No abstract available.

A 46 year-old female patient underwent cholecystectomy under general anesthesia. During the preoperative preparation, pulmonary edema developed from fluid overloading in the early septic condition. Pulmonary edema contributed significantly to the acute respiratory failure, which played a major role in the pathogenesis of multiple organ failure. For this condition, early surgical intervention is most important. After preoperative evaluaion, the authors anesthetized the patient with Morphine, used Enfluane intermitently, along with pancronium and oxygen and used endotracheal semiclosed circle absorption techniques with CMV incorporated PEEP. PEEP level was 5cm H2O. Inspired oxygen fraction was 1.0. Arterial oxygen tension increased from 62 torr to 183 torr despite the overt pulmonary edema. A-aDO2 was greater than 480 mmHg during the anesthesia of 2 hrs 40 minutes. For further treatment of pulmonary edema and postoperative respiratory care, synchronized IMV with PEEP, along with conventional methods for pulmonary edema and sepsis, were used in the ICU. After 6 days of intensive care, the patient was transferred to the general ward in good cardiovascular and respiratory function.
Absorption ; Anesthesia* ; Anesthesia, General ; Cholecystectomy ; Cholecystitis* ; Female ; Humans ; Critical Care ; Middle Aged ; Morphine ; Multiple Organ Failure ; Oxygen ; Patients' Rooms ; Pulmonary Edema* ; Respiratory Insufficiency ; Sepsis

No abstract available.
Brain* ; Depression* ; Dexamethasone*

No abstract available.
Transplants

Segmental fracture of the femoral shaft is known as an unusual injury, usually caused by severe force and associated with marked damage to the soft tissue, and is difficult to treat due to these causes it is a controversal topic in regard to the treatment. Authors analysed 14 cases of segmental fracture of the femoral shaft, except cases associated with hip fracture, which had received operative treatment at Dept. of Orthopaedic Surgery, College of Medicine, Chosun University, from Jan. 1985 to Dec. 1990. The results are summarized as follows; 1. Of 14 cases, there were 12 cases of male and 2 cases of female: male was predominant. Most cases were at their 3rd and 6th decades of age. 2. Traffic accidents were the main causes of injury(11 out of 14 cases.) 3. There were 13 closed fracture and 1 open fracture. 4. In most cases, they accompanied injuries to other vital organ. Among 14 cases, 5 cases accompanied head injury. 5. We treated these fracture by flexible intramedullary nailing in 7 cases, open reduction and internal fixation with plate in 5 cases, locked intramedullary nailing in 2 cases. Bony union was more rapid in the distal fracture than in the proximal fracture. 6. Among 14 cases, primary bone grafting was done in 2 cases. In the group where primary bone grafting had not been done, dealyed union appeared but nonunion was not seen. 7. We could obtain rapid bony union and decreased operation time in the cases which were treated with intramedullary fixation, and thought that intramedullary fixation was a relatively good method in type of this fracture.
Accidents, Traffic ; Bone Transplantation ; Craniocerebral Trauma ; Female ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hip ; Humans ; Male ; Methods

The present study was undertaken to observe the quality and quantity of lipid constituents by the developing Ascaris suum eggs. The collected eggs from the uterus of A. suum were classified into 3 groups, i.e., single cell stage, morula stage and embryonated eggs, and were subjected to analyse their lipid fractions. To obtain the morula stage eggs, 10 to 11 incubation days at 30 degree C were needed and for the embryonated eggs, 30 to 31 days were lasted. At the time of experiment, their indices of development by Hoffman were 285(morula stage) and 42 (embryonated stage) respectively. Lipid extraction was done by the methods of Folch et a1. (1957) and Kenny (1952), and then the extracted lipid fractions from the above 3 groups of eggs were separated by thin layer chromatography. Those fractions were also subjected to perform the quantitative analyses of fatty acids, glycerides, cholesterol and phospholipids. The results obtained were summarized as follows. Total amount of fatty acid was decreased from 12.9 mg per gram of eggs (single cell stage) to 6.6 mg/gm (embryonated eggs), whereas the proportion of free fatty acid to total fatty acid was constantly increased from 77.5 percent to 89.4 percent during the period of egg development. Total amount of glycerides was also increased from 33.0 mg/gm of single cell stage to 55.9 mg/gm of the embryonated eggs. The most abundant glyceride among 3 glycerides discovered from A. suum eggs was triglyceride, and the least was monoglyceride. The amount of free cholesterol was much larger than that of ester form in general, and it reached maximum in the eggs of morula stage (4.6 mg/gm). The increase of total cholesterol was monitored during the development of A. suum eggs from 3.3 mg/gm to 5.4 mg/gm. The following 8 phospholipids were detected in the embryonated eggs, i.e., lysophosphatidyl choline, phosphatidyl inositol, sphingomyelin, phosphatidyl choline, phosphatidyl glycerol, phosphatidyl serine, phosphatidyl ethanolamine and unknown phospholipid. But in the single cell stage eggs, 4 kinds out of the above 8 phopholipids were not observed, and in the morula stage eggs, 2 kinds were absent among the 8 phospholipids.
parasitology-helminth-nematoda ; Ascaris suum ; ovum ; lipid ; fatty acid ; glycerides ; triglyceride ; monoglyceride ; cholesterol ; lysophosphatidyl choline ; phosphatidyl inositol ; sphingomyelin ; phosphatidyl choline ; phosphatidyl glycerol ; phosphatidyl serine ; phosphatidyl ethanolamine ; phopholipids ; biochemistry

One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.
Knee ; Ligaments ; Patella ; Posterior Cruciate Ligament ; Spine ; Tibia ; X-Ray Film

No abstract available.
Rectal Neoplasms* ; Recurrence*

Twenty-five patients presenting with severe hemorrhage from benign peptic ulcers were randomized to either endoscopic injection sclerosis using a combination of hypertonic saline- epinephrine solution and 5% ethanolamine or to hypertonic-saline epinephrine solution only. Only high risk patients with active bleeding or endoscopic stigmata of recent hemorrhage of ulcers were considered. A median duration of hospital admission and median transfusion requirements between the two types of treated groups were not significant difference. The initial hemestatic effects of HS-E solution injection group(n=l5) or combination of HS- E solution and 5% ethanolamine injection group(n=l0) were 93%, 90% respectively. The rebleeding rate of HS-E solution injection group(n =15) or combination of HS-E solution and 5% ethanolamine injection group(n=10) were 33%, 30%, respectively. So, both HS-E solution therapy group and comination of HS-E solution & 5% ethanolamine injection group were effective in initial hemostasis for bleeding peptic ulcer patients. However, for the further evaluation of therapeutic effect and comparison of rebleeding rate between the two types of therapy, we think that it will be indispensable to collect more cases and to compare with control group.
Christianity ; Epinephrine ; Ethanolamine ; Hemorrhage* ; Hemostasis ; Humans ; Peptic Ulcer* ; Sclerosis* ; Ulcer

A perplexing developmental error is 46,XX congenital absence of vagina ( Mayer-Rokitan-sky-Kster-Hauser syndrome, Mullerian dysgenesis, vaginal aplasia ). The Mayer-Rokitansky-Kster-Hauser syndrome refers to the climical entity consisting of primary amenorrhea associated with congenital absence of the vagina, 46,XX karyototype, a rudimentary uterus or complete absense, normal overian function and normal ovulation, normal female breast development, body proprotion and body hair, frequent association of renal, skeletal and other cpngenital anomalies. This syndrome results from agenesis of both Mllerian ducts or from a failure of the Mllerian ducts to estavlish a proper communication with that part of the vagina from the urogenital sinus. A case of mayer-Rokitansky-Kster-Hauser syndrom was reviewed briefly.
Amenorrhea ; Breast ; Female ; Hair ; Humans ; Ovulation ; Uterus ; Vagina