A number of drug administered during anesthesia can provoke pathologic response by immunologic or nonimmunologic mechanisms. Known drugs involved in hypersensitivity reactions are muscle relaxants, local anesthetics, narcotics, barbiturates, contrast media, protamine and antibiotics. Clinical manifestations of anaphylaxis are diverse, but during anesthesia, cardiovascular collapse is predominate. We experienced a case of anaphylactoid reaction with erythema on upper thoracic region, severe hypotension, tachycardia and ventricular fibrillation. After defibrillation, the patient was recovered. During follow-up, we knew that this patient was exposed aprotinin repeatedly, and suspect the possibility of anaphylactoid reaction due to aprotinin.
Anaphylaxis ; Anesthesia ; Anesthetics, Local ; Anti-Bacterial Agents ; Aprotinin ; Barbiturates ; Contrast Media ; Erythema ; Follow-Up Studies ; Heart Arrest* ; Humans ; Hypersensitivity ; Hypotension ; Narcotics ; Tachycardia ; Ventricular Fibrillation

Reexpansion pulmonary edema(RPE) is a complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion or atelectasis, and generally believed to occur ipsilaterally when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid. Clinical manifestations of RPE are dyspnea, tachypnea, cyanosis, frothy blood-tinged sputum, wet rale, and expiratory wheezing. Hypotension and decrease in organ perfusion can occur. We experienced intraoperative tension pneumothorax probably due to positive pressure ventilation or pleural injury during central venous catheterization through internal jugular vein. And bilateral RPE combined with acute renal failure occurs after spontaneous decompression of tension pneumothorax with chest tube insertion, even with brief duration of lung collapse.
Acute Kidney Injury ; Catheterization, Central Venous ; Central Venous Catheters ; Chest Tubes ; Cyanosis ; Decompression* ; Dyspnea ; Edema ; Hypotension ; Jugular Veins ; Lung ; Perfusion ; Pleural Effusion ; Pneumothorax* ; Positive-Pressure Respiration ; Pulmonary Atelectasis ; Pulmonary Edema* ; Respiratory Sounds ; Sputum ; Tachypnea

PURPOSE: To evaluate whether radial rigidity measured using RigiScan(R) represents the intracorporeal pressure effectively. MATERIALS AND METHODS: From January 1998 to May 1999, total of 23 patients with erectile dysfunction were evaluated by RigiScan(R) and duplex ultrasonography after the intracorporeal injection of prostaglandin E1. Peak systolic velocity and end diastolic velocity were measured by duplex ultrasonography and then the resistance index was calculated as (peak systolic velocity-end diastolic velocity)/(peak systolic velocity). Radial rigidity of penile tip and base was measured by RigiScanR . The results were analyzed statistically by PC-SPSS version 7.5. RESULTS: There were statistically significant correlations between radial rigidity of penile tip and base and the resistance index by Spearman's correlation analysis, respectively (r=0.680, p<0.001)(r=0.703, p<0.001). When radial rigidity of penile tip and base exceeded 60% of maximum, radial rigidity of penile tip and base again correlated well with the resistance index, respectively (r=0.659, p=0.020)(r=0.759, p=0.011). Based on clinically determined degree of erection, radial rigidity of penile tip and base represented the intracorporeal pressure effectively. CONCLUSIONS: Radial rigidity measured by RigiScan(R) represents the intracorporeal pressure effectively.
Alprostadil* ; Erectile Dysfunction ; Humans ; Male ; Ultrasonography

No abstract available.
Stroke*

Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were presc ribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

The authors report a case of falx meningioma which was first diagnosed with apopletic symptom due to intratumoral hemorrhage. A 72-year-old man was admitted to our hospital with a sudden deterioration of his level of consciousnesss down to a deep drowsiness, generalized seizure, and right hemiparesis. Radiological examinations, including brain CT(Computed Tomographic) scan and MRI(Magnetic Resonance Image) revealed a giant falx meningioma with intratumoral hemorrhage. During the operation the authors found a massive hemorrhage inside the tumor. Histologically, the tumor was meningotheliomatous meningioma and showed a hemorrhagic area with diffuse hemosiderin deposition. The authors also review the relevant literature and discuss the possible mechanism of hemorrhage in the meningioma.
Aged ; Brain ; Brain Neoplasms ; Hemorrhage* ; Hemosiderin ; Humans ; Meningioma* ; Paresis ; Seizures ; Sleep Stages

Sarcoidosis is a multisystem granulomatous disorder commonly affecting young adults. Diagnosis is confirmed by evidence of non-caseating granuloma in more than one organ. A case is presented where the diagnosis was made on a bone marrow biopsy, the first case in Korea. A 54-year-housewife was admitted because of multiple variable sized, skin papules and macules, who showed pancytopenia and evidence of liver cirrhosis on ultrasound. We performed skin biopsy and bone marrow biopsy, which showed non-caseating granulomas. The chest CT, opthalmologic examination was performed and showed the involvement of sarcoidosis of mediastinal lymph nodes and uvea. Multiple joints of both hands and feet also seemed to be involved in view of simple X-ray. By this case, we emphasize the significance of bone marrow biopsy in the sarcoidosis with pancytopenia.
Biopsy ; Bone Marrow* ; Diagnosis ; Foot ; Granuloma ; Hand ; Humans ; Joints* ; Korea ; Liver Cirrhosis ; Liver* ; Lymph Nodes ; Pancytopenia ; Sarcoidosis* ; Skin* ; Tomography, X-Ray Computed ; Ultrasonography ; Uvea* ; Young Adult

Postpubertal mumps may result in ochitis and permanent testicular atrophy may develop following infection. This present study was initiated to evaluate the preventive effect of interferon-alpha2B on infertilty after mumps orchitis. There were 21 patients with mumps orchitis between May 1990 and June 1997. Patients were randomly distributed into 2 groups: group 1 patients (n=13) maintained therapy with interferon-alpha2B (3x10(6) IU per day) and group 2 were managed by conservatively. All of the patients were evaluated with testis size measurement, mumps virus titer, hormone level, and if possible semen analysis. For group 1 patients symptoms disappeared within 2 to 3 days and the volume of testis returned to normal within 11 days and testis atrophy was not observed in all patients in follow up. But asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). For group 2 patients symptoms disappeared within 5 to 6 days and the volume of testis returned to normal within 10 days and testis atrophy was observed in 3 patients (unilateral 2, bilateral 1) in floow up. Asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). Sperm count and morphology were recovered all the recover in group 1, 4 patients had persistent reduced sperm count and morphology in group 2, respectively. These observations suggest that systemic interferon-alpha2B treatment is highly effective in preventing infertility as well as testicular atrophy after mumps orchitis.
Atrophy ; Follow-Up Studies ; Humans ; Infertility* ; Male ; Mumps virus ; Mumps* ; Orchitis* ; Semen Analysis ; Sperm Count ; Testis

The number of low vision patients and the demand for low vision rehabilitation are increasing as the life expectancy and visual impairment due to largely untreatable ocular conditions are.It is therefore, imperative to recognize the importance of low vision aids, which have recently been developed actively.To evaluate the efficacy of low vision aids for low vision rehabilitation, we reviewed the clinical records of 350 patients who had visited our low vision clinic more than twice and had been prescribed with low vision aids. According to the data analysed, optic nerve atrophy, macular degeneration and retinitis pigmentosa were the leading causes of visual impairment in those patients.The purposes to visit our low vision clinic were to read books, read letters on the black board, identify a person at a distance, etc.Hand-held magnifiers, aspheric doublet lens and telemicroscope with plus cap were commonly used for near vision, while Keplerian and Galilean telescope were popular aids for distant vision.Visual acuity after prescription was improved when it was compared with that before prescription.Majority of the patients benefited from attending low vision clinic.These results suggest that the optical low vision aids were required to rehabilitate the visually impaired patients.
Atrophy ; Humans ; Life Expectancy ; Macular Degeneration ; Optic Nerve ; Prescriptions ; Rehabilitation ; Retinitis Pigmentosa ; Telescopes ; Vision Disorders ; Vision, Low*

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*