Bronchopleural fistula is an uncommon but serious complication of lung resection, with a high mortality and morbidity. Problems associated with bronchopleural fistula and empyema are related to positive-pressure ventilation, which may result in infectious contamination of healthy lung tissue, loss of air, decreased alveolar ventilation leading to carbon dioxide retention, and the development of a tension pneumothorax. We experienced difficult intubation in patient who has large bronchopleural fistula and anatomic deviations of intact bronchus of the left lung, so we used a long single lumen tube made by attaching an another cuffed endotracheal tube under direct vision. The arterial oxygenation was effective, but carbon dioxide elimination was inadequate. After the operation, the ordinary cuffed endotracheal tube was intubated orally and the patient was transferred to the ward without problems 6 days after the operation.
Anesthesia* ; Bronchi ; Carbon Dioxide ; Empyema ; Fistula* ; Humans ; Intubation ; Lung ; Mortality ; Oxygen ; Pneumothorax ; Positive-Pressure Respiration ; Ventilation

OBJECTIVE: A Multicenter open-label study was conducted to evaluate the clinical efficacy and safety of venlafaxine for the treatment in patients with major depression. METHOD: The study was done in patients with major depression diagnosed by DSM-IV who accepted venlafaxine medication. In cases of the patients taking other antidepressants, 6 weeks of venlafaxine medication was carried out after 14 days of drug excretion period and evaluation using HAM-D, MADRS, and CGI was done at baseline, and after 1, 2, 4, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, relationship with venlafaxine, managements and results have been putted into the records. RESULTS: A total of 141 patients were enrolled. Among 94 of them finished the 6 weeks of research and 41 of them did not make it through the research. Total HAM-D scores showed significant decrease after 1 week of venlafaxine medication and continous decrease through the study period. Total scores of MADRS also showed significant improvement after 1 week and continuous decrease through the study period. Similarly, CGI showed significant improvement between baseline, 1, 2, 4, and 6 weeks. There were no significant changes in vital sign, CBC, chemistry, and EKG. The commonly reported side effects of venlafaxine were nausea (10.6%), indigestion (9.5%), constipation (8.5%), and dizziness (8.5%). CONCLUSION: According to the results, venlafaxine was effective and safe in the treatment of patients with major depression.
Antidepressive Agents ; Chemistry ; Constipation ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Dizziness ; Dyspepsia ; Electrocardiography ; Humans ; Incidence ; Nausea ; Vital Signs ; Venlafaxine Hydrochloride

OBJECTIVE: The aim of this study is to determine effects of nefazodone on depression, anxiety, sleep and sexual function in depressive patients. SUBJECTS AND METHODS: This is an open, non-comparative, multi-center study. Antidepressant and other clinical effects of nefazodone were evaluated in 230 patients of 26 centers, aged 14 years or more, who met DSM-IV criteria to major depressive disorder or dysthymic disorder and didn't have other psychiatric disorders and were physically healthy. The clinical efficacy was assessed at week 1, 2, 4 and 8 using Clinical Global Improvement (CGI), Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory-State Anxiety (STAI-SA). Other clinical effects were assessed with Weekly Sleep Questionnaire, Sexual Functioning Questionnaire and GHQ-QOL-12, a scale for quality of life. Adverse drug reactions were checked with a questionnaire. Post-treatment effects of drug were compared with pre-treatment baseline condition. RESULTS: The response rates by Clincal Grobal Improvement and HAM-D after 8 weeks treatment were 62.4% and 75.2% respectively. Comparing to baseline, nefazodone was proved to have significantly higher antidepressant and antianxiety effects in depressive patients and it improved also sleep, sexual functions and quality of life. Both patients and physicians satisfied with the effects of drug. Adverse drug reactions were a few and not serious, and most of them disappeared as treatment continued. CONCLUSION: These results suggest that not only nefazodone has antidepressant effects and antianxiety effects, but also it improves sleep disturbance, sexual dysfunction and the quality of life in depressive patients. Adverse drug reactions were a few and not serious.
Anti-Anxiety Agents ; Anxiety* ; Depression* ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Drug-Related Side Effects and Adverse Reactions ; Dysthymic Disorder ; Humans ; Quality of Life* ; Surveys and Questionnaires