Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

No abstract available.
Humans ; Pneumoconiosis*

Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

PURPOSE: We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. METHODS: This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. RESULTS: Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. CONCLUSION: The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.
Child ; Electroencephalography ; Epilepsy ; Humans ; Neurology ; Pediatrics ; Seizures

The purpose of this study was to investigate the variations of the skeletal and dentoalveolar dimensions in relation to vertical facial patterns. Lateral cephalogram of 200 cases (100 cases of male and 100 cases of female, average age of which was 23.2 years) were traced and some measurements of skeletal and dentoalveolar dimensions were measured. The ratio of UAFH/LAFH was employed to classify the samples into groups of excess and short lower anterior facial height. And the comparison between two groups were taken statistacally. The following results were obtained. 1. The dentoalveolar height, lower anterior facial height, lower gonial angle, and FMA in the excess-lower-anterior-facial-height group were significantly larger than those in short-lower-anterior-facial-height group. 2. The dentoalveolar height, ramus height, and Jarabak ratio in the male subjects were significantly larger than those in the female subjects. 3. The UAFH/LAFH ratio showed a significant correlation to upper, lower facial height, AUDH, PUDH, ALDH, PLDH, Lower gonial angle, FMA, and Bjok`s Sum.
Female ; Humans ; Male

A 50-yr-old man presented with intermittent hemoptysis and was diagnosed small cell lung cancer. 18F-FDG PET/CT for staging demonstrated extensive hypermetabolic lesions throughout the skeleton and liver. Interestingly, skeletal muscles of limbs, mediastinum, bowel, and especially brain showed very low FDG uptake. Because of some characteristics in common with super scan on skeletal scintigraphy, this case could be considered as 'metabolic super scan'.
Carcinoma, Small Cell/complications/radionuclide imaging ; Fluorine Radioisotopes/diagnostic use ; Fluorodeoxyglucose F18/*diagnostic use ; Hemoptysis/complications/radionuclide imaging ; Humans ; Liver Neoplasms/diagnosis/secondary ; Lung Neoplasms/complications/radionuclide imaging ; Male ; Middle Aged ; *Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use

A neonate may incur liver injury during spontaneous delivery. The liver is the organ most likely to be injured during the birth process. Breech presentation and manipulation are the most common causes of hepatic trauma. However, hepatic hemorrhage can occur in any infant, regardless of size and the type of delivery. Infants with subcapsular hemorrhage are usually asymptomatic at birth, and gross hepatic rupture from these lesions is unusual. In patient with primary rupture, major bleeding takes place immediately, explaining the high percentage of neonatal deaths with massive liver rupture. If subcapsular hemorrhage remain intracapsular with spontaneous resolution, the only treatment needed in subcapsular hemorrhage may be transfusion. We experienced one case of neonatal subcapsular hemorrhage with persistent hyperbilirubinemia. We report this case with the brief review of related literature.
Breech Presentation ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Liver ; Parturition ; Pregnancy ; Rupture

OBJECTIVES: To report on the skin discoloration experienced by three workers handling 2 , 5 -hexanedione METHODS: Three workers, who showed orange-brown discoloration of the palms during observation under the Kumi occupational disease surveillance system, had their history evaluated and underwent physical examination. A workplace survey was performed by an occupational physician and an industrial hygienist. RESULTS: The three workers were determined to have been experiencing skin discoloration since the introduction of a new cleaning solvent. The new solvent contained 2,5-hexanedione, which is reported in the literature to be possibly capable of causing orangebrown discoloration of the skin. After discontinuation of solvent use, the workers recovered within a week. CONCLUSIONS: These cases demonstrate that 2,5-hexanedione can produce skin pigmentation.
Gyeongsangbuk-do ; Occupational Diseases ; Physical Examination ; Skin Pigmentation* ; Skin*

PURPOSE: To evaluate the diagnostic value of gross bloody stools as a predictor of intussusception. METHODS: We reviewed 159 cases retrospectively that had an ultrasound examination for diagnosis of intussusception from January 2001 to December 2003 at Ilsin Christian Hospital. We compared each symptom and assessed the diagnostic value of gross bloody stools in the patients with suspected intussusception. RESULTS: Thirty-six of the 159 patients had intussusception. Of 36 patients with intussusception, 19 (52.8%) children were male and 28(77.8%) children were younger than two years. The most common symptom was intermittent abdominal pain or irritability. But its frequency among the intussusception (24.2%) was lower than frequency of gross bloody stools(50.9%). The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of gross bloody stools in patients with suspected intussusception were as follows; sensitivity=77.8%(95% CI 60.8-89.9), specificity=78.0%(95% CI 69.7-85.0), PPV=50.9%(95% CI 37.1-64.6), NPV=92.3%(95% CI 85.4-96.6)(Diagnostic accuracy 78.0 %; 95% CI 70.7-84.2). CONCLUSION: It is useful for diagnosis of intussusception to confirm the presence of gross blood in stools.
Abdominal Pain ; Child ; Diagnosis ; Humans ; Intussusception* ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Animals ; Coal* ; Dust* ; Lung* ; Rats* ; Silicon Dioxide*