No abstract available.
Dacryocystorhinostomy*

Obturator nerve block has been commonly used for pain management to prevent involuntary reflex of the adductor thigh muscles. One of several options for this block is chemical neurolysis. Neurolysis is done with chemical agents. Chemical agents used in the neurolysis of the obturator nerve have been alcohol, phenol, and botulinum toxin. In the current case, a patient with spasticity of the adductor thigh muscle due to cervical cord injury had obturator nerve neurolysis done with botulinum toxin type B (BoNT-B). Most of the previous studies have used BoNT-A with only a few reports that have used BoNT-B. BoNT-B has several advantages and disadvantages over BoNT-A. Thus, we report herein a patient who successfully received obturator nerve neurolysis using BoNT-B to treat adductor thigh muscle spasm.
Botulinum Toxins ; Botulinum Toxins, Type A ; Humans ; Muscle Spasticity ; Muscles ; Nerve Block ; Obturator Nerve ; Pain Management ; Phenol ; Reflex ; Spasm ; Thigh

No abstract available.
Spinal Cord Compression* ; Spinal Cord* ; Thymoma*

No abstract available.
Atrophy ; Pityriasis* ; Tinea Versicolor*

Prirnary sclerosing cholangitis, a chronic progressive cholestatic hepatobiliary disorder of unknown etiology, is characterized by inflammation, scarring and obliteration of bile duct leading to biliary cirrhosis and liver failure. Because histologic finding has only a limited role in the diagnosis, the gold standard for establishing the diagnosis is cholangiographic demonstration of typical diffuse biliary stricutre or beading. The natural history is extremely variable. We report two cases of primary sclerosing cholangitis diagnosed by repeated endoscopic retrograde cholangiographies. They were followed up for 7 and 2 years, respectively.
Bile Ducts ; Cholangiography ; Cholangitis, Sclerosing* ; Cicatrix ; Diagnosis ; Inflammation ; Liver Cirrhosis, Biliary ; Liver Failure ; Natural History

A patient with a large bronchopleural fistula presents several intraoperative challenges for the anesthesiologist, particularly if bullae coexist bilaterally. Ideally, a double lumen tube is inserted while the patient is conscious or breathing spontaneously under general anesthesia to prevent possible tension pneumothorax in the contralateral lung due to positive-pressure ventilation and the possibility of inadequate ventilation due to an air leak from the fistula. However, we inserted a single lumen tube instead of a double lumen tube, because this patient had multiple giant bullae bilaterally and the contralateral lung tissue was almost completely compressed and destroyed. We report the use of a single lumen tube under volatile general anesthesia with synchronized intermittent mandatory ventilation with small tidal volume. In addition, we used permissive hypercapnia to further minimize barotraumas. Due to permissive hypercapnia, there were no cardiovascular consequences.
Anesthesia, General ; Barotrauma ; Bronchial Fistula ; Fistula* ; Humans ; Hypercapnia ; Lung ; Pneumothorax ; Positive-Pressure Respiration ; Respiration ; Rupture* ; Tidal Volume ; Ventilation

Biliary complications after orthotopic liver transplants are a continuing cause of morbidity and mortality. Biliary stones and sludge are less well known complications of hepatic transplantation, although they have long been recognized. Recently we experienced two cases of biliary stones developed after liver transplantation. One 32-year-old male, who frequently admitted due to recurrent cholangitis, was treated with percutaneous transhepatic biliary drainage and choledochojejunostomy with cholecystectomy. The other 58-year-old male, who had stones in commone bile duct, was treated by endoscopic manipulation. They are in good condition without recurrent bile duct stones or its accompanying complications. Although stones and sludge are relatively infrequent after liver transplantation, surgical or interventional radiologic treatments are usually performed for treatment.
Adult ; Case Report ; Common Bile Duct Calculi/ultrasonography ; Common Bile Duct Calculi/radiography ; Common Bile Duct Calculi/etiology* ; Human ; Liver Transplantation/adverse effects* ; Male ; Middle Age ; Tomography, X-Ray Computed/methods

No abstract available.
Atrioventricular Block

BACKGROUND: Lumbar transforaminal epidural steroid injections (TFESIs) are performed to provide symptom relief in patients with radicular pain. Recent articles suggested that injected volume itself have analgesic effects and higher volumes are associated with better outcomes. To date, few studies have been conducted to investigate the effects of volume. Therefore, well-designed controlled studies were necessary to confirm the effect of volume itself on pain relief. The purpose of this study was to examine the effectiveness of a forceful saline injection on lumbar TFESI using non-particulate steroids. METHODS: Fifty consecutive patients with lumbar radicular pain were enrolled. The participants were allocated into one of two groups: dexamethasone with volume (Group DV) and dexamethasone alone (Group DO). The volume was delivered by a forceful injection of 5ml of normal saline. The primary end-point for this study was a VAS pain score and modified MacNab score indicating the rate of effectiveness at the four-week follow-up. RESULTS: There were no significant post-procedural VAS differences between two groups (P = .252). The effectiveness rate among the patients was 47.8% in DV group, 34.8% in DO group, measured by modified MacNab score. The difference was not statistically significant (P = .117). CONCLUSIONS: A forceful saline injection did not have a significant effect during the treatment of radicular pain. Further studies with greater volumes and with additional techniques would offer a more conclusive perspective.
Dexamethasone ; Follow-Up Studies ; Humans ; Radiculopathy ; Steroids

Acne fulminans (AF) is a rare severe form of acne associated with systemic symptoms. It primarily affects male adolescents and is clinically characterized by painful ulcerative nodules on the face, chest, and back. The associated systemic symptoms, such as fever, myalgia, and arthralgia, are usually present at the onset. The etiology of AF remains unknown, but there are many theories, such as increased androgens, autoimmune complex disease, and genetic predisposition. Treatment can be challenging because its response to traditional acne therapies is poor. A combination of oral steroids and isotretinoin is the most recommended treatment. Herein, we report a case of a 16-year-old Korean man with acne fulminans presenting with tender, hemorrhagic, crusted, inflammatory nodules on the upper chest, which occurred after isotretinoin use. After treatment with oral isotretinoin and pulsed dye laser for 23 weeks, most of the lesions healed leaving some scars.
Acne Vulgaris* ; Adolescent ; Androgens ; Arthralgia ; Cicatrix ; Fever ; Genetic Predisposition to Disease ; Humans ; Isotretinoin* ; Lasers, Dye ; Myalgia ; Steroids ; Thorax ; Ulcer