The purpose of this study is to investigate the protective role of esmolol during cross-clamping of descending thoracic aorta on the ischemic myocardium induced by the ligation of the left anterior descending coronary artery(LAD) in dogs. LAD was ligated for 15 min followed by reperfusion. Nitroglycerin with or without esmolol were continuously infused throughout procedure and the thoracic aorta was cross-clamped for 45 mins. Eighteen dogs were divided into three groups; group C-no drug administerd, group N-nitroglycerin(5 ug/kg/min), and group NE-nitroglycerin(5 ug/kg/min) with esmolol(0.5 mg/kg as loading dose following 50 ug/kg/min as maintenance dose). Heart rate(HR), mean arterial pressure(MAP), stroke volume(SV), cardiac index(CI), left ventricular stroke work index(LVSWI), pulmonary capillary wedge pressure(PCWP), triple index(TI), mixed venous oxygen tension of great cardiac vein(PgvO2), Ca-vDO2(carotid arterial oxygen content-great cardiac vein oxygen content) and lactate were measured three times in each group before ligation of LAD(stage 1), 15 minutes after LAD ligation(stage 2) and 45 minutes after cross-clamping of descending thoracic aorta(stage 3). The results were as follows: 1) MAP of group NE at stage 3 was significantly high compared with group C but low compared with group N (P<0.05). 2) SV of group NE at stage 3 was significantly high compared with group C and group N. A significant change was observed between group C and group N(P<0.05). 3) CI, LVSWI, PgvO2 of group NE at stage 3 were significantly high compared with group C but not significantly high compared with group N(P<0.05). 4) HR, PCWP, Lactate level of group NE at stage 3 were significantly low compared with group C and group N. A significant change was also observed between group C and group N(P<0.05). 5) TI, Ca vDO2 of group NE at stage 3 were significantly low compared with group C and group N, but no significant change was observed between group C and group N(P<0.05). These results suggest that esmolol could protect ischemic myocardium from progressive damage via reduction of myocardial oxygen consumption without decrease of cardiac output and left ventricular stroke work index.
Animals ; Aorta, Thoracic* ; Capillaries ; Cardiac Output ; Dogs ; Heart* ; Hemodynamics* ; Lactic Acid ; Ligation ; Myocardium ; Nitroglycerin* ; Oxygen Consumption ; Oxygen* ; Reperfusion ; Stroke ; Veins

Foreign body aspiration into the airway causes airway obstruction that may be acutely life-threatening or if undected result in severe lung damage. In case of bilateral bronchial obstruction, the impairment of gas exchange is usually severe enough to threaten the patient's life. And the gas exchange will become worsen during bronchoscopy. So, anesthesia and bronchoscopy for removal of the foreign body should be carried out by skilled personel with appropriate equipment, especially in case of bilateral bronchial obstruction. A 16 month old, cyanotic and dyspneic female infant was brought to operating room for removal of bronchial foreign bodies . The anesthesia was induced and maintained with enflurane(1-2%) -oxygen(100%)- vecuronium using Jackson- Rees breathing system which was connecting to the side arm of ventilating brochoscope. Foreign bodies (peanut), which were two pieces of peanut 4X4X6 mm sized from right and 4X8X12 mm sized from left main bronchus, were sucessfully removed.
Airway Obstruction ; Anesthesia* ; Arm ; Bronchi* ; Bronchoscopes ; Bronchoscopy ; Female ; Foreign Bodies* ; Humans ; Infant ; Lung ; Operating Rooms ; Respiration ; Vecuronium Bromide

BACKGROUND: Obesity has been generally diagnosed by 'Body Mass Index (BMI)' in primary care. Recently the use of Bioelectrical Impedance Analyzer' has become popular in Korea to evaluate body fat rate (BFR), as cost is inexpensive and the method to use is simple. As a result, the opposed finding of normal BMI and elevated BFR vice versa in same individuals are being encountered frequently. We designed this study to find out the characteristics and cardiovascular risk of people in these groups. METHODS: The medical records of health promotion center were obtained and 22,704 applicants visitor who undeerwent health risk questionnaire, screening tests and physical examination for cardiovascular disease were reviewed. RESULTS: After adjusting for age, sex, exercise and education level, cardiovascular risk such as hypertension, DM, and hypercholesterolemia, LDL tended to increase linearly and HDL tended to decrease linearly with increase of BFR or BMI. In comparison with normal BMI and BFR group, the odds ratios of normal BMI and elevated BFR group or vice versa were increased. CONCLUSION: If either one of BMI or BFR of a person was elevated, even though the other was within normal range, the cardiovascular risk of that person was shown to be high.
Adipose Tissue* ; Body Mass Index* ; Cardiovascular Diseases ; Education ; Electric Impedance ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Mass Screening ; Medical Records ; Obesity ; Odds Ratio ; Physical Examination ; Primary Health Care ; Reference Values ; Risk Factors* ; Surveys and Questionnaires

BACKGROUND/AIMS: The efficacy and adverse effects of two different dosages of recombinant a2b interferon were studied in 45 patients with chronic active hepatitis B from March 1991 to December 1996. METHODS: The 19 patients received in a dose of 3MU thrice weekly for 16 weeks, the 14 patients received in a dose of 5MU thrice weeldy for 16 weeks and the 12 patients received conservative management. We evaluated serologic examination and adverse effects. Results 1) The rate of improvement in aminotransferase was significantly higher in interferon treated group (75.0%) compared to control group (16.7%) and it tended to be higher in 5MU group (85.6%) than 3MU group (68.4%) but, the latter had no statistical signifcance (P=0.27). 2) The disappearance rate of HBV-DNA was significantly higher in interferon treated group (72.7%) compared to control group (0%) and it tend to be higher in 3MU group (78.5%) than 5MU group (62.5%) but, the latter had no stastical significance (P=037). 3) The loss rate of HBeAg was significantly higher in interferon treated group (50.0%) compared to control group (O%) and it tend to be higher in 5MU group (66.7%) than 3MU group (37.5%) but, the latter had no stastical significance(P=0.13). 4) Fever (75.8%), leukopenia (41.2%), headache (30.3%), myalgia (18.2%), thrombocytopenia (17.6%), anorexia (11.8%) were noted and fever was significantly higher in 5MU group compared to 3MU group (P=0.02). Conclusion The effective improvement of liver function test and disappearance rate of HBeAg tended to be higher in 5MU group than 3MU group, but it was not stastistically significant. Fever was significantly higher in 5MU group compared to 3MU group.
Anorexia ; Fever ; Headache ; Hepatitis B e Antigens ; Hepatitis, Chronic* ; Humans ; Interferons* ; Leukopenia ; Liver Function Tests ; Myalgia ; Thrombocytopenia

OBJECTIVE: Cerebral vasospasm still remains a major cause of the morbidity and mortality, despite the developments in treatment of aneurysmal subarachnoid hemorrhage. The authors measured the utility and benefits of external lumbar cerebrospinal fluid (CSF) drainage to prevent the clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage in this randomized study. METHODS: Between January 2004 and March 2006, 280 patients with aneurysmal subarachnoid hemorrhage were treated at our institution. Among them, 107 patients met our study criteria. The treatment group consisted of 47 patients who underwent lumbar CSF drainage during vasospasm risk period (about for 14 days after SAH), whereas the control group consisted of 60 patients who received the management according to conventional protocol without lumbar CSF drainage. We created our new modified Fisher grade on the basis of initial brain computed tomography (CT) scan at admission. The authors established five outcome criteria as follows : 1) clinical vasospasm; 2) GOS score at 1-month to 6-month follow-up; 3) shunt procedures for hydrocephalus; 4) the duration of stay in the ICU and total hospital stay; 5) mortality rate. RESULTS: The incidence of clinical vasospasm in the lumbar drain group showed 23.4% compared with 63.3% of individuals in the control group. Moreover, the risk of death in the lumbar drain group showed 2.1% compared with 15% of individuals in the control group. Within individual modified Fisher grade, there were similar favorable results. Also, lumbar drain group had twice more patients than the control group in good GOS score of 5. However, there were no statistical significances in mean hospital stay and shunt procedures between the two groups. IVH was an important factor for delayed hydrocephalus regardless of lumbar drain. CONCLUSION: Lumbar CSF drainage remains to play a prominent role to prevent clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage. Also, this technique shows favorable effects on numerous neurological outcomes and prognosis. The results of this study warrant clinical trials after endovascular treatment in patients with aneurysmal SAH.
Aneurysm ; Brain ; Drainage ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Length of Stay ; Prognosis ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial

Many organic and nonorganic agents can cause chemical pneumonitis. Chemical pneumonitis induced by inhalation of acetic acid is a rare clinical condition. As acetic acid is a water soluble agent, it causes chemical irritation to respiratory tract and causes variable symptoms. We experienced a case of acute lung injury due to inhalation of acetic acid fume. A 56-year-old male patient was admitted due to dyspnea with vomiting for one day. After he inhaled acetic acid fume in occupational situation, he had chest tightness, chilling sense, and productive cough. Our case was good response to oxygen inhalation, antibiotics, and systemic steroids.
Acetic Acid* ; Acute Lung Injury ; Anti-Bacterial Agents ; Cough ; Dyspnea ; Humans ; Inhalation* ; Male ; Middle Aged ; Oxygen ; Pneumonia* ; Respiratory System ; Steroids ; Thorax ; Vomiting ; Water

The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.
Biopsy ; Body Weight ; Cyclosporine ; Edema ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Leg ; Oliguria ; Porphyrins ; Prednisolone ; Weight Gain

Transurethral resection syndrome (TURS) is one of the complications of endoscopic transurethral operation with irrigation fluid. TURS comprehensively refer to several clinical symptoms and signs caused by intravascular absorbtion of irrigation fluid, hypertension, bradycardia, arrhythmia, respiratory distress, hypotension, confusion, blindness, seizure, coma, hyponatremia, and hypoosmolarity. TURS is mainly known as the complication of the transurethral resection of prostate (TURP), and rarely found in the procedures such as transurethral resection of bladder tumor (TUR-BT), hysteroscopy, cystoscopy, and arthroscopy. Only a few cases of TURS after TUR-BT have been reported. The patients on maintenance hemodialysis were restricted in the amount of water intake for volume control. They were susceptible to the absorption of irrigation fluid during TUR-BT since they had anuria. We hereby report the 2 cases maintenance hemodialysis patients who were led to TURS after TUR-BT.
Absorption ; Anuria ; Arrhythmias, Cardiac ; Arthroscopy ; Blindness ; Bradycardia ; Coma ; Cystoscopy ; Drinking ; Humans ; Hypertension ; Hyponatremia ; Hypotension ; Hysteroscopy ; Kidney Failure, Chronic ; Renal Dialysis ; Seizures ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND/AIMS: Juxtapapillary duodenal diverticuli are often associated with biliary stones. The aim of this study was to investigate the prevalence of juxtapapillary duodenal diverticuli in biliary stones. METHODS: Three hundred and thirteen patients underwent endoscopic retrograde cholangiopancreatography were studied prospectively. RESULTS: Seventy-five patients had juxtapapillary duodennl diverticuli(24%). The occurrence of diverticuli increased with age and more commomly in female patients. The prevalence of diverticulii was higher in patients with commom bile duct stones(35.6% vs 17.6%; P 0.002) and gallbladder stones(33.3% vs 17.6%; P=0,001) than in patients without biliary stones (17.6%). CONCLUSIONS: We conclude that biliary stones are associated with juxtapapillary diverticuli.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Gallbladder ; Gallstones* ; Humans ; Prevalence ; Prospective Studies

BACKGROUND/AIMS: The purpose of this study was to examine the clinical observations of patients with hematochezia in attempt to determine the appropriate evaluation and treatment of this group of patients. METHODS: Seventy patients with hematochezia were admitted to Intemal medicine (IM) Department of Chungnam National University Hospital from January 1990 to August 1997. The clinical observations of patients with hematochezia were reviewed and the results are as follows. RESULTS: 1) The causes of the hematochezia were ischemic colitis (18.6%), hemorrhoids (15.7%), ulcerative colitis (14.3%), unknown (12.8%), rectal cancer (7.1%), nonspecific ulcers (rectum; 4.3%, colon; 1.4%), diverticulosis (5.7% ), colon cancer (4.3%.), mdiation colitis (2.9%), angiodysplasia (2.9%), polyps (2.9%), Samonella colitis (2.9%), rectal varix (1.4%), ileitis(1.4%) and ileal ulceration (1.4%). 2) The average hemoglobin of the patients with hematochezia was 9.6 g/dl. Forty percent of the patients with hematochezia required a transfusion and the average transfusion amount was 4.4 packs (Pack Red Cell). Patients with nonspecific ulcers (recutum, colon), angiodysplasia, colon cancer, ilieal lesion and rectal varix required more transfusions (average transfusion amount, 5.7 packs). 3) Patients who improved with eonservative treatment only were 85.7%, and 11.4% required surgical intervention. Also 2.9% required endoscopic intervention. 4) Confirmative modalities of hematochezia included colonoscopy (80%), and others (angiography, barium enema, and operation etc.). CONCLUSIONS: In patients with hematochezia admitted to the IM Department, the cause of hematochezia was confirmed by colonoscopy and patients with hematochezia were mainly managed using conservative treatment.
Angiodysplasia ; Barium ; Chungcheongnam-do ; Colitis ; Colitis, Ischemic ; Colitis, Ulcerative ; Colon ; Colonic Neoplasms ; Colonoscopy ; Diverticulum ; Enema ; Gastrointestinal Hemorrhage* ; Hemorrhoids ; Humans ; Polyps ; Rectal Neoplasms ; Ulcer ; Varicose Veins