In this article by Kim et al. in the page of 263 "Table 2 and 3" shoud be corrected as "Table 2".

BACKGROUND: Esmolol has been applied to lower myocardial oxygen consumption and creates a quieter operative field by reducing systemic blood pressure and heart rate but can cause a certain amount of hemodynamic instability during minimally invasive direct vision coronary artery bypass graft (MIDCAB). The aim of this study was to compare the hemodynamic differences between two methods; inducing hypotension and bradycardia between esmolol infusion alone, and concomitant use of neostigmine during MIDCAB anesthesia. METHODS: Twenty MIDCAB patients were randomly allocated into two groups, group E (n = 10) receiving esmolol 0.3 mg/kg/min, group EN (n = 10) receiving esmolol 0.2 mg/kg/min and neostigmine 1.0 mg for induced hypotension and bradycardia during coronary anastomosis. The hemodynamic parameters were evaluated 10 minutes after induction of anesthesia (T1), 10 minutes after beginning of operation (T2), 5 minutes before the end of anastomosis (T3) and 10 minutes after the end of anastomosis (T4). Data were analyzed by ANOVA test for intragroup comparisons, and by T-test for intergroup comparisons with significance set at a P value of < 0.05. RESULTS: Heart rate significantly decreased at T3 in both groups and more in group EN. Systolic blood pressure decreased at T3 in both groups and there were no group differences but more episodes of extreme hypotension in group E. The cardiac index significantly decreased at T3 in both groups and more in group E. There was a small but significant increase in pulmonary capillary wedge pressure at T3 and T4 in group E and no change of central venous pressure in both groups. CONCLUSION: Concomitant use of neostigmine during esmolol infusion produces more reliable induced hypotension and bradycardia than esmolol infusion alone for MIDCAB anesthesia in terms of prevention of myocardial ischemia and easiness of anastomosis technique.
Anesthesia* ; Blood Pressure ; Bradycardia* ; Central Venous Pressure ; Coronary Artery Bypass ; Heart Rate ; Hemodynamics ; Humans ; Hypotension* ; Myocardial Ischemia ; Neostigmine* ; Oxygen Consumption ; Pulmonary Wedge Pressure ; Transplants

Open tracheostomy has been indicated for patients who require prolonged mechanical ventilation or respiratory care in order to avoid lots of complications during long-term endotracheal intubation. Because there are a number of disadvantages and serious complications in standard open tracheostomy, a simpler, safe and minimally invasive procedure such as percutaneous dilatational tracheostomy (PDT) and translaryngeal tracheostomy (TLT) were introduced as an appropriate procedure that can be administered at bedside. In terms of prevention of complications, minimal invasive tracheostomy techniques are more advisable for post open heart surgery patients. After two failed attempts at respirator weaning, we experienced a successful TLT for a 71-year-old male patient with intractable post CABG pneumonia post-op 15 days in an intensive care unit. During and post-TLT courses were not eventful. The cannula was removed 2 weeks after TLT and the patient was subsequently discharged to ward.
Aged ; Catheters ; Heart* ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Pneumonia ; Respiration, Artificial ; Thoracic Surgery* ; Tracheostomy* ; Ventilator Weaning

The transforaminal epidural injection (TFEI) has been preferred in many cases because it can deliver the injected dose of medication closer to the nerve root and better facilitate ventral epidural flow compared to other methods. However, in patients with deformities not demonstrated on fluoroscopic imaging, the needle may enter unwanted locations. We treated two cases of intradiscal injection of contrast dye, during the TFEI, in patients with lumbar disc herniation.
Congenital Abnormalities ; Discitis ; Humans ; Injections, Epidural ; Needles

Intraaortic balloon counterpulsation (IAB) has been shown to prolong survival in the critically ill cardiac patients. Originally developed for use in the patients with cardiogenic shock, the indications have been expanded. But despite technical advances, the complication rate associated with IAB remains high. The most commonly reported complications include damage to the femoral artery and distal embolization. Other reported major complications are balloon rupture, limb loss, bleeding, systemic infection and bowel infarction. We report a patient complicated by ischemic colitis causing stenosis and intestinal obstruction after IAB insertion.
Colitis, Ischemic* ; Constriction, Pathologic* ; Counterpulsation* ; Critical Illness ; Extremities ; Femoral Artery ; Hemorrhage ; Humans ; Infarction ; Intestinal Obstruction ; Rupture ; Shock, Cardiogenic

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Activity-dependent dendritic translation in CNS neurons is important for the synapse-specific provision of proteins that may be necessary for strengthening of synaptic connections. A major rate-limiting factor during protein synthesis is the availability of eukaryotic translation initiation factor 4E (eIF4E), an mRNA 5'-cap-binding protein. In this study we show by fluorescence in situ hybridization (FISH) that the mRNA for eIF4E is present in the dendrites of cultured rat hippocampal neurons. Under basal culture conditions, 58.7 +/- 11.6% of the eIF4E mRNA clusters localize with or immediately adjacent to PSD-95 clusters. Neuronal activation with KCl (60 mM, 10 min) very significantly increases the number of eIF4E mRNA clusters in dendrites by 50.1 and 74.5% at 2 and 6 h after treatment, respectively. In addition, the proportion of eIF4E mRNA clusters that localize with PSD-95 increases to 74.4 +/- 7.7% and 77.8 +/- 7.6% of the eIF4E clusters at 2 and 6 h after KCl treatment, respectively. Our results demonstrate the presence of eIF4E mRNA in dendrites and an activity-dependent increase of these clusters at synaptic sites. This provides a potential mechanism by which protein translation at synapses may be enhanced in response to synaptic stimulation.
Animals ; Cells, Cultured ; Dendrites/*metabolism ; Eukaryotic Initiation Factor-4E/genetics/*metabolism ; Hippocampus/*cytology ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Microscopy, Confocal ; Neurons/cytology/*physiology ; Potassium Chloride/pharmacology ; Protein Biosynthesis ; RNA, Messenger/genetics/*metabolism ; Rats ; Rats, Sprague-Dawley ; Synapses ; *Up-Regulation

BACKGROUND: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. METHODS: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. RESULTS: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. CONCLUSIONS: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.
Compensation and Redress ; Consensus ; Diagnosis ; Dissent and Disputes* ; Forensic Medicine ; Humans ; Informed Consent ; Insurance, Liability* ; Korea* ; Lumbosacral Region ; Malpractice* ; Medication Errors ; Nerve Block ; Pain Clinics ; Pain Management* ; Specialization ; Unconsciousness

Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.
Brain ; Epidural Space ; Fluoroscopy* ; Headache ; Humans ; Injections, Epidural ; Middle Aged ; Neck Pain ; Pneumocephalus*

Breast surgery is a common procedure performed in women. Many women who undergo breast surgery suffer from ill-defined pain syndromes. A nerve block is used in the treatment of the acute and chronic pain, but the effectiveness of the treatment has been limited because of its short duration. Recently, the advent of pulsed radiofrequency lesioning (PRF) has proved a successful treatment for chronic refractory pain involving the peripheral nerves. We experienced a case of a 52-year-old female patient complaining of chronic breast neuropathic pain after breast reduction, which was relieved after PRF lesioning of the 4th thoracic spinal nerve and its root.
Breast ; Chronic Pain ; Female ; Humans ; Middle Aged ; Nerve Block ; Neuralgia ; Pain, Intractable ; Peripheral Nerves ; Spinal Nerves