BACKGROUND: Total intravenous anesthesia with propofol can cause respiratory depression and apnea especially during induction of anesthesia. To study the possibility of reversal of respiratory depression during anesthesia with propofol, pretreated with nabuphine or not, the respiratory effects of doxapram to spontaneously ventilating patients were investigated. METHODS: Patients were divided into 4 groups - saline-propofol-saline group (SPS), saline-propofol- doxapram group (SPD), nalbuphine-propofol-saline group (NPS), and nalbuphine-propofol-doxapram group (NPD). After saline or nalbuphine pretreatment, anesthesia was induced with propofol and then doxapram or saline was intravenously injected. Apneic time interval, blood pressure, heart rate, respiratory rate, minute ventilation, end tidal CO2 partial pressure and oxygen saturation were measured in every minutes during induction of anesthesia. Percent changes of each values were compared. RESULTS: There is no differences in apneic time intervals in each groups. The percent change of first minute ventilation in SPD group after doxapram injection unchanged significantly compared with those depressions of SPS, NPS and NPD group (p<0.05). Respiratory rates increased in SPD and SPS groups after laryngeal mask insertion. There is no differences in minute ventilation, respiratory rate and end-tidal CO2 concentration between nalbuphine pretreated groups regardless of doxapram injection. CONCLUSIONS: Doxapram has effect in increasing minute ventilation after propofol induction within first few minutes, but it cannot reverse respiratory depression during propofol induction pretreated with nalbuphine.
Anesthesia ; Anesthesia, Intravenous* ; Apnea ; Blood Pressure ; Depression ; Doxapram* ; Heart Rate ; Humans ; Laryngeal Masks ; Nalbuphine* ; Oxygen ; Partial Pressure ; Propofol* ; Respiratory Insufficiency ; Respiratory Rate ; Ventilation

Many types of meniscal anomalies were reported. Authors found a double-layered lateral meniscus, with one meniscus overlying another. The 39-year old male patient had torn medial and lateral menisci. We performed partial medial and lateral meniscectomy, and incidentally found that lateral meniscus was double-layered. It was characteristic that the upper small accessory meniscus was firmly connected from the posterior horn to middle segments of the lower main meniscus along its peripheral edge. We left it alone. The symptoms were gone, So, it was thought that this anomaly was not related to the patient's symptoms.
Animals ; Horns ; Humans ; Male ; Menisci, Tibial

No abstract available.
Hematoma*

Congenital mesoblastic nephroma(CMN) is an important differential diagnosis of a renal mass occurring in the newborn or in early childhood. It was first described by Bolande as a separate disease entity distinct form Wilms' tumor. In 1974, Beckwith has predicted that this tumor has a pathologic spectrum with classic congenital mesoblastic nephroma at one extreme, unequivocally mallignant spindle cell sarcomas at the other, and intermediate "gray zone" lesions of indeterminate biologic significanse. In 1986, Joshi has described "atypical mesoblastic nephroma" as a potentially aggressive variant of CMN, which shows atypical gross and microscopic features such as hemorrhage, necrosis, high cellularity, and mitotic index. We report of a case of atypical mesoblastic nephroma presenting in a 38 days-old male infant. Grossly, the tumor involved the upper and midportion of the left kidney. On section, the cut surface was fleshy, grayish-white, and homogeneous. Microscopically, the tumorshowed high degree of cellularity and arrangement of fusiform cells in sheets and vague interlacing bundles. The individual tumor cells showed fusiform to oval nuclei, indistinct scanty pale-eosinophilic cytoplasm and many mitotic figures.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans ; Diagnosis, Differential

We report a case of complicated cataract aggravated after taking herbal medication for atopic dermatitis. An 11-yr-old boy was referred for the evaluation of decreased visual acuity in both eyes for 2 months. Past history showed that he had been diagnosed with atopic dermatitis when he was 1 yr old. He had been treated only with herbal medication for a period of 8 months prior to visiting our clinic. He had his visual acuity checked in a local ophthalmic clinic one year before, and the visual acuity was 20/20 in both eyes at that time. When attending our clinic the ophthalmologic examination showed that his best corrected visual acuity was 20/200 in both eyes. Lenses of both eyes had severe posterior subcapsular and posterior capsular opacity. Phacoemulsification, posterior chamber intraocular lens implantation, and posterior continuous curvilinear capsulectomy were performed in both eyes. After 3 months postoperatively, the best corrected visual acuity was recovered to 20/20 in both eyes without any complication. Our case suggests that there may be a risk of aggravation of cataract or development of cataract after treatment with some unidentified herbal medication in a patient with atopic dermatitis.
Cataract/*chemically induced ; Cataract Extraction ; Child ; Dermatitis, Atopic/*drug therapy ; Drugs, Chinese Herbal/*adverse effects ; Humans ; Male ; Visual Acuity/drug effects

Smooth muscle hamartoma is a benign hamartomatous condition, presenting clinically as a skin-colored or hyperpigmented patch or plaque and histologically as dermal smooth muscle hyperplasia. It is thought that Becker's nevus and smooth muscle hamartoma are distinct entities at either end of a spectrum. It can either be congenital or acquired We herein report a case of acquired smooth muscle hamartoma with follicular spotted appearance. We consider it as a rare clinical variant of smooth muscle hamartoma, which is clearly different from Becker's nevus.
Hamartoma* ; Hyperplasia ; Muscle, Smooth* ; Nevus

Lupus miliaris disseminatus faciei (LMDF) is an eruption of discrete red-brown, dome-shaped papules, histologically characterized by epithelioid cell granulomas. Although it is thought that LMDF might occur by an unusual reaction to pilosebaceous units, the exact reason for facial predominant occurrence is not clear. There have been extrafacial reports of LMDF on the axillae, shoulders, arms, hands, groins and legs together with facial lesions, but reports on LMDF solely involving the extrafacial areas have not been made. Herein we report a rare case of LMDF on the neck of a patient without any facial manifestations.
Arm ; Axilla ; Epithelioid Cells ; Granuloma ; Groin ; Hand ; Humans ; Leg ; Neck* ; Shoulder

No abstract available.
Diagnosis* ; Pyloric Stenosis, Hypertrophic*

Sclerosis is a disease process in which idiopathic hardening occurs in the skin and/or internal organs as a result of the accumulation of type I collagen, induced mainly by transforming growth factor-beta. Colchicine and D-penicillamine are widely used for its treatment. Their effects are known to be due to post-translational down-regulation of type I collagen synthesis, with colchicine also up-regulating interstitial collagenase. To determine whether or not they have any pre-translational effect on type I collagen and MMP-1, and also to observe their effects on the action of TGF-beta, cultured neonatal foreskin fibroblasts were treated with colchicine and D-penicillamine, singly and together. The amount of type I collagen and MMP-1 mRNA were quantitated by Northern blot hybridization. Colchicine suppresses the basal level of type I collagen mRNA but minimally stimulates the mRNA expression of MMP-1, whereas D-penicillamine does not have any significant effects on either. Colchicine was also able to significantly suppress the TGF-beta-induced up-regulation of type I collagen mRNA expression.
Cells, Cultured ; Colchicine/pharmacology* ; Collagen/genetics* ; Fibroblasts/metabolism ; Gene Expression Regulation/drug effects* ; Human ; Interstitial Collagenase/genetics* ; Penicillamine/pharmacology* ; RNA, Messenger/analysis* ; Skin/metabolism ; Skin/cytology ; Transforming Growth Factor beta/pharmacology

In the current literature, correction using penile skin of the proximal penile shaft type hypospadias with or without chordee have been performed only when sufficient penile skin was present. There have been no known reports of using the penile skin in a single staged correction of patients without sufficient skin. We present a case where total correction of a hypospadias of the proximal penile shaft was achieved using bilateral penile pedicled skin flaps in a patient with insufficient penile skin who previously underwent chordectomy with urethroplasty.
Female ; Humans ; Hypospadias* ; Male ; Skin*