Aspiration pneumonia rarely occurs during general anesthesia; however, it can result in fatal pulmonary complications. To reduce aspiration pneumonia, a preoperative fasting time of 8 hours is recommended. A 4-year-old boy with ankyloglossia was scheduled for frenotomy. He completed preoperative fasting time and had no digestive symptoms. Pulmonary aspiration due to unexpected massive vomiting occurred during anesthesia induction. The patient's airway was immediately secured by endotracheal tube. The vomitus in the airway tract was removed by fiberoptic bronchoscopy. Abdomen radiograph taken after this event showed paralytic ileus which can cause aspiration of gastric contents. We describe a case of pneumonia caused by aspiration of gastric contents in a pediatric patient who followed fasting instructions and who was scheduled for outpatient surgery.
Abdomen ; Ambulatory Surgical Procedures ; Anesthesia ; Anesthesia, General* ; Bronchoscopy ; Child, Preschool ; Fasting* ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Pneumonia ; Pneumonia, Aspiration* ; Vomiting

The purpose of this study was to know the effect of short termed fasting on the usage of metabolic energy sources and the metabolic differences between non-athletic and athletic subjects. Subjects were divided into non-athletic and athletic group and exercise was loaded on both groups after feeding and fasting. Exercise was loaded by a treadmill running at the speed of 8 km/hour for 30 minutes in both groups. The experiment yielded following results. In the fed state, the level of plasma FFA increased markedly after 15 and 30 minutes of exercise compared with it's level of pre-exercise period in both groups. In the fated state, the level of plasma FFA in non-athletic group increased steadily according to the duration of exercise, while it's level in athletic group showed no changes. At pre-exercise period, the level of plasma FFA was higher in fasted state than fed state. Immediately before the exercise and 15 and 30 minutes after the exercise, blood for the determination of plasma free fatty acid (FFA), glucose, triglyceride (TG) and cholesterol was sampled from antecubital vein, and simultaneously heart rate was measured. In the fed state, the level of plasma glucose was increased mildly according to exercise, and in the fasted state it's level increased according to exercise in both groups also. In the fasted state, the level of plasma TG was lower than that in the fed state. The level of plasma TG and cholesterol in the fed state was no changed by the exercise from the pre-exercise period. The level of plasma cholesterol in athletic group had tendency to lower than that in non-athletic group. Heart rate increased markedly according to exercise in both groups, but the athletic group's increasing rate of heart rate was lower than the non-athletic group's heart rate increased according to exercise and athletic groups heart rate increased early period of exercise, but did not change during latest post-period of exercise.
Blood Glucose ; Cholesterol ; Fasting* ; Glucose ; Heart Rate ; Plasma ; Running ; Sports ; Triglycerides ; Veins

The effectiveness of alternate flexion and extension splint(splint group) in restoring the range of motion(ROM) following total knee arthroplasty(TKA) was evaluated, comparing with the continuous passive motion(CPM) group. One hundred and twenty knees of 87 patients(21–80 years old:12 males & 75 females) who were followed for 2.7 years(ranging from 1.2 to 5.3 years) were involved in this study. The ROM of following groups were compared each other and the results were analyzed statistically with Wilcoxon rank sum test and the differences between each prosthesis were compared with Kruskal-Wallis test. 1) Splint(51 knees, 42.5%) v.s CPM group(69 knees, 57.5%) 2) RA(43 knees, 35.8%) v.s. OA(77 knees, 64.2%) 3) Various types of prosthesis(PSCK, PCA, Tricon-M, M/G, Oxford Knee, PFC) The results were as follws:1. The ROM of splint group(average 132.2°, ranging from 85–145°) was significantly greater than that of CPM group(average 110.5°, ranging from 50–140°)(p<0.01). 2. The ROM of osteoarthritic knees(average 122.2°) was slightly greater than that of rheumatoid knees(average 115.8°) without statistical significance(p) 0.05). 3. There was statistically significant difference between ROM of the various types of implant(p < 0.01). However this difference seemed due to different methods of rehabilitation rather than different types of prosthesis. From this result it is suggested that the alternate flexion and extension splint following TKA is a useful method in restoring ROM, comparing to gradual ROM exercise with CPM.
Arthroplasty, Replacement, Knee ; Humans ; Knee ; Male ; Methods ; Passive Cutaneous Anaphylaxis ; Prostheses and Implants ; Rehabilitation ; Splints

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder characterized by prolonged bleeding time, ad deficient or absent clot retraction in the presence of normal platelet count. The major underlying abnormality in this disease is grossly defective first-phase aggregation of platelet, which are unresponsive to ADP or other platelet agonists such as epinephrine, collagen, thrombin in any concentration. This disability is caused by a decrease or absence of the platelet membrans glycoprotein IIb-IIIa complex, a member of the integrin family of adhesive receptors involved in cell-cell and cell-matrix fibronectin, and vitronectin On the development of surface labeling technique, a variety of biochemical techniques such as radioimmunoassay, crossed immunoelectrophoresis and SDS-PAGE have been used to study the structure and the function of platelet membrane glycoproteins, and to detect the platelet functional defect. But all of these techniques demand a relatively large amount of homogeneous paletelet population that requires manipulation through isolation and washing procedures before analysis. In order to eliminaste such an intricate procedure, we have applied method for analyzing platelet surface components in whole blood using monoclonal antibody and flow cytometry to recognize the absence of severe reduction of platelet membrane glycoprotien llb-llla complex. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as well as for carriers of this disease. Fow cytometry technique provides a sensitive tool for investigating platelet functional defects caused by altered expression or deficiency of platelet surface proteins.
Adenosine Diphosphate ; Adhesives ; Bleeding Time ; Blood Platelets* ; Clot Retraction ; Collagen ; Electrophoresis, Polyacrylamide Gel ; Epinephrine ; Fibronectins ; Flow Cytometry* ; Glycoproteins ; Hemorrhagic Disorders ; Humans ; Immunoelectrophoresis, Two-Dimensional ; Membrane Glycoproteins* ; Membrane Proteins ; Membranes* ; Platelet Count ; Platelet Membrane Glycoproteins ; Radioimmunoassay ; Thrombasthenia* ; Thrombin ; Vitronectin

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

No abstract available.
Body Temperature*

No abstract available.
Anti-Bacterial Agents ; Muscle Relaxation ; Muscles

The effect of exercise on plasma insulin, free fatty acid, and glucose uptake and glycogen concentration in soleus, and intravenous glucose tolerance of streptozotocin treated, diabetic Sprague-Dawley rats were studied. Diabetic-trained animals were subjected to a regular program of treadmill running for 4 weeks. Seventy-two hours after the last training session, basal and insulin-stimulated glucose uptake was studied in incubated strips (about 20 mg) of soleus muscle in vitro. Glucose tolerance was measured with intravenous infusion of 0.5 g glucose/kg body weight. In diabetic rats, training was associated with increase glucose uptake in basal and maximal insulin concentrations, decreased fasting glucose concentrations, and increased muscle glycogen levels, but there were no changes in glucose tolerance curve and plasma insulin concentrations. These results suggest that regular running program for 4 weeks improve responsiveness of insulin on soleus muscle, but fails to cause improvement of impaired intravenous glucose tolerance in mild degree streptozotocin induced diabetic rats.
Animals ; Body Weight ; Exercise* ; Fasting ; Glucose Tolerance Test* ; Glucose* ; Glycogen ; In Vitro Techniques ; Infusions, Intravenous ; Insulin ; Muscle, Skeletal ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Running ; Streptozocin*

No abstract available.
Humans ; Supine Position* ; Tongue* ; Tracheostomy*

No abstract available.
Humans ; Supine Position* ; Tongue* ; Tracheostomy*