Rieger's syndrome is a rare autosomal dominant developmental anomaly characterized by ocular and systemic abnomalities. These disorders are typically bilateral and usually diagnosed at birth or in the childhood. The most common ocular defects are hypoplasia of the iris, a prominent Schwalbe's line with iris strands and corectopia. A large number of patients have glaucoma due to devel-opmental defects of the anterior chamber angle structure. The authors experienced a case of Rieger's syndrome which was found in 31-year-old female, who had characteristic ocular and other systemic abnormalities. Associated glaucoma was well controlled by filtering surgery.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

BACKGROUND: The saddle block with heavy bupivacaine is confinal to the lower lumbar and sacral dermatomes. We reduced the infusion dose of bupivacaine to confine the blocked area to the perineum, and evaluated intrathecal bupivacaine with intrathecal bupivacaine and tramadol or clonidine for their anesthetic and analgesic effect in patients undergoing hemorrhoidectomy. METHODS: Sixty patients (ASA I - II, aged 20 to 55) scheduled for hemorrhoidectomy were divided into three groups. We gave a 0.2 ml placebo (0.9% normal saline) in the control group (n = 20), 0.2 ml tramadol (10 mg) in the tramadol group, and 0.2 ml clonidine (50 microgram) in the clonidine group (n = 20) intrathecally 1 minute after saddle block with 0.5% heavy bupivacaine 2 mg. We compared the effects of the sensory and motor blocks by using the analgesic time and the degree of anal relaxation and the side effects. RESULTS: The analgesic time was greater in the tramadol group than is the control group (P < 0.05), and in the clonidine group if was group then in the tramadol group (P < 0.05) and the control group (P< 0.01). Anal relaxation for hemorrhoidectomy in the tramadol group and the clonidine group was better than that of the control group. The incidence of paresthesia of the foot in the clonidine group (n = 16) was higher than in tramadol group (n = 3) and the control group (n = 1) (P < 0.01). The incidence of patients with urinary retention was significantly lower in the control group than in the tramadol group (n = 3) and the clonidine group (n = 4). CONCLUSIONS: Both bupivacaine 2 mg with tramadol and clonidine were efficient in hemorhoidectomy provided good conditions for hemorhoidectomy.
Bupivacaine* ; Clonidine* ; Foot ; Hemorrhoidectomy ; Humans ; Incidence ; Paresthesia ; Perineum ; Relaxation ; Tramadol* ; Urinary Retention

BACKGROUND: The saddle block with heavy bupivacaine is confinal to the lower lumbar and sacral dermatomes. We reduced the infusion dose of bupivacaine to confine the blocked area to the perineum, and evaluated intrathecal bupivacaine with intrathecal bupivacaine and tramadol or clonidine for their anesthetic and analgesic effect in patients undergoing hemorrhoidectomy. METHODS: Sixty patients (ASA I - II, aged 20 to 55) scheduled for hemorrhoidectomy were divided into three groups. We gave a 0.2 ml placebo (0.9% normal saline) in the control group (n = 20), 0.2 ml tramadol (10 mg) in the tramadol group, and 0.2 ml clonidine (50 microgram) in the clonidine group (n = 20) intrathecally 1 minute after saddle block with 0.5% heavy bupivacaine 2 mg. We compared the effects of the sensory and motor blocks by using the analgesic time and the degree of anal relaxation and the side effects. RESULTS: The analgesic time was greater in the tramadol group than is the control group (P < 0.05), and in the clonidine group if was group then in the tramadol group (P < 0.05) and the control group (P< 0.01). Anal relaxation for hemorrhoidectomy in the tramadol group and the clonidine group was better than that of the control group. The incidence of paresthesia of the foot in the clonidine group (n = 16) was higher than in tramadol group (n = 3) and the control group (n = 1) (P < 0.01). The incidence of patients with urinary retention was significantly lower in the control group than in the tramadol group (n = 3) and the clonidine group (n = 4). CONCLUSIONS: Both bupivacaine 2 mg with tramadol and clonidine were efficient in hemorhoidectomy provided good conditions for hemorhoidectomy.
Bupivacaine* ; Clonidine* ; Foot ; Hemorrhoidectomy ; Humans ; Incidence ; Paresthesia ; Perineum ; Relaxation ; Tramadol* ; Urinary Retention

No abstract available.
Brain Stem* ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Infant*

The effect of hemodialysis on intraocular pressure(IOP) was studied in 20 non-glaucomatous patients(40 eyes) with chronic renal failure. The IOP, body weight and systolic blood pressure were measured at pre- and post-hemodialysis and at every hour during 4 hours' hemodialysis period. IOP(Right: 13.4 +/- 2.2mmHg, Left: 13.9 +/- 2.3mmHg) was measured before hemodialysis. Following hemodialysis, blood pressure and body weight decreased significantly(P<0.05) and IOP increased significantly(Right: 14.2 +/- 2.5mmHg, Left: 14.8 +/- 2.6mmHg, P<0.05). However, there Was not statistical significance between increased IOP and the decreased body weight(Right r=0.05, Left r=-0.03) and systolic blood pressure(Right r=-0.05, Left r=0.23). This study shows that chronic renal failure patients may have a possibility for increased IOP after long period hemodialysis.
Blood Pressure ; Body Weight ; Humans ; Intraocular Pressure* ; Kidney Failure, Chronic ; Renal Dialysis*

In contrast to younger patients, geriatric patients are generally considered to be a poor risk for anesthesia and surgery and greater care should be taken in anesthetic management, because many have chronic systemic diseases in addition to a decrease in physiologic function. To evaluate geriatric anesthetic experiences, we received clinical records of 1,062 patients aged over 65 out of 21,656 surgical cases performed at Korea University Hye-Wha Hospital from January 1980 to December 1986. The cases were analysed according to age, sex, department, preoperative physical status, anesthetic techniques and agents, duration of anesthesia, operation site, length of hospital stay, laboratory data(Chest X-ray, EKG), associated diseases, postoperative complications and mortality. The results are as follows: 1) Of the 1,062 geriatric surgical patients, 516 cases(48.6%) were 65~69 years of age. 2) The number of geriatric surgical cases was 1,062 of which 672(63.3%) were male and 390(36.7%) were female. 3) Most surgical cases were general surgery(401 cases, 37.8%). 4) The rate of elective and emergency surgery was 78.0%(829 cases) and 22.0%(233 cases), respectively. The ratio of insurance patients (737 cases, 69.4%) versus noninsurance patients(325 cases, 30.6%) was approximately 2:1. 5) The number of general anesthesia cases was 777 (73.2%), spinal anesthesia 244( 23.0%), epidural anesthesia, 21(.20%), and brachial plexus block, 5( 0.5%). The anesthetics were thalamonal and meperidine hydrochloride(238 cases, 22.4%), halothane(204 cases, 19.2%) and tetracaine(244 cases, 23.0%). 6) The duraion of anesthesia was within 1hour in 88 cases( 8.3%), 1~2 hours in 421 cases(39.6%), and 2~3 hours in 291 cases(27.4%). 7) The number of lower abdominal surgery cases was 497 (46.8%) and the number of upper abdominal surgery cases was 188(17.7%). 8) Preoperative laboratory findings were as follows: The findings of preoperative chest X-rays revealed that 219 cases(21.4%) were within normal mits. 182 cases(17.8%) had hypertensive heart, and 208 cases(20.4%) had atherosclerosis. The EKG, which was done on 90.8% of the patients, revealed that 333 cases (34.5%) were within normal limits, 77 cases(8.0%) showed left ventricular hypertrophy, 65 cases(6.7%) showed sinus bradycardia, and 27 cases(2.8%) showed myocardial ischemia. 9) Hypertension(88cases, 49.4%) was the most commonly associated disease. 10) The total number of postoperative complication cases was 73(6.9%). Seventeen cases showed wound infection and delayed skin closure, 19 cases showed pneumonia, and 7 cases showed atelectasis. 11) The total number of postoperative deaths was 18 cases(1.7%).
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Anesthetics ; Atherosclerosis ; Brachial Plexus ; Bradycardia ; Electrocardiography ; Emergencies ; Female ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Insurance ; Korea ; Length of Stay ; Male ; Meperidine ; Mortality ; Myocardial Ischemia ; Pneumonia ; Postoperative Complications ; Pulmonary Atelectasis ; Skin ; Thorax ; Wound Infection

Consecutive anesthesia records of transurethral resection. (TUR) on 97 patients have been reviewed. The patients' anesthetic management and complications were discussed. Operations in this series were classified as follows: 65 cases of TUR of the benign prostate hypertrophy(BPH), 8 cases of TUR of prostate ca, 24 cases of TUR of the bladder tumor. Of all the 97 cases of TUR, 62 cases had some systemic disease. Circulatory diseases, such as hypertension, abnormal EKG and ischemic heart disease were encountered most frequently, namely in 24 cases(26%). The patients who underwent TUR of the BPH had the highest mean age(70 years old). Spinal anesthesia was given 79.4%, and general anesthesia in 18. 6%. Complications did not occur during or after TUR. There was no death associated with anesthesia and operation in this study.
Anesthesia* ; Anesthesia, General ; Anesthesia, Spinal ; Electrocardiography ; Humans ; Hypertension ; Myocardial Ischemia ; Prostate ; Urinary Bladder Neoplasms

In ocular surgery, many studies have been carried but in order to evaluate intraocular pressure chance during induction and maintenance of anesthesia. In this study, Vecuronium (Norcuron), new monoquaternary analogue of pancuronium, has been used in a group of patient undergoing elective sugery in order to evaluate its influe-nce on intraocular pressure. 40 patients without a history of eye digease, in age from 20 to 60 years, were evaluated. Their condition fell into ASA class l. On arrival, initial measurement of intraocular pressure(as control value) was taken with Shiotg tonometer after instilling a 0.5% pontocaine into conjuntival sac. Subsequent measurements were taken after thiopental injeotion as soon at the lid reflex was lost, then 2 minutes after Vecuronium injection, 1,3,5,10 and 20 minutes after endot-racheal intuhation. Blood pressure and pulse rate were measured together. The results were as follows, 1. At 2 minutes after intubation, intraocular pleasure was decreased as compared with the control value. 2. At 1 minute after intutation, intraocular pressure was more increased than the value of 2 minutes after vecuronium injection. but was not significantly changed as compared with control valule. 3. All values measured followed 3 minutes after intubation were significantly derceased. 4. Mean arterial pressure and pulse rate were increased at 1 minute after intubation but all the other values were not significantly changed as compared with control value.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation ; Pancuronium ; Pleasure ; Reflex ; Tetracaine ; Thiopental ; Vecuronium Bromide*

Lecanora is one of the largest genera of lichens worldwide. These lichens can be easily seen, and are commonly found on trees and rocks. Most Korean Lecanora species belong to the Lecanora subfusca group, which has well-defined superficial thallus, red–brown apothecia, and soredia. The new species of L. neobarkmaniana grows on rocks, farinose soredia coalescing, usually covering the whole thallus, and containing atranorin and zeorin. We used internal transcribed spacer (ITS) and mitochondrial small subunit (mtSSU) sequence data to identify the phylogenetic relationship across Lecanora sequence data and found the species to form different clades. In this study, we reported some interesting findings and described the genetic relationship with other sorediate Lecanora species and the characteristics of the new species. An identification key for the Korean sorediate Lecanoraspecies is given.

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.
Adult* ; Anesthesia ; Eating* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Risk Factors ; Water*