Purpose: To investigate the clinical efficacy of MS-Amnion amniotic membrane contact lenses. Methods: MS-Amnion amniotic membrane contact lenses were placed for 1 week in patients with severe superficial punctate keratitis or corneal epithelial defects that did not respond to medical treatment. Eighteen eyes followed-up for ≥3 months were evaluated in terms of the best-corrected visual acuity, tear break-up time, and corneal sensation and opacity before and after application of the MS-Amnion amniotic membrane contact lens. The success and recurrence rates, and complications during follow-up, were recorded. Results: Out of 18 eyes, 15 (83.3%) healed within 2 weeks without any treatment other than the amniotic membrane; three eyes (16.7%) were unresponsive, and thus underwent temporary amniotic membrane transplantation. Recurrence developed in three eyes (20%). The amniotic membrane contact lens dropped out in five eyes (27.8%) and folded over in two (11.1%). The mean best-corrected visual acuity improved from 0.89 to 0.27 logarithm of the minimal angle of resolution after 3 months, while the mean corneal opacity decreased from 0.38 to 0.11 after 3 months; the changes were statistically significant. The tear break-up time and corneal sensation also improved, but they were not statistically significant. We encountered no significant complications. Conclusions The MS-Amnion amniotic membrane contact lenses can heal the amniotic membrane and do not require suturing when applied in the outpatient clinic. This may be beneficial for patients with intractable ocular surface disorders.

BACKGROUND: Despite the established efficacy of dexamethasone and lidocaine for preventing postoperative airway symptoms, no study has investigated the effects of dexamethasone plus lidocaine for attenuating postoperative airway symptoms. The purpose of this study was to explore whether combined dexamethasone and lidocaine are superior to dexamethasone alone in reducing postoperative sore throat, cough, and hoarseness for 24 h after tracheal extubation. METHODS: In total, 70 female patients undergoing breast mass excision were randomized in a prospective, double-blinded manner into two groups: Group DL received intravenous dexamethasone (8 mg) plus lidocaine (1.5 mg/kg) 5 min before induction of anesthesia, and lidocaine was injected once more at the end of surgery. Group D received dexamethasone (8 mg) plus normal saline instead of lidocaine in the same manner as Group DL. We assessed the incidence and severity of postoperative sore throat, cough, and hoarseness 1 and 24 h after extubation. RESULTS: The incidence of sore throat for 24 h after tracheal extubation was significantly lower in Group DL than in Group D (62.9% vs. 85.7%, respectively; P = 0.029). The severity of sore throat and hoarseness for 24 h after extubation was lower in Group DL than in Group D (P < 0.05). The incidence and severity of cough did not differ between the two groups for 24 h after extubation. CONCLUSIONS: Lidocaine combined with dexamethasone is more effectively reduces the incidence and severity of sore throat and severity of hoarseness for 24 h after extubation in patients who have undergone breast mass excision surgery.
Airway Extubation ; Anesthesia ; Breast ; Cough* ; Dexamethasone* ; Female ; Hoarseness* ; Humans ; Incidence ; Lidocaine* ; Pharyngitis* ; Prospective Studies

No abstract available.
Adrenoleukodystrophy* ; Anesthesia* ; Child* ; Humans

BACKGROUND: Laparoscopic appendectomy (LA) is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. We expected that dexmedetomidine would compensate for the problems arising from spinal anesthesia alone. Thus, we performed a feasibility study of spinal anesthesia with intravenous dexmedetomidine infusion. METHODS: Twenty-six patients undergoing LA received spinal anesthesia with intravenous dexmedetomidine infusion. During surgery, the patient's pain or discomfort was controlled by supplemental fentanyl or ketamine injection, and all adverse effects were evaluated. RESULTS: No patient required conversion to general anesthesia, and all operations were completed laparoscopically without conversion to open surgery. Seventeen (65.4%) patients required supplemental injection of fentanyl or ketamine. Bradycardia occurred in seven (26.9%) patients. CONCLUSIONS: Spinal anesthesia with dexmedetomidine infusion may be feasible for LA. However, additional analgesia, sedation, and careful attention to the potential development of bradycardia are needed for a successful anesthetic outcome.
Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Spinal* ; Appendectomy* ; Bradycardia ; Conversion to Open Surgery ; Dexmedetomidine* ; Feasibility Studies ; Fentanyl ; Humans ; Ketamine

BACKGROUND: Laparoscopic appendectomy (LA) is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. We expected that dexmedetomidine would compensate for the problems arising from spinal anesthesia alone. Thus, we performed a feasibility study of spinal anesthesia with intravenous dexmedetomidine infusion. METHODS: Twenty-six patients undergoing LA received spinal anesthesia with intravenous dexmedetomidine infusion. During surgery, the patient's pain or discomfort was controlled by supplemental fentanyl or ketamine injection, and all adverse effects were evaluated. RESULTS: No patient required conversion to general anesthesia, and all operations were completed laparoscopically without conversion to open surgery. Seventeen (65.4%) patients required supplemental injection of fentanyl or ketamine. Bradycardia occurred in seven (26.9%) patients. CONCLUSIONS: Spinal anesthesia with dexmedetomidine infusion may be feasible for LA. However, additional analgesia, sedation, and careful attention to the potential development of bradycardia are needed for a successful anesthetic outcome.
Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Spinal* ; Appendectomy* ; Bradycardia ; Conversion to Open Surgery ; Dexmedetomidine* ; Feasibility Studies ; Fentanyl ; Humans ; Ketamine

No abstract available.
Anesthesia, General* ; Ulcer* ; Vocal Cords*

A coronary artery spasm (CAS) during noncardiac surgery is rare, but it can lead to catastrophic consequences. Furthermore, cardiac arrest caused by CAS, while a patient is in a lateral decubitus position and under contralateral thoracotomy conditions, represents a major challenge to both the anesthesiologist and the surgeon. We present a case of cardiac arrest due to CAS in a 69-year-old man undergoing Ivor Lewis esophagogastrectomy surgery for esophageal cancer in the left lateral decubitus position and the right thoracotomy state. The patient was successfully resuscitated with conventional cardiopulmonary resuscitation after repositioning him to a supine position.
Aged ; Cardiopulmonary Resuscitation ; Coronary Vessels ; Esophageal Neoplasms ; Heart Arrest* ; Humans ; Spasm* ; Supine Position ; Thoracotomy*

A coronary artery spasm (CAS) during noncardiac surgery is rare, but it can lead to catastrophic consequences. Furthermore, cardiac arrest caused by CAS, while a patient is in a lateral decubitus position and under contralateral thoracotomy conditions, represents a major challenge to both the anesthesiologist and the surgeon. We present a case of cardiac arrest due to CAS in a 69-year-old man undergoing Ivor Lewis esophagogastrectomy surgery for esophageal cancer in the left lateral decubitus position and the right thoracotomy state. The patient was successfully resuscitated with conventional cardiopulmonary resuscitation after repositioning him to a supine position.
Aged ; Cardiopulmonary Resuscitation ; Coronary Vessels ; Esophageal Neoplasms ; Heart Arrest* ; Humans ; Spasm* ; Supine Position ; Thoracotomy*

Tracheo-innominate artery fistula (TIAF) is rare, yet the most fatal complication after tracheostomy. In the absence of immediate diagnosis and surgical management, the mortality rate is very high, because the complication can lead to sudden massive tracheal hemorrhage. Tracheal obstruction and hypovolemic shock are the major life threatening conditions. The 46-year-old woman received tracheostomy tube insertion after stroke. Three months later, there was occurrence of active bleeding at the site of tracheostomy in the patient, who participated in comprehensive rehabilitation program. Immediately, the patient received an endotracheal tube insertion into the tracheostomy site and thus massive bleeding was controlled. The patient was transferred to the intensive care unit, where her breathing was maintained by mechanical ventilation. Based on computed tomography and laryngoscopy, no remarkable findings about TIAF were detected. Nevertheless, transfemoral angiography findings revealed that innominate artery made small luminal outpouching to trachea at the carotid artery and at the subclavian artery bifurcation level, based on which a diagnosis of TIAF was made. She had an operation for TIAF, tracheoplasty with bypass graft. Subsequently, she was discharged after 15 weeks. In the present report, we describe a case of TIAF, which can occur in the patients with tracheostomy tube during rehabilitation.
Angiography ; Arteries ; Brachiocephalic Trunk ; Carotid Arteries ; Female ; Fistula ; Hemorrhage ; Humans ; Intensive Care Units ; Laryngoscopy ; Phenobarbital ; Respiration ; Respiration, Artificial ; Shock ; Stroke ; Subclavian Artery ; Trachea ; Tracheostomy ; Transplants

OBJECTIVE: To estimate hours of leisure time physical activity (LTPA) performed by people with chronic spinal cord injury (SCI) and to identify the demographic and injury-related characteristics associated with LTPA of people with chronic SCI. METHOD: Seventy nine persons with SCI living in Busan and Gyongsangnam-do were recruited. They completed a self-administered questionnaire, which consisted of items about personal characteristics, type of LTPA, hours of LTPA, LTPA intensity, and LTPA satisfaction. RESULTS: Most participants (92.4%) did not work. The respondents reported a daily mean of 3.13 hours (+/-1.47) of LTPA; however, 3.8% reported no LTPA whatsoever. Years post-injury, income sources, and type of medical payment emerged as a predictors of LTPA. Years post-injury were positively correlated with amount of leisure activity. In the case of self income, LTPA was longer than for groups with different income sources (e.g.partner, parents). For patients receiving workers' compensation insurance, LTPA was longer than for patients receiving non-WC insurance. Most LTPA was done at a moderate intensity. The three most frequently reported types of LTPA were wheeling (26%), sports (19%), and stretching exercise (15%). There was overall dissatisfaction with LTPA. CONCLUSION: Daily LTPA hours were longer than previously reported, but wheeling accounted for a large part of the activity. Intensity of activity was generally moderate. The employment rate was very low. Clearly, participating in regular LTPA for health purposes is very important to people with chronic SCI, but it is also important for them to have jobs.
Surveys and Questionnaires ; Employment ; Humans ; Insurance ; Korea ; Leisure Activities ; Motor Activity ; Spinal Cord ; Spinal Cord Injuries ; Sports ; Workers' Compensation ; Surveys and Questionnaires