Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

The purpose of this study was to investigate setting and thermal expansion of dental soldering investments. In order to compare expansion rates and to investigate the effect of water/powder ratio on expansion, setting and thermal expansion of four dental soldering investments were measured under three different water/powder ratio conditions: standard, 20% decreased and 20% increased. Setting expansion of investments was measured by use of dialgauge method. Each measurement was started two minutes later from the beginning of spatulation and recorded every one minute for one hour. Thermal expansion of cylindrical test specimens, 10mm diameter, 50mm length, was recorded in a Thermodilatometer at heating rate of 10degrees C per minute from 25degrees C to 700degrees C. The results of this study were obtained as follows: 1. Setting expansion rates under the standard water/power ratio condition were 0.198% in Speed-E, 0.090% in Deguvest, 0.080% in CM and Hi-temp. Setting expansion of Speed-E was significantly different from those of CM, Deguvest and Hi-temp, and setting expansion of Deguvest was significantly different from those of CM and Hi-temp(p<.05). 2. Under the decreased water/powder ratio condition, there was significant increase in setting expansion of 4 dental soldering investments(p<.05). 3. There were no significant differences in setting expansions of investments except Hi-temp between standard and increased water/powder ratio condition(p<.05). 4. Thermal expansion rates under the standard water/powder ratio condition were 1.923% in Deguvest, 1.629% in Speed-E, 1.619% in Hi-temp and 1.580% in CM. No significant difference in thermal expansions under the standard water/powder ratio condition existed only between Speed-E and Hi-temp(p<.05). 5. Under the decreased water/powder ratio condition, there was significant increase in thermal expansion of CM and Deguvest but decrease in thermal expansion of Speed-E(p<.05). 6. Under the increased water/powder ratio condition, there was significant decrease in thermal expansion of CM, Deguvest and Speed-E but decrease in thermal expansion of Hi-temp(p<.05).
Dental Soldering* ; Heating ; Hot Temperature ; Investments*

No abstract available.
Sarcoma, Endometrial Stromal*

No abstract available.
Classification* ; Dermatoglyphics* ; Yersinia*

Squamous cell carcinoma (SCC) of the stomach is relatively rare. We report a patient with a primary SCC of the stomach that was initially misdiagnosed as a submucosal tumor. The patient was a 64-year-old male who had a large submucosal tumor in the gastric fundus. Gastric endoscopy, endoscopic ultrasonography and abdominal computed tomography indicated a malignant submucosal tumor with multiple lymph node metastases. The patient underwent a total gastrectomy and a regional lymph node dissection. Histologically, the tumor was identified as a primary SCC of the stomach.
Carcinoma, Squamous Cell* ; Endoscopy ; Endosonography ; Gastrectomy ; Gastric Fundus ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Stomach*

During childhood, meningioma is an uncommon tumor, and in infants, extracranial meningioma is very rare. We report a case of primary cutaneous menigioma occurring on the scalp of a ten-month-old girl.
Female ; Humans ; Infant* ; Meningioma* ; Scalp*

BACKGROUND: Most surgical patients experience preoperative anxiety. This anxiety can effect the amount of preanesthetic medication and anesthetic agents needed, and contribute to postoperative pain. Music has been recognized as a way to reduce anxiety and fear. The effect of hymn and sutra-chanting on the preanesthetic patient's anxiety in the operating room were studied. METHODS: 98 patients were divided into two groups according to the religionist or atheism. Group I(n=50, religionist) and Group II(n=48, atheism) listened to hymn or sutra-chanting according to the patient's religion and choice. At ward, hemodynamic variables including systolic and diastolic blood pressure and pulse rate were measured as control values. Hemodynamic variables and measurements of anxiety score with Hamilton anxiety rating scale were made at pre-music and post-music in the operating room. Also, patient's response to the music was measured on the postoperative 5-6th day. RESULTS: There were no difference between ward, pre-music, and post-music in terms of systolic pressure, diastolic pressure and pulse rate except the systolic pressure at pre-music that is grater than that of controls in both groups. Both group, anxiety score at post-music was significantly lower than that of pre-music (10.2+/-3.4 vs 4.4+/-2.9, 11.0+/-3.2 vs 5.7+/-3.1). At post-music, anxiety score in Group I showed significant reduced compaired with Group II (p<0.05). Patients showed relatively good satisfaction with music in both groups. CONCLUSION: The results suggest that music with hymn and Sutra-chanting were effective to reduce preanesthetic anxiety in both religionist group and atheism group.
Anesthesia ; Anesthetics ; Anxiety* ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Music ; Operating Rooms* ; Pain, Postoperative ; Preanesthetic Medication ; Premedication

BACKGROUND: A randomized, multicenter, open-label, parallel group study was performed to compare the effects of remifentanil and morphine as analgesic drugs on the duration of weaning time from mechanical ventilation (MV). METHODS: A total of 96 patients with MV in 6 medical and surgical intensive care units were randomly assigned to either, remifentanil (0.1-0.2 mcg/kg/min, n = 49) or morphine (0.8-35 mg/hr, n = 47) from the weaning start. The weaning time was defined as the total ventilation time minus the sum of controlled mode duration. RESULTS: Compared with the morphine group, the remifentanil-based analgesic group showed a tendency of shorter weaning time (mean 143.9 hr, 89.7 hr, respectively: p = 0.069). Secondary outcomes such as total ventilation time, successful weaning rate at the 7th of MV day was similar in both groups. There was also no difference in the mortality rate at the 7th and 28th hospital day. Kaplan-Meyer curve for weaning was not different between the two groups. CONCLUSIONS: Remifentanil usage during the weaning phase tended to decrease weaning time compared with morphine usage.
Analgesics ; Humans ; Critical Care ; Morphine* ; Mortality ; Respiration, Artificial* ; Ventilation ; Ventilator Weaning ; Weaning*

No abstract available.
Morphine* ; Respiration, Artificial* ; Weaning*

No abstract available.
Anesthesiology