No abstract available.
Quality of Life*

Contusions ; Facial Bones ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Humans ; Incidence ; Lacerations ; Orbit ; Salivary Glands ; Skin ; Soft Tissue Injuries ; Wounds and Injuries

PURPOSE: To determine whether triple-phase multi-detector-row helical CT images of the liver improves the detection rate of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Forty-one patients with 103 HCCs underwent triple-phase multi-detector-row helical CT imaging of the entire liver after contrast administration. Early and late arterial phase images were obtained serially during a single breath-hold, and portal venous-phase images were then obtained. Each image set was independently assessed for the presence of HCC by two radiologists unaware of the possible presence of tumors, and for each phase the detection rate was determined. For each arterial-phase image, lesion conspicuity (attenuation of a tumor compared with that of its parenchyma) was calculated. RESULTS: For reader 1, the detection rates for the early arterial, late arterial, and portal venous phase were 81%, 77%, and 55%, respectively, and for reader 2 were 83%, 81%, and 68%, respectively (p>0.05). When triplephase imaging findings were combined, the detection rate was significantly higher than when only those of the early or late arterial, and portal venous, phase were used (p<0.05). Mean lesion conspicuity for the late arterial phase was higher than for the early arterial phase, but the difference was statistically insignificant (p>0.05). CONCLUSION: Triple-phase imaging of the liver, involving the early arterial, late arterial, and portal venous phase, and using multi-detector-row helical CT, increases the detection rate of HCC.
Carcinoma, Hepatocellular ; Humans ; Liver* ; Tomography, Spiral Computed*

BACKGROUND: Aspiration of gastric contents into the lungs is one of the most feared complications during anesthesia. Various factors combine to make pediatric patients more susceptible to regurgitation and aspiration than adults. We compared the risk of incidence of acid aspiration in two groups, after examining the pH, and volume of gastric contents in pediatric and adult patients. METHODS: This study was carried out with inpatients scheduled for elective surgery under general anesthesia. Sixty patients from 1 to 13 years old were included in the pediatric age group, and sixty patients from 18 to 60 years old were included in the adult age group. After induction of anesthesia and stabilization of the condition of the patient, gastric contents were collected via a 10 - 18 French Salem Sump tube. Gastric volume and pH were measured. RESULTS: The mean gastric volume in the pediatric group was significantly higher than those in the adult group, whereas, The mean gastric pH in the adult group was significantly higher than those in the pediatric group. CONCLUSIONS: We concluded that pediatric patients have a lower gastric pH but a higher gastric volume than adult patients.
Adolescent ; Adult* ; Anesthesia ; Anesthesia, General ; Child* ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Inpatients ; Lung ; Middle Aged

No abstract available.
Barium* ; Child* ; Humans ; Intussusception* ; Ultrasonography*

BACKGROUND: For anesthesia in cesarean section N2O and low concentrations of inhalation anesthetics are regarded as the anesthetic agent of choice. But a low level of anesthesia frequently leads to increased maternal hemodynamic responses and awareness. The effects of a 3 microgram/kg fentanyl bolus injection after umbilical cord clamping was evaluated in 20 full-term parturients, scheduled for elective cesarean section, versus to 20 parturients without fentanyl. METHODS: The forty parturients (ASA physical status 1, 2) scheduled for cesarean section were randomized to either a N2O-enflurane (E group) or a N2O-enflurane-fentanyl (F group). Thiopental sodium (4 mg/kg) and succinylcholine (1.5 mg/kg) were administered intravenously for the induction and endotracheal intubation. Anesthesia was maintained with 50% N2O and 1% enflurane in oxygen until delivery. After delivery, the intravenous injection of 0.5 mg/kg of atracurium was administered, controlled ventilation was applied to maintain PetCO2 at 30 to 35 mmHg with N2O (3 L/min) and O2 (1.5 L/min). Immediately after clamping the umbilical cord, 3 microgram/kg of fentanyl (F group only) was administered. Heart rate, blood pressure, awareness, recovery time, postoperative complication and recall were evaluated. RESULTS: Heart rate values at 10 and 20 min after umbilical cord clamping and 5 min after extubation, and mean arterial pressure at 5, 10 and 20 min after umbilical cord clamping in group F were found to be significantly lower than in group E. CONCLUSIONS: We conclude that N2O-enflurane-fentanyl at 3 microgram/kg is clinically satisfactory in anesthesia for cesarean section, having no adverse effects on the mother.
Anesthesia ; Anesthesia, General ; Anesthetics, Inhalation ; Arterial Pressure ; Atracurium ; Blood Pressure ; Cesarean Section* ; Constriction* ; Enflurane ; Female ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Injections, Intravenous ; Intubation, Intratracheal ; Mothers ; Oxygen ; Postoperative Complications ; Pregnancy ; Succinylcholine ; Thiopental ; Umbilical Cord* ; Ventilation

No abstract available.
Cytosine Deaminase* ; Cytosine* ; Genetic Therapy* ; Osteocalcin* ; Prostate* ; Prostatic Neoplasms*

OBJECTIVE: Density of the chronic subdural hematoma (cSDH) is variable. It often appears to be mixed density. Multiple densities of cSDH may result from multiple episodes of trauma. We investigated the frequency of mixed density and the causes of head injuries representing each density. METHODS: We could collect 242 cases of chronic SDH. The cSDHs were classified into four groups; hypodensity, homogeneous isodensity, layered type, and mixed type on the basis of CT scans. RESULTS: The density of cSDH was isodense in 115 patients, hypodense in 31 patients, mixed in 79 cases, and layered in 17 cases. The cSDH was on the left side in 115 patients, on the right side in 70 patients, and bilateral in 40 patients. The history of trauma was identifiable in 122 patients. The etiology could be identified in 67.7% of the hypodense hematomas, while it was obscure in 59.5% of the mixed hematomas. CONCLUSION: Mixed density of cSDH results from multiple episodes of trauma, usually in the aged. It is hard to remember all the trivial traumas for the patients with the mixed density cSDHs. Although there were membranes within the mixed density hematomas, burr-holes were usually enough to drain the hematomas.
Aged ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural, Chronic ; Humans

Acute neurologic deterioration is not a rare event in the surgical decompression for thoracic spinal stenosis. We report a case of transient paraparesis after decompressive laminectomy in a 50-yr-old male patient with multi-level thoracic ossification of the ligamentum flavum and cervical ossification of the posterior longitudinal ligament. Decompressive laminectomy from T9 to T11 was performed without gross neurological improvement. Two weeks after the first operation, laminoplasty from C4 to C6 and additional decompressive laminectomies of T3, T4, T6, and T8 were performed. Paraparesis developed 3 hr after the second operation, which recovered spontaneously 5 hr thereafter. CT and MRI were immediately performed, but there were no corresponding lesions. Vascular compromise of the borderlines of the arterial supply by microthrombi might be responsible for the paraparesis.
*Cervical Vertebrae/pathology/surgery ; Decompression, Surgical/adverse effects ; Humans ; Laminectomy/*adverse effects ; *Ligamentum Flavum/pathology/surgery ; *Longitudinal Ligaments/pathology/surgery ; Male ; Middle Aged ; *Ossification, Heterotopic ; Paraparesis/*etiology

OBJECTIVE: Chronic subdural hematoma (CSDH) is known to have a significant recurrence rate. There are different criteria defining the recurrence of CSDH. We evaluated the postoperative course of CSDH and tried to propose the reasonable criteria of recurrence. METHODS: We retrospectively examined the medical records and pre- and postoperative CT scans of 149 consecutive patients who underwent surgery from January 2005 to December 2009. Diagnosis was confirmed by CT scanning or MRI. The postoperative courses were either resolved or recurrent. The resolved CSDH was one of the three types; early resolution, delayed resolution, or late resolution. The recurrent CSDH was one of the four types; recurrence without resolution, early recurrence after resolution, late recurrence after resolution, or recurrent-and-resolved type. RESULTS: The CSDH was resolved within 30 days after surgery in 58 (39%) patients, between 1 to 3 months in 62 (42%), and after 3 months in 11 (7%) patients. The CSDH was recurred in 18 (12%) patients. Late resolution or recurrence was more common in the aged. The recurrent hematoma was seen on the same side in 11 patients, on the different side in 7 patients. Recurrence was significantly more common in the thick hematomas. CONCLUSION: For a working criteria of the recurrence of CSDH, we propose the early recurrence as return of symptoms or reaccumulation of the hematoma after a surgery within 3 months regardless of the location, amount or repeated operations. The late recurrence can be defined as reappearance or enlargement of a liquefied hematoma within the cranial cavity surrounded by the membranes or persistent CSDH beyond 3 months after surgery.
Aged ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural, Chronic ; Humans ; Medical Records ; Membranes ; Recurrence ; Retrospective Studies ; Risk Factors