We performed the interscalene technic of brachial plexus block for an operation of the upper extremity in 94 patients. We used 1%, 1.5% or 2% lidocaine solution with or without 1:200,000 epinephrine. There were paresthesias in all cases of needle puncture with the interscalene approach. The resutls were as follows: 1) Onset of anesthesia was observed in 3~10 minutes(average: 5 min.) 2) Complete anesthesia was observed in 10~30 minutes(average: 18 min.) 3) The mean interval of anesthesia to operation was 22 minutes. 4) We observed satisfactory blocks in 81 cases, unsatisfactory block in 8 cases and failure in 5 cases. 5) There were not any complications such as pneumothorax, dyspnea, convulsions, subarachnoid or epidural injection, etc.
Anesthesia ; Brachial Plexus* ; Dyspnea ; Epinephrine ; Humans ; Injections, Epidural ; Lidocaine ; Needles ; Paresthesia ; Pneumothorax ; Punctures ; Seizures ; Upper Extremity

No abstract available
Adenocarcinoma*

An evaluation of axillary block in 803 clinical cases, during the period from January 1974 to June 1979, was made. Satisfactory results were obtained in 756 out of 803 blocks (94. 2%) with the axillary perivascular technique. The authors feetl that the axillary perivascular technique in which a relatively large volume(40~50ml) of anesthetic solution was administered into the perivasculsr space of the axilla was simple, convenient and had no serious complications compared to the supra-or subclavian perivascular technique and interscalene block for a diagnosis and treatment of upper extremities.
Axilla ; Brachial Plexus* ; Diagnosis ; Upper Extremity

Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year-old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.
Acute Disease ; Humans ; Male ; *Mesenteric Veins ; Middle Aged ; Pancreatitis/complications/*diagnosis ; Tomography, X-Ray Computed ; Venous Thrombosis/*diagnosis/etiology/radiography

The aim of this study was to determine the usefulness of quantitative analysis of multiphasic dynamic contrast-enhanced magnetic resonance (MR) imaging in differentiating early homogeneously enhancing hemangiomas from hepatocellular carcinomas (HCCs). Four-phased dynamic MR imaging at 10 sec (first phase of dynamic contrast-enhanced imaging, P1), 35 sec (second phase, P2), 60 sec (third phase, P3) and 300 sec (delay phase, P4) immediately after intravenous administration of 0.1 mmol/kg Gadolinium-DTPA was obtained with 1.5-T unit with breath-hold multisection FLASH (fast low angle-shot) sequence (TR/TE, 113-130 msec/4.1 msec; flip angle, 80 degrees). Thirty-three HCCs and 18 hemangiomas, homogeneously enhanced on P1, were included in the study. The images were evaluated quantitatively (SNR, signal-to-noise ratio; and CNR, contrast- to- noise ratio of lesions). Quantitatively, mean CNR was higher for hemangiomas than for HCCs on all phases, and the difference in CNRs between hemangioma and HCCs was statistically significant on P3 and P4 (p < 0.0001). When the cutoff for CNR was set at a value of 7.00 on P3 and 1.00 on P4, sensitivity, specificity and accuracy were 94.4%, 93.9%, and 94.1% on P3, and 94.4%, 81.8%, and 86.3% on P4, respectively. There was no statistically significant difference in SNRs between HCC and hemangioma. The differential diagnosis between early, homogeneously enhancing hemangiomas and HCCs was more confidently made with CNRs of lesions on P3 and P4 in dynamic contrast-enhanced MR imaging.
Adult ; Aged ; Carcinoma, Hepatocellular/diagnosis* ; Contrast Media ; Diagnosis, Differential ; Female ; Hemangioma/diagnosis* ; Human ; Image Enhancement ; Liver Neoplasms/diagnosis* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Age

PURPOSE: A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. MATERIALS AND METHODS: Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were available, respectively. Cervical lymph node metastases was observed in 5 patients(N1;4/33, N2b;1/33). Patients were classified as 3 groups according to management method. The first group, named as "FAR" (16 patients), was consisted of preoperative intra-arterial chemotherapy with5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered;3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as "SR"(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). Her third group, named as "R"(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. RESULTS: Local recurrence free survival rate in the end of 2 year was 100%, 5-% and 0% in FAR, SR and R group, repectively. Disease free survival rate in 2 years was 88.9%, 40% and 50% in Far, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survival rates. But diffeence of each survival rate between SR and R group was not significant. CONCLUSION: In this study FAR group revealed better results that SR or R group. In the future prospective randomized study is in need.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Jeollanam-do ; Kaplan-Meier Estimate ; Lymph Nodes ; Male ; Maxillary Sinus* ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Temporal Arteries ; Vitamins

Brainstem auditory response abnormalities directly reflect disturbance of neural function rather than the underlying anatomic cause of that disturbance. The test has advantage in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply and permeability. A sequence of seven low-amplitude potentials that occur in the initial 10 msec following click signals can be recorded from scalp electrodes in 44 patient with focal brain lesions using computer averaging techniques. The potentials, termed auditory brainstem responses, are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brainstem. We have studied auditory brainstem evoked potential responses in a variety of focal brain lesions and found them to be of assistance in evaluating the localization of pontomedullary, pons, midbrain, thalamus, subcortical and functional recovery. 1) Distortion of early components (type I) was occured in the brainstem lesions. 2) Distortion of late components (type II) was developed in the diencephalon or subcortical lesions. 3) Distortion of all components (type III) was developed in the brainstem and diffuse brain contusions. 4) Serial recordings provided information about the evolution of brain stem lesions and good functional recovery marker.
Auditory Pathways ; Brain Injuries ; Brain Stem* ; Brain* ; Diencephalon ; Electrodes ; Electrophysiology ; Evoked Potentials* ; Evoked Potentials, Auditory, Brain Stem ; Humans ; Mesencephalon ; Permeability ; Pons ; Scalp ; Thalamus

Brainstem auditory response abnormalities directly reflect disturbance of neural function rather than the underlying anatomic cause of that disturbance. The test has advantage in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply and permeability. A sequence of seven low-amplitude potentials that occur in the initial 10 msec following click signals can be recorded from scalp electrodes in 44 patient with focal brain lesions using computer averaging techniques. The potentials, termed auditory brainstem responses, are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brainstem. We have studied auditory brainstem evoked potential responses in a variety of focal brain lesions and found them to be of assistance in evaluating the localization of pontomedullary, pons, midbrain, thalamus, subcortical and functional recovery. 1) Distortion of early components (type I) was occured in the brainstem lesions. 2) Distortion of late components (type II) was developed in the diencephalon or subcortical lesions. 3) Distortion of all components (type III) was developed in the brainstem and diffuse brain contusions. 4) Serial recordings provided information about the evolution of brain stem lesions and good functional recovery marker.
Auditory Pathways ; Brain Injuries ; Brain Stem* ; Brain* ; Diencephalon ; Electrodes ; Electrophysiology ; Evoked Potentials* ; Evoked Potentials, Auditory, Brain Stem ; Humans ; Mesencephalon ; Permeability ; Pons ; Scalp ; Thalamus

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay