Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

No abstract available.
Humans

No abstract available.
Humans ; Kidney Transplantation* ; Tissue Donors*

No abstract available.
Humans ; Organophosphate Poisoning* ; Respiratory Insufficiency*

Hydrofluoric acid(HF) burn is characterized by progressive tissue necrosis and severe pain. A 31 year old employee in the semiconductor industry came in contact with the 50% aqueous HF through a pin hole in the thumb of his protective gloves. About 2 hours after exposure, h noted deep, severe burning, excruciating pain and svtelling of right thumb. Thereafter, clark bluish eclematous necrotic patches were visible through the nail plate and on the distal end of right thumb. Pain was not effectively relieved by digital nerve block.
Adult ; Burns* ; Gloves, Protective ; Humans ; Hydrofluoric Acid* ; Necrosis ; Nerve Block ; Semiconductors ; Thumb

Syringoma of the vulva is a rare disorder and limitation of the lesions to this site appears unique. Lesions can be clinically diagnosed without difficulty, since it is characterized by multiple, bilateral, asymptomatic skin-colored papules. Vuluar syringoma should be considered in the differential diagnosis of multicentric papular lesions of the vulva. The patient presented here is a 30-year-old healthy woman; lesions are multiple, biiateral, asymptomatic, angular or round, skin-colored to yellowish brown, firm papules localized on the vulvar region and showing a characteristic histologic findings.
Adult ; Diagnosis, Differential ; Female ; Humans ; Syringoma* ; Vulva*

Demodex is easily found from eyelashes and suggested as the one of the causes of some eye diseases. This study was to investigate the occurence rate, and classification of Demodex from eyelashes, and its relationship with blepharitis. The data of this study were compiled from 27 blepharitis patients and 173 patients without blepharitis (control group) who had visited St. Paul's Hospital from October 1981 to December 1981. Three eyelashes from each eyelid-total 12 lashes from a patient-were extracted under the slit lamp, located on a slide glass and fixed with polyvinyl lactophenol mounting medium. (countinued..)
Blepharitis ; Classification ; Eye Diseases ; Eyelashes* ; Glass ; Humans ; Polyvinyls

Cervical tab is one of the congenital anomalies, originated from an accessory tragus or a remnant of branchial cartilage on the head a.nd neck. A 41 year old male patient was seen with 1.1 x0.8cm sized cartilage consistent intredermal nodule on the left supraclavicular area. Histopathologic findings showed the oval shaped cartilags surrounded with connective tissue and interstitial substance stained black with Verhoeff van Gieson stain.
Adult ; Cartilage ; Connective Tissue ; Head ; Humans ; Male ; Neck

The T cell responses to hepatitis B surface antigen (HBsAg) were analyzed in acute hepatitis patients, chronic active hepatitis (CAH) patients and asymptomatic carriers. Neither proliferative responses nor substantial cytokine production of peripheral blood mononuclear cells (PBMC) in response to HBsAg was detected. For further studies, HBsAg- reactive T cell lines were prepared from PBMC of the hepatitis patients and asymptomatic carriers. No proliferative response of the T cell lines was observed. Interestingly, however, T cell lines obtained from acute hepatitis patients were found to produce IFN-r, but not IL- 4, in response to HBsAg stimulation, whereas T cell lines obtained from CAH patients and carriers were not. Results of this study suggest that HBsAg-reactive T cells producing Thl type cytokines may play an important role in the viral clearance during acute infections, while defects in those T cells may be responsible for the viral persistency.
Cell Line ; Cytokines ; Hepatitis ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; T-Lymphocytes*

Urticaria pigmentosa developed in twins at the age of 6 weeks. They have numerous round to oval shaped, discrete or confluent reddish brown colored macules over whole body surface and neither twin had vomiting, diarrhea, flushing or irritability. Their relatives are unaffected. Biopsy specimen of. back lesion showed. pooling of mast cells in the upper dermis, and electron microscopic examinattion revealed normal mast cells.
Biopsy ; Dermis ; Diarrhea ; Flushing ; Humans ; Mast Cells ; Twins* ; Urticaria Pigmentosa* ; Urticaria* ; Vomiting