Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

Since the first report of completely amputated thumb replantation by Tamai in 1965, replantation surgery has been popularized with increasing success rate and improving functional regain. Recently, difficult replantation such as traction avulsion amputation has been challenged and good success rate and function have been reported. We have analized 34 cases of upper extremity and finger replantation in 23 patients, which were performed at the Dept. of Orthopedic surgery. Hyun Dai Hae Seong Hospital, Ulsan, Korea, from June 1982 to January 1986. The results were as follows: 1. Male patients were 22, female was 1, left upper limbs and digits injuries were more prevalent(16: 7), and average age was 25 years old. 2. The most common injury was done by cutting machine. 3. The number of amputations of fingers were almost same in all fingers and most prevalent in zone III(26 cases, Danial classification). 4. Success rate of replantation was 82.4% In cases of less than 6 hrs ischemic time, the rate was 93.4%, and more than 6 hrs ischemic time, rate was 33.3% 5. Performing arterial anastomosis prior to venous anastomosis, can find out main draining vein, and with one vein and one artery anastomosis, can get good results distal to zone IV. 6. Functional results were satisfactory, evaluating by modified. Tamai score, average 87.5. 7. 6 cases of digital replantations distal to sublimis tendon insertion have good results functionally, cosmetically and technically easy (Tamai score 98). 8. 5 cases of traction avulsion amputations needed many additional surgery to restore function, but end results were relatively satisfactory.
Amputation ; Arteries ; Clinical Study ; Female ; Fingers ; Humans ; Korea ; Male ; Orthopedics ; Replantation ; Tendons ; Thumb ; Traction ; Ulsan ; Upper Extremity ; Veins

A number of recent reports haTe described the usefulness of the epidural injection of narcotics for the relief of postpoerative pain. But the epidural or intrathecal uke of a narcotic agonist-antagonist, especially one with a high lipid solubility such as penta97cine, has not been reported. The present studr was undertaken to evaluate the feasibility of pentagocine as an agent for postoperative pain relief when injected epidurally. 80 patients involved in this study were divided raadomlr into four groups: 10 ml saline (group 1, n=20); 0.2 mg/kg pentazocine in 10m1 saline(group 2, n=20): 0.3mg/kg penta- zocine in 10 ml saline(group 3, R= 20) ; 0.4 mg/kg pentazocine in 10 ml(group 4, n=20). she results were as follows : 1) 20(100%) patients from the 0.2 mg pentazocine group, 18(90%) form the 0.3mg/kg pentazocine group and 20(100%) from the 0.4 mg/kg pentazocine group obtained analgesic effects following the epidural injection of pentagzocine. 2) The peak analgesic effect following epidural pentafocine ocurred at 15 min(mean val-ue). 3) The duration of analgesia following epidural pentazocine ranged from 6 to 13 hours. 4) No patient had respiratory depression, itching or vomiting but some patients had urinary retention and nausea. In conclusion, the present study suggests that pentazocine is a useful agent for postope-ratilve pain relief when injected epidurally.
Analgesia ; Hate ; Humans ; Injections, Epidural ; Narcotics ; Nausea ; Pain, Postoperative* ; Pentazocine* ; Pruritus ; Respiratory Insufficiency ; Solubility ; Urinary Retention ; Vomiting

Pure lipoma, originating from the trachea is a very rara disease entity A-37-ycar-old-male patient had suf'leered from intermittent episodes of dyspnea and has been treated under the diagnosis of bronchial asthma for 6 months. On chest CT scan and bronchofiberscopic examination, a round mass with the pedunculated neck was found in the mid-portion of the membranous portion of the intrathoracic trachea. Under the guide of fiberoptic bronchoscope, the mass was extirpated using polypectomy w re loop and eletrocauterization. He was discharged without any events on third postoperative day of operation and has been well without recurrence for 6 months.
Asthma ; Bronchoscopes ; Diagnosis ; Dyspnea ; Humans ; Lipoma* ; Neck ; Recurrence ; Tomography, X-Ray Computed ; Trachea

BACKGROUND AND OBJECTIVES: The myocardial protective effect of ischemic preconditioning is well known. However, the mechanism is remains unclear. The purpose of this study is to determine the role of adenosine, protein kinase C, KATP channel and the change of monophasic action potential duration on cardioprotective effect of ischemic preconditioning in cat. Materials AND METHODS: In this experiment, 66 cats were allocated into 7 groups:control (n=10), ischemic preconditioning (n=10), adenosine pre-treated (n=10), SPT (8-p-sulfophenyl theophylline) pre-treated (n=9), polymyxin B pre-treated (n=9), glibenclamide pre-treated (n=9) and nicorandil pre-treated (n=9) groups. Ischemic preconditioning was performed in ischemic preconditioning, SPT pre-treated, polymyxin B pre-treated and glibenclamide pre-treated groups by 3 episodes of 5 minutes ischemia and 10 minutes reperfusion. All animals were subjected to 40 minutes of ischemia and 40 minutes reperfusion. Monophasic action potential duration at 50% repolarization (MAP50) was measured in the ischemic and non-ischemic area respectively by epicardial probe throughout the experiment. The effect of ischemic preconditioning was determined by infarct size (% area at risk). RESULTS: Ischemic preconditioning, adenosine pre-treatment and nicorandil pre-treatment groups demonstrated a significant reduction in infarct size (26+/-4%, 25+/-4% and 34+/-8% infarction of the risk zone, respectively, p<0.01, p<0.01 and p<0.05 vs. control) with respect to control (41+/-8% infarction of the risk zone). However, pretreatment with SPT, polymyxin B or glibenclamide abolished the effect of ischemic preconditioning. Ischemic preconditioning group exhibited a significant reduction of MAP50 duration in the ischemic area during preconditioning;at the first preconditioning 128+/-11 msec vs. 144+/-10 msec control, at the second preconditioning 110+/-10 msec vs.147+/-10 msec control (p<0.01), at the third preconditioning 114+/-10 msec vs. 145+/-11 msec control (p<0.05). But, pretreatment with SPT, polymyxin B and glibenclamide prevented the reduction of MAP50 in the ischemic area during ischemic preconditioning. During 40 minutes ischemia, the shortening of MAP50 was more pronounced in the preconditioned group than in control group;at 5 minutes 112+/-13 msec vs. 124+/-10 msec control, at 10 minutes 89+/-12 msec vs. 133+/-11 msec control (p<0.05 ), at 20 minutes 93+/-12 msec vs. 136+/-11 msec control (p<0.05), and at 30 minutes 107+/-19 msec vs. 144+/-14 msec control (p<0.05). In adenosine pre-treated group, the MAP50 was significantly shortened than control group throughout 40 minutes occlusion period;at 5 minutes 90+/-8 msec (p<0.05), at 10 minutes 77+/-9 msec (p<0.05), at 20 minutes 92+/-8 msec (p<0.05), and at 30 minutes 103+/-8 msec (p<0.05). Nicorandil pretreatment pronounced the ischemic shortening of MAP50 in ischemic area and the effect was significant during early ischemic period;at 10 minutes 98+/-22 msec (p<0.05 vs. control). In pretreatment groups with SPT, polymyxin B or glibenclamide, the ischemic preconditioning of MAP50 measured in non-ischemic area was not significantly different compared with control group. MAP50 measured in ischemic area during reperfusion was not significantly different between groups. CONCLUSION: Based on this study, adenosine receptor-protein kinase C-KATP channel activation and monophasic action potential duration shortening during ischemia play an important role in myocardial protection during ischemic injury.
Action Potentials* ; Adenosine* ; Animals ; Cats* ; Glyburide ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Nicorandil ; Phosphotransferases ; Polymyxin B ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion

BACKGROUND: The purpose of this study was to find additional effects of intrathecal nalbuphine 1 mg to morphine 0.1 mg for pain relief during a cesarean section. METHODS: Sixty healthy patients at full term who were scheduled for an elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 0.5% bupivacaine 10 mg with either morphine 0.1 mg (group M), or nalbuphine 1 mg (group N), or morphine 0.1 mg nalbuphine 1 mg (group M + N). Analgesic effects were evaluated by a verbal rating scale on the duration of complete analgesia (time from the intrathecal injection to the first pain report), effective analgesia (time from the intrathecal injection to the first analgesic request), and cumulative doses of additional analgesics. Hemodynamic changes and adverse effects were also observed. RESULTS: The duration of complete analgesia increased significantly in group M, compared with group N and group M + N. Effective analgesia was longer in group M and group M + N, compared with group N. The incidence of pruritus was significantly lower in group N, compared with group M and M + N. The incidence of nausea and vomiting was the same among all groups. CONCLUSIONS: We concluded that intrathecal addition of nalbuphine 1mg to morphine 0.1 mg during spinal anesthesia for a cesarean delivery reinforced intraoperaitive analgesia compared with intrathecal morphine 0.1 mg. However, it reduced the duration of complete analgesia and had no effect on the incidence of pruritus.
Analgesia ; Analgesics ; Anesthesia, Spinal ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Incidence ; Injections, Spinal ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

No abstract available.