That gallamine causes tachycardia during general anesthesia is well known, but the efficacy of its anticholinergic action or an adrenergic beta blocking action remains to be determined. Twelve patients were subjected to this study, in which under halothane anesthesia small doses of propranolol. an adrenergic beta-blocker, was administered. In all cases bradycardia resulted and the greatest decrease was noted five minutes after intravenous injection of propranolol(0. 5 1. 0mg). At the height of bradycardia, gallamine 80 mg was administered intravenously. In all cases gallamine produced a significant increase of heart rate over the level before the injection of propranolol, but not so much as without propranolol pretreatment. But fifth minute values after propranolol expressed as 100 per cent, (per cent change in heart rate after propranolol followed by gallamine,) and after gallamine were similar effectively. This study suggested that gallamine-induced tachycardia is modified, but its anticholinergic action is not impaired by propranolol, and that gallamine-induced tachycardia is caused by anticholiaergic action of gallamine.
Anesthesia* ; Anesthesia, General ; Bradycardia ; Gallamine Triethiodide ; Halothane* ; Heart Rate ; Humans ; Injections, Intravenous ; Propranolol* ; Tachycardia*

Four patients underwent surgery for idiopathic epiretinal membrane at macula. The follow-up was from 5 to 8 months. The epiretinal membrane was removed by vitreous surgical technique with sutherland scissors and forceps. By electron microscopic study of the membrans, four typical cells(fibrous astrocytes, macrophages, fibrocytes and myofibroblast-like cells) were found in one case and hyalocytes in another case. In all cases visual acuity improved by more than 2 lines in Snellen chart.
Astrocytes ; Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Macrophages ; Surgical Instruments ; Visual Acuity

For the assessment of the effect of succinylcholine(SCh) on pancuronium, 62 adult patients undergoing elective surgery under gerieral anesthesia were subjected tc this study in which the EMG response(twitch hight) of the hand to TOF stimulation(0.2 Hz) of ulnar nerve was monitored and recorded with Datex Relaxograph. According to the amount and mode of the drugs administered, the patients were divided into four experimental groups: 1) Group I, a bolus intravenous injection of pancuronium in dose of 0.05 mg/kg. 2) Group II, intravenous injection of pancuronium 0.1 mg/kg, a double dose of group I. 3) Group III, intravenous injection of pancuronium(0.05 mg/kg) after 25 to 50 recovery of initial twitch height from twitch height depression induced by SCh(1 mg/kg). 4) Group IV, mixed intravenous injection of SCh(1 mg/kg) and pancuronium(0.05 mg/kg). Followings were the results. 1) Mean onset time of the effect of pancuronium, was 15.6+/-1.1 minutes in group I and 13.8+/-1.5 minutes in group II, to 2,9+/-0.4 and 1.3+/-0.1 minutes in group III and IV respectively, and decreased(p< 0.001). 2) Duration of action of pancuronium was 47.1+/-4.5 minutes in group I and 87.7+/-7.4 minutes in group II, the prolongation of the latter being significantg<0.001). It was, however 48.3+/-5.2 minutes in group III, indicating that SCh showed a little effect, while it was 21.2+/-1.9 minutes in group IV, being significantly shorter than those of group I and III(p<0.001), 3) Potency of pancuronium expressed by the percentage changes of initial twich height was 34.3+/-6.0% in group I and it was noted to decrease significantly to 4.0+/-1.0% in group II and 0% in group IV(p<0.001). This pattern of decrease was almost similar to group II. 4) Presence of pancuronium(0.05 mg/kg) in group IV did not have any effect on the intensity of fasciculation induced by SCh. These results indicate that succinylcholine could potentiate the onset time and action potency of pancuronium by facilitating quick action on the receptor, but it have an antagonistic effect on the duration of action of pancuronium.
Adult ; Anesthesia ; Depression ; Fasciculation ; Hand ; Humans ; Injections, Intravenous ; Pancuronium* ; Succinylcholine* ; Ulnar Nerve

Glycopyrrolate(Robinul) is a potent anticholinergic drug. Being a quaternary ammonium compound, it dose not cross the blood-brain barrier and thus dose not have the central effects. It has been shown that glycopyrrolate has a pharmacologic properties similar to that of atropine, belladonna alkaloid, but it has lesser effect on the heart rate than that of atropine. The author administered a small dose of glycopyrrolate intravenously to 18 people who were awake, 21 compatous cases and 17 halothane anesthetized cases. The effect on the heart rate in these 3 groups was compared. The results are as follows: 1) In the awake state, glycopyrrolate(0.1mg) produced a slight decrease in the heart rate. 2) In the comatose state, glycopyrrolate(0.1mg) produced a slight increase in the heart rate. 3) In the halothane anesthetized state, glycopyrrolate(0.1mg) produced a significant increase in the heart rate. 4) In the comatose state, the absence of bradycardia after a small dose of glycopyrrolate is similar to a small dose of atropine. Therefore we suggest that bradycardia after glycopyrrolate and atropine is caused by sympathetic ganglion block.

OBJECTIVES: This study was designed to integrate the results of community based studies which assessed a relationship between depression and alcoholism by meta-analysis. METHODS: We identified the previons studies and included in meta-analysis by searching MEDLINE. Overall, 21 results of the studies for relationship between depression and alcoholism were selected for quantitative meta-analysis. Before the integration of the each effect size of the relationship between depression and alcoholism, a homogeneity test was conducted. For the publication bias, we also conducted the analyses of funnel plot, normal quantile plot, rank correlation test and the fail-safe n. RESULTS: We used the random effect model to estimate the overall effect size, because the homogeneity of studies was rejected in a fixed effect model. Our quantitative meta-analysis yielded that integrated odds ratio between depression and alcoholism was 2.42 (95% C.I. 1.98-2.97). From the results of analyses of the publication bias, the probability of publication bias is considered low. CONCLUSION: The published evidences suggested that there may be a significant positive relationship between depression and alcoholism.
Alcoholism* ; Depression* ; Odds Ratio ; Publication Bias

OBJECTIVES: This study was designed to integrate the results of community based studies which assessed a relationship between depression and alcoholism by meta-analysis. METHODS: We identified the previons studies and included in meta-analysis by searching MEDLINE. Overall, 21 results of the studies for relationship between depression and alcoholism were selected for quantitative meta-analysis. Before the integration of the each effect size of the relationship between depression and alcoholism, a homogeneity test was conducted. For the publication bias, we also conducted the analyses of funnel plot, normal quantile plot, rank correlation test and the fail-safe n. RESULTS: We used the random effect model to estimate the overall effect size, because the homogeneity of studies was rejected in a fixed effect model. Our quantitative meta-analysis yielded that integrated odds ratio between depression and alcoholism was 2.42 (95% C.I. 1.98-2.97). From the results of analyses of the publication bias, the probability of publication bias is considered low. CONCLUSION: The published evidences suggested that there may be a significant positive relationship between depression and alcoholism.
Alcoholism* ; Depression* ; Odds Ratio ; Publication Bias

Two schizophrenic patients who had been taking medication for a long period presented with visual disturbance of 6-month duration. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted. Although we strongly suspected that the patient might have taken one of the drugs of the phenothiazine family, we were unable to obtain a history of medications other than haloperidol and risperidone, which were taken for 3 yr. We performed a drug profiling test using urine samples and detected methotrimeprazine. The patient underwent surgery for anterior subcapsular lens opacities. Visual acuity improved in both eyes, but the corneal deposits remained. We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.
Adult ; Antipsychotic Agents/*adverse effects/therapeutic use/urine ; Cataract/*chemically induced ; Corneal Diseases/*chemically induced ; Female ; Humans ; Male ; Mental Retardation/diagnosis/drug therapy ; Methotrimeprazine/*adverse effects/therapeutic use/urine ; Middle Aged ; Schizophrenia/diagnosis/drug therapy ; Visual Acuity

PURPOSE: We performed this study in order to evaluate the incidence and characteristics of urolithiasis in patients with malignant hematologic diseases. MATERIALS AND METHODS: Nine hundred one patients who underwent medical treatment for malignant hematologic disease and 40,543 patients who visited the emergency room and without malignant hematologic diseases were included in our study. The patients with malignant hematologic diseases were divided into two groups depending on their primary treatment. Group I included patients with acute and chronic leukemia (AML, ALL, CML, CLL) for which chemotherapy and steroid therapy was necessary, and group II included patients with anaplastic anemia and myelodysplastic syndrome and who had undergone repeated transfusion for treatment. Comparisons were made between the two groups in respect to the incidence of urolithiasis and the stones' radiopacity. RESULTS: Twenty nine patients (3.2%) of the 901 malignant hematologic patients were diagnosed with urolithiasis, compared to 575 patients (1.4%) of 40,543 emergency room patients. There was a significant increase of the incidence of urolithiasis in the malignant hematologic group. Compared to the general patients, the patients with malignant hematologic diseases had a higher rate of radiolucent stones (46.6% versus 16.3%, respectively), and the difference was significant. CONCLUSION: The incidence of urolithiasis for malignant hematologic patients was significantly higher than that for the control group.
Adult ; Aged ; Female ; Hematologic Diseases/*complications/epidemiology ; Humans ; Incidence ; Leukemia/complications/epidemiology ; Male ; Middle Aged ; Myelodysplastic Syndromes/complications/epidemiology ; Retrospective Studies ; Urolithiasis/*epidemiology/*etiology ; Young Adult

BACKGROUND: The intravenous injection of rocuronium bromide is often painful, and different methods have been used to minimize the incidence and severity of this pain. This study determined the effective dose of alfentanil to minimize the injection pain of rocuronium and the cardiovascular response after endotracheal intubation. METHODS: Eighty ASA physical status 1 and 2 adult patients were divided into four groups. Sixty seconds before administering rocuronium 0.6 mg/kg, the groups were given 10 ml of intravenous normal saline or alfentanil 10, 15, and 20microgram/kg. Pain was assessed after rocuronium injection. The mean arterial pressure and heart rate were measured before induction and before and after intubation. RESULTS: Both 15 and 20microgram/kg alfentanil minimized the rocuronium injection pain, although 20microgram/kg alfentanil caused an undesirable decrease in the mean arterial pressure. CONCLUSIONS: A 15microgram/kg bolus of alfentanil may be useful for minimizing the rocuronium injection pain and blunting the cardiovascular response after endotracheal intubation.
Adult ; Alfentanil ; Androstanols ; Arterial Pressure ; Heart Rate ; Humans ; Incidence ; Injections, Intravenous ; Intubation, Intratracheal