Since in 1963 Waters first described the techniques of guiede blind tracheal intubation to solve the problem of difficult in airway maintenance in patients who have deformity of the upper jaw, several methods are recommended to overcome a difficult intubation. We experienced successful retrograde endotracheal intubation without significant complications as follows. Using loca anethesia, 16G Tuohy needle was passed through the anterior wall of the trachea 1.5 to 2.0 cm below the cricoid cartilage in the midline. The needle was directd upward foward the larynx and the epidural catheter was insertedc through it and advanced retrograde between the vocal cords and into mouth or nose. The endotracheal tube was threaded over the catheter and the proximal end of the catheter was clamps by kelly forceps. By keeping the catheter taut and coincidently pulling back, the tube was adnvanced in to trachea.
Catheters* ; Congenital Abnormalities ; Cricoid Cartilage ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Larynx ; Mouth ; Needles ; Nose ; Surgical Instruments ; Trachea ; Vocal Cords

Since in 1963 Waters first described the techniques of guiede blind tracheal intubation to solve the problem of difficult in airway maintenance in patients who have deformity of the upper jaw, several methods are recommended to overcome a difficult intubation. We experienced successful retrograde endotracheal intubation without significant complications as follows. Using loca anethesia, 16G Tuohy needle was passed through the anterior wall of the trachea 1.5 to 2.0 cm below the cricoid cartilage in the midline. The needle was directd upward foward the larynx and the epidural catheter was insertedc through it and advanced retrograde between the vocal cords and into mouth or nose. The endotracheal tube was threaded over the catheter and the proximal end of the catheter was clamps by kelly forceps. By keeping the catheter taut and coincidently pulling back, the tube was adnvanced in to trachea.
Catheters* ; Congenital Abnormalities ; Cricoid Cartilage ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Larynx ; Mouth ; Needles ; Nose ; Surgical Instruments ; Trachea ; Vocal Cords

We report a case of Hunter' s syndrome with characteristic nodules on the upper back. The patient was a 7-year-old Korean boy who presented with ivory-colored papules and nodules on both sides of the scapula, pectoral regions and lateral aspects of the upper arms. These lesione are regarded as pathognomonic cutaneous markers for Hunter s syndrome. He also presented with truncal hypertrichosis, retarded growth, short neck, round face, claw like contractures of hands, multiple joint contractures, and a clear cornea. Severely elevated glycosaminoglycan levels were present in the patient s urine samples. The patient s 5-year-old brother had similar clinical features.
Animals ; Arm ; Child ; Child, Preschool ; Contracture ; Cornea ; Hand ; Hoof and Claw ; Humans ; Hypertrichosis ; Joints ; Male ; Mucopolysaccharidosis II* ; Neck ; Scapula ; Siblings

To understand the role of Transglutaminase K(TGase K) in skin diseases, the expression of TGase K protein was studied in hyperkeratotic inflammatory skin diseases, and in several different kinds of benign and malignant skin tumors. Immunohistochemistry was used to detect the TGase K protein with a new anti-human TGase K polyclonal antibody. This antibody showed the same immuno- histochemical staining pattern as in previously published immunofluorescence data with the exception that the immunohistochemical stain showed a slightly weaker stain in the granular layer. However, the staining intensity was decreased in psoriasis, which is opposite for results obtained with the widely used TGase K monoclonal antibody B.C1. In other hyperkeratotic inflammatory skin diseases, like pityriasis rubra pilaria, lichen planus, and pityriasis rosea, the staining patterns were similar while the staining intensity was decreased, compared to normal epidermis. Squamous cell carcinoma showed a diffuse staining pattern in tumor cells with a small intensity increase in well differentiated tumor cells. However, in actinic keratosis and Bowen's disease, which are thought to be precursors of squamous cell carcinoma, the staining intensity was weak. The tumor cells of basal cell carcinoma, malignant melanoma, and seborrheic keratosis showed a weak staining intensity.
Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epidermis ; External Fixators ; Fluorescent Antibody Technique ; Immunohistochemistry ; Keratosis, Actinic ; Keratosis, Seborrheic ; Lichen Planus ; Melanoma ; Pityriasis ; Pityriasis Rosea ; Psoriasis ; Skin Diseases* ; Skin*

This study was designed to investigate the variation of mandibular pattern and cranial base and their association in the craniofacial malocclusion. The material was the 165 cephalometric radiographs taken from craniofacial malocclusion. The sample was devided into two groups by age child group aged from 10 to 13 years and adult group aged over 18 years, and each group was devided into 3 types of malocclusion, class I, Class II div. 1 and Class III malocclusion. Child group consist of 35 samples and adult group consist of 20 samples in each malocclusion type. Various angular and linear measurements on the cephalometric radiographs were recorded and statistically analyzed. The results of the study were as follows, 1. The cranial base angle was largest in Class II div, 1 malocclusion and smallest in Class III malocclusion 2. The anterior cranial base length was largest in Class II div 1 malocclusion but posterior cranial base length did not show statistical difference 3. The mandibular body length of Class III malocclusion was larger than those of Class I and Class II div 1 malocclusion in the adult group but did not shown difference in the child group. The ramus height of Class III malocclusion was larger than those of Class I and Class II div 1 malocclusion in the child and adult group, but there were no difference between Class I and Class II div, 1 malocclusion. 4. The mandibular position was showed low correlation with the cranial base angele.
Adult ; Child ; Humans ; Malocclusion* ; Skull Base*

No abstract available.
Humans ; Recurrence*

Rhino-orbito-cerebral muconnycosis is an uncommon fatal fringal infection, almost exclusively seen in diabetic or other itnmunocompromised patients. Recurrent transient ischemic attacks(TIAs) as initial presenting sign of rhino-orbito-cerebral mycormycosis has not been reported to our knowledge. We report a patient with muconnycosis unusually presenting with recurrent TIAs, followed by central retinal artery occlusion, multiple cranial nerve palsies, and then cerebral infarction in the territory of middle cerebral artery.
Cerebral Infarction ; Cranial Nerve Diseases ; Humans ; Middle Cerebral Artery ; Mucormycosis* ; Retinal Artery Occlusion

Spinal anesthesia has been widely used for operations performed in the lower abdomen, inguinal regions, lower extremities, and perineum. When patient have aevere systemic disease and a full . stomach, spinal anesthesia is may be more safe than general aneethesia. Bradycardia and hypotension have been accepted to be the most common complications in cardio-vascular system during spinal anesthesia. The mechanisms are a decrease in total peripheral vascular resistance, a decrease in cardiac output or a combination of both. Accessory factors include bradycardia resulting from block of accelerator impulses to the heart or decrease in endogeneous release of norepinephrine from sympathetic nerve endings, thereby reducing myocardial contractility. We report 2 cases of sudden extreme bradycardia and hypotension in patients who had received spinal anestesia. Although the exact pathophysiology of this phenomenon is unknown, the etiology is probably vagal effect. Thus the patient who receives spinal anestbesia should be required constant monitoring and vigilance throughout all procedures.
Abdomen ; Anesthesia, Spinal* ; Bradycardia* ; Cardiac Output ; Heart ; Humans ; Hypotension* ; Lower Extremity ; Nerve Endings ; Norepinephrine ; Perineum ; Stomach ; Vascular Resistance

No abstract available.
Acrocephalosyndactylia*

Malignant hyperthermia is an inherited disorder of skeletal muscle, characterized by temperature elevation, muscle destruction, muscle rigidity and high oxygen consumption, etc. It is triggered by anesthetic agents, usually potent inhalation anesthetics and succinylcholine. It is fatal in the majority of cases unless early diagnosis andtreatment are performed. We experienced a case of malignant hyperthermia after general anesthesia with succinylcholine and halothane. The case is presented of an 11 year old male weighing 35.5kg. He had developed the strabismus one year prior, but he was relatively healthy and had no considerable past or family history. He underwent surgery for correction of the strabismus under N2O-O2-halothane anesthesia with induction by thiopental and succinycholine. Approximtely 25 minutes after induction tachycardia developed, followed by severe arrhythmia with unstable BP, temperature elevation and cyanosis. About 30 minutes after induction, anesthesia was stopped and aggressive emergency management was performed. Unfortunately, the patient died 4 hours and 30 minutes after induction. We discuss this case and review the history, incidence, etiology, pathophysiology, symptoms, diagnosis, pervention and treatment.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Child ; Cyanosis ; Diagnosis ; Early Diagnosis ; Emergencies ; Halothane ; Humans ; Incidence ; Male ; Malignant Hyperthermia ; Muscle Rigidity ; Muscle, Skeletal ; Myasthenia Gravis* ; Oxygen Consumption ; Strabismus ; Succinylcholine ; Tachycardia ; Thiopental ; Thymectomy*