Percutaneous radial artery cannulation has become a common technique for continuous monitoring of arterial blood pressure and serial sampling fo arterial blood in critically ill patients and hypotensive anesthesia. Although the method is generally safe and simple it frequently results in temporary radial artery occlusion, which is usually asymptomatic and resolves spontaneously. But occationally which the ulnar arterial collateral circulation is poor, occlusion of the radial artery can cause ischemia or even frank gangrene of the hand. The influence of cannula size or shape, duration of cannulation, frequency of puncture trial and patient's age on the incidence of vessel occlusion remains controversial. We evaluated radial arterial function utilizeing physical examination and Doppler flow measurement in fourty-seven patients following percutaneous cannulation. Arterial occlusion occured in 12.8% and hematoma in 31.9% of fourty-seven patients. The incidences of occlusion and hematoma were more frequent when the attempted puncture was more than three times and the duraion of cannulation was more than six hours. Hematoma disappeared spontaneously several days after and collateral circulation was good without other vascular complication in all six patients who had arteiral occlusion.
Anesthesia ; Arterial Pressure ; Catheterization* ; Catheters ; Collateral Circulation ; Critical Illness ; Gangrene ; Hand ; Hematoma ; Humans ; Incidence ; Ischemia ; Physical Examination ; Punctures ; Radial Artery*

In complete heart block(CHB), there is a complete failure of the atrial impulse leading into a ventricular response, the atria and ventricles beat independently, with the latter having a slower rate. Approximately one-third of infants with congenital CHB have associated structural heart disease such as corrected transposition of the great arteries, single ventricle, and the heterotaxy syndrome. For those patients without associated anomalies in whom bradycardia causes heart failure unresponsive to drugs, a pacemaker is necessary. We report a case of congenital complete heart block showing a ventricular beat of 57 /min despite atrial beat of 125/min. The mother of the baby was asymptomatic but her serologic tests were positive for connective tissue disease. The patient had positive serologic tests for anti-Ro antibody and anti-La antibody but associated structural heart anomalies were not found. He remained well without signs and symptoms of heart failure and no treatment was required except 02 supply.
Arteries ; Bradycardia ; Connective Tissue Diseases ; Heart Block* ; Heart Diseases ; Heart Failure ; Heart* ; Heterotaxy Syndrome ; Humans ; Infant ; Mothers ; Serologic Tests

PURPOSE: The objective of this study was to analyze the relationship between the electrophysiological studies(EEG and BAEP) and brain ultrasonography and the prognosis of the newborn infants with asphyxia. METHODS: Clinical records, including electrophysiological findings of EEG and BAEP and brain ultrasonography, of 29 term infants with neonatal asphyxia, who had been admitted to the Pediatric Department of Chosun University Hospital between January 1994 and June 1997 were reviewed retrospectively. RESULTS: Out of the 29 cases that returned for follow up, 23 cases were neurodevelopmentally normal, but 6 cases showed delayed development on the Korean Denver Developmental Scale Test(KDDST). Of 19 cases with abnormal EEG findings, 5 showed delayed developrnent on the KDDST(P>0.05). Follow up EEG was performed in 10 cases', 8 of them were normalized, and two remained abnormal without delayed development on the KDDST. Of 8 cases with abnormal brain ultrasonographic findings, 5 showed delayed development on the KDDST(P<0.05). Of 12 with abnormal BAEP findings, 3 showed delayed KDDST(P>0.05). Follow up BAEP was performed in 8 cases, and all cases were normal. CONCLUSION: These results suggest that abnormal findings of EEG and BAEP in the asphyxiated term newborn were reversible, but abnormal brain ultrasonographic findings, especially intracranial hemorrhage, were significantly correlated with delayed development.
Asphyxia ; Brain Stem* ; Brain* ; Electroencephalography* ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Intracranial Hemorrhages ; Prognosis ; Retrospective Studies ; Ultrasonography

Paragonimiasis is a chronic inflammatory process which frequently involve to the lung. The lung is the main site of infection with Paragonimus westermani, but any place of the body including brain, orbit, liver, intestinal wall, diaphragm, subcutaneous tissue, and etc. may be infected with the larva We report a case of ectopic Paragonimus westermani arising from the adrenal gland, in 70-year-old male.
Adrenal Glands* ; Aged ; Brain ; Diaphragm ; Humans ; Larva ; Liver ; Lung ; Male ; Orbit ; Paragonimiasis ; Paragonimus westermani* ; Paragonimus* ; Subcutaneous Tissue

Since Murray, et al performed the first successful human kidney transplantaion in 1954, the renal allograft has become a well documented and accepted method for the treatment of the patient in the final stage of renal failure. However from the anesthetist's point ef view, most patients with renal failure are poor risk due to such factors as hypertension, anemia, hyperkalemia, acidosis, bleeding tendency, hyper-or hypovolemia, although these factors may be controlled to a great extent by hemodialysis and antihypertensive drugs. Therefore every anesthetist should keep in mind the risk factors for anesthetic management of the patient in renal failure. Fifty-six cases of renal allograft from living donors were performed under general anesthesia at Severance Hospital, Seoul, Korea, between April 1979 and August 1981. We report our experiences with anesthetic management of these cases along with precautions and give references.
Acidosis ; Allografts ; Anemia ; Anesthesia, General ; Antihypertensive Agents ; Hemorrhage ; Humans ; Hyperkalemia ; Hypertension ; Hypovolemia ; Kidney ; Kidney Transplantation* ; Korea ; Living Donors ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Seoul

Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21–52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.

PURPOSE: This study is to assess the pharmacologic effects of ethanol and its metabolite, acetaldehyde on potassium channels of the corpus cavernosal smooth muscle of the rabbit. MATERIALS AND METHODS: Cavernosal strips from New Zealand white rabbits were harvested and pharmacophysiologic organ bath studies were executed. In equilibrium state after incubation, zaprinast (PDE5 inhibitor) induced relaxations were monitored in strips precontracted with phenylephrine (PE, 10(-4)M). The inhibitory effects of ethanol and acetaldehyde (2, 20, 40, 80 mmol) on zaprinast-induced relaxations were recorded. Pinacidil (K(ATP) channel opener) and phloretin (BK channel opener) were tested to reverse the inhibitory effects of ethanol and acetaldehyde on zaprinast-induced relaxations. RESULTS: Both ethanol and acetaldehyde inhibited the zaprinast-induced relaxations in a dosedependent manner (p<0.05). Both pinacidil and phloretin abolished the inhibition by both ethanol and acetaldehyde (p<0.05). Ethanol and acetaldehyde inhibits cavernosal relaxation, possibly through BK channels and K(ATP) channels. CONCLUSIONS: These results suggest that ethanol and its metabolite may affect the corpus cavernosal smooth muscle directly and lead to consequent erectile dysfunction. Furthermolecular and electrophysiological studies will help reveal the underlying mechanisms to which this process occurs.
Acetaldehyde ; Baths ; Erectile Dysfunction ; Ethanol ; Large-Conductance Calcium-Activated Potassium Channels ; Male ; Muscle, Smooth ; Penis ; Phenylephrine ; Phloretin ; Pinacidil ; Potassium Channels ; Purinones ; Rabbits ; Relaxation

BACKGROUND: Primary empty sella syndrome (PES) is thought to arise from an incompetent diaphragma allowing progressive herniation of arachnoid membrane with secondary compression and atrophy of the pituitary gland. As a consequence of the improvement and widespread use of neuroradiological techniques, such as computerized tomography (CT) and magnetic resonance imaging (MRI), empty sella is more frequently disclosed. The aim of this study is to assess the associated clinical characteristics and endocrinologic disturbance in empty sella syndrome. METHODS: From January 1986 to June 1996, 171 patients with empty sella syndrome have undergone analysis for clinical characteristics and associated disease. RESULT: In our study, PES was diagnosed in 131 of the 171 patients (77%). Primary empty sella syndrome was frequent in middle aged women (female:male 115:16, mean age: 50.6+12.6 years). The common clinical features were headache (80.2%), obesity (72.5%), and hypertension (27.5%). Most of patients with PES have normal pituitary function (75%). The frequent pituitary dysfunction was hyperprolactinemia in PES (21%). Partial and total emptiness of sella on sella CT or MRI were in 111 (84.7%) patients, and in 20 (15.4%) patients, respectively. The most common associated disease with empty sella syndrome was pituitary adenoma. CONCLUSION: PES should be considered as a possible cause in obese middle aged women with unexplained headache. The combined pituitary function test should be considered for evaluation of pituitary dysfunction when clinically suspected.
Arachnoid ; Atrophy ; Empty Sella Syndrome* ; Female ; Headache ; Humans ; Hyperprolactinemia ; Hypertension ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Obesity ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Neoplasms

Today rapid medical and socio-economic progress has increased life expectancy and this has also increased the number of aged in the population. it is well known that the geriatric patient is generally considered to be a poor risk for anesthesia and surgery compared with the younger age group, because many have associated chronic systemic diseases in addition to the aging of physiological function. The purpose of this clinical study is to evaluate factors affecting complications and mortality in patients over 65 years of age during anesthesia and the postoperative period. Among 53,288 cases of total anesthesia performed from January 1970 to December 1979 at Severance Hospital, 1,097 cases over 65 years of age were reviewed. The results are as follows: 1) Anesthesia for geriatric patients over 65 years of age comprised 2.1% of total cases, of which the number of male patients(57.2%) was slightly greater than that of female patients (2.84%). 2) Overall mortality was 6.4%. 3) The mortality rate was related to preoperative physical status of patients: 2.7% of cases were elective and 21.3% were for emergency surgery. 4) high mortality rate following surgery was, in order of frequency, intrathoracic(11.1%), intracranial(11%) and upper abdomen(9.4%). 5) preoperative concomittant disease was, in order of frequency, hypertension(25.3%), chronic obstructive pulmonary disease(13.3%), pulmonary tuberculosis(12.1%) and anemia(9.9%). 6) The mortality rate was clearly proportional to anesthesia time. 7) General anesthesia(81.0%) was administered more often than regional anesthesia(19.0%). No direct relationship between the anesthetic agent and morthality rate was noted. 8) Common complications during anesthesia were hypertension(23.9%) and hypotension(19.4%). 9) The leading causes of mortality were respiratory complications(24.3%), cardiac failure (17.1%) and renal failure(17.1%).
Aging ; Anesthesia ; Emergencies ; Female ; Heart Failure ; Humans ; Life Expectancy ; Male ; Mortality ; Postoperative Period

The structures of the intact synaptosomal plasma membrane vesicles (SPMVs) isolated from bovine cerebral cortexs, and the outer and the inner monolayer separately, were evaluated with 1,6-diphenyl-1,3,5-hexatriene (DPH) and 1,3-di(1-pyrenyl)propane (Py-3-Py) as fluorescent reporters and trinitrophenyl groups as quenching agents. The methanol increased bulk rotational and lateral mobilities of SPMVs lipid bilayers. The methanol increased the rotational and lateral mobilities of the outer monolayers more than of the inner monolayers. n-(9-Anthroyloxy)stearic acid (n-AS) were used to evaluate the effect of the methanol on the rotational mobility at the 16, 12, 9, 6, and 2 position of aliphatic chains present in phospholipids of the SPMVs outer monolayers. The methanol decreased the anisotropy of the 16-(9-anthroyloxy)palmitic acid (16-AP), 12-(9-anthroyloxy)stearic acid (12-AS), 9-(9-anthroyloxy)stearic acid (9-AS), and 6-(9-anthroyloxy)stearic acid (6-AS) in the SPMVs outer monolayer but it increased the anisotropy of 2-(9-anthroyloxy)stearic acid (2-AS) in the monolayers. The magnitude of the increased rotational mobility by the methanol was in the order at the position of 16, 12, 9, and 6 of aliphatic chains in phospholipids of the outer monolayers. Furthermore, the methanol increased annular lipid fluidity and also caused membrane proteins to cluster. The important finding is that was far greater increase by methanol in annular lipid fluidity than increase in lateral and rotational mobilities by the methanol. Methanol alters the stereo or dynamics of the proteins in the lipid bilayers by combining with lipids, especially with the annular lipids. In conclusion, the present data suggest that methanol, in additions to its direct interaction with proteins, concurrently interacts with membrane lipids, fluidizing the membrane, and thus inducing conformational changes of proteins known to be intimately associated with membranes lipids.
Anisotropy ; Cell Membrane ; Cerebral Cortex ; Diphenylhexatriene ; Lipid Bilayers ; Membrane Lipids ; Membrane Proteins ; Membranes ; Methanol ; Neurons ; Palmitic Acids ; Phospholipids ; Proteins ; Stearic Acids