No abstract available.
Lower Extremity

A 24 year-old Korean male, has had an eruption on the Lt. foot for 3 years. The lesion consists of single large macule of reddish purplish brown coloration scattered over the great toe, dorsum and inner part of the Lt. foot. Recently, there is no new lesions and lymphadenopathy on any part of the body. Laboratory tests were all negative, including serology. X-ray findings of the chest and Lt. foot showed normal limits but, angiographic findings which was performed under the local anesthesia through the femoral artery showed the arterio-venous plexus and markedly increased vascularity on the inner side of Lt foot area. Biopsy of a macule on the inner part of the Lt. foot was confirmed as Kaposi's sarcoma. X-ray therapy (100Kv at 50cm distance with 2 mm of AL. filter) was directed to the involved sites daily for 6 days to a total of 1,800 roentogens, after lesion was progressively improved day by day.
Anesthesia, Local ; Biopsy ; Femoral Artery ; Foot ; Humans ; Lymphatic Diseases ; Male ; Sarcoma, Kaposi* ; Thorax ; Toes ; X-Ray Therapy ; Young Adult

The disorders of cardiac and pulmonary function as complications of scoliosis, have been described by numerous investigators since Hippocrates. The abnormalities of respiratory and cardiovascular function in scoliosis include reduced lung volume and compliance of the total respiratory system, arterial hypoxemia, which may be associated with hypercapnia, impaired chemical regulation of ventilation and increased pulmonary vascular resistance. We recently had experienced of two cases of severe scoliosis of Cesarean section (onse was a severe kyphoscoliotic patient) in Eul Zi Hospital, and was anesthetized with halothane or ethrane. The following conclusions were observed: 1) Arterial blood gas must be checked serially. 2) Anesthesiologists must know the degree of abnormality of the spine and the cardiopulmonary dysfunction. 3) During anesthesia, intermittent positive pressure breatheing(IPPB) or positive end expiratory pressure(PEEP) is needed for good oxygenation. 4) Intubation tube length and tube location are very important. 5) For treatment of postoperative complications, digitalization, bronchodilators, and mechanical ventilation may be needed.
Anesthesia ; Anoxia ; Bronchodilator Agents ; Cesarean Section* ; Compliance ; Enflurane ; Female ; Halothane ; Humans ; Hypercapnia ; Intubation ; Lung ; Oxygen ; Postoperative Complications ; Pregnancy ; Research Personnel ; Respiration, Artificial ; Respiratory System ; Scoliosis ; Spine ; Vascular Resistance ; Ventilation

Persistent hiccups are described as a recurring troublesome series of involuntary inspirations accompanied by glottic closure, lasting longer than a month. Recently, baclofen, the most effective treatment for intractable hiccups was found to be a useful drug for the management of chronic hiccups, and that substituting gabapentin for baclofen can be effective. Moreover, gabapentin was used successfully in combination with baclofen. We report here on three patients with persistent hiccups, where gabapentin was used successfully as an "add-on" with baclofen.
Baclofen* ; Hiccup* ; Humans

BACKGROUND/AIMS: Physical activity (PA) is associated with a reduced risk of colorectal cancer. Thus, we examined the colon transit time (CTT) according to the physical activity level (PAL) in Korean adults. METHODS: The study subjects were 49 adults: 24 males and 25 females. The subjects used an accelerometer for 7 consecutive days to measure the 1-week PAL. The subjects took a capsule containing 20 radio-opaque markers for 3 days. On the fourth day, a supine abdominal radiography was performed. According to the total activity count of all study subjects, the upper 25%, middle 50% and lower 25% were classified into the high (H), moderate (M) and low (L) physical activity (PA) groups, respectively. RESULTS: The total CTT was significantly longer in the female (25.8 hours) than in the male subjects (7.4 hours) (P = 0.002). In regard to difference on PAL, although there was no significant difference among the male subjects, the right CTT in the female subjects was significantly shorter in H group than in M group (P = 0.048), and the recto-sigmoid CTT was significantly shorter in H group than in L group (P = 0.023). Furthermore, there were significant differences in total CTT between L and M groups (P = 0.022), M and H groups (P = 0.026) and between L and H groups (P = 0.002). CONCLUSIONS: The female, but not male, subjects showed that moderate and high PAL assisted colon transit.
Adult ; Colon ; Colorectal Neoplasms ; Female ; Humans ; Male ; Motor Activity ; Radiography, Abdominal

Direct arterial pressure(DAP) and heart rate were observed in normal patients during and after intravenous injection of d-Tc at varying rates of administration. The injection of d-Tc was preceeded by antihistmine(hydroxysine) in group ll. The results were as follows: 1) Alteration of pulse rate was minimal following varied administration of d-Tc in all groups. 2) DAP showed maximal change following a bolus injection of d-Tc, and a minimal change at the end of 180 seconds of d-Tc administration. 3) DAP showed minimal change following the premediction with antihistamine in comparison to a bolus administration. 4) Manifestation of flushing and tachycardia due to histmine release were not observed in group l and group ll.
Blood Pressure* ; Flushing ; Heart Rate ; Humans ; Injections, Intravenous ; Premedication* ; Tachycardia

A healthy, 25-year old female patient with no medical history complained of excessive palmar, plantar, axillary, back, and thigh sweating due to stress or a high temperature. Her whole body hyperhidrosis was often disabling and embarrassing in daily life. Plantar hyperhidrosis interfered with her social activities, and accordingly, she was suggested to have a lumbar sympathetic ganglion block with alcohol. Right side ganglion block was performed without any problem at the 3rd and 4th lumbar vertebrae. After sympathetic block, right foot sweating stopped, but phantom sweating continued for a week, and an ache in the pelvic area and flushing of the right foot continued for more than 10 days. Thus a left side procedure was postponed, but all symptoms disappeared after 21 days and the chemical neurolytic block of left side was subsequently performed, and plantar hyperhidrosis was resolved. However, 2 days after completing the lumbar sympathetic block, excessive sweating occurred in the facial, axillary, and back regions with upper body flushing. Two months later, her whole body, excepting the lower extremity showed running sweat after a 10 minute walk on exertion. To reduce the sweating, aluminum chloride, and oral and topical glycopyrrolate were prescribed to no affects. She is currently waiting for the return of normal lumbar sympathetic ganglion function.
Adult ; Aluminum ; Female ; Flushing ; Foot ; Ganglia, Sympathetic* ; Ganglion Cysts ; Glycopyrrolate ; Humans ; Hyperhidrosis* ; Lower Extremity ; Lumbar Vertebrae ; Running ; Sweat ; Sweating ; Thigh

We describe the case of a 61-year-old woman who manifested with paroxysmal supraventricular tachycardia (PSVT). She was scheduled with gastrectomy and partial hepatectomy because of stomach cancer metastasis. EKG findings were normal in the preoperative period but she had symptoms of palpitation, restlessness, and a high systolic blood pressure (180 mmHg) in the operating room before anesthesia induction. On her EKGs, we recognized a PSVT characterized by a high pulse rate of 180 beats per minute, a narrow QRS complex of 40 msec, and no P wave. These findings were not terminated by carotid massage or antiarrhythmics (verapamil and lidocaine), but were completely treated by the beta-blocker, esmolol. We consider that esmolol is a good choice for the treatment of PSVT with a narrow QRS complex combined with a high blood pressure in case with known hypertension or that have experienced preoperative anxiety or stress.
Anesthesia* ; Anxiety ; Blood Pressure ; Electrocardiography ; Female ; Gastrectomy ; Heart Rate ; Hepatectomy ; Humans ; Hypertension ; Massage ; Middle Aged ; Neoplasm Metastasis ; Operating Rooms ; Preoperative Period ; Psychomotor Agitation ; Stomach Neoplasms ; Tachycardia, Supraventricular*

OBJECTIVE: This study was to estimate the prevalence of and identify the predisposing risk factors of delirium and to determine the effect of delirium on the prognosis, especially death in burn patients. METHOD: The study was completed by thorough examination of medical records, with additional confirmation, of the 245 patients who were admitted to the Burn ICU in Burn treatment center of Hangang Sacred Heart Hospital during last one year (Jan. 1. 1998-Dec. 31. 1998). Delirium was retrospectively diagnosed according to DSM-IV. Only when disturbance of consciousness and attention, cognitive dysfunction especially disorientation, or perceptual disturbance were observed, diagnosis of delirium were given. Final outcome such as death was discriminated through examination of medical records or question to those who knew the patient. RESULTS: One year prevalence of delirium in burn patients is 34.4%. Statistically significant predisposing risk factors of delirium were five;Age 65 and over (OR=45.51, 95% CI:6.07-341.11), burn size over 60% of total body surface (OR=6.48, 95% CI:3.16-13.28), current psychiatric disorder (OR=6.81, 95% CI:1.42-32.57), current medical disease (OR=3.00, 95% CI:1.40-6.45), alcohol abuse (OR=3.17, 95% CI:1.07-9.43) Statistically significant deathrelated risk factors were three;burn size over 60% of total body surface (OR=4.58, 95% CI:2.00-10.46), delirium (OR=2.94, 95% CI:1.25-6.94), current psychiatric disorder (OR=4.09, 95% CI:1.05-15.87). Aging is not the death-related factor in this study. CONCLUSION: Three factors, such as delirium, organic brain damage, and burn size over 60% of total body surface may predict higher risk of death in burn patients.
Aging ; Alcoholism ; Brain ; Burns* ; Consciousness ; Delirium* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart ; Humans ; Critical Care* ; Medical Records ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors

Suprasellar meningiomas are uncommon intracranial tumors representing approximately 4-10% of intracranial meningiomas and the total excision is sometimes hazardous because of surrounding vital structures. We have experienced four cases of this lesion during last three years and the masses were approached through frontoparietal craniotomy and lateral subfrontal approach and were removed completely with microsurgical technique. Visual disturbances were improved in three cases and unchanged in one case. The literatures are also reviewed.
Craniotomy ; Meningioma* ; Microsurgery