Vitamin E Reduces Symptoms in a CFA-induced Model of Monoarthritis / 대한마취과학회지

BACKGROUND: Adjuvant arthritic animals show immunologic and inflammatory features which are also observed in patients with rheumatoid arthritis. This study investigated whether high dose vitamin E (alpha-tocopherol) has any additional anti-inflammatory or analgesic effects, or both, in Complete Freund's adjuvant (CFA) induced arthritic rat model. METHODS: Male Sprague-Dawley rats (300-350 g, n = 3) underwent testing up to 26 days after induction of the model. Vitamin E (100 mg/kg) or vehicle was given daily intraperitoneally (IP) for 10 or 20 days following induction. Thus, groups were as follows: group 1, untreated, n = 3; group 2, CFA + vehicle, n = 10; group 3, CFA + vitamin E for 10 days, n = 10; group 4, CFA + vitamin E for 20 days, n = 10. Parameters compared between groups included ankle circumference, range of articulation of the arthritic joint, extravasation of plasma proteins in the tissues around the arthritic joint and sensory withdrawal threshold to von Frey filament mechanical stimulation. RESULTS: Compared to CFA rats administered drug vehicle, those given vitamin E for 20 days exhibited a reduction in all symptoms of monoarthritis, including less ipsilateral ankle swelling, reduced loss of the range of joint articulation, low plasma extravasation and reversal of the decrease in sensory withdrawal threshold. But, vitamin E for 10 days has only analgesic effect until 10 days. CONCLUSIONS: This study showed relatively long duration of high-dose vitamin E treatment have anti-inflammatory and early onset analgesic effects. The findings raise the possibility of high dose vitamin E, or potentially other antioxidants, as adjuvant therapy for alleviation of symptoms of rheumatoid arthritis.

Orotracheal Intubation with Magnet / 대한마취과학회지

BACKGROUND: Every practitioner, however skilled, will encounter patients who are unexpectedly difficult to intubation. The incidence of difficult laryngoscopy appears to be approximately 0.5% to 2%. So many methods are used to intubate the trachea, but endotraheal intubation by them is not always possible. The purpose of the this study is to evaluate the effectiveness of magnet on the endotracheal intubation. METHODS: Twenty patients(aged 30 to 59yr, ASA physical status 1) required general anesthesia with an endotracheal tube. Anesthesia was induced with thiopental sodium and succinylcholine, ventilation was controlled with 100% O2. The tip of the epiglottis was exposed wtih a No.3 MacIntosh laryngoscope. A catheter with ferrous stylet was placed behind epiglottis close to tracheal lumen and a magnet was placed over the cricoid cartilage allowing the stylet to be pulled. Endotraheal tube was guided into the trachea over the stylet. The time to intubation, the blood pressure and heart rate of pre- and postintubation, and the difficulty of intubation were recorded and the complications of the endotracheal intubation such as bronchial spasm, oral and tracheal mucosal trauma, and sore throat, were observed. RESULTS: The mean time to intubation was 31.2+/- 8(18 to 50)sec. There were statistically signigicant increase in blood pressure and heart rates following intubation. The incidence of excellent and good intubating condition were 14 and 6 respectively. Seventeen and three intubations were successful on the 1st and 2nd attempts respectively. There were no differences in incidence of complications of endotracheal intubation compared to other reports. CONCLUSIONS: Though magnet guided technique has some limitations to use in case of difficult laryngoscopy, it can be used with merits such as simplicity and cheapness when other methods are not available.

Delayed Pneumothorax During General Anesthesia after Chest Injury: A case report / 대한마취과학회지

A 62-year-old female patient was scheduled for emergent explo-laparotomy under general anesthesia because of traffic accident. Preoperative checked chest x-ray showed multiple fractures of the ribs but didn't show the sign of pneumothorax or hemothorax. she had no dyspnea. Compared with previous value(PaO2; 210.5 mmHg), Arterial PO2 value(PaO2; 143.0 mmHg) was reduced significantly two hours after starting general anesthesia. Chest x-ray was taken in the operating room, which showed pneumothorax in the right side lung. The patient was treated with immediate closed thoracostomy. She recovered uneventfully three days later with complete resorption of the pneumothorax.

A Clinical Study of the Unstable Pelvic Fractures involving Sacro-iliac Joint / 대한정형외과학회잡지

The unstable pelvic fracture involving sacro-iliac joint produced by excessive force, is relatively rare but causes a multiplicity of complications and presents a major therapeutic problem. The clinical results were obtained as follows: 1. 9 patients out of 16 were in age group between 20 to 29 year, Male and female ratio was 5:3 2. 10 patients out of 16 were produced by traffic accident. 7 patients among 16 were included in vertical shear type and 5 in lateral compression type. 3. There were 44 associated injuries in 15 patients. Fractures in other region were the most common associated injury in 20 and injuries of the genito-uninary system in 8. 4. All of the cases were treated conservatively and their result were excellent or good except 1 patient in pelvic disruption type, who has had paraplegia due to fracture-dislocation of L4-5.