BACKGROUND: It has been said that anesthesia and surgery tend to increse 'stress hormone' followed by reduction of GFR and urine flow. We have been noticed a polyuria during mastoidectomy with anesthesia. We hypothesized that a reduction of ADH secretion related to operative procedure might be a cause of a transient polyuria. METHODS: In 41 patients who were in ASA class I, mean arterial pressure (MAP), heart rates (HR), temperature, central venous pressure (CVP) were measured at before induction, just before drilling with irrigation, 30 minutes and 60 minutes after drilling with irrigation, and on arrival in recovery room by groups (room temperatured irrigating fluid and warm fluid were used in group 1 and group 2) during procedures. In 7 of 41, blood samples for antidiuretic hormone (ADH) and plasma osmolalities (Posm) were withdrawn at the same time points. In all patients, fluid were administered with 4 ml/kg/hour throughout the procedures. RESULTS: In group 1, mean urine volume were 5.0 and 6.4 ml/min during anesthesia and drilling with irrigation that was significantly more than in group 2 (3.6 and 4.2 ml/min). In 7 patients, ADH concentration was decreased during surgery compared to pre-induction level, while the Posm were in normal ranges. None of the MAP, HR and CVP showed significant changes. ADH concentrations were not significantly correlated to Posm. CONCLUSIONS: We suggest that a reduction of ADH secretion may have a major role in transient polyuria during mastoidectomy, which might be related to the mechanism that; 1) lowered temperature of hypothalamo-pituitary system by cold irrigating fluid may induce a transient ischemic changes of pituitary gland, 2) absorption of hypoosmolar irrigating fluid to central circulation may reduce central osmotic pressure.
Absorption ; Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Central Venous Pressure ; Heart Rate ; Humans ; Osmolar Concentration ; Osmotic Pressure ; Pituitary Gland ; Plasma* ; Polyuria ; Recovery Room ; Reference Values ; Surgical Procedures, Operative

BACKGROUND: The afferent and efferent pathways of fentanyl cough response (FCR) and central organization are poorly understood at present. The aim of this study was to investigate the pretreatment effects of morphine, propofol, atropine, and midazolam on FCR. METHOD: The 120 healthy patients were randomly assigned to six equal pretreatment groups. They received 2ug/kg fentanyl rapidly through a peripheral venous catheter. The patients in each group were pretreated before the time necessary for peak plasma levels with different drugs as follows: group 1, no premedication; group 2, morphine 0.05 mg/kg iv; group 3, morphine 0.05 mg/kg iv naloxone 0.01mg/kg iv; group 4, propofol 0.5 mg/kg iv; group 5, atropine 0.01 mg/kg iv; group 6, midazolam 0.05 mg/kg iv. The patients were observed for any coughing or side effects, including oxygen desaturation, bronchoconstriction, chest wall rigidity and seizure. RESULT: 40% of patients in group 1 (control) had a cough response to fentanyl. Group 2 (morphine) and group 3 (morphine naloxone) showed a reduced FCR of 10%. The incidence of coughing was 60% of the patients in group 4 (propofol), 30% in group 5 (atropine), and 40% in group 6 (midazolam). These were not statistically significant. CONCLUSION: FCR is not altered by pretreatment with propofol, atropine, or midazolam, but morphine inhibits cough response and this antitussive effect was not antagonized by naloxone.
Atropine* ; Bronchoconstriction ; Catheters ; Cough* ; Efferent Pathways ; Fentanyl* ; Humans ; Incidence ; Midazolam* ; Morphine* ; Naloxone ; Oxygen ; Plasma ; Premedication ; Propofol* ; Seizures ; Thoracic Wall

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

This experimental study was performed on 5 rabbits to ascertain if oxygenated Ringer's lactate Could be used in place of fluorocarbons through peritoneal administration. Oxygen was bubbled through solutions of Ringer's lactate at two different rates and the oxygen tension of each solution was determined. The solution used in vivo had oxygen delivered at a rate of 5 L/min; the mean PO2 and pH were 575.5 mmHg and 6.34 respectively, while the rate of oxygenation of the in vitro solution was 3 L/min. with a mean PO2 and pH of 416.6 mmHg and 6.08. After peritoneal administration of the oxygenated solution the PaO2 values were significantly increased from the control value. Other parameters such as pH, PaCO2, HCO3, BE, SO2 (oxygen saturation), Na and K were not shown to be statistically significant. Some degree of oxygenation could be obtained by the introduction of oxygenated Ringer's solution. This result suggested that this solution can be used for oxygenation via the transperitoneal administration, and that this method of oxygenation may possibly be used to treat some forms of respiratory failure.
Animal ; Infusions, Parenteral ; Isotonic Solutions/administration & dosage* ; Oxygen/administration & dosage* ; Oxygen/blood ; Rabbits

The aim of this study was to compare the changes of serum electrolyte concentration during the peri-induction period of anesthesia with depolarizing muscle relaxant or nondepolarizing muscle relaxant for endotracheal intubation. The study population was from 60 patients scheduled for elective surgery at Yeungnam University Hospital, who belonged to physical status I or II of ASA classification. Patients were divided into 2 groups; a) succinylcholine administered grouy (control group, Group A), b) vecuronium administered group (study group, Group B). The results were as follows; 1) The serum potassium concentration was significantly increased (p<0.05) in 5 minute post-induction compared with pre-induction in control group, but significantly decreased (p<0.05) in study group.2) The serum sodium and chloride concentrations were slightly deceased in 5 minute post-induction compared with pre-induction in both control and study groups, but no statistical significance was noticed in both groups. It is concluded that intravenous administration of nondepolarizing muscle relaxant (Vecuronium) for endotracheal intubation is safer than depolarizing muscle relaxanf (Succinylcholine) in the critical hyperkalemia conditions such as burn, multiple trauma, spinal cord injury, neuromuscular disease and uremia.
Administration, Intravenous ; Anesthesia ; Burns ; Classification ; Computer Systems ; Expert Systems ; Humans ; Hyperkalemia ; Information Systems ; Intensive Care Units ; Intubation, Intratracheal ; Multiple Trauma ; Neuromuscular Diseases ; Potassium ; Sodium ; Spinal Cord Injuries ; Succinylcholine ; Uremia ; Vecuronium Bromide

The Humphrey circuit system function with the efficiency of the Lack system for spontaneous respiration and of the Bain system for controlled ventilation. It is designed to incorporate into a single system the advantages of the Mapleson A, D, and E type systems and to be available in coaxial and non-coaxial forms. This study was done to study the functions of a new anesthetic breathing system and to evaluate the adequacy of the recommended fresh gas flow. For spontaneous and controlled ventilation the system required a low fresh gas flow to achieve normocarbia(In the Lack circuit system, 60ml/min., is useded and in the Bain circuit system, 70ml/min.). The advantage of this system was that it was simple to operate and maintain, more easily sterilized and applicable in academic use. Further more the non-coaxial form of the circuit overcame the hazard of the inner tube complication. But this form was thought to have the problem of humidifying the inspired gas which still has to be sutdied. This multicircuit system was used satisfactorily with low fresh gas flow under spontaneous and controlled ventilation maintaining normal range of arterial carbon dioxide. It may become one of the preferred semiclosed breathing systems because of simplicity, multipurpose usefulness and other advantages.
Carbon Dioxide ; Reference Values ; Respiration ; Ventilation

No abstract available.

BACKGROUND: Vibrio parahaemolyticus belonged to the new 03:K6 serotype was demonstrated an unusual potential to spread and an enhanced propensity to cause infection in the worldwide. Recently, increased numbers of V. parahaemolyticus 03:K6 had been isolated in Korea, and we analyzed the prevalence and molecular genetic characteristics of V. parahaemolyticus 03:K6 isolates. METHODS: V. parahaemolyticus were isolated from clinical specimens of patients with diarrhea in Hanyang University Hospital, Seoul, Korea, from 1998 to 2005. The serovars of isolates were determined by slide agglutination test with specific antisera. All isolates were examined for the presence of tdh/trh genes. AGS-PCR method detecting the new 03:K6 clone was used in this study. We analyzed clonality of these isolates by infrequent restriction site-polymerase chain reaction (IRS-PCR). RESULTS: Thirty-six strains were isolated from 1998 to 2005. The main serotype of isolates were 03:K6 (24/36: 67%), All of them have tdh gene but not trh gene and an unique toxRS gene of the new 03:K6. The morphotypes of 03:K6 isolates show a same pattern of IRS-PCR, but can easily be differentiated from non-03:K6 and 04:K68 isolates. CONCLUSION: The 03:K6 was a main serotype of V. parahaemolyticus isolated from 1998 to 2005 and they show same molecular characteristics.
Agglutination Tests ; Clone Cells ; Diarrhea ; Humans ; Immune Sera ; Korea ; Molecular Biology* ; Prevalence* ; Seoul ; Vibrio parahaemolyticus* ; Vibrio*

This experimental work was performed on 4 rabbits to demonstrate that administrations of oxygenated Ringer's lactate through the central venous infusion could be used as a means of oxygenation. The oxygen tensions of Ringer's lactate were determined upon changing the amount of oxygen being bubbled and the solutions with the mean PO2 and pH of 575.5 mmHg and 6.34 were used in this study. We did not use the solutions having the values below 416.6 mmHg PO2 and pH 6.08. After the infusion of the oxygenated solution through central vein, PaO2 values throughout the 1 hour experimental procedure were significantly increased above the control value. Other parameters such as pH, PaCOs, HCO3-, BE, O2 saturation did not show any statistically significant changes. Some degree of oxygenation could be obtained by infusing the oxygenated Ringer's solution. This suggested that oxygenation by infusion through the central venous line could used clinically in the treatment of some forms of hypoxia with hypovolemia.
Analysis of Variance ; Animals ; Blood Gas Analysis ; Infusions, Intravenous ; Isotonic Solutions/*administration & dosage ; Oxygen/*administration & dosage ; Rabbits

PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.
Mammography ; Population Characteristics ; Retrospective Studies