No abstract available.
Thyroid Gland* ; Thyroid Nodule*

BACKGROUND: Bupivacaine is a amide type local anesthetic agent, widely used for its excellent quality of analgesia and long duration of action. But unintended intravenous injection causes severe complication such as convulsion and cardiovascular collapse, which is known for its difficulty in resuscitation. With all the study, the exact mechanism is still unclear and there are much debate on the method of resuscitation. METHOD: We studied the effect of clonidine pretreatment on bupivacaine-induced cardiac toxicity and resuscitation in anesthetized dog. Twelve dogs were divided into two groups. : saline pretreatment group (control, N=6) and clonidine pretreatment group (clonidine group, N=6). The dogs were anesthetized with N2O-O2-enflurane and vecuronium. Thoracotomy was done in 4th or 5th intercostal space for open cardiac massage. After confirming stability of vital signs, we administered clonidine (10 mcg/kg) or saline, and then administered bupivacaine with the rate of 2 mg/kg/min. When the electeocardiogram showed asystole, 20 mcg/kg of epinephrine was administered via central venous line and open cardiac massage with the rate of 120 beat/min. was performed. We observed electrocardiogram (lead II), arterial blood pressure, heart rate, dose of infused bupivacaine to be required for QRS widening and arrest, required time and administered dose of epinephrine for resuscitation. RESULTS: Clonidine group showed significant decrease of heart rate after pretreatment (p<0.05). There was no significant difference in required dose for QRS widening between two groups. The dose administered for inducing arrest was less in clonidine group than control group (p<0.05). The time required for resuscitation was shorter in clonidine group than control group (p<0.05). The total dose of epinephrine required for resuscitation was less in clonidine group than control group (p<0.05). The blood concentration of catecholamine did not showed significant difference during the whole course of experiment. CONCLUSIONS: Above results demonstrated that clonidine, a central nervous system-mediated sympatholytic agent, facilitated cardiac arrest when bupivacaine was infused intravenously and cardiac rescucitation.
Analgesia ; Animals ; Arterial Pressure ; Bupivacaine ; Clonidine* ; Dogs* ; Electrocardiography ; Epinephrine ; Heart Arrest ; Heart Massage ; Heart Rate ; Injections, Intravenous ; Resuscitation* ; Seizures ; Thoracotomy ; Vecuronium Bromide ; Vital Signs

The purpose of this study was to define the optimum dose of lidocaine required to reduced pain on injection of diazepam. We conducted a prospective, randomized trial on l20 patients undergoing anesthesia. patients were allocated to four groups according to the lidocaine do sage: group A(control), no lidocaine; group B, lidocaine 0.1 mg/kg; group C, lidocaine 0.2 mg/kg; group D, lidocaine 0.4 mg/kg. our results sbowed that a dose of lidocaine 0.4 mg/kg significa ntly reduced the incidence of pain.
Anesthesia ; Diazepam* ; Humans ; Incidence ; Lidocaine* ; Prospective Studies

The development of endotracheal tubes with high-volume and low-pressure cuffs has decreas ed the incidence of associated tracheal injury. If room air used for inflation of the cuff during general anesthesia using N2O-O2, mixtures, however, endotracheal tube cuff result in distention and potential pressure changes. Therefore, tracheal pressure injury may occur during long general anesthesia(especially, head and neck surgery). For the prevention of this problems and the determination of proper methods, we performed this study relating to nitrous oxide diffusion into a gas filled endotracheal tube cuff.
Anesthesia, General ; Diffusion ; Head ; Incidence ; Inflation, Economic ; Neck ; Nitrous Oxide*

Efforts from various approaches have been made to anesthetize myasthenic patients associated with thymoma and, on a ehoice of kinds and dosage of the muscle relaxants, there were considerable solicitude of the anesthesiologist. In recent years, intermediate aeting none depolarizing muscle relaxants were developed and its use tends to increase. we used with the divided dose administration of small amount vecuronium and observed the degree of relaxation using peripheral nerve stimulator for endotracheal intubation and maintenance of anesthesia. On the basis of our experience, we would like to recommand techniques that administrate the divided dose of small amount vecuronium as a musde relaxant and use peripheral nerve stimulator during general anesthesia.
Anesthesia ; Anesthesia, General ; beta-Aminoethyl Isothiourea ; Humans ; Intubation, Intratracheal ; Myasthenia Gravis* ; Neuromuscular Depolarizing Agents ; Peripheral Nerves ; Relaxation ; Thymectomy* ; Thymoma* ; Vecuronium Bromide

No abstract available.
Estradiol* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Progesterone*

No abstract available.
Anemia ; Gaucher Disease* ; Humans ; Siblings* ; Thrombocytopenia

Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was 2.5x3.0 cm sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.
Abdominal Pain ; Adult ; Emergencies ; Hamartoma ; Hepatitis ; Hepatitis A ; Humans ; Intussusception ; Laparotomy ; Physical Examination ; Rare Diseases ; Vomiting

No abstract available.
Pregnancy*

Teratogenic effects of a diphenylhydantoin on the neurulation of the explanted early chick embryos were studied using the punched-out filter paper explantation technique. The 6th to 9th Hamburger and Hamilton staged chick embryos were explanted and cultured in the Ham's F-10 media treated with 15 microgram/ml, 30 microgram/ml, 60 microgram/ml, 90 microgram/ml, 120 microgram/ml of diphenylhydantoin in the CO2 incubator for 6-9 hours. The morphological chracteristics and the ultrastructural changes of the neuroepithelium of early chick embryos were compared with the control and experimental group using the stereomicroscope and the electron microscope. Of th 40 chick embryos cultured in the Ham's F-10 media without drug, 37 embryos(92.5%) developed normally and 3 embryos(7.5%) developed abnormally in 94 embryos(61.4%). The frequent anomalous features of the embryos were deformities of the neural folds in the cranial regions, failure of neural tube closure, dispersion of somites and developmental arrest. The scanning electron microscopic findings of neuropithelial cells of abnormally developed embryos were diminished surface blebs and microvilli, flattened and smooth cellular surfaces, and irregular size of cells. The transmission electron microscopic findings of neuroepithelial cells of abnormally developed embryos showed no significant changes of the development of intracellular organelles except the smooth cellular surface and mild underdevelopment of microfilaments.
Actin Cytoskeleton ; Animals ; Blister ; Chick Embryo* ; Congenital Abnormalities ; Embryonic Structures ; Incubators ; Microvilli ; Neural Crest ; Neural Tube ; Neuroepithelial Cells ; Neurulation* ; Organelles ; Phenytoin* ; Somites