No abstract available.
Humans ; Intensive Care Units* ; Critical Care* ; Poisoning*

BACKGROUND: The dose-responses of neuromuscular blocking agents may be influenced by many factors including age and inhalation anesthetics. This study was designed to determine the dose-response relationships of a new, short-acting muscle relaxant, mivacurium during nitrous oxide-halothane or nitrous oxide-enflurane anesthesia in two age groups, infants and 1 to 6 years old preschool children. METHODS: Neuromuscular blockade was monitored by recording the accelerographic activity of the adductor pollicis muscle resulting from supramaximal stimulation at the ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. To estimate dose-response relationships, 24 infants or children of two anesthetic subgroups for each age group received single bolus doses of 45~100 g/kg of mivacurium. The ED50 and ED95 were estimated from linear regression plots of log-dose vs probit of twitch depression. The lag time, onset time and maximal depression of twitch height for the selective medium dose were mesured. RESULTS: The ED50 and ED95 for the infants group were 38.2 and 53.3 g/kg during halothane anesthesia, and 29.8 and 48.6 g/kg during enflurane anesthesia, respectively. And, those for preschool children group were 49.4 and 90.7 g/kg during halothane anesthesia, and 32.3 and 81.4 g/kg during enflurane anesthesia, respectively. There was a parallelism of the dose-response curve between halothane and enflurane anesthesia in either age group. Also, there was statistically significant difference in the maximal twitch depression for the selective medium dose of mivacurium between halothane and enflurane anesthesia in either group. CONCLUSIONS: The potency of mivacurium during enflurane anesthesia is higher than that during halothane anesthesia in infants and preschool children, and during either inhalation anesthesia the dose of mivacurium is less required in infants than preschool children.
Anesthesia* ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; Child ; Child, Preschool* ; Depression ; Enflurane* ; Halothane* ; Humans ; Infant* ; Linear Models ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Ulnar Nerve

No Abstract Available.
Posterior Cruciate Ligament*

Acute renal failure was induced to investigate it effects on the neuromuscular blocking actions and reversals of metocurine in 14 adult cats, either sex, weighing 2.5-4.5 kg. Ligation of both renal pedicles in 6 cats (Group II) and its sham operations in 8 cats (Group I) were done under the pentobarbital anesthesia. Neuromuscular monitoring was done using a common peroneal nerve-tibialis anterior muscle preparation. The mean blood pressures, acid-base status and serum electrolytes at the time of injection of metocurine or neostigmine were not significantly different between two groups. The heart rates at the administration of neostigmine were significantly decreased probably due to the decreased body temperatures in group I. The onset time of metocurine with 3 X ED95 in acute renal failure was simiiar to that in normal renal function. However, the duration of metocurine with 3 X ED95 in acute renal failure was significantly longer that that in normal renal function. The effeets of neostigmine administered at 15%-spontaneous twitch recovery for the recovery indices and antagonism effects were not significantly different between two groups. In conclusion, acute renal failure prolongs the duration of metocurine, but not interfere its onset. Additionally, there is no effect on the reversal actions of neostigmine if administered at the spontaneous recovery of twitch height more than 15%.
Acute Kidney Injury* ; Adult ; Anesthesia ; Animals ; Body Temperature ; Cats* ; Electrolytes ; Heart Rate ; Humans ; Ligation ; Neostigmine ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Pentobarbital

The gastric adenoma, which is also called as borderline epithelial lesion, dysplasia, atypical epithelial lesion, is occasionally encoutered during gastroscopy, but the natural history of a gastric adenoma has not been clarified in view of the pre-melignant potential. In Korea, there has been few report for its gastroscopic feature, gastroscopic diagnostic accuracy, or loag-term clinical follow-up yet. (continue...)
Adenoma* ; Follow-Up Studies* ; Gastroscopy ; Korea ; Natural History

A case of leiomyoma of the urinary bladder is presented.
Leiomyoma* ; Urinary Bladder*

BACKGROUND: The speed of injection of local anesthetic solutions into the subarachnoid space may influence the spread of these agents in the cerebrospinal fluid by the amount of turbulence generated, especially with large volume. To determine the proper injection speed of anesthetics in hypobaric spinal anesthesia on jack-knife position, the anesthetic level and duration were measured with the fast or slow injection speed. METHODS: Twenty patients for perianal surgery in jack-knife position under hypobaric spinal anesthesia were randomly assigned to one of two groups. Tetracaine (0.1%) in distilled water 5 ml was administered to all the patients. Group I patients received the drug with the speed of injection as 5 ml/20 sec (15 ml/min) and the others (Group II) as 5 ml/4 min (1.25 ml/min). The mean arterial pressures and heart rates at the preanesthetic period, and 5, 10, 15 and 20 min after the end of injection were measured. The anesthetic levels at 5, 10, 15 and 20 min after the injection and anesthesia duration were measured. RESULTS: There was no significant difference in mean arterial pressures, heart rates and anesthetic duration between two groups. The anesthetic level 20 min after the injection was higher in Group I than Group II, and not different at the other time sequences. CONCLUSION: At the injection speed within 1.25-15 ml/min in hypobaric spinal anesthesia on jack-knife position at 15o head-down, we acquired appropriate anesthetic level and duration for perianal surgery without any undesirable effects.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Arterial Pressure ; Cerebrospinal Fluid ; Head-Down Tilt* ; Heart Rate ; Humans ; Subarachnoid Space ; Tetracaine* ; Water

BACKGROUND: Thoracoscopic sympathicotomy was, at first, thought to be a simple and safe method for treatment of hyperhydrosis. However, few studies refer to the cardiac effects of this procedure, despite the fact that the T2 ganglia are in the direct pathway of the sympathetic innervation of the heart. An imbalance of right and left sympathetic efferent activity has been proposed as a mechanism for arrhythmia in patients with long QT syndrome. The aim of this study was to compare hemodynamic effect as well as ECG changes after right and left side sympathicotomy. METHODS: 42 patients with essential hyperhydrosis in ASA physical status class 1 undergoing thoracoscopic sympathicotomy were randomly divided into two groups: left side first operation group (group L, n = 22) and right side first operation group (group R, n = 20). Anesthesia was induced with thiopental sodium (5 mg/kg) and pancuronium (0.05 mg/Kg) and maintained with enflurane. During the procedure, we recorded blood pressure at both forearms and heart rate and ECG were recorded after anesthetic induction as baseline values, immediately after one side resectioned of sympathetic trunk, and after complete resectioning of both side. All operations were done with usual methods by experienced surgeons. All the records were coded and analysed singl blind by one author. RESULTS: After sympathicotomy, there was a significant decrease in heart rate but not in blood pressure. However, statistically there were no significant changes in QT interval during sympathicotomy either right side first operation or left side first operation. CONCLUSIONS: The main result of this study was that there were no significant changes in QT interval during sympathicotomy of either right or left side first operations. However, This does not mean that there was no possibility of prolongation of QT interval during thoracoscopic sympathicotomy. Careful observation of QT interval changes is needed during sympathicotomy.
Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Electrocardiography ; Enflurane ; Forearm ; Ganglia ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Long QT Syndrome ; Pancuronium ; Thiopental

Gastric submucosal tumors are occasionally symptomatic (bleeding) but usually found incidentally at endoscopy. To evaluate comparisons of gastric endoscopy and upper gastrointestinal series in the submucosal tumor, we studied 50 patients which were diagnosed as submucosal tumor at SNUH from 1985 to 1988. The results were as follow: 1) Gastric submucosal tumors occupied 2.2% of the stomach cancer. (continue...)
Endoscopy* ; Humans ; Stomach Neoplasms

BACKGROUND: Chronic shoulder pain draws the attention of doctors since it is a very common and serious disease at primary care level. The patients with this pain usually have a tendency to see many doctors, to take an abundance of medication, and sometimes to even suffer from depression. The pain and the symp- toms thereof often disable the patients in their every day lives. This study aims to seek the most efficient way of treatment between two therapies, namely, the existing drug therapy based on NSAID and the intramuscular stimulation(herein after IMS) therapy, which has re- cently been introduced, by comparing them in accordance with the following method. METHODS: The two therapies were applied for 3 weeks to female patients aged between 50 and 70 who had visited a hospital over a period of more than 3 months due to this type of pain. The patients were randomly given each therapy although the treatment and monitoring was done by the same physiotherapist. The monitoring was performed four times, the day before the start of treatment, 1 week, 2 weeks and 3 weeks after respectively. It measured the following elements: (1) pain scale by VAS(Visual Analogue Scale), (2) Sleep hygiene scale by VAS, (3) ROM(Range of Motion), Repeated measure ANOVA was used for analysis. RESULTS: While both therapies reduced the pain significantly during the 3 weeks, the study showed that IMS was more effective than the drug therapy in every element monitored(p<0.05). IMS turned out to be more effective the 1st week in every measured element, however, the drug therapy was more effective the 3rd week if compared to the 2nd week in terms of Sleep VAS score. CONCLUSION: IMS is more effective in easing chro nic shoulder pain since it has better results than NSAID in pain VAS score, sleep VAS score and ROM.
Chronic Pain ; Depression ; Drug Therapy ; Female* ; Humans ; Hygiene ; Physical Therapists ; Primary Health Care ; Shoulder Pain* ; Shoulder*