No abstract available.
Ear* ; Humans ; Tissue Donors* ; Transplants*

This case was an acquired aplastic anemia patient who required a major operation for excision of a mediastinal mass. The authors previewed that the coagulation abnormalities would be developed due to major operation. Thus we decided to monitoring the coagulation function using the thromboelastography during the perioperative period and checked the complete blood count, concommitantly. The total blood volume lost during operation was 1800 ml, so we gave him a transfusion of 10 U's of platelet concentrate, 10 U's of pheretic platelet rich plasma and 5 U's of whole blood. The thromboelastography was a good guide that helped us to avoid excessive treatment of the coagulation abnormalities. We concluded that the thromboelastograhy was a reliable and effective monitoring system at the intraoperative coagulation management.
Anemia, Aplastic* ; Anesthesia, General ; Blood Cell Count ; Blood Platelets ; Blood Volume ; Humans ; Perioperative Period ; Platelet-Rich Plasma ; Thrombelastography

No Abstract Available.

Ae opposed to most other drug eruptions, drug-induced pemphigus may not develop for at least several months following the initiation of therapy with the offending agent. Unlike sporadically occuring pemphigus, the clinical and hietopathologic patterns of drug-induced pemphigus are most often those of pemphigus foliaceus. We report a case of diphenylhydantoin-induced pemphigus occuring in 30-year-old male with epilepsy. A few coinsized erythematous scaly patches developed on his fae, chest, snd left wrist, and two flaccid bullae on erythemstous base developed on his abdomen after three years snd nine months of therapy with diphenylhydantcin. Histopathologicslly, a biopsy specimin taken from a bullous lesion revealed that bulla is formed just beneath the granular layer and aeaitholytic cells are seen within the bulla. Direct and indirect irnmunofluorescence studies showed regitive findings. Administration of diphenylhydantoin was discontinued and he was treated with systemi and topical corticoeteroid. After 4 weeks, the skin lesions were healed with postinflammatory hysroigmentation and no new lesions were developed thereafter.
Abdomen ; Adult ; Biopsy ; Blister ; Drug Eruptions ; Epilepsy ; Humans ; Male ; Pemphigus* ; Phenytoin* ; Skin ; Thorax ; Wrist

No abstract available.
Breast ; Paget's Disease, Mammary*

BACKGROUND: Livedo vasculitis shows variable clinical and histopathologic features according to its courses. There are also some discrepancies in histopathologic findings between the authors. OBJECTIVE: Our purpose is to clarify the clinical and istopathologic feat tures of livedo vasculitis. METHODS: We reviewed the clinical and histopathologic features in cluding direct immunofluorescence study and response to treigtment in eight patients with livedo vasalitis. RESULTS: The ratio of males to females was 1:3 with female predusm nance. Age of onset was predominant, in young to middle-age, ranging from 19 to 64 years old. In seven patients skin lesions were aggravated during the summe, and in one patient during the winer. All patients had purpuric or telangiectatic lesions on the lower extremities. Painful ulcers developed in seven patients and some of the ulcers healed with whitish atrophic scars. Five patients had preceeding livedo reticularis. One patient had Raynauds phenomenoin and the other patients did not show alinormal findings related to the systemic diseases. Histopathologically, in two patients fibrinoid materi.il was deposited in the vessel walls mildly, and in six patients obviously with partial to complete obst,r iction of blood vessels. Extravasation of RBCs and thrombus formation were found clearly in seven patients, but in one patient these findings were observed in a mild degree. Endothelial swellings were obserrved in all patients. Perivascular infiltrations of mononuclear cells were also observed in all patients in various degrees. But only two patients with secondary bacterial infection showed neutrophil infilt ations or nuclear dusts. So, histopathologic findings are corripatible with lymphocytic vasculitis. The locations of predominantly affected vessels were variable. Direct immunofluorescence studies were done in six patients. Four of these patients showed positive findings. At least 4 months were needed for the complete healing of the skin lesions. CONCLUSION: Livedo vasculitis is chronic vasculit is aggravated in mostly summer. Most of the initial purpuric lesions progress to ulcers which is healed with whitish atrophic scars. Histopathoiogic findings suggest livedo vasculitis is a sort of lymphocytic vasculitis.
Age of Onset ; Bacterial Infections ; Blood Vessels ; Cicatrix ; Dust ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Livedo Reticularis ; Lower Extremity ; Male ; Middle Aged ; Neutrophils ; Skin ; Thrombosis ; Ulcer ; Vasculitis*

The chin plays a decisive role in the contour of the lower face. And harmonious jaw will correspond to good facial profile and positive image. Osseous genioplasty is a widely used method to correct the 3-dimensional(sagittal, vertical, tranverse) deformity of the chin with minimal complications. During an 8 year period from 1988, the authors at the In-Je University Seoul Paik Hospital experienced 198 patients of osseous genioplasty. Results of clinical analysis are as follows : 1) Male to female ratio was 1 : 3 with female being predoniment. The average age was 24.9 years. 2) Horizontal advancement genioplasty in 169 cases was the most common procedure with 7.0mm of average advancement. There was 4 cases of horizontal retrusion with average retrusion of 4.3mm. 52 cases had vertical augmentation with average of 7.5mm increase. 9 cases had vertical reduction with average redution of 4.9mm. 3) Although malocclusion is not necessarilly contraindication to genioplasty alone, genioplasty following surgical with or without orthodontical correction of malocclusion is the way to get better result with patient satisfaction. 4) 77% of the patients had adjunctive procedures simultaneously to acheive a better contour and profile 5) Complications such as hematoma, infection, fracture, nerve damage were minimal.
Chin ; Congenital Abnormalities ; Female ; Genioplasty* ; Hematoma ; Humans ; Jaw ; Male ; Malocclusion ; Patient Satisfaction ; Seoul

BACKGROUND: Epidural anesthesia is becoming an increasingly important aspect of anaesthetic practice because it has many advantages. To achieve the appropriate sedation, various methods have been described. The authors applied the ketamine for this purpose in subanesthetic dose and compared with the midazolam that has been most commonly used for intravenous sedation. METHODS: Fifty-seven adult patients undergoing lower abdominal and extremity surgery who were receiving epidural anesthesia were randomely enrolled into this clinical study. They were allocated to three groups to receive only normal saline (group C), midazolam 0.05 mg/kg (group M) and ketamine 0.5 mg/kg midazolam 0.05 mg/kg (group K) in normal saline 10ml, respectively. Hemodynamic and respiratory measurements were recorded at baseline, 1 minute, 3 minute, 5 minute, 10 minute, 20 minute and 30 minute after sedation. The degree of sedation was assessed by a blinded observer using sedation score. RESULTS: There were no significant differences for hemodynamic and respiratory parameters, but decrements of arterial pressure at 1 minute after sedation were most remarkable in the group M. Sedation was satisfactorily achieved by combination of ketamine and midazolam without significant emergence reaction. CONCLUSIONS: The combination of ketamine and midazolam was judged to be suitable alternative for sedation during epidural anesthesia.
Adult ; Anesthesia, Epidural* ; Arterial Pressure ; Extremities ; Hemodynamics ; Humans ; Ketamine* ; Midazolam*

No abstract available.
Cytomegalovirus* ; DNA* ; Humans* ; Polymerase Chain Reaction*

No abstract available.
Citrobacter* ; Enterobacter*