A number of drug administered during anesthesia can provoke pathologic response by immunologic or nonimmunologic mechanisms. Known drugs involved in hypersensitivity reactions are muscle relaxants, local anesthetics, narcotics, barbiturates, contrast media, protamine and antibiotics. Clinical manifestations of anaphylaxis are diverse, but during anesthesia, cardiovascular collapse is predominate. We experienced a case of anaphylactoid reaction with erythema on upper thoracic region, severe hypotension, tachycardia and ventricular fibrillation. After defibrillation, the patient was recovered. During follow-up, we knew that this patient was exposed aprotinin repeatedly, and suspect the possibility of anaphylactoid reaction due to aprotinin.
Anaphylaxis ; Anesthesia ; Anesthetics, Local ; Anti-Bacterial Agents ; Aprotinin ; Barbiturates ; Contrast Media ; Erythema ; Follow-Up Studies ; Heart Arrest* ; Humans ; Hypersensitivity ; Hypotension ; Narcotics ; Tachycardia ; Ventricular Fibrillation

No abstract available.
Compliance*

Reexpansion pulmonary edema(RPE) is a complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion or atelectasis, and generally believed to occur ipsilaterally when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid. Clinical manifestations of RPE are dyspnea, tachypnea, cyanosis, frothy blood-tinged sputum, wet rale, and expiratory wheezing. Hypotension and decrease in organ perfusion can occur. We experienced intraoperative tension pneumothorax probably due to positive pressure ventilation or pleural injury during central venous catheterization through internal jugular vein. And bilateral RPE combined with acute renal failure occurs after spontaneous decompression of tension pneumothorax with chest tube insertion, even with brief duration of lung collapse.
Acute Kidney Injury ; Catheterization, Central Venous ; Central Venous Catheters ; Chest Tubes ; Cyanosis ; Decompression* ; Dyspnea ; Edema ; Hypotension ; Jugular Veins ; Lung ; Perfusion ; Pleural Effusion ; Pneumothorax* ; Positive-Pressure Respiration ; Pulmonary Atelectasis ; Pulmonary Edema* ; Respiratory Sounds ; Sputum ; Tachypnea

OBJECTIVES: The purpose of this study was to identify the correlation coefficient of knowledge about multicultural, and attitude toward migrant wives by nursing Students. METHODS: Research participants of this study were 212 students attending nursing university in Seoul, Gyeonggi-do, Jeollanam-do. A self-report instrument was used to measure knowledge about multicultural and attitudes toward migrant wives. Descriptive statistics, t-test, Mann-Whitney test, ANOVA and Pearson's correlation analysis with SPSS/Win 20.0 were used. RESULTS: The mean knowledge about multicultural was 8.10 out of 13 and the mean attitudes toward migrant wives was 2.45 out of 5. Factors affecting knowledge about multicultural were age. Factors affecting attitudes toward migrant wives were age, residential district, experience of overseas trip, experience of living abroad and foreign language fluency. There was a positive correlation between knowledge about multicultural and attitudes toward migrant wives. CONCLUSION: Developing knowledge about multicultural and positive attitudes toward migrant wives is necessary in nursing school curricula. Therefore, nursing educator should make actual and effective education program.
Curriculum ; Education ; Gyeonggi-do ; Humans ; Jeollanam-do ; Nursing* ; Schools, Nursing ; Seoul ; Spouses* ; Students, Nursing* ; Transients and Migrants*

Renal cell carcinoma may metastasize to various portions of the body but dissemination to the prostate is very rare. The presenting symptom of a 79 year old man was acute urinary retention which was clinically thought to be benign prostatic hyperplasia. Radical nephrectomy was performed 22 months ago due to renal cell carcinoma. The histologic examination of the transurethral resection specimen demonstrated metastatic renal cell carcinoma and there was no distant metastasis except the lymph node.
Aged ; Carcinoma, Renal Cell* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Nephrectomy ; Prostate* ; Prostatic Hyperplasia ; Urinary Retention

PURPOSE: To report a case of trochlear nerve palsy caused by quadrigeminal cistern lipoma located in the dorsal midbrain. CASE SUMMARY: A 65-year-old male visited our clinic for intermittent vertical diplopia over 2-year period. Symptoms of diplopia had worsened over the past two weeks. He had no previous medical history except having had diabetes for 1 month. The best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. Pupillary examination was not remarkable. Extraocular examination showed 4 prism diopters (PD) left hypertropia at distant gaze and 4 PD exotropia at near gaze, with adduction elevation of the left eye. The Bielschowsky head tilt test revealed 6 PD left hypertropia on the left gaze and orthotropia on the right tilt. Fundus examination showed excyclotorsion of the right eye and incyclotorsion of the left eye. Brain magnetic resonance imaging revealed quadrigeminal cistern lipoma. Prism glasses were prescribed to alleviate diplopia, and we followed up the lesions without further treatment. CONCLUSIONS: Trochlear nerve palsy can be caused by quadrigeminal cistern lipoma; however, it is uncommon for this condition to be caused by a compressive lesion. Prompt neuroimaging can be helpful to rule out the causes of this condition in patients with atypical symptoms.
Aged ; Brain ; Diplopia ; Exotropia ; Eyeglasses ; Glass ; Head ; Humans ; Lipoma ; Magnetic Resonance Imaging ; Male ; Mesencephalon ; Neuroimaging ; Strabismus ; Trochlear Nerve Diseases ; Trochlear Nerve ; Visual Acuity

Swallowing syncope is thought to be induced by an abnormal esophagovagal reflex arc that leads to transient bradyarrhythmia. Bradyarrhythmia in the response to swallowing produce decreased cardiac output and cerebral perfusion which result in loss of consciousness. Dysarrhythmia are common during any procedure which involves the manipulation of upper gastrointestinal tract, such as endoscopy of the esophagus or stomach. Swallowing syncope represents an extreme form of this phenomenon. We report a patient who had bradycardia and fainting episode during endoscopic examination. High degree atrioventricular block was detected in 24 hr Holter monitoring.
Atrioventricular Block ; Bradycardia ; Cardiac Output ; Deglutition* ; Electrocardiography, Ambulatory ; Endoscopy ; Esophagus ; Humans ; Perfusion ; Reflex ; Stomach ; Syncope* ; Unconsciousness ; Upper Gastrointestinal Tract

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*

PURPOSE: To evaluate the clinical and radiographic findings of localized foreign body (FB) granulomas onmammograms. MATERIALS AND METHODS: This study involved 13 patients with localized FB granulomas on mammograms;their history of mammoplasty or other plastic procedures was obtained by telephone interviews. Two radiologistsanalyzed the location and morphology of FB granulomas and the presence of associated linear densities orparenchymal distortion on mammograms. Four patients underwent ultrasonography. RESULTS: No patient had a historyof mammoplasty. All 13, however, had a history of plastic procedure, three to 22 (average, 12) years previously,as follows : foreign materials including silicone liquid and oil such as paraffin been injected into the anteriorneck area of nine patients, the infra-auricular area of two, and the nose of two. Multiple small, high-density,flocculent nodules representing FB granulomas were distributed bilaterally in nine patients; they were noted inthe upper inner portion of 11 of 26 breasts. In eight patients, mammograms showed linear opacities suggestingfibrosis. There was no calcification or parenchymal distortion. Though in three cases, the masses were palpable.Ultrasonography revealed several anechoic nodules with posterior enhancement in subcutaneous fatty layers, and inone, 0.2cc of oil droplet had been aspirated under ultrasonographic guidance. CONCLUSION: Localized FB granulomasof the breast could be caused by the migration of FB from cervicofacial areas. Mammography showed characteristicdistribution of upper inner portions, and the findings were similar to those of mild interstitial mammoplasty.
Breast* ; Female ; Foreign Bodies* ; Granuloma ; Granuloma, Foreign-Body* ; Humans ; Interviews as Topic ; Mammaplasty ; Mammography ; Nose ; Paraffin ; Plastics ; Silicones ; Ultrasonography

Ulcerative colitis is a chronic relapsing inflammatory disease localized on the colon. This disease is rare in children under 10 years of age. We experienced a case of ulcerative colitis in a 3-year-old male child. He was admitted due to fever, abdominal pain and diarrhea for 5 days, followed by rectal bleeding for 2 days. The diagnosis was established by clinical features, endoscopic and histologic findings. Taking combined medication of prednisolone and sulfasalazine, he achieved symptomatic remission and remained asymptomatic.
Abdominal Pain ; Child* ; Child, Preschool* ; Colitis, Ulcerative* ; Colon ; Diagnosis ; Diarrhea ; Fever ; Hemorrhage ; Humans ; Male ; Prednisolone ; Sulfasalazine ; Ulcer*