ABSTRACT
No abstract available.
Subject(s)
Anesthesia, General , Joint Dislocations , Temporomandibular JointABSTRACT
Retroperitoneal paragangliomas are uncommon neuroendocrine tumors which are derived from extra-adrenal paraganglioma with various clinical signs and symptoms. Although most extra-adrenal paragangliomas are histologically benign, some tumors can synthesize and secrete excess catecholamine from the tumor. Excessive production of catecholamine causes numerous cardiovascular manifestations such as severe hypertension, cardiomyopathy, cardiac arrhythmias, and even multiorgan failure. It can lead to high risks of morbidity and mortality, especially in patients who are unrecognized or not adequately prepared. We present a female patient who was preoperatively undiagnosed of secreting retroperitoneal paraganglioma that caused cardiac tachyarrhythmia and severe intraopertive hypertension not controlled by usual antihypertensive agents. A secreting extra-adrenal paraganglioma should be included in differential diagnosis for patient who have incidentaloma and show wide range of hypertension with hemodynamic instability that is not well controlled by common antihypertensive drugs.
Subject(s)
Female , Humans , Antihypertensive Agents , Arrhythmias, Cardiac , Cardiomyopathies , Diagnosis, Differential , Hemodynamics , Hypertension , Mortality , Neuroendocrine Tumors , Paraganglioma , Paraganglioma, Extra-Adrenal , TachycardiaABSTRACT
No abstract available.
Subject(s)
Bronchoscopes , Intubation, Intratracheal , Laryngeal MasksABSTRACT
BACKGROUND: It is well known that anticonvusant drugs such as carbamazepine are effective in the management of various neuropathic pain conditions. Oxcarbazepine, a keto analogue of carbamazepine, might also be expected to have an analgesic effect because it is a derivative of carbamazepine. The aim of this study is to evaluate the analgesic effect of oxcarbazepine in a rat neuropathic pain model. METHODS: Male Sprague-Dawley rats were prepared by tightly ligating the L5 and L6 spinal nerves to reproduce neuropathic pain. Sixty neuropathic rats were randomly assigned into 6 groups for the intraperitoneal administration of drugs. Normal saline, vehicle (polyethylene glycol 400), oxcarbazepine (10 mg/kg, 20 mg/kg, 30 mg/kg and 50 mg/kg) were administered respectively to the individual groups. We examined mechanical and cold allodynia preadministration, and 15, 30, 60, 90, 120, 150 and 180 min after intraperitoneal drug administration. Mechanical allodynia was quantified by measuring the withdrawal frequency to stimuli with two von Frey filaments of 35.6 mN and 115.2 mN. Cold allodynia was quantified by measuring the frequency of foot lift to 100% acetone. Pain behavior may be influenced by the adverse effects of anticonvulsants, which include sedation, motor incoordination. We therefore measured the locomotor function of the neuropathic rats by using the rotarod test. RESULTS: The vehicle group showed no significant differences in the mechanical and cold allodynia versus the saline group. In the oxcarbazepine-treated groups, withdrawal frequencies to mechanical and cold stimuli were significantly reduced versus the pre-administration values and versus the vehicle group. The duration of antiallodynic effects increased dose-dependently, and these were maintained for 150 min at the highest dose. Only at the highest dose (50 mg/kg) did oxcarbazepine reduce the rotarod performance time. CONCLUSIONS: We conclude that oxcarbazepine reduces mechanical and cold allodynia in a rat neuropathic pain model and may be a candidate for the management of neuropathic pain.
Subject(s)
Animals , Humans , Male , Rats , Acetone , Anticonvulsants , Ataxia , Carbamazepine , Foot , Hyperalgesia , Models, Animal , Neuralgia , Rats, Sprague-Dawley , Rotarod Performance Test , Spinal NervesABSTRACT
BACKGROUND: Bone marrow transplantation is increasingly common as a therapeutic modality. Large volume of bone marrow has been aspirated under general anesthesia and can cause hemodynamic instability and complications. The purpose of this study is to review the cases of bone marrow harvesting in healthy donors and to find the proper anesthetic management for this procedure. METHODS: We retrospectively analyzed the medical records of 479 cases of bone marrow harvesting in healthy donor performed in Catholic University of Korea, St. Mary's hospital. RESULTS: Mean harvest volume was 1097.2 120.6 ml and duration of aspiration was 53.8 22.6 minutes. Aspirated harvesting volume was mainly replaced by blood products and crystalloid solutions. 55.7% of donors received homologous blood products and 74.5% of donors received autologous blood during the perioperative period. Mean hemoglobin concentration before harvesting was 12.3 1.8 gm/dL and there was no significant changes in hemoglobin concentrations after harvesting. The incidence of hypotension and tachycardia was 22.3 and 20.5%, respectively with higher incidence in the female group (p<0.05). The incidence of febrile reaction after harvesting was 15.5%. Average duration of admission for harvesting was 3.5 0.9 days and there were no life-threatening complications. CONCLUSION: We conclude that 479 cases of bone marrow harvesting were performed safely but we should consider to reduce the volume of homologous transfusion in healthy donors.
Subject(s)
Female , Humans , Anesthesia, General , Bone Marrow Transplantation , Bone Marrow , Hemodynamics , Hypotension , Incidence , Korea , Medical Records , Perioperative Period , Retrospective Studies , Tachycardia , Tissue DonorsABSTRACT
BACKGROUND: Recently Umeyama et al. reported that cerebral blood flow is definitely increased on the ipsilateral side after the blockade of stellate ganglion. Considering that the most obvious solution to the problem of poor cerebral blood flow is to augment the flow, cervical sympathectomy may reduce the volume and extent of the brain damage by increasing the cerebral blood flow. We studied the effects of cervical sympathectomy on ischemic brain damage in a middle cerebral artery occlusion model in rats. METHOD: The experimental animals were divided into three groups. In the sham-operated control group (n=7), middle cerebral artery was occluded without cervical sympathectomy. In the experimental group I (n=7), cervical sympathectomy was performed 5 minutes before middle cerebral artery occlusion. In the experimental group II (n=7), cervical sympathectomy was performed 5 minutes after middle cerebral artery occlusion. The neurological grade of each experimental animal was evaluated at 24 hours post occlusion and then the animals were sacrificed. The brain was cut into coronal sections. The volume of infarct was computed and the edema volume was calculated. RESULTS: 1. There were no differences in the physiological variables in all groups. 2. Cervical sympathectomy, compared with the controls, significantly reduced the volume of infarct (P<0.05). 3. There was no significant difference in ischemic brain edema between each group. 4. The neurologic deficit was less severe in sympathectomized groups compared with the control group (P<0.05). And neurological grades were significantly correlated with the volume of infarction (P<0.05). CONCLUSION: These results suggest that cervical sympathectomy may improve the neurologocal deficit and reduce the infarct volume measured 24 hours following induction of focal cerebral infarction.