No abstract available.
Anthrax*

No abstract available.
Fistula*

BACKGROUND: The purpose of this study was to compare prospectively two different anesthetic techniques with isoflurane or propofol for postoperative nausea, vomiting and recovery after tonsillectomy in children. METHODS: Sixty children, ASA physical status I, were assigned randomly to one of two groups. In group I, anesthesia was induced with thiopental 5 mg/kg and maintained with isoflurane 1~1.5 vol%. In group P, anesthesia was induced with fentanyl 1 mcg/kg, propofol 2 mg/kg and maintained with propofol infusion 5~10 mg/kg/hr. Both group received vecuronium 0.1 mg/kg for tracheal intubation and were ventilated with 33% O2 in N2O. The time to extubation, time to eye opening, PACU time, incidence and numbers of postoperative nausea and vomiting, and degree of sedation were recorded as well as perioperative complications. RESULTS: There were no significant difference in the duration of anesthesia and PACU time between two groups. The time to extubation and eye opening of group P were significantly shorter than group I (p<0.05). The degree of sedation and incidence of postoperative nausea and vomiting of group P were significantly lower than group I (p<0.05). But the frequency of intraoperative bradycardia was significantly higher in group P than group I (p<0.05). CONCLUSIONS: Propofol-fentanyl anesthesia results in less nausea and vomiting during postoperative period and more rapid recovery compared to isoflurane anesthesia and may be recommended in children undergoing tonsillectomy and adenoidectomy.
Adenoidectomy ; Anesthesia* ; Bradycardia ; Child* ; Fentanyl ; Humans ; Incidence ; Intubation ; Isoflurane* ; Nausea ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Propofol* ; Prospective Studies ; Thiopental ; Tonsillectomy* ; Vecuronium Bromide ; Vomiting*

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop hyponatremia. Although the underlying pathophysiology of polydipsia among psychiatric patients, recent reports indicate that clozapine treatment improves polydipsia-hyponatremia in schizophrenia. Two schizophrenic patients with polydipsia, followed for more than two years, showed improvement on clozapine. Case 1 was a patient without history of hyponatremia who improved from polydipsia and psychosis. Case 2 was an inpatient with polydipsia and hyponatremia who showed improvement of polydipsia and did nor recur hyponatremia. The limited information provided by these case reports suggest the need for controlled studies of the clozapine effect on schizophrenic patients with polydipsia.
Clozapine* ; Humans ; Hyponatremia ; Inpatients ; Polydipsia* ; Psychotic Disorders ; Schizophrenia*

Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

Based on the histopathologic findings of the lacrimal gland tumor, the lesion is classified as either epithelial or nonepithelial tumor. 22% of lacrimal gland lesions were primary epithelial neoplasm. 4%of epithelial tumor of lacrimal glands were primary malignant tumor. Squamous cell carcinoma arising from pleomorphic adenoma of lacrimal gland is a very rare(0.4%). Inspite of surgical intervention, postoperative radiation and chemotherapy, the mortality and recurrence rate of the carcinoma ex pleomorphic adenoma of lacrimal gland is very high. We report a case of squamous cell carcinoma ex pleomorphic adenoma of lacrimal gland, which was completely removed via lateral orbitotomy with bicoronal incision and had no major complication or recurrence.
Adenoma* ; Adenoma, Pleomorphic ; Carcinoma, Squamous Cell ; Drug Therapy ; Lacrimal Apparatus* ; Mortality ; Neoplasms, Glandular and Epithelial ; Recurrence

The lumbosacral joint is an unstable area from an anatomical yiewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint The purpose of this study is to assess the differences in the efiicacy of the lumbosacral angles among low back pain patients. The following lumbosacial angles were measured and evaluated in 65 patients with only low back pain, in 70 patients with spondylolysis, and in 51 patients with spondylolisthesis. 1. Ferguson angle. 2. Sacrovertebral angle. 3. L-5 horizontal angle. 4. Meschan angle. 5. Line of weight bearing. 6. Wedging of the lumbar spine. 7. Interrelationship between slipping and wedging of the lumbar spine. The results are as follows: 1. The Ferguson angle was increased in spondylolisthesis, 2. The L-5 horizontal angle was increased in spondylolisthesis, meaning unstability of the lumbosacral joint. 3. There was no interrelationship between stability of the lumbosacral joint and the sacro-vertebral angle. 4. The Meschan angle indicated high sensitivity in spondylolisthesis, but the changes were also observed in some of the other back pain patients. 5. Most of the cases showed instability when judged by the line of weight bearing. This was especially true in spondylolisthesis. 6 The lumbar index was in 92.7% of simple low back pain patients, 82.2% in spondylolysis, and 80.2% in spondylolistheysis, The average wedging of the L-5 vertebra was significantly greater in spondylolysis and spondylolisthesis than in patients without slipping of the vertebral body. 7. The degrees of wedging and of slipping showed a statistically valid correlation, although their etiological relationship remains to be further investigated.
Back Pain ; Humans ; Joints ; Low Back Pain ; Spine ; Spondylolisthesis ; Spondylolysis ; Statistics as Topic ; Weight-Bearing

The most important congenital abnormality of the foot is clubfoot or talipes equinovarus, a deformity easy to diagnose but difficult to correct completely, even in the hands of an experienced orthopaedic surgeon. Furthermore approximately 50% of congenital clubfoot are resistant to non-operative methods such as manipulation and cast correction and consequently, under these circumstances, continuation of non-operative treatment leads to eventual failure, due either to incomplete correction, or recurrence of the deformity. In such resistant clubfoot it is better judgement to perform a relatively minor soft tissue operation at the time for resistance rather than to delay surgical treatment and beforced to perform a major operation at a late date for recurrence. Eighteen patients who presented twenty-five resistant congenital clubfoot abnormalities were followed at our department for 9 years and 4 months from February of 1970 to May of 1979. These were subjected to analysis clinically and radiologically, and the following results were obtained. 1. These patients consisted of: 11 male patients, 7 female patients, 11 single clubfeet and 7 bilateral clubfeet. 2. Age categories at operation were as follows: 6 feet below 1 year old, 8 feet 1 year old, 5 feet 2 years old, 3 feet 3 years old and one each age 4, 5 and 6. 3. Treatment period before operation: 19 clubfeet for 3 months to 6 months, 6 clubfeet for 7 months to 1 year. 4. Operations performed: posterior release-four, medial and posterior release-twelve, medial-plantar and posterior release-three, one stage posteromedial release-four, Evans procedure-one and tibialis anterior to lateral cuneiform-one. 5. Operations performed at an early age showed better results than those performed on older patients. 6. Of all operations performed the one stage posteromedial release with internal fixation showed the best results.
Clubfoot ; Congenital Abnormalities ; Female ; Foot ; Fractures, Open ; Hand ; Humans ; Male ; Recurrence