BACKGROUNDS: Carbon Dioxide (CO2) insufflation during thoracoscopy may result in adverse hemodynamic consequences such as increase in central venous pressure, decrease in cardiac output and increase in arterial carbon dioxide pressure. But the cerebral effects of CO2 insufflation during thoracoscopy are not known yet. To evaluate the cerebral effect of CO2 insufflation during thoracoscopy, jugular bulb venous blood oxygen saturation and pressure were measured. METHODS: Nine patients were underwent thoracic surgery by thoracoscopy and one lung ventilation. After operation, CO2 was insufflated and hemodynamic parameters, arterial blood pressure, heart rate, central venous pressure, jugular bulb pressure, arterial blood gases and jugular bulb venous blood gases were measured at intrathoracic pressure 5 mmHg, 10 mmHg and 15 mmHg respectively. RESULTS: Central venous pressure was increased with insufflation of CO2 of 10 mmHg and 15 mmHg. Jugular bulb pressure was increased with insufflationof of CO2 of 5mmHg, 10 mmHg and 15 mmHg. Arterial PCO2, jugular bulb venous PO2 and jugular bulb venous blood oxygen saturation were increased with insufflation of CO2 of 5 mmHg, 10 mmHg and 15 mmHg. CONCLUSION: CO2 insufflation pressure of 5 mmHg or greater resulted in significant increase in jugular bulb venous blood oxygen saturation and pressure.
Arterial Pressure ; Carbon Dioxide ; Cardiac Output ; Central Venous Pressure ; Gases ; Heart Rate ; Hemodynamics ; Humans ; Insufflation* ; Jugular Veins ; One-Lung Ventilation ; Oxygen* ; Thoracic Surgery ; Thoracoscopy*

Survival after acute myocardial infarction (AMI) is related to the number of diseased vessel, ejection fraction, extent of residual ischemic tissue, presence of ventricular arrhythmia. Because a variety of revascularization modalities are tried in recent years, the natural course after AMI seems to become difficult ot assess. From the experience of 129 cases of coronary angiography in AMI from Jan 1984 to Apr 1987, the factors related to invasive modality were analysed to evaluate the effect on the survival after AMI. The following results are obtained. 1) Single vessel disease and insignificant lesion were present in 60%, and multivessel disease comprised 40% in all group. 2) Patients were followed for a mean of 16.3 months and 2 cases(1.6%) expired suddenly and reinfarction developed in 6 cases(4.7%). 3) After exclusion of 4 cases taken CABG operation, the event free survival of all patients was 0.98, 0.90, 0.78, 0.78, 0.78 in double vessel disease, 0.94, 0.87, 0.87, 0.77, 0.51 in triple vessel disease. The survival was better in single vessel disease compared to multivessel disease (p<0.05), but no difference was present between double and triple vessel disease. 5) Event free survival in group with left ventricular end diastolic pressure(LVEDP) >16mm Hg was better than that of a group with LVEDP <16mm Hg. But no difference was present between group with ejection fraction <40% and group with ejection fraction >40%. From the above results, it can be concluded that the event free survival after mainly uncomplicated AMI in Koreans depends on the number of diseased vessel and LVEDP.
Arrhythmias, Cardiac ; Coronary Angiography ; Disease-Free Survival* ; Humans ; Myocardial Infarction*

We experienced one case of renal arteriovenous fistula that was treated with superselective transcatheter arterial embolization of the renal artery. The patient presented with colicky pain, gross hematuria, and acute urinary retention. At that time, we suspected renal stone because of a radio-opaque density on the right renal area of excretory urography. However, an acoustic shadow could not identified by renal ultrasonogram. When gross hematuria reappeared one week later, selective renal angiography was performed, and arteriovenous fistula was found on the right kidney. We used superselective tanscatheter arterial embolization with a Gelfoam fragment on right arterial branch as the treatment modality.
Acoustics ; Angiography ; Arteriovenous Fistula* ; Abdominal Pain ; Gelatin Sponge, Absorbable ; Hematuria ; Humans ; Kidney ; Renal Artery ; Ultrasonography ; Urinary Retention ; Urography

BACKGROUND: The laparoscopy requires carbon dioxide (CO2) insufflation and Trendelenburg position for operational convenience. However, the above circumstances affect the cardiopulmonary systems significantly and intraocular pressure (IOP) may be also influenced. METHODS: In 27 non-glaucoma patients right and left intraocular pressure (RIOP, LIOP) were measured 5 minutes after induction of general anesthesia (control value), 15 and 30 minutes after CO2 insufflation and endelenburg-lithotomy position. RESULTS: The control values of RIOP and LIOP were 11.3 4.7 mmHg and 11.5 4.7 mmHg respectively. At 15 minutes after CO2 insufflation and Trendelenburg-lithotomy position, they increased to 16.6 5.3 mmHg and 17.0 5.9 mmHg (p<0.05). At 30 minutes, 18.4 3.5 mmHg and 18.2 4.1 mmHg (p<0.05). CONCLUSION: CO2 insufflation and Trendelenburg-lithotomy position increase IOP significantly in non-glaucoma patients during laparoscopy.
Anesthesia, General ; Carbon Dioxide ; Head-Down Tilt ; Humans ; Insufflation* ; Intraocular Pressure* ; Laparoscopy*

BACKGROUND: Spontaneous echo contrast(SEC) is known to predict the increased incidence of thromboembolism in a variety of heart diseases. Transesophageal echocardiography can be useful for the detection of SEC due to proximity of the probe to the left atrium. We performed this study (1) to evaluate the incidence of SEC in mitral stenosis and its relation to the past history of thromboembolism and (2) to characterize the echocardiographic and hemodynamic indices in patients with SEC compared with those without SEC. METHODS: Transesophageal and thransthoracic echocardiographies were done in 89 patients with mitral stenosis. Biplane probe was used in transesophageal echocardiography. In 47patients cardiac catheterization and angiography were performed. RESULTS: (1) SEC was found in 56 out of 89 patients(63%), and left atrial thrombus was found in 32 patients. (2) Left atrial dimension was larger in patients with SEC than in patients without SEC(57.3%+/-8.4mm vs 49.3+/-6.8mm, p<0.05) and mitrial valve area was smaller in patients with SEC than in patients without SEC(0.85+/-0.27cm2 vs 0.97+/-0.24cm2) (3) Association of SEC to thrombi or previous history of arterial embolism showed a high sensitivity and negative predictive value. CONCLUSION: SEC was an useful finding to predict the increased risk of thromboembolism in patients with mitral stenosis. Patients with SEC had severe mitral stenosis than patients without SEC.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Atria ; Heart Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Stenosis ; Thromboembolism ; Thrombosis

No Abstract Available.
Depression* ; Primary Health Care*

Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre-and post- procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drain efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were lower than than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we though that it will be very helpful to the treatment of patients as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.
Abscess ; Catheters* ; Drainage ; Humans ; Viscosity

No Abstract Available.
Depression* ; Primary Health Care*

No abstract available.
Gestational Age* ; Mortality

Authors analyzed the findings of findings of chest radiographs and high-resolution CT(HRCT) of chronic mercury vapor poisoning in 12 patients who were diagnosed by previous working history for mercury-thermometer and high level of mercury in blood and urine. The purpose of this paper is to introduce the HRCT findings of chronic mercury vapor poisoning. Duration of mercury exposure was ranged from 10 to 41 months(mean, 21.8 months). Estimated value of serum mercury was ranged from 3.6 to 8.7µg/dl(mean, 5.3 µg/dl: normal value is less than 0.5µg/dl). Estimated value of mercury in urine was ranged from 104 to 482µg/1(mean, 291.4µg/1: normal value is less than 20µg/1). Chest radiographs showed positive findings such as ground-glass opacities and peribronchial cuffings in only 2 out of 12 patients, but HRCT showed positive findings such as ground-glass opacities in 8 patients, peribronchial cuffings in 7 patients, centrilobular abnormalities in 5 patients, interface sign in 4 patients, interlobular septal thickening with intralobular lines in 2 patients and lobular consolidation in one patient. In conclusion, chest HRCT is superior to chest radiograph to show the pulmonary manifestation of chronic mercury vapor poisoning. In patients with chronic mercury vapor poisoning, HRCT findings of centrilobular distributed ground-glass opacities and peribronchial cuffinges are characteristic.
Humans ; Lung* ; Poisoning* ; Radiography, Thoracic ; Reference Values ; Thorax