No abstract available.
Diskectomy ; Ear Cartilage ; Temporomandibular Joint ; Transplants

OBJECTIVE: We analyzed 200 cases of prenatal amniocentesis and compared them with other reported studies. Thus we propose the necessity of metanalysis for prenatal amniocentesis. METHOD: We analyzed 200 cases that have undergone amniocentesis at Masan Samsung hospital from January 1996 to December 1997. The results of our study was compared with other reported studies of amniocentesis by indication and maternal age. The proportion of age-class and indication are compared between previous study subjects and our 200 cases. RESULTS: Triple marker abnormality was the most common indication of amniocentesis(51%) and the most common age distribution was 25-29 years (43.5%). Chromosomal aberration was diagnosed in 20 cases (10%) of which the numerical aberration was 9 cases (4.5%) and the structural aberration was 11 cases (5.5%). 5 cases (2.5%) out of ll cases of the structural aberration were normal variant. There were 7 cases (trisomy 21) of autosomal aberration and 2 cases (Turner syndrome) of sex chromosome aberration. Arnong the structural aberration, there was only one reported case of 46, t(7:10) reciprocal translocation. There were no cases of fetal death except for a little self limited preterm labor. There were no neonatal complications. In the comparison of indication and maternal age with other studies, abnormal triple test was the most common indication of amniocentesis. The number of young pregnant women under 35 years old who underwent genetic amniocentesis was increased year by year. CONCLUSION: Triple maker screening test and genetic amniocentesis become popular method of antenatal diagnosis in Korea. Now, it is the proper time to establish standard indication of prenatal amniocentesis in this country by systemic and objective statistic examination. So we address the need for metanalysis in our country as comparing with other studies.
Adult ; Age Distribution ; Amniocentesis* ; Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Korea ; Mass Screening ; Maternal Age ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Prenatal Diagnosis ; Sex Chromosome Aberrations

Animals ; Bone Matrix ; Hardness ; Methylprednisolone ; Rats

No abstract available.
Gynecology* ; Laparoscopy*

A 75-year-old male patient with a left intertrochanteric fracture underwent emergency total hip arthroplasty under spinal anesthesia. He had an operation for laryngeal cancer about 10 years ago. Bronchiectasis and atelectasis were noticed in his preoperative roentgenogram. He underwent spinal anesthesia with 13 mg of 0.5% isobaric tetracaine. The level of spinal anesthesia was T7. The SpO2 (oxygen saturation of pulse oxymeter) decreased to 55% at 1 hour after start of operation. Breath sounds on the right lung were diminished. Tracheal intubation was performed for endotracheal suction. A large amount of yellowish secretion was aspirated through suction catheter. The SpO2 returned to 98%. We report a case of severe hypoxemia due to inability of expectoration in patient with bronchiectasis who underwent spinal anesthesia.
Aged ; Anesthesia, Spinal* ; Anoxia* ; Arthroplasty, Replacement, Hip ; Bronchi* ; Bronchiectasis* ; Catheters ; Emergencies ; Humans ; Intubation ; Laryngeal Neoplasms ; Lung ; Male ; Pulmonary Atelectasis ; Suction ; Tetracaine

The bradycardiac and presor to intravenous and intraventricular methoxamine were examined in urethane-anesthetized rabbits 1) Intravenous methoxamine produced bradycardiac pressor responses. Atropine (2 mg/kg, i,v.) weakened but not abloished the bradycardiac effect. 2) The bradycardiac effect elicited by intravenous methoxamine was not affected by int-ravenous prazosin, rehimbiine, guanethidine and propranolol, butt was attenuated by intra venous chlorisondamine reserpine. 3) The pressor effect elioited by intravenous methoxamine was weakened by prazosin, but was scarcely affected, rather potentiated, by intraTenous yohimblne, guanethidine, chlorisondamine, propranolol and resperpine. 4) Intraventricular methoxamine produced pressor and bradycardiac responses. 5) The bradycardiac effect elicited by intraventricular methoxamine was net affected by intravenous atropine, prasosin and yohimbine. This was attenuated by intravenous guane- thidine, chlorisondamine, propranolol and reserpine, and by intraventricular atropine prazosin and propranolol, respectively. 6) The pressor effect elicited by intraventricular methoxamine was attenuated by intra- ventricular and intravenous prazosin. This was not affected by intravenous atropine, gua-nethidine, chlorisondamine, propranolol, reserpine and yohimbine, and by intraventricular atropine, prasosin and Propranolol, respectivelr. 7) From these results it was inferred that bradycardiac effect elicited by methoxamine was not an action through the mediation of aleph 1-adrenoceptors but was a result from non-specific actions on some brain receptors.
Atropine ; Brain ; Chlorisondamine ; Guanethidine ; Methoxamine* ; Negotiating ; Prazosin ; Propranolol ; Rabbits* ; Reserpine ; Yohimbine

No abstract available.
Heart Diseases* ; Heart*

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

Two patients with respiratory paralysis by cervical(C) injury were treated by sequential four-pole stimulation of the phrenic nerves to pace the diaphragm. With sequential four-pole nerve stimulator, full-time bilateral electroventi-lation were achieved and the conditioning of the diaphragm have been performed in 72 hours. According to other papers using unipolar or bipolar electrode, conditioning of the hypotrophic diaphragm took 2 to 1l months, and full-time electroventilation was possible in only about half of the patients, so part-time mechanical ventilation was needed in remained half of the patients. These results suggest that the conditioning time in patients with high quadriplegia could be significantly shortened and it should be possible to achieved independence from the mechani-cal ventilator when sequential four-pole stimulator was used.
Diaphragm* ; Electrodes* ; Humans ; Phrenic Nerve* ; Quadriplegia* ; Respiration, Artificial ; Respiratory Paralysis ; Ventilators, Mechanical

BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation