No abstract available.
DNA* ; Female* ; Humans* ; Prevalence* ; Uterine Cervical Neoplasms*

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

Common methods of suicide are hanging, toxic substance ingestion, descent from height, and drowning. However, suicide by cutting the tongue is very rare and there are almost no reported cases in the literature. A 76-year-old man who had terminal gastric cancer with multiple liver metastases was found dead in his home. Upon autopsy, it was noted that his tongue was cut by a pair of scissors four times and copious blood was identified in the stomach and intestine. The total loss of blood volume was approximately 750 mL. He had also cut his finger-tip and stabbed his abdomen with a pair of scissors. We concluded that lingual artery injury by scissors was the cause of death.
Abdomen ; Aged ; Arteries ; Autopsy ; Blood Volume ; Cause of Death ; Drowning ; Eating ; Humans ; Intestines ; Liver ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms ; Suicide* ; Tongue*

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies

We report a 72-year-old female patient with spontaneous rupture of the left external iliac vein. She visited our hospital for abdominal and back pain. She had the abnormal finding of hemoperitoneum. We performed an emergency operation with diagnosis of left ovarian cyst rupture though she suffered from spontaneous rupture of the left external iliac vein. This case provides insight to the experience of spontaneous rupture of the left external iliac vein.
Aged ; Back Pain ; Emergencies ; Female ; Hemoperitoneum ; Humans ; Iliac Vein ; Ovarian Cysts ; Rupture ; Rupture, Spontaneous

The author observed clinical study and response of -interferon treatment of 43 cases of chronic hepatitis who were admitted to Department of Pediatrics Pusan National University College of Medicine during the period of 4 year 6 months from Jenuary, 1988 to Jun, 1992. The results were as follows: 1) Of 43 patients with chronic hepatitis, CPH was 17 cases (39.5%) and CAH was 26 cases (60.5%). 2) Of 43 patients, chronic hepatitis caused by HBV was 37 cases (86.0%) 2 cases were by Wilson's disease, 1 case was by glycogen storage disease and in the 3 cases, the cause was undetermined and CPH by HBV and CAH were 14 cases (82.4%), 23 cases (88.5%) respectively. 3) A peak frequency (46.5%) of chronic hepatitis occurred between 6 to age and male predominated in a propotion of 3.5:1. 4) On the clinical manifestation, jaundice and hepatomegaly was higher frequency on CAH than on CPH. 5) On the laboratory findings, CAH had higher serum ALT and direct bilirubin level than CPH. 6) On effect of -interferon treatment for patients of CAH, serum ALT and AST levels normalized in 81.8% of patients, negative conversion of HBeAg was 38.5%, Anti-HBe serocoversion was 7.7%, negative conversion of HBsAg was 7.7% and the clearnce of HBV-DNA from seum showed 60.0%. 7) The HBeAg seroconversion (28.6%) on children of HBsAg(+) mother showed lower reponse than HBeAg seroconversion (50.0%) of HBsAg(-) mother after -interferon treatment for patients of CAH.
Bilirubin ; Busan ; Child* ; Glycogen Storage Disease ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Hepatolenticular Degeneration ; Hepatomegaly ; Humans ; Jaundice ; Male ; Mothers ; Pediatrics

Unilateral adsence of a pulmonary artery is frequently undiagnosed. Unless this entity is recognized, a patient with a potentially curable lesion may become inoperable. The importance of considering unilateral absence of a pulmonary artery in the diffirential diagnosis of cyanotic congenital heart disease and pulmonary hypertension has become clear. We exeperienced a case of congenital isolated unilateral absence of it. pulmonary artery confirmed by clinical features, lung scan, echocardiogram and angiogram.
Diagnosis ; Heart Defects, Congenital ; Humans ; Hypertension, Pulmonary ; Lung ; Pulmonary Artery*

The massively dilated ureter is one of major therapeutic challenges that face the urologists. The goals of reconstructive procedures are the elimination of residual urine, effective ureteral peristalsis, efficient and/or urgent drainage. 6 cases of primary obstructive megaureter were presented with review of literatures. The results obtained were as follows ; 1. 6 cases were divided into 2 groups according to etiology with 4 adynamic segments and 2 intrinsic stenosis. 2. The underlying histopathologic features included 1 submucosal inflammation,2 submucosal fibrosis with inflammation and 2 submucosal fibrosis. 3. 5 cases were treated with Hendren's technique and 1 case treated by ureteral meatotomy. 4. All cases showed obvious improvement of upper tract without complication during follow-up period from 5 to 26 months.
Constriction, Pathologic ; Drainage ; Fibrosis ; Follow-Up Studies ; Inflammation ; Peristalsis ; Ureter

We had experienced anesthetic management of two patients with bilateral pheochromocytoma. They had been treated with phenoxybenzamine for 4 weeks preoperatively. Anesthesia was managed with thiopental sodium for induction,enflurane-N2O-O2 for maintenance, vecuronium for muscle relaxation, and sodium nitroprusside for controlling severe hypertension. After tumor resection, severe hypotension was controlled by rapid transfusion, fluid and dopamine infusion. A tolerable blood pressure and pulse rate were maintained throughout the procedure. Preoperative preparation, sufficient sedation, smooth anesthetic induction, complete analgesia, good muscle relaxation, adequate ventilation and proper cardiovascular control are required in resection of pheochromocytoma.
Analgesia ; Anesthesia ; Blood Pressure ; Dopamine ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Muscle Relaxation ; Nitroprusside ; Phenoxybenzamine ; Pheochromocytoma* ; Thiopental ; Vecuronium Bromide ; Ventilation

No abstract available.
DNA* ; Flow Cytometry* ; Gestational Trophoblastic Disease*