Succinylcholine (1.5mg/kg) without pretreatment, or succinylcholine (1.5mg/kg) with pretreatment by vecuronium (0.015 mg/kg, 0.045 mg/kg, 0.15 mg/kg) or d-tubocurarine (0.1 mg/kg, 0. 3 mg/ kg, 1mg/kg) was given to cats of the same genus (body weight 2.5-3.5kg) under subcutaneous urethane anesthesia to determine the effect of the intracrainal pressure increase in each method. The results are summarized as follows: 1) The intracranial pressure was significantly increased (0.005< p< 0.01)with the administration of succinylcholine(1.5mg/kg). 2)The intracranial pressure was not increased with the administration of vecuronium. 3)As the dosage of d-tubocuraine administration increased, the intracranial pressure was increased. 4)The increase of the intracranial pressure by succinylcholine was depressed dose-dependently by vecuronium pretreament. 5)The increase of the intracranial pressure by succinylcholine was depressed by d-tubocurarine(0.3mg/kg)pretreatment.
Anesthesia ; Animals ; Cats* ; Intracranial Pressure* ; Succinylcholine* ; Tubocurarine ; Urethane ; Vecuronium Bromide

The renal polycystic disease is familial, almost always bilateral and often involves liver and pancreas as well. It is the most common form of cystic kidneys it humans. Adult renal polycystic disease usually presents in the 4th or 5th decade as an abdominal mass or with signs and symptoms of hematuria, infection, hypertension or renal failure. A clinical observation was made on 13 congenital renal polycystic disease patients who were admitted to our department from June, 1968 to May, 1980. The results obtained were as follows 1. Of 2252 cases hospitalized, 13 cases were congenital renal polycystic disease, giving a ratio of 173:1. The age ranged from 22 to 58 years, and most favorable age was over 35 years (62%). 2. The chief complaints were palpable abdominal mass in 51%, pain in 38% and gross hematuria in 15%. 3. Hypertension was found in 85%, hepatic cyst in 23% and renal stone in 15%. 4. Familial tendency was noted in 54%. 5. Laboratory study showed anemia in 38%, azotemia in 31%. hematuria in 62%, proteinuria in 46% and pyuria in 38%. 6. Ultrasonography appears to be superior to excretory urography in diagnosis of the renal polycystic disease. On pyelography, increased intercalyceal length was exhibited, 11.0 (1.00cm on left kidney and 10.6 ( 1. 97 cm on right kidney. The cortical thickness was also increased to 5.0 ( 1. 54 cm on left kidney and 4.6 ( 0. 86cm on right kidney 7. The patients were managed by medical treatment in 46%, nephrectomy 23% and marsupialization of the cyst in 15%.
Adult ; Anemia ; Azotemia ; Diagnosis ; Hematuria ; Humans ; Hypertension ; Kidney ; Kidney Diseases, Cystic ; Liver ; Nephrectomy ; Pancreas ; Proteinuria ; Pyuria ; Renal Insufficiency ; Ultrasonography ; Urography

The aim of this study was to compare with the effects of baclofen using an animal model of neuropathic pain. The sciatic nerve of rats was ligated unilaterally about dorsal half-portion in the tight according to the method of Seltzer and his colleague. After surgical operation, the rats showed painful symptoms of the ipsilateral hind paw, suggesting the possibility of spontaneous pain. And then, the paw withdrawal latency to the local heating on the paw through the glass plate and the frequency of paw withdrawal response to innocuous mechanical stimulation with modified von Frey filaments were determined to compare with the effects of pre-and post-medication of baclofen, respectively, at postoperative 3, 7, and 10 days. The results obtained were as follows: 1) The thermal hyperalgesia and mechanical allodynia produced by partially tight ligation of sciatic nerve appeared continously postoperative 3 days later. 2) In the hyperesthetic rats, the thermal hyperalgesia was inhibited from the 3rd posroperative day with orally administered baclofen 0.2mg and 1.0mg. 3) In the hyperesthetic rats, the mechanical allodynia was inhibited with baclofen 0.2mg, but not with baclofen 1.0mg, These results suggest that baclofen have more specific effects on thermal hyperalgesia than mechanical allodynia.
Animals* ; Baclofen* ; Glass ; Heating ; Hot Temperature ; Hyperalgesia ; Ligation ; Models, Animal* ; Neuralgia* ; Rats ; Sciatic Nerve

Differential independent lung ventilation is gaining growing attention for management of patients with unilateral pulmonary pathology. This case presents the method for the intraoperative anesthetic management of a patient with empyema and bronchopleural fistula of the left lung which could be controlled by the use of dual-mode asynchronous lung ventilation. The healthy right lung was ventilated by a conventional mechanical ventilator and disessde left lung by a high frequency jet ventilator. The use of endotracheal anesthesia and high frequency ventilation were necessary to prevent drainage of infected secretions into the right side healthy lung and to achieve good gas exchange in the presence of a bronchoplsural fistula. The method used by us, high frequency ventilation for the diseased lung a conventional mechanical ventilation for the other, demonstrated that differential independent lung ventilation using double lumen tube as in this case was suited for handling the problem of a bronchopleural fistula and empyema, further extending the indication for a giant lung bulls, lung cyst, major tracheobronchial disruption and one lung contaminating the other lung with either infected material or blood.
Anesthesia ; Drainage ; Empyema ; Fistula ; High-Frequency Ventilation ; Humans ; Lung* ; Pathology ; Respiration, Artificial ; Ventilation* ; Ventilators, Mechanical

PURPOSE: Foreign body ingestion is a commonly encountered problem in the pediatric emergency department (ED). This retrospective review aimed to investigate data gathered on the presentation and management of foreign body ingestions in children presented to ED. METHODS: This is a retrospective review of patients presented to the Seoul National University Hospital Pediatric ED between January 2005 and May 2009. The hospital electronic medical record database was used to identify children less than 15 years of age who presented with foreign body ingestion. RESULTS: Two hundred and fifteen children were reviewed for this study. The age of the patients ranged from 0 months to 14 years and the median age was 28 months. The most common foreign body ingested was coins (23.3%). At the time of presentation, most of the foreign bodies were located in the stomach (38.6%). One hundred and thirty four patients (62.3%) were managed expectantly and received no other treatment. At endoscopic examination, the foreign body was visible in seventy-one patients and removal was successful in sixty-nine patients (success rate 97.2%). Two patients required surgical removal of the ingested foreign body. One hundred patients (46.5%) were referred to our pediatric ED from other institutions, mostly for endoscopy. Two patients developed significant complications as a result of the ingestion and management of the foreign body. CONCLUSION: Most children presented with ingested foreign body followed an uneventful course and complications following management were rare. Primary and emergency physicians should be familiar with the recommended guidelines in the management of foreign body ingestion in children.
Child ; Eating ; Electronic Health Records ; Emergencies ; Endoscopy ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Numismatics ; Retrospective Studies ; Stomach

The antioxidant effects of HS-1580 derived from Brown seaweeds in comparison with NOS inhibitor, L-NAME, were tested in the Parkinson's disease animal model. C57BL/6 mice were implanted with osmotic pump containing vehicle, HS-1580 or L-NAME intraperitoneally 2 days before MPTP injection. The Parkinson's animal model were prepared by intraperitonal injection of MPTP (20 mg/kg, 4 times with 2 hours intervals in a ay).The mice were perfused with Zamboni fixative 2 days or 7days after MPTP injection. The 30 micrometer cryostat section were immunostained with free-floating method. Rabbit anti-tyrosine hydroxylase (TH)and rat anti-mouse MAC-1 were used as the primary antibodies. The following results were obtained. The number of TH-immunoreactive (ir)neurons in substantia nigra (SN)and the relative density of TH-ir axon terminals in striatum were decreased by MPTP injection. But the ecrease was significantly attenuated with 10%HS-1580 or L-NAME (50 mg/kg)pretreatment before MPTP injection. MAC-1-ir activated microglia were observed in substantia nigra 2 days after MPTP injection. Activated microglia were showed as thickened processes with round cell bodies. The morphological changes of MAC-1-ir activated microglia were inhibited by HS-15980 or L-NAME pretreatment before MPTP injction. Above results mean that the damage of nigrostriatal dopaminergic system was rescued by pretreatment of HS-1580 or L-NAME in MPTP-induced Parkinson's disease animal model.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals* ; Antibodies ; Antioxidants ; Mice ; Microglia ; Models, Animal* ; NG-Nitroarginine Methyl Ester ; Parkinson Disease* ; Presynaptic Terminals ; Rats ; Specific Gravity ; Substantia Nigra

No abstract available.
Bacteremia*

We report a first case of meningitis due to listeria monocytogenes after cardiac transplantation in Korea. This patient is a 40-year-old man with Dilated cardiomyopathy, he presented with intermittent dyspnea and abdominal distension for about 1 year. After cardiac transplantation, he was treated with azathioprine, cyclosporine and prednisolone for graft rejection. He was presented with intermittent fever, headache and lethargy for about 10days after cardiac transplantation. Listeria monocytogenes was isolated from blood culture and CSF culture. He was treated with intravenous penicillin G for 10days successfully and changed with ampicillin for 10days, took oral ampicillin for 10days without any complication after discharge.
Adult ; Ampicillin ; Azathioprine ; Cardiomyopathy, Dilated ; Cyclosporine ; Dyspnea ; Fever ; Graft Rejection ; Headache ; Heart Transplantation* ; Heart* ; Humans ; Korea ; Lethargy ; Listeria monocytogenes* ; Listeria* ; Meningitis* ; Penicillin G ; Prednisolone

Background: Injuries pose a significant global health challenge due to their high incidence and mortality rates. Although injury surveillance is essential for prevention, it is resource-intensive.This study aimed to develop and validate locally deployable large language models (LLMs) to extract core injury-related information from Emergency Department (ED) clinical notes. Methods: We conducted a diagnostic study using retrospectively collected data from January 2014 to December 2020 from two urban academic tertiary hospitals. One served as the derivation cohort and the other as the external test cohort. Adult patients presenting to the ED with injury-related complaints were included. Primary outcomes included classification accuracies for information extraction tasks related to injury mechanism, place of occurrence, activity, intent, and severity. We fine-tuned a single generalizable Llama-2 model and five distinct Bidirectional Encoder Representations from Transformers (BERT) models for each task to extract information from initial ED physician notes. The Llama-2 model was able to perform different tasks by modifying the instruction prompt. Data recorded in injury registries provided the gold standard labels. Model performance was assessed using accuracy and macro-average F1 scores. Results: The derivation and external test cohorts comprised 36,346 and 32,232 patients, respectively. In the derivation cohort’s test set, the Llama-2 model achieved accuracies (95% confidence intervals) of 0.899 (0.889–0.909) for injury mechanism, 0.774 (0.760–0.789) for place of occurrence, 0.679 (0.665–0.694) for activity, 0.972 (0.967–0.977) for intent, and 0.935 (0.926–0.943) for severity. The Llama-2 model outperformed the BERT models in accuracy and macro-average F1 scores across all tasks in both cohorts. Imposing constraints on the Llama-2 model to avoid uncertain predictions further improved its accuracy. Conclusion Locally deployable LLMs, trained to extract core injury-related information from free-text ED clinical notes, demonstrated good performance. Generative LLMs can serve as versatile solutions for various injury-related information extraction tasks.

Background: Injuries pose a significant global health challenge due to their high incidence and mortality rates. Although injury surveillance is essential for prevention, it is resource-intensive.This study aimed to develop and validate locally deployable large language models (LLMs) to extract core injury-related information from Emergency Department (ED) clinical notes. Methods: We conducted a diagnostic study using retrospectively collected data from January 2014 to December 2020 from two urban academic tertiary hospitals. One served as the derivation cohort and the other as the external test cohort. Adult patients presenting to the ED with injury-related complaints were included. Primary outcomes included classification accuracies for information extraction tasks related to injury mechanism, place of occurrence, activity, intent, and severity. We fine-tuned a single generalizable Llama-2 model and five distinct Bidirectional Encoder Representations from Transformers (BERT) models for each task to extract information from initial ED physician notes. The Llama-2 model was able to perform different tasks by modifying the instruction prompt. Data recorded in injury registries provided the gold standard labels. Model performance was assessed using accuracy and macro-average F1 scores. Results: The derivation and external test cohorts comprised 36,346 and 32,232 patients, respectively. In the derivation cohort’s test set, the Llama-2 model achieved accuracies (95% confidence intervals) of 0.899 (0.889–0.909) for injury mechanism, 0.774 (0.760–0.789) for place of occurrence, 0.679 (0.665–0.694) for activity, 0.972 (0.967–0.977) for intent, and 0.935 (0.926–0.943) for severity. The Llama-2 model outperformed the BERT models in accuracy and macro-average F1 scores across all tasks in both cohorts. Imposing constraints on the Llama-2 model to avoid uncertain predictions further improved its accuracy. Conclusion Locally deployable LLMs, trained to extract core injury-related information from free-text ED clinical notes, demonstrated good performance. Generative LLMs can serve as versatile solutions for various injury-related information extraction tasks.