BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

The convulsive seizure brings about cerebral hypoxic damage through the respiratory impediment caused by uncorrdinated muscle spasm and rising metabolic demand of contracting muscles. Therefore, it should be treated adequately by providing the patient with anticonvulsants and supplementary oxygen, as soon as it is develops from any cause. We experienced a 9-year old male patient with tonic convulsive seizure and come at about 12 hours after spinal anesthesia for appendectomy. It was suspected by the cerebrospinal fluid findings, clinical signs and symptoms that his convulsive sizure was symptom of aseptic meningitis, arare delayed neurologic complication, following spinal anesthesia. This patient was treated successfully by continuous intravenous drip of thiopental solution and the approptiate symptomatic therapy.
Male ; Humans

Glycopyrrolate(Robinul) is a potent anticholinergic drug. Being a quaternary ammonium compound, it dose not cross the blood-brain barrier and thus dose not have the central effects. It has been shown that glycopyrrolate has a pharmacologic properties similar to that of atropine, belladonna alkaloid, but it has lesser effect on the heart rate than that of atropine. The author administered a small dose of glycopyrrolate intravenously to 18 people who were awake, 21 compatous cases and 17 halothane anesthetized cases. The effect on the heart rate in these 3 groups was compared. The results are as follows: 1) In the awake state, glycopyrrolate(0.1mg) produced a slight decrease in the heart rate. 2) In the comatose state, glycopyrrolate(0.1mg) produced a slight increase in the heart rate. 3) In the halothane anesthetized state, glycopyrrolate(0.1mg) produced a significant increase in the heart rate. 4) In the comatose state, the absence of bradycardia after a small dose of glycopyrrolate is similar to a small dose of atropine. Therefore we suggest that bradycardia after glycopyrrolate and atropine is caused by sympathetic ganglion block.

No abstract available.
Tuberculosis, Meningeal*

Sixty healthy adult patients undergoing general anesthesia for elective surgery were randomly allocated to three group(n = 20), and their EMG response(twitch height) of the adductor digiti mini muscle(hypothena) to TOF stimulation of ulnar nerve by Datex relaxograph was monitored. The patients were received a bolus injection of vecuronium(0.1mg/kg) alone in group I, vecuronium(0.1 mg/kg) after 25-50% recovery from SCh(l mg/kg) in group II, and the mixed injection of SCh(1 mg/kg) and vecuronium(O.I mg/kg) in group III. The onset time(mean SEM) of effect of vecuronium(0.1 mg/kg) in group II(2.2+/-0.4 min) and group III(1.7+/-0.2 min) significantly was shorten when compared with a bolus injection of vecuronium alone in group(4.4+/-0,4 min)(p<0.05). The duration(mean+/-SEM) of vecuronium(0.1 mg/kg), however, had no significant differences among three group. It was 33+/-2 min in group I, 39+/-3 min in group II, and 34+/-2 min in group III. The potency of twitch height depression of vecuronium(0.1 mg/kg) was increased significantly following preinjection of SCh(1 mg/kg) and at the mixed injection of SCh and vecuronium The intensity of fasciculation induced by SCh was not affected at the mixed injection of vecuronium in group III. The peak increases in arterial pressare and heart rate on the endotracheal intubation were attenuated significantly at the mixed injection of SCh (1 mg/kg) and vecuronium(0.1 mg/kg) when compared with its effect of SCh (1 mg/kg) in group II(p<0.05).
Adult ; Anesthesia, General ; Depression ; Fasciculation ; Heart Rate ; Humans ; Intubation, Intratracheal ; Neuromuscular Blockade* ; Succinylcholine* ; Ulnar Nerve ; Vecuronium Bromide*

Adult respiratory distress syndrome(ARDS) is a descriptive term that has been applied to many acute, diffuse infiltrating lung lesions of various etiology when they are accompanied by severe arterial hypoxemis. Despite the various eiology, clinical symptom and nonspecific pathophsiologic derangement, ARDS has a high mortality rate. But early diagnosis and prompt good management including PEEP therapy will decrease the mortality rate. This report described a case of ARDS following anesthesia and also discussed with literature.
Adult* ; Anesthesia* ; Early Diagnosis ; Humans ; Lung ; Mortality ; Respiratory Distress Syndrome, Adult*

It is well known that small dose of belladonna alkaloid(atropine, scopolarnine) has the effect of decreasing the heart rate in normal conscious subjects, but the mechanism involved in it remains still unanswered. Based on various lines of evidence, the most likely mechanism seems to be the blockade of sympathetic ganglion caused by the alkaloids and it is possible that the effect on the slower heart rate may differ in the depressed state of the sympathetic ganglion when under halothane anesthesia. The present study was undertaken, therefore, on comatose patients and halothane anesthetized patients with and without atropine premedication about 1 hour before anesthesia to observe the effect of a small dose of scopolamine(0.1 mg) which affects the heart rate more significantly than atropine in conscious subjects. The results were as follows: 1) In the comatose patients, scopolamine(0.1 mg) produced a significant decrease in heart rate. 2) During halothane anesthesia without atropine premedication, scopolamine produced a slight decrease in heart rate. 3) During halothane anesthesia with atropine premedication, scopolamine produced a significant increase in the heart rate. These results indicate that scopolamine can further affect the sympathetic ganglion already depressed by halothane, and it is suggested that scopolamine is more effective in blocking the sympathetic ganglion than halothane.
Alkaloids ; Anesthesia ; Atropa belladonna ; Atropine ; Coma ; Ganglia, Sympathetic ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Premedication ; Scopolamine Hydrobromide*

The purpose of this study was to evaluate the surface roughness of Ni-Cr-Be alloy(Verabond ~, Aalba Dent Inc. USA) according to electrolyte concentration and etching time. Total of 150 metal specimens (12x 10 X 1.5mm) composed of 5 polisded specimens, 5 sandblasted specimens, 140 etched specimens were prepared. Etched groups were divided into 28 groups by the HC1O4 con= centrations(10, 30, 50, 70%) and etching times(15, 30, 60, 120, 180, 240, 300 seconds). The mean surface roughness(Ra) and the etching depth were measured with Optical 3-dimensional surface roughness measuring machine(Accura 1500M, Intek Engineering Co., Korea) and observed under SEM. The results obtaind were as follows 1. Surface roughness(Ra) and etching depth were affected by the order of etching time, electrolyte concentration, and their interaction (NO.05) . 2. Surface roughness(Ra) and etching depth were increased with etching time in 10%, 30% electrolyte concentrations, but they had no significant difference with etching time in 70%(P<0.05). 3. Surface roughness(Ra) and etching depth decreased in the order of 30, 10, 50, 70% electrolyte concentrations from 120 seconds etching time(p<0.05). 4. The remarkable morphologic changes in etched surface were observed along the grain boundaries in 15, 30 seconds of 10%, 30% concentrations and the morphologic changes could be denoted in the grains themselves as well as along the boundaries with the lapse of time. Even though the noticeable morphologic changes also took place in etched surface with 50% concentration, the degree of changes were less than that of changes with 10%, 30%. However, there were little morphologic changes with 70% concentration regardless of etching time. 5. Surface roughness(Ra) of sandblasting group with 50um A1203 had no significant difference with 30%-30 seconds etched group(p<0.05).
Alloys* ; Edible Grain

When antagonism to neuromuscular block is needed, glycopyrrolate is the new anticholinergic drug emplyed to counteract the muscarinic action of neostigmine. To know the effect on heart rate after an injection of glycopyrrolate and neostigmine mixture, we observed the changes in heart rate after injection of the mixtures and changing the ratio of glycopyrrolate(0.2mg/vial) to neostigmine(0.5mg/smpul) using 2 to 1, 2 to 1.5, 1 to 1, 1.5 to 2 and 1 to 2 during halothane anesthesia. The result of this study showed that the heart rates were more stable in the group given the ratio of glycopyrrolate 1 vial(0.2mg) to neostigmine 1 ampule(0.5mg) than any other gorups.
Anesthesia ; Glycopyrrolate* ; Halothane ; Heart Rate* ; Heart* ; Neostigmine* ; Neuromuscular Blockade

Anatomical variations of the meniscus are a common anomaly that knee surgeons frequently encounter. However, anomalies of the anterior horn of the lateral meniscus (AHLM) are extremely rare. In this report, we present a newly discovered anomaly of the AHML: an anterolateral meniscofemoral ligament is described with clinical features and radiographic and arthroscopic findings.
Animals ; Horns ; Knee ; Ligaments ; Menisci, Tibial ; Surgeons