BACKGROUND: High-frequency jet ventilaion is considered a reliable technique for anesthesia and critical care including respiratory failure but there are adverse reactions such as carbon dioxide retension and dry of respiratory mucosa. The purpose of this study was to confirm the effects of combined high- frequency jet ventilation (HFJV) and converntional mechanical ventilation (CMV) on the cardiovascular system, arterial blood gases tension and mean airway pressure in 9 Korea mongrel dogs with pulmonary edema induced by oleic acid. METHODS: During CMV with 20 breaths/minute, 10 ml/kg of tidal volume and F1O2 1.0, parameers were evaluated (base line value). When pulmonary edema was developed, HFJV was applied initially with 120 breaths/minute, inspiratory time 30% and driving pressure 40 psi F1O2 1.0 for 60 minutes (control value) and thereafter simultaneous use of CMV was applied with the tidal volume of 10 ml/kg and each respiratory rate 8, 4, 2, 1, 0.5 per minute for 30 minutes. RESULTS: Combined application of HFJV and CMV (above repiratory rate 1 per minute) achieved the improvement of oxygenation and carbon dioxide elimination, and Paw was decreased without undesirable effects on cardiovascular system in case of the induced pulmonary edema. CONCUSIONS: From above results we recommanded that HFJV combined with CMV may be a useful method of treatment for respiratory failure.
Anesthesia ; Animals ; Carbon Dioxide ; Cardiovascular System ; Critical Care ; Dogs* ; Gases ; High-Frequency Jet Ventilation* ; Korea ; Oleic Acid* ; Oxygen ; Pulmonary Edema* ; Respiration, Artificial* ; Respiratory Insufficiency ; Respiratory Mucosa ; Respiratory Rate ; Tidal Volume ; Ventilation

BACKGROUND: Even though surgery and anesthesia give stress to patients, adequate anesthesia could attenuate stress reactions and minimize side effects from these reactions. Abnormal glucose homeostasis is well documented side effect during anesthesia, especially when inhalational anesthetics are used. We planned this study to investigate and compare the effects of two popular anesthetics-between propofol, intravenous anesthetics, and enflurane, inhalational agents on blood glucose level. METHODS: Adult patients free of diabetes mellitus and any other endocrine disease were randomly allocated into two groups. In both groups, anesthesia was induced with 2.5% pentothal sodium 5 mg/kg and succinylcholine 1 mg/kg. After intubation, propofol 6~10 mg/kg with 50 % N2O-O2 mixture 4 liter were used for maintenance in one group (Group P). In other group, enflurane 1.5~2% with 50% N2O-O2 mixture 4 liter were used (Group E). Hartmann's solutions were used for maintenance fluid in both groups. Blood glucose levels were measured at preintubation period, postintubation 5, 10, 15 minutes and just-preincision period. Blood glucose level at admission was regarded as control value and statistical analysis was done by Student's t-test. RESULTS: In group E, there was significant increase of the blood glucose level about 23 minutes after induction but in group P, there was no significant increase of glucose level during entire experimental time. Blood glucose levels were higher from postintubation 5 minutes to just-preincision period with statistical significance in group E than group P. CONCLUSIONS: Propofol maintained stable blood glucose level compared to enflurane during general anesthesia.
Adult ; Anesthesia ; Anesthesia, General ; Anesthetics ; Anesthetics, Intravenous ; Blood Glucose* ; Diabetes Mellitus ; Endocrine System Diseases ; Enflurane* ; Glucose ; Homeostasis ; Humans ; Intubation ; Propofol* ; Sodium ; Succinylcholine ; Thiopental

The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.
Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Critical Illness ; Diabetes Mellitus/diagnosis/drug therapy ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Humans ; Kidney Failure, Chronic/diagnosis/therapy ; Liver Cirrhosis/diagnosis/therapy ; Peptic Ulcer/*therapy ; Risk Factors

Primary cardiac sarcoma is rare, and intimal sarcoma is an extremely rare and highly lethal disease. We report a case of a 62-year-old woman who was incidentally diagnosed with a primary cardiac sarcoma originating from the left atrial appendage and extending to the left superior pulmonary vein. The location of the tumor was very complicated, posing a major challenge for complete resection. We successfully performed complete resection of the cardiac sarcoma via cardiac autotransplantation with left pneumonectomy. The patient recovered uneventfully, without any adjuvant therapy as of 6 months postoperatively. Autotransplantation of the heart may be suggested as a reasonable surgical option for extensive left atrial tumors.

OBJECTIVES: The purpose of this study was to investigate the regional differences of the basal ganglia volume between the boy subjects who have Tourette's disorder and the control group who don't have this disorder by using Brain MRI. METHODS: Sixteen subjects who were diagnosed as Tourette's disorder using DSM-IV criteria, and sixteen healthy subjects were selected. For analysis the coronal slice images of the basal ganglia were collected and collected MR images were analyzed with NIH Image (version 6.1 ppc). RESULTS: The total brain volume in the subjects with Tourette's disorder were smaller than control group by 6.2% (F=6.2, d.f.=1, p=0.019). The right putamen volume in boys with Tourette's disorder were significant smaller than control group statistically (F=3.2, d.f.=3, p=0.040). The asymmetry (left>right) in the globus pallidus decreased significantly in the boys with Tourette's disorder (p=0.06) were found from this experiment. CONCLUSION: These findings suggest that boys with Tourette's disorder may have neuropathological abnormalities in the basal ganglia. Moreover, the present findings point out the important role of basal ganglia, especially putamen, in pathophysiology of Tourette's disorder. More studies about the structural and functional analysis of the basal ganglia in Tourette's disorder are highly required.
Basal Ganglia ; Brain ; Diagnostic and Statistical Manual of Mental Disorders ; Globus Pallidus ; Putamen ; Tourette Syndrome

No abstract available.
Chickenpox ; Herpesvirus 3, Human*

No abstract available.
Brain* ; Conus Snail* ; Dermoid Cyst* ; Magnetic Resonance Imaging ; Rupture

Hemophagocytosis refers to the pathologic finding of activated macrophages engulfing erythrocytes, leukocytes, platelets, and their precursor cells. Hemophagocytic syndrome (HS) (more properly referred to as hemophagocytic lymphohistiocytosis) is a distinct clinical entity characterized by fever, pancytopenia, splenomegaly, and hemophagocytosis in the bone marrow, spleen, and lymph nodes. HS is associated with a variety of viral, bacterial, fungal, and parasitic infections, as well as with collagen vascular diseases and malignancies. Epstein-Barr virus (EBV)-associated HS is almost always a fatal disease. The authors present a case of EBV-associated HS. The patient had fever and hepatosplenomegaly and showed pancytopenia, jaundice, and positive EBV viral markers in serum, positive EBV DNA in the liver biopsy specimen, and hemophagocytosis in the bone marrow. The patient died unexpectedly 1 month after admission. We report the details of this case of fatal EBV-associated hemophagocytic syndrome along with a brief review of the literature.
Biomarkers ; Biopsy ; Blood Platelets ; Bone Marrow ; Collagen ; DNA ; Erythrocytes ; Fever ; Herpesvirus 4, Human ; Humans ; Jaundice ; Leukocytes ; Liver ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic ; Macrophages ; Pancytopenia ; Spleen ; Splenomegaly ; Vascular Diseases

L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the 7th RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.
Aged ; Disease Progression ; Female ; Humans ; Hypothyroidism ; Iodine ; Lymph Nodes ; Middle Aged ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Pleural Effusion ; Pleural Effusion, Malignant* ; Pleurodesis ; Quality of Life ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Neoplasms ; Thyrotropin ; Thyroxine

Even though arterial embolization was introduced as a treatment tool for postpartum hemorrhage, it is not performed frequently. As authors applied arterial embolization successfully to the patient who contracted retroperitoneal hematoma after delivery, we reported this case with a brief review of literature.
Arteries* ; Hematoma ; Humans ; Postpartum Hemorrhage