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*

STATEMENT OF PROBLEM: Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the actual effect of dimensional change in implant geometry on initial stability. PURPOSE: The purpose of the current study was to investigate the influence of diameter and length changes on initial stability of implants. MATERIAL AND METHODS: Four types of dummy bone (D1, D2, D3 and D4) consisted of cortical and cancellous layers with different thickness were simulated. Implants which had similar surface area to each other (3.5 x 13.0-mm, 4.0 x 11.5-mm, 4.5 x 10.0-mm, 5.0 x 8.5-mm) were inserted in dummy bones. Implant stability as a function of peak insertion torque and resonance frequency values were recorded for each implant. RESULTS: 1. Bone quality was a major influential factor to achieve initial stability (P < .05). 2. In D1, D2 and D3 dummy bones, implant stability quotient values were not significantly different to each other (P > .05), however insertion torques were increased with wider and shorter implants (P < .05). 3. In D4 dummy bone, implant stability quotient values and insertion torques were decreased with wider and shorter implants (P <. 05). CONCLUSION: From a point of view of initial stability, it is suggested that use of wide and short implant may be helpful in avoiding bone augmentation procedures in area of adequate bone quality.
Torque

BACKGROUND: Straight raising of the legs in the supine position or Trendelenburg positioning has been used to treat hypotension or shock, but the advantages of these positions are not clear and under debate. We performed a crossover study to evaluate the circulatory effect of full flexion of the hips and knees in the supine position (exaggerated lithotomy), and compare it with straight leg raising. METHODS: This study was a prospective randomized crossover study from the tertiary care unit at our university hospital. Twenty-two patients scheduled for off-pump coronary artery bypass surgery were enrolled. Induction and maintenance of anesthesia were standardized. Exaggerated lithotomy position or straight leg raising were randomly selected in the supine position. Hemodynamic variables were measured in the following sequence: 10 min after induction, 1, 5, and 10 min following the designated position, and 1 and 5 min after returning to the supine position. Ten min later, the other position was applied to measure the same hemodynamic variables. RESULTS: During the exaggerated lithotomy position, cerebral and coronary perfusion pressure increased significantly (P < 0.01) without a change in cardiac output. During straight leg raising, cardiac output increased at 5 min (P < 0.05) and cerebral and coronary perfusion pressures did not increase except for cerebral perfusion pressure at 1 min. However, the difference between the two groups at each time point in terms of cerebral perfusion pressure was clinically insignificant. CONCLUSIONS: Full flexion of the hips and knees in the supine position did not increase cardiac output but may be more beneficial than straight leg raising in terms of coronary perfusion pressure.
Anesthesia ; Cardiac Output ; Coronary Artery Bypass, Off-Pump ; Cross-Over Studies ; Hemodynamics ; Hip ; Humans ; Hypotension ; Knee ; Leg ; Perfusion ; Prospective Studies ; Shock ; Supine Position ; Tertiary Healthcare