No abstract available.
Autonomic Nervous System* ; Humans ; Kidney Failure, Chronic*

No abstract available.
Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic*

No abstract available.
Blood Pressure* ; Extremities*

In order to prevent cross-infection, the sterilization of used and/or contaminated anesthetic- apparatus is still a difficult problem in clinical practice, particularly, following anesthesia for known advanced pulmonary tuberculosis cases. Therefore the antibacterisl activities of, an amphoteric detergent, Dodecyl diaminoethyl glycin hydrochloride (Hygien 51) were tested in vitro as a disinfectant against mycobacteria (M. tuberculosis H37 Rv, M. bovis, M. avium, M. tuberculosis H37 Ra, M. phlei, B.C.G.) The antimycobacterial activity tests were performed according to the modified Kolmer method. The testing organisms were cultured in Dubos broth at 37 degrees C, and the detergent, Hygien 51, was: diluted with sterile distilled water to 1,3,5 and 10%. One half milliliter of culture was pipetted into each tube containing 4.5 ml of diluted detergent, and at intervals of 3, 15, 30, 60, 120, 180 and 240 minutes, a 4mm loopful of the material was removed from each tube, and transferred to Ogawa media. The tests were carried out at two different temperatures, 20 degrees C and 50 degrees C. The subcultures were incubated at 37 degrees C for more than 8 weeks. The results were obtained as follows: 1) At room temperature (20 degrees C), all mycobateria, except M. bovis, were destroyed by treatment- with 10% solution of the detergent for more than 60 minutes. M. bovis was relatively sensitive to the detergent, and was killed by 5% solution for 30 min. and 10% for 15 min., but M. avium. was very resistant, and was not killed by 10% solution for 240 min. 2) By treatment with the detergent at 50 degrees C, the antimycobacterial activities of the detergent were highly increased. All mycobacteria were destroyed by 1% solution for 180 min, and by 10% for less than 30 min at 50 degrees C. In the comparison of the antibacterial activities against mycobacteria and other bacteria, it shows that mycobacteria are generally more resistant to the detergent, Hygien 51.
Anesthesia ; Bacteria ; Detergents ; Sterilization ; Tuberculosis ; Tuberculosis, Pulmonary ; Water

Microsurgery of the larynx using direct laryngoscopy is becoming an increasingly popular technique for the otorhinolaryngologist. Many techniques of anesthesia have been developed for these procedures but they all have the same drawbacks. General anesthesia with endotracheal intubation decreases the field of vision for the surgeon or it requires unusual surgeon anesthetist co-operatives. Therefore neuroleptic analgesia has been adapted to the suspension laryngoscope. Because of the greater stability of the circulatery and respiratory systems associated with their use. Thalamonal(droperidol 2.5mg/ml with fentanyl 0.05mg/ml) was found to be preferable to other anesthstic for the production of neuroleptic analgesia. Thus in 28 patients requiring laryngomicrosurgery in Severance hospital duriag the past 4 years(May, 1975-March, 1979), a butyrophenon derivative, droperidol and fentanyl has been used for the production of neuroleptic analgesia. Consequently. we concluded that, in most cases of suspension laryngoscopy, we could gain a good analgesic and anesthetic condition with 3.02ml(mean value) Thalamonal adveres action for a 55 minute(mean value) operation without remarkable undesirable adveres effects. In addition to this. this technique was of great benefit to the operator, because not only the patient awake during operation and cooperative to the operation but also vocal cord mobility can be observed during the operation.
Analgesia ; Anesthesia ; Anesthesia, General ; Droperidol ; Fentanyl ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy ; Larynx ; Microsurgery ; Respiratory System ; Vocal Cords

No abstract available.
Buprenorphine* ; Meperidine*

Pain is a sensory experience that is subjective and individual. It frequently exceeds its protective function and becomes destructive. We have met one case of causalgia, three cases of Buergers disease, and one case of arteriosclerosis obliterance. They sufferred from persistent pain and exkausted with the marked distrophy of affected limbs. Management of these patient involving lower limbs is a continuing challenge. Many other therapheutic procedures could be tried for these patients, but we tried chemical lumbar sympathectomy for these cases. With respect to the lower extremity, four patients had neurolysis of the 1st, 2nd and 3rd ipsilateral or 2nd and 3rd bilateral lumbar ganglia using 3 to 5 ml pure alcohol for each space under the image intensifier. Immediately after these procedure, rest pain has relieved dramatically in most cases and marked skin temperature rising. This implied increased peripheral blood flow of sympathectomised portion and the relief of rest pain is probably explained by destrcution of the afferent pain fibres running with the sympathetic trunk.
Arteriosclerosis ; Causalgia ; Extremities ; Ganglia ; Humans ; Lower Extremity ; Running ; Skin Temperature ; Sympathectomy* ; Thromboangiitis Obliterans

PURPOSE: This study was done to analyze the changes in smokers' subjectivity about smoking before and after participation in a 5-day hospitalized smoking cessation program. Design: Q-methodology, which provides a scientific method on subjectivity, was applied. Findings: Nine types of subjectivity changes about smoking were identified; Type I, Nicotine craving --> Confident of self control for smoking; Type II, Nicotine craving --> Cognition of the link between habituation and smoking, Type III, Nicotine craving --> Nicotine craving, Type IV, smoking as a social behavior --> Cognition of the link between habituation and smoking, Type V, smoking as a social behavior --> Motive to turn away from being addicted to smoking to being healthy, Type VI, Habitual smoking --> Confident of self control for smoking, Type VII, Habitual smoking --> Cognition of the link between habituation and smoking, Type VIII, Habitual smoking --> Motive to turn away from being addicted to smoking to being healthy and Type IX, Denial of the negative effects of smoking --> Confident of self control for smoking CONCLUSION: The types of changes in smokers' subjectivity before and after the smoking cessation program in this study suggest a better tailored intervention for individual smokers. The types of changes on smokers' subjectivity provide insight about which factors of the interventions for smoking cessation are especially valued for a particular group of smokers.
Smoking Cessation/*psychology ; Smoking/prevention & control/*psychology ; Middle Aged ; Male ; Humans ; Hospitalization ; Female ; *Attitude to Health ; Adult

SIMV (synchronized intermittent mandatory ventilation) is a volume assisted mode which a patient inspiratory demand results in a clinician-controlled tidal volume and flow rate. However, PSV (pressure support ventilation) has the ability to augment spontaneous breaths with a variable amount of inspiratory positive pressure with a clinician-selected level of inspiratory airway pressure. To compare the effects of SIMV and PSV on respiratory function, experiments were performed on 12 stable patients during the weaning process and tidal volume, airway pressure, arterial blood gas tensions, blood pressure, and heart rates were measured during SIMV, and after 2 mins after removal of mechanical ventilation support. The same measurement as SIMV (except mandatory respiratory rates) were performed during PSV. The PSV level was reduced in the 5 cm2O step every 10-15 mins. The results of respiratory parameters and hemodynamic data showed that tidal volume, blood pressure, heart rates, and arterial blood gas tensions were similar, but there were significantly lower ventilatory rates, lower peak airway pressure and lower mean airway pressure during PSVmax than SlMV, and PSV resulted in improved patient comfort. It was concluded that PSV could be used to unload the patients ventilatory muscles and provide an appropriate level of mechanical ventilation support similar to SIMV weaning approaches.
Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Respiration, Artificial ; Respiratory Muscles ; Tidal Volume ; Ventilation* ; Weaning*

Since 1957 clinical studies and animal experiments have reported that a solution of hydroxyethyl starch in saline (HES) was effective as a plasma expander. We have studied hydroxyethyl starch as compared to dextran after experimental bleeding. Thirteen dogs averaging 10 kg body weight were utilized in this study. Without premedicants anesthesia was induced with intravenous thiopenthal sodium and subsequently endotracheal intubation was performed. Respiration was controlled with a Harvard Pump, setting the respiratory rate at 15 times a minute and tidal volume at 20 ml/kg. Arterial blood pressure, central venous pressure and EKG lead II were recorded by polygraph. RIHSA was used for the measurement of plasma volume and extracellular volume. Experimental bleeding was equalled 25ml/kg for 15 minutes and the same amount of plasma expander (HES or Dextran) was infused 30 minutes after bleeding. The results were as follows: 1. Blood pressure was markedly decreased after experimental bleeding, but on administration of HES or Dextran it returned to nomal values. In the control group blood pressure persisted at about 90 mmHg. Central venous pressure after the administration of HES or Dextran also recovered to the level before bleeding. Pulse rate was slightly decreased after infusion of plasma expanders. 2. The values of hemoglobin and hematocrit were reduced about 40 percent after infusion of HES or Dextran. 3. Plasma volume was increased about 130 percent and blood volume was increased about 110 percent immediatly after infusion of HES or Dextran. A significant change in ECF could not be observed. 4. A persistent dilutional acidosis after infusion of HES or Dextran was not found. 5. In the HES or Dextran groups osmotic diuresis was observed. In the results of our experimental study no significant differences between HES and Dextran were observed, and it is thought that HES is safe and useful as a plasma expander.
Acidosis ; Anesthesia ; Animal Experimentation ; Animals ; Arterial Pressure ; Blood Pressure ; Blood Volume ; Body Weight ; Central Venous Pressure ; Dextrans ; Diuresis ; Dogs ; Electrocardiography ; Heart Rate ; Hematocrit ; Hemorrhage ; Intubation, Intratracheal ; Plasma Volume ; Plasma* ; Respiration ; Respiratory Rate ; Sodium ; Starch ; Tidal Volume