Under hypothermia and extracorporeal circulation 187 cases of open-heart surgery were done between November 1963 and October 1974. The results obtained are summarized as follows. 1. Out of 187 cases, 116 cases were male (62.0%) and 71 cases were female (37. 9%). 2. There were 134 cases (72%) in A.S.D., V.S.D., and T/F, and 70 cases (37%) were under 10 years of age and 154 cases (82%) under 30 year age group. 3. Premedicants were secobarbital (83.8%) and atropine sulphate (27.9%) 4. Induction of anesthesia was mainly by the use of thiopental and succinylcholine after preoxygenation with 100% O2, and anesthesia was maintained by N2O-O2, halothane or methoxyuflrane during maintenance. 5. During by-pass, anesthesia was maintained by hypothermia, muscle relaxants or ketamine. 6. From 1963 to 1966, low flow and moderate hypothermia were used with a Zuhdi-Greer oxygenator and a sigma pump and since then high flow was used, utilizing various bubble oxygenators with a De-Bakey's roller pump. 7. Blood pressure, electrocardiogram (ECG), central venous pressure, respiration, temperature, urine output, hemoglobin, hematocrit, arterial blood gas study, pH, intake, output, and electrolytes were monitored before and during anesthesia. 8. There were 28 fatalities (15%) among 187 cases. Death were mostly from bleeding, renal failure, lung edema, low cardiac output syndrome and complete heart block.
Anesthesia ; Anesthesia, General* ; Atropine ; Blood Pressure ; Cardiac Output, Low ; Central Venous Pressure ; Edema ; Electrocardiography ; Electrolytes ; Extracorporeal Circulation ; Female ; Halothane ; Heart Block ; Hematocrit ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Hypothermia* ; Ketamine ; Lung ; Male ; Oxygen ; Oxygenators ; Renal Insufficiency ; Respiration ; Secobarbital ; Succinylcholine ; Thiopental

The lower 2(nd) molar eruption is beginning to mesiolingually, then rotate to distobuccally so it has a tendency to be tilted and impacted mesially. Signs and symptoms of impacted 2(nd) molar are similar to impacted 3(rd) molar's. However, treatment plan for impacted 2nd molar is different from that of impacted 3(rd)'s. The former is the preservation and uprighting of 2(nd) molar so that it could act to recovery of mastication, symmetrical facial growth, maintaining the symmetry of dental arch, stable occlusion, while the latter is the extraction of tooth. If the uprighting treatment is planned, most proper protocol of treatment and the additional treatment opition should be applied with consideration for it's crown exposure, present of 3(rd) molar which interrupt the uprighting process, extrusion of opposite tooth. Although it could not improve the esthetic result, it could prevent many dental problems. Therefore, uprighting for impacted lower 2(nd) molar is meaningful treatment.
Crowns ; Dental Arch ; Mastication ; Molar* ; Tooth ; Tooth Movement

The present study was conducted to investigate dietary habits and biochemical indices according to the obesity index of elementary school students visiting a hospital for diagnosis. The subjects of this study were 150 elementary school students and their mothers. The overweight rates of child subjects were 37.5% for males and 40.9% for females, whereas the rates of underweight children were 35.0% for males and 14.5% for females. Children's obesity index significantly decreased with an increase in the average monthly income of children's families. Children's obesity index, mothers's weights, BMI, and percent ideal body weight were all positively correlated. Blood biochemical values in children (hemoglobin, hematocrit, albumin, globulin, glucose, total cholesterol, and triglyceride levels) and their obesity index also showed positive correlation. For the underweight group, the frequency of iron-deficiency anemia was significantly high, whereas for the overweight group, the frequency of dyslipidemia was high. There was a significant increase in children's obesity index and a decrease in frequency of regular exercise with time spent on the TV/computer. The normal weight group recorded the highest total scores for mothers' nutritional knowledge, whereas the overweight group recorded the lowest total scores. Therefore, to maintain healthy weight in children, nutritional education programs for mothers and children should be developed.
Anemia, Iron-Deficiency ; Child ; Cholesterol ; Dyslipidemias ; Female ; Food Habits ; Glucose ; Hematocrit ; Hospitals, General ; Humans ; Ideal Body Weight ; Male ; Mothers ; Obesity ; Overweight ; Thinness ; Weights and Measures

Air can be used as a carrier for volatile agent, ether, with a clear airway, normal pulmonary function and normal oxygenation. In 1858 John Snow, the Father of British Anesthesia stated in his book on Chloroform and Other Anesthetics that he believed it to be almost impossible for death to occur from ether administered with ordinary intelligence and attention. Today ether is probably still the safest anesthetic drug we possess. Ether is cheap and easily obtained; with controlled respiration 3% is adequate. Recovery smooth and rapid. Vomiting may be no different from other agents. Most machines depend upon cylinders of oxygen and other gases, and there are difficulties of refilling cylinders and the cost of transporting them. In such circumstances the E.M.O. Inhaler, allowing ether to be vaporized in known concentrations in air, has many advantages as an alternative to the open method administration. From all types of patients chosen at random 22 patients were studied for ether-air anesthesia. Anesthesia was induced with intravenous thiopental and subsequent endotracheal intubation was performed within 30 seconds with the aid of intravenous succinylcholine. SatO2, PaO2, pH, and Base E. were measured 3 times during pre-anesthesia, immediately after the intubation, and post-operatively by Radiometer, using the oxy-hemoglobin dissociation curve and the Siggard-Anderson alignment nomogram. Vital signs were recorded every 5 minutes. It is the purpose of this paper to present this series of 22 anesthetics by the use of the E.M.O. Inhaler with air and to discuss the possibility of hypoxia, advantages and limitations that became apparent. The results obtained may be summarized as follows. 1. It is essential that endotracheal intubation by carried out rapidly and that everything necessary be ready and immediately at hand before starting the anesthetic. 2. In all patients ventilated room air during anesthetic induction, no significant decreases of PaO2 and SatO2 were observed immediately after the endotracheal intubation. 3. The duration of any period of complete apnea inflicted on the patient must be carefully controlled. 4. 100% oxygen prevented the possibility of hypoxia on extubation after all the reflexes had returned. 5. Ether-air anesthesia is recommended without hesitation for use where economy and portability of anesthetic machine are needed.
Anesthesia* ; Anesthetics ; Anoxia ; Apnea ; Chloroform ; Ether ; Fathers ; Gases ; Hand ; Humans ; Hydrogen-Ion Concentration ; Intelligence ; Intubation ; Intubation, Intratracheal ; Nebulizers and Vaporizers ; Nomograms ; Oxygen ; Reflex ; Respiration ; Snow ; Succinylcholine ; Thiopental ; Vital Signs ; Vomiting

Grice extra-articular subtalar arthrodesis has been performed as either a temporizing or a definite procedure in young children to correct the dynamic hindfoot valgus deformity without affecting subsequent growth of the foot. Fifty eight extra-articular subtalar arthrodesis in thirty patients, performed at Seoul National University Children's Hospital from setpember 1985 to June 1989, were retrospectively reviewed to evaluate the clinical and radiographic results. There were 52 valgus feet in 26 patients and 6 varus feet in 4 patients secondary to cerebral palsy, meningomyelocele, congenital snomalies, and other neuromuscular diseases. In many instances, additional tendon surgeries were also required to correct deformities or achieve the muscle balance. The review consisted of personal interview, physical examination, and radiological assessment. On physical examination, preoperative hindfoot valgus deformty(mean: 14.3°clinically) was well corrected, postoperative hindfoot valgus ranging from neutral to valgus 5°clinically in 35 of 52 cases(67.3%). Correction of the lateral talocalcaneal angle on standing lateral radiographic view averaged 8.5 degrees(from 57.3 degrees preoperatively to 37.6 degrees postoperatively). In valgus feet, there were 3 cases with mild pain around the ankle joint. There were 5 cases of graft resorption and 2 cases of nonunion. Graft failure was more frequent when the proximal end of the graft was directed anterior to the weight bearing axis. With original Grice subtalar arthrodesis, satisfactory results were obtained in 34 of 52(65.4%) hindfoot valgus feet. In 6 varus feet, there were 1 undercorrection and 2 recurrence of varus deformity. We re-emphasize the importance of strict operative technique to obtain satisfactory results. We also believe that Grice procedure may be used for the correction of subtalar instability in selected cases of varus foot before muscle baancing procedures.
Ankle Joint ; Arthrodesis ; Cerebral Palsy ; Child ; Congenital Abnormalities ; Foot ; Humans ; Meningomyelocele ; Neuromuscular Diseases ; Physical Examination ; Recurrence ; Retrospective Studies ; Seoul ; Tendons ; Transplants ; Weight-Bearing

Proliferating trichilemmal tumor is relatively rare, and is generally considered to be a benign tumor that can be histologically mistaken for well-differentiated squamous cell carcinoma. The proliferating trichilemmal tumor is thought to be a tumor with differentiation toward the hair structure because the characteristic trichilemmal keratinization in this tumor is analogous to that of the outer root sheath of anagen hair or the trichilemmal sac surrounding catagen hair. We report four cases of proliferating trichilemmal tumor removed by surgical excision.

The authors have experienced, during general anesthesia with methoxyflurane-nitrous oxide- oxygen for explorative laparatomy to perform appendectomy, a case of acute pulmonary edema, which is rare and it's etiology is various. The patient had no specific past or family history and the only predisposing factor was myocardial ischemia caused by cardio-vascular collapse due to severe dehydration. In this case, the authors believed that pre-existing myocardial ischemia, rapid transfusion of 5% dextrose and myocardial depressants (methoxyflurane and d-tubocurarine) were the causative factors. For this reason at least, myocardial depressants should be avoided in severely dehydrated patients. There are many preventive measures and treatments for acute pulmonary edema during general anesthesia. As in this case, we believe that prompt recognition and attention by the anesthesiologists are the most important preventive and therapeutic measures.
Anesthesia, General* ; Anti-Arrhythmia Agents ; Appendectomy ; Causality ; Dehydration ; Edema* ; Glucose ; Humans ; Myocardial Ischemia ; Oxygen ; Pulmonary Edema

Methoxyflurane was used as the sole inhalational analgesic in the dressing of 76 burns performed on 10 patients. It was used in air by analgizer(method 1) or analgizer with mask(method 2), or used by the semiclosed circle absorber by Pentec vaporizer(Cyprane) in 100% oxygen with the concentration of mathoxyflurane set at 0.5%(method 3) or at 0.7%(method 4). Comparative study concerning the analgesic action gave the following results: 1. Methoxyflurane through on analgizer(method 1) produced poor to good annalgesic action in burned patients. 2. Analgizer with mask(method 2) produced better analgesic action than analgizer alone. 3. 0.5% setting(method 3) was similar to analgizer with mask(method 2). 4. 0.7% setting(method 4) was produced complete analgesia, amnesia and partial loss of consciousness.
Amnesia ; Analgesia ; Bandages* ; Burns* ; Humans ; Methoxyflurane* ; Oxygen ; Unconsciousness

The authors present the one case of a 22-year-old man admitted with intermittent quadriparesis and respiratory difficulty. On investigation, atlantoaxial instability and upper cervical cord compression due to abnormal soft tissue were revealed. We have performed transoral decompression and biopsy, and then posterior transarticular facet screw fixation with interspinous wiring and fusion. We could obtain immediate and long-term postoperative stability with Philadelphia collar only. The pathologic examination reveald connective soft tissue hypertrophy due to chronic mechanical irritation.
Biopsy ; Decompression* ; Humans ; Hypertrophy ; Quadriplegia ; Young Adult

This survey was conducted to investigate Farmers' Syndrome and its related factors in Chonnam province. 5,920(men 6,148, women 6,722) persons in urban area and 12,870(men 6148, women 6,722) persons in rural area were selected in stratified cluster sampling manner, and interviewed individually with structured questionnaire in April, 1992. The results were summarized as follows: 1. In rural area of Chonnam province, the prevalence of Farmers' syndrome positive was 283 per 1,000 persons(203 in male, 355 in female). In urban area of Chonnam province, control area, the prevalence of Farmers' syndrome positive was 113(72 in male, 145 in female). The prevalence of Farmers' syndrome positive in rural area was 2.5 times higher that of urban area, and the prevalence in female was 1.7 times higher than that of male. The prevalence in total respondents was 256. 2. In rural area of Chonnam province, the age standardized prevalence of Farmers' syndrome positive was 209 per 1,000 persons(140 in male, 267 in female). In urban area of Chonnam province, control area, the age standardized prevalence of Farmers' syndrome positive was 122(79 in male, 158 in female). The age standardized prevalence in total respondents was 194. 3. The associated factors with Farmers' syndrome in univariate analysis were having illness during recent 15 days ,age, sex, occupation, area, monthly income, education, medical security status, family size and duration of farming. 4. When applying multiple logistic regression for Farmers' syndrome, the significant variables were having illness during recent 15 days, area, sex, age, education, medical security status, family size and duration of farming.
Surveys and Questionnaires ; Education, Medical ; Epidemiologic Studies* ; Family Characteristics ; Female ; Humans ; Jeollanam-do* ; Logistic Models ; Male ; Occupations ; Prevalence ; Surveys and Questionnaires