Clinical study has been carried out on the 80 consecutive cases of traumatic hyphema who had been admitted to Won-Kwang University Hospital for the 3 year period between March of 1985 and February of 1988. Based on these 80 patients, a clinical analysis was conducted as to the degree of bleeding, the time of arrival to hospital after injury, the frequency of rebleeding and the final visual acuity. The followings were the results. 1. Male patients were 67(83.8%) of 80 and the younger age group occupied more than half of all cases; 23(28.8%) in teenagers, 21(26.3%) in third decade. 2. There were varieties of trauma for hyphema such as stone blow(cases, 16.3%), fist(8 cases, 10.0%) and glass pieces(8 cases, 10.0%). 3. Grade I hyphema(bleeding less than one third of anterior chamber) was 45 cases(56.3%) of all. The associated ocular injuries were eyelids laceration (20 cases, 25.0%), angle recession(cases, 15.0%), corneal damage and iris sphinctor rupture(11 cases, 13.8%) and vitreous hemorrhage(10 cases, 12.5%). 4. Of 10 cases of rebleeding encountered in non-perforating group, nine was in Grade II hyphema(bleeding 1/3 and 1/2 of anterior chamber) and the bleeding was noted four to six days after initial trauma. 5. The final visual acuity of above 0.5 increased from 2.3% to 65.1% in Grade I hyphema, from 9.1% to 54.5% in Grade II huphema and from 0 to 36.4% in Grade III hyphema(bleeding more than one half of anterior chamber). 6. The major causes of impaired visual acuity were disorders of vitreous and retina(11 cases, 40.8%) and cataract(5 cases, 18.5%).
Adolescent ; Eyelids ; Glass ; Hemorrhage ; Humans ; Hyphema* ; Iris ; Lacerations ; Male ; Visual Acuity

No abstract available.
Acetazolamide* ; Aneurysm* ; Brain* ; Humans ; Perfusion* ; Subarachnoid Hemorrhage* ; Tomography, Emission-Computed, Single-Photon*

Although halothane is one of the most widely used inhalational anesthetics, it may cause postanesthetic complications such as halothane hepatitis. Halothane hepatitis has been reported lintermittently since 1958 with variable incidence. Changes in hepatic functions by halothane hepatitis are usually mild and reversible but they may be fatal it the patient had already shock, sepsis, massive blood transfusion, previous hepatic disease, hypoxia or induction of microsomal enzyme system. Hepatitis due to blood transfusion has high incidence especially in Korea where 10~20% of all population has vital hepatitis. Most of transfusion hepatitis is also mild but it may progress to chronic condition and eventually death. We experienced 2 cases of fulminant hepatitis after operation. Several factors such as massive whole blood transfusion, upper abdominal trauma, inhalational anesthetic agent, induction of microsomal enzyme system and shock might be attributed to development of the fulminant hepatitis.
Anesthetics ; Anoxia ; Blood Transfusion ; Halothane ; Hepatitis* ; Humans ; Incidence ; Korea ; Sepsis ; Shock

Isolated masseter spasm after succinylcholine administration is a rare abnormal response, but has been reported by a number of authors and is considered and early manifestation of malignant hyperpyrexia. We experienced a isolated masseter spasm after a small dose of succinylcholine administration in a facial palsy patient of central type due to brain tumor. It was likely that the intensity of this spasm was dose dependent to the amount of succinylcholine administration, and the spasm was prevented by pretreatment of nondepolarizing muscle relaxant. Anesthesia was performed safely for about 5 hours with nitrous oxide and halothane. We considered that this spasm was due to supersensitivity appearing at the denervated muscle.
Anesthesia ; Brain Neoplasms ; Facial Paralysis ; Halothane ; Humans ; Malignant Hyperthermia ; Nitrous Oxide ; Spasm ; Succinylcholine* ; Trismus*

A total of 132 cases of structural scoliosis have been followed since Jan. 1963 up to Dec. 1976 at the Hanyang University Hospital. The present paper classified scoliosis according to the etiology and analyzed curve patterns and spinal deformties such as rotation and wedging. Various kinds of treatment were done and these included Milwaukee brace, posterior spinal fusion with or without Harrington instrumentation. The end results of these treatment were also analyzed. The results concluded from the present studies were as follows: 1. Poliomyelitis was the most common cause of structural scoliosis. Of 132 cases of scoliosis, paralytic scoliosis was 48.5% while idiopathic scoliosis was 31.1% and congenital scoliosis 9.8%. 2. In paralytic scoliosis lumbar curves were the most common pattern and thoracic and thoracolumbar curves were the next. 3. In idiopathic scoliosis, the most common pattern was the right thoracic. 4. Very severe curves over 80° were more frequent in paralytic than in idiopathic scoliosis, showing the percentage of 20.3% in paralytic scoliosis and 10.3% in idiopathic scoliosis respectively. 5. The number of vertebrae involved in primary curve was approximately the same in both paralytic and idiopathic scoliosis. 6. In paralytic scoliosis, as the curves progressed, rotation of vertebrae became more marked in lumbar curve than in thoracic curve, while wedging deformity was more severe in thoracic curve than in Jumbar curve. 7. The tendency of the rotation and wedging in thoracic and lumbar curve was the same in both idiopathic scoliosis and paralytic scoliosis. When the degree of curves was the same, rotation and wedging were slightly more severe in idiopathic than in paralytic scoliosis. 8. In congenital scoliosis hemivertebrae were the most common anomaly and the majority of congenital anomalies were located at lumbar region. 9. Treated with Milwaukee brace, 22.1% of original curve angle was corrected in idiopathic coliosis, 9.8% in paralytic scoliosis, and 7.3% in congenital scoliosis, respectively. The Milwaukee brace was effective in thoracic and thoracolumbar curves but not in lumbar curves. 10. In paralytic scoliosis treated with posterior spinal fusion without Harrington instrumentation, the final degree was 43.2 and the correction loss was 12.6% but with both posterior fusion and Harrington instrumentation, the final degree was 50.2 and the correction loss was 6.8%. 11. There were 2 cases of complication after posterior spinal fusion without Harrington instrumentation. One was pseudarthrosis and the other was bending of graft with some loss of correction. One case of complication occured after posterior spinal fusion with Harrington instrumentation. It was a case of displacement of distraction hook on the rod.
Braces ; Clinical Study ; Congenital Abnormalities ; Lumbosacral Region ; Poliomyelitis ; Pseudarthrosis ; Scoliosis ; Spinal Fusion ; Spine ; Transplants

Pneumothorax was recognized as a potential hazard of mechanical ventilation after tracheal intubation. Excessive pressure the trachea during general anesthesia could produce lung rupture and pneumothorax. The incidence of pneumothorax has increased as a result of increased application of invasive diagnostic and therapeutic procedures. Emphysematous bleb rupture afterlaryngospasm, bronchospasm, or cough may be causes of pneumothorax. Tension pneumothorax during anesthesia is often difficult to diagnosis, but it needs prompt dignose and treatment. We experienced 3 cases of tension pneumothorax during and after general anesthesia.
Anesthesia ; Anesthesia, General* ; Blister ; Bronchial Spasm ; Cough ; Diagnosis ; Incidence ; Intubation ; Lung ; Pneumothorax ; Respiration, Artificial ; Rupture ; Trachea

No abstract available.
Animals ; Chiroptera* ; Korea* ; Murinae* ; Polymerase Chain Reaction* ; Puumala virus

BACKGROUND: Selective diagnostic blocks of the medial branches of the dorsal primary ramus are usually performed under the guidance of fluoroscopic or computed tomography. Recently, however, ultrasound guidance has been suggested as an alternative method. In this study, the distances between the vertebral structures were measured and compared with the values measured using magnetic resonance imaging (MRI) to assess the clinical feasibility of using ultrasound-guided block in Korean patients. METHODS: Five male and 15 female patients were enrolled in this study. The target point of the medial branch block in our study was the groove at the base of the superior articular process. We measured the depth from the skin to the target point at the transverse process (d-TP) and to the most superficial point of the superior articular process (d-AP). RESULTS: The d-TP and d-AP values measured under ultrasound guidance were concordant with the values measured using MRI. CONCLUSIONS: The images of the bony landmarks obtained under ultrasound examination could be useful for ultrasound-guided lumbar medial branch block.
Female ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Skin ; Ultrasonography ; Zygapophyseal Joint

BACKGROUND: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. METHODS: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients' baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of 26.1±16.7 months. RESULTS: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. CONCLUSION: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.
Bronchiolitis Obliterans ; Cause of Death ; Chungcheongnam-do ; Demography ; Follow-Up Studies ; Heart ; Heart-Lung Transplantation* ; Hope ; Humans ; Korea ; Liver Transplantation ; Lung ; Lung Diseases ; Mortality ; Postoperative Complications ; Shock, Septic ; Survival Rate ; Tissue Donors

Subcutaneous emphysema can occur as the result of trauma, surgical procedure and anesthetic complication. As increasing numbers of laparoscopic procedures are performed, increasing numbers of complications directly related to laparoscopy will occur. A case is presented of subcutaneous emphysema without pneumothorax or pneumomediastinum during laparoscopic cholecystectomy in difficultly intubated patient. The cause is suspected of inadvertent subcutaneous insufflation of carbon dioxide during the initial Verres needle puncture for the establishment of pneumoperitoneum. Etiology and evaluation of subcutaneous emphysema possibly associated with this case are reviewed.
Carbon Dioxide ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Emphysema ; Humans ; Insufflation ; Laparoscopy ; Mediastinal Emphysema ; Needles ; Pneumoperitoneum ; Pneumothorax ; Punctures ; Subcutaneous Emphysema*