No abstract available.
Intussusception*

No abstract available.
Reye Syndrome*

BACKGROUND: Bag and mask devices are used frequently to provide patients with positive-pressure-assisted ventilation. One of the disadvantages is the fact that they do not deliver high concentrations of oxygen without special adaptors or attention to technique. In order to investigate the variables affecting oxygen delivery, we designed a study to determine the fractions of delivered oxygen (FDO2) under varying ventilating techniques and conditions. METHODS: We designed special wooden box, in which the Laerdal resuscitator bag had been. We measured the fractions of delivered oxygen with or without reservoir bag in various tidal volumes, respiration rates and oxygen flows. RESULTS: Without reservoir bag, the fractions of delivered oxygen were increased up to only 73% in spite of 15 l/min oxygen flow. With reservoir bag, the fractions of delivered oxygen were increased up to nearly 96% in 5-7.5 l/min oxygen flow. CONCLUSIONS: While using the Laerdal resuscitator bag, it is desirable to adapt reservoir bag and supply 5 l/min oxygen in conventional ventilation and 7.5 l/min in hyperventilation minimally for higher fraction of delivered oxygen.
Humans ; Hyperventilation ; Masks ; Oxygen* ; Respiratory Rate ; Tidal Volume ; Ventilation

BACKGROUND: Propofol inhibits postoperative bronchospasm. Ketamine prevents bronchospasm in asthmatic patients. The present study was designed to evaluate the effects and mechanisms of propofol and ketamine on tracheal smooth muscles. METHODS: After isolating guinea-pig tracheal preparations, the maximal tracheal tones were induced by smooth muscle constrictors(2 10 7 M carbachol, 10 5 M histamine, 30 mM K+ Krebs solution, 124 mM K+ Krebs solution). When tracheal tones stabilized, propofol or ketamine was added cumulatively to obtain the concentration-relaxation curves, and calculated the ED50 and ED95. RESULTS: Propofol and ketamine decreased maximal tracheal tones in the concentration-dependent manners. The ED50 and ED95 of propofol were lowest in the histamine group, highest in the 30 mM K+ Krebs solution group. The ED50 and ED95 of ketamine were lowest in the 124 mM K+ Krebs solution group, highest in the histamine group. CONCLUSIONS: The relaxant effects of propofol and ketamine involve with all receptors in nonspecific way. However, propofol may inhibit more strongly the histamine mediated mechanism of tracheal contraction and ketamine may involve more strongly with Ca++ channel.
Bronchial Spasm ; Carbachol ; Histamine ; Humans ; Ketamine* ; Muscle, Smooth* ; Propofol*

BACKGROUND: Methylmethacrylate monomer (MMA) bone cement has been associated with sudden systemic hypotension. The present study was aimed to explore the mechanism of direct myocardial depressant actions of MMA. METHODS: The isometric contraction of isolated guinea pig's right ventricular papillary muscle was measured. Normal and slow action potentials were evaluated by a conventional micro-electrode technique. The effects of MMA on sarcoplasmic reticulum (SR) function were evaluated by its effect on: rapid cooling contractures, rested state contraction of rat papillary muscle in normal Tyrode's solution and of guinea pig's papillary muscle in low Na+ Tyrode's solution. To measure the inward calcium currents (ICa), whole cell patch clamp techniques were applied. RESULTS: MMA caused a dose-dependent depression of the peak force (PF) and maximal rate of peak force (dF/dt-max). About a 30% depression of PF was shown at rested state (RS) contraction in rat myocardium and under low Na+ Tyrode's solution in guinea pig myocardium, respectively. In the 26 mM K+ Tyrode's solution, MMA caused dose-dependent depression of late force development without alteration in early force development. MMA depressed rapid cooling contracture accompanied by prolongation of time to peak contracture. MMA did not alter the amplitude or maximum depolarization rate of normal and slow action potentials. Action potential durations were significantly reduced. In patch clamp studies, MMA reduced ICa in a dose-dependent manner. CONCLUSIONS: MMA depressed cardiac contractility in a dose-dependent manner and may be partly related to the depression of Ca2+ influx through the cardiac membrane. SR Ca2+ release seems to be mildly inhibited by MMA. Based on common clinical concentrations, the direct myocardial depressant effect of MMA may not be a main cause of hypotension during an operation.
Action Potentials ; Animals ; Calcium ; Contracture ; Depression ; Guinea ; Guinea Pigs ; Hypotension ; Isometric Contraction ; Membranes ; Methylmethacrylate* ; Myocardium ; Papillary Muscles ; Patch-Clamp Techniques ; Rats ; Sarcoplasmic Reticulum

PURPOSE: Colorectal cancer (CRC) has a high risk for postoperative thromboembolic complications such as venous thromboembolism (VTE) compared to other surgical diseases, but the relationship between VTE and CRC in Asian patients remains poorly understood. The present study examined the incidence of symptomatic VTE in Korean patients who underwent surgery for CRC. We also identified risk factors, incidence and survival rate for VTE in these patients. MATERIALS AND METHODS: The patients were identified from the CRC database treated from January 2011 to December 2012 in a single institution. These patients were classified into VTE and non-VTE groups, their demographic features were compared, and the factors which had significant effects on VTE and mortality between the two groups were analyzed. RESULTS: We analyzed retrospectively a total of 840 patients and the incidence of VTE was 3.7% (31 patients) during the follow-up period (mean, 17.2 months). Histologic subtype (mucinous adenocarcinoma) and previous history of VTE affected the incidence of VTE on multivariate analysis. There was a statistically significant difference in survival rate between the VTE and non-VTE group, but VTE wasn't the factor affecting survival rate on multivariate analysis. Comparing differences in survival rate for each pathologic stage, there was only a significant difference in stage II patients. CONCLUSION: Among CRC patients after surgery, the incidence of VTE was approximately 3% within 1 year and development of VTE wasn't a significant risk factor for death in our study but these findings are not conclusive due to our small sample size.
Asian Continental Ancestry Group ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Mortality ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sample Size ; Survival Rate ; Venous Thromboembolism*

No abstract available.
Lung Diseases, Interstitial* ; Sjogren's Syndrome*

No abstract available.
Humans ; Immunity, Cellular* ; Lymphocytes* ; Tuberculosis, Pulmonary*

Colonoscopy is frequently used for lower GI tract screening tests. Although rare, splenic injury may develop in the high-risk patients on anticoagulants or antiplatelet agents. A 78-year-old female visited our hospital complaining of chest pain. She had taken antihyperlipidemic and antiplatelet agent with hyperlipidemia and 20%-stenosis in the left anterior descending artery. She was taken polypectomy after colonoscopy 4 years ago. The next day, after a follow-up colonoscopy for polypectomy, she complained epigastric and left upper abdominal discomfort. Pain intensity was not high, but next day, epigastric pain was increased, so coronary angiography was performed 2 days later using anticoagulants. Coronary angiography showed 40~50%-stenosis in the left anterior descending artery. Another antiplatelet agent was added. After 72 hours on colonoscopy, her pain was localized upper left abdominal area. Abdominal CT showed intracapsular bleeding in the spleen with a small amount of hemoperitoneum in the pelvis. Since her vital signs were stable, she was treated with conservative management. Her pain improved and discharged. One month later, she was taken Abdominal CT. CT showed the size of intracapsular fluid collection in the spleen was increased, but the whole fluid collection was liquidized. 2 weeks later, follow-up sonography showed the size of fluid collection conspicuously was reduced. The case reported herein is a splenic Injury after Colonoscopy in patient on antiplatelet agents.
Aged ; Anticoagulants ; Arteries ; Chest Pain ; Colonoscopy* ; Coronary Angiography ; Female ; Follow-Up Studies ; Hemoperitoneum ; Hemorrhage ; Humans ; Hyperlipidemias ; Lower Gastrointestinal Tract ; Mass Screening ; Pelvis ; Platelet Aggregation Inhibitors ; Spleen ; Tomography, X-Ray Computed ; Vital Signs

BACKGROUND: Hemodynamic derangement during the displacement of the beating heart in off-pump coronary artery bypass graft surgery (OPCAB) might be related with right ventricular (RV) dysfunction. This study evaluated the influence of displacing and stabilizing the heart, for the anastomosis of coronary arteries, on hemodynamic alterations and RV function in patients undergoing OPCAB. METHODS: Twenty patients with triple vessel coronary artery disease underwent OPCAB using single pericardial sutures: a tissue stabilizer was included. The hemodynamic variables and right ventricular ejection fraction (RVEF) were obtained using a right-heart ejection fraction thermodilution pulmonary artery catheter after the induction of anesthesia, before and after anastomosis of each coronary artery and after sternal closure. RESULTS: No significant hemodynamic changes were observed during the displacement of the heart or the placement of a stabilizer on all of the coronary arteries, except the obtuse marginal artery (OM) before anastomosis. RVEF, left ventricular stroke work index (LVSWI), stroke volume index and cardiac index (CI) decreased and mean pulmonary artery pressure increased significantly whist positioning the graft to the OM. Right ventricular volumes were not significantly changed, although central venous pressure and pulmonary capillary wedge pressure increased. Changing CI had a close relationship with LVSWI (r2 = 0.537, P <0.05) but not with RVEF (r2 = 0.118). These hemodynamic compromises recovered to baseline values after sternal closure. CONCLUSIONS: The displacement of the beating heart for positioning during anastomosis of the graft to the OM caused significant hemodynamic instability and LV functional changes in addition to RV functional changes seemed to be responsible for hemodynamic derangements.
Anesthesia ; Arteries ; Catheters ; Central Venous Pressure ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease ; Coronary Vessels ; Heart* ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Stroke ; Stroke Volume ; Sutures ; Thermodilution ; Thoracic Surgery* ; Transplants ; Ventricular Function, Right*