The effect of ambient pressure oxygen apply via T-piece in thoracoscopic surgery or thoracotomy

BACKGROUND: This prospective, randomized study was to investigate whether ambient pressure oxygen administration via T-piece can be used to reduce arterial desaturation during one-lung ventilation. It can be more beneficial for thoracoscopic surgery, where partial inflation of the non-ventilated lung by continuous positive airway pressure can make the operation itself difficult, delayed, or impossible. METHODS: Patients undergoing thoracotomy (Thoracotomy group, n = 50) or video-assisted thoracoscopic surgery (VATS) (VATS group, n = 50) were enrolled into this study. Each group was further divided into two groups: control group (n = 25), and ambient pressure group (n = 25), respectively. Fifteen minutes after two-lung ventilation (TLV1) PaO2, peak inspiratory pressure, plateau pressure, and tidal volume were measured. Then, in control group, one-lung ventilation was started as usual method while in ambient pressure group, the lumen of the non-ventilated lung was connected to a T-piece with 10 L/min flow rate of oxygen. Same measurements were repeated at 15 minutes and 1 hour after one-lung ventilation (OLV1, OLV2), and 15 minutes after resuming two-lung ventilation (TLV2). Fluid input, urine output, estimated blood loss, operation side/time, and one-lung ventilation time were recorded after operation. RESULTS: In thoracotomy group, there were no significant differences in PaO2 between control group and ambient pressure group. However, in VATS group, PaO2 at OLV1 and OLV2 were significantly higher in ambient pressure group than in control group. CONCLUSIONS: In patients undergoing VATS, application of ambient pressure oxygen to the non-ventilated lung during one-lung ventilation was effective in increasing PaO2.

Left Main Stem Bronchus Compression Occurred in Primary Pulmonary Hypertension Patient: A case report / 대한마취과학회지

Eleven year-old boy was scheduled for right encephalo-duro arterial synangiosis (EDAS). He received left EDAS 4 months ago, and there was no problem during the perioperative period. Mild cardiomegaly was suspected in his preoperative chest PA. After intubaton, we couldn't hear the breathing sound of left chest, and the saturation went down to 95%. There was large opaque hemithorax on emergency chest AP, and on the fiberoptic bronchoscopic examination, left main stem bronchus (LMSB) was observed slit-like appearance. Echocardiography revealed severely dilated right atrium and ventricle. In his chest CT, the LMSB was nearly obliterated. The patient was diagnosed as primary pulmonary hypertension, and received full sedation, controlled ventilation, and NO gas. However, the blood pressure of this patient was not maintained in spite of using high-dose inotropics. He expired two days later and this case warns that suspected mild cardiomegaly might hide more ominous sign of primary pulmonary hypertension.

The Effect of Early Amniotic Membrane Transplantation in the Rabbits' Corneal Ulcer by Staphylococcus Epidermidis

PURPOSE: Untill now, AMT at the early stage of corneal ulcer has been prohibited by the reasons that measurement of progression of ulcer by active pathogens was difficult through the transplanted amniotic membrane and anxiety about worsening by decreased permeability of antibiotics. This study has investigated the effect of early AMT in the bacterial corneal ulcer. METHODS: We made experimental bacterial corneal ulcer in 10 rabbits with Staphylococcus epidermidis, which typically has a more indolent clinical course. After certification of infection, fresh amniotic membranes, soaked by fortified antibiotics was transplanted to 5 eyes to which we dropped fortified antibiotics. And to another 5 eyes we applied only fortified antibiotics. After observing the progression of corneal ulcer for 4 weeks, we compared the degree of corneal opacity and histopathologic changes between the two groups to measure the effect of early AMP in the bacterial corneal ulcer. RESULTS: Corneal ulcer was healed in the all 5 cases of early AMT-performed group, And compared with the group without AMT, successful decrement of corneal opacity was observed in the 4 cases of early AMT-performed group. Histopathologic observation has revealed only mild inflammation and the maintenance of parallel architecture of stromal collagens. CONCLUSIONS: In the experimental corneal ulcer with Staphylococcus Epidermidis, we observed healing of the ulcer with decrement of corneal opacity, result from early transplantation of amniotic membrane, soaked in fortified antibiotics followed by dropping of fortified antibiotics at an early stage of ulcer.

A Case of Optic Nerve Evulsion

PURPOSE: The authors report a case of optic nerve evulsion with literature review. METHOD: 15-year-old boy, who had optic nerve evulsion by tear of inferior rectus and medial rectus muscles, and hypotony by retinal and choroidal detachment RESULTS: we could preserve the eyeball with normal pressure by pars plana vitrectomy, endolaser photocoagulation and silicone oil injection

Antitumor and Immunomodulatory Activities of Mushroom ( Phellinus linteus ) Cultured on Oak and Mulberry / 대한면역학회지

No abstract available.

The Neurons Related to Lateral Rectus Muscle in Cerebellum of Rats Using Pseudorabies Virus

We investigated the location of neurons related to lateral rectus muscle in the cerebellum of rats. Horseradish peroxidase (HRP) and Pseudorabies virus (PRV) were injected into right lateral rectus muscle of rats. After 84~90 hours, cardiac perfusion was performed with 4% paraformaldehyde in HRP injection group and 4% paraformaldehyde-lysine-periodate in PRV injection group. Tetramethylbenzidine (TMB) neurohistochemical stain in HRP injection group and immuno-histochemical stain in PRV injection group were performed after frozen section. HRP-reactive neuronal cells were observed in ipsilateral abducens nucleus. PRV-immunoreactive neuronal cells were observed ipsilaterally in abducens nucleus, flocculus, paraflocculus, ansiform lobule, declive, dentate nucleus, infracerebellar nucleus and y nucleus and also bilaterally in nodulus, lobulus centralis, lingula, uvula vermis and fastigial nucleus. These findings show the existence of neuronal projection from the abducens nucleus to the cerebellum. This projection could be part of nerve circuits through which the cerebellum modulates visuomotor activities.