No abstract available.

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

No abstract available.

No abstract available.
Animals ; Rats* ; Urinary Bladder*

No abstract available.
Animals ; Intercellular Signaling Peptides and Proteins* ; Rats* ; Urinary Bladder Neck Obstruction* ; Urinary Bladder*

No abstract available.
Intercellular Signaling Peptides and Proteins*

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting

No abstract available.
Polyesters* ; Urinary Incontinence*

PURPOSE: To study the refractive outcome of cataract surgery employing partial coherence interferometry (PCI) and to compare this outcome with that of A-scan ultrasound in a prospective study of 96 eyes of 96 patients that underwent phacoemulsification with intraocular lens (IOL) implantation. METHODS: The SRK-T formula was employed, using PCI (IOL Master(R): the only commercially available model) and A-scan ultrasound data, to predict patients' implanted IOL power. Four to six weeks after cataract surgery, the refractive outcome was determined, and results from the two different biometry methods were compared. RESULTS: Ninety-six patients (mean age: 67.64, SD: 9.91) underwent phacoemulsification with IOL implantation. The optical axial length obtained using the IOL Master(R) was significantly longer (p<0.001, Student's t-test) than the axial length obtained via by A-scan ultrasound, 24.29 (SD 1.80) mm vs. 24.19 (1.75) mm. When using the IOL Master(R), the mean prediction error (PE; planned target of refraction - postoperative refraction) was 0.30 (0.60) D, and the mean absolute prediction error (APE) was 0.51 (0.44) D. When using A-scan ultrasound, the mean PE was 0.01 (0.64) D, and the mean APE was 0.47 (0.43) D. The difference in mean APE between the two biometry methods was not statistically significant (p=0.236, Wilcoxon signed rank test). Among the eyes with an axial length greater than 25 mm, as determined by A-scan ultrasound, the difference in the mean APE was not statistically significant (0.48 (0.87) vs. 0.58 (0.61), p=0.094). Likewise, among the eyes for which with axial length measured by A-scan ultrasound longer than IOL Master(R), the difference in the mean APE error was not statistically significant, (0.33 (0.30) vs. 0.46 (0.41), p=0.110). CONCLUSIONS: IOL power calculation using the PCI is as accurate as that using A-scan ultrasound for predicting the postoperative refractive state of patients who have undergone cataract surgery.
Biometry ; Cataract ; Hominidae ; Humans ; Interferometry ; Lenses, Intraocular ; Phacoemulsification ; Prospective Studies ; Ultrasonography*

The corrected transposition of the great arteries is a rare congenital heart anomaly consisting of the discordant connections of both the atria to ventricles and the ventricles to the great arteries. But its circulation is physiologically corrected and therefore it is compatible with life unless there are associated lesions. Our case was associated with VSD, COA, and PDA. He was slightly cyanotic and irritable. Despite of oxygen supply, his symptoms were not improved and he eventually died in 52 hours after delivery. Medical record revealed severe respiratory and metabolic acidosis.
Acidosis ; Arteries* ; Heart ; Medical Records ; Oxygen