We had experienced anesthetic management of two patients with bilateral pheochromocytoma. They had been treated with phenoxybenzamine for 4 weeks preoperatively. Anesthesia was managed with thiopental sodium for induction,enflurane-N2O-O2 for maintenance, vecuronium for muscle relaxation, and sodium nitroprusside for controlling severe hypertension. After tumor resection, severe hypotension was controlled by rapid transfusion, fluid and dopamine infusion. A tolerable blood pressure and pulse rate were maintained throughout the procedure. Preoperative preparation, sufficient sedation, smooth anesthetic induction, complete analgesia, good muscle relaxation, adequate ventilation and proper cardiovascular control are required in resection of pheochromocytoma.
Analgesia ; Anesthesia ; Blood Pressure ; Dopamine ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Muscle Relaxation ; Nitroprusside ; Phenoxybenzamine ; Pheochromocytoma* ; Thiopental ; Vecuronium Bromide ; Ventilation

BACKGROUND: Since up to 90% of a theophylline dose is biotransformed, probably by interaction with one or more the variants of the cytochrome P-450 drug metabolism system, anti-tuberculosis agents including drugs influencing microsomal enzyme systems, such as isoniazid and rifampicin, may be affect the elimination of theophylline. METHODS: The effect of combination therapy with isoniazid(INH), rifampicin(RFP), ethambutol(EMB) and pyrazinamide(PZA) on the pharmacokinetics of theophylline was evaluated by a computer program using Bayesian method. Three group were divided as follows. Group lis control, Group II is treated with INH, RFP, EMB and PZA and Group lll is treated with INH, RFP and EMB. All of them were non-smoker who were normal in liver and renal functions, and not administered drugs affecting on the clearance of theophylline with exception of anti-tuberculous agents. RESULTS: When it compared control with test groups, the clearance of theophylline in Group ll and Group lll was significantly decreased(p<0.001), and half life in Group ll and Group lll showed significant elevation(p<0.001). However there were no significant differences in clearance and half life between the Group ll and Group lll. CONCLUSION: These results suggest that theophylline dose may be need of readjustment in concurrent medica fion of anti-tuberculous agents including INH, RFP, and EMB.
Bayes Theorem ; Cytochrome P-450 Enzyme System ; Ethambutol* ; Half-Life ; Isoniazid* ; Liver ; Metabolism ; Pharmacokinetics* ; Pyrazinamide ; Rifampin* ; Theophylline*

BACKGROUND/AIMS: Drug-eluting stents (DES) are superior to bare metal stents (BMS) in reducing restenosis rates across a wide range of patients and lesion subsets.This study compared the clinical outcomes of DES versus BMS in patients with large coronary arteries (> or = 3.5 mm). METHODS: The study compared 134 patients (59.9 +/- 10.6 years, 90 men, 44 women) who underwent single vessel angioplasty with DESimplantation in large vessels with 115 patients (60.3 +/- 8.9 years, 82 men, 33 women) who received BMS. The clinical outcomes at 12 months were compared between groups. The study end points were major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and the need for target vessel and target lesion revascularization. RESULTS: The baseline clinical coronary angiography and procedural characteristics were similar in both groups. The duration of dual antiplatelet therapy was longer in the DES group than in the BMS group (240 +/- 2.7 vs. 348 +/- 1.7 days, p = 0.042). During the 12-month clinical follow-up, MACE were observed in 13 patients (11.3%) with BMS and 12 patients (9.0%) with DES (p = 0.486). CONCLUSIONS: For coronary stents implanted in large coronary arteries, DES seems to be more favorable, although no significant differences were observed in the clinical outcomes between DES and BMS during a 1-year clinical follow-up.
Angioplasty ; Arteries ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Death ; Drug-Eluting Stents ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Male ; Myocardial Infarction ; Prognosis ; Stents