No abstract available.

Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in infants. Life-threatening RSV infection is often reported in young children and immunocompromised hosts. Since there is no report on ribavirin therapy for RSV pneumonia in pediatric cancer patients in Korea, we report one case of RSV pneumonia that developed in an infant with acute lymphoblastic leukemia (ALL). Despite administration of oral ribavirin and intravenous immunoglobulin, the patient's respiratory distress worsened and admission to an intensive care unit was necessary. Chest x-ray showed multifocal consolidation, pneumothorax, and pneumomediastinum. Treatment with aerosolized ribavirin led to significant clinical improvement. The role of aerosolized ribavirin is still controversial, but it might have a therapeutic potential for severe RSV pneumonia in children with leukemia.
Child ; Humans ; Immunocompromised Host ; Immunoglobulins ; Infant ; Intensive Care Units ; Korea ; Leukemia ; Mediastinal Emphysema ; Pneumonia ; Pneumothorax ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Ribavirin ; Thorax

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming a standard method for invasive mediastinal staging and for the diagnosis of paratracheal and peribronchial lesions. It is essential to understand the technical aspects of EBUS-TBNA to ensure safe and efficient procedures. In this review, we discuss the practical aspects to be considered during EBUS-TBNA, including anesthesia, manipulation of equipment, understanding mediastinal ultrasound images, target selection, number of aspirations needed per target, sample handling, and complications.
Anesthesia ; Aspirations (Psychology) ; Bronchoscopy ; Handling (Psychology) ; Lung Neoplasms ; Needles* ; Ultrasonography

No abstract available.
Gram-Positive Bacterial Infections* ; Teicoplanin*

Clinical study was done on 119 patients with atrial fibrillation in the aspect of underlying diseases, particulary. The results were as follow : 1) In the underlying diseases of atrial finbrillation, rheumatic heart disease, hepertension and ischemic heart disease were common, which occupied 27.8%, 22.7% and and 15.1%, respectly. No apparent underlying disease was found in 21.0%, but in the transient atrial fibrillation, no apparent underlying disease in 42.9%. 2) There were no significant correlations between the ventricular rate, amplitude of f wave and underlying diseases of atrial fibrillation. 3) Complications were found in 29.4% of all cases, such as congestive heart failure(22.7%), embolism(6.7%). Otherwise, atrial fibrillation without underying cardiovascular diseases, congestive heart failure was found only(7.7%).
Atrial Fibrillation* ; Cardiovascular Diseases ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Humans ; Myocardial Ischemia ; Rheumatic Heart Disease

Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal tumors of the digestive tract. They have been commonly observed in adults but have been rarely described in children. They arise typically from the intestinal wall and rarely in the mesentery, omentum, or retroperitoneum. GISTs originate from the interstitial cell of Cajal and are characterized by overexpression of the receptor tyrosine kinase c-kit. Up to 94% of these tumors express the CD117 on immunohistochemical stain. Surgery is the main modality of treatment for primary resectable GIST. Completely resectable GIST with low risk has excellent prognosis after primary surgical intervention, with over 90% of the 5-year survival. We report a case of 10-year-old girl presenting with an upper gastrointestinal bleeding caused by gastrointestinal stromal tumor.
Adult ; Child* ; Female ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Mesentery ; Omentum ; Prognosis ; Protein-Tyrosine Kinases

BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE* ; Cardiovascular System ; Complement System Proteins ; Critical Care* ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units* ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

No abstract available.
Lymphoma, Large-Cell, Anaplastic

Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a variant presentation of severe preeclampsia/eclampsia. A 24-year old woman presented herself at 34 wk of pregnancy. Based on the clinical and laboratory assessment, HELLP syndrome was diagnosed. Cesarean section was performed under general anesthesia without invasive monitoring due to stable blood pressure. The course of anesthesia and surgery was uneventful and she delivered female neonate weighing 1770 gram. After the operation, the patient was transferred to the intensive care unit immediately. During the intensive care bleeding started and signs of disseminated intravascular coagulopathy showed up. Any improvement was not made after transfusion and every other supportive therapy. By the request of guardian, she was transferred to tertiary hospital, where she died.
Anesthesia* ; Anesthesia, General ; Anesthesia, Obstetrical ; Blood Pressure ; Cesarean Section* ; Female ; HELLP Syndrome* ; Hemolysis ; Hemorrhage ; Humans ; Infant, Newborn ; Critical Care ; Intensive Care Units ; Liver ; Pregnancy ; Tertiary Care Centers ; Young Adult

BACKGROUND: The recovery of spontaneous ventilation is delayed in elderly patients in whom muscle relaxants has been administered for general anesthesia. We evaluated the appropriateness of microscopic cataract surgery without using muscle relaxants in elderly patients. METHODS: Forty two ASA physical status I and II patients for cataract surgery were randomly assigned to two groups. Glycopyrrolate 0.2 mg, fentanyl 2 mcg/kg and propofol 2 mg/kg were administered intravenously followed by vecuronium 1 mg/kg iv in group I and 10% lidocaine 1.5 mg/kg spray into oropharynx in group II. Laryngeal mask (LMA) was inserted for airway management and anesthesia was maintained by only propofol infusion in both groups. Whether the patient moved during the surgery, whether ephedrine was administered and the propofol infusion rate were recorded. RESULTS: Six patients of group I and 1 patient of group II were moved during surgery. Only in group II, 7 patients received intravenously ephedrine administration. Mean infusion rate of propofol was 0.114 mg/kg/min in group I and 0.159 mg/kg/min in group II. CONCLUSION: In general anesthesia for microscopic cataract surgery, the combination of fentanyl 2 mcg/kg, propofol 2 mg/kg and infusion, 10% lidocaine spray and laryngeal mask without muscle relaxants is a good alternate method of keeping airway.
Aged ; Airway Management ; Anesthesia* ; Anesthesia, General ; Cataract* ; Ephedrine ; Fentanyl ; Glycopyrrolate ; Humans ; Laryngeal Masks ; Lidocaine ; Oropharynx ; Propofol ; Vecuronium Bromide ; Ventilation