This rare tumor has been diagnosed postoperatively in a 64-years-old male patient. Herein a case of extra-adrenal paraganglioma of the retroperitoneum is presented with brief review of literatures.
Humans ; Male ; Paraganglioma, Extra-Adrenal*

Blood pressures and heart rates were recorded with Twin-Viso (Sanborn, USA) for comparative estimations of cardiovascular responses by injection of intravenous anesthetic agents-2.5% solution of Pentothal Sodium (Abbott Laboratory, USA) and Thiotal (Samsung Pharmaceutical Co., ROK) mongrel dogs. Dogs were evaluated the hepatic function by biochemical studies of blood such as total protein, albumin, total bilirubin, direct bilirubin, thymol turbidity test, alkaline phosphatase, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGOT). Liver biopsies were performed in dogs for identifications of hepatic darnages by injection of the above barbiturates, The following results were observed: 1) It was observed the remarkable negative inotropic effect in myocardium of the mongrel dogs intravenously injected with 20 mg/kg of the above barbiturates for three minutes (Table 7, Fig. 8) 2) It was noted slight negative inotropic effect in mongrel dogs intravenously injected with 10 mg/ kg of the above barbiturates for thirty seconds (Table 8, Fig. 8). 3) It was more shorter recovery time from negative inotropic effects in mongrel dogs injected with Thiotal than in the dogs injected with Pentothal Sodium. 4) It was noted no significant changes in pathological studies of Hematoxylin-Eosin stained liver specimen and liver function studies of the blood by biochemical analysis in mongrel dogs intravenously injected everyday with 10 mg/kg of the above barbiturates. 5) It was noted slight changes in mongrel dogs injected with 20 mg/kg of the above barbiturates on TTT, Alkaline Phosphatase, SGOT and SGPT as biochemical analysis in comparing with controI values. These values, however, were not concided with the pathological findings of HematoxyIin-Eosin stained liver biopsy specimen. The facts explain to be inquired into further investigations in the pathological and biochemical aspect.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Barbiturates ; Bilirubin ; Biopsy ; Dogs ; Heart Rate ; Liver ; Myocardium ; Sodium ; Thiopental* ; Thymol

The authors have experienced five cases of general anesthesia for repair of diaphragmatic hernia in children, and following results were obtained. Whether it was congenital or traumatic in origin, prompt reduction and repair is desirable if accurate diagnosis was made and patients condition was acceptable, for increased postoperative survival rate and prevention of possible complications. When the intermittent positive pressure breathing was needed during preoperative, intraoperative or postoperative period, the greatest concern of anesthetist is that excessive positive ventilation should be avoid. The most important factors in this situation probably are the use of chest drainage, daily Roentgen-ray examination, and better use of postoperative ventilatory assistance, for prevention of postoperative atelectasis and other pulmonary complications.
Anesthesia, General* ; Child* ; Diagnosis ; Drainage ; Hernia, Diaphragmatic* ; Humans ; Intermittent Positive-Pressure Breathing ; Postoperative Period ; Pulmonary Atelectasis ; Survival Rate ; Thorax ; Ventilation

PURPOSE: To gain insight on transcriptional repression of Topo II a in HL-60 cells arrested to G2/M and M phase, the levels of Topo IIa mRNA and the binding activity of ATF have been investigated with Northern blot hybridization and DNA mobility shift assay, respectively. MATERIALS AND METHODS: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-mactivated fetal bovine serum and antibiotics in a humidified 5% CO2 at 37C degree. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. A Xho I-Mlu I fragment of phTOP2 was used as probe for Northern blot analysis of Topo II a mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA oligomer (upper strand, 5-TCTCCGCTATGACGCCGAGTGGTG-3) for ATF binding activity was mixed with nuclear extracts in a 20 pl reaction volume containing 60 mM KC1, 12 mM HEPES, pH 7.9, 5 mM MgCl2, 0.2 mM EDTA, 0.2 mM DTT, 12% glycerol, and 2 ug of poly [dI-dC]. RESULTS: HL-60 cells were arrested at G2/M phase and M phase after taxol or nocodazole treatment. The levels of Topo II a mRNA were reduced at 24 hours after exposure with nocodazole or taxol but the unknotting activities were not changed. DNA mobility shift assay using oligonucleotide containing the ATF binding site showed that ATF binding activity was reduced after pretreatment of nododazole or taxol. CONCLUSIONS: These results suggest that the reduction of ATF binding activity may be important to transcriptional repression of Topo II a gene by nocodazole and taxol in HL- 60 cells.
Anti-Bacterial Agents ; Binding Sites ; Blotting, Northern ; Cell Division* ; DNA Topoisomerases, Type I* ; DNA Topoisomerases, Type II* ; DNA* ; Edetic Acid ; Electrophoretic Mobility Shift Assay ; Genes, vif ; Glycerol ; HEPES ; HL-60 Cells ; Humans ; Hydrogen-Ion Concentration ; Magnesium Chloride ; Nocodazole ; Paclitaxel ; Repression, Psychology ; RNA ; RNA, Messenger

Caroli's disease is associated with the combination of congenital dilation of the intrahepatic bile ducts, polycystic disease of the kidney and congenital hepatic fibrosis. The disease entity was first reported by Caroli and associates(1958) and was extensively reviewed in a monograph by Caroli and Corcos (1964). The original first description of Carolis disease is characterized by congenital saccular dilation of the intrahepatic bile ducts, a high incidence of stone formation and cholangitis, absence of hepatic fibrosis and portal hypertension but associated with renal tubular ectasia or other forms of cystic disease of the kidneys, possibly of the pancreas. However the pure form, as described above, has been uncommon. We have experience with a case of general anesthesia for a 12 year old female patient who had Caroli's disease, which was confirmed preoperatively by computerized tomography in Kyung Hee Medical Center. As the Carolis disease may involve hypofunction of the liver and kidney, anesthetics with less action on the liver and kidney are-preferable. This patient was premedicated with atropine and meperidine. Anesthesia was induced with thiopental and succinylcholine for intubation, then maintained with N2O-O2 pancuronium and meperidine. The anesthetic and immediate postoperative course was uneventful, but the patient expired with expected cardiac arrest one week later.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Atropine ; Bile Ducts, Intrahepatic ; Caroli Disease* ; Cholangitis ; Dilatation, Pathologic ; Female ; Fibrosis ; Heart Arrest ; Humans ; Hypertension, Portal ; Incidence ; Intubation ; Kidney ; Liver ; Meperidine ; Pancreas ; Pancuronium ; Succinylcholine ; Thiopental

For many years it has been known that the dosage of thiopental required to induce anesthesia depends on the age of the patient, but this information ha resulted from clinical experience with the drugs rather than from planned study. In our study, to elucidate the influence of age on the size of the sleeping dosage of thiopental, 144 patients who underwent minor orthopedic and gynecological operations were studied. This patients had no evidence of a disease other than that scheduled for operation and were within normal values in hematologic examination, liver function and kidney function. Using a simple "yes" or "no" verbal command response, as sleeping response, to a single bolus of thiopental in mg/kg body weight, we have attemted to minimize uncontroliable factors such as cerebral perfusion, circulation time and plasma protein binding which would alter response to thiopental infusions continued to the end points. The results were as follows: 1) There was no statistical difference in verbal command response to thiopental according to age in age groups below 59 years. 2) Compared with age groups below 59 years, 60~79yrs, group failed to respond to the verbal command in 33% by 2.2mg/kg and 100% by above 2.6mg/kg.(p<0.05) 3) The mean time for loss of verbal command response after thiopental injection was 27.4+/-10.3 seconds and 80.4% of theses patients lost lid reflex with a mean time of 41.7+/-9.1 seconds after thiopental injection. 4) All groups showed statistically non-significant alterations of systolic blood pressure and heart rate after injection of thiopental.
Anesthesia ; Blood Pressure ; Body Weight ; Heart Rate ; Humans ; Kidney ; Liver ; Orthopedics ; Perfusion ; Plasma ; Protein Binding ; Reference Values ; Reflex ; Thiopental*

Continuous monitoring of central venous pressure is now considered standard practice in the management of the critically ill patients. Some of these patients require support by mechanical ventilation, often with the concomitant use of PEEP. To determine the existence and amgnitude of systemic differences during mechanical ventilation and after disconnection of ventilation, we studied 120 central venous pressure measurements serially. The results show that mechanical ventilation reading were 11.0 CmH2O (+/-2.53) and ventilation disconnection readings were 8.0CmH2O(+/-2.39) with a mean difference of 3.0 CmH2O. both mechanical ventilation and ventilation disconnection readings were sensitive to hemodynamic changes when taken continuously. We feel that mechanical ventilation readings will more accurately reflect the patient's cariopulmonary status during ventilation support.
Central Venous Pressure* ; Critical Illness ; Hemodynamics ; Humans ; Reading ; Respiration, Artificial* ; Ventilation*

No astract is available
Radiosurgery*

A review was made four cases for intraoperative or immediate postoperative cardiac arrest which occurred during the period from Jan. 1. 1980 to May 31. 1981 and resulted in death. The probable causes of death were: Case l: inadequate monitoring, hemorrbage, body fluid loss, lengthy operation and sepsis. Case ll: untoward effect of succinylcholine or an underlying cardiac problem. Case lll: cardiac failure due to cardiopulmonary dysfunction caused by kyphoscoliosis. Case lV: peripheral circulatory failure due to massive hemorrhage.
Body Fluids ; Cause of Death ; Heart Arrest* ; Heart Failure ; Hemorrhage ; Sepsis ; Shock ; Succinylcholine

Pulmonary blastoma are a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or embryonal in appearance. We report a pulmonary blastoma occurring in a 31 years old man. An abnormal shadow was detected in the right lower lung field in a routine chest X-ray film. The preoperative imaging films showed about a 5cm sized well circumscribed solid tumor of the right lung. A preoperative clinical diagnosis of primary lung cancer was considerd. The operative field showed that the hard, round mass, 6 x 5 x 4cm in diameter was localized in middle lobe of the right lung, and partially adhered to the upper lobe, pericardium and diaphragm. Right middle lobe lobectomy, right upper lobe wedge resection, partial pericardiectomy and diaphragm resection with plication was performed with radical lymph node dissection. Histopathologic diagnosis was pulmonary blastoma (Biphasic blastoma). It is considered that the prognosis of biphasic blastoma is worse than WDFA(well differentiated fetal adenocarcinoma). There are no other available treatments except for surgical resection. It is suggested that it is necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.
Adult ; Classification ; Diagnosis ; Diaphragm ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Mesoderm ; Pericardiectomy ; Pericardium ; Prognosis ; Pulmonary Blastoma* ; Thorax ; X-Ray Film