BACKGROUND: Induction of general anesthesia with tracheal intubation and skin incision are potent stimuli that can induce increased sympathetic activity, heart rate and blood pressure. We compared the hemodynamic response and catecholamine concentration during general anesthesia with intravenous clonidine pretreatment, a centrally acting -2 adrenoceptor agonist, and without pretreatment. METHODS: Forty ASA I or II patients aged from 20 to 60 years undergoing elective surgery were randomly allocated to two groups. In group I, 5 ml of 0.9% normal saline as control administered intravenously 10 minutes before induction of anesthesia, and anesthesia was induced with thiopental sodium, succinylcholine and maintained with N2O (2.5L/min)-O2 (2.5L/min)-enflurane (1.3~1.8 vol%). In group II, 4 g/kg clonidine diluted in 5ml of normal saline administered intravenously 10 minutes before induction of anesthesia, and anesthesia was induced with thiopental sodium, succinylcholine and maintained with N2O-O2-enflurane (0.5~1.0vol%) and 2 g/kg/hr clonidine was continuously infused. We measured blood pressure, heart rate and plasma catecholamine at preinduction, 1 minute after intubation (T1), 1 (T2) and 30 minutes after skin incision (T3) and compared with group I. RESULTS: There was statistical significance in systolic and diastolic pressure at T1 between two groups. There was statistical significance in heart rate, epinephrine and norepinephrine at T1, T2 and T3 between two groups. CONCLUSION: The elevation of blood pressure, heart rate and plasma catecholamine accompanying tracheal intubation and skin incision may be prevented by administration of intravenous clonidine.
Adult ; Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Brain ; Clonidine* ; Epinephrine ; Heart Rate* ; Heart* ; Hemodynamics ; Hemorrhage ; Hope ; Humans ; Incidence ; Intubation* ; Larynx ; Male ; Norepinephrine ; Plasma* ; Skin ; Spondylitis, Ankylosing ; Succinylcholine ; Thiopental

We report a case of granular cell tumor in a 62-year- old female. She had a 1. 5 cm sized, asymptomatic, firm nodule with central depression on the lateral aspect cf the left orbit. Histologically, the dermis had many large, pale tumor cells arranged in clusters and strands. The cells had a distinct cellular membrane and a pale cytoplasm filled with faintly eosiinophilic,coarse granules. The characteristic faint granules within the tumor cells are PAS-positive and diastase-resistant. The overlying epidermiis showed pseudocarcinomatous hyperplasia. We treated it with total excision.
Cytoplasm ; Depression ; Dermis ; Female ; Granular Cell Tumor* ; Humans ; Hyperplasia ; Membranes ; Orbit

Posteroanterior radiographs of normal wrist were taken in seventeen volunteers, and analysed to determine the dynamic relationships between the radiocarpal and midcarpal joint during radioulnar deviation. The total arc of radioulnar deviation was 59 degrees, and the motion was 44% radiocarpal and 56% midcarpal. During radioulnar deviation, the motion at the midcarpal joint was more than that at the radiocarpal joint. It is suggested thst dorsoradial and palmar-ulnar flexion as it occurs at the midcarpal joint can be correlated in radio-ulnar deviation of the wrist more than the coronal sliding motions as it occurs mainly at the radiocarpal joint.
Joints ; Volunteers ; Wrist

Treatment of a paralysed or flail shoulder falls into two categories; arthrodesis and reconstructive surgery. Of these the latter is preferable in view of mobility. Most authors have tried to reconstruct the paralysed abductor by transferring the trapezius muscle only. The final result of these procedures were poor in severe paralysis of the deltoid muscle or combined paralysis of the deltoid and the rotator cuff muscles. Noting the importance of the action of the rotator cuff muscles in abduction of the shoulder, Saha, in 1967, recommended simultaneous reconstruction of tne paralysed deltoid and rotator cuff muscles. We treated a case of paralysed shoulder that followed poliomyelitis by the Saha meshod, i.e., transfer of the trapezius muscle for the paralysed deltoid, transfer of the levator scapulae muscle for the supraspinatus, transfer of the pectoralis minor muscle for the subscapularis, all in one stage. Duration of the follow up was 3 months and the initial result seemed to be good in view of stability, mobility, and abductor power.
Accidental Falls ; Arthrodesis ; Deltoid Muscle ; Follow-Up Studies ; Methods ; Muscles ; Paralysis ; Poliomyelitis ; Rotator Cuff ; Shoulder ; Superficial Back Muscles

No abstract available.

Eosinophilic granuloma of bone well-documented in the literature. This lytic bone disease most commonly occurs in children, but a fraction of the cases does occurs in adult. When the disease occurs in adults, the bone most often affected include the skull, ribs, mandible, clavicle, pelvis, and long bone of the extremities. We report the case of a 31-year old woman with isolated eosinophilic granuloma of the thoracic spine. She had a 1-month history of progressive back pain that radiated to the right anterior chest. Authors performed resection of vertebral body lesion and soft tissue lesion and anterior fusion from T7 to T9. Immunochemical staining showed a positive S100 protein stain. EM demonstrated characteristic Birbeck granule. Postoperatively, the patient underwent a 5-day course of RT to the T6-T10 spine with 200cGY fractions (total dose 1000cGY). Postoperatively, the patient's back and chest pain had disappeared. There is no evidence of local recurrence or distant metastasis at 18 months follow-up. Though rare, eosinophilic granuloma of the adult spine could be considered in the differential diagnosis of osteolytic lesions.
Adult* ; Back Pain ; Bone Diseases ; Chest Pain ; Child ; Clavicle ; Diagnosis, Differential ; Eosinophilic Granuloma* ; Eosinophils* ; Extremities ; Female ; Follow-Up Studies ; Humans ; Mandible ; Neoplasm Metastasis ; Pelvis ; Recurrence ; Ribs ; Skull ; Spine* ; Thorax

Glomus tumor is a kind of vascular tumor that arises from the glomus body, which regulates skin temperature and is placed in the skin and the subcutaneous area. It is a benign tumor that usually presents in the subungal area. It is relatively common in areas other than the fingers, but its occurrence in peripheral nerves is known to be comparatively rare. We report our experience with a case of glomus tumor arising from the brachial plexus, a rare site of occurrence for glomus tumors.
Brachial Plexus ; Fingers ; Glomus Tumor ; Peripheral Nerves ; Skin ; Skin Temperature

The authors have reviewed 71 cases (70 patients) of the ankle fractures that were treated through the admission in Orthopedic Department, Paik Foundation Hospital, from June 1972 to April 1978. The average duration of the follow-up waa 15 months. The summary of the results were as follows; 1. Of the 71 cases, male was 54 cases and female 17 cases. The average age of the patients was 32. 2. The main cause of the injuries was traffic accident, and the other causes were sliding down and falling from a height, industrial accident, and sports injury in order. 3. By the classification of Lauge-Hansen, the pronation-external rotation and,supination-adduction types were commoner than the other types. 4. Open reduction was performed in 48 cases, and closed reduction in 23 cases. 5. The average duration of the cast immobilization after the closed reduction was 8 weeks, and that of the open reduction was 6 weeks. 6. The result of the treatment was better in those cases of the open reduction than that of, the closed reduction. 7. The good clinical results could be achieved by obtaining the anatomical position of the talus in the mortise and the reduction was achieved more satisfactorily when the key role of the lateral malleolus in complete reduction was well understood.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Orthopedics ; Talus

No abstract available.
Pelvic Bones*

No abstract available.
Epilepsies, Partial* ; Paragonimiasis*