Malignant hyperthermia still carries a high mortality despite of the increased understanding of the problem involved. A 33 year old relatively healthy male patient was admitted to this hospital via emergency room because of panperitonitis due to peptic ulcer perforation. We experienced acase of malignant hyperthermia which developed 20 minutes after induction of general anesthesia with thiopental sodium, succinylcholine chlovide, halothane, N2O and O2. The body temperature(esophageal) rose altupthy up to 41.2 degrees C and continued as a high fever for about 3 hours. The blood pressure and heart rate also increased and ventricular dyarrhythmia appeared. The etiology, triggering gactors, factors, clinical features, diagnosis treatment and safe anesthesia of malignant hyperthermia are discussed.
Male ; Humans ; Mortality

No abstract available.
Colitis, Ulcerative* ; Polyneuropathies ; Ulcer* ; Vasculitis

BACKGROUND: Motor conduction slowing in diabetic distal symmetrical polyneuropathy (DSP) generally exceeds that in distal axonal polyneuropathy. Additional mechanisms secondary to axonal injury may contribute towards this slowing. However, clinical and pathophysiological significances of motor conduction slowing have been rarely discussed. The purpose of this study is to evaluate the clinical and pathophysiological significance of conduction slowing in DSP. METHODS: We analyzed motor conduction studies of 39 patients with symptomatic painful DSP and 24 patients with asymptomatic painless DSP. Motor conduction studies of 39 patients with amyotrophic lateral sclerosis (ALS) were used as controls for the amplitude-dependent slowing of conduction. Percentages of normal limits were calculated for the compound muscle action potential amplitude (CMAP), distal motor latency (DL), and conduction velocity (CV), and converted to a square root (SQRT) form. The changes of SQRT-DL or SQRT-CV according to SQRT-CMAP changes were plotted and analyzed. RESULTS: Regression analysis showed that DL and CV were amplitude-dependent in both painless DSP and ALS. The changes of DL and CV in painful DSP did not show amplitude-dependency except DL in the lower extremities. CONCLUSIONS: This data supports the hypothesis that the mechanism of slowing is similar in both painless DSP and ALS and results from the loss of large, fast-conducting fibers. Lack of amplitude-dependency of conduction slowing in painful DSP may reflect the combined axonal and demyelinating changes, possibly due to inflammation.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Axons ; Diabetic Neuropathies* ; Electrophysiology ; Humans ; Inflammation ; Lower Extremity ; Neural Conduction ; Polyneuropathies

BACKGROUND: For the early detection and prevention of diabetic neuropathy, it is important to identify subclinical diabetic neuropathies. A routine nerve conduction study often fails to detect the early stages of neuropathy. The purpose of this study is to evaluate the clinical usefulness of electrophysiological indexes including the residual latency(RL), terminal latency index (TLI) and modified F ratio (MFR) in detecting early diabetic neuropathy with no objective clinical or electrophysiological abnormalities. METHODS: A nerve conduction study of the upper/lower limbs was investigated in 38 subclinical diabetic neuropathy patients with normal nerve conduction studies (group I), 35 clinical diabetic neuropathy patients with normal nerve conduction studies (group II) and 31 normal controls. RL, TLI and MFR were calculated and compared among the groups. RESULTS: Compared with the control group, the MFR of the lower limbs and TLI of both the upper/lower limbs were significantly decreased in both group I and II (p<0.05). RL was increased in both groups, but the difference was not statistically significant. Comparing the indexes between group I and II, there was no significant difference. CONCLUSIONS: RL, TLI and MFR are useful indexes for reflecting distal conduction slowing especially in slowly progressing polyneuropathies such as diabetic neuropathy. The results also suggest that electrophysiological changes veiled in a routine nerve conduction study were present before the clinical manifestations.
Diabetic Neuropathies* ; Extremities ; Humans ; Lower Extremity ; Neural Conduction* ; Polyneuropathies

Following the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), disability-adjusted life years (DALYs) have been widely used as a summary measure of population health. The DALY metric is a comprehensive measurement of population health, enabling comparison among groups. However, the available data and reliance on estimates to supplement the data gap require contextualization at the national level, and the outcomes of which are more appropriate for national policymakers. The Korean National Burden of Disease (KNBD) study was initiated by the Research and Development Project of the Ministry of Health and Welfare, funded by a 5-year grant from 2013, to contextualize the GBD method to the Korean population. Here, we provide a comprehensive overview of the KNBD study with its achievements and challenges and discuss the implications for public health policies.

No abstract available.
Central Nervous System Neoplasms ; Cerebral Ventricle Neoplasms ; Lymphoma*

BACKGROUND: The contingent negative variation (CNV) reflects neuronal activities related to sensorimotor integration and motor planning or execution and is probably originated from the frontal-subcortical circuit. The aim of this study is to investigate the neurophysiologic changes in uremia and the effect of hemodialysis to them by utilizing the CNV test. METHODS: Fifteen right-handed healthy subjects and 12 patients with end stage renal disease (ESRD) were studied. CNV was recorded from Fz, Cz, and Pz referenced to linked ear lobes by using an S1 (click)-S2 (flashes)-key press paradigm. The amplitude of initial CNV (iCNV) was calculated as the average amplitude of 550~750 msec after S1. The amplitude of late CNV (lCNV) was calculated as the average amplitude between 200 msec before S1 and S2. The test was repeated for the patients group at the time of pre- and post-hemodialysis. Neuropsychological measurements, the trail making test (TMT) and mini-mental state score (MMSE), were conducted at the time of each test. RESULTS: Both the mean amplitudes of iCNV and lCNV at the vertex (Cz) were significantly lower in the patient group than those in the control group (p<0.05). The MMSE score and TMT were also significantly different between the patient and control group (p<0.05). There was no significant correlation between the values of neuropsychological tests and the parameters of CNV. Both iCNV and lCNV were not significantly different between the pre- and post-dialysis test. CONCLUSIONS: It appears that CNV negativity in uremia reflects dysfunctions in the frontal-subcortical circuit. In addition, hemodialysis seems to have no significant effect on it in patients with ESRD.
Contingent Negative Variation* ; Ear ; Evoked Potentials ; Humans ; Kidney Failure, Chronic* ; Neurons ; Neuropsychological Tests ; Renal Dialysis ; Trail Making Test ; Uremia

Fetus in fetu is a poorly understood and rare congenital malfomation. This is a rare form of monozygotic twin that asymmetric twin becomes internalized in the other twin thus acting endoparasitically. Fetus in fetu can be distinguised from teratoma, because of vertebral column, skeletal axis, and well-differentiated internal organs. We present the findings in the two cases of fetus in fetu that were diagnosed with prenatal ultrasonography. After birth, we removed fetus-like structures and confirmed by pathologic examination. Fetus-like structures were consisted of vertebral column, extremities, and other well-developed internal organs.
Axis, Cervical Vertebra ; Extremities ; Fetus* ; Humans ; Parturition ; Spine ; Teratoma ; Twins, Monozygotic ; Ultrasonography, Prenatal*

Gastric volvulus is characterized by an abnormal rotation of the stomach typically 180degrees left to right around a line joining the relatively fixed pylorus and the esophagus. Gastric volvulus can be classified anatomically as organoaxial, mesenteroaxial or combined, and symptomatically as acute or chronic. Acute gastric volvulus is an extremely rare emergency surgical condition. The classical triad of gastric volvulus are severe nausea with a paradoxical inability to vomit, localized epigastric pain and an inability to pass a nasogastric tube. Gastric volvulus may be suspected on a plain radiological examination of the abdomen as well as by its symptoms. It is confirmed by the specific findings on the esophagogastroduodenoscopy. We report a case of acute mesenteroaxial gastric volvulus, that was treated using laparoscopic reduction and anterior gastropexy.
Abdomen ; Emergencies ; Endoscopy, Digestive System ; Esophagus ; Gastropexy ; Gastroscopy ; Nausea ; Pylorus ; Stomach ; Stomach Volvulus*

Recent evidence has strongly suggested that the CAP/TC10 pathway is involved in the trafficking, docking,and fusion of vesicles containing the insulin- responsive glucose transporter Glut4 to the plasma membrane. However, little is known about how the genes employed in the CAP/TC10 pathway are associated with the development of type 2 diabetes mellitus. In this study, we sequenced 4 genes of the CAP/TC10 pathway [SORBS1, CBL, CRK, and RHOQ] in 24 individuals to identify genetic variations in these loci. A total of 48 sequence variants were identified, including 23 novel variations. To investigate the possible association with type 2 diabetes mellitus, 3 single nucleotide polymorphisms from SORBS1, 3 from CBL , and 4 from RHOQ were genotyped in 1122 Korean type 2 diabetic patients and 1138 nondiabetic controls. Using logistic regression analysis, 1 significant association between SNP rs1376405 in RHOQ and type 2 diabetes mellitus [OR = 8.714 (C.I. 1.714-44.29), p = 0.009] was found in the recessive model. Our data demonstrate a positive association of the RHOQ gene in the CAP/TC10 pathway with T2DM in the Korean population.
Cell Membrane ; Diabetes Mellitus, Type 2 ; Genetic Variation ; Glucose Transport Proteins, Facilitative ; Humans ; Insulin ; Logistic Models ; Polymorphism, Single Nucleotide ; Signal Transduction