Drowning is a leading cause of accidental deaths worldwide, but its pathological diagnosis remains a challenge for forensic pathologists owing to a lack of pathognomonic findings in drowning deaths and inconclusive autopsy findings caused by postmortem changes. The aim of the present study was to investigate the pathway taken by inhaled drowning medium through the airway after death in a variety of experimental conditions, including underwater pressurization. We used methylene blue dye to monitor the spread of drowning medium to the lungs. Results of theses experiments demonstrated that it is possible for a significant amount of downing medium to enter the airway during immersion after death. Our results suggest that autopsies of immersed bodies and interpretation of these findings should be performed with special care.
Animal Experimentation* ; Animals* ; Autopsy ; Diagnosis ; Drowning* ; Immersion ; Inhalation* ; Lung ; Methylene Blue* ; Postmortem Changes

The advantage of the radiofrequency lesion method are presented, with excellent control of the lesion volume, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The presence of afferent fibers in the ventral root which are spared by dorsal rhizotomy suggested an explanation for the failure of this procedure. Nerve fibers with their cells in the ganglion from ventral root will be destructed with streotactic radiofrequency ganglionotomy. Since the dorsal root ganglion cells are more sensitive to than are other structures within the bundle, one is using a differential heat lesion to specifically affect pain pathways while leaving motor pathways. proprioception, and afferent input relatively intact. In the higher thoracic regions, the pleura can be injured when using an traditional approach. Hence in the upper thoracic region(T2-T9), this type of approach requires that a small burr-hole be made at the superior aspect of the corresponding thoracic zygapophyseal joint. Stereotactic thoracic dorsal root ganglionotomy have carried out under local anesthesia on an inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have treated with stereotactic radiofrequency lesioning of the thoracic dorsal root ganglion. Four out of these 6 patients have been relieved of pain without serious complications. I think this should be a good armamentarium to the pain therapists in the management of intractable pain. (Korean J Anesthesiol 1997; 32: 857~862)
Anesthesia, Local ; Efferent Pathways ; Electrodes ; Fractures, Compression ; Ganglia, Spinal ; Ganglion Cysts ; Hot Temperature ; Humans ; Inpatients ; Nerve Fibers ; Pain, Intractable ; Pleura ; Proprioception ; Rhizotomy ; Spinal Nerve Roots ; Zygapophyseal Joint

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

Disodium cromoglycate(DSCG) has been widely used in the treatment of bronchial asthma and has become the prophylactic drug of choice in patients with mild-to-moderate asthma, because it has anti-allergic, anti-inflammatory and mast cell stabilizing properties. DSCG has been considered one of the safest medications among drugs for asthma treatment. The most common side effects are irritation of throat and dry mouth. Bronchospasm and chest tightness have been reported, but they were usually experienced by patients using spinhaler powdered capsules rather than metered dose inhalers (MDI). In this report, we presented a case of recurrent DSCG-induced bronchoconstriction with brief review of the literature. He had had an aspirin-induced asthma and had been well controlled with steroid inhalers and DSCG-MDI. After aspirin-bronchopro vocation test, he complained of chest discomfort and tightness immediately after inhaling DSCG-MDI. On serial monitoring of peak expiratory flow rate (PEER), there was a significant decline of PEER after two puffs inhalation of DSCG-MDI. Thus we performed DSCG-inhalation broncho provocation test with the nebulizer solution, which was pure DSCG without any addition of ingradients or propellants. This produced an early asthmatic reaction with more than 40% decline of FEV,. He was diagnosed as DSCG-induced bronchoconstriction and his clinical conditions were improved after avoidance of DSCG-MDI.
Asthma* ; Asthma, Aspirin-Induced ; Bronchial Spasm ; Bronchoconstriction* ; Capsules ; Humans ; Inhalation ; Mast Cells ; Metered Dose Inhalers ; Mouth ; Nebulizers and Vaporizers ; Occupations ; Peak Expiratory Flow Rate ; Pharynx ; Thorax

No abstract available.
Emergencies* ; Emergency Medical Services*

About 85-97% of patients get to lose an ejaculatory function with a little difference according to the level of spinal cord injury. Fifty eight trials of electroejaculation stimulation were performed in total 17 patients that failed in chemoejaculation with physostigmine. Mean age was 36.9 years. Of the 17 spinal cord injured patients, 1 had cervical, 13 thoracic 3 lumbar paraplegia; 7 had complete and 10 had incomplete lesions. Semens could be obtained in 14 patients ( 82.4%) among total 17 patients and in 51 of total 58 trials( 87.9%). Average total sperm counts and motile sperm numbers were 35.98 x 106 and 6.09 x 106 respectively in the obtained semen. However, motility was very poor. We performed more than 4 trials in 6 patients, but there results were not predictable. Two pregnancies were achieved in their spouse after an artificial insemination. Side effects were trivial. and there were lower abdominal discomforts or pains in 7 patients among incomplete paraplegics. In conclusion we could expect high successful rates of ejaculation in anejaculatory spinal cord injured patients by electroejaculation stimulation in case of the failure in chemoejaculation. However, we suggest that in vitro fertilization with advanced recent technology should be tried with adequate preparation after an experimental electroejaculation, because a quality of sperm motility was very poor and sperm motility was not improved after several trials.
Ejaculation ; Fertilization in Vitro ; Humans ; Insemination, Artificial ; Male ; Paraplegia ; Physostigmine* ; Pregnancy ; Semen ; Sperm Count ; Sperm Motility ; Spinal Cord Injuries ; Spinal Cord* ; Spouses

No abstract available.
Bone Regeneration* ; Bone Substitutes*

No abstract available.
Tinea* ; Trichophyton*

Epidural anesthesia is the most commonly used anesthesia for cesarean section. But preg- nant women under epidural anesthesia for cesarean section are particularly prone to arterial hypotension following sympathetic blockade. Its prevention is the most important thing to obstetric anesthetists. Forty women at term were randomly allocated to receive either 1,500ml of crystalloid (Hartmann's solution) or 500ml of colloid solution (10% pentastarch) in order to preload the circulation prior to elective cesarean section under epidural anesthesia. And to investigate the adverse effect of pentastarch on coagulation, other forty mothers undergoing cesarean section under general anesthesia were examined with computerized thrombelastograph coagulation analyzer(TEG) before and after 1,500ml of Hartmanns solution or 500ml of 10% pentastarch preloading (each group n=20). There were no differences in the incidence of hypotension, degree of hemodilution, umbilical cord blood gas tension and TEG findings between the two groups. But the serial change of the central venous pressure of the Hartmann group from fluid preloading to anesthesia and operation was significantly different from that of pentastarch group (p<0.05). The TEG findings before fluid preloading presented the hypercoagulable stste of the pregnant women at term, and no adverse effect of pentastarch on coagulation except hemodilution. It was concluded that 10% pentastarch was a good choice as a circulatory preloading agent for cesarean section under epidural anesthesia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Central Venous Pressure ; Cesarean Section* ; Colloids ; Female ; Fetal Blood ; Hemodilution ; Humans ; Hydroxyethyl Starch Derivatives* ; Hypotension ; Incidence ; Mothers ; Pregnancy ; Pregnant Women

No abstract available.
Blood Pressure* ; Metoclopramide* ; Rabbits*