The authors observed the anesthetic effects of an intravenous drip of ketamine hydrochloride supplemented with diazepam and nitrous oxide on the cardiovascular system and the psychotomimetic reaction in 38 relarively healthy patients who underwent abdominal surgery at Chonbuk National Hospital from May to Sept., 1985. The results were compared with those obtained from patients anesthetized with halothanenitrous oxide-oxygen. 1) The rate of intravenous drip of ketamine was 1mg/kg/hr, which adequately maintained the level of surgical anesthesia. The total amount of pancuronium required for satisfactory skeletal muscle relaxation was 40% more in the ketamine group than in the halothane group. 2) Following ketamine anesthesia, systolic pressure revealed a transient increase immediately after induction, and about 4minutes after the commencement of surgery it thereafter returned to the preinduction level and remained stable during the operation this is in contrast with halothane anesthesia in which the systolic pressure decreased and remained below the level of preinduction after a transient increase immediately after induction. 3) The difference in diastolic pressure between ketamine and halothane anesthesia was significant(p<0.05) as the pressure increased and remained at a high level in the ketamine group while it decreased to the preinduction level following a treansient increase after induction in the halothane group. 4) pulse rate exhibited a greater increase in the ketamine group than in the halothane group after induction, but there was no statistical significance between the two groups(p>0.05). 5) Contrary to halothane anesthesia, anticholinergic premedication could not completely prevent endotracheal secretion following ketamine anesthesia. 6) Premedication with diazepam could not completely relieve psychotomimetic reactions including convulsion and hallucination after ketamine anesthesia.
Anesthesia* ; Anesthetics ; Blood Pressure ; Cardiovascular System* ; Diazepam ; Hallucinations ; Halothane ; Heart Rate ; Humans ; Infusions, Intravenous ; Jeollabuk-do ; Ketamine ; Muscle, Skeletal ; Nitrous Oxide ; Pancuronium ; Premedication ; Relaxation ; Seizures

Scleroderma is rare disease of unknown etiology characterized by fibrosis of skin and internal organs such as lung, gastrointestinal tract, kidney, heart and so on. The association between scleroderma and malignancy has been a controversy during recent years. We report a 77-year old female who had scleroderma and squamous cell carcinoma of esophagus. She was diagnosed as esophageal carcinoma and then sclerotic skin change developed in both hands and feet 3 months later. We present this case with a review of literatures.
Aged ; Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Esophagus ; Female ; Fibrosis ; Foot ; Gastrointestinal Tract ; Hand ; Heart ; Humans ; Kidney ; Lung ; Rare Diseases ; Skin

Polyarteritis nodosa (PAN) has a broad spectrum of clinical presentation, since it affects small and medium-sized muscular arteries with microaneurysm formation, aneurysmal rupture with hemorrhage, thrombosis, and, consequently, organ ischemia or infarction. Although skeletal muscle involvement is well documented in patients with PAN, it can mimic more common diseases, and cause confusion and delays in diagnosis. PAN muscular involvement may have limited or early systemic forms with a benign course and excellent clinical response to corticosteroid therapy. Herein, we describe the clinical course and outcome of four unusual cases of PAN manifested by acute onset of pain and pitting edema in both lower extremities; in addition, we reviewed the relevant literature.
Aneurysm ; Arteries ; Diagnosis ; Edema* ; Hemorrhage ; Humans ; Infarction ; Ischemia ; Lower Extremity* ; Muscle, Skeletal ; Musculoskeletal Pain ; Polyarteritis Nodosa* ; Rupture ; Systemic Vasculitis ; Thrombosis

BACKGROUND AND OBJECTIVES: The presence and distribution of NADPH-diaphorase activity in the olfactory bulb during development has been reported. But the precise localization of NO-synthase (NOS) in the olfactory bulb during the developmental stages has not been studied yet. Therefore, we investigated the localization of NOS-immunoreactivity in a developing rat olfactory bulb by immunohistochemistry. MATERIALS AND METHODS: A total of 32 male and female Sprague-Dawley rats. They were of several prenatal and postnatal stages, such as the following: embryonic day 16 (E16), E18, E20, postnatal day 1 (P1), P5, P7, P14 and adult. Indirect immunoperoxidase method using rabbit polyclonal anti-bNOS antibody was performed for detecting the NOS immunoreactivity. RESULTS: In the main olfactory bulb, the first NOS-immunoreactive (IR) neurons were observed in the presumptive granule cell layer (GCL) by E18, and in the glomerular layer (GL) by P1. The density of these neurons was increased as the development stage approached the adult stage. In the GCL, two types of NOS-immunoreactive neurons were observed: intensively stained large, short axon cells and weakly stained small, granule cells. The first, localized in the deeper part of the GCL, was observed in the earlier developmental stages, and the latter which increased in number to the adult period was observed by P1. In the accessory olfactory bulb, NOS-IR neurons were first detected in the GCL by P1, and increased in number to the adult period. The pattern of NOS-IR neurons in the GCL of the accessory olfactory bulb is similar to that in the main olfactory bulb. CONCLUSION: Our results demonstrated that bNOS had a characteristic temporal and spatial patterns of expression in the main and accessory olfactory bulb of the rat during development.
Adult ; Animals ; Axons ; Female ; Humans ; Immunohistochemistry ; Male ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Olfactory Bulb* ; Rats* ; Rats, Sprague-Dawley