Postherpetic neuralgia is the most frequent complication of herpes zoster. Treatment of this neuropathic pain syndrome is difficult and often disappointing. Although postherpetic neuralgia is generally a self-limited condition, it can last indefinitely. Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment. However, continuous epidural block has some complications such as infection, dural puncture, and total spinal and nerve damages. We report a case of myoclonus during continuous epidural block with ropivacaine, morphine, and ketamine in an acute zoster patient.
Amides ; Analgesia ; Herpes Zoster ; Humans ; Ketamine ; Morphine ; Myoclonus ; Neuralgia ; Neuralgia, Postherpetic ; Punctures

No abstract available.

No abstract available.
Down Syndrome* ; Leukemia, Megakaryoblastic, Acute*

Pigmented neurofibroma, a variant of neurofibroma, has rarely been observed in patients with or without neurofibromatosis. Pigmented neurofibroma is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. We report a case of pigmented neurofibroma in a 22-year-old female patient.
Female ; Humans ; Neurofibroma* ; Neurofibromatoses ; Young Adult

No abstract available.
Korea* ; Thoracic Surgery*

No abstract available.
Female ; Granulosa Cells* ; Interferon-alpha* ; Rodentia*

No abstract available.
Maxillary Sinus Neoplasms* ; Maxillary Sinus*

We report a case of eosinophilic fasciitis occurring in a 48-year-old man who showed tender, edemstous, indurated, and tight skin on the left forearm and elbow joint. Laboratory findings showed peripheral blood eosinophilia and hypergammaglobulinemia. Other laboratory tests were negative or within normal limits including ANA and anti-DNA. Histopathological findings revealed sclerosis of dermis and thickening of fat and fascia with intense infiltrations of lymphocytes, histiocytes and eosinophils. He was treated successfully with oral prednisolone for 2 weeks.
Dermis ; Elbow Joint ; Eosinophilia ; Eosinophils* ; Fascia ; Fasciitis* ; Forearm ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Lymphocytes ; Middle Aged ; Prednisolone ; Sclerosis ; Skin

BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation

PURPOSE: To assess clinical and angiographic outcomes after endovascular treatment (EVT) in ischemic stroke patients according to anesthesia types (general anesthesia vs. conscious sedation). MATERIALS AND METHODS: A systematic literature review through an online data base between January 1990 and September 2017 was performed. A fixed effect model was used in cases of <50% heterogeneity. The primary outcomes were good clinical outcome at the 3-month follow-up and successful recanalization. A meta-regression analysis was done to estimate primary outcomes of log odds ratio (OR) on onset-to-puncture time (OTP) differences. Publication bias was determined using Begg’s funnel plot and additional the Trim and Fill method. RESULTS: Sixteen articles including 2,662 patients (general anesthesia, n=1,275; conscious sedation, n=1,387) were included. General anesthesia significantly decreased good outcomes than conscious sedation (OR, 0.564; 95% confidence interval [CI], 0.354–0.899). However, outcomes did not differ significantly in randomized controlled trials (RCTs; OR, 1.101; 95% CI, 0.395–3.071). Anesthesia type was not associated with successful recanalization (OR, 0.985; 95% CI, 0.787–1.233). General anesthesia increased the risk of mortality (OR, 1.532; 95% CI, 1.187–1.976) and pneumonia (OR, 1.613; 95% CI, 1.172–2.221), but not symptomatic intracranial hemorrhage (OR, 1.125; 95% CI, 0.767–1.652). The meta-regression analysis showed no linear relationship between OTP differences and log OR of good outcome (coefficient, 0.0004; P=0.95) or successful recanalization (coefficient, 0.0005; P=0.94), respectively. CONCLUSION: General anesthesia seemed to be associated with adverse clinical outcome after EVT. However, its efficacy was not demonstrated in RCTs. Successful recanalization did not differ according to anesthesia type. Studies using individual patient data based on further RCTs are necessary to elucidate anesthesia effect on procedural and clinical outcomes.
Anesthesia ; Anesthesia, General ; Conscious Sedation ; Follow-Up Studies ; Humans ; Intracranial Hemorrhages ; Methods ; Mortality ; Odds Ratio ; Pneumonia ; Population Characteristics ; Publication Bias ; Stroke