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

No abstract available.
Abscess* ; Magnetic Resonance Imaging*

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.
Neurilemmoma*

No abstract available.
Chordoma*

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

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

No abstract available.
Glioma*

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

As craniopharyngioma is histologically benign, recent trend of managing this tumor has been complete surgical removal without adding any adjuvant therapy. But because of its close relation with surrounding vital structures, total removal sometimes results in unacceptable neurologic sequelae. To avoid these serious complications various management options have been suggested. Among these, bleomycin injections into the cystic cavity have been sporadically reported with satisfactory results. The authors report a 50-year-old woman presented with visual symptoms, who was found to have a largely cystic craniopharyngioma. Because the boarder between the tumor and hypothalamus was ill defined, intracystic bleomycin injection followed by delayed surgery was scheduled. A total of 80mg bleomycin was given over the 8 days. After the treatment high fever, skin rash and mental change developed but these symptoms were gradually subsided and the cysts were shrunken with surrounding infarction. During the follow-up period, visual symptoms became rapidly worse for which surgery was undertaken. Optic nerve was severely compressed by the underlying solid tumor and overlying A1 portion of the anterior cerebral artery. The tumor was near totally removed without any vascular insult. After the operation, the patient remained drowsy and lapsed into coma 6 days later and died. CT scan just before her death showed an infarct in the right ACA and MCA territories suggesting ICA occlusion. The cause of ICA occlusion remained to be unsolved.
Anterior Cerebral Artery ; Bleomycin* ; Coma ; Craniopharyngioma* ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Hypothalamus ; Infarction ; Middle Aged ; Optic Nerve ; Tomography, X-Ray Computed