Congenital Abnormalities ; Female ; Humans ; Jaw ; Jeollabuk-do ; Male ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Rehabilitation ; Surgery, Oral

We report two cases of recurrent extramarnmary Pagets disease after wide local excision. Both cases involved the scrotum and the penoserotal junction, respectively. On histopathological examination, we could observed many Paget cells confined to the epidermis and the hair follicle, but not invading the underlying dermis in both cases. There was no evidence of internal malignancy. Both cases were treated with wide local reexcision.
Dermis ; Epidermis ; Hair Follicle ; Paget Disease, Extramammary* ; Scrotum

No abstract available.
Hemangioma*

473 patients who underwent orthopedic surgery of the upper extremities from July 1978 to August 1983 were studied and the results are as follows. 1) Among 473 patients 294 patients given general anesthesis. Axillary brachial piexus block(141 cases), intraveonus regional anesthesia(10 cases), interscalene block(2 cases) and continuous brachial plexus block were given to the rest of the patients. 2) 267 patients were male and 106 patients were female. Age distribution was from 2 to 74 years. 3) Physical status of the patients was A.S.A. (American Society of Anesthesiologists) class 2(52.5%), class 1(43.4%), class 3(4.4%) in the order. 47.2% of the patients underwent emergency operation. 4) There was a tendency that regional anesthesis has been increasing year by year. 5) The type of operations were open reduction(160cases), tendon repair(112cases), and surgery for neuropathy(65 cases). 6) The operations for upper arm, elbow, and forearm were performed mostly under general anesthesia, while regional anesthesia prevailled for hand, wrist, and digits operations. 7) Brachial plexus block was considered as a method of choice for upper extremity surgery, especially for emergency surgical procedures in patients with significant medical problems. 8) A new method was tried in which a flexible disaposable intravenous catheter was introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solutions to block the axillary brachial plexus. The catheter method constitutes an interesting alternative to the conventional needle techniques and offers a continuous axillary block and a method for postoperative pain relief.
Age Distribution ; Anesthesia, Conduction ; Anesthesia, General ; Arm ; Axilla ; Brachial Plexus ; Catheters ; Elbow ; Emergencies ; Female ; Forearm ; Hand ; Humans ; Male ; Needles ; Orthopedics ; Pain, Postoperative ; Tendons ; Upper Extremity* ; Wrist

No abstract available.
Antibodies*

BACKGROUND: Malignant hyperthermia (MH) is a disorder of the skeletal muscle manifested as a life threatening hypermetabolic crisis in susceptible individuals following exposure to inhalation anesthetics and depolarizing muscle relaxants. The gold standard for determination of MH susceptibility is the in vitro contracture test (IVCT). However, it is invasive, requiring skeletal muscle biopsy and is not widely available. We attempted to reevaluate the MH in Korea using a Clinical Grading Scale (CGS) developed by Larach and colleagues to assist in clinical diagnosis. We intend to study CGS as a standardized means for estimating the qualitative likelihood of MH and establishing a Korean MH registry system. METHODS: We obtained twenty-seven case reports from the Korean Journal of Anesthesiology and applied a CGS developed by Larach and colleagues. The raw score of each case was obtained by scoring rules for the MH clinical grading scale, translated to a MH rank, and ranked by the MH likelihood. RESULTS: The overall mortality rate of reported MH was 44.4%. We described for MH rank and likelihood by CGS of cases. The CGS was missing a process in 13 cases for process II, 5 cases for process III and 4 cases for others. CONCLUSIONS: MH CGS is useful to aid the objective definition of this disease and for establishing a national registry system.
Anesthesiology ; Anesthetics, Inhalation ; Biopsy ; Contracture ; Korea ; Malignant Hyperthermia ; Muscle, Skeletal ; Neuromuscular Depolarizing Agents

Malignant hyperthermia (MH) is a potentially fatal pharmacogenetic disorder manifested as a life threatening hypermetabolic crisis in susceptible individuals following exposure to inhalation anesthetics and to depolarizing muscle relaxants. The preoperative diagnosis of MH susceptibility is difficult. The gold standard for determination of MH susceptibility is the in vitro contracture test. However, it is invasive, requiring skeletal muscle biopsy and is not widely available. Recent advances in genetic testing for mutations that result in MH during anesthesia have helped some genetic test have limitations in clinical application due to the diversity of mutations. In Korea, we found the RYR1 genetic mutation by molecular genetic testing for MH susceptibility in a family for which MH had occurred. Based on the results of genetic testing, we could known MH susceptibility of 2 patients. We believe that the genetic testing for MH can be developed and used with some limitations in clinical settings in Korea.
Anesthesia ; Anesthetics, Inhalation ; Biopsy ; Contracture ; Genetic Testing ; Humans ; Korea ; Malignant Hyperthermia ; Molecular Biology ; Muscle, Skeletal ; Neuromuscular Depolarizing Agents ; Ryanodine Receptor Calcium Release Channel

The disorders of cardiac and pulmonary function as complications due to scoliosis have been described by numerous investigators since Hippocrates. The abnormalities of respiratory and cardiovascular function in scoliosis include reduced lung volume and compliance of the total respiratory system, arterial hypoxemia, which may be associated with hypercarbia, imparied chemical regulation of ventilation and increased pulmonary vascular resistance. We recently had six severs scoliotic patients who underwent Cesarean section under balanced anesthesia in Chonbuk National University Hospital. The following conclusions were obtained through our experiences in regards to the anesthetic management. 1) Arterial blood gas must be checked serially. 2) Anesthesiologists must know the degree of abnormality of the spine and the cardiopulmonary dysfunction. 3) During anesthesia intermittent positeve pressure breathing(IPPB) or positive end expiratory pressure(PEEP) is nedded ofr good oxygenation. 4) Length and location of endotracheal tube is very important. 5) For treatment of postoperative complication, digitalizations, hronchodilators and mechanical ventilation may be needed.
Anesthesia ; Anoxia ; Balanced Anesthesia ; Cesarean Section* ; Compliance ; Female ; Humans ; Jeollabuk-do ; Lung ; Oxygen ; Postoperative Complications ; Pregnancy ; Research Personnel ; Respiration, Artificial ; Respiratory System ; Scoliosis ; Spine ; Vascular Resistance ; Ventilation

OBJECTIVE: Malignant gliomas with neuronal marker expression (MGwNM) are rare and poorly characterized. Increasingly diverse types of MGwNM have been described and these reported cases underscore the dilemmas in the classification and diagnosis of those tumors. The aim of this study is to provide additional insights into MGwNM and present the clinicopathological features of 18 patients. METHODS: We reviewed the medical records of 18 patients diagnosed as MGwNM at our institute between January 2006 and December 2012. Macroscopic total resection was performed in 11 patients (61%). We evaluated the methylation status of O6-methylguanine-DNA methyltransferase (MGMT) and expression of isocitrate dehydrogenase 1 (IDH-1) in all cases, and deletions of 1p and 19q in available cases. RESULTS: The estimated median overall survival was 21.2 months. The median progression-free survival was 6.3 months. Six patients (33%) had MGMT methylation but IDH1 mutation was found in only one patient (6%). Gene analysis for 1p19q performed in nine patients revealed no deletion in six, 19q deletion only in two, and 1p deletion only in one. The extent of resection was significantly correlated with progression free survival on both univariate analysis and multivariate analysis (p=0.002 and p=0.013, respectively). CONCLUSION: In this study, the overall survival of MGwNM was not superior to glioblastoma. The extent of resection has a significant prognostic impact on progression-free survival. Further studies of the prognostic factors related to chemo-radio therapy, similar to studies with glioblastoma, are mandatory to improve survival.
Classification ; Diagnosis ; Disease-Free Survival ; Glioblastoma ; Glioma* ; Humans ; Isocitrate Dehydrogenase ; Medical Records ; Methylation ; Multivariate Analysis ; Neurons*

Paraneoplastic cancer polyarthritis is a very rare manifestation of musculoskeletal disorders associated with several solid and hematologic malignancies. We describe a 71-year-old woman who presented initially with an abrupt onset of rheumatoid arthritis-like symmetrical polyarthritis. The patient was diagnosed with pancreatic cancer with multiple hepatic metastases approximately six months later. Her symptoms of polyarthritis improved after the introduction of medication including non-steroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs. This case suggests that a hidden malignancy should always be considered in elderly patients, who present with an abrupt onset of symmetric polyarthritis for the first time in their life.
Aged ; Antirheumatic Agents ; Arthritis ; Arthritis, Rheumatoid ; Female ; Hematologic Neoplasms ; Humans ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Paraneoplastic Syndromes