The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T on seizure duration. The results were follows ' 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine 0.0093mg kg(-1), pentothal 2.76mg kg(-1) or propofol 1.42mg kg(-1). 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal(35.7 sec)(p<0.001). This suggest the possibility that additional treatment may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.
Atropine ; Bipolar Disorder ; Delusions ; Depressive Disorder, Major ; Dihydroergotamine ; Electroconvulsive Therapy ; Humans ; Inpatients ; Propofol* ; Schizophrenia ; Seizures* ; Thiopental*

Intraaortic balloon counterpulsation (IAB) has been shown to prolong survival in the critically ill cardiac patients. Originally developed for use in the patients with cardiogenic shock, the indications have been expanded. But despite technical advances, the complication rate associated with IAB remains high. The most commonly reported complications include damage to the femoral artery and distal embolization. Other reported major complications are balloon rupture, limb loss, bleeding, systemic infection and bowel infarction. We report a patient complicated by ischemic colitis causing stenosis and intestinal obstruction after IAB insertion.
Colitis, Ischemic* ; Constriction, Pathologic* ; Counterpulsation* ; Critical Illness ; Extremities ; Femoral Artery ; Hemorrhage ; Humans ; Infarction ; Intestinal Obstruction ; Rupture ; Shock, Cardiogenic

No abstract available.
Free Tissue Flaps* ; Lower Extremity* ; Soft Tissue Injuries*

Rhino-orbito-cerebral muconnycosis is an uncommon fatal fringal infection, almost exclusively seen in diabetic or other itnmunocompromised patients. Recurrent transient ischemic attacks(TIAs) as initial presenting sign of rhino-orbito-cerebral mycormycosis has not been reported to our knowledge. We report a patient with muconnycosis unusually presenting with recurrent TIAs, followed by central retinal artery occlusion, multiple cranial nerve palsies, and then cerebral infarction in the territory of middle cerebral artery.
Cerebral Infarction ; Cranial Nerve Diseases ; Humans ; Middle Cerebral Artery ; Mucormycosis* ; Retinal Artery Occlusion

No abstract available.
Genioplasty*

No abstract available.
Adult* ; Femur* ; Humans

BACKGROUND: Video-assisted thoracic surgery (VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. MATERIAL AND METHOD: Group I (n=18) underwent video-assisted thoracic surgery, and group II (n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. RESULT: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I (155.6+/-77.8cc) than in group II (572.8+/-280.1cc) (p<0.05). CONCLUSION: The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.
Analgesics, Opioid ; Anesthesia ; Chest Tubes ; Drainage ; Esophageal Achalasia ; Esophageal Diseases* ; Humans ; Leiomyoma ; Length of Stay ; Pain, Postoperative ; Pleural Effusion ; Thoracic Surgery, Video-Assisted* ; Thoracotomy* ; Vocal Cord Paralysis

Fibrous dysplasia is a bone disease of unknown etiology in which cellular fibrous tissue gradually replaces normal bone and involves the cranium infrequently. Recently, we have experienced 3 cases of fibrous dysplasia which involved the frontal, sphenoid and parietal bones with vault deformity. The 2 cases, in which the frontal and sphenoid bones were involved, presented with proptosis and exophthalmos. All of the cases manifested vault deformity which caused cosmetic problems. We performed decompressive and plastic surgery for the purpose of relieving the compression of cranial nerves and for the sake of the cosmetic effect. The clinical courses were uneventful.
Bone Diseases ; Congenital Abnormalities ; Cranial Nerves ; Exophthalmos ; Parietal Bone ; Skull ; Sphenoid Bone ; Surgery, Plastic

The clinical analysis was carried out with 182 cases of craniocerebral injuries under 15 years of age, admitted at the Department of Neurosurgery, Chung Nam National University Hospital during the period from September, 1990 to September 1993. Following results were obtained: 1) There were 133 males and 49 females and sex ratio was 2.7%. 2) Age incidence of the accidents was greatest at 6 years of age and mostly distributed to the age group between 4 to 7. 3) Seasonal peak of the accidents was at May. 4) The accident occurred mostly between 4 P.m. and 6 P.m. in a day. 5) The most frequent cause of the craniocerebral injuries was traffic accident(105 cases, 57.69%). 6) No deterioration of cans ciousness before and after the admission was doserved in 68 cases(37.36%). 7) Pupillary change was observed in 25 cases and Babinski sign was elicitable in 31 cases. 8) Early convulsion and vomiting were frequent symptoms in childhood. 9) Skull fracture was observed in 72 cases(39.56%) in which linear fracture was most frequent and predilection site was parietal bone. 10) The accompanying rate of skull fracture in intracranial hemorrhage was 65.54%. 11) Associated injuries were found in 44 cases(24.18%). The frequent ones were extremity fracture, clavicle fracture. 12) The overall mortality was 7.14%.
Child* ; Clavicle ; Craniocerebral Trauma* ; Extremities ; Female ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhages ; Male ; Mortality ; Neurosurgery ; Parietal Bone ; Reflex, Babinski ; Seasons ; Seizures ; Sex Ratio ; Skull Fractures ; Vomiting

Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*