Growth Hormone Therapy in Intrauterine Growth Retardation(IOGR) / 대한소아내분비학회지

No abstract available.

Changes in Both Palmar Skin Temperature during Video Endoscopic Thoracic Sympathicotomy for Hyperhidrosis / 대한마취과학회지

BACKGROUND: Monitoring the skin temperature changes of the palm during video endoscopic thoracic sympathicotomy has been used as a measure of the success of the surgery. When general anesthesia is used during sympathicotomy, increases of skin temperature on the ipsilateral palm is less than that observed in percutaneous chemical sympathectomy. Contralateral skin temperature has been found to be decreased. So we measured palmar skin temperature on both sides during sympathicotomy to learn whether we can use it as a indicator of success under general anesthesia, and to see contralateral sympathetic responses. METHODS: Thirty patients have been examined. The skin temperature of both their thenar areas was measured before sympathicotomy, and 5 and 10 minutes after sympathicotomy under general anesthesia, using N2O, O2, enflurane, vecuronium. RESULTS: Under general anesthesia, there was a significant increase of post-sympathicotomy skin temperature on the ipsilateral palm, in contrast to a decrease on contralateral ones. The absolute value was minimal but statistically significant. CONCLUSIONS: Thoracic sympathicotomy may producc simultaneous but different types of sympathetic response on both sides of the hands, though this response is lessened with a use of general anesthesia because inhalation anesthetics induced central and peripheral sympathetic inhibition. We conclude that continuous and careful monitoring of palmar skin temperature yields useful information about intraoperative success during thoracic sympathicotomy under general anesthesia and that we should conduct further study of the contralateral sympathetic response.

A Comparison of the Effects of Isoflurane and Desflurane on Myocardial Contractility in Isolated Sprague-Dawley Hearts / 대한마취과학회지

BACKGROUND: Desflurane has some cardiovascular effects similar to isofl-urane. Desflurane has decreased systemic vascular resistance and demonstrated a myocardial depressant property in vivo animal stulies. The purpose of this study was to compare the myocardial and coronary effects of desflurane and isoflurane. METHODS: Cardiac effects were examinated in 24 rat hearts perfused with modified Krebs solution containing 1 MAC and 2 MAC desflurane or isoflurane for 10 min. at each concentration in a retrograde manner. Left ventricle pressure, heart rate and rate of change of ventricular pressure (dp/dt) were mea-sured, as were coronary flow and partial oxygen pressure. Oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated by each measurement. RESULTS: Heart rate, left ventricle pressure and dp/dt decreased each anesthetic similarly in a concentration-dependent manner. Heart rate decreased by 243.86 15.7 beats/min at 1 MAC and 219.14 15.8 beats/min at 2 MAC with isoflurane (control: 262.99 2.35 beats/min.) and by 250 23 beats/min at 1 MAC and 223.89 23 beats/min at 2MAC with desflurane (control 266.94 22.30 beats/min). Coronary flow increased by 13.72 0.99 ml/g/min at 1 MAC and 14.30 1.05 ml/g/min at 2 MAC with isoflurane (control :12.04 0.84 ml/g/min) and by 12.80 1.63 ml/g/min at 1 MAC and 13.71 1.46 ml/g/min at 2 MAC with desflurane (control 14.04 1.22 ml/g/min). Oxygen delivery increased proportionally with coronary flow. The increase in MVO2 was accompanied by a decrease in heart rate and pressure but there were no significant differences. Percent oxygen extraction decreased in a concentration dependent manner. CONCLUSIONS: This study shows that desflurane and isoflurane decreased heart rate, myocardial depression and coronary vasodilating effects, resulting in improved oxygen perfusion effects.