Background: Insulin is known to act as second effector that provides potassium transfer from extracellular fluid to intracellular fluid, thus causing hypokalemia and arrythmia. We evaluated the effect of magnesium sulfate treatment on hemodynamics and serum potassium concentration, induced by continuous infusion of regular insulin solution in rabbits. Method: Twenty-four rabbits were divided into four groups for the experiment. Group I was given intravenouse injection of 5 ml of normal saline and continuous dripping of 7.5 U of RI. Group II was pretreated with 30 mg/kg of magnesium sulfate, followed by continuous dripping of 7.5 U of RI. Group III was given 5 ml of normal saline and 15 U of RI. And Group IV was administered 15 U of RI after 30 mg/kg of magnesium sulfate pretreatment. Venouse blood sampling was done before pretreatment, and after 5, 30, 60 and 120 minutes respectively. Heart rate and arterial blood pressure were taken at the same intervals. Result: 1) There was no significant change in serum potassium concentration in groups injected with 7.5 units of RI respectively (groups I and II), regardless of magnesium pretreatment. But in groups injected with 15 units of RI, the group that was not pretreated with magnesium (Groups III) showed a decrease in serum potassium concentration from 3.39+/-0.57 Eq/L to 2.29+/-0.71 mEq/L, while the concentration in the pretreated group (Group IV) decreased more significantly from 3.35+/-0.50 mEq/L to 1.81+/-0.41 mEq/L. 2) Pulse rate did not change significantly in groups that received continuous infusion of 7.5 units of RI (groups I and II) regardless of magnesium pretreatment, but increased significantly in groups injected with 15 units of RI (groups III and IV), pretreated or not. The pretreated group (group IV) had a more significant rise in pulse rate compared with the group that was not pretreated (group III). 3) In all of the groups, those pretreated with magnesium (groups II and IV) and those not pretreated (groups I and III), there was no significant change in systolic and diastolic blood pressures. Nor was arrhythmia detected. Conclusion: The above results indicate that while magnesium sulfate pretreatment at 30 mg/kg with insulin infusion affects serum potassium concentration, has an antiarrhythmic effect, and may induce tachycardia, it does not have any significant effect on blood pressure.
Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Extracellular Fluid ; Heart Rate ; Hemodynamics* ; Hypokalemia ; Insulin ; Intracellular Fluid ; Magnesium Sulfate ; Magnesium* ; Potassium* ; Rabbits* ; Tachycardia

A 6-year-old boy with porokeratotic eccrine ostial and dermal duct nevus on the left sole is reported. The patient was born with keratotic plugs, each measuring 1-2 mm in diameter, on the left sole. Light-microscopic examination revealed epidermal invagination and cornoid lamella, which was found to be connected with hyperplastic intraepidermal and dermal eccrine duct. The present case can be histologically differentiated from nevus comedonicus and punctate porokeratotis.
Child ; Humans ; Male ; Nevus*

BACKGROUND: As undergoing general anesthesia for Cesarean Section, we usually maintain a light anesthesia until delivery. It provokes the high incidence of waketulness for the mothers. We surveyed the incidence of maternal wakefulness when thiopental was used as an induction agent. METHODS: Forty pregnant women (ASA class I or II) at term who underwent general anesthesia and cesarean section received thiopental, 4mg/kg. As the 'isolated forearm technique', a pressure cuff was inflated to isolate one arm from the the effects of succinylcholine so that wakefulness during anesthesia could be assessed by asking the patient to move her hand. To assess wakefulness,the patient was commanded to squeeze the investigator's hand a specified number of times. If the patient promptly squeezed the investigator's hand the appropriate number of times, the command was repeated but a different number of times specified. Only if the patient responded correctly both times, then we noted as a positive response. This test was repeated at 1 minute intervals beginning 1 minute after thiopental injection through the delivery. RESULTS: Five of the forty patients (12.5%) showed wakefulness. Twenty nine of the forty patients showed 'reaching movements'. One patient showed both wakefulness and 'reaching movements'. CONCLUSIONS: When we undergo general anesthesia for Cesarean Section, especially using thiopental as an induction agent, we should consider the maternal wakefulness seriously.
Anesthesia ; Anesthesia, General ; Anesthesia, Obstetrical ; Arm ; Cesarean Section* ; Female ; Forearm* ; Hand ; Humans ; Incidence ; Mothers ; Pregnancy ; Pregnant Women ; Succinylcholine ; Thiopental ; Wakefulness*

No abstract available.

Primary irritant dermatitis is one of the most common skin disease caused by various hazardous chemicals produced from the environment. For the detection of skin irritant potency, in vivo models such as human and animal patch test have been used, Keratinocyte culture method which has been set up very recently is another alternative in vivo method of detecting skin irritarlcy. LVe have investigated the effects of three skin irritants, phenol, benzoyl peroxide (BP), and sodium lauryl sulfate(SLS) on the keratinocyte culture system. Prostaglandin E(PGE) measurement, cell count and electron microscopic observation were performed after adding three irritants of different concentrations to the cultured keranocyte cells. The main results of this study were as follows : 1. There were statistically significant decreased cell number in concentration of 10 M phenol, 10 4M BP and SLS. The order of cytotoxic potency was SLS>BP >phenol. 2. In case of PGE production, decreased PGE production was observed 6 hours after addition of the irritants, except 10 M phenol and 10M BP groups. Decrea sing tendency sustained until 24 hours, however all were statistically nonsignificant comparing with control group. 3. Electron microscopic finding showed that dilatation of endoplasmic reticulums in 10 M phenol group, condensation and dilatation of mitochondrias in 10 4M BP group, and most of the cells were swollen in 10 4M SLS group. These results suggest that cell count is a useful model for performing cytotoxi city test in keratinocyte culture decreased PGE production represents cytotoxic effect in high concentration of primary irritants and ultrastructural changes may reflect the different pathomechanisms in cytotoxicity.
Animals ; Benzoyl Peroxide ; Cell Count ; Dermatitis, Irritant ; Dilatation ; Dinoprostone ; Endoplasmic Reticulum ; Hazardous Substances ; Humans* ; Irritants* ; Keratinocytes* ; Mitochondria ; Patch Tests ; Phenol ; Prostaglandins E ; Skin ; Skin Diseases ; Sodium

We report an autopsy of a male fetus that showed multiple congenital anomalies that could best be designated as Meckel-Gruber syndrome. The fetus was born dead at the gestational age of 38 weeks. His parents denied any history of congenital malformation. And the parity of the mother was 0-0-0-0, but she had the past history of receiving herb medication for common cold. The congenital anomalies found in this case consited of occipital meningoencephalocele, midline cleft palate, bifid epiglottis, hepatic fibrosis, choledochal cyst, bilateral polycystic kidneys, postaxial polydactyly of both hands and feet, aplasia of the left testis, secundum type atrial septal defect and patent ductus arterious. This malformation syndrome is rare and lethal. The prenatal diagnosis should be made by ultrasound study or analysis of the amniotic fluid for alpha-feto protein during intrauterine period. The kidneys showed Potter type III cystic change and there was a characteristic hepatic fibrosis.
Male ; Humans

Tracheal intubation has become a commonplace technique often used for general anesthesia. There are few complications due to recent developement of endotracheal tube. The complications of cuffed endotracheal tubes occur as a result of callapse, kinking, foreign body, or secretion within the lumen; occlusion by biting; dislodged cuff overiding the distal orifice: bevel of the tube against tracheal wall; or imperfections on the tube causing flaplike valves. The complications, although infrequent, are relatively formidable and tent to negate to a varing degree the lifesaving potential of prolonged artificail ventilation. We experienced this cuff induced complication and treated patient under the diagnosis of bronchial asthma at begining. But, after extubation, We knew that attack occured as a result of cuff induced ball valve effect.
Anesthesia, General* ; Asthma ; Diagnosis ; Foreign Bodies ; Humans ; Intubation ; Ventilation

Surgical Treatment for low back pain with or without sciatica has been one of perplexing problem in the field of clinical neurosurgery. There has no clearcut explanation yet been given on an exact cause of lumbago in spite that most neurosurgeon has spent their considerable time and effort in complete relief of low back pain. Although there reveal many different types of low back pain associated with various kind of neurological signs, it would be important for the neurosurgeon to clarify that what exactly cause such pain or trouble. An active attempt on searching true site of the pain has been carried out by the author during the disc surgery in the past nine years. Conservative treatment with a bed rest should of course be applied to the patient before the surgery decided. If there is no adequate effect and if there show a persistent pain and positive neurological signs one should decide performing a laminectomy. To confirm the accurate pain origin during the surgery mechanical and electronic stimulation on and around the nerve root must be at tempted with the patient under local anesthesia. These stimulations should also be applied on posterior longitudinal ligament, annulus fibrosus, part of ligamentum flavum and dura. The patient is placed in the operation table in lateral position so that some clinical tests including Lasegue's maneuver, active pelvic movement and coughing could be instructed on him during the disc exploration. Local infiltration with 2% procaine HCL solution to the skin and 0.5% procaine solution to the subsequent layers should be used. Partial heminectomy can be done without pain. Ligamentum flavum is then be removed in one piece with a pointed knife and the wound is enlarged by a rongeur laterally in order to get the nerve root in view. At this point 0.3-0.5% procaine solution is injected to the root with a #26 needled syringe. The anesthesia is immediate and the nerve root may then be dissected and displaced without pain. After the complete removal of ruptured and degenerated nucleus pulposus through a circular incision made on annulus fibrosus, one should start detecting any pain remaind in the disc area by means of various stimulations and clinical tests in cooperation with the patient. By the time finishing the total removal of degenerated nucleus pulposus the surgeon may notice the nerve root become sensitive to the stimulation as anesthetic getting absorbed and this would help the pain detection procedure. Pain associated with adhered loops and tissue inflammation can easily be detected and relieved by section of the adhered loop and inflamed posterior longitudinal ligament. After the through hemostasis and irrigation with saline the wound is closed meticulously in routine fashion. No blood transfusion or IV. Infusion required during the surgery. There was no operative mortality. Satisfactory and excellent surgical result revealed in 99.5% of 405 cases treated during past nine years at author's hospital9. Advantages by this method are: 1. No special pre-Op or post-Op care required. 2. Patient is placed in lateral position at ease during surgery. 3. Myelography is not necessarily required. 4. The surgery can be applicable in aged or illed patients. 5. No blood transfusion or IV. Infusion is required except for the bad conditioned patient. 6. Lateral position allows the confirmation of pain origin and it's relief during the surgery. 7. Minimal or no mortality. 8. Early ambulation can be started.
Anesthesia ; Anesthesia, Local* ; Bed Rest ; Blood Transfusion ; Cough ; Early Ambulation ; Hemostasis ; Humans ; Inflammation ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Low Back Pain ; Mortality ; Myelography ; Neurosurgery ; Operating Tables ; Procaine ; Sciatica ; Skin ; Syringes ; Wounds and Injuries

We report a case of MALT lymphoma in a 49-year-old woman. Her disease occurred simultaneously in the mucosa of her right upper eyelid conjunctiva and in her left nostril as ulcerating tumors associated with itchy ichthyosiform skin lesions on the trunk, hyperkeratotic palms and soles, and dystrophic nails. Histopathological examinations revealed consistent findings of MALT lymphoma with dissemination; i.e., diffuse infiltrates of lymphoplasmacytoid cells with a few Russel body-like structures, eosinophils, some shoddy granulomas under the irregularly hyperplastic epidermis, and diffuse infiltrates of CCL ( centrocyte-like ) cells and small lymphocytes inside and outside many lymphoid follicle-like structures in the subcutaneous tissue forming florid lymphoepithelial lesions. She died after 27 months duration of her disease with worsening of ichthyosiform skin lesions and dystrophic nails in spite of total excision of the tumors. We discuss the clinical and histopathologic features of MALT lymphoma with dissemination and the various similar diseases to differentiate.
Conjunctiva ; Eosinophils ; Epidermis ; Eyelids* ; Female ; Glycogen Storage Disease Type VI ; Granuloma ; Humans ; Lymphocytes ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Mucous Membrane ; Skin ; Subcutaneous Tissue ; Ulcer

We report a case of fibrous hamartoma of infancy in a 7-month-old male infant, in which a solitary, asymptomatic, walnut-sized, nomal skin-colored plaque occurred on the left middle back for about one month. Histopathologic findings showed the distinctive features of fibrous hamartoma of infancy, ie, trabeculae of dense collagenous tissue, whorls of immature spindle cells within a mucoid matrix, and interspersed mature adipose tissue, in the lower dermis. The lesion was excised without recurrence.
Adipose Tissue ; Collagen ; Dermis ; Hamartoma* ; Humans ; Infant ; Male ; Recurrence