BACKGROUND: Various kinds of methods had been tried to reduce pain on injection of propofol. In this study, the effect of lidocaine pretreatment and that of temperature controlled injections were compared and evaluated its clinical utility. METHODS: One hundred and twenty patients were randomly allocated into 4 groups after permission. Room temperature propofol was used as induction agent in group P,. In group C, cooling (4 degrees C) propofol was used and warming propofol (37 degrees C) in group H. And room temperature propofol following lidocaine (1 mg/kg) was used in group L. Injection dosage of propofol was 2 mg/kg and injection speed was 2 ml/sec in all groups. In each patients, pain score and visual analog scale were measured and tested by ANOVA or Kruskal-Wallis test. RESULTS: There were no statistical significant difference in pain score among the 4 groups. But in visual analog scale analysis, group L markedly reduced values than the other groups by statistically significant manner (in Duncan grouping). CONCLUSION: The alleviating effect of lidocaine pretreatment on painful injection was better than that of changing temperature of propofol itself. More over effectiveness, in view of simplicity, we recommend lidocaine pretreatment.
Humans ; Lidocaine ; Propofol* ; Visual Analog Scale

No abstract available.
Child* ; Hematuria* ; Humans

A case of retroperitoneal teratoma, found in a ten month old female infant was reported. Twenty four hours after the direct retroperitoneal air insufflation, a retrograde pyelography was performed using B.B. 16F. cytoscope. These two studies were essential to make preoperative diagnosis. Review of retroperitoneal tumor was also added.
Diagnosis ; Female ; Humans ; Infant ; Insufflation ; Teratoma* ; Urography

There has not been any report on massive air-containing liver abscess in diabetic patients, although emphysematous cholecystitis or pyelonephritis is a well-known complication in them. Authors report two cases of emphysematous liver abscess in diabetic patient, which showed typical findings of massive air-containing hepatic abscess on ultrasonography and computed tomography, but very poor progrosis in spite of immediate and successful percutanoeus drainage procedure.
Drainage ; Emphysematous Cholecystitis ; Humans ; Liver Abscess* ; Liver* ; Pyelonephritis ; Ultrasonography

The management of the patient undergoing posterior fossa surgery meets with various difficulties during and after the surgery due to the anatomical characteristics of the posterior fossa. Sitting position has been used popularly for its advantage of proper exposure of the posterior fossa lesions, but this position presents disastrous complications such as hypotension and air embolism not infrequently. Hydrocephalus, frequently complicating the posterior fossa lesions, also presents many problems during and after surgery. Postoperative brain swelling, CSF leakage and infection are other important problems of the posterior fossa surgery. The authors obtained following results with analysis of surgical results in 71 posterior fossa lesions. 1) The posterior fossa lesions are frequently present hydrocephalus and signs of increased intracranial pressure due to blockade of CSF flow. Their proper management such as steroid, diuretics and preoperative shunt made the operative manipulation easier and improved the postoperative course. 2) The major intraperative problems were air embolism and postural hypotension which were mainly related to th4 sitting position. To avoid these complications, the author propose lateral position for very old patients and those with cardiopulmonary disease or in surgery for CP angle lesion and cerebellar hemispheric lesion which can be exposed adequately with this position. 3) It way easy to detect and manage possible postoperative problems such as brain swelling, hematoma and persistent hydrocephalus with aid of CT scan and their serious outcome could be reduced.
Brain Edema ; Diuretics ; Embolism, Air ; Hematoma ; Humans ; Hydrocephalus ; Hypotension ; Hypotension, Orthostatic ; Intracranial Pressure ; Tomography, X-Ray Computed

Moyamoya disease is a rare occlusive cerebrovascular disease characterized by stenosis or occlusion of the main cerebral arteries. It has a tendency for multifactorial inheritance and familial occurrence, although its pathogenesis is not clear. We observed this disease in two girls from the same family:one was eight years old and the other was 45 months. They presented with transient ischemic attacks. We performed cerebral angiography on both patients and magnetic resonance angiography (MRA) on the younger. Both approaches showed the typical features of moyamoya disease, and MRA successfully revealed abnormal findings specific for the disease in the second child. Both children received encephaloduroarteriosynangiosis (EDAS) and this produced good results. MRA is thus a powerful and noninvasive way of detecting individuals at high risk of developing this disease. Considering the reported familial incidence of moyamoya disease in Japan, a careful search for family members using MRA would probably reveal many more such cases in Korea.
Cerebral Angiography ; Cerebral Arteries ; Child ; Constriction, Pathologic ; Female ; Humans ; Incidence ; Ischemic Attack, Transient ; Japan ; Korea ; Magnetic Resonance Angiography ; Moyamoya Disease* ; Multifactorial Inheritance

Two cases of malignant histiocytosis, in which skin involvement was a prominent finding at initial clinical presentation, are reported. 1nteresting histopathologic findings, including Langerhans granule in one case and numerous eosinophils in another, were observed. In one case remission was achieved with BACOP chemotherapy (Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, and Prednisone). In the other case, the patient died nine months after the onset of the disease without any treatment.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Eosinophils ; Histiocytic Sarcoma* ; Humans ; Skin ; Vincristine

BACKGROUND: Postintubational sore throat and hoarseness are usually mild symptoms but they are very common complaints among the patients after endotracheal general anesthesia. In addition, some might have severe discomfort and need invasive procedure to relieve these problems. We tried new method of endotracheal tube cuff filling with local anesthetics to reduce postoperative sore throat and hoarseness and evaluated the results. METHODS: Endotracheal cuff filling was done with air 5 ml in healthy 20 patients (ASA I-II, control group). And in another healthy (ASA I-II) 35 patients, the cuffs were filled with 4% lidocaine 3.5 ml and 8.4% sodium bicarbonate 1.5 ml mixture. After 24 hours following general anesthesia, patients were visited and asked whether there were sore throat or hoarseness, if any, how the degree was. RESULTS: In lidocaine-treated group, the incidence of postintubational sore throat was less compared to control group significantly. There was no difference in incidence of hoarseness between two groups. CONCLUSION: Endotracheal cuff filled with lidocaine and sodium bicarbonate mixture is suggested as an effective protective method that reduces the frequency of postintubational sore throat.
Anesthesia* ; Anesthesia, General ; Anesthetics, Local ; Hoarseness* ; Humans ; Incidence ; Lidocaine* ; Pharyngitis* ; Sodium Bicarbonate* ; Sodium*

From March 1988 to August 1989, 51 knees with clinically suspected meniscus injuries were examined by both MRI and arthroscopy and compared their findings prospectively on the basis of arthroscopic findings to determine the accuracy of MRI in detecting meniscus injury of the knee. We used 2.0 tesla superconducting magnet imager(Spectro-20000, GoldStar, Korea) to obtain MR imaging. Our protocol for imaging was producing Tl sagittal images by spinecho technique and T2 coronal images by gradient echo technique, interleaved at 4mm continuously while the patient's knee was in 8–10 degrees of external rotation and surface coil was placed posteriorly to the knee in supine position. We grouped and correlated the findings of MRI with the arthroscopic findings. With this noninvasive MRI, we could obtain multiplanar, high quality images without compliations. Compared with the arthroscopic findings, MRI resulted in a high diagnostic accuracy of 96 and 86 percent for the medial and lateral meniscus, respectively. And it aided in optimal surgical planning for the clinically suspected meniscus injuries.
Arthroscopy ; Knee ; Magnetic Resonance Imaging ; Menisci, Tibial ; Prospective Studies ; Supine Position

Metastasis to bone with destruction of the skeletal system is a common problem in old patients with malignancy. Destruction of the musculoskeletal system poses major problems for the patients, including uncontrollable pain, forced immmobilization, pathologic fracture and hypercalcemia. The purpose of this study is to evaluate the effectiveness of surgical treatment and to suggest treatment guidelines for impending or established pathologic fractures due to metastasis of the femur. Between 1985 and 1995, thirty six patients who had pathologic or impending fractures in the femur underwent surgical treatment. The indications of surgery for pathologic fractures are 1) the possibility of survival time more than three months, 2) more benefits of sungical treatment than those of conservative treatment, 3) the possibility of rigid internal fixation, 4) patient s general condition allowing surgery, and those in impending fractures are 1) cortical destruction more than 50% or lytic lesion more than 2.5cm. The method of surgery was excision of the tumor and rigid internal fixation to allow early ambulation with or without bone cement augmentation. The results were analyzed by three criteria, the performance status, pain relief and survival time. Pain relief more than Lots was achieved in 80.6% of patients according to the Kaiko's criteria. The performance status improved more than one grade in all patients except one who died of acute respiratory failure and the mean improvement was 1.8 grade by the Functional Classification of the New York Heart Association. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and felt comfortable at rest and ordinary activities. The survival time was 20.9 months in patients with single metastasis and 10.2 months in patients with multiple metastases. But there was no statistical significance due to large deviation of survival time in each case. In summary, surgical stabilization of the pathologic lesion involving the femur provided definite improvement of quality of life including pain relief and early ambulation. In selected patients with single metastasis, low grade malignancy, or good performance status, postoperative survival time may be expected to be prolonged. More aggressive treatment for the metastatic lesion of the femur is suggested.
Classification ; Early Ambulation ; Femur* ; Fractures, Spontaneous ; Heart ; Humans ; Hypercalcemia ; Motor Activity ; Musculoskeletal System ; Neoplasm Metastasis ; Quality of Life ; Respiratory Insufficiency