PURPOSE: Functional MR imaging is the method of demonstrating changes in regional cerebral blood flow produced by sensory, motor, and any other tasks. Functional MR of visual cortex os performed as a patient stares a photic stimulation, so adaptable photic stimulation is necessary. The purpose of this study to evaluate whether the size of photic stimulation can affect the degree of visual cortex activation. MATERIALS AND METHODS: Functional MR imaging was performed in 5 volunteers with normal visual acuity. Photic stimulator was made by 39 light-emitting diodes on a plate ,operating at 8 Hz. The sizes of photic stimulator were full field, half field and focal central field. The MR imager was Siemens 1.5-T Magenton Vision system, using standard head coil. Functional MRI utilized EPI sequence (TR/TE=1.0/51. 0msec, matrix No.=98x128, slice thickness=8mm) with 3sets of 6 imaging during stimulation and 6 imaging during stimulation and 6 imaging during rest, all 36 scanning were obtained. Activated images were obtained using postprocessing software(statistical analysis by Z-zone, and these images were combined with T-1 weighted anatomical images. The activated signals were quantified by numbering the activated pixels, and activation index was obtained by dividing the pixel number of each stimulator size with the sum of the pixel number of 3 study using 3 kinds of stimulators. The correlation between the activation index and the stimulation size was analysed. RESULTS: Mean increase of signal intensities on the activation area using full field photic stimulator was about 9.6%. The activation index was greatest on full field. second on half field and smallest in focal central field in 4, The index of half field was greater than that of full field in 1. The ranges of activation index were full field 43-73%(mean 55%), half field 22-40%(mean 32%), and focal central field 5-24%(13%). CONCLUSION: The degree of visual cortex activation increases with the size of photic stimulator.
Head ; Humans ; Magnetic Resonance Imaging* ; Photic Stimulation ; Visual Acuity ; Visual Cortex* ; Volunteers

BACKGROUND: It has been a standard practice in many institutions to combine light general anesthesia with epidural block for abdominal and pelvic surgery. We attempted to prove the effectiveness of prehydration and to find an suitable epidural local anesthetic dose in terms of hemodynamic stability for upper abdominal surgery. METHODS: For preliminary studies, 11 patients scheduled for elective upper abdominal surgery had received general anesthesia immediately after epidural anesthesia. After epidural injection of 10~16 mL of 2% plain lidocaine into the T9~10 intervertebral space, the changes in blood pressure were observed. Thirty-two patients scheduled for elective upper abdominal surgery were divided into two groups. In group A (study group), after prehydration with Hartmann solution (10 mL/kg), 5~7 mL of 2% plain lidocaine was injected into T8~9 or T9~10 intervertebral space and general anesthesia was then induced. Group B (control group) received general anesthesia only. RESULTS: There were no significant differences in hemodynamics between the epidural with general anesthesia and the control group except SVR (systemic vascular resistance). SVR in group A increased in contrast to the group B in which it remained unchanged. CONCLUSIONS: The combined epidural and general anesthesia, using prehydration and 0.5~1 mL/segment of 2% plain lidocaine at the T8~9 or T9~10 intervertebral space was safe without significant hemodynamic changes.
Anesthesia, Epidural ; Anesthesia, General* ; Blood Pressure ; Hemodynamics* ; Humans ; Injections, Epidural ; Lidocaine

Three cases who were successfully treated for cardiac injuries by open thoracotomy were reported. The range of the ages of the patients was 3rd decade. Two of the 3 were males with blunt injuries by motor vehicle accident and one was male with stab wound by knife. In the case of blunt injuries, the right atrium was involved in one case and the right and left atrium were involved in the other. The site of stab wound was the right atrium. There were two cases with the pre-operative diagnosis of cardiac injuries and they were blunt injuries. The case of stab wound was not diagnosed pre-operatively. All cases were treated with open thoracotomy-one posterolateral thoracotomy, one median sternotomy and one Clam shell incision. All of them had an uneventfull post-operative course.
Bivalvia ; Diagnosis ; Heart Atria ; Humans ; Male ; Motor Vehicles ; Sternotomy ; Thoracotomy ; Wounds, Nonpenetrating ; Wounds, Stab

Authors reviewed the records of sixteen patients with traumatic diaphragmatic injuries from May 1992 through December 1996. Thirteen patients were male and three were female(M:F=4.3:1). The age distribution ranged from 2 to 46 years with the mean age of 30.2 years. The sixteen patients included thirteen who had blunt trauma and three with penetrating trauma. Of those thirteen blunt trauma, twelve patients(92.3%) were left sided and one(7.7%) involved the right diaphragm. Three patients with penetrating trauma had left sided diaphragmatic injuries. The diagnosis was made preoperatively in thirteen patients(81.3%) and during surgery in three patients(18.8%). Thoracotomy was performed in eleven patients and thoracoabdominal incision in five. There was one death and the mortality rate was 6.3%.
Age Distribution ; Diagnosis ; Diaphragm ; Humans ; Male ; Mortality ; Thoracotomy

No abstract available.
Hedgehogs ; Tinea ; Trichophyton

BACKGROUND: Hemodynamic instability is one of the main concerns for anesthesiologists during orthotopic liver transplantation (OLTX). The most troublesome event would be an increase of central venous pressure associated with sudden right ventricular (RV) filling without any change in heart contractility. An acute increase in RV outflow pressure depresses RV contractility and eventually causes overt RV failure. To avoid such disaster, it would be wise to evaluate right heart pressure/volume relationship and assess contractility when anticipating acute increase of pressure in right heart chamber. METHODS: RV function was assessed in 15 patients undergoing OLTX. RV function was monitored using an ejection fraction catheter and a monitor. Complete hemodynamic profile was obtained on regular intervals. Statistical analysis was performed using ANOVA for repeated measures. Correlation between variables were determined by simple regression analysis and ANCOVA. RESULTS: RV end-diastolic volume was in the range of supranormal values. No correlation was observed between right atrial pressure and RV end-diastolic volume index (RVEDVI). There was a significant correlation between stroke index and RVEDVI. RV ejection fraction and E-single were relatively constant throughout the procedure. There was weak negative correlation between E-signle and RVEDVI. CONCLUSION: RV function appeared to be well preserved during OLTX. However, RV contractility tends to decrease in response to RVEDV increase because RVEDV of endstage liver disease might increase to their maximal value. Right heart filling pressure was less reliable clinical indicator of RV preload.
Atrial Pressure ; Catheters ; Central Venous Pressure ; Disasters ; Heart ; Hemodynamics ; Humans ; Liver Diseases ; Liver Transplantation* ; Liver* ; Myocardial Contraction ; Stroke

No Abstract Available.
Cell Line* ; Humans* ; Vascular Endothelial Growth Factor A*

No Abstract Available.
Cell Line* ; Humans* ; Vascular Endothelial Growth Factor A*

The incidence of malignant schwannoma in the head and neck is extremly rate. Most tumors apper as a rapidly expanding nonpainful mass and the symptoms are usually attributablet to local expansion of the mass. About one half occurs in association with von Recklinghausen's disease. Wide surgical excision is generally recommended as a primary treatment. Recently, there has been a trend to include postoperative radiation therapy as a primary modality. Prognosis of head and neck malignant schwannoma has been reported as particularly poor. However, recent authors advocate that prolonged survival is possible after adequate therapy including postoperative radiation therapy.We present our experience with these tumors on very rare locations such as the ethmoid sinus and the larynx, with the review of literatures.
Ethmoid Sinus* ; Head ; Incidence ; Larynx* ; Neck ; Neurilemmoma* ; Neurofibromatosis 1 ; Prognosis

BACKGROUND: We examined the ability of thiopental known to have protective effect on brain to prevent brain damage resulting from cerebral ischemia due to global imbalance in cerebral metabolic rate for oxygen and cerebral blood flow during rewarming period in cardiopulmonary bypass. METHODS: Jugular venous oxygen saturation(SjO2) was used as a reflection of cerebral oxygen balance. Thiopental 20 mg/kg(thiopental 10 mg/kg bolus and 10 mg/kg continuous infusion) was received during rewarming from hypothermic cardiopulmonary bypass of 27~30.5degrees C to 36degrees C and SjO2 compared with control group. RESULTS: In 8 patients of the 25 control group(32%) and 7 patients of the 24 thiopental group(29.2%), SjO2 were < or =50% with no difference between groups. Artery-jugular vein oxygen content differences (C(a-j)O2) and O2 extraction ratios increased significantly in SjO2 < or =50% patients suggesting increased oxygen consumption. Awake time prolonged significantly with thiopental. CONCLUSIONS: Thiopental(20 mg/kg) administration during rewarming in cardiopulmonary bypass for cerebral protection is not recommended.
Anesthetics ; Brain ; Brain Ischemia ; Cardiopulmonary Bypass* ; Heart ; Humans ; Oxygen Consumption ; Oxygen* ; Rewarming* ; Thiopental* ; Veins