No abstract available.
Animals ; Captopril* ; Cisplatin* ; Nifedipine* ; Rats*

The purpose of this study was to compare the cardiovascular changes with various administration method of lidocaine. This study was performed 40 patients scheduled for elective surgery at chosun university hospitaL Patients were randomly assigned to recieve lidocaine by intravenous, larynogotracheal spray, transtracheal injection before tracheal intubation. Systolic blood pressure(SBP), diastolic blood pressure(DBP) mean arterial pressure(MAP) and Heart rate(HR) were measured at preinduction and 1, 2, 3, & 5 minutes after intubation. The results were as follows; 1) Control group; not administered lidocaine; SBP, DBP, MAP % HR were significantly increased at 1, 2 minutes after intubation(P<0.05, P<0.01). 2) Group 1; intravenous lidocaine administration(2 mg/kg);, SBP, DBP, MAP were increased but not statistically significant. Heart rate was significantly increased at 1, 2, 3 minutes after intubation(P<0.05, P<0.01). Compared with control group, SBP, DBP & MAP were statistically significant (P<0.05). 3) Group 2; laryngotracheal spray(2 mg/kg); Similar to group 1 but DBP was increased at 1 minute after intubation(P<0.05). and SBP, DBP, MAP & HR were maintained higher level than group I at every time. 4) Group 3; Transtracheal injection of l% lidocaine 2~3 ml; SBP, DBP & MAP were not exceed baseline level at 1 minute but HR was significantly increased at l, 2 minutes after intuhation(P<0.05). Compared with control group, SBP, DBP, and MAP were statistically singnificant (P<0.05). This study suggest that administration of lidocaine attenuate sympathetic stimulation follwing tracheal intubation. Intravenous injection of lidocaine is recommendable method to prevent the sympathetic stimulation following tracheal intubation.
Heart ; Heart Rate ; Humans ; Injections, Intravenous ; Intubation* ; Lidocaine*

BACKGROUND: Aspiration pneumonia remains a serious result associated with general anesthesia. Therefore, we studied the effectiveness of preanesthetic ranitidine in increasing gastric pH to prevent aspiration pneumonia. METHODS: Eighty patients scheduled for elective surgery were randomly divided into four groups with twenty patients in each group. Patients in control group were not given preanesthetic ranitidine; patients in group I received 300 mg of ranitidine orally at night before surgery, patients in group II received 150 mg of ranitidine orally both the night before surgery and one hour before surgery respecvtively and patients in group III recieved 150mg of ranitidine orally one hour before surgery. RESULTS: Compared with control group, the mean gastric pH of preanesthesia and 1 hour after anesthetic induction increased significantly in the group I, II, III (P<0.0001). There was significant increased gastric pH in the group II compared with group I and III. CONCLUSIONS: These results demonstrate that ranitidine markedly increase the gastric pH. So, we recommend that patients receiving general anesthesia would be taken Hz-antagonist such as ranitidine preoperatively.
Anesthesia, General ; Humans ; Hydrogen-Ion Concentration* ; Pneumonia, Aspiration ; Premedication ; Ranitidine*

BACKGROUND/AIM: Serial measurement of serum carcinoembryonic antigen was assessed to define its significance and to determine the adequacy in detecting recurrence after curative resection for colorectal cancer. METHODS: Six hundred forty-five patients with colorectal cancer underwent curative resection were included. The median follow-up period was 49 months (range, 24~94 months). Serum CEA was analyzed in accordance with location, histologic differentiation, stage of the tumor, recurrence and survival. RESULTS: The incidence of elevated preoperative serum CEA (> 6 ng/ml) was correlated with tumor stage (stage I vs. II, P=0.01; stage II vs. III, P=0.0001). Fifty five patients among 87 patients with recurrence (63.2%) had concomitant elevation of serum CEA, whereas 32 of 558 patients (5.7%) without recurrence showed a false-positive result. Measurement of serum CEA was more sensitive in patients with elevated preoperative serum CEA and liver metastases than in patients without elevated preoperative serum CEA and local recurrence (P=0.0397). The leading time of serum CEA between the first elevated serum CEA and the identification of recurrence was 3.5 months (range, 1~12 month). Tumor stage and preoperative serum CEA level were found to be significant prognostic variables by multivariate analysis. The overall 5-year survival rate in the normal preoperative serum CEA and the elevated group were 76% and 64% respectively (P=0.00019). CONCLUSION: Serum CEA seemed to be closely correlated with survival and to be an useful tool to detect recurrence after curative resection for colorectal cancer. The appropriate measurement of serum CEA might be suggested in stage II and III postoperatively: every three month for two years, every 6 month for succeeding 2 years, and annually thereafter. Monitoring of serum CEA in stage I could be individualized by preoperative serum CEA and clinical course.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Liver ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Survival Rate

Motor neuropathy of a lower extremity is well recognized potential complication of procedures performed on patients in a lithotomy position. Mechanisms of nerve injury are unclear but the incidence of perioperative nerve injuries can be reduced if anesthetists are aware of their causes and pathophysiolgies. It is important to note that reduced duration in lithotomy position may reduce the risk of lower extremity neuropathies. We experienced two case of common peroneal nerve palsy after lithotomy positioning. Diagnosis was based on history, a clinical examination and electrophysiologic studies. A neurologic examination revealed hypersthesia over the dorsum of the left foot with inability to perform active dorsiflexion. Electrophysiologic studies showed delayed latency and low amplitude of nerve action potential.
Action Potentials ; Diagnosis ; Foot ; Humans ; Incidence ; Lower Extremity ; Neurologic Examination ; Paralysis* ; Peroneal Nerve*

BACKGROUND: BRAF mutation has been recognized as an important biomarker of colorectal cancer (CRC) for targeted therapy and prognosis prediction. However, sequencing for every CRC case is not cost-effective. An antibody specific for BRAF V600E mutant protein has been introduced, and we thus examined the utility of BRAF VE1 immunohistochemistry for evaluating BRAF mutations in CRC. METHODS: Fifty-one BRAF-mutated CRCs and 100 age and sexmatched BRAF wild-type CRCs between 2005 and 2015 were selected from the archives of Asan Medical Center. Tissue microarrays were constructed and stained with BRAF VE1 antibody. RESULTS: Forty-nine of the 51 BRAF-mutant CRCs (96.1%) showed more than moderate cytoplasmic staining, except for two weakly stained cases. Six of 100 BRAF wild-type cases also stained positive with BRAF VE1 antibody; four stained weakly and two stained moderately. Normal colonic crypts showed nonspecific weak staining, and a few CRC cases exhibited moderate nuclear reactivity (3 BRAF-mutant and 10 BRAF wild-type cases). BRAF-mutated CRC patients had higher pathologic stages and worse survival than BRAF wild-type patients. CONCLUSIONS: BRAF VE1 immunohistochemistry showed high sensitivity and specificity, but occasional nonspecific staining in tumor cell nuclei and normal colonic crypts may limit their routine clinical use. Thus, BRAF VE1 immunohistochemistry may be a useful screening tool for BRAF V600E mutation in CRCs, provided that additional sequencing studies can be done to confirm the mutation in BRAF VE1 antibody-positive cases.
Cell Nucleus ; Chungcheongnam-do ; Colon ; Colorectal Neoplasms ; Cytoplasm ; Humans ; Immunohistochemistry ; Mass Screening ; Mutant Proteins ; Prognosis ; Sensitivity and Specificity ; Sequence Analysis, DNA

Video-assisted thoracic surgery (VATS) has been increasingly used because of it is a less invasive procedure than the open thoracotomy. Neither commercially available double-lumen tubes nor the univent tube can be used in small children. An ordinary uncuffed tracheal tube was introduced into the main bronchus of the right lung. This technique proved to be a simple and effective method of isolating and ventilating the other lung. We describe our experience providing one-lung ventilation with ordinary endotracheal tube during VATS in two young children. (Korean J Anesthesiol 2001; 40: 824 ~ 828)
Bronchi ; Child* ; Humans ; Lung ; One-Lung Ventilation ; Thoracic Surgery, Video-Assisted* ; Thoracotomy

Extracorporeal shock wave lithotripsy(ESWL) for urinary calculi is usually performed under general anesthesia, regional anesthesia or intravenous anesthesia. We evaluated the sedativeanalgesic effeet and untoward effects of diazepam-fentanyl for ESWL. 60 patients were belonged to physical status 1 or 11 of ASA classification who injected diazepam(5~10 mg) and fentanyl(1.5 ug/kg) at 2 minutes were as follows The results were as follows; 1) Mean arterial pressure(MAP) was significantly decreased in 3-10 minutes after injection compared to baseline value. 2) Heart rate(HR) was statistically nonsignificant but slightly decreased from 2 minutes after injection. 3) Respiratory rate(RR) and arterial oxygen saturation(SaO2) were significantly decreased until 15 miuntes after injection but SaO was not decreased below 92.7% and RR was not decreased below 13 rates/minute. 4) Pain and movement during ESWL developed in 18 cases but repositioning and discon- tinuation of EWSL were not necessary. Episodes of desaturation(SaO2<90%) developed in 2 cases. 5) Postoperative dizziness developed in 24 cases. nausea and vomiting developed in a few cases. We concluded that intravenous administration of diazepam-fentanyl is more convenient and simpler than other anesthetic technique for ESWL.
Administration, Intravenous ; Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Intravenous ; Classification ; Diazepam* ; Dizziness ; Fentanyl* ; Heart ; Humans ; Lithotripsy* ; Nausea ; Oxygen ; Shock* ; Urinary Calculi ; Vomiting

It is well known that most anesthectis and drugs are metabolized and excreted in the liver. There are many controversies regarding postoperative halothane hepatotoxicitr and often reported postoperative hepatic dysfunction following enflurane anesthesia. It appears that the development of hepatic necrosis after anesthesia depends on a chance combination of events but not anesthetics itself. Common causes of postoperative hepatic damages ia possibly due to viral heatitis, since in oar country viral hepatitis B are increasing in frequency recently. This study was performed to evaluate the effect of enflurane on liver function in 25 asy-mptomatic patients hepatitis B surface antigen positive. The results seems favorable for anesthesia and sureery. on asymptomatic viral hepatitis B patients.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Enflurane ; Halothane ; Hepatitis B ; Hepatitis B Surface Antigens* ; Humans ; Liver* ; Necrosis

The incidence of autonomic neuropathy is high in diabetic patients. Cardiovascular complications including sudden cardiorespiratory arrest, bradycardia, hypotension can occur in diabetic patients complicated with autonomic neuropathy. The causes of sudden deaths in diabetics may not always be due to silent myocardial infarction but may also be due to autonomic neuropathy. Patients with diabetic autonomic neuropathy are less able to withstand hypoxia compare to normal people due to sympathetic nerve system damage. We present a case of acute respiratory arrest that occured in a 38 years old diabetic autonomic neuropathy patient after general anesthesia. Even though the patient was carried rapid and adequate airway management within 5 minutes, the patient had severe brain sequale. We conclude that the diabetic autonomic neuropathy patients require more careful monitoring and management for the hypoxia and cardiovascular status because they are more sensitive in hypoxia.
Adult ; Airway Management ; Anesthesia, General* ; Anoxia ; Bradycardia ; Brain* ; Death, Sudden ; Diabetic Neuropathies* ; Humans ; Hypotension ; Incidence ; Myocardial Infarction