Three groups of healthy adults were premedicated with diaxepam or secobarbital and anesthetized with propanidid or thiopental. The concentration of serum potassium wes measured before induction and after succinylchaline iodide administration. The increases of potassium in diazepam-thiopental, diaxepam-propanidid and secobarbital propanidid groups were 0. 14, 0. 06, and 0. llmEq/L (3. 29, l. 38 and 2. 58%) respectively. Serum potassium changes were least in diazepam-propanidid group, but there were no significant differences among the 3 groups. The choice of induction agent is of importance for the changes in serum potassium which follow the subsequent injection of succinylcholine iodide. For instance, intravenous induction by barbiturate is followed by a lesser increase in serum potassium after succinylcholine injection than induction by halothane. As barbiturates are so commonly used as intravenous induction agents, we chose thiopental and succinylcholine iodide as standard with which to compare the other induction agents, propanidid and succinylcholine iodode. And also, we wanted compare two premedicants, secobarbital and diaepam. The results were as follows: (1) The thiopental-succinylcholine iodide group and the propaaidid-succinylcholine iodide group revealed no significant differences in serum potassium level. (2) There was a lesser increase in serum potoassium level after premedication with diazepam than premedicstion with secobarbital in the propanidid-succinylcholine iodide group. (3) Induction by propanidid succinylcholine iodide and premedication by diazepam are recommendable for least increasing the serum potassium level.
Adult ; Barbiturates ; Diazepam ; Halothane ; Humans ; Potassium* ; Premedication ; Propanidid ; Secobarbital ; Succinylcholine ; Thiopental

The pathogenicity of free-living amoeba, Naegleria fowleri, is influenced according to the strain, cultural condition and host (Culbertson et al., 1968; Carter, 1970; Wong et al., 1975). Phillips (1973) demonstrated that Entamoeba histolytica became avirulent after more than 2 year maintenance in axenic culture in vitro. This study was carried out to compare the difference in pathogenicity between two strains of N. fowleri, one of a prolonged maintenance in axenic medium and the other one obtained by serial brain passage in mice. The 0 strain was that N. fowleri had cultivated axenically more than 7 years in CGVS medium. The 2-1 strain was obtained from the brain of mouse inoculated intranasally with a strain, which was from the mouse brain infected with 0 strain, and cultured for 15 weeks until the beginning of this experiment. White male mice weighing 18-22 g were used. Mice were anesthetized by an intraperitoneal injection of about 1 mg secobarbital, and inoculated intranasally with 10 x 10(4) live N. fowleri trophozoites in a 5 microliter cell suspension. Sluggish behaviour, nervousness, rotation and leg paralysis were developed earlier and more frequently in the 2-1 experimental group than the control 0 group. Pathological changes such as inflammatory and necrotic lesion were observed in the olfactory and anterior portion of brain, and these changes were more extensive in the 2-1 group. The edematous and inflammatory changes in lung were demonstrated in mice died after 13th day post-inoculation. The experimental mice of 2-1 group began to die suddenly from 7th day post-inoculation, and the survival time in 2-1 group mice was shorter than 0 group mice. The typical primary amoebic meningoencephalitis was developed in the mice inoculated intranasally with N. fowleri. The prolonged maintenance of N. fowleri amoebae in axenic CGVS medium was observed to have lost their original pathogenicity for mice, but their pathogenicity was restored by serial brain passage in mice.
parasitology-protozoa ; Naegleria fowleri ; pathogenesis ; mouse ; brain ; primary amoebic meningoencephalitis ; secobarbital ; CGVS medium ; pathology ; nervousness ; leg paralysis

Involucrin is a recently recognized structural component of mature squamous epithelial cells and is considered as a marker of normal eratinocyte differentiation and ma.turation. In this study peroxidase-antiperoxidase techniques were used to assess involucrin expression in histologic sections of normal skin and a variety of epidennal tumors including squamous cell carcinomas(25 cases), keratoacanthomas(11 cases), basal cell carcinomas(20 cases), trichoepitheliomas(5 cases), Howens diseases(12 cases), arsenic keratoses(10 cases), actinic keratoses(10 cases) and Pagets diseases(2 cases). The results were as follows : l. In normal skin, the upper third of the viable epidermis showed diffuse cytoplasmic staining for involucrin. In hair follicles, the lower area of inner root sheath and inner area of the outer root sheath stained positively. The sebareous glands did not stain, but the ducts of sebaceous glands were positive. 2. Keratoacanthomas showed a relatively homogeneous staining pattern for inirolucrin ', all cells except basal cells stained with mild to moderate intensity. In contrast, squamous cell carcinomas disclosed a highly irregular involucrin staining pattern with marked variation in staining intensity from cell to cell. 3. Basal cell carcinomas were negative for involucrin except squamous horn cysts, and the epidermis overlying basal cell carcinomas showed the field effect, that is, the epidermis overlying the tumors exhibited diffuse, homogeneous positive staining of cells in all layers of the epidermis. 4. ln trichoepitheliomas, the involucrin reactivity was negative as in basal cell carcinoma.s, but the field effect was not observed. 5. In Elowens disease, actinic keratosis, arsenic keratosis and Pagets disease, the positivit.y for involucrin staining extended deeper into the stratum malpighii than was observed wit,h normal epidermis. And areas showing irregular patchy pattern of involucrin staining were considered to have the potentiality of malignant invasive change much more than the negative or homogeneous areas. Paget's cells were negative for involucrin as the adjoining keratinocytes in the lower portion af epidermis.
Actins ; Animals ; Arsenic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Epidermis ; Epithelial Cells ; Hair Follicle ; Horns ; Keratinocytes ; Keratoacanthoma ; Keratosis ; Keratosis, Actinic ; Sebaceous Glands ; Secobarbital ; Skin

In order to determine the usefulness of Ketamine for the shocked patient, 31 cases were divided into 3 groups. Group 1: No hemorrhage or shock. Well maintained vital signs, 10 cases Group 2: Mild to moderate degree of hemorrhage. Fluid and blood replaced, 10 cases. Group 3: Hemorrhagic or septic shock state, 11 cases. The result of case analysis and change of vital sign after ketamine injection were as follows: 1. Physical status: Range of class of physical states in group 1, 2 and 3 were 1~3, 2~4 and 3~4 respectively, and 50% of group 1 and all cases of group 2 and 3 were emergency surgery. 2. Age distribution: The range of age distribution in groups 1, 2 and 3 was 23~62, 18~65 and 16~64 years old respectively. 3. Type of operation: In group 1, lobectomy, laparotomy and other operations were performed. Howrever in group 2 and 3, thoracotomy, laparotomy and other procedures were performed for hemostatic purposes. except one total hysterectomy for sepsis. 4. Premedicants: In one third of the total cases, mostly in group 1, secobarbital, meperidine or diazipam were: given. Atropire was given in 45% of the total cases, and 45%, mostly in group 2 snd 3, were not given any premedicants. 5. Anesthesia induction: Following preoxygenation, mastly in group 2 and 3, anesthesia was induced with ketamine (1~2 mg/kg) and intubation was done with succinylcholine, except for 3 cases in group 1. 6. Anesthesia maintenance: Ketamine as a sole anesthetic agent was given to 9 cases in operations of less than 1(1/2) hrs. duration. In other cases N2O or N2O with ether, halothane or methoxyflurane were administered according to the vital signs, and muscle relaxants (succinylcholine or gallamine) were given if necessary. 7. Duration of anesthesia: The range of duration of anesthesia in group 1, 2 and 3 was 40~360, 60~315 and 85~4845 min respectively. The average duration was 2.6, 2.5 and 4.3 hr in each group. 8. Blood and fluid replacement during anesthesia: The average blood replacement in each group was 259.6, 886.7 and 954.5 ml/hr for the entire surgical procedure, whole fluid replacement averaged 243.1, 228.0 and 432. 3 ml/hr respectively. 9. Hemoglobin: The range of Hb in preanesthetic state 8.2~14,9.5~12.8 and 7, 913.9 gm/dl in groups 1,2 and 3 and averaged 11 .8, 10.9 and 10.8. These Hb values increased after operation with blood and fluid to 12. 3, 11.0 and 12.3 gm/dl respectively. 10. Blood pressure: Before anesthesia the average systolic and diastolic Bp was 122.5/84.0, 94.5/68.0 and 108/79 mmHg in each group. Following the administration of ketamine, the systolic pressure increased 5.3, 14.3 and 26.7% respectively after 10 min. 11. Pulse rate: Change in pulse rate after ketamine injection was not significant in mast of cases. 12. Respiration: No remarkable change in respiration was observed however respiration was assiteded or controlled adequately through the anesthesia. With the above results, the rise of BP induced by ketamine during the induction period was found to be advantageous with such patients. We concluded that ketamine anesthesia for shocked patients of any etiology was safe, useful and satisfactory.
Age Distribution ; Anesthesia* ; Blood Pressure ; Emergencies ; Ether ; Halothane ; Heart Rate ; Hemorrhage ; Humans ; Hysterectomy ; Intubation ; Ketamine* ; Laparotomy ; Meperidine ; Methoxyflurane ; Respiration ; Secobarbital ; Sepsis ; Shock* ; Shock, Septic ; Succinylcholine ; Thoracotomy ; Vital Signs

OBJECTIVETo explore the efficacy of Tuina for postpartum lactation and work out a optimal protocol involved.

METHODSWith a randomized, controlled and clinical method, 84 primiparas were divided into a Tuina group and a control group. While patients in the control group received rooming-in conventional managements, those in the Tuina group were additionally treated with Tuina, including local manipulations on breasts combined with acupoint manipulations. The colostrum-time, lactation quantity and prolactin were observed to make the comparisons between two groups.

RESULTSThe scores of lactation quantity after 1th, 2nd, 3rd of the treatment were 1.660 +/- 0.785, 2.530 +/- 1.030, 2.880 +/- 1.171 in Tuina group and 1.270 +/- 0.533, 1.460 +/- 0.811, 1.500 +/- 0.583 in control group respectively, where there were significant differences in each time stage between two groups (all P < 0.001). The time of colostrum was (21.6 6 +/- 10.508) h in the Tuina group and (22.5 +/- 9.762) h in the control group, in which the difference was not statistically significant (P > 0.05). The levels of prolactin (314.35 +/- 110.37) ng/mL and (321.56 +/- 109.61) ng/mL in Tuina group, (385.78 +/- 85.19) ng/mL and (340.12 +/- 103.10) ng/mL in control group before and after treatment, there were no significant differences (both P > 0.05).

CONCLUSIONPostpartum Tuina on breasts could increase the quantity of lactation and delay the decreasing of the levels of prolactin, which contributes primiparas to lactate more and sooner.

Adult ; Amobarbital ; Breast ; secretion ; Breast Feeding ; Colostrum ; secretion ; Drug Combinations ; Female ; Humans ; Lactation ; Milk, Human ; secretion ; Postpartum Period ; physiology ; Prolactin ; metabolism ; Secobarbital ; Young Adult

OBJECTIVETo evaluate clinical therapeutic effect of post-stroke shoulder pain treated by acupuncture combined with Tuina.

METHODSThree hundred cases of post-stroke shoulder pain were randomly divided into an acupuncture and Tuina group and a rehabilitation group by double-center randomized controlled clinical trial method. In acupuncture and Tuina group, normalized electroacupuncture and Tuina therapy were applied, that was electroacupuncture at main points, such as Chize (LU 5), Quze (PC 3), Shaohai (HT 3), Jianyu (LI 15), Jianliao (TE 14) and Jianjing (GB 21),etc., combined with traditional Tuina manipulations; in rehabilitation group, the rehabilitation methods such as the electrostimulation through nervus cutaneus and the squeezing and stabilizing manipulations of Proprioceptive Neuromuscular Facilitation (PNF), etc. were applied. The treatment courses of both groups were 6 weeks. The main therapeutic effect indices were the Assessment Face Scale (AFS) for pain when shoulder was in passive motion and the Fugl-Meyer Motor Assessment for upper limbs active function; the secondary indices were the moditied Rankin Scale (mRS) and the clinical incidences of shoulder-hand syndrome of hemiplegia and shoulder joint subluxation of hemiplegia.

RESULTSAfter 6 weeks treatment and 12 weeks follow-up, AFS score, Fugl-Meyer motor assessment of upper limbs active function and mRS evaluation in acupuncture and Tuina group were more obviously improved than those in rehabilitation group (P < 0.05, P < 0.01). Although the clinical incidences of shoulder-hand syndrome of hemiplegia and shoulder joint subluxation of hemiplegia in acupuncture and Tuina group was equal to those in rehabilitation group [3.55% (5/141) vs 8.45% (12/142), 1.42% (2/141) vs 5.63% (8/142), both P > 0.05], the data indicated that there was a superiority tendency in acupuncture and Tuina group.

CONCLUSIONThe combined therapy of electroacupuncture and Tuina is a normative manipulation, and the therapeutic effect is satisfying for post-stroke shoulder pain, superior to that of comprehensive rehabilitation treatment.

Aged ; Amobarbital ; Combined Modality Therapy ; Drug Combinations ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Secobarbital ; Shoulder Pain ; etiology ; physiopathology ; therapy ; Stroke ; complications

OBJECTIVETo explore the mechanism on senile osteoporosis of kidney deficiency pattern in the prevention and treatment with acupuncture and Tuina therapy.

METHODSSixty-four cases were randomized into an acupuncture and Tuina therapy group (group A, 34 cases) and a calcium carbonate group (group B, 30 cases). In group A, the patients were treated with acupuncture at the distal acupoints and Tuina therapy in the local area. Acupuncture was applied to bilateral Weizhong (BL 40) and Taixi (KI 3). Tuina therapy was given in the lumbar region. Totally 30 treatments were required. In group B, the Calcium Carbonate D3 were prescribed for oral administration, continuously for 12 weeks. The changes in lumbar curvature, lumbar lordosis index, sacral inclination angle, lumbosacral angle, L5 vertebral index and L3 vertebral index of lumbar biomechanical indices were observed and compared before and after treatment in two groups.

RESULTSIn group A, the lumbar lordosis index and sacral inclination angle were increased after treatment, indicating the statistical significant differences before and after treatment (P < 0.05, P < 0.01). The improvement of lumbar lordosis index in group A was superior to that in group B [(19.59 +/- 19.16)mm vs (14.47 +/- 13.28)mm, P < 0.05]. After treatment, in group B, L5 vertebral index was improved as compared with that before treatment (P < 0.05). It was required to have a study on the reasons of its lumbar morphological change.

CONCLUSIONThe acupuncture and Tuina therapy regulate the lumbar biomechanical structure through the positive stress stimulation and reconstruct the mechanical equilibrium of the lumbar vertebra. It plays the active significance in the prevention and treatment of osteoporosis.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Amobarbital ; Biomechanical Phenomena ; Combined Modality Therapy ; Drug Combinations ; Female ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Osteoporosis ; physiopathology ; therapy ; Secobarbital

A 21 year-old female underwent resection of a pheochrocytoma under general anesthesia. The patient was treated with phenoxybenzamine for 5 days preoperatively and premedicated with triflupromazien, Librium, Seconal, pethidine, hydroxyzine and atropine in combination. Following indution of anesthesia with intravenous morphine and thiopental sodium, succinylchoine was administered intravenously and endotracheal intubation was performed. Anesthesia was maintained with nitrous oxide, oxygen and methoxyflurane, using a semiclosed carbon dioxide absorption circle system, and alcuronium was injection intermittently. Blood pressure during manipulation of tumor was increased up to 190/130 torr without arrhythmia and transiently dropped to 70/50 torr immediately after removal. Blood pressure was controlled by i.v. Hartmann's solution and whole blood with Solucortef and Effortil but not norepinephrine was needed. There was no marked tachycardis or arrhythmia during anesthesia, so a beta-adrenergic blocker(Inderal) was not used. The importance of preoperative preparation, premedication and selction of anesthetics is discussed.
Absorption ; Alcuronium* ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Atropine ; Blood Pressure ; Carbon Dioxide ; Chlordiazepoxide ; Etilefrine ; Female ; Humans ; Hydroxyzine ; Intubation, Intratracheal ; Meperidine ; Methoxyflurane* ; Morphine ; Nitrous Oxide ; Norepinephrine ; Oxygen ; Phenoxybenzamine ; Pheochromocytoma* ; Premedication ; Secobarbital ; Thiopental ; Triflupromazine*

Cardiac catheterization in man was first deseribed by Forasmann in 1929 and introduced as a diagnostic procedure by Caurnand in 1941. The purpose of the catheterization is to evaluate the nature of cardiac abnormalities. The information from the ivnestigation includes pressure and oxygen content of blood in the various chamhers of the heart and the presence of abnormal communications between them. Most of the blood samplings and recordings of pressure at the various sites are not carried out simultaneously but are collected continuously. Therefore, a steady cardiorespiratory state is essential during the procedure in order to allow comparison of pressure and oxygen saturation observed at all stages of the procedure. Inhalation anesthesia used to provide a steady state in children might alter the pressures or oxygen saturatian because of its higher inspired oxygen content. Therefore room air breathing is essential far this investigation. In Yonsei Medical Center, from September 1964 to December 1974 we used thiopental (1964~1970) and ketamine (1971 ~1974) with spontaneous respiration in 170 children with congenital .heart disease, ranging in age from 50 days to 13 years. Thiopental was administered rectally (38 cases) intravenously (10 cases) and both together (10 cases), Ketamine was administered intravenously (13 cases), intramuscularly (8 cases) and both together 119 cases). For premedication, secobarbital was given orally one and a half hours before. Atropine was omitted. The rate of administration, time of operation, anesthesia and. recovery, and alteration in body temperature, blood pressure, pulse rate and respiratory rate were observed statistically. It was concluded that: In the ketamine groups. 1) General anesthesia was obtained satisfactorily without frequent administration and supplementary administration of meperidine or diazepam. Furthermore the drug is stable and requires no prior mixing. 2) Sleep occurs quickly after both intravenous ar intramuscular injection and analgesia is profound. Therefore investigation was begun quickly after injection, and time of operation and anesthesia was shorter. 3) Postoperative increase in body temperature was observed but less than when thiopental was administered. 4) Blood pressure, pulse rate and respiratory rate were increased 5~18% after induction. but returned to previous state after about 15 minutes. 5) Cardiovascular complication was minimal. Profuse salivation was seen in 0.8% of patients, but there were preservation of jaw tone and laryngo-pharyngeal reflexes, so maintenance of the airway was excellent if suction was available. In conclusion, general anesthesia using ketamine was superior to thiopental for cardiac catheterization in children.
Analgesia ; Anesthesia ; Anesthesia, General* ; Anesthesia, Inhalation ; Atropine ; Blood Pressure ; Body Temperature ; Cardiac Catheterization* ; Cardiac Catheters* ; Catheterization ; Catheters ; Child* ; Diazepam ; Heart ; Heart Diseases ; Heart Rate ; Humans ; Injections, Intramuscular ; Jaw ; Ketamine ; Meperidine ; Oxygen ; Premedication ; Reflex ; Respiration ; Respiratory Rate ; Salivation ; Secobarbital ; Suction ; Thiopental

Special problems face the anesthesiologist in anesthetizing patients with coarctation of aorta. Two patients each 7 years old, a boy and a girl were admitted for surgical correction of coarctation of the thoracic aorta. These patients were premedicated with secobarbital and atropine. One to 1 (1/2) hours later, anesthesia was induced with sodium thiopental and succinylcholine followed by intubation. Anesthesia was maintained with nitrous oxide, oxygen and halothane. A radial artery was cannulated for blood gas sampling and direct arterial pressure, E.K.G., C.V.P. and rectal temperature were monitored continuously. Mild hypothermia (about 34degrees C) was induced by surface cooling technique with mattress. In each case, in order to repair of coarctation by dacron graft and prosthesis, left atriofemoral by pass was used. Acute hemodynamic changes, such as sudden hypertension of the upper extremity and head following cross clamping of the aorta or profound hypotension following declamping, did not develop with this technique. Possible causes and prevention of hemodynamic changes are discussed.
Anesthesia* ; Aorta ; Aorta, Thoracic* ; Aortic Coarctation ; Arterial Pressure ; Atropine ; Child ; Constriction ; Female ; Halothane ; Head ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Hypothermia ; Intubation ; Male ; Nitrous Oxide ; Oxygen ; Polyethylene Terephthalates ; Prostheses and Implants ; Radial Artery ; Secobarbital ; Sodium ; Succinylcholine ; Thiopental ; Transplants ; Upper Extremity