Malignant hyperthermia is a dramatic syndrome that rarely arises during anesthesia and which is still fatal in the majority of cases. It is a hypermetabolic muscle condition characterized by hyperpyrexia and skeletal muscle rigidity. Any potent inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catast rophic reaction. A case is presented of a 28 year old femal with a family history of malignant hyperthermia in herrelatives. She sunderwent repair of a retinal detachment under N2O-O2-halothane withcinduction by thiopenthal and succinylcholine. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia, muscular rigidity. Anesthesia was ended and vigorous emergency treatment was attempted. But she died postoperatively on the 4th day after anesthesia. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Incidence

The present study was designed to define the role of prostaglandin in the development and hatching of mouse embryo. The effects of indomethacin, an inhibitor of prostaglandin synthesis, on the development and hatching of morula and blastocyst were examined. In early morula stage, embryos were degenerated significantly at 100 muM and 200 muM indomethacin. However, :he viability of embryos was not influenced by concentration in any other embryonic stages. In all embryonic stages, the hatching was suppressed with concentration dependent manner, but expansion was not suppressed. Particularly, in 84h embryos post hCG injection, the hatching was suppressed significantly compared with post hCG 72h or 96h embryos. When embryos were treated with 100 muM indomethacin for a specific time (12h) in according to the development stage, the hatching was suppressed all groups. These suppressional effect was decreased as embryonic development stage was progressed. However, the expansion was not affected in all treatment group. This study suggests that hatching-related metabolic substances are synthesized from morula stage and intraembryonic signaling mediated prostaglandin was important for development and hatching of mouse embryo.
Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures* ; Female ; Indomethacin* ; Mice* ; Morula ; Pregnancy

Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.
Acinetobacter ; Aeromonas hydrophila ; Ampicillin ; Anti-Infective Agents ; Bacteremia ; Burkholderia cepacia ; Cross Infection ; Enterobacteriaceae ; Escherichia coli ; Glucose ; Gram-Positive Cocci ; Humans ; Incidence ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Salmonella paratyphi A ; Salmonella typhi ; Serratia ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus

No abstract available.
Adenocarcinoma* ; Estrogens*

Pure red cell aplasia in uncommon disorder characterized by finding of anemia, absence of nucleated red blood cell in the marrow, absence of reticulocytes in the peripheral blood and normal peripheral platelet and leukocytes counts. We experienced one case of pure red cell aplasia associated with hemolytic anemia characterized by hemoglobinuria, reticulocytopenia, and erythroid hypoplasia of the bone marrow. The cause of the illness was not definitely identified, but we concluded that this patient had simultaneous occurrence of PRCA and hemolytic anemia following administration of diphenylhydantoin after craniotomy rather than virus or bacteria induced. The simultaneous occurrence of PRCA and hemolytic anemia in uncommon and the mechanism for diphenylhydantoin induced PRCA and hemolytic anemia is unclear.
Anemia ; Anemia, Hemolytic ; Bacteria ; Blood Platelets ; Bone Marrow ; Craniotomy ; Erythrocytes ; Hemoglobinuria ; Humans ; Leukocytes ; Phenytoin ; Red-Cell Aplasia, Pure* ; Reticulocytes

By means of a sensitive radioirnrnunoassay method,ferritin was assessed in the cerebrospinal fluid (CSF) of 50 hospitalized subjects to evaluate its potential value for the diagnosis of tuberculous rneningititis. The rnean ferritin value obtained in the controls was 4.29ng /rnl with ranging between 1.7 and7.4ng/rmL The differences of CSF ferritin content between controls and patients with aseptic rneningitis as well as other non-infectious neurologic disorder were not significant. But rnarked elevation ranging 14 and 88ng/rnl (rnean, 37.4ng/rnl) were observed in patients with tuberculous rneningitis. And the ratio of CSF ferritin to serum ferritin in paients with tuberculous rneningitis was elevated significantly rnore than those in other groups inculuding controls, patients with aseptic rneningitis and other non-infectious neurologic disorder. The level in the serurn and CSF were independent, but that in CSF correlated vrith its total protein content. Results of this study suggest rneasuring CSF ferritin level are a valuable adjunct in differentiating aseptic meningitis from uncomplicated tuberculous meningitis.
Cerebrospinal Fluid ; Diagnosis ; Ferritins* ; Humans ; Meningitis* ; Meningitis, Aseptic ; Nervous System Diseases ; Tuberculosis, Meningeal

Lumbar apophyseal ring fracture occurs between the vertebral ring apophyses and the cartilaginous rim of the superior or inferior margins of the vertebral end plates. This fracture is an unusual disease that if typically seen in adolescents or young adults. We analyzed the clinical records and neuroradiologic imagings of 49 patients who were less than 29 years old diagnosed with posterior lumbar apophyseal ring fractures in regards to the age, trauma history, the type and distribution of the fracture, clinical presentation, and postoperative outcome. The posterior lumbar apophseal ring fractures were detected in 29(9.2%) out of 533 young adult patients with herniated lumbar discs. There was trauma history in 37(75.5%) out of the 49 patients. The main presenting symptoms in most of the patients were low back pain and radiating leg pain. In patients who presented with symptoms, thirty-five patients(75.5%) had a positive straight leg-raising test. According to classification by Takata, they were type I in 12 cas es(24.0%), type II in 9 cases(18.0%), and type III in 29 cases(58.0%). The type III with trauma history was more common than with non-trauma history(p<0.01). Twenty-one patients(42.0%) had bony fragments projecting into the spinal canal from the upper border of S1. Partial hemilaminectomy(18 patients) and total laminectomy(3 patients) were performed. We could easily remove the bony fragments in all of the surgical cases. Chemonucleolysis were done in three patients. The overall results were good. We conclude that knowledge of this entity and correct radiographic diagnosis will help to facilitate the operative planning.
Adolescent ; Adult ; Classification ; Diagnosis ; Humans ; Intervertebral Disc Chemolysis ; Laminectomy ; Leg ; Low Back Pain ; Spinal Canal ; Young Adult*

It is well known that involvement of the cranial nerves is a relatively common manifestation of tuberculous meningitis because tuberculous exudate is most likely to be located at the base of brain and in the basal cisterns. We reviewed 73 adult patients under the diagnosis of tuberculous meningitis at Hanyang University Hospital during last three and a half years from March, 1986. Patients were classified into two groups according to the presence or absence of cranial nerve palsies. Cranial nerve palsies were noted in 22 patients (30.1%) at the time of admission or in the early period of antituberculous therapy. The oculomotor and abdcens nerves were most commonly involved, followed by the optic nerve. In 10 cases with oculomotor nerve palsy, 7 cases were noted to have involvement of both pupils and extraocular movements, 2 had involvement of one pupil only and one remaining case involved extraocular movements only (spared pupil). Cranial nerve palsies developed 7 to 89 days (median, 21.5) after initial symptoms, and in 10 cases their palsies disappeared within 15 to 65 days (median, 40.9). The incidence of SIADH and basal meningeal involvement were much higher in the cranial nerve palsy group. Increase of total protein and decrease of sugar in initial CSF examination were significant (p<0.05) in the cranial nerve palsy group.
Adult* ; Brain ; Cranial Nerve Diseases* ; Cranial Nerves* ; Diagnosis ; Exudates and Transudates ; Humans ; Inappropriate ADH Syndrome ; Incidence ; Oculomotor Nerve Diseases ; Optic Nerve ; Paralysis ; Pupil ; Tuberculosis, Meningeal*

Non-specific periventricular white matter lucencies on computed tomography(leukoaraiosis) were found in 130(40%) of 324 patients with ischemic or hemorrhagic strokes. Patients with leukoaraiosis were significantly older than those without it and correlated with hypertension and lacunar infarction but not with cortical infarction. In patients with hemorrhage, leukoaraiosis occurred sinigificantly more often when aneurysm or arteriovenous malformation were not demonstrated. Our fiindings suggest that leukoaraiosis in cerebrovascular disease is associated with small vessel disease.
Aneurysm ; Arteriovenous Malformations ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Leukoaraiosis* ; Stroke ; Stroke, Lacunar

No abstract available.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Humans