No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Humans ; Infant, Newborn*

Malignant hyperthermia is a well-recognized syndrome of uncertain etiology. The confusing facts are: the variety and different nature of the triggering agents, the variation in time of onset of rigidity and fever coupled with a variation in response to succinylcholine, the lack of family history in some patients, and its occurence in some who have had previously normal general anesthetics. A case is a 23 year old relatively healthy male patient in whom subtotal gastrectomy was performed under N2O-O2-ether and gallamine anesthesia with induction after pentothal sodium and succinylcholine. This was complicated by an abrupt, high rise in body temperature, muscle rigidity, flushing with peripheral cyanosis, disseminated intravascular coagulation and hyperpnea 40 minutes after induction. He died 3 hours after cessation of anesthesia without effective response to any active antipyretic therapy. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Anesthesia* ; Anesthetics, General ; Body Temperature ; Cyanosis ; Disseminated Intravascular Coagulation ; Fever ; Flushing ; Gallamine Triethiodide ; Gastrectomy ; Humans ; Incidence ; Male ; Malignant Hyperthermia* ; Muscle Rigidity ; Prognosis ; Sodium ; Succinylcholine ; Thiopental

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

Apoptosis ; Bone Regeneration ; Calcium ; Calcium Phosphates ; Cell Cycle ; Cell Proliferation ; Ceramics ; Durapatite ; Gene Expression ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoblasts ; Osteogenesis ; Signal Transduction

BACKGROUND: Pneumoperitoneum for a gynecologic laparoscopic surgery induces hemodynamic changes. We evaluated the effects of nicardipine on induction, maintenance, and recovery. METHODS: Thirty patients scheduled for gynecologic laparoscopic surgery were randomly allocated to two groups: control group (placebo group, n = 15), group N (nicardipine group, 10 microgram/kg followed by 0.5-2.0 microgram/kg/min). The systolic arterial pressure, mean arterial pressure, and heart rate were measured at preinduction, induction, intubation and 5, 10, 15, 20 min after insufflation. Loss of consciousness, induction dose, effective site concentration, propofol maintenance dose (the maintenance dose of propofol from intubation to end of anesthesia, PMD) were also measured. Propofol was titrated to maintain a bispectal index value of 40-60. RESULTS: There was a significant difference in PMD between two groups. The PMD of group N was significantaly less than group C. Nicardipine adminstration attenuated increase in the blood pressure, but did not affect on heart rates during CO2 insufflation. CONCLUSIONS: Co-administration of nicardipine was effective in attenuating the hemodynamic changes after pneumoperitoneum during gynecologic laparoscopic surgery, without changes of induction and recovery.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Intubation ; Laparoscopy* ; Nicardipine* ; Pneumoperitoneum ; Propofol ; Unconsciousness

No abstract available.
Diagnosis* ; Intussusception* ; Ultrasonography

BACKGROUND: A "difficult airway" can be simulated with an extrication collar, which restricts cervical motion and mouth opening. The purpose of this study is to compare the efficacy of the GlideScope and the McGrath in difficult airway simulation. METHODS: Patients were randomized using computer-generated numbers and were placed into the GlideScope group or the McGrath group. The total intubation time was defined as the time measured from when the anesthesiologist picks up the device to the time at which three successive end-tidal CO2 values are acquired after intubation. RESULTS: There was no significant difference in total intubation time between the two groups (73.0 ± 25.3 sec vs. 72.3 ± 20.9 sec, P = 0.92). The success rates of the first intubation attempt did not differ between the two groups (82.8% vs. 83.3%, P = 0.95). CONCLUSIONS: Our results suggest that there are no significant differences in the intubations with GlideScope and McGrath using vascular forceps and tube exchangers in difficult intubation scenarios.
Airway Management ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Mouth ; Surgical Instruments*

BACKGROUND: The Rhodes index of nausea, vomiting and retching (RINVR) is a reliable and valid instrument to assess PONV. The purpose of this study was to investigate the incidence of PONV in high risk group with using RINVR. METHODS: Patients scheduled for elective surgery under general anesthesia were classified in three groups (group I:two risk factors, group II:three risk factors, group III:four risk factors) by using a simplified risk score.We investigated the incidences of PONV in each group. RESULTS: The incidence of PONV was 12.8% in group I, 25% in group II, and 33.1% in group III, which showed a significant difference between group I and group II, between group I and group III.The incidence of PONV, which was over moderate was significantly increased in group III. CONCLUSIONS: For patients with three or four risk factors a multimodal antiemetic strategy should be considered.
Anesthesia, General ; Humans ; Incidence ; Nausea ; Postoperative Nausea and Vomiting ; Risk Factors ; Vomiting

A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was bluish opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined cell borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Chest Pain ; Chondrosarcoma ; Chromatin ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils* ; Female ; Humans ; Mesothelioma ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pleural Cavity ; S100 Proteins ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed