A 32 year-old man was scheduled for tracheal reconstruction after having special radiological studies and pulmonary function tests. Atropine was given preoperatively. A radial artery cannula was inserted for blood gas sampling and direct arterial pressure monitoring. The E,K.G. was monitored continuously. With the patient breathing a high concentration of oxygen from a mask, halothane was added to the inspired gas. After intramuscular injection of ketamine, halothane was discontinued. Spontaneous respiration was preserved with assistance when necessary. The larynx, pharynx and trachea were topically anesthetized and then a large-bore rubben orotracheal tube was placed in the trachea above the lesion. Anesthesia was maintained with additional ketamine injection. The trachea was explored through an anterior transverse cervical incision with a median sternotomy. The segment distal to the obstruction as dissected and found to be maligant tissue extending down to near the carina and behind the aortic arch. So, it was imperative to postpone further the surgery. Immediately after skin closure, the trachea was almost completely obstructed and PaCO2 value was above 150 mmHg. Therefore the airway was preserved by a pediatric bronchoscope, which was replaced by a pediatric endotracheal tube. Anesthetic management and tracheal resection and reconstruetion have been reviewed problems of induction in a patient with tracheal obstruction are discussed, and the technics for retaining control of the airway and reducing the hazards of hypoxia and hypercarbia are also stressed.
Adult ; Anesthesia* ; Anoxia ; Aorta, Thoracic ; Arterial Pressure ; Atropine ; Bronchoscopes ; Catheters ; Halothane ; Humans ; Injections, Intramuscular ; Ketamine ; Larynx ; Masks ; Oxygen ; Pharynx ; Radial Artery ; Respiration ; Respiratory Function Tests ; Skin ; Sternotomy ; Trachea

To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.

To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.

To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.
Adolescent ; Animals ; Child ; Fever ; Humans ; Infant ; Influenza, Human ; Orthomyxoviridae ; Oseltamivir ; Pediatrics ; Rats ; Virus Shedding

PURPOSE: To evaluate the therapeutic results of communited intercondylar fractures of the distal humerus that were treated by surgical treatment. MATERIALS AND METHODS: From January, 1998 to December, 2004, we reviewed fifteen cases of intercondylar fracture of the distal humerus, which were treated by surgical treatment. The follow up period ranged from six month to 5 years. The functional results were evaluated using Broberg and Morrey's functional scale according to surgical approach, type of plate and location of plating. RESULTS: The functional results were as follows; seven excellent, six good, one fair and one poor. The mean range of motion in elbow joint was 7~106 degrees. The mean functional score was 86.6 points through olecranon osteotomy, 90.5 points through Campbell's posterior approach. The mean functional score was 91.6 points in cases using 2 reconstruction plate, 78 points in cases using 1 reconstruction plate and 1/3 semitubular plate, and 86 points in case using 1 reconstruction plate and lag screws. The mean functional score was 88.9 points in cases by posterior and lateral fixation, 86 points in cases by both posterior fixation and 97 points in case by both lateral fixation. CONCLUSION: There are no significant differences in treatment outcome according to surgical approach, different plate and location of plating.
Adult* ; Elbow Joint ; Follow-Up Studies ; Humans ; Humerus* ; Olecranon Process ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome

PURPOSE: To evaluate the Three years clinical results of a total knee arthroplasty using the NexGen LPS-Flex fixed bearing system. MATERIALS AND METHODS: One hundred knees(65 patients) which used the LPS-Flex system for primary TKA and were followed up for a minimum Three years were evaluated. Evaluations included preoperative and postoperative range of motion(ROM), factors affecting the postoperative ROM that included age of the patient, the body mass index, the flexion contracture, degree of varus deformity, and Hospital for Special Surgery score. RESULTS: Knee ROM increased from preoperative 122.8 degrees to postoperative 130.5 degrees. The mean HSS score improved from preoperative 58.4 to postoperative 91.3. The femoral-tibial angle was changed from preoperative 6.4 degrees varus to a pos- toperative 5.5 degrees valgus. The most important factor that influenced the range of motion after an arthroplasty was the preoperative range of motion. One deep infection developed, but was cured with synovectomy and administration of antibiotics. CONCLUSION: Primary TKR with NexGen LPS-Flex system showed satisfactory early results including excellent ROM. We found that preoperative ROM had a significant effect on postoperative ROM.
Anti-Bacterial Agents ; Arthroplasty* ; Body Mass Index ; Congenital Abnormalities ; Contracture ; Follow-Up Studies* ; Humans ; Knee* ; Range of Motion, Articular

PURPOSE: To compare the clinical and radiological results between patellar resurfacing, group and patellar retention group in total knee arthroplasty. MATERIALS AND METHODS: Of the 74 patients who underwent total knee arthroplasty on due to knee osteoarthritis since March 1996, and followed-up for at least for 5 years, there were 42 and 32 cases in the patellar retention and patellar resurfacing groups respectively. These subjects were evaluated preoperatively and at 1 and 5 years postoperatively using the pain score, Hospital for Special Surgery (HSS) knee score, walking and stair-climbing in knee function score and radiological analysis. The radiological evaluation was achieved by measuring the patellar tilt angle and displacement with a 45degreesmerchant view. The results were analyzed using the student's t-test. RESULTS: There were no significantly differences between the patellar resurfacing and patellar retention groups in the pain score, HSS knee score, walking in knee function score and radiological analysis (p>0.05), but the patellar retention group achieved superior results in stair-climbing (p<0.05). CONCLUSION: The clinical and radiological results were similar in the patellar retention and patellar resurfacing groups. The use of selective indications of patellar resurfacing is required in order to achieve better results for total knee arthroplasty.
Arthroplasty* ; Follow-Up Studies* ; Humans ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee ; Patella ; Walking

The coronary arteriovenous fistula (CAVF) is a rare congenital anomaly but constitutes the most common hemodynamically significant coronary artery anomaly. Transcatheter embolization is as an effective alternative to surgery even though procedure may be complicated by migration of the coil into peripheral vessels or pulmonary arteries. To our knowledge, the association of CAVF with Turner syndrome was not reported. We report a case of successful coil embolization of CAVF using a complex, helical-fibered platinum coil in patient with Turner phenotype with 46,XX.
Arteriovenous Fistula* ; Coronary Vessels ; Embolization, Therapeutic* ; Humans ; Phenotype* ; Platinum ; Pulmonary Artery ; Turner Syndrome

Ticlopidine is an antiplatelet agent used as a drug to prevent the recurrence of cerebral infarction or ischemic heart disease. Close attention has recently been paid to the superiority of this drug to aspirin in the prevention of stroke. Its mechanism of action differs from aspirin, dipyridamole, and sulfinpyrazone. Inhibition of the adenosine diphosphate induced pathway of platelet aggregation, along with the activation of adenylate cyclase and suppression of platelet-activating factor and thromboxane A2, are the postulated mechanisms of action of ticlopidine. Because ticlopidine causes neutropenia and agranulocytosis in roughly 1% of treated patients, usually within the first 3 months of treatment, this drug has been reserved for patients intolerant to aspirin therapy. We reported two cases of ticlopidine-induced neutropenia and one patient hospitalized with severe neutropenia and pneumonia.
Adenosine Diphosphate ; Adenylyl Cyclases ; Agranulocytosis ; Aspirin ; Cardiovascular Diseases* ; Cerebral Infarction ; Dipyridamole ; Humans ; Myocardial Ischemia ; Neutropenia* ; Platelet Aggregation ; Pneumonia ; Recurrence ; Stroke ; Sulfinpyrazone ; Thromboxane A2 ; Ticlopidine

Ticlopidine is an antiplatelet agent used as a drug to prevent the recurrence of cerebral infarction or ischemic heart disease. Close attention has recently been paid to the superiority of this drug to aspirin in the prevention of stroke. Its mechanism of action differs from aspirin, dipyridamole, and sulfinpyrazone. Inhibition of the adenosine diphosphate induced pathway of platelet aggregation, along with the activation of adenylate cyclase and suppression of platelet-activating factor and thromboxane A2, are the postulated mechanisms of action of ticlopidine. Because ticlopidine causes neutropenia and agranulocytosis in roughly 1% of treated patients, usually within the first 3 months of treatment, this drug has been reserved for patients intolerant to aspirin therapy. We reported two cases of ticlopidine-induced neutropenia and one patient hospitalized with severe neutropenia and pneumonia.
Adenosine Diphosphate ; Adenylyl Cyclases ; Agranulocytosis ; Aspirin ; Cardiovascular Diseases* ; Cerebral Infarction ; Dipyridamole ; Humans ; Myocardial Ischemia ; Neutropenia* ; Platelet Aggregation ; Pneumonia ; Recurrence ; Stroke ; Sulfinpyrazone ; Thromboxane A2 ; Ticlopidine