No abstract available.
Blood Pressure* ; Pancreatectomy* ; Subclavian Artery* ; Subclavian Steal Syndrome*

Lingual tonsillar hypertrophy (LTH) is a rare and dangerous condition in the management of the upper airway. It is not detectable from the history or on routine preoperative physical examination. Enlarged lingual tonsils can cause posterior displacement. A 56 year old man was scheduled for emergency laryngeal microscopic surgery for the removal of a throat foreign body. After the induction of general anesthesia, intubation with a rigid laryngoscope was impossible due to LTH. After recovery of self respiration, the endotracheal tube intubation was possible by the combined use of a laryngoscope, Magil forceps and fiberoptic bronchoscope.
Anesthesia, General ; Bronchoscopes ; Emergencies ; Foreign Bodies ; Humans ; Hypertrophy* ; Intubation* ; Laryngoscopes ; Middle Aged ; Palatine Tonsil ; Pharynx ; Physical Examination ; Respiration ; Surgical Instruments

This study was conducted to investigate the choline intake of Korean adults for the purpose of preparing a basal data required for the establishment of choline adequate intake (AI). The subjects of 56 Korean young adults were recruited from college students of 20 to 30 years old in Daejeon city. The aliquots of foods that the subjects ate for one day were collected with use of duplicate food collection method and choline content of one day meal directly was analyzed with the use of enzymatic method. Choline intakes of male subjects were in the range of 353.5 ~ 1222.5 mg and those of female subjects were in the range of 213.1 ~ 722.3 mg. Mean intakes of choline were 658.2 +/- 243.9 mg/day in male subjects and 423.3 +/- 133.6 mg/day in female, therefore choline intake of men was about 200mg higher than that of women. Median value in total subjects was 496 mg, male's median was 608.8 mg, female's median was 419.9 mg. When the subjects were devided into 4 groups by choline intake, as less than 75%, 75 ~ 100%, 100 ~ 125% and over 125% based on choline AI of USA (males: 550 mg, females: 425 mg), there was no significant difference between men (64.3%) and wemen (67.9%) in the distribution of the subjects whose choline intake is under the range of 75 ~ 125% AI of USA. However, 10.7% of men and 21.4% of female had choline intake less than 75% AI of USA while the cases of choline intake higher than 125% AI were 25% in male and 10.7% in female. Thus, it is assumed that female case in choline-deficient state would be two times more than male. When adjusted by body weight, choline intake was 9.5 +/- 3.4 mg/kg in men, 8.1 +/- 3.1 mg/kg in women and 8.8 +/- 3.3 mg/kg in total subjects. And choline intake per 1,000 kcal of men, women and total subjects were 277.1 +/- 78.4 mg, 275.9 +/- 62.1 mg and 276.5 +/- 70.1 mg respectively. From these results, it is suggested that these levels of 276.5 +/- 70.1 mg/ 1,000 kcal or 8.8 +/- 3.3 mg/kg B.W. can be used as a reference value for the establishment of AI of choline for Korean, because overall choline intake of these subjects was not in lower state compared to other nutrients intakes obtained from calculation of the food the subjects had taken.
Adult ; Body Weight ; Choline* ; Female ; Humans ; Male ; Meals ; Reference Values ; Young Adult

Objectives: : Tianeptine is an antidepressant that has drawn attention recently. Unlike traditional monoaminergic antidepressants, tianeptine is known to affect glutamate neurotransmission like ketamine. However, there has been paucity of studies investigating the role of tianeptine on glutamate transporters, especially excitatory amino acid transporter type 3 (EAAT3). Methods: : After expression of EAAT3 by intracellular injection of EAAT3 mRNA, we investigated the effect of tianeptine on the activity of EAAT3, by measuring membrane current in response to L-glutamate administration using Xenopus oocyte expression system and two-electrode voltage clamps.. Results: : Tianeptine (1mM for 72h) significantly reduced Vmax (6.9±0.6 vs. 4.8±0.3mC, n=14-22, p<0.05) without changing Km (27.0±7.6 vs. 23.3±4.9mM, n=14-22, p=0.72). Conclusion : When tianeptine was exposed for 72h, it decreased the activity of EAAT3 in a concentration-dependent manner (1-100mM). Our results suggest that tianeptine decreases EAAT3 activity by reducing the available number or turnover rate of EAAT3.

BACKGROUND: Magnesium sulfate (MgSO4) is the first-line therapy for managing preeclampsia in obstetrics. Its perioperative administration has been proved to be an effective analgesic adjuvant, which we investigated in parturients undergoing Cesarean section (C-sec). METHODS: A retrospective chart review examined 504 parturients who underwent C-secs between June 2006 and August 2010, including normal parturients (group N, n = 401) and those diagnosed with preeclampsia (group P, n = 103). A postoperative numeric rating scale (NRS) was used to assess pain, and the number of rescue analgesic administrations and frequency of transfusions were investigated. Perioperative magnesium concentrations were recorded for patients in group P. RESULTS: Patients in group P had longer operation and anesthesia times, and more postoperative admission days than those in group N. The NRS of pain was significantly lower in group P at postoperative day (POD) 1 (4 vs. 5, P < 0.001), and the frequency of rescue drug administration was lower in group P at POD 1 (36.0% vs. 80.3%, P < 0.001) and POD 2 (9.7% vs. 21.1%, P = 0.005) than in group N. Red blood cell transfusions were given more frequently in group P (21.4% vs. 2%, P < 0.001). Pre- and postoperative serum magnesium concentrations in group P were 2.2 (0.5) and 2.1 (0.6) mmol/L, respectively. CONCLUSIONS: Postoperative pain after C-sec was less severe and intravenous patient-controlled analgesia was more efficacious in the preeclampsia group than in the non-preeclampsia group. These findings likely resulted from peripartum intravenous MgSO4 administration in the preeclampsia group.
Analgesia ; Analgesia, Patient-Controlled ; Anesthesia ; Cesarean Section ; Erythrocyte Transfusion ; Female ; Humans ; Magnesium ; Magnesium Sulfate ; Obstetrics ; Pain, Postoperative ; Peripartum Period ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies

BACKGROUND: Sensitive skin has been described as a skin type showing higher reactivity than normal skin and developing exaggerated reactions when exposed to internal stimulants and external irritants. The lactic acid sting test is widely accepted as a marker of skin sensitivity and employed for the selection of subjects experiencing invisible sensory irritation. OBJECTIVE: To carry out an epidemiological study to assess the prevalence and possible related factors of sensitive skin in a regional population, and to examine the relationship between sensitive skin and subjective irritation using the lactic acid sting test. METHODS: A total of 514 people responded to self-assessment questionnaires composed of questions about the self-perception, related factors, symptoms and signs of sensitive skin. We assessed subjective irritation using the lactic acid sting test in 54 volunteers. RESULTS: The results are summarized as follows: 1. The incidences of self-reported sensitive skin were 55.7% for women, 38.9% for men and 51.0% for all responders. 2. The family history and seasonal variation of sensitive skin were significantly more common in sensitive skin group. 3. The face especially the cheek area was the most sensitive portion of body, cosmetics were common irritants. 4. The lactic acid stinging scores were significantly higher in the sensitive skin group. CONCLUSION: Our survey indicated that sensitive skin is a common problem for people and a complex problem with genetic, individual, environmental implications and the lactic acid sting test is a valuable method to define skin sensitivity.
Bites and Stings* ; Cheek ; Epidemiologic Studies ; Female ; Humans ; Incidence ; Irritants ; Lactic Acid* ; Male ; Patient Selection ; Prevalence ; Seasons ; Self Concept ; Self-Assessment ; Skin* ; Volunteers ; Surveys and Questionnaires

BACKGROUND: This study was designed to evaluate the efficacy and safety of midazolam premedication administered by a jet-injector in pediatric patients. METHODS: Children undergoing outpatient surgery were randomized into three groups: intravenous induction with thiopental sodium (control group, n = 20), oral midazolam premedication (PO-med group, n = 20) or midazolam premedication using a jet-injector (Jet-med group, n = 20). In the PO-med and Jet-med group patients, anesthetic induction was performed by sevoflurane inhalation and an intravenous catheter (IVC) was inserted after the children had been anesthetized by sevoflurane inhalation. For the control group patients, an IVC was placed in the preoperative holding area. Agitation scores were recorded in the preoperative holding area and recovery room. Anesthesia times and the views of the medical staff concerning the technique benefits were also noted. Patients and parents were interviewed on the following day. RESULTS: Maximum agitation scores in the preoperative holding area and during separation with parents were significantly lower in the PO-med and Jet-med groups. The induction time was significantly longer in the PO-med and Jet-med groups. No statistically significant differences were found for the recovery characteristics. Though interviews with patients and parents produced similar results for patients in each group, the medical staff satisfaction levels were significantly higher for patients in the PO-med and Jet-med groups. CONCLUSIONS: The findings of this study suggest that the application of the jet-injector for midazolam premedication may be clinically useful in children who do not have an IVC. The use of the jet-injector could be a substitute for the oral route for midazolam administration.
Ambulatory Surgical Procedures ; Anesthesia ; Catheters ; Child ; Dihydroergotamine ; Humans ; Inhalation ; Medical Staff ; Midazolam ; Parents ; Preanesthetic Medication ; Premedication* ; Recovery Room ; Thiopental

Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen, and it can be an unpredictable and life-threatening cause during anesthesia. Latex is the second most common cause of anaphylaxis following the use of neuromuscular blocking agents during general anesthesia or surgery. We report on a 67-year-old male who had undergone surgery under general anesthesia without any problem but who presented with severe intraoperative anaphylaxis to latex surgical gloves. This case emphasizes the need for anesthesiologists to quickly diagnose and properly manage an allergic reaction in patients under general anesthesia.
Aged ; Anaphylaxis ; Anesthesia ; Anesthesia, General ; Gloves, Surgical ; Humans ; Hypersensitivity ; Latex ; Male ; Neuromuscular Blocking Agents

Tension pneumothorax during one-lung ventilation is an insidious, life threatening emergency. Even though early diagnosis and rapid intervention are necessary to prevent mortality, treatment may be difficult because of the clinical diagnosis-mediastinal shift, hypoxemia, hypotension and increased airway pressure may be confusing in the operative setting. We present here the case of a patient who underwent right thoracotomy with one-lung ventilation and the patient developed left tension pneumothorax with resulting cardiac arrest.
Anoxia ; Early Diagnosis ; Emergencies ; Heart Arrest* ; Humans ; Hypotension ; Mortality ; One-Lung Ventilation ; Pneumothorax* ; Thoracotomy*

A 36-year-old woman with an unremarkable medical history presented for laparoscopic cholecystectomy. Routine preoperative assessment of the patient's airway revealed normal jaw opening. Upon induction of anesthesia, her jaw locked in a nearly closed position. X-ray and MRI of the temporomandibular joints that were taken postoperatively showed normal findings except for the steeper posterior angles of the articular eminences. During the next induction of anesthesia, intubation was readily accomplished by opening the mandible with a forward pulling of the chin.
Adult ; Anatomic Variation* ; Anesthesia ; Chin ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Intubation ; Jaw ; Magnetic Resonance Imaging ; Mandible ; Temporomandibular Joint*