No abstract available.
Humans

No abstract available.
Humans ; Infant, Newborn* ; Respiration, Artificial*

No abstract available.
Gestational Age* ; Mortality

BACKGROUND: Recently, using propofol as intravenous anesthetic agent is increasing. And it is known that propofol has little effects on liver function even after long operation such as plastic surgery. But its effect on liver functon after hepatobilliary operation which may damage liver was not studied. Thus, authors carried out this study to evaluate the effect of propofol on liver function by comparing with enflurane in the patients who had laparoscopic cholecystectomy. METHODS: Patients's anesthesia records and hospital charts from January 1994 to June 1996 were anlaysed retrospectively. Three hundred and thirty three patients who had normal liver function preoperatively and had no complications during and after operation were selected. They were divided into two groups ; propofol group (n=191) and enflurane group (n=142). The preoperative values of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were compared with those of 1 and 3 days after operation. RESULTS: One day after operation, both propofol and enflurane group showed significant increase in AST and ALT (p<0.05) and decrease in ALP (p<0.05). But there was no difference between two groups. CONCLUSION: Concerned to liver function, propofol is as useful as enflurane to the patients who scheduled for laparoscopic cholecystectomy.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia* ; Aspartate Aminotransferases ; Cholecystectomy, Laparoscopic* ; Enflurane* ; Humans ; Liver* ; Propofol* ; Retrospective Studies ; Surgery, Plastic

In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 58 patients with mitral stenosis and sinus rhythm, 22 patients with mitral stenosis and newly appeared atrial fibrillation, 62 patients with mitral stenosis and atrial fibrillation, 14 patients with sinus rhythm who undergone mitral valve replacement, 18 patients with atrial fibrillation who undergone mitral valve replacement,17 patients with idiopathic atrial fibrillation and 22 control persons. In all groups of mitral stenosis, atrial fibrillation was rare when left atrial dimension was below 40mm but common when this dimension exceeded 40 mm. When left atrial dimension exceeded 50 mm, sinus rhythm was rare even in patients who undergone mitral replacement operation. These data suggest that left atrial size is an important factor in the development of atrial fibrillation. To reduce the risk of systemic embolism complicating atrial fibrillation and to reduce the need of long term anticoagulant therapy postoperatively, the left atrial dimension should be followed closely for the patients with mitral stenosis.
Atrial Fibrillation* ; Echocardiography* ; Embolism ; Heart Atria* ; Humans ; Mitral Valve ; Mitral Valve Stenosis

BACKGROUND: Although impaired endothelial function is well known in patients with diabetes mellitus, the precise mechanism and the factors that contribute to this dysfunction remain to be clarified. We examined the effect of acute hyperglycemia on patients with impaired glucose metabolism in vivo by plethysmography. METHODS: Seven patients with diabetes mellitus or impaired glucose metabolism were studied. In each patient, endothelial function was examined in the fasting state and at two levels of hyperglycemia, which were achieved by the infusion of glucose, insulin, and somatostatin. Forearm blood flow was measured while acetylcholine was infused in increasing concentrations(7.5, 15, and 30 microgram/min) through the brachial artery. RESULTS: Glucose concentrations increased accordingly at each stage, from 135.3+/-18.4 mg/dl at stage 1(the fasting state), to 239.0+/-15.2 mg/dl at stage 2(the first level of hyperglycemia), and to 378.3+/-25.3 at stage 3 (the second level of hyperglycemia) [p<0.01]. Maximal acetylcholine-dependent vasodilation achieved by infusion of acetylcholine at 30 microgram/min was significantly aftenuated during stages 2 and 3 compared with stage 1(p<0.05 by AVOVA; forearm blood flow ratio was 2.87+/-0.18 and 2.56+/-0.14 versus 3.58+/-0.21, respectively). This was also evident during the infusion of 15 microgram/min and 7.5 microgram/min of acetylcholine. CONCLUSIONS: Endothelium-dependent vasodilation is significantly aftenuated by acute hyperglycemia in patients with diabetes mellitus or impaired glucose metabolism. Our findings suggest that elevated glucose may contribute to the endothelial dysfunction observed in patients with diabetes mellitus or impaired glucose metabolism.
Acetylcholine ; Brachial Artery ; Diabetes Mellitus* ; Endothelium ; Fasting ; Forearm ; Glucose* ; Humans ; Hyperglycemia* ; Insulin ; Metabolism* ; Plethysmography ; Somatostatin ; Vasodilation*

No abstract available.
Chest Pain* ; Emergencies* ; Emergency Service, Hospital* ; Thorax*

PURPOSE: To assess the changes of corneal aberration in the front and rear surface measured by Pentacam(R) following cataract surgery. METHODS: Thirty-two eyes of 30 consecutive patients that underwent phacoemulsification and IOL insertion via 3 mm superotemporal corneoscleral incision were examined. The corneal aberration was measured with Pentacam(R) (Oculus, Wetzlar, Germany) at 1 week and 1 month after the surgery, and these postoperative values were compared with values taken before the operation. The data were analyzed from 6 mm pupil size, using Zernike's polynomial expansion. RESULTS: In anterior corneal aberration, Z (4, -2); secondary astigmatism at 1 week postoperatively and Z (3, -3); the trefoil at 1 month postoperatively changed significantly (p<0.05). By contrast, in posterior corneal aberration, Z (2, -2), Z (2, 0), Z (2, 2), Z (3, 1), Z (4, -4), and Z (4, -2) changed significantly (p<0.05). However, there were no significant changes at 1 month postoperatively (Paired t-test). CONCLUSIONS: There were significant changes in posterior corneal aberration compared to anterior corneal aberration at 1 week postoperatively. However, the corneal aberration recovered to the preoperative level at one month after the operation. Presumably, these results might be due to the corneal edema of the incision site, caused by measuring the corneal thickness in the early phase of surgery.
Astigmatism ; Cataract ; Corneal Edema ; Eye ; Humans ; Lotus ; Phacoemulsification ; Pupil

BACKGROUND: This study was planned to evaluate the influence of propranolol and esmolol on cerebral circulation and to estimate clinical implications and usefulness. METHODS: This study was designed to measure vital signs, cerebrospinal fluid pressure, cerebral perfusion pressure and blood flow velocity of common carotid artery. This was measured by Doppler Flowmeter after intravenous administration of propranolol 12.5, 25, 50 microgram/kg (P-12.5, P-25, P-50, respectively), and esmolol 0.5, 1.0, 2.0 mg/kg (E-0.5, E-1.0, E-2.0 group, respectively) at 1 or 2 minute intervals for 14 minutes. RESULTS: In the propranolol group (P-12.5, P-25 and P-50), the systolic blood pressure (SBP) significantly decreased since postinjection 1 minute and this decreased pressure continued throughout the entire experiment. But in esmolol group (E-0.5, E-1.0 and E-2.0), the SBP decreased significantly and rapidly recovered within 4 minutes. Heart rate significantly decreased in the propranolol group and continued throughout the experiment, but in the esmolol group the heart rate decreased and rapidly recovered within 10 minutes. The duration of the decreased heart rate in the esmolol group was shortened by decreasing the dosage. The blood flow velocity of the common carotid artery significantly decreased at 1 to 14 minutes after the injection of propranolol, but in group E-1.0, it was significantly decreased at 1 to 2 minutes, and in group E-2.0 at 1 to 3 minutes. CONCLUSIONS: The esmolol group showed less changes of SBP, heart rate and common carotid artery flow, and shorter duration of effect than the propranolol group. Mean blood pressure, cerebrospinal fluid pressure and cerebral perfusion pressure had no significant differences between propranolol and esmolol groups.
Administration, Intravenous ; Blood Flow Velocity ; Blood Pressure ; Carotid Artery, Common* ; Cerebrospinal Fluid Pressure ; Flowmeters ; Heart Rate ; Perfusion ; Propranolol* ; Rabbits* ; Vital Signs*

BACKGROUND: To evaluvate the hypothesis that reperfusion injury and reperfusion arrhythmia could be caused by oxyzen free redicals and that prolonged myocardial dysfunction could be induced by oxyzen free redical. METHODS: Experimnetal model of anesthetized open chest dogs was used. Coronary artery was occluded for 60 minutes and reperfusion was performed 4 hours. In 5 dogs, superoxide dismutase and catalase were infused concomitantly 15 minutes after coronary occlusion to 15 minutes after reperfusion. In 9 dogs, 0.9% saline was infused instead of free redical scavengers. Hemodynamic parameters such as heart rate, left ventricular peak systolic pressure, end-diastolic pressure, peak positive dP/dt, and peak negative dP/dt were analysed. Infarct size was estimated by the unstained area in nitroblue tetrazolium staining and risk area was calculated from the unstained area after methylen blue infusion. Regional systolic function was observed in systolic thickening of ischemic area by echocardiogram. RESULTS: 1) Reperfusion arrhythmia occurred in 67% of control group and in 50% of drug treated group. 2) Systolic hemodynamic parameters such as peak systolic pressure, peak positive dP/dt showed no difference between control and drug-treated group. 3) Diastolic parameters such as end-diastolic pressure and peak negative dP/dt were not different in two groups. 4) Regional systolic parameter measured by systolic thickening in ischemic area improved after reperfusion and continued to be better in drug treated group than in control group. 5) Infarct size, risk area, ratio of infarct size to risk aera were not different in two groups. CONCLUSION: Superoxide dismutase and catalase showed no effect in reducing the infarct size in anesthetized open chest canine model with 60 minutes of coronary occlusion 4 hours of reperfusion. However, postischemic prolonged myocardial dysfunction tended of improve-after reperfusion in drug treated group.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Catalase* ; Coronary Occlusion ; Coronary Vessels ; Dogs ; Heart Rate ; Hemodynamics ; Myocardial Infarction* ; Necrosis* ; Nitroblue Tetrazolium ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase* ; Superoxides* ; Thorax