Successful block of the celiac plexus denervates the denervatives of the foregut and therefore can successfully interrupt nociceptive stimuli from the pancreas, stomach, liver, etc. Although permanent neurolytic block is much less successful for malignant chronic pancreatitis syndrome, it is specifically useful for treatment of intractable pain that often accompanies carcinoma of the pancreas or other upper abdominal visceral tumors. This was a case report in which intractable pain due to malignant gastric cancer was successfuly controlled by the permanent neurolytic celiac plexus block.
Celiac Plexus ; Liver ; Pain, Intractable ; Pancreas ; Pancreatitis, Chronic ; Stomach ; Stomach Neoplasms*

Many studies have shown that epidural narcotics produce prolonged analgesic action. We instillated 2mg of morphine on the dura just before wound closure which was exposed for lumbar laminectomy. Sixty patients scheduled for laminectomy were devided into two groups i.e., morphine group (30 patients) and control group(30 patients). The results of this study were as follows: 1) In morphine group, 17 patients (56.6%) tolerated the postoperative pain without narcotic injection for over 20 hours, but 13 patients(43.3%) of the control group required narcotic injection within 5 hours. 2) Severe respiratory depression was noted in two cases from the morphine group. 3) It is a very simple and effective method for postoperative pain control.
Humans ; Laminectomy ; Morphine* ; Narcotics ; Pain, Postoperative* ; Respiratory Insufficiency ; Wounds and Injuries

Of the 11 advanced bladder cancer patients who received M-VAC (Methotrexate, Vinblastine, Doxorubicin and Cisplatin) combination chemotherapy, complete and partial remission were observed in 63.6%. Of the 17 advanced bladder cancer patients who received MAC (Methotrexate, Doxorubicin and Cisplatin) combination chemotherapy, complete and partial remissions were observed in 17%. Complete remission was achieved in 18.2% of the patients clinically, pathologically in M-VAC group and 5.9% in MAC group. Partial remission was occurred in 46.5% of the patients in M-VAC group and 41.2% in MAC group. All metastatic sites including the bone and liver, lung were well responded in M-VAC group, but poorly responded in MAC group. Toxicity was significant but tolerable.
Doxorubicin ; Drug Therapy, Combination* ; Humans ; Liver ; Lung ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine

The insertion of a levine tube in the anesthetized or comatose patients who is intubated, is often difficult. Various methods used to facilitate the procedure have been reported, but none of them are completely reliable. So we are going to describe our method which showed satisfactory results. insertion of well lubricated suction catheter into the oral cavity is made iva the nose and followed by the orossophageal insertion of a Magill tube without cuff under direct laryngoscopy. At the same time, pulling out the suction catheter from the oral cavity is made by using Magill forceps under direct vision. The distal tip of the levine tube is then threaded into the guide Magill tube and advanced into the stomach. After identification of the presence of the tip of levine tube in the stomach by palpation by the surgeon or the aspiration of gastirc contents, the guide Magill tube is withdrawn from the esophagus. Next, connection between the proximal end of Levine tube and the distal tip of the suction catheter is mad and pulled out through the nose by pulling the suction catheter. The levine tube is made held by adhesive tape.
Adhesives ; Anesthesia* ; Catheters ; Coma ; Esophagus ; Humans ; Laryngoscopy ; Mouth ; Nose ; Palpation ; Stomach ; Suction ; Surgical Instruments

No abstract available.
Female ; *Health Status Disparities ; Humans ; Male ; Obesity/*epidemiology

OBJECTIVE: The objective of this study was to provide guidelines for the diagnosis and successful treatment of orthodontic treatment with upper premolar extraction only. METHODS: The sample group consisted of 40 patients (20 with upper premolar extraction only, 20 with both upper and lower premolar extractions) who showed an overjet of more than 7 mm and were finished successfully. Lateral cephalographs were taken before and after orthodontic treatment. Landmarks showing the position of the upper and lower incisors and the position of the upper and lower lip were determined and angular measurement of these values were obtained for statistical analysis (Mann-Whitney test). RESULTS: At pre-treatment, the position of the lower incisor was less labially inclined and the convexity of the lower lip was smaller in the upper premolar extraction only group than in the upper/lower premolar extraction group. At post-treatment, there was no difference in all measurements except for the position of the lower incisor. A comparison of changes between pre- and post-treatment showed that the retraction of upper & lower incisors and the decrease in convexity of the lower lip were greater in the upper/lower premolar extraction group. CONCLUSIONS: Treatment by upper premolar extraction can be of benefit for patients whose lower incisor proclination and lower lip protrusion are not excessive.
Bicuspid* ; Diagnosis ; Humans ; Incisor ; Lip

The current recommendations for the treatment of obese people include increased physical activity and reduced calories intake. When the behavioral approach is not sufficient, a pharmacologic treatment is recommended. In past years, numerous drugs have been approved for the treatment of obesity; however, most of them have been withdrawn from the market because of their adverse effects. In fact, amphetamine, rimonabant and sibutramine licenses have been withdrawn due to an increased risk of psychiatric disorders and non-fatal myocardial infarction or stroke. Even if orlistat is not as effective as other drugs in reducing body weight, orlistat is presently the only available choice for the treatment of obesity because of its safety for cardiovascular events and positive effects on diabetic control. Hopefully, more effective and better tolerated anti-obesity drugs will be developed through an improved understanding of the multiple mechanisms and complex physiological systems targeting appetite.
Amphetamine ; Anti-Obesity Agents ; Appetite ; Body Weight ; Cyclobutanes ; Lactones ; Licensure ; Motor Activity ; Myocardial Infarction ; Obesity ; Piperidines ; Pyrazoles ; Stroke

This study was performed to establish Korean soft tissue cephalometric norms, to compare the norms between sexes and between races, and then to suggest a guideline to execute orthodontic diagnosis and treatment planning for dentofacial deformities in Korean. Young Korean adults were selected. They were 27 males (23.8 2.6-year-old) and 20 females (22.5 1.7-year-old) who had harmonious facial balance. After taking lateral cephalograms under the natural head position which is widely known as a highly reliable and reproducible reference position, films were traced and analysing factors were measured as introduced by Arnett et al. Comparisons were done between male and female groups and between Korean and Caucasian groups using unpaired t-test. From the results it was concluded that Korean male had generally thicker lower facial soft tissue and smaller nasolabial angle, longer facial height, deeper facial depth, and more protrusive lower face than Korean female. From the comparison with Caucasian norms adopted from the research of Arnett et al., both Korean male and female showed longer facial lengths generally except less exposed maxillary incisor, and shorter facial depth than Caucasian counterparts. Also, both races showed similar horizontal position of maxillary structures from TVL (true vertical line), but there were more significant anteroposterior differences of maxilla-mandible in Korean groups. These results mean Korean had relatively more retruded mandibular structures from the reference line, TVL. Individuals who had harmonious facial balance showed similar facial angle, more or less 170 degree, regardless of sexes or races.
Adult ; Continental Population Groups ; Dentofacial Deformities ; Diagnosis ; Female ; Head ; Humans ; Incisor ; Male ; Young Adult*

OBJECTIVES: The MVV reflects subjective dyspnea, exercise capacity, postoperative complication. But, the MVV embodies certain disadvantages and is dependent on coordination, endurance and motivation. A timed vital capacity for calculation of an indirect maximal voluntary ventilation is used. We evaluated differences in prediction formulas for the MUV according to the status of ventilatory function. METHODS: Forty-seven normal subjects, 68 patients with obstructive ventilatory impairment, and 23 patients with restrictive ventilatory impairment were studied. The relationships between the MVV and Flow or time parameters in forced expiratory volume and flow volume curves were compared among normal subjects and patients with obstructive or restrictive ventilatory impairment. RESULTS: 1) High correlation coefficients(R>or=0.87) were found between the FEV0.5, 0.75, 1 and the MVV in 47 normal subjects and 91 patients with ventilatory impairment. 2) The MVV can be conveniently estimated from the FEV1 values. The following regression formulas for the prediction of the MVV were obtained. Normal: MVV=44.01 X FEV1-21.09(r(2)=0.771, SEE=11.085) Obstructive ventilatory impairment: MVV=38.34 X FEV1-4.58(r(2)0.812, SEE=4.816) Restrictive ventilatory impairment: MVV=45.20 X FEV1-3.80(r(2)=0.899, SEE=6.929). 3) There were significant differences in prediction formulas for the MVV obtained by FEV1 between each group (P<0.05). CONCLUSION: These results suggest that different prediction formulas for the MVV, by multiplying the FEV1 by a constant, are respectively required in normal subjects and patients with obstructive or restrictive ventilatory impairment.
Dyspnea ; Forced Expiratory Volume ; Humans ; Maximal Voluntary Ventilation ; Motivation ; Postoperative Complications

Takayasu's arteritis is a chronic and occlusive inflammatory disease of uncertain etiology affecting medium to large sized arteries. We anesthetized a patient who had Takayasu's arteritis affecting both common carotid arteries, the left anterior descending coronary artery, and the left subclavian artery. During beating heart coronary artery bypass graft and aorto-carotid bypass graft we chose a cervical epidural block combined with light general anesthesia as an anesthetic technique. We managed the patient successfully with consistant hemodynamic stability. The operation was done without cardiopulmonary bypass and the patient was returned to consciousness immediately after the end of the operation. We extubated the endotracheal tube in the operating room without pain. The patient maintained hemodynamic stability in the intensive care unit and we controlled the pain via a cervical epidural catheter with morphine and 0.1% bupivacaine.
Anesthesia, General* ; Arteries ; Bupivacaine ; Cardiopulmonary Bypass ; Carotid Artery, Common ; Catheters ; Consciousness ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Hemodynamics ; Humans ; Intensive Care Units ; Morphine ; Operating Rooms ; Subclavian Artery ; Takayasu Arteritis* ; Transplants