No abstract available.
Intussusception*

No abstract available.

No abstract available.

Mauriac syndrome consists of a triad of poorly controlled diabetes, profound growth retardation and hepatomegaly. We experienced a case of Mauriac syndrome in an 18-year-old girl who had poorly controlled diabetes mellitus, short stature, hepatomegaly and central obesity. Also at the time of examination, she had complications of diabetic cataract and nephropathy. Fourteen years prior to admission, she was diagnosed as diabetes mellitus at a hospital. Thereafter, she had been managed with irregular insulin injection. On physical examination at admission, her height was 135cm(<3 percentile) and her weight was 39kg(<3 percetile). She was short and obese. The liver was 5 cm palpable below the right subcostal margin. Her sexual maturation was Tanner stage I. On ophthalmologic examination, the cataracts were observed on both eyes and diabetic retinopathy was absent. Diabetic nephropathy could not be confirrned by kidney biopsy due to her mother's refusal. We studied the hormonal, radiographic and histological abnormalities. The hormonal study was normal and the bone age was by delayed as much as 10 years. The liver biopsy revealed glycogen accumulation in hepatocyte. She was consistent with Mauriac syndrome. She was managed by strict diabetic control with insulin therapy, diabetic diet and intensive education. She was discharged with well controlled blood glucose. Five months later, growth acceleration and sexual maturation have not been observed, but hepatomegaly subsided. (J Korean Pediatr Soc 2000;43-837-841)
Acceleration ; Adolescent ; Biopsy ; Blood Glucose ; Cataract ; Diabetes Mellitus* ; Diet, Diabetic ; Diabetic Nephropathies ; Diabetic Retinopathy ; Disulfiram ; Education ; Female ; Glycogen ; Hepatocytes ; Hepatomegaly ; Humans ; Insulin ; Kidney ; Liver ; Obesity, Abdominal ; Physical Examination ; Sexual Maturation

BACKGROUND: A tourniquet is commonly used to achieve a bloodless field in surgery of the extremities. However, the anesthesiologist is concerned about the adverse effects of hypertension which occur during general anesthesia. In this study, we assessed the effects of lidocaine infiltration in the tourniquet site on blood pressure and heart rate during tourniquet inflation under general anesthesia. METHODS: Forty patients of ASA class I or II, scheduled for knee surgery, were randomly divided into two groups. In group 1 underwent general anesthesia and in group 2 also underwent general anesthesia and combined with 1% lidocaine infiltration in the tourniquet site. The changes of systolic and diastolic blood pressure and heart rate were measured before and after toumiquet inflation, after skin incision and 30 min after inflation. RESULTS: Comparing group 1 with group 2, there were significant increases after tourniquet inflation to 30 min after inflation in systolic and diastolic blood pressure in group 1 (p<0.05). However, there were no significant changes in heart rates in either group. CONCLUSIONS: The above results demonstrate that patients who received lidocaine infiltration in the tourniquet site showed less increase in blood pressure during tourniquet inflation.
Anesthesia, General ; Anesthetics ; Blood Pressure* ; Extremities ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Inflation, Economic ; Knee ; Lidocaine* ; Skin ; Tourniquets*

A rare case of uterine lipoleiomyoma is reported with presentation of computed tomography, histomorphologic and immunohistochemical findings. This tumor is predominantly lipomatous with an admixture of smooth muscle fiber and hyalinized fibrous tissue. Immunohistochemical study revealed a positive reaction of S-100 protein in fat cells and desmin in smooth muscle fibers. Its histogenesis also has been discussed.

Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

Sodium nitroprusside is reported to inhibite platelet aggregation. We studied the effects of sodium nitroprusside on platelet aggregation function were in 30 adult patients undergoing spine surgery with enflurane anesthesia. Platelet-rich plasma from patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated serially from the samples collected at post-induction (pre-sodium nitroprusside infusion), 30 min and 90 min after sodium niroprusside infusion. The mean maximum aggregation rate of adenosone diphosphate, epinepherine and collagen at post-induction decreased significantly 30 min and 90 min after sodium nitroprusside infusion (P 0.05),but maximum aggregation time showed no significant changes. The correlation between total sodium nitroprusside dose delivered and maximum aggregation rate of adenosine diphosphate, epinepherine and collagen were r=-0.54 (P<0.05), r=-0.706 (P<0.05) and r=-0.794 (P<0.05). In summary, in situation in which sodium nitroprusside is administered during deliberate hypotensive anesthesia, the anesthesiologist must be aware of the potential for the inhibition of platelet aggregation.
Adenosine Diphosphate ; Adult ; Anesthesia* ; Blood Platelets* ; Collagen ; Enflurane ; Epinephrine ; Humans ; Nitroprusside* ; Platelet Aggregation* ; Platelet-Rich Plasma ; Sodium* ; Spine

Pulmonary edema is a recognized complication of acute airway obstruction, laryngospasm, especially after endotracheal extubation. It usually follows relief of the obstruction and is likely to be of noncardiogenic origin. The mechanism by which an upper airway obstruction causes pulmonary edema is likely due to the combination of the increased reduction of intrapulmonary pressure, increased capillary permeability and hypoxia. We present a case of pulmonary edema that occurred in an adult patient after upper airway obstruction following extubation of the trachea.
Adult ; Airway Extubation* ; Airway Obstruction* ; Anoxia ; Capillary Permeability ; Edema ; Humans ; Laryngismus ; Lung ; Pulmonary Edema* ; Trachea

BACKGROUND: Laryngoscopy and tracheal intubation often induced an undesirable increase in blood pressure and heart rate. We evaluated the preventing effect of nicardipine infusion on the increase of the blood pressure (BP) and heart rate (HR) following a direct laryngoscopy and tracheal intubation. METHODS: Sixty, ASA physical status 1-2, adult patients were selected with informed consent, and randomly allocated into two groups; control group (n = 30) and nicardipine group (n = 30). In the control group, 1.8 ml/kg/h of normal saline was infused, and in the nicardipine group, 5microgram/kg/min of nicardipine was infused continuously from 2 minutes before intubation to 3 minutes after intubation. BP and HR were measured by non-invasive method after arrival at the operating room, before tracheal intubation, shortly after tracheal intubation, and 1, 3, 5, and 10 minutes following intubation. Data were analyzed by repeated measure of ANOVA and t-test. RESULTS: Systolic and diastolic BP were significantly lower in the nicardipine group than in the control group (P < 0.05). HR showed significantly higher value in the nicardipine group (P < 0.05). CONCLUSIONS: The continuous infusion of nicardipine (5microgram/kg/min) was effectively attenuating an increase of BP during tracheal intubation. But the increase in HR is not blunted by nicardipine infusion and there is a significant increase in HR. Although rate-pressure product (RPP) does not increase, the use of nicardipine for blunting hemodynamic responses should be considered carefully in patients with ischemic heart disease.
Adult ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Myocardial Ischemia ; Nicardipine* ; Operating Rooms