BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

The stress distribution generated in the surrounding bone was calculated and compared for various geometry of the dental implants by means of the finite element methods. The models were designed to represent the screw type endosseous implants (varing the size, shape, direction of the screw thread and the angle of the body) with supporting bone and the cylinder type endosseous implants (varing the lower portion-Round type, tapered type) with supporting bone. Static mean bite forces were applied 100N vertically and 25N horizontally on the center of the implant and three dimensional finite analysis was undertaken using software ANSYS 5.1 Version. The result demonstrated that different implant shape leads to significant variations in stress distribution in the bone. In the case of variation of the screw size, direction and shape the implant model with normally directional and triangular screw implied lower stress than with upper directional or lower directional and quadrangular screw but among models a different screw size, within a variation of 0.2mm there was no meaningful difference in maximum stress. In the case of variation of angle of body the straight implied lower stress than the tapered. As a result of analysis of cylinder type, the implants with larger radius of curvature of the round form and larger diameter of the tapered form implied lower stress.
Bite Force ; Dental Implants ; Radius

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

Gestational trophoblastic tumors including choriocarcinoma bave become one of the most curable human malignancies with an overall cure rate exceeding 90%. Although systemic chemotherapy is the initial treatment for chorio- carcinoma, some patients with chemotherapy-resistant choriocarcinorna can be treated by integration of cbemotherapy, surgery and radio- therapy. We report two cases of persistent localized choriocarcinoma which was treated by surgical intervention.
Choriocarcinoma* ; Drug Therapy ; Female ; Humans ; Neoplasm Metastasis ; Pregnancy ; Trophoblastic Neoplasms

Glomus tumors, also called paragangliomas, originate from nonchromaffin cells. They are slow-growing benign lesions and represent the most common primary neoplasm of the middle ear. It is worth mentioning that the most common symptoms are pulsating tinnitus and hearing loss. Imaging studies (CT and MRI) are necessary for diagnosis. Although most of cases are limited to the middle ear, this article reports a glomus tumor presented with a polypoid mass in the external auditory canal.
Ear Canal ; Ear, Middle ; Glomus Tumor ; Hearing Loss ; Paraganglioma ; Tinnitus

No abstract available.
Child* ; Humans ; Hydrocephalus*

Aneurysmal bone cyst is an uncommon spinal tumor of vascular origin and represents less than 1% primary bone tumors. A case of 15-year-old girl who presented with low back pain and severe left leg pain. The lesion was expansile in nature involving anterior and posterior bony elements of the spine. It also showed expanision into the intraspinal canal and paraspinal soft tissue. Surgical treatment consisted of tumor excision and pedicle screw fixation via extracavitary approach. Postoperative course was uneventful and her symptoms and signs were improved. Extracavitary approach, as applied to our case, seemed to be an ideal surgical method in such cases because of its nature and extent of involvement.
Adolescent ; Aneurysm* ; Bone Cysts* ; Female ; Humans ; Leg ; Low Back Pain ; Spine

BACKGROUND AND OBJECTIVES: There is evidence which suggests that mammals have functional olfactory systems at birth or shortly before birth. This study was performed to investigate perinatal development of the olfactory mucosa. MATERIALS AND METHODS: Sprague-Dawley rats at the 19th gestational day, and of the 1st, 3rd, 7th, 14th, 21st, and 28th postnatal day were sacrificed. The light microscopic investigation of the olfactory mucosa was conducted with hematoxylineosin stain, immunohistochemical stain for proliferating cell nuclear antigen (PCNA) and protein gene product (PGP) 9.5. RESULTS: Number of the cell layers, epithelial thickness, and density of the olfactory receptor cell peaked at the postnatal 14th day. The cells of the basal layer changed from globose cells to basal cell proper with age. The number of the basal cells to the receptor cells decreased with age. PCNA was positive both in the supporting and basal layers. PCNA positivity decreased with age in the supporting layer but stayed stationary in the basal layer. PGP 9.5 was strongly positive in the olfactory receptor cells, dendrites, and the nerve bundles but negative in the supporting and basal layers. CONCLUSION: The olfactory epithelium proliferated maximally at postnatal 14 day, and afterwards the olfactory mucosa tended to show their characteristic maturation with slowed neurogenesis.
Animals ; Dendrites ; Mammals ; Neurogenesis ; Olfactory Mucosa* ; Parturition ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley

Congenital intraspinal epidermoid tumors, while rare, do occur ; that they are related to spinal puncture is less well understood. This article describes the case of a 10 year-old boy with intraspinal epidermoid tumor, who five years previously had undergone lumbar puncture. A striking clinical features of this case is pain in the lower extremity. In this report, we review the literature and discuss the probable developmental mechanism of such tumor.
Child ; Humans ; Lower Extremity ; Male ; Spinal Puncture* ; Strikes, Employee

No abstract available.
Emergencies* ; Hematoma, Subdural, Acute* ; Trephining*