Clinical experiences of performing transforaminal balloon adhesiolysis in patients with failed back surgery syndrome: two cases report / 대한마취과학회지

Epidural fibrosis is a contributing factor to the persistent pain that is associated with failed back surgery syndrome (FBSS) and other pathophysiologies, particularly as it inhibits the passage of regional medications to areas responsible for pain. Therefore, effective mechanical detachment of epidural fibrosis can contribute to pain reduction and improve function in FBSS patients. In this report, we describe the successful treatment of FBSS patients with epidural adhesiolysis using a Fogarty catheter via the transforaminal approach.

Treatment of digit ulcers in a patient with Buerger's disease by using cervical spinal cord stimulation: a case report / 대한마취과학회지

Buerger's disease (thromboangiitis obliterans) is known as a segmental inflammatory vasculitis that involves the small-sized and medium-sized arteries, veins, and nerves. Most effective treatment for Buerger's disease is smoking cessation. Except for the cessation of tobacco use, surgical revascularization is available in severe ischemia and a distal target vessel. Amputation has been used as the last treatment option of the disease up to the present. Increasing limb survival and decreasing amputation rate is important. This case describes the use of spinal cord stimulation (SCS) in patient with Buerger's disease and its effect is not only the complete healing of ulcers but also amputation is not performed.

Effect of pretreatment with gabapentin on withdrawal movement associated with intravenous rocuronium injection / 대한마취과학회지

BACKGROUND: The major disadvantage of rocuronium is the withdrawal movement associated with its injection. The analgesic effect of perioperative gabapentin has been evaluated. We investigated the effects of gabapentin on the withdrawal movement induced by rocuronium injection. METHODS: 86 ASA physical status I or II patients, aged 18-69 years who were scheduled to undergo elective surgery with general anesthesia were enrolled. Patients were randomly allocated into two groups to receive either gabapentin 600 mg or placebo 2 hours prior to surgery. The patient's response to rocuronium injection was graded using a 4-point scale. RESULTS: The incidence of withdrawal movement after rocuronium administration was significantly lower in the gabapentin group (55.0% in the control group vs 28.6% in the gabapentin group). The number of patients with generalized response indicating severe pain, was 9 (22.5%) in the control group and 3 (7.1%) in the gabapentin group. CONCLUSIONS: Pretreatment with a single oral dose of gabapentin 600 mg reduced the incidence and severity of withdrawal movement after rocuronium administration.

Diffuse Esophageal Leiomyomatosis in a Child with Alport Syndrome: Case Report

Diffuse esophageal leiomyomatosis is an exceedingly rare, benign, neoplastic condition occurring predominantly in children and young adults. This condition may occur as an isolated finding, or it may be associated with Alport syndrome. We report a case of diffuse esophageal leiomyomatosis with Alport syndrome in a 5-year-old girl who had presented with recurrent pneumonia, and present a review of the literature. We suspected Alport syndrome in the patient because she had a clinical history of congenital cataracts and hematuria, as well as imaging findings of diffuse esophageal leiomyomatosis. Alport syndrome was subsequently confirmed by electron microscopy of the kidney.

Unusual Infarction of the Accessory Spleen or Polysplenia in Two Children: Case Report

The usual imaging findings of common splenic infarction are well known, while the findings for splenic infarctions in the accessory spleen or polysplenia are rare; these unusual imaging findings may make the diagnosis difficult. We report here on two patients who have complained of abdominal pain, and they were diagnosed as splenic infarction that developed in either the accessory spleen or as has having polysplenia. We can diagnose splenic infarction that unusually develops in the accessory spleen or polysplenia when we identify a round, hyperechoic, avascular solid mass on US, or when we identify a round, rim-enhancing, hypodense solid mass with adjacent inflammatory changes and a small amount of ascites on CT that is adjacent to the normal spleen or in one of splenules of polysplenia in the clinical settings of acute abdominal pain.