OBJECTIVETo investigate the middle and distal circum peeling with bleeding control technique for redundant prepuce.

METHODSThe middle and distal part of prepuce was circum peeled with bleeding control and electrical scalpel. More preputial inner plate was reserved.

RESULTSFrom January 2004 to July 2008, 51 patients with redundant prepuce were treated with this procedure. The average blood loss was 1 to approximately 2 ml with minimal edema. The proportion of inner and outer plates was suitable.

CONCLUSIONSThis technique has the advantages of minimal blood loss and slight edema. The cosmetic result is also satisfactory.

Adolescent ; Adult ; Blood Loss, Surgical ; prevention & control ; Child ; Child, Preschool ; Circumcision, Male ; methods ; Humans ; Male ; Middle Aged ; Premedication ; Young Adult

OBJECTIVES: To identify the optimal pharmacological method of preparing patients for nasal endoscopy. METHODS: Twenty healthy volunteers were enrolled in this prospective, randomized, double-blind study. Four types of medications were applied in their nostrils with binary combinations of spray bottles on four different days in a random order: placebo (normal saline [NS]+NS), decongestant (NS+oxymetazoline), anesthetic (NS+lidocaine), and decongestant plus anesthetic (oxymetazoline+lidocaine). Rigid nasal endoscopy was performed 10 minutes after spray application. The volunteers evaluated the discomfort caused by each spray application, and nasal pain scores due to the passage of the endoscope. The physicians quantified nasal decongestion using a visual analogue scale. Endoscopy duration as well as pulse and mean blood pressure (MBP) before spray application, 10 minutes after the application, and immediately after endoscopic examination were also recorded. RESULTS: The discomfort caused by lidocaine was significantly higher than that caused by the other sprays (P<0.001). The lowest pain score related to endoscopy was obtained for oxymetazoline+lidocaine (P<0.001). Nasal decongestion was best achieved with NS+oxymetazoline (P<0.001). Endoscopy duration was the shortest for oxymetazoline+ lidocaine (P<0.05). Statistically significant MBP changes were only seen with the application of NS+oxymetazoline (P<0.05). However, neither MBP nor pulse rate change was significant clinically. CONCLUSION: Application of decongestant and anesthetic sprays together seems to be the best method of pharmacological preparation of patients for nasal endoscopy.
Anesthetics ; Blood Pressure ; Double-Blind Method* ; Endoscopes ; Endoscopy* ; Healthy Volunteers ; Heart Rate ; Humans ; Lidocaine ; Methods* ; Nasal Decongestants ; Oxymetazoline ; Premedication* ; Prospective Studies* ; Volunteers

Pediatric anesthetic experiences of 221 cases (under 2 years old) during two recent years were analyzed statistically according to age, sex, disease, risk, premedication, anesthetic method, hospital days, repeat operation, complications and mortality. All those infants were operated on under general anesthesia The results were as follows; 1) Age & sex; 40 cases(18. 1%) were in under 3 months age group and 136 males (61. 5%) far exceeded 85 females (38. 5%). 2) Disease; Most common diseases in order were intussusaeption (24 cases), burn, ingoinaI hernia and cleft lip. 3) Risk; elective surgery were 181 (59. 3%) cases and emergency were 90 (40. 7%) cages. 4) Premedication; Maimly used premedicant was atropine only (78 cases). 6) Anesthetic method; Most cases had endotracheal intubation with non rebreathing technique and halothane was mainly used (154 cases). 6) Hospital days; Mean hospital Stay was ll. 1 days. 7) Repeat operation; 26 cases (15. 6%) received repeated operations of 2 times or more under the same diagnosis. 8 Complications; 8cases of pneumonia and 5 cases of wound infection were seen. 9) Mortality; 6 cases (2. 7%) died during postoperative period.
Anesthesia* ; Anesthesia, General ; Atropine ; Burns ; Cleft Lip ; Diagnosis ; Emergencies ; Female ; Halothane ; Hernia ; Humans ; Infant ; Intubation, Intratracheal ; Length of Stay ; Male ; Methods ; Mortality ; Pneumonia ; Postoperative Period ; Premedication ; Wound Infection

Adult ; Antiviral Agents ; administration & dosage ; therapeutic use ; Hepatitis C ; complications ; drug therapy ; Humans ; Kidney Transplantation ; methods ; Male ; Premedication ; Renal Dialysis ; Uremia ; complications

BACKGROUNDCapsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition of simethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by a few investigators.

METHODSSixty-four participants were randomly divided into two groups to receive a bowel preparation of polyethylene glycol (PEG) solution (Group 1) and both PEG solution and simethicone (Group 2). The PEG solution and simethicone were taken the night before and 20 min prior to capsule endoscopy, respectively. Frames taken in the small intestine were examined and scored for luminal bubbles by two professional capsule endoscopists. Gastric emptying time and small bowel transit time were also recorded.

RESULTSSimethicone significantly reduced luminal bubbles both in the proximal and distal small intestines. The mean time proportions with slight bubbles in the proximal and distal intestines in Group 2 were 97.1% and 99.0%, respectively, compared with 67.2% (P<0.001) and 68.8% (P<0.001) in Group 1. Simethicone had no effect on mean gastric emptying time, 32.08 min in Group 2 compared with 30.88 min in Group 1 (P=0.868), but it did increase mean small intestinal transit time from 227.28 to 281.84 min (P=0.003).

CONCLUSIONBowel preparation with both PEG and simethicone significantly reduced bubbles in the intestinal lumen and improved the visualization of the small bowel by capsule endoscopy without any side effects observed.

Adult ; Aged ; Capsule Endoscopes ; Female ; Humans ; Image Enhancement ; methods ; Intestine, Small ; cytology ; drug effects ; Male ; Middle Aged ; Premedication ; methods ; Simethicone ; administration & dosage ; Surface-Active Agents ; administration & dosage ; Young Adult

This study was undertaken to investigate the effects of halothane anesthesia alone on blood glucose metabolism in ten surgical patients by determining plasma growth hormone ,(HGH), insulin and glucose, and to compare these with the effects of halothane anesthesia plus surgery. Each patient was premedicated with diazepam, 5 mg and atropine sulfate, 0. 5mg intramuscu Jarly one hour before the induction of halothane anesthesia. After endotracheal intubatien had been carried out following SCC 30-40mg, anesthesia was mairrtained with halothane and oxygen. The muscle relaxant (gallamine) in divided doses was injected during surgery when needed and ventilation was controlled or assisted intermittently throughout the procedure. A moderate depth of anesthesia was maintained according to clinical judgement, based on signs including blood pressure, pulse rate and somatie reflex responses to the surgical xtimulation. Eight blood samples were obtained from each patient:( I ) at 09.00 a.m. immediately before :induction of anesthesia (this sample served as acoatrol value) (2) the next three were after 15. 30 and 45 minutes of halothane anesthesia but before the start of the operation; (3) further three, 15,30 and 45 minutes, after the start of the operation;(4) in the recovery room after fully awaking. HGH RIAKIT was utilized as a kit for determination of human growth hormoae by radioimmunoassay and also lNSULIN-RIAKlT for insulin levels in the blood, For the determination of blood glucose level, OTB method was utilized. The ratio between male and female pgtients was 5:5, mean age 39. 2+/-12. 1 and average body weights 55. 5+/-8 .5 kg. The mean control plasma growth hormone level(HGH) in 10 surgical patients after premedication, and immediately before induction of anesthesia was 2. 03+/-0. 28ng/ml. The mean yre-surgical concentration of HGH in plasma after 15, 30 and 45 minutes of halothane anesthesia rose to 2.63+/-0.41 ng/ml, 2.76+/-0.35 ng/ml, and 2.95+/-0.42 ng/ml, respectively but these values were not significantly elevated above the control value. The plasma levols significantly increased to 3. 42+/-0. 5 mg/ml (P <0. 05), 6. 64+/-0. 6 mg/ml (p <0.001) and 7.83+/-0,75 ng/ml. (p<0.001) 15 minutes, 30 minutes and 45 minutes respectively after the start of the operation. It decreased to 3. 58+/-0. 68 ng/ml. (p<0. 05) in the recovery room when the patient awoke fully. The mean pre-anesthetic control insulin level in plasma. in 10 surgical patients was 12. 6+/-2. 0 ng/ml which was within the normal range. This level. did not vary appreciably during halothane anesthesia alone, during operation or in the post-operative period. The mean control pre-anesthetic blood glucose level was 78. .7+/-3.9 mg/100ml. It rose to 80. 6+/-2. 9 mg/100ml. 83. 2+/-3. 6mg/100 ml 30minutes, 45minutes and of halothane anesthesia alone and 15 minutes of the start of the operation but these changes were not significant. It increased significanty to 98. 2+/-4. 4 mg/100ml(p<0. 05) and 103. 9+/-4. 0 mg/100ml (p<0. 001) 30 minutes and 45 minutes respectively after the start of the surgery but it rose to 95.7+/-3.1mg/ 100ml (p <0. 01) in the post-operative period. Consequently the plasma HGH level during halothane anesthesia alone for 45 minutes was slightly, increased and rose significantly during operation and in the post-operative period. The peak level was achieved 45 minutes after the start of surgery. Plasma insulin levels did not change appreciably during anesthesia alone or during surgery. Blood glucose levels increased slightly during anesthesia alone but rose significantly during operation and in the post-operative period.
Anesthesia* ; Atropine ; Blood Glucose ; Blood Pressure ; Body Weight ; Diazepam ; Female ; Glucose* ; Growth Hormone ; Halothane* ; Heart Rate ; Human Growth Hormone* ; Humans* ; Insulin ; Male ; Metabolism ; Methods ; Oxygen ; Plasma* ; Premedication ; Radioimmunoassay ; Recovery Room ; Reference Values ; Reflex ; Ventilation

We evaluated the effects of a combined therapy of pre-blockade endogenous nitric oxide synthase (NOS) with N-nitro-L-arginine methyl ester (L-NAME) and continuous inhaled NO (iNO) on the gas exchange and hemodynamics of Escherichia coli pneumonia and sepsis in newborn piglets. Seven to ten day old ventilated newborn piglets were randomized into 5 groups: control, E. coli pneumonia control, pneumonia with iNO 10 ppm, pneumonia pre-treated with L-NAME 10 mg/kg, and pneumonia with the combined therapy of L-NAME pretreatment and iNO. E. coli pneumonia was induced via intratracheal instillation of Escherichia coli, which resulted in progressively decreased cardiac index and oxygen tension; increased pulmonary vascular resistance index (PVRI), intrapulmonary shunting, and developed septicemia at the end of 6 hr experiment. iNO ameliorated the progressive hypoxemia and intrapulmonary shunting without affecting the PVRI. Only two of 8 animals with L-NAMEpretreated pneumonia survived. Whereas when iNO was added to infected animals with L-NAME pretreatment, the progressive hypoxemia was abolished as a result of a decrease in intrapulmonary shunting without reverse of the high PVRI and systemic vascular resistance index induced by the L-NAME injection. This result suggests that a NOS blockade may be a possible supportive option for oxygenation by iNO treatment in neonatal Gram-negative bacterial pneumonia and sepsis.
Treatment Outcome ; Swine ; Survival Rate ; Sepsis/diagnosis/drug therapy/physiopathology ; Pulmonary Gas Exchange/*drug effects ; Premedication/*methods ; Pneumonia, Bacterial/diagnosis/*drug therapy/physiopathology ; Oxygen Consumption/*drug effects ; Nitric Oxide Synthase/antagonists & inhibitors ; Nitric Oxide/*administration & dosage ; NG-Nitroarginine Methyl Ester/*administration & dosage ; Injections, Intravenous ; Escherichia coli Infections/diagnosis/*drug therapy/physiopathology ; Drug Therapy, Combination ; Animals, Newborn ; Animals ; Administration, Inhalation

We evaluated the effects of a combined therapy of pre-blockade endogenous nitric oxide synthase (NOS) with N-nitro-L-arginine methyl ester (L-NAME) and continuous inhaled NO (iNO) on the gas exchange and hemodynamics of Escherichia coli pneumonia and sepsis in newborn piglets. Seven to ten day old ventilated newborn piglets were randomized into 5 groups: control, E. coli pneumonia control, pneumonia with iNO 10 ppm, pneumonia pre-treated with L-NAME 10 mg/kg, and pneumonia with the combined therapy of L-NAME pretreatment and iNO. E. coli pneumonia was induced via intratracheal instillation of Escherichia coli, which resulted in progressively decreased cardiac index and oxygen tension; increased pulmonary vascular resistance index (PVRI), intrapulmonary shunting, and developed septicemia at the end of 6 hr experiment. iNO ameliorated the progressive hypoxemia and intrapulmonary shunting without affecting the PVRI. Only two of 8 animals with L-NAMEpretreated pneumonia survived. Whereas when iNO was added to infected animals with L-NAME pretreatment, the progressive hypoxemia was abolished as a result of a decrease in intrapulmonary shunting without reverse of the high PVRI and systemic vascular resistance index induced by the L-NAME injection. This result suggests that a NOS blockade may be a possible supportive option for oxygenation by iNO treatment in neonatal Gram-negative bacterial pneumonia and sepsis.
Treatment Outcome ; Swine ; Survival Rate ; Sepsis/diagnosis/drug therapy/physiopathology ; Pulmonary Gas Exchange/*drug effects ; Premedication/*methods ; Pneumonia, Bacterial/diagnosis/*drug therapy/physiopathology ; Oxygen Consumption/*drug effects ; Nitric Oxide Synthase/antagonists & inhibitors ; Nitric Oxide/*administration & dosage ; NG-Nitroarginine Methyl Ester/*administration & dosage ; Injections, Intravenous ; Escherichia coli Infections/diagnosis/*drug therapy/physiopathology ; Drug Therapy, Combination ; Animals, Newborn ; Animals ; Administration, Inhalation