BACKGROUND: Although blood is very important therapeutic agent in bleeding patients, it may transmit disease, cause an adverse reaction in the recipients, raise the cost of patient care. Since the misuse and inappropriate use of blood is common, we are to review the transfusion practice in our hospital and to reduce unnecessary blood transfusion. METHODS: During a 10-month period from June 1994 through March 1995, 347 patients received blood transfusion during the operation. Among them, we reviewed retrospectively the charts of 211 patients available. We analyzed the transfusion pattern of 47 patients whose postoperative hematocrit exceeded 32 percent to determine the magnitude and cause of unnecessary blood transfusion. RESULTS: The patients of postoperative hematocrit over 32 percent were 119 patients out of 211 patients(56.4%). The main cause of overtransfusion was no reevaluation of the patients hematocrit after the prior unit was given. CONCLUSIONS: Guidelines for transfusing patients must be constructed based on acceptable intraoperative hematocrits. Unnecessary transfusion can be decreased when the transfusion done according to the guidelines, insisting on each reevaluation of the hematocrit prior to the administration of unit of blood.
Blood Transfusion ; Hematocrit ; Hemorrhage ; Humans ; Patient Care ; Retrospective Studies

BACKGREOUND: The sympathetic investigations during thoracic sympathectomy are essential to an adequate sympathectomy that will lead to sufficient and lasting relief of palmar hyperhidrosis. The measurement of palmar skin temperature has been used as an indicator of success of transcutaneous chemical thoracic sympathectomy. We measured intraoperative palmar skin temperature to know whether it can be used as a same purpose in the endoscopic thoracic sympathectomy under general anesthsia. METHODS: Fifteen patients (18 to 25 years old) with palmar hyperhidrosis underwent endoscopic thoracic sympathectomy under general anesthesia. The palmar skin temperature was measured with a skin probe of a thermometer applied on the both index finger tips. The palmar skin temperature was monitored continuously from the beginning of anesthesia to the complete arousal. RESULTS: The palmar skin temperature increased significantly by about 3 degrees C just after induction. There was no significant difference in the palmar skin temperature between just before sympathectomy and soon after sympathectomy during the endoscopic thoracic sympathectomy. CONCLUSIONS: Intraoperative measurement of palmar skin temperature can not indicate a definite sympathectic denervation during the endoscopic thoracic sympathectomy under general anesthesia.
Anesthesia ; Anesthesia, General ; Arousal ; Denervation ; Fingers ; Humans ; Hyperhidrosis* ; Skin Temperature* ; Skin* ; Sympathectomy* ; Thermometers

Split hand and split foot(SHSF) is a human developmental defect characterized by missing digits, fusion of remaining digits, and a deep median cleft resulting in a clawlike appearance of the hands and feets. SHSF is usually inherited in an autosomer dominant fashion. The incidence of SHSF is between 1/10,000 and 1/90,000. Thirteen cases of SHSF and chromosomal aberrations involving 7q21-22 have been described so far in the world. We experienced a case of typical tetramelic SHSF in neonate. Chromosome studies showed a pericentric inversion of chromosome 7:46,XY,inv(7) (p22q22). Inspection of the extremities and chromosome studies in the parents were normal.
Chromosome Aberrations ; Chromosomes, Human, Pair 7* ; Extremities ; Foot* ; Hand* ; Human Development ; Humans ; Incidence ; Infant, Newborn ; Parents

During the long-term COVID-19 pandemic, wearing a mask is inevitable for protecting individuals from airborne infection. In this case, we found out that mask may exacerbate atopic dermatitis and it can be treated simply and effectively using silicone tape. We suggest that throughout the COVID-19 pandemic, silicone tape can be beneficial in both preventing and treating eczema caused by mask-wearing, especially in patients with atopic dermatitis.

An epithelioid angiomyolipoma is an uncommon clinicopathological variant of an angiomyolipoma. A 25-year-old man presented with a huge right renal tumor and underwent a radical nephrectomy. The pathological diagnosis was an epithelioid angiomyolipoma, which showed a positive reaction to the HMB-45 monoclonal antibody and negative to epithelial cell markers. A year later, multiple metastases developed to the liver, lungs and bones. A hepatic lobectomy was performed, and a metastatic epithelioid angiomyolipoma, from the original renal tumor, was pathologically confirmed. The case is presented with a review of the literature.
Adult ; Angiomyolipoma* ; Diagnosis ; Epithelial Cells ; Humans ; Kidney* ; Liver ; Lung ; Neoplasm Metastasis* ; Nephrectomy

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
Azoospermia* ; Biopsy ; Humans ; Male ; Oligospermia ; Pregnancy ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

PURPOSE: Placenta growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family. PlGF is implicated in several pathologic processes, including the growth and spread of cancer and tumor angiogenesis. The aim of this study was to evaluate the expression and the clinical implications of PlGF in colorectal cancer. METHODS: In order to ascertain the clinical significance of PlGF expression in colorectal cancer, the researcher analyzed the expression pattern of PlGF by using an immunohistochemical method and attempted to establish if a relationship existed between PlGF expression and microvessel density (MVD), and subsequently between PlGF expression and the predicted prognosis. A total of 83 patients with colorectal cancer were included for immunohistochemical staining. Clinicopathological characteristics were defined according to the tumor-node-metastasis (TNM) criteria of the Union for International Cancer Control. Clinicopathologic factors, such as age, sex, histological types of tumors, tumor cell grade, TNM stage, lymphovascular invasion, and lymph-node metastasis, were reviewed. RESULTS: In this study, the PlGF protein expression level was significantly correlated with MVD, patient survival, and clinicopathological factors such as lymph-node metastasis, TNM staging, lymphatic invasion and vascular invasion. CONCLUSION: PlGF may be an important angiogenic factor in human colorectal cancer, and in this study, PlGF expression level was significantly correlated with positive lymph-node metastases, tumor stage, and patient survival. These findings suggest that PlGF expression correlates with disease progression and may be used as a prognostic marker for colorectal cancer.
Angiogenesis Inducing Agents ; Colorectal Neoplasms ; Disease Progression ; Humans ; Microvessels ; Neoplasm Metastasis ; Neoplasm Staging ; Pathologic Processes ; Placenta ; Pregnancy Proteins ; Prognosis ; Vascular Endothelial Growth Factor A

For the purpose of providing the basic data for health management of workers who are exposed to chromium and for improving the quality of working environment, the authors evaluated blood and urinary level of chromium, the occupational history, AST, ALT, Hb, Hct, nasal specular examination on 287 workers who have been dealed chromium compounds in 56 manufacturing industries of five types, that is, 38 metal plating services(plating), 4 manufacture of other fabricated metal products (fabricated metal product), 5 manufacturing of dyestuff(dyestuff), 6 dressing and dyeing of leather (leather), 3 others (manufacture of pottery and ceramic household wares, motor vehicles, electronic valves and tubes and other electronic components) and also measured the level of chromium in air from February to october 1993. The results were as follows; 1. The utilized type of chromium compounds was the hexavalent state in plating, fabricated metal product, dyestuff leather and the trivalent state in other, and atmospheric chromium concentration as geometric mean was 0.0138m3(0.001~0.068 mg/m3) in plating, 0.0115 mg/m3(0.006~0.015 mg/m3) in fabricated metal product, 0.068 mg/m3 (0.002~0.019 mg/m3)in dyestuff, 0.0083 mg/m3(0.002~0.028 mg/m3) in leather, 0.0039 mg/m3(0.003~0.005 mg/m3) in other by the type of industry and it exceeded TLV-TWA (0.05 mg/m3) in five(13.6%) of plating services. 2. The geometric mean of chromium in blood was 1.54 microgram/dl(0.10~3.62 microgram/dl) in planting, 0.94 microgram/dl(0.27~2.82 microgram/dl) in fabricated metal product, 0.51 microgram/dl(0.10~3.25 microgram/dl) in dyestuff, 0.87 microgram/dl(0.15~8.00 microgram/dl) in leather 0.55 microgram/dl(0.20~2.28 microgram/dl) in other by the type of industry(P<0.001). 3. The geometric mean of chromiurn in urine was 14.47 microgram/l(6.90~28.00 microgram/l) in planting, 4.63 microgram/l(0.24~43.00 microgram/l) in fabricated metal product, 5.93 microgram/l(1.00~33.00 microgram/l) in dyestuff. 11.09 microgram/l(0.80~48.00 microgram/l) in leather, 12.41 microgram/l(10.10~41.00 microgram/l) in other by the type of industry(P<0.001). 4 As the result of nasal specular examination, twenty four cases(8.4%) of nasal septal perforation among 287 total subjects was observed, and there were 17(9.7%) cases in plating, 4 cases(14.3%) in dressing and dyeing of leather. In the comparison of chromium concentration in blood and urine between the perforated group and nonperforated group the perforated group showed a significantly higher value as 1.883+/-3.055 microgram/dl and 0.793+/-0.815 microgram/dl(P<0.001). 21.31+/-34.610 microgram/L and 9.304+/-11.079 microgram/L(P<0.001). 5. The mean concentration of chromium in blood, urine and the mean level of AST, ALT, Hb and Hct in exposure group were higher than those of control group(P<0.001).
Bandages ; Ceramics ; Chromium Compounds ; Chromium* ; Electroplating ; Family Characteristics ; Motor Vehicles ; Nasal Septal Perforation ; Plants ; Threshold Limit Values

BACKGROUND: Rocuronium(ORG 9426) is a new steroid nondepolarizing neuromuscular blocking drug with fast onset and intermittent duration of action. Its effects on vital signs are controversial. We studied onset, clinical duration, recovery index of rocuronium and its effects on blood pressures and heart rates. METHODS: We selected thirty healthy children who would receive inguinal herniorrhaphy and allocated them to 2 groups(control and rocuronium group). Without premedication or with oral medication of PocralTM (20 mg/kg), they administrated propofol(2.5 mg/kg) intravenous for loss of consciousness and we maintained anesthetic states with 20 mg/kg/hr of propofol. After 2 minutes, we checked BP(SBP/ DBP/MBP) and HR at every minutes and checked TOF, T1 height compare to control, T4 to T1 at every twenty seconds. We injected intravenously rocuronium(0.8 mg/kg, 2ED95) to rocuronium group and nothing to control group. We determined intubation time(from injection to 90% depression of maximal block), onset time(to maximal depression or T1=0), clinical duration(to T1=25%) and recovery index(from T1=25% to T1=75%). RESULTS: In children, intubation time was 93.8sec, onset time was 146.2sec, clinical duration was 34.6min, recovery index was 15.4min. SBP, DBP, MBP and HR were not changed independent of injection of rocuronium. CONCLUSION: Rocuronium is a muscle relaxant with rapid onset and intermittent clinical duration in children. It does not affect BP and HR.
Anesthesia* ; Anesthetics ; Blood Pressure* ; Child* ; Depression ; Heart Rate* ; Heart* ; Herniorrhaphy ; Humans ; Intubation ; Neuromuscular Blockade ; Premedication ; Propofol* ; Unconsciousness ; Vital Signs

PURPOSE: The prevalence of allergic diseases, including bronchial asthma, increases markedly to make those disease as one of the most important and common disease in pediatric field. As the basic data for managing patients with allergic diseases, we tried to get prevalence of allergic disease and comparison the normal children with the ones related with allergic diseases in primary school-aged children. RESULTS: 1) 1637(57.4%) children among total 2850 children had the history of allergic disease. 2) The most frequent allergic disease was atopic dermatitis(38.9%) followed by urticaria (26.4%), bronchial asthma(10.3%), and allergic rhinitis(8.8%). 3) Among family members of children with allergic disease, mother had allergic disease most frequently(31.1%) followed by father(25.1%), siblings(24.4%), and grandparents(13.9%). 4) 1528(53.6%) children had the symptoms suggesting bronchial asthma. Among them frequent upper respiratory infection was the most frequent complaints(75.6%), followed by history of some weak bronchi(45.4%), having sinusitis(24.2%), and reluctant to do sports(11.7%). 5) 76% of children had the smoker in the house. Father was the most frequent smoker(94.1%), followed by grandparents(13.9%), and mother was only 1.6%. 6) The total number of cigarettes smoked in the house was less than 20 in 89%. 7) The crowdedness of the house, got by the number of family members divided by the number of rooms, was less than 3 in 85.9% of the children. It was more than 5 in 28 children's house. 8) Non of the items of pulmonary function test was consistent in any asthma related conditions when we compare with normal children. Only crowdedness shows statistically significant difference in FVC, FEV(1), and PEFR.
Asthma* ; Child* ; Fathers ; Humans ; Mothers ; Peak Expiratory Flow Rate ; Prevalence* ; Respiratory Function Tests* ; Smoke ; Tobacco Products ; Urticaria