Increased intracranial pressure from nitrous oxide five days after pneumoencephalography.
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Biomedical subjects
Publications and source records attributed to Y J Sohn.
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Plasma and urine concentrations of d-tubocurarine (d-TC) were determined and twitch tension was monitored before and after the intravenous administration of d-TC, 0.5 mg/kg in patients anethetized with halothane and nitrous oxide with (N=5) and without (N=5) renal failure. Terminal half lives of d-TC of 231 and 330 minutes predicted from other studies for patients with and without renal function were consistent with plasma concentrations measured. In patients with normal renal function, 38% of unchanged d-TC was eliminated in urine in 25 hours as opposed to 13% in those patients with a newly transplanted kidney. However, we still conclude that a newly transplanted kidney can eliminate d-TC effectively since the kidney was inserted 3.5 hours after administration of d-TC. Absence of renal function significantly prolonged the duration of neuromuscular blockade but did not alter the plasma concentrations of d-TC required for neuromuscular blockade. Thus, prolonged neuromuscular blockade from d-TC in patients with renal failure is due to decreased elimination rate of the drug as a consequence of lack of renal function rather than increased sensitivity.
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An evaluation of the accuracy, perdision, and clinical safety of the IBC indwellling catheter electrode for the continuous monitoring of arterial oxygen tension during and after general anesthesia was made in a total of 62 patients. A comparison of the standard bench-type electrode (Radiometer) with the International Biophysics Corporation (IBC) electrode for the measurement of oxygen tension in tonometered blood also was performed. Three hundred and fifty comparisons in 51 patients were made of the indwelling electrode with a standard Radiometer unit and, while there was good correlation, there also was ome scatter. An additional small series of 44 comparisons in 11 patients was performed, the primary difference being that the electrode was maintained intr-arterially for approximately 1 day. In both in vivo studies there was excellent correlation but questionable precidion. Four IBC electrodes and eight Radiometer Pao2 electrodes in an additional study were compared at 11 different tonometered oxygen tensions in blood. The IBC electrodes measured oxyygen tension more accurately than did the Radiometer, and standard deviations were consistently smaller at all of 11 different oxygen tensions for the IBC unit. The authors believe that the poor precision within both in vivo studies might be due to the fact that the IBC probe, which was of unknown accuracy and precision, was compared to a standard device (the Radiometer) which in the in vitro investigation proved to be less accurate and less precise. No complications due to the insertion and maintance of this in vivo electrode were encountered. The authors suggest that the IBC method for measuring Pao2 continuously in vivo be considered as an alternative to intermittent gas analysis of oxygen tension.
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We report eight additional cases of focal fibrocartilaginous dysplasia (FFCD) in the proximal tibia (five), distal ulna (one), and distal femur (two). Spontaneous, complete resolution of the lesion was observed in two tibiae and one ulna. Three tibial lesions with genu varum deformity were managed with osteotomy. Two femoral FFCDs caused persistent or progressive deformity: one genu valgum with patellar dislocation, and one genu varum. These patients underwent concomitant deformity correction and lengthening by the Ilizarov method. The final results were satisfactory in all patients except one, who underwent valgus tibial osteotomy and developed mild postoperative genu valgum. The analysis of a total of 46 cases in the literature and our experience suggests that (a) FFCD has a wide histopathologic spectrum, ranging from purely dense, fibrous tendon-like tissue to benign fibrocartilaginous tissue; (b) at least 45% of tibial FFCD demonstrates progressive, spontaneous resolution; (c) in contrast, femoral and humeral FFCDs appear to have a slim possibility of spontaneous regression of the deformity; and (d) corrective osteotomy is indicated when the deformity is increasing or persistent, or when the existing deformity is severe enough to jeopardize adjacent joint mechanics and alignment.
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