Authors reviewed mammographic ultrasonographic and MRI findings a patient with breast cysticerocosis, which was operated and pathologically proved. Mammography showed a 1 cm sized round radioopaque lesion with curvilinear calification, which was located near the pectoralis major muscle. Ultrasonograiphic findings showed heterogenous hypoechoic cystic lesion with internal hyperechoic nodule and posterior acoustic shadowing. T2Wl and proton density MR image showed low signal intensity with cresentic high signal intensity portion. 2D-FLASH dynamic MRI showed intermediate signal intensity and peripheral signal void area, which was not enhanced with Gd-DPTA. The possibility of cysticercosis can be considered be considered when a cytic lesion is discovered near the pectoralis muscle in a patient living in an endemic area.
Acoustics ; Breast* ; Cysticercosis* ; Humans ; Magnetic Resonance Imaging ; Mammography ; Pectoralis Muscles ; Protons ; Shadowing (Histology)

No abstract available.
Oocytes* ; Pregnancy* ; Spermatozoa*

No abstract available.
Cardiomyopathy, Hypertrophic* ; Humans ; Infant* ; Mothers*

BACKGROUND: Explicit recall in a cesarean section under general anaesthesia can be a terrifying experience and may cause psychological sequelae. Administering low doses of midazolam, we investigated the changes of the bispectral index (BIS) and the occurrence of explicit recall of specific events after fetal expulsion in a cesarean section under general anesthesia. METHODS: The investigation was carried out on 30 ASA 1 or 2 parturients who underwent a cesarean section under general anesthesia. Anesthesia was maintained with 50% N2O in oxygen and 0.75% of isflurane. We randomly allocated parturients into a control group (n = 10), group A (n = 10), and B (n = 10). Neither midazolam nor any other drugs except oxytocin were administered in the control group. In the group A and B, midazolam 0.02 and 0.03 mg/kg respectively, were injected immediately after umbilical cord clamping. An isolated forearm test were done to all the parturients at 5, 10, and 20 minutes after fetal expulsion. We assessed the changes of the BIS at 1, 2, 3, 4, 5, 10, 15, and 20 minutes after fetal expulsion, at discontinuance of isoflurane administration and extubation. The wav file, "clench your left or right hand" was binaurally played, simultaneously with the isolated forearm test. The wav file, "one, two, three, four, five" was also binaurally played 15 minutes after fetal expulsion. We interviewed all the parturients the next day and assessed the occurrence of explicit recall. RESULTS: The BIS values after fetal expulsion in the control group and group A was maintanied above 60 and group B, below 60 (P < 0.05). The lowest median BIS value was 54.5 in the group A, 36.4 in the group B (P < 0.05). There were two parturients in the control group and in the group A, respectively, who showed explicit recall. The results of the isolated forearm test were negative for all groups. The extubation times and PAR scores failed to show significant differences among the three groups. CONCLUSIONS: The authors confirmed the occurrence of explicit recall for specific events after fetal expulsion. The BIS values after fetal expulsion could be maintained below 60 until the end of surgery,and explicit recall could be prevented when we injected midazolam 0.03 mg/kg immediately after fetal expulsion.
Anesthesia ; Anesthesia, General* ; Cesarean Section* ; Constriction ; Female ; Forearm ; Isoflurane ; Midazolam* ; Oxygen ; Oxytocin ; Pregnancy ; Umbilical Cord

BACKGROUND: In some cases of one-lung ventilation (OLV), hypoxemia may occur secondarily to the obligatory right to left transpulmonary shunt through the collapsed lung. We investigated the efficacy of high frequency jet ventilation (HFJV) to the non-dependent lung which rendered to be manually collapsed by surgeon and not to be reinflated, in improving systemic oxygenation and ventilation during OLV while ventilating the dependent lung with intermittent positive pressure ventilation. METHODS: Investigation was carried out on 20 ASA 2 or 3 patients who underwent thoracotomy in lateral decubitus position. The patients were randomly allocated into HFJV group (n = 11) or CPAP group (n = 9). In HFJV group, 20 minutes after OLV began, HFJV with driving pressure 1.0 bar, Ti 30%, and frequency 150 cycles/min, was applied to the non-dependent lung. In CPAP group, 5 cmH2O of CPAP was applied to the non-dependent lung without re-inflation. We compared the changes of PaO2, PaCO2, AaDO2 and pulmonary shunt, before and after HFJV or CPAP was applied to the non-dependent lung during OLV. RESULTS: AaDO2 and pulmonary shunt were decreased significantly and therefore, PaO2 was increased significantly when HFJV was applied to the non-dependent lung (P < 0.05, respectively). PaO2, AaDO2 and pulmonary shunt were not improved after 5 cmH2O of CPAP was applied to the non-dependent lung without re-inflation. In HFJV group, PaCO2 measured after HFJV was not decreased significantly compared with that before HFJV. CONCLUSIONS: HFJV to the non-dependent lung during OLV improved systemic oxygenation, even after the non-dependent lung collapsed completely but did not enhance CO2 elimination. 5 cmH2O of CPAP to the non-dependent lung, which was completely collapsed and not re-inflated, did not improve systemic oxygenation.
Anoxia ; High-Frequency Jet Ventilation* ; Humans ; Intermittent Positive-Pressure Ventilation ; Lung* ; One-Lung Ventilation* ; Oxygen* ; Thoracotomy ; Ventilation

BACKGROUND: As the clinical-end point is not clear-cut in conscious sedation, there are no objective and feedback-providing methods to assess the depth of sedation within the levels appropriate for conscious sedation. METHODS: The investigation was carried out on 19 ASA PS 1 patients. The authors developed a system to measure the reaction time to visual (red colored flash, 40 lux for 30 msec) and auditory (beep, 1,000 Hz, 67.5 dB for 30 msec) stimulations. The authors confirmed the beeps to be audible to all the patients before the test began. When they perceived a visual or auditory stimulation, the authors instructed the patients to signal by pushing a button as soon as possible. The reaction time was defined as the time from the beginning of stimulation to the push of a button. The patients were gradually sedated with propofol TCI. The authors measured the visual and auditory reaction time and BIS after every 0.1 microgram/ml increment of the effect site concentration of propofol. RESULTS: As the effect site concentration of propofol increased, the reaction time to visual and auditory stimulations tended to be prolonged (P < 0.0001, respectively). The estimate was 409 and 498, respectively, which means the slope a in y = ax; x means unit change of the effect site concentration of propofol; y means the estimated values of the reaction time. The BIS values at loss of response to visual and auditory stimulations were 86 +/- 7 and 78 +/- 7 (mean +/- SD). CONCLUSIONS: The responses to visual and auditory stimulations were prolonged and ultimately abolished as the effect site concentration of propofol increased. The loss of response to visual stimulations preceded the loss of response to auditory stimulations. The BIS values at loss of responses to visual and auditory stimulations suggested light and moderate sedation, respectively.
Acoustic Stimulation ; Conscious Sedation* ; Humans ; Photic Stimulation ; Propofol* ; Reaction Time*

BACKGROUND: Pain on injection of propofol is a common problem, the cause of which remains unKnown. We evaluated the optimum time of a tourniquet with intravenous lidocaine, to decrease the intensity of pain during intravenous propofol injection. METHODS: In 72 patients undergoing general anesthesia, we subdivided all patients into 4 groups. Patients in group 1 (n = 18) received propofol only (1 mg/Kg IV) without a tourniquet, patients in group 2 (n = 18) received 1% lidocaine 20 mg IV with an upper arm tourniquet inflated to 50 mmHg applied for 1 minute followed by propofol (1 mg/Kg IV). We applied a tourniquet to patients in group 3 (n = 18) and 4 (n = 18) for 3 minutes and 5 minutes respectively. The intensity of pain along the forearm was classified in 4 degrees (none, mild, moderate, severe) by the patients and the observer simultaneously. The mean arterial pressure and heart rate were recorded before injection and at the time when the patient complained of pain. RESULTS: All groups were similar in age, sex, weight and height. The group with the tourniquet applied for 5 minutes followed by a lidocaine injection showed the lowest intensity of pain. However, between the group with 3 minutes and 5 minutes, the difference of the pain score was not statistically significant. CONCLUSIONS: We conclude that intravenous lidocaine administered after a tourniquet has been inflated to 50 mmHg for 3 minutes before propofol injection attenuates profoundly the pain associated with intravenous propofol injection.
Anesthesia, General ; Arm ; Arterial Pressure ; Forearm ; Heart Rate ; Humans ; Lidocaine* ; Propofol* ; Tourniquets*

Hydranencephaly is congenital absence of the cerebral hemispheres which are replaced by a large fluid-filled cavity. The brain stem and basal ganglia are well formed and rudiments of frontal k occipital cortex may be present. We experienced a case of hydranencephaly caused by both internal carotid artery stenosis. We diagnosed it through the brain CT sonogram and doppler sonogram. A brief review of the related literatures was made.
Basal Ganglia ; Brain ; Brain Stem ; Carotid Artery, Internal* ; Carotid Stenosis* ; Cerebrum ; Hydranencephaly*

The purpose of the present study lied in examining the incidence, treatment and failure causes of peri-implantitis by analyzing medical charts of those patients who underwent implant placement for the past 2 years. The subjects included those patients who underwent implant placement at the present hospital from January 2001 to December 2002. 3i implants were used for the analysis for the comparison of significance. A total of 301 patients were examined, among whom 102 were females and 199, males. Implants were placed in a total of 578 cases. The number of peri-implantitis was present in a total of 29 cases (21 males and 8 females), giving the incidence at 9.6%. The evidence of peri-implantitis was seen in 60 cases, which was in 10.4% of the patients. Among those cases with peri-implantitis, 28 cases (47%) underwent bone graft and 22 cases (43%) underwent maxillary sinus lift. Furthermore, 4 of these patients had systemic diseases such as diabetes or hypertension. Regular management is important for the preven ion of peri-implantitis. In other words, early prevention through regular follow-ups to check the status of surrounding soft tissue would be needed to maintain implants.
Female ; Humans ; Hypertension ; Incidence ; Male ; Maxillary Sinus ; Peri-Implantitis* ; Retrospective Studies* ; Transplants

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development