Pulsed Radiofrequency Lesioning of the Medial Branch in a Patient with Cervical Pain Caused by a Metastatic Tumor: A case report / 대한마취과학회지

Metastatic spinal tumor may cause pain by direct tumor involvement of bone with activation of local nociceptors or compression of adjacent structures. As an adjunct to pharmacologic therapy, many patients benefit from the use of additional nerve blocks to treat cancer pain. However, they require repeated injections as nerve block under local anesthetic sometimes only give the patient temporary relief of pain. Recently, the advent of pulsed radiofrequency application has proved a successful treatment for refractory pain disorders. A 43 year-old man was presented with a constant, dull, aching pain in the posterior neck with radicular pain referred to right shoulder due to metastatic cervical spinal tumor. Right C5 and C6 medial branch nerve blocks, with local anesthetic-steroid injections were effective, but short pain relief for a couple of days. However, the pain relief lasted longer and was effective with pulsed radiofrequency application over 3 months.

Pars Interarticularis Injections in a Patient with Spondylolysis: A case report / 대한통증학회지

Spondylolysis, also known as stress injury of pars interarticularis, is a common cause of back pain in athletes, particularly children and young adults. Repeated minor traumas during flexion and extension of the spine are thought to result in bony failure due to excessive bone resorption. These lesions are common in the low back, with the majority found at the L5 vertebra. In the majority of cases of spondylolysis, non-operative treatments are recommended, such as NSAIDs, physiotherapy and bracing. Only if symptoms do not respond to conservative treatments should surgical intervention be considered. Recently, pars interarticularis injections for diagnostic and therapeutic purposes have been found to allow significant pain relief from spondylolysis for long periods. Here, the case of a 57-year-old man with spondylolysis, who suffered from back pain, which was not relieved by an epidural steroid injection, but in whom pars interarticularis injections of local anesthetic and steroid induced complete transient pain relief, following by moderate long-term relief, is presented.

Consistent and Specific Suppression of Mucin Release from Cultured Hamster Tracheal Surface Epithelial Cells by Poly-L-Lysine

Poly-L-lysine (PLL) was reported to suppress mucin release from airway goblet cells during 30 min treatment period. In this study, we investigated whether PLL consistently suppresses mucin release from cultured airway goblet cells during 24 h after 30 min treatment and also specifically suppresses the release of mucin without any effects on the other releasable glycoproteins. Confluent primary hamster tracheal surface epithelial (HTSE) cells were metabolically radiolabeled with 3H-glucosamine for 24 h and chased for 30 min in the presence of varying concentrations of PLL to assess the effects on 3H-mucin release and on the total elution profile of the treated culture medium. The total mucin content during 24 h after 30 min treatment of PLL was assesed to investigate the consistency of effects. PLL did not affect the release of the other releasable glycoproteins whose molecular weights were less than mucin, and decreased the total mucin content during 24 h after 30 min treatment. We conclude that PLL can specifically suppress mucin release from cultured airway goblet cells and the suppression on mucin release is consistent. This finding suggests that PLL might be used as a specific airway mucin-regulating agent by directly acting on airway mucin-secreting cells.

A Case of Paroxysmal Atrial Fibrillation before Induction of General Anesthesia in an Elderly Patient

Atrial fibrillation(AF) diagnosed by fibrillatory waves of atrial activity and an irregular ventricular response on ECG is a common arrhythmia associated with increased cardiovascular morbidity and mor- tality. The incidence of AF increases markedly with advancing age and the presence of congestive heart failure. Most patients with AF can be attributed to organic heart disease such as rheumatic, atherosclerotic and hypertensive heart disease. But there is an increasing awareness of so-called lone AF which has no underlying cardiac or metabolic abnormality. We report a case of paroxysmal AF developed just before the induction of anesthesia in a 73-year-old patient who had no history of cardiovascular disease.

Vasovagal Syncope during a Caudal Epidural Block in a Patient with Vertebral Fractures: A case report / 대한마취과학회지

Age-related vertebral fractures occur frequently in the elderly recently. An epidural block has been introduced as an effective management for the treatment of pain with vertebral compression fractures. While an epidural block is considered to be reasonably safe, serious complications may occur even when this invasive procedure is related to pain. Vasovagally mediated episodes of hypotension and bradycardia are thought to be a common cause of recurrent unexplained syncope. Precipitating factors include pain, trauma, fatigue, blood loss, or prolonged motionless standing. We report one case of vasovagal syncope associated with severe bradycardia and hypotension in a 78 year-old male patient with vertebral fractures. Syncopal attacks occurred during a caudal epidural block. The patient was resuscitated successfully and recovered without any adverse effects.

Mucosal Resection in the Corrosive Esophageal Stricture: A new technique / 대한흉부외과학회지

Balloon dilatation is a popular method in corrosive esophageal stricture but swallowing difficulty due to recurrent or intractable stricture even in the repeated dilatation needs a esophageal reconstruction. Stomach, colon or jejunum has been used for the prosthesis of esophagus. Many problems such as leakage in anastomosis site, stricture, reflex, adhesion, strangulation, and engrafted esophageal cancer are associated with the remnant esophageal stricture in the esophago-gastrostomy and esophageal bypass surgery. Easy and reproduceable method of operation with lower complication and without functional disability is needed. A new operation method of mucosal resection and plasty is introduced in the corrosive esophageal stricture that are not relieved by repeated dilatation.

Clinical Comparison of Complications Between Cervical and Thor acic Esophagogastrostomy After Resection of Esophageal Cancer / 대한흉부외과학회지

BACKGROUND: For resection of esophageal cancer, esophagogastrostomy caused serous multiple complications such as leakage of anastomosis site, stenosis, recurrence of cancer, etc. Especially, accoding to the anastomosis site of esophagogastrostomy, patients in post operation state was felt various subjective symptom, multiple complications and longer hospital periods, etc. Therefore, there was a demand for comparison and analysis of complication between cervical and thoracic esophagogastrostomy. MATERIAL AND METHOD: From January 1995 to May 1999, 55patients with esophageal cancer underwent cervical esophagogastrostomy(23patients) or thoracic esophagogastrostomy(32patients). Cancer was grouped according to the postoperative staging(I--5pt, II--27pt, III--23pt) by the AJCC classification and location: upper thoracic(3pt), middle(34pt) and lower(18pt). Cancer was mostly squamous cell carcinoma except 2 adenocarcinoma. Fifty five patients were male with average age of 59 years for cervical anastomosis and 55 years for thoracic anastomosis. The staple anastomosis was done in one cervical anastomosis patient and 23 thoracic anastomosis patients. RESULT: There was one mortality from cervical anastomosis and two from thoracic anastomosis. Fourty six complications(respiratory and digestive system, etc..) occurred in 15cervical anastomosis patients and 37 complication in 13thoracic anastomosis patients. In 23cervical esophagogastrostomy patients, 11patients had moderate to severe dysphagea during swallowing. However, only 2thoracic anastomosis patients experienced this dysphagea. The postoperative hospital stay was above 20days in 18 cervical anastomosis patients, and in 13thoracic anastomosis patients. CONCLUSION: Among esophageal tumor cases, respiratory, digestive, infection and other complications did occur after esophagogastric anastomosis. Particularly, mortality rate secondary to respiratory complication was high. Anastomotic leakage was more frequent in manual anastomosis than in staple anastomosis, and was also seen more frequently among cervical anastomosis than among thoracic anastomosis. In the cases of cervical anastomosis, the patients complained more of dysphagea while their hospital stays were significantly long.

A case of Bronchogenic Cyst in Diaphragm / 대한흉부외과학회지

Isolated bronchogenic cysts of the diaphragm are rare abnormalities. They are usually asymptomatic unless secondarily infected or large enough to cause compression of vital structures. The patient was a 31-year-old man and had no symptoms except mild postprandial epigastric discomfort. The chest X-ray and chest C-T examination revealed a mediastinal mass at the left cardio-vertebro-phrenic angle. We performed the operation under the impression of solid mass at mediastinum. We revealed that the mass was bronchogenic cyst in diaphragm. Therefore we report this case with review of literatures.

Three Cases of Adrenoleukodystrophy

Adrenoleukodystrophy is an inborn error of metabolism characterized by adrenal insufficiency and progressive demyelmation of brain white matter and peripheral nerves. Authors experienced three cases of adrenoleukodystrophy in a 7 year old boy, a 17 and a 210 year old males that were diagnosed by increased plasma content of very long chain fatty acid(VLCFA). The clinical symptoms include seizure, visual impairment, and hemiparesis. Two cases showed typical radiological findings and sural nerve biopsy was performed in one.

Solitary Plasmacytoma associated with Peripheral Neuropathy

Solitary plasmacytoma, in contrast to the disseminated neoplastic proliferation of plasma cells with marked infiltration of multiple organ system in multiple myeloma, is plasma cell neoplasm of a single focus occuring either in bone or soft tissue. The association between a solitary plasmacytoma and peripheral neuropathy is rare, and it is a progressive sensorimotorneuropathy, with a raised CSF protein and mixed demyelination and axonal loss in nerve biopsy. Localized radiotherapy indeed proves to be effective of not only arresting the progress of the neuropathy but also allowing a degree of recovery. We experienced a 55-year-old male with a solitary plasmacytoma and peripheral neuropathy confirmed by the radiologic studies, immunohistochemical stain of nasopharyngeal mucosa biopsy and sural nerve biopsy, which has loss of myelinated fiber and axonal degeneration. Until now, the reported cases are very rare in Korea, so we presented a case of solitary plasmacytoma associated with peripheral neuropathy.

A case of thoracophagus diagnosed by abdominal ultrasonorgaphy at second trimester / 대한산부인과학회잡지

No abstract available.

A Study on Lighting in school

No abstract available.