The caudal epidural anesthesia has been popular due to the postoperative pain relief and the reduction of the amount of general anesthetics. It is also technically simple and safe both for inpatients and outpatients under the age of 7 Year. The aim of this study was to determine the adequate dosage and degree of postoperative pain relief according to the different local anesthetics. We have performed the caudal anesthesia in 60 patients from the age of 10 month to 7 year. All caudal blocks were performed under light general anesthesia in order to relief the fear and anxiety of operation. The patients were divided by 4 groups of each 15 children. Group 1 (control group) for 1% lidocaine 1 ml/kg, Group 2 for 1% lidocaine 0.8 ml/kg, Group 3 for 0.25% bupivacaine 0.8 ml/kg, Group 4 for 0.25% bupivacaine 0.6 ml/kg. All groups were given 1:200,000 epinephrine. The overall success rate of caudal blocks was 98%. Complication was 3 cases. As the result of this study, Group 1 (control group): There was sensory block over T4 (20%). The degree of motor block was very high(73.3%). Group 2 and 3: There was no sensory block over T4. Duration of postoperative analgesia was long enough compared to the control group (p<0.05). The degree of motor block was less than the control group. Group 4: The height of most sensory block was below T8 (80%). The degree of motor block was very low (p<0.05) and duration of postoperative analgesia was short compared to the control group (p<0.001). Therefore it is considered that caudal blocks in Group 2 & 3 were adequate dosage for the pediatric operation.
Analgesia ; Anesthesia, Caudal* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics, General ; Anesthetics, Local ; Anxiety ; Bupivacaine ; Child ; Epinephrine ; Humans ; Inpatients ; Lidocaine ; Outpatients ; Pain, Postoperative*

Microform cleft lip is a mild form of incomplete cleft lip, also known as a minimal occult, abortive, forme fruste cleft lip. However, it has no definition and few methods have been reported for its correction. A microform cleft lip is characterized as the incomplete union of the superficial portion of the orbicularis oris muscle. It is more prominent during facial expression than in a resting state. We confined microform cleft lip in our study to the absence of philtral skin change and a contracted position on the top of cupid's bow. During the past 5 years, 17 patients of microform cleft lip were operated on. We corrected the defect of the upper vermilion border and nostril sill with minimal incision, and repaired the underlying lip musculature in superficial discontinuity. Reduction of the widened alar base was performed. Deformed alar cartilage was dissected via rim incision, and suspended in a medial and upper direction with pull-out sutures. The most important thing is precise repair of the superficial portion of the separated orbicularis oris muscle via minimal incision, and it is best to operate after 1-year of age for accurate repair. The results were satisfactory and the parents were also satisfied. The advantages of this procedure are as follows: 1. Less visible, minimal scar on upper lip 2. Simultaneous correction of vermillion notching, deformed cupid's bow and nasal deformity. 3. Eversion of philtral ridge due to tenting effect of horizontal mattress suture 4. Philtral elongation effect by reduction of alar base and Z-plasty of cupid's bow.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Facial Expression ; Humans ; Lip ; Microfilming* ; Parents ; Skin ; Sutures

No abstract available.
Gastrointestinal Tract* ; Muscle, Smooth* ; Smooth Muscle Tumor*

A 51-year-old female developed a distinctive perioral rash, conisting of discrete or confluent erythematous papules for one and a half years. Histopathologic examiriation revealed upper dermal granulomas admixed with lymphoytes. Pieces of hair shaft were staincd peri-dish by AFB in the center of granuloma, which might play a role in the formation of the granuloma She also had used corticosteroid ointment intermittently duririg this time. There were no associated systemic abnormalities. The lesions resolved after two month treatment with oral corticosteroid and tetrac cline.
Dermatitis, Perioral* ; Exanthema ; Female ; Granuloma ; Hair ; Humans ; Middle Aged

A case of plane xanthoma arising in type IV hyperlipoproteinemia in a 53-year old woman is reported. The patient had well-defined yellowish to orange colored slightly elevated plaques on both upper eyelids, cheeks, neck, and upper chest. The laboratory findings showed increased serum triglyceride on lipid profile, and widening of pre-beta band on electrophoresis lipoprotein. She had a fatty liver, mild hepatomegaly, but other systemic diseases such as multiple myeloma, leukemia and lymphoma were not found.
Cheek ; Citrus sinensis ; Electrophoresis ; Eyelids ; Fatty Liver ; Female ; Hepatomegaly ; Humans ; Hyperlipoproteinemia Type IV* ; Leukemia ; Lipoproteins ; Lymphoma ; Multiple Myeloma ; Neck ; Thorax ; Triglycerides ; Xanthomatosis*

Leicmyomas represent benign painful tumor principally derived from cutaneous smooth muscle. The majority of these lesions arised from arrector pili muscles, the media of blood vessels, or smooth muscle of scrotum, labia majora, and nipples. Cutaneous leiomyomas may be solitary or rnultiple and generally present as pink, red or dusky brown firm derrnal nodules of varying sizes. We present a case of multiple leiomyoma cutis in a 44-year-old male. The skin lesions were characterized clinically by numerous, miliary to bean sized, reddish brow papules and nodules on the both shoulders, right arm, right side of the neck, upper chest, and upper back, which were pinful by pressure. The histopathologic examination revealed interlacing bundles of the smooth muscle fibers in the dermis, slight atrophy of epidermis, and a grenz zone of normal corium hetween the epidermis and the tumor.
Adult ; Arm ; Atrophy ; Blood Vessels ; Dermis ; Epidermis ; Humans ; Leiomyoma* ; Male ; Muscle, Smooth ; Muscles ; Neck ; Nipples ; Scrotum ; Shoulder ; Skin ; Thorax

Basal cell carcinoma(BCC) is the most common human malignancy. It involves the face and neck most frequently. However, BCC can very rarely occur on external glenitalia such as scrotum and vulva. We report two cases of serotal and vulvar BCCs in a 67 year old imale and a 43 year old female. He suffered from well defineril erythematous to violet colored plaque with central erosion on the left scrotum for 5 years. She had a brown black colored plaque on the left vulva for 8 years. They did not show any metastatic foci from g!rimary cutaneous lesions, and underwent surgical excision and curettage respectively.
Adult ; Aged ; Carcinoma, Basal Cell* ; Curettage ; Female* ; Genitalia* ; Humans ; Male* ; Neck ; Scrotum ; Viola ; Vulva

No abstract available.
Fructosamine* ; Hyperthyroidism*

BACKGROUND: During bilateral transthoracic endoscopic sympathicotomy (TES), we have noticed a tendency for hypoxemia during deflation of the second lung despite adequate reinflation of the first one. This study was designed to compare PaO2 during TES of the first side with that of TES of the second side and to investigate whether PaO2 during the sequential one-lung ventilation (OLV) was correlated with two-lung ventilation (TLV) time after reinflation of the collapsed first lung. METHODS: Forty patients were randomly allocated into two groups. After TES of the first side, OLV of the second side was immediately performed after reinflation of the collapsed first lung (group A), or after 10 minutes of TLV when switching between the operated sides (group B). Arterial blood gas samples were taken at TLV before surgery, at 2 minute intervals during OLV, and during the period of TLV when switching between the operated sides. RESULTS: In group A, the significantly decreased PaO2 was observed during TES of the second side compared with TES of the first side (P < 0.01). In group B, there was no significant difference in PaO2 except 2 minutes after OLV. PaO2 during TLV and 4 and 6 minutes after OLV of the second side TES in group A significantly decreased compared with those of group B (P < 0.05). The lowest PaO2 during OLV of the second side TES was significantly lower in group A (93.5 +/- 28.7 mmHg) than in group B (154.1+/- 48.3 mmHg). CONCLUSIONS: A significantly decreased PaO2 was observed during TES of the second side, compared with TES of the first side, and time was needed after lung collapse for its full oxygenation function to recover.
Anoxia ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen ; Pulmonary Atelectasis ; Ventilation*

BACKGROUND: During bilateral transthoracic endoscopic sympathicotomy (TES), we have noticed a tendency for hypoxemia during deflation of the second lung despite adequate reinflation of the first one. This study was designed to compare PaO2 during TES of the first side with that of TES of the second side and to investigate whether PaO2 during the sequential one-lung ventilation (OLV) was correlated with two-lung ventilation (TLV) time after reinflation of the collapsed first lung. METHODS: Forty patients were randomly allocated into two groups. After TES of the first side, OLV of the second side was immediately performed after reinflation of the collapsed first lung (group A), or after 10 minutes of TLV when switching between the operated sides (group B). Arterial blood gas samples were taken at TLV before surgery, at 2 minute intervals during OLV, and during the period of TLV when switching between the operated sides. RESULTS: In group A, the significantly decreased PaO2 was observed during TES of the second side compared with TES of the first side (P < 0.01). In group B, there was no significant difference in PaO2 except 2 minutes after OLV. PaO2 during TLV and 4 and 6 minutes after OLV of the second side TES in group A significantly decreased compared with those of group B (P < 0.05). The lowest PaO2 during OLV of the second side TES was significantly lower in group A (93.5 +/- 28.7 mmHg) than in group B (154.1+/- 48.3 mmHg). CONCLUSIONS: A significantly decreased PaO2 was observed during TES of the second side, compared with TES of the first side, and time was needed after lung collapse for its full oxygenation function to recover.
Anoxia ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen ; Pulmonary Atelectasis ; Ventilation*