Acute hyperkalemia may result from many causes, i.e. excessive load, transcellular shift, decreased renal excretion, and so on, and may be associated with irreversible and fatal cardiac manifestations, muscle weakness, ventilatory and adrenal insufficiency, etc. We experienced a case of acute hyperkalemia probably due to red cell lysis which was evident immediately after the induction of general anesthesia with thiopental sodium and succinylcholin in 1 33 year-old female patient with common bile duct obstructive jaundice. In spite of active management during anesthesia and posoperative period, eventually she died of cardiac arrest. For the successful management of the acute hyperkalemia, the anesthesiologist should be aware of its etiologies, pathophysiology, diagnosis & treatment.
Adrenal Insufficiency ; Adult ; Anesthesia ; Anesthesia, General* ; Common Bile Duct ; Diagnosis ; Female ; Heart Arrest ; Humans ; Hyperkalemia* ; Jaundice, Obstructive ; Muscle Weakness ; Thiopental

The antihypertensive effect and side reaction of pindolol were studied in 48 cases of essential hypertension 5mg to 15mg once regiment for average period of 6 weeks. 1) Average reduction of 25.11mmHg in systolic and 16.36mmHg in diastolic pressure were observed and their percentile reduction was 15.20% and 14.79%, respectively. The overall effect rate was 83.21%. The blood pressure was lowered significantly since 1 week of both in systolic and diastolic pressure with the daily of 10-15mg. 2) There was no significant change in heart rate before and after treatment. 3) No specific side reaction was observed except 1 cases in which discontinued the medication because of severe headache and fatigability on 2nd day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Pindolol

We evaluated the clinical effects of Nicorandil in 27 patients (17 male and 10 female) with ischemic heart disease (17 patients of stable effort angina, 3 patients of unstable effort angina, 6 patients of spontaneous angina, 1 patient of variant angina) in terms of the effect on the anginal pain, electrocardiographic changes and side effects. The results obtained were as follows; 1. The pulse rate was not changed by the drug administration and blood pressure were decreased slightly by Nicorandil in a daily dose of 15 mg divided into 3 dose, but these decrease were not significant in statistical meaning. 2. Improvement in EKG changes was observed in 9 patients (69%) among the 13 patients who showed abnormal EKG initially. 3. Anti-anginal effect of nicorandil were excellent in 14 patients, good in 8 patients, fair in 3 patients and so the rate of global improvement was 82%. 4. Nicorandil had side effects in 7 patients, headache (4 patients), palpitation, ocular pain, edema, but these were transitory and tolerable except of one case who could not be continued because of severe headache.
Angina Pectoris* ; Blood Pressure ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Nicorandil*

The antihypertensive effect and side reactions of perdipine was studied in 22 cases of essential hypertension using 20mg 3 times daily regimen for average period of 5 weeks. 1) Average reduction of 20mmHg in systolic and 17mmhg in diastolic pressure was observed and percentile reduction was 11.90% and 14.92%, respectively. The overall effect rate was 81.82%. The blood pressure lowered significantly after 2 weeks of treatment both in systolic and diastolic pressure. 2) There was no significant change in heart rates before and after treatment. 3) No specific side reaction was observed except 1 case in which discontinued the medication because of severe headache and fatigability on the 1st day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

OBJECTIVE: The purpose of this study was to evaluate the incidence of inability to flex proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint in normal Koreans. The opposition palm ratio and thumb index ratio was also of interest. METHOD: Randomly selected eighty nine normal Korean adults of 48 men and 41 women, with ages 20 to 79 years. The finger flexion was measured using the standard flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) screening tests. Thumb index ratio and opposition palm ratio was also assessed additionally. RESULTS: In the sample population, 2 subjects (2.2%) were unable to bilaterally flex their fifth PIP joints independently. Four subjects (4.4%) were unable to flex one or both of their fourth or fifth DIP joints. These results show far less incidence of FDS dysfunction comparing with 52% of FDS dysfunction rate in Americans. The opposition palm ratio in men were 63.6% and in women 69.9%, indicating lower ratio in men. The thumb index ratio was not different statistically between the men and women. CONCLUSION: These data suggest that the different incidences of FDS and FDP dysfunction should be considered in interpretation. The opposition palm ratio and thumb index ratio might be useful in the hand rehabilitation.
Adult* ; Female ; Fingers ; Hand ; Humans ; Incidence ; Joints ; Male ; Mass Screening ; Rehabilitation ; Thumb*

Cytogenetic techniques were used to detect specific chromosomal losses and / or stuctural changes in 6 meningioma cell population of 11meningioma patients. Polymorphic DNA markers were uti.lized to investigate the loss of constitutional heterozygosity on chromosomes 8. 17 and 22 in 9 meningioma cell population of 1l meningioma patients. As a result, 5 cases(M-2.4,5.9, and 10) represented 45. XX. -22 or 45, XY.-22 as stem line. In addition to chromosome 22, other chromosomes were lost randomly. In one case(M-3) normal karyotypic pattern was oberved. The 9q+ structural change was also noted in case M-2. This structural change was thought to be the chromosomal involvement secondary to the loss of chromosome 22 in meningioma. Retentions of constitutional heterozygosity on chromosomes 8 and 17 were found in all cases. Loss of constitutional hererozygosity on chromosome 22 were found at Hind m RFLP of v-sis in cases M-1 and M-7. EcoRI RFLP of v-sis in case M-1. Bgl II RFLP of v-sis case M-1. Xba I RFLP of v-sis in cases M-6. M-9 and M-11. And EcoRI RFLP of bcr in all cases. Rearrangement of chromosome 22 in case M-1 was detected on the Xba I RFLP of v-sis as extra band(3.14kb). The reduction to hemizygosity on chromosome 22 was one important step in tumorigenesis of meningioma. Monosomy 22 might operate at the primary level of tumor initiation. Random losses of other chromosomes or structural changes as 9q+ were postula!ed to be related to tumor development.
Carcinogenesis ; Chromosomes, Human, Pair 22 ; Cytogenetic Analysis ; Cytogenetics* ; Genetic Markers ; Humans* ; Meningioma* ; Monosomy ; Polymorphism, Restriction Fragment Length

A postoperative recovery room serves to care for patients until they are sufficiently recovered from the physiologic derangements produced by surgery and general anesthesia. Upon emergence from general anesthesia, airway obstructuion, hypoxemia, pneumothorax, hypotension, hypertension, aspiration or excitement may occur. A Case of presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema in the recovery room. This complication was the result of an accidental sealing of the tracheal tube with plaster by an aid nurse. The patients was discharged with no problems. We report this case along with a review of the literature.
Anesthesia, General ; Anoxia ; Humans ; Hypertension ; Hypotension ; Pneumothorax* ; Recovery Room* ; Subcutaneous Emphysema*

A postoperative recovery room serves to care for patients until they are sufficiently recovered from the physiologic derangements produced by surgery and general anesthesia. Upon emergence from general anesthesia, airway obstructuion, hypoxemia, pneumothorax, hypotension, hypertension, aspiration or excitement may occur. A Case of presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema in the recovery room. This complication was the result of an accidental sealing of the tracheal tube with plaster by an aid nurse. The patients was discharged with no problems. We report this case along with a review of the literature.
Anesthesia, General ; Anoxia ; Humans ; Hypertension ; Hypotension ; Pneumothorax* ; Recovery Room* ; Subcutaneous Emphysema*

This study was carried out to observe and evaluate the middle ear pressure(MEP) change by nitrous oxide(N2O) and end tidal PCO2 during general anesthesia with halothane or enflurane. MEP was measured during general anesthesia by impedance audiometer(GSI 28 Auto tymp model) in 50 patients who were relatively healthy without upper respiratory tract infection and otologic problems from August 1987 at Chonbuk National University Hospital. The results were as follows: 1) During general anesthesia with 100% O2 and halothane or enflurane, MEP was decreased progressively under the preinduction level with time. 2) The decrease in MEP during general anesthesia with 100% O2 and halothane or enflurane was reversed by relative hypoventilation, but MEP showed negative values in all patients. 3) End tidal PCO2 was increased progressively by relative hypoventilation and returned gradually to pre-hypoventilation level by normoventilation. 4) MEP was increased during general anesthesia using N2O, which is propotional to the concentration of N2O by 20 minutes. Thereafter, MEP remained increased until termination of N2O administration. From the above results, it is concluded that MEP is increased during anesthesia using N2O. MEP can also be affected by end tidal PCO2 even though physiologic range. Therefore, it is prudent to avoid N2O especially when hyperventilation is not adequately permitted during general anesthesia for middle ear surgery and patient with middle ear disease.
Anesthesia ; Anesthesia, General* ; Ear, Middle* ; Electric Impedance ; Enflurane ; Halothane ; Humans ; Hyperventilation ; Hypoventilation ; Jeollabuk-do ; Nitrous Oxide ; Respiratory Tract Infections

Endovascular stent graft placement is a minimally invasive technique that can be applied to treat many diseases of the descending thoracic aorta. For accurate stent graft placement, clear identification of aortic lesion is important and transesophageal echocardiography (TEE) is an ideal imaging tool for descending thoracic aortic aneurysms. Also TEE is able to detect a perigraft leak that cannot be confirmed by angiography. Unlike angiography, TEE image acquisition capability is not dependent on nephrotoxic contrast dye. The analysis of perioperative cardiac function provided by TEE may be helpful in the perioperative anesthetic management. Furthermore, the tip of the transesophageal echocardiographic probe can be used as a marker to guide stent graft positioning. We report a case of endovascular stent graft placement using TEE in a patient with descending thoracic aortic aneurysm under general anesthesia.
Anesthesia, General ; Angiography ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Echocardiography, Transesophageal ; Endoleak ; Humans ; Stents ; Transplants