We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
Cysts

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

PURPOSE: It is known that single umbilical artery is frequently associated with gastrointestinal or urogenital anomaly, however, routine renal sonography has been debated in healthy neonate with isolated single umbilical artery. This study is designed to determine the usefulness of routine renal sonography in apparently healthy infants with an isolated single umbilical artery. METHODS: Thirty healthy neonates with a single umbilical artery without a major anomaly from January 1995 to July 2002 were enrolled. The authors investigated the clinical background of babies and their mothers after renal sonography after 72 hours of age. When the abnormalities were found at the first renal sonography, the severity of hydronephrosis and degree of obstruction and renal function were analyzed by follow up renal sonography, voiding cystourethrography(VCUG) and technetium-99m-dimercaptosuccinic acid(DMSA) scan or technetium-99m-mercaptoacetyl-triglycerine (MAG3) scan. RESULTS: Among the 30 healthy patients with isolated single umbilical artery, five patients(16.7%) showed abnormalities on first renal sonography with one major(3.3%) and four(13.4%) minor renal anomaly(minimal or mild hydroneohrosis). One major renal anomaly(severe hydronephrosis) showed severe decreased renal function on MAG3 scan without reflux, and the other four minor regressed spontaneously on follow up study. CONCLUSION: The value of routine early renal sonograpy for detecting renal anomaly in healthy infants with an isolated single umbilical artery remained unclear because most of the anomalies would regress spontaneously in the follow up study.
Follow-Up Studies ; Humans ; Hydronephrosis ; Infant* ; Infant, Newborn ; Mass Screening* ; Mothers ; Single Umbilical Artery*

No abstract available.
Heart Septal Defects, Atrial*

No abstract available.
Appendicitis* ; Child* ; Humans

BACKGROUND: Postoperative pain after a spinal laminectomy has very harmful effects on human physiology, and many people are trying to control it more easily and safely. There are controversies in methods used for controlling postoperative pain after a spinal laminectomy. The purpose of this study was to examine an effective way to control postoperative pain after a spinal laminectomy. METHODS: Ninety patients (ASA I-II, aged 40 to 70) scheduled for a spinal laminectomy were divided into three groups. In group A, we administered fentanyl 1,000 microgram and morphine 5 mg (mixed in 0.9% normal saline) using the continuous epidural infuser; in group B, we administered fentanyl 500 microgram and morphine 5 mg and 0.25% bupivacaine (mixed in 0.9% normal saline) using the continuous epidural infuser; in group C, we administered fentanyl 1,500 microgram and morphine 10 mg (mixed in 0.9% normal saline) using the continuous IV infuser. We compared effects between the continuous epidural infusion and the continuous intravenous infusion by using the visual analogue scale and side effects. RESULTS: There was no significant difference between continuous epidural infusion groups. When the continuous epidural infusion groups and the continuous IV infusion group were compared, there were significant differences in 3 hr, 6 hr, and 12 hr VAS scores (P < 0.01). The incidence of side effects was very low, and there was no significant difference in side effects between the continuous epidural infusion and the continuous IV infusion groups. CONCLUSIONS: It was found that continuous epidural infusion methods were more effective than the continuous IV infusion method, but none of them showed satisfactory postoperative pain control in the early periods.
Bupivacaine ; Fentanyl ; Humans ; Incidence ; Infusions, Intravenous ; Laminectomy* ; Morphine ; Pain, Postoperative ; Physiology

The thyroid nodules are the most frequent encountered disorders of the endocrine system. A clinical study of 34 cases with thyroid nodules, which were treated by surgical excision and confirmed pathologically at the department of otolaryngology-head and neck surgery, Kon-Kuk University hospital, from January 1990 to July 1995, was conducted. This study was designed for early diagnosis and proper treatment of thyroid nodules through clinical analysis. The clinical analysis results were obtained as follows: 1) The sexual distribution showed the preponderance of female with 1:5.8. 2) The most prominent sign was palpable nodule on anterior neck. 3) The duration of illness within 3 months was most common(51.5%), and the size of thyroid nodules was parallel to the duration of illness. 4) Most nodules were unilateral in 29/34(85.2%), among them, right lobe in 47%, lower lobe in 38.2%. 5) The consistency of nodules was soft in 12 cases(31.5%) and most nodules were single in 26 cases(76.4%). 6) Fine needle aspiration biopsy showed consistent with surgical result in 13/19 cases(70%) at benign nodules and in 3/4 cases(75%) at malignant nodules. 7) The histopathologic classification of benign diseases in decreasing order of the frequency were adenomatous goiter, 17.28 cases(60.7%); follicular adenoma, 7/28 cases(25%); Graves' disease, 0 cases. The malignant diseases were papillary carcinoma, 6/6 cases(100%). 8) The frequent performed operative procedure was unilateral lobectomy 28/34(82.3%) in both benign and malignant disease. 9) The postoperative complication occured in 12/34 cases(35.2%) including 5 cases of mild dysphagia(14.7%) and 2 cases of transient hoarseness(5.8%) and 1 case of hypocalcemia(2.9%) and 1 case of ecchymosis(2.9%) in wound and were related to the extent of the surgical procedure.
Adenoma ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Classification ; Early Diagnosis ; Endocrine System ; Female ; Goiter ; Graves Disease ; Humans ; Neck ; Postoperative Complications ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Nodule* ; Wounds and Injuries

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.
Adult* ; Anesthesia ; Eating* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Risk Factors ; Water*

A case of Isaacs syndrome with Trousseau s phenomenon wac studied electrophysiologically and histologically. The needle electromyography showed typical neuromyotonic discharges of spontaneous recurrent high-frequency(150-300Hz) bursts of motor unit activity with 0.5-3 second of duration and typical waning pattern This discharge was not suppressed by brachial plexus block Motor and sensory nerve conduction velocities were either s!ightly below or in the lower range of normal. In repetitive nerve stimulation test a decremental response to low rate stimulation was noted in abductor digiti quinti muscle. On sural nerve biopsy, there was a decrease in the number of myelinated nerve fibers showing both axonal and myelin degeneration The clinical and electrophysiologic abnormalities improved considerably after treatment with phenytoin.
Axons ; Biopsy ; Brachial Plexus ; Electromyography ; Isaacs Syndrome* ; Myelin Sheath ; Needles ; Nerve Fibers, Myelinated ; Neural Conduction ; Phenytoin ; Sural Nerve

Female ; Pregnancy ; Pregnancy, Ectopic*