No abstract available.
Child* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant* ; Poisoning*

It is now well established that acute subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm can precipitate life-threatening cardiac arrhythmia. We experienced a 60 year old patient with a subarachnoid hemorrhage (neurologic grade III) due to rupture of anterior communicating artery aneurysm who presented with such intraoperative electrocardiographic changes as ST segment elevation and T wave inversion which are hallmark of acute myocardial infarction. The operation was uneventfully ended. On the postoperative laboratory examination about suspected acute myocardial infarction, the patient was found to have normal triple enzyme study and echocardiographic finding. The electrocardiogram three days after subarachnoid hemorrhage due to cerebral aneurysm returned to normal sinus rhythm. This case suggests that this patient's electrocardiographic change simulating acute myocardial infarction is transient change due to subarachnoid hemorrhage.
Arrhythmias, Cardiac ; Echocardiography ; Electrocardiography* ; Humans ; Intracranial Aneurysm ; Middle Aged ; Myocardial Infarction* ; Rupture ; Subarachnoid Hemorrhage*

Between January 1990 and February 1991, ureteroscopic removal of ureteral stone was performed in 40 cases at outpatient department under local anesthesia(36 cases) and epidural anesthesia(4 cases). The results were as follows. The success rate of ureteral stone removal was 82.1% (32 among 39 cases) in lower ureter, 86.7 %(26 among 30 cases) in female and 70.0%(7 among 10 cases) in male. Anesthetic methods were local(36 cases), and epidural(4 cases), Mean duration of hospitalization was 1.4 days(0-7 days). The associated complication rate was low, with most patients being treated conservatively. Therefore, we believe that the ureteroscopic stone removal at outpatient department can be done safely if we select patients properly(especially women). have adequate equipment and execute properly the basic technique.
Female ; Hospitalization ; Humans ; Male ; Outpatients* ; Ureter* ; Ureteroscopy

BACKGROUND: Etomidate is short-acting non-barbiturate intravenous anesthetic with minimal cardiovascular depression. As a small change in venous capacitance significantly alters venous return and thus cardiac output, it is important to know the effects of intravenous anesthetics on venous capacitance. The purpose of this study was to examine the effect of etomidate or pentobarbital (control agent) on venous capacitance. METHOD: All twenty rats (etomidate group: 10, pentobarbital group: 10), weighing 350-450 gram, were anesthetized with pentobarbital 50 mg/kg given intraperitoneally for surgical preparation. Mean arterial pressure (MAP), heart rate (HR), and mean circulatory filling pressure (MCFP) were measured in the awake state(recovered from pentobarbital anesthesia for surgical preparation) as well as during anesthesia with etomidate or pentobarbital. Venous capacitance was assessed before and during anesthesia with etomidate or pentobarbital by measuring MCFP. MCFP was measured during a brief period of circulatory arrest produced by inflating a balloon inserted in right atrium. RESULTS: As compared with MCFP in the corresponding awake state, MCFP was not significantly altered by etomidate but significantly decreased by pentobarbital. As compared with MAP in the corresponding awake state, MAP was not significantly altered by etomidate but significantly decreased by pentobarbital. CONCLUSION: The results suggest that unaltered venous capacitance by etomidate may contribute to a maintained MAP but increased venous capacitance by pentobarbital decrease in MAP of the normovolemic rat.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Arterial Pressure ; Cardiac Output ; Depression ; Etomidate* ; Heart Atria ; Heart Rate ; Pentobarbital ; Rats*

PURPOSE: The purpose of this study was to investigate the quantitative evaluation of the corticospinal tract (CST) at the multiple levels by using functional MRI (fMRI) co-registered to diffusion tensor tractography (DTT). MATERIALS AND METHODS: Ten normal subjects without any history of neurological disorder participated in this study. fMRI was performed at 1.5 T MR scanner using hand grasp-release movement paradigm. DTT was performed by using DtiStudio on the basis of fiber assignment continuous tracking algorithm (FACT). The seed region of interest (ROI) was drawn in the area of maximum fMRI activation during the motor task of hand grasp-release movement on a 2-D fractional anisotropy (FA) color map, and the target ROI was drawn in the cortiocospinal portion of anterior lower pons. We have drawn five ROIs for the measurement of FA and apparent diffusion coefficient (ADC) along the corona radiata (CR) down to the medulla. RESULTS: The contralateral primary sensorimotor cortex (SM1) was mainly found to be activated in all subjects. DTT showed that tracts originated from SM1 and ran to the medulla along the known pathway of the CST. In all subjects, FA values of the CST were higher at the level of the midbrain and posterior limb of internal capsule (PLIC) than the level of others. CONCLUSION: Our study showed that co-registered fMRI and DTT has elucidated the state of CST on 3-D and analyzed the quantitative values of FA and ADC at the multiple levels. We conclude that co-registered fMRI and DTT may be applied as a useful tool for clarifying and investigating the state of CST in the patients with brain injury.
Anisotropy ; Brain Injuries ; Diffusion ; Evaluation Studies as Topic ; Extremities ; Hand ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Mesencephalon ; Nervous System Diseases ; Pons ; Pyramidal Tracts ; Seeds ; Track and Field

To see the effectiveness of preoperatively administered furosemide for preventing Hypo-osmolarity and hyponatremia during TURP, 30 patients undergoing TURP were followed every preoperatively, 30 min intra-operatively as well as immediate postoperatively, 6 hours and 24 hours postoperatively with measurements of serum sodium, serum potassium and serum osmolarity. Among the 30 patients, 15 patients (experimental group) were administered furosemide immediately before TURP, the other 15 patients (control group) were not administered. We compared the changes of serum sodium, serum potassium and osmolarity of experimental group with those of control group. The result showed that the serum sodium and serum osmolarity were decreased significantly (p<0.01) in control group, but were not decreased significantly in experimental group. Thus, the preoperatively administered furosemide may prevent the dilutional hyponatremia and hypo-osmolarity during TURP, and may be helpful in high risk patient such as congestive heart failure and poor renal function.
Furosemide* ; Heart Failure ; Humans ; Hyponatremia ; Osmolar Concentration* ; Potassium ; Sodium ; Transurethral Resection of Prostate

BACKGROUND: The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts. MATERIALS AND METHODS: Twenty-four (n=24) patients with intrathoracic bronchogenic cysts were treated surgically between August 1990 and December 2009 at our institution. Patients were divided into two groups by bronchogenic cyst location: mediastinal or intrapulmonary. Symptoms at diagnosis, radiologic findings, locations, surgical methods, pathological findings, and surgical outcomes were investigated retrospectively from consecutive patient medical records. RESULTS: There were 12 females (50.0%). The mean age was 26.8 (range, 5 to 64) years. The mean follow-up period was 27.3 (range, 1 to 121) months. There were 15 (62.5%) mediastinal and 9 (37.5%) intrapulmonary bronchogenic cysts. Symptoms occurred in 8 patients with mediastinal bronchogenic cysts (53.3%) and 5 patients with intrapulmonary bronchogenic cysts (55.6%) (p=1.000). On computed tomography (CT), 7 patients (46.7%) showed homogenous solid masses in mediastinal bronchogenic cysts and five (55.6%) patients exhibited heterogeneous cystic masses with air-fluid levels in intrapulmonary bronchogenic cystic masses. Open thoracotomy was performed in 17 (70.8%) patients, and video-assisted thoracic surgery was performed in 7 (29.2%) patients. On pathological findings, there were 16 (66.7%) complicated cysts, and in 13 symptomatic patients, 11 (84.6%) patients had complicated cysts. There was no operative death in this study. During the follow-up period, no recurrence was detected. CONCLUSION: Intrathoracic bronchogenic cysts have a wide variety of clinical characteristics and radiologic findings. Even though some patients do not experience symptoms and signs caused by bronchogenic cysts, serious symptoms and complications may develop with the passage of time.
Bronchogenic Cyst ; Female ; Follow-Up Studies ; Humans ; Lung ; Mediastinum ; Recurrence ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thoracotomy

BACKGROUND: The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts. MATERIALS AND METHODS: Twenty-four (n=24) patients with intrathoracic bronchogenic cysts were treated surgically between August 1990 and December 2009 at our institution. Patients were divided into two groups by bronchogenic cyst location: mediastinal or intrapulmonary. Symptoms at diagnosis, radiologic findings, locations, surgical methods, pathological findings, and surgical outcomes were investigated retrospectively from consecutive patient medical records. RESULTS: There were 12 females (50.0%). The mean age was 26.8 (range, 5 to 64) years. The mean follow-up period was 27.3 (range, 1 to 121) months. There were 15 (62.5%) mediastinal and 9 (37.5%) intrapulmonary bronchogenic cysts. Symptoms occurred in 8 patients with mediastinal bronchogenic cysts (53.3%) and 5 patients with intrapulmonary bronchogenic cysts (55.6%) (p=1.000). On computed tomography (CT), 7 patients (46.7%) showed homogenous solid masses in mediastinal bronchogenic cysts and five (55.6%) patients exhibited heterogeneous cystic masses with air-fluid levels in intrapulmonary bronchogenic cystic masses. Open thoracotomy was performed in 17 (70.8%) patients, and video-assisted thoracic surgery was performed in 7 (29.2%) patients. On pathological findings, there were 16 (66.7%) complicated cysts, and in 13 symptomatic patients, 11 (84.6%) patients had complicated cysts. There was no operative death in this study. During the follow-up period, no recurrence was detected. CONCLUSION: Intrathoracic bronchogenic cysts have a wide variety of clinical characteristics and radiologic findings. Even though some patients do not experience symptoms and signs caused by bronchogenic cysts, serious symptoms and complications may develop with the passage of time.
Bronchogenic Cyst ; Female ; Follow-Up Studies ; Humans ; Lung ; Mediastinum ; Recurrence ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thoracotomy

No abstract available.
Adrenal Hyperplasia, Congenital*

Patients with fixed orthodontic appliances frequently have increased levels of plaque accumulation leading to the possibility of gingivitis or enamel decalcification. Although many methods may be helpful in reducing dental plaque formation, the optimal mechanical removal of plaque is the most important factor during orthodontic treatment. The purpose of this study was to evaluate the efficacy of an electric toothbrush (with a specially designed orthodontic brush head) compared to a manual toothbrush in controlling plaque and gingivitis for patients with fixed orthodontic appliances. Oral hygiene status was measured in thirty-four patients using a plaque index, a gingival index and a bleeding index, before and four weeks after the attachment of fixed orthodontic appliances. Patients were randomly divided into two groups: electric and manual toothbrush groups. Oral hygiene instruction was given according to the type of toothbrush used. The Braun Oral-B D9511 with Braun Oral-B Ortho OD 15-1 brush head was used as the electric toothbrush while the Butler G.U.M. 124 was given as the manual toothbrush. After four and eight weeks, oral hygiene status was measured again. Through a comparison between the electric and the manual toothbrush groups, the following results were obtained. 1. All oral hygiene indices showed an increasing tendency after four weeks of fixed orthodontic appliance. 2. All indices presented a decreasing tendency four and eight weeks after oral hygiene instruction. 3. In case of the gingival index and bleeding index, the decreasing tendency did not show a statistically significant difference between the electric and the manual toothbrush groups. 4. The decreasing tendency of plaque index presented a statistically significant difference between the two groups, showing that the electric toothbrush was more effective in terms of oral hygiene. These findings suggest that an electric toothbrush is useful to orthodontic patients with fixed appliances.
Dental Enamel ; Dental Plaque ; Gingivitis ; Head ; Hemorrhage ; Humans ; Oral Hygiene Index ; Oral Hygiene* ; Orthodontic Appliances ; Periodontal Index