BACKGROUND: Induction of general anesthesia with tracheal intubation and skin incision are potent stimuli that can induce increased sympathetic activity, heart rate and blood pressure. We compared the hemodynamic response and catecholamine concentration during general anesthesia with intravenous clonidine pretreatment, a centrally acting -2 adrenoceptor agonist, and without pretreatment. METHODS: Forty ASA I or II patients aged from 20 to 60 years undergoing elective surgery were randomly allocated to two groups. In group I, 5 ml of 0.9% normal saline as control administered intravenously 10 minutes before induction of anesthesia, and anesthesia was induced with thiopental sodium, succinylcholine and maintained with N2O (2.5L/min)-O2 (2.5L/min)-enflurane (1.3~1.8 vol%). In group II, 4 g/kg clonidine diluted in 5ml of normal saline administered intravenously 10 minutes before induction of anesthesia, and anesthesia was induced with thiopental sodium, succinylcholine and maintained with N2O-O2-enflurane (0.5~1.0vol%) and 2 g/kg/hr clonidine was continuously infused. We measured blood pressure, heart rate and plasma catecholamine at preinduction, 1 minute after intubation (T1), 1 (T2) and 30 minutes after skin incision (T3) and compared with group I. RESULTS: There was statistical significance in systolic and diastolic pressure at T1 between two groups. There was statistical significance in heart rate, epinephrine and norepinephrine at T1, T2 and T3 between two groups. CONCLUSION: The elevation of blood pressure, heart rate and plasma catecholamine accompanying tracheal intubation and skin incision may be prevented by administration of intravenous clonidine.
Adult ; Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Brain ; Clonidine* ; Epinephrine ; Heart Rate* ; Heart* ; Hemodynamics ; Hemorrhage ; Hope ; Humans ; Incidence ; Intubation* ; Larynx ; Male ; Norepinephrine ; Plasma* ; Skin ; Spondylitis, Ankylosing ; Succinylcholine ; Thiopental

The clinicopathologic characteristics, treatments and prognosis of retinoblastoma, the most common intraocular tumor in children, were studied retrospectively in 101 cases(128eyes) who visited our clinic from 1987 to 1996. All patients were followed for 2 years or longer. Twenty seven cases were bilateral and seventy four cases were unilateral,. Eihgty four eyes were enucleated. Twenty one eyes were successfully treated by conservative modality. The rest refused any type of treatment. Orbital recurrence or distant metastasis were observed in 5 cases after enucleation without systemic treatment, and one died in spite of irradiation and aggressive chemotherapy. It is widely recognized that the prognosis for survival of retinoblastoma patients, especially unilateral, is excellent, however the authors emphasize the importance of careful postoperative histopathologic review and long term periodic follow-up to improve long-term prognosis.
Child ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Orbit ; Prognosis* ; Recurrence ; Retinoblastoma* ; Retrospective Studies

Meibomian gland adenocarcinoma is a rare neoplasm which may be overlooked until it spreads into the orbit. We have experienced a case of meibomian gland adenocarcinoma which spread into the orbit, and performed orbital exenteration. Two months later, the patient had a recurrence at the superolateral margin of the orbit that surgically excised. The radiation therapy with total dose of 5000 rads over a period of one month was performed and the tumor mass was regressed. There was no evidence of recurrence at 12 months after radiation therapy.
Adenocarcinoma* ; Humans ; Meibomian Glands* ; Orbit* ; Recurrence

Limb-Body Wall complex is a complicated with the essential features of neural-tube defects, body-wall disruption, and limb abnormalities. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall is uniformly poor. We have experienced one case of limb-body wall complex in a 22-year-old primigravida, which is presented with a brief review of the literature.
Extremities ; Gastroschisis ; Hernia, Umbilical ; Humans ; Prognosis ; Young Adult

Congenital nystagmus is an involuntary, rhythmic oscillation of the eyes noted during the first months of life. The nystagmus may diminish in a particular pasition of gaze referred to as the null point or neutral zone. If the null point is located in the primary position, there is no need for a compensatory head posture, But, if a patient has an eccentric null point, torticollis occurs in which the head is rotated so that the eyes have a minimal nystagmus. This abnormal head posture can be very marked, cosmetically disturbing and disadvantageous both to the body posture and psyche. Attempts at surgical management were reported by Kestenbaum and Anderson in early 1950's. We obtained following results in 4 cases operated on utilizing similar procedures of Park's method and Dyer's principles of strabismus operations that recession of a medial rectus and lateral rectus muscle must not exceed 4.5mm - 5.5mm and 6.5mm - 7.5mm, respectively. One week after the operation, the head turn disappeared in 3 of 4 cases, and one revealed mild residual turn. Two months after the operation, 2 of 4 cases kept their head straight, and the other two showed a return of head turn in about one half amount of the preoperative condition.
Head ; Humans ; Nystagmus, Congenital* ; Posture ; Strabismus ; Torticollis

Congenital nystagmus is an involuntary, rhythmic oscillation of the eyes noted during the first months of life. The nystagmus may diminish in a particular position of gaze referred to as the null point or neutral zone. If the null point is located in the primary position, there is no need for a compensatory head posture. But, if a patient has an eccentric null point, torticollis occurs in which the head is rotated so that the eyes have a minimal nystagmus. This abnormal head posture can be very marked, cosmetically disturbing and disadvantageous both to the body posture and psyche. Attempts at surgical management were reported by Kestenbaum and Anderson in early 1950's. We obtained following results in 4 cases operated on utilizing similar procedures of Park's method and Dyer's principles of strabismus operations that recession of a medial rectus and lateral rectus muscle must not exceed 4.5mm-5.5mm and 6.5mm-7.5mm, respectively. One week after the operation, the head turn disappeared in 3 of 4 cases, and one revealed mild residual turn. Two months after the operation, 2 of 4 cases kept their head straight, and the other two showed a return of head turn in about one half amount of the preoperative condition.
Head ; Humans ; Nystagmus, Congenital* ; Posture ; Strabismus ; Torticollis

Congenital nystagmus is an involuntary, rhythmic oscillation of the eyes noted during the first months of life. The nystagmus may diminish in a particular position of gaze referred to as the null point or neutral zone. If the null point is located in the primary position, there is no need for a compensatory head posture. But, if a patient has an eccentric null point, torticollis occurs in which the head is rotated so that the eyes have a minimal nystagmus. This abnormal head posture can be very marked, cosmetically disturbing and disadvantageous both to the body posture and psyche. Attempts at surgical management were reported by Kestenbaum and Anderson in early 1950's. We obtained following results in 4 cases operated on utilizing similar procedures of Park's method and Dyer's principles of strabismus operations that recession of a medial rectus and lateral rectus muscle must not exceed 4.5mm-5.5mm and 6.5mm-7.5mm, respectively. One week after the operation, the head turn disappeared in 3 of 4 cases, and one revealed mild residual turn. Two months after the operation, 2 of 4 cases kept their head straight, and the other two showed a return of head turn in about one half amount of the preoperative condition.
Head ; Humans ; Nystagmus, Congenital* ; Posture ; Strabismus ; Torticollis

The uptake of glucose for metabolism and growth is essential to most animal cells and is mediated by glucose-transporter (GLUT) proteins. The aim of this study was to determine which class of glucose transporter molecules was responsible for uptake of glucose in the mouse early embryo and at which stage the corresponding genes were expressed. In addition, co-culture system with vero cell was used to investigate the effect of the system on GLUT expression. Two-cell stage embryos were collected from the superovulated ICR female and divided into 3 groups. As a control, embryos were cultured in 0.4% BSA-T6 medium which includes glucose. For the experimental groups, embryos were cultured in either co-culture system with vero cells or glucose-free 76 medium supplemented with 0.4% BSA and pyruvate as an energy substrate. 2-cell to blastocyst stage embryos in those groups were respectively collected into microtubes (50 embryos/tube). Total RNA was extracted and RT-PCR was performed. The products were analysed after staining ethidium bromide by 2% agarose gel electrophoresis. Blastocysts were collected from each group at 120hr after hCG injection. They were fixed in 2.5% glutaraldehyde, stained with hoechst, and mounted for observation. In control, GLUT1 was expressed from 4-cell to blastocyst. GLUT2 and GLUT3 were expressed in morula and blastocyst. GLUT4 was expressed in all stages. When embryos were cultured in glucose-free medium, no significant difference was shown in the expression of GLUTI1, 2 and 3, compared to control. However GLUT4 was not expressed until morular stage. When embryos were co-cultured with vero cell, there was no significant difference in the expression of GLUT1, 2, 3 and 4 compared to control. To determine cell growth of embryos, the average cell number of blastocyst was counted. The cell number of co-culture (93.8+/-3.1, n=35) is significantly higher than that of control and glucose-free group (76.6 +/- 3.8, n=35 and 68.2+/-4.3, n=30). This study shows that the GLUT genes are expressed differently according to embryo stage. GLUTs were detectable throughout mouse preimplantation development in control and co-culture groups. However, GLUT4 was not detected from 2- to 8-cell stage but detected from morula stage in glucose-free medium, suggested that GLUT genes are expressed autocrinally in the embryo regardless of the presence of glucose as an energy substrate. In addition, co-culture system can increase the cell count of blastocyst but not improve the expression of GLUT. In conclusion, expression of GLUT is dependent on embryo stage in preimplantation embryo development.
Animals ; Blastocyst ; Cell Count ; Coculture Techniques ; Electrophoresis, Agar Gel ; Embryonic Development ; Embryonic Structures* ; Ethidium ; Female ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Glutaral ; Humans ; Metabolism ; Mice* ; Morula ; Pregnancy ; Pyruvic Acid ; RNA ; Vero Cells

No abstract available.
Cartilage*

The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T on seizure duration. The results were follows ' 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine 0.0093mg kg(-1), pentothal 2.76mg kg(-1) or propofol 1.42mg kg(-1). 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal(35.7 sec)(p<0.001). This suggest the possibility that additional treatment may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.
Atropine ; Bipolar Disorder ; Delusions ; Depressive Disorder, Major ; Dihydroergotamine ; Electroconvulsive Therapy ; Humans ; Inpatients ; Propofol* ; Schizophrenia ; Seizures* ; Thiopental*