No abstract available.
Renal Artery Obstruction* ; Renal Artery*

No abstract available.
Ankle Fractures* ; Ankle*

No abstract available.
Renal Artery Obstruction ; Renal Artery

BACKGROUNDS: This study was investigated for assessing of the sedative dose of midazolam and its influence on neonatal Apgar score that intravenously injected immediately before operation during epidural anesthesia for cesarean section. METHODS: Midazolam, 1 mg, was given into a freely running IV line every 30s 2 min after 2 mg of midazolam was initiately injected. Ten seconds prior to each injection patients were asked to open the eye. No response, as determined by the anesthesiologists, to three promptly repeated and increasingly louder commands was considered the end-point for the study and no further midazolam was given. RESULTS: The sedative dose of midazolam in our study was 3.3 1.1 mg and interindividual variation (range: 2~7 mg) were wide. Respiratory depression was occurred in one of pregnant women with midazolam. All of the Apgar scores of the newborn infants at 1 and 5 min in both groups were higher than seven. CONCLUSIONS: When the intravenous injection of midazolam for sedation immediately before operation is required in pregnant women during epidural anesthesia for cesarean section, we would like to suggest that one should initiately administer the small dose and then inject the incremental dose with careful observation of the respiratory status.
Anesthesia, Epidural* ; Apgar Score ; Cesarean Section* ; Female ; Humans ; Infant, Newborn ; Injections, Intravenous ; Midazolam* ; Pregnancy ; Pregnant Women* ; Respiratory Insufficiency ; Running

The birth of conjoined twins remains an extremely rare event. Most of such twins are stillborn and one third of the live births die within first day of life. In Korea, there are only three reports on the anesthesia for separation of different kinds of conjoined twins. In view of anesthesia for separation of such twins prematurity, low birth weight, and anomalous shared organ play the major role on the perioperative morbidity and mortality. Such anesthesia therefore is one of the exceedingly complex fields among the pediatric anesthesia and require mobilization of all possible methods and monitoring devices used for pediatric anesthesia. We performed careful preoperative evaluation of extent of joining, discussion and rehearsal of separation procedure between separation team, and anesthetic care such as all possible monitoring, preservation of body temperature, appropriate fluid therapy, awake intubation, avoid neuromuscular blockers, and thorough separation of duty. The separated twins showed normal weight gain postoperatively and discharged postoperative 31th day without any complications.
Anesthesia* ; Body Temperature ; Fluid Therapy ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intubation ; Korea ; Live Birth ; Mortality ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Parturition ; Twins, Conjoined ; Weight Gain

Ovarian tumor in pregnancy is not rare and benign cystic teratoma is most common ovarian tumor in pregnancy. Most ovarian tumor in pregnancy is found at first and second trimester but sometimes found at third trimester and it is difficult to make a decision for management. Moreover physician should consider fetal age and mother's condition, and weigh outcome of operation for complicated ovarian tumor in pregnancy. Torsion of ovarian tumor is not an uncommon complication during first trimester of pregnancy and puerperium but rare occurs during the third trimester of pregnancy. We have experienced a case of torsion of benign cystic teratoma of ovary which occurred at 37 weeks gestation in a 25 year-old woman. So we report this case with a brief review of literature.
Adult ; Female ; Gestational Age ; Humans ; Impetigo* ; Ovary ; Postpartum Period ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Teratoma

Three cases who were successfully treated for cardiac injuries by open thoracotomy were reported. The range of the ages of the patients was 3rd decade. Two of the 3 were males with blunt injuries by motor vehicle accident and one was male with stab wound by knife. In the case of blunt injuries, the right atrium was involved in one case and the right and left atrium were involved in the other. The site of stab wound was the right atrium. There were two cases with the pre-operative diagnosis of cardiac injuries and they were blunt injuries. The case of stab wound was not diagnosed pre-operatively. All cases were treated with open thoracotomy-one posterolateral thoracotomy, one median sternotomy and one Clam shell incision. All of them had an uneventfull post-operative course.
Bivalvia ; Diagnosis ; Heart Atria ; Humans ; Male ; Motor Vehicles ; Sternotomy ; Thoracotomy ; Wounds, Nonpenetrating ; Wounds, Stab

No abstract available.

BACKGROUND: Recently, measurement of heart rate variability and the nonlinear complexity of heart rate dynamics have been used as indicators of cardiovascular health. Hypertensive patients showed alternation of cardiovascular homeostasis. We designed this study to evaluate the effect of anesthesia in hypertensive patients with approximate entropy (ApEn), representing the nonlinear complexity. METHODS: With informed consent, none premedicated normotensive (n=18) and hypertensive patients (n=18) were included in this study. ECG data were collected from 10 minutes before induction to 15 minutes after induction. Collected ECG data were stored into computer binary files. We calculated ApEn from the collected ECG data. RESULTS: Before induction, ApEn of hypertensive patients was significantly lower than that of normotensive patients (p<0.05). During induction and maintenance of anesthesia, there was no difference of ApEn between the two groups. ApEn of normotensive patients during induction and maintenance of anesthesia was significantly lower than that of pre-induction (p<0.05). ApEn during maintenance of anesthesia was lower than that of induction of anesthesia (p<0.05). ApEn of hypertensive group during maintenace of anesthesia was significantly lower than that of pre-induction of anesthesia (p<0.05). CONCLUSIONS: As the ApEn of hypertensive patients is lower than that of normotensive patients during pre-inducton period, the heart rate dynamics of hypertensive patients is more regular normotensive patients. The anesthesia is deepened, the heart rate dynamics of the both group is more regular. During the maintenance of anesthesia, the regularity of the heart rate dynamics that not different in both group from the results.
Anesthesia* ; Electrocardiography ; Entropy* ; Heart Rate ; Homeostasis ; Humans ; Hypertension* ; Informed Consent

The purpose of this study is to compare the effects of the femoral attachment points of the graft and knee flexion angles at the time of graft fixation on stability of posterior cruciate ligament reconstruction. We analyzed the posterior stability of the knee on 23 patients(24 knees) with posterior cruciate ligament injury whose posterior cruciate ligament had been reconstructed arthroscopically and followed for minimum 1 year period at Asan Medical Center from May 1992 to June 1994. The patients were divided into the two groups according to femoral attachment points of the graft and knee flexion angles at the time of graft fixation. The distance from the junction of the intercondylar notch with trochlear groove of the femoral attachment points and knee flexion angles were 11mm and 0°-30° in group A and 7mm and 70°-90° in group B, respectively. 11 knees were included in group A and 13 knees in group B. Posterior stability was determined by difference in posterior tibial translation between the injured and the opposite knee with Telos device. In group A, 5 cases were at the range of 0-2mm, 3 cases 3-5 mm, 3 cases 6-10mm. In group B, 10 cases were at the range of 0-2mm and 3 cases 3-5mm, respectively. Differences in posterior tibial translation on average were 3.6mm and 1.7mm in group A and B, respectively. Conclusively, arthroscopic postrior cruciate ligament reconstruction with femoral attachment point at 7mm from the junction of interconlylar notch with trochlear groove and 70°
Chungcheongnam-do ; Humans ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Transplants