Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

No abstract available.
Humans

No abstract available.
Humans ; Kidney Transplantation* ; Tissue Donors*

No abstract available.
Humans ; Organophosphate Poisoning* ; Respiratory Insufficiency*

Sudoriparous angioma is an unusual form of angioma with pain and hyperhidrosis. We present two cases of typical sudoriparous angioma. Case 1: 9-year-old female showed 0. 8 to 2. 0cm multiple dark brownish tender palpable hypertrichotic masses on the right lower leg after birth. Muscular atrophy and flexion contracture was also developed on the right lower leg for 2 years. Case 2: 4-year-old rnale showed 3 * 3cm tender elevated mass on the left shin after birth. Marked hyperhidrosis was developed when even slight pressure applied on the lesion in these cases. On histologic examination, these two cases showed proliferation of varible sized blood veasels hyperplasia and dilated hyperplastic eccrine glandular and ectopic adipose tissue on the mid and deep dermis. Muscular biopsy from case 1 showed fibrotic and degenerative change. Electromicroscopic examination done from case 1. The secretory epithelial cell of eccrine gland showed cytoplastic degradation and slight dilated intercellular canaliculi (Fig. 11). The lumen of subepithelial capillaries were dilated and some of endothelial cells showed degenerative changes evidenced by RER dilation, mitochondrial swelling and detachment from underlying tissue(Fig. l2). The cutaneous nerve showed many non-myelinated axons enclosed in cytoplasm of Schwann cells.
Adipose Tissue ; Axons ; Biopsy ; Capillaries ; Child ; Child, Preschool ; Contracture ; Cytoplasm ; Dermis ; Eccrine Glands ; Endothelial Cells ; Epithelial Cells ; Female ; Hemangioma* ; Humans ; Hyperhidrosis ; Hyperplasia ; Leg ; Mitochondrial Swelling ; Muscular Atrophy ; Parturition ; Schwann Cells

Syringoma of the vulva is a rare disorder and limitation of the lesions to this site appears unique. Lesions can be clinically diagnosed without difficulty, since it is characterized by multiple, bilateral, asymptomatic skin-colored papules. Vuluar syringoma should be considered in the differential diagnosis of multicentric papular lesions of the vulva. The patient presented here is a 30-year-old healthy woman; lesions are multiple, biiateral, asymptomatic, angular or round, skin-colored to yellowish brown, firm papules localized on the vulvar region and showing a characteristic histologic findings.
Adult ; Diagnosis, Differential ; Female ; Humans ; Syringoma* ; Vulva*

Demodex is easily found from eyelashes and suggested as the one of the causes of some eye diseases. This study was to investigate the occurence rate, and classification of Demodex from eyelashes, and its relationship with blepharitis. The data of this study were compiled from 27 blepharitis patients and 173 patients without blepharitis (control group) who had visited St. Paul's Hospital from October 1981 to December 1981. Three eyelashes from each eyelid-total 12 lashes from a patient-were extracted under the slit lamp, located on a slide glass and fixed with polyvinyl lactophenol mounting medium. (countinued..)
Blepharitis ; Classification ; Eye Diseases ; Eyelashes* ; Glass ; Humans ; Polyvinyls

PURPOSE: Intestinal atresia is a well-recognized cause of bowel obstruction in the newborn. The management of neonates with intestinal atresia has improved in recent decades due to refinements in neonatal intensive care, operative techniques, use of total parenteral nutrition (TPN), and neonatal anesthesia. More recently, the survival rate has risen rapidly up to 90%. METHODS: Twenty-five (25) cases of intestinal atresia were encountered at Kwangju-Christian Hospital between January 1985 and December 1998. We reviewed sex, gestational age, body weight, clinical manifestations, associated ano malies, causes, interval to operation, preoperative complications, operative methods, and postoperative complications. RESULTS: Sites involved were the duodenum (n=10; 40%), the jejunum (n=5; 20%), and the ileum (n=10; 40%). The sex distribution was male predominant (1.8:1). The overall survival rate in our hospital was 76%. CONCLUSION: Refinements in neonatal intensive care and perioperative management were important in decreasing postoperative mortality.
Anesthesia ; Body Weight ; Duodenum ; Gestational Age ; Humans ; Ileum ; Infant, Newborn ; Intensive Care, Neonatal ; Intestinal Atresia* ; Jejunum ; Male ; Mali ; Mortality ; Parenteral Nutrition, Total ; Postoperative Complications ; Sex Distribution ; Survival Rate

Urticaria pigmentosa developed in twins at the age of 6 weeks. They have numerous round to oval shaped, discrete or confluent reddish brown colored macules over whole body surface and neither twin had vomiting, diarrhea, flushing or irritability. Their relatives are unaffected. Biopsy specimen of. back lesion showed. pooling of mast cells in the upper dermis, and electron microscopic examinattion revealed normal mast cells.
Biopsy ; Dermis ; Diarrhea ; Flushing ; Humans ; Mast Cells ; Twins* ; Urticaria Pigmentosa* ; Urticaria* ; Vomiting

Epidermal cysts may develop on any part of the body. Most of them are thought to occur following inflammation of the epithelium of the hair follicle. These found on the palm and sole where the hair follicle is absent have been considered to developmant of following a traumatic inclusion of the epidermis into the Dermis. Because only a few cases w re known to be related to preceding trauma, the latter assumption has been questioned. Reerly, the HPV-like virions and papillomavirus genus-speciric antigen were detected in the epicrml cyst of the sole in some reports. 1 our cases of plantar epidermal cyst were studied for the presence of human papillomavirus using conventional histologic and immunohistochemical examinator Histologic examination showed three characteristic findings, that is, intracytoplasmic eosinophil odies in the cyst wall, parakeratosis within the cyst caviti, and vacuolar structures disperse the wall and cavity. In all of the cases, immunohistochernical staining was positive for papule evirus antigen. These findings suggest an etiologic as.iation between the papillomavirus infection and plantar epidermal cyst.
Dermis ; Eosinophils ; Epidermal Cyst* ; Epidermis ; Epithelium ; Hair Follicle ; Humans* ; Inflammation ; Papilloma* ; Papillomavirus Infections ; Parakeratosis ; Virion