BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

The glaucomatocyclitic crisis was first described by Posner and Schlossman in 1948, and belongs to the classification of secondary open angle glaucoma. It is unilateral and recurrent. and characterized by minimal inflammatory signs and symptoms. The inflammation may be confined to the trabecular mesh work. The facility of outflow reduced while attacks last from a few hours to over 2 weeks. Etiopathogenic nature of glaucomatocyclitic crisis is not clear but recently the role of allergy is suggested in this disease entity. A 35 year old man was found to have a glaucomatocyclitic crisis in his right eye that was treated with systemic diamox and topical corticosteroid.
Acetazolamide ; Adult ; Classification ; Glaucoma, Open-Angle ; Humans ; Hypersensitivity ; Inflammation

Papilloma is a benign epithelial tumor and may be divided etiologically into two types: viral infectious and neoplastic; histologically the two types are indistinguishable. In the field of ophthalmology, Norris reported for the first time in 1879 that papilloma begins on the bulbar conjunctiva and spreads toward the cornea. Since then, many other cases of papilloma have been reported and these reports showed that it can occur on any portion of the epithelium of the external eye and has a predilection for sites where the epithelium undergoes a transition. We have seen three patients with papillomas: a 6 year old girl with a papilloma on the caruncle; a 29 year old man, on the lower fornix; and a 42 year old woman, on the limbus. The caruncle and lower fornix papillomas were asymptomatic; the limbal papilloma was accompanied by foreign body sensation, epiphora, photophobia, and mild visual disturbance. On examination, the lesion on the caruncle was grayish-red; the surface was smooth with diffuse small red spots The lesion on the lower fornix was bright red, smooth surfaced, pedunculated, strawberry-like in appearance and showed papillary vascular proliferations. The margins of the limbal lesion extended to bulbar conjunctiva and cornea and the masswas firmly adherent to the cornea. The strawberry-like mass was grayish-white in color, hard, slightly elevated and showed papillary vascular proliferations. We feel that the papillomas on caruncle and lower fornix are viral infectious type and the one on the limbus is neoplastic type, based on the site of lesion, clinical symptoms and signs, and the age of the patient. The lesions of the above cases were removed by simple excisional biopsy and the one on the limbus also received post-excisional radiation treatment with Strontium 90. There has been no sign of complication in the four months of follow-up on the caruncle papilloma and two months of follow-up on the lower fornix and limbal papilloma.
Adult ; Biopsy ; Child ; Conjunctiva ; Cornea ; Epithelium ; Female ; Follow-Up Studies ; Foreign Bodies ; Humans ; Lacrimal Apparatus Diseases ; Ophthalmology ; Papilloma* ; Photophobia ; Sensation ; Strontium

No abstract available.

BACKGROUND AND PURPOSE: Manganese could be toxic to the human nervous system. Therefore, it is important to detect the over-exposed patients in their early course of intoxication. The aim of this study is to find a valuable methods of clinical examination and applicable parameters for early detection of manganese intoxication. METHODS: we investigated the 35 men who had been exposed to manganese over 5 years. All the subjects were examined and video monitored by three physicians. We separated them into the two groups(Group A: clinically suspicious, Group B: clinically normal) in terms of their motor functions, gait, posture, expression. Motor functions(finger and foot tapping, rapid alternating movement, pegboard exam, writing and walking velocity etc.), MRIs, and biochemical data were measured and compared. RESULTS: No one showed significant effects of manganese intoxication . Also there were no significant differences between the two groups for their biochemical data except for elevated serum Adenosine deaminase(ADA) in clinically suspicious group. But there was a trend that motor functions were decreased especially for the finger and foot tapping, walking velocity and stride, writing velocity. A large number of subjects showed MRI changes in both groups. So MRI is not necessarily correlated with clinical findings and not a specific diagnostic tool for manganese intoxication but a sensitive one for the exposed subjects to manganese. CONCLUSION: From this study, the decreased motor functions were the only clinically significant neurologic manifestation in those who over-exposed subjects to manganese. The level of serum ADA and brain MRI could be a helpful supportive diagnostic tools for the over-exposure. Even if the subjects with these positive results do not show any significant sign of intoxication , we ought to modify their working environment to reduce further exposure.
Adenosine ; Brain ; Fingers ; Foot ; Gait ; Humans ; Magnetic Resonance Imaging ; Male ; Manganese* ; Nervous System ; Neurologic Manifestations ; Posture ; Walking ; Writing

The fat embolism syndrome is a serious and potentially life threatening complication of long bone trauma, blunt trauma and intramedullary manipulation. A 26-year-old woman underwent an intramedullary nailing of the femur under general anesthesia 45 hours after a traffic accident. The operation ended uneventfully and the patient was extubated in the operatirg room. About one hour after the patient arrived at the recovery room, she progressively developed tachycardia, tachypnea, cyanosis and drowsiness. The fat embolism syndrome was suspected because of the above clinical signs, and because pulmonary edema appeared on a simple chest A-P. During six days of intensive treatment in response to the fat embolism syndrome, the patient,s vital signs and ventilatory status progressively improved. The patient was uneventfully discharged from the hospital 19 days after her operation.
Accidents, Traffic ; Adult ; Anesthesia, General ; Cyanosis ; Embolism, Fat* ; Female ; Femur* ; Fracture Fixation, Intramedullary* ; Humans ; Pulmonary Edema ; Recovery Room* ; Sleep Stages ; Tachycardia ; Tachypnea ; Thorax ; Vital Signs

No abstract available.
Humans ; Ranitidine* ; T-Lymphocyte Subsets* ; T-Lymphocytes*

BACKGROUND/AIMS: Eosinophilia has numerous diverse causes, and in many patients, it is not possible to establish the cause of eosinophilia. Recently, toxocariasis was introduced as one cause of eosinophilia. The aims of this study were to evaluate the prevalence of toxocariasis and the clinical impact of albendazole treatment for toxocariasis in patients suspected of eosinophilia of unknown origin. METHODS: We performed a retrospective chart review. After evaluation of cause of eosinophilia, the patients suspected of eosinophilia of unknown origin performed immunoglobulin G antibody specific assay for the Toxocara canis larval antigen by enzyme-linked immunosorbent assay. RESULTS: This study evaluated 113 patients, 69 patients (61%) were suspected of eosinophilia of unknown origin. Among these 69 patients, the frequency of T. canis infection was very high (45 patients, 65.2%), and albendazole treatment for 45 eosinophilia with toxocariasis was highly effective for a cure of eosinophilia than no albendazole group regardless of steroid (82.3%, p = 0.007). Furthermore, among the nonsteroid treated small group (19 patients), albendazole treatment for eosinophilia were more effective than no albendazole group, too (83.3% vs. 28.6 %, p = 0.045). CONCLUSIONS: The prevalence of toxocariasis was high among patients suspected of eosinophilia of unknown origin; therefore, evaluation for T. canis infection is recommended for patients with eosinophilia of unknown origin. Furthermore, for patients suspected of eosinophilia of unknown origin who have positive results for T. canis, albendazole treatment may be considered a valuable treatment option.
Albendazole ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia* ; Humans ; Hypereosinophilic Syndrome ; Immunoglobulin G ; Prevalence* ; Retrospective Studies ; Toxocara canis ; Toxocariasis*

BACKGROUND/AIMS: Eosinophilia has numerous diverse causes, and in many patients, it is not possible to establish the cause of eosinophilia. Recently, toxocariasis was introduced as one cause of eosinophilia. The aims of this study were to evaluate the prevalence of toxocariasis and the clinical impact of albendazole treatment for toxocariasis in patients suspected of eosinophilia of unknown origin. METHODS: We performed a retrospective chart review. After evaluation of cause of eosinophilia, the patients suspected of eosinophilia of unknown origin performed immunoglobulin G antibody specific assay for the Toxocara canis larval antigen by enzyme-linked immunosorbent assay. RESULTS: This study evaluated 113 patients, 69 patients (61%) were suspected of eosinophilia of unknown origin. Among these 69 patients, the frequency of T. canis infection was very high (45 patients, 65.2%), and albendazole treatment for 45 eosinophilia with toxocariasis was highly effective for a cure of eosinophilia than no albendazole group regardless of steroid (82.3%, p = 0.007). Furthermore, among the nonsteroid treated small group (19 patients), albendazole treatment for eosinophilia were more effective than no albendazole group, too (83.3% vs. 28.6 %, p = 0.045). CONCLUSIONS: The prevalence of toxocariasis was high among patients suspected of eosinophilia of unknown origin; therefore, evaluation for T. canis infection is recommended for patients with eosinophilia of unknown origin. Furthermore, for patients suspected of eosinophilia of unknown origin who have positive results for T. canis, albendazole treatment may be considered a valuable treatment option.
Albendazole ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia* ; Humans ; Hypereosinophilic Syndrome ; Immunoglobulin G ; Prevalence* ; Retrospective Studies ; Toxocara canis ; Toxocariasis*

Actinomycosis is a rare form of disease that is caused by Actinomyces such as A. israelii and A. bovis, which may take the form of an acute or a subacute disease progression. 55% of this disease arises in the head and neck area, and the remaining 45% of the disease occurs in the chest and the gastrointestinal tract, Our cases show the rare routes of invasion of actinomycosis. The first case was a 40-year-old man complaining of headache for 5-6 months and of a recently developed trismus. Soft brownish bulging mass was observed in his posterior nasopharyngeal wall. CT showed the skull base involvement, and biopsy confirmed actinomycosis. The patient was successfully cured with penicillin. The second case was a 49-year-old female presenting a firm and fragile mass in her left nasal cavity. She was treated with endoscopic removal of the mass including the adjacent mucosa followed by ampicillin administration for 8 months. The last case was a 78-year-old female having a painful mass on the right cheek, Diagnosis was confirmed with the fine needle aspiration biopsy. She was successfully treated with surgical excision and antibiotic treatment. We present, with the appropriate review, 3 cases of actinomycosis that developed in three different areas of the head.
Actinomyces ; Actinomycosis* ; Adult ; Aged ; Ampicillin ; Biopsy ; Biopsy, Fine-Needle ; Cheek ; Diagnosis ; Disease Progression ; Female ; Gastrointestinal Tract ; Head* ; Headache ; Humans ; Middle Aged ; Mucous Membrane ; Nasal Cavity ; Nasopharynx ; Neck* ; Penicillins ; Skull Base ; Thorax ; Trismus