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A 50 year-old woman was scheduled for clipping of giant middle cerebral artery (MCA) aneurysm. Preoperative four-vessel angiography and computed tomography scan revealed a giant aneurysm (3.5x3.3x3.5 cm) at bifurcation of right MCA. Induced hypotension and brain protection using sodium nitroprusside (SNP) and thiopental loading were planned to prevent cerebral damage during the operation. Before induction, esmolol, lidocaine and vecuronium were administered. Mask ventilation with isoflurane in N2O and O2 was performed over 5 minutes and then tracheal intubation was done. Anesthesia was maintained by isoflurane+N2O+O2 with pancuronium. Electrocardiography, pulse oxymetry, capnography, central venous pressure, evoked potential and invasive arterial blood pressure were monitored. She was hyperventilated intraoperatively with a PaCO2 around 30 mmHg. Perioperative hypotension was achieved with infusion of SNP (0.3~1.0 microg/kg/min). During the actual aneurysm surgery, mean arterial pressure was lowered to approximately 50 mmHg. Adjuvant drugs such as methylprednisolone, mannitol and furosemide to reduce intracranial pressure were also administered. This technique established good brain conditions during clipping of the aneurysm. A thiopental loading (4 mg/kg) was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained after thiopental and SNP. Postoperatively, the patient was transferred to the intensive care unit.
Anesthesia ; Aneurysm ; Angiography ; Arterial Pressure ; Brain ; Capnography ; Central Venous Pressure ; Electrocardiography ; Evoked Potentials ; Female ; Furosemide ; Humans ; Hypotension ; Intensive Care Units ; Intracranial Aneurysm* ; Intracranial Pressure ; Intubation ; Isoflurane ; Lidocaine ; Mannitol ; Masks ; Methylprednisolone ; Middle Cerebral Artery ; Nitroprusside ; Pancuronium ; Thiopental ; Vecuronium Bromide ; Ventilation

6.Radiologic findings of rib tumors

Young Seok LEE ; Byung Ihn CHOI ; Jung Gi IM

Journal of the Korean Radiological Society 1983;19(4):844-850

Authors reviewed 21 cases of histologically confirmed rib tumor except metastasis and myeloma from Nov. 1973 to Dec. 1982 at Seoul National University Hospital. The resuls are as follows: 1. Major clinical findings are painand mass. 2. Pathologic diagnosis of rib tumors are 5 cases of fibrous dysplasia, 3 chondroma, 2 osteochondroma, 2desmoplastic fibroma, 3 chondroma, 2 osteochondroma, 2 desmoplastic fibroma, 5 osteosarcoma, 1 aneurysmal bonecyst, 1 eosinophilic granuloma, 1 cavernous hemangioma, 1 chondrosarcoma. 3. Radiologic findings are osteolyticchange and cortical expansion without marginal sclerosis in fibrous dysplasia, central location, well-definedosteolytic change with marginal sclerosis and no cortical destruction in desmoplastic fibroma, corticaldestruction, soft tissue mass and pleural effusion in malignant tumors.
Aneurysm ; Chondroma ; Chondrosarcoma ; Diagnosis ; Eosinophilic Granuloma ; Fibroma ; Fibroma, Desmoplastic ; Hemangioma, Cavernous ; Neoplasm Metastasis ; Osteochondroma ; Osteosarcoma ; Pleural Effusion ; Ribs ; Sclerosis ; Seoul

1.A Trend of Serum C3 and C4 levels in Acute Poststreptococcal Glomerulonephirtis.

2.Abterior cervical fusion with ASIF plate.

3.Genitoplasty by horizontal osteotomy.

4.The clinical analysis of choledochal cyst.

5.Anesthetic Management of Giant Intracranial Aneurysm.

6.Radiologic findings of rib tumors

7.A Case of Semicircular Lipoatrophy.

8.A Case of Poland's Syndrome.

9.Radial motor nerve conduction study using surface electrode in normal adults.

10.The treatment of neglected patellar fracture: report of 2 cases.

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