No abstract available.
Humans ; Infant* ; Korea*

No abstract available.
Humans ; Infant Formula* ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

Trigeminal neuralgia is characterized by recurrent episodes of intense lancinating pain affecting the face localized to the sensory supply areas of the trigeminal nerve. There is a lack of certainty regarding the etiology and pathophysiology of trigeminal neuralgia. The diagnosis of idiopathic typical trigeminal neuralgia requires the absence of clinically evident neurological deficit. Treatment must be individualized to each patient. Various trigeminal neural blockades can be options when medical therapy fails to relieve pain. Neural blockades include peripheral nerve branch blocks and intracranial nerve root or ganglion blocks such as RF thermocoagulation, percutaneous balloon compression and glycerol rhizolysis. Neural blockade with local anesthetics produces temporary effects, but neural blockade with neurolytics like alcohol lasts longer, around one or two years. They are very useful for patients with poor general condition or high risk. RF rhizotomy and balloon compression of trigeminal ganglion are relatively more invasive treatment options, but have more cost effectiveness with less serious complications compared to other surgical procedures. The continuous improvement of neural block techniques is necessary for better treatment of trigeminal neuralgia.
Anesthetics, Local ; Cost-Benefit Analysis ; Electrocoagulation ; Ganglion Cysts ; Glycerol ; Humans ; Peripheral Nerves ; Rhizotomy ; Trigeminal Ganglion ; Trigeminal Nerve ; Trigeminal Neuralgia

BACKGROUND: Balloon volume is a very important factor in microcompression of the gasserian ganglion. Up until now, the range of figures for balloon inflation volumes came from foreign data. Experience has shown that the optimal range of balloon inflation volumes is somewhat different in Korean patients. Our aim was to determine mean, minimal, and maximal volumes among Korean patients. METHODS: In each case balloon volume was measured when protrusion through the porus trigemini occurred. From a total of thirty-three cases seen over a one year period, thirty will be considered here. The remaining three were excluded because of unsuccessful outcomes due to improper positioning of the balloon. This resulted in extreme balloon volumes in these three cases. RESULTS: The values determined from this group of patients were as follows: the mean was 0.55 ml, the maximum was 1.0 ml, and the minimum was 0.35 ml. The mean was 0.75 ml for males and 0.50 ml for females. However due to differences in age and height, this variation in the mean was not statistically significant. CONCLUSIONS: Although a comparison of the mean values is not possible because it has never been reported before now in foreign articles, the balloon volumes measured in Korean patients are generally smaller than those reported from Europe and North America.
Europe ; Female ; Humans ; Inflation, Economic ; Male ; North America ; Trigeminal Ganglion* ; Trigeminal Neuralgia*

No abstract available.
China*

The advantage of the radiofrequency lesion method are presented, with excellent control of the lesion volume, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The presence of afferent fibers in the ventral root which are spared by dorsal rhizotomy suggested an explanation for the failure of this procedure. Nerve fibers with their cells in the ganglion from ventral root will be destructed with streotactic radiofrequency ganglionotomy. Since the dorsal root ganglion cells are more sensitive to than are other structures within the bundle, one is using a differential heat lesion to specifically affect pain pathways while leaving motor pathways. proprioception, and afferent input relatively intact. In the higher thoracic regions, the pleura can be injured when using an traditional approach. Hence in the upper thoracic region(T2-T9), this type of approach requires that a small burr-hole be made at the superior aspect of the corresponding thoracic zygapophyseal joint. Stereotactic thoracic dorsal root ganglionotomy have carried out under local anesthesia on an inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have treated with stereotactic radiofrequency lesioning of the thoracic dorsal root ganglion. Four out of these 6 patients have been relieved of pain without serious complications. I think this should be a good armamentarium to the pain therapists in the management of intractable pain. (Korean J Anesthesiol 1997; 32: 857~862)
Anesthesia, Local ; Efferent Pathways ; Electrodes ; Fractures, Compression ; Ganglia, Spinal ; Ganglion Cysts ; Hot Temperature ; Humans ; Inpatients ; Nerve Fibers ; Pain, Intractable ; Pleura ; Proprioception ; Rhizotomy ; Spinal Nerve Roots ; Zygapophyseal Joint

There are many surgical alternatives to medical therapy for trigeminal neuralgia. Among open procedures, Jannetta's procedure for microvascular decompression have widest favor. But there is no justification for exposing patients to such dangers when there are effective and safe alternatives such as percutaneous procedures. Of the percutaneous procedures, the most widely used are thermocoagulation, glycerolization, and microcompression of the gasserian ganglion. Percutaneous microcompression of the gasserian ganglion was introduced by Mullan in 1978 and its description was published in 1983. In the 1950's and 1960's deliberate compression of the gasserian ganglion was performed through an open operation. Mullan carried out this precedure using an inflatable balloon under brief anesthesia. 15 procedures were performed under brief general anesthesia in order to ensure maximum comfort for the patient in the operating room. The instruments consisted of a 14 gauge blunt tip needle, a 4F Fogarty catheter and a tuberculin syringe. The compression was maintained usually for 1 to 1.5 minutes. 14 out of 15 patients were relieved from their pain without serious complications.
Anesthesia ; Anesthesia, General ; Catheters ; Electrocoagulation ; Glycerol ; Humans ; Microvascular Decompression Surgery ; Needles ; Operating Rooms ; Syringes ; Trigeminal Ganglion ; Trigeminal Neuralgia* ; Tuberculin

Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.
Agranulocytosis ; Antithyroid Agents ; Depressive Disorder ; Drug Therapy ; Goiter* ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Lithium Carbonate* ; Lithium* ; Mass Screening ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis ; Thyroxine

The endotracheal silicon T-tube may be place both as a tracheostomy and as a splint to maintain the shape of the reconstructed airway during the healing process. For intermittent positive pressure ventilation throughout the side arm of the T-tube, the upper limb must be obstructed to prevent gases from escaping through the pharynx. Thus anesthesiologists should be aware of the special problems of establishing an airway through a tracheal T-tube. We recently experienced a case of anesthesia using an urinary drainage catheter which was inserted endotracheally to prevent gases from escaping through the upper limb or a T-tube under the laryngoscopy in a patients with a tracheal T-tube stent. We recommended the use of an urinary drainage catheter to facilitate positive pressure ventilation in patients with tracheal T-tube.
Anesthesia* ; Arm ; Catheters* ; Drainage* ; Gases ; Humans ; Intermittent Positive-Pressure Ventilation ; Laryngoscopy ; Pharynx ; Positive-Pressure Respiration ; Silicones ; Splints ; Stents* ; Tracheostomy ; United Nations ; Upper Extremity

Although the incidence of partial-thickness rotator cuff tears (PTRCTs) was reported to be from 13% to 32% in cadaveric studies, the actual incidence is not yet known. The causes of PTRCTs can be explained by either extrinsic or intrinsic theories. Studies suggest that intrinsic degeneration within the rotator cuff is the principal factor in the pathogenesis of rotator cuff tears. Extrinsic causes include subacromial impingement, acute traumatic events, and repetitive microtrauma. However, acromially initiated rotator cuff pathology does not occur and extrinsic impingement does not cause pathology on the articular side of the tendon. An arthroscopic classification system has been developed based on the location and depth of the tear. These include the articular, bursal, and intratendinous areas. Both ultrasound and magnetic resonance image are reported with a high accuracy of 87%. Conservative treatment, such as subacromial or intra-articular injections and suprascapular nerve block with or without block of the articular branches of the circumflex nerve, should be considered prior to operative treatment for PTRCTs.
Cadaver ; Incidence ; Injections, Intra-Articular ; Magnetic Resonance Spectroscopy ; Nerve Block ; Rotator Cuff ; Tendons