No abstract available.

A procedure descried by Fontan and Baudet in 1971 successfully bypassed the right ventricle in Tricuspid Atresia patients, after then many modification of the Fontan operation had been described and applied to many cyanotic complex heart patients. Forty patients with a variety of cardiac malformation underwent the Fontan operation at Seoul National University hospital (September 1978 to June 1986). The age at operation ranged 2 months to 18 years. Each number of cases according to basic cardiac anomaly was as follows; 17 in Tricuspid Atresia, 17 in Univertricular Heart, 2 in Double outlet of Right Ventricle, 2 in Transposition of the Great Arteries and 2 in Criss-cross heart. Total mortality rate after the Fontan operation was 50%. There was only one late death (>30 days). Mortality rate under 4 years of age (67%) was higher than that between 4 and 18 years of age (40%). we observed a significantly higher mortality for patients who, in the immediate postoperative period, had central venous pressure greater than 25cm H2O. 45% among survivals did not require further medication. Although mortality rate after the Fontan operation is much higher than that in the foreign literature, operative mortality will decline with the increased expirence of surgeon and the effective patients selection.
Arteries ; Central Venous Pressure ; Crisscross Heart ; Fontan Procedure* ; Heart ; Heart Ventricles ; Humans ; Mortality ; Postoperative Period ; Seoul ; Tricuspid Atresia

A case of Factor V deficiency, the first case in Korea, is reported in a 9-year-old boy whose plasma concentration of Factor V was 6%. He complained of easy bruisability, prolonged bleeding from the mouth after minor trauma and hemarthrosis and flexion contracture of the right knee. His parents are heterozygous (maternal Factor V concentration 52%, paternal 40%).
Child ; Factor V Deficiency/*congenital ; Humans ; Male

As 8 year old boy with a tracheal cannula because of tracheal stenosia was admitted for tracheal raconstruction. The tracheal stenosis site was 2cm below the tracheal soma and 4cm above the carina. The stenotic area was 5mm in diameter and 1.5cm in length. After proper premedication, anesthesia was induced with intramuscular ketamine and maintained mainly with 0.1% ketamine intravenous drip infusion and supplemented by small amounts of muscle relaxants and N2O EKG, direct arterial pressure and arterial blood gas tensions were monitored during anesthesia. Tracheal segmental resection and reconstruction were performed without serious hypoxia and hypercarbia. Anesthetic management for possible risk during operation was discussed and the literature reviewed.
Anesthesia* ; Anoxia ; Arterial Pressure ; Carisoprodol ; Catheterization* ; Catheters ; Child* ; Electrocardiography ; Humans ; Infusions, Intravenous ; Ketamine ; Male ; Premedication ; Tracheal Stenosis*

No abstract available.
Child* ; Humans

The use of steroid preparations by the external route was first employed in 1953 by Lievre. Since then a number of similar series have been published which confirm the value of the method. The present study was carried out in Wonju Christian hospital over a 4 year period. Of a total of 141 patients complaining of back pain and sciatica were treated by epidural in-jection .of methyl-prednisolone acetate(Depo-Medrol). The results were encouraging and this treatment seems to be a valuable adjunct to the management of lumbosciatic syndrome.
Back Pain* ; Epidural Space* ; Gangwon-do ; Humans ; Sciatica*

To compare the first report of our anesthetic experiences with 16,457 Cases performed by the Department of Anerthesiology of Wonju Christian Hospital, Wonju Medical College, Yonsei University, from Nov. 1959 to Dec. 1977 which was published in 1980, the anesthetic experiences of 12,608 cases performed from Jan. 1978 to Dec. 1982 were analyzed, according to age, sex, department, physical status, emergency Procedureornotn, anesthetic agent, complication, and in addition, the ratio of medical insurance patients after enforcement of medical insurance patients. The results are as follows; 1) The number of cases receiving anesthesia tended, to increase year by year and the rate of increasi was remarkable for female patients. 2) Sexual distribution was 6049 males(48.0%), and 6559 females(52.0%). 3) 44.4% of patients were in the 2nd to 4th. decade of life and the patients over 60 years had increased markedly, 4) Among the departments General Surgery accounted for 30.7%, aner Obstetric sand Gynecology for 30.0%. 5) General anesthesia was use in 76.2% and regional anesthesia 23.8%. 6) The main anesthetic agent was halothane(47.9%). 7) Emergency operations were 37.6%, of the total. 8) Medical insurancs patients have increasied remarkably year by year. 9) Cardiac arrest in the operating room and the recovery room consisted of 4 cases. (0.032%).
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Emergencies ; Female ; Gangwon-do ; Gynecology ; Heart Arrest ; Humans ; Insurance ; Operating Rooms ; Recovery Room ; Silicon Dioxide

PURPOSE: This study was performed to examine the impact of gestational diabetes mellitus (GDM) on perinatal outcomes, especially macrosomia and metabolic complications in Korean women. Subjects and METHODS: We studied perinatal outcomes of 65 women with GDM who delivered a singleton infant and were not complicated by medical disease that might effect the fetal growth, 65 women with normal glucose tolerance were selected to match subject with GDM matched to age, height, and prepregnancy weight. RESULTS: 1) Mean birth weight in infants of mothers with GDM was significantly heavier than that in infants of control mothers, even though the delivery was almost one week earlier (3524 vs. 3364gm). 2) Although length and head circumference of infants were not different between 2 groups, chest circumference and Ponderal index were significantly higher in infants of mothers with GDM. 3) The frequencies of LGA infants and macrosomia were higher in GDM group, but frequency of prematurity was not different between 2 groups. 4) The proportion of disproportionate growth among macrosomic infants was significantly higher in GDM group. 5) In infants of mothers with GDM, the frequencies of LGA infants were not significantly different between 2 groups which were separated according to the fasting glucose level measured at the time of diagnosis. 6) In infants of mothers with GDM, the frequencies of hypoglycemia, polycythemia, hypocalcemia and hyperbilirubinemia were 21.5%, 18.5%, 3.1% and 33.8% respectively. When infants of mothers with GDM were divided to 2 groups (LGA, AGA), the frequencies of polycythemia and hyperbilirubinemia in LGA infants were higher than those in AGA infants (30.8 vs. 10.3% and 50.5 vs. 23.1%, respectively). 6) There was a significant positive correlation between Ponderal index and chest circumference/head circumference ratio (r=0.37, p<0.01). CONCLUSIONS: Inspite of tight metabolic control of mothers with GDM, perinatal complications, such as macrosomia, hypoglycemia, hyperbilirubinemia were frequent in infants of mothers with GDM. In case of infants of mothers with GDM, perinatal complication should be treated earlier or prevented by careful physical examination and intensive management.
Birth Weight ; Diabetes, Gestational* ; Diagnosis ; Fasting ; Female ; Fetal Development ; Glucose ; Head ; Humans ; Hyperbilirubinemia ; Hypocalcemia ; Hypoglycemia ; Infant* ; Mothers* ; Physical Examination ; Polycythemia ; Pregnancy ; Thorax