No abstract available.
Female ; Nifedipine* ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine*

Tracheobronchopathia osteochondroplastica is a rare and usually benign disorder characterized by cartilaginous and/or osseous submucosal nodules projecting into the laryngotracheobronchial lumen. It has been an incidental finding at autopsy but nowadays it is discovered during fiberoptic bronchoscopy or chest computed tomography. We describe a case of 61-year-old man who was diagnosed to have tracheobronchopathia osteochondroplastica due to unpredicted difficult intubation.
Autopsy ; Bronchoscopy ; Humans ; Incidental Findings ; Intubation ; Middle Aged ; Thorax

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

This case report describes the treatment of a 23-year, 8-month-old female patient with a Class II malocclusion who showed severe bidentoalveolar protrusion and anterior crowding. The treatment plan consisted of extracting all the first premolars, decrowding and en masse retraction of the upper six anterior teeth and lower anteriors. The upper C-plate placed in the midpalatal area combined with lingual sheath fixtures were used as substitutes for posterior anchorage teeth during upper anterior retraction. Preadjusted brackets (0.022-inch) were used for upper anterior decrowding. A 0.9 mm diameter stainless steel lever-arm soldered to the main arch wire facilitated controlled retraction of upper anteriors. The upper and lower dentition was detailed using a tooth positioner during the finishing stage. Correct overbite and overjet were obtained by decrowding and retraction of the upper six anterior teeth into their proper positions. Use of the C-plate and lingual appliances provided ideal anchorage to enhance the improvement in facial balance. The active treatment period was 19 months. The treatment result was stable 13 months after debonding.
Bicuspid ; Crowding ; Dentition ; Female ; Humans ; Infant ; Malocclusion ; Overbite ; Stainless Steel ; Tooth

PURPOSE: To investigate the in vitro effects of Dehydroepiandrosterone (DHEA)-pyruvate on human osteoarthritic chondrocytes. METHODS: Chondrocytes isolated from human osteoarthritic knee cartilage were three-dimensionally cultured in Alginate beads. Cells were treated with dehydroepiandrosterone in the presence or absence of IL-1. The effects on chondrocytes were analyzed by MTS assay (for chondrocytes proliferation), DMB assay (for glycosaminoglycan synthesis), and indole assay (for DNA amount). Gene expressions of MMP-1,3, TIMP-1 as well as IL-1 induced gene expression of MMP-1, 3 were analyzed using RT-PCR. The protein synthesis of MMP-1,3 and TIMP-1 was determined by ELISA. RESULTS: Treatment of chondrocytes with DHEA-pyruvate did not affect chondrocytes proliferation regardless of concentrations when compared with control. GAG synthesis was not changed significantly during culture period regardless of concentrations. DHEA-pyruvate suppressed the expression of MMP-1 significantly at a concentration of 50 micrometer and above. The gene expression of MMP-3 was also suppressed. The expression of TIMP-1 was significantly increased by DHEA-pyruvate at concentration of 50 micrometer. The effects of DHEA-pyruvate were also prominent in the presence of IL-1, in which IL-1induced gene expressions of not only MMP-1, but also MMP-3 were suppressed at a lower concentration of 10 micrometer and 50 micrometer, respectively. In enzyme activity measurement, the results came in line with the results obtained by RT-PCR, which means DHEA-pyruvate influences on the gene transcription level. CONCLUSION: Our study clearly demonstrated that DHEA-pyruvate has the ability to modulate the imbalance between MMPs and TIMP-1 during osteoarthritis at the transcription level, suggesting its protective role against loss of articular cartilage.
Cartilage ; Cartilage, Articular ; Chondrocytes* ; Dehydroepiandrosterone ; DNA ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans* ; Interleukin-1 ; Knee ; Matrix Metalloproteinases ; Osteoarthritis ; Tissue Inhibitor of Metalloproteinase-1

Traumatic bilateral abducens nerve palsy is rare and is associated with intracranial, skull and cervical spine injuries. We report a case of bilateral abducens nerve palsy in a 40-month-old patient with a skull base fracture. The injury mechanism was associated with direct nerve injury caused by a right petrous bone fracture and indirect injury by frontal impact on the abducens nerve at the point of fixation to the petrous portion and Dorello`s canal. The emergency physician should be aware of injuries and the mechanism of abducens nerve palsy in head trauma.
Abducens Nerve ; Abducens Nerve Diseases ; Craniocerebral Trauma ; Emergencies ; Humans ; Petrous Bone ; Preschool Child ; Skull ; Skull Base ; Spine

No abstract available.
Autoantibodies* ; Humans*

BACKGROUND: Postoperative pain control is provided for humanitarian reasons and to alleviate nociception-induced responses, such as endocrine metabolic responses, autonomic reflexes, which have adverse effects on organ function, and other undesirable results. Of the various methods of treatment, patient-controlled analgesia (PCA) is considered the gold standard for the of control postoperative pain. PCA can be administered via intraveous, epidural, or subcutaneous routes. Although patient-controlled epidural analgesia (PCEA) has been compared to IV-PCA, there is no optimal administrative route for the treatment of postoperative pain. This randomized study compared the effectiveness of PCEA and IV-PCA on postoperative pain and the side-effects after gynecologic surgery. METHODS: Ninety-seven patients undergoing gynecologic surgery were randomly assigned to receive either IV-PCA using a mixture of morphine and ketorolac or PCEA using 0.1% bupivacaine and morphine. Pain intensity was tested using a visual analog scale (VAS) until postoperative day 2. Nausea, vomiting, sedation, and pruritus were also measured. RESULTS: Among the 97 patients, 12 patients were excluded during study. Pain relief was better at rest and after coughing in the PCEA group during the 2 postoperative days, except at the first visit. Additional analgesics were used significantly less in the PCEA group, whilst the incidence of other complications was comparable in the IV-PCA and PCEA groups. CONCLUSIONS: After gynecologic surgery, PCEA using bupivacaine and morphine provides better pain relief than IV-PCA using morphine and ketorolac.
Analgesia, Epidural ; Analgesia, Patient-Controlled* ; Analgesics ; Bupivacaine ; Cough ; Female ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Ketorolac ; Morphine ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Pruritus ; Reflex ; Visual Analog Scale ; Vomiting

PURPOSE: Recently, the use of radiosurgery as a local therapy in patients with early stage non-small cell lung cancer has become favored over surgical resection. To evaluate the efficacy of radiosurgery, we analyzed the results of stereotactic body radiosurgery in patients with primary or recurrent non-small cell lung cancer. MATERIALS AND METHODS: We reviewed medical records retrospectively of total 24 patients (28 lesions) with non-small cell lung cancer (NSCLC) who received stereotactic body radiosurgery (SBRT) at Inha University Hospital. Among the 24 patients, 19 had primary NSCLC and five exhibited recurrent disease, with three at previously treated areas. Four patients with primary NSCLC received SBRT after conventional radiation therapy as a boost treatment. The initial stages were IA in 7, IB in 3, IIA in 2, IIB in 2, IIIA in 3, IIIB in 1, and IV in 6. The T stages at SBRT were T1 lesion in 13, T2 lesion in 12, and T3 lesion in 3. 6MV X-ray treatment was used for SBRT, and the prescribed dose was 15~60 Gy (median: 50 Gy) for PTV1 in 3~5 fractions. Median follow up time was 469 days. RESULTS: The median GTV was 22.9 mL (range, 0.7 to 108.7 mL) and median PTV1 was 65.4 mL (range, 5.3 to 184.8 mL). The response rate at 3 months was complete response (CR) in 14 lesions, partial response (PR) in 11 lesions, and stable disease (SD) in 3 lesions, whereas the response rate at the time of the last follow up was CR in 13 lesions, PR in 9 lesions, SD in 2 lesions, and progressive disease (PD) in 4 lesions. Of the 10 patients in stage I, one patient died due to pneumonia, and local failure was identified in one patient. Of the 10 patients in stages III-IV, three patients died, local and loco-regional failure was identified in one patient, and regional failure in 2 patients. Total local control rate was 85.8% (4/28). Local recurrence was recorded in three out of the eight lesions that received below biologically equivalent dose 100 Gy10. Among 20 lesions that received above 100 Gy10, only one lesion failed locally. There was a higher recurrence rate in patients with centrally located tumors and T2 or above staged tumors. CONCLUSION: SBRT using a CyberKnife was proven to be an effective treatment modality for early stage patients with NSCLC based on high local control rate without severe complications. SBRT above total 100 Gy10 for peripheral T1 stage patients with NSCLC is recommended.
Carcinoma, Non-Small-Cell Lung ; Follow-Up Studies ; Humans ; Lung ; Medical Records ; Pneumonia ; Radiosurgery ; Recurrence ; Retrospective Studies

BACKGROUND: Remifentanil is a novel, ultra-short acting opioid. This study was performed to compare the hemodynamic responses of remifentanil and nitrous oxide under propofol-based anesthesia during the intraoperative period. METHODS: Forty patients undergoing gynecologic surgery were randomly allocated to either remifentanil (R group) or N2O group (N group). In the R group, remfentanil was continuously infused from the induction of anesthesia (0.5 microgram/kg/min) to the end of surgery (0.1-0.5 microgram/kg/min). In the N group, fentanyl (2 microgram/kg) was injected intravenously and N2O was used thereafter. In both groups, target-concentration infusion of propofol was applied. We compared mean arterial pressure (MAP) and heart rate (HR) before and after tracheal intubation and during the rest of anesthetic time between the two groups. Postoperative parameters such as nausea/vomiting, consciousness level and pain at 2 and 24 hours were also compared. RESULTS: The magnitude of MAP and HR after tracheal intubation were significantly smaller and more stable in the R group than in the N group. Hypertensive (systolic blood pressure > 140 mmHg) episodes were significantly less frequent in the R group (3.0%) than in the N group (12.4%) during the operation. R group showed less MAP (76+/-12 mmHg) and HR (61+/-10 bpm) compared with those of N group (86+/-17 mmHg, 63+/-8 bpm, P < 0.05 respectively). Other postoperative measures were comparable between the two groups. CONCLUSIONS: We conclude that the continuous infusion of remifentanil can provide more stable hemodynamic status than N2O without significant adverse effects, in propofol-based general anesthesia.
Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics ; Humans ; Intraoperative Period ; Intubation ; Nitrous Oxide ; Propofol