Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and incresed pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was assciated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered. reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather incresed than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Anesthetics ; Anesthetics, Local ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Cardiovascular System* ; Central Nervous System ; Central Venous Pressure ; Cough ; Diazepam* ; Dogs* ; Heart Rate ; Hemodynamics ; Intubation ; Laryngoscopy ; Lidocaine* ; Nerve Block ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reflex ; Stroke ; Vascular Resistance

Opacification of the gallbladder after parenteral administration of contrast material usually indicates diminished renal function but can occur with normal renal function. The authors recently experienced 13 cases of such vicarious excretion of contrast media. Among 13 patients. 9 patients had renal disease unilateral ureteral stone(n=3), staghorn calculi(n=2), acute renal failure from sepsis(n=1), renal contusion(n=2) and unilateral renal artery involvement by dissecting aortic aneurysm(n=1). Of these 9 patients, 3 patients showed abnormal serum creatinine levels at the time of presentation or shortly thereafter. In 6 patients, injection of a large amount of contrast media was possibly the additional cause of vicarius excretion. There was no detectable cause in the remaining 4 patients. Heterotopic excretion of contrast media is clearly a complex phenomenon, the reason for which it is difficult to establish with certainty in each individual case. Anyhow, vicarius excretion of contrast media occurs more frequently than previously thought, and it can occur not only with abnormal renal function but with normal function also.
Acute Kidney Injury ; Contrast Media ; Creatinine ; Gallbladder* ; Humans ; Renal Artery ; Ureter

No abstract available.
Anemia, Hypoplastic, Congenital*

Snap Gauge bands were applied to measure nocturnal penile rigidity in the impotent patients and the results were compared with PBI and findings of the papaverine induced artificial erection. The results were as follows: 1. The results of Snap Gauge test were relatively competitive with the degree of erectile dysfunction which organic impotent patients complained of. 2. PBI less than 0.85 implied insufficient rigidity and PBI over 0.95 showed sufficient rigidity in Snap Gauge tests. 3. The possibility of "false positive" or "false normal" in diagnosis of the impotence was higher in the papaverine induced artificial erection tests than in the Snap Gauge tests. Conclusively, Snap Gauge band is simple to use and effective to measure quantitatively the penile rigidity reached during nocturnal erections in impotent patients.
Diagnosis* ; Erectile Dysfunction* ; Humans ; Male ; Papaverine

Prediction f chemical composition of gallstones is a prerequisite in contemplating the chemical dissolution or extracorporeal shock wave lithotripsy of gallstones. The author retrospectively analysed the correlation between quantitative chemical composition of gallstones and their ultrasonographic and computed tomographic findings. The ultrasonography(US) and computed tomography(CT) of 100 consecutive stones obtained from 100 patients were performed under the in vitro condition. Their US and CT fingings were grouped with certain patterns and each group was compared with the chemical composition of the stones. Stones with entirely discernible cirumsference and homogeneous internal echo on US had high bilirubin and low cholesterol content. Acoustic shadows were frequently absent with those stones. Stones with variable internal echo on US had relatively high cholesterol content but their distribution range were wide. There was no correlationship between the cholesterol content and the CT No. of the gallstones. There was positive correlationship between the calcium content and the CT No. of gallstones. The near totally calcified gallstones had very low cholesterol and high residue content. There was no relationship betweenthe calcification type and the ultrasonographic pattern. In conclusion, those stones with entirely discernible circumsference and homogeneous internal echo on US were pigment stones. On the contrary, stones with variable internal echo had relatively high cholesterol content. CT could predict the calcium content with CT No., but could not predict the cholesterol content.
Acoustics ; Bilirubin ; Calcium ; Cholesterol ; Gallstones* ; Humans ; In Vitro Techniques ; Lithotripsy ; Retrospective Studies ; Shock ; Ultrasonography*

No abstract available.
Ectromelia*

BACKGROUND: The relationship between the NO and its vasodilatory effect of propofol has been a somewhat controversial matter. And, the effects of propofol has not been evaluated in septic condition whether it is solely due to its increased iNOS activity. METHODS: First experiment is to study that the vasodilatory effect of propofol could be caused by NO. Isolated aortic rings with or without endothelium were contracted phenylephrine (10(-9)-10(-5)M) cumulatevely after porpofol (10(-5)M) administration. The effects of L-NAME (3 x 10(-4)M) and methylene blue (10(-5)M) on contractile responses for phenylephrine were evaluated. Second experiment is to study the effect of propofol on septic vesseles. the no LPS (lypopolysaccaride) and LPS treated rings with or without endothelium were contracted phenylephrine (10(-9)-10(-5)M) cumulatevely after porpofol (10(-5)M) administration. The development of sepsis was confirmed by iNOS expression using RT-PCR. RESULTS: All the aortic rings showed decreased response on phenylephrine contractile response with propofol administration. These responses were significantly less in denuded ones than in ones with intact endothelium. The endothelium dependent relaxation of propofol was inhibited by pretreatment with L-NAME and methylene blue in rat aortic rings having intact endothelium. All the aortic rings incubated with LPS showed decreased phenylephrine contractile response. The addition of propofol produced significantly more decrease in contractile response in LPS incubated rings in a greater than additive effect. The LPS induced hyporesponsiveness to phenylephrine was reversed by addition of cycloheximide. However, with the addition of propofol to LPS treated rings, complete reversal of this hyporesponsiveness to phenylephrine, failed to occur by addition of cycloheximide. CONCLUSIONS: 1) The vasodilatory effect of propofol seems to be mediatede by EDRF/NO, 2) The vasodilatory effect of propofol is increased in septic vesseles. Moreover, the inability of nitric oxide synthase inhibitior to reverse this response completely suggest that increased induction of iNOS may not be a sole responsible factor for this finding.
Animals ; Arteries* ; Cycloheximide ; Endothelium ; Methylene Blue ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Phenylephrine ; Propofol* ; Rats* ; Relaxation ; Sepsis

A persistent left superior vena cava is the most common anomaly of the superior caval system. Usually the persistent left superior vena cava is connected with the right atrium via the coronary sinus, resulting in no physiologic derangement : however in 7 to 8 percents of the patietns with a persistent left superior vena cava, the anomalous vessel communicates with the left atrim. In the absence of obstruction to the flow from the left atrium to the left ventricle. this anatomic situation usually results in right to left shunting of varying degress. We recently experienced a case of persistent left superior vena cava in a 52-year-old female who complained of chest discomfort, epigastric pain and dyspnea(NYHA functional class II). Cine-angiography showed that the contrast passed from the left SVC through the dilated coronary sinus into right atrium. And right sided SVC was not seen. The patient was treated with conservative measures and discharged with improved condition.
Coronary Sinus ; Female ; Heart Atria ; Heart Ventricles ; Humans ; Middle Aged ; Thorax ; Tricuspid Valve Insufficiency* ; Vena Cava, Superior

The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.
Age Distribution ; Chest Pain ; Cough ; Dyspnea ; Female ; Hemoptysis ; Humans ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule* ; Strikes, Employee ; Tuberculoma

No abstract available.
Bacteremia*