• 제목/요약/키워드: caudal

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유.소아 서혜부 수술을 위한 미추마취 (Caudal Anesthesia for pediatric Inguinal Region Surgery)

  • 이경숙;박대팔
    • Journal of Yeungnam Medical Science
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    • 제7권1호
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    • pp.127-131
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    • 1990
  • 10세 미만의 유 소아 환아중 서혜부 수술 50예에서 1% Lidocaine에 epinephrine(1:200,000)을 혼합한 용액 10mg/kg을 주입해서 미추마취를 시행하여 다음과 같은 결과를 얻었다. 1. 유 소아에서 미추마취를 쉽게 시행할 수 있었다. 2. Lidocaine 10mg/kg 투여로 서혜부 수술을 하였으며 술후 진통효과가 우수하였다. 3. 미추 마취의 합병증이 드물게 나타날 수 있었으므로 기술상의 숙련 및 세심한 환자 감시가 필요하다. 이상의 결과를 얻은 바 소아 미추 마취는 적응이 되는 부위의 수술에 좋은 마취방법이라 사료된다.

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Common Sites, Etiology, and Solutions of Persistent Septal Deviation in Revision Septoplasty

  • Jin, Hong Ryul;Kim, Dae Woo;Jung, Hahn Jin
    • Clinical and Experimental Otorhinolaryngology
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    • 제11권4호
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    • pp.288-292
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    • 2018
  • Objectives. To investigate the common causes of persistent septal deviation in revision septoplasty and to report the surgical techniques and results to correct them. Methods. A total of 100 consecutive patients (86 males) who had revision septoplasty due to persistent septal deviation from 2008 and 2014 were included in the study. Their mean age was 35.6 years and the mean follow-up duration was 9.1 months. Presenting symptoms, sites of persistent septal deviation, techniques used to correct the deviation, and surgical results were reviewed. Results. The mean interval between primary and revision surgery was 6.2 years. Forty-eight patients received revision septoplasty and 52 received revision septoplasty combined with rhinoplasty. Nasal obstruction was the most presenting symptom in almost all patients. The most common site of persistent septal deviation was middle septum (58%) followed by caudal septum (31%). Correcting techniques included further chondrotomy and excision of deviated portion in 76% and caudal batten graft in 39%. Rhinoscopic and endoscopic exams showed straight septum in 97% and 92 patients had subjective symptom improvement postoperatively. Conclusion. Middle septum and caudal septum were common sites of persistent deviation. Proper chondrotomy with excision of deviated middle septum and correction of the caudal deviation with batten graft are key maneuvers to treat persistent deviation.

The impact of caudally administrated tramadol on immune response and analgesic efficacy for pediatric patients: a comparative randomized clinical trial

  • Sayed, Jehan Ahmed;Elshafy, Sayed Kaoud Abd;Kamel, Emad Zareif;Riad, Mohamed Amir Fathy;Mahmoud, Amal Ahmed;Khalaf, Ghada Shalaby
    • The Korean Journal of Pain
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    • 제31권3호
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    • pp.206-214
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    • 2018
  • Background: Immune responses appear to be affected by anesthetics and analgesics. We investigated the effects of caudal tramadol on the postoperative immune response and pain management in pediatric patients. Methods: Sixty ASA-I pediatric patients aged 3-10 years undergoing lower abdominal surgery. Patients were randomly assigned either to a caudal bupivacaine (0.25%) group (group B), or a group that received caudal tramadol (1 mg/kg) added to the bupivacaine (0.25%) (group T). Both were diluted in a 0.9% NaCl solution to a total volume of 1ml/ kg. The systemic immune response was measured by collecting blood samples preoperatively, at the end of anesthesia, and at 24 and 72 hours postoperatively, and studied for interleukin IL-6, C-reactive proteins (CRP) cortisol levels, and leucocytes with its differential count. Postoperative pain was assessed along with sedation scales. Results: Postoperative production of IL-6 was significantly higher in group B at the end of anesthesia, than at the $24^{th}$ hour, and at the $72^{nd}$ hour in group B and group T, respectively. The immune response showed leukocytosis with increased percentages of neutrophil and monocytes, and a decreased lymphocyte response rate within both groups with no significant differences between the groups. Cortisol and CRP were significantly higher in group B. Conclusions: Adding tramadol to a caudal bupivacaine block can attenuate the pro-inflammatory cytokine response, Cortisol, and CRP in children undergoing lower abdominal surgery.

The Electrophysiological Characteristics of Medullospinal Tract Cells in Cat Ventrolateral Medulla

  • Lee, Woo-Yong;Kim, Sang-Jung;Kim, Jun
    • The Korean Journal of Physiology
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    • 제25권2호
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    • pp.211-221
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    • 1991
  • Although the existence of nerve cells which determine the activity of sympathetic nervous system in ventrolateral medulla is advocated recently, there are wide varieties on the location and function of them according to authors. Present study aimed to identify and characterize the medullospinal tract cells in rostral and caudal medulla of cats .which branch to the lateral horn of the upper thoracic spinal cord. Cats were anesthetized with ${\alpha}-chloralose$. The upper thoracic spinal cord and floor of the IVth ventricle were exposed. Medullospinal tract cells in rostral and caudal medulla were identified by anti-dromic stimulation of the intermediolateral nucleus in the upper thoracic cord and then the location and physiological characteristics of these cells were studied. A total of seventy cells in medulla had constant latency and responded to high frequency stimulation to thoracic cord. Among them fifty-six cells were identified as medullospinal tract cells either by collision with spontaneous activities or activities evoked by sciatic nerve stimulation(27/56), or by determining the refractory period (29/56). Thirty-one of these cells branched to the contralateral thoracic spinal cord, twenty-one cells to the ipsilateral side and remaining four cells branched to both sides. The conduction velocity of cells branching to the contralateral side was $29{\pm}2.9\;m/sec$ and that of cells to the ipsilateral side was $39.1{\pm}6.0\;m/sec$. When medulla was devided into two by a horizontal plane at 3 mm rostral to the obex, fifty-one among seventy cells were in the rostral medulla and nineteen were in the caudal medulla. The conduction velocities of these two groups were $21.6{\pm}1.0\;and\;33.3{\pm}3.9\;m/sec$, respectively. In this study, we confirmed the existence of two groups of medullospinal tract cells in rostral and caudal ventrolateral medulla, which branch to the lateral horn of thoracic cord and these cells have relatively few spontaneous activities and rapid conduction velocity, so we concluded that these cells are different from the previously known sympatho-related cells in ventrolateral medulla.

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Effects of Exposure to Estradiol Benzoate or Flutamide at the Weaning Age on Expression of Connexins in the Caudal Epididymis of Adult Rat

  • Lee, Ki-Ho
    • 한국발생생물학회지:발생과생식
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    • 제20권4호
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    • pp.349-357
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    • 2016
  • The present research was chiefly designed to determine the effect of the treatment of estrogenic agonist, estradiol benzoate (EB), or antiandrogenic compound, flutamide (Flu), at the weaning age on the expression of connexin (Cx) isoforms in the caudal epididymis of adult male rat. Animals were subcutaneously administrated with a single shot of either EB at a low-dose ($0.015{\mu}g$ of EB/kg body weight (BW)) or a high-dose ($1.5{\mu}g$ of EB/kg BW) or Flu at a low-dose ($500{\mu}g$ of EB/kg BW) or a high-dose (5 mg of EB/kg BW). Expressional changes of Cx isoforms in the adult caudal epididymis were examined by quantitative real-time PCR analysis. The treatment of a low-dose EB caused significant increases of Cx30.3, Cx31, Cx32, and Cx43 transcript levels but reduction of Cx31.1, Cx37, and Cx45 expression. Exposure to a high-dose EB resulted in very close responses observed in a low-dose EB treatment, except no significant expressional change of Cx37 and a significant induction of Cx40. Expression of all Cx isoforms, except Cx45, was significantly increased by a low-dose Flu treatment. Expressional increases of all Cx isoforms were detected by a high-dose Flu treatment. The current study demonstrates that a single exposure to estrogenic or antiandrogenic compound during the early postnatal developmental period is sufficient to disrupt normal expression of Cx isoforms in the adult caudal epididymis.

Comparison of the Efficacy of Caudal, Interlaminar, and Transforaminal Epidural Injections in Managing Lumbar Disc Herniation: Is One Method Superior to the Other?

  • Manchikanti, Laxmaiah;Singh, Vijay;Pampati, Vidyasagar;Falco, Frank J.E.;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • 제28권1호
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    • pp.11-21
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    • 2015
  • Background: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions: The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting.

물고기 로봇 개발을 위한 유연한 꼬리 지느러미 관절의 강성에 따른 최대 추력 조건 연구 (Maximum Thrust Condition by Compliant Joint of a Caudal Fin for Developing a Robotic Fish)

  • 박용재;정우석;이정수;권석령;김호영;조규진
    • 제어로봇시스템학회논문지
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    • 제18권2호
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    • pp.103-109
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    • 2012
  • Fish generates large thrust through an oscillating motion with a compliant joint of caudal fin. The compliance of caudal fin affects the thrust generated by the fish. Due to the flexibility of the fish, the fish can generate a travelling wave motion which is known to increase the efficiency of the fish. However, a detailed research on the relationship between the flexible joint and the thrust generation is needed. In this paper, the compliant joint of a caudal fin is implemented in the driving mechanism of a robotic fish. By varying the driving frequency and stiffness of the compliant joint, the relationship between the thrust generation and the stiffness of the flexible joint is investigated. In general, as the frequency increases, the thrust increases. When higher driving frequency is applied, higher stiffness of the flexible joint is needed to maximize the thrust. The bending angles between the compliant joint and the caudal fin are compared with the changes of the thrust in one cycle. This result can be used to design the robotic fish which can be operated at the maximum thrust condition using the appropriate stiffness of the compliant joint.

노인에서 경막외강에 3회 분할 투여된 Triamcinolone 60 mg이 혈중 포도당, ACTH와 Cortisol에 미치는 영향 (The Effect of Three 20 mg Caudal Epidural Injections of Triamcinolon on the Blood Glucose, ACTH and Cortisol Concentrations in the Elderly Women)

  • 고지은;민순;정영주;이헌근
    • The Korean Journal of Pain
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    • 제18권1호
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    • pp.15-18
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    • 2005
  • Background: Epidural steroid injections (ESI) have been used widely for the treatment of back and radiating extremity pain. Although its effects on the metabolic and endocrine system have been studied, the effects following repeated injections remain to be determined. We studied the effects of three repeated caudal epidural injections of low dose triamcinolone. Methods: the subject were 10 elderly women with spinal stenosis. Caudal epidural injections were performed biweekly. Triamcinolone (20 mg), mixed with 15 ml of 0.25% lidocaine, was used as the ESI injectate. The procedures were performed with the patient in the prone position. Blood sampling was performed just before the first injection, and used as the baseline, and then just before each injection on the same day of the 2nd and 4th weeks, with the last samples taken 2 weeks after the third injection. Results: The blood glucose concentrations showed no significant changes. The blood cortisol and ACTH concentrations were significantly decreased after the first injection, but there were no further decreases after each of the subsequent injections. The cortisol concentrations were maintained within the normal range. Conclusion: Caudal epidural injections, with low dose triamcinolone, suppressed the hypothalamus-pituitary-adrenal (HPA) axis, but no further suppression followed the subsequent repeated injections. Three consecutive caudal injections at 2 week intervals seems to be a safe procedure.

Clinical Experience of Symptomatic Sacral Perineural Cyst

  • Jung, Ki-Tae;Lee, Hyun-Young;Lim, Kyung-Joon
    • The Korean Journal of Pain
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    • 제25권3호
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    • pp.191-194
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    • 2012
  • Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst.

한국산 꿩 난관의 혈관분포에 관한 해부학적 연구 (The Anatomical Study on the Distribution of Oviductal Vessels in Korean Native Pheasants)

  • 최성도;이영훈;김인식;양홍현
    • 한국가금학회지
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    • 제26권1호
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    • pp.27-33
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    • 1999
  • The distribution of oviductal vessels of eight Korean native pheasants was observed after Latex casts of vessels. Latex was injected into thoracic aorta and posterior vena cava of these birds for cast preparation. The results were as follows: 1. The arteries suppling oviduct of the Korean native pheasants contained A. oviductalis cranialis, media, caudalis and vaginalis. The veins drainaging oviduct were stretched along the following ateries and all of the oviductal vessels were situated on the left side of the body. 2. The anterior oviductal artery arose from the pubic artery of the left external iliac artery and distributed to the infundibulum and the magnum of the oviduct. 3. The middle oviductal artery arose from the left sciatic artery and distributed to the isthmus and shell gland of the oviduct. 4. The caudal artery arose from the left internal pudendal artery of the median sacral artery and distributed to the caudal part of uterus and the cranial part of vagina. 5. The vaginal artery arose from the left internal pudendal artery of median sacral artery and distributed to the caudal part of vagina.

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