No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Humans ; Infant, Newborn*

Malignant hyperthermia is a well-recognized syndrome of uncertain etiology. The confusing facts are: the variety and different nature of the triggering agents, the variation in time of onset of rigidity and fever coupled with a variation in response to succinylcholine, the lack of family history in some patients, and its occurence in some who have had previously normal general anesthetics. A case is a 23 year old relatively healthy male patient in whom subtotal gastrectomy was performed under N2O-O2-ether and gallamine anesthesia with induction after pentothal sodium and succinylcholine. This was complicated by an abrupt, high rise in body temperature, muscle rigidity, flushing with peripheral cyanosis, disseminated intravascular coagulation and hyperpnea 40 minutes after induction. He died 3 hours after cessation of anesthesia without effective response to any active antipyretic therapy. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Anesthesia* ; Anesthetics, General ; Body Temperature ; Cyanosis ; Disseminated Intravascular Coagulation ; Fever ; Flushing ; Gallamine Triethiodide ; Gastrectomy ; Humans ; Incidence ; Male ; Malignant Hyperthermia* ; Muscle Rigidity ; Prognosis ; Sodium ; Succinylcholine ; Thiopental

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

Apoptosis ; Bone Regeneration ; Calcium ; Calcium Phosphates ; Cell Cycle ; Cell Proliferation ; Ceramics ; Durapatite ; Gene Expression ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoblasts ; Osteogenesis ; Signal Transduction

BACKGROUND: Pneumoperitoneum for a gynecologic laparoscopic surgery induces hemodynamic changes. We evaluated the effects of nicardipine on induction, maintenance, and recovery. METHODS: Thirty patients scheduled for gynecologic laparoscopic surgery were randomly allocated to two groups: control group (placebo group, n = 15), group N (nicardipine group, 10 microgram/kg followed by 0.5-2.0 microgram/kg/min). The systolic arterial pressure, mean arterial pressure, and heart rate were measured at preinduction, induction, intubation and 5, 10, 15, 20 min after insufflation. Loss of consciousness, induction dose, effective site concentration, propofol maintenance dose (the maintenance dose of propofol from intubation to end of anesthesia, PMD) were also measured. Propofol was titrated to maintain a bispectal index value of 40-60. RESULTS: There was a significant difference in PMD between two groups. The PMD of group N was significantaly less than group C. Nicardipine adminstration attenuated increase in the blood pressure, but did not affect on heart rates during CO2 insufflation. CONCLUSIONS: Co-administration of nicardipine was effective in attenuating the hemodynamic changes after pneumoperitoneum during gynecologic laparoscopic surgery, without changes of induction and recovery.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Intubation ; Laparoscopy* ; Nicardipine* ; Pneumoperitoneum ; Propofol ; Unconsciousness

No abstract available.
Diagnosis* ; Intussusception* ; Ultrasonography

BACKGROUND: A "difficult airway" can be simulated with an extrication collar, which restricts cervical motion and mouth opening. The purpose of this study is to compare the efficacy of the GlideScope and the McGrath in difficult airway simulation. METHODS: Patients were randomized using computer-generated numbers and were placed into the GlideScope group or the McGrath group. The total intubation time was defined as the time measured from when the anesthesiologist picks up the device to the time at which three successive end-tidal CO2 values are acquired after intubation. RESULTS: There was no significant difference in total intubation time between the two groups (73.0 ± 25.3 sec vs. 72.3 ± 20.9 sec, P = 0.92). The success rates of the first intubation attempt did not differ between the two groups (82.8% vs. 83.3%, P = 0.95). CONCLUSIONS: Our results suggest that there are no significant differences in the intubations with GlideScope and McGrath using vascular forceps and tube exchangers in difficult intubation scenarios.
Airway Management ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Mouth ; Surgical Instruments*

BACKGROUND: Accumulating evidence shows that interleukin(IL)-1 plays a critical role in inflammation and connective tissue destruction observed in both osteoarthritis and rheumatoid arthritis. IL-1 induces gene expression related to cytokines, chemokines and matrix metalloproteinases by activation of many different transcription factors. MATERIALS AND METHODS: The chondrosarcoma cell line, SW1353, is known to be a valuable in vitro system for investigating catabolic gene regulation by IL-1beta in chondrocytic cells. To explore and analyze the changes in gene expression by IL-1 responsible for arthritis, SW1353 was treated with IL-1 for 1, 6 and 24 h and then total RNAs were purified for each time. The changes in gene expression were analyzed with 17k human cDNA microarrays and validated by semi-quantitative RT-PCR. RESULTS: Greater than a two-fold change was observed in 1,200 genes including metallothioneins, matrix metalloproteinases, extracellular matrix proteins, antioxidant proteins, cytoskeleton proteins, cell cycle regulatory proteins, proteins for cell growth and apoptosis, signaling proteins and transcription factors. These changes appeared to be correlate with the pathophysiological changes observed in early osteoarthritis. CONCLUSION: cDNA microarray analysis revealed a marked variability in gene expression, and provided insight into the overall molecular changes. The result of this study provide initial information for further studies to identify therapeutic targets in osteoarthritis pathogenesis.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Cell Cycle Proteins ; Cell Line ; Chemokines ; Chondrosarcoma* ; Connective Tissue ; Cytokines ; Cytoskeleton ; DNA, Complementary* ; Extracellular Matrix Proteins ; Gene Expression ; Humans* ; Inflammation ; Interleukin-1 ; Interleukin-1beta ; Interleukins* ; Matrix Metalloproteinases ; Metallothionein ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis* ; Osteoarthritis ; RNA ; Transcription Factors

The Shikani Optical Stylet(TM) (SOS, Clarus Medical, USA) is another tool to facilitate tracheal intubation. It combines the benefits of a lightwand and a fiberoptic bronchoscope. We report the application of SOS in facilitating the tracheal intubation of two-person with history of difficult airway management. A 25-year-old woman with micrognathia was scheduled to undergo an exploratory laparotomy. Intubation attemps failed with a direct laryngoscope because of difficulty in her mouth opening. Although airway management was re-attempted by a laryngeal mask airway, it also failed for the same reason. Airway management was successfully performed using the SOS instead of a laryngeal mask airway. The second case was a 38-year-old woman with ankylosing spondylitis, scheduled for spinal fusion. She had difficulty in extending her neck. Intubation was successfully performed via the SOS. We believe that intubation by the SOS is a useful and readily available alternative technique for patients with difficult airways.
Adult ; Airway Management ; Bronchoscopes ; Female ; Humans ; Intubation ; Laparotomy ; Laryngeal Masks ; Laryngoscopes ; Mouth ; Neck ; Spinal Fusion ; Spondylitis, Ankylosing