It is well-known that the course of phototherapy, stool colour changes from yellow to green. The occurrence of frequent loose green stools, commencing a few hours after the beginning of treatment, has been observed in several different centers. In order to elucidate the machanism by which phototherapy induces loose stools in newborns, studies were perforned on the speed of intestinal transit by performing the carmine red ftest on 15fullterm newborns, 15jaundiced newborns before and after phototherapy and 15 healthy newborns exposed to phototherapy. The following results were obtained. 1) Intestinal transit time in 15 full term newborns was 12.75+_3.54 hours.(Fig. 1). 2) Intestinal transit time before phototherapy was 13.63+_3.21 hours in 15 jaundiced newborns and it was 7.32+_2.76 hours after phototherapy (Fig. 1). 3) Intestinal transit time in 15 healthy newborns was 13.74+_5.14 hours(Fig. 1). A statistically accelerated intestinal transit was observed in jaundiced newborns treated with phototherapy. The increased rate of intestinal transit produced by phototherapy is probably due to the action of the phototherapy.
Carmine ; Humans ; Infant, Newborn* ; Phototherapy*

The following results were obtained through the clinical review of 89 cases of tuberculous meningitis which were treated at the Department of Pediatrics of Seoul National University Hospital during the period of 3 years from June 1973 till May. 1976. 1. The highest incidence by age was noted as 80.9% under the age of 6years and 24.7% of cases were between the age of 1 and 2 years, Male to female ration was 1.2:1. 2. 35%of cases were noted in the spring 28%, in the summer, 19%, in the autumn and 18% in the winter. 3. The chief complaints on admission were in the order of vomiting, Fever, convulsion, drowsiness and headache. Meningeal irritation sign was noticed in 80.9% of cases . 4. Tuberculin test revealed positive reaction in 72.1%of cases. 5. Clinical stage on admission revealed 35cases of stage I. 1cases (2.9%)died and 30cases(85.7%)recovered. Stage II was 32cases and 6cases(18.8%)died and 14cases (43.8%) recovered. Stage III was 32cases and 7cases (31.8%) died and only 3cases (13.6%) recovered. Overall mortality was 15.7% 6. Family history of tuberculosis was found in 29 cases (32.5%) 7. Chest X-ray revealed tuberculous lesions in 59.5%of all cases and miliary tuberculosis were found,. In 20.2%of all cases. 8. Mean leukocyte count in the cerebrospinal fluid was 261/mm3 and 80.2% of all cases were in the range of 50~500/mm3, in 75.3% of all cases, differential count of lymphocyte was over 75%. Mean protein level in the cerebrospinal fluid was 170mg%and 91.5% of all cases were in the range of 50~300mg%. Sugar level in the cerebrospinal fluid was decreased below 40mg% in the 73.2% of all cases and the mean was 31.7%. Mean chloride level was 112.1mEq/l and 93.1% of all cases were below 120mEq/l. 9. Mortality rate was slightly lower in the group treated with triple therapy and corticosteroid than the group treated with only INH, PAS, and SM.
Cerebrospinal Fluid ; Child* ; Female ; Fever ; Headache ; Humans ; Incidence ; Leukocyte Count ; Lymphocytes ; Male ; Mortality ; Pediatrics ; Seizures ; Seoul ; Sleep Stages ; Thorax ; Tuberculin Test ; Tuberculosis ; Tuberculosis, Meningeal* ; Tuberculosis, Miliary ; Vomiting

Generally, traumatic penile amputation is rare. Amputation of penis is likely to be self-inflicted most commonly. When penis is amputated, reimplantation requires microvascular surgery. Herein we present a case of successful reimplantation of completely amputated penis in 40 years old schizophrenia.
Adult ; Amputation ; Humans ; Male ; Penis ; Replantation ; Schizophrenia

Monorchism is a rare condition which incidence figures in the range of 3 to 5 percent of surgical exploration for undescended testis. Herein we present a case of monorchism associated with hypospadia and inguinal hernia in a 17-year-old boy with review of related literatures.
Adolescent ; Cryptorchidism ; Female ; Hernia, Inguinal* ; Humans ; Hypospadias* ; Incidence ; Male

Statistical analysis for mortality of in-patient in pediatric ward in Seoul National University Hospital was carried out during the 3 years from Jan. 1974 to Dec. 1976. Total number of admitted patients was 2,234, of whom 172 expired. The following results were observed. 1. Total number of admission during the 3 years was 2,234, and male to female ratio was 1.78:1. 2. Case mortality rate was 7.7% among the admitted cases. Sex difference in mortality rates was not recognized. 3. Monthly distribution of death cases revealed as high in May(11.6%), August(11.0%), September(11.0%) in order of frequency. 4. According to age, infants below one year of age comprised 38.4% of all expired patients. 5. On the duration from admission to death, 46.5% of expired cases of in-patients were died within the 48hours. 6. The leading causes of death proved to be infectious disease(48.8%), neoplasm, congenital anomaly, pulmonary disease in orders. 7. Causes of death by age were as follows; a) In the neonatal period, neonatal tetanus was the most frequent(47.4%) and sepsis(21.1%), neonatal hyperbilifubinemia(10.5%), congenital heart disease(7.9%) etc. b) In the age of one month to 1 year, congenital heart disease was the most frequent(28.6%), and sepsis(14.3%), tuberculous meningitis(10.7%), Reye Syndrome(10.7%) etc. c) In the age of 1 year to 2 years, tuberculous meningitis was the most frequent(36.0%) and pneumonia(8.0%), encephalitis(8.0%), hepatitis(8.0%) etc. d) In the age of 2 years to 6 years, leukemia was the most frequent(23.1%) and encephalitis(11.5%), congenital heart disease(7.7%) diphtheria(7.7%) etc. f) In the age of 12 years to 15 years, sepsis was the most frequent(15.0%) and leukemia(10.0%), renal failure(10.0%), aplastic anemia(10.0%), encephalitis(10.0%) etc. Though causes of death were different by age, causes of death in all age were mostly due to infectious diseases.
Cause of Death ; Communicable Diseases ; Female ; Heart ; Heart Defects, Congenital ; Humans ; Infant ; Leukemia ; Lung Diseases ; Male ; Mortality* ; Seoul ; Sepsis ; Sex Characteristics ; Tetanus ; Tuberculosis, Meningeal

No abstract available.
Meconium* ; Peritonitis*

BACKGROUND: Emergence agitation frequently occurs after desflurane anesthesia in children. We designed this study to find the optimal dose of fentanyl for the prevention of emergence agitation after desflurane anesthesia in children for tonsillectomy. METHODS: Eighty-one patients (3-10 yr) receiving desflurane anesthesia for tonsillectomy was randomly allocated to one of 3 groups. Fentanyl 1 microg/kg (group 1, n = 26), 2 microg/kg (group 2, n = 27), 3 microg/kg (group 3, n = 28) was administered intravenously just before inducing anesthesia. Anesthesia was maintained with desflurane. The recovery characteristics, such as the time to first movement, extubation and discharge from the recovery room were assessed. And patients reported their frequency of emergence agitation and severity of postoperative pain at recovery room. RESULTS: There were no significant differences between the three groups regarding the time to extubation and discharge from the recovery room. The incidence of emergence agitation was 42% in group 1, 25% in group 2, 10% in group 3 and that was significantly lower in group 3 than in group 1 (P < 0.05). The incidence of severe pain was lower in group 3 than in group 1 and group 2 (P < 0.05). CONCLUSIONS: In children undergoing tonsillectomy with desflurane anesthesia, 2 microg/kg and 3 microg/kg of fentanyl given just before induction had a reduced incidence of emergence agitation without a delay in recovery.
Anesthesia ; Child ; Dihydroergotamine ; Fentanyl ; Humans ; Incidence ; Isoflurane ; Pain, Postoperative ; Recovery Room ; Tonsillectomy

BACKGROUND: The aim of this study was to compare the streamlined liner of the pharynx airway (SLIPA), a new supraglottic airway device (SGA), with the laryngeal mask airway ProSeal(TM) (PLMA) during general anesthesia. METHODS: Sixty patients were randomly allocated to two groups; a PLMA group (n = 30) or a SLIPA group (n = 30). Ease of use, first insertion success rate, hemodynamic responses to insertion, ventilatory efficiency and positioning confirmed by fiberoptic bronchoscopy were assessed. Lung mechanics data were collected with side stream spirometry at 10 minutes after insertion. We also compared the incidence of blood stain, incidence and severity of postoperative sore throat and other complications. RESULTS: First attempt success rates were 93.3% and 73.3%, and mean insertion time was 7.3 sec and 10.5 sec in PLMA and SLIPA. There was a significant rise in all of hemodynamic response from the pre-insertion value at one minute following insertion of SLIPA. But, insertion of PLMA was no significant rise in hemodynamic response. There was no statistically significant difference in the mean maximum sealing pressure, gas leakage, lung mechanics data, gastric distension, postoperative sore throat and other complication between the two groups. Blood stain were noted on the surface of the device in 40% (n = 12) in the SLIPA vs. 6.7% (n = 2) in the PLMA. CONCLUSIONS: The SLIPA is a useful alternative to the PLMA and have comparable efficacy and complication rates. If we acquire the skill to use, SLIPA may be considered as primary SGA devices during surgery under general anesthesia.
Anesthesia ; Anesthesia, General ; Blood Stains ; Bronchoscopy ; Hemodynamics ; Humans ; Incidence ; Laryngeal Masks ; Lung ; Mechanics ; Pharyngitis ; Pharynx ; Rivers ; Spirometry

BACKGROUND: We made a comparative study on the antiemetic effect of midazolam and ondansetron added to intravenous patient-controlled analgesia (PCA) using fentanyl with gynecologic patients undergoing pelviscopic surgery. METHODS: The PCA using 20 microg/kg of fentanyl was started in all groups postoperatively. A dose of 16 mg of ondansetron was added to the PCA of group O (n = 30). A dose of 5 mg of midazolam was added to the PCA of group M (n = 30). While 16 mg of ondansetron and 5 mg of midazolam were added to the PCA of group MO (n = 30). Total volume of the PCA was 60 ml, and the PCA system was programmed to deliver 0.5 ml/h of continuous doses and a 0.5 ml bolus on demand, with a 15 minutes lockout interval. The incidence of postoperative nausea and vomiting (PONV), sedation score, visual analog scale (VAS) for pain, and rescue drug dose for PONV were investigated at the postanesthesia care unit (PACU), 6 hours, and 24 hours after recovery. RESULTS: The incidence of PONV in group MO was significantly lower than in group O at PACU, 24 hours after recovery (P < 0.05). The sedation score and VAS pain score showed no differences among all groups. CONCLUSIONS: Midazolam added to PCA using fentanyl proved more effective than ondansetron in preventing PONV without adverse effects.
Analgesia, Patient-Controlled ; Antiemetics ; Fentanyl ; Humans ; Incidence ; Midazolam ; Ondansetron ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting

BACKGROUND: The margin of safety is the length of the mainstem bronchi, over which double-lumen endotracheal tubes (DLTs) can be moved and still be correctly positioned. A negative value of margin of safety means that DLTs may not be safe. We measured the length of the left and right mainstem bronchi and margin of safety in Korean adults. METHODS: One hundred and fifty-six ASA I or II adult patients undergoing an elective surgery were examined. After nduction of general anesthesia, we measured the lengths from the upper incisor to the tracheal carina, to the proximal margin of the left and right upper lobe bronchial opening using a fiberoptic bronchoscope. We calculated the lengths of the left and right mainstem bronchi and margin of safety using the measured lengths. RESULTS: In Korean adults, the average margin of safety of left-sided DLTs of males and females was 2.4 +/- 1.0 cm and 1.9 0.7 cm and right-sided DLTs of males and females was 1.0 +/- 0.9 cm and 0.8 +/- 0.3 cm, respectively. The percentage of a negative value of the margin of safety in positioning right-sided DLTs was 10.4% in males and 8.6% in females. However, all values of the margin of safety in left-sided DLTs were positive. CONCLUSIONS: Using left-sided DLTs, regardless of the operative side, is better than right-sided DLTs because left-sided DLTs have a greater margin of safety in positioning. If we use right-sided DLTs, we should confirm the proper position of tubes using a fiberoptic bronchoscope.
Adult* ; Anesthesia, General ; Bronchi ; Bronchoscopes* ; Female ; Humans ; Incisor ; Male ; One-Lung Ventilation