The present studies were carried out, under natural room condition from June to July in 1969. The period required for growth of eggs and larva varied according to various temperatures and methods of rearing. The average number of eggs laid by the Culex pipiens pallens was 137 per egg raft. The period of gonotrophic cycle was from 3 to 6 days: incubation period of eggs was from 1.5 to 2 days: larva period was from 10 to 14 days: pupa period was from 2 to 3 days. Accordingly, the period from the beginning of gonotrophic cycle to the adult mosquitos in next generation required 25 days at the longest and 16.5 days at the shortest.
parasitology-arthropodology-Culex pipiens pallens ; life cycle ; egg ; pupa ; larva ; mosquito

The purpose of this study is to make an emphasis the necessity of the dynamization after interlocking intramedullary nailing. We reviewed 75 cases of the fractures of the shaft of femur or tibia fixed with static interlocking intramedullary nailing. We excluded the cases in whom the locking screws were removed for the purpose of the relief of pain from the irriataion by those screws. The parameter we reviewed were the type of fracture, postoperative gap between the major fragments. Early callus formation, the union time, postoperative dynamization and controlled weight bearing. In those cases in which the contact surface between the major fragments was more than 50% and there noticed no early callus within 6 weeks after operation, the union time was shortened after dynamization, when the contact surface was less than 50% and there noticed no early callus, the union time was shortened after bone graft and dynamization which resulted in some shortening in the length in acceptable ranges. In cases with a major gap of more than 2mm, the union time was shortened after dynamization. The rate of early callus formation was a little higher in cases with postoperative controlled weight bearing than those to whom we did not permit a controlled weight bearing.
Bony Callus ; Femur ; Fracture Fixation, Intramedullary ; Tibia ; Transplants ; Weight-Bearing

BACKGROUND: Propofol can produce a dose-dependent reduction in blood pressure by providing titratable sedation and rapid recovery. It has been reported that a combination of midazolam and propofol resulted in the significant reduction in the total dose of propofol needed. It was hypothesized that the addition of low-dose midazolam to propofol may provide sufficient sedation without compromising the hemodynamic stability. METHODS: A total of 40 consecutive patients were randomly assigned to one of two groups (n = 20 each). Group M-P received a bolus of 0.02 mg/kg of midazolam, followed by a propofol infusion with a fixed target concentration of 1.0microgram/ml. Group P received only a propofol infusion with an initial target plasma concentration of 2.5microgram/ml. Subsequent titration of the infusion rates in Group P or the additional midazolam boluses in Group M-P were made in order to maintain a predetermined sedation level. RESULTS: In Group P, a mean dose of 5.4 +/- 0.7 mg/kg/h propofol was used compared with 2.7 +/- 0.5 mg/kg/h in Group M-P (P<0.0001, plus additional 2.96 +/- 1.8 mg of midazolam). Ephedrine was administered to 15 patients in Group M-P and 17 patients in Group P. Recovery was significantly fast (Group P, 6.8 +/- 2.9 min vs. Group M-P, 9.8 +/- 4.4 min, P<0.05). CONCLUSIONS: Sedation with propofol plus midazolam requires a lower total dose of propofol compared with propofol alone but has no superior hemodynamic stability. A further study using younger patients and combinations of different doses of each drug will be needed.
Anesthesia, Spinal* ; Blood Pressure ; Ephedrine ; Hemodynamics ; Humans ; Hypotension ; Midazolam ; Plasma ; Propofol* ; Prospective Studies*

Fatal airway obstruction due to the presence of blood clot occurs in a variety of clinical settings. Initial efforts to remove an airway clot, if warranted, involve suctioning, lavage, and forceps extraction through a flexible bronchoscope. If unsuccessful, further management options include rigid bronchoscopy, balloon-tip embolectomy catheter dislodgement, and the application of topical thrombolytic agents. We report a case of complete airway obstruction that developed after the aspiration of a blood clot during emergency operative vessel ligation in a 86-year-old female patient with gastric ulcer bleeding. Initial conventional suctioning was unsuccessful, in this case, due to a large firmly adherent clot. Therefore we peformed the alternative suctioning technique using suction attached directly to the existing tracheal tube in situ, with the cuff deflated. However, repeated direct tracheal suctioning alone failed to prevent cardiac arrest. Thereafter, simultaneously with several CPR chest compressions, large cylindrical clots were sucked up by direct tracheal suctioning. Presumably simultaneous chest compression has the potential advantage of creating higher airway pressures that provide effective kinetic energy to obstructing object.
Aged, 80 and over ; Airway Obstruction ; Bronchoscopes ; Bronchoscopy ; Cardiopulmonary Resuscitation ; Catheters ; Embolectomy ; Emergencies ; Female ; Fibrinolytic Agents ; Heart Arrest* ; Hemorrhage* ; Humans ; Ligation ; Resuscitation ; Stomach Ulcer ; Suction ; Surgical Instruments ; Therapeutic Irrigation ; Thorax ; Trachea

Objectives: ：We investigated relationship between sleep time and depression in the aged 65 years or older. Methods: ：This study was based on the data from seventh Korean National Health and Nutrition Examination Survey (KNHANES). 3,285 people aged 65 years or older were selected as the subjects of this research. The demographic characteristics, sleep time and Patient Health Questinnaire-9 (PHQ-9) were administered for each subjects. Depression was defined as above 10 points of PHQ-9. Results: ：All the demographic variables such as age, sex, education, household income, marital status, drinking and smoking except Body Mass Index (BMI) were correlated with the depression. When we corrected the variables, inadequate sleep time groups (less than 6 hours or more than 9 hours) tended to be depressed. Conclusions ：The study results showed the significant correlation between sleep time and depression in the aged 65 years or older. Adequate sleep time is important to prevent the depression of the aged.

Premature infants with respiratory distress syndrome may have clinically significant shunting through a patent ductus arteriosus (PDA). Left-to-right shunting through the PDA may lead to left ventricular volume overload and pulmonary edema. We present a case of perioperative management for severe respiratory distress syndrome in a premature infant who underwent surgical closure of PDA. Under general anesthesia, the infant was successfully managed by inhaled nitric oxide, high frequency oscillation ventilation with intermittent mandatory ventilation despite intermittent hypoxia. The operation was performed safely in the neonatal intensive care unit.
Anesthesia, General ; Anoxia ; Ductus Arteriosus, Patent* ; High-Frequency Ventilation ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Nitric Oxide ; Pulmonary Edema ; Ventilation

The clinical syndrome of hyperammonemic encephalopathy is often encountered in the context of decompensated liver disease. Although it is rare in patients without hepatic disease, non-hepatic causes cannot be excluded. Anesthesiologists should be careful in choosing the anesthetic agent and perioperative management for hyperammonemic patients in order to avoid acute hyperammonemia and encephalopathy. We report successful general anesthesia during GDC (Guglielmi detachable coil) embolization for a large unruptured aneurysm in the right distal internal carotid artery in a female patient with hyperammonemic encephalopathy that was caused by a portal-systemic shunt.
Anesthesia ; Anesthesia, General ; Aneurysm ; Carotid Artery, Internal ; Female ; Hepatic Encephalopathy* ; Humans ; Hyperammonemia ; Intracranial Aneurysm* ; Liver Diseases

BACKGROUND: It has been suspected that laparoscopic surgery exacerbates hypothermia to a greater extent than open surgery. Thus, this study was designed to compare the intraoperative thermoregulatory profiles of three different operative techniques: open surgery, low pressure (LP: 8 mmHg) or conventional pressure (CP: 13 mmHg) laparoscopic surgery. METHODS: Forty five patients who were scheduled for radical hysterectomy were allocated to three groups, 15 in each group: group O (open surgery), group LP and group CP. Anesthesia was maintained with 2.5% sevoflurane. Intraoperative core temperature and forearm minus fingertip skin temperature gradients were measured at 15-min intervals during the first three hours. Vasoconstriction threshold was defined by the esophageal temperature at which the skin temperature gradient equalled 0 degree C. RESULTS: All groups were comparable in terms of the characteristics of patients and preoperative body temperatures. Core temperatures and forearm minus fingertip skin temperature gradients were not significantly different among the three groups at all measurements. Thermoregulatory vasoconstrictions were observed in 6 of group O and 6 of laparoscopic surgical patients (4 patients from group LP and 2 patients from group CP). These 12 patients were divided into open (n = 6) and laparoscopic (n = 6) surgery group. There were no significant difference between the groups with regard to the vasoconstriction threshold and threshold time. CONCLUSIONS: Laparoscopic procedures with conventional insufflation pressure have similar profiles in terms of intraoperative thermoregulation, when compared to open surgery. Lowering insufflation pressure to 8 mmHg can not reduce the risk of intraoperative hypothermia.
Anesthesia ; Body Temperature ; Body Temperature Regulation* ; Female ; Forearm ; Gynecologic Surgical Procedures* ; Humans ; Hypothermia ; Hysterectomy ; Insufflation* ; Laparoscopy ; Pneumoperitoneum ; Skin Temperature ; Vasoconstriction

When a patient with a fractured anterior tooth visits the clinic, clinician has to restore the tooth esthetically and quickly. For esthetic resin restoration, clinician can use 'Natural Layering technique' and an index for palatal wall may be needed. In this case report, we introduce pre-restoration index technique on a Class IV defect, in which a temporary filling material is used for easy restoration. Chair-side index fabrication for Class IV restoration is convenient and makes a single-visit treatment possible.
Humans ; Tooth

BACKGROUND: Pencil-point needle currently are used for spinal anesthesia because of an alleged lowered incidence of postdural puncture headache. Although the direction of the side hole is one of the important factors that might affect the level and the duration of anesthesia, those data are not readily available. The aim of this study was to assess if the side hole direction of pencil-point needle during hyperbaric tetracaine injection affects the level and the duration of anesthesia. METHODS: We induced spinal anesthesia in 80 young men presenting for elective orthopedic surgery. Patients were allocated randomly with the side hole direction of the 25 gauge pencil-point needle in one of the four directions; cephalad, caudad, left lateral, right lateral. Hyperbaric 0.5% tetracaine 15~17 mg (3 to 3.4 ml) was injected with the speed of 0.75 ml/sec. Maximum sensory block level, time to maximum sensory block level, duration of sensory block (2 segments regression time) were assessed by a blinded observer with the pin-prick test and degree of motor block were measured by Bromage motor scale. Data were analysed using the Kruskal-Wallis test followed by the Mann-Whitney U test and chi-square test as appropriate (SAS v. 6.04). RESULTS: Time to maximum sensory block level was significantly fast in group 'cephalad'. Other values have no statistical differences. Post-spinal headache was observed in one case in group 'caudad'. CONCLUSIONS: Using the pencil-point needle, the time to maximum sensory block level was fast in group cephalad but there were no differences in the maximum sensory block level and the duration of sensory block among the four groups.
Anesthesia ; Anesthesia, Spinal* ; Headache ; Humans ; Incidence ; Male ; Needles* ; Orthopedics ; Post-Dural Puncture Headache ; Tetracaine*