No abstract available.
Pneumothorax* ; Risk Factors*

No abstract available.
Craniocerebral Trauma* ; Head* ; Hematoma*

No abstract available.
Lung*

No abstract available.
Aortic Coarctation* ; Child, Preschool* ; Humans

No abstract available.
Drug Resistance* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium*

The clinical analysis of cranial nerve injuries was performed on 435 cases with cranoicrerbral trauma. This prospective study included the correlation between cranial nerve injuries and risk factors such as intracranial hematoma, initial Glasgow Coma Scale(GCS) score, pneumocephalus, and other combined injuries. The results were revealed as follows : 1) 133 cranial nerve injuries(on 97 patients) were noted among 435 craniocerebral trauma victims(97/435=22.2%). 2) The order of frequent cranial nerve injuries was facial nerve(7.3%), olfactory nerve(6.9%), oculomotor nerve(4.4%), abducens nerve(3.9%), optic nerve(3.2%), etc. 3) Bilateral involvment of cranial nerve injuries was noted in 16.5%(22/133). 4) The incidence of immediate onset of cranial nerve injuries was 66.9%(89/133). 5) The incidence of cranial nerve injuries was significantly high in patients with pneumocephalus and low initial GCS score. 6) The functional recovery of injured cranial nerve within 3 months was noted in 30.1%(40/133).
Coma ; Cranial Nerve Injuries* ; Cranial Nerves* ; Craniocerebral Trauma* ; Hematoma ; Humans ; Incidence ; Pneumocephalus ; Prospective Studies ; Risk Factors

A propecive analysis of 50 patients with acute interhemisphric subdural hemorrhage and tentorial hemorrhage, an unusual pattern of acute subdural hematoma, who were managed in a uniform way was analyzed to related outcome to hemorrhagic site, initial Glasgow Coma Scale(GCS) and combined injuries. The incidence of acute interhemisphric subdural hemorrhage(ISH) and tentoria hemorrhage(TH) after head trauma was 3.83%, 50 cases among 1303 head injured cases. And 80% of the above hemorrhage disapperaed within two weeks after trauma. There was no significant relationship between feature of hemorrhage and intial GCS(P>0.05), but there was highly significant relationship between initial GCS and Glasgow Outcome Scale(GOS) (p<0.001). There noted significant relationship between initial combined injury and GOS(p<0.01), and also brainstem injury and GOS(p<0.001).
Brain Stem ; Coma ; Craniocerebral Trauma ; Head ; Hematoma, Subdural* ; Hematoma, Subdural, Acute ; Hemorrhage* ; Humans ; Incidence

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

Total intravenous anesthesia(TIVA) is desirable technique for a number of reasons. The first is that it implies all the components of general anesthesia : hypnosis, amnesia, analgesia, and muscle relaxation by combination of several drugs and the lungs are ventilated with oxygen-enriched air. A combination of fentanyl-propofol were used as TIVA for laryngomicrosurgery (LMS) with high frequency jet ventilation(HFJV). 41 patients were studied. Glycopyrrolate was given 1 hour before anesthetic induction. Propofol 2 mg/kg was intravenously administered 1 minute after fentanyl 1.5 ug/kg intravenously injection for induction. Endotracheal intubation was performed after succinylcholine administration with internal diameter 4.0-6.0 mm LASER tube through oral cavity or 8 fr. polyethylene catheter through nasal airway. After then, HFJV was started with frequency 108-120 cycles/minute and driving pressure 2.0-2.5 kg/cm(2). The adequacy of ventilation was evaluated with arterial blood gas analysis. For maintenance a continuous propafol infusion of 10 mg/kg/hour was used for the first 10 minutes, followed by 8 mg/kg/hour for the next 10 minutes and 6 mg/kg/hour, thereafter. Continuous dripping of succinylcholine was used for muscle relaxation. The patients showed relatively stable hemodynamic status during procedure (Fig. 1). Two recovery times were as followed: the interval from cessation of infusion until opening eyes on command(4.90+/-3.41 min), and that until correct response to simple question (5.50+/-3.49 min). There was a correlation between total amount of propofol given to patients and recovery times(P<0.05)(Table 1). Interestingly. a group of patients weighed over 70 kg showed carbon dioxide retension on arterial blood gas analysis(Fig. 2). In conclusion, fentanyl-propofol cobination with muscle relaxant is proper regimen for TIVA in LMS with HFJV. More stable and better recovery are the main reasons. However, carbon dioxide retension should be consider to the patients weighed over 70 kg with the HFJV.
Amnesia ; Analgesia ; Anesthesia, General ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Carbon Dioxide ; Catheters ; Fentanyl ; Glycopyrrolate ; Hemodynamics ; High-Frequency Jet Ventilation* ; Humans ; Hypnosis ; Intubation, Intratracheal ; Lung ; Mouth ; Muscle Relaxation ; Polyethylene ; Propofol ; Succinylcholine ; Ventilation

After the definition of Cushing's ulcer, it is well recognized that neurosurgical patients have the high risk of acute gastrointestinal bleeding, especially in severe head trauma. Acute gastrointestinal bleeding after burn, respiratory failure, hepatic failure, renal failure and sepsis as "stress ulcer" also were studied. The prevention and management of bleeding was discussed in medico-surgical field for several years. Despite of these regimen, the prognosis of the bleeding have not significantly improved and bleeding affected the patient's outcome more than initial neurosurgical intervention. The authors experienced 25 cases of acute gastrointestinal bleeding among our neurosurgical patients between January, 1984 to June, 1988. We analysed these patients respectively and concluded as follows: 1) The incidence of acute gastrointestinal bleeding was 0.61%. 2) The bleeding developed on 12th day, average, and clinical manifestation were anemia, hematemesis and melena in order of frequency within the first 4-week in almost all cases. 3) The initial neurological sign such Glasgow Coma Scale may well predict the hallmark to suspect the acute gastrointestinal bleeding. 4) The systemic insults such as shock, renal failure, hepatic failure, respiratory failure and sepsis significantly affected to re-bleeding chance and rendered the patient's outcome poorer. 5) The overall mortality due to gastrointestinal bleeding was 32% and the operative mortality was 50%.
Anemia ; Burns ; Craniocerebral Trauma ; Glasgow Coma Scale ; Hematemesis ; Hemorrhage* ; Humans ; Incidence ; Liver Failure ; Melena ; Mortality ; Prognosis ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Shock ; Ulcer