No abstract available.
Humans ; Hyperbilirubinemia, Hereditary* ; Siblings*

Various kinds of spinal instruments have been developed for the treatment of lumbar spinal disordors. Recently, the Graf instrument as soft stabilizer has been introduced in treating lumbar spinal disordors associated with instability. To determine the reliability of Graf instrument providung spinal stability we have analysed 19 cases of unstable lumbar degenerative disease treated with adequate decompression and Graf instrumentation between May 1991 and March 1992. There were 15 females and 4 males. Average age at operation was 50.8 years (Range, 35 to 70). Minimum follow up was 14 months. The main surgical indication was serious limitation of daily activity caused by intractable symptoms and signs with spinal instability. Clinical assesment based on authors modified criteria revealed satisfactory (Exellent/Good) in 16 cases (84.2%). The Graf instrument has many advantages over rigid implant such as enough stability without arthrodesis after extensive surgical decompression, rapid rehabilitation, less operative risk and preservation of spinal motion. These results suggests Graf instrument instead of rigid implant is highly recommendable in managing unstable lumbar disordors.
Arthrodesis ; Decompression ; Decompression, Surgical ; Equidae ; Female ; Follow-Up Studies ; Humans ; Male ; Rehabilitation

No abstract available.
Joints*

No abstract available.
Amnion* ; Endometriosis* ; Endometrium* ; Female

The use of high-pressure air instruments has become more common. Consequently, there have been a number of cases of orbital emphysema caused by contact with high-pressure air. In this case, a 62-year-old male patient visited an emergency medical center after his left eye was shot by an air compressor gun that was used to wash cars. Lacerations were observed in the upper and lower eyelids of his left eye. Radiological examinations revealed orbital emphysema, optic nerve transection, pneumocephalus, and subcutaneous emphysema in the face, neck, shoulder, and mediastinum. Canalicular injury repair was performed, and the emphysema resolved. However, there was near-complete vision loss in the patient's left eye. Because most optic nerve transections occur after a severe disruption in bone structure, pure optic nerve transections without any injury of the bone structure, as in the present case, is extremely rare.
Compressed Air ; Emergencies ; Emphysema ; Eyelids ; Humans ; Lacerations ; Male ; Mediastinum ; Middle Aged ; Neck ; Optic Nerve Injuries* ; Optic Nerve* ; Orbit ; Pneumocephalus ; Shoulder ; Subcutaneous Emphysema

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin

BACKGROUND: Calcium disturbance may clinically produce diaphragmatic weakness. Extracellular calcium is necessary for diaphragmatic contraction, suggesting that the diaphragm behaves more like cardiac muscle. The effect of extracellular Ca2 concentrations on the relaxation action of vecuronium was studied in rat hemidiaphragm-phrenic nerve preparations. METHODS: Hemidiaphragm-phrenic nerve preparations were obtained from male Sprague-Dawley rats (200 300 g). Preparations were bathed in Kreb's solution of (mM): NaCl 118, KCl 5, CaCl2 2.5, NaHCO3 30, KH2PO4 1, MgCl2 1 and glucose 11, then maitained at 37oC when aspirated with a mixture of 95% O2 and 5% CO2. Isometric forces generated in response to 0.1 Hz, 2 Hz for 2 seconds and, 50 Hz for 2 seconds with supramaximal electrical stimulation (0.2 msec, rectangular) to the phrenic nerve, were measured with a force transducer. Single twitch tension and peak tetanic tension were calculated as a percentage of control. TOF fade was calculated as (1-(T4/T1))x100. Each preparation was exposed to the alterations in calcium concentrations of the Kreb's solution (3.75, 3.125, 1.5, 1.25, 0.625, 0.3125 (mM)), and the adequate volume of vecuronium stock solution was added to the tissue bath for desired bath concentration. The effects of calcium and vecuronium were allowed to reach a steady state before measurement of tension parameters was done. Single twitch tensions or peak tetanic tensions, which were measured at each calcium concentration, were compared respectively. EC5, EC25, EC50, EC75, and EC95 of vecuronium for a single twitch tension, TOF fade, and peak tetanic tension at each calcium concentration, were calculated using a sigmoid Emax model. We compared the EC50 of vecuronium according to calcium concentrations. Data was compared by the Kruskal-Wallis test with a post hoc Wilcoxon rank sum test. A p-value of below 0.05 was considered significant. RESULTS: The range of calcium concentration studied didn't produce differences among single or tetanictensions respectively. The EC50's of vecuronium decreased as calcium concentration decreased. CONCLUSIONS: The reduction of calcium concentration can augment the action of vecuronium on the diaphragm.
Animals ; Baths ; Calcium* ; Colon, Sigmoid ; Diaphragm ; Electric Stimulation ; Glucose ; Humans ; Magnesium Chloride ; Male ; Myocardium ; Neuromuscular Agents* ; Paralysis ; Phrenic Nerve ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Transducers ; Vecuronium Bromide*

PURPOSE: The surgical techniques and postoperative care for gastric cancer have significantly improved in recent years. However, the incidence of several complications that can result in relatively increased mortality remains high. The aim of this study was to evaluate the risk factors associated with postoperative morbidity in surgery for gastric cancer. METHODS: Four hundreds and one consecutive patients, who underwent surgery for gastric cancer at National Medical Center between January 1994 and December 2002, were reviewed. RESULTS: The overall morbidity and mortality rates were 10.2 and 1.5%, respectively. A univariate analysis of multiple clinical variables revealed that age, leukocyte counts, albumin, protein, comorbid disease, combined resection, operation time, blood loss, operation type, curability, extent of lymph node dissection and stage were significantly associated with morbidity. However, a multivariate analysis showed that comorbid diseases and low curability were independent factors associated with morbidity (P<0.05). CONCLUSION: In patients with comorbid diseases and a noncurative resection, the complication rate was significantly higher. More attention should be paid to the early diagnosis, preoperative evaluation and intraoperative caution of patients with preoperative risk factors.
Early Diagnosis ; Humans ; Incidence ; Leukocyte Count ; Lymph Node Excision ; Mortality ; Multivariate Analysis ; Postoperative Care ; Postoperative Complications* ; Risk Factors* ; Stomach Neoplasms*

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of low-flow anesthesia with a semi-closed circle anesthesia system in infants. METHODS: Twenty, ASA physical status 1 or 2, infants were randomly assigned into two groups: high-flow anesthesia (HFA) or low-flow anesthesia (LFA). An identical semi-closed Dr ger circle anesthesia system (Cato) was used to all patients. Initial fresh gas flow (FGF) was N2O 1.5 L/min and O2 1.5 L/min in both groups. This FGF of 3 L/min was maintained in the HFA group. After 10 min of HFA, the FGF was reduced to 500 ml/min (N2O 250 ml/min and O2 250 ml/min) in the LFA group. RESULTS: Hypoxic or hypercarbic gas concentrations were not observed in all patients. Enflurane consumption during LFA was about 1/3 of that during HFA (6.8 +/- 1.3 ml vs. 19.5 +/- 5.8 ml). The mean highest esophageal temperature was similar in both groups. The mean highest inspiratory gas and soda lime temperatures were significantly higher in the LFA group than in the HFA group. CONCLUSIONS: Low-flow anesthesia in a circle system with a fresh gas flow of N2O 250 ml/min and O2 250 ml/min could be performed safely and economically for infants.
Anesthesia* ; Enflurane* ; Humans ; Infant*

Metastasis of neuroblastoma into the central nervous system is well known, but, in fact, rare clinically. Recently we had experienced one such case, which was characterized by sudden onset of paraplegia and blindness and delayed appearance of radiologic findings. A 7 years old Korean boy was admitted to the pediatric ward of the Seoul National University Hospital on September 28, 1975 due to sudden onset of paraplegia. All physical, laboratory and simple thoracic spine X-ray findings were normal except for albuminocytologic dissociation in the C.S.F. Guillain-Barre syndrome was suspected and steroid therapy was recommended. On November 10, 1975, he was readmitted due to sudden loss of visual acuity bilaterally. At first all radiologic examinations revealed no clue to the lesion. After 4 months from the onset, there appeared typical pedicular destruction of the thoracic spine and confirmed it as neuroblastoma by surgery.
Blindness ; Central Nervous System ; Child ; Guillain-Barre Syndrome ; Humans ; Male ; Neoplasm Metastasis ; Neuroblastoma* ; Paraplegia ; Seoul ; Spine ; Visual Acuity