Background: Gastric juice volume and acidity are influenced by food, drugs, and patient factors such as age, sex, weight, and fasting time. But almost studies were performed without controlling of these confounding variables. This study was designed to determine the change of gastric juice volume and acidity in relation to the fasting time within a constant food intake. Methods: Fifty-seven healthy patient randomly allocated to one of two groups. Group I was instructed to ingest 200 ml of milk up to 8 hours before anesthesia and Group II was instructed to drink 200 ml of water up to 1~2 hours before anesthesia. After the endotracheal intubation the volume and acidity of gastric juice were measured. Relationships between gastric volume or acidity and fasting time were analysed using correlation analysis. The data were analyzed using Wilcoxon rank sum test, comparing Group I with Group II. Results: There is no significant relationship between gastric juice volume or acidity and the fasting time within the same food intake. Gastric juice volume and acidity of the patients who ingested milk at 8~9 hours before anesthesia were similar to that of those patients who drank water at 1~2 hours before anesthesia. Conclusion: It is necessary to individualize the fasting time of the patients and it seems that water ingestion up to 1~2 hours before anesthesia may be safe.
Anesthesia ; Confounding Factors (Epidemiology) ; Eating ; Fasting* ; Gastric Juice* ; Humans ; Intubation, Intratracheal ; Milk ; Water

No abstract available.
Adenocarcinoma, Papillary*

The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

Dermatofibroma with granular cells is composed mainly of spindle shaped cells mixed with in-conspicuous foamy cells that contain granular cytoplasm. We present a case of dermatofibroma with granular cells in a 36-year-old male who visited our clinic to evaluate a slow-growing nodule on the medial side of the left lawer leg. He have had the nodule for five years and sometimes felt an itching sensation. Biopsy of the nodule identified a dermal nodular tumor showing cellular spindle cell proliferation admixed with peripheral foamy histiocytes. With the immunohistochemical staining, the granular cell was positive for alpha-1-antitrypsin and CD68, and negative for S-100. A few electron-dense granules were seen in the cytoplasm on the electronmicroscopic study. These results suggested that the granular cells originated from histiocytes.
Adult ; Biopsy ; Cell Proliferation ; Cytoplasm ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Leg ; Male ; Pruritus ; Sensation

No abstract available.
Heart Valve Prosthesis* ; Heart Valves*

BACKGROUND: High Frequency Jet Ventilation(HFJV) has been applied safely to microlaryngeal endoscopic surgery(MES) via 14-16 gauge angiocath which is located around the carina. If HFJV is applied via the injection cannula of the Weerda distending operating laryngoscope(Weerda laryngoscope) which is located in 10cm above the vocal cord, complications associated with intubation and airway firing during laser surgery can be minimized. But increased dead space is expected. OBJECTIVES: We observed arterial blood gas changes after HFJV to determine how increased dead space influence arterial blood gases. MATERIALS AND METHODS: Eighteen patients scheduled for MES were studied. We analyzed arterial blood gases at just before HFJV, 5, 10, 15 and 20 minutes after HFJV and 15 minutes after postanesthetic recovery room(PAR) arrival. Complications were also evaluated via physical examination and chest X-ray films. RESULTS: 1) All arterial oxygen tensions during HFJV with 100% oxygen(we do not have exact inspired oxygen fraction because of Venturi effect.) were above 200 mmHg. 2) Arterial carbon dioxide tension at 5 and 10 minutes after HFJV were significantly(p<0.05) greater than arterial carbon dioxide tension before HFJV. Statistical analysis was not performed due to small number of case(N=4, 3) at 15 and 20 minutes after HFJV, but progressive increasing tendency of arterial carbon dioxide tension was observed. 3) Complications such as mild abdominal distension, hypercarbia and moderate mucosal dryness were observed. CONCLUSION: HFJV via the injection cannula of Weerda laryngoscope can be used with caution such as prevention of hypercarbia.
Carbon Dioxide ; Catheters ; Fires ; Gases* ; High-Frequency Jet Ventilation* ; Humans ; Intubation ; Laryngoscopes* ; Laser Therapy ; Oxygen ; Physical Examination ; Thorax ; Vocal Cords ; X-Ray Film

An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.
Epidermal Cyst*

Candida is a saprophytic fungus in the human host. However, in an immune- suppressed host, the organism can become pathogenic. The most common site of end organ involvement in premature infants with candidemia is the kidneys. A conglomeration of fibrillar hyphae results in fungus balls, which may cause a urinary tract obstruction and acute renal failure in premature infants. We recently experienced two cases of premature infants who had fungus balls in their urinary tracts. They were treated successfully with percutaneous nephrostomy, in combination with antifungal agents.
Acute Kidney Injury ; Antifungal Agents ; Candida ; Candidemia ; Candidiasis* ; Fungi ; Humans ; Hyphae ; Infant ; Infant, Newborn ; Infant, Premature* ; Kidney ; Nephrostomy, Percutaneous ; Urinary Tract

No abstract available.
Meningitis*

No Abstract Available.
Churg-Strauss Syndrome*