No abstract available.
Prognosis* ; Stomach Neoplasms*

We have experienced a case of incompatible blood transfusion during general anesthesia in which 300ml of improperly typed blood were transfused. Upon discovery of the error, the transfusion was discontinued and the patient was immediately, carefully and aggressively treated with proper fresh blood, plasma expander(Rheomacrdex-D), fluids(Hartmanns solution and 10% dextrose in water) and drugs (Solu-Cortef 300 mg, furosemide 400 mg, 20% manitol 500 ml, digoxine 0. 5 mg, morphine 15 mg). The free hemoglobin in the plasma and urine and blood gas of the femoral or radial artery were rnonitorecl throughout the resuscitative procedure. It is felt that accidental incompatible blood transfusion of more than 300 ml should be preventable and that the patients life may be saved without serious complications with immediate and proper management.
Anesthesia, General* ; Blood Transfusion* ; Digoxin ; Furosemide ; Glucose ; Humans ; Morphine ; Plasma ; Radial Artery

Four cases of malignant hyperpyrexia were reported in Korea since 197I and three of these cases expired. We discuss here the four cases of malignant hyperpyrexia with clinical features and management, and the importance of early recorgnition and aggressive treatment of malignant hyperpyrexia are stressed.
Korea* ; Malignant Hyperthermia*

PURPOSE: We used MRI to retrospectively analyze the brain of patients suffering from cerebral palsy. Our aim is to determine MRI's role in the assessment of brain damage, the relationship of gestational age. METHODS: A total of 66 patients(29 preform group and 37 term group), who visited Kang-Dong Sacred Heart Hospital from January, 1994 to July, 1998, were enrolled in this study. RESULTS: Among the 29 in the preform group, 13 patients showed MR images of hypoxic ischemic injury in which periventricular leukomalacid(PVL) and multifocal ischemic necrosis in 12(41.3%) and 1(3.4%) respectively. Neuronal migration disorders were 6(20.8%), other congenital malformations 5(17%) and normal MR images 5(17%) in this preform group. Among the 37 in the term group, 22 patients showed MR images of hypoxic ischemic injury in which selective neuronal necrosis were 11(29.7%), PVL 4(10.8%), focal and multifocal ischemic necrosis 4(10.8%) and status marmoratus 3(8.1%). Neuronal migration disorders were 4(10.8%), other congenital malformations 5(13.5%) and normal MR images 6(16.2%) in the term group. CONCLUSION: MRI provided useful information in a majority of children with cerebral palsy. Hypoxic ischemic injury was significantly different in preform and term groups. PVL was frequent in the preterm group and selective neuronal necrosis was statistically common in the term group.
Brain* ; Cerebral Palsy ; Child* ; Gestational Age ; Heart ; Humans ; Magnetic Resonance Imaging* ; Movement Disorders ; Necrosis ; Neuronal Migration Disorders ; Neurons ; Paralysis* ; Retrospective Studies

No abstract available.
Histocompatibility Antigens* ; Histocompatibility* ; Humans ; Young Adult*

It is well known that increasing tendency of emergency surgery of congenital snomalies such as tracheoesophageal fistu1a, esophageal atresia, esophageal hiatal hernia, hypertrophic pyloric stenosis,intestinal obstruction, imperforated anus, omphalocele, and meconium ileus by virtue of improvement of pediatric surgical procedure, anesthetic agent, and anesthetic method. The possibility of a low gastric pH and the resultant pulmonary damage if aspirated must be considered in the initial care of the newborn with poor muscle tone or reflex activity as well as in the anesthetic management of neonates. We became interested in the factors determining neonatal gastric pH in this point of view, and have measured gastric pH in 75 unselected neonates, 55 of whom were born vaginally and 20 by cesarean section. In premature infants, pH was high regardless of mode of delivery. In mature infants, pH was 1) significantly lower after vaginal delivery than after cesarean section; 2) tended to be lower after section preceded by labor than after elective section; and 3) was lowest after precipitate delivery. There was no correlation between neonatal gastric pH and duration of rupture of membranes, birth weight, or Apgar score. It was concluded that the mature human fetus produces gastric acidity in response to stresses associated with labor and vaginal delivery.
Anal Canal ; Apgar Score ; Birth Weight ; Cesarean Section ; Emergencies ; Esophageal Atresia ; Female ; Fetus ; Gastric Acid* ; Hernia, Hiatal ; Hernia, Umbilical ; Humans ; Hydrogen-Ion Concentration ; Ileus ; Infant ; Infant, Newborn ; Infant, Premature ; Meconium ; Membranes ; Pregnancy ; Reflex ; Rupture ; Virtues

Recently, with the remarkable theoretical progress made in anesthesiology these years, reports are being made on the results of the study on the complications, minor or major, caused by previous general anesthesia. However, .the reports on incidence vary according to the reporters. According to Riding, the recent development of anesthesiology, anesthetic inatruments, knowledge of physiology, anesthetics, induction agents and muscle relaxants are said to have reduced the incidence of complications to a great extent. Riding, Gold and Dyrberg report that the factors capable of influencing the incidence of complication, in the post-operative period include age, sex, premedicants for anesthetics, inhalation method of anesthetics, time of anesthesia, muscle relaxant, use of induction agent, acid-base imbalance and developed knowledge of physioloy, operation site, mental state of patients before operation, general condition, anesthetic technique, and. adequate selection of medicine. Working for Department of Anesthesiology, Hanyang University, from October 1976 to August 1977, we selected, out of the patients who received general anesthesia, 523 males and 372 females, totalling 895, who showed no abnormal symptoms in their respiratory systems, circulatory systems and metabolic systems and observed the incidence of complication in the light of sex, age and operation site, the factors supposed to affect the incidence. An hour prior to the general anesthesia, the patients were given intramuscular injection with premedicants atropine 0. 01 mg per kg, Valium 0. 2 mg or Demerol 1 mg per kg of body weight. For induction of anesthesia, Epontol 10 mg per kg and succinylcholine 1 mg per kg of body weight were injected in the veins, then ventilation was made for a minute with mask and then endotracheal tubes were inserted. and then a minimum amount of air was injected. into the cuff of the endotracheal tube, and the ventilation was done in a semi-closed system. During the period of maintenance, anesthesia was administered in a semi-closed system with 0. 5~l. 0% halothane, 3 L/min of nitrous oxide, 2 L/min of oxygen; and if need be, muscle relaxant was injected into the vein. In case a nondenolarizing agent was used in the course of maintenance, atropine 0. 5~1. 0 mg and neostigmine 2.0 ~ 4.0 mg were injected into the vein for reversion at the recovery time. After the patient was completely recovered, the endotracheal tube was cautiously removed, so as not to give trauma to the throat. As for method of observations, 24 hours after the patient had recovered, we visited the patient in the ward, first observing the existence or nonexistence of incidence of minor complications, and then calculating the incidence by the distribution of sex, age and operation site. The outcome of the observation of the above results by statistics and by chi square test is as follows; 1) the incidence of complications after general anesthesia was high in females. 2) Age has not affected the incidence of complications. 3) The incidence of nausea was highest in the patients with abdominal operation. 4) The incidence of sore throat was highest in the head and neck patients. 5) The incidence of fever was highest in the abdomen patients. 6) The incidence of headache was highest in the head and neck patients.
Abdomen ; Acid-Base Imbalance ; Anesthesia ; Anesthesia, General* ; Anesthesiology ; Anesthetics ; Anesthetics, Inhalation ; Atropine ; Body Weight ; Diazepam ; Female ; Fever ; Halothane ; Head ; Headache ; Humans ; Incidence ; Injections, Intramuscular ; Male ; Masks ; Meperidine ; Methods ; Nausea ; Neck ; Neostigmine ; Nitrous Oxide ; Oxygen ; Pharyngitis ; Pharynx ; Physiology ; Propanidid ; Respiratory System ; Succinylcholine ; Veins ; Ventilation

PURPOSE: Good compliance with an anticonvulsant medication regimen is essential for the successful management of epilepsy. However, pediatric compliance with anticonvulsant therapy did not well be studied. The aim of this study was to identify the following key in noncompliance in pediatric out patients receiving anticonvulsant therapy determining factors. METHODS: Eighty-one epileptic outpatients under fifteen years of age with anticonvulsant therapy from the pediatric department of Kang-Dong Sacred Heart Hospital was enrolled for the study. Variables such as age, sex ratio, the reason of poor compliance, medication regimen and seizure frequency were extracted from each patients'medical record. RESULTS: Up to 37% of the patients was labeled as a poor compliant group. Compliance was low at the under 6 year and over 13 year-old patient group, and was also low for those who hadn't had a seizure in a while and for those who had a low seizure rate since last year. The mean plasma level of anticonvulsants was higher in the good compliant group than in the poor compliant group. The most reported obstacle to good compliance was forgetfulness. Side effect and drug rejection were also reported. CONCLUSION: To the high risk group of poor compliance, reminding, decreasing side effects, making simple administration adjustments have been reported to be useful in promoting compliance with medication regimens.
Adolescent ; Anticonvulsants ; Child* ; Compliance* ; Epilepsy ; Heart ; Humans ; Medication Adherence ; Outpatients ; Plasma ; Seizures ; Sex Ratio

Although the acupuncture is not accepted medical therapeutic method in Korea, the author has been undertaken to treat various conditions of pain in an pain clinic at HANYANG University Hospital during 11 months from 1975 to 1976 to 62 patients who had not responding to conventional treatments such as medication, nerve block, physiotherapy and psychotherepy .etc. At the result of the electrical Acupumcture stimulation, 17 patients (27.4%) showed marked improvement, 21 patients (33. 9%) showed improvement and 21 patients (33. 9%3 transient improvement. The total confidence showed O8 patients (61. 3%), furthermore the longterm results of these follow up study will be carried continuously with the questioners within 6 months. And also the mechanisms of the stimulation produced analgesia reviewed with the recent reported several literatures. In conclusion, acupuncture can be used to relief of various pain for which coventional treatments are less effective. Acupuncture is relatively easy to learn and to practice by the acquisition of minimal knowledge of the technique.
Acupuncture* ; Analgesia ; Electric Stimulation Therapy* ; Follow-Up Studies ; Humans ; Korea ; Methods ; Nerve Block ; Pain Clinics*

The cardiovascular and CNS effects of MIDAZOLAM 0.25 mg/kg were studied in 40 patients, randomised and emergency operations(20 males and 20 females). The effects of the administration of MIDAZOLAM intravenously on the cardiovascular and central nervous system were determined. The results were as follows: 1) It had short duration of action and absence of vascular irritation compared with MIDAZOLAM. 2) Three minutes after injection, mean systolic pressure decreased from 132+/-16 mmHg to 115+/-18 mmHg and diastolic pressure from 87+/-11mmHg to 77+/-13 mmHg. One minute after injection heart rate increased from 89+/-19 beat/min to 95+/-20 beat/min and after three minutes returned to prior level. 3) Our study shows that the intraveous administration of MIDAZOLAM 0.25mg/kg produces. a statistically significant, but clinically unimportant, decrease in blood pressure and an increase in heart rate. 4) The effects of MIDAZOLAM on the central nervous system were determined from the time of onset of injection. Spontaneous eye closure, loss of eyelash reflex and apnes were observed at 113+/-66 sec, 133+/-65 sec, and 147+/-58 sec, after injection of MIDAZOLAM. 5) MIDAZOLAM as an induction agent for anesthesia is not indicated for in out-patient surgery due to the extended duration of drowsiness losting over 3 hours in the recovery room. 6) MIDAZOLAM was sufficient as an induction agent for general anesthesia.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Central Nervous System ; Emergencies ; Heart Rate ; Humans ; Male ; Midazolam ; Outpatients ; Recovery Room ; Reflex ; Sleep Stages