No abstract available.

No abstract available.
Pregnancy*

No abstract available.
Acute Kidney Injury* ; Cardiopulmonary Bypass* ; Renal Replacement Therapy*

No abstract available.
Perfusion* ; Transplants*

No abstract available.
Mitral Valve* ; Quinidine*

PURPOSE: To evaluate the characteristics of the bronchiectasis in diffuse panbronchiolitis using HRCT. MATERIALS AND METHODS: We retrospectively studied 12 HRCT scans and two bronchography of 12 patients with diffuse panbronchiolitis(DPB). According to Akira et al., DPB was classified into four types: small nodules around the end of bronchovascular branchings(CT type I), small nodules in the centrilobular area connected with small branching linear opacities(CT type II), nodules accompanied by ring-shaped or small ductal opacities connected to proximal bronchovascular bundles(CT type III), large cystic opacities accompanied by dilated proximal bronchi(CT type IV). We compared the type and the extent of bronchiectasis, CTtypes of DPB, and pulmonary function test. RESULTS: Bronchiectasis was defined in 12 cases with the tubular type predominantly involving small and medium-sized bronchi. These bronchiectasis involved the proximal bronchi of the centrilobular lesions of DPB. Among eight cases of advanced DPB(CT type III & IV) which extended to both upper lobes, seven showed tubular bronchiectasis at the same area. Cystic bronchiectasis was shown in eight cases predominantly involving right middle lobe(n=7). There was no linear correlation between the values of pulmonary function test and CTtypes of DPB. CONCLUSION: Characteristic feature of the bronchiectasis in DPB is the tubular ectasis predominantly involving the small and medium-sized bronchi. DPB with associated tubular bronchiectasis can involve whole lung field in advanced cases. HRCT is useful not only to depict the findings of DPB but also to demonstrate the extent of lesion.
Bronchi ; Bronchiectasis* ; Bronchography ; Humans ; Lung ; Respiratory Function Tests ; Retrospective Studies

No abstract available.
Heart, Artificial*

Epidural anesthesia is widely practiced for lower abdominal operation and delivery in many hospital and its complication in minimal compared with spinal anesthesia. Lidocaine has been used extensively for epidural anesthesia with very satisfactory results. It has a very rapid onset of action, producing complete analgesia and has a reasonable duration of action(about 1-1(1/2)hr). A concentration of 1. 5% lidocaine causes effective sensory and autonomic blockade but it is unlikely to produce motor paralysis. More recently, bupivacaine(0.5%) has tended to supplement lidocaine as the drug of choice of epidural anesthesia. Firstly, the duration of action is longer. Secondly, it has better affinity for the tissue so that less will be absorbed into the circulation, thus reducing the risk of a toxic reaction. Thirdly, when used with a continuous technique, there is much chance of tachyphylaxis. Using a standardized anesthesia technic, we compared level of sensory anesthesia with a 0. 5% bupivacaine and 1. 5% lidocaine under elective and emergency surgery. When equal volume of local anesthetic solution were injected(20 ml of 0.5% bupivacaine and l. 5% lidocaine) there were no statistically significant differences in sensory level in bupivacaine and lidocaine, but the duration of anesthesia in bupivacaine from 2 to 3 times longer than lidocaine.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Bupivacaine ; Emergencies ; Lidocaine ; Paralysis ; Tachyphylaxis

In the era of coronary artery bypass grafting, the intraaortic balloon pump(IABP) is more widely used and its indication has been expanded. We performed retrospective clinical analysis on the patients who have received IABP pre and/or postoperatively during the course of CABG. From January 1981 to June 1995, total 322 patients have received CABG at the Seoul National University Hospital and among them 50 patients(15.5%) were supported by IABP during the course of the operation. The mean age at the time of the operation was 57.2 years(39-75 years) and the male to female ratio was 33:17. The preoperative diagnosis was unstable angina in 33(66%), stable angina in 7(14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13 cases(26%) with left main disease, 13(26%) with class IV angina, 12(24%) with difficulty in CPB weaning, 6(12%) with postinfarct angina and 3(6%) with severe LV dysfunction. In the remaining 3 cases, one patient was operated on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low cardiac output syndrome. All IABPs were introduced via femoral artery and among them 45 cases(90%) percutaneously. The mean postoperative assist time was 22.3 hours(0.5-168 hours) and IABP could be removed within 48 hours in most of them(44/50). The operative mortality was 6.1%(3 cases) and postoperative morbidity was only one with lower extremity ischemia. The more general application of the IABP during the course of the CABG ,especially in patients with high preoperative risk factors or difficulty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.
Angina, Stable ; Angina, Unstable ; Cardiac Output, Low ; Coronary Artery Bypass* ; Coronary Vessels* ; Diagnosis ; Emergencies ; Female ; Femoral Artery ; Humans ; Intra-Aortic Balloon Pumping ; Ischemia ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Risk Factors ; Seoul ; Weaning

This investigation was carried out in healthy twenty-four pregnant women undergoing elective Caesarean section and twelve nonpregnant women of the same age group, The premedication was performed with glycopyrroiate 0.2 mg and hydroxyzine l mg/kg IM respectively in the nonpregnant women, and glycopyrrolate 0.2 mg IM only in the pregnant women. Anesthesia was induced with IV pentothal sodium(4-5 mg/kg), vecuronium(0.08 mg/ kg) and ketamine(0.2 mg/kg) in the nonpregnant(Group I, N =12) or pregnant women(Group II, N=12), and pentothal sodium(4-Smg/kg), vecuronium(reducing dose of 20% from 0.08mg/kg) and ketamine(0.2 mg/kg) in the pregnant women(Group III, N=12). Anesthesia was maintained with 1-2% enflurane, 50% N2O, and O2. The ulnar nerve was stimulated supramaximally at the wrist with train-of-four stimuli every 20 sec. with ABM(Datex Co.) and the electromyographic response of the adductor pollicis muscle was measured. The onset of 50% block of first twitch height(T1) was faster in the group II(1.33+/-0.3min) than in the group I(1.9+/-0.6 min) and group III(1.6+/-0.3 min)(p<0.05). Also, the onset of 95% block of T 1 was faster in the group II(2.5+/-0.5 min) and III(1.6+/-0.3 min) than in the group I(3.8+/-0.9min)(p<0,05). The time of recovery of Tl to 10%, 25% and 50% of control were longer in the group II(34.9+/-5.3, 43.1+/-7.2 and 53.3+/-9.1 min respectively) and III(22.3+/-3.2, 29.5+/-4.5, 38.8+/-8.3 min respectively) than in the group I(21.1+/-4.8, 25.6+/-4.8 and 32.6+/-6.3 min respectively)(p<0.05). The conditions of intubation at 50% block of Tl were adequate in the group I and II but poor in the group III(p<0.05). Apgar score at 1 and 5 minutes after delivery were not significantly different between group II and III. Conclusively, administration of vecuronium dose on body weight basis in the pregnant women resulted in a more rapid onset and prolonged recovery of neuromuscular block than in the nonpregnant women without any adverse effects. Moreover, the conditions of intubation was poor when the dose of vecuronium was reduced by 20% in the pregnant women, Therefore, it is inadequate to reduce the dose of vecuronium concerning about relative overdose in the pregnant women undergoing Caesarean section.
Anesthesia ; Apgar Score ; Body Weight ; Cesarean Section ; Enflurane ; Female ; Glycopyrrolate ; Humans ; Hydroxyzine ; Intubation ; Neuromuscular Blockade* ; Pregnancy ; Pregnant Women ; Premedication ; Thiopental ; Ulnar Nerve ; Vecuronium Bromide* ; Wrist