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

Herpes zoster is primarily a disease of sensory portion of the nervous system and one of motor portion as well. Herpes zoster radiculopathy can be usually easily diagnosed in the presence or previous history of the characteristic cutaneous eruptions. Motor involvement dose not always coincide in location with the cutaneous lesions. Along with the radicular distribution of pain, motor neuron involvement can mimic other clinical conditions such as disc herniation, tumor infiltration, or infection. Even if the diagnosis of herpes zoster radiculopathy may be delayed, it must be put off until any other diseases or underlying causes are ruled out, especially in case motor symptoms and signs are major clinical features, or there is a topographic dissociation between dermatomes and myotomes involved. We report a patient with spinal cord tumor revealed in the evaluation and management of herpes zoster-related radiculopathy.
Diagnosis ; Herpes Zoster* ; Humans ; Motor Neurons ; Nervous System ; Paresis ; Radiculopathy* ; Spinal Cord Neoplasms* ; Spinal Cord*

Herpes zoster is primarily a disease of sensory portion of the nervous system and one of motor portion as well. Herpes zoster radiculopathy can be usually easily diagnosed in the presence or previous history of the characteristic cutaneous eruptions. Motor involvement dose not always coincide in location with the cutaneous lesions. Along with the radicular distribution of pain, motor neuron involvement can mimic other clinical conditions such as disc herniation, tumor infiltration, or infection. Even if the diagnosis of herpes zoster radiculopathy may be delayed, it must be put off until any other diseases or underlying causes are ruled out, especially in case motor symptoms and signs are major clinical features, or there is a topographic dissociation between dermatomes and myotomes involved. We report a patient with spinal cord tumor revealed in the evaluation and management of herpes zoster-related radiculopathy.
Diagnosis ; Herpes Zoster* ; Humans ; Motor Neurons ; Nervous System ; Paresis ; Radiculopathy* ; Spinal Cord Neoplasms* ; Spinal Cord*

We evaluated thirty normal human eyes(aged from 22 to 95) to investigate the changes with age of the cellularity and acid mucopolysaccharides in the trabecular meshwork. The cellularities were evaluated from the number of the cells per unit area of trabecular meshwork and the number of cells per unit length of trabecular meshwork. In addition, acid mucopolysaccharides(AMS) were investigated by counter staining the trabecular meshwork specimens, with Van Gieson following colloidal iron. The results were as follows: 1. With age, cellularities of the whole trabecular meshwork and the counterpart of filtration region decreased significantly(p0.05). 2. The trabecular meshwork cellularity and the absolute number of cells were decreased by 40.0% and 35.9%, respectively, for those aged from 22 to 95. 3. There was no strong relation between the change of acid mucopolysaccharides of the trabecular meshwork and aging process. The grade +1 AMS was observed in 15 eyes(50.0%) and was the most prevalent.
Aging ; Colloids ; Filtration ; Glaucoma ; Glycosaminoglycans* ; Humans ; Iron ; Trabecular Meshwork*

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

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

BACKGROUND: Controlling postoperative pain after knee replacement while reducing opioid-induced adverse effects and improving outcomes remains an important challenge. To assess the effect of combined capsicum plaster at the Korean hand acupuncture point on opioid consumption and outcomes after total knee replacement. METHODS: One hundred and two patients, received total knee replacement, were included in a randomized, double-blinded study: 51 patients were in the placebo group, and 51 patients were in K-M26 group. Capsicum plaster was applied at the K-M26 point in K-M26 group, whereas in the placebo group, an inactive tape was fixed at K-M26 point of both hands. The capsicum plaster was applied before induction of anesthesia for 8 h, and attached during 3 days postoperatively. They received postoperative pain treatment with intravenous patient-controlled analgesia (PCA) during the first postoperative 48 h. Visual analog scale (VAS) scores at rest were used to assess pain. Total PCA volume delivered, number of PCA requests, supplemental analgesics, overall satisfaction score and adverse events were evaluated. RESULTS: K-M26 group reported significant lower VAS and supplemental analgesic doses at 3 days postoperatively compared with placebo group. No significant differences were found in delivered doses and requested number of PCA, and satisfaction score between two groups. There was a tendency of decrease in postoperative nausea and vomiting in K-M26 group, but no significant differences. CONCLUSIONS: PCA with capsicum plaster at in K-M26 point is thought to be potent and safe for postoperative pain relief after total knee replacement with the lesser adverse events.
Acupuncture Points* ; Acupuncture* ; Analgesia, Patient-Controlled ; Analgesics ; Anesthesia ; Arthroplasty, Replacement, Knee ; Capsicum* ; Hand* ; Humans ; Knee* ; Pain Management* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Visual Analog Scale