Since 1954 when the first biodegradable polymer, polyglycolic acid(PGA), was synthesized, many different biodegradable and tissue-tolerant materials have been invested and studied for internal fixation devices. The use of biodegradable materials for the internal fixation of fractures would avoid the need for later removal of the implant. However, problems of a physical and chemical nature have delayed the development of biodegradable implants applicable to fracture management. The authors reviewed 17 cases in which the absorbable pins made of poly-p-dioxanone were used for internal fixation at Seoul National University Hospital between December, 1987 and September, 1989, and report on 11 patients who had at least 6 months follow-up(average 9.1 months). The results were graded as excellent(5 cases), good(4 cases), poor(0 case), and questionable(2 cases). In the 9 cases where the absorbable pins were used for internal fixation of the intraarticular fractures or defects, satisfactory(excellent or good) results were obtained. In the 2 cases where the absorbable pins were used for intramedullary nailing, the role of the pins was questionable. There were no complications such as wound sinus formation, secondary displacement of the fragemts and delayed union or nonunion.
Absorbable Implants ; Fracture Fixation, Intramedullary ; Humans ; Internal Fixators ; Intra-Articular Fractures ; Polymers ; Seoul ; Wounds and Injuries

BACKGROUND: We evaluated laryngeal mask airway (LMA) insertion conditions, hemodynamic changes and bispectral index (BIS) responses during the induction of anesthesia with target controlled infusion (TCI) of propofol. METHODS: Ninety patients (ASA 1 or 2, 18-64 years) were allocated randomly to receive an infusion to achieve and maintain target blood concentration of a 4, 5 and 6micro gram/ml. LMA was inserted after loss of consciousness. LMA insertion conditions, hemodynamic and BIS responses were evaluated. RESULTS: Loss of consciousness and LMA insertion were more rapid in patients with propofol target blood concentration of a 6micro gram/ml than at the other concentrations. Also, full attenuation of larygeal reflexes on the first try was greater in the 6micro gram/ml group than the other groups. CONCLUSIONS: We conclude that propofol administration at a target blood concentration of 6micro gram/ml allow successful insertion of LMA without major hemodynamic changes.
Anesthesia ; Hemodynamics ; Humans ; Laryngeal Masks* ; Plasma* ; Propofol* ; Reflex ; Unconsciousness

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To evaluate the clinical course of optic nerve sheath meningioma (ONSM) in Korean patients. METHODS: A retrospective study of 11 eyes of 11 patients with a diagnosis of ONSM between 2002 and 2015 at Severance Hospital. RESULTS: The mean age at symptom onset was 47.6 years. Ten females and 1 male participated in the study and all tumors were unilateral. Patients typically presented with visual loss and proptosis. Three patients complained of limited extraocular movements and seven patients exhibited visual field defects. Three patients who had a greater growth rate with intracranial involvement and two patients who had decreased vision received treatments. Five patients maintained good vision and visual field during the follow-up period. However, one patient who underwent surgical treatment presented significant visual loss and deterioration of visual field defect. One out of two patients who received three-dimensional conformal radiotherapy (3D-CRT) experienced improvement in visual field, and the other showed no change in visual field defect but remained stable with decreased tumor size. One out of two patients who underwent gamma-knife surgery showed aggravated visual field defect and the other presented with visual loss. CONCLUSIONS: ONSM is typically a slow-growing tumor. Deterioration of visual loss and visual field defect can occur after treatment of ONSM. Therefore, management should be considered carefully and should be limited to cases in which progression of the disease is advanced or tumor growth is fast. 3D-CRT can be considered in patients in need of treatment.
Diagnosis ; Exophthalmos ; Female ; Follow-Up Studies ; Humans ; Male ; Meningioma* ; Optic Nerve* ; Radiotherapy, Conformal ; Retrospective Studies ; Visual Fields

A 43-year-old man who had had a history of atrial septal defect (ASD) device closure 31 months previously presented with abrupt chest and back pain along with progressive cardiogenic shock and cardiac arrest. After resuscitation, he was diagnosed with cardiac tamponade. Diagnostic and therapeutic surgical exploration revealed left atrium (LA) perforation due to LA roof erosion from a deficient aortic rim. Device removal, primary repair of the LA perforation site, and ASD patch closure were performed successfully. The postoperative course was uneventful. The patient was discharged after 6 weeks of empirical antibiotic therapy without any other significant complications.
Adult ; Back Pain ; Cardiac Tamponade ; Device Removal ; Heart Arrest ; Heart Atria ; Heart Septal Defects, Atrial* ; Humans ; Resuscitation ; Septal Occluder Device ; Shock, Cardiogenic ; Thorax

PURPOSE: There are few reports describing objective and subjective outcomes in aged patients undergoing distal urethral polypropylene sling (DUPS) and canal transobturator tape (canal TOT) placement, which make the submucosal mesh 'tension-free' state in the operating room. We evaluated surgical outcomes and subjective satisfaction in patients over 70 years of age who underwent DUPS and canal TOT for the treatment of stress urinary incontinence (SUI). MATERIALS AND METHODS: We studied 29 consecutive patients over 70 years of age who underwent DUPS and canal TOT for genuine SUI between January 2006 and April 2008. Surgical outcomes were determined on the basis of hemoglobin change, operative time, hospital stay, and complications. Subjective satisfaction was determined on the basis of disease-specific quality of life, measured via the Incontinence Impact Questionnaire-short form (IIQ-7) and the Urogenital Distress Inventory-short form (UDI-6). RESULTS: No intraoperative or major postoperative complications were reported. No concomitant procedures were performed, including cystocele repair (n=0) or rectocele repair (n=0). The mean IIQ-7 and UDI-6 scores both decreased significantly after DUPS and canal TOT. Moreover, 82% of patients reported no SUI symptoms under any circumstances, and 91% of patients reported being rarely or never bothered by SUI symptoms. CONCLUSIONS: The surgical outcomes and subjective satisfaction seen with DUPS and canal TOT in this study were superior to those seen in other studies. However, it is possible that this study overestimated the effects of DUPS and canal TOT in aged women because of the small study sample. Therefore, additional studies are needed.
Aged ; Cystocele ; Female ; Hemoglobins ; Humans ; Length of Stay ; Operating Rooms ; Operative Time ; Polypropylenes ; Postoperative Complications ; Quality of Life ; Rectocele ; Suburethral Slings ; Urinary Incontinence

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of urolithiasis since it was first introduced in 1980. ESWL is a well-established, safe and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. We present a case of a young female patient who developed a huge hepatic subcapsular hematoma accompanied by hypovolemic shock after ESWL for a 9 mm stone in the right kidney. The hematoma measured 13x6 cm. Conservative care with no surgical intervention was chosen because there was no evidence of active bleeding on the computed tomography. After conservative therapy, the hematoma was gradually absorbed and the patient was discharged.
Female ; Hematoma ; Hemorrhage ; Humans ; Kidney ; Lithotripsy ; Shock ; Urolithiasis

BACKGROUND: Postoperative nausea and vomiting are common postoperative complaints. The purpose of this study was to assess the effect of preoperative midazolam on vomiting after appendectomy. METHODS: Sixty patients, aged 10 64 yr, undergoing emergency appendectomy were randomly allocated to receive midazolam 30, 50, 75 microgram/kg or placebo after induction of anesthesia. Anesthesia consisted of 67% nitrous oxide, 33% oxygen and propofol infusion 6 10 mg/kg/h. Postoperative vomiting was checked by the recovery room nurse at 1 h after operation and we examined the incidence of postoperative vomiting at 24 h after operation. RESULTS: Midazolam reduced the overall incidence of vomiting, especially in the midazolam 50 and 75 microgram/kg groups, completely abolishing vomiting (P< 0.05). However, in the midazolam 75 microgram/kg group, there was a delay in eye opening time (P< 0.05). CONCLUSIONS: Preoperative injections of midazolam 30 or 50 microgram/kg were useful to prevent postoperative vomiting in patients undergoing appendectomy without delayed recovery.
Anesthesia ; Antiemetics* ; Appendectomy* ; Emergencies ; Humans ; Incidence ; Midazolam* ; Nitrous Oxide ; Oxygen ; Postoperative Nausea and Vomiting ; Propofol ; Recovery Room ; Vomiting

This study aimed to investigate the clinical implication of surgical resection for the malignancies of heart and great vessels. Between January 2001 and May 2011, a retrospective review of the results in 12 patients was conducted. There were 6 patients with primary cardiac tumor including leiomyosarcoma, angiosarcoma, undifferentiated type sarcoma and malignant fibrous histiocytoma. The remaining 6 patients had the metastatic tumors or adjacent invasion to the heart and great vessels. Six of seven patients who underwent complete resection had no evidence of recurrence. However, four of five patients who underwent incomplete resection or biopsy showed local recurrence or distant metastasis of residual tumor, and one of them required reoperation for recurred tumor. In-hospital mortality was 8.3% and the mean survival of all patients was 22.2 +/- 6.1 months. Survival of the incomplete resection group, except for the two biopsy cases, was 25.9 +/- 7.9 months, and there was no mortality in the complete resection group. Therefore, clinical outcomes in patients who had malignancies of the heart and great vessels may be improved when the aggressive and complete resection, or possible debulking for palliation, was performed. Moreover, adjuvant multimodality therapy may be imperative to prevent recurrence or metastasis, and to provide improved survival.
Adult ; Aged ; Female ; Follow-Up Studies ; Heart Neoplasms/mortality/pathology/*surgery ; Humans ; Intensive Care Units ; Kaplan-Meier Estimate ; Length of Stay ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Sarcoma/mortality/pathology/*surgery ; Tomography, X-Ray Computed

BACKGROUND: The purpose of this study is to investigate the frequency of and errors in citation of references in articles from the Korean Journal of Anesthesiology (KJA) from the first application of the present contribution rules (1996) to 1998 and to suggest a clue to improve the quality of our journal. METHODS: All references cited from KJA were reviewed using a computerized searching system. If any differences are found during the review, we compare it with the original article. Errors on the contribution rules were examined according to the instructions for the authors revised in 1995. RESULTS: Overall 74% of the articles had more than one reference cited from KJA. The average number of the references cited from KJA per article was 1.73. In such references, citation errors were found in 48% of articles published in 1996, 44% in 1997, and 43% in 1998. The percentages of general errors and errors involving the contribution rules were 62% and 38%, respectively. Common general errors were found in titles (164 cases), pages (102 cases), and name (60 cases). Those involving the contribution rules found in the notation of name (120 cases), pages (54 cases), and inadequate notation of the number of issue (49 cases). CONCLUSIONS: Despite numerous efforts, the incidence of citation errors was still high when the articles of KJA were cited as references. Improvement in the quality of our journal will be possible only by rigid adherence to contribution rules, thorough review of the articles, and a lucid explanation of contribution rules.
Anesthesiology* ; Incidence