No abstract available.
Humans ; Intracranial Pressure*

It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and it may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylchohne injections. Intracranial pressure and MAP were measured in 13 patients who underwent craniotomy. All the patients were monitored cerebral epidural ICP and intraarterial pressure preoperatively. The results were as follow: 1. Intracranial pressure was increased of 7.1±7.23 mmHg. 2. Arterial pressure was increased of 43.5±25.46 mmHg. 3. Cerebral perfusion pressure was increased of 33.3±27.53 mmHg. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.
Anesthesia, General ; Arterial Pressure ; Cerebrovascular Circulation ; Craniotomy ; Humans ; Intracranial Pressure* ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Thiopental

No abstract available.
Colorectal Neoplasms, Hereditary Nonpolyposis*

No abstract available.
Mesenteric Artery, Superior*

No abstract available.

PURPOSE: There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior. METHODS: We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness. RESULTS: The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group. CONCLUSION: Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.
Abdomen, Acute ; Analgesics ; Appendectomy* ; Appendicitis ; Female ; Hospital Charges ; Humans ; Length of Stay ; Male ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Wound Infection

No abstract available.
Cardiovascular Agents*

The technique of radial artery cannulation and its complications are well documented, but serious complications are rare. This is a report of one case of amputation of wrist due to finger necrosis developed from the radial artery cannulation in patient who had craniectomy surgery. This 52-year-old 79 kg male underwent subdural hematoma removal surgery. Right radial artery cannulation was carried out percutaneously using 22 gauge Teflon extracath needle after modified Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. His arterial blood pressure was maintained 100/70-110/80 mmHg and 5 units of banked whole blood and 1 unit of fresh frozen plasma were transfused during 8-hours operation. Cannula was removed on the 9th hour after operation because that was obstructed. On the 12th hour after removal of cannula, his right hand noted to be cool and cyanotic. So, warm towel and hot bag applied continuously on the right hand and the right stellate ganglion block was carried out every day for 4 times. However, on the 10th day after removal of cannula, necrotic change of all fingers of the right hand became worse and skin of fingers were shrunken. Therefore, disarticulation of the right wrist carried out on the 71th day of his hospitalization.
Amputation* ; Arterial Pressure ; Catheterization* ; Catheters ; Disarticulation ; Extremities* ; Fingers ; Hand ; Hematoma, Subdural ; Heparin ; Hospitalization ; Humans ; Male ; Middle Aged ; Necrosis ; Needles ; Plasma ; Polytetrafluoroethylene ; Radial Artery* ; Skin ; Stellate Ganglion ; Wrist

This study deals with the changes in the concentrations of blood glucose and electrolytes during open heart surgery. Blood glucose and electrolytes in connection with age, disease and anesthetic period were measured in 25 patients about to undergo heart surgery which were performed between June 1986 and August 1986 in Yeungnam University Hospital. Because glucose solution is commonly used as priming solution, and the priming solution is hyperglycemic and hyperosmolar, glucose level of priming solution in this study was adjusted to 100-200 mg% level to minimize hyperglycemic and hyperosmolar effect. The following results were obtained. 1. Glucose level of priming solution before extracorporeal circulation was 151.6+31.3 mg%. 2. With body cooing, blood glucose level was elevated. As duration of extracorporeal circulation is prolonged, blood glucose level was elevated more, but no difference between age and diseases were observed. On warning, blood glucose level was progressively lowered. 3. Despite the low serum potassium level during by-pass, the potassium level was progressively elevated following by pass, cut the serum potassium level was low compared to control values. Elevated calcium level was maintained during by pass.
Blood Glucose* ; Calcium ; Electrolytes ; Extracorporeal Circulation ; Glucose ; Heart* ; Humans ; Potassium ; Thoracic Surgery*

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*