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*

Neuroimaging of the brain is useful diagnostic evaluation of patients with hepatic encephalopathy msofar as it is able to exclude other causes of abno rmal mental status. Recently, changes of basal ganglia on MRI characteriwd by increased signal mtensity on Tl-weighted images were reported m patients with liver cirrhosis. Signal abnormality involves mainly the globus pallidus and seems to be specific for patients with chronic liver disease. Its pathogenesis and significance are obscure, and no pathological reports have been made. We experienced 3 cases of Chronic acquired hepatic failure whose MRI showed increased signal in-tensity in the basal ganglia on Tl-weighted imaging. Our findings su-ggest that basal ganglia signal abnormality could arise as a marker of brain impairment related to deposition of an unidentified paramagnetic substance or altered intracellular water relaxation.
Basal Ganglia ; Brain ; Globus Pallidus ; Hepatic Encephalopathy ; Humans ; Liver Cirrhosis ; Liver Diseases ; Liver Failure* ; Magnetic Resonance Imaging ; Neuroimaging ; Relaxation

Serum myoglobin concentrations were studied in 46 patients during orthopedic and plastic operations that required the application of a pneumatic limb tourniquet. Serum myoglobin was measured at preoperation, during tourniquet and after touriquet release. In the general anesthesia patients, serum myoglobin was after tourniquet release(172.72+/-29.49 ng/ml) significantly increased(p<0.01) than at preoperation(103.06+/-24.03 ng/ml). In the regional block patients, serum myoglobin after tourniquet release(117.69+/-10.08ng/ml) also increased(p<0.05) than at preoperation(67.08+/-14.99ng/ml). In the male patients, serum myoglobin was significantly increased(p<0.05) during tourniquet and after tourniquet release(123.36+/-15.42ng/ml & 158.86+/-21.10ng/ml) than at preoperation (93.58+/-17.11ng/ml). In the female patients, there was no significant difference to regardless of tourniquet application. In the patients that tourniquet application time was within one hour, serum myoglohin was significantly increased(p<0.01) during tourniquet and after tourniquet release(125.66+/-18.86 & 126.20+/-14.99ng/ml) than at preoperation(86.12+/-15.29ng/ml). In the patients that tourniquet application time was over one hour, serum myoglobin was sig- nificantly increased(p<0.01) during tourniquet(l05.92+/-21.84ng/ml) than at preoperation(91.16+/-31.17ng/ml) and in the after tourniquet release(183.88+/-40.96ng/ml), serum myoglobin was more significantly(p<0.05) increased than during tourniquet.
Anesthesia, General ; Extremities ; Female ; Humans ; Male ; Myoglobin* ; Orthopedics ; Plastics ; Tourniquets*

The effects of fentanyl pretreatment on controlling the hemodynamic changes during induc- tion have been compared in 58 adult normotensive patients undergoing elective operation. Two groups of 29 patients were observed. Patients were randomly assigned to receive thiopental 5 mg/kg alone(control group) or fentanyl 8 ug/kg pretreatment with thiopental 3 mg/kg (fentanyl group) for induction of anesthesia. The changes of mean arterial pressure(MAP), heart rate(HR), peak flow index(PFI), ejection Fraction(EF), end diastolic index(EDI), cardiac indx(CI) and stroke index(SI) were checked and compared with preinduction control values. The results were compared between two groups. The results were as follows. MAP and HR 1 minute after intubation increased significantly compared with preinduction values(p<0.001) in control group but showed minimal changes in the fentanyl group. The changes of PFI, EF, EDI, CI and SI showed decreasing tendencies after 30 seconds of thiopental injection in both groups, but the changes were small in the fentanyl group. Sinus tachycardia, premature ventricu1ar contraction, bigeminy were observed in both groups but the incidences were very low in the fentanyl group. It is suggested from the above results that fentanyl pretreatment(8ug/kg) reduces the hemo- dynamic changes during induction of general anesthesia and is more safe method for induction of cardiac or cerebrovascular disease patients.
Adult ; Anesthesia ; Anesthesia, General* ; Fentanyl* ; Heart ; Hemodynamics* ; Humans ; Incidence ; Intubation ; Stroke ; Tachycardia, Sinus ; Thiopental

The cardiac output and hemodynamic indices were measured by the bioimpedance method using NCCOM3 in 38 selected spinal anesthetic cases with 0.5% bupivacain. The authors observed MAP, HR, PFI, EDI, CI and SI changes before-and during spinal anesthesia. The results were as follows: The mean values for MAP before, 10 minutes and 30 minutes after spinal anesthesia were observed to be 96.18+/-14.25 and 9.45+/-14.89 mmHg. These values during spinal anesthesia were significantly decreased compared with the value before spinal anesthesia(P<0.01). The mean values for HR before, and 30 minutes after spinal anesthesia were observed to be 71.34+/-17.25 and 72.39+/-19,01 beat/min. The value during spinal anesthesia was significantly decreased compared with the value before spinal anesthesia(P<0.01). The mean value for PFI before and during spinal anesthesia were observed to be 306.55+/-75.63 and 285.47+/-73.60 1/sec/m2 . The value duing spinal anesthesia was insignificantly decreased compared with the value before spinal anesthesia.(P<0.05). The changes of mean values of EF, EDI and SI were insignificant statistically. The mean values for CI before and 30 minutes after spinal anesthesia were observed to be 3.49+/-1.02 and 3.11+/-0.86(1/min/m2) The value during spinal anesthesia was significantly decreased compared with the value before spinal Anesthesia(P<0.01)
Anesthesia, Spinal* ; Cardiac Output ; Hemodynamics*