Establishing the cut-off point for the Oppositional Defiant Behavior Inventory.

The purpose of the present paper was to make a detailed examination of the cut-off point for the Oppositional Defiant Behavior Inventory (ODBI). The subjects were 56 untreated boys (age 6-15 years), who were diagnosed to have oppositional defiant disorder and who presented between December 2001 and March 2008. Controls were 690 boys with no history of contacting hospitals and no developmental or behavioral disorders at two elementary schools and two junior high schools in a city and its suburbs. It was shown that the level of opposition in boys could be evaluated regardless of the age groups by the ODBI, because there was no significant difference in the ODBI score for the one-way analysis of variance. Based on the sensitivity (88.2%), specificity (90.0%), positive predictive value (75.0%) and negative predictive value (95.7%), a score of 20 points was thus established as a suitable cut-off point to distinguish the children who are eligible for ODD diagnosis from those who are not.

[Induced hypotension for endoscopic sinus surgery].

The purpose of the present investigation is to examine whether induced hypotension can improve the dryness of the surgical field in endoscopic sinus surgery (ESS). ASA physical status I and II adult patients with chronic sinutitis undergoing ESS were studied. All patients were not premedicated. Anesthesia was induced with propofol and maintained with sevoflurane and fentanyl. The patients were allocated randomly into two groups. In patients of Group C, mean arterial blood pressure (MAP) was maintained around 80 mmHg. In Group H, sodium nitroprusside was infused to maintain controlled hypotension with MAP around 60 mmHg. Blood loss, dryness of the surgical field, volume of fluid infusion and urine output, and surgical as well as anesthetic time were compared. Blood loss and dryness of the surgical field were significantly different between the groups. Volume of infused fluid, urine output, and surgical as well as anesthetic time were not significantly different. Induced hypotension with sodium nitroprusside improved surgical conditions and decreased blood loss in ESS.

[Intraoperative awareness during propofol anesthesia with epidural anesthesia].

This report describes a case of awareness and recall during propofol anesthesia combined with epidural anesthesia in a 32-year-old woman scheduled for a resection of left ovarian tumor. After induction, anesthesia was maintained with propofol and epidural anesthesia. About one hour into maintenance, the patient was moving with haemodynamic signs suggesting inadequate analgesia. Immediately after extubation, the patient could recall the abdomen being touched during laparotomy. This case indicates that even if appropriate dose of propofol is administrated, intraoperative awareness may occur especially with inadequate analgesia.

[Cervical spondylosis revealed after general anesthesia].

We present a case of complicated postoperative nerve injury. A 70-year-old man complained of partial paralysis and numbness of the left forearm 1.5 hour after operation for femoral artery bypass graft. Postoperative cervical spine MRI revealed cervical spondylotic radiculopathy. The MRI findings could account for his symptom. Not only peripheral nerve injury but the cervical radiculopathy may play an important role in perioperative neuropathy.