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.
Nose* ; Paranasal Sinuses*

No abstract available.
Rhinomanometry*

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

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*

Traditionally, surgical access to the midface structures for the removal of benign or malignant tumors has been through paranasal sinuses, external facial incisions, or hard palate. However, large or malignant lesions of the nose, paranasal sinuses and nasopharynx have a particularly difficult problem of these surgical approach. The midfacial degloving approach combined with/without medial maxillectomy provide an alternative method that requires no facial incisions and minimal functional impairment. Exposure and surgical facility may be equal or superior to that of traditional procedures in selected cases. Combining this method with bi-frontal, brow, transtemporal, and transpalatal approach is also possible for extensive lesions. We did midfacial degloving in 13 patients who were seen with benign or malignant lesions involving the midface structures from Jan. 1991 to Dec. 1994. Thus we analysed the clinical data including the advantage and complications of this method retrospectively.
Humans ; Nasopharynx ; Nose ; Palate, Hard ; Paranasal Sinuses ; Retrospective Studies