No abstract available.

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Ketamine is a safe and effective drug for pediatric anesthesia, sedation and analgesia. We hoped to identify that surgeons could operate a pediatric hernia with the ketamine anesthesia without general anesthesia. The study was a consecutive case series of 2230 inguinal hernia patients aged 1 months to 17 years in a Joo's day-surgical clinic during 11-year period. The patients had pediatric inguinal hernia surgery without general anesthesia under the day-surgery system. We retrospectively analyzed the medical record of patients who were registered with the Diagnosis Related Group (DRG) system. All patients received ketamine (5mg/kg) and atropine (0.01mg/kg) intramuscularly before surgery. After anesthesia, we injected 1~2% lidocaine (Less than 5ml) subcutaneously at the site of incision and started operation. The surgical method was the high ligation method of the hernia sac.) In total 2230 patients, male were 1756 and female were 474. 2076 patients were a unilateral inguinal hernia at the time of surgery and 154 were bilateral hernia patients. Less than three months, depending on the age of the patients was 391, and less than 12 months the patient was 592 people (26.5%). After surgery, there were no accidents or long term complications associated with ketamine anesthesia. We think the surgeon can safely do the pediatric inguinal hernia surgery using ketamine and lidocaine without anesthesiologist through 11 years of our surgical experiences.
Analgesia ; Anesthesia ; Anesthesia, General ; Atropine ; Child ; Diagnosis ; Female ; Hernia ; Hernia, Inguinal* ; Hope ; Humans ; Ketamine* ; Lidocaine* ; Ligation ; Male ; Medical Records ; Retrospective Studies

No abstract available.
Endometriosis* ; Female

Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the besis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7%), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the most common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patients(79.1%) with stage I disease were treated by surgery alone. Adjuvant such as chemotherapy (CT) and/or radiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase diaease-free survival significantly in stage I disease. In stageII disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patients with stageII disease received no adjuvant therapy and the others received CT and/or RT, however, there was no difference in outcome of recurrence and survival. In advanced stage. 15% of patients received no adjuvant therapy after initial debulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each groups were noticed , too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%. Long-term survival at 15~20 years was also good. Although it is quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removal of the tumor and careful follow-up of patients are all that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is definitely needed.
Drug Therapy ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Japan ; Korea ; Mucins ; Peritoneal Cavity ; Prospective Studies ; Recurrence

The transition from preinvasive to invasive disease is a crucial juncture in the development of cervical cancer. The clinical experience that microvasive lesions carry a better prognosis justifies a sepetate diagnostic category. Besides clinical and cliagmostic problerns, the rnicroinvasive cervical cancer presents morphological peculiarities. To investigate the clinieal and pethological aspects of micrenvasive eervical carcinornn, a retrospective study was made on 40 cases, histologically reconfirrned surgical specimens, which had been treated during the period from March, 198I3 to March, 1992 at, Departrnent of Obstetrics and Gynecology, Pusan Paik Hospital, Inje University. The results obtained were as follows ; 1. Mean age of 40 patents was 44.6 year old, all were rnultipatous. Nineteen cases helonged to I s, and 21 cases to I a2. 2. Main presenting symptoms were leukorr hea and/or genital bleeding and the majority of patients showed cervical erosion on groas finding, 3. The corresponding rate of Pap, smear to histologic diagnosis was approximately 67.5%, However, corresponding rate within one histologie grade was about 85%. 4, Aecording to the eolpuacapie examination, less than half of the examined cases revealed suspected abnormal findings suggeeting invasive lesion. 5. As to the reports of punch biopsy, 64.8% of cases showed microinvasive and/or inuasive lesian. With additional diagnostic conization of cervix, the preoperative diagnosis were correct in 82.5%. 6. Histopathological reevaluatin ef surgiral specimens revealed positive correlation between depth of stromal invasion and width of leaior, confluent growth pattern, numher of invasive foci, and invasion of capillary-like spaee, respectively.
Biopsy ; Busan ; Cervix Uteri* ; Conization ; Diagnosis ; Female ; Gynecology ; Hemorrhage ; Humans ; Obstetrics ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms

No abstract available.

Giant congenital melanocytic nevi may lead to severe cosmetic and psychosocial problems. Another important problem is the relatively high potential to undergo malignant transformation. The management of congenital melanocytic nevi remains controversial as there is no universal agreement. We report two cases of giant congenital melanocytic nevi which were removed by curettage and dermatomes. There is relatively less intra and postoperative morbidity using these methods than with other treatment modalities. They were also considered as acceptable surgical methods and there are potentially more pleasing cosmetic results.
Curettage* ; Nevus, Pigmented*