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

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*

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*

Brachial plexus block, axillary approach appears to be a safe and reliable technique for upper extremity surgery from shoulder to hand. However, the maximum dose of lidocaine that is recommended by the manufactured is 4 mg per kg (approximately 300 mg) regardless of the injection site. The maximum recommended dose for lidocaine with epinephrine is 7 mg per kg (approximately 500 mg). These maximum recommended amounts are insufficient for brachial plexus block. We question the logic behind these recommended dosages and may exceed them. The aim of this study was to determine whether commonly acceptable dosages used in brachial plexus block within a safe range. The time courses of the plasma concentration were observed in 20 healthy patients to whom were axillary injected with 1.5% lidocaine mixed 1: 200,000 epinephrine. The plasma concentrations were measured by immunofluororesence assay at the intervals of 5, 10, 20, 30 and 60 minutes. The values of plasma concentration were 2.65+/-75, 4.29+/-2.75, 5.95 +/-2.02, 4.76+/-1.91 and 4.48+/-1.90 pg/ml in group 1, and 3.71+/-1.68, 4.76+/-1.91, 6.68+/-3.43, 5.57+/-3.08 and 5.56+/-2.86 ug/ml in group 2, and 2.86+/-1.82, 5.08+/-3.74, 5.92+/-3.84, 6.82+/-3.84 and 5.49+/-3.29 ug/ml in group 3 (Mean+SD). The peak plasma concentration was 5.95+/-2.02 and 6.68+/-3.43 ug/ml at 20 minutes in group 1 and 2 respectively and 6.82+/-3.84 ug/ml at 30 minutes in group 3. These results indicated that the lidocaine 750 mg with epinephrine (5 ug/ml) in brachial plexus block is considered to be safe because plasma concentration dose not exceed the toxic level.
Brachial Plexus* ; Epinephrine ; Hand ; Humans ; Lidocaine* ; Logic ; Plasma* ; Shoulder ; Upper Extremity

Comparison of the perivascular and paresthetic techniques of axillary brachial plexus block was made in two groups of 40 patients undergiong elective upper limb surgery. The results were as follows. Complete block were 16 cases(80%) in perivascular group, 17 cases(85%) in paresthetic group and total failure was abscent. Among incomplete block, radial nerve were 6 cases, ulnar never 2 cases and median nerve 1 case. There is no statistical difference between the two techniques. It is suggested that the axillary brachial plexus block is best suited for surgery of the forearm and hand, especially when surgery is in the area innervated by the median and ulnar nerves.
Brachial Plexus* ; Forearm ; Hand ; Humans ; Median Nerve ; Radial Nerve ; Ulnar Nerve ; Upper Extremity

The effects of lidocaine and fentanyl on controlling the hemodynamic responses to laryngoscopy and intubation have been compared in 39 adult normotensive patients undergoing elective thyroidectomy surgery. Three groups of 13 patients were observed. Patients were randomly assigned to receive thiopenta15 mg/kg alone (control group), lidocaine 1 mg/kg with thiopental 5 mg/kg (lidocaine group) or fentanyl 3 ug/kg with thiopental 5 mg/kg (fentanyl group) for induction of anesthesia. The changes of systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), heart rate and ECG abnormalities were recorded every minute throughout and compared with preinduction control values. The results were as follows. Control and lidocaine groups showed significant increase of SBP, MAP and DBP (p<0.001, p<0.05) but no significant increases were noted in fentanyl group with tracheal intubation. Significant elevation of heart rate following intubation were observed in all group (p<0.001) and sustained for several minutes. Sinus tachycardia, premature ventricular contraction, bigeminy were observed in every group during induction but the incidences were low in the fentanyl group. It is suggested from the above results that intravenous injection of the lidocaine or fentanyl reduces the magnitude of blood pressure elevation following intubation effectively but heart rate, and cardiovascular respones are more stable with fentanyl than lidocaine.
Adult ; Anesthesia ; Arterial Pressure ; Blood Pressure* ; Electrocardiography ; Fentanyl* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Lidocaine* ; Tachycardia, Sinus ; Thiopental ; Thyroidectomy ; Ventricular Premature Complexes

Forty-four patients with sudden sensorineural hearing loss were treated with stellate ganglion block. The results were as follows. The results showed highest incidence in the decade between 30 and 50 years. The incidence of unilateral involvement were 40 cases (90.9%), among them 26 cases (59.1%) were right side. Among 44 patients 8 (18.2%) showed complete recovery, 9 (20.5%) partial recovery and 16 cases (36.4%) slight improvement by pure tone gain. These results showed a relative superiority of stellate ganglion block to other therapeutic regimens such as vasodilators, corticosteroids, anticoagulants etc. The time interval from onset of symptoms to start of stellate ganglion block seems to be important. Prognosis was slight poor in cases of sudden hearing loss with vertigo.
Adrenal Cortex Hormones ; Anticoagulants ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Incidence ; Prognosis ; Stellate Ganglion* ; Vasodilator Agents ; Vertigo