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

This study was designed to develop a program for unemployed matriarchs and show if the program affected their view on the meaning in life. The subjects were women registered in an occupational training program for unemployed matriarchs, which is being practiced in the 'Working Women Center' located in Busan. The researchers selected 44 persons from the group who agreed to our program. This study was done from the 10th of March, 1999 to the 9th of October. The researchers used the measurement tools, The Purpose in Life, Self-esteem, Hope and Meaning in Life which was composed of 63 items developed by them. Their Cronbach's alpha were .88, .79, .76 and .95. The researchers analyzed the data with frequency, percentage, Mean, S.D, Wilcoxon signed ranks test which were deduced from SPSS 10.0 WIN program. The results of this study were as follows: 1) The program is composed of 'becoming intimate', 'open-minded', 'exploration on self', 'relax of repressed emotion', 'self- acceptance', 'establishing the life-goal', 'enrichment of human relationship' and closing. It took 20 hours for this program to come into practice. 2) According to the analysis of the general traits of all subjects, average age was 39.36. High school graduates were 86%, college graduates were 14% and divorce were 57%, bereavement were 18%, and the rest were 25%. 3) The result of 1st progam showed self-esteem during the program was high. 4) The result of 2nd progam showed self-esteem during the program was high. 5) The result of 3rd progam showed the sum scores of meaning in life, creative meaning, and attitudinal meaning during the program was high. 6) The result of 4th progam showed the sum scores of meaning in life and creative meaning during the program was high. On the viewpoint of above results, we convinced that 'a program for unemployed matriarch is effective to establish a stronger meaning in life. Therefore, it is demanded that support for unemployed matriarchs should not only be economic help such as technical training and help of living expenses, but also psychological, professional and systematic support.
Bereavement ; Busan ; Counseling* ; Divorce ; Education ; Female ; Hope ; Humans

Widespread use of amitriptyline in clinical practice has led to extensive knowledge of its therapeutic and toxic effects. In cases of amitriptyline overdose, delirium, arrhythmia, convulsion, and adult respiratory distress syndrome have been reported, but amitriptyline-associated rhabdomyolysis has been rarely reported in the literature. Several drugs are associated with myositis or myopathy, but amitriptyline-related myositis has not been reported. We describe a 40-year-old woman with rhabdomyolysis and localized myositis in left proximal thigh after she had taken 625mg of amitriptyline.
Adult ; Amitriptyline ; Arrhythmias, Cardiac ; Delirium ; Female ; Humans ; Muscular Diseases ; Myositis* ; Respiratory Distress Syndrome, Adult ; Rhabdomyolysis* ; Seizures ; Thigh

PURPOSE: To evaluate the radiologic and clinical outcomes of AO type C pelvic ring injury and identify the prognostic factors. MATERIALS AND METHODS: We studied 53 patients who were treated for AO type C pelvic ring injury from January 2002 to February 2010. Mean age and mean follow-up duration were 42.4 years and 14 months, respectively. We had 8 cases of AO type C1-1, 19 cases of C1-2, 11 cases of C1-3, 6 cases of C2 and 9 cases of C3 injury. We analyzed type of fracture, displacement, method of fixation and associated injuries. Radiologic outcome was evaluated with Matta and Saucedo criteria and clinical outcome was evaluated using Majeed score. RESULTS: The average Majeed score was 86.2 distributing as 36 excellent cases, 15 good cases and 2 fair cases. Using radiologic Matta and Saucedo criteria, patients were divided as 31 excellent cases, 17 good cases and 5 fair cases. There was no significant difference between the outcomes of anterior, posterior and antero-posterior fixation. Neurologic injury was the reason for an unsatisfactory functional outcome. We identified two cases with complication, one with postoperative infection and the other with nonunion following anterior-posterior fixation. CONCLUSION: Satisfactory radiologic and clinical outcomes were obtained with open reduction and internal fixation in the management of AO type C pelvic ring injuries. Neurologic injuries affected the clinical outcome.
Follow-Up Studies ; Humans ; Pelvis