Mesna has been used with ifosfamide to prevent urotoxicity in the treatment of testicular cancers. This drug also protected the toxicities of adriamycin without compromising cytostatic activity. With n idea of radioprotective role of sulfhydryl group of radioprotectors and of mesna decreasing the toxic effect of adriamycin which produces free radicals, mesna and radiation were administered to mice to study the protective effect of this drug and to identify the difference in regenerative capacity of the germ cells in the testis between radiation-treated and both mesna- and radiation-treated groups. The shape and numbers of spermatogenic cells in the seminiferous tubules were examined every week after irradiation. In both groups, initial reduction and later recovery in germ seel numbers and shape was observed. The lowest germ cell number was found around three weeks after irradiation. Mean germ cell number of the mesna-treated group was significantly higher than radiation-treated group at all observed periods (p<0.05). More competent regeneration was present in mesna-treated group. These results suggest that mesna protect the testis from radiation injury. Further study will be necessary to identify whether mesna protects other tissues from radiation and it does not hamper tumor control.
Animals ; Doxorubicin ; Free Radicals ; Germ Cells ; Ifosfamide ; Mesna* ; Mice* ; Radiation Injuries ; Regeneration ; Robenidine ; Seminiferous Tubules ; Testicular Neoplasms ; Testis*

From April 1985 to September 1989, 26 patients with stage IandII non-Hodgkin's lymphoma of unfavorable histology localized in head and neck region were treated with combined modality (combination chemotherapy plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 26 patients, 23 showed complete response and 3 partial response. Between these two groups there were no statistical differences according to the variables. Three-year survival and disease-free survival rate were 62.4% and 65.2%, respectively. Unilateral involvement of neck node (p<0.05), radiation dose over 5000 cgy (p<0.01,) and 6 or more cycles chemotherapy (p=0.06) had a favorable effect on 3-year survival rate. There were 8 recurrences including 3 partial responders, 1 local failure, 1 distant failure, 1 contiguous failure, and 2 simultaneous local and distant failure. It could be suggested that combined modality treatment might be necessary for the treatment of stage IandII Non-Hodgkin's lymphoma of unfavorable histology.
Disease-Free Survival ; Drug Therapy ; Gyeongsangbuk-do ; Head* ; Humans ; Lymphoma, Non-Hodgkin* ; Neck* ; Radiation Oncology ; Recurrence ; Survival Rate

BACKGROUND: Studies in animals suggest that pipecuronium dose not induce hemodynamic chan-ges related to histamine release or to an effect on the autonomic nervous system. Therefore the effects of bolus administration of large doses of pipecuronium, up to 0.20 mg/kg, on the intubation condition, onset and duration of neuromuscular blockade, heart rate and blood pressure were studied during fentanyl- nitrous oxide anesthesia. METHOD: Forty adults were randomly assigned to receive a bolus injection of either 0.05, 0.10, 0.15, 0.20 mg/kg of pipecuronium. Neuromuscular blockade was measured using mechanomyographic activity of the adductor pollicis muscle after supramaximal stimulation of the ulnar nerve. Four subgroups of 10 patients received pipecuronium doses of 0.05, 0.10, 0.15 and 0.20 mg/kg, respectively, as an intubating dose. RESULTS: The times of onset and clinical duration (mean sem) after each dose were as follows: 0.05 mg/kg, 2.98 0.42 and 41.5 2.42 min; 0.10 mg/kg, 1.54 0.06 and 82.9 7.48 min; 0.15 mg/kg, 1.41 0.14 and 124.8 13.1 min; 0.20 mg/kg, 1.12 0.05 and 187.1 12.8 min. The intubation condition, time of onset and duration after doses of 0.05 mg/kg were significantly different from values after the higer doses. The duration was increased with dose-increments. No dose-related changes in heart rate or blood pressure were observed. CONCLUSION: The authors conclude that dose of 0.10 mg/kg and over has good intubation condition clinically and large bolus dose of pipecuronium can be safely used with a significantly prolonged duration of action without hemodynamic change.
Adult* ; Anesthesia ; Animals ; Autonomic Nervous System ; Blood Pressure ; Heart Rate ; Hemodynamics ; Histamine Release ; Humans ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Nitrous Oxide ; Pipecuronium* ; Ulnar Nerve

No abstract available.

We report a case of pseudoaneurysm formation after aneurysmal clipping. An aneurysm, which was located on the beginning of orbitofrontal artery, was clipped and wrapped with Surgicel(R) and fibrin glue. Four weeks later, an enlarged aneurysm was detected at the same site on postoperative angiography. We could not find a new aneurysm in the second operation except inflated wrapping region. And clip had been slipped from the original aneurysmal neck. So we concluded that a new aneurysm was a pseudoaneurysm made with surgicel and fibrin glue. And it had been formed from continuous minor leakage caused by slipped clip.
Aneurysm* ; Aneurysm, False* ; Angiography ; Arteries ; Fibrin Tissue Adhesive ; Neck

Adult ; Connective Tissue ; Extremities ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Maxilla ; Neck ; Radiotherapy ; Sarcoma

From 1984 to 1988, fourt two patients with nasopharyngeal cancer were treated at the Department of Radiation Oncology in Kyungpook National University Hospital. Thirteen patients refused treatment and the median survival time was 7.8 months. Twenty nine patients received a full course of radiation at least 70 gy to the primary site and 60 gy to the nodal sites. These patients were all belonged to stage III or IV. The local control rate was 75% in squamous cell carcinomas, and all the patients with lymphoepithelioma showed a complete response. Overall locoregional failure was 27.6%. Distant metastasis was the predominant pattern of failures; 4/6 in lymphoepithelioma, 4/10 in squamous cell carcinoma. The Three-year-survival rate for squamous cell carcinoma was 40.5%, and for lymphoepithelioma 25.9%, respectively. This may be due to the more frequent distant metastases in lymphoepithelioma and ineffective chemotherapy. No survival correlation was found with the level of neck node involvement. Though adjuvant chemotherapy was found to be of no benefit in overall survival, more prudent and aggressive chemotherapy would be necessary.
Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Drug Therapy ; Gyeongsangbuk-do ; Humans ; Nasopharyngeal Neoplasms* ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy

Fluoroquinolones are antimicrobial agents that have a broad range of activity against both gram-negative and gram-positive organisms. Anaphylactoid reactions have been sporadically reported with fluoroquinolones. There have been a few reports that describes cross-reactivity between fluoroquinolones. We experienced a case of ofloxacin-induced anaphylactoid reaction, and confirmed cross-reactivity between ofloxacin and ciprofloxacin with the oral challenge test. Cross-reactivity between fluoroquinolones may be important, and avoidance of any fluoroquinolones should be mandatory for patients with hypersensitivity reaction to one of these drugs.
Anti-Infective Agents ; Ciprofloxacin ; Fluoroquinolones* ; Humans ; Hypersensitivity ; Ofloxacin*

Insertion of indwelling arterial catheter has become a valuable procedure for blood pressure monitoring and for measurement of blood gas tension during anesthesia. A 34-year-old man with chronic alcoholism and diabetes mellitus was admitted to the hospital because of hyperosm-olar coma. On the first hospital day, percutaneous left radial artery cannulation was carried out for hemodynamic monitoring and arterial blood gas analysis after a modified Allen's test appear-ed to be positive. On the eleventh hospital day, the catheter was removed because of fever and sign of infection at the insertion site. Treatment with vancomycin by sensitivity test was begun on day 13, after continued for 2 weeks. On day 34 a pulsatile mass was noted at the insertion site. During surgery, a pseudoaneurysm of 1X1.2 cm size was found, and liquified hematoma and necrotic material were noted. The aneurysm was removed and end to end anastomosis was successfully completed. We suggest that risk factors for pseudoaneurysm may include abnormal state of vessel wall, multiple attempts at cannulation, increased duration of catheterization, adva-nced age, prolonged hospitalization, hematoma and infection at cannulation site.
Adult ; Alcoholism ; Anesthesia ; Aneurysm ; Aneurysm, False* ; Blood Gas Analysis ; Blood Pressure Monitors ; Catheterization* ; Catheters ; Coma ; Diabetes Mellitus* ; Fever ; Hematoma ; Hemodynamics ; Hospitalization ; Humans ; Radial Artery* ; Risk Factors ; Vancomycin

BACKGROUND: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of metocurine, atracurium, doxacurium, and pipecuronium. This study examine neuromuscu-lar blocking effect and recovery of mivacurium in isolated rat phrenic-hemidiaphragm with two-weeks phenytoin pretreatment. METHOD: After the administration of 14 days of phenytoin 40 mg/kg, administered intraperitoneally twice daily (n=10), ED90, antagonism of neostigmine and 4-aminopyridine on the electrically evoked twitch response and train-of-four (TOF) stimulation were compared to control groups in isolated rat phrenic-hemidiaphragm preparation. RESULTS: ED90 was significantly greater in the phenytoin group than in the control group (319 +/- 39.5 g vs. 209.5 +/- 52.2 g, respectively). After the administration of neostigmine 0.75 M, the recovery of the single twitch and TOF ratio were significantly lesser in the phenytoin group than in the control group (single twitch; 19.6 +/- 6.6% vs. 69.2 +/- 9.4%, TOF ratio; 0.258 +/- 0.149 vs. 0.543 +/- 0.1, respectively). After the administration of 4-aminopyridine 40uM, the recovery of the single twitch and TOF ratio were no significant differrence between the phenytoin group and the control group (twitch; 118.1 +/- 25.3% vs. 122.6 +/- 24.8%, TOF ratio; 0.937 +/- 0.051 vs. 0.949 +/- 0.067, respectively). CONCLUSION: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of mivacurium.
4-Aminopyridine ; Animals ; Atracurium ; Drug Interactions ; Neostigmine ; Neuromuscular Blockade* ; Phenytoin* ; Pipecuronium ; Rats*