A 17-year-old high School boy showed multiple, various sized, grayish or violaceous scaly verrucous plaques on the entire body including the oral mucosa, both soles and palms. We considered this is the first case that involves entire body including the oral mucosa, both soles and palms in dermatologic literatures. We reported this case and reviewed briefly literature
Adolescent ; Humans ; Lichen Planus* ; Lichens* ; Male ; Mouth Mucosa

Cortex mori (Morus alba L.: Sangbaikpi), the root bark of mulberry tree, has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine. Previous studies have demonstrated that the phenolic extract of Cortex mori have hypotensive, hypoglycemic, antifungal, antiviral, antiinflammatory, and anticancer effects, and the hot water extract from Cortex mori has inhibitory effects on compound 48/80- induced mast cell degranulation and histamine release from rat peritoneal mast cells (RPMCs). This study was perforrned to investigate the effects of polysaccharide fraction from Cortex mori (PFCM) on compound 48/80-induced degranulation, histamine release, calcium influx, changes of intracellular cAMP and cGMP level, and morphological changes of RPMCs. The results were summarized as follows. 1) Compound 48/80-induced cytomorphological changes such as swelling, degranulation, intracellular vacuoles, and interrupted cell boundary were significantly inhibited by pretreatment with either hot water or polysaccaride fractions frorn Cortex mori (PFCM), 2) the compound 48/80-induced histamine release from RPMCs pretreated with PFCM was significantly inhibited, compared to that of control without PFCM pretreatment, 3) the PFCM inhibited remarkably the compound 48/80-induced calcium influx into the RPMCs, 4) the PFCM increased significantly the intracellular cAMP levels and decreased the intracellular cGMP levels of RPMCs, compared to those of normal control, and 5) the compound 48/80-induced cAMP levels of RPMCs pretreated with PFCM were significantly increased, compared to those of positive control without PFCM, and the compound 48/80-induced cGMP levels of RPMCs pretreated with PFCM were remarkably decreased, compared to those of positive control without PFCM. From the above results, it is suggested that PFCM have an activity to inhibit the compound 48/80-induced mast cell activation.
Animals ; Calcium ; Herbal Medicine ; Histamine Release ; Mast Cells* ; Morus ; Phenol ; Rats ; Trees ; Vacuoles ; Water

A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.
Adenocarcinoma ; Aged ; Anemia ; Angina, Unstable ; Chest Pain ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Gastrectomy* ; Hemorrhage ; Humans ; Male ; Physical Examination ; Stomach Neoplasms ; Transplants

BACKGROUND: This study was performed to investigate the outcomes of vascular operations that were done in patients with atheroscerosis obliterans (ASO) of lower limb. MATERIAL AND METHOD: Forty patients underwent vascular operations from December 1996 to June 2004. The patient's records were analyzed retrospectively. Mean age was 66+/-8 years (range, 47~81 years). Gender ratio was 37:3 (male:female). RESULT: The operations were done on 50 lower limbs of 40 patients. The names of operations were femoropopliteal bypass in 12 patients (30%), femorofemoral bypass in 12 (30%), femorofemoral bypass and femoropopliteal bypass in five (12.5%), aorta-lower limb artery bypass in five (12.5%), axillofemoral bypass in two (5%), iliopopliteal bypass in two (5%), and endarterectomy in two (5%). All bypass surgeries were done with prosthetic conduits. Mean follow up period was 33.2+/-23.2 months (range, 3.8~90.2 months). The cumulative patency rates of 1 and 5 years were 75.5 and 58.7% respectively. In six patients, amputation of the lower limb was done. In eight patients, 12 complications occurred. After the first operation, 10 patients underwent reoperations. CONCLUSION: Our lower limb arterial bypass surgery revealed acceptable patency rate, but not a few patients required reoperations. An epochal treatment modality that can inhibit the progress of ASO and improve long term patency should be established.
Amputation ; Arteries ; Atherosclerosis* ; Endarterectomy ; Extremities ; Follow-Up Studies ; Humans ; Lower Extremity* ; Retrospective Studies

OBJECTIVE: Using Lee et al (1996) model, we assessed the effect of opioid within the PAG on the manifestations of the neuropathic pain, and we studied the effects of naloxone on the analgesic effects of opioid. METHOD: Under pentobarbital anesthesia, male Sprague-Dawley rats were implanted with cannula in the ventral (n=10) and dorsal (n=6) PAG after the unilateral tibial and sural nerves were ligated and cut, leaving the common peroneal nerve intact. Pain sensitivity was assessed using the von Frey filament (8 mN) and acetone applied to the sensitive area for 1 week postoperatively. Rats with neuropathic pain were intracerebrally microinjected with DAMGO (0.1microgram/5microliter) and enkephaline (20microgram/5microliter) into the ventral and dorsal PAG and the pain sensitivity was assessed. Naloxone was injected to assess the observed change of pain sensitivity. RESULTS: Intracerebral microinjection of DAMGO and enkephaline into the ventral PAG, but not the dorsal PAG, increased the pain threshold which was reversed by naloxone. CONCLUSION: The results suggest that stimulation of the ventral PAG in neuropathic rats may reduce neuropathic pain via opioid-mediating pathway of the descending pain inhibition system.
Acetone ; Anesthesia ; Animals ; Catheters ; Enkephalin, Ala(2)-MePhe(4)-Gly(5)- ; Enkephalins ; Humans ; Male ; Microinjections ; Naloxone ; Neuralgia* ; Pain Threshold ; Pentobarbital ; Periaqueductal Gray* ; Peroneal Nerve ; Rats* ; Rats, Sprague-Dawley ; Sural Nerve

The purpose of this study is to identify the prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit (ICU). Methods: A retrospective descriptive correlational study design was used. Among 675 older adults who admitted to ICU after cardiac surgery in a tertiary hospital from May 2021 to April 2022, 528 were selected for data analysis. Data were collected through electronic medical records. Delirium and pain intensity were evaluated using the Confusion Assessment Method-Intensive Care Unit and Critical Care Non-verbal Pain Scale, respectively. Results: The incidence rate of delirium was 41.3% (n=218). Multivariate logistic regression analysis of the variables identified that ICU length of stay (odds ratio [OR]=1.77, p<.001), anesthesia time (OR=1.21, p=.016), pain intensity (OR=1.14, p=.044), and age (OR=1.07, p=.002) were identified as risk factors of delirium after cardiac surgery. Conclusion: ICU length of stay, anesthesia time, pain score, and advanced age should be considered as the prevention and management of delirium at the intensive care unit of older adults after cardiac surgery.

The purpose of this study is to identify the prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit (ICU). Methods: A retrospective descriptive correlational study design was used. Among 675 older adults who admitted to ICU after cardiac surgery in a tertiary hospital from May 2021 to April 2022, 528 were selected for data analysis. Data were collected through electronic medical records. Delirium and pain intensity were evaluated using the Confusion Assessment Method-Intensive Care Unit and Critical Care Non-verbal Pain Scale, respectively. Results: The incidence rate of delirium was 41.3% (n=218). Multivariate logistic regression analysis of the variables identified that ICU length of stay (odds ratio [OR]=1.77, p<.001), anesthesia time (OR=1.21, p=.016), pain intensity (OR=1.14, p=.044), and age (OR=1.07, p=.002) were identified as risk factors of delirium after cardiac surgery. Conclusion: ICU length of stay, anesthesia time, pain score, and advanced age should be considered as the prevention and management of delirium at the intensive care unit of older adults after cardiac surgery.

The purpose of this study is to identify the prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit (ICU). Methods: A retrospective descriptive correlational study design was used. Among 675 older adults who admitted to ICU after cardiac surgery in a tertiary hospital from May 2021 to April 2022, 528 were selected for data analysis. Data were collected through electronic medical records. Delirium and pain intensity were evaluated using the Confusion Assessment Method-Intensive Care Unit and Critical Care Non-verbal Pain Scale, respectively. Results: The incidence rate of delirium was 41.3% (n=218). Multivariate logistic regression analysis of the variables identified that ICU length of stay (odds ratio [OR]=1.77, p<.001), anesthesia time (OR=1.21, p=.016), pain intensity (OR=1.14, p=.044), and age (OR=1.07, p=.002) were identified as risk factors of delirium after cardiac surgery. Conclusion: ICU length of stay, anesthesia time, pain score, and advanced age should be considered as the prevention and management of delirium at the intensive care unit of older adults after cardiac surgery.

The purpose of this study is to identify the prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit (ICU). Methods: A retrospective descriptive correlational study design was used. Among 675 older adults who admitted to ICU after cardiac surgery in a tertiary hospital from May 2021 to April 2022, 528 were selected for data analysis. Data were collected through electronic medical records. Delirium and pain intensity were evaluated using the Confusion Assessment Method-Intensive Care Unit and Critical Care Non-verbal Pain Scale, respectively. Results: The incidence rate of delirium was 41.3% (n=218). Multivariate logistic regression analysis of the variables identified that ICU length of stay (odds ratio [OR]=1.77, p<.001), anesthesia time (OR=1.21, p=.016), pain intensity (OR=1.14, p=.044), and age (OR=1.07, p=.002) were identified as risk factors of delirium after cardiac surgery. Conclusion: ICU length of stay, anesthesia time, pain score, and advanced age should be considered as the prevention and management of delirium at the intensive care unit of older adults after cardiac surgery.

Purpose: This study was conducted to demonstrate objective stability of postoperative pain management status managed by nurse-based, anesthesiologist-supervised Acute Pain Service (APS). Methods: A retrospective descriptive review was conducted with 5,748 patients who had used intravenous Patient Controlled Analgesia (PCA) from January to December 2017. Data were analyzed using descriptive statics, Frequency analysis, ANOVA, Cross tabulation with X2 test, and Correlation coefficient. Results: As the APS nurse's education date increased, the period of using PCA was statistically significantly longer, and the period of stopping PCA while using it became shorter (p<.001). Statistically significant, the most painful operations were extremities, spine, upper abdomen, and thorax, while the least painful surgery was lower abdomen (p<.001). Lower abdominal surgery used the highest amount of PCA (p<.001), and extremities and spinal surgery, the lowest amount of PCA and frequently stop using it (p<.001). The most common side effects were nausea and vomiting after surgery, with an incidence of 16.0% within 24 hours and 9.8% within 48 hours. The overall error caused by PCA was 1.5%, with 84.3% being caused by human errors. Conclusion With the pain management effect of APS nurses, patients used PCA more effectively. There were also fewer side effects and error rates compared to prior studies.Therefore, it is suggested that this system is safe and effective for pain management.