No abstract available.
Paranasal Sinuses*

Four cases of malignant hyperpyrexia were reported in Korea since 197I and three of these cases expired. We discuss here the four cases of malignant hyperpyrexia with clinical features and management, and the importance of early recorgnition and aggressive treatment of malignant hyperpyrexia are stressed.
Korea* ; Malignant Hyperthermia*

Papillary serous carcinoma of the peritoneum (PSCP) is a primary tumor of peritoneal lining (mesothelioma) of the abdomen and is histologically difficult to differentiate from papillary serous carcinoma of the ovary. It is very rare tumor that involves the surface of the pelvic and/or abdominal peritoneum. Most patients with this tumor have been treated with optimally surgical cytoreduction and postoperative chemotherapy. However, long term survival has not been achieved in many studies. In recent years, platinum-paclitaxel combination therapy was reported as a effective initial therapy for recurrent PSCP. We have experienced one case of recurrent PSCP which was successfully treated with heptaplatin and paclitaxel. We report the toxicity and long term result of the patient.
Abdomen ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Ovary ; Paclitaxel ; Peritoneum

PURPOSE: To evaluate the effects of cheap tinted contact lenses on corneal swelling and ocular surface inflammation, compared to hydrogel and silicone hydrogel contact lenses. METHODS: Forty eyes of 20 New Zealand white rabbits were randomly assigned to 4 groups. Two types of tinted contact lenses, hydrogel lenses, and silicone hydrogel lenses were each applied to 10 rabbit eyes. Corneal thickness and tear lactate dehydrogenase (LDH) activity were measured at 1 and 4 days after contact lens wear, and the inflammation of ocular surface was scored at 4 days after contact lens wear. The internal surface of the cheap tinted lens was examined with a scanning electron microscope to compare the surface quality between the tinted and non-tinted area. RESULTS: Although the corneal swelling of the silicone hydrogel lens group was significantly lower than the other 3 lens groups after contact lens wear (p<0.01), the common hydrogel lens group was not different from the 2 tinted contact lens groups (p>0.1). Tear LDH activity at 1 and 4 days after contact lens wear showed no significant difference among the 4 groups (p>0.29). The scores of ocular surface inflammation in the 2 tinted contact lens groups were greater than the hydrogel and silicone hydrogel lens groups (p=0.03). The scanning electron microscope revealed the internal surface of the tinted area in the tinted contact lens was coarse and irregular though the surface of the non-tinted area was relatively smooth. CONCLUSIONS: Regarding corneal swelling and tear LDH activity, the cheap tinted contact lenses used in Korea were not significantly different from the common hydrogel contact lenses. However, tinted contact lenses showed a greater tendency to provoke ocular surface inflammation than other lenses. The coarse and irregular surface of the tinted area in the tinted contact lens appears to play a role in provoking severe ocular surface inflammation.
Contact Lenses ; Electrons ; Eye ; Hydrogel ; Inflammation ; Korea ; L-Lactate Dehydrogenase ; Rabbits ; Silicones

Recently, several versatile approaches via limited incision have been developed for minimally invasive cardiac surgery. As the incision is limited, it is often dfficult to get a satisfactory operative field, especially for the manipulation of two separate lesions such as simultaneous mitral and aortic valve disease with a single limited incision. Here, we describe a case of successful double valve replacement via ministernotomy, which was followed by two cases of minimally invasive aortic valve replacement via transsternal approach. The operative field was unexceptionally satisfactory and the postoperative patient's acceptance was high. The methodology is described with a review of the relevant literatures.
Aortic Valve ; Esophageal Perforation ; Thoracic Surgery

The segmental spread of epidural analgesia was measured in seventeen surgical patients aged between 17 and 52 years, and in fourteen patients between 60 and 77 years. The upper level in the young was 6.29(+/-1.56) thoracic vertebra level, but in the elderly was 4 (+/-0.65_ thoracic vertebra level at 20 minutes after epidural injection of 1.5% lidocaine 20 ml. A given volume of solution spreads to 0.9, 1.07, 1.54, 2.29 segments greater upper extent at 5, 10, 15, 20 minutes after epidural injection and 0.57, 1.07 segments greater lower extent at 5, 10 minutes in the elder than young. So with increasing age relatively small amounts of solution are required, to produce the same extent of anesthesia in the young.
Aged* ; Analgesia, Epidural* ; Anesthesia ; Humans ; Injections, Epidural ; Lidocaine ; Spine

Many studies have cited occurrences of severe and long-lasting emotional disturbances of almost every kind after surgical procedures, particularly due to the sedatives or narcotics which were administered to control the post-operative pain. In order to control this post-operative pain, pediatric caudal analgesia was performed in 15 infants and children from the age 2 months to 6 years, who were to undergo lower abdomen, perineum and lower extremity surgery. They were induced with inhalation anesthoeia, using nitrous oxide, oxygen and halothane by mask before and during the block. Following the block, infants and children were turned to supine position and the initial concentration of halothane was reduced. All cases were given 10mg/kg of 1% solution of lidocaine. On examination of the level of the analgesia, 13 out of 15 cases had spread higher level than T10, with effective block for surgical procedures. The identification of the sacral cornu is easy and technical failureis lees in comparison than with the lumbar epidural block for infants and children. Thus we can perform this block successfully for infants and children without any complications or accidents. It is especially helpful in the management of postoperative cases due to the effect in control of the postoperative pain. Thus it gives satisfaction to their parents, nurses and doctors. Despite no follow-up study on postoperative emotional reactions, it was considered that there were minimal occurrences of emotional and behavioral sequelae following the hospital and surgical experiences.
Abdomen ; Affective Symptoms ; Analgesia ; Anesthesia, Caudal* ; Child ; Follow-Up Studies ; Halothane ; Humans ; Hypnotics and Sedatives ; Infant ; Inhalation ; Lidocaine ; Lower Extremity ; Masks ; Narcotics ; Nitrous Oxide ; Oxygen ; Pain, Postoperative ; Parents ; Perineum ; Supine Position

Four modes of administrating atropine and neostigmine to reverse pancuronium block were studied in thirty-eight anesthetized patients, with special reference to their effects on heart rate and electrocardiogram. At the end of operation in group 1 a mixture of atropine (0. 5 mg) and neostigmine(1. 0 mg) was rapidly injected together. In group 2 the same mixture was slowly injected in 3 minutes. In group 3 atropine was rapidly injected and 2 minutes later neostigmine was rapidly injected. In group 4 neostigmine was slowly injected in 1 minute and then immediately atropine was rapidly injected. The results were as follows. 1) In all groups a transient increase in heart rate was followed by a decrease which continued over 30 minutes. 2) The changes in heart rate were most pronounced when atropine was given before neostigmin(group 3) On the other hand when atropine was given immediately after neostigmine the changes in heart rate seemed to be smallest. 3) A small number of cases showed transient ECG changes in each group. It is considered that one must be careful about arterial gas and ECG changes although the number of cases is small and certain correlation was not indicated but the ECG of the five of 38 patients are abnormal, four of these are among the abnormal cases in the gas study, two of the four abnormals are under PaO2, 60 mmHg.
Atropine* ; Electrocardiography* ; Hand ; Heart Rate* ; Heart* ; Humans ; Neostigmine* ; Pancuronium

Shared decision-making may increase the effectiveness of inflammatory bowel disease (IBD) treatment, as different anti-tumor necrosis factor (anti-TNF) administrations may have different effects on the quality of life (QOL). Patient preference is integral to the selection of anti-TNFs and their routes of administration, however, previous studies on the patient preference to anti-TNFs are inconsistent and limited. We evaluated the predictive factors for preferences to anti-TNF administrations in IBD patients between March and August in 2015. Consecutive adult IBD patients who received care at one of four university hospitals in Korea were invited to participate in this study. Patients were administered questionnaires about their preferences regarding anti-TNF therapy and QOL. During the study period, 322 IBD patients completed the questionnaires. IBD patients preferred intravenous anti-TNFs to subcutaneous anti-TNFs (2.4:1), and 58.4% of patients preferred shared decision-making. When comparing subcutaneous anti-TNF therapy with intravenous anti-TNF therapy, patients with higher income levels, patients who experienced adverse events with prior medication and patients with a longer disease duration preferred subcutaneous anti-TNF therapy over intravenous anti-TNF therapy (P = 0.043, P = 0.000, and P = 0.029, respectively). In a logistic regression analysis, high income level (odds ratio [OR] 2.0; 95% confidence interval [CI] 1.1–3.5; P = 0.026) and an adverse event with prior medication (OR 4.0; 95% CI 2.2–7.2; P = 0.000) and were found to be independent predictors for preference to subcutaneous anti-TNF therapy. Therefore, physicians should share decision-making with their IBD patients regarding the mode of anti-TNF administration.
Adult ; Colitis, Ulcerative ; Crohn Disease ; Hospitals, University ; Humans ; Inflammatory Bowel Diseases* ; Korea ; Logistic Models ; Necrosis ; Patient Preference ; Quality of Life

STUDY DESIGN: A retrospective study. PURPOSE: To assess the radiographic progression of degenerative lumbar scoliosis after short segment decompression and fusion without deformity correction. OVERVIEW OF LITERATURE: The aims of surgery in degenerative lumbar scoliosis are the relief of low back and leg pain along with a correction of the deformity. Short segment decompression and fusion can be performed to decrease the level of low back and leg pain provided the patient is not indicated for a deformity correction due to medical problems. In such circumstance, the patients and surgeon should be concerned with whether the scoliotic angle increases postoperatively. METHODS: Forty-seven patients who had undergone short segment decompression and fusion were evaluated. The average follow-up period was more than 3 years. The preoperative scoliotic angle and number of fusion segments was 13.6+/-3.9degrees and 2.3+/-0.5, respectively. The preoperative, postoperative and last follow-up scoliotic angles were compared and the time of progression of scoliotic angle was determined. RESULTS: The postoperative and last follow-up scoliotic angle was 10.4+/-2.3degrees and 12.1+/-3.6degrees, respectively. In eight patients, conversion to long segment fusion was required due to the rapid progression of the scoliotic angle that accelerated from 6 to 9 months after the primary surgery. The postoperative scoliosis aggravated rapidly when the preoperative scoliotic angle was larger and the fusion was extended to the apical vertebra. CONCLUSIONS: The scoliotic angle after short segment decompression and fusion was not deteriorated seriously in degenerative lumbar scoliosis. A larger scoliotic angle and fusion to the apical vertebra are significant risk factors for the acceleration of degenerative lumbar scoliosis.
Acceleration ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Leg ; Retrospective Studies ; Risk Factors ; Scoliosis ; Spine