No abstract available.
Parathyroid Neoplasms*

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

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

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*

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

To evaluate the effectiveness of computed tomography for the differential diagnosis of cervical lymphadenopathy, we reviewed CT scans of 26 patients with cervical lymphadenopathy retrospectively. These included 10 patients with tuberculous lymphadenitis, 11 patients with metastasis and 5 patients with lymphoma, We evaluated the CT scans with a special attention to internal nodal density, feature of contrast enhancement and location of lymphadenopathy. Tuberculous lymphadenitis involved multiple nodes unilaterally and showed central low density with even or uneven rim enhancement, usually occurring in young patients (mean: 31.6 years). Two cases with tuberculous lymphadenitis showed calcifications within the lymph nodes. Lymphoma involved unilateral or bilateral nodes and appeared as conglomerated isodense mass with even rim enhancement. Metastasis involved multiple nodes unilaterally and showed focal, diffuse of mixed pattern of central low density with variable rim enhancement, usually occurring in old patients (mean: 59.4 years). Locations of most frequent lymph node involvements were internal jugular group (76%), spinal accessory group (54%) and retropharyngeal group(12%).
Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Neoplasm Metastasis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

The purpose of this study was to evaluate the shock absorbing effect of 4 restorative materials and intramobile connector. The damping effect of four restorative materials used to veneer test crown rigidly connected to IMZ implant and subjected to an impact force was measured. These materials included a gold alloy(stabilor G) : a noble metal ceramic alloy(Degudent H) : porcelain(Duceram) : composite resin(Dentacolor). In addition, this study compared damping effect of same restoretive materials after using polyoxymethylene intramobile connector(POM IMC). The result of this study suggest that : *In case of using metal IMC 1. Veneered composite resin(group IV) reduced the impact force by 75%, when compared to an equivalent thickness of porcelain(group III). Group IV reduced the impact force by 87% and 89%, respectively, when compared to Stabilor G(group I) and Degudent H(group II). 2. The impact force recorded was higher for the alloy with the higher elastic modulus.(Stabilor G, group I, Young's modulus 107 Gpa, versus Degudent H, Group II, Young's modulus 95 Gpa) 3. It took the longest time for composite resin veneered group(IV) to reach to peak force when compared group I, II, III. *In case of using POM IMC 4. The mean impact force recorded were reduced by 79%(group I), 78%(group II), 69%(group III), 84%(group IV), respectively, when compared to using metal IMC. 5. The time required to reach the peak force were increased by 78%(group I, II) 87% (group III), 34% (group IV), respectively, when compared to using metal IMC
Alloys ; Ceramics ; Crowns ; Elastic Modulus ; Shock

No abstract available.

BACKGROUND: The purpose of this study was to evaluate the historical anesthetic trends for last 35 years at Chonnam National University Hospital (CNUH). METHODS: The anesthetic records of total 101,637 anesthetic cases performed at CNUH from January 1961 to December 1996 were reviewed and analyzed according to age, sex, department, operation site, physical status, preoperative findings, anesthetic methods and agents, duration of operation, etc. RESULTS: Annual anesthetic cases was increased remarkably year by year; annual surgical patients increased 19 times for 35 years. The ratio of male to female was 1.18:1. The percent of geriatric anesthesia was increased year by year. In preoperative physical status from ASA definitions, 83.6 % of total patients was assigned class I and II. The average departmental distributions in descending order were surgery, orthopedic surgery, obstetrics and gynecology, neurosurgery, urology, ENT, thoracic surgery, ophthalmology, plastic surgery, oral and maxillofacial surgery, and others. The distributions of operation site in descending order were lower abdomen, neck, upper abdomen, lower extremities, head, chest, spine, upper extremities, and breast. Inhalational anesthesia was the most frequent used methods. Ether was abandoned from 1983, and major volatile anesthetics was halothane from 1981 to 1991. The use of enflurane has steadily increased and isoflurane has also been used with increasing frequency since 1992. CONCLUSIONS: Anesthetic cases are markedly increased year by year, and major volatile anesthetics and neuromuscular blocker were changed from halothane to enflurane and from pancuronium to vecuronium, respectively.
Abdomen ; Anesthesia ; Anesthetics ; Breast ; Enflurane ; Ether ; Female ; Gynecology ; Halothane ; Head ; Humans ; Isoflurane ; Jeollanam-do* ; Lower Extremity ; Male ; Neck ; Neuromuscular Blockade ; Neurosurgery ; Obstetrics ; Ophthalmology ; Orthopedics ; Pancuronium ; Retrospective Studies* ; Spine ; Surgery, Oral ; Surgery, Plastic ; Thoracic Surgery ; Thorax ; Upper Extremity ; Urology ; Vecuronium Bromide

No abstract available.
Colon*