No abstract available.
Liver* ; Neoplasm Metastasis*

BACKGROUND: Many studies have demonstrated that nitrous oxide diffuses into the cuffs of endotracheal tubes and increases cuff volumes and pressures. Such increments of cuff pressure maybe result in damage to the trachea. We evaluated the increase of intracuff pressure, volume and the statistical significance was analyzed with personal computer. METHODS: Fourty-nine patients ranging in age 37+/-15 years, in ASA physical status class 1~2 , they were 26 males and 23 females. They divided into two groups, group I(n=25) were anesthesia with nitrous oxide : oxygen (2 L/min : 2 L/min), group II were(n=24) anesthesia with nitrous oxide : oxygen (4 L/min : 2 L/min). The cuff pressure was measured every 30 minutes and compared with each others and group I and II. RESULTS: Our results suggest that a significant intracuff volume and pressure changes developed between two groups (p<0.05), more significant intracuff pressure changes occured at group II than group I (p=0.001) and significant increment changes according to time and different concentration of nitrous oxide between two groups (p<0.05). CONCLUSIONS: This study was conducted to determine the degree of intracuff pressure and volume changes during general inhalation anesthesia with different concentration of nitrous oxide. These results suggest that a nitrous oxide significantly increases cuff pressure and volume in a concentration and time related fashion.
Anesthesia ; Anesthesia, Inhalation* ; Female ; Humans ; Inhalation* ; Male ; Microcomputers ; Nitrous Oxide* ; Oxygen ; Trachea

We experienced a case of achondroplasia in 34 month old male infant. Diagnosis was suspected by clinical features and radiologic examination. A review of literature was made briefly.
Achondroplasia* ; Child, Preschool ; Diagnosis ; Humans ; Infant ; Male

BACKGROUND: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. MATERIAL AND METHOD: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1 cm) seen on the computed tomography. RESULT: There were 50 men and 8 women with a mean age of 28.2 years (range: 14~54 years). The mean length of hospitalization was 5.3 days (range: 2~10 days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: 10~58 months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intraoperative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1% for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. CONCLUSION: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.
Blister ; Chest Tubes ; Drainage ; Early Diagnosis ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Lung ; Lung Diseases ; Male ; Pneumothorax ; Recurrence ; Retrospective Studies

The following experiment was performed to clarify distributional change of the Mac1-positive cells at 1, 4, 8 ,12 and 40 weeks after birth. Thymuses, spleens and lymph nodes were removed and immunocytochemical staining using the specific Mac1 antibody was performed The results obtained from the present experiment were as follows : 1. Mac1-positive cell was absent at 1 week, they were increased by 4 weeks and decreased at 40 weeks in the thymus after birth. 2. There was no Mac1-positive cell in the marginal zone of the spleen at 4, 40 weeks, but they were shown at 8 weeks. 3. Mac1-positive cells were increased at 4 weeks in the subfollicular area of lymph nodes. There was no change of distribution in the lymph nodes. From the above results, we suggest that the age-related decrease of the immunity might be caused by decrease of Mac1-positive cells in the antigen-presenting area.
Animals ; Lymph Nodes* ; Mice* ; Parturition ; Spleen* ; Thymus Gland*

Direct arterial pressure monitoring by means of an intra-arterial catheter has been considered benefit for assessment of the critically ill patients, safe conduct of controlled hypotension and frequent obtaining arterial samples for blood gas analysis. However in stead of these advantages, there would be high incidence of potential complications of arterial catheterization, such as pain, trauma to the artery and surrounding tissues(e. g., nerve), hematoma, infection, thrombosis, and distal embolization of air, clot, pieces of the catheter, and other debris. We have recently experienced an unexpected episode of amputation of the upper extremity resulting from axillary arterial occlusion following accidental injection of diphenylhydantoin through the radial arterial catheter in 57 year old neurosurgical patient. To prevent these serious and unexpected complications following arterial cannulation, we have to keep a continuous interest and vigilance to those who have invasive monitorings and those who are stranger to handle the arterial cannulation.
Amputation ; Arterial Pressure ; Arteries ; Axillary Artery* ; Blood Gas Analysis ; Catheterization ; Catheters* ; Critical Illness ; Hematoma ; Humans ; Hypotension, Controlled ; Incidence ; Middle Aged ; Phenytoin ; Radial Artery* ; Thrombosis ; Upper Extremity

Combining benzodiazepine with opioid has been used for analgesia and sedation during spinal anesthesia, but many authors have warned that combined administration of these drugs produces potent drug interaction that places patients at high risk for hypoxemia and apnea. This study was undertaken to observe the effect of combined use of diazepam with fentanyl on hemodynamic response and change in SaO in twenty healthy adult patients undergone elective surgery with spinal anesthesia. All of the patients were divided into the control and experimental group, and whom spinal anesthesia with 0.5% tetracaine the 12 mg and epinephrine 0.2 mg, were performed. To the control(Group I) and experimental group(Group 2) the combined dose of diazepam 0. 075 mg/kg with fentanyl 1 ug/kg, and diazepam 0.15 mg/kg with fentanyl 2 ug/kg, were given, respectively, by intravenous injection 1 hour after spinal anesthesia started. Blood pressure, heart rate and SaO2 of the two groups were compared at the time before administration of study drugs and 1 min, 2 min, 2 min, 4 min, 5 min, 10 min, 30 min and 60 min after administration of study drugs. The results were as follows. 1) SaO2 was significantly decreased in group 2 than Group 1 after study drugs were administed intravenously. 2) In both group, decrease in SaO2 was significant at the first 5 minutes after intravenous administration of study drugs. 3) SaO2 fell to 90% of the control value after the administration of study drugs in 6 patients of Group 2(60%). 4) Hemodynamic changes after intravenous administration of study drugs were statistically significant but not so clinically in both group. We concluded that combined intravenous administration of benzodiazepine and opioid under spinal anesthesia requires the careful monitoring of hemodynamic response and ventilatory status continuosly with those monitoring devices already in use and pulse oximeter. Availiability of skilled anesthesiologists for airway management and administration of supplemental oxygen are very important in combined intravenous administration of benzodiazepine and opioid.
Administration, Intravenous ; Adult ; Airway Management ; Analgesia ; Anesthesia, Spinal* ; Anoxia ; Apnea ; Benzodiazepines ; Blood Pressure ; Diazepam* ; Drug Interactions ; Epinephrine ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Injections, Intravenous ; Oxygen ; Tetracaine

No abstract available.
Bone Density* ; Gonads*

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.
Eosinophilic Granuloma ; Eosinophils ; Fractures, Spontaneous ; Histiocytosis, Langerhans-Cell ; Mandibular Condyle ; Temporomandibular Joint

Administration of kainate (KA) results in the induction of epileptiform activity and limbic motor seizures. Nitric oxide (NO) is a gaseous messenger that plays a role in neural transmission, long term potentiation, depression and cerebral blood flow. NO is formed by NO synthase (NOS) from arginine. NO mediates the increase in cerebral blood flow during seizure activity. However, the production site of NO has not been clearly defined. Recent report showed that constitutive NOS may be induced under certain conditions. Therefore, the present study was aimed to investigate the change of NOS and calbindin D28k in the rat cerebral cortex following seizure. Rats were injected with KA and killed at 6 hours, 1, 3, 6 and 12 days after seizure. Expressional change of nNOS and calbindin D28k was assessed by histochemistry, immunohistochemistry and RT-PCR in the rat brain. Induced NADPH-d positive neurons were observed in the cerebral cortex of 1, 3, 6 and 12 days after seizure and found in specific cortical areas, such as motor cortex, somatosensory cortex, auditory cortex, visual cortex, ectorhinal cortex and perirhinal cortex. The level of nNOS mRNA increased at 1, 3, 6 and 12 days after seizure compared with control group. Induced calbindin D28k positive neurons were observed in motor cortex and somatosensory cortex 1 and 3 days after seizure. The level of calbindin D28k mRNA in the cerebral cortex was slightly decreased at 1 day after seizure. Therefore, in this study, the induced NADPH-d, calbindin D28k positive neurons and upregulated NADPH-d positive neurons may influence the cerebral blood flow and neuronal activity in the cerebral cortex during post-seizure period.
Animals ; Arginine ; Auditory Cortex ; Brain ; Calbindin 1* ; Calbindins* ; Cerebral Cortex* ; Depression ; Immunohistochemistry ; Kainic Acid ; Long-Term Potentiation ; Motor Cortex ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase ; Rats* ; RNA, Messenger ; Seizures ; Somatosensory Cortex ; Synaptic Transmission ; Visual Cortex