No abstract available.

No abstract available.
Extremities* ; Myokymia*

BACKGROUND: Punch biopsy has been used frequently as a diagnostic method in dermatologic field. However dermatologist administrated antibiotics is routine for the prevention of wound infection. OBJECTIVE: The purpose of this study was to evaluate the efficacy of prophylactic antibiotics in punch biopsy. METHODS: Four hundred and one patients undergoing punch biopsy were studied prospectively. Patients were randomly split in to two groups: group I received prophylactic antibiotics after punch biopsy (197 patients), group II didn't receive any antibiotic after punch biopsy (204 patients). Wound infection was defined as a condition of erythema, edema, and pain or purulent discharge. RESULTS: Patients demographics and skin disease were similar between two groups. Biopsy site were infected in 3 patients of group I and 5 patients of groups II. Staphylococcus aureus, Staphylococcus epidermidis and Bacteroides fragilis were isolated from the infected biopsy site. There was no significant difference of infection rate between two groups. CONCLUSION: This result suggests that the routine use of prophylactic antibiotics after skin punch biopsy is unnecessary.
Anti-Bacterial Agents* ; Bacteroides fragilis ; Biopsy* ; Demography ; Edema ; Erythema ; Humans ; Prospective Studies ; Skin ; Skin Diseases ; Staphylococcus aureus ; Staphylococcus epidermidis ; Wound Infection

OBJECTIVES: Tympanic membrane perforations are common, but there have been few studies of the factors determining the extent of the resulting conductive hearing loss. The aims of this study were to determine whether the size of tympanic membrane perforation, pneumatization of middle ear & mastoid cavity, and location of perforation were correlated with air-bone gap (ABG) of patients. METHODS: Forty-two patients who underwent tympanoplasty type I or myringoplasty were included and preoperative audiometry were analyzed. Digital image processing was applied in computed tomography for the estimation of middle ear & mastoid pneumatization volume and tympanic membrane photograph for the evaluation of perforation size and location. RESULTS: Preoperative mean ABG increased with perforation size (P=0.018), and correlated inversely with the middle ear & mastoid volume (P=0.005). However, perforations in anterior versus posterior locations showed no significant differences in mean ABG (P=0.924). CONCLUSION: The degree of conductive hearing loss resulting from a tympanic membrane perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid.
Audiometry ; Ear, Middle ; Hearing Loss, Conductive* ; Humans ; Mastoid ; Myringoplasty ; Tympanic Membrane ; Tympanic Membrane Perforation* ; Tympanoplasty

Medullary thyroid carcinoma accounts for 3% of all thyroid gland malignancies. It commonly metastasizes to liver, lung, and bone. It rarely metastasizes to skin, and only a few such cases have been documented. Cutaneous metastasis suggests a poor prognosis, with a mean survival of 7.5-19 months. The most effective treatment for skin metastasis is complete surgical removal of all local and regional lesions. The response to systemic chemotherapy is typically poor. We report a case of medullary thyroid carcinoma with cutaneous metastases, which responded to chemotherapy.
Liver ; Lung ; Neoplasm Metastasis ; Prognosis ; Skin ; Thyroid Gland ; Thyroid Neoplasms

No abstract available.

BACKGROUND: Opioid tolerance may involve activation of the N-methyl-D-aspartate (NMDA) system. The possible involvement of the NMDA system suggests that one of the NMDA receptor antagonists, magnesium may be a useful adjunct to opioids for the treatment of postoperative pain following remifentanil infusion. METHODS: For this study, 70 patients scheduled for major abdominal surgery under remifentanil-based anesthesia were randomly allocated into groups that received either magnesium sulfate (group M) or saline (group C) intravenously. The patients in the group M received 25% magnesium sulfate at a dose of 50 mg/kg in 100 ml of saline, and those in the group C received an equal volume of saline prior to the induction of anesthesia. In addition, patients in both groups received 10 mg/kg/h infusion of either magnesium sulfate (group M) or an equal volume of saline (group C) until the end of surgery. Pain was assessed using a visual analog scale at 30 min, and 6, 12, 24, and 36 hours after operation. The time to the first use of postoperative analgesic and cumulative analgesic consumption in both groups were also evaluated. RESULTS: The visual analog scale scores for pain and cumulative analgesic consumption were significantly lower in the group M than in the group C. The time to the first use of postoperative analgesic was significantly shorter in group C than in the group M. CONCLUSIONS: Use of the NMDA-receptor antagonist, magnesium sulfate as an adjuvant analgesic reduced postoperative pain in patients undergoing major abdominal surgery under remifentanil-based anesthesia.
Analgesics, Opioid ; Anesthesia ; Humans ; Magnesium ; Magnesium Sulfate ; N-Methylaspartate ; Pain, Postoperative ; Piperidines

BACKGROUND: Early oral intake (EOI) associated with early recovery of normal bowel function has been shown to be an important determinant for improving patients' satisfaction. We investigated the tolerability of EOI and its effects on the recovery of bowel function after epidural anesthesia. METHODS: A prospective randomized trial of patients undergoing lower extremities surgery under epidural anesthesia was performed. A liquid drink was given to 150 patients in the EOI group 1 hours after surgery, and to 150 patients in the delayed oral intake (DOI) group 8 hours after surgery. We recorded presence of bowel sounds immediately after operation, symptoms of ileus, time to the first flatus, time to the first defecation, degree of appetite before the first meal, and patients' satisfaction. RESULTS: There was no significant difference in the presence of immediate postoperative bowel sounds, the degree of appetite before the first meal, mild ileus, and severe ileus between groups. Time to the first flatus and time to the first defecation in the EOI group were shorter than those of the DOI group. The patients' satisfaction in the EOI group was higher than that of the DOI group. CONCLUSIONS: For uncomplicated patients undergoing lower extremities under epidural anesthesia, beginning oral hydration as early as 1 hour after the operation is safe and well tolerated and resulting in faster recovery of bowel function and higher patients' satisfaction.
Anesthesia, Epidural ; Appetite ; Defecation ; Flatulence ; Humans ; Ileus ; Lower Extremity ; Meals ; Prospective Studies

To identify the long-term survival rate and prognostic factors of AMI in Korea, total 404 patients who presented between Jan 1984 and mar 1989 at Seoul National University Hospotal were followed for and average of 24.9+/-18.2 months(range 1 to 69 months). 50 patients(12.4%) died during the in-hospital period and 25 patients(6.2%) died after discharge. Among the survivors reinfarction developled in 11 patients(3.3%). Overall survival rates were 0.87, 0.85, 0.83, 0.81, 0.79, 0.77 and event-free survival rates were 0.87, 0.84, 0.83, 0.79, 0.77, 0.72 at 1, 6, 12, 24, 36, 48 months respectively. During the in-hospital period sex, age, peak creatine kinase level, Killip class, Q wave in ECG, heart failure, and AV block in anterior infarction were of prognostic value. After discharge age, exercise duration on pre-discharge treadmill test, cardiac index, ejection fraction, and presence of heart failure were significant prognostic factors. Pre-discharge coronary angiographies were performed in 217 cases. There was no statistically significant difference in survival rate between multiple vessel disease and single vessel disease. But the more the number of involved vessels was, the higher the incidence of reinfarction was. In the group with jeopardy score less than 8, event-free survival rate was signigicantly higher. Overall survival rate was higher and reinfarction rate was lower in the group, but both were not statistically significant. On discriminant analysis of in-hospital prognostic factors, Killip class, heart failure and age were independent prognostic factors, but other factors had no additional prognostic value.
Atrioventricular Block ; Coronary Angiography ; Creatine Kinase ; Disease-Free Survival ; Electrocardiography ; Exercise Test ; Heart Failure ; Humans ; Incidence ; Infarction ; Korea ; Myocardial Infarction* ; Seoul ; Survival Rate* ; Survivors

We report a case of extraluminal leiomyosarcoma of inferior vena cave(IVC) in a 56 year old woman. She was admitted to our hospital because of right lower quadrant discomfort for a month. Radiologic finding including ultrasonography, computerized tomography, magnetic resonance imaging showed heterogenous solid mass adhering to IVC and the confirmative diagnosis was made by ultrasonography guided percutaneous needle biopsy. She underwent radical resection surgery. No adjuvant treatment was performed and she has been in the follow up without recurrence of the disease.
Biopsy, Needle ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Leiomyosarcoma* ; Magnetic Resonance Imaging ; Middle Aged ; Recurrence ; Ultrasonography