The authors have experienced with two cases of acute pulmonary edema; one underwent an intestinal resection under local anesthesia for panperitonitis due to typhoid perforation, and the other under general anesthesia received splenectomy and mesocaval shunt for portal hypertension and splenomegaly. There are many predisposing factors for acute pulmonary edema, namely, left sided heart failure due to cardiac diseases or overloading, pulmonary capillary endothelial damages from bacterial infections, toxins or irritant gases, oxygen poisoning, water (especially salt water) drowning, rarely central nervous system injuries and pulmonary hypersensitivity reactions. For the cases presented, we believe that overloading was the causative factor. There are many preventive measures and treatment for acute pulmonary edema. However in such cases as these, we conclude that prompt recognition and attention by the anesthesiologisis are the most important preventive measure.
Anesthesia* ; Anesthesia, General ; Anesthesia, Local ; Bacterial Infections ; Capillaries ; Causality ; Central Nervous System ; Drowning ; Gases ; Heart Diseases ; Heart Failure ; Hypersensitivity ; Hypertension, Portal ; Oxygen ; Poisoning ; Pulmonary Edema* ; Splenectomy ; Splenomegaly ; Typhoid Fever ; Water

Ever since Mixter and Barr demonstrated the relationship between disk protrusion and radicular pain nearly 50 years ago, there has been a swing toward mechanical explanations for all problems of this type. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that the causal irritant is likely to be a chemical product of disk degeneration. That administration of steroids reduces the inflammatory process is well known. The present study was undertaken to acess our experience in using epidural steroid injection ofr patients suffering from diskogenic low back pain. Ten patients with the clinical diagnosis of sciatica and with post larninectomy sequelae were referred to the anesthesia department of Maryknoll hospital. Our routine epidural injection of the lumbar spine(L3-4) consists of 2ml of 2% xylocaine and 120mg of methylprednisolone(Depo medrol). Following the injection of Depo Medrol patients were encouraged to ambulate actively and were asked to evaluate their subsequent pain relief. Of the 10 patients studied, all patients experience pain relief within 10 minutes of the epidural injection. A follow up study of these patients was done between 5 and 10 months after injection. The results were as follows: 1) 3 patients: Complete relief. 2) 3 patients: moderate relief. 3) 3 patients: no relief. 4) 1 patient: technical failure.
Anesthesia Department, Hospital ; Back Pain ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Injections, Epidural ; Intervertebral Disc Degeneration ; Lidocaine ; Low Back Pain ; Methylprednisolone ; Sciatica ; Steroids*

To evaluate the maternal and fetal effects of propanidid, clinical observations were carried out in 160 cases of Cesarean section out of 4, 230 deliveries made during the past three years. Upon having the obstetricians ready for incision, 10ml. of 5 per cent propanidid and 40mg. of succinylcholine chloride were administered intravenously, and surgery was begun almost simultaneously with endotracheal intubabation. Thereafter, anesthesia was maintained with N2O-O2-fluothane, N2O-O2 -ether, or ether-O2 in semiclosed circle absorption system. Umbilical cord was ligated within 3-5 minutes after the commencement of induction. This method of anesthesia did not seriously affect the maternal respiration or circulation, and Apgar scores were good or fair in the majority of cases. No undesirable side effects or complications directly attributable to propanidid were encountered.
Absorption ; Anesthesia ; Anesthesia, General* ; Cesarean Section ; Female ; Methods ; Pregnancy ; Propanidid* ; Respiration ; Succinylcholine ; Umbilical Cord

A total of 18,413 cases had anesthesia at Maryknoll Hospital in Pusan from January 1970 to December 1979. These data were analyzed statistically and the following results were obtained. 1) The number of general anesthesia cases steadily increased while those of local anesthesia decreased. 2) Of all departments, general surgery had the largest number of cases. 3) Sex ratio was equal when the OB-GYN cases were included. 4) The 20-30yr age group numbered nearly the total number of cases. 5) Geriatric and pediatric cases increased progressively. 6) Among anesthetic agents used, ether was used mostly, but halothane was used with increasing frequency. 7) Of the anesthetic techniques used in general anesthesia, the circle system was mostly used and the non-rebreathing system was used for all pediatric cases, which also have increased in number. 8) For induction of anesthesia, thiopental sodium was mainly used. Since 1975, pancuronium was mainly used in addition to S.C.C. fro muscle relaxation.
Anesthesia* ; Anesthesia, General ; Anesthesia, Local ; Anesthetics ; Busan ; Ether ; Halothane ; Humans ; Muscle Relaxation ; Pancuronium ; Sex Ratio ; Thiopental

Thirty consecutive anesthesia records of transurethral resection (TUR) have been reviewed. Patient's physical status, anesthetic management and complications were also discussed. Operations in this series were classified as follows: 25 cases of TUR for carcinoma of the prostate, 3 cases of bladder tumor. In all the thirty cases of TUR, circulatory diseases, such as hypertension were encountered most frequently. (10 cases) The patients had the highest mean age(66.5 years old) and their physical status was almost all ASA class II or III. Hypotension occurred in 1 patient during TURP. There was no death associated with anesthesia and operation in this study. Pain control after operation with epidural block was satisfactory in nearly all cases. Continuous epidural anesthesia for TUR and pain control after operation was desirable.
Anesthesia ; Anesthesia, Epidural* ; Humans ; Hypertension ; Hypotension ; Pain, Postoperative* ; Prostate ; Transurethral Resection of Prostate ; Urinary Bladder Neoplasms

The following is a report of the anesthetic experience in the surgical management of two cases of surgery for pheochromocytoma performed at Maryknoll Hospital, Busan, between the dates of June and July, 1982, The report covers the pre-surgical tests and the laboratory results on the two cases, which was similar, and the anesthetic agents halothane and enflurane, was used on the cases, respectively. During surgery using the anesthetic agent halothane, which was chosen because of the high blood pressure of the patient, and our effect to control it, we encountered dangerous arrythmia. In the case where enflurane was the anesthetic agent uaed, it was found that while the blood pressure of the patient was more difficult to control, the incidence of arrythmias was much less frequent. In one of the cases, becsuse of hemorrhage from the operative site during the immediate surgical period, re-exploration was done with adequate replacement of whole blood and catecholamines administered as needed during the anesthetic management. In comparing the two cases, the one case in which alpha-sdrenergic blockers were not administered during the pre-surgical period, when compared with the case in which the the blockers were used, showed, after removal ef the tumor, a decrease in the need for alpha-adrenergic stimulators.
Anesthesia* ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Busan ; Catecholamines ; Enflurane ; Halothane ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Pheochromocytoma*

Spinal hemangioma is the uncommon, slowly growing benign tumor that arises from the blood vessels and commonly located in thoracic spine. We have recently experienced a caseof capillary Hemangioma in intradural extramedullary space of thoracic spine level. The patient presented with a slowly progressive weakness of both lower extremities and hypesthesia below T6 dermatome. The plain X-ray films, thoracic spine myelography and CT scan disclosed an intradural mass at T5 level. The mass was surgically removed and conformed by histological examination.
Blood Vessels ; Capillaries* ; Hemangioma ; Hemangioma, Capillary* ; Humans ; Hypesthesia ; Lower Extremity ; Myelography ; Spine ; Tomography, X-Ray Computed ; X-Ray Film

PURPOSE: Inter-arm blood pressure differences of more than 10 mmHg are measured not only in patients who have vascular diseases, such as aortic dissections, and aortic aneurysms, but also in heathy patients. We investigated the degree of and the factors for normal inter-arm blood pressure variations in our country. METHODS: We prospectively studied the cases of 351 patients who visited the Emergency Department of Korea University Hospital between May 1 and July 31, 2001. we collected clinical and demographic data, including age, sex, right/left handedness, and bilateral blood pressure. After we divided the cases into a Normal blood pressure group and a High blood pressure group, we compared the inter-arm blood pressure difference and influencing factors between the two group. RESULTS: The variation in the inter-arm blood pressure was unrelated to age, sex, right/left handedness, and right/left arm in both groups. In the Normal blood pressure group (n=180), the systolic inter-arm blood pressure difference was 3.9+/-0.4 mmHg, and the diastolic inter-arm blood pressure difference was 3.6+/-0.4 mmHg. In the High blood pressure group (n=171), the systolic inter-arm blood pressure difference was 5.2+/-0.5 mmHg, and the diastolic interarm blood pressure difference was 4.8+/-0.5 mmHg. CONCLUSION: The variation in the inter-arm blood pressure was unrelated to age, sex, right/left handedness, and right/left arm. But inter-arm blood pressure difference was significant among subjects without exclusion criteria and was measured as about 5 mmHg in two groups.
Aortic Aneurysm ; Arm* ; Blood Pressure* ; Emergency Service, Hospital ; Functional Laterality ; Humans ; Hypertension ; Korea ; Prospective Studies ; Vascular Diseases

OBJECTIVES: We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. METHODS: Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1: 1. Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test. RESULTS: Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, and systolic blood pressure. From multivariate regression analysis, there was significant difference (p< 0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. CONCLUSIONS: We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier detection for neurological abnormality in lacunar infarction.
Blood Pressure ; Case-Control Studies* ; Cerebrovascular Disorders ; Drinking ; Education ; Female ; Humans ; Magnetic Resonance Imaging ; Multivariate Analysis ; Reaction Time ; Seoul ; Stroke, Lacunar*

Hypertensive intracerebral hematoma is a serious and potentially lethal condition. The indication of surgery in this hematoma is still controversial. Authors have treated 335 cases of hypertensive intracerebral hematomas which were confirmed by computerized tomography between July 1, 1982 and June 30, 1986. The hematomas have been classified according to their modes of extension on computerized tomography. The outcome was assessed on their basis of activity daily living. According to our study, moderate and severe types of putaminal hematoma cases have shown better results with surgery than conservative management. Mortality was 23.7 percent in surgery and 35.3 percent in conservative management.
Hematoma* ; Mortality ; Putaminal Hemorrhage