No abstract available.
Anesthesia, General* ; Humans ; Laryngeal Masks* ; Pierre Robin Syndrome*

It is well established that mast cell proliferation and maturation are regulated by two principle cytokines, IL-3 and the c-kit ligand stem cell factor (SCF). Previous reports have demonstrated that bone marrow-derived IL-3-dependent mast cells exhibit the characteristic apoptosis on removal of IL-3. To know how the number of mast cells is controlled, we observed the effects of nitric oxide (NO) on the murine bone marrow-derived cultured mast cells (BMCMC). Apoptosis was measured by the analysis of flow cytometric data and electrophoretic evidence of DNA fragmentation. Our data showed that sodiurn nitroprusside (SNP)-a NO releasing substance- induced apoptosis in BMCMC. Cell cycle analysis showed that the number of the G,/G, and S phase decreased markedly, while the percentage of cell in G,/M phase was increased. Also, SNP alone induced cell death, whereas SNP in combination with SCF markedly decreased cell death of BMCMC. SNP-induced apoptosis was partially inhibited by the treatment of BMCMC with SCF. Our results suggest that NO might have sorne role in the regulation of the number of mast cells.
Apoptosis ; Bone Marrow* ; Cell Cycle ; Cell Death ; Cytokines ; DNA Fragmentation ; Interleukin-3 ; Mast Cells* ; Nitric Oxide* ; Nitroprusside ; S Phase ; Stem Cell Factor

In order to investigate the effects of methoxyflurane on reneal functions, small dose of methoxyflurane was administered intravenously ot rabbits without anesthesia, or directly injected into the renal artery of the rabbits under urethane anesthesia and the following results were obtained. 1) 5ml/kg of 0.5% saturated solution of methoxyflurane administered intravenously over 10 minutes did not influence the excretion of urine, creatinine, elecrolyte or osmolarity. 2) 1ml/kg of the solution injected directly into the renal artery over 10 minutes markedly reduced urine volume. 3) Reduced urine volume was closely related to decreased renal blood flow by direct administeration of methoxyflurane into the renal artery. 4) From the above results, it is suggested that methoxyflurane has a direct effect on renal functions by hemodynamic change in the renal circulation.
Anesthesia ; Creatinine ; Hemodynamics ; Methoxyflurane* ; Osmolar Concentration ; Rabbits* ; Renal Artery ; Renal Circulation ; Urethane

This 17 year-old male patient had an experience of a difficult intubation problem on miniplate removal operation after orthognathic surgery, but he didn't have the same problem on a previous orthognathic surgery 1 year before. He suffers from mental retardation and speaking disability due to congenital brain damage. I think difficult exposure of the larynx was caused by the imbalance of neck muscle force and jaw instability, as result from surgery. The preoperative airway evaluation is very important because findings may dictate choice of intubation technique. A flexible fiberoptic laryngoscope may be the most useful aid to awake intubation in the patient with a known difficult airway.
Adolescent ; Brain ; Humans ; Intellectual Disability ; Intubation* ; Jaw ; Laryngoscopes ; Larynx ; Male ; Neck Muscles ; Orthognathic Surgery

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*

PURPOSE: Pathologic tumor volume is closely related with pathologic stage, pathologic Gleason grade, surgical margin status, and disease progression after radical prostatectomy. Therefore, an accurate assessment of prostate cancer volume is essential in prediction of pathologic stage. We evaluated that the calculated prostate cancer volume (cVca), a new clinical parameter, can predict for pathologic stage T3 in patients with clinical stage T1, 2 prostate cancer. MATERIALS AND METHODS: The cVca was determined in 26 men treated with radical prostatectomy in clinically localized prostate cancer (clinical stage T1, T2) based on pretreatment PSA, biopsy Gleason score, and prostate ultrasound volume. Logistic regression analysis evaluating the value of the PSA, biopsy Gleason score, cVca was performed. RESULTS: The mean of cVca was 4.07cm3 and the mean of cVca in localized and extensive prostate cancer was 1.77cm3 and 6.74cm3, respectively. The difference between the mean of cVca in localized and extensive prostate cancer was statistically significant (p<0.05). PSA and cVca were significant predictors of pathologic stage T3 disease in patients with clinical stage T1, T2 disease on univariate analysis, but cVca was only significant predictor on multivariate analysis. CONCLUSIONS: The cVca was more reliable parameter than PSA and Gleason score in predicting of pathologic stage T3 disease in patients with clinical stage T1 and T2 prostate cancer. Therefore, this new parameter can be used to select patients who are likely to have pathologic organ-confined disease.
Biopsy ; Disease Progression ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Neoplasm Grading ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Tumor Burden ; Ultrasonography

BACKGROUND: The worst problem in anesthetic management of maxillofacial surgery is bleeding from bone cutting site. Induced hypotension reduces bleeding and minimizes the need for blood transfusion. This study was performed to evaluate the effects of induced hypotension with labetalol on blood loss and blood pressure in maxillofacial surgical patients. METHODS: Twenty-four adult patients, either sex, ASA physical status I or II, undergoing orthognathic surgery were randomly selected and divided into two groups; one group was administered 20 mg of labetalol and the other group was not. Anesthetic maintenance was consisted of O2-N2O-enflurane (2~2.5 vol%). Then 20 mg of labetalol was given intravenously at skin incision time in the labetalol group. Hemodynamic variables were recorded before induction of anesthesia, at the beginning of the labetalol infusion and at 10 min, 20 min, 30 min, 60 min and 90 min after the infusion. Blood loss determined by measuring the weight of the sponges and by measuring the volume of blood in suction-trap bottle. RESULTS: There was no significant difference in preoperative hemoglobin and postoperative hemoglobin between two groups. The amount of blood loss in the labetalol group (408 +/- 202 ml) was less than those in the control group (450 +/- 255 ml), but statistically not significant. The blood pressure was significantly decreased in the labetalol group than those of the control group at 20 minutes after the labetalol infusion. CONCLUSIONS: Labetalol is a useful agent for inducing hypotension. But 20 mg of labetalol was insufficient to decrease the blood loss. So I think the more amount of labetalol required to reduce the blood loss.
Adult ; Anesthesia ; Blood Pressure* ; Blood Transfusion ; Hemodynamics ; Hemorrhage ; Humans ; Hypotension* ; Labetalol* ; Orthognathic Surgery ; Porifera ; Skin ; Surgery, Oral

BACKGROUND: The Flexiblade laryngoscope has a unique structure that is composed of a blade and a handle with a trigger. When the trigger of the Flexiblade laryngoscope is squeezed, the hyoepiglottic ligament is depressed, the epiglottis is moved anteriorly, and then the laryngoscopic grade is improved. This study was designed to compare the Flexiblade laryngoscope with the conventional Macintosh blade laryngoscope in the laryngoscopic view in endotracheal intubation. METHODS: Following induction of general anesthesia, the laryngoscopic grades of 110 patients were evaluated while five different blade positions of the Flexiblade laryngoscope and a laryngoscopy with the Macintosh blade were performed. The laryngoscopic grades which were described by Cormack and Lehane were classified from 1 to 4. RESULTS: With the Macintosh blade laryngoscope, 98.2% of the patients were grade one and two, and 98.2% of the patients was laryngoscopic grade one and two with partial depression of the trigger of the Flexiblade laryngoscope. The laryngoscopic grade of maximal depression of the Flexiblade trigger had similar results to partial depression of the trigger. However, the partial depression of the Flexiblade laryngoscope showed better laryngoscopic views than the maximal depression of the Flexiblade laryngoscope or the Macintosh blade laryngoscope, respectively. In the overall success rate of endotracheal intubation and using the adjusting maneuvers, the Flexiblade laryngoscope was superior to the Macintosh blade laryngoscope. CONCLUSIONS: The Flexiblade laryngoscope is comparable to the Macintosh blade laryngoscope for endotracheal intubation, therefore, the Flexiblade laryngoscope can be recommended as the first choice for endotracheal intubation.
Anesthesia, General ; Depression ; Epiglottis ; Humans ; Intubation, Intratracheal* ; Laryngoscopes* ; Laryngoscopy ; Ligaments

BACKGROUND: The laryngeal mask airway (LMA) has an established role in difficult airway management as a ventilatory device and airway intubator. It is ease to view the laryngeal aperature with a fiberscope through a laryngeal mask airway, so it offers a route to obtaining rapid access to the larynx. The objective of this study was to evaluate a narrowing degree of LMA by the epiglottis and to compare the intubation time and success rate of the blind intubation techinique with the fiberscope-guided intubation techinique through the laryngeal mask airway. METHODS: The LMA (#4) was placed into the hypopharynx after induction of anesthesia and muscle paralysis. The fiberscopic findings through the lumen of the LMA were recorded after the LMA placements. The degree of narrowing of the LMA by the epiglottis was estimated as 0%, 1 25%, 26 50%, 51 75%, or 76 100%. The breathing circuit of the anesthesia circle system was then disconnected from the LMA and a well-lubricated, cuffed, 5.5 mm ID endotracheal tube was inserted into the trachea through the lumen of the LMA either by the blind techiniques or fiberscope-guided techniques, and then intubation time and success rate were measured. RESULTS: The most frequent incidence (44/60, 73.3%) of narrowing by epiglottis in both groups was 76 100%. The success rate for fiberscope-guided intubation was 100%, while the success rate for blind intubation was 20%. The average intubation time of fiberscope-guided intubation was 26.0 s, while the average intubation time of blind intubation was 17.7 s. CONCLUSIONS: The fiberscope-guided tracheal intubation technique through the LMA is a more reliable method than the blind intubation technique through the LMA.
Airway Management ; Anesthesia ; Epiglottis ; Hypopharynx ; Incidence ; Intubation* ; Laryngeal Masks* ; Larynx ; Paralysis ; Respiration ; Trachea

BACKGROUND: The laryngeal mask airway (LMA) has an established role in difficult airway management as a ventilatory device and airway intubator. It is ease to view the laryngeal aperature with a fiberscope through a laryngeal mask airway, so it offers a route to obtaining rapid access to the larynx. The objective of this study was to evaluate a narrowing degree of LMA by the epiglottis and to compare the intubation time and success rate of the blind intubation techinique with the fiberscope-guided intubation techinique through the laryngeal mask airway. METHODS: The LMA (#4) was placed into the hypopharynx after induction of anesthesia and muscle paralysis. The fiberscopic findings through the lumen of the LMA were recorded after the LMA placements. The degree of narrowing of the LMA by the epiglottis was estimated as 0%, 1 25%, 26 50%, 51 75%, or 76 100%. The breathing circuit of the anesthesia circle system was then disconnected from the LMA and a well-lubricated, cuffed, 5.5 mm ID endotracheal tube was inserted into the trachea through the lumen of the LMA either by the blind techiniques or fiberscope-guided techniques, and then intubation time and success rate were measured. RESULTS: The most frequent incidence (44/60, 73.3%) of narrowing by epiglottis in both groups was 76 100%. The success rate for fiberscope-guided intubation was 100%, while the success rate for blind intubation was 20%. The average intubation time of fiberscope-guided intubation was 26.0 s, while the average intubation time of blind intubation was 17.7 s. CONCLUSIONS: The fiberscope-guided tracheal intubation technique through the LMA is a more reliable method than the blind intubation technique through the LMA.
Airway Management ; Anesthesia ; Epiglottis ; Hypopharynx ; Incidence ; Intubation* ; Laryngeal Masks* ; Larynx ; Paralysis ; Respiration ; Trachea