No abstract available.
Keratins*

BACKGROUND: Tourniquet pain is probably mediated by C-fiber. The ability of fentanyl to interrupt this nociceptive conduction was studied by administering either fentanyl or saline intrathecally along with hyperbaric bupivacaine for spinal anesthesia. METHOD: The incidence of tourniquet pain was evaluated in 60 patients having orthopedic surgery of the lower extremities during spinal anesthesia by administering either 30 mcg fentanyl (group 2) or saline (group 1) along with 0.5% hyperbaric bupivacaine 10 mg. We measured the maximal sensory spread of analgesia to pinprick, the incidence of tourniquet pain, and the sensory anesthesia to pinprick at the onset of tourniquet pain. RESULTS: The average maximal sensory spread of analgesia was the same in both groups (T9). The incidence of tourniquet pain was significantly greater in group 1 (33%) than in group 2 (10%). The sensory levels of anesthesia at the onset of tourniquet pain were not different in two groups. CONCLUSIONS: Intrathecal fentanyl was effective against tourniquet pain for 2 hours of the orthopedic surgery of the lower extremities.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Fentanyl* ; Humans ; Incidence ; Lower Extremity ; Orthopedics ; Tourniquets*

BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

We report two cases of dyschromatosis symmetrica hereditaria. One is a 12-year- old female and her family had five individuals with similar pigmentary disorder through three generation. The other is a 22-yesr-old female who had no family history of similar disease. Fontana-Masson stain revealed increased and decreased melanin granules in the basal cell layers in the pigmented and depigmented lesions respectively.
Female ; Humans ; Melanins

Malignant fibrous histiocytoma is the most common soft tissue sarcoma in adult life and shows a mixed proliferation of both fibroblsstic & histiocytic cells. We report a case of myxoid malignant fibrous histiocytoma involving right lower leg in a 68-year-old male patient, who presented with a childs palm-sized nodular mass of 3 years duration. Histoapthologically, the tumor had varying proportion of myxoid cellular components. The myxoid areas showed spindle and pleomorphic cells arranged in a vague storiform pattern, abrupt transition between a solidly cellular area and a myxoid area, and lipoblast-like cells. The cellular areas showed spindle cells arranged in a storiform pattern characteritic of the typical pleomorphic malignant fibrous histiocytorna.
Adult ; Aged ; Child ; Histiocytoma, Malignant Fibrous* ; Humans ; Leg ; Male ; Sarcoma

The authors present 4 cases of spondylolisthesis, 1 case of spondylolysis and 2 cases of Tbc spondylitis of lower lumbar spine treated by posterior lumbar interbody fusion, with follow-up periods of 3 months to 2 years. All cases had severe low back pain. Other common manifestations were radiating pain to leg. All cases were treated with laminectomy, which included a mesial facetectomy followed by posterior lumbar interbody fusion. The spondylolisthesis was reduced to zero degrees in three cases by the use of vertebral spreader. The fusion rate of intervertebral space in radiological finding was 100%. On case become pain free, 4 cases had mild degree of pain, 1 case had moderate degree of pain and 1 case was not improved. The authors conclude that posterior lumbar interbody fusion is applicable as a surgical treatment of patient with spondylolisthesis and Tbc spondylitis.
Follow-Up Studies ; Humans ; Laminectomy ; Leg ; Low Back Pain ; Spine ; Spondylitis ; Spondylolisthesis ; Spondylolysis

From January, 1984 to January, 1985 twelve patients with unstable fracture and fracture-dislocation of the thoraco . lumbar spine with neurologic deficits were treated with Harrington Instrument. Fixation by Harrington Instrumentation appeared to provide stabilization, reduction and return of neural function. Author performed Harrington Instrumentation with experience of 12 cases of unstable thoraco . lumbar spine fructure and fracture-dislocation with neurologic deficits. Results were as follows : 1) Spinal fracture and fracture-dislocation were most common in thoraco . lumbar Junction. 2) Harrington Instrumentation was very effective for keeping the spine stability in unstable fracture. 3) Six cases (50%) had a complete neurologic deficit and six cases (50%) had a incomplete neurologic deficit, two cases of the six patients with complete neurologic deficits recovered slightly but two cases with incomplete neurological deficit gained complete recovery. 4) During the postoperative period, early ambulation was possible and average admission period were 71 days. 5) Correction of spinal deformity. A. Average value of kyphotic angle (12.5 degrees). B. Average value of Iw(Index of weding) (1.32). C. Displacement was completely corrected in eight patients (100%).
Congenital Abnormalities ; Early Ambulation ; Humans ; Neurologic Manifestations ; Postoperative Period ; Spinal Fractures ; Spine*

OBJECTIVE: Nitric oxide and endothelin-1 are two endothelium derived relaxing and constricting factors probably involved in the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage. The aim of this study is to ascertain the effects of nitric oxide donor(nitroglycerine) to reverse endothelin-1 induced cerebral vasoconstriction in vivo, when administered to the adventitial side of the basilar artery exposed through a transclival approach and common carotid artery exposed through a transcervical approach. METHODS: The exposed arteries were subjected to pharmacological manipulations and direct observation of the changes of their sizes under surgical microscope. Measurements of blood pressure, pulse rate and cerebral blood flow using thermal diffusion flowmetry during the drug infusion were done. RESULTS: 1) Nitroglycerine rapidly and completely reversed endothelin-1-induced vasoconstriction. The average value for maximal vasoconstriction by endothelin-1/synthetic cerebrospinal fluid was 58.3% of baseline arterial diameter and occurred within 30 minutes. 2) The nitroglycerine administered via adventitial side of the blood vessel was not associated with any changes in systemic blood pressure nor other vital signs. 3) Same changes occurred in the common carotid artery, although the severity of the occurrence and reversal of vasospasm were not significant compared to those of basilar artery. CONCLUSION: Intrathecally administered nitroglycerine was effective in reversing cerebral vasoconstriction without causing systemic hypotension. These findings provides the potential for the development of targeted therapy to reverse cerebral vasospasm after subarachnoid hemorrhage using nitric oxide donors.
Arteries ; Basilar Artery ; Blood Pressure ; Blood Vessels ; Carotid Artery, Common ; Cerebrospinal Fluid ; Endothelin-1* ; Endothelium ; Heart Rate ; Hypotension ; Nitric Oxide ; Nitric Oxide Donors ; Nitroglycerin* ; Rheology ; Subarachnoid Hemorrhage ; Thermal Diffusion ; Vasoconstriction ; Vasospasm, Intracranial ; Vital Signs

No abstract available.

BACKGROUND: For the diagnosis of malaria, examination of blood smear slides by light microscopy is used as standard, and commercial kits detecting malarial antibodies and antigens are available, and molecular methods such as polymerase chain reaction (PCR) are used additionally. But, these diagnostic methods can be performed when clinicians request them, so problems of misdiagnosing the patients who are not suspected malaria may be occurred. METHODS: In 42 Korean patients with malaria, the author analyzed the characteristic signals of malaria using granularity (90 degrees depolarized) versus lobularity (90 degrees polarized) graph of Cell-Dyn 4000 (CD4000) automatic hematologic analyzer. And, the author examined the presence of malaria in 421 random samples by CD4000 and Giemsa stain. RESULTS: The usefulness of CD4000 in diagnosing malaria are as follows, 93.0% sensitivity, 99.3% specificity, 93.0% positive-predictive value, and 99.3% negative-predictive value. CONCLUSION: CD4000 automatic hematology analyzer has high diagnostic sensitivity and specificity in diagnosing malaria. Because complete blood count (CBC) is the routine test for most patients, this method has advantage of time and cost effectiveness and can even detect malaria in unsuspected cases.
Antibodies ; Azure Stains ; Blood Cell Count ; Cost-Benefit Analysis ; Diagnosis* ; Hematology* ; Humans ; Malaria* ; Microscopy ; Polymerase Chain Reaction ; Sensitivity and Specificity