Authors have experienced a case of long standing chronic gonorrheal orbital cellulitis in a 50 years old Korean male. Surgical evacuation of pus discharges and microscopcially confirmed the gram negative intncellular and extracellular gonococcus. A brief review of the related literatures is present.
Humans ; Male ; Middle Aged ; Neisseria gonorrhoeae ; Orbit* ; Orbital Cellulitis* ; Suppuration

A 53-year-old man developed some erythematous follicular macules accompanied with tingling sensation on both shoulders. Histologic finding showed a dense lymphocytic infiltrate around the infundibular portion of the follicle, where separation of the dermoepidermal junction was seen. The insect, obtained from the skin lesion, was identified as a larva of an Ap- hid
Aphids ; Cryptococcosis* ; Humans ; Insect Bites and Stings ; Insects ; Larva ; Middle Aged ; Sensation ; Shoulder ; Skin

No abstract available.
Data Interpretation, Statistical ; Humans ; Randomized Controlled Trials as Topic/*methods

Orbital neuroblastoma is the most common childhood metastatic malignant tumor almost always originating from the adrenal medulla; orbital primary origin is very rare. The authors experenced a case of orbital neuroblastoma. The patient was 3 year old Korean female child who was in apparently good health and no abnormalities noted of physical examminations when she developed ecchymosis of right lower lid. About two week later, she quickly developed a growing mass in the right lower orbital soft tissue. The mass was removed and his topathologically diagnosed as neuroblastoma. Radiotherapy was recommended. About 4 months bter, the patient was readmitted because of recurrence of orbital mass 3t the same site. At surgery, tumor was found invading inner and flooe wall of the orbital bone. The patient died of poor course of the disease, about one year after the onset of symptoms. It was suggested that this case was represented metastatic orbital neuroblastoma on histopathological base, but authors were unable to determine the primary site. A brief review of the related literatures is present.
Adrenal Medulla ; Child ; Child, Preschool ; Ecchymosis ; Female ; Humans ; Neuroblastoma* ; Orbit* ; Radiotherapy ; Recurrence

The incidence of airway difficulty in the general surgical population varies greatly depending on the degree of airway difficulty. Much of the anesthesia related morbidity attributable to managing a difficult airway comes from an interurruption of gas exchange (hypoxia and hypercarbia) which may cause cardiovascular instability and brain damage. Most airway catastrophes ocurrs when possible difficulty with the airway was not recognized. Although fiberoptic intubation is reliable method in patients with difficult airways, there are many cases of difficulty in visualizing the structure of the larynx with conventional fiberoptic technique due to copious secretion, swelling and hemorrhage in the pharyngeal cavity. Recently, we experienced a success in difficult tracheal intubation with LMA in the 27 year old male patient diagnosed ankylosing spondylitis. We hope that using a #4 LMA as a conduit for 6.0 mm cuffed endotracheal tube with the aid of fiberscope attached to the video camera system would be an alternative method for difficult intubation.
Adult ; Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Brain ; Clonidine* ; Epinephrine ; Heart Rate* ; Heart* ; Hemodynamics ; Hemorrhage ; Hope ; Humans ; Incidence ; Intubation* ; Larynx ; Male ; Norepinephrine ; Plasma* ; Skin ; Spondylitis, Ankylosing ; Succinylcholine ; Thiopental

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

This study was undertaken to investigate the immunological mechanism of Behqet s syndrome, considered to be important in the pathogenesis of the disease. Seventy- three patients with complete, incomplete and suspected types of Behget's syndrotne were tested for leukocyte migration ingibition factor(LIF), one of the lymphokines. The results were as follows : 1. There was no difference between the average LIF activity of all the patients and that of eontrol. 2. LIF activity of complete type, according to Shirnizus classification, was significaritly lower than the control value. 3. LIF activity of ocular type, according to Lehners classification, was signficantly lower than the control value. 4. LIF activity for patients with 4 clinical symptoms was well below the value for patients with less symptomes 5. For patients with single clinical symptom, LIF activity of complete type was well below the values of incomplete and suspected types. 6. In suspected and mucocutaneous types, LIF activity was low when the patients showed two clinical symptoms than one. Thus, LIF activity was low for patients with complete, ocular and neurological types and with multiple symptorns.
Behcet Syndrome* ; Classification ; Humans ; Leukocytes* ; Lymphokines

The Department. of Anesthesiology of Hanyang University had a case of operation for pheo- chromocytoma. For the operation of pheochromocytoma, used to prazosin for preoperative treatment of hypertension and used to enflurane as inhalational anesthetic, treated with sodium nitroprusside for severe elevation of blood pressure during operation, used to vecuronium for neuromuscular blocker. Also we tried to get the knowledge about the variation of catecholamine concentration in blood through operation. As we used to the other drugs with adequate amount of fluid without any other complication in this operation we reported here with other references and our experience of a case of operation for remove of pheochromocytoma.
Anesthesiology ; Blood Pressure ; Enflurane* ; Hypertension ; Neuromuscular Blockade ; Nitroprusside ; Pheochromocytoma* ; Prazosin ; Vecuronium Bromide

The methods commonly used for monitoring neuromuscular transmission do not allow evaluating of an intense neuromuscular blockade. A sufficient dose of non-depolarizing relaxant used for endotracheal intubation causes disappearance of the response to single, tetanic and train of four (TOF)nerve stimulation for a variable period of time during which the magnitude of neuro-muscular blockade can not be evaluated by the traditional stimulation forms. Enhancement of posttetanic twitch tension in partially curarized patients remains constant regardless of the dose of non-depolarizing muscle relaxant or magnitude of neuromuscular blockade. If this also holds true for an intense neuromuscular blockade, the response to posttetanic twitch stimulation after the injection of a non-depolarizing muscle relaxant must appear earlier than the response to pretetanic twitch or TOF neve stimulation. The present study was designed to evaluate neuromuscular blockade during the period of no response to single or TOF stimulation by quantifying the degree of posttetanic potentiation. The possibility existed that the relatively frequent use of a tetanic stimulation (every 6 minutes) might have influenced the recovery of neuromuscular blockade. Therefore, we have studied the conventional TOF stimulation comparing with posttetanic count stimulation which may affect the recovery of intravenous pancuronium(0.08 mg/kg) induced neuromuscular block. The results were as follows; 1) The time of the T1 appearance was 815 seconds and 50% T4 ratio was 1,214.3 seconds in TOF group. 2) The time of the T1 appearance was 790 seconds and 50% T4 ratio was l,l35.5 seconds in PTC group, The recovery time appeared to be shorter in this group but statistically not signifi cant. 3) ln PTC group, TOF recovery was observed after average 2.3 times of tetanic stimulation. Above findings may suggest that intense pancuronium block in rabbit is not affeced by the TOF or PTC stimulation.
Humans ; Intubation, Intratracheal ; Neuromuscular Blockade* ; Pancuronium

The domestic product of a non-depolarizing muscle relaxant, Metuben, was studied on its effect in rabbit. Twenty four rabbits of either sex weighing 2~3kg were divided into four groups (consisting of 6 animals each) to administer Metuben in doses of 0.05 mg/kg, O.l mg/kg, 0.2 mg/ kg and 0.4 mg/kg, respectively. All animals were anesthetized with 20% urethane 5 ml/kg given intraperitoneally and 2.5% pentothal sodium 10 mg/kg intravenously. ECG was monitored by Physio-contro1(lifepak 7)model. The animal lungs were mechanically ventilated through a tracheostomy and Shinano animal respirator set to deliver a 30 ml/kg tidal volume at 30 breaths/min. This ventilatory pattern resulted in the PaCO2 values within the range of 30-40 mmHg. Twitches of the tibialis anterior muscle were elicited at 0.1 Hz, "Train of four" via the peroneal branch of the sciatic nerve, and the Myotest stimulator were applied at supramaximal voltage. Twitch recording was done via Biophysiograph. Results were as follows: 1) The effect of Metuben as a dose-dependent long lasting non-depolarizing muscle relaxant was confirmed. Their relaxant effect in rabbits were quite different from man. 2) In rabbits, Metuben showed great individual differences in its effect even with the s'ame dosage. The length of muscle relaxing activity.and the occurence of recurarization after neostigmine reverse were extremely variable suggesting its safety margin is quite narrow.
Animals ; Electrocardiography ; Individuality ; Lung ; Muscle Relaxation* ; Neostigmine ; Rabbits ; Sciatic Nerve ; Sodium ; Thiopental ; Tidal Volume ; Tracheostomy ; Urethane ; Ventilators, Mechanical