No abstract available.
Plasmapheresis* ; Prednisolone* ; Purpura, Thrombotic Thrombocytopenic*

No abstract available.
Anemia, Hemolytic* ; Humans ; Infant, Newborn ; Infant, Premature* ; Vitamin E* ; Vitamins*

A retrospective analysis was performed on 461 pediatric patients under one year of age who had received operation from 1983 to 1990 in department of anesthesiology of Ewha Womans University Hospital. Total number of operation showed incresing tendency, annually, 37 in 1983, 36 in 1984, 43 in 1985, 41 in 1986, 54 in l987, 89 in 1989, 81 in 1989, and 80 in 1990. The eletive and emergency operation com- prised 79% and 21%, respectively. The distribution of the patients by department was general surgery 217, plastic surgery l09, orthopedic surgery 23, neurosurgery l6, cardiothoracic surgery l6, urology 14, and otolaryngology 6. The average age distribution was 149 in 6.to l2 months, l00 in 1 to 3 months, 81 in 1 week to 1 month, 81 in 3 to 6 months, and 50 under 1 week of age. The male to female ratio was 2.7: l. The distribution of induction agents of general anesthesia was ketamine and succinylcholine (SCC) 317, without induction agent(awake intubation) 84, thiopental or diazepam and SCC 23, ketamine and pancronium or vecuronium l2. The most common technique of maintenence anesthesia was the balaced anesthesia. The distribution of disease entity by department was the following inguinal hernia was the most frequent in general surgery, cleft lip in palstic surgery, and hydrocephalus in neurosurgery. The postoperative complication developed in 31 of 461. The most common complications were the respiratory problems, the others were sepsis, heart failures, and convulsions. The motality rate was 1.73%.
Age Distribution ; Anesthesia ; Anesthesia, General ; Anesthesiology ; Cleft Lip ; Diazepam ; Emergencies ; Female ; Heart ; Hernia, Inguinal ; Humans ; Hydrocephalus ; Ketamine ; Male ; Neurosurgery ; Orthopedics ; Otolaryngology ; Postoperative Complications ; Retrospective Studies ; Seizures ; Sepsis ; Succinylcholine ; Surgery, Plastic ; Thiopental ; Urology ; Vecuronium Bromide

Granular cell tumors were originally described in 1926 by Abrikossoff as myoblastic myomas. They usually occur as solitary tumors but can be multiple in about 10% of cases. They have a predilection for the skin, subcutaneous tissue and tongue, but also occur in many other organs. We report a case of solitary granular cell tumor on the palm. This is a very unusual location of this disease which merits consideration.
Granular Cell Tumor* ; Myoblasts ; Myoma ; Skin ; Subcutaneous Tissue ; Tongue

No abstract available.
Perfusion*

BACKGROUND: A number of anesthetic factors may influence the risk of postoperative nausea and vomiting (PONV) throughout various mechanisms. This study analyzed the effect of different anesthetics and opioids with regards to PONV. METHODS: Ninety ASA physical status 1 and 2 patients, who were scheduled for minor orthopedic or plastic surgery, were randomly assigned for three groups to receive either propofol-fentanyl (Group PF), propofol-femifentanil (Group PR) or sevoflurane-fentanyl (Group SF). Anesthesia was induced with propofol or pentothal sodium, rocuronium and fentanyl (2microg/kg) or remifentanil (1microg/kg). Anesthesia was maintained with BIS (bispectral index) value in the range of 40-60 and blood pressure and heart rate within 20% of baseline. The incidence and severity score of PONV, the administration of metoclopramide, visual analogue scale (VAS) for pain were assessed at 2, 12, 24 hours postoperatively. RESULTS: The incidence of PONV in SF group was significantly higher than in PF and PR group during 0-2 hours period (P < 0.05). The incidence of PONV in SF and PF group was significantly higher than in PR group during 2-12 h period (P < 0.05). There were no significant differences among the groups in gender, the administration of antiemetics and postoperative VAS. CONCLUSIONS: With propofol based anesthesia, short-cting remifentanil resulted in a lower incidence of PONV during 2-12 h period than fentanyl. Propofol-fentanyl anesthesia decreases the incidence of PONV compared with sevoflurane-entanyl during 0-2 hours postoperatively.
Analgesics, Opioid* ; Anesthesia ; Anesthesia, General* ; Anesthetics* ; Antiemetics ; Blood Pressure ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Metoclopramide ; Orthopedics ; Postoperative Nausea and Vomiting* ; Propofol ; Sodium ; Surgery, Plastic ; Thiopental

No abstract available.
Humans

A case of supratentorial ependymoma in a 48-year-old man. After operation and radiological treatment, metastasis to scalp and cervical lymph node occurred, without recurrence of primary focus. 11 cases of intracranial ependymoma with extracranial metastasis were reviewed. Metastasizing intracranial ependymomas are 3 times as frequent in males and originate above tentorium. The most effective transmission of metastasis of ependymoma is through the blood stream and the frequent sites of metastasis are lungs, pulmonary hilus, mediatinum, liver, scalp, vertebra, femoral bone and cervical lymph nodes. Our case is the oldest among reported cases and metastasized to relatively rare site.
Ependymoma* ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis* ; Recurrence* ; Rivers ; Scalp ; Spine

PURPOSE: To compare the usefulness of three MR sequences for the depiction and staging of advanced gastriccancer (AGC). MATERIALS AND METHODS: MR imaging was performed in 20 patients in whom AGC was proven by endoscopy.Axial scans with T1-weighted fast low-angle shot (FLASH), T2-weighted turbo spin-echo (TSE), and true fast imagingwith steady state precession (TrueFISP) MR sequences were obtained. We measured the signal-to-noise ratio (S/N) ofgastric cancer and signal difference-to-noise ratio (SD/N) between cancer and intraluminal fluid, cancer and thepancreas, and cancer and perigastric fat in each MR sequence. We also graded lesion conspicuity (poor, fair, orgood), and the degree of serosal invasion in each sequence. All results were correlated with histopathologicfindings. RESULTS: TrueFISP was superior to FLASH or TSE in lesion conspicuity, and showed the highest value ofSD/N between cancer and intraluminal fluid. FLASH showed the highest value of SD/N between cancer and thepancreas, and cancer and perigastric fat. The accuracy of T-staging of AGC with MRI was 75% using FLASH, 70% usingTrueFISP, and 60% using TSE. FLASH sequence understaged in three cases(15%) and overstaged in two (10%). In Usingthe TrueFISP sequence, six cases(30%) were overstaged. CONCLUSION: TrueFISP showed the best lesion conspicuity,but tended to overstage the lesion. T1-weighted FLASH sequence showed the highest value of SD/N on theextraluminal side of the gastric wall, and was better than T2-weighted TSE or TrueFISP for T-staging of AGC.
Humans ; Magnetic Resonance Imaging* ; Signal-To-Noise Ratio ; Stomach Neoplasms*

BACKGROUND: Aspiration of gastric contents is an ever -present risk in the use of general anesthesia, particularly in emergency and obstetric situations, and morbidity and mortality associated with this complication increases with the volume and acidity of the aspirate. Since direct inhibition of acid secretion may be a preferable method, we studied the effectiveness of ranitidine in increasing gastric pH. METHODS: Sixty patients scheduled for elective cesarean section under general anesthesia before midday were randomly divided into three groups. The control group (n=20) did not received preanesthetic ranitidine. Group I (n=20) received a slow intravenous injection of 50 mg ranitidine, one hour before surgery. Group II (n=20) received 150 mg ranitidine orally, both the night before surgery and the morning of surgery. RESULTS: Compared with the control group, the mean gastric pH increased significantly in group I and II (P<0.05). There was no significant difference of gastric pH between group I and II. CONCLUSIONS: The results of this study indicate that ranitidine is a useful agent in increasing the gastric pH in women undergoing elective cesarean section. Ranitidine administered intravenously and orally were equally effective means in increasing the gastric pH.
Anesthesia, General ; Cesarean Section* ; Emergencies ; Female ; Gastric Acid* ; Humans ; Hydrogen-Ion Concentration ; Injections, Intravenous ; Mortality ; Pregnancy ; Ranitidine*