BACKGROUND: Diabetic cardiovascular autonomic neuropathy (CAN) causes perioperative cardiovascular instability. A rapid increase in the desflurane concentration induces tachycardia and hypertension (HTN). This study examined the effects of the cardiovascular response to desflurane on patients with diabetic CAN. METHODS: Forty diabetes mellitus (DM) patients with CAN were divided two groups: one with HTN (DM+HTN group, n = 17) and one without HTN (DM group, n = 23). The control group (n = 20) was composed of healthy patients without DM or HTN. In each group, the concentration of desflurane inspired was increased abruptly to 12.0 vol% 2 minutes after a thiopental injection. The target was to produce an end-tidal concentration of desflurane of 10.0 vol%, which was maintained until the end of the study by adjusting the vaporizer dial setting. The heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) were measured. RESULTS: The HR, MAP and CI increased significantly in all three groups when compared with the baseline (P<0.05). Additionally, the HR and MAP showed did not differ among the three groups at any of sampling times. However, the CI of the DM group and the DM+HTN group differed when compared with the control group at 90 and 120 seconds after intubation (P<0.05). CONCLUSIONS: In diabetic patients with CAN, the hemodynamic responses to a rapid increase in desflurane concentration are similar to those in non-diabetic patients before endotracheal intubation. However, after endotracheal intubation, increments in CI are blunted in diabetic patients with CAN.
Arterial Pressure ; Diabetes Mellitus ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal ; Isoflurane ; Nebulizers and Vaporizers ; Tachycardia ; Thiopental

Diplopia ; Ecchymosis ; Edema ; Enophthalmos ; Epistaxis ; Frontal Bone ; Humans ; Orbit ; Subcutaneous Emphysema ; Zygoma

Orthognathic Surgery ; Politics ; Prognosis ; Social Change

Superficial siderosis results from the deposition of hemosiderin in subpial layers of the central nervous system following hemorrhage in subarachnoid spaces. Infratentorial superficial siderosis (ISS) presents with unique clinical features including progressive hearing loss, ataxia, and myelopathy, and the most common cause of idiopathic ISS is dural abnormality. Here we report a case of idiopathic ISS with radiological findings of spontaneous intracranial hypotension, whose clinical symptoms of ISS including cerebellar dysfunction improved after supine position was maintained for 2 months.
Ataxia ; Central Nervous System ; Cerebellar Diseases ; Hearing Loss ; Hemorrhage ; Hemosiderin ; Intracranial Hypotension ; Siderosis ; Spinal Cord Diseases ; Subarachnoid Space ; Subdural Effusion ; Supine Position

Neovascular glaucoma is a subtype of secondary glaucoma that is characterized by proliferation of fibrovascular tissue in the anterior chamber angle. This condition may be acutely aggravated by carotid revascularization therapies. There have been few previous reports of acute aggravation of neovascular glaucoma following carotid artery stenting. We report the case history of a patient who had acute exacerbation of neovascular glaucoma following carotid artery stenting and required surgical management.
Anterior Chamber ; Carotid Arteries ; Carotid Stenosis ; Glaucoma ; Glaucoma, Neovascular ; Humans ; Stents

Knee pain is rarely an initial symptom of colon cancer, because most bone metastases develop in the late stage of cancer. Therefore, patients with colorectal cancer usually present with gastrointestinal symptoms. Recently, we experienced a 46-year-old female with rectal cancer that presented as knee pain due to tibial metastasis without other organ metastasis. She was evaluated for knee pain and diagnosed with a rectal cancer after biopsies of the tibial and rectal masses. We report the first such case in Korea with a review of the literature.
Biopsy ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Knee ; Korea ; Middle Aged ; Neoplasm Metastasis ; Rectal Neoplasms ; Tibia

BACKGROUND: Proteinuria is a predictor of chronic kidney disease and a common risk factor for cardiovascular disease. Previous studies have reported that a urinary albumin-creatinine ratio and a glomerular filtration rate was related to the metabolic syndrome. However, there have been few studies on association between the metabolic syndrome and proteinuria by the urine dip-stick test. We examined the association between the metabolic syndrome and the proteinuria by the urine dip-stick test. METHODS: The subject of this study included 20,075 adults aged more than 18 years old who visited the Health Promotion Center of the Seoul National University Hospital from April 2001 to March 2007. The metabolic syndrome was defined according to the criteria of the American Heart Association and National Heart, Lung and Blood Institute, and proteinuria was defined as a dipstick test above the '1+' level. The crude and multivariated-adjusted odds ratios of proteinuria were calculated by using logistic regression models with each component of the metabolic syndrome. RESULTS: Proteinuria was noticed in 5.7% of the subjects with metabolic syndrome, and 2.7% without metabolic syndrome. The multivariate-adjusted odds ratios of proteinuria in participants with elevated blood pressure level, elevated plasma glucose level and high triglyceride level were 2.23 (95% confidence interval [CI], 1.95 to 2.55), 2.33 (95% CI, 2.06 to 2.62), 1.64 (95% CI, 1.45 to 1.84). The multivariate-adjusted odds ratio of proteinuria in participants with the metabolic syndrome compared with participants without the metabolic syndrome was 2.30 (95% CI, 1.91 to 2.76), respectively. CONCLUSION: These findings suggest that proteinuria by the urine dip-stick test might be an important predictor in the metabolic syndrome.
Adult ; Aged ; American Heart Association ; Blood Pressure ; Cardiovascular Diseases ; Glomerular Filtration Rate ; Glucose ; Health Promotion ; Heart ; Humans ; Logistic Models ; Lung ; Odds Ratio ; Plasma ; Proteinuria ; Renal Insufficiency, Chronic ; Risk Factors ; Urinalysis

Congenital cytomegalovirus (CMV) infection is one of the most frequent congenital infections in neonates. It can manifest as asymptomatic infection in 90% or symptoms may appear in 10% of the patients. Asymptomatic congenital CMV infection is likely to be a leading cause of sensorineural hearing loss, mental retardation and microcephaly. Incontinentia pigmenti is a rare multisystemic ectodermal disorder, which is characterized by vesicular, verrucous, and pigmented cutaneous lesions, and is frequently associated with various developmental defects of the eyes, CNS, teeth, hair, and nail. It is regarded as an X-linked dominent genetic disorder. We are reporting a case of neonate who presented with delayed development and bilateral hearing loss due congenital CMV infection which was incidentally assoicated with incontinentia pigmenti.
Asymptomatic Infections ; Cytomegalovirus ; Ectoderm ; Hair ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Loss, Sensorineural ; Humans ; Incontinentia Pigmenti* ; Infant, Newborn ; Intellectual Disability ; Microcephaly ; Tooth

OBJECTIVE: In this study, we tested the correlation between the body temperature measured by non-contact temporal artery thermometer which has been developed recently and the rectal temperature using conventional glass mercury thermometer, also evaluate the reliability of non-contact temporal artery thermometer by comparing with other methods of temperature measurement. METHODS: One-hundred-and-seventeen newborn infants who were born at Samsung Cheil Hospital were included in this study. Tympanic and forehead temperatures were taken three times each with tympanic thermometer and non-contact infrared temporal artery thermometer respectively on a newborn infant by two authors. we also measured the rectal and axillary temperatures by using a mercury-in-glass thermometer. RESULTS: The normal body temperature measured by non-contact temporal artery thermometer was 36.2 +/- 0.22degrees C, and rectal, axillary and tympanic temperatures were 36.8 +/- 0.30degrees C, 36.7 +/- 0.30 and 36.1 +/- 0.27degrees C, respectively. There was a significant correlation between temperatures measured by non-contact temporal artery thermometer and rectal temperature (p<0.01, r=0.891). The differences between repeated measurements by non-contact temporal artery thermometer were significantly less than those by tympanic thermometer (p<0.01). CONCLUSION: Forehead temperature measured by non-contact temporal artery thermometer is correlated with rectal temperature and has good reproducibility. It can be used to measure body temperature in newborn infants.
Body Temperature* ; Forehead ; Glass ; Humans ; Infant, Newborn* ; Temporal Arteries* ; Thermometers*