No abstract available.
Bupivacaine* ; Morphine* ; Prospective Studies*

Fracture of the occipital condyle is rare. We report the case of a patient with this fracture who presented with negative plain films and delayed hypoglossal nerve palsy. Diagnosis was estabilished with high resolution computed tomography. In a trauma patient with neck or occipital pain, with or without cranial nerve palsy, this fracture should be considered, even if a plain radiograph is negative.
Cranial Nerve Diseases ; Diagnosis ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Neck

No abstract available.
Aneurysm*

We present a case of Brown-Sequard syndrome due to a massive cervical disc herniation at C5/6 level, presenting sings of sudden and severe spinal cord compression. The lesion was diagnosed by MRI and herniated cervical disc was removed under the surgical microscope via anterior route. The result of operation was good. A brief review of the literature is given.
Brown-Sequard Syndrome* ; Magnetic Resonance Imaging ; Spinal Cord Compression

No abstract available.
Kidney Transplantation*

BACKGROUND: The bispectral index (BIS) has been used as an indicator of a sedative state and has been considered to be related to anesthetic agents and noxious stimulus. In this study, we measured the BIS, blood pressure (BP) and heart rate (HR) during induction of anesthesia after premedication with or without midazolam or morphine and evaluated the bispectral index as an indicator of an objective evaluation of midazolam premedication and relation to the cardiovascular response to the anesthetic induction. METHODS: Seventy five patients scheduled to undergo elective surgery under general anesthesia were divided into 3 groups. Each group received midazolam and glycopyrrolate (midazolam group, n = 25), or morphine and glycopyrrolate (morphine group, n = 25), or glycopyrrolate only (control group, n = 25) as premedication (midazolam 0.08 mg/kg IM, morphine 0.05 mg/kg IM, glycopyrrorate 0.2 mg IM). Then, anesthetic induction (propofol 2 mg/kg, succynylcholine 1 mg/kg) was done. The bispectral index, blood pressure, and heart rate were measured at before induction, after propofol injection, and intubation. RESULTS: The Bispectral index was significantly lower in the midazolam group and the morphine group compared with the control group before anesthetic induction. Blood pressure was not significantly different among the three groups. Heart rate was significantly lower in the midazolam group compared with the control group before anesthetic induction. CONCLSIONS: Midazolam or morphine premedicated patients appear to maintain a stable heart rate and have a low BIS at before induction. The Bispectral index could be objectively used in midazolam-premedicated patients when evaluating the degree of sedation and predicting hemodynamic changes, and probably in morphine-premedicated patients also.
Anesthesia ; Anesthesia, General ; Anesthetics ; Blood Pressure ; Glycopyrrolate ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Midazolam* ; Morphine* ; Premedication* ; Propofol

BACKGROUND: Priming significantly shortened the onset of neuromuscular blockade(NMB), but also results in a high incidence of side effects. This study was designed to determine the effect of infusion priming method on the side effects, intubation condition, and onset of NMB compared with divided priming method. METHOD: The effects of different priming method of vecuronium on onset time and endotracheal intubation condition were investigated. 40 patients were studied in two parts. In control part, 20 patients were allocated into two groups(n=10 in each group) receving 10, 20 g/kg vecuronium as a priming dose, followed by a intubating dose(0.1 mg/kg-priming dose) 3 min later; the other part, 20 patients were allocated into two groups(n=10 in each group) receving 0.2 mg/kg/hr vecuronium continuous intravenous infusion, followed by a intubating dose(0.1 mg/kg-total infusion dose) 3, 5 min later. Onset time is calculated by single twitch stimulation test from injection of the intubating dose to maximum depression of the single twitch. Intubatin condition was appreciated based on vocal cord reflex, coughing, and jaw relaxation and scored. RESULTS: The times to fade out on the single twitch of the intravenous infusion priming group were shorter than control priming group. There was no difference between control priming group and infusion priming group to evaluate the intubation conditions. Side effects in the continuous infusion group were lesser than control priming group. CONCLUSION: This results suggest that the use of continuous infusion method is one of the promising methods to shorten the neuromuscular blockade and to provide more comfort to the patients.
Cough ; Depression ; Humans ; Incidence ; Infusions, Intravenous* ; Intubation ; Intubation, Intratracheal* ; Jaw ; Neuromuscular Blockade ; Reflex ; Relaxation ; Vecuronium Bromide* ; Vocal Cords

BACKGROUND: Adhesion molecules are related to cell-to-cell interaction and inflammatory interaction. In addition, adhesive interactions between tumor cells and adjacent cells and/or extracellular matrix play important roles in the complex process of tumor growth and development. Among these adhesion molecules, expression of intercellular adhesion molecule-1 (ICAM-1) has been identified in colon cancer, bladder cancer, lung cancer, melanoma, pancreatic cancer and hepatocellular carcinoma. In the current study, we analyzed serum ICAM-1 concentrations to investigate the relationship between the serum ICAM-1 level and prognosis in patients with lung cancer METHODS: Serum ICAM-1 was measured in 84 patients with lung cancer according to the pathologic type and clinical stage using the ICAM-1 ELISA kit. The Kaplan-Meier method was used to analyse survival time. RESULTS: There was no difference in serum ICAM-1 concentration among the different stages of lung cancer. Furthermore, there was no difference observed between histologic tumor type with regard to serum ICAM-1 concentration. Although the difference was not significant, the overall survival times of patients with a low serum ICAM-1 concentration (< 306 ng/mL) was longer than that of patients with a high concentration (> or=306 ng/mL) in non-small cell lung cancer patients. CONCLUSION: These results suggest that high levels of serum ICAM-1 reflect poor prognosis for patients with non-small cell lung cancer.
Aged ; Carcinoma, Non-Small-Cell Lung/*blood/mortality/pathology ; Carcinoma, Small Cell/*blood/mortality/pathology ; Female ; Human ; Intercellular Adhesion Molecule-1/*blood ; Lung Neoplasms/*blood/mortality/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Analysis

BACKGROUND: Adhesion molecule is related to cell-cell interaction and inflammatory interaction. In addition, adhesive interactions between tumor cells and adjacent cells and/or extracellular matrix are important role in the complex process of tumor growth and develpment. Of these adhesion molecules, expression of intercellular adhesion molecule-1 (ICAM-1) have been identified in colon cancer, bladder cancer, lung cancer, melanoma, pancreatic cancer, hepatocellular carcinoma. In the current study, we analyzed serum ICAM-1 concentrations to investigate the relationship between the sICAM-1 level and the prognosis of the disease in patients with lung cancer METHODS: Serum sICAM-1 was measured in 84 patients with lung cancer according to the pathologic types and clinical staging using ICAM-1 ELISA kit. The Kaplan-Meier method was used to analyse survival time. RESULTS: There was no difference in sICAM-1 concentration among the stage of lung cancer. And no difference was observed among histologic tumor types with regard to sICAM-1 concentration. The overall survival of patients with low sICAM-1 concentration (<306 ng/mL) were longer than that of patients with high concentration (>or=306 ng/mL) in non-small cell lung cancer patients, but no difference was observed in small cell lung cancer patients. CONCLUSION: These results suggest that high levels of sICAM-1 reflect the poor prognosis of patients with non-small cell lung cancer.
Adhesives ; Carcinoma, Hepatocellular ; Carcinoma, Non-Small-Cell Lung ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Extracellular Matrix ; Humans ; Intercellular Adhesion Molecule-1* ; Lung Neoplasms* ; Lung* ; Melanoma ; Pancreatic Neoplasms ; Prognosis* ; Small Cell Lung Carcinoma ; Urinary Bladder Neoplasms

PURPOSE: To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. MATERIALS AND METHODS: We evaluated 41 cases(M :F=1.7:1, average age=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II ;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. RESULTS: Submucosal fibrosis was present in 4 cases in Grade I (n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001 and p=.002, respectively) CONCLUSION: Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis.
Fibrosis ; Humans ; Retrospective Studies ; Stomach Neoplasms*