No abstract available.

Balloon-tipped, flow-directed (Swan-Ganz) catheters are used commonly for monitoring of cardiac function in patients undergoing cardiac surgical procedures. We report a case of pulmonary hypertension with hypoxemia which may be caused by incorrect positioning of pulmonary artery catheter (PAC) during CABG. Pulmonary arterial pressure (PAP) of 70/40 mmHg which was nearly high as systemic pressure was measured when we tried to wean patient from cardiopulmonary bypass. But, TEE (transesophageal echocardiography) showed nonspecific finding. PAP decreased soon and maintained about 33/16 mmHg for a few minutes. But, the PAP elevated high to 70/40 mmHg again and the arteral oxygen tension (PaO2) decreased to 61.2 mmHg. When we withdrew the PAC to the depth of 35 cm, the PAP and systolic pressure returned to normal range and PaO2 elevaed to 320 mmHg. End tidal CO2 was elevated from 30 mmHg to 35 mmHg.
Anoxia* ; Arterial Pressure ; Blood Pressure ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheters* ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Hypertension, Pulmonary* ; Oxygen ; Pulmonary Artery ; Reference Values

BACKGROUND: Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in humans. Paraquat especially leads to irreversible progressive pulmonary fibrosis, which is related to oxygen free radicals. However, its biochemical mechanism is not clear. Natural mechanisms that prevent damage from oxygen free radicals include changes in glutathione level, G6PDH, superoxide dismutase(SOD), catalase, and glutathione peroxidase. The authors think catalase is closely related to paraquat toxicity in the lungs METHOD: The effects of 3-amino-1,2,4-triazole(aminotriazole), a catalase inhibitor, on mice administered with paraquat were investigated. We studied the effects of aminotriazole on the survival of mice administered with paraquat, by comparing life spans between the group to which paraquat had been administered and the group to which a combination of paraquat and aminotriazole had been administered. We measured glutathion level, glucose 6-phosphate dehydrogenase(G6PDH), superoxide dismutase(SOD), catalase, and glutathione peroxidase(GPx) in the lung tissue of 4 groups of mice: the control grouts, group A(aminouiazole injected), group B(paraquat administered), group C(Paraquat and aminotriazole administered). RESULTS: The mortality of mice administered with paraquat which were treated with aminotriazole was significantly increased compared with those of mice not treated with aminotriazole. Glutathione level in group B was decreased by 20%, a significant decrease compared with the control group. However, this level was not changed by the administration of aminotriazole(group C). The activity of G6PDH in all groups was not significantly changed compared with the control group. The activities of SOD, catalase, and glutathione peroxidase(GPx) in the lung tissue were significantly decreased by paraquat administration(group B); catalase showed the largest decrease. Catalase and GPX were significantly decreased by aminotriazole treatment in mice administered with paraquat but change in SOD activity was not significant.(group C). CONCLUSION: Decrease in catalase activity by paraquat suggests that paraquat toxicity in the lungs is closely related to catalase activity. Paraquat toxicity in mice is enhanced by aminotriazole administration, and its result is related to the decrease of catalase activity rather than glutathione level in the lungs. Production of hydroxyl radicals, the most reactive oxygen metabolite, is accelerated due to increased hydrogen peroxide by catalase inhibition and the lung damage probably results from nonspecific tissue injury of hydroxyl radicals.
Amitrole* ; Animals ; Catalase ; Free Radicals ; Glucose ; Glutathione ; Glutathione Peroxidase ; Humans ; Hydrogen Peroxide ; Lung* ; Mice* ; Mortality ; Multiple Organ Failure ; Oxygen ; Paraquat* ; Pulmonary Fibrosis ; Superoxides

Previous applications of laser bone and cartilage ablation have focused largely on the CO2 and the Nd:Yag lasers, using both the continuous wave and rapid superpulsed mode, which revealed severe thermal damage such as tissue necrosis and carbonization of the remaining tissue. In contrast, Excimer lases have provided better histologic results with minimal or no thermal damage, but the ablation rate and cutting efficiency have remained unsatisfactory. Though arthroscopic partial menisectomy has become the accepted technique for dealing with tears in menisci, division of the meniscus is sometimes difficult in the confined joint space of the knee and is associated with iatrogenic injury to the articular cartilage. The ability to quickly and safely divide or remove meniscal tissue would be a distinct advantage. The Holmium:Yag laser has many potential advantages over the CO2 laster, the Nd:Yag laser and the Excimer laser. Its principal advantages include minimal mechanical trauma to the articular cartilage, greater access to tight or restricted area of the knee joint, and its ability to function in a saline medium and to resect meniscus with minimal tissue necrosis. We have evaluated the effectiveness of the Holmium:Yag laser 74 partial menisectomies of 57 patients. Among 74 meniscal tears, there were 35 medial and 39 lateral meniscal tears. The average operation time was 33 minutes in the menisectomy and hospital stay was average 3 days. There was no significant carbonization on the surrounding tissue. Menisectomy of the posterior horn was safe and easy and there was minimal iatrogenic articular cartilage damage.
Animals ; Carbon ; Cartilage ; Cartilage, Articular ; Holmium ; Horns ; Humans ; Joints ; Knee ; Knee Joint ; Lasers, Excimer ; Lasers, Solid-State ; Length of Stay ; Necrosis ; Tears

Extravasation necrosis due to intravenously administered fluids and drugs is an increasing problem in hospital practice. The incidence of extravasation is variable but skin necrosis is a potentially devastating complication of intravenous therapy. Local injection of hyaluronidase has been recommended for several types of infusion extravasations. The previous studies found hyaluronidase to be effective in the prevention of necrosis following intradermal nafcillin, 12% dextrose, sodium bicarbonate, aminophylline or vince alkaloids.The objectives of the study are to determine the dosage of hyaluronidase which is effective in reducing extravasation necrosis caused by 10% calcium-gluconate and to establish how soon after this extravasation it must be given to retain its effectiveness.Study I evaluated control versus only normal saline group and normal saline with hyaluronidase groups (dose:75,150,300,450 units; all in volume 2 ml, treatment delay:immediate, 15-minutes delay, half hour delay, one hour delay, three hour delay). Size and rate of eschar were compared between groups. Study II was undertaken to examine the evolution of calcium-gluconate induced soft tissue injury in the rabbit. The histologic findings of extravasation sites were compared between groups. A statistically significant protective effect was found in the treated group versus the nontreated group within 15 minutes to 30 minutes. The most effective protection was achieved by the immediate injection of 300 units dosage of hyaluronidase.In conclusion, in the 10% calcium gluconate-induced extravasation, the given data suggest that one can expect the most protective effect with a 300 units dosage of hyaluronidase and within half-hour delay in the treatment group.
Aminophylline ; Calcium* ; Glucose ; Hyaluronoglucosaminidase* ; Incidence ; Nafcillin ; Necrosis* ; Skin ; Sodium Bicarbonate ; Soft Tissue Injuries

PURPOSE: To describe the MR features of intraspinal cysticercosis. MATERIALS AND METHODS: Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. RESULTS: There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1 -C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2 weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single I cm cystic lesion at C2 level, which showed hypointense signal on T1 weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. CONCLUSION: lntraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis.
Arachnoid ; Arachnoiditis ; Cysticercosis* ; Edema ; Ischemia ; Magnetic Resonance Imaging* ; Medical Records ; Retrospective Studies ; Spinal Cord ; Subarachnoid Space

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

No abstract available.
Paraffin* ; Silicones*

PURPOSE: The purpose of this study was to find if any clinical or laboratory factors have significant correlations with blood loss caused by a transurethral resection of the prostate (TURP). MATERIALS AND METHODS: The medical records of 218 patients who had undergone a TURP were retrospectively reviewed. For each patient, the preoperative factors evaluated included age, type of presentation (patients who had been treated due to acute urinary retention; retention group, patients who had been treated due to lower urinary tract symptoms; symptomatic group), blood pressure, complete blood count, coagulation screening, prostate size on transrectal ultrasonography (TRUS), urine analysis, urine culture, ECG and drugs. Intraoperative and postoperative factors were also evaluated, including type of anesthesia, operator, operating time, weight of resected prostate tissue, blood transfusion and prostate histology. These factors were analyzed with respect to blood loss during the TURP using student's t, ANOVA and chi-square tests. RESULTS: The mean intraoperative blood loss and resected prostate weight were 415 ml and 15g, respectively. The factors which were found to significantly correlate with blood loss during a TURP were: resected prostate weight (r=0.44, p=0.0001), prostate size on TRUS (r=0.32, p=0.001), operating time (r=0.31, p=0.001), preoperative urine culture (p= 0.020), preoperative antimicrobials taken (p=0.020), and prostate histology (p=0.048). CONCLUSIONS: Of the factors found to correlate with blood loss during the TURP, the only reversible factor was a preoperative urinary tract infection. So, we expect that the prevention of preoperative urinary tract infection and its effective treatment in patients might be helpful in decreasing blood loss during a TURP.
Anesthesia ; Blood Cell Count ; Blood Loss, Surgical ; Blood Pressure ; Blood Transfusion ; Electrocardiography ; Humans ; Lower Urinary Tract Symptoms ; Mass Screening ; Medical Records ; Prostate* ; Retrospective Studies ; Risk Factors* ; Transurethral Resection of Prostate ; Ultrasonography ; Urinary Retention ; Urinary Tract Infections

We reviewed charts of patients on the clinical characteristics and factors which affect the prognosis of surgical results in the 77 patients(77 eyes) who were diagnosed with rhegmatogenous retinal detachment and operated on and followed for at least 3 months postoperatively at Korea University Guro hospital. We evaluated the characteristics of rhegmatogenous retinal detachment in Korea by comparing with other reports on retinal detachment as well. The factors associated with anatomic success were the duration of retinal detachment and the prescence of proliferative vitreoretinopathy. High success rate was achieved when the duration was less than 1 month and there was no proliferative vitreoretinopathy. The factors associated with functional success included the duration of retinal detachment, proliferative vitreoretinopathy, preoperative refractive error and the degree of retinal detachment(P<0.05).
Humans ; Korea ; Prognosis ; Refractive Errors ; Retinal Detachment* ; Retinaldehyde* ; Vitreoretinopathy, Proliferative