No abstract available.

No abstract available.
Cholecystectomy, Laparoscopic*

No abstract available.
Liver*

We investigated mean keratometric vale(K) after penetrating keratoplasty(PKP) and analyzed the factors which affected the postoperative mean K. We obtained mean K at postoperative 3 months in the 65 eyes of 65 patients which PKP of PKP combined with intraocular lens(IOL) implantation was done, and analyzed those values according to sex, age, preoperative diagnosis, preoperative corneal neovascularization, methods of trephination, methods of suture and methods of operation. The postoperative mean K of all patients was 42.83 diopters(D) and 43.32D in the recipient cornea without neovascularizaion, 42.51D with neovascularization, 42.72D in the cases of hand-held trephination and 43.27D in Hessvurg-Varron trephination, which had no statistical significant difference between K and sex, age, preoperative diagnosis, methods of suture, and methods of operation. This results will be helpful to predict the change of K ofter PKP, and give a better refractive results to use the operator's own mean K for the IOL calculation in the case of PKP comvined with IOL implantation.
Cornea ; Corneal Neovascularization ; Diagnosis ; Humans ; Keratoplasty, Penetrating* ; Sutures ; Trephining

Systolic time intervals were studied in a total of 83 patients with pure or predominant isolated valvular heart disease. They consisted of three groups of patients : namely, 38 cases of mitral stenosis, 25 cases of mitral regurgitation and 20 cases of aortic regurgitation. The mean of the electromechanical systole was within normal ranges in all three groups, and threre was no significant difference between the groups. The mean of the left ventriclar ejection time was also within normal limits in all groups, as was that of the electromechanical systole, but it was significantly shorter in patients with mitral regurgitation than in the others, and was significantly longer in patients with aortic regurgitation. The mean of the pre-ejection period and the ratio of the pre-ejection period to the left ventricular ejection time were within normal ranges in patients with aortic regurgitation, whereas both parameters were significantly increased in patients with mitral stenosis or mitral regurgitation, particularly in the latter.
Aortic Valve Insufficiency ; Heart Valve Diseases* ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Reference Values ; Systole*

We compared Healon which is widely used as a viscoelastic with Hyal 2000, recently produced in Korea. We evaluated anterior chamber reaction, intraocular pressure, and specular microscopy after injection of 0.2ml Healon and Hyal 2000, respectively, into anterior chamber of 20 cats, and performed light microscopy and scanning electron microscopy 8 weeks later. We calculated the corneal swelling rate after 0.2ml Healon and Hyal 2000 were coated on the corneal endothelium of 10 rabbits and GBR solution with 0.5mM H2O2 was perfused. Anterior chamber reaction disappeared after 2 days of injections, and intraocular pressure(IOP) increased after 6 hours of infection but normalized after 24 hours in both 2 groups. Corneal endothelial cell count was 4956cells/mm2 in the Healon group and 5021cell.mm2 in the Hyal 2000 group on the first post-injection day. and 4827cells/mm2 and 4810cell/mm2, 1 week later, without a statistical difference. The histologic abnormality was not detectable in light microscopy or scanning electron microscopy in both groups. The corneal swelling rate with Healon was 15.85micrometer/hr and 12.72micrometer/hr with Hyal 2000, while it increased to 69.29micrometer/hr and 67.51micrometer/hr in controls(p<0.05), respectively. The clinical findings showed no difference and histologic findings appeared normal in both the Healon and the Hyal 2000 groups. The inhibitory effect on the corneal swelling was similar during in vitro perfusion in both groups.
Animals* ; Anterior Chamber ; Cats ; Endothelial Cells ; Endothelium, Corneal ; Hyaluronic Acid* ; Intraocular Pressure ; Korea ; Microscopy ; Microscopy, Electron, Scanning ; Perfusion ; Rabbits

BACKGROUND: Propofol is useful agents for anesthesia induction and maintenance, but pain on injection and possible hypotension are a commonly encountered problems during induction. Meanwhile, ketamine has potent analgesic and sympathomimetic effect. Therefore, we evaluated the effect of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. METHODS: Premedicated one hundred and twenty ASA physical status I or II patients scheduled for elective surgery were randomly allocated into one of four groups (group 1; propofol only, group 2, 3, 4; pretreatment with 25%, 50%, 75% dose of hypnotic ED50 of ketamine, respectively) groups. Intensity and frequency of injection pain, mean arterial pressure and pulse rate were checked for evaluation of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. RESULTS: Incidence of pain on injection was significantly reduced in group 2,3 and 4 compared with group 1. Group 2 and 3 showed more stable hemodynamic changes than Group 1 and 4. CONCLUSIONS: 25-50% of hypnotic ED50 of ketamine (0.17-0.33 mg/kg) pretreatment reduced pain on injection and hemodynamic changes during propofol induction significantly.
Anesthesia* ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Ketamine* ; Propofol* ; Sympathomimetics

BACKGROUND: Both propofol and ketamine are useful hypnotics for induction of anesthesia, and the combination of propofol and ketamine has been used for total intravenous anesthesia. The aim of this study was to evaluate the dose response of propofol, ketamine and combination of these drug, and determine possible interaction between two drugs in patients. METHODS: The effect of ketamine on the dose response curve for propofol was studied in unpremedicated 165 ASA physical status I or II patients who were scheduled for elective operation. As an endpoint of hypnosis, ability to open eyes on verbal command was checked. Dose response curves for propofol and ketamine were determined with a probit procedure and their type of pharmacologic interaction was determined by fractional and isobolographic analysis. RESULTS: At the hypnotic endpoint, the ED50s were 1.13 mg/kg propofol, 0.66 mg/kg ketamine, and the ED95s were 1.67 mg/kg propofol, 1.09 mg/kg ketamine. The type of interaction between two drugs for hypnosis was found to be additive and ketamine was 1.7 times potent than propofol as an equieffective dose of hypnosis. CONCLUSIONS: The type of interaction between propofol and ketamine for hypnosis was additive.
Anesthesia* ; Anesthesia, Intravenous ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Ketamine* ; Propofol*

BACKGROUND: The potent bronchodilatory effects of ketamine on airway smooth muscle tone are important in the management of patients with asthma, but its mode of action is unclear. In the present study we evaluated that effects on isolated guinea pig tracheal smooth muscle. METHODS: Changes of isometric contraction of strip were measured. (1) Serial stimulation with acetylcholine(ACh) in Krebs solution or with A23187, nifedipine, ketamine were evaluated. After that, ACh stimulation was induced in Ca2+ free solution. (2) In Ca2+ free solution, ACh contraction was obtained(L1) and emptied by repetitive ACh stimulation. Internal stores were refilled by Ca2+ with ACh stimulation. During the incubation period, A23187, nifedipine, ketamine, cyclopiazonic acid + ketamine was added and tested for their ability to inhibit refilling. Refilling was evaluated by ACh produced contraction (L2) with ratio (L2/L1). (3) Effects of ketamine on the contraction induced by caffeine were also checked. RESULTS: Ketamine inhibited amplitude dose-dependently by successive application of ACh in modified Krebs solution and Ca2+ free solution. Ca2+ influx through voltage gated channels were inhibited with nifedipine but not with A23187. ACh sensitive internal store were different when A23187, nifedipine and ketamine were applied in Ca2+ free solution. Refilling of internal store were potentiated by A23187, but decreased by nifedipine and ketamine. Caffeine produced contractions in the presence of ketamine were not significantly different from control. CONCLUSION: We concluded that the inhibitory effects of ketamine in guinea pig trachea were by acting through voltage and receptor gated channels in dose-depedent manner and these effects may be interferences of intracellular second messengers system.
Animals ; Asthma ; Caffeine ; Calcimycin ; Guinea Pigs* ; Guinea* ; Humans ; Isometric Contraction ; Ketamine* ; Muscle, Smooth ; Nifedipine ; Second Messenger Systems ; Trachea*

Spontaneous spinal epidural hematoma is a rare cause of spinal cord compression. Recently, at our hospital, the author et al had the opportunity of observing case with spontaneous cervical epidural hematoma in a 28 years old woman who had suddenly felt a strong pain in interscapular area. Rapidly after she noticed weakness in her legs and one day later she was completely paraplegia. The MRI of spine was done. There show tubular like low signal intensity at posterior epidural space of C7 level and ghigh signal intensity of cord at C7 level due to cord compression effect. In this article, we are adding one more rare case of spontaneous cervical spinal epidural hematoma confirmed by MRI.
Adult ; Epidural Space ; Female ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Laminectomy ; Leg ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord Compression ; Spine