No abstract available.
Mouth* ; Neurilemmoma*

BACKGROUND: Exogenously administered epinephrine under enflurane anesthesia was known to have mild myocardial sensitizing effect. And N2O activates the sympathetic nervous system mildly. We planed this study to confirm cadiovascular effects of clinically administered epinephrine for hemostasis under the enflurane-N2O anesthesia during tonsillectomy. METHODS: Eighty children scheduled to have tonsillectomy were selected randomly and divided into 2 groups as follows; Group E: 1:100,000 epinephrine 2ug/kg and Group EL: 1:100,000 epinephrine containing 1% lidocaine 2 g/kg. Blood pressure, heart rate, and the occurrence of arrhythmia were evaluated before injection, at injection, 1 min, 2 min, 3 min, 5 min and 10 min after injection and 1 min after operation start. RESULTS: In both groups, systolic and diastolic blood pressure and heart rate are increased. But there are no significant statistical differences in each group and between groups. One min after operation, there are significant increases in systolic and diastolic blood pressure and heart rate in both groups (p<0.05), but there is no significant difference between groups. CONCLUSION: Under the enflurane-N2O anesthesia of children, 1:100,000 epinephrine 2ug/kg used for hemostasis could be used comparatively safe without any significant hemodynamic changes. But because there is always the possibility of myocardial sensitization, careful observation is necessary during epinephrine injection under the enflurane-N2O anesthesia.
Anesthesia* ; Arrhythmias, Cardiac ; Blood Pressure ; Child ; Enflurane ; Epinephrine* ; Heart Rate ; Hemodynamics ; Hemostasis* ; Humans ; Lidocaine ; Sympathetic Nervous System ; Tonsillectomy*

No Abstract Available.
Sezary Syndrome*

To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

Proliferative fasciitis is a rare reactive condition that presents with pseudosarcomatous lesions in subcutaneous tissues. Clinically, most patients present with firm, rapidly growing subcutaneous nodule and two thirds of patients complained of pain and tenderness. Most of lesions occur in the extremities, with the upper extremity (especially the forearm) affected more commonly than the lower extremity. Microscopically, proliferative fasciitis is composed of spindle cells that are deposited in a variably myxoid and collagenous stroma. It is characterized by the presence of large basophilic cells with one or two vesicular nuclei. Proliferative fasciitis could be confused with sarcomas because of intense cellularity, high mitotic index, and rapid growth. A 26-year-old woman complained of a painful nodule on her right second finger. Its size was gradually increased and pain was worsened. Histopathological examination revealed that the lesion consisted predominantly of spindle-shaped cells intermingled with a few gangliocyte-like giant cells. We herein report a rare case of proliferative fasciitis in the finger in a 26-year-old woman.
Adult ; Basophils ; Collagen ; Extremities ; Fasciitis* ; Female ; Fingers* ; Giant Cells ; Humans ; Lower Extremity ; Mitotic Index ; Sarcoma ; Subcutaneous Tissue ; Upper Extremity

We observed a 25-year-old male patient who had developed juvenile rheumatoid arthritis(RA) associated with alopecia areata at 14 years of age. When he received treatment for RA, his symptoms of RA and hair loss improved at approximately the same time. One year later, as the symptoms of RA aggravated, the hair loss had progressed eventually to alopecia universalis(AU). Thus we suggest that RA and AU may be associated with a common immunologic factor in etiology of the two diseases.
Adult ; Alopecia Areata ; Alopecia* ; Arthritis, Juvenile* ; Hair ; Humans ; Male

Purpose: To introduce a method of correcting lower eyelid epiblepharon with severe epicanthal fold combined with minimal incision of medial epicanthoplasty (Hiraga method) and to report its clinical outcomes. Methods: We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid epiblepharon and minimal incision of medial epicanthus from January 2015 and January 2019. Seventy-eight eyes of 39 patients were analyzed for surgical outcomes, subjective symptoms, recurrence, and complications for more than six months of the follow-up period. Results: A total of 39 patients (14 male, 25 female) were included in the analysis. The mean patient age was 8.4 ± 4.3 years, and the mean postoperative follow-up was 14 ± 5.2 months. Eyelid shape and function were well maintained in 39 patients (100%), with no recurrence during follow-up. Conclusions For patients with lower eyelid epiblepharon with severe medial epicanthal fold, lower eyelid epiblepharon with a minimal incision of medial epicanthoplasty (Hiraga method) is a simple surgical technique to prevent recurrence of medial cilia touch, showing successful results without complications.

A 28-year-old woman presented with multiple, asymptomatic, erythematous to bluish papules located on the chest. Histopathologically, three round, well defined cystic structures were seen on the upper and lower dermis. The first cyst was milia, the second was apocrine hidrocystoma and the other, largest cyst was an eruptive vellus hair cyst (EVHC). A diagnosis of multiple pilosebaceous cysts combined with apocrine hidrocystoma was made. Since the milia and EVHC originate from the pilosebaceous unit, and the apocrine duct opens to the pilosebaceous orifice, we suggest that they can occur simultaneously in the same unit.
Adult ; Biopsy ; Dermis ; Female ; Hair ; Hidrocystoma ; Humans ; Thorax

Pseudoxanthoma elasticum is a rare, heritable disorder of elastic fibers characterized by yellowish, coalescing papules on the loose and wrinkled flexural skin. An 18-year-old man presented cutis laxa-like marked wrinkling on the axillae, trunk and thighs for about 10 years. There was no similar skin lesion on his family members and no other systemic involvement was found. Histopathological examination of the abdomen revealed fragmentation and calcification of elastic fibers in the middle and lower dermis. Von Kossa staining showed calcium deposition along the altered elastic fibers. Herein, we report a rare case of autosomal recessive pseudoxanthoma elasticum presenting generalized cutaneous laxity.
Abdomen ; Adolescent ; Axilla ; Calcium ; Dermis ; Elastic Tissue ; Humans ; Pseudoxanthoma Elasticum* ; Skin ; Thigh

Local anesthesia in strabismus surgery allows for the evaluation of ocular alignment during the operation and enables early postoperative recovery.However, extraocular muscle traction results in decreased heart rate and discomfort for the patient. Therefore, it is our attempt to reveal the degree of of decreased heart rate during extraocular muscle traction and the patient`s pain perception. This was done prospectively on personalities of the patient, preoperative heart rate in the operating room, change of heart rate and pain perception of the patient during surgery. The statistically significant decrease in heart rate due to the ocular cardiac reflex occurs during medial rectus resection, lateral rectus recession, and leads to less satisfaction in the anxious patients. Strabismus surgery under topical anesthesia does not decrease the heart rate significantly, therefore it is relatively safe and the patient`s personality was influence on the intraoperative pain perception of the patients.
Anesthesia* ; Anesthesia, Local ; Heart Rate ; Humans ; Operating Rooms ; Pain Perception ; Prospective Studies ; Reflex ; Reflex, Oculocardiac ; Strabismus* ; Traction