No abstract available.
Fistula* ; Humans ; Infant*

No abstract available.
Carcinoma, Squamous Cell* ; Colon* ; Colonic Polyps* ; Female* ; Humans ; Urethra*

No abstract available.
Prostate* ; Testis*

BACKGROUND: Thoracic epidural anesthesia(TEA) is not commonly used for the purpose of pure regional anesthesia. To investigate the usefulness of TEA as a method of regional anesthesia, we performed TEA in patients(n=20) with breast mass. METHODS: After placement of thoracic epidural catheter at one of the 3rd, 4th, 5th or 6th thoracic intervertebral space according to the position of the mass, we injected 8ml of 2% plain lidocaine solution as initial dosage and 2~4 ml as additional dosage if necessary. Blood pressure and heart rate were measured before and at 5, 10, 15, 20, 25, 30, 60 and 90 minutes after epidural injection. Fifteen minutes after epidural injection, the extent of sensory block was measured at cephalad and caudad directions. Two-dermatome regression time was recorded postoperatively. We also investigated whether surgeon used lidocaine locally and anesthetist used intravenous analgesics or sedatives. And we observed the occurrence of complications associated with TEA. RESULTS: The induction dose of 2% lidocaine was 10.1+/-2.1 ml and total dose used was 11.4+/-2.1 ml. The extent of sensory block was T1.1+/-1.1 to T9.1+/-2.3 and two-dermatome regression time was 73+/-24 minutes. Blood pressure and heart rate showed stable pattern of change perioperatively. In two of the subjects, the surgeon used 4 ml of 1% lidocaine locally and in one of the subjects, 50 microgram of fentanyl was used intravenously. Another one of the subjects developed Horner's syndrome postoperatively, which soon disappeared without specific treatment. CONCLUSIONS: Above results suggest that TEA is suitable for breast mass excision as a method of regional anesthesia.
Analgesics ; Anesthesia, Conduction ; Anesthesia, Epidural* ; Blood Pressure ; Breast* ; Catheters ; Fentanyl ; Heart Rate ; Horner Syndrome ; Hypnotics and Sedatives ; Injections, Epidural ; Lidocaine ; Tea

No abstract available.
Pregnancy*

PURPOSE: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. MATERIALS AND METHODS: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. RESULTS: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. CONCLUSION: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.
Cryotherapy ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Humans ; Lower Extremity ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Transplants ; Upper Extremity

BACKGREOUND: Acute normovolemic hemodilution (ANH) is one of the methods of autologous transfusion drawing much attention recently. It is economical and easy to apply to many surgeries requiring multiple transfusions. When used as a drug for induced hypotension, esmolol can avoid many drawbacks of sodium nitroprusside and reduce the amount of intraoperative bleeding with better operative field. Considering recent trend of combining ANH and induced hypotension to increase the success rate of autotransfusion, esmolol-induced hypotension with ANH will be used more frequently in the future. However, tissue oxygen balance may be in danger because of decreased tissue perfusion pressure by induced hypotension and reduced arterial oxygen content by ANH. Thus it is necessary to evaluate effects of induced hypotension combined with ANH on cardiovascular system and systemic oxygen balance. METHODS: In 8 mongrel dogs anesthetized with N2O-O2-enflurane and paralyzed with vecuronium, ANH was performed up to half of initial level of hemoglobin with isovolemic pentastarch infusion, and then mean arterial pressure (MAP) was lowered by 30% of the initial value by intravenous administration of esmolol. Various hemodynamic parameters were measured before and after ANH and 15, 30, 60 and 90 minutes after induction of hypotension and 30 minutes after the end of hypotension. RESULTS: Heart rate began to decrease after ANH and showed significant decrease at 60 and 90 minutes after hypotension compared with initial value. Central venous pressure increased significantly after ANH and hypotension. Pulmonary arterial pressure showed significant increase at 15 and 90 minutes after hypotension. Cardiac output was increased markedly by ANH but began to decrease after hypotension and showed significant decrease at 60 minutes after hypotension. Systemic vascular resistance showed significant decrease after ANH, 15 minutes after hypotension and 30 minutes after discontinuation ofesmolol. Pulmonary capillary wedge pressure and pulmonary vascular resistance showed no significant change. Oxygen flux was decreased markedly by esmolol but recovered after discontinuation of esmolol. Oxygen consumption was maintained throughout the study. Oxygen extraction ratio was increased dly after hypotension. There were no acidemia and hypoxemia throughout the study. CONCLUSION: In conclusion, the results of this study suggest that tissue oxygen delivery might be decreased by anemia but that systemic oxygen balance might be preserved by ANH and induced hypotension within the range used in this study.
Administration, Intravenous ; Anemia ; Animals ; Anoxia ; Arterial Pressure ; Blood Transfusion, Autologous ; Cardiac Output ; Cardiovascular System* ; Central Venous Pressure ; Dogs* ; Heart Rate ; Hemodilution* ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Hypotension* ; Nitroprusside ; Oxygen Consumption ; Oxygen* ; Perfusion ; Pulmonary Wedge Pressure ; Vascular Resistance ; Vecuronium Bromide

Giant cell tumor is a predominantly benign condition but often the tumor is locally aggressive and tends to have high rate of recurrence and it can evolve into a malignant tumor. Thus the lesions have a practically difficult therapeutic problem for the orthopaedic surgeon and any method of treatment has not been satisfied. Between March 1984 and March 1993, clinical observation was carried out on 22 cases of giant cell tumor of bone to analyse the recurrence rate and functional evaluation of the joint according to the treatment methods, pathological grade and cortical destruction. The mean follow-up time was 75. 2 months. The recurrence rate of the intralesional excision group was 54.5% and that of the wide excision group was 9%, There was no relationship between the pathologic grade and recurrence rate. There was no recurrent case in the grade I cortical destruction but almost all of recurrence was occurred in the grade I or II cortical destruction. The functional result of the giant cell tumor occurred around the knee joint was that the mean ratings in the intralesional excision group were 79% and in the wide excision group were 51%. In conclusion, to achieve better joint function and less recurrence rate, intralesional or marginal excision with heat using bone cement or with chemical cauterization using phenol and alcohol can be used for cases of radiological grade I or II, and wide excision for grade III.
Cautery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hot Temperature ; Joints ; Knee Joint ; Methods ; Phenol ; Recurrence

Generally, the left kidney from a living donor is more commonly preferred but the right kidney is occasionally donated because of multiple left renal arteries or repeated transplantation. The right donor nephrectomy is usually more difficult compared to the left because the right renal vein is often multiple and short, which complicates dissection of the vascular pedicle. From Jan. 1989 to Sep. 1992, 112 consecutive cases of right donor nephrectomies out of a total of 771 cases were retrospectively reviewed with the preoperative renal angiography and the intraoperative assessment of the right renal vascular pedicle. The indications for right donor nephrectomy include 1) multiple or proximal bifurcating renal arteries of the left kidney (89.3%), 2) repeated transplantation in the recipient (9%). In 26.8% of the cases, there were more than two right renal veins. In the right donor nephrectomy, it is often necessary to perform vena cava cuff resection because of short and frequently occurring multiple right renal veins. For the dissection of the inferior vena cava (IVC), the aberrantly occurring right gonadal vein, the adrenal vein draining above the junction of the renal vein and IVC, and the lumbar vein below the junction should always be looked for and must be ligated if any are found.
Adult ; Blood Vessels/anatomy & histology ; Female ; Human ; Intraoperative Period ; Kidney/*blood supply ; Male ; Nephrectomy/*methods ; Retrospective Studies ; *Tissue Donors

The previous reports have indicated that both the DMSA scan and the DTPA scan were significantly related with the relative renal function ( RRF) and there was a close relationship between the DMSA scan and the DTPA scan in the evaluation of the RRF We reviewed our experience with 24 cases, in which the DMSA scan and the DTPA scan were performed within 2 weeks from January 1987 to April 1991. The DMSA scan was more reliable than the DTPA scan and the difference of the RRF between right and left side by the DMSA scan was more apparent than that by the DTPA scan. However, in infants, both scans showed the reversed results. Our study suggests that DMSA scan is more reliable than the DTPA scan in the evaluation of the RRF, but both renal scans are inappropriate in infants, especially under the age of 1 months.
Humans ; Hydronephrosis* ; Infant ; Pentetic Acid* ; Succimer*