No abstract available.
Calcium* ; Child* ; Humans

It is easy to view the laryngeal aperature with a flexible fiberscope through a laryngeal mask airway (LMA). This is a case report that the LMA could facilitate a fiberscope-aided tracheal intubation easily. Patient was a 59 year old female who had some limitation of mouth opening due to ankylosis of bilateral temporomandibular joints. After thiopental (200 mg) and succinylcholine chloride (50 mg) were given intravenously, a number 3 sized LMA was inserted and the lungs were ventilated via the LMA. The anesthesia cirele system is then disconnected from the LMA and a fiberscope, with the proximal end jacketed with a well-lubricated, cuffless, 6-mm-ID endotracheal tube (ETT); was inserted into the trachea through the lumen of the LMA. The 6-mm-ID ETT was threaded over the fiberscope into the trachea before fiberscope was withdrawn, and a traeheal tube exchanger was inserted through the ETT after enough ventilation for a while, followed withdrawal of the LMA and ETT. Finally, we can make the 7 mm-ID ETT with cuff insert into the trachea over a tracheal tube exchanger very easily without any difficulties.
Anesthesia ; Ankylosis ; Bronchoscopes* ; Female ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngeal Masks* ; Lung ; Middle Aged ; Mouth ; Succinylcholine ; Temporomandibular Joint ; Thiopental ; Trachea ; Ventilation

OBJECTIVES: To evaluate the effects of progesterone/progestin and in combination with estrogen in relaxation of rat aorta. METHODS: Eight weeks after bilateral oophorectomy, the descending aorta of Spague-Dawley rats (n=10) were quickly removed and placed in organ bath containing Krebs solution. Each aorta ring in 2-3 mm length was connected to an isometric force transducer (FT 03, Grass, USA) and the changes in tension were recorded with an AD converter system (MP 100, Biopac Inc, USA) in a personal computer. After precontraction of the rings with norepinephrine (1 umol/L) or KCl (40 mmol/L), estradiol, progesterone, medroxyprogesterone acetate (MPA), norethisterone acetate (NETA) (10-5-10-8 M/L in each) were added to each ring and they were incubated for 15 minutes. The relaxation was expressed as a percentage of the tonic contraction. RESULTS: Estrogen relax the aorta in all concentrations. The degree of relaxation was dose dependent (P<0.001). All of the progesterone, MPA, NETA relax the aorta and the effects was different according to the concentration of steroids (P<0.0001). The degree of relaxation was not different between estrogen and those of progesterone, MPA, NETA except MPA 10-8 M, NETA 10-5 M. Addition of progesterone, MPA and NETA to the estrogen showed similar vascular effects compared to those of estrogen alone. CONCLUSION: Not only estrogen but also progesterone, MPA, and NETA acutely relax aorta. Progesterone/progestin have not been found attenuate the action of estrogen in our animal in vitro study.
Animals ; Aorta ; Aorta, Thoracic ; Arteries ; Baths ; Estradiol ; Estrogens ; Female ; Medroxyprogesterone Acetate ; Microcomputers ; Norepinephrine ; Norethindrone ; Ovariectomy ; Poaceae ; Progesterone ; Rats ; Relaxation ; Steroids ; Transducers

We report a case of 41-year-old male with pulmonary metastasis from a recurrent intracranial malignant meningioma, which had two more recurrence, multiple intracranial metastasis. Pulmonary metastasis was developed five years after resection of primary lesion. The metastatic routes and treatment of pulmonary metastatic malignant meningiomas were described.
Adult ; Humans ; Male ; Meningioma* ; Neoplasm Metastasis* ; Recurrence

Actinomycosis is a subacute-to-chronic infection caused by gram-positive, anaerobic bacteria. Actino- mycetes reside in oral cavity, gastrointestinal tract, female genital tract as normal flora, but may provoke an opportunistic infection under certain circumstances, resulting in contiguous spread, suppurative and granu- lomatous inflammatory reaction, and formation of multiple abscesses. Abdominal and pelvic actinomycosis in women are related to a history of abdominal surgery or intrauterine contraceptive device (IUD) insertion and have variable nonspecific symptoms that make an initial diagnosis difficult. We experienced a case of pelvic actinomycosis related to IUD that diagnosed pathologically after laparotomy.
Abscess ; Actinomycosis* ; Bacteria, Anaerobic ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Intrauterine Devices* ; Laparotomy ; Mouth ; Opportunistic Infections

OBJECTIVE: The purpose of this experimental study was to evaluate the effect of immediate orthodontic loading on the stability at the bone-implant interface of titanium miniscrews in a rabbit model. METHODS: Forty titanium miniscrews (1.6 mm diameter, 8 mm length) were inserted in the tibiae of 10 rabbits. Twenty test group miniscrews were subjected to continuous orthodontic forces of 200 g immediately after implantation for a period of 6 weeks. The remaining 20 control group miniscrews were left unloaded for the same follow-up interval. Removal torque values were recorded using a digital torque gauge. An independent t-test was performed. RESULTS: All the miniscrews were stable, and exhibited no mobility or displacement throughout the experimental period. Histologically, miniscrews were well-integrated into bone. No statistically significant differences in removal torque data were found between the loaded test and the unloaded control groups. CONCLUSIONS: These findings suggest that titanium miniscrews can be used as anchoring units for orthodontic tooth movement immediately after insertion.
Follow-Up Studies ; Rabbits ; Tibia ; Titanium ; Tooth Movement ; Torque*

OBJECTIVE: Aneurysms arising from the posterior inferior cerebellar artery(PICA) are uncommon. We review literature on that and surgical results on aneurysmal treatment by choice of surgical approach. METHODS: On the basis of radiologic findings & charts, we review retrospectively the surgical results of 12 cases from Mar 1999 to Dec 2003. RESULTS: The mean age of the 12 patients was 55.8(ranged from 36 to 71) and female was predominant (female: male=8: 4). Locations of PICA aneurysms revealed variously(vertebral artery-PICA junction: 8, lateral medullary segment: 2, PICA-anterior inferior cerebellar artery common trunk: 1, telovelomedullary: 1). Surgical approaches & treatments were attempted in 11 cases and embolization was done in 1 case(Far lateral transcondylar or supracondylar approach & clipping: 9, Far lateral transcondylar or supracondylar approach and trapping: 2, suboccipital approach & clipping: 1). The surgical result were 8 of 12 patients were good outcome, 1 of 12 was severely disabled and 3 of 12 were died. CONCLUSION: First, we choose surgical approach by the laterality of aneurysms and surgical or interventional treatment is attempted as soon as possible. The PICA aneurysm is regarded as having a relatively good surgical outcome without drilling of the posterior arch of the atlas.
Aneurysm* ; Arteries* ; Female ; Humans ; Pica ; Retrospective Studies

PURPOSE: The purpose of this study was to review our experience with the use of self-expandable metallic stents as the initial interventional management for acute malignant large-bowel obstruction. METHODS: The records of 35 patients who underwent placement of a colonic stent for acute malignant obstruction at our institution between January 2003 and December 2004 were reviewed. RESULTS: Stents were placed for palliation in 19 patients and as bridge to surgery in 16 patients. Technical success of stent placement was achieved in all patients (100%), but clinical failure occurred in two patients due to limited expansion of the metallic stent. One of them who had clinical failure underwent an emergency operation, and the other needed no further procedure because of his death. Complications occurred in 4 patients (12%), including one pelvic abscess associated with colon perforation, two minor bleedings, and one anal pain. All the patients in the bridge-to-surgery group underwent an elective colon resection without stoma. In the palliative group, stent reocclusion was observed in three patients during the follow-up (median: 65 days; range: 27~440 days), two of which were managed by reinsertion of a stent. In the remaining patients, the stent was patent until death or the last follow up date (median: 65 days). CONCLUSIONS: Placement of a self-expandable metallic stent is a safe and effective procedure for immediate decompression of acute malignant large-bowel obstruction. It provides a chance of elective surgery for patients with resectable disease, as well as relief of symptoms for those with unresectable disease.
Abscess ; Colon ; Decompression ; Emergencies ; Follow-Up Studies ; Humans ; Stents*

OBJECTIVE: Stroke is the third leading cause of death in the Republic of Korea. Time is the most important factor in hyperacute stroke. Yet, there had been no protocol for mechanical thrombolysis. We have treated patients with hyperacute stroke by mechanical thrombolysis for 3 years. In current study, we analyzed the outcome of mechanical thrombolysis. METHODS: From March 2008 to February 2011, 36 patients were treated with mechanical thrombolysis. Initially we treated the patients by aggressive mechanical clot disruption (AMCD) who were admitted within 6 hours after the symptom onset. If revascularization was not achieved, balloon angioplasty was performed, followed by stenting or temporary endovascular bypass was performed. The result in 15 cases was not so successful. Since then, we started using the thromboaspiration method as the first line treatment of the mechanical thrombolysis. RESULTS: After using the thromboaspiration, we had better results in recanalization rate, modified Rankin Score (mRS) and reperfusion injury compared to AMCD. The recanalization rate was 80.85%, mRS is 2.85, and there was only 0.09% hemorrhagic formation. CONCLUSION: Even though thromboaspiration is not statistically significant due to the limited numbers of patients enrolled in this study, we think it is a good way in mechanical thronbolysis for hyperacute stroke.
Angioplasty, Balloon ; Cause of Death ; Humans ; Mechanical Thrombolysis ; Reperfusion Injury ; Republic of Korea ; Stents ; Stroke

Twin-twin transfusion syndrome(TTTS) is a serious complication of monozygotic mu-ltiple pregnancy. TTTS is associated with high perinatal mortality rate. The acute form has been attributed to rapid transfer of blood through superficial artery-to-artery or vein-to- vein anastomoses during labor and delivery, resulting in a hypovolemic, anemic donor twin and a hypervolemic, plethoric recipient twin of similar birth weight. The authors present a case of acute twin-twin transfusion syndrome with a review of literature.
Birth Weight ; Humans ; Hypovolemia ; Perinatal Mortality ; Pregnancy ; Tissue Donors ; Veins