No abstract available.
Child* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

BACKGROUND: It has been a standard practice in many institutions to combine light general anesthesia with epidural block for abdominal and pelvic surgery. We attempted to prove the effectiveness of prehydration and to find an suitable epidural local anesthetic dose in terms of hemodynamic stability for upper abdominal surgery. METHODS: For preliminary studies, 11 patients scheduled for elective upper abdominal surgery had received general anesthesia immediately after epidural anesthesia. After epidural injection of 10~16 mL of 2% plain lidocaine into the T9~10 intervertebral space, the changes in blood pressure were observed. Thirty-two patients scheduled for elective upper abdominal surgery were divided into two groups. In group A (study group), after prehydration with Hartmann solution (10 mL/kg), 5~7 mL of 2% plain lidocaine was injected into T8~9 or T9~10 intervertebral space and general anesthesia was then induced. Group B (control group) received general anesthesia only. RESULTS: There were no significant differences in hemodynamics between the epidural with general anesthesia and the control group except SVR (systemic vascular resistance). SVR in group A increased in contrast to the group B in which it remained unchanged. CONCLUSIONS: The combined epidural and general anesthesia, using prehydration and 0.5~1 mL/segment of 2% plain lidocaine at the T8~9 or T9~10 intervertebral space was safe without significant hemodynamic changes.
Anesthesia, Epidural ; Anesthesia, General* ; Blood Pressure ; Hemodynamics* ; Humans ; Injections, Epidural ; Lidocaine

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Recently, NAG activity has gained increasing importance as and aid in the diagnosis of renoparenchymal diseases. Elevation of urine NAG activity has been found to be an indicator of renoparenchymnal diseases. To evaluate the diagnostic value of the NAG activity test in the renal disease, we carried out clinical study on 31 cases of renal disease patients who had been admitted to the Department of Pediatrics, Chung-Ang University Hospital between March 1992 and February 1993. We analyese by two data: (1) Stastical Package for the Social Science. (2) Students'T test. The results were as follows 1) The urine NAG activity significantly increased (p<0.05) to 69.9+/-5165.69U/hr/mg Creatinine (U/hr/mg Cr) in the renal disease group compared to 3.6+/-1.91U/hr/mg Cr in the control group. 2) The serum NAG activity was 11.69+/-5.18U/L in the renal disease group and 10.58+/-4.04U/L in the control group. There was no significant difference in the serum NAG sctivity between two groups. 3) In the renal disease group, the serum NAG activity was 10.78+/-3.32U/L in male 12.53+/-6.47U/L in female. There was no significant difference between both sexes. In the renal disease, the urine NAG activity was 33.62+/-30.67U/hr/mg Cr in male and 114.05+/-241.62U/hr/mg Cr female. There was no significant difference between both sexes (p<0.05). 4) In the renal disease group, the urine NAG activity increased 314.73+/-420.39U/hr/mg Cr in the 2 years old group but there was no significant difference of urine NAG activity compared to above 2 years old group . 5) The urine NAG activities were 93.1+/-0193.04U/hr/mg Cr in the poteinuria subgroup and 13.3+/-47.62U/hr/mg Cr in the nonproteinuria subgroup and 3.66+/-1.91U/hr/mg Cr in the control group. There was no significant difference between the proteinuria subgroup and the nonproteinuria subgroup. but there was significant difference between nonproteinuria subgroup and control grouop(p<0.005).
Child, Preschool ; Creatinine ; Diagnosis ; Female ; Humans ; Male ; Pediatrics ; Proteinuria ; Social Sciences

No abstract available.
Patella*

PURPOSE: The study aimed to analyze changes in patient indicators and surgical indices in relation to bariatric surgery performed at a university hospital and determine the development direction of its obesity center. MATERIALS AND METHODS: From December 2010 to June 2018, a total of 35 obese patients underwent surgery at the center. Patients' height, weight, body mass index (BMI), abdominal circumference, and hip circumference before surgery were measured. Laboratory tests were performed to observe changes before and after surgery. Patients underwent Roux-en Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), and postoperative complications were analyzed. RESULTS: A total of 35 patients underwent obesity surgery: 23 with RYGB and 12 with LSG. Postoperative complications occurred: bleeding in one case, abscess in one case, respiratory failure in one case, and incisional hernia in two cases. The mean preoperative weight was 105.1±27.2 kg and postoperative weight was 84.3±19.9 kg. The difference was 20.7±13.5 kg. BMI also decreased from 38.3±8.4 preoperatively to 31.0±6.4 postoperatively by 7.3±4.6. CONCLUSION: Through our study, we determined that in this hospital, a multidisciplinary team approach to postoperative weight management and health care should be undertaken as well as continuous and systematic management after surgery.
Abscess ; Bariatric Surgery ; Body Weight ; Delivery of Health Care ; Gastrectomy ; Gastric Bypass ; Hemorrhage ; Hip ; Humans ; Incisional Hernia ; Obesity ; Obesity, Morbid ; Postoperative Complications ; Respiratory Insufficiency ; Weight Loss

Between March 1995 and March 1996, we used a newly-designed neurosurgical procedure, based on 'keyhole surgery', to operate on 20 patients diagnosed as suffering from lumbar spinal stenosis without instability. The unique surgical steps involved in this procedure are: 1) three-quarter prone position of the patient; 2) small paramedian skin incision; 3) half-way incision of the spinous process; 4) small turnover funnel shaped unilateral laminectomy and wide forminotomy using high speed drills; 5) extensive ligament flavectomy; 6) microsurgical decompression without using nerve root retractor; 7) cosmetic wound closure. In some cases, if bilateral radicular symptom was present, the contralateral nerve root was explored through the unilateral laminectomy opening; this was achieved by changing the inclination of the base of the spinous process and extensively removing of the ligamentum flavum. Compared with conventional procedures, these technical innovations offer both procedural adventages and a better clinical outcome. Because of the small patient populations and short follow-up period, this technique requires further investigation, but we hope it will provide another option for future lumbar stenosis surgery. Further technical refinements and long-term follow-up results will be reported elsewhere.
Constriction, Pathologic* ; Decompression* ; Follow-Up Studies ; Hope ; Humans ; Laminectomy ; Ligaments ; Ligamentum Flavum ; Neurosurgical Procedures ; Prone Position ; Skin ; Spinal Stenosis ; Wounds and Injuries

The authors report a rare case of air gunshot wound to the thoracic spinal cord in Korea. A case of 17 year-old girl with a air-gunshot wound to the thoracic spine was presented with paraplegia. Radiologic studies revealed a bullet in the fifth thoracic spinal canal. The cerebrospinal fluid leaked through the entry point of the bullet was noted. After laminectomy and dural opening, a intramedullary hematoma with lodged bullet in the contused cord was found. They are removed successfully with any postoperative complications. The bullet was composed of lead. We report this case focusing on the pathophysiology and surgical treatment with review of literatures.
Adolescent ; Cerebrospinal Fluid ; Female ; Hematoma ; Humans ; Korea ; Laminectomy ; Paraplegia ; Postoperative Complications ; Spinal Canal ; Spinal Cord ; Spinal Cord Injuries ; Spine* ; Wounds and Injuries* ; Wounds, Gunshot

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*