Despite current practice there is no evidence to demonstrate the efficacy of intraurethral 2% lidocaine gel as an anesthetic for rigid cystoscopy. To evaluate the usefulness of lidocaine on decreasing pain associated with cystoscopy, we performed a randomized controlled study comparing 2% lidocaine gel with a plain water based lubricant. Pain was recorded on a visual analogue scale by the patient and by the physician. Physician perception of pain experienced by the patient was compared with the actual pain experienced. We found decrease in pain perception in men following lidocaine gel instillation with a 5 or 10 minute dwell time compared to instillation of the plain lubricant.
Anesthetics ; Cystoscopy* ; Humans ; Lidocaine* ; Male ; Pain Perception ; Water

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

Heterotopic pregnancy is defined as coexistence of intrauterine and ectopic pregnancy. The reported incidence of heterotopic pregnancy, which is normally rare, is particularly high (1%) after IVF treatment. It is important to have a high index of suspicion for the occurrence of heterotopic pregnancies because only 40% to 84% of cases can be diagnosed with transvaginal ultrasound at the initial presentation. Edwards syndrome occurs in 8,000 newborns and the incidence is much higher in elderly gravidas. We report a case of heterotopic pregnancy following IVF-ET resulting in 16 weeks of intrauterine pregnancy with fetal Edwards syndrome, and tubal pregnancy with a brief review of literature.
Aged ; Female ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Tubal

BP201, porcine lung tissue-derived phospholipids, consists of phosphatidylcholine as a major phospholipid species. BP201 promoted hair growth after application onto the shaved backs of BALB/c and C3H mice. Its effect was enhanced when applied together with minoxidil (MNX) in C3H mice. When the tissue specimens prepared from the shaved skins of BP201-treated and control mice were microscopically examined, the total numbers of hair follicles in both anagen and telogen phases of BP201-treated mice were significantly higher than those of control mice. The numbers of hair follicles in the anagen phase of BP201-treated mice were also higher than those of control mice. In combination with MNX, BP201 further increased the total number of hair follicles, but did not alter the percentage of hair follicles in the anagenic phase. BP201 also increased the proliferation of human hair follicle dermal papilla cells. Collectively, BP201 possesses hair growth promoting potential, which would suggest its use singly or in combination for hair growth products.
Animals ; Hair Follicle ; Hair* ; Humans ; Lung* ; Mice ; Mice, Inbred C3H ; Minoxidil ; Phosphatidylcholines ; Phospholipids* ; Skin

Popular use of intravascular catheterization of both diagnostic and therapeutic purposes led to increase in iatrogenic intravascular foreign bodies for which percutaneous removal has been accepted as the treatment of choice. The majority of percutaneously removed intravascular foreign bodies are located in the right side of the heart, large veins, and pulmonary arteries and intraarterial foreign body is rare. We recently experienced a case of intraarterial fragmented catheter which was removed with a basket percutaneously without any complication.
Catheterization ; Catheters ; Foreign Bodies* ; Heart ; Pulmonary Artery ; Veins

OBJECTIVE: We analyzed 200 cases of prenatal amniocentesis and compared them with other reported studies. Thus we propose the necessity of metanalysis for prenatal amniocentesis. METHOD: We analyzed 200 cases that have undergone amniocentesis at Masan Samsung hospital from January 1996 to December 1997. The results of our study was compared with other reported studies of amniocentesis by indication and maternal age. The proportion of age-class and indication are compared between previous study subjects and our 200 cases. RESULTS: Triple marker abnormality was the most common indication of amniocentesis(51%) and the most common age distribution was 25-29 years (43.5%). Chromosomal aberration was diagnosed in 20 cases (10%) of which the numerical aberration was 9 cases (4.5%) and the structural aberration was 11 cases (5.5%). 5 cases (2.5%) out of ll cases of the structural aberration were normal variant. There were 7 cases (trisomy 21) of autosomal aberration and 2 cases (Turner syndrome) of sex chromosome aberration. Arnong the structural aberration, there was only one reported case of 46, t(7:10) reciprocal translocation. There were no cases of fetal death except for a little self limited preterm labor. There were no neonatal complications. In the comparison of indication and maternal age with other studies, abnormal triple test was the most common indication of amniocentesis. The number of young pregnant women under 35 years old who underwent genetic amniocentesis was increased year by year. CONCLUSION: Triple maker screening test and genetic amniocentesis become popular method of antenatal diagnosis in Korea. Now, it is the proper time to establish standard indication of prenatal amniocentesis in this country by systemic and objective statistic examination. So we address the need for metanalysis in our country as comparing with other studies.
Adult ; Age Distribution ; Amniocentesis* ; Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Korea ; Mass Screening ; Maternal Age ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Prenatal Diagnosis ; Sex Chromosome Aberrations

Nodular type malignant melanoma is uncommon in fingers. In previous publications, treatment, diagnosis and case reports of subungal melanoma is often, however fingertip lesion was not focused. A 64-year-old woman who had a non-healing red and dark colored nodular mass with ulceration over the finger tip in the right thumb visited our clinics. Biopsy results was malignant melanoma then we performed amputation surgery of distal phalanx. Lymph node biopsy and resection margin was negative for melanoma. Chemotherapy was administered immediately. After 5 months, pulmonary nodular lesion was found and diagnosed as metastatic malignant melanoma by the wedge resection surgery. The patient is treated for additional chemotherapy consistently and disease free for 2 years. Nodular type melanoma of the finger is uncommon and it could be presented as ulceration and amelanotic nodular mass. Therefore we recommend biopsy to diagnose correctly if there are chronic non healing lesions on the fingers.
Amputation ; Biopsy ; Diagnosis ; Drug Therapy ; Female ; Fingers ; Humans ; Lymph Nodes ; Melanoma* ; Middle Aged ; Thumb* ; Ulcer

STUDY DESIGN: A retrospective radiologic study. OBJECTIVES: We wanted to compare the compression ratio and kyphosis of thoracolumbar and lumbar fractures according to the radiologic measuring methods and we wanted to analyze their relationship with the stability of fracture. SUMMARY OF THE LITERATURE REVIEW: There are several methods for measuring the compression ratio and kyphotic angle in thoracolumbar fractures, but no definitive measurements and no different values according to the stability have been established. MATERIALS AND METHODS: From July 2002 to August 2008, the plain films, CT, MRI and medical records of thoracolumbar and lumbar fracture were reviewed. The compression ratio and kyphotic angle were calculated by several different formulas with using the lateral view of the plain X-ray film, the sagittal reconstruction image of CT and the sagittal image of MRI and the results were compared. Each subject was classified according to both McAfee's classification and the TLISS classification. RESULTS: Two hundred forty eight vertebral bodies of 205 thoracolumbar fracture patients were analyzed. The compression ratio according to formula 1, which was calculated as 1-anterior vertebral height/posterior vertebral height, was significantly correlated with Cobb's angle and the local kyphotic angle. There was no significant difference between the Cobb's angle calculated using the lateral X-ray and that using the sagittal view of CT; however, it was significantly less using the sagittal MRI view. The unstable fractures according to McAfee's classification showed a significantly higher compression ratio and kyphotic angle compared to those of the stable fractures. CONCLUSIONS: The compression ratio formula 1 was most significantly correlated with the kyphotic deformity. The unstable fractures showed a mean compression ratio higher than 30%, a mean Cobb's angle of 15degrees and local kyphotic angle of 18degrees. The sagittally reconstructed CT was a useful measuring method for the evaluation of kyphotic deformity, and it was more accurate than that of the plain film.
Congenital Abnormalities ; Humans ; Kyphosis ; Medical Records ; Retrospective Studies ; X-Ray Film

We experienced a case of a cesarean section of a 32-year-old female with an thoracic aortic dissection under general anesthesia. An aortic dissection in pregnancy is rare but a potentially catastrophic occurrence. There is a poor prognosis if an aortic dissection occurs in pregnancy in the third trimester. The importance in anesthetic management of these patients should prevent any hypertension in response to intubation and surgery with appropriate preoperative care and monitoring.
Adult ; Anesthesia* ; Anesthesia, General ; Cesarean Section* ; Emergencies* ; Female ; Humans ; Hypertension ; Intubation ; Pregnancy ; Pregnancy Trimester, Third ; Preoperative Care ; Prognosis

Malignant hyperthermia is a recently described and drmatic syndrome which rarely occurs during anesthesia, but when & dose occur is still fatal in the majority of cases with unknown etiology. It si a rypermetabolic condition characterized by tachycardia, tachypnea, skeletal muscle rigidity, respiratory and metabolic acidosis and cyanosis etc. A case is presented of a 20 year old gerveralcy healthy female with a family history of congenital eye-ild ptosis in herself as well as in all her brothers and sisters( male 2, female 4) and a generalized muscle weakness of unknown origin for several years in her father. She underwent a minor operation for correction of the congenital eyelid ptosis under N2O-O2-tachycardia developed followed by severe arrhythmia with unstable BP, minutes after induction tachycardia developed followed by sever arrhythmia with unstable BP, muscle rigiditiy and hyperpyrexia. 15 minutes after induction anesthesia was stopped and aggressive emergency treatment was atlemted. Unfortunately, she died postoperatively on the 8th day after anesthesia. Possible etiologic factors, the clinical features and management of malignant hyperthermia are discussed.
Acidosis ; Anesthesia ; Anesthesia, General* ; Arrhythmias, Cardiac ; Blepharoptosis ; Cyanosis ; Emergency Treatment ; Fathers ; Female ; Humans ; Male ; Malignant Hyperthermia* ; Muscle Weakness ; Muscle, Skeletal ; Siblings ; Tachycardia ; Tachypnea ; Young Adult