Two-hundred cases of brachial plexus block by parascalene technique for the surgery of upper extremity, shoulder and/or neck were evaluated for the period from November, 1989 to October, 1990 at the Department of Anesthesiology, Hallym University, Kangdong Sacred Heart Hosipital in Seoul, Korea. Local anesthetics we used in this technique were mixture of equal amount of 2% lidocaine and 0.5% bupivacaine with 1: 200,000 epinephrine. Total amount of local anesthetics injected were varies from 20 to 40 ml for each block. The results were as follows: 1) Of the 200 Patietns, 153(76,5%) were male and 47(23.5%) were female. Their ages ranged from 5 to 83 years. One hundred twenty-one or 60.5% of this total group's ages fell between 20 to 39 years. 2) The most common site of operation was the hand; ll6 cases of the 200 blocks(55.3%). 3) Paresthesia was most often elicited at the superior nerve trunk; 80 cases of the 200 blocks (40%). 4) The average depth of needle from the skin to eliciting the parethesia is 1.954 cm. 5) The onset of anesthesia was within 5 minutes in 166.cases(84,4%). 6) The duration of anesthesia ranged from 180 to 1,800 minutes, and average was 657+/-113 minutes. 7) The extent of anesthesia by sensory dermatomes were average from cervical 2.3+/-1.0 to thoracic 2.90+/-5. 8) Shoulder surgery(e.g. clavicle fracture) and neck biopsy were performed successfully by this technique. 9) Parascalene approach to the brachial plexus has proven both safe and reliable. It provide satisfactory anesthesia of the upper extremity, shoulder and neck in 98.5%(l97 cases) of the 200 patients. 10) Complications of parascalene brachial plexus block were 2 cases of Horners syndrom, 1 cases of recurrent laryngeal nerve paralysis and 2 cases of subclavian artery puncture. We presumed that the complications other than Horners syndrome were due to technical error.
Anesthesia ; Anesthesiology ; Anesthetics, Local ; Biopsy ; Brachial Plexus* ; Bupivacaine ; Clavicle ; Epinephrine ; Female ; Hand ; Heart ; Horner Syndrome ; Humans ; Korea ; Lidocaine ; Male ; Neck ; Needles ; Paralysis ; Paresthesia ; Punctures ; Recurrent Laryngeal Nerve ; Seoul ; Shoulder ; Skin ; Subclavian Artery ; Upper Extremity

Two-hundred cases of brachial plexus block by parascalene technique for the surgery of upper extremity, shoulder and/or neck were evaluated for the period from November, 1989 to October, 1990 at the Department of Anesthesiology, Hallym University, Kangdong Sacred Heart Hosipital in Seoul, Korea. Local anesthetics we used in this technique were mixture of equal amount of 2% lidocaine and 0.5% bupivacaine with 1: 200,000 epinephrine. Total amount of local anesthetics injected were varies from 20 to 40 ml for each block. The results were as follows: 1) Of the 200 Patietns, 153(76,5%) were male and 47(23.5%) were female. Their ages ranged from 5 to 83 years. One hundred twenty-one or 60.5% of this total group's ages fell between 20 to 39 years. 2) The most common site of operation was the hand; ll6 cases of the 200 blocks(55.3%). 3) Paresthesia was most often elicited at the superior nerve trunk; 80 cases of the 200 blocks (40%). 4) The average depth of needle from the skin to eliciting the parethesia is 1.954 cm. 5) The onset of anesthesia was within 5 minutes in 166.cases(84,4%). 6) The duration of anesthesia ranged from 180 to 1,800 minutes, and average was 657+/-113 minutes. 7) The extent of anesthesia by sensory dermatomes were average from cervical 2.3+/-1.0 to thoracic 2.90+/-5. 8) Shoulder surgery(e.g. clavicle fracture) and neck biopsy were performed successfully by this technique. 9) Parascalene approach to the brachial plexus has proven both safe and reliable. It provide satisfactory anesthesia of the upper extremity, shoulder and neck in 98.5%(l97 cases) of the 200 patients. 10) Complications of parascalene brachial plexus block were 2 cases of Horners syndrom, 1 cases of recurrent laryngeal nerve paralysis and 2 cases of subclavian artery puncture. We presumed that the complications other than Horners syndrome were due to technical error.
Anesthesia ; Anesthesiology ; Anesthetics, Local ; Biopsy ; Brachial Plexus* ; Bupivacaine ; Clavicle ; Epinephrine ; Female ; Hand ; Heart ; Horner Syndrome ; Humans ; Korea ; Lidocaine ; Male ; Neck ; Needles ; Paralysis ; Paresthesia ; Punctures ; Recurrent Laryngeal Nerve ; Seoul ; Shoulder ; Skin ; Subclavian Artery ; Upper Extremity

Autoimmune pancreatitis is a distinct entity with characteristic histologic, morphologic, and clinical features. It may be isolated or associated with Sjogren syndrome, primary biliary cirrhosis, primary sclerosing cholangitis, Crohn's disease and ulcerative colitis, or other immune-mediated disorders. Recent studies have reported the profiles of autoantibodies in autoimmune pancreatitis. Also a number of reports on single cases or small series of cases have been published. We report three cases of autoimmune pancreatitis; one case was associated with primary sclerosing cholangitis, which was misdiagnosed as pancreatic cancer; the other two cases were improved with steroid therapy.
Autoantibodies ; Cholangitis, Sclerosing ; Colitis, Ulcerative ; Crohn Disease ; Liver Cirrhosis, Biliary ; Pancreatic Neoplasms ; Pancreatitis* ; Sjogren's Syndrome

PURPOSE: We tried to evaluate whether the detection rate of Helicobacter pylori in gastric biopsy specimens could be improved by using pre-embedding immunoelectron microscopy. METHODS: A total of 119 children who complained of upper gastrointestinal symptoms were endoscoped at the Gyeongsang National University Hospital from July, 1996 to July, 1999. Five biopsy specimens(three for urease test, one for hematoxylin-eosin(H and E) staining, and one for pre- embedding immunoelectron microscopy) were obtained from each antrum and body. Immunoblotting analysis were also performed. RESULTS: Among the 119 patients, H. pylori were found in 116 patients(97.5%) by the immunoelectron microscopy. Among three patients who were found H. pylori negative in immunoelectron microscopy, two patients showed H. pylori in H and E stained slides and one patient was urease test positive(color change within six hours). Urease tests were positive in 107 patients(89.9 %). The positive rate of immunoblotting tests was 81.5%. However, only 13 patients(10.9%) showed H. pylori on the H and E stained antrum or body tissue. CONCLUSION: In this study, we found H. pylori histopathologically in most of the pediatric patients who complained of upper gastrointestinal symptoms. This study showed that pre-embedding immunoelectron microscopic examinations can be used as a gold standard in the diagnosis of childhood H. pylori infection. However, this method also has limited capacity to detect widely scattered H. pylori compared to the other histopathologic diagnostic methods.
Biopsy ; Child ; Diagnosis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoblotting* ; Microscopy, Immunoelectron* ; Urease