Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult ; Anesthesia ; Cardiomyoplasty* ; Cardiopulmonary Bypass ; Exercise Tolerance ; Fentanyl ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Intensive Care Units ; Isoflurane ; Male ; Midazolam ; Muscle, Skeletal

Leiomyoma is a benign solitary tumor which is originated from a smooth muscle cell and grows slowly. It is most commonly found in the uterus and can develop anywhere that smooth muscle is present, including esophagus, lower extremity, stroma of GI tract, and pleura. However, the occurrence of leiomyoma in the hand is so uncommon. We present one case of solid type leiomyoma found in the right 4th finger of a young woman.
Esophagus ; Female ; Fingers ; Gastrointestinal Tract ; Hand ; Humans ; Leiomyoma ; Lower Extremity ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Pleura ; Uterus

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head* ; Humeral Fractures ; Humerus* ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve*

No abstract available.
Humans

No abstract available.
Humans

No abstract available.
Laparotomy* ; Sutures* ; Wound Infection* ; Wounds and Injuries*

No abstract available.
Biopsy, Fine-Needle* ; Melanoma*

Certain motion in the sports of volleyball can cause injury. For examples, excessive spiking, jumping, receiving and rolling may produce strain, sprain and stress fracture, etc. of all extremities and spine. The authors analized injuries of 160 Korean young women volleyball players treated and managed at Department of Orthopedic Surgery, National Police Hospital from September, 1973 to October, 1977. The results were as followings: 1. Of 160 cases, age distribution was ranged from 15 to 26 years and average was 20. 7 years. 2. Out of 495 injuries, 113 (23%) were upper extremities, 93 (19%) were lumbar and lumbosacral regions and 289(58%) were lower extremities. The most common site of injury was knee joint. 3. As to the ratio of the side, in the upper extremities 77% were in the right side and 23% in the left, but in the lower extremities both sides were nearly equal. 4. The injuries were composed of strain, sprain and the others, including stress fracture in 14, linear fracture of patella in 2, chip fracture of ulnar styloid process in 4, H.I.V.D. in 4 and meniscus tear in 6, etc.. 5. The injuries were supposed to be prevalent for the first one month after change from one to another team (14%). 6. The injury was usually more frequent in incidence among the exercise in winter and the heating in Gymnasium also one of the important factors to induce the injury, the injuries were less frequent at the good heating (40%). 7. It was concluded that the career of play did not affect significantly to incidence of the injury.
Age Distribution ; Athletic Injuries ; Extremities ; Female ; Fractures, Stress ; Heating ; Hot Temperature ; Humans ; Incidence ; Knee Joint ; Lower Extremity ; Lumbosacral Region ; Orthopedics ; Patella ; Police ; Spine ; Sports ; Sprains and Strains ; Tears ; Upper Extremity ; Volleyball

Systemic lupus erythematosus is a systemic disorder which has frequent involvement of gastrointestinal tract. Non specific symptoms such as anorexia, nausea, diarrhea and abdominal pain are well known symptoms when the gastrointestinal tract is involved. The most feared gastrointestinal complication of systemic lupus erythematosus is lupus enteritis. The pathological change in lupus enteritis is usually a result of mesenteric vasculitis. Major complications such as intestinal bleeding and perforation may occur and sometimes result in sugery. Because of high mortality rate in case of major complications, early diagnosis and appropriate treatment is very important. We experienced three patients with lupus enteritis who presented with severe abdominal pain and dirrhea. They were diagnosed by characteristic radiographical findings of small bowel series and barium study. All radiographical findings has been resolved completely with the steroid therapy. Conclusively we can induce complete remission by steroid therapy alone, if we diagnose lupus enteritis in the early period of disease course.
Abdominal Pain ; Anorexia ; Barium ; Diarrhea ; Early Diagnosis ; Enteritis* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Lupus Erythematosus, Systemic ; Mortality ; Nausea ; Vasculitis

Jehovah,s Witnesses who require operation represent a challenge to the physician because of the patient,s refusal to accept blood transfusion. An orthotopic heart transplantation was succesfully performed in a 40-year old Jehovah,s Witness without use of any blood product. During the operation, cell saver was used for shed blood and aprotinin was administered intravenously. The use of blood conserving methods, meticulous operative technique and brisk postoperative diuresis has added to the efficacy of heart transplantation in this patient. Total postoperative drainage was 860 ml and the lowest hemoglobin level was 11.8 g%. The patient recovered uneventfully and discharged on the 60th postoperative day.
Adult ; Anesthesia* ; Aprotinin ; Blood Transfusion ; Disulfiram ; Diuresis ; Drainage ; Heart Transplantation* ; Heart* ; Humans ; Transplantation