The term Down's syndrome is preferred to mongolism. The most constant characteristic of disease is mental retardation. The incidence of Down's syndrome is about 1/600 in the general population, being roughly the same in various parts of world and in all races. The patient's mother's age at the same time of conception as well as the nature of chromosomalmalformation are in genetic counseling. We reported a case of Down's syndrome in 5 year old female who was bone in 38 year old mother, and she was noted epicanthus, nystagmus, esotropia, Brush-field spots. Other systemic manifestation-, Simian crease, short extrimites, inward curved 5th finger, Sandal gap foot, congenital heart disease, prominent abdomen-, was also noted.
Adult ; Child, Preschool ; Continental Population Groups ; Down Syndrome* ; Esotropia ; Female ; Fertilization ; Fingers ; Foot ; Genetic Counseling ; Heart Defects, Congenital ; Humans ; Incidence ; Intellectual Disability ; Mothers

Epidurally administered clonidine, a selective alpha2-adrenergic agonist, has been reported to produce postoperative analgesia. The aim of this study was to see if the addition of a small dose of clonidine to a mixture of bupivacaine, fentanyl and epinephrine prolonged the duration of analgesia and reduce the number of injections or the total bupivacaine requirement and the incidence of side effects. Forty patients presenting for TAH in ASA physical status 1 or 2, were randomly divided into two groups group 1 was given a 10 ml epidural solution of bupivacaine 12.5 mg combined with fentanyl 50 pg and epinephrine 50ug ; group 2 was given the same solution with clonidine 75 ug. Changes in the systolic and diastolic blood pressure and the pulse rate were recorded at 5, 10, 20, 30, 45, 60, 75, 90, 105 and 120 minutes after drug administration, and the analgesic effects were assessed by measuring pain score (Prince Henry Score), analgesic duration, total bupivacaine requirement for 24 hours and side effect. The results were as follows; 1) Heart rate changed little in group 1 and decreased significantly in group 2. 2) Systolic and diastolic blood pressure decreased significantly in all groups (earlier in group 2 than in group 1). 3) The mean duration of analgesia was significantly prolonged in group 2, compared with group 1 (437 min in group 2; 229 min in group 1). For 24 hours after the first injection, numbers of injections (6 in group 1; 3.15 in group 2) and total bupivacaine requirements (75.0 mg in group 1 ; 39.1 mg in group 2) were significantly reduced. 5) The side effects including hypotension, nausea and vomiting, pruritus, and respiratory depression were not significantly different from each other. These results show that epidurally administered clonidine helps to prolong analgesic duration, and decreased need for supplemental bupivacaine, after lower abdominal surgery.
Analgesia ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine* ; Fentanyl* ; Heart Rate ; Humans ; Hypotension ; Hysterectomy* ; Incidence ; Nausea ; Pruritus ; Respiratory Insufficiency ; Vomiting

OBJECTIVES: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. METHODS: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI) : control (n=24), and patients with sleep apnea (n=70). RESULTS: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p< 0.05) CONCLUSION: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.
Humans ; Medical Records ; Oropharynx ; Palatine Tonsil ; Physical Examination ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

Clinically, neostigmine is most commonly used as the reversal agent for to the competitive muscle relaxants. Atropine (group 1) and glrcopyrrolate (group 2) were studied in doses of 15ug/kg, 20 ug/kg and 77ug/kg, 10ug/kg given intravenously in a mixture with neostigm-ine 40ug/kg, during operation and at the end of operation 20 ASA class I patients, aged between 15 to 60, were selected in each group. Anesthesia was maintained with enflurane (1-1.5%), N2O (2L/min), O2(2L/min) and pancuronium (50ug/kg) was used as a muscle relaxant. The results were as fellows : 1) Group 1 showed significant increase and decrease in purse rate compared with group 2. 2) Atropine neostigmine mixture significantly showed initial increase and late decrease in pulse rate than glycopyrrolate-neostigmine mixture. 3) In group 2, 20ug/kg dose of atropine, when administered in a mixture with neostigmine, showed significant initial increase in pulse rate, 15ug/kg dose of atropine showed significant late bradycardia. 4) In group 2, 7 ug/kg, 10 ug/kg dose of glycopyrrolate was not associated with initial tachy cardia but late bradycardia was obserred and 10 ug/kg dose of glycopyrrolate was associated with more stable heart rate.
Anesthesia ; Atropine ; Bradycardia ; Cardia ; Enflurane ; Glycopyrrolate ; Heart Rate* ; Heart* ; Humans ; Neostigmine ; Pancuronium

It is well known that most anesthectis and drugs are metabolized and excreted in the liver. There are many controversies regarding postoperative halothane hepatotoxicitr and often reported postoperative hepatic dysfunction following enflurane anesthesia. It appears that the development of hepatic necrosis after anesthesia depends on a chance combination of events but not anesthetics itself. Common causes of postoperative hepatic damages ia possibly due to viral heatitis, since in oar country viral hepatitis B are increasing in frequency recently. This study was performed to evaluate the effect of enflurane on liver function in 25 asy-mptomatic patients hepatitis B surface antigen positive. The results seems favorable for anesthesia and sureery. on asymptomatic viral hepatitis B patients.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Enflurane ; Halothane ; Hepatitis B ; Hepatitis B Surface Antigens* ; Humans ; Liver* ; Necrosis

A 4 year old girl was admitted for correction of PDA under the general anesthesia. A 4.5mm ID cuffed orotracheal Rusch tube was inserted and the Jackson-Rees system was used for maintenance of anesthesia with enflurane-nitrous oxide-oxygen. During surgery a mild increase in airway resistance was noticed and tachycardia was seen but all other vital signs were within normal limits. In the recovery room, she exhibited signs of complete airway oibstruction, and so the endotracheal tube was extubated. The obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube.
Airway Resistance ; Anesthesia ; Anesthesia, General* ; Child, Preschool ; Female ; Humans ; Recovery Room ; Tachycardia ; Vital Signs

A 4 year old girl was admitted for correction of PDA under the general anesthesia. A 4.5mm ID cuffed orotracheal Rusch tube was inserted and the Jackson-Rees system was used for maintenance of anesthesia with enflurane-nitrous oxide-oxygen. During surgery a mild increase in airway resistance was noticed and tachycardia was seen but all other vital signs were within normal limits. In the recovery room, she exhibited signs of complete airway oibstruction, and so the endotracheal tube was extubated. The obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube.
Airway Resistance ; Anesthesia ; Anesthesia, General* ; Child, Preschool ; Female ; Humans ; Recovery Room ; Tachycardia ; Vital Signs

No abstract available.
Humans* ; Intercellular Adhesion Molecule-1* ; Lung Neoplasms* ; Lung*

No abstract available.
Lung*

PURPOSE: In order to clarify the correlation of mandibular setback using bilateral intraoral vertical ramus osteotomy (BIVRO) and post-surgical transverse mandibular width (TMW), this study examined the pre- and postsurgical changes in hard and soft tissues of TMW and the relationship of TMW and the amount of mandibular setback. PATIENTS AND METHODS: One-hundred seven patients who had undergone BIVRO were evaluated radiographically and clinically. A comparison study of the changes in hard and soft tissue after surgery in all 107 patients was performed with preoperative, 1 month, 3 month, 6 month and 1 year postoperative posteroanterio cephalograms and clinical photographs by tracing. And this changes were evaluated in parts to amounts of mandibular setback. RESULTS: Statistically significant increases of TMW in hard and soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue from 1 month to 1 year postopertive were gradually decreased. TMW in soft tissue was not changed uniformly but almost equal to pre-operative width. And there was no significant correlation between TMW and amount of mandibular setback. CONCLUSIONS: The results show that mandibular setback using BIVRO did not significantly influence increasing of TMW in soft tissue.
Humans ; Osteotomy*