The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

No abstract available.
Parathyroid Neoplasms*

STUDY DESIGN: A prospective clinical study with radiologic assessment was conducted. OBJECTIVES: To analyze the height changes of the intervertebral disc and neural foramen and width changes of the neural foramen after anterior lumbar interbody fusion and posterior fixation in the lumbar spine. SUMMARY OF LITERATURE REVIEW : Anterior lumbar interbody fusion distracts the height of the intervertebral disc and neural foramen and the width of the neural foramen. MATERIALS AND METHODS: Minimal anterior lumbar interbody fusion and posterior fixation were performed in 20 cases from January 1999 to January 2001. The measuring factors were the height of the anterior and posterior discs, and the height and width of the neural foramen, measured with a caliper in 1mm reconstructive, computed tomography, sagittal images before and 6 months after anterior lumbar interbody fusion. The factors were independently measured by three different persons. RESULTS: The height of the anterior and posterior discs was increased by mean 32.2% and 40.5%, respectively. The height of the right and left neural foramen was increased by mean 15.7% and 18.3%, respectively. The width of the superior, middle and inferior neural foramen was increased by mean 20.6%, 30.3% and 38.6%, respectively. There were significant increases in all measuring factors after minimal anterior lumbar interbody fusion. CONCLUSIONS: Minimal anterior lumbar interbody fusion significantly increased the height of the anterior and posterior intervertebral discs, and the height and width of the neural foramen, and produced neural decompression.
Decompression ; Humans ; Intervertebral Disc* ; Prospective Studies ; Spine*

Seventy-seven patients who were treated regularly for more than 5 years in the Taegu Leprosy Mission were investigated with regard to the change of the bacillary index(BI) after treatment of either dapsone(DDS) alone or a combination of DDS and clofazimine. The results were as follows: 1) In the group that took only DDS 400-500 mg per week, the BI conversion to negative took average 51 months. 2) In the group that took only 600-700 mg per week, the BI conversion to negative took average 34 months. 3) In the group that took only DDS 400 mg per week initially and 600-700mg per week secondarily, the BI conversion to negative took average 64 months, the last 33 months of which marked the time period that 600-700 mg were taken per week. 4) In the group that took only DDS 400-500mg per week initially and a combination of DDS gpp 700 mg per week and clofazimine. 3pp-4pp mg per week secondarily, the BI conversion to negative took average 63 months, the last 35 months of which marked the time period for the combined therapy. 5) In the group that took a combination of DDS 600- 700 mg per week and clofazimine 400 mg per week, the BI conversion to negative took average 42 months.
Clofazimine* ; Daegu ; Dapsone* ; Humans ; Leprosy* ; Missions and Missionaries

BACKGROUND: Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. METHODS: Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5 microgram, or neostigmine 25 microgram intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500 microgram and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. RESULTS: There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. CONCLUSIONS: These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Ketorolac ; Nausea ; Neostigmine* ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Umbilical Veins ; Vomiting

No abstract available.

No abstract available.
Colon*

No abstract available.
Amikacin* ; Cefuroxime* ; Hysterectomy* ; Sodium*

BACKGROUND: Transient global cerebral ischemia can cause selective hippocampal lesion and spatial learning impairment. To evaluate whether some commonly used laboratory animal anesthetics, pentobarbital, ketamine and xylazine, can affect ischemic brain injury, the effects of the anesthetics on Morris water maze task following transient global ischemia were investigated in Mongolian gerbils. METHODS: The ischemia was induced by bilateral carotid artery occlusion for 2 or 5 min. Morris water maze task was started 3 days later and performed for 15 days. RESULTS: Every animal acquired Morris water maze task as trial proceeded and there was no difference in the latency time on the last (15th) trial. However the ischemic groups (2 min and 5min) showed delayed acquisition of a Morris water maze task and the longer the ischemic time was the more the acquisition delayed. There were no differences in the acquisition of the maze task among pentobarbital-, ketamine- and ketamine/xylazine-anesthesia in either sham- or 2 min-ischemic group, but ketamine/ xylazine anesthesia significantly reduced the acquisition delay in 5 min-ischemic group compared with pentobarbital- or ketamine-anesthesia. CONCLUSIONS: These results suggest that ketamine/xylazine anesthesia have more neuroprotective effect on ischemia-induced brain injury, compared with pentobarbital- or ketamine-anesthesia, in gerbil global ischemia.
Anesthesia ; Anesthetics ; Animals ; Animals, Laboratory ; Brain ; Brain Injuries ; Brain Ischemia ; Carotid Arteries ; Gerbillinae* ; Ischemia* ; Ketamine* ; Learning* ; Neuroprotective Agents ; Pentobarbital* ; Sympathetic Nervous System ; Xylazine*

Hemodynamic variables in 8 verapamil pretreated patients(the verapamil pretreated group) were compared with those in 10 patients without pretreatment(the control group) during nitroglycerin(NTG) induced hypotension under halothane-N2O anesthesis. The results were as follows: 1) In the control group, there were statistically significant decreases in mean arterial pressure (MAP)(25%), pulmonary arterial pressure(PAP)(32%), pulmonary capillary wedge pressure(PCWP)(30%), central venous pressure(CVP)(33%), but the heart rate(HR), cardiac output(CO), cardiac index(CI) and stroke volume index(SVI) remained unchanged. After discontinuance of NTG, all parameters returned to baseline levels. 2) Verapamil alone produced a small decrease in MAP(6%) and CVP(9%), but other hemodynamic values did not change. 3) In the verapamil pretreated group, there were significant decreases in MAP(23%), PAP(30%), PCWP(27%), CVP(20%), SVR(24%) and PVR(31%), but HR, CO, CI, and SVI remained unchanged. 4) These results indicated that verapamil did not significantly affect the hemodynamic response to NTG under halothane-N2O Anesthesis.
Anesthesia* ; Arterial Pressure ; Capillaries ; Heart ; Hemodynamics* ; Humans ; Hypotension ; Nitroglycerin* ; Stroke Volume ; Verapamil*