No abstract available.
Anxiety* ; Depression* ; Humans ; Kidney Transplantation* ; Kidney* ; Renal Dialysis*

Cutis verticis gyrata is a descriptive term for the condition characterized by ridges and furrows of the scalp resembling the convolutions of the brain. Cutis verticis gyrata can be categorized into primary and secondary types according to various etiologic factors and associated conditions capable of inducing the disease process. We report a case of essential primary cutis verticis gyrata in a 29-year-old male who did not have any other underlying or associated conditions.
Adult ; Brain ; Humans ; Male ; Scalp

No abstract available.

The temporomandibular joint (TMJ) is unique among joints in the human body, since it can be dislocated without external force. Manipulation of the upper airway other than laryngoscopy is a risk factor in patients who have a history of habitual dislocation of the TMJ. The case report illustrates that severe limitation of the jaw opening ("closed lock") requiring manipulation for restoration may occur during induction of general anesthesia.
Anesthesia* ; Anesthesia, General ; Dislocations ; Human Body ; Humans ; Jaw* ; Joints ; Laryngoscopy ; Risk Factors ; Temporomandibular Joint

BACKGROUND: Prostacyclin administered intravenously has demonstrated intermediate pulmonary specificity and its aerosol form has an even greater pulmonary selectivity. There have been few systematic analyses of the difference in response according to the route of administration and the dose of administration of prostacyclin. So we have compared prostacyclin infusion versus inhalation in various concentrations in an animal model. METHODS: Pulmonary hypertension was induced by continuous intravenous infusion of the vasoconstrictor U46619 and prostacyclin solutions of 10, 50, 100, 200 mcg/ml were inhaled using a jet nebulizer. Prostacyclin infusion was done at a rate of 100, 200, 400 ng/kg/min. RESULTS: With inhalation of 10, 50, 100, 200 mcg/ml prostacyclin, PVR fell to values of 85%, 76%, 64%, 55% of the preinhalation value and SVR fell to values of 94%, 80%, 76%, 64% of the preinhalation value, respectively (p<0.05). PVR/SVR ratios decreased significantly in all inhalation doses (p<0.05). With infusion of prostacyclin at a rate of 100, 200, 400 ng/kg/min, PVR fell to values of 73%, 60%, 50% of the preinfusion value and SVR fell to values of 68%, 54%, 38% of the preinfusion value, respectively (p<0.05). PVR/SVR ratios increased at an infusion rate of 400 ng/kg/min. CONCLUSION: Prostacyclin inhalation did not result in selective pulmonary vasodilation without causing any efects on the systemic vascular bed (absolute pulmonary selectivity). But it did cause more predominant vasodilation on the pulmonary vascular bed (relative pulmonary selectivity). By contrast, prostacyclin infusion caused more predominant vasodilation on the systemic vascular bed, creating the risk of severe systemic hypotension.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Epoprostenol* ; Hypertension, Pulmonary* ; Hypotension ; Infusions, Intravenous ; Inhalation ; Models, Animal ; Nebulizers and Vaporizers ; Sensitivity and Specificity ; Vasodilation

Pneumothorax is the most common complication after central venous catheterization and routinely assessed by a chest X-ray within 4 hours after catheter placement. The diagnosis of pneumothorax may be delayed for hours or days because of minimal clinical symptoms or radiologic signs on initial evaluation. Pneumothorax may progress to tension pneumothorax after positive-pressure ventilation with a potentially fetal outcome. We report a case in which a patient developed a tension pneumothorax while positive-pressure ventilation for general anesthesia 1 day after subclavian vein catheterization, although initial post-insertion chest X-ray was normal.
Anesthesia, General ; Catheterization* ; Catheterization, Central Venous ; Catheters* ; Central Venous Catheters ; Diagnosis ; Humans ; Pneumothorax* ; Positive-Pressure Respiration* ; Subclavian Vein* ; Thorax

BACKGREOUND: The ideal drug for treatment of pulmonary hypertension would be a vasodilator which acts preferentially on the pulmonary vascular bed. The aim of this study was to compare the effects of prostaglandin I2 (PGI2) on central hemodynamics and right ventricular function with the more widely used vasodilators, prostaglandin E1 (PGE1) and nitroglycerin (NTG) and to investigate whether PGI2 is more selective to the pulmonary vascular bed compared with PGE1 and NTG in dogs. METHODS: We have used a method for producing sustained pulmonary hypertension in vivo by continuous infusion of U46619 adjusting the infusion rate until a mean pulmonary artery pressure (PAP) exceeded 25 mmHg. And the pulmonary and systemic effects of the three pulmonary vasodilators were compared at doses producing equivalent, lowered approximately 20% of mean arterial pressures (MAP) or mean PAP returned to baseline. RESULTS: After infusion of the three vasodilators, heart rate, cardiac output, and mean PAP/MAP ratio were significantly increased, but there was no statistical significant differences among the three vasodilators. PGI2 and PGE1 significantly increased (worsened) the PVR/SVR ratio, but NTG decreased. However there was no significant difference among the three vasodilators. After infusion of the three vasodilators, the arterial oxygen tension (PaO2), mixed venous oxygen tension (PO2), O2 deliver, and O2 uptake were increased, and shunt ratio (s/t(%)) were significantly decreased, but there were no significant differences among three vasodilators. CONCLUSIONS: PGI2, PGE1, and NTG all decreased both PVR and SVR. None of these vasodilatorswere more selective to the pulmonary vascular bed, myocardial performance, and improved gas exchange.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Alprostadil* ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Epoprostenol* ; Heart Rate ; Hemodynamics* ; Hypertension, Pulmonary* ; Nitroglycerin* ; Oxygen ; Pulmonary Artery ; Vasodilator Agents ; Ventricular Function, Right

PURPOSE: This study was designed to assess the efficacy, tolerability and safety of oral fluconazole in the treatment of pityriasis versicolor(PV). METHODS: Fifty-nine patients, 48 males and 11 females aged 12-57(mean 30 years) were enrolled in this study. Oral fluconazole in 300mg single dosage once weekly for 2 weeks was administered. Clinical and mycological evaluation by global assessment, Wood's lamp examination, and KOH mount was performed. Evaluation was done before and after treatment, at week 1, 2, 3, 4 and 6. RESULTS: Forty-two patients(71.2%) showed clinical and mycological response at week 6. Tolerability of the drug was acceptable while two patients experienced mild dizziness during the therapy. Otherwise, there were no significant side effects to be attentioned. CONCLUSION: Oral fluconazole could be considered as an effective and safe alternative in the treatment of pityriasis versicolor.
Dizziness ; Female ; Fluconazole* ; Humans ; Male ; Pityriasis* ; Tinea Versicolor*

BACKGROUND: Low flow anesthesia provides many advantages, including reduced cost, conservation of body heat and airway humidity. This study was performed to compare low flow anesthesia with high flow anesthesia and to investigate whether the advantages of low flow anesthesia during positive pressure ventilation can be combined with the laryngeal mask airway in paralyzed pediatric patients. METHODS: Thirty-one pediatric patients of ASA physical status 1 or 2 were studied and divided into two groups according to the fresh gas flow (FGF) in the breathing system; low flow group (FGF approximation 1 L/min, n = 17) or high flow group (FGF approximation 4 L/min, n = 14). Each respiratory parameter was measured when a steady state was reached at 20 min after induction. RESULTS: There were no significant differences of respiratory data between the two groups except that the inspired oxygen concentration was lower in the low flow group than in the high flow group. Hemodynamic changes with the laryngeal mask airway insertion were not statistically significant. CONCLUSIONS: A laryngeal mask airway is an effective airway device for low flow anesthesia as well as for high flow anesthesia in paralyzed pediatric patients.
Anesthesia* ; Hemodynamics ; Hot Temperature ; Humans ; Humidity ; Laryngeal Masks* ; Oxygen ; Pediatrics* ; Positive-Pressure Respiration* ; Respiration

We had an opportunity to evaluate a child who developed fever approximately two to three weeks after the open heart surgery for tetralogy of Fallot. His peripheral blood smear showed rings and various stages of Plasmodium vivax. The patient had received packed red blood cells during the surgery and postoperative care, one unit of which was later proved sero-positive for malaria. The possibility of malaria should be included in the differential diagnosis of the patients with unexplained fever after multiple blood product transfusions for the open heart surgery.
Animal ; Blood Transfusion/*adverse effects ; Cardiac Surgical Procedures ; Case Report ; Fever/parasitology ; Human ; Infant ; Korea ; Malaria, Vivax/*transmission ; Male ; *Plasmodium vivax ; Tetralogy of Fallot/*surgery