Anesthetic management in Joubert syndrome.

We review the anesthetic implications of Joubert syndrome and report that spinal anesthesia under intravenous propofol sedation proved satisfactory for repair of an inguinal hernia in a spontaneously ventilating infant with this syndrome. We caution that anatomical peculiarities may complicate performance of a caudal epidural block and suggest consideration of the use of caffeine to ameliorate the apneic episodes seen in early infancy in this syndrome.

Patient gender-related performance of nonfocused helical computed tomography in the diagnosis of acute appendicitis.

Objective: To determine the impact of patient gender on the performance of helical computed tomography (CT) in the diagnosis of acute appendicitis.

Materials And Methods: From January 1, 1996 to December 31, 2000, 650 consecutive nonfocused helical abdominal CT scans were performed in adult patients presenting with acute lower abdominal pain. In general, most patients received both intravenous and oral contrast with 5-mm scan collimation through the lower abdomen and pelvis; details regarding technique and overall accuracy have been published previously.

Accuracy of nonfocused helical CT for the diagnosis of acute appendicitis: a 5-year review.

Objective: The clinical usefulness of routine, nonfocused helical CT was evaluated in diagnosing acute appendicitis or providing an alternative diagnosis in patients presenting to the emergency department with acute lower abdominal pain.

Materials And Methods: We reviewed CT reports and clinical records of 650 consecutive adult patients who presented between January 1996 and December 2000 with right lower quadrant pain or lower abdominal pain and clinical findings suggestive of appendicitis. Helical CT was performed with oral contrast material in 610 cases (93.

Minimizing diaphragmatic injury during radio-frequency ablation: efficacy of subphrenic peritoneal saline injection in a porcine model.

Purpose: To investigate if a targeted subphrenic peritoneal infusion of normal saline to separate liver from diaphragm before radio-frequency (RF) ablation could minimize or eliminate diaphragmatic injury.

Materials And Methods: With a 2-cm-diameter, eight-prong RF needle electrode, 37 hepatic dome RF lesions were created in 10 pigs. Seventeen lesions were created before (non-saline group) and 20 lesions after (post-saline group) intraperitoneal infusion of approximately 500 mL of normal saline.

Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the "heat sink" effect.

Objective: The effect of vessels and their size on radiofrequency lesion creation in the liver was evaluated with respect to potential for vascular injury and perfusion-mediated "heat sink" effect.

Subjects And Methods: Radiofrequency lesions targeted to tissue adjacent to a variety of vessels were created in vivo in the liver of 10 Yorkshire pigs. Postablation contrast-enhanced CT and then histopathologic analysis of the vessels and lesions were performed after sacrifice of the pigs.