BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

The infradiaphragmatic type of Total Anomalous Pulmonary Venous Return(TAPVR) is a rare congenital cardiacanomaly which usually results in death during the period of early infancy. A two month-old baby boy with cyanosisand respiratory distress was suspected of having a TAPVR clinically and the two-dimensional echocardiographicfindings were compatible with the infradiaphragmetic type of TAPVR. The subsequent cardiac catheterization andcineangiogram revealed the common pulmonary vein connected with portal vein and inferior vena cava in theinfradiaphragmetic area with obvious obstruction. The surgery and the autopsy confiremd the preopeative diagnosis.Among infants presenting pulmonary venous congestion in the newborn period. TAPVR below the diaphragm shold be oneof the important diagnostic cosiderations.
Autopsy ; Cardiac Catheterization ; Cardiac Catheters ; Diaphragm ; Humans ; Hyperemia ; Infant ; Infant, Newborn ; Male ; Portal Vein ; Pulmonary Veins ; Scimitar Syndrome ; Vena Cava, Inferior

BACKGROUND: Several studies have demonstrated that the transient administration of oxygen improves cognitive performance. However, the effect of long-term oxygen administration remains unknown. This study investigated the impact of long-term oxygen administration on cognitive enhancement. METHODS: Six week old Sprague-Dawley rats (n = 46) were randomly allocated to one of three groups: the control (Control; n = 15), 30 min/day oxygen administration (Oxy30min; n = 16) and 60 min/day oxygen administration groups (Oxy60min; n = 15). The rats in all three groups were administered air or oxygen for 10 weeks. The Morris water maze test was employed to assess the latency (L & Lt), dwelling time (DT) and the total fraction above the mean dwelling time (FmDT) for cognitive performance. RESULTS: Compared to the control group, the Oxy30min and Oxy60min groups showed no differences in their L and Lt. There was a dose-response trend due to oxygen administration. Compared to the control group, the Oxy60min group had a significantly improved DT (P< 0.05). The FmDT also significantly increased in both of the oxygen administration groups, which also showed a dose-response trend (P<0.05). CONCLUSIONS: The present results suggest that long-term (10 weeks) oxygen administration can dose-dependently enhance cognitive performance.
Animals ; Oxygen* ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Animals ; Hypothermia* ; Rats*

We evaluated ten ptotic eyes of two hundred thirty eight eyes which had a peri bulbar anesthesia in aspects of sex, age and type of operation. Also we clinically evaluated the degree of ptosis, the function of levator muscle and postoperative interval to recovery of ptosis. The results were as follows: 1. Ptosis developed in 10 eyes (4.2%). Sex distribution was 8 females (80.0%) and 2 males (20.0%), and age distribution was from 44 to 83 years old. 2. At the postoperative 1 day, the most common degree of ptosis was severe form (60.0%), followed by mild form (30.0%) and moderate form (10.0%). In the function of levator muscle, 5 eyes (60.0%) were fair, followed by poor (30.0%) and good (20.0%). 3. The postopertive interval to recovery of ptosis was from 2 to 60 days, and then 5 eyes (50.0%) were Group II, followed by Group I (30.0%) and Group Ill (20.0%).
Age Distribution ; Aged, 80 and over ; Anesthesia* ; Female ; Humans ; Male ; Sex Distribution

The authors reviewed 11 consecutive patients with hemorrhage in pituitary adenomas, which were treated by transsphenoidal approach from Jan. 1992 to Dec. 1997. We evaluated nine cases of female and 2 cases of male patients(mean age: 43.4 years old). The diagnosis of pituitary apoplexy was made by severe neurologic sign with sudden onset of headache and visual disturbance, in the setting of hemorrhage in the pituitary adenoma on computed tomographic or magnetic resonance imaging scans. Two cases were diagnosed as pituitary apoplexy and the remaining cases were diagnosed as intratumoral hemorrhages. In our series, the most common symptoms were headache(81.8%) and visual disturbance(81.8%). Other symptoms and signs were hormonal symptoms(63.6%) due to preexisting tumor, cranial nerve signs(18.2%) and alteration of mentality(18.2%). Radiologic findings were changes of sellar contour(double floor sign, widened sellae and obliteration of anterior or posterior clinoid processes) on plain skull X-ray, high density lesion in sellar area on computed tomographic scan. The magnetic resonance images were taken in all patients. Among 11 patients, 9 cases showed subacute hemorrhage(high signal intensity on T1 weighted image) and 2 showed that of chronic stage(iso signal intensity on T1 image and high signal intensity on T2 image). According to the hormonal type, the most common type of tumors associated with intratumoral hemorrhage was non-functioning adenoma(7 cases) compared to other types(GH secreting: 2, ACTH secreting: 1, Prolactin secreting: 1). All patients showed significant improvement of symptoms after surgery(average follow-up, 12.5 months). Rapid diagnosis with computed tomography and/or magnetic resonance imaging, hormonal replacement and transsphenoidal decompression constituted effective therapy.
Adrenocorticotropic Hormone ; Cranial Nerves ; Decompression ; Diagnosis ; Female ; Follow-Up Studies ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pituitary Apoplexy ; Pituitary Neoplasms* ; Prolactin ; Skull

A patient of cerebral sparganosis is reported: The patient, a 47-year-old female complained of frequent seizures and headache. The disease was involved on right frontal lobe, and the lesion was successfully removed by BRW stereotaxic system. The characteristic features of sparganosis are reviewed.
Female ; Frontal Lobe ; Headache ; Humans ; Middle Aged ; Seizures ; Sparganosis*

OBJECTIVE: There were reports about weight gain, hyperglycemia, diabetes mellitus and hyperlipidemia associated with atypical antipsychotics. Moreover, these adverse effects of atypical agents, especially clozapine and olanzapine were reported to be able to precipitate cardiovascular disease. Accordingly, we investigated the incidence rate of hypertension in schizophrenic patients treated with clozapine or olanzapine by retrospective chart review. METHOD: We reviewed charts of patients with schizophrenia who admitted at St. Mary's Hospital, The Catholic University of Korea, and Naju National Hospital and selected records of patients treated with clozapine and olanzapine during at least 6 weeks. Patients treated with mood stabilizers, antidepressants, and antipsychotics other than clozapine and olanzapine were excluded. Finally, the records of 52 clozapine-treated patients and 76 olanzapine-treated patients were analyzed. Changes of systolic and diastolic blood pressure between before treatment and discharge time were analyzed by paired t-test. The incidence rates of hypertension before and after treatment were compared by McNemar test, and Cochran-Mantel-Haenszel test was used to compare incidence rates between clozapine and olanzapine treated group. Group difference of changes were analyzed by repeated measures ANOVA. RESULTS: The incidence rate of hypertension in clozapine treated group was increased after treatment. There was significant differences in the change of hypertension incidence rate in patients receiving clozapine versus olanzapine. However, there was no significant change in both systolic blood pressure and diastolic blood pressure in clozapine-treated patients. In olanzapine-treated patients, there was significant change in systolic and diastolic blood pressure. Repeated measures ANOVA indicated that antipsychotics medication induced decrease in systolic blood pressure, and diastolic blood pressure was decreased in olanzapine-treated patients. CONCLUSION: Our findings suggest that long-term clozapine treatment is associated with increased rates of hypertension, which may have a significant impact on medical morbidity and mortality.
Antidepressive Agents ; Antipsychotic Agents ; Blood Pressure ; Cardiovascular Diseases ; Clozapine* ; Diabetes Mellitus ; Humans ; Hyperglycemia ; Hyperlipidemias ; Hypertension* ; Incidence* ; Jeollanam-do ; Korea ; Mortality ; Retrospective Studies ; Schizophrenia ; Weight Gain

Cryptococcosis of central nervous system in uncommon, but fatal if untreated. We experienced a case of cryptococcal ventriculitis with hydrocephalus. The symptom was an increased intracranial pressure without meningeal irritation sign. It was confirmed by pathology and cytology taken from fibrous material, which caused an obstruction of shunt catheter in the lateral ventricle. We report a case of cryptococcal ventriculitis in 6 years old male child.
Catheters ; Central Nervous System ; Child ; Cryptococcosis ; Humans ; Hydrocephalus ; Intracranial Pressure ; Lateral Ventricles ; Male ; Pathology

Recently we experienced stereotaxic endoscopic biopsy and resection of intracranial tumors using the Brown-Robert-Wells system. Surgical exploration was undertaken under the local anesthesia:1 germinoma in pineal region, 1 arachnoid cyst in basal cistern. The method is described, and the its potential clinical applications is discussed.
Arachnoid ; Biopsy ; Endoscopy* ; Germinoma