No abstract available.
Kidney Transplantation*

The use of a tissue expander and implant is the simplest option for breast reconstruction after mastectomy. Use of a round dome-shaped prosthesis and the commonly used one-stage technique with a Becker type prosthesis, however, often produces an undesirable upper pole fullness. To overcome this and to achieve improved aesthetic results, we started using an anatomically-shaped expander and implant, as described by Maxwell, as a two-stage breast reconstruction. We reviewed the results of our 21 reconstructed breasts in 22 patients who were deemed suitable for reconstruction using this technique since January 1995. The most commonly used expander was 350cc (range 350-550cc) and an average of 4.2 inflations were required before replacing the expander with a permanent implant. All the expanders were placed in submuscular pockets and implant volume. The longest follow-up was 36 months. Few complications developed and most patients were satisfied with the results. We found that the anatomically-shaped expander and implant produced better aesthetic results compared to a done-shaped prosthesis.
Breast* ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy ; Prostheses and Implants ; Tissue Expansion Devices

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

A 26-year-old female presented herself to our clinic due to noduloulcerative lesions of one month duration on her face and trunk with accompaning headache and mild fever. In family history, her husband was reported to have a history of chaner. On physical examinat.ion, rice sized eythematous papules and bean sized nodules with central ulceration were seen on the face and trunk. VDRL was 1:31 positive. A skin biopsy iif a noduloulcerative lesion showed ulceration, vascular dilatation with fibrinoid changes and perivascular inflarnmatory cellu infilt.rations, especially plasma cells. Immunoperoxidase stain showed T. pallidum at the epidermis and papillary dermis. The diagnsis was made asecondary syphilis with unusual clinical presentation as noduloucerative skin lesions. The skin lesions completely disappeared one month after treatment with injection of benzathine pelnicillin G 2.4 million unit intramuscularly weekly for three times.
Adult ; Biopsy ; Dermis ; Dilatation ; Epidermis ; Female ; Fever ; Headache ; Humans ; Plasma Cells ; Skin ; Spouses ; Syphilis* ; Ulcer

No abstract available.

No abstract available.
Dermoid Cyst*

No abstract available.
Eyelids* ; Sarcoidosis* ; Skin

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

No abstract available.
Dermatitis, Seborrheic* ; Humans

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps