Anoxia ; Oxygen* ; Recovery Room*

Anesthetic managment of bronchial asthmatic patient requires understanding of the patho- physiology of the disease and the drug interaction with anesthetics and the drugs related to the treatment. A 53-year old male patient with hemorrhagic pancreatitis had been operated for exploratory laparotomy. He had history of the bronchial asthma. After the operation was completed, patient was transfered to recovery room after extubation. Sudden airway obstruction signs and patients agitation were noted 5 minutes after arrival in the recovery room. Asthmatic attack was relieved with salbutamol, corticosteroid, aminophylline, and isoproterenol intravenously. We have experienced one case of severe asthmatic attack in the postoperative recovery room. We report this case and review the anesthetic managements and drug interactions.
Airway Obstruction ; Albuterol ; Aminophylline ; Anesthetics ; Asthma ; Dihydroergotamine ; Drug Interactions ; Humans ; Isoproterenol ; Laparotomy ; Male ; Middle Aged ; Pancreatitis ; Physiology ; Recovery Room*

Dyke-Davidoff syndorme is a rare congenital disorder which developed hemiatropy of brain, enlargement of ventricles and prominent pneumatization of petrous pyramid of the temporal bone. It mainfests unilateral invountary movement such as seizure, athetosis, chorea and mental retardation. This disorder have strong evidence of significance to differential diagnosis of cerebral palsy because of different therapeutic approach and outcome. Recently we examined 10 years old girl who developed seizure at 2 years old and gradually progressed with hemiparesis, hypoplaisa of right side of the body. The brain CT scan showed marked dilatation of lateral ventricle, prominent sylvian fissure and cortical sulci with somewhat thickened skull vault and pneumatization of petrous pyramid of the temporal bone on left side. EEG showed high voltage slow wave and spikes. So we report a case of Dyke-Davidoff syndrome with review of literature.
Athetosis ; Brain ; Cerebral Palsy ; Child ; Child, Preschool ; Chorea ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diagnosis, Differential ; Dilatation ; Electroencephalography ; Female ; Humans ; Intellectual Disability ; Lateral Ventricles ; Paresis ; Petrous Bone ; Seizures ; Skull ; Temporal Bone ; Tomography, X-Ray Computed

Lively discussion has been underway regarding primary care in South Korea as an alternative medical policy in the face of rising medical costs and health care disparities. However, the lack of research about primary care in South Korea makes it difficult to move policymakers, so it is time to enhance primary care research in South Korea. Primary care research can be defined as research directed toward the better understanding and practice of the primary care function. Primary care research traditionally has included basic research, clinical research, health services research related to primary care, health systems research, and research on primary care training; and each field is complementary. In primary care research, participation of primary care physicians is essential because primary care research is different from other conventional studies of disease prevalence, patient characteristics, diagnostic methods, and the treatment environment. Primary care research findings in other countries cannot be applied to South Korea as the characteristics of the health system and medical practice are different. To enhance the research on primary care in South Korea, financial assistance, promoting the research capacity of primary care physicians, and more attention from primary care physicians to research are needed.
Health Services Research ; Healthcare Disparities ; Humans ; Physicians, Primary Care ; Prevalence ; Primary Health Care ; Republic of Korea

Candida was found in the oral cavity, jejunum, and ileum of the healthy population. In case of alimentary tract, the factors of favorable to candida colonization include old age, malnutrition, diabetes, burns, trauma, surgical operations, parenteral nutrition, intravascular or bladder catheterization, H2-blocker therapy, steroid therapy, immunosuppresive treatment and the use of wide spectrum antibiotics: however, gastrointestinal candida colonization is rarely found in the healthy adult. No case of duodenal ulcer with candidiasis has been reported in healthy people. Recently we experienced a case of asymptomatic duodenal ulcer with candidiasis in a healthy male, who had taken H2-blocker and proton pump inhibitor for 3 months after primary closure of duodenal ulcer perforation. Therefore we report this case with review of several literatures.
Adult ; Anti-Bacterial Agents ; Burns ; Candida ; Candidiasis* ; Catheterization ; Catheters ; Colon ; Duodenal Ulcer* ; Humans ; Ileum ; Jejunum ; Male ; Malnutrition ; Mouth ; Parenteral Nutrition ; Proton Pumps ; Urinary Bladder

PURPOSE: Complications are quite common in surgery to correct spinal deformities due to the long duration under anesthesia and massive blood loss. The aim of this study was to evaluate and compare the effectiveness of Aprotinin in spinal deformity surgery. MATERIALS AND METHODS: Fifty-nine patients who underwent spinal deformity surgery were analyzed. Thirty-two patients were administered Aprotinin, and 27 control patients were not. The Pre- and Post- operative hemoglobin and hematocrit, blood loss, transfusion requirements, operative time, postoperative blood loss through suction drains and duration of suction drains were measured in both groups. RESULTS: There were no differences in age, gender, height, weight, hemodynamic indices, postoperative blood loss through the suction drains and the duration of the suction drains between the two groups. Intraoperative blood loss, transfusion and operative time were 1,345+/-425 cc, 1,008+/-721 cc, and 247 minutes in the Aprotinin (+) group and 2,070+/-1,276 cc, 2,552+/-2,791 cc, and 279 minutes in the Aprotinin (-) group, respectively. The postoperative hemoglobin and hematocrit levels were also significantly different (12.9+/-1 cc and 38.3+/-3.1% in the Aprotinin (+) group, and 11.9+/-1.8 cc and 35+/-5.5% in the Aprotinin (-) group, respectively). CONCLUSION: There was significantly less intraoperative blood loss, transfusion and surgery time in the group administered Aprotinin. Therefore, Aprotinin can be used in spinal deformity surgery that has a high risk of massive blood loss.
Anesthesia ; Aprotinin* ; Congenital Abnormalities* ; Hematocrit ; Hemodynamics ; Humans ; Operative Time ; Postoperative Hemorrhage ; Suction

Objective: Urgent upper endoscopy is performed to achieve acute hemostasis in patients with high-risk bleeding sources. Emergency physicians must identify patients who require urgent endoscopic treatments. This study assessed the performance of blood urea nitrogen (BUN) for predicting severe bleeding that necessitates urgent endoscopic hemostasis compared to the risk assessment scores in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB). Methods: The presumed ANVUGIB patients were classified into endoscopic and non-endoscopic hemostasis groups. Data including historical features, symptoms, signs, and routine laboratory tests were collected and compared. Results: Three hundred and ninety-one patients were analyzed, including 116 patients in the endoscopic hemostasis and 275 patients in the non-endoscopic hemostasis group. In the area under curve (AUC) of the receiver operator characteristic curve, BUN (AUC 0.733; 95% confidence interval [CI], 0.681-0.785) and BUN/creatinine (AUC, 0.727; 95% CI, 0.672-0.783) were superior to total protein, Glasgow-Blatchford score (GBS), modified GBS (AUC, 0.649, 0.623 and 0.646, respectively) for predicting endoscopic hemostasis. Pre-endoscopy Rockall score and AIMS65 were statistically insignificant. The same results were obtained when the patients with liver and chronic kidney diseases were excluded. Conclusion The current results suggest that BUN was an independent predictor of endoscopic hemostasis in patients with ANVUGIB. Further studies will be needed to determine if BUN can be used in clinical practice.