BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

No abstract available.
Rhinomanometry*

No abstract available.
Biopsy* ; Salivary Glands* ; Sjogren's Syndrome*

No abstract available.
Nose* ; Paranasal Sinuses*

No abstract available.

Endotracheal intubation is especially necessary for ventilatory care in Positive End Expiratory Pressure (PEEP) therapy. In many circumstances it is difficult to obtain an adequate view of the vocal cords, and thus various technics have been used for airway management. Retrograde tracheal intubation was performed on a 73-year old male patient suffering from postoperative noncardiogenic pulmonary edema who needed ventilatory PEEP therapy. This procedure was successful and a tracheostomy was not needed. Following improvement he was discharged with out complication.
Aged ; Human ; Intubation, Intratracheal/methods* ; Male

No abstract available.
Tongue Neoplasms* ; Tongue*

Two autopsied cases of dissecting aneurysms of intracranial vertebral artery are reported and the appropriate literature is reviewed to investigate the pathological characteristics and pathogenesis. The location and pathological features of the aneurysms are similar in the two cases. The aneurysms in both cases are confined to the intracranial vertebral artery and massive subarachnoid hemorrhage in basal cistern develop caused by the rupture of the arterial wall. And the aneurysms show mainly subadventitial dissection and display intimal thickening, disruption of internal elastic lamina, and degeneration of the media. Based on their pathological investigation of these two cases and a review of reported cases, the authors propose that weakness of internal elastic lamina may be responsible for initiating dissection in susceptible individuals and hypertention is one of contributing factors that result in weakness of internal elastic lamina.
Aneurysm ; Aneurysm, Dissecting* ; Autopsy* ; Rupture ; Subarachnoid Hemorrhage ; Vertebral Artery*

The hypothesis that administration of neostigmine in divided doses might accelerate the antagonism of nuromuscular blockade was investigated. Neostigmine 0.05mg/kg was adminsitered either in a single bolus dose (Group I, n=10) or in an initial dose of 0.01 mg/kg 1 minute later (Group II, n=10), 2 minutes later (Group III, n=10) and 3 minutes later (Group IV, n=10) for antagonism of vecuronium- induced blockade. Reversal was attepted at 10 percent spontaneous recovery of twitch height. The mean time (+/-SE) from the first injection of the drug until the train-of-four(TOF) ratio value had reached 0. 75 was signifincantly longer in Group II and IV (594.8+/-63.9 seconds and 555.6+/-22.2 seconds respectively) than Group I and III (380.6+36.0 seconds and 357.8+/-44.2 seconds respectively). It is concluded that adminstration of neostigmine in divided doses with 0. 01 mg/kg and 0.04 mg/kg did not produce a significantly faster reversal of residual vecuronium-induced neuromuscular blockade as compared to a single bolus administration.
Neostigmine* ; Neuromuscular Blockade ; Vecuronium Bromide*

BACKGROUND: Since ciliary dysfunction of the respiratory system impair mucosal ciliary clearance, it is associated with recurrent or persistent upper respiratory infections, chronic bronchitis, chronic sinusitis, recurrent pneumonia, recurrent otitis media, bronchiectasis and chronic rhinitis. Primary ciliary dyskinesia has a familial tendency and it is known to have autosomal recessive trait, and rarely acquired trait. OBJECTIVES: We had this study in order to inspect whether primary ciliary dyskinesia is associated with recurrent or persistent upper respiratory problems or not. MATERIAL AND METHODS: From May 1995 through April 1996, by electron microscopy of the nasal mucosa, the authors analysed nine patients who had recurrent or persistent respiratory symptoms. RESULTS: Electron microscopic findings revealed primary ciliary dyskinesia in 4 patients with the symptoms of upper respiratory tract problems. CONCLUSION: It is concluded that nasal mucosal biopsy may be necessary for rule out primary ciliary dyskinesia in the patients with recurrent respiratory infections.
Biopsy ; Bronchiectasis ; Bronchitis, Chronic ; Humans ; Kartagener Syndrome* ; Microscopy, Electron ; Nasal Mucosa ; Otitis Media ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Rhinitis ; Sinusitis