.04–1.81; P=0.025). Patients with ≥4 resected hemorrhoids had a higher odds ratio (OR) of 1.46 (95% CI, 1.12–1.89; P=0.005) than patients with <4 resected hemorrhoids. Among the supplementary medication, patients who used analgesics had a higher OR of 2.06 (95% CI, 1.57–2.68; P=0.001) than those who did not. Conclusion Male sex, age, high BMI, number of resected hemorrhoids, and supplementary analgesics are independent risk factors for urinary retention after semiclosed hemorrhoidectomy.

Purpose: This study aimed to identify the factors affecting the chemotherapy medication errors made by new nurses and to use the results as basic data for the development of a chemotherapy medication nursing education program for new nurses. Methods: This cross-sectional study was conducted with 189 new nurses working at a general hospital and a tertiary general hospital in Korea. The data collection period was from January 11 to February 7, 2021. The data collected during this study were analyzed using the IBM SPSS statistics version 25.0 program. Data analysis included descriptive statistics, independent t-test, ANOVA, and logistic regression analysis. Results: One factor influencing chemotherapy medication errors was new nurses’ educational needs (odds ratio=.18, p=.005). As educational needs increased, the probability of making errors in medication was reduced by .18. Conclusion It is necessary to develop a chemotherapy medication education program tailored to the educational needs of new nurses by considering the education period, method, and content, with a focus on the content with high demand from new nurses.

Purpose: According to recent studies, magnetic resonance imaging (MRI) assessment of complex fistulas provides a significant benefit compared to fistulography, computed tomography, and ultrasonography. The aim of this study was to describe the accuracy of MRI and the importance of identifying puborectalis muscle involvement on MRI in patients with complex fistula. Methods: All patients who were clinically diagnosed with ‘complex’ or showed multiple fistula tracts underwent fistula MRI. Eligible patients were consecutive patients who underwent fistula MRI between September 2018 and September 2019 at our hospital. Results: A total of 83 patients (74 males, 9 females; 116 tracts) were included in this study. The sensitivity and specificity of MRI in diagnosing fistula tracts were 94.8% and 98.2%, respectively. The sensitivity and specificity in identifying internal opening were 93.9% and 97.3%, respectively. Of the 35 patients with puborectalis muscle involvement in the MRI, 31 images of suprasphincteric-type patients on the Park’s classification were classified. The patients of puborectalis involvement were divided into 2 groups according to the surgical procedure that was performed. There were 12 sphincter-saving procedures and 19 sphincter division procedures performed. Recurrence was seen in 2 patients in the sphincter-saving procedure group, while no case was seen in the sphincter division procedure group. Five complications were found in the sphincter division procedure group, of which 2 reported incontinence. Conclusion Fistula MRI is a highly accurate examination for evaluating complex fistulas, and the puborectalis muscle involvement findings are very important for diagnosis and treatment.

More than half of patients presenting with hoarseness show benign vocal cord changes. However, in rare cases with benign mucosal lesions, it can be diagnosed as a malignant disease after histopathological examination. A 53-year-old man with a 30-pack-year smoking history was admitted for the evaluation of hoarseness, and using a laryngoscope, an enclosed, sac-like cystic lesion was detected on the midpoint of the right true vocal cord. The cystic lesion was deemed to be an intracordal cyst and treated with laryngeal microsurgery. However, pathological findings showed squamous cell carcinoma of the larynx arising in the intracordal cyst, which is exceptionally rare. Therefore, even if a benign lesion is initially suspected, a biopsy must be performed on a patient with smoking history to confirm the diagnosis. In conclusion, we report a case of squamous cell carcinoma of the larynx arising in the intracordal cyst.

More than half of patients presenting with hoarseness show benign vocal cord changes. However, in rare cases with benign mucosal lesions, it can be diagnosed as a malignant disease after histopathological examination. A 53-year-old man with a 30-pack-year smoking history was admitted for the evaluation of hoarseness, and using a laryngoscope, an enclosed, sac-like cystic lesion was detected on the midpoint of the right true vocal cord. The cystic lesion was deemed to be an intracordal cyst and treated with laryngeal microsurgery. However, pathological findings showed squamous cell carcinoma of the larynx arising in the intracordal cyst, which is exceptionally rare. Therefore, even if a benign lesion is initially suspected, a biopsy must be performed on a patient with smoking history to confirm the diagnosis. In conclusion, we report a case of squamous cell carcinoma of the larynx arising in the intracordal cyst.

No abstract available.
Child* ; Humans ; Measles*

BACKGROUND: We performed this study to evaluate the appropriate effect-site concentrations of propofol and alfentanil for LMA insertion in ambulatory breast surgery without neuromuscular blockade. METHODS: Seventy-three ASA physical status 1 patients were enrolled. The administration of propofol and alfentanil was titrated versus bispectral index (BIS < 60), systolic blood pressure (SBP > or = 80 mmHg) and heart rate (HR > or = 50/min), respectively. The condition of LMA insertion was assessed as grade 1 (excellent), 2 (acceptable), and 3 (poor) according to gag, cough, movement, and laryngospasm. We recorded SBP, HR and BIS before and after LMA insertion, the effect-site concentrations of propofol and alfentanil at the time of LMA insertion, and the LMA removal time at recovery. RESULTS: The condition of LMA insertion at first attempt was grade 1 in 71.6% of patients, grade 2 in 20.3%, and grade 3 in 8.1%. After the first attempt at LMA insertion, movement occurred in 25.7% and the BIS increased above 60 in 31.5%. The range of the effect-site concentrations of propofol and alfentanil at the first attempt were 2.0 6.0 (3.7 +/- 0.7)microgram/ml and 30.0 150.0 (71.6 +/- 24.4) ng/ml, which reflected a large inter-individual variability. The incidences of hypertension, tachycardia, hypotension, and bradycardia were 6.8%, 1.4%, 11.0% and 5.5%, respectively. The mean LMA removal time was 4.7 min. CONCLUSIONS: LMA was inserted successfully in 91.7% at first attempt and removed promptly at recovery. Movement and increase of BIS above 60 occurred frequently after the first attempt of LMA insertion with the effect-site target-controlled infusion of propofol and alfentanil without neuromuscular blockade.
Alfentanil* ; Blood Pressure ; Bradycardia ; Breast* ; Cough ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Incidence ; Laryngeal Masks* ; Laryngismus ; Neuromuscular Blockade* ; Propofol* ; Tachycardia

BACKGROUND: The disposable patient-controlled analgesia (PCA) devices are convenient for portability and management. An ideal PCA can be developed as an electronic device with various functions of safety and control. Recently, Accumate 1000(R) was developed as an electronic pump in Korea, and has passed the relevant laboratory criteria of safety and efficacy. We conducted a clinical study on the safety and efficacy when the device is applied to patients. METHODS: Fentanyl 1,500microgram, ketorolac 180 mg, and ondansetron 8 mg were used for PCA. Continuous infusion rate, bolus dose, and lockout time were set at 1 ml/h, 1 ml, and 15 min, respectively. Fifty patients were monitored for 48 h. The safety of Accumate 1000(R) was evaluated by backflow and siphonage, auto-clamp function, and lockout time intraoperatively. The efficacy was evaluated by the accuracy of bolus and total infused dose, and the satisfaction rates of patients and users. RESULTS: Backflow and siphonage did not occur, and the auto-clamp function was excellent. There was no bolus infusion during lockout time, and the bolus dose was infused accurately after lockout time. For the accuracy of the total infused dose, the mean and median value of performance error between the infused and target doses were -0.55%, and -0.29%, respectively. Noise, button sense, and convenience of cable were rated as satisfactory by 90%, 78%, and 84%, of patients respectively. CONCLUSIONS: The safety and efficacy of Accumate 1000(R) were established by clinical trial. We can provide patients with the more precise and optimal analgesia. The history of drug infusion can be used as research data.
Analgesia ; Analgesia, Patient-Controlled* ; Fentanyl ; Humans ; Ketorolac ; Korea ; Noise ; Ondansetron ; Passive Cutaneous Anaphylaxis

No abstract available.
Encephalitis* ; Humans ; Neurologic Manifestations ; Sweet Syndrome*