No abstract available.
Drug Therapy* ; Extremities* ; Osteosarcoma*

From Sept. 1987 to Mar. 1993, 14 cases of pelvic bone tumors took surgical treatment. Male to female ratio was 7:7, with an average age of 31.9 years. Pathological diagnosis were chondrosarcoma 7(1 ; secondary), metastatic thyroid cancer 2, and each one case of giant cell tumor, desmoplastic fibroma, metastatic synovial sarcoma, malignant fibrous histiocytoma(MFH), and enchondroma. According to the Enneking's classification for the type of surgical resection, we performed 4 cases of type II+III resection, 4 type IA, 2 type I+II, 2 type III, and each one of II and IIA+III. Types of reconstruction were hip fusion(3 cases), heat treated autogenous bone graft combined with total hip replacement arthroplasty(4), bone graft(2), cement spacer(1) or saddle prothesis(1). Simple resection was done for 3 cases. Wide surgical margin was achieved in 12 cases, marginal margin in 1 and intralesional magin in 1. Complications occurred in 3 cases(21.4%) : 1 graft failure ; 1 lymphedema ; and 1 delayed union. The average follow-up period was 27.4(8-60) months. During follow up, lung metastasis developed in MFH case but no local recurrence was noted in all. By the criteria of American Musculoskeletal Tumor Society(MSTS), the average score for functional activities was 21(70% of normal). The function of the extremity with reconstructed or undestroyed pelvic ring was better than that with disrupted pelvic ring(functional scores ; 24.6 vs 12.3 respectively). Due to the Korean life style using hypocaust, fused hip was not good for indoor activity. For the malignant pelvic bone tumor not involving femoral neurovascular bundle, limb-salvage using internal pelvectomy and reconstruction of pelvic ring can be indicated as a surgical procedure, instead of the hindquarter amputation.
Amputation ; Arthroplasty, Replacement, Hip ; Chondroma ; Chondrosarcoma ; Classification ; Diagnosis ; Extremities ; Female ; Fibroma, Desmoplastic ; Follow-Up Studies ; Giant Cell Tumors ; Hip ; Hot Temperature ; Humans ; Life Style ; Lung ; Lymphedema ; Male ; Neoplasm Metastasis ; Pelvic Bones ; Recurrence ; Sarcoma, Synovial ; Thyroid Neoplasms ; Transplants

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.
Carcinoma, Renal Cell ; Classification ; Cystadenocarcinoma, Mucinous ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Liposarcoma ; Orthopedics ; Ovary ; Prostatic Neoplasms

Of the complictions of cataract extraction, it is well known that hemorrhage, infection and delayed wound healing are more frequent in diabetics than in nondiabetics. But if the extraction was performed after diabetes has adequately controlled for several weeks prior to operation, the visual results are almost as good in diabetics as in non-diabetics. However, with precautions for these complications, the aut hers carefully performed cataract extraction in two juvenile diabetics, whose blood sugar level had been poorly controlled in spited of diabetic diet and subcutaneous injection of the insulin before and after operation. The visual results were very good in spite of high blood sugar level before operation.
Blood Glucose ; Cataract Extraction ; Cataract* ; Diet, Diabetic ; Hemorrhage ; Injections, Subcutaneous ; Insulin ; Wound Healing

We have experienced acute hepatitis after general anesthesia. We guess that acute hepatitis is caused by enflurane anesthesia. We will report this case with references. A 34 year old pregnant woman suffered from preeclamsia. She admitted for emergence repeat cesarean-section due to labor pain. In this operation general anesthesia was performanced with enflurane. The preoperative liver enzyme were normal and other tests were within normal range. She developed high fever, marked elevation of serum glutamic oxaloacetic transaminase(SGOT)/serum glutamic pyrubic transaminase(SGPT)/ alkaline phosphatase(ALP)/total bilirunbin(T-B) on the 2nd postoperative day. She recovered gradually and discharged after 13 day's hospitalization. A possible cause of the acute hepatitis in this case were considered to be the enflurane.
Adult ; Anesthesia ; Anesthesia, General* ; Enflurane* ; Female ; Fever ; Hepatitis* ; Hospitalization ; Humans ; Labor Pain ; Liver ; Pregnancy ; Pregnant Women ; Reference Values

Although it is known that small cell carcinoma most commonly occurs in the lung, it may also originate outside the thorax. Primary extrapulmonary small cell carcinoma has been reported in various organs, including the pharynx, larynx, esophagus, stomach, small intestine, salivary glands, pancreas, skin, breast, cervix, vagina, kidneys, ureter, prostate and urinary bladder. Primary pure small cell neuroendocrine carcinoma of the bladder is a rare condition. It is an aggressive tumor with an average five-year survival rate of less than 10%, as cited by multiple case reports. The mean age of these patients is 67.8 years. The prognosis of small cell carcinoma of the urinary bladder is poor because its behavior is more aggressive than bladder transitional cell carcinoma. We review here 4 cases with small cell carcinoma of the urinary bladder, including our own patient who we treated.
Breast ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell* ; Carcinoma, Transitional Cell ; Cervix Uteri ; Esophagus ; Female ; Humans ; Intestine, Small ; Kidney ; Korea* ; Larynx ; Lung ; Pancreas ; Pharynx ; Prognosis ; Prostate ; Salivary Glands ; Skin ; Stomach ; Survival Rate ; Thorax ; Ureter ; Urinary Bladder* ; Vagina

BACKGROUND: Many patients with type I Diabetes Melitus treated by insulin therapy were observed their blood sugar dropped even after meal. The ecology and treatment for this phenomenon was unknown. A clinical research making an approach to treat this phenomenon is inevitable. METHODS: 9 patients whose blood sugar dropped right after meal (from 15 minutes to 1 hour) were selected among 58 IDDM(Insulin Dependant Diabetes Mellitus) patients admitted in Daejon Sungsim Hospital from March 1999 to Feb. 2000. The subjects were consist of 6 female and 3male, average age was 57.2. Blood samples were taken from their capillaries and measured by Super Glucocard II glucometer. Insulin was injected 30 minutes before breakfast and 50% glucose 30 ml was taken orally 15 minutes after the insulin injection. Breakfast was taken 15 minutes after the glucose taken. Bolld sugar was measured 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 120 minutes and 2 hours after a breakfast. RESULTS: Though average blood sugar dropped after breakfast was 44.5 mg/dl, average blood sugar after taken 50% glucose 30 ml was 114.1 mg/dl. 2 patients had good effect among 3 male patients and every 6 female patients had good effect. CONCLUSION: Taking 50% glucose 30 ml was in oral 15 minutes after insulin injection improved the IDDM patient's blood sugar drop right after meal.
Blood Glucose ; Breakfast ; Capillaries ; Daejeon ; Diabetes Mellitus, Type 1 ; Ecology ; Female ; Glucose ; Humans ; Hypoglycemia* ; Insulin ; Male ; Meals*

BACKGROUND: Recently, epidural anesthesia for elective and emergency cesarean section is increasing in popularity and graudally replacing general anesthesia. However, the complications from the epidural anesthesia such as hypotension, dyspnea, nausea and vomiting have often been reported. This study was designed to estimate the efficacy of crystalloid administration on blood pressure and heart rate change during epidural anesthesia in cesarean section. METHODS: Forty ASAI and II patients scheduled for cesarean section under epidural anesthesia were randomly allocated to receive either only maintained fluid administration(group I) or 15 ml/kg crystalloid solution over 15 minutes(group II). Epidural anesthesia was performed in a lateral decubitus position. According to the patient's height, 20~23 ml of 2% lidocaine was injected through epidural catheter at the L3~4 interspace. RESULTS: Cardiovascular responses and complications after induction of epidural anesthesia were compared and results were as follows. The incidence of hypotension was 14/20 (70%) in the groupI and 4/20(25%) in the group II(p<0.05). Systolic blood pressure after induction of epidural anesthesia in the group I significantly decreased from 6 min to 12 min as compared to the group II. The mean heart rate after induction of epidural anesthesia in the both group was no significant difference to baseline heart rate. CONCLUSIONS: Considering above results, we conclude that a prophylactic crystalloid solution infusion is effective for minimizing and managing hypotension associated with epidural anesthesia in cesarean section.
Anesthesia, Epidural* ; Anesthesia, General ; Blood Pressure* ; Catheters ; Cesarean Section* ; Dyspnea ; Emergencies ; Female ; Heart Rate* ; Heart* ; Humans ; Hypotension ; Incidence ; Lidocaine ; Nausea ; Pregnancy ; Vomiting

BACKGROUND: Fluoroscopy has been an integral part of modern interventional pain management. Yet fluoroscopy can be associated with risks for the patients and clinicians unless it is managed with appropriate understanding, skill and vigilance. Therefore, this study was designed to determine the amount of radiation received by a primary operator and an assistant during interventional pain procedures that involve the use of fluoroscopy METHODS: In order to examine the amount of radiation, the physicians were monitored by having them wear three thermoluminescent badges during each single procedure, with one under a lead apron, one under the apron collar and one on the leg during each single procedure. The data obtained from each thermoluminescent badge was reviewed from September 2008 to November 2008 and the annual radiation exposure was subsequently calculated. RESULTS: A total of 505 interventional procedures were performed with C-arm fluoroscopy during three months. The results of this study revealed that the annual radiation exposure was relatively low for both the operator and assistant. CONCLUSION: With proper precautions, the use of fluoroscopy during interventional pain procedures is a safe practice.
Fluoroscopy ; Humans ; Leg ; Pain Management

BACKGROUND: Bispectrum and bicoherence analysis that is the frequency domain methods of EEG analysis was examined to elucidate the correlation with the depth of anesthesia. METHODS: 25 patients under the gynecological surgery were studied. EEG was surveyed by PhysioLab 400. Analysis of EEG was done according to the progress of anesthesia, normal state before anesthesia, before incision of skin, operation 1, operation 2, awake and post-anesthesia. EEG is applied to filtering of signal, base line correction, linear detrend removal to get more reliable analysis. The appearance rate of bispectrum peaks are calculated by bispectrum operation. And bicoherences are calculated by bispectrum and power spectrum of AR model. RESULTS: In awaking state of patient in pre-anesthesia and post anesthesia, appearance rate of bispectral coupling was observed that a strong appearance rate was represented in all area (0-35 Hz). During the anesthesia, the low frequency area (3-15 Hz) revealed a strong appearance. Also the 2D map of a appearance rate is divided into four sections for more objectivity. Of four sections Bipara#4 is considered that the best parameter which showed progress of anesthesia (P < 0.01). In bicoherence study, in awake state which patient is in pre-anesthesia and post anesthesia, appearance rate of bicoherence value was observed that a strong appearance rate was represented in high frequency range (15-30 Hz). However, under the anesthesia of patients, the low frequency area (0-10 Hz) revealed a strong appearance. And, of four sections Bicpara#2 and Bicpara#4 are considered that the best parameter which showed progress of anesthesia effectively (P < 0.01). CONCLUSIONS: The analysis of the peak appearance of bispectrum and bicoherence is useful monitoring for the depth of anesthesia.
Anesthesia ; Electroencephalography ; Female ; Gynecologic Surgical Procedures ; Humans ; Skin