In small infants or neonates, open heart surgery without transfusion can have many risks regarding inadequate oxygen delivery and coagulopathy. However, if parents refuse blood transfusion, cardiac surgery without transfusion should be considered. We report a case of bloodless cardiac surgery in a 2.89 kg neonate with Jehovah's Witness parents. Blood conserving strategies were used. Preoperatively, erythropoietin and iron were supplemented to increase the hemoglobin level. Intraoperatively, techniques for minimizing blood loss were used, such as reducing priming volume for cardiopulmonary bypass, a blood salvage system, and modified ultrafiltration. Postoperatively, pharmacologic agents were administered and blood sampling was minimized.
Blood Transfusion ; Cardiopulmonary Bypass ; Erythropoietin ; Heart ; Hemoglobins ; Humans ; Infant ; Infant, Newborn ; Iron ; Jehovah's Witnesses ; Oxygen ; Parents ; Thoracic Surgery ; Ultrafiltration ; Wit and Humor as Topic

Since 1976, 938 cases of E.R.C.P. were performed at the Kwangju Christian Hospital & since December 1981, 19 cases of Endoscopic papillotomy(E.P.T.) were performed, following Results were obtained: 1) Out of 19 cases which were diagnosed by E.R.C.P.; 17 cases of C.B.D. stones, 1 case of ascaris in bile duct, 1 case of remained C.B.D. stone diagnosed by T-tube cholangiogram after operation, & E.P.T. was done in total 19 casees. 2) During 1st E.P.T., 2 cases were removed by Dormia basket under direct visualization & during 2nd E.P.T., 5 cases were removed by Dormia basket under direct visulization & 12 cases were passed in stool & 3x3.5cm large stone passage was found. 3) Complications of E.P.T. were noted in 2 cases: 1 case of bleeding was treated by blood transfusion & 1 case of Acute pancreatitis was treated by medical care.
Ascaris ; Bile Ducts ; Blood Transfusion ; Common Bile Duct* ; Gwangju ; Hemorrhage ; Pancreatitis ; Sphincterotomy, Endoscopic*

No abstract available.
Humans ; Laryngectomy ; One-Lung Ventilation ; Tracheostomy

No abstract available.
Humans ; Spine

Iatrogenic femoral pseudoaneurysm (IPA) is a troublesome complication related to the femoral arterial access site used for invasive cardiovascular procedures. Several therapeutic strategies have been developed to treat this complication. They include surgical repair, ultrasound-guided compression repair, and minimally invasive percutaneous treatments (thrombin injection, coil embolization, and insertion of covered stents). Traditionally, surgical repair has been the main treatment for IPA, particularly when the size of the pseudoaneurysm is larger than 4 cm or when anticoagulation or GP-IIb/IIIa inhibitors are extensively used during the procedure. However, if the site of the pseudoaneurysm, such as deep femoral artery, was more deeply located, thrombin injection might be simpler or more useful compared to surgical ligation. Here, we report the successful treatment of huge IPA by percutaneous thrombin injection in a case complicated with giant pseudoaneurysm of deep femoral artery after the endovascular intervention for peripheral arterial occlusive disease.
Aneurysm, False ; Arterial Occlusive Diseases ; Femoral Artery ; Ligation ; Thrombin

Objectives: The water fluoridation program in Hapcheon township area has been implemented since 2000. This study aimed to evaluate the caries-preventive effect of water fluoridation on permanent teeth after implementation of an 18-year community water fluoridation program in a suburban area. Methods: A survey was conducted in 2018 with 359 subjects, aged 8, 10, and 12 years, residing in the Hapcheon township area. In this prospective cohort study, the data on caries prevalence obtained from 671 subjects, aged 8, 10, and 12 years, in 2000, when the community water fluoridation program was initiated in the township, were used as a cohort to evaluate the caries-preventive effect after 18 years. The caries-preventive effect of community water fluoridation on permanent teeth was estimated by comparison of the adjusted DMFT scores between the program and the control group, and between the pre- and post-program data after 18 years. The confounding factor, mean number of fissure-sealed teeth, was adjusted to estimate the caries-preventive effect of fluoridation on permanent teeth. Results: Based on the results of the surveys conducted in Hapcheon-eup in 2000 and 2018, the mean number of fissure-sealed permanent teeth was 2.24 in 2000 and 1.38 in 2018. The mean DMFT scores of subjects aged 8, 10, and 12 years in 2018, adjusted for fissure-sealed permanent teeth in the fluoridated area, were significantly lower than those reported by the 2018 Korea National Children’s Oral Health Survey. In addition, the mean values of the adjusted DMFT scores of subjects aged 8, 10, and 12 years in 2018, after the 18-year fluoridation program, were significantly lower than those reported in 2000, the year the fluoridation program was initiated. Conclusions Community water fluoridation has a high caries-reducing effect; thus, the reintroduction of water fluoridation program is desirable to prevent dental caries.

Objectives: The purpose of this study was to investigate the risk factors related to periodontal health in middle school and high school adolescents. Methods: This study was conducted using data from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES, 2013-2015). Among the 22,948 participants in the Sixth KNHANES, 1,222 participants (aged 12-18 years) who completed the systemic and oral health examinations and questionnaires were included in this study. Independent variables related to demographic socioeconomic status and oral health-related behaviors were the following: age, gender, household income, frequency of daily toothbrushing, smoking, alcohol drinking, annual dental visit, and periodontal treatment. The dependent variables were the prevalence of gingival bleeding or calculus and the number of sextants with gingival bleeding or calculus. Results: Among the total participants, 34.1% were diagnosed with prevalence of gingival bleeding or calculus, and periodontal health was found to be at its worst at 17 years of age (41.6% of participants). Moreover, household income, alcohol drinking, annual dental visits, and frequency of daily toothbrushing were related to prevalence and the number of sextants with gingival bleeding or calculus. The adjusted odds ratio (aOR) for prevalence of gingival bleeding or calculus by alcohol consumption, toothbrushing less than twice per day, and number of DMFT were 5.00 (95% CI: 2.24-11.18), 2.21 (95% CI: 1.21-4.04), and 1.09 (95% CI: 1.02-1.17), respectively. Conclusions To prevent periodontal disease among adolescents, it is necessary to improve oral health-related behavior and its associated factors and continuous oral health education.

OBJECTIVES: This study aims to compare the fluoride-release between different fluorine varnish under in vitro experimental conditions.METHODS: In this study, 5 fluoride varnish products distributed in Korea were selected. V-varnish™ (Vericom, Korea: VV), CavityShield™ (3M ESPE, USA: CS), Clinpro™ White varnish™ (3M ESPE, USA: CP), MI Varnish™ (GC, Japan: MI), and Fluor Protector (Ivoclar Vivadent, Liechtenstein: FP). For the in vitro study, 10 mg of each fluoride varnish was thinly applied to the same area of the specimen. The specimen was then immersed in 3 ml of distilled water at consistent intervals to confirm fluoride release. Nine specimens per group were used. Fluoride ion electrodes were used to measure the fluoride concentration of the solution. The Kruskal-Wallis nonparametric test was performed to compare between each experimental group, and the Wilcoxon signed-rank nonparametric test was performed to compare experimental groups over time. The significance level for a Type I error was set at 0.05. All statistical analyses were performed using SPSS 25.0 (IBM Co., Armonk, NY, USA).RESULTS: In vitro experiments showed that the amount of fluoride released from MI was higher than the other groups during the first 12 hours after application. However, the amount of fluoride released from CP and CS was higher than MI as the immersion time increased over 12 and 20 hours, respectively. The fluoride release from FP was the lowest at all measurement points.CONCLUSIONS: The results of this study showed that the remaining fluoride effect from rosin type fluoride varnishes was higher than liquid type fluoride varnishes. There were differences in the residual fluoride concentrations despite each fluoride varnish having the same fluoride content.
Dental Caries ; Electrodes ; Fluorides ; Fluorides, Topical ; Fluorine ; Immersion ; In Vitro Techniques ; Japan ; Korea ; Liechtenstein ; Paint ; Water

BACKGROUND: There can be changes in the cardiac function during laparoscopic cholecystectomy. In this study, QTc interval changes were compared between total intravenous anesthesia (TIVA) group and inhalation anesthesia group during laparoscopic cholecystectomy. METHODS: The study was conducted on adult patients, ages ranging from 20 to 65 years old, and classified as the American Society of Anesthesiologists physical status I or II. At random, the patients were divided into group 1 (TIVA, n = 20) and group 2 (inhalation anesthesia, n = 19). Group 1 patients were induced and maintained with continuous infusion of remifentanil and propofol using a target controlled infusion device. Patients in group 2 were induced with sevoflurane and N2O using mask ventilation, and then anesthesia was maintained with sevoflurane and N2O. The QTc interval, heart rate and mean arterial pressure were measured prior to induction, immediately following intubation, 10 minutes following intubation, following CO2 inflation, immediately following head-up position, 10 minutes following head-up position, following CO2 deflation-supine position respectively. RESULTS: In group 1, the ECG sampling showed no prolongation in the QTc intervals at all measured points. In group 2, QTc interval was significantly longer at all other measured points compared to prior to induction (P < 0.05). Except prior to induction, QTc intervals were significantly longer at all other measure points in group 2 compared to those in group 1 (P < 0.05). CONCLUSIONS: There was no QTc interval prolongation under the TIVA using propofol and remifentanil during laparoscopic cholecystectomy.
Adult ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Arterial Pressure ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Electrocardiography ; Heart Rate ; Humans ; Inflation, Economic ; Inhalation ; Intubation ; Masks ; Methyl Ethers ; Piperidines ; Propofol ; Ventilation

A 63-year-old woman was diagnosed with ovarian cancer and peritoneal carcinomatosis. The day after paclitaxel was administered, an acute myocardial infarction occurred. Emergency coronary angiography revealed a filling defect in the left main coronary artery and total occlusion in the distal left anterior descending coronary artery, with no luminal irregularity or narrowing. Intravascular ultrasonography showed no significant plaque in the left main coronary artery. A thrombophilia work-up was negative, and the patient was treated with tirofiban, clopidogrel, and aspirin. The follow-up coronary angiogram showed that the occlusion of the distal obtuse marginal branch and distal left anterior descending artery had cleared. Paclitaxel has been associated with acute myocardial infarction. However, the pathogenesis of myocardial infarction associated with paclitaxel is not known. This case raises the possibility that paclitaxel can induce coronary artery thrombosis, resulting in myocardial infarction.
Arteries ; Aspirin ; Carcinoma ; Coronary Angiography ; Coronary Thrombosis ; Coronary Vessels ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Myocardial Infarction ; Ovarian Neoplasms ; Paclitaxel ; Phenobarbital ; Thrombophilia ; Thrombosis ; Ticlopidine ; Tyrosine ; Ultrasonography, Interventional