No abstract available.
Child* ; Humans

OBJECTIVES: This study was conducted to evaluate the effects of using an epidural steroid sponge for postoperative pain control in lumbar discectomy.SUMMARY OF LITERATURE REVIEW: There are many methods to control postoperative pain after lumbar discectomy, including opioid analgesics, epidural catheters, and epidural steroid Gelfoam sponges. MATERIALS AND METHODS: A total of 72 patients who underwent surgery between March 2011 and February 2014 were enrolled. Their average age was 54 years (range, 24–82 years). In group A (35 patients), Gelfoam was inserted after being soaked with a solution of 2% lidocaine (400 mg/20 mL; 1 vial) and dexamethasone (5 mg/mL; 1 ampoule). In group B (37 patients), it was inserted after soaking with normal saline. Postoperative pain was assessed by visual analogue scale (VAS) scores. Pain above 5 points was controlled by a narcotic analgesic agent, and the duration and number of postoperative interventions, the period of time before walking after the operation, and the period until the date of discharge after surgery were assessed and compared. The Mann-Whitney U test was used as a nonparametric method. P-values less than 0.05 were considered to indicate statistical significance. RESULTS: In group A, 15 patients did not require analgesics on the day of surgery. In 20 patients, no analgesics were needed on postoperative day (POD) 1. In group B, 8 patients on the day of surgery and 13 patients on POD 1 did not require analgesics. In group A, 26 patients were able to walk on the day of surgery, and all patients were able to walk on POD 1. In group B, 19 patients was able to walk on the day of surgery and all patients were able to walk on POD 1. The mean number of hospital days before discharge was 6.3 in group A and 8.2 in group B. CONCLUSIONS By continuously releasing low doses of steroids into the epidural space, this technique provided satisfactory results for postoperative pain control.

STUDY DESIGN: Retrospective study. OBJECTIVES: This study was conducted to evaluate the effects of using an epidural steroid sponge for postoperative pain control in lumbar discectomy. SUMMARY OF LITERATURE REVIEW: There are many methods to control postoperative pain after lumbar discectomy, including opioid analgesics, epidural catheters, and epidural steroid Gelfoam sponges. MATERIALS AND METHODS: A total of 72 patients who underwent surgery between March 2011 and February 2014 were enrolled. Their average age was 54 years (range, 24–82 years). In group A (35 patients), Gelfoam was inserted after being soaked with a solution of 2% lidocaine (400 mg/20 mL; 1 vial) and dexamethasone (5 mg/mL; 1 ampoule). In group B (37 patients), it was inserted after soaking with normal saline. Postoperative pain was assessed by visual analogue scale (VAS) scores. Pain above 5 points was controlled by a narcotic analgesic agent, and the duration and number of postoperative interventions, the period of time before walking after the operation, and the period until the date of discharge after surgery were assessed and compared. The Mann-Whitney U test was used as a nonparametric method. P-values less than 0.05 were considered to indicate statistical significance. RESULTS: In group A, 15 patients did not require analgesics on the day of surgery. In 20 patients, no analgesics were needed on postoperative day (POD) 1. In group B, 8 patients on the day of surgery and 13 patients on POD 1 did not require analgesics. In group A, 26 patients were able to walk on the day of surgery, and all patients were able to walk on POD 1. In group B, 19 patients was able to walk on the day of surgery and all patients were able to walk on POD 1. The mean number of hospital days before discharge was 6.3 in group A and 8.2 in group B. CONCLUSIONS: By continuously releasing low doses of steroids into the epidural space, this technique provided satisfactory results for postoperative pain control.
Analgesia, Epidural ; Analgesics ; Analgesics, Opioid ; Catheters ; Dexamethasone ; Diskectomy ; Epidural Space ; Gelatin Sponge, Absorbable ; Humans ; Lidocaine ; Methods ; Pain, Postoperative ; Porifera ; Retrospective Studies ; Steroids ; Walking

PURPOSE: To report a case of endophthalmitis treated with surgical removal of the inflammatory endothelial plaque. CASE SUMMARY: A 61-year-old male was transferred to our clinic due to corneal laceration of the left eye. An emergency operation for the lacerated cornea was performed. After the operation, the patient had no specific symptoms for 8 months but then visited our clinic with sudden decreased visual acuity. On slit lamp examination, the patient had some chamber reactions. Anterior chamber reactions exacerbated after 2 months and the best corrected visual acuity was decreased from 1.0 to 0.08. An inflammatory corneal endothelial plaque and endothelial precipitates had developed. The posterior segment was not visualized due to the severe anterior chamber inflammatory reaction. No growth was observed on bacterial or fungal cultures. However, administration of eye drops and oral voriconazole were initiated based on a clinical impression suspicious of fungal infection. Despite the treatment, the infection did not respond. Voriconazole was then directly injected into the vitreous and anterior chamber. Although the patient's best corrected visual acuity slightly improved, the inflammatory reactions of the anterior chamber and vitreous did not. The inflammatory endothelial plaque on the patient's cornea was then surgically removed and the best corrected visual acuity improved to 1.0. Mycelium was detected on the KOH smear of the endothelial plaque. There were no further inflammatory reactions in the anterior chamber or vitreous after surgical removal of the endothelial plaque.
Anterior Chamber ; Cornea ; Emergencies ; Endophthalmitis ; Endothelium, Corneal ; Eye ; Humans ; Lacerations ; Male ; Middle Aged ; Mycelium ; Ophthalmic Solutions ; Pyrimidines ; Triazoles ; Visual Acuity

We report two cases of macular edema treated with the oral administration of furosemide. The first case presented here was a 78-year-old male patient with visual disturbance of the left eye. He had been taking an oral agent for diabetes and had chronic renal failure for 7 years. From 10 days prior to the visit, he had visual disturbance of the left eye accompanied by systemic edema. There were no specific findings in the anterior segment, but sub-retinal fluid was observed in the left fundus. Macular edema was observed on fluorescein angiography and optical coherence tomography; therefore, the oral administration of furosemide was initiated. After seven days, the sub-retinal fluid disappeared. The second case was a 43-year-old female patient with visual disturbance of the left eye who had been taking hypoglycemic agents for diabetes for 13 years. There were no specific findings in the anterior segment, but flame-shaped retinal hemorrhages were scattered over both posterior poles, neovascularization was observed in the left eye, and, of particular note, sub-retinal fluid was detected in the macula of the left eye. Macular edema was also observed on fluorescein angiography and optical coherence tomography, and oral administration of furosemide was initiated. After 3 weeks, the macular edema had significantly decreased.
Administration, Oral ; Adult ; Aged ; Diabetes Complications/diagnosis/*drug therapy ; Diuretics/administration & dosage/*therapeutic use ; Female ; Fluorescein Angiography ; Furosemide/administration & dosage/*therapeutic use ; Humans ; Macular Edema/diagnosis/*drug therapy ; Male ; Tomography, Optical Coherence

A 54-year-old female patient who had been undergoing anti-cancer chemotherapy and radiotherapy for seven years after surgery for left breast cancer visited our clinic for visual disturbance in the right eye at nine months after paclitaxel administration. The best-corrected visual acuity was 0.5 in the right eye and 1.0 in the left eye. The patient was diagnosed with maculopathy due to paclitaxel administration based on the finding of cystoid macular edema in the right eye on fundus examination and optical coherence tomography; however, no leakage was detected on fluorescein angiography. Thus, drug replacement was planned. On the other hand, no abnormal finding was observed in the left eye. However, as the anti-cancer effect of paclitaxel is significant, replacing paclitaxel with another agent was not warranted; therefore, maintenance therapy with methazolamide was performed before and after administering the anti-cancer agent. Aggravation of cystoid macular edema was prevented, and vision improvement was achieved by oral maintenance therapy with methazolamide. In addition, the same fundus findings as shown in the right eye were detected in the left eye at 16 months after paclitaxel administration. After administering methazolamide, macular thickness was reduced, and vision was improved in the left eye. Paclitaxel administration was discontinued due to cutaneous metastasis from the breast cancer, and another anti-cancer agent was then administered. No subsequent cystoid macular edema has occurred.
Antineoplastic Agents, Phytogenic/*adverse effects ; Breast Neoplasms/drug therapy ; Diuretics/*therapeutic use ; Female ; Humans ; Macular Edema/*chemically induced/*drug therapy ; Methazolamide/*therapeutic use ; Middle Aged ; Paclitaxel/*adverse effects ; Visual Acuity

Aneurysms of peripheral pulmonary arteries are uncommon. It may appear as a coinlesion in a plain chest film. In general, a popular and effective method for pathologic diagnosis of solitary lung lesion is needle aspiration biopsy, a technique which is safe in most instances. Also, ultrasonograhic or fluoroscopic methods are needed for the evaluation of this lesion. If pulmonary artery aneurysm is untreated, the prognosis of this disease is poor. Sixty percents of the patients with pulmonary artery aneurysm died following rupture of the aneurysm. Surgical correction is the preferred treatment. We are reporting a case of pulmonary aneurysm with the review of literature.
Aneurysm* ; Biopsy, Needle ; Diagnosis ; Humans ; Lung ; Needles ; Prognosis ; Pulmonary Artery* ; Rupture ; Thorax ; Tuberculosis

PURPOSE: To report a case of subconjunctival foreign body migration in both eyes after collagen-containing filler injection. CASE SUMMARY: A 51-year-old female, who had been treated with collagen-containing filler in her eyelid, nose, and forehead for cosmetic complaints four months earlier, presented to our clinic with decreased visual acuity and foreign body sensation in both eyes. Slit lamp examination revealed moderate nucleosclerosis and subcapsular opacity in her crystalline lens, in addition to scattered subconjunctival foreign body infiltration in both eyes. Cataract extraction with posterior chamber lens implantation was performed, and the subconjunctival foreign body was also partially removed. Biopsy of the remaining foreign body was performed, and examination revealed foreign material and multivacuolated cells in the conjunctiva. CONCLUSIONS: Clinicians and patients should be aware of the risk of migration of collagen-containing filler inject at or near the eyelid, to the eyeball, including the conjunctiva.
Biopsy ; Cataract Extraction ; Collagen ; Conjunctiva ; Cosmetics ; Eye ; Eyelids ; Female ; Forehead ; Foreign Bodies ; Foreign-Body Migration ; Humans ; Lens, Crystalline ; Middle Aged ; Nose ; Sensation ; Visual Acuity

Purpose: This study was performed to identify levels of self-leadership, professional self-concept, emotional labor and professional quality of life, and investigate the relationship among these variables in hospital nurses. Methods: This study was a cross-sectional survey. The data were collected from May 20 to June 30, 2019. Participants were 200 nurses working at 4 general hospitals in Korea. Data were analyzed using the SPSS/WIN 25.0 program. Results: There was a positive relationship between compassion satisfaction and self-leadership, professional self-concept and emotional labor, and a negative relationship between burnout and the other variables in this study. There were positive and negative relationships between secondary traumatic stress and the other variables in this study.Compassion satisfaction, which is one sub-factors of professional quality of life, was influenced by professional self-concept and emotional labor, and these variables explained 55% of compassion satisfaction. Burnout was only influenced by professional self-concept which explained 47% of burnout. Secondary traumatic stress was influenced by emotional labor and gender which accounted for 5% of secondary traumatic stress. Conclusion These results show that professional self-concept is very important in promoting quality of life for nurses. So nurse managers should try to strengthen nurses’ professional self-concepts.

Hemobilia is a cause of obscure gastrointestinal hemorrhage. Most cases have an iatrogenic or traumatic origin but cases of hemobilia with non-traumatic causes are rare. The non-traumatic causes of hemobilia are inflammation, gallstones, neoplasm and vascular lesions. Currently, various therapeutic options are available for hemobilia, and transarterial embolization is now the first line of intervention used to stop the bleeding of hemobilia, which shows a high success rate of approximately 80% to 100% with a lower morbidity and mortality rate than with surgery. We report a rare case of non-traumatic hemobilia caused by a pseudoaneurysm of the hepatic artery that was successfully treated with transarterial embolization.
Aneurysm, False* ; Gallstones ; Gastrointestinal Hemorrhage ; Hemobilia* ; Hemorrhage ; Hepatic Artery* ; Inflammation ; Mortality