No abstract available.
Fracture Fixation, Intramedullary*

PURPOSE: To analyze hemodynamic parameters of electrical bioimpedance on increased blood pressure induced by pneumoperitoneum and compare hemodynamic effects of propofol and isoflurane during laparoscopic cholecystectomy. METHODS: Systemic vascular resistance index(SVRI), index of contractility(IC), end diastolic index(EDI), mean arterial pressure(MAP) and heart rate(HR) were measured after anesthetic induction, 5, 10, 15 and 30 minutes after CO2 insufflation and after CO2 removal. RESULTS: In isoflurane group, MAP, IC, SVRI were increased but EDI was decreased after induction of pneumoperitoneum. In propofol group, MAP, SVRI were increased but IC was decreased after induction of pneumoperitoneum. HR was not changed during operartion. CONCLUSION: After induction of pneumoperitoneum, MAP is increased by increased IC and SVRI in isoflurane. In case of propofol, the MAP is increased by increased SVRI. It seems that increased transmural pressure of lymphatics and splanchnic vasculatures rather than sympathetic stimulation increases SVRI after pneumoperitoneum.
Blood Pressure* ; Cholecystectomy, Laparoscopic* ; Heart ; Hemodynamics* ; Insufflation ; Isoflurane ; Pneumoperitoneum* ; Propofol ; Vascular Resistance

INTRODUCTION: The purpose of positioning is to allow the procedure to be performed as simply as possible and to achieve the best possible results free of complications. In a normal person, many investigators have researched the hemodynamic changes during positional adjustments. But the delicate qualitative hemodynamic changes in various positions has not been recorded very much. So we studied the qualitative hemodynamic changes in various positions with a noninvasive bioimpedance method. METHOD: Healthy adult males were studied (n=25). The protocol was that the position changed from supine to head-up, head-down, lithotomy, sitting, right-lateral, prone and Jackknife (J-K) position. Each position was sustained for three minutes. The mean arterial pressure (MAP), heart rates (HR), left cardiac work index (LCWI), systemic vascular resistance index (SVRI), cardiac index (CI), stroke index (SI) and end diastolic index (EDI) were measured with the bioimpedance method and an automated blood pressure device. Result: The contractility of heart expressed by LCWI, CI and SI decreased in head-down, sitting, right-lateral, prone and J-K positions. The preload expressed by EDI decreased in right-lateral and J-K positions. The afterload expressed by SVRI increased in sitting, prone and J-K positions, and decreased in right-lateral position. CONCLUSIONS: These results may be used as reference for anesthesiologist managing many patients of various physical status.
Adult* ; Arterial Pressure ; Blood Pressure ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Male ; Research Personnel ; Stroke ; Vascular Resistance

BACKGROUND: This study was aimed to elucidate the effect of ketamine anesthesia on circulatory response to hemorrhage in rats by power spectral analysis of heart rate and blood pressure variability. METHODS: Nineteen male Sprague-Dawley rats weighing 290~475 g were divided into ketamine (100 mg/kg, im)-anesthetized(K, n=10) and conscious(C, n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3 ml/kg/min for 5 min. Arterial pressure was measured with a pressure transducer connected to the contralateral femoral artery for 5 min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of sytolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency(VLF, 0.02~0.26 Hz), low frequency (LF, 0.26~0.75 Hz) and high frequency(HF, 0.75~5.00 Hz) band were expressed as percent of total power. RESULTS: Before hemorrhage blood pressure was higher in K(152.4+/-3.7/99.9+/-4.9 mmHg) than in C(143.3+/-5.7/95.5+/-4.1 mmHg) rats, but was changed by hemorrhage in both groups. Before hemorrhage HR in K and C rats were 361.4+/-17.5 and 363.4+/-18.5 beats/min . HR were significantly increased to 403.2+/-20.3 and 396.2+/-18.9 beats/min during and after hemorrhage in K rats, and increased to 409.1+/-20.9 beats/min during hemorrhage in C rats. Before hemorrhage total powers of blood pressure and HR variability were higher in K than in C rats. During hemorrhage, total powers of blood pressure and heart rate variability tended to increase in both groups. Before hemorrhage, percent powers of systolic pressure variability of HF and VLF were higher in K than in C rats and LF was lower in K than in C rats. During hemorrhage, K group showed no significant changes but C group showed significant changes. Before hemorrhage, percent powers of diastolic pressure variability of VLF was higher in Kthan in C rats, and HF and LF were lower in K than in C rats. During and after hemorrhage, K group showed no significant changes, but C group showed significant decrease in LF and increase in VLF. Before hemorrhage, percent powers of heart rate variability of K rats showed higher HF and VLF, and lower LF than C rats. During and after hemorrhage HF and VLF of both groups showed no significant changes except significant increase in VLF after hemorrhage in C rats, but LF of both groups showed significant decrease. CONCLUSIONS: It was concluded that autonomic activity, especially cardiac sympathetic activity, was increased in response to hemorrhage in K rats. Ketamine anesthesia stimulated overall autonomic activity, especially sympathetic activity and vasomotor tone. In C rats hormonal factor contributed to blood pressure and heart rate variability during hemorrhage.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Ketamine ; Male ; Rats* ; Rats, Sprague-Dawley ; Transducers, Pressure

PURPOSE: The role of peritoneal washing cytology in determining further treatment strategies after surgery for gastric cancer remains unclear. One reason for this is the fact that optimal procedures to increase the accuracy of predicting peritoneal metastasis have not been established. The aim of this study was to evaluate the efficacy of cytology using samples harvested from two different abdominal cavity sites during gastric cancer surgery. MATERIALS AND METHODS: We prospectively recruited 108 patients who were clinically diagnosed with locally advanced gastric cancer (higher than cT1 stage disease). Peritoneal washing fluids were collected from the pouch of Douglas and the subphrenic area. Patients were prospectively followed up for 2 years to determine the recurrence and survival rates. RESULTS: Thirty-three patients dropped out of the study for various reasons, so 75 patients were included in the final analysis. Seven patients (9.3%) showed positive cytology findings, of whom, three showed peritoneal recurrence. Tumor size was the only factor associated with positive cytology findings (P=0.037). The accuracy and specificity of cytology for predicting peritoneal recurrence were 90.1% and 94.2%, respectively, whereas the sensitivity was 50.0%. The survival rate did not differ between patients with positive cytology findings and those with negative cytology findings (P=0.081). CONCLUSIONS: Peritoneal washing cytology using samples harvested from two different sites in the abdominal cavity was not able to predict peritoneal recurrence or survival in gastric cancer patients. Further studies will be required to determine whether peritoneal washing cytology during gastric cancer surgery is a meaningful procedure.
Abdominal Cavity ; Humans ; Neoplasm Metastasis ; Peritoneum ; Prospective Studies* ; Recurrence* ; Sensitivity and Specificity ; Stomach Neoplasms* ; Survival Rate

We report a case of 15-year-old man with beneficial effects of short term growth hormone treatment presenting with cardiomyopathy combined with neuromuscular dystrophy. Transthoracic echocardiography revealed that LV chamber was markedly dilated and global LV systolic function was severely reduced. The findings of electromyography were compatible with neuromuscular dystrophy. Under the impression of cardiomyopathy combined with neuromuscular disease, maximal medical treatments such as inotropic agents, diuretics and ACE inhibitor were tried but we could not attain remarkable clinical improvement. Finally, we started growth hormone injection and after treatment for 3 months, we could attain remarkable clinical and hemodynamic improvement without any side effect.
Adolescent ; Cardiomyopathies* ; Diuretics ; Echocardiography ; Electromyography ; Growth Hormone* ; Heart Failure* ; Heart* ; Hemodynamics ; Humans ; Neuromuscular Diseases

PURPOSE: To assess the MR findings of chondromalacia patella and correlate the grade and associated lesionswith the arthroscopic findings. MATERIALS AND METHODS: Twenty-five patients with pain in the anterior part of theknee underwent fat-suppressed axial and coronal T2-weighted, dual echo sagittal proton density-weighted andT2-weighted, and in some cases, T1-weighted and T2*-weighted imaging, using a 10-cm field of view, and a 5-inchgeneral purpose coil. We retrospectively assessed these find dings, and the locations, grades and associatedlesions, and correlated these with the arthroscopic findings. RESULTS: Fourteen cases(56%) of chondromalaciapatellae were arthroscopic grade I / II, nine(36%) were grade III, and two(8%) were grade IV; associated lesionswere medial synovial plicae (16 cases, 64%), meniscus tear (10 ; 40%), cruciate ligament injury (two ; 8%),complete or incomplete discoid meniscus (four ; 16%), bipartite patella (one ; 4%) and Osgood-Schlatter disease(one ; 4%). In 24 cases, MR imaging indicated chondromalacia patella ; 17 cases were grade I / II, five were gradeIII, and two were grade IV. the location of chondromalacia patella was the medial facet (five cases ; 20%), lateralfacet (three ; 12%), junction of the medial and odd facet (13 ; 52%), and diffuse involvement (four ; 16%). Thesensivity and specificity of MR imaging were 72% and 96% respectively. CONCLUSION: We evaluated the exact locationand grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopicfindings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of anappropriate surgical method and plan.
Cartilage Diseases* ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Patella* ; Protons ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVES: To investigate brain oscillatory characteristics according to brightness and color temperature of light emitting diode (LED) light in young and elderly subjects. METHODS: We analyzed 22 young (age, 29.0±5.2 years) and 23 elderly (age, 64.8±4.5 years) healthy subjects. A LED light source was used with a combination of two color temperature (6,500 K vs. 3,000 K) and two brightness (700 lx vs. 300 lx) conditions. Participants were exposed to each light condition in relaxed wakefulness. Then, we analyzed power spectral density and functional connectivity from eye-open electroencephalography. RESULTS: A main effect of brightness on delta (p=0.044) and theta (p=0.038) power was significant in the elderly subjects. Bright light enhanced delta and theta power in the frontal region. By contrast, power spectral density of young subjects was affected by color temperature; high color temperature significantly increased beta-band power of the central region (p=0.034). Regarding functional connectivity, a significant effect of color temperature was observed in delta (p=0.006) and beta (p=0.046) frequencies. High color temperature light enhanced beta connectivity of young subjects (p=0.007), while not affecting that of elderly subjects (p=0.979). CONCLUSIONS: The present study demonstrated that spectral power and functional connectivity as well as subjective feelings are affected by the brightness and color temperature of LED light. These results might help us to understand the neurophysiological effects of light and identify the optimal indoor lighting conditions for an individual's environment.
Aged ; Brain ; Electroencephalography ; Healthy Volunteers ; Humans ; Wakefulness

Endobronchial lipoma is a rare, benign neoplasm of the large bronchi, which makes up about 0.1 percent of all lung tumors. It can produce irreversible parenchymal lung damage or bronchiectasis if diagnosis and treatment are delayed. The treatment of endobronchial lipoma is early removal and surgical procedures depend on the status of distal parenchymal lung damage. We experienced a case of endobronchial lipoma in 53 year-old female patient, which caused total collapse of left lung and save left lung by enucleation of tumor via bronchotomy.
Bronchi ; Bronchiectasis ; Diagnosis ; Female ; Humans ; Lipoma* ; Lung* ; Middle Aged ; Pulmonary Atelectasis*

Cholangiocarcinoma is a malignant disease originating from the epithelium of the biliary tract, and its prognosis is dismal due to distant metastasis in its early stages. The most common metastatic sites are the intra-abdominal organs, lymph nodes, and lungs. A patient was diagnosed with intrahepatic cholangiocarcinoma and underwent surgical resection. During the follow-up period, metastases were detected at the remnant liver and both lung fields. Eleven months after resection, the patient complained of severe headache. An approximately 5-cm cystic mass was found at the left occipital lobe of the cerebrum, and metastatic malignant cells were present on cerebrospinal fluid cytology. The patient underwent whole-brain radiotherapy. We herein report a rare case of cholangiocarcinoma with cystic brain metastasis together with a review of the relevant literature.
Biliary Tract ; Brain ; Cerebrum ; Cholangiocarcinoma ; Epithelium ; Follow-Up Studies ; Headache ; Humans ; Liver ; Liver Neoplasms ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis ; Neoplasm Metastasis ; Occipital Lobe ; Prognosis