No abstract available.
Antibodies* ; Immunoglobulin G* ; Immunoglobulin M*

BACKGROUND: Recently, using propofol as intravenous anesthetic agent is increasing. And it is known that propofol has little effects on liver function even after long operation such as plastic surgery. But its effect on liver functon after hepatobilliary operation which may damage liver was not studied. Thus, authors carried out this study to evaluate the effect of propofol on liver function by comparing with enflurane in the patients who had laparoscopic cholecystectomy. METHODS: Patients's anesthesia records and hospital charts from January 1994 to June 1996 were anlaysed retrospectively. Three hundred and thirty three patients who had normal liver function preoperatively and had no complications during and after operation were selected. They were divided into two groups ; propofol group (n=191) and enflurane group (n=142). The preoperative values of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were compared with those of 1 and 3 days after operation. RESULTS: One day after operation, both propofol and enflurane group showed significant increase in AST and ALT (p<0.05) and decrease in ALP (p<0.05). But there was no difference between two groups. CONCLUSION: Concerned to liver function, propofol is as useful as enflurane to the patients who scheduled for laparoscopic cholecystectomy.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia* ; Aspartate Aminotransferases ; Cholecystectomy, Laparoscopic* ; Enflurane* ; Humans ; Liver* ; Propofol* ; Retrospective Studies ; Surgery, Plastic

Hyperthyroidism is a well known cause of atrial fibrillation. It is also known that control of hyperthyroidism can usually curb thyrotoxic atrial fibrillation and restore sinus rhythm. In this study, 282 patients with hyperthyroidism were investigated to quantify the incidence of atrial fibrillation, and to identify the vulnerable groups. In addition, we compared two groups of subjects with atrial fibrillation-one group with hyperthyroidism and the other group without
Aged ; Atrial Fibrillation ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Hyperthyroidism ; Incidence ; Male ; Sex Ratio ; Thyroid Gland

BACKGREOUND: Mass casualties from organophosphrous inhalation die from respiratory depression. Gas supplies and equipment are limited for mechanical ventilation of multiple subjects. Endobronchial insufflation of air (EIA) requires only a compresssor and airway catheters. We examined clinical usefulness of EIA in a model of apnea produced by tetrodotoxin (TTX) infusion. METHODS: Five anesthetized dogs were applied the conventional mechanical ventilation (CMV) while 12 mcg/kg TTX was infused IV over 90 min to produce apnea. EIA at 1 L/kg/min was delivered through a 35 cm long 0.8 cm I.D. catheter with a forked end placed astride the carina. Measurements of cardiovascular and respiratory function were made after TTX (time=0) on CMV, and then serially for 4 hours of EIA. RESULTS: All dogs survived through 4 hours study. PaO2 decreased significantly within 30 min and then slowly increased significantly after 60 min. PaCO2 increased significantly within 30 min and decreased significantly after 60 min. HR increased significantly after 20 min and MAP increased significantly after 60 min. Mean SD of PaO2, PaCO2, pHa, SaO2, cardiac output, mean pulmonary pressure, mean arterial pressure, systemic vascular resistance, central venous pressure and Qs/Qt are shown in table. Spontaneous respiratory efforts slowly returned after 45 min of EIA and resulted in the improvement of gas exchange. CONCLUSION: EIA is a field ventilatory technique useful when other equipment may not be available. The airway catheter can be placed by cricothyroidotomy. EIA supports life and produces normal survivors in apneic dogs.
Animals ; Apnea ; Arterial Pressure ; Cardiac Output ; Catheters ; Central Venous Pressure ; Dogs* ; Equipment and Supplies ; Humans ; Inhalation ; Insufflation* ; Mass Casualty Incidents ; Respiration, Artificial ; Respiratory Insufficiency ; Survivors ; Tetrodotoxin ; Vascular Resistance

BACKGROUND: Outpatient surgery has recently grown at a substantial rate. The development and use of short acting anesthetic and analgesic agents have played a major role in the growth of outpatient surgery. This study was designed to evaluate the intraoperative hemodynamic responses and recovery characteristics, using propofol or isoflurane to maintain the anesthesia. METHODS: A total number of 30, ASA physical status I-II patients scheduled for outpatient surgery, all of whom were to undergo excision of breast mass. The patients were randomly allocated to receive either total intravenous anesthesia with propofol, or inhalation anesthesia with isoflurane after induction of anesthesia with propofol. All patients were ventilated via a laryngeal mask airway (LMA) using a mixture of oxygen and air so that the FiO2 would be 0.4. RESULTS: There were no significant differences in hemodynamic changes during anesthesia in recovery time, or in complications between the two groups. CONCLUSIONS: We conclude that both methods provide reasonably rapid and reliable recovery from anesthesia and are equally acceptable to the patients.
Ambulatory Surgical Procedures* ; Analgesics ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Breast ; Hemodynamics ; Humans ; Isoflurane ; Laryngeal Masks ; Outpatients* ; Oxygen ; Propofol*

Glycogen storage diseases are inherited disorders of carbohydrate metabolism caused by a deficiency of enzymes that are involved in degradation of glycogen in the liver. The accumulation of glycogen occurs in the liver and other organs. Type Ia is the most common form and clinically may manifest of glycogen storage disease itself rather than growth hormone deficiency. But in this case the patient showed exceptional extreme growth retardation. Growth hormone stimulation test with clonidine and L-dopa revealed that the patient had growth hormone deficiency. Therefore, we report of a case of glycogen storage disease type Ia with the presence of GH deficiency with review of literature. A 16-year-old male was admitted for the evaluation of hepatomegaly and extreme short stature. The height was 113.5cm, less than third percentile of same age group, and compatible with fiftieth percentile of height of 6 years of age. After laboratory work up including liver biopsy, he was diagnosed with type I glycogen storage disease. The patient was presented with metabolic acidosis, hyperuricemia, and hypoglycemia. Hypoglycemia was managed with frequent feeding with high starch diet and intravenous glucose infusion. Metabolic acidosis was treated with sodium bicarbonate. Secondary hyperuricemia was treated with allopurinol. The patient is being followed at out-patient clinic with clinical improvement after of GH administration.
Acidosis ; Adolescent ; Allopurinol ; Biopsy ; Carbohydrate Metabolism ; Clonidine ; Diet ; Glucose ; Glycogen Storage Disease* ; Glycogen* ; Growth Hormone ; Hepatomegaly ; Humans ; Hyperuricemia ; Hypoglycemia ; Levodopa ; Liver ; Male ; Outpatients ; Sodium Bicarbonate ; Starch

The treatment of moya moya disease, a chronic occlusive cerebrovascular disease of unknown etiology, isn't settled ut various operative methods to maximize cerebral revascularization have been reported. Two cases in children treated surgically are presented, one with cerebroarteriosynangiosis and the other with encephalo-duro-arterio-synangiosis(EDAS). The methods of cerebral revascularization are discussed in detail.
Cerebral Revascularization ; Child* ; Humans ; Moyamoya Disease*

BACKGROUND: Left ventricular failure (LVF) after an acute myocardial infarction occurs during the perioperative period, and since this condition can lead to severe complications, intensive care is required for the patient. LVF is characterized hemodynamically by a raised left heart filling pressure and volume and global depression of the hearts pumping performance. Several effective drugs for patients with heart failure are catecholamines such as dopamine and dobutamine, vasodilators such as nitroglycerin and nitroprusside, and noncatecholamine inotropes such as amrinone, which are either infused alone or in combination. However, as of now, there has been no study as to clarifying either the exact dosage, drug combination, or how they affect the heart. METHODS: By inducing a state of experimental acute left ventricular failure in 20 dogs through ligation of the left anterior descending coronary artery, this study compared the hemodynamic parameters of two treatment groups-one group using amrinone alone (bolus 1 mg/kg, continuous infusion 15micro gram/kg/min), and another group using a combination of dopamine (10micro gram/kg/min) and nitroglycerin (2micro gram/kg/min). RESULTS: Cardiac output of dogs with postinfarct heart failure increased in both treatment groups. But, there was a significant decrease in systemic vascular resistance, pulmonary vascular resistance and left ventricular end diastolic pressure in the group treated with amrinone than dopamine-nitroglycerin. Amrinone also revealed a favorable effect on oxygen utility. CONCLUSIONS: These results showed that amrinone might be more effective than the combination of dopamine and nitroglycerin for acute left ventricular failure in terms of myocardial function, hemodynamic stability and oxygen utility.
Amrinone* ; Animals ; Blood Pressure ; Cardiac Output ; Catecholamines ; Coronary Vessels ; Depression ; Dobutamine ; Dogs* ; Dopamine ; Heart Failure* ; Heart* ; Hemodynamics* ; Humans ; Critical Care ; Ligation ; Myocardial Infarction ; Nitroglycerin ; Nitroprusside ; Oxygen ; Perioperative Period ; Vascular Resistance ; Vasodilator Agents ; Ventricular Function

BACKGROUND: Left ventricular failure (LVF) after an acute myocardial infarction occurs during the perioperative period, and since this condition can lead to severe complications, intensive care is required for the patient. LVF is characterized hemodynamically by a raised left heart filling pressure and volume and global depression of the hearts pumping performance. Several effective drugs for patients with heart failure are catecholamines such as dopamine and dobutamine, vasodilators such as nitroglycerin and nitroprusside, and noncatecholamine inotropes such as amrinone, which are either infused alone or in combination. However, as of now, there has been no study as to clarifying either the exact dosage, drug combination, or how they affect the heart. METHODS: By inducing a state of experimental acute left ventricular failure in 20 dogs through ligation of the left anterior descending coronary artery, this study compared the hemodynamic parameters of two treatment groups-one group using amrinone alone (bolus 1 mg/kg, continuous infusion 15micro gram/kg/min), and another group using a combination of dopamine (10micro gram/kg/min) and nitroglycerin (2micro gram/kg/min). RESULTS: Cardiac output of dogs with postinfarct heart failure increased in both treatment groups. But, there was a significant decrease in systemic vascular resistance, pulmonary vascular resistance and left ventricular end diastolic pressure in the group treated with amrinone than dopamine-nitroglycerin. Amrinone also revealed a favorable effect on oxygen utility. CONCLUSIONS: These results showed that amrinone might be more effective than the combination of dopamine and nitroglycerin for acute left ventricular failure in terms of myocardial function, hemodynamic stability and oxygen utility.
Amrinone* ; Animals ; Blood Pressure ; Cardiac Output ; Catecholamines ; Coronary Vessels ; Depression ; Dobutamine ; Dogs* ; Dopamine ; Heart Failure* ; Heart* ; Hemodynamics* ; Humans ; Critical Care ; Ligation ; Myocardial Infarction ; Nitroglycerin ; Nitroprusside ; Oxygen ; Perioperative Period ; Vascular Resistance ; Vasodilator Agents ; Ventricular Function

A 5-year-old Korean boy was admitted with dyspnea, intermittent cyanosis and finger clubbing. He was diagnosed to be suffering measles pneumonia 3 years ago. Plain radiograph showed collapse of the right lung, mediastinal shifting and infiltration on both lower lung fields. High resolution computerized tomography revealed a central bronchiectasis with mosaic hyperinflation. All of the clinical information indicated that the severity of illness score was 4 of bronchiolitis obliterans (BO). The bronchoalveolar lavage cellular profile showed predominant neutrophilia. BO with finger clubbing has been rarely reported previously in childhood. We report a case of BO with finger clubbing in children with regard to clinical presentation of measles complicated pneumonia.
Bronchiectasis ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Bronchoalveolar Lavage ; Child ; Child, Preschool ; Cyanosis ; Dyspnea ; Fingers* ; Humans ; Lung ; Male ; Measles* ; Pneumonia