No abstract available.
Respiratory Syncytial Virus Infections* ; Respiratory Syncytial Viruses*

We report two colorectal trauma patients whose rectosigmoid region was ruptured due to a jet of compressed air directed to their anus while they were playing practical jokes with their colleagues in their place of work. It was difficult to diagnose in one patient due to vague symptoms and signs and due to being stunned by a stroke of the compressed air. Both patients suffered from abdominal pain and distension, tension pneumoperitoneum and mild respiratory alkalosis. One patient was treated with primary two layer closure, and the other with primary two layer closure and sigmoid loop colostomy. Anorectal manometry and transanal ultrasonography checked 4 weeks after surgery, revealed normal anorectal function and anatomy. The postoperative courses were favorable without any wound infection or intraabdominal sepsis.
Accidents, Occupational ; Case Report ; Colon/*injuries/surgery ; Female ; Human ; Male ; Middle Age ; Play and Playthings ; Pneumoperitoneum/*complications/surgery ; Rectum/*injuries/surgery ; Rupture

Nausea and vomiting are common problems after strabismus surgery in pediatric patients. We compared the effects of droperidol and ephedrine with conventional regimen consisting of halothane-N2O to the effects of conventional regimen itself, 69 children. ASA physical status l, ages 1-12yrs, were studied. Each child was randomly assigned to receive droperidol 0.04mg/kg., ephedrine 0.5mg/kg or normal saline 2ml intramuscularly, 10 minutes before the end of surgery. The incidence of postanesthetic nausea and vomiting was 17% in the droperidol group(p<0.05)., 13% in the ephedrine group(p<0.05), which were significantly less than the control group(43%). But there was no significant difference between droperidol group and ephedrine group. We concluded that droperidol and ephedrine have significant postoperative antiemetic effect in patients undergoing strabismus surgery.
Antiemetics ; Child* ; Droperidol ; Ephedrine ; Humans ; Incidence ; Nausea ; Postoperative Nausea and Vomiting* ; Strabismus* ; Vomiting

The coronary vasospasm has usually been readily reversible by sublingual, intravenous or intracoronary nitroglycerin. Relief of spasm, either spontaneous or following nitrate therapy, results in reperfusion. Occurence of ventricular tachyarrhythmia during release of coronary spasm is attractive as a possible cause of sudden death because of significant proportion of sudden death victims do not have acute myocardial infarction. Recently, we experienced a 36 year old man who developed spontaneous coronary vasospasm, and the patients suffered from repetitive reperfusion ventricular tachyarrhythmia, and died suddenly in spite of administration of isosorbide dinitrate, lidocaine and several trials of cardioversion and cardiopulmonary resuscitation, and we report.
Adult ; Cardiopulmonary Resuscitation ; Coronary Vasospasm ; Death, Sudden* ; Electric Countershock ; Humans ; Isosorbide Dinitrate ; Lidocaine ; Myocardial Infarction ; Nitroglycerin ; Reperfusion* ; Spasm ; Tachycardia*

BACKGROUND: Transtracheal jet ventilation (TTJV) has been used for 'Cannot Ventilate/Cannot Intubate' situation, lefe-saving situations, by simply introducing an IV catheter (angiocatheter) through the cricothyroid membrane. To decrease the occurrence of barotrauma caused by a continuous high pressure oxygen supply while applying TTJV, it would be ideal to have a TTJV system equipped with an inspiration time adjustable function which any currently commercially available TTJV does not have. METHODS: Recently, we made a prototype of an inspiration time adjustable TTJV and measured the corresponding injection volumes and peak inflation pressures according to the changes of oxygen supply pressure and inspiration time using catheters ranging from 14 to 20 G in a simulated human adult trachea-lung model. RESULTS: A 16 G angiocatheter provided 465 +/- 5 ml of injected volume with a peak inflation pressure of 25 cmH2O under a 50 psi oxygen supply at 1 second of inspiration, which would be adequate for an adult tidal volume. When a 14 G catheter was used under the same conditions as above, the injected volume was 1128 +/- 9 ml. All injected volumes were under 310 ml when 18 and 20 G angiocathers were used at variosus driving pressures (10 - 50 psi) and inspiration time (0.5, 0.75, and 1 s). CONCLUSIONS: An inspiration time adjustable TTJV can easily provide enough tidal volume to maintain oxygenation, and could be expected to prevent or reduce barotraumatic complications such as pneumothorax.
Adult* ; Barotrauma ; Catheters ; Humans* ; Inflation, Economic ; Membranes ; Oxygen ; Pneumothorax ; Tidal Volume ; Ventilation ; Ventilators, Mechanical*

PURPOSE: This study was performed to characterize clinical features of benign convulsions with acute gastroenteritis(CwG) in infants. METHODS: We reviewed 83 consecutive seizures in 42 patients with CwG between January 1995 and December 2003. CwG was defined as convulsions having the following two characteristics : (a) seizures accompanied with symptoms of gastroenteritis without clinical signs of dehydration or electrolyte derangement; and (b) the body temperature remained less than 37.5 before and after the seizures. The clinical characteristics were compared between rotavirus positive and negative groups. RESULTS: Their ages ranged from 6 to 37 months(mean, 18.1 months). The average interval between the onset of astroenteritis and that of seizures was 56.4 hours. The seizure episodes ranged from one to seven times in cluster. Two or more seizures occurred in 23 patients(54.8%) within one episode of gastroenteritis. The seizure types constituted of generalized tonic-clonic(89.2%), generalized tonic(9.6%), or generalized clonic(1.2%). Only four of 42 patients showed abnormal electroencephalogram(EEG) findings, which reverted to normal during the follow-up period. All patients displayed normal psychomotor development without recurrent seizures, except two patients who had febrile seizures and a recurrence of CwG. Comparing the rotavirus positive group with the rotavirus negative group, the rotavirus positive group had more females, older patients and longer durations of seizure, significantly(P<0.05). CONCLUSION: The prognosis of afebrile seizures following acute gastroenteritis was benign.
Body Temperature ; Dehydration ; Female ; Follow-Up Studies ; Gastroenteritis* ; Humans ; Infant ; Prognosis ; Recurrence ; Rotavirus ; Seizures* ; Seizures, Febrile

Apert's syndrome(acrocephalosyndactyly) is a rare congenital anomaly that is characterized by the combination of premature fusion of multiple cranial sutures primarily involving the coronal suture and severe symmetrical syndactyly of fingers and toes. Some patients of this syndrome have various abnormalities of the central nervous system. We experienced a case of Apert's syndrome with craniofacial malformations, symmetric syndactyly, occipital encephalocele and hypogenesis of corpus callosum. She had a oxycephalic head with small sized anterior fontanelle, elongated forehead, hypertelorism, down-slanting palpebral fissures, flattened nose, cleft palate, low set ears and short neck. A 5x3 cm sized scalp-covered soft mass protruded in the occipital area through defect of the occipital bone. MRI showed hypogenesis of corpus callosum, occipital encephalocele, dilatation of the lateral and the third ventricles. She also had hands and feet with symmetric syndactyly involved skin and soft tissue but not bones.
Central Nervous System ; Cleft Palate ; Corpus Callosum* ; Cranial Fontanelles ; Cranial Sutures ; Dilatation ; Ear ; Encephalocele* ; Fingers ; Foot ; Forehead ; Hand ; Head ; Humans ; Hypertelorism ; Magnetic Resonance Imaging ; Neck ; Nose ; Occipital Bone ; Skin ; Sutures ; Syndactyly ; Third Ventricle ; Toes

Neurological grade on admission is an important prognostic factor for aneurysmal patients. The decision for operation in comatose patients with ruptured aneurysm is difficult and remains controversial. Recent literatures tend to emphasize the benefit of operative treatment for these patients because of the higher mortality of the patients who were managed conservatively. We performed early surgery in ten comatose aneurysmal patients combining lumbar drainage, intravenous and cisternal nimodipine therapy, and intermittent brain retraction. Among these ten patients, four showed survival over three months. We suggest that early surgery with aggressive postoperative management should be considered in comatose aneurysmal rupture patients for life-saving.
Aneurysm ; Aneurysm, Ruptured ; Brain ; Coma* ; Drainage ; Humans ; Intracranial Aneurysm* ; Mortality ; Nimodipine ; Rupture

BACKGROUND: Markedly reduced urine have been commonly observed during mastoidectomy under general anesthesia. The aim of study was to evaluate the surgery-related mechanism of reduced urine during mastoidectomy. METHODS: 11 patients undergoing mastoidectomy were studied. Blood samples were drawn from CVP line inserted through right internal jugular vein just before drilling (Pre-D); at 15 min after drilling (D-15); at the time closest to the inner ear (CHP-1); at 15 min (CHP-2) and 30 min (CHP-3) after CHP-1 and just before emergence (End). MAP, HR, temperature, CVP, and urine output (UO) were recorded at each period. 0.9% normal saline with room temperature was used to irrigate surgical field. Serum ADH, and the osmolalities (serum and urine) were measured. In 6 patients, serum TSH and FSH were measured, simultaneously. RESULTS: There were no significant hemodynamic changes during procedure. UO was decreased in 50% during and after the drilling. No differences showed in UO between before and after the drilling of CHP. Plasma ADH level after the CHP was increased 2-3 fold than before. Serum osmolality was unchanged throughout the periods, while the urine osmolality was significantly increased after the period of CHP. FSH was not changed during the periods and TSH was decreased slightly than in Pre-D. CONCLUSIONS: The reduced urine output during mastoidectomy may be influenced by the drilling-related vibration, which may affect the supraoptico-hypophyseal tract, resulting in ADH release. The irrigated isotonic saline with higher osmolality (308 mOsm/kgH2O) than plasma osmolality may partly contributed to the increased ADH.
Anesthesia, General* ; Ear, Inner ; Hemodynamics ; Humans ; Jugular Veins ; Osmolar Concentration ; Plasma ; Vibration

We investigated the association between the oxidative stress and the concentration of heavy metals in blood among welders. The study subjects were male manual CO2 welders(N=127) exposed to several heavy metals. The age distribution was from 20 to 63 (GM=33.7) and the geometric mean(GM) of work duration was 4.2 years. We analyze the level of blood lead, cadmium, managese and chromium which was related with the oxidative stress in the animal studies. Blood selenuim, plasma malondialdehyde (MDA), plasma alpha-tocopheol and orythrocyte superoxide dismutase (SOD) were analyzed as biological markers of the oxidative stress. The results of univariate analysis showed that the plasma MDA was significantly correlated with D-tocopherol (r=0.327) and blood selenium (r=0.313) concentration. But we could not find out any relationship between the erythrocyte SOD activities and those metal concentrations. Neither smoking nor alcohol consumption was related to the level of heavy metals and the oxidative stress biomarkers. As the results of multiple regression analysis with stepwise selection method, 1) the change of MDA level were dependant with the level of alpha-tocopherol and blood selenium concentration (R2=19.7), 2) the plasma alpha-tocopherol level was dependant with MDA and blood chromium concentration (R2=15.6), 3) in case of erythrocyte SOD activity, only the duration of work was significantly selected.
Age Distribution ; Alcohol Drinking ; alpha-Tocopherol* ; Animals ; Biological Markers ; Cadmium ; Chromium ; Erythrocytes* ; Humans ; Male ; Malondialdehyde* ; Metals, Heavy* ; Oxidative Stress ; Plasma* ; Selenium ; Smoke ; Smoking ; Superoxide Dismutase* ; Superoxides*