No abstract available.
Empyema*

No abstract available.
Pulmonary Aspergillosis*

No abstract available.
Leriche Syndrome*

No abstract available.
Mediastinoscopy*

PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.
Aged ; Anesthesia ; Anterior Chamber ; Conjunctiva ; Cryotherapy ; Female ; Glaucoma ; Humans ; Ischemia* ; Mannitol ; Muscles ; Ophthalmic Artery ; Paracentesis ; Retinal Artery Occlusion ; Retinal Detachment ; Retinal Perforations ; Young Adult

BACKGROUND: For resection of esophageal cancer, esophagogastrostomy caused serous multiple complications such as leakage of anastomosis site, stenosis, recurrence of cancer, etc. Especially, accoding to the anastomosis site of esophagogastrostomy, patients in post operation state was felt various subjective symptom, multiple complications and longer hospital periods, etc. Therefore, there was a demand for comparison and analysis of complication between cervical and thoracic esophagogastrostomy. MATERIAL AND METHOD: From January 1995 to May 1999, 55patients with esophageal cancer underwent cervical esophagogastrostomy(23patients) or thoracic esophagogastrostomy(32patients). Cancer was grouped according to the postoperative staging(I--5pt, II--27pt, III--23pt) by the AJCC classification and location: upper thoracic(3pt), middle(34pt) and lower(18pt). Cancer was mostly squamous cell carcinoma except 2 adenocarcinoma. Fifty five patients were male with average age of 59 years for cervical anastomosis and 55 years for thoracic anastomosis. The staple anastomosis was done in one cervical anastomosis patient and 23 thoracic anastomosis patients. RESULT: There was one mortality from cervical anastomosis and two from thoracic anastomosis. Fourty six complications(respiratory and digestive system, etc..) occurred in 15cervical anastomosis patients and 37 complication in 13thoracic anastomosis patients. In 23cervical esophagogastrostomy patients, 11patients had moderate to severe dysphagea during swallowing. However, only 2thoracic anastomosis patients experienced this dysphagea. The postoperative hospital stay was above 20days in 18 cervical anastomosis patients, and in 13thoracic anastomosis patients. CONCLUSION: Among esophageal tumor cases, respiratory, digestive, infection and other complications did occur after esophagogastric anastomosis. Particularly, mortality rate secondary to respiratory complication was high. Anastomotic leakage was more frequent in manual anastomosis than in staple anastomosis, and was also seen more frequently among cervical anastomosis than among thoracic anastomosis. In the cases of cervical anastomosis, the patients complained more of dysphagea while their hospital stays were significantly long.
Acyclovir* ; Adenocarcinoma ; Anastomotic Leak ; Carcinoma, Squamous Cell ; Classification ; Constriction, Pathologic ; Deglutition ; Digestive System ; Esophageal Neoplasms* ; Humans ; Length of Stay ; Male ; Mortality ; Postoperative Complications ; Recurrence

PURPOSE: To determine the frequency of complications and diagnostic accuracy of CT-guided percutaneous automated gun biopsy, and to compare the results with those reported for fine needle aspiration. MATERIALS AND METHODS: Using automated biopsy devices, 118 CT-guided percutaneous biopsies of pulmonary lesions were performed. An 18-gauge needle was used. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 118 biopsies. RESULT: Four of 118(3.3%) patients developed pneumothorax and two of these required chest tube insertion. Other complications were resolved spontaneously. 106 biopsies (89.8%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and of benign disease, sensitivity was 91.8% and 87.7% respectively ; the corresponding figures for diagnostic accuracy were 88.5% and 78.9%. CONCLUSION: CT-guided automated gun biopsy of the pulmonary lesions is safe, witha pneumothorax rate comparable to that of fine needle aspiration. In the absence of a trained cytologist at the time of biopsy, the diagnostic accuracy of automated gun biopsy of pulmonary lesions compared favorably with the reported accuracy of fine needle aspiration.
Biopsy* ; Biopsy, Fine-Needle ; Chest Tubes ; Diagnosis ; Needles ; Pneumothorax ; Retrospective Studies

OBJECTIVE: To investigate the cases of intracranial abnormal brain MRI findings even in the negative brain CT scan after mild head injury. METHODS: During a 2-year period (January 2009-December 2010), we prospectively evaluated both brain CT and brain MRI of 180 patients with mild head injury. Patients were classified into two groups according to presence or absence of abnormal brain MRI finding even in the negative brain CT scan after mild head injury. Two neurosurgeons and one neuroradiologist validated the images from both brain CT scan and brain MRI double blindly. RESULTS: Intracranial injury with negative brain CT scan after mild head injury occurred in 18 patients (10.0%). Headache (51.7%) without neurologic signs was the most common symptom. Locations of intracranial lesions showing abnormal brain MRI were as follows; temporal base (n=8), frontal pole (n=5), falx cerebri (n=2), basal ganglia (n=1), tentorium (n=1), and sylvian fissure (n=1). Intracranial injury was common in patients with a loss of consciousness, symptom duration >2 weeks, or in cases of patients with linear skull fracture (p=0.00013), and also more frequent in multiple associated injury than simple one (35.7%>8.6%) (p=0.105). CONCLUSION: Our investigation showed that patients with mild head injury even in the negative brain CT scan had a few cases of intracranial injury. These findings indicate that even though the brain CT does not show abnormal findings, they should be thoroughly watched in further study including brain MRI in cases of multiple injuries and when their complaints are sustained.
Basal Ganglia ; Brain ; Craniocerebral Trauma ; Head ; Headache ; Humans ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Multiple Trauma ; Neurologic Manifestations ; Prospective Studies ; Skull Fractures ; Unconsciousness

One-lung anesthesia can be very helpful to the surgeon during operations on the lung, mediastinum, esophagus, and thoracic aorta The standard method for one-lung anesthesia uses a double-lumen tube (Carlens, Robertshaw, etc). However, these tubes are diffieult to place and may not remain in a correct position. In addition, the lumen of each channel is inevitably too smaU for proper ventilation and suctioning. We have designed a new device for one-lung anesthesia which overcomes these disadvantages. This new device, named SLT (single-lumen tube), was made by amoured wire tube, the proximal end of which was connected to the Rusch rubber tube. So, this tube is larger in diameter, available in various sizes and very economic. We intubated 25 cardiothoracic patients with SLT under the fiberoptic guidance (Group A), and the other 25 cardiothoracic patients were intubated with Bobertshaw double-lumen tube by the direct laryngoscopy (Group B). There were no significant differences in heart rate, blood pressure, PH, PaCO2, PaO2 BE, HCO3, SaO2 and ETCO2 between the two groups compared with induction, one-lung ventilation, and two-lung ventilation values.
Anesthesia ; Aorta, Thoracic ; Blood Gas Analysis* ; Blood Pressure ; Esophagus ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Laryngoscopy ; Lung ; Mediastinum ; One-Lung Ventilation* ; Rubber ; Suction ; Ventilation

Hepatitis A can cause serious illness among adolescents and adults with low vaccination coverage. Even though hepatitis A vaccine is one of the strong candidates for Korean national immunization program, adolescents aged older than 12 yr would not benefit. Our purpose was to assess the willingness and analyze the correlates of Korean mothers for hepatitis A (HepA) vaccination to develop strategies for HepA vaccination. A national telephone survey on 800 mothers with children aged 7-18 yr was conducted with random-digit dialing method. Sixty-two percent and 92% of the mothers reported that they were willing to HepA vaccination at current cost and at half of the current cost, respectively. However, at current cost, only 79% wished to vaccinate their child in an epidemic and 32% wished to vaccinate promptly. Having two or more children, not having future plans to send the child overseas, and low family income were significantly associated with not willing to HepA vaccination. Low perception of the susceptibility for hepatitis A and perception of the current cost as barrier increased the odds of unwillingness to vaccination at current cost and to prompt vaccination. The mothers' willingness to HepA vaccination for the children aged 7-18 yr in Korea was not very high at current cost and associated socioeconomic status and health-belief. Targeted intervention or strategies are needed to increase the HepA vaccination rate among children in Korea.
Adolescent ; Adult ; Child ; Demography ; Female ; Health Status ; Health Surveys ; Hepatitis A/economics/*prevention & control ; Hepatitis A Vaccines/economics/*immunology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Mothers/psychology ; Republic of Korea ; Social Class ; *Vaccination