BACKGROUND: Caudal anesthesia is considered a safe and reliable anesthetic technique for many pediatric surgical procedures. It is well known that extradural clonidine produces analgesia in adult. The purpose of this study is to assess its efficacy in children. METHODS: We randomized 45 pediatric patients aged under 10 years, weighted under 25 kg presented for lower abdominal surgery with duration of operation would be shorter than 2 hours, into three groups of 15 each. After sedation with the use of intravenous thiopental sodium, caudal anesthesia was performed with the use of 1 mL/kg of 0.25% bupivacaine. We allocated randomly the patients who received no additional medication in 0.25% bupivacaine (group I), with epinephrine 1/200,000 (group II), and with 1 mcg/kg of clonidine (group III). The degree of postoperative analgesia was evaluated using the Broadman ""Objective Pain/discomfort Scale"" (OPS) at hourly intervals for 24 hours. RESULTS: Duration of sleep in the recovery room was significantly longer in group III than in group I and group II, and statistical significant difference was found between the group I and group II. Duration of analgesia was significantly longer in group III than in group I and group II. Overall hourly OPS scores were lower in group III than in group I and group II. CONCLUSION: Duration of postoperative analgesia with caudal bupivacaine was increased by addition of 1 mcg/kg of clonidine.
Adult ; Analgesia ; Anesthesia, Caudal* ; Bupivacaine ; Child ; Clonidine* ; Epinephrine ; Humans ; Recovery Room ; Thiopental

Mutant p53 is associated with the advanced stages of some human tumor but there is a wide variation in the reported incidence of p53 mutation in renal cell carcinoma and its prognostic significances. We designed this study to assess the expression of p53 in renal cell carcinomas and to compare with the established prognostic factors. Immunoreactivity for p53 protein and proliferating cell nuclear antigen (PCNA) were assessed in 44 cases of primary renal cell carcinoma, and flow cytometric analysis of DNA ploidy was perfon-ned in 37 of those cases. p53 protein was over-expressed in 16/44 (36.4%) renal cell carcinomas and 5 rumors had more than 10 immunoreactive tumor cells. The expression of p53 protein was positively related to nuclear grade (p=0.007) and PCNA index (p=0.002), but was independent of stage and DNA ploidy. In univariate survival analysis, stage (p<0.001), nuclear grade (p=0.017), DNA ploidy (p=0.045) and PCNA index (p<0.001) were significantly associated with patient survival. However, considering the stage, all of the last three factors had no prognostic influence. Cases showing strong positivity of p53 expression had worse prognosis than those with no or weak p53 expression, especially in early lesions (stage I,II) (p<0.001).
Carcinoma, Renal Cell* ; DNA* ; Humans ; Incidence ; Oncogene Proteins* ; Oncogenes* ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen*

Mullerian Mucinous papillary Cyatadenernas of Borderline tumor(MMBT) is lined by mucinous epithelium of endocervical type and is characterized by papillae architecturally similer to those of serous horderline tumors, It has been described rarely in the literature, Thia case was reported with a brief review of the concerened literatures. It has important clinical and pathological diBerences from mucinous birderline tumors with intestinal differentiation, but has many similatities to mixed epithelial borderline tumora of Mulierian type. Recently, a case of MMBT in a 22 years old woman was experienced at our department. We presented this case with a brief review of literature.
Cystadenoma, Papillary* ; Epithelium ; Female ; Humans ; Mucins* ; Young Adult

No abstract available.
Uterus*

No abstract available.
Child* ; Hemagglutination* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

Following chemotherapy for acute myelomoncytic leukemia, an 3-year-old boy developed several painful erythematous indurated patches at previous sampling sites and at the site where an arm board and adhesive tape were used in securing an intravenous infusion set. The lesions rapidly progressed to ulcers with central black eschars. Biopsies and cultures demonstrated a fungus, Aspergillus flavs, as the etiologic agent, without evidence of systemic dissemination. Local care, including s irgical debridement, were performed. The patient also received treatment with intravenous; amphotericin B followed by oral itraconazole. Six months later, the skin lesions had healed, leaving some scar and deformities.
Adhesives ; Amphotericin B ; Arm ; Aspergillosis* ; Aspergillus ; Biopsy ; Child* ; Child, Preschool ; Cicatrix ; Congenital Abnormalities ; Debridement ; Drug Therapy ; Fungi ; Humans ; Infusions, Intravenous ; Itraconazole ; Leukemia* ; Male ; Skin ; Ulcer

An analytic study on 431 cases of cardiac conduction disturbance has been made by review of the clinical records and electrocardiograms taken from the adult patients registered at Kyung Hee University Hospital for 3 years from May, 1973 to April, 1976. 1. The total incidence of conduction disturbance was 6.50%, the atrioventricular block 3.14% and the intraventricular block was 3.36% of total 6,616 cases of E.C.G. reviewed. Among of these, the first degree atrioventricular block was 3.02% which was the most common occurred one, the incomplete right bundle branch block was 2.25% and the complete right bundle branch block was 0.57%. 2. The ratio of male to female was 1.6:1 for the first degree atrioventricular block, and 1.6:1 for the incomplete right bundle branch block, 2.5:1 for the complete atrioventricular block, 2:1 for the left bundle branch block, and 1.7:1 for the complete right bundle branch block. The first degree atrioventricular block was seen most frequently in the fifth and sixth decade of age group, and the third degree block was over 40 years. The incomplete right bundle branch block in order was forth decade, third decade and fifth decade. The complete right bundle branch block and left posterior hemiblock were common in the sixth decade. The left bundle block and the posterior hemiblock were common in fifty years of age group. 3. The cardinal underlying diseases of the first degree atrioventricular block among cardiac diseases group in order of frequency were: hypertensive heart disease (25.0%) arteriosclerotic heart disease (8.0%) and rheumatic valvular heart disease (5.0%). The most common etiology of those non-cardiac disease group was neuropsychiatry disorder (11.5%) and the next was infection (11.0%). 4. All of the complete atrioventricular block were associated with the cardiac disease, that is, 57.0% with arteriosclerotic heart disease, 28.5% with pericarditis and 14.3% with hypertensive heart disease, respectively. 5. The cardinal underlying disease of the incomplete right bundle branch block in order of frequency were: hypertensive heart disease (10.7%), arteriosclerotic heart disease (8.1%) among the cardiac disease group, and infections (15.4%) among the non-cardiac disease group. The incidence of healthy persons was 14.1%. 6. Those of complete right bundle branch block in order of frequency were: arteriosclerotic heart disease (13.2%), and hypertensive heart disease (10.1%) among the cardiac disease group, and infection(13.2%) and neurosis (10.1%), respectively among the non-cardiac disease group. 7. The major etiologies of the left bundle branch block was hypertensive heart disease and arteriosclerotic heart disease (33.3% each), and that of left posterior hemiblock was showed arteriosolerotic heart disease and cor-pulmonale. The most common etiological disease of the left anterior hemiblock was hypertensive heart disease in cardiac disease group, and infection and gatrointestinal disease in non-cariac disease group. 8. The abnormal electrocardiographic findings with the first degree atrioventricular block were left ventricular hypertrophy (24.8%), sinus tachycardia (11.0) and sinus bradycardia (5.8%). Those with the complete atrioventricular block were right ventricular hypertrophy (15.8%) and left bundle branch block (15.8%). In complete right bundle branch block, the majority (52.5%) showed single sign without other abnormality on E.C.G. In the left bundle branch block, there were 18.9% of left ventricular hypertrophy and 15.7% of first degree atrioventricular block. In the left anterior hemiblock, there were 28.5% of right bundle branch block, and 19.0% of right ventricular hypertrophy. In the left posterior hemiblock, there were 40.0% of atrial fibrillation and 20.0% of left atrial hypertrophy.
Adult ; Male ; Female ; Humans ; Incidence

No abstract available.
Heart Defects, Congenital* ; Plasma*

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer

No abstract available.
Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory*