Bilateral vocal cord paralysis following coronary artery bypass surgery / 대한마취과학회지

No abstract available.

Successful weaning from mechanical ventilation in the quadriplegia patient with C2 spinal cord injury undergoing C2-4 spine laminoplasty: A case report / 대한마취과학회지

In patients with cervical spine injuries, respiratory function requires careful attention. Voluntary respiratory control is usually possible with lesions below C4 level although paralysis of the abdominal musculature results in a decreased ability to cough and to clear secretions, which may later lead to respiratory insufficiency. Therefore, injuries above C5 usually necessitate long term mechanical ventilation. Even though weaning criteria are not definitive for the quadriplegic patient, M-mode ultrasonography of the diaphragm may be useful in identifying patients at high risk of difficulty weaning. Diaphragmatic dysfunction (vertical excursion < 10 mm or paradoxical movements) results in frequent early and delayed weaning failures. We present our clinical experience with successful weaning by using M-mode ultrasonography and a cough-assist device for secretion clearance after extubation in a quadriplegic patient undergoing C2-4 spine laminoplasty.

Postoperative pulmonary edema in a patient with POEMS syndrome / 대한마취과학회지

No abstract available.

An Intrathecally Located Broken Catheter Used for an Intrathecal Drug Delivery System

The intrathecal drug delivery system (ITDDS), an effective treatment tool for intractable spasticity and pain, is associated with various complications but breakage of the catheter is rare. We report the case of a 50-yr-old man with ITDDS, in whom an intrathecal catheter was severed, resulting in a 28.6-cm-long intrathecal fragment. The catheter completely retracted into the intrathecal space from the anchor site. The catheter was severed during spine flexion, and the total distal fragment was repositioned in the intrathecal space. Although the outcome of ITDDS was associated with the length or diameter of the broken catheter, no neurologic complications occurred in our patient. Thus, we inserted another catheter instead of removing the old one. Thereafter, the patient has been regularly followed up, and no neurologic complications have developed during the 28 months.

The Proportional Mortality Ratios of Specific-cause Mortality by Occupation and Education among Men Aged 20-64 in Korea (1993-2004) / 예방의학회지

OBJECTIVES: This study investigated the relationship of occupational class and educational background with proportional mortality ratios in Korea. METHODS: Mortality was investigated using the entire registered death data from 1993 to 2004, obtained from the Korean National Statistics Office. Proportional mortality ratios (PMRs) for specific diseases were calculated according to the occupational class and educational background of men aged 20-64. RESULTS: Manual workers were found to have higher PMRs for liver disease and traffic accidents, as did the lower educated group. Especially, this study showed trends of an increasing of the wide gap between lower and higher socioeconomic stati for liver disease, traffic accidents, diabetes mellitus and cerebral vascular disease. The mortality for cerebrovascular disease, diabetes mellitus, heart disease, traffic accident and liver disease showed increasing trends according to the calendar year for the lower than the higher social class. CONCLUSIONS: The specific conditions that had higher PMRs in the Korean lower social class were liver disease and traffic accidents. Especially, there was an increasing trend for a widening of the gap between manual and nonmanual groups in relation to mortality from liver disease, diabetes mellitus and traffic accidents.

A Case of Cowden's Syndrome / 대한소화기내시경학회지

A 17-year-old man was referred to our hospital because of dizziness and mild dyspnea. He had a history of partial thyroidectomy due to benign mass when he was 10 year-old. His conjunctiva was anemic and acral keratosis was noted. He had a goiter and a previous surgical scar on the anterior neck just below the thyroid cartilage. Blood counts were as follows; Hb was 4.3 g/dL, WBC 5,500/mm3, PLT 366,000/ mm3. Esophagogastroduodenoscopy and colonoscopy showed esophageal acanthosis and numerous variable sized polyps in the stomach, duodenum and colon. The small bowel series showed numerous polypoid lesions in the entire small bowel. Gastric polyps revealed hamartoma and colon polyps revealed inflammatory polyp with lymphoid hyperplasia by pathologic examination. Thyroid ultrasonograph showed multiple nodules and cysts and I131 scintigraphy showed multiple cold and hot nodules in his remnant thyroid gland. We diagnosed the patient as Cowden's syndrome.

A Case of Chronic Neutrophilic Leukemia Associated with Increased Respiratory Burst Activity of Neutrophils / 대한혈액학회지

Chronic neutrophilic leukemia is a rare myeloproliferative disorder. We have experienced a typical case of chronic neutrophilic leukemia in a 76-year-old man who complained abdominal distension due to hepatosplenomegaly. White blood cell count of peripheral blood was 50,500/nL with 90% segmented neutrophils. The underlying disease for a leukemoid reaction had not been detected. Leukocyte alkaline phosphatase score and the serum levels of vitamin B12 and uric acid were elevated. Chromosome study showed a normal karyotype without Philadelphia chromosome or bcr/abl rearrangement. Phorbol myristate acetate-activated respiratory burst activity of neutrophils measured with chemiluminescence showed increased activity.

Efficacy of Amiodarone in Tachycardia Induced Cardiomyopathy due to Non-Valvular Atrial Fibrillation

BACKGROUND AND OBJECTIVES: Drug therapy to treat atrial fibrillation has been achieved unsatisfactory results due to the frequent failure to maintain a sinus rhythm as well as the occurrence of adverse side effects. This study investigated the efficacy of amiodarone for the treatment of tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation. SUBJECTS AND METHODS: We treated twenty-seven patients with tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation with amiodarone in order to convert to and maintain the sinus rhythm. We followed up and compared the functional status, electrocardiography and parameters of echocardiography before and after treatment with amiodarone. RESULTS: Patients treated with amiodarone showed cardiac functional improvement based on New York Heart Association classification. Eighteen patients (66.7%) out of the total 27 converted to sinus rhythm. The pulse rate decreased from 109.0+/-34 bpm (beats per min) before the administration of amiodarone to 70.3+/-13.0 bpm after medication. The size of the left atrium decreased from 50.7+/-6.7 (mm) to 46.9+/-5.6 (mm). The ejection fraction (EF) improved from 36.2+/-14.9 (%) to 51.2+/-17.7 (%). CONCLUSION: Amiodarone is effective in the conversion to sinus rhythm as well as ventricular rate control in patients with atrial fibrillation induced cardiomyopathy. The cardiac functional status and the echocardiographic parameters of left ventricular function in patients with tachycardia-induced cardiomyopathy due to atrial fibrillation improved with amiodarone therapy.