BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

No abstract available.
Prostate* ; Testis*

There is increasing need for network connecting personal computers(PC) together. Thus Local Area Network(LAN) emerged, which was designed to allow multiple computers to access and share multiple files and programs and expensive peripheral devices and to communicate with each user. We built PC-LAN in our department that consisted of 1) hardware-9 sets of personal computers(IBM compatible 80386 DX, 1 set:80286 AT, 8sets) and cables and network interface cards (Ethernet compatible, 16bits) that connected PC and peripheral devices 2) software - network operating system and database management system. We managed this network for 6 months. The benefits of PC-LAN were 1) multiuser (share multiple files and programs, peripheral devices) 2) real time data processing 3) excellent expandibility and flexibility, compatibility, easy connectivity 4) single cable for networking ) rapid data transmission 6) simple and easy installation and management 7) using conventional PC's software running under DOS(Disk Operating System) without transformation 8) low networking cost. In conclusion, PC-LAN provides an easier and more effective way to manage multiuser database system needed at hospital departments instead of more expensive and complex network of minicomputer or mainframe.
Database Management Systems ; Hospital Departments ; Humans ; Microcomputers* ; Minicomputers ; Pliability ; Running

No abstract available.
Mitral Valve*

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

No abstract available.
Shoulder*

The review of normal intravenous pyelography can give us important criteria of the diseases of the urinary system and the adjacent organs. Authors analyzed 200 cases of intravenous pyelography of normal Korean adults and measured the following points; the length of kidneys, the distance from midline to both poles, the slope degree of longitudinal axis, the ureteral length and width, the shortest distance from midline to abdominal ureters, the longest distance form midline to pelvic ureters, and configuration of urinary bladder. The results were obtained as follows; 1. The average length of kidneys in adult male was 12.53±0.78 cm on right, 12.83±0.82cm on left; in adult female, 12.08±0.72cm on right, 12.46±0.73cm on left. In the age distribution, the length gradually became shorter by getting old. In 20% of cases, right kidney was longer than left. 2. The average distance from both the renal poles to midline was longer in male compared to female. The distance from upper pole to the midline was longer in left side than right in male, but in the lower pole, there was no difference in both sexes. 3. The slope degree of the renal longitudinal axis was larger in male than in female, and lager in right kidney compared to left. 4. The length of ureter was longer on left, but there was no remarkable difference between both sexes. 5.The short set distance from midline to abdominal ureter, there was no remarkable difference between both sexes and also between right and left side. But concerning the longest distance from midline to pelvic ureter, it was longer in female; and especially in female, right side was shorter than left. 6. The longitudinal diameter of urinary bladder was longer in male, but horizontal diameter was longer in female.
Adult ; Age Distribution ; Female ; Humans ; Kidney ; Male ; Ureter ; Urinary Bladder ; Urinary Tract ; Urography

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

The suprascapular nerve entrapment syndrome is a rare neuropathy. Clein described the frist case report of this syndrome and operative procedure in 1975. The cardinal sign is pain in and around the shoulder, weakness of abduction and external rotation and atrophy of the supraspinatus and infraspinatus muscles, This syndrome can be diagnosed by clinical symptoms, physical examination, special roentgenogram and electromyogram. We experienced a case of the suprascapular nerve entrapment syndrome. We treated it by resection of the superior transverse ligament of suapula, and obtained good result.
Atrophy ; Ligaments ; Muscles ; Nerve Compression Syndromes ; Physical Examination ; Shoulder ; Surgical Procedures, Operative

From January 1986 to December 1990, preliminary percutaneous nephrostomy (PCN) was performed on 16 children for hydronephrosis. Infection was the most frequent presenting feature. This procedure was useful for providing drainage of pyonephrotic kidneys, for accessing recovery of renal function after relief of obstruction, and for preserving or regaining renal function in patients who were not fit for major surgery. Complications were uncommon and usually minor. Our experience has encouraged us to accept this procedure, both diagnostically and therapeutically. And we believe that it is safe, easily performed and effective and has become a valuable non-surgical alternative that should be favorable to manage children, especially infants, with urinary tract obstruction.
Child ; Drainage ; Humans ; Hydronephrosis* ; Infant ; Kidney ; Nephrostomy, Percutaneous* ; Urinary Tract