The composition and the structure of the sacrum present the sexual and the racial difference. The variation of the structure is meaningful in the administration of caudal anesthesia which used one of the safest and the most valuable means of local anesthesia. In this study, a morphological investigation of the sacrum in Korean adults was done using 145 dry sacral bones. Non-metrical morphological variations were observed and ten measurements were undertaken. The results of the study were as follows. 1. The five segmented sacrum appeared most commonly (62.1%). Six segmented sacrum appeared 37.2% and the incidence tended to increse according to the age. Four segmented sacrum was noted in one case (0.7%). 2. In 9.7%, deficiences existed in the upper dorsal wall of the sacral canal. In 5.5%, deficiences existed in the middle of the dorsal wall of the sacral canal. 3. The apex of the sacral hiatus was found mostly (28.9%) at the upper third of the body of fifth sacral vertebra. 4. The sacral hiatus was classified into five groups by shape with triangular being the most frequent. 5. There was a significant sexual difference in the antero-posterior and transverse diameters of the first sacral vertebral body, the length of the sacrum, and the length of the sacral hiatus. 6. The average sacral index I was 98.2 in male, and 104.4 in female. Sacral index I was the relationship between the greaster breath to the length of the sacrum. 7. The average sacral index II was 46.6 in male, and 44.8 in female. Sacral index II was the relationship between the first sacral body diameter to the greaster breath of the sacrum. A thorough knowledge of the anatomical features of the dorsum of the sacrum including above results will lead to the decrease in the number of failures in administration of caudal anesthesia.
Adult* ; Anesthesia, Caudal ; Anesthesia, Local ; Female ; Humans ; Incidence ; Male ; Sacrum* ; Spine

A morphometric study on the trigeminal ganglion and the intracranial portion of the ophthalmic, maxillary and mandibular nerves was done in 50 Korean adult cadavers. The shape of the ganglion was classified into 7 types and semicircular shape was most common (54%). Mean width of the trigeminal root at porus trieminus was 6.08mm. The length of the trigemnal root from porus to the trigeminal ganglion was 8.28mm at ophthalmic portion, 10.16mm at maxillary portion, and 8.90mm at mendibular portion. Maximum width of the ganglion was 15.48mm and the breadth of the ophthalmic, and maxillary portion were 5.25mm and 5.26mm, respectively, and that of the mandibular portion (4.92mm) was narrow than the other portion. Intracranial ophthalmic nerve was 4.30mm of width and 17.89mm of length, and this nerve inclined average 39.7。 (range 14.56。) from sagital plane. It was observed infrequently that the cavernous sinus extended to the lateral border of the maxillary nervw and the emissary sinus ran under the mandibular nerve.
Adult* ; Cadaver ; Cavernous Sinus ; Ganglion Cysts ; Humans ; Mandibular Nerve* ; Ophthalmic Nerve ; Trigeminal Ganglion*

Hyperinsulinemic hypoglycemia is a relatively rare disease in childhood period except neonate, but hypoglycemia due to delicate imbalance between glucose production & consumption is evoked easily and left permanent damage to brain at these period. The definition is that serum insulin level is above 10microU/ml when blood sugar level is below the 40mg/dl and so I/G ratio is higher than 0.4. The clinical manifestations are irrtability, frequent feeding and seizures etc. and there is no specific pancreatic pathology in most cases. We experienced 2 cases of hyperinsulinemic hypoglycemia with pancreatic hyperplasia and pancreatic adenoma each other. The diagnosis was made on clinical manifestations, laboratory results, radiologic and pathologic findings. We reported these cases with brief review of literature.
Adenoma ; Blood Glucose ; Brain ; Diagnosis ; Glucose ; Humans ; Hyperplasia ; Hypoglycemia* ; Infant, Newborn ; Insulin ; Pathology ; Rare Diseases ; Seizures

BACKGROUND: This study was performed to compare anesthetic agents and adjuvants for general anesthesia or regional anesthesia between university hospitals, resident-training general hospitals and hospitals without training program of residents. METHODS: We surveyed university hospitals, resident-training hospitals and hospitals without training program of residents and divided randomly each hospital groups to become twenty hospitals. We compared the use frequency of inhalation anesthetics, muscle relaxants, induction agents, reversing agents, local anesthetics, premedicants, cardiovascular drugs and plasma expanders. RESULTS: Enflurane was most commonly used inhalation anesthetic in all hospital groups. Isoflurane was less commonly used inhalation anesthetic in hospitals without training program of residents. Pancuronium was most commonly used muscle relaxant in university hospitals. Midazolam, ketamine, fentanyl, propofol were commonly used induction agents during induction in university hospitals and resident-training general hospitals. Differences of use frequency of local anesthetics among hospital groups were not significant, but epinephrine mixing with local anesthetics was more frequent in university hospitals and resident-training general hospitals. Midazolam as a premedicant and norepinephrine, phenylephrine, amrinone, esmolol, pentastarch were less used in hospitals without training program of residents. CONCLUSIONS: These results suggest that university hospitals and resident-training general hospitals didn't show difference in anesthestics or adjuvants but hospitals without training program of residents used less commonly isoflurane, atracurium, midazolam, ketamine, propofol, fentanyl, cardiovascular drugs and pentastarch.
Amrinone ; Anesthesia, Conduction ; Anesthesia, General ; Anesthetics* ; Anesthetics, Inhalation ; Anesthetics, Local ; Atracurium ; Cardiovascular Agents ; Education ; Enflurane ; Epinephrine ; Fentanyl ; Hospitals, General* ; Hospitals, University* ; Hydroxyethyl Starch Derivatives ; Inhalation ; Isoflurane ; Ketamine ; Midazolam ; Norepinephrine ; Pancuronium ; Phenylephrine ; Plasma ; Propofol

No abstract available.
Constriction, Pathologic* ; Spinal Canal*

Renal artery embolization was induced experimentally in rabbits and microvascular changs were studiedangiographically, microangiographically and histopathologically. The results were as follows; 1. The mainmicroangiographic findings of renal artery embolization were arterial occlusion and collateral vessels arecharacterized by spiralling, dilatation, irregular lumen with abrupt caliber change, disoriented course andincreased number. 2. Collateral vessel formation was demonstrated in all cases of renal artery embolization bymicroangiography. 3. Recanalization of embolized vessels was better visualized by renal angiography thanmicorangiography. It was considered that microangiography is a valuable method for the observation ofmicrovascular changes in renal artery embolization and other renal diseases.
Angiography ; Dilatation ; Methods ; Rabbits ; Renal Artery

The study was carried out to analyze the roentgenological findings associated with clinical symptoms andphysical findings about 18 cases of congenital hydronephrosis confirmed at the Dept. of Urology, Chonnam NationalUnversity Hospital from Jan. 1977 to Dec. 1981. The results were summarized as follows; 1. The congenitalhydronephrosis developed mostly in male (89%) and the distribution of age was between 4 months and 34 years. 2.The incidence of pathological side was 10 patients in left, 3 patients in right and 5 patients in bilateral. 3.The most common etiological factor was congenital UPJ stricture (33%), others composed of aberrant renal vessel(22%), ureterocele(22%), posterior urethral valve (11%), fibrous band(6%) and renal fusion(6%). 4. The mainsymptom was flank pain(56%) and in 7 cases (395) abdominal mass was palpable. 5. On laboratory examination, serumBUN and creatinine level were normal in 14 cases (78%) and 15 cases (825) respectively. In 2 cases of posteriorurethral valves, renal function was severely damaged. 6. Intravenous pyelography was performed in all cases andshowed pelvicaliceal dilatation in 13 cases, non-visualizing kidney in 5 cases, and characteristic crescent signin one case.
Constriction, Pathologic ; Creatinine ; Dilatation ; Humans ; Hydronephrosis ; Incidence ; Jeollanam-do ; Kidney ; Male ; Urography ; Urology

Teratomas, usually arising in the anerior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends fromthe third branchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere,containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenicmass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.
Acoustics ; Branchial Region ; Diagnosis ; Mediastinum ; Notochord ; Shadowing (Histology) ; Teratoma ; Ultrasonography

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and incresed pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was assciated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered. reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather incresed than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Anesthetics ; Anesthetics, Local ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Cardiovascular System* ; Central Nervous System ; Central Venous Pressure ; Cough ; Diazepam* ; Dogs* ; Heart Rate ; Hemodynamics ; Intubation ; Laryngoscopy ; Lidocaine* ; Nerve Block ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reflex ; Stroke ; Vascular Resistance