This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Female ; Heart Rate ; Humans ; Intraoperative Awareness ; Ketamine* ; Memory ; Pregnancy ; Skin ; Thiopental*

We studied the cardiovascular and intracranial pressure(ICP) effects of Vecuronium in cats with normal and artificially increased ICP. Under pentobarbital and nitrous oxide anesthesia, monitors for ICP, Mean Arterial Pressure(MAP), Heart Rate(HR), and Central Venous Pressure(CVP) were placed in the cats. The cats were then divided into two groups: one with normal ICP( N-ICP) (n=8) and the other with artificially increased ICP (AI-ICP) (n=8). In the AI-ICP group, a size 8F Foley catheter was placed in the epidural space through a 5 mm trephined hole on the right parietal area. In each group, ICP, MAP, HR, CVP, and Cerebral Perfusion Pressure(CPP) were measured after Vecuronium injection(80ug/kg)(CPP=MAP-ICP). Results showed no statistically significant changes in cats with N-ICP and AI-ICP.
Anesthesia ; Animals ; Catheters ; Cats* ; Epidural Space ; Heart ; Hemodynamics* ; Intracranial Pressure* ; Nitrous Oxide ; Pentobarbital ; Perfusion ; Rabeprazole ; Vecuronium Bromide*

This report is concerned with our clinical experience of 150 cases of anesthesia for open heart surgery at department of anesthesiology, In chon Gil hospital from Februry, 1990 to April, 1993. The results were as follows ; 1) Among 150 cases, 68 cases (45.3%) were congenital heart disease and 82 cases (54.7%) were acquired heart disease. 62 cases (41.3%) were males and 88 cases (58.7%) were females. 2) Glycopyrrolate, diazepam, morphine, were used as premedicants. 3) Fentanyl, ketamine, diazepam, thiopental sodium were used as induction agents and injected singly or in combination. 4) In congenital cyanotic heart diseases, ketamine was used as main anesthetic agent. In other heart diseases, fentanyl, isoflurane, diazepam were used. 5) Vecuronium was used for intubation and maintenance of muscle relaxation. 6) Overall mortality rate was 3.3% (5 cases) and the causes of death were low cardiac output, respiratory insufficiency, mediastinal infection.
Anesthesia ; Anesthesiology ; Cardiac Output, Low ; Cause of Death ; Diazepam ; Female ; Fentanyl ; Glycopyrrolate ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Incheon ; Intubation ; Isoflurane ; Ketamine ; Male ; Morphine ; Mortality ; Muscle Relaxation ; Respiratory Insufficiency ; Thiopental ; Thoracic Surgery* ; Vecuronium Bromide

Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterized by hyperpyr-exia and skeletal muscle rigidity. It can be induced by all of the currently used inhalation anesthetics or by injection of succinylcholine. This case is presented of a 32 year old healthy male patient in whom a orthopedic operation was performed under O2-N2O-enflurane anesthesia with induction by pentothal sodium and succinylcholine. One hour after induction, tachycardia developed and was followed by unstable blood pressure, hyperpyrexia, arrhythmia and muscle rigidity. Anesthesia was terminated and vigorous emergency treatment was attempted. But the patient died about 4 hours after induction of anesthesia. The etiologic factors, clinical feature, treatment and prevention of malignant hyperthermia are discussed.
Adult ; Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Blood Pressure ; Emergency Treatment ; Humans ; Male ; Malignant Hyperthermia* ; Muscle Rigidity ; Muscle, Skeletal ; Orthopedics ; Sodium ; Succinylcholine ; Tachycardia ; Thiopental

Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterized by hyperpyr-exia and skeletal muscle rigidity. It can be induced by all of the currently used inhalation anesthetics or by injection of succinylcholine. This case is presented of a 32 year old healthy male patient in whom a orthopedic operation was performed under O2-N2O-enflurane anesthesia with induction by pentothal sodium and succinylcholine. One hour after induction, tachycardia developed and was followed by unstable blood pressure, hyperpyrexia, arrhythmia and muscle rigidity. Anesthesia was terminated and vigorous emergency treatment was attempted. But the patient died about 4 hours after induction of anesthesia. The etiologic factors, clinical feature, treatment and prevention of malignant hyperthermia are discussed.
Adult ; Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Blood Pressure ; Emergency Treatment ; Humans ; Male ; Malignant Hyperthermia* ; Muscle Rigidity ; Muscle, Skeletal ; Orthopedics ; Sodium ; Succinylcholine ; Tachycardia ; Thiopental

BACKGROUND: Infants are very different from children and adults in the point of anatomy, physiology, pharmacology and psychology. The mortality rate of infant anesthesia is higher than that of child and adult. So that this study is to analyze the infant's operation and to recognize the tendency and problems of infant's anesthesia and also to improve the outcome. METHODS: A retrospective analysis was performed on 1436 infants who had operations from april 1987 to february 1995 according to age, sex, department, disease, operation time, postoperative complications, mortality rate and anesthetic method. RESULTS: Total number of operation tend to increase annually. The male to female ratio was 67.5% to 32.5%. The distribution of patients by department was 60.6% of general surgery, 21.0% of plastic surgery and small percentage of other department. The distribution of disease was the following : inguinal hernia - the most common; cleft lip and palate, intussusception and others. The postoperative complications developed in 98 of 1436. The most common complication was the respiratory problems, the others were sepsis, electrolyte unbalance, gastrointestinal and CNS problems. The total mortality rate was 3.6%. The emergency operation case was 17.9%. CONCLUSIONS: The most common distribution of age was neonate and the most commm department was general surgery and the most common disease was inguinal hernia. The most common postoperative complication was respiratory problems and the second was infection and sepsis. The mortality rate in preterm infant, neonate, emergency operation and long duration operation was higher than total motality rate.
Adult ; Anesthesia* ; Child ; Cleft Lip ; Emergencies ; Female ; Hernia ; Hernia, Inguinal ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intussusception ; Male ; Mortality ; Palate ; Pharmacology ; Physiology ; Postoperative Complications ; Psychology ; Retrospective Studies* ; Sepsis ; Surgery, Plastic

BACKGROUND: Infants are very different from children and adults in the point of anatomy, physiology, pharmacology and psychology. The mortality rate of infant anesthesia is higher than that of child and adult. So that this study is to analyze the infant's operation and to recognize the tendency and problems of infant's anesthesia and also to improve the outcome. METHODS: A retrospective analysis was performed on 1436 infants who had operations from april 1987 to february 1995 according to age, sex, department, disease, operation time, postoperative complications, mortality rate and anesthetic method. RESULTS: Total number of operation tend to increase annually. The male to female ratio was 67.5% to 32.5%. The distribution of patients by department was 60.6% of general surgery, 21.0% of plastic surgery and small percentage of other department. The distribution of disease was the following : inguinal hernia - the most common; cleft lip and palate, intussusception and others. The postoperative complications developed in 98 of 1436. The most common complication was the respiratory problems, the others were sepsis, electrolyte unbalance, gastrointestinal and CNS problems. The total mortality rate was 3.6%. The emergency operation case was 17.9%. CONCLUSIONS: The most common distribution of age was neonate and the most commm department was general surgery and the most common disease was inguinal hernia. The most common postoperative complication was respiratory problems and the second was infection and sepsis. The mortality rate in preterm infant, neonate, emergency operation and long duration operation was higher than total motality rate.
Adult ; Anesthesia* ; Child ; Cleft Lip ; Emergencies ; Female ; Hernia ; Hernia, Inguinal ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intussusception ; Male ; Mortality ; Palate ; Pharmacology ; Physiology ; Postoperative Complications ; Psychology ; Retrospective Studies* ; Sepsis ; Surgery, Plastic

Mitochondrial neurogastrointestinal encephalomyopahty (MNGIE) is a rare disorder and is clinically characterized by ophthalmoparesis, peripheral neuropathy, leukoencephalopathy, gastrointestinal symptoms with intestinal dysmotility, and histologically abnormal mitochondria in muscle. A 32-year-old female showed external ophthalmoparesis, bilateral ptosis, quadriparesis, and sensory change below both ankle joints. Level of serum lactic acid was highly increased. The brain MRI showed diffusely increased signal intensity in the centrum semiovale and white matter. Electron microscopic finding showed paracrystalline inclusions in mitochondria of a few muscle fibers. (J Korean Neurol Assoc 19(3):309~312, 2001)
Adult ; Ankle Joint ; Brain ; Female ; Humans ; Lactic Acid ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Mitochondria ; Mitochondrial Encephalomyopathies ; Ophthalmoplegia ; Peripheral Nervous System Diseases ; Quadriplegia

Axillary osmidrosis is caused by excessive secretion of apocrine gland, which causes an acidic spicy odor and social embarrassment. Recently, many kinds of treatment for osmidrosis are introduced, but one of the conventional surgical method, dermal shaving is still the most effective method for osmidrosis. But it is often accompanied by complications like seroma, hematoma, necrosis, large scar, and long immobilization period. So, to reduce these disadvantages, we used fibrin glue which has the effect of reducing hematoma, encouraging capillary ingrowth by reinforcement of the flap fixation. Then, we compared the dermal shaving with fibrin glue spraying group with only dermal shaving group by retrospective study for clinical effect. From January 2001 to January 2005, a total of 56 patients were underwent dermal shaving operation for treatment of osmidrosis. Fibrin glue using group, the study group was 11 patients, 22 cases and dermal shaving only group without using fibrin glue, the control group was 45 patients, 90 cases. During operation, fibrin glue was sprayed after dermal shaving, just before completing skin closure. We compared the data from the view point of complications, the time for graft take(pressure dressing) and total occlusive dressing period(immobilzation period). Complication rate was lower in study group. There was 1 case of hematoma in the study group (4.5%), and 10 cases of hematoma, 1 case of seroma and 1 case of partial necrosis in the control group(13.3%). In both group, hematoma was the most common complication. The time for graft take were shorter in the study group than the control group(11.6 vs 13.6 days) and total dressing period was shorter in study group, too(14.3 vs 17.7 days). Statistically, significant difference was found in both the time for graft take and total dressing period. Using fibrin glue in dermal shaving was effective for lowering complication rate, reducing the time for graft take and total dressing period.
Apocrine Glands ; Bandages ; Capillaries ; Cicatrix ; Fibrin Tissue Adhesive* ; Fibrin* ; Hematoma ; Humans ; Immobilization ; Necrosis ; Occlusive Dressings ; Odors ; Retrospective Studies ; Seroma ; Skin ; Transplants

Bleeding frorn the duodenal varix is an unusual event. Upper gastrointestinal endoscopy is the diagnostic procedure of choice in diagnosing duodenal varices. If performed during active bleeding, it can differentiate between esophageal and duodenal varices as the source, which has important therapeutic implications. A thorough examination of the duodenum for varices is important in an upper gastrointestinal hemorrhage. Treatment modalites for bleeding duodenal varices are sclerotherapy, varix suture ligation, portocaval shunt, and duodenal resection. Although endoscopic sclerotherapy has lirnited success in controlling active duodenal varix as initial treatment, endoscopic injection sclerotherapy is a useful first-line therapeutic measure in the treatment of bleeding duodenal varices. In this study we present a case of a ruptured duodenal varix, which was defected by an endoscopy, in a 61-year-old male. An endoscopic examination showed small and nonbleeding esophageal varices and a prominant ulcerated varix was identified in the 2nd portion of the duodenum. Endoscopic sclerotherapy was performed by injecting ethanolamine oleate into the varix. Our report demonstrate that endoscopic sclerotherapy can be efficient even in the presence of acute bleeding and that it can provide a definitive method of curing of a bleeding duodenal varix.
Duodenum ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices ; Ethanolamine ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ligation ; Male ; Middle Aged ; Oleic Acid ; Sclerotherapy* ; Sutures ; Ulcer ; Varicose Veins*