Selective infusion of the epinephrine into the renal artery has been used in the field fo the diagnostic andthe therapeutic radiology for correct diagnosis and effective treatment, respectively. However, administration ofoverdose of epinephrine may cause serious complication, renal infarction. The study was undertaken to evaluate thesequential change of renal arterial constrictive effect of selective infusion of epinephrine into renal artery andto determine the critical doses of epinephrine producing irreversible renal infarct. A total of 25 rabbits areused, which are devided into 5 groups. Under the general anesthesia is made the selective infusion of variousdoses of epinephrine into the right renal arter of the rabbits. At the various time interval during and after theepinephrine infusion, renal angiography was doen, and 24 hrs. later, gross and microscopic findings of the kidneywere observed. The results are as follows; 1. Vasoconstriction of renal artery occurred within 2 mins. infusion,and maximum effect within 5 mins. 2. It seems that there is correlation between the amount of infused epinephrineand the time taken to recover from constiction of renal artery. 3. When epinephrine is infused into the renalartery in the rate of 1ug/min., renal infarct is not noticed below the level of 10 mins., but correlation betweenthe amount of infused epinephrine and the frequency of renal infarct occures above 20 mins. infusion.
Anesthesia, General ; Angiography ; Diagnosis ; Epinephrine ; Infarction ; Rabbits ; Radiation Oncology ; Renal Artery ; Vasoconstriction

We report CT and MR findings in tow cases of primary malignant melanoma of the vagina, one arising from cervicovaginal junction mimicking squamous cell carcinoma of the cervix and the other one recurring at vagina after resection. Two cases of malignant melanoma had high-attenuation on CT and high signal intensity on T1-weighted MR images and enhanced well after gadopentetate dimeglumine administration.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gadolinium DTPA ; Melanoma* ; Vagina*

We report CT and MR findings in tow cases of primary malignant melanoma of the vagina, one arising from cervicovaginal junction mimicking squamous cell carcinoma of the cervix and the other one recurring at vagina after resection. Two cases of malignant melanoma had high-attenuation on CT and high signal intensity on T1-weighted MR images and enhanced well after gadopentetate dimeglumine administration.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gadolinium DTPA ; Melanoma* ; Vagina*

OBJECTIVE: To investigate the symptom prevalence and aspects of symptoms for cumulative trauma disorders in dentists and elucidate their associated factors. METHODS: A questionnaire-based investigation on demographic factors, work-related characteristics, psychosocial factors and symptoms of 512 dentists practicing in Daegu metropolitan city was conducted. Subsets of psychosocial characteristics, including job demand(5 items), psychosomatic strain(5 items), job insecurity, and type A behavior were also assessed. For the evaluation of symptoms early developed questionnaire by Song(1997)was used to investigate the parameters related to pains in the neck, shoulder, arm and elbow, wrist, finger, back or discomforts, such as pricking and numbing. RESULTS: The symptom prevalence of cumulative trauma disorders, calculated based on NIOSH criteria, was high at 63.3 %; the most frequent site of complaint was the shoulder, followed by neck, back, hand and wrist, knee, foot and ankle. The most common approach position was direction of 9 to 10 o'clock. Most subjects had 5-10 years of work experience and those with such years of experience also complained most frequently of symptoms in the neck and shoulder areas. As to rate of symptom complaint according to the type of dental procedure, the highest rate was associated to periodontic treatment. According to age, those between the age of 30-40 had the highest symptom prevalence rate at 70 %. According to sex, women had the higher symptom prevalence rate. Unmarried subjects also had higher symptom prevalence rate. The results of logistic analysis showed that the higher the psychosomatic strain and job demand, the higher the symptom prevalence rate of cumulative trauma disorders. Moreover, the higher the score of type A behavior, the higher the symptom prevalence rate, and even those who changed the location of their practice for the last three months also showed high symptom prevalence rate. CONCLUSIONS: The results of multiple logistic regression analysis, which incorporated demographic, work-related and psychosocial characteristics as independent variables, showed that women were at a higher risk than men in developing cumulative trauma disorders; and that the higher the psychosomatic strain and more frequent type A behavior, the higher the risk of developing cumulative trauma disorders. The above results seem to suggest that not only continual, repeated fine and skillful musculoskeletal movements and lengthy hours in an uncomfortable position but also the psychological stress related to patient satisfaction, can lead to cumulative trauma disorders.
Ankle ; Arm ; Cumulative Trauma Disorders* ; Daegu* ; Demography ; Dentists* ; Elbow ; Female ; Fingers ; Foot ; Hand ; Humans ; Knee ; Logistic Models ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Neck ; Patient Satisfaction ; Periodontics ; Prevalence ; Psychology ; Questionnaires ; Shoulder ; Single Person ; Stress, Psychological ; Wrist

A 31-year-old woman admitted because of fever, chilling and sore throat for 4 days. The symptom was developed after receiving methimazole 20mg per day and carteolol 10mg per day due to Graves disease during last 4 weeks. Physical examination revealed hyperemic enlarged tonsils with whitish plaque. The peripheral blood total neutrophil count was 1,400/mm3 (absolute neutrophil count, ANC 36) and a peripheral blood smear revealed rare neutrophil with lymphocytosis. On the first day of hospitalization, the patient was severely ill with ANC 0, it was decided to administer G-CSF 2ug/kg daily. On the fifth day of hospitalization, ANC in peripheral blood count was persistently zero and bone marrow aspiration and biopsy were performed, which revealed hypocellularity and myeloid hypoplasia. G-CSF given daily for 7days, it was discontinued when the ANC reached 1,539/mm3. The availability of G-CSF may help to shorten the course of agranulocytosis and to reduce its mortality rate.
Adult ; Agranulocytosis* ; Biopsy ; Bone Marrow ; Carteolol ; Colony-Stimulating Factors* ; Female ; Fever ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Graves Disease ; Hospitalization ; Humans ; Lymphocytosis ; Methimazole* ; Mortality ; Neutrophils ; Palatine Tonsil ; Pharyngitis ; Physical Examination

PURPOSE: Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and improving tight adhesion between the graft and the recipient bed. To reduce post burn scar contracture and improve aesthetical result, many types of dermal substitutes have been invented and used widely. The goal of this study is to evaluate usefulness of the VAC(Kinetic concepts Inc., San Antonio, TX) in improving the take rate and time to incorporation of Integra(R) in reconstruction of burn scar contracture. METHODS: A retrospective study was performed from October, 2006 to December, 2008. The VAC was utilized for 11 patients. The patient's ages ranged from 5 to 27 with an average of 19.7 years. The surface area ranged from 24 to 1,600cm2 with an average of 785cm2. The burn scars were excised deep into normal subcutaneous tissue to achieve complete release of the scar, Integra(R) was sutured in place with skin staple and Steri-strip(R). Then slit incisions were made on silicone sheet only with No.11 blade for effective drainage. The VAC was used as a bolster dressing over Integra(R). Negative-Pressure ranging from 100 to 125mm Hg was applied to black polyurethane foam sponge trimmed to the appropriate wound size. An occlusive seal over the black polyurethane foam sponge was maintained by a combination of the occlusive dressing, OP-site(R). The VAC dressing changes were performed every 3 or 4 days until adequate incorporation was obtained. The neodermis appeared slightly yellow to orange color. When the Integra(R) deemed clinically incorporated, The VAC was removed and take was estimated with visual inspection. Very thin STSG(0.006-0.008 inches) was performed after silicone sheet removal. RESULT: The mean time for clinically assessed incorporation of Integra(R) was 10.00 days(range 9-12). The mean dressing change was 3.5 times until take was obtained. In All patients, Integra(R) had successful incorporation in tissue without serious complications. CONCLUSION: Integra(R) in combination with Vacuum- Assisted Closure(VAC) may be incorporated earlier than conventional dressing method.
Acceleration ; Bandages ; Burns ; Cicatrix ; Citrus sinensis ; Contracture ; Drainage ; Humans ; Hypogonadism ; Microcirculation ; Mitochondrial Diseases ; Occlusive Dressings ; Ophthalmoplegia ; Polyurethanes ; Porifera ; Retrospective Studies ; Silicones ; Skin ; Subcutaneous Tissue ; Transplants ; Wound Healing

Abdominoplasty may be applied to achieve aesthetic outcome and it also can be combined with other surgeries. In addition, liposuction has been offered to patients to improve contour. Liposuction combined with abdominoplasty gives us the advantage of higher patient satisfaction, better aesthetic outcome, and one-staged surgery. The authors performed a retrospective study to evaluate the outcomes. A total of 6 patients who underwent lipoabdominoplasty were included. The patients were all female and the mean age of the patients was 50.5 years old(age range, 32 to 58 years). This study surveyed lipoabdominoplasty based on the purpose of operation, type of suture, and application of quilting suture. Complication rates, patient satisfaction, and postoperative contour of the abdomen were questioned. A mild abdominal complication occurred in one patient, flap bullae, but this was healed within a week and overall flap survival was excellent with good satisfactory outcome. It appears that complication rates of simple lipoabdominoplasty group is low(1/6), and only minor complication occurs. Preservation of perforators during liposuction accounts for improved flap survival. In addition, abdominoplasty may be combined with other abdominal surgeries since other abdominal surgeries usually involve the lower abdomen, which will eventually be cut away curing the abdominoplasty stage.
Abdomen ; Abdominal Wall ; Abdominoplasty ; Adipose Tissue ; Blister ; Female ; Humans ; Imidazoles ; Lipectomy ; Nitro Compounds ; Patient Satisfaction ; Retrospective Studies ; Surgery, Plastic ; Sutures

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.
Adenocarcinoma* ; Aged ; Female ; Humans ; Intensive Care Units ; Lung* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilators, Mechanical ; Erlotinib Hydrochloride

PURPOSE: To evaluate the effect of clear corneal incisional size on astigmatism during cataract surgery. METHODS: Randomized prospective study of 78 patients (108 eyes) who had received cataract surgery for a corneal astigmatism over against-the-rule (ATR) 1.0 Diopter (D) was performed. The eyes were checked by corneal topography and autorefractor preoperatively and one week, one month, two months, and six months postoperative. Group 1 included patients who received an inserted foldable intraocular lens (IOL) through a 2.8 mm incision, and Group 2 included patients who underwent IOL implantation through a corneal incision enlarged to 4 mm. RESULTS: Postoperative visual acuity showed a better visual acuity in Group 2 at both one week postoperatively (0.598+/-0.352 vs., 0.713+/-0.345, for Groups 1 and 2, respectively, p=0.046) and one month postoperatively (0.604+/-0.237 vs., 0.791+/-0.242, respectively, p=.043). There were no statistically significant differences between the groups after two and six months (p=.135, .087). Postoperative astigmatism measured by corneal topopgraphy showed 1.62+/-0.44D and, 0.94+/-0.30D for groups 1 and 2 respectively, (P=.045) at 2 months, and 1.73+/-0.45 D and, 0.92+/-0.34 D (P=.042) at six months. These results showed a statistically significant amount of residual astigmatism in Group 2. Autorefractor measurements showed similar results. There were no complications, such as wound leakage, resulting from the increased incision size. CONCLUSIONS: Widening of the incision during cataract surgery can reduce corneal astigmatism without significant complications.
Astigmatism ; Cataract ; Corneal Topography ; Eye ; Humans ; Lenses, Intraocular ; Prospective Studies ; Visual Acuity

Pneumothorax was recognized as a potential hazard of mechanical ventilation during anesthesia. Because the gases used in anesthesia are delivered from cylinder and wall outlets at higher than atmospheric Pressure, the possibility of damage to the lung is over present. Alveolar rupture may occur when there is free transmission of high pressure to the alveoli during tracheal intubation at the start of anesthesia. We had a case of tension pneumothorax developed during the use of Jackson-Rees modification with Ayres T-piece for primary closure of laceration on right hand in 4 years old child under general anesthesia. The patient was presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema just after tracheal intubation. The tension pneumothorax was noticed on chest X-ray. This complication was the result of undesirable alveolar ventilation with high fresh gas flow by accidental using of oxygen flush valve. With the prompt decision of diagnosis of tension pneumothorax and aggresive treatment, the patient recovered uneventfully and discharged 7 days later.
Anesthesia ; Anesthesia, General ; Atmospheric Pressure ; Child ; Child, Preschool ; Diagnosis ; Gases ; Hand ; Humans ; Intubation ; Lacerations ; Lung ; Oxygen ; Pneumothorax* ; Respiration, Artificial ; Rupture ; Subcutaneous Emphysema ; Thorax ; Ventilation