Myasthenia Gravis is a neuromuscular disorder manifested by increasing weakness and fatigability of voluntary muscles with exercise, and partial or complete restoration of function following rest or the administration of anticholinesterase drugs. The anesthesiologists may be called upon to assist in the diagnosis of myasthenis, in treating the patient by artificial ventilation during acute exacerbations, to anesthetise the patient for thymectomy or other surgery. Therefore, the anesthesiologists must be familiar with the diagnosis and treatment of myasthnia gravis to carry on the appropriate therapy. Two cases of anesthesia for thymectomy in myasthenia gravis without using muscle relaxants was experienced, and no respiratory problems were encountered postoperatively.
Anesthesia* ; Cholinesterase Inhibitors ; Diagnosis ; Humans ; Muscle, Skeletal ; Myasthenia Gravis* ; Thymectomy* ; Ventilation

BACKGROUND: The purpose of this study was to find out the effect of hypnotics and analgesics on oxygen saturation by pulse oximetry in surgery patients under spinal anesthesia. METHODS: Sixty-five patients classified ASA physical status 1 or 2 scheduled for surgery under spinal anesthesia were studied. These patients were divided into three groups. The 22 subjects of the first group did not receive either midazolam or fentanyl. The 22 subjects of the second group received midazolam. The 21 subjects of the third group received midazolam (0.03 mg/kg) and fentanyl (1.0 microgram/ kg). Oxygen saturation was measured with a pulse oximetry. Measurements were made before spinal anesthesia, 5 minutes, and 10 minutes after starting of spinal anesthesia, 5 minutes, 10 minutes, 30 minutes, and 60 minutes after the start of the operation or intravenous injection of drugs. In addition, measurements were made on arrival in the recovery room, and 5 minutes, 10 minutes, 20 minutes, and 30 minutes after arrival in the recovery room. RESULTS: There were statistically significant differences in oxygen saturation at 5 minutes after the start of the operation or intravenous injection of drugs. The mean oxygen saturation for the first group was 98.2 +/- 1.8%, for the second group 97.9 +/- 2.6%, and for the third group 92.4 +/- 2.8%. Hypoxia cases at 5 minutes after the start of the operation or intravenous injection of a drug occurred in 4.5% of the first group, 9.1% of the second group, and 57.1% of the third group CONCLUSIONS: We concluded that oxygen saturation monitoring should be done routinely in patients receiving hypnotics and analgesics during spinal anesthesia, and oxygen should be administered to patients who develope hypoxia during spinal anesthesia.
Analgesics* ; Anesthesia, Spinal* ; Anoxia* ; Fentanyl ; Humans ; Hypnotics and Sedatives* ; Incidence* ; Injections, Intravenous ; Midazolam ; Oximetry ; Oxygen ; Recovery Room

Congenital branchial anomalies are developmental defects resulting from incomplete obliteration of branchial clefts, arches and pouches, and usually found as cysts, fistulas and sinuses. The sinus or fistula is usually noted during infancy and young childhood due to recurrent infection. We have experienced a case of branchial cleft fistula in a 12-year-old male. It was a skin colored, nontender nodule which had mucus secreting from a small opening pore. We performed complete surgical removal and histopathologically the lumen was lined by pseudostratified columnar cells and the stroma was composed of aggregates of lymphocytes with many germinal centers. So we finally diagnosed it as branchial cleft fistula of second type branchial anomaly.
Branchial Region* ; Child ; Fistula* ; Germinal Center ; Humans ; Lymphocytes ; Male ; Mucus ; Skin

No abstract available.
Leiomyosarcoma* ; Rectum*

BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described inss case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. RESULTS: The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of thether risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). CONCLUSION: Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be comm.
Alcohol Drinking ; Case-Control Studies ; Diabetes Mellitus ; Humans ; Infarction ; Moyamoya Disease* ; Prevalence ; Surveys and Questionnaires ; Respiratory Tract Infections ; Risk Factors ; Smoke ; Smoking ; Stress, Psychological ; Stroke

No abstract available.

No abstract available.
Lipoma*

Aneurysmal fibrous histiocytoma(AFH) is a histologic variant of dermatofibroma. The importance of the recognition of AFH as a variant of dermatofibroma lies in the differential diagnosis because the histologic appearance of AFH is very similar to dermatofibrosarcoma protuberans and other vascular malignancies, such as Kaposi's sarcoma and angiosarcoma. A 32-year-old man was seen for a nodular mass on the right popliteal fossa of 4 years' duration. The excisional biopsy specimen showed a relatively well circumscribed tumor mass in the dermis. In addition to compact storiform proliferation of spindle cells, there were multiple, irregular, blood-filled, aneurysmal tissue spaces that were devoid of lining of endothelial cells. Also, deposition of hemosiderin was prominent, particularly in the periphery of the aneurysmal spaces. Immunohistochemical stain for CD34 were negative to most tumor cells. After excisional therapy, there was no evidence of recurrence during the period of ten months' follow-up.
Adult ; Aneurysm* ; Biopsy ; Dermatofibrosarcoma ; Dermis ; Diagnosis, Differential ; Endothelial Cells ; Follow-Up Studies ; Hemangiosarcoma ; Hemosiderin ; Histiocytoma, Benign Fibrous* ; Humans ; Recurrence ; Sarcoma, Kaposi

We report a case of primary cutaneous adenoid cystic carcinoma in a 39-year-old male patient. It was a slightly erythematous hard nodule on left chin and composed of cribriform and tubular masses of basaloid cells. Lumina formed by neoplastic cells contained mucin and hyalin, and similar constituents were located between neoplastic cell masses and adjacent dermis. Immunohistochemically, the neoplastic cells stained only focally with S-100 protein and negative with carcinoembryonic antigen(CEA). Therapy should employ wide surgical excision that extends well beyond the clinical confines of the neoplasm.
Adenoids* ; Adult ; Carcinoma, Adenoid Cystic* ; Chin ; Dermis ; Humans ; Hyalin ; Male ; Mucins ; S100 Proteins

The incidence of skull tuberculosis is very rare, with only a few cases reported as a result of a simple radiography and computed tomographic findings. In this study, we report the magnetic resonance image (MRI) findings of a case of skull tuberculosis, which was confirmed histologically.
Frontal Bone ; Incidence ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Skull ; Tuberculosis ; Tuberculosis, Osteoarticular