The authors report a case of thoracic outlet syndrome in left side. Thoracic outlet syndrome is a collective term in which symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is a rare case in neurosurgical field. So we had experienced one case of thoracic outlet syndrome which was improved by transaxillary approach for resection of first rib. The clinical features, diagnostic test, radiological findings, and operative technique are presented with review of literatures.
Brachial Plexus ; Diagnostic Tests, Routine ; Ribs* ; Thoracic Outlet Syndrome*

The purposes of this study were to investigate the changes of plasma ADH and beta-endo-rphin levels during general anesthesia. Tweleve patients, who had surgery at Krungpook National University Hospital, were selected without specific hepatic, renal and other endocrinologic disorders. The patients were anesthetized with thiopental sodium and succinylcholine chloride followed by O2-N2O-ha1othane(4 cases), anti O2-N2O-enflurane(8 cases) , The plasma ADH and beta endorphin levels were chocked before anesthesia(control group), 20 minutes after endotracheal intubation, 20 minutes after surgical incision and at recovery roam when the patients responded to the pain. The plasma ADH levels were 5.69+/-2.19, 12.72+/-14.90. 11.47+/-9.62 and 24.42+/-23.23 ru/ml, respectively. It were progressively incresed and significantly incresed at recovery room (P<0.05). The Plasma beta endorphin levels were 4.1+/-3.54, 6.44+/-3.75, 6.68+/-3.90 and 17.88 +/-12.08 Pmol/l, resPectiTely. Plasma beta endorphin levels at 20 minutes after endotracheal intubation and 20 minutes after surgical incision were significantly increased(p<0.05) and it was very significantly increased at recovery room(P<0.01) . Albo serum electrrolytes(Na+, K+, Cl-, CO2-) were evaluated, but statistically or clinically not significant. Urine electrolytes(Na+, K+) and osmolality were evaluated before, during and after ane Sthesia, but statistically not significant. From the view of inhalation anesthetics, there were no diffrences between halothane and enflurane in plasma ADH and beta endorphin levels.
Anesthesia, General* ; Anesthetics, Inhalation ; beta-Endorphin* ; Enflurane ; Halothane ; Humans ; Intubation, Intratracheal ; Osmolar Concentration ; Plasma* ; Recovery Room ; Succinylcholine ; Thiopental

Mean arterial pressure, PaO2, PaCO2, pH, bicarbonate and base-excess in connection with disease and anesthetic periods were measured in 49 cases of open heart anesthesia which were perfarmed between 1976 and 1979 in the Department of Anesthesiology, Kyungpook National University School of Medicine. The following results were obtained in the mean values of total cases. Mean arterial pressure was decreased but PaO2 was progreasively increased with increased anesthetic time. PaCO2, was slightly decreased following anesthetic time, especially on total bypass. The pH was progressively increased from the time of partial bypass. Base excesa and bicarbonate were decreased before bypass but gradually increased from partial bypass and reached a peak after bypass. The TOF group showed the lowest values of mean arterial pressure, PaO2, and pH among the other groups, and resulted in the poorest patient's condition. In the other hand, the miscellaneous group showed the lowest values of PaCO2, no increased bicarbonate, and became the best condition among the other groups. Metabolic acidotic change persisted during the initial period but gradually changed to an alkaIotic tendency after bypass.
Anesthesia* ; Anesthesiology ; Arterial Pressure ; Gyeongsangbuk-do ; Hand ; Heart* ; Humans ; Hydrogen-Ion Concentration

This study was undertaken to determine the incidence of the endotrcheal tube contamination by malignant cells in patients with upper respiratory tract cancer undergoing general anesthesia. In 17 patients endotracheal intubation was done and the tube was extubated after completion of the excision of the tumor mass. Following the procedures the outide of the endotracheal tube was swabbed by the cotten tip applicators and the specimens examined cytologically. Two positive cytologic specimens were obtained, they were class III and laryngeal carcinoma in both. This study provides evidence that contamination of the outside of the endotracheal tube can occur when it is passed directly over a carcinoma of the larynx.
Anesthesia, General ; Humans ; Incidence ; Intubation, Intratracheal ; Larynx ; Respiratory System*

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

The chronic myelogenous leukemic K562 cell line carrying Bcr-Abl tyrosine kinase is considered as pluripotent hematopoietic progenitor cells expressing markers for erythroid, granulocytic, monocytic, and megakaryocytic lineages. Here we investigated the signaling modulations required for induction of erythroid differentiation of K562 cells. When the K562 cells were treated with herbimycin A (an inhibitor of protein tyrosine kinase), ras antisense oligonucleotide, and PD98059 (a specific inhibitor of MEK), inhibition of ERK/MAPK activity and cell growth, and induction of erythroid differentiation were observed. The ras mutant, pZIPRas61leu-transfected cells, K562-Ras61leu, have shown a markedly decreased cell proliferation rate with approximately 2-fold doubling time, compared with the parental K562 cells, and about 60% of these cells have shown the phenotype of erythroid differentiation. In addition, herbimycin A inhibited the growth rate and increased the erythroid differentiation, but did not affect the elevated activity of ERK/MAPK in the K562-Ras61leu cells. On the other hand, effects of PD98059 on the growth and differentiation of K562-Ras61leu cells were biphasic. At low concentration of PD98059, which inhibited the elevated activity of ERK/MAPK to the level of parental cells, the growth rate increased and the erythroid differentiation decreased slightly, and at high concentration of PD98059, which inhibited the elevated activity of ERK/MAPK below that of the parental cells, the growth rate turned down and the erythroid differentiation was restored to the untreated control level. Taken together, these results suggest that an appropriate activity of ERK/MAPK is required to maintain the rapid growth and transformed phenotype of K562 cells.
Androstadienes/pharmacology ; Ca(2+)-Calmodulin Dependent Protein Kinase ; Cell Differentiation/drug effects ; Enzyme Inhibitors/pharmacology ; Erythroid Progenitor Cells/physiology* ; Erythroid Progenitor Cells/cytology ; Erythropoiesis* ; Flavones/pharmacology ; Human ; K562 Cells ; Leukemia, Myeloid/pathology ; Oligonucleotides, Antisense/pharmacology ; Quinones/pharmacology ; ras Proteins/metabolism*

It has been reported that a rapid elevation in the intracranial pressure is associated with increased arterial pressure, reduced heart rate and irregular respiration. In the present study an effort was directed to observe the possible blocking effect of dibenzyline, an alpha-sympathetic blocking agent, administered prior to the intracranial pressure elevation. Alhino rabbits were divided into two experimental groups: in one group, the intracranial pressure was raised by infusing normal saline into the extradural space and was sustained for 30 minutes, while in the other group, dibenzyline(12mg/kg B.W.) was administered 16 hours prior to the intracanial pressure elevation. In both groups, the arterial pressure, heart rate and respiratory rate were measured for 30 minutes at 5 minuteintervals. In the intracranial pressure elevated group, the arterial pressure increased to 99 mmHg at 10 minutes in comparison with 88mmHg in the beginning. At 25 minutes, it returned to or near its initial level. The slowing of the heart rate was seen toward the end of the response, i.e. in the beginning, 269 rate/min, at the end, 214 rate/min. The respiratory rate did not show any significant change. In the dibenzyline pretreated group, the arterial pressure and heart rate did not change markedly from the initial levels. From the above result, it can be stated that dibenzyline has blocking effects on the increased arterial pressure and reduced heart rate in rabbits during increased intracranial pressure.
Arterial Pressure ; Blood Pressure* ; Heart Rate* ; Heart* ; Intracranial Pressure ; Phenoxybenzamine* ; Rabbits* ; Respiration ; Respiratory Rate*

Because wide swings in temperature can occur during cardiac anesthesia all patients undergoing cardiac anesthesia should have their temperatures monitered. This is especially true in situations where deliberate hypothermia during cardiopulmonary surgery is an area of controversy. This study of 20 cases of open heart surgery was undertaken to compare the changes in tympanic membrane, nasopharyngeal, rectal and great toe temperatures and of to evaluate their correlation during the induction, cardiopulmonary bypass, rewarming and post-cardiopulmonary bypass periods. The temperature at each site was monitored every 10 minutes for 60 minutes of each period. The results were as follows, During the induction period, the temperature of the tympanic membrane, nasopharynx and rectum decreased significantly(p<0.05~p<0.01), but the temperatures of the great toe temperatures increased for 20 minutes and then slowly decreased during the next 30 to 60 minutes. During the cardiopulmonary bypass period, the sympanic membrane temperatures which were best correlated with the nasopharyngeal temperatures(p<0.05~p<0.01), decreased faster than the rectal, nasopharyngeal and great toe temperatures. During the rewarming period, the tympanic membrane temperatures increased most quickly and were significantly correlated with the nasopharyngeal temperatures(p<0.05) only at 0 and 10 minutes. During the post-cardiopulmonary bypass period, the tympanic membrane and nasopharyngeal temperatures decreased slowly and were significantly correlated with each other(p<0.01), but the rectal and the great toe temperatures increased slowly.
Anesthesia* ; Cardiopulmonary Bypass ; Heart* ; Humans ; Hypothermia ; Membranes ; Nasopharynx ; Rectum ; Rewarming ; Thoracic Surgery* ; Toes ; Tympanic Membrane

The purpose of this study were to investigate the changes in serum SGOT, CK and CK-MB levels and the significance of these changes during general anesthesia for open heart surgery. Fourteen patients, who had open heart surgery at Kyungpook National University hospital, were chosen at random their serum SGOT, CK and CK-MB levels were recorded before anesthesia(control group), pre cardiopulmonary bypass, during cardiopulmonary bypass and in the recovery room. The results were as follows: The serum SGOT levels were 21.83+/-4.91 IU/L, 27.20+/-11.83, 34.81+/-16.60 and 72.58+/-37.77, respectively. They very significantly increased (p<0.01) during cardiopulmonary bypass and recovery room compared with pre anesthesia. The serum CK levels were 58.07+/-6.31 IU/L, 91.79+/-44.58, 141.93+/-66.55 and 347.43+/-84.61 respectively. They significantly increased (p<0.05) at pre cardiopulmonary bypass, very significantly increased(p<0.01) during cardiopulmonary hypass and recovery room compared with the preanesthesia. The serum CK-MB levels were 0.00 U/L, 4.54+/-11.80, 14.66+/-17.61 and 80.07+/-34.72 respectively. They very significantly increased(p<0.01) during the cariopulmonary bypass and recovery room.
Anesthesia* ; Anesthesia, General ; Aspartate Aminotransferases* ; Cardiopulmonary Bypass ; Gyeongsangbuk-do ; Heart* ; Humans ; Recovery Room ; Thoracic Surgery*

Spinal Anesthesia employing 0.5% plain bupivacaine was administered to 40 patients scheduled for lower limb or perineum surgery at Kyungpook National University Hospital. Two different volumes(3 and 4ml) and 2 different injection sites(lumbar interspaces L2/3 and L3/4) were used and their effects were compared. The patients were divided into four groups of 10: group A received 3ml of bupivacaine at L3/4, group B 3ml at L2/3, group C 4ml at L3/4 and group D 4ml at L2/3. The results were as follows: No significant difference were found between the 4 groups of patients in relation to age, height weight and length of surgery. The time for maximal sensory spread was 18.0+/-7.15 and 18.5+/-7.84 minutes in group B and C (p<0.05) and 20.0+/-7.84 minutes in group D (p<0.01) which showed a significant increase compared with 11.0+/-5.6 minutes in group A. Significant differences(p<0.05) in maximal sensory spread levels were observed between group A, B(T9) and group C, D(T7). No significant differences were found among the four groups in relation to the time of maximal motor blockade. Complete motor block was observed in all groups 20 minutes after spinal injection. Changes in blood pressure and pulse rate showed a significant(p<0.05) decrease in 10~15 minutes, and a very significant(p<0.01) decrease 20~30 minutes after spinal injection. Four patients experienced hypotension or bradycardia and two patients developed nauses or vomiting, but none of the patients developed a postspinal headache or micturition difficulty.
Anesthesia, Spinal* ; Blood Pressure ; Bradycardia ; Bupivacaine* ; Gyeongsangbuk-do ; Headache ; Heart Rate ; Humans ; Hypotension ; Injections, Spinal ; Lower Extremity ; Perineum ; Urination ; Vomiting