A new benzodiazepine derivative, Rohypnol (Ro 5-4200), was used for management of general anesthesia with nitrous oxide, narcotics and muscle relaxants to evaluate the effect on the cardiovascular and respiratory system in 35 surgical patients. In each patient, we observed the blood pressure, pulse rate, minute volume and arterial blood gas analysis and also local effects, postoperative recovery state and amnesia. The results are as follows; 1) Induction dosage of Rohypnol was not constant as other benzodiazepines. 2) Rohypnol showed a little effect an the cardiovascular system. 3) The effects of Rohypnol on the respiratory system were negligible but slight depression was seen. 4) If respiration became shallower or apnea occured during induction with Rohypnol, it was preferred to use assisted or controlled ventilation with 100% oxygen. 5) It was thought better to give oxygen through a nasal catheter for prevention of decreased PaO2 in recovery room. 6) When we used the non-depolarizing muscular relaxants instead of S.C.C. for intubation, we observed that a significantly decreased amount of relaxant was needed for maintenance of general anesthesia.
Amnesia ; Anesthesia, General ; Apnea ; Balanced Anesthesia* ; Benzodiazepines ; Blood Gas Analysis ; Blood Pressure ; Cardiovascular System ; Catheters ; Depression ; Flunitrazepam* ; Heart Rate ; Humans ; Intubation ; Narcotics ; Nitrous Oxide ; Oxygen ; Recovery Room ; Respiration ; Respiratory System ; Ventilation

Sine 1961, Dr. Safar postulated the new form of patient, so called "progressive patient care", the hospital service in all countries are fashioned with intensive therapy unit. Particulary the- World Federation Society of Anesthesiologists who have discusincerly at several International congress. we were interested from the literature and visited England, Denmark, United States. and Japan. Of course in Korea, the intensive therapy unit developed from the recovery room and is thus intimately oonnected with anesthesiologists. Here we reviewed with literature and introduced the activities af the intensive therapy unit of Hanyang University Hospital from May 1972 to October 1973, from the point view of the definition, building design, location, capacity, equipment, staff organization and charge of patient, several problems and regulations. Furthermore we recommended with the following new ideas for establishment in hospital of an intensive therapy. unit. a. The design should be arranged on the same floor (OR-RR-Anes.-1TU) and in central part of building. b. Several isolation rooms should be made in 1-T-U. c. One central monitoring system will serve each units. d. The 1-T-U equipment should be used with wall trolly system. e. The regulations of 1-T-U should be noted and advocated by all hospital members. f. The beds in 1-T-U should be arranged with open system.
Denmark ; England ; Humans ; Japan ; Korea ; Recovery Room ; Social Control, Formal ; United States

BACKGROUND: Pulmonary complications following bonemarrow transplantation(BMT) are common and associated with a high mortality rate, We investigated the yield, safety, and impact of fiberoptic bronchoscopy(FOB) for diagnosis of postBMT pneumoniae. METHODS: From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with repiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL(bronchoalveolar lavage), TBLB(transbronchial lung biopsy), PSB(protected specimen brush). RESULTS: The characteristics of the subjects were as follows:37 males, 15 females, mean age of 31.3 years(17-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following:12 cytomegalovirus(CMV) (21.4%), 7 pneumocystis carinii(PC) (12.5%), 11 CMV with PC (19.6%), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases(23.2%), 13 died of CMV pneumoniae(n=2), PCP(n=2), mixed infection with CMV and PC(n=3), underlying GVHD(n=1), underlying leukemia progression(n=1), or respiratory failure of unknown origin(n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleedig and 1 episode temporary hypoxemia. CONCLUSION: Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.
Anoxia ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoscopy* ; Coinfection ; Diagnosis* ; Female ; Glass ; Humans ; Leukemia ; Lung ; Male ; Mortality ; Pneumocystis ; Pneumonia* ; Respiratory Insufficiency ; Siblings ; Streptococcus ; Tissue Donors ; Tuberculosis

No abstract available.
Transplants*

Purpose: We aimed to identify risk factors for transurethral coagulation (TUC) using bipolar electrocautery for hemostasis during holmium laser enucleation of the prostate (HoLEP) surgery for benign prostatic hyperplasia (BPH). Methods: We analyzed the clinical outcomes of HoLEP surgery performed by a single surgeon between January 2010 and April 2020 at the Seoul National University Hospital. Patient characteristics and perioperative parameters were used to identify the risk factors for TUC. The TUC group was defined as a case of conversion to hemostasis using electrocautery during the hemostasis step after enucleation. Results: Of 1,563 patients, 357 underwent TUC (TUC group; 22.8%) as an adjuvant (n=299, 19.1%) or salvage (n=58, 3.7%) therapy. Patients in the TUC group were older (mean±standard deviation, 70.6±7.3 years vs. 69.3±7.0 years; P=0.002), had more 5-alpha reductase inhibitor (5-ARI) use (35.6% vs. 25.9%, P<0.001), higher serum prostate-specific antigen (PSA) (5.4 ±4.8 ng/mL vs. 3.8 ±4.5 ng/mL, P <0.001), larger total prostate volume (TPV) (89.5 ±44.7 mL vs. 66.0 ±32.6 mL, P<0.001), and larger transitional zone volume (TZV) (57.3±34.9 mL vs. 37.7±24.2 mL, P<0.001) than those who did not undergo TUC (non-TUC group). In univariate logistic regression analysis, age, 5-ARI use, PSA, TPV, and TZV correlated with TUC, whereas in multivariate logistic regression analysis, only TZV was associated with TUC. The odds ratios (ORs) of TUC were analyzed per TZV quartile. Compared to TZV<22.3 mL, the OR was 2.42 in 34.1 mL≤TZV<53.5 mL (95% confidence interval [CI], 1.58–3.72; P<0.001), 5.17 in ≥53.5 mL (95% CI, 3.44–7.77; P<0.001). Conclusions The risk of TUC during HoLEP surgery increases in patients with TZV >35 mL. Therefore, TUC may be potentially necessary in patients with a large transition zone volume in patients with BPH.

PURPOSE: To describe CT and MR findings of Primary nasal NK/T-cell lymphoma and to evaluate the usefulness ofCt and MR imaging for initial diagnosis and during follow-up. MATERIALS AND METHODS: Thirteen patients withbiopsy-proven primary nasal NK/T-cell lymphoma (M:8, F:5;age 30-78, mean:47.3 years) were included in this study.CT scans were obtained in seven patients and MR images in ten, and both CT and MR images in four. Duringfollow-up, CT images were obtained in four patients, MR images in eight, and both types of image in two. Signalintensity or attenuation, location, and shape of the tumor were assessed on CT and MR images, which were alsocompared in terms of evaluation of the extent of the tumor and the assessment of residual tumor during follow-up. RESULTS: Enhanced CT scans showed slightly lower(6/7) or iso-attenuation (1/7) or the tumor than of the wall ofthe nasal cavity. In all cases, the tumor was of slightly lower signal intensity on T2WI and gadolinium-enhancedT1WI than nasal cavity mucosa. Infiltrative wall thickening of the nasal cavity (13/13) and a polypoid mass (5/13)were demonstrated on CT and MR images. The tumor margin was partially indistinct (6/7) or distinct (1/7) oninitial CT, but distinctily identified on initial MR images in all cases. During follow-up, MR was superior to CTfor the assessment of residual tumor in two patients. CONCLUSION: Infiltrative wall thickening of the nasalcavity may be a characteristic feature of primary nasal NK/T-cell lymphoma, and MR images were superior to CT forthe assessment of tumor extent and for the diagnosis of residual tumor during follow-up.
Diagnosis* ; Follow-Up Studies* ; Humans ; Lymphoma* ; Magnetic Resonance Imaging* ; Mucous Membrane ; Nasal Cavity ; Neoplasm, Residual ; Tomography, X-Ray Computed

PURPOSE: The aim of this study was to evaluate the effect of metal primers on the bonding of dental alloys and veneer resin. Polyvinylpyrrolidone solution's tarnish effect on bonding strength was also investigated. MATERIALS AND METHODS: Disk-shape metal specimens (diameter 8 mm, thickness 1.5 mm) were made from 3 kinds of alloy (Co-Cr, Ti and Au-Ag-Pd alloy) and divided into 4 groups per each alloy. Half specimens (n=12 per group) in tarnished group were immersed into polyvinylpyrrolidone solution for 24 hours. In Co-Cr and Ti-alloy, Alloy Primer (MDP + VBATDT) and MAC-Bond II (MAC-10) were applied, while Alloy Primer and V-Primer (VBATDT) were applied to Au-Ag-Pd alloys. After surface treatment, veneering composite resin were applied and shear bond strength test were conducted. RESULTS: Alloy Primer showed higher shear bond strength than MAC-Bond II in Co-Cr alloys and Au-Ag-Pd alloy (P<.05). However, in Ti alloy, there was no significant difference between Alloy Primer and MAC-Bond II. Tarnished Co-Cr and Au-Ag-Pd alloy surfaces presented significantly decreased shear bond strength. CONCLUSION: Combined use of MDP and VBATDT were effective in bonding of the resin to Co-Cr and Au-Ag-Pd alloy. Tarnish using polyvinylpyrrolidone solution negatively affected on the bonding of veneer resin to Co-Cr and Au-Ag-Pd alloys.
Alloys ; Dental Alloys* ; Povidone

Radiation therapy is one of the cardial therapeutic modality on breast cancer. Three decades ago, the heart was considered to be radioresistant, but now it is generally recognized that the heart is also radiosensitive. The most common clinical syndromes after irradiation are pericarditis in acute and chronic forms, cardiomyopathy, valvular disease and, to a lesser degree, complete atrioventricular block. However, lesions of coronary vessels had been considered exceptionally rare and even questionable. And then there have been a few case reports for acute myocardial infartion after irradiation for left sided breast cancer and it may be considered that radiation therpy can injure endothelium of coronary artery and cause ischemic coronary artery disease. We report the case of a 38 years old women who developed acute anterior wall myocardial infarction after irradiation for left sided breast cancer.
Adult ; Anterior Wall Myocardial Infarction ; Atrioventricular Block ; Breast Neoplasms* ; Breast* ; Cardiomyopathies ; Coronary Artery Disease ; Coronary Vessels ; Endothelium ; Female ; Heart ; Humans ; Myocardial Infarction* ; Pericarditis

Centric occlusion-maximum intercuspation (CO-MI) discrepancy is one of main causes of evoking premature contact and resultant mandibular shift. These non-physiological conditions can induce temporomandibular disease, periodontitis, and non-carious cervical lesion. Therefore, if CO-MI discrepancy exists in patients who need extensive prosthetic rehabilitation, it must be corrected and then physiological occlusion must be restored. This report describes the treatment procedure of removing CO-MI discrepancy and prosthetic rehabilitation in a patient with 3.5 mm discrepancy, multiple caries and periodontitis. Proper mandibular position and modified opening & closing movement were confirmed by ARCUSdigma II and transcranial radiograph.
Centric Relation ; Humans ; Periodontitis ; Rehabilitation*

Mediastinal interfaces on a chest radiograph result from contact between mediastinal structures and the adjacent lung, while mediastinal lines result from contact between the two lungs across the midline. A variation of mediastinal interface is mediastinal stripe, a narrow band produced by contact of both sides of a mediastinal structure with the lungs. Alterations in mediastinal interfaces and lines may be due to variations in normal anatomy, or may reflect the presence of abnormalities within the mediastinum. Familiarity with the various normal mediastinal interfaces and lines, and the changes that occur with disease is important for the interpretation of the chest radiograph and in the diagnosis of mediastinal abnormalities. The purpose of this pictorial essay is to illustrate the most important normal and abnormal interfaces and lines and also to correlate radiographic and CT findings.
Diagnosis ; Lung ; Mediastinum ; Radiography, Thoracic ; Recognition (Psychology)