No abstract available.
Cerebrospinal Fluid* ; Child* ; Humans ; Meningitis, Aseptic* ; Tuberculosis*

BACKGROUND: The nature of operation alters the volume of distribution at steady state (Vdss) of drug. The hepatic extraction ratio of midazolam (0.3~0.7) could be influenced by hepatic blood flow (HBF), and hepatic enzyme activity. The pharmacokinetics of intravenous midazolam were determined in patients undergoing lung surgery. METHODS: Midazolam, 0.2 mg/kg, was administered to five patients undergoing lung surgery at 30 minutes after induction of anesthesia. Anesthesia was maintained with O2-enflurane for one lung ventilation. Blood samples from artery were drawn at increasing intervals for 12 h. Plasma midazolam concentrations were measured by gas chromatography. Computer simulations of the times required for 20%, 50%, and 80% decreases in midazolam concentrations were performed. RESULTS: A three compartment model best described the concentration versus time data. The volume of the central compartment (Vc) and volume of distribution at steady state (Vdss) were 4.3 2.8 l and 59.9 20.1 l, respectively. The elimination half-life was 3.4 2.2 h. Simulations indicate that under all the situations, the concentrations would decrease more rapidly in our patients in spite of similar Vdss and elimination half-life of patients undergoing minor gynecological surgery. CONCLUSION: The elimination half-life was in the range of previously reported values. The shorter recovery time is apparently due to relatively faster redistrubution, and relatively greater capacity for redistribution.
Anesthesia ; Arteries ; Chromatography, Gas ; Computer Simulation ; Female ; Gynecologic Surgical Procedures ; Half-Life ; Humans ; Lung* ; Midazolam* ; One-Lung Ventilation ; Pharmacokinetics* ; Plasma

No abstract available.
Abscess* ; Magnetic Resonance Imaging*

No abstract available.
Chordoma*

No abstract available.
Neurilemmoma*

The association of varicose vein, soft tissue and bony hypertrophy and cutaneous hemangi-oma of the port-wine variety confined to one extremity was first reported in 1900 by Klippel and Trenaunay, and then Weber. A case of Klippel-Trenaunay-Weber Syndrome with macrodactylia in a 2 months old male infant(dizygotic) is presented who was asmitted to B.N.U.H. with chief complaints of nevus fla-mmeus, swelling of the left lower extremity.
Extremities ; Humans ; Hypertrophy ; Infant ; Klippel-Trenaunay-Weber Syndrome* ; Lower Extremity ; Male ; Nevus ; Port-Wine Stain ; Varicose Veins

Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.
Arm ; Constriction, Pathologic ; Decompression ; Intervertebral Disc Displacement ; Pathology ; Recognition (Psychology) ; Spine ; Surgical Procedures, Minimally Invasive ; Synovial Cyst

OBJECTIVE: Although the L5-S1 has distinct structural features in comparison with other lumbar spine segments, not much is known about adjacent segment degeneration (ASD) at the L5-S1 segment. The aim of study was to compare the incidence and character of ASD of the cephalad and L5-S1 segments after L5 floating lumbar fusion. METHODS: From 2005 to 2010, 115 patients who underwent L5 floating lumber fusion were investigated. The mean follow-up period was 46.1 months. The incidence of radiological and clinical ASD of the cephalad and the L5-S1 segments was compared using survival analysis. Risk factors affecting ASD were analyzed using a log rank test and the Cox proportional hazard model. RESULTS: Radiological ASD of the L5-S1 segment had a statistically significant higher survival rate than that of the cephalad segment (p=0.001). However, clinical ASD of the L5-S1 segment was significantly lower survival rates than that of the cephalad segment (p=0.038). Risk factor analysis showed that disc degeneration of the cephalad segment and preoperative spinal stenosis of the L5-S1 segment were risk factors. CONCLUSION: In L5 floating fusion, radiological ASD was more common in the cephalad segment and clinical ASD was more common in the L5-S1 segment. At the L5-S1 segment, the degree of spinal stenosis appears to be the most influential risk factor in ASD incidences, unlike the cephalad segment.
Follow-Up Studies* ; Humans ; Incidence ; Intervertebral Disc Degeneration ; Proportional Hazards Models ; Risk Factors* ; Spinal Stenosis ; Spine ; Survival Rate*

Six cases of juvenile diabetes mellitus who were admitted Busan National University Hospital from Jan., 1976 to Dec., 1979 were observed. The result were summarized as follows; 1) The mean age of onset was 11 & male to female ratio was 2 to 1 with male preponder ance. One half cases were occrred during spring. Two had family history of diabetes inclu ding one case of diabetic sibling. 2) Polyuria and polydipsia were noted in all cases as initial symptoms and symptoms of polyphagia(4), weight loss(4), weakness(3), enuresis(2) and altered consciousness(2) were noted in order of frequency. More rapid onset, more severe clinical features were observed. Associated illness were noted 4 cases of infection & 1 case of cataract. Mean blood glucose level was 430mg%, urine sugar above 3+and S.G. of urine was above 1.030. 3) Three cases of ketoacidosis & diabetic coma were occurred on admission. Consciousness cleared in 3 days, and ketonuria disappeared in 2 days after insulin & fluid therapy. 4) Mean duration of admission was 24 days. At discharge, dose of insulin needed was 10 to 50 units/day. Two cases were readmitted due to ketoacidosis and postoperative complication but all cases were not sufficiently followed up.
Age of Onset ; Blood Glucose ; Busan ; Cataract ; Consciousness ; Diabetes Mellitus* ; Diabetic Coma ; Female ; Fluid Therapy ; Humans ; Insulin ; Ketosis ; Male ; Polydipsia ; Polyuria ; Postoperative Complications ; Siblings

Intramuscular hemangioma (IMH) primarily develops in the skeletal muscles of the limbs or trunk. The occurrence of IMH in the neck muscle is very rare. In the present report, we describe a case of IMH in the posterior neck muscle. A 58-year-old woman presented with a mass on the right posterior neck area, which had developed 2 years previously. The tumor was round in shape, had a size of 3.5x3.0 cm, and was fixed to the surrounding soft tissue. The patient complained of mild dull pain and tenderness at the mass without reddish discoloration. The mass showed a diurnal variation in size - the mass grew in size in the morning and became smaller in the afternoon. Preoperative study confirmed the vascular nature of the tumor. During peritumoral dissection, the mass shrank rapidly following profuse bleeding and arterial cauterization, and hence, it was difficult to distinguish the mass from the surrounding tissues. A total resection was possible with careful dissection of its fibrotic boundary. Based on the histological findings, a definitive diagnosis of cavernous type IMH was made. An initial suspicion of IMH, according to the clinical findings, would be helpful for decision making of further evaluations and surgical plan.
Cautery ; Decision Making ; Diagnosis ; Extremities ; Female ; Hemangioma* ; Hemorrhage ; Humans ; Middle Aged ; Muscle, Skeletal ; Neck ; Neck Muscles