Coronary artery bypass grafting (CABG) without extracorporeal circulation (ECC) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. We experienced a case of CABG without ECC in a 20 year old female patient with complete occlusion of the right coronary artery. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. Nitroglycerine and dopamine were given to stabilize the hemodynamics during intra- and post-operative periods. And esmolol was administered with a loading dose of 30 mg over 1 min, followed by a continuous infusion of 50~100 g/kg/min to maintain the heart rate (50~60 beats/min) and systolic blood pressure (60~80 mmHg) during distal anastomosis. The patient was recovered uneventfully and discharged on the 8th postoperative day.
Anesthesia* ; Arterial Occlusive Diseases ; Blood Pressure ; Coronary Artery Bypass* ; Coronary Vessels* ; Dopamine ; Extracorporeal Circulation ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Isoflurane ; Midazolam ; Myocardial Revascularization ; Nitroglycerin ; Young Adult

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

Tracheopathia osteoplastica is a rare, benign pathologic condition chahacterized the occurrence of numerous cartilage and bony nodules within the tissue of mucosa. We report a case of tracheopathia osteoplastica that involved both larynx and trachea. The patient was 73 years old male and had hoarseness. The neck CT showed thickened and irregular wall of the trachea extending to the level of the carina with multiple calcified nodules and plaques of bony density projecting into the lumen.
Cartilage ; Hoarseness ; Humans ; Larynx ; Male ; Mucous Membrane ; Neck ; Trachea

No abstract available.
Bronchi*

No abstract available.
Spinal Stenosis*

The purpose of this study was to compare microleakage and marginal hybrid layer in class V restorations using two one-bottle adhesives and one self-etching adhesive. Class V cavity preparations with occlusal margins in enamel and gingival margins in dentin were prepared on buccal and lingual surfaces of 30 extracted human molar teeth. Prepared teeth were randomly divided into three treatment groups (n=30) and restored with three adhesives and composites: Single Bond/Filtek Z-250 (Group 1), Prime&BondNT/Esthet.X (Group 2), UniFil Bond/UniFil F (Group 3). For microleakage, samples were stored in room temperature water for 24 hours, thermocycled, stained with 2% methylene blue dye, sectioned into halves, scored and analysed using Mann-whitney test and Wilcoxon signed rank sum test. For marginal hybrid layer, samples were sectioned into halves, treated with 10% phosphoric acid for 5 seconds, stored in 5% NaOCL solution for 24 hours, dried and gold coated. Occlusal and gingival margins of each sample were inspected under SEM. The results of this study were as follows; 1. Microleakage at the occlusal margins was not evident in group 1 and group 2, but it showed in group 3 (p<0.05). 2. Microleakage in group 1 and group 3 was significantly lower than in group 2 at gingival margins (p<0.05). 3. Microleakage at gingival margins was greater than at occlusal margins in group 1 and group 2, but microleakage at occlusal margins was greater than at gingival margins in group 3 (p<0.05). 4. In group 1 and group 2, no gaps at occlusal margins showed. But gaps showed in group 3. Occlusal margins were free from a hybrid layer in all groups. 5. The thickness of the marginal hybrid layers was 2.5~5 microm thick in group 5 microm thick in group 2 and 1.5 microm thick in group 3. 6. There was no corelation between microleakage and thickness of marginal hybrid layer. In coclusion, the effect of dentin adhesives on microleakge in class V composite restorations was excellent when one-bottle adhesives were applied on enamel margin, and it was good when a self-etching adhesive was applied on dentinal margin. There was no corelation between microleakage and thickness of marginal hybrid layer.
Adhesives ; Chimera ; Dental Enamel ; Dentin ; Humans ; Methylene Blue ; Molar ; Phosphoric Acids ; Tooth ; Water

STATEMENT OF PROBLEM: In cemented implant-supported porstheses, it is still controversy what kind of cement to use. However, the effect of thermocycling on retentive strength of cemented implantsupported prostheses has not been well investigated. PURPOSE: This study was tested to evaluate the effects of various cements and thermocycling on retentive strengths of cemented implant-supported prostheses. MATERIAL AND METHODS: Prefabricated implant abutments, height 5mm, diameter 6mm, 3- degree taper per side, with light chamfer margins were used. Ten specimens of two-unit fixed partial denture were fabricated. The luting agents used for this study were three provisional luting agents which were Temp bond, Temp bond NE, IRM and four permanent luting agents which were Panavia F, Fuji-cem, Hy-bond Zinc cement, Hy-bond Polycarboxylate cement. 24 hours after cementation, the retentive strengths were measured by the universal testing machine with a cross-head speed of 0.5mm/min. Then cementation procedures were repeated and specimens were thermocycled 1000 times at temperature of 5degrees C and 55degrees C. After thermocycling, the retentive strengths were measured. RESULTS: Before thermocycling, the retentive strengths were decreased with the sequence of Panavia F, Fuji-cem, Hy-bond Zinc cement, Hy-bond Polycarboxylate cement, IRM, Temp bond NE and Temp bond, and there were significant differences among each groups(p<0.05). After thermocycling, the retentive strengths were decreased with the sequence of Panavia F, Fuji-cem, Hybond Zinc cement, Hy-bond Polycarboxylate cement, IRM, Temp bond NE and Temp bond, and there were no significant differences among Panavia F, Fuji-cem and Temp bond NE, Temp bond(p>0.05). The retentive strengths before and after thermocycling showed significant differences in Hy-bond Zinc cement. IRM, Temp bond NE and Temp bond(p<0.05). CONCLUSION: Within the limitation of this study, thermocycling do not affect the retentive strengths of permanent luting agents but the retentive streng ths of temporary cements were reduced significantly after thermocyling.

Disseminated Fusarium infection has rarely been encountered in neutropenic cancer patients. The clinical features include fever, positive blood cultures, severe myalgias, disseminated ecthyma gangrenosum-like skin lesions, ocular symptoms and multi-organ-system involvement. The mortality rate reported so far exceeded 70% despite antifungal treatments. We report here the first two cases of disseminated fusarial infections in Korea. The first patient contracted pneumonia during severe neutropenic period following consolidation chemotherapy for acute myelogenous leukemia(AML). Fusarium oxyshrum was cultured from bronchoalveolar lavage fluid. The patient remains free of fungemia after successful antifungal treatment of high-dose amphotericin B and terbinafine. The second patient had relapsed AML and suffered from disseminated fusarial infection involving lungs with characteristic skin lesions. The patient succumbed to refractory leukemia and the fungal infection. A brief review of the literature ensues with the case report.
Amphotericin B ; Bronchoalveolar Lavage Fluid ; Child* ; Consolidation Chemotherapy ; Ecthyma ; Fever ; Fungemia ; Fusariosis ; Fusarium ; Humans ; Korea ; Leukemia* ; Lung ; Mortality ; Myalgia ; Pneumonia ; Skin

OBJECTIVE: The LiquoGuard® system is a new ventricular-type monitoring device that facilitates intracranial pressure (ICP)-controlled or volume-controlled drainage of cerebrospinal fluid (CSF). The purpose of this study is to report the authors' experience with the LiquoGuard® ICP monitoring system, as well as the clinical safety, usefulness, and limitations of this device in the management of patients with traumatic brain injury (TBI). METHODS: Intraventricular ICP monitoring was performed on 10 patients with TBI using the LiquoGuard® monitoring system. ICP measurements, volume of drained CSF, and clinical outcomes were analyzed and discussed. RESULTS: ICP monitoring was performed on 10 patients for a mean duration of 6.9 days. With a mean 82,718 records per patient, the mean initial ICP was 16.4 mm Hg and the average ICP across the total duration of monitoring was 15.5 mm Hg. The mean volume of drained CSF was 29.2 cc/day, with no CSF drained in 4 patients. Seven of 10 patients showed 1 or 2 episodes of abnormal ICP measurements. No patient exhibited complications associated with ICP monitoring. CONCLUSION: The LiquoGuard® system is a versatile tool in the management of TBI patients. Its use is both reliable and feasible for ICP monitoring and therapeutic drainage of CSF. However, episodes of abnormal ICP measurements were frequently observed in patients with slit ventricles, and further study may be needed to overcome this issue.
Brain Injuries* ; Cerebrospinal Fluid ; Drainage ; Humans ; Injections, Intraventricular ; Intracranial Pressure* ; Monitoring, Physiologic

No abstract available.
Radiation Oncology*