No abstract available.
Ascites ; Hydrops Fetalis* ; Pleural Effusion ; Ultrasonography

PURPOSE: Neonatal lupus erythematosus (NLE) is a rare disorder caused by the transplacentally transmitted maternal autoantibodies. It is characterized by congenital complete atrioventricular block (CCAVB), skin lesion and less commonly hepatic and hematologic abnormalities. This study was designed to investigate the clinical characteristics and outcome of systemic lupus erythematosus (SLE) mothers and their neonates. METHODS: 29 neonates born to 25 SLE mothers were admitted to the Neonatal Intensive Care Unit of Chonnam University Hospital between January 1994 and June 2005. We investigate the medical records retrospectively. RESULTS: Among 25 SLE mothers, 32.4% had history of spontaneous abortion or stillbirth in previous pregnancy, and 7 (28.0%) of preeclampsia and 3 (12.0%) of premature rupture of membranes in present pregnancy. Among 29 newborns, 14 (48.2%) were premature, 4 (13.7%) were intrauterine growth retardation, and 11 (37.9%) were confirmed as NLE. Anti-SSA/Ro was positive in 13 (52.0%) of 25 examined neonates including 6 (85.7%) of 7 neonates with electrocardiographic abnormalities. Two cases of CCAVB were diagnosed during the pregnancy. One patient didn't show heart failure, he is on the followed up without medical treatment until 4 years of age. The other one showed heart failure, cardiac pacemaker was inserted at 7 days of age, dilated cardiomyopathy developed at 4 years of age. Five neonates with sinus bradycardia resolved spontaneously. One (3.4%) had typical lupus skin lesion with thrombocytopenia and elevated liver enzyme, one (3.4%) had leukopenia, and two (6.9%) had elevated liver enzymes only. CONCLUSIONS: With careful antenatal monitoring of SLE mothers and their fetuses, neonates should be monitored by autoantibody, EKG, and laboratory test.
Abortion, Spontaneous ; Atrioventricular Block ; Autoantibodies ; Bradycardia ; Cardiomyopathy, Dilated ; Electrocardiography ; Female ; Fetal Growth Retardation ; Fetus ; Heart Failure ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Jeollanam-do ; Leukopenia ; Liver ; Lupus Erythematosus, Systemic* ; Medical Records ; Membranes ; Mothers* ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Rupture ; Skin ; Stillbirth ; Thrombocytopenia

Ocular muscle manipulation used to elicit varying cardiac arrythmias, even cardiac arrest, due to oculocardiac reflex. The authors experienced two cases of typical arrythmias during general anesthesia(halothane-N20), in spite of medication of belladonna alkalold preoperatively. According to other reports, was observed bradycardia in case of ocular muscle manipulation during general anesthesis, but we observed ventricular extrasystole and nodal rhythm. The use of belladonna alkaloid for the prevention of cardiac arrythmias during ocular muscle manipulation might be questioned.

No abstract available.

Halothane, in common use today, sensitizes the myocardium to endogenous and exogenous sympathomimetic amines arid induces cardiac arrhythmia, sometimes life threatening. Sympatbomimetic amines, however, are frequently injected subcutaneously for hemostasis or intravenously far cardiovascular stability. Therefore, this study was performed to investigate the effect of lidocaine 1 mg/kg, pro-pranolol 0.02 mg/kg, and droperidol 0.1 mg/kg pretreatment on arrhythmias(A.R.) and changes in heart ramie(H.R.), systolic bood pressure(T.B.P ) and diastolic blood pressure (D.B.P.) Induced by lV administered ephedrine 0.2 mg/kg. Patients were divided into 5 groups: 20 cases without pretreatment(Group l ), 10 cases with lidocaine prtreatment(Group ll), 10 cases with propranolol pretreatment(Group lll), 20 eases with lidocaine-propranolol pretreatment(Group lV) and 20 cases with droperidol pretreatment(Group V ). The results were as follows: 1) In Group l, ephedrine produced A.R. in 16 cases(80%) and significant increase in H.R.(d~11 bpm, p<0.001) and S.B.P. (8~22 torr, p<0.001), but D.B.P. increased insignif-icantly(2~10 torr, NS). 2) In Group ll, ephedrine produced A.R. in 5 cases(57%) and 5.B.p.(10~17 terr, p<0, 01) increased significantly, but H.R. remained unaltered. 3) In Group lll, ephedrine produced A.R. in 3 cases(30%) and H.R. (6~8 bpm, p<0.05) decreased, but S.B.P.(12~21 torr, p<0.01) and D.B.P (8~16 torr, p<0.01) increased signi-ficantle. 4) In Group lV, ephedrine produced A.R. in 2 cases(10.%) and H.R.(3~6 bpm, p<0.05) decreased, but S.B.P (4~11 torr, p<0.05) and D.B.P.(3~9 torr, p<0.01) increased signific-antly. 5) In Group V. ephedrine produced A.R. in 2 cases(10%) and H.R.(9~13 bum, p<0.001) increased siginificantly, but S.B.P. and D.B.P. remained unaltered. From the above results, it is concluded that lidocaine and propranolol mixture or droperidol protects most effectively against ventricular arrhythmias induced by ephedrine during halothane-N2O anesthesia in human volunteers.
Amines ; Anesthesia* ; Arrhythmias, Cardiac* ; Blood Pressure ; Droperidol* ; Ephedrine* ; Halothane ; Healthy Volunteers ; Heart ; Hemostasis ; Humans ; Lidocaine* ; Myocardium ; Propranolol* ; Sympathomimetics

Symmetrical Digital Gangrene (SDG) is characterized by the sudden onset of peripheral, symmetrical gangrene in the absence of any major vascular occlusive disease. Catecholamine inotropes are frequently used for the treatment of septic shock combined with an unstable hemodynamic state, and their usage can rarely induce SDG. There is no standard treatment for the SDG. Early recognition and prompt management of sepsis and expeditious process of weaning off of the inotropes are necessary to prevent progression of SDG. To the best of our knowledge, this is the first report in Korea regarding the treatment of SDG induced by catecholamine inotropes.

BACKGROUND: This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast.METHODS: Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into three groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively com-pared between three groups.RESULTS: No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time—group 1, 71.3±46.6 min; group 2, 33.0±13.7 min; and group 3, 24.6±8.0 min. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient.CONCLUSION: Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.
Cystoscopes ; Cystoscopy ; Humans ; Retrospective Studies ; Sex Ratio ; Ultrasonics ; Urinary Bladder Calculi ; Urinary Bladder

BACKGROUND: This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast. METHODS: Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into three groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively com-pared between three groups. RESULTS: No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time—group 1, 71.3±46.6 min; group 2, 33.0±13.7 min; and group 3, 24.6±8.0 min. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient. CONCLUSION Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.

Aneurysmal bone cysts are uncommon bony lesions that usually occur in the metaphyseal region of the long bones in adolescents. Approximately 20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region. These lesions commonly arise from the posterior elements(ex, spinous process, laminae) and occasionally invade the pedicles and the vertebral body. We experienced a case of aneurysmal bone cyst on the entire 5th cervical vertebra(vertebral body, pedicle, laminae, spinous process and transverse process). We perfomed C5 corpectomy and fusion with ORION plate and autologous bone graft on C4-5-6, and C5 total laminectomy with gross total mass removal and posterior fusion with Heid lateral plate system and autologous bone graft and wiring on C4-5-6. The patient showed good recovery. We report a rare case of aneurysmal bone cyst on the whole involved 5th cervical vertebra
Adolescent ; Aneurysm* ; Bone Cysts* ; Bone Cysts, Aneurysmal ; Humans ; Laminectomy ; Lumbosacral Region ; Spine* ; Transplants

PURPOSE: Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea. MATERIALS AND METHODS: We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants' opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey. RESULTS: SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule. CONCLUSION: The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.
Appointments and Schedules ; Carcinoma, Non-Small-Cell Lung* ; Electronic Mail ; Korea* ; Practice Patterns, Physicians' ; Radiation Oncology ; Radiosurgery ; Radiotherapy* ; Specialization ; Surveys and Questionnaires