No abstract available.
Biopsy, Needle* ; Needles*

The usefulness of a nondepolarizing muscle relaxant for endotracheal intubation is limited by its relatively slow onset of neuromuscular block compared to that achieved with succinylcholine. Several attempts have been made to produce a more rapid onset of muscle relaxation for endotracheal intubation. A large dose of nondepoarizing muscle relaxant may produce rapid onset but cauae undesirable side effects and a prolonged duration of neuromuscular block. The authors observed the degree of vocal cord relaxation and intubation condition 2 minutes after administration of atracurium and measured changes in mean arterial blood pressure and heart rate at the time of arrival in the operating room, just before abministration of atracurium, 2minutes after administration, and 5mins after intubation. The 40 of patients in this observation were divided into four groups. Group 1; 10patients, received 0.3 mg/kg of atracurium Group 2; 10patients, received 0.4 mg/kg of atracurium Group 3; 10patients, received 0.5 mg/kg of atracurium Group 4; 10patients, received 0.6 mg/kg of atracurium The results were as follows; 1) There were better intubating conditions in Group 3 and 4 than in Group 1 and 2(p<0.001). 2) Mean arterial blood pressure and heart rate did not change significantly after administration of atracurium in all four groups. From the above results we conclude that 0.5~0.6 mg/kg of atracurium provides satisfactory intubation condition 2 minutes after administration without hemodynamic changes.
Arterial Pressure ; Atracurium* ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal* ; Muscle Relaxation ; Neuromuscular Blockade ; Operating Rooms ; Relaxation ; Succinylcholine ; Vocal Cords

PURPOSE: Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries in the world today. However, there is no consensus regarding whether LC can be performed in patients with acute cholecystitis while on antithrombotic therapy. The objective of our study was to describe postoperative outcomes of patients who underwent emergent LC without interruption to antithrombotic therapy. METHODS: We performed a retrospective review of patients who underwent LC for acute cholecystitis while on antithrombotic therapy from 2010 to 2015 at Soonchunhyang Universtiy Cheonan Hospital. Patients were divided into 2 groups as underwent emergent LC and elective LC. RESULTS: A total of 67 patients (emergent group, 22; elective group, 45) were included in the analysis. Elective group had significantly longer duration between the admission and operation (8 [7–10] days vs. 2 [1–3] days, P < 0.001) and longer duration of antithrombotic drugs discontinuation (7 days vs. 1 [0–3] days, P < 0.001). Emergent group had significantly more postoperative anemia (6 patients vs. 0 patient, P = 0.001) and 3 of 6 patients received packed RBC transfusion in postoperative period. However, there was no significant difference in length of postoperative stays, length of intensive care unit stays and mortality rates. CONCLUSION: Emergent LC without interruption to antithrombotic therapy was relatively safe and useful. A well-designed multicenter study is needed to confirm the safety and efficacy of LC without suspension of antithrombotic therapy and to provide a simple guideline.
Anemia ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Chungcheongnam-do ; Consensus ; Humans ; Intensive Care Units ; Mortality ; Postoperative Period ; Retrospective Studies

PURPOSE: Several studies suggest that tumor angiogenesis is a significant prognostic factor in carcinoma of the breast, lung, prostate, oral cavity, and colon. We assessed whether intensity of tumor angiogenesis, as measured by microvessel counts in histologic sections, correlates with prognosis in patients with stage III gastric cancer. MATERIALS AND METHODS: Paraffin-embedded sections from 49 patients (23 stage IIla, 26 stage IIIb) with primary gastric cancer that had been completely removed were analyzed for angiogenesis. Vessels were stained with anti-factor VIII polyclonal antibody, and areas with the most discrete microvessels were counted in a 200X field. RESULTS: Patients with stage IIIa gastric cancer had fewer microvessels than those with stage IIIb gastric cancer (32.8+-14.5 vs. 40.3+-16.1, P=0.106). The mean microvessel count from patients who were alive were significantly lower than that from patients who had died at the time of follow-up (24.8+-10.0 vs. 42.9+- 14.5, P=O.OOO). The 5-year survival rate of patients with count less than 33 microvessels was higher than that of patients with count more than 33 microvessels (59.9% vs. 11.6%, P= 0.000). On multivariate analysis by Cox proportional hazards model, the microvessel count was a significant prognostic factor of stage III gastric cancer. CONCLUSION: Tumor angiogenesis assessed by microvessel count may be a significant prognostic factor of stage III gastric cancer and may prove valuable in selecting patients with stage III gastric cancer for aggressive adjuvant therapy and closer postoperative follow-up.
Breast ; Colon ; Follow-Up Studies ; Humans ; Lung ; Microvessels ; Mouth ; Multivariate Analysis ; Prognosis* ; Proportional Hazards Models ; Prostate ; Stomach Neoplasms* ; Survival Rate

Pheochromocytoma is functioning tumor which originates in the adrenal medulla or in chromaffin tissue along the paravertebral sympathetic chain. This tumor releases epinephrine and norepinephrine causing increase of peripheral resistance and resulting in increased blood pressure and reducing plasma volume. The anesthetic management of patients with pheochromocytoma presents many difficult problems such as hypertension, cardiac arrhythmias, and hypotension. A 40 year-old female underwent resection of pheochromocytoma under general anesthesia. Thiopental was used for induction followed N2O-O2-enflurane supplemented with fractional doses of fentanyl and vecuronium for muscle relaxation. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside, and premature ventricular beats were controlled with lidocaine. We experienced marked fluctuation of blood pressure during anesthetic course.
Adrenal Medulla ; Adult ; Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Epinephrine ; Female ; Fentanyl ; Humans ; Hypertension ; Hypotension ; Lidocaine ; Muscle Relaxation ; Nitroprusside ; Norepinephrine ; Phentolamine ; Pheochromocytoma* ; Plasma Volume ; Thiopental ; Vascular Resistance ; Vecuronium Bromide ; Ventricular Premature Complexes

No abstract available.
Anesthesia* ; Bronchial Spasm* ; Humans ; Infant, Newborn ; Infant, Premature* ; Ventilation*

No abstract available.
Humans ; Pericardial Effusion*

No abstract available.
Anesthesia* ; Emergencies*

No abstract available.
Humans ; Intensive Care Units* ; Critical Care* ; Korea*

BACKGROUND: Obesity is a risk factor for metabolic abnormalities. We investigated the relationship of adiponectin levels and visceral adiposity with insulin resistance and β-cell dysfunction. METHODS: This cross-sectional study enrolled 1,347 participants (501 men and 846 women aged 30–64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Serum adiponectin levels and visceral fat were measured using enzyme-linked immunosorbent assay kits and dual-energy X-ray absorptiometry, respectively. Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance (HOMA-IR) and Matsuda insulin sensitivity index. β-cell dysfunction was evaluated using the homeostatic model assessment of β-cell function (HOMA-β), insulinogenic index, and disposition index. RESULTS: Regarding insulin resistance, compared with individuals with the highest adiponectin levels and visceral fat mass < 75th percentile, the fully adjusted odds ratios (ORs) for HOMA-IR ≥ 2.5 and Matsuda index < 25th percentile were 13.79 (95% confidence interval, 7.65–24.83) and 8.34 (4.66–14.93), respectively, for individuals with the lowest adiponectin levels and visceral fat ≥ 75th percentile. Regarding β-cell dysfunction, the corresponding ORs for HOMA-β< 25th percentile, insulinogenic index < 25th percentile, and disposition index < 25th percentile were 1.20 (0.71–2.02), 1.01 (0.61–1.66), and 1.87 (1.15–3.04), respectively. CONCLUSION: Low adiponectin levels and high visceral adiposity might affect insulin resistance and β-cell dysfunction.
Absorptiometry, Photon ; Adiponectin* ; Adiposity ; Cross-Sectional Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat* ; Male ; Metabolic Diseases ; Obesity ; Odds Ratio ; Risk Factors