BACKGROUND: The concentration of the blood including ACTH, catecholamine, serum prolactine, cortisol is increased due to responding on stress by carrying out endotracheal intubation upon the mutiple trauma patients who were taken to the emergency room. Diazepam is a kind of benzodiazepine pharmacon and common pharmacon used for stability of the patients, relief and pretreatment as a booster for the relaxation of skeletal muscle. This research aims to know how effectively medication of diazepam before endotracheal intubation helps to constrain the reaction on the part of cardiovascular system due to laryngoscopy and endotracheal intubation, and makes concentration of catecholamine in blood changed. METHODS: The subjects are consisted of the patient asked for endotracheal intubation instantly, suffering from caput trauma (GCS 8.0) among the multiple trauma patient, more than 20-year-old who were taken to the emergency room in Chosun university hospital from October 1, 1995 to September 30, 1996. They were decided into 2 classes, 30 people each class, and one (group I ) was carried out endotracheal intubation without injecting diazepam,0.3 mg/kg, and the other (group II) was done with the endotracheal intubation by injecting diazepam, 0.3mg/kg. Group I and group II were measured blood pressure and heart rate before intubation and at 1, 3, 5, 7 minute after endotracheal intubation, sampled arterial blood from femoral artery, and then compared and analyzed. All of the data were recorded by mean, standard deviation, and percentage and repeated measures ANOVA test was used for the statistical test and the data was regarded as statistically significant when p value is below 0.05. RESULTS: 1) They were no significant differences statistically between 2 groups in the distribution of the age, weight, sex of the patients. 2) The changes in the systolic blood pressure had no statistical significance in the comparison between group I and group II, but diastolic blood pressure and the change of heart rate had statistical significance because p value was shown below 0.05. 3) Norepinephrine of blood was significantly lower in group II than group I. 4) Epinephrine of blood was significantly lower in group II than group I. CONCLUSION: It was shown that medication of diazepam before endotracheal intubation made stability of the patients and it changed significantly the reaction on the part of cardiovascular system from stress caused by laryngoscopy and endotracheal intubation. So it will be a good thing to inject diazepam for pretreatment to bring relief of the patients and cardiovascular stability before endotracheal intubation.
Adrenocorticotropic Hormone ; Benzodiazepines ; Blood Pressure ; Cardiovascular System ; Diazepam* ; Emergency Service, Hospital ; Epinephrine ; Femoral Artery ; Heart Rate ; Humans ; Hydrocortisone ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Multiple Trauma* ; Muscle, Skeletal ; Norepinephrine ; Prolactin ; Relaxation ; Young Adult

From May, 1971 to June, 1984, we performed extensive saucerization on the chronic osteomyelitis of long bones eradicating all pathologic foci; not only sequestra but sclerotic involocurum and necrotic original cortex embeded by new bone, which was different from the conventional methods such as sequestrectomy or guttering in its extensiveness. Clinical analysis on the base of radiologic evaluation after saucerization was done on the 16 patients; for average 5 years of follow-up. The results obtained were as follows; 1. The angulatory deformity of the long bones after pathologic fracture complicated by the chronic osteomyelitis was not corrected satisfactorily due to the bony sclerosis or hyperostosis at the fracture site, especially in cases of posterior or medial angulation. 2. The recurrence was closely related to the persisting non-sequestered original cortical lesion after incomplete saucerization, which was embeded by the new bone. So to prevent the recurrence the non-sequestered original cortical lesion must be removed completely. 3. The cortical defect after saucerization was restored completely in patients under the age of 14, but which was not the way in patients over the age of 16.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Hyperostosis ; Osteomyelitis ; Recurrence ; Sclerosis

Thirty one free vascularized fibula bone grafts were performed for treatment of osteonecrosis of the femoral head in 26 patients, 24 men and 2 women aged from 16 to 48(mean:32 years). Twenty one patients had unilateral disease. Five patients had bilateral disease underwent staged bilateral free vascularized fibula grafts three months apart. Associated etiological factors included alcohol(9 patients), steroid(7 patients), and trauma(one patient). The condition was considered idiopathic in the remaining 9 patients. Radiologic staging by Ficat included stage 1 in one hip, stage II in 15 hips, stage III in 14 hips, and stage IV in one hip. A skin island flap was used for monitoring purpose for the grafted fibula. One monitoring, flap was necrotized due to vascular occlusion but the fibula bone graft was left in place to use as a nonvascularized bone graft. Average follow-up period was 21 months in 31 hips. Pain was relieved in 28 hips(93.3 percent) and aggravated in 2 hips(6.7 per cent). On radiographic evaluation, 26 hips(86.7 per cent) demonstrated excellent preservation of the femoral head contour. Progressive collapse of the femoral head (greater than 1-2 mm) occurred in 2 hips, i mm depression in one hip with stage III and 2 mm collapse in one hip with stage IV. In conclusion, the free vascularized fibula bone graft is an excellent treatment modality for preserving the femoral head and relieving symptoms in cases of the osteonecrosis of the femoral head.
Depression ; Female ; Fibula* ; Follow-Up Studies ; Head* ; Hip ; Humans ; Male ; Osteonecrosis* ; Skin ; Transplants

The number of cancers in the head and neck areas has been increasing due to the increasing life span of the patients and a free flap is a common procedure to reconstruct defect in the head and neck area. From March 1990 to February 1998, 105 patients underwent 110 free flap operations after head and neck cancer ablation and they were reviewed retrospectively. Among 110 free flaps, 93 are forearm flaps, 6 jejunal flaps, 5 vascularized fibular osteocutaneous flaps, 2 lateral arm flaps, 2 rectus abdominis myocutaneous flaps and 1 latissimus dorsi muscle flap and 1 latissimus dorsi myocutaneous flap. Sixty-five radial forearm flaps and 4 ulnar forearm flaps were utilized in patched type and 24 radial forearm flaps in tubed type mainly for the reconstruction of intraoral and hypopharyngeal defects. Sis jejunal flaps were utilized for the esophageal reconstruction and 5 vascularized fibular osteocutaneous flaps for the mandibular reconstruction. The remaining flaps were for the reconstruction of other areas of head and neck.Overall survival rate of the flap was 95.5%. Immediate complications were fistula formation(3 cases), total flap loss (4 cases) or partial flap loss(3 cases) and donor site problems(10 cases). Superior thyrodial artery was the most commonly used recipient artery(89 cases) which was followed by facial artery, lingual artery and transverse cervical artery. Size discrepancy was not remarkable between the donor and recipient arteries. However, there was usually a marked size discrepancy between donor and recipient veins. More than two venous anastomoses were performed to increase the success rate of the flap surgery. An average follow-up period was 38 months ranging from 3 months to 6 years. There was no patient who died during or right after the operations, but 23 patients died due to recurrence of tumors or underlying heart disease during the follow-up period. Remaining patients lived well excluding 6 late postoperative complications such as 4 cases of esophageal stenosis and 2 cases of osteoradionecrosis. We conclude that free flap reconstruction after head and neck cancer ablation improves the quality of life and minimizes the loss of function.
Arm ; Arteries ; Esophageal Stenosis ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps* ; Head and Neck Neoplasms* ; Head* ; Heart Diseases ; Humans ; Mandibular Reconstruction ; Myocutaneous Flap ; Neck ; Osteoradionecrosis ; Postoperative Complications ; Quality of Life ; Rectus Abdominis ; Recurrence ; Retrospective Studies ; Superficial Back Muscles ; Survival Rate ; Tissue Donors ; Veins

No abstract available.
Fetal Development* ; Gestational Age*

No abstract available.
Fetal Development* ; Gestational Age*

No abstract available.
Diagnosis* ; Ectopia Cordis*

No abstract available.
Animals ; Aorta, Thoracic* ; Rats*

No abstract available.
Animals ; Carbon* ; Rats*

No abstract available.
Animals ; Carbon* ; Rats*