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*

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 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

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*

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*

Acute fatty liver of pregnancy are relatively rare but extremely dangerous, because they may quickly develop into a fulminant disease and become a serious life-threatening disorder for mother and fetus in the third trimester. Therefore, early diagnosis, prompt delivery and intensive supportive care the cornerstones in the management of acute fatty liver of pregnancy. Clinical findings in acute fatty liver of pregnancy vary because it may occur with varying degrees of clinical severity and in conjunction with other third trimester symptoms, making early diagnosis difficult. However, careful history and physical examination, in conjunction with compatible laboratory and imaging results, are often sufficient to make the diagnosis, and liver biopsy is rarely indicated. We have experienced a case of acute fatty liver of pregnancy presenting as early hepatic encephalopathy, renal failure which developed during the third trimester. We diagnosed acute fatty liver of pregnancy based on clinical presentation and laboratory abnormalities. Despite of prompt delivery and adequate supportive care management, this severe complication of pregnancy has had an adverse outcome for mother.
Biopsy ; Early Diagnosis ; Fatty Liver ; Female ; Fetus ; Hepatic Encephalopathy ; Humans ; Liver ; Mothers ; Physical Examination ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Third ; Renal Insufficiency

This experiment was undertaken to study the effects of different ratios of N2O-O2 in N2O- halothane anesthetized rabbits weighing about 4-4.5 Kg. The N2O-O2 ratios were 2:1 (group 1), 3:1 (group 2) and 4:1 (group 3). We measured the mean arterial pressure, intracranial pressure and cerebral pressure and analysed the blood gas and electrolytes in each group and compared each group to the other two. The results are summarized as follow; The mean arterial pressure was 101.7+/-14.6, 92.7+/-11.0 and 89.4+/-15.1mmHg in each group respectively. The mean arterial pressure of the group 3 decreased more significantly than that of group 1. The intracranial pressure was 12.7+/-4.3, 11.8+/-4.2 and 13.6+/-4.6mmHg in each group respectively and was non-significant as compared to other groups. The cerebral perfusion pressure was 90.8+/-13.3, 82.6+/-9.9 and 76.9+/-16.9mmHg in each group respectively and the cerebral perfusion pressure of group 3 decreased more significantly than that of group l. In the blood gas analysis, PaQ2 was 162+/-27, 119+/-13 and 105+/-8 mmHg in each group respectively and was non-significant in respect to other groups. PaCO2 and O2 content were not different significantly in each group and were within normal values. The oxygen saturation was 98.9+/-0.3, 97.8+/-0.4 and 97.6+/-1.1% in each group respectively and group 2 and 3 decreased more significantly than group 1. Na+, Cl-, HCO-(3), pH and BE were not different significantly in each group, pH, BE and HCO-(3) were measured as being slightly low values, but PaCO2 was kept within normal values. These are explained as probably being due to metabolic acidosis. The serum K' was 2.94+/-0.46, 3.07+/-0.44 and 3.40+/-0.7 mEq/1 in each group respectively and the serum K+ of group 3 increased more significantly than groups 1 and 2. With these results, it is suggested that a ratio above a 2:1 ratio of N2O-O2 is more dangerous in halothane-N2O anesthesia.
Acidosis ; Anesthesia* ; Arterial Pressure* ; Blood Gas Analysis ; Electrolytes* ; Halothane* ; Hydrogen-Ion Concentration ; Intracranial Pressure* ; Oxygen ; Perfusion ; Rabbits* ; Reference Values

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*