No abstract available.
Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic*

The cerebrospinal fluid(CSF) contains only negligible concentrations of buffer anions other than HCO3- because there is no hemoglobin buffer syatem. CSF gas values have been reported and it has been shown that arterial CO2 diffuses easily into the blood brain barrier to form H2CO3 in the CSF. No study for normal valuea of CSF gaaes in Koreans has been reported. The study was attempted to obtain the normal. values of CSF gases and also to compare values of gases in the three different components, j,e. CSF, arterial and venous blood. Relatively healthy patients with no respiratory or systemic disturbances who were sch-eduled for simple operations have been studied. Prior to the induction of aneathesia, Ium-bar tapping was Performed at a level of L3-4 using a 22 gauge needle and CSF samples-were obtained. Then the racial samples were taken. The subclavian vein was cannulated with a 20 gauge catheter and venous b1ood samples were obtained. All the gas values were-compared as shown in the tab1es and figures. The results obtained were as fallows: PCSF O2 was 76.5+/-8.6 torr and PcsF CO2 was 44.9+/-3.6 torr. Both data in the CSF fall in the middle of the arterial and venous valses. The pH of the CSF was 7.329+/-0.017, HCO3- was 23.6+/-1.8 mEq/L and the base excess was -2.2+/-1.5. All the above data are the lowest among the three components, The pH of the CSF is more acid than arterial or venous blood and that pH regulation of the CSF is seemed to be limited because there is no compensatory hemoglobin buffer in the CSF. The finding of the CSF gas values obtained in this study is introduced as a normal data for further physiological study of the CSF.
Anions ; Blood-Brain Barrier ; Catheters ; Gases ; Humans ; Hydrogen-Ion Concentration ; Needles ; Subclavian Vein

Alcohol as a classic neurolytic agent is frequently used for the management of intractable cancer pain, but the side reactions such as motor weakness and sphincter incontinence clinically developed following their application, occasionally annoying anesthesiologists or other physicians. To observe functional changes of hind limbs and neuropathologic changes in the sciatic nerve after alcohol application, highlighting the time of nerve regeneration, we undertook this experimental study utilizing a rat. Experimental groups were injected or dripped on the right sciatic nerve, and control groups were injected normal saline on the left. The functional changes of hind limbs were observed for 6 weeks and the distal part of the alcohol injected or dripped on the sciatic nerve was severed in 3 rats of each group respectively at 10 minutes, 1 hour, 24 hours, 3 days, 1 week, 2 weeks, 4 weeks and 6 weeks. The severed nerves were prepared for electron microscopic examination and pathologic changes were observed under the electron microscope. The results were as follows: The functional changes of the rats hind limbs after alcohol or saline application were as follows. When the rats emerged from the ether anesthesia, all showed motor loss of both hind limbs, and after several minutes, normal function returned in the saline injected limbs. The alcohol injected or dripped hind limbs showed more pronounced motor weakness and gait changes were obvious. About 2 weeks after the alcohol application, gradual improvement of gait changes begun, and after 6 weeks, motor weakness and gait changes were no longer perceptible. The neuropathologie events after alcohol application were as follows. In the group with alcohol injection, at 10 minutes after injection, destructive lesions were confined to unmyelinated fibers and the myelin sheath of small myelinated fibers. At 1 hour and 24 hours, axonal fibers and Schwann cells were shrunk and separated from the myelin sheath and empty spaces respectively. On the 3rd day and at 1 week, pathologic changes on axonal fibers and Schwann cells were in progression with phagocytosis in spite of myelin restitution. From 2 to 4 weeks, axonal regeneration and remyelination appeared concurrent with myelin disintegration and axonolysis, and hlytologic findings at 6 weeks were similar to those of the control group. In the group with alcohol drip, the histologic chanaes of the sciatic nerve were very similar to the injection groups. These results suggest that histopathologic findings such as degeneration and regeneration have good correlation with functional loss and gain, and histopathologic lesions after an alcohol application on the peripheral nerves are not influenced by application methods. The progress of histopathologic changes is obvious according to the time interval following the alcohol application. Accordingly, side reactions that developed following the use of neurolytic agents may be improved around the time when the nerve regeneration occurs, between second and forth weeks after the injection.
Anesthesia ; Animals ; Axons ; Ether ; Extremities ; Gait ; Myelin Sheath ; Nerve Regeneration ; Peripheral Nerves ; Phagocytosis ; Rats ; Regeneration ; Schwann Cells ; Sciatic Nerve*

Efforts from many different approaches have been made to cure Raynand's phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial administration in normal subjects as well as patients with Raynaud's syndrome has demonstrated a significant rise in blood flow to the hands. We used intermittent stellate ganglion blocks in conjunction with intra-arterial injections of reserpine and procaine in 10 patients suffering from finger necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1mg and procaine 50mg through a butterfly needle inserted in the radial or brachial artery. The administration of reserpine and procaine was done only twice at intervals of 1 week because of the development of suspected arterisclerosis. The stellate ganglion block was carried out once a week for about 3 months, then once a month as needed for 6 to 12 months. AS the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were healed completely and the rest improved considerably but were not followed to the end. We concluded that the intra-arterial administration of reserpine and procaine helped initiate and accelerate increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.
Brachial Artery ; Butterflies ; Epinephrine ; Fingers ; Granulation Tissue ; Hand ; Humans ; Injections, Intra-Arterial ; Lidocaine ; Necrosis ; Needles ; Nitroglycerin ; Procaine ; Reserpine* ; Stellate Ganglion* ; Sympathectomy

Myasthenia gravis is a neuromuscular disorder manifested by fatigability and weakness of the skeletal muscles. The basic defect in the myasthenia is the reduction of available acetylchopline receptors at neuromuscular junctions by an autoimmune mechanism. The thymus gland seems intimately involved in the disease process and removal of the thymus gland plays an important role in the management of this disease. In this article, we had three cases of thymectomies for myasthenia gravis. The first two were females, 17 and 26 year old. They were anesthetized for thymectomies using succinylcholine, pancuronium, sodium pentothal and. N2O-Halothane. The third case, a 40 year old female was not given any muscle relaxants because of the severity of the disease and her respiration was controlled for a month postoperatively. For the cases, the preoperative, intraoperative and postoperative management of anesthesia and the use of muscle relaxants are described.
Adult ; Anesthesia* ; Female ; Humans ; Muscle, Skeletal ; Myasthenia Gravis* ; Neuromuscular Junction ; Pancuronium ; Respiration ; Sodium ; Succinylcholine ; Thiopental ; Thymectomy* ; Thymus Gland

Intraspinal(intrathecal, epidural) narcotics administration had been widely used and well estabilished for pain control. The action mechanism of intraspinal narcotics has been well defined, and meperidine and pentazocine have been reported to be used as a sole agent for spinal anesthesia. The authors have already reported good loeal anestheticlike effets of meperidine and pentazocine clinically in patients scheduled for various surgeries, followed by experimen- tal evaluation of toxic effects of two drugs on the sciatic nerve of rats and dogs. This investigation was primarily undertaken to examine the difference in neurophysiological action between meperidine and morphine and also to evaluate early histological changes on aciatic nerve of rabbits within one week after injection of the each narcotics. Adult Korean rabbits were chosen as experimental animals because it is easy to observe neurophysiological activity with responses and to avoid of manipulating trauma. The rabbits were anesthetized using ketamine 10 mg/kg intramuscularly. The sciatic nerve of the rabbits was exposed and stimulated by a nerve stimulator to observe myoneural response as a control and then injected with 0.1% morphine 0.2 mg(Group I), 0.5% meperidine 10 mg(Group 2) and 0.3 % pentazocine 6 mg(Group 3). The sciatic nerve was stimulated for 20 minutes at 5 minutes interval and gait changes were carefully observed in the recovery room to see the myoneural activity, A specimen was taken at 4 and 24 hours, and 1 week after injection. The results were as follows, When the sciatic nerve was stimulated by a nerve stimulator, the normal muscle twitch was observed clearly in Group I with the morphine injection. However, in Group 2 with meperidine and Group 3 with pentazocine injection, muscle twitching decreased gradually and finally disappeared about after 10 minutes, Complete motor paralysis ceased after 60 minutes and muscle reaction returned to normal about 90 minutes after injection, Therafter, myoneural complications were not noticed in the 3 groups for a period of I week. All specimens of the 3 groups were inyestigated under light and with electron microscopic examination and they revealed mild vacuolziations scattered in axons of myelinated and unmyelinated nerves of some of the specimens but these were not significant. As a result of this investigation, we concluded that neurophysiologically, meperidine and pentazocine have local anesthetic-like effect, such as motor paralysis, but not with morphine, and neurohistologically, the above three norcotics have no significant toxic effects on nervous tissues.
Adult ; Anesthesia, Spinal ; Animals ; Axons ; Dogs ; Gait ; Humans ; Ketamine ; Meperidine* ; Morphine* ; Myelin Sheath ; Narcotics ; Paralysis ; Pentazocine* ; Peripheral Nerves ; Rabbits* ; Rats ; Recovery Room ; Sciatic Nerve*

No Abstract Available.
Clone Cells* ; Cloning, Organism* ; Mycobacterium tuberculosis* ; Mycobacterium*

Trimellitic anhydride (TMA) is widely used industrially to make epoxy and alkyd resins, plasticizers and surfactants. The purpose of this study was to investigate whether contact dermatitis is induced by repeated TMA challenge and the role of interleukin (IL)-10 in the TMA-induced contact dermatitis. The repetition of the challenge enlarged the extent of an early and a late phase of contact dermatitis in IL-10(+/+) and IL-10(-/-) mice. In the late phase of TMA-induced contact dermatitis, the peak of ear swelling responses by single challenge showed at 12 h after challenge, but the peak was observed at 8 h after repeated challenge. In the IL-10(-/-) mice, the repetition of the TMA challenges enlarged the extent of the contact dermatitis, but less than those in IL-10(+/+) mice. These results indicate that mice sensitized by TMA could possibly offer a useful model to study the mechanism of contact dermatitis, and IL-10 may act as potential modulators in the TMA-induced contact dermatitis. IL-10 may provide therapeutic tools for the treatment of TMA-induced contact dermatitis.
Animals ; Dermatitis, Contact ; Ear ; Interleukin-10 ; Interleukins ; Mice ; Phthalic Anhydrides ; Plasticizers ; Plastics

Epidural and intrathecal injection of narcotics for postoperative pain relief have been well reported. In an attempt to assess the postoperative analgesic effect of demerol in anal surgery, caudal block was carried out with 1.5% lidocaine mixed with demerol 5 mg(Group II) in 15 patients and demerol 1 0 mg(Group II) in 15 patients. As a control group(Group I), 16 patients were injected with 1.5% lidocaine alone in the epidural space for caudal anesthesia. The incidence of postoperative injection of demerol as needed by the patients for pain control were recorded and compared. As a result of this study, the 3rd group in which 10 mg of demerol were used, appeared to have a significantly prolonged analgesic effect and there were no serious complications observed in our experience such as nausea, vomiting or respiratory depression.
Anesthesia, Caudal ; Epidural Space ; Humans ; Incidence ; Injections, Spinal ; Lidocaine ; Meperidine* ; Narcotics ; Nausea ; Pain, Postoperative ; Respiratory Insufficiency ; Vomiting

Percutaneous antegrade pyelography guided by ultrasonography and fluoroscopy was attempted in 25 patients with supravesical obstructive hydronephrosis and suctessful in 23 patients to evaluate the site and nature of urinary obstruction. The etiology of the obstructive uropathies were urinary stricture in 11 cases,urinary Tbc. in 5 cases, urinary stone in 3 cases, uterine prolapse with cystocele, pyonephrosis, ureteral metastatic testicular carcinoma in 1 case respectively. No significant complication of the percutaneous antegrade pyelography was observed. Percutaneous antegrade pyelography provides significant diagnostic informations on the obstructive lesion and can be accomplished with ease and safe in patients with obstructiv hydronephnosis as a diagnostic procedure of choice in infants and children or as an alternative to a retrograde pyelography.
Child ; Constriction, Pathologic ; Cystocele ; Fluoroscopy ; Humans ; Hydronephrosis ; Infant ; Pyonephrosis ; Ultrasonography ; Ureter ; Urinary Calculi ; Urography ; Uterine Prolapse