Adult ; Animals ; Bone Density ; Calcium Sulfate ; Depression ; Dogs ; Golgi Apparatus ; Humans ; Organelles ; Osteoblasts ; Osteogenesis ; Secretory Vesicles ; Transplants ; Wounds and Injuries

Eight patients in the state of ASA classification l, ll were investigate. Blood samples were collected before, just after, 30 minutes after and 60 minutes after induction of anesthesia. Glucose and electrolyte changes in relation to maintenance fluids in balanced and halothane anesthesia were as follows. 1) In both anesthetic techniques blood sugar level showed increasing tendency according to duration of anesthesia. 2) There were no specific changes in serum electrolytes related to type of anesthesia. 3) The administration of D/S and H/D showed a little increase in Na+ and Cl- level compared to the administration of just DsW. 4) The administration of H/d showed less increase in K+ level than the administration of DsW or D/S. 5) Just after induction of anesthesia the K+ level increased a little and decreased gradually thereafter.
Anesthesia ; Anesthesia, General* ; Blood Glucose* ; Classification ; Electrolytes* ; Glucose ; Halothane ; Humans

Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.
External Fixators ; Female ; Follow-Up Studies ; Humans ; Humerus* ; Neck* ; Shoulder ; Transplants

Juvenile pemphigus vulgaris (JPV) is a rare variant of pemphigus vulgaris (PV) occurring in childhood and adolescence that has similar symptoms and the same histological and immunopathological features as classic adult PV. Although rare, advanced cases of JPV can be fatal due to secondary sepsis. Many patients with JPV are misdiagnosed and therefore not properly treated in the early stages of the disease. Although systemic corticosteroids are the therapeutic mainstay, long-term corticosteroid use has various adverse effects. Intravenous immunoglobulin (IVIG) was recently reported to reduce the side effects of corticosteroids. Here, we report a case of JPV in a 14-year-old boy treated with IVIG.
Adolescent ; Adrenal Cortex Hormones ; Adult ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Male ; Pemphigus* ; Sepsis

BACKGROUND: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. METHODS: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. RESULTS: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. CONCLUSIONS: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.
Biopsy ; Bronchiectasis ; Bronchoscopy* ; Cytodiagnosis ; Fistula ; Humans ; Lung Neoplasms ; Respiration ; Tuberculosis

Carbol fuchsin is a mixture of phenol and basics fuchsin, used in bacterial staining procedures. It is a component of Ziehl-Neelsen stain. Phenol in Carbol fuchsin is a toxic agent which can lead to various gastrointestinal, ocular, skin, neurologic and renal side effects. We hereby report a case of Carbol fuchsin poisoned patient. Acute renal failure with metabolic acidosis was rapidly progressed. However, she was treated successfully by continuous veno-venous hemodiafiltration.
Acidosis ; Acute Kidney Injury ; Dialysis ; Hemodiafiltration ; Hemoperfusion ; Humans ; Phenol ; Rosaniline Dyes ; Skin

PURPOSE: It has been reported recently that peritoneal protein clearance (Pcl) is a marker of endothelial dysfunction and cardiovascular disease in peritoneal dialysis patients. We evaluated whether baseline or longitudinal follow-up Pcl is a factor to consider in predicting the outcome in peritoneal dialysis patients for the follow-up period. METHODS: Patients who initiated continuous ambulatory peritoneal dialysis at our center from September 1994 to January 2006 and had a baseline peritoneal equilibration test, measurement of dialysis adequacy, and 24-h dialysate Pcl (24hr dialysate protein loss/ [serum albumin/0.4783]) were included. Demography, comorbidities, and biochemical data were retrospectively collected. Follow-up was until death or the end of the period studied (November 2009). RESULTS: A total of 203 patients (56% men, mean age 55.0+/-12.5; 55.2% with diabetes; 22.2% with cardiovascular disease) were included. The mean follow up period was 38 months (3-170 months). Baseline Pcl was 128.2 ml/day. Follow up data of Pcl were not changed from baseline period. Cox's analysis revealed the predictors of mortality (and technical failure) were age and diabetes mellitus but not dialysate/plasma creatinine ratio (D/Pcr) and Pcl. On multivariate analysis, Pcl was negatively correlated with serum albumin and triglyceride and positively correlated with D/Pcr and peritoneal creatinine clearance. CONCLUSION: Our study showed that the changes in Pcl over time were not significant from baseline up to 53 months. Neither baseline nor mean Pcl during the follow-up period were independent predictors for technical or patient survival.
Ascitic Fluid ; Cardiovascular Diseases ; Comorbidity ; Creatinine ; Demography ; Diabetes Mellitus ; Dialysis ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Retrospective Studies ; Serum Albumin ; Treatment Outcome

PURPOSE: Since the successful application of total atrio-pulmonary connection(TAPC) to patients with various types of physiologic single ventricles in 1971, post-operative survival rates have reached more than 90%. However some patients have been shown to present with late complications such as right atrial thrombosis, atrial fibrillation and protein losing enteropathy eventually leading to re-operation to control the long-term complications. The aim of this study is to review the results of total cavo-pulmonary connection(TCPC) in cases with late complications after TAPC. METHODS: Between Jan. 1995 and Dec. 2000, 6 patients(5 males and 1 female) underwent cardiac catheterization 11+/-3 months after conversion of previous TAPC to TCPC. We compared the hemodynamic and morphologic parameters before and after TCPC and also assessed the clinical outcomes. The indications for TAPC were tricuspid atresia in 4 cases and complex double-outlet right ventricle with single ventricle physiology in 2 cases. RESULTS: There was no peri-operative mortality and all patients were clinically and hemodynamically improved at a mean follow-up of 11 months(range: 4 to 13). However, protein losing enteropathy recurred in 2 patients; this was were successfully treated with subcutaneous administration of heparin. Right atrial pressure before TCPC was 18.0+/-3.6 mmHg, but baffle pressure, corresponding to right atrial pressure decreased to 14.8+/-3.6 mmHg after TCPC. The size of the pulmonary arteries did not regress after TCPC. CONCLUSION: The conversion of TAPC to TCPC improves clinical and hemodynamic status by decreasing the right atrial pressure and by providing a laminar cavo-pulmonary flow which enhances the effective pulmonary circulation in the so-called Fontan circulation.
Atrial Fibrillation ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle ; Follow-Up Studies ; Hemodynamics* ; Heparin ; Humans ; Male ; Mortality ; Physiology ; Protein-Losing Enteropathies ; Pulmonary Artery ; Pulmonary Circulation ; Survival Rate ; Thrombosis ; Tricuspid Atresia

BACKGROUND: This study was carried out to compare the effect of intravenous anesthesia with fentanyl or alfentanil on the hemodynamic profile, sedation, recovery and side effect in the patients undergoing oocyte retrieval. METHODS: The patients were designed to receive alfentanil (group A, n = 70) or fentanyl (group F, n = 70) intravenous anesthesia. The patients were given midazolam 0.6 mg/kg and alfentanil 15 microgram/kg in group A or fentanyl 1.5 microgram/kg in group F. Propofol 0.7 mg/kg was given if patient was awaken during procedure. Hemodynamic changes, propofol used dosage and initial propofol injecting time, Ramsay Sedation Scales, cough reflex on opioid injection, recovery time, duration of apnea and postoperative nausea, vomiting at the recovery room were recorded. RESULTS: Group A had rapid onset, deep sedation, less amount of propofol used, more frequent apnea than group F. There were no significant differences in postoperative nausea, vomiting and recovery time between the two groups. CONCLUSIONS: The intravenous anesthesia with fentanyl or alfentanil are suitable for oocyte retreival but apnea happened more frequent in alfentanil group, so the use of alfentanil needs to monitor ventilation and hemodynamic changes carefully.
Alfentanil ; Anesthesia, Intravenous ; Apnea ; Cough ; Deep Sedation ; Fentanyl ; Fertilization in Vitro ; Hemodynamics ; Humans ; Midazolam ; Oocyte Retrieval ; Oocytes ; Organothiophosphorus Compounds ; Postoperative Nausea and Vomiting ; Propofol ; Recovery Room ; Reflex ; Ventilation ; Vomiting ; Weights and Measures

BACKGROUND: This study was carried out to compare the effect of intravenous anesthesia with fentanyl or alfentanil on the hemodynamic profile, sedation, recovery and side effect in the patients undergoing oocyte retrieval. METHODS: The patients were designed to receive alfentanil (group A, n = 70) or fentanyl (group F, n = 70) intravenous anesthesia. The patients were given midazolam 0.6 mg/kg and alfentanil 15 microgram/kg in group A or fentanyl 1.5 microgram/kg in group F. Propofol 0.7 mg/kg was given if patient was awaken during procedure. Hemodynamic changes, propofol used dosage and initial propofol injecting time, Ramsay Sedation Scales, cough reflex on opioid injection, recovery time, duration of apnea and postoperative nausea, vomiting at the recovery room were recorded. RESULTS: Group A had rapid onset, deep sedation, less amount of propofol used, more frequent apnea than group F. There were no significant differences in postoperative nausea, vomiting and recovery time between the two groups. CONCLUSIONS: The intravenous anesthesia with fentanyl or alfentanil are suitable for oocyte retreival but apnea happened more frequent in alfentanil group, so the use of alfentanil needs to monitor ventilation and hemodynamic changes carefully.
Alfentanil ; Anesthesia, Intravenous ; Apnea ; Cough ; Deep Sedation ; Fentanyl ; Fertilization in Vitro ; Hemodynamics ; Humans ; Midazolam ; Oocyte Retrieval ; Oocytes ; Organothiophosphorus Compounds ; Postoperative Nausea and Vomiting ; Propofol ; Recovery Room ; Reflex ; Ventilation ; Vomiting ; Weights and Measures