No abstract available.
Burns* ; Humans ; Interleukin-2*

No abstract available.
Neurofibroma, Plexiform* ; Urinary Bladder*

BACKGROUND: To evaluate the effects of thoracic epidural anesthesia, with or without bilateral vagotomy, epinephrine-induced arrhythmias were studied in 31 rabbits anesthetized with 1 MAC enflurane. METHODS: Logdose protocol was used for the infusion of epinephrine; its arrhythmic dose being defined as the smallest infusion rate produced four or more continuous or intermittent arrhythmias within 15 seconds. RESULTS: The values (geometric mean) of arrhythmic doses and the plasma concentration of epinephrine during arrhythmia were as follows: 10.21 g.kg 1.min 1 and 83.16 ng/ml in epidural control group; 118.90 g.kg 1.min 1 and 677.76 ng/ml in epidural lidocaine group (p<0.05); 6.34 g.kg-1.min 1 and 96.42 ng/ml in intravenous lidocaine group; 8.65 g.kg 1.min-1 and 44.64 ng/ml in vagotomized-epidural control group; and 12.03 g.kg 1.min 1 and 95.35 ng/ml in vagotomized- epidural lidocaine group. CONCLUSIONS: The data suggest that thoracic epidural anesthesia raises the threshold for enflurane- epinephrine arrhythmias in rabbits and that this effect is eliminated by bilateral vagotomy.
Anesthesia, Epidural* ; Arrhythmias, Cardiac* ; Enflurane ; Epinephrine ; Lidocaine ; Plasma ; Rabbits* ; Vagotomy*

OBJECTIVES: To evaluate retrospectively, the possible difference in diffusion tensor imaging (DTI) metric of fractional anisotropy (FA) between good and poor surgical outcome cochlear implantation (CI) patients using investigator-independent voxel-wise analysis. METHODS: Eighteen patients (11 males, 7 females; mean age, 5.9 years) with profound sensorineural hearing loss underwent DTI scans using a 3.0 Tesla magnetic resonance scanner. Among the 18 patients, 10 patients with categories of auditory performance (CAP) score over 6 were classified into the good outcome group and 8 patients with CAP score below 6 were classified into the poor outcome group. The diffusion tensor scalar measure was calculated from the eigenvalues of the tensor on a voxel-by-voxel basis from each subject and two-sample t-test evaluation between good and poor outcome subjects were performed for each voxel of FA values, across the entire brain, with a voxel-wise intensity threshold of P<0.0005 (uncorrected) and a contiguous cluster size of 64 voxels. Individual values of FA were measured by using the region-of-interest based analysis for correlation analysis with CAP scores, open sentence and open word scores. RESULTS: Two-sample t-test evaluation using SPM voxel-wise analysis found significantly higher FA values at the several brain areas including Broca's area, genu of the corpus callosum, and auditory tract in good outcome subjects compared to poor outcome subjects. Correlation analyses between FA and CAP scores, open sentence and open word scores revealed strong correlations at medial geniculate nucleus, Broca's area, genu of the corpus callosum and auditory tract. CONCLUSION: Investigator-independent voxel-based analysis of DTI image demonstrated that good outcome subjects showed better neural integrity at brain areas associated with language and auditory functions, suggesting that the conservation of microstructural integrity of these brain areas is important. Preoperative functional imaging may be helpful for CI.
Anisotropy ; Brain ; Cochlear Implantation ; Cochlear Implants ; Corpus Callosum ; Diffusion ; Diffusion Tensor Imaging ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Retrospective Studies

Metastatic basal cell carcinoma (MBCC) is very rare with incidences estimated to range from 0.0028% to 0.5% in the Caucasian population. The incidence of basal cell carcinoma is known to be much lower in Asian populations including Koreans. We present a rare case of metastatic BCC in a Korean woman who showed lymph node, lung and bone metastasis, with a review of the MBCC cases reported in the Korean literature.
Asian Continental Ancestry Group ; Carcinoma, Basal Cell ; Female ; Humans ; Incidence ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Scalp

To determine th effects of experimental extrahepatic cholestasis in the pharmacodynamics of vecumnium, the author administered vecuronium 500 ug/kg intravenously to six normal cats(control group), and into each of six cats with hepatic failure (hepatic failure group) and cholestasis (cholestasis group). The hepatic failure was induced with galactosamine hydrochloride and the cholestasis with the ligation of the common bile duct and cystic duct, 16 hours and 8 days prior to the neuromuscular study, respectively. The force of the anterior tibialis muscle in response to supramaximal common peroneal nerve stimulations were recorded. The time intervals from vecuronium administration to attain 100% twitch depression (onset time), from vecumnium administration to recovery of 25% twitch tension (duration) and from 25% to 75% twitch recovery (recovery index) were compared among the three groups. The results are as follows: 1) There were no significant differences between the groups with respect to rectal temperature, heart rate and mean arterial pressure immediately before vecuronium administration. 2) According to the differences of base excesses, the pH of arterial blood was significantly lower in the hepatic failure and cholestasis groups than in the control groups. 3) After induction of the hepatic failure and cholestasis group, SGOT, SGPT and prothrombin time were significantly increased when compared to the preinduction data in the two groups and data from the control group. Total bilirubin, BUN and creatinine concentration after cholestasis was significantly higher than those of the control group and the hepatic failure group. 4) The onset time in the hepatic failure and cholestasis group was slightly prolonged as compared with that in the control group. However, there was no statistical significance. The duration was significantly longer in hepatic failure and cholestasis than in the control group, and also the recovery index was significantly increased in the hepatic failure and cholestasis groups, as compared with the control group, There were no significant differences between the hepatic failure and cholestasis groups. These vesults indicate that experimental extrahepatic cholestasis induced by complete obstruction of biliary tract prolongs the duration and recovery index of vecuronium, and the effects may be caused by the impairment of direct biliary excretion, hepatic dysfunction and renal impairment.
Alanine Transaminase ; Animals ; Arterial Pressure ; Aspartate Aminotransferases ; Biliary Tract ; Bilirubin ; Cats* ; Cholestasis* ; Cholestasis, Extrahepatic ; Common Bile Duct ; Creatinine ; Cystic Duct ; Depression ; Galactosamine ; Heart Rate ; Hydrogen-Ion Concentration ; Ligation ; Liver Failure* ; Neuromuscular Blockade* ; Peroneal Nerve ; Prothrombin Time ; Vecuronium Bromide*

Marjolin's ulcer is a malignant lesion, which arises in a chronic wound. When squamous cell carcinoma occurs in Marjolin's ulcer, the prognosis is known to be worse than that of cutaneous squamous cell carcinoma, due to other etiologies. A 56-year-old male who was diagnosed as chronic osteomyelitis was recommended for a surgical amputation of the left lower leg. After amputation, the histology of chronic ulcer revealed squamous cell carcinoma. In a few months period, multiple suppurative ulcers and nodules appeared near the amputation stump, as well as the proximal sites of the left leg, which appeared to spread rapidly. Biopsy of a representative lesion and positron emission tomography-computed tomography revealed a metastatic squamous cell carcinoma and malignant lymphadenopathy. Aggressive amputation without appropriate preoperative evaluation to detect the locoregional metastasis may be an inadequate option of the treatment for the patient due to a rapid spread of cancer metastasis, which may happen immediately after an amputation. Therefore, it is important to obtain a thorough preoperative evaluation of recalcitrant ulcer from osteomyelitis before the decision to undergo an amputation.
Amputation ; Amputation Stumps ; Biopsy ; Carcinoma, Squamous Cell ; Electrons ; Humans ; Leg ; Lymphatic Diseases ; Male ; Middle Aged ; Neoplasm Metastasis ; Osteomyelitis ; Prognosis ; Ulcer

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7~32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.
Brachytherapy ; Bronchi ; Bronchitis ; Bronchoscopy ; Cough ; Exudates and Transudates ; Follow-Up Studies ; Hemoptysis ; Humans ; Necrosis ; Recurrence ; Ulcer

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed