Balloon-tipped, flow-directed (Swan-Ganz) catheters are used commonly for monitoring of cardiac function in patients undergoing cardiac surgical procedures. We report a case of pulmonary hypertension with hypoxemia which may be caused by incorrect positioning of pulmonary artery catheter (PAC) during CABG. Pulmonary arterial pressure (PAP) of 70/40 mmHg which was nearly high as systemic pressure was measured when we tried to wean patient from cardiopulmonary bypass. But, TEE (transesophageal echocardiography) showed nonspecific finding. PAP decreased soon and maintained about 33/16 mmHg for a few minutes. But, the PAP elevated high to 70/40 mmHg again and the arteral oxygen tension (PaO2) decreased to 61.2 mmHg. When we withdrew the PAC to the depth of 35 cm, the PAP and systolic pressure returned to normal range and PaO2 elevaed to 320 mmHg. End tidal CO2 was elevated from 30 mmHg to 35 mmHg.
Anoxia* ; Arterial Pressure ; Blood Pressure ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheters* ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Hypertension, Pulmonary* ; Oxygen ; Pulmonary Artery ; Reference Values

No abstract available.
Female ; Pregnancy ; Pregnancy, Multiple*

No abstract available.
Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen*

No abstract available.
Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen*

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

No abstract available.
Apnea* ; Humans

BACKGROUND:We experienced unintentional hyperventilation during mechanical ventilation in infants under general anesthesia. It is very difficult to decide upon respiratory rate or tidal volume for adequate ventilation without respiratory gas monitoring. During pulmonary ventilation using a Mapleson D circuit, the utilization of high fresh gas flow dilutes the expired gas and causes an underestimation of end-tidal CO2. We undertook to find a proper respiratory rate (RR) with a fixed tidal volume during controlled ventilation in infant general anesthesia. METHODS: We studied 50 infants weighing below 10 kg during general anesthesia. An uncuffed endotracheal tube was selected 3.5 or 4.0 mm (inner diameter). After intubation with midazolam, thiopental sodium and vecuronium, controlled ventilation was applied: total fresh gas flow 3 L/minute, peak inspiratory pressure 15-20 cmH2O, and RR 19 or 20/minute. Arterial blood gas analysis was done 20 minutes later. We calculated the RR for a PaCO2 of 36 mmHg according to the equation: RR (applied) = estimated RR x estimated PaCO2/ideal PaCO2. In addition, linear regression was performed to analyze the relation between age and RR. RESULTS: The estimated regression equation for RR using Pearson's correlation coefficient was as follows: RR = 22.835 - 0.415 x age (months). CONCLUSIONS: The equation (RR = 22.835 - 0.415 x age [months]) could be used as an index for safe ventilatory management without severe hyper- or hypo-carbia in infants during general anesthesia.
Anesthesia, General* ; Blood Gas Analysis ; Humans ; Hyperventilation ; Infant* ; Intubation ; Linear Models ; Midazolam ; Pulmonary Ventilation ; Respiration, Artificial ; Respiratory Rate* ; Thiopental ; Tidal Volume ; Vecuronium Bromide ; Ventilation*

This study was undertaker to define the usefuness of preoperative CA-125 assay as a diagnostic bmor marker in differentiating malignancy from benign ovarian mass. Senun CA-125 were imneasured by Microparticle Enzyme Immunoassay(MEIA) in 94 patients with ovarian mass. The results were of follows ; 1. The mean value of preopentive senun CA-125 was 18.40u/ml in benign ovarian mass and 225.99u/ml in malignant ovarian mass (P<0.001). 2. The positive rete of Ca-125 in benign ovarian mass was 10%, compared 80% in malignant ovarian mass. 3. In analysis of histolovgic type, posisitive rate of serum CA-125 in malignant serous tumor was 82%, cornpared 50% in malignant mucinoins tumor. 2. No statistically significant correlation was observed between CA-125 value and patient's age. 5. The sensitivitiy, specifieity, positive predictive value & negative predictive value were 80%, 90%, 60% & 96%, respectively in cut off value, 35u/ml, And increasing cut off value 65u/ml, sensitivity, specificity, positive predictive value & negative predictive value were 40%, 96%, 67%, 90%, resqxetively. These data suggest the preperative serum CA-125 level correlate with maignant stattis in ovarian mass. And cut off value 35u/ml was better than 65u/ml in screening for ovarian cancer.
Humans ; Mass Screening ; Ovarian Neoplasms ; Sensitivity and Specificity

Adult ; Child ; Dentistry ; Facial Bones ; Head ; Humans ; Incidence ; Jaw ; Mandibular Fractures ; Mouth ; Postoperative Complications ; Sex Distribution ; Surgery, Oral

No abstract available.
Rhinoplasty*