Spinal anesthesia with pentazocine for total abdominal hysterectomy

Intraspinal pentazocine, 1.5 mg/kg, produced sufficient analgesia and moter block in 50 cases of abdominal total hysterectomy. Pentazocine, a derivative of benzomorphans, shares some common characteristics with local anesthetics in the chemical structure. Both agents have an aromatic ring and an intermediate chain, in common, which connects the former to nitrogen moiety, and the local anesthetic action was anticipated. The onset of the sensory block was 3.2 +/- 0.9 (mean +/- SD) min, and the maximum level was T10 and T4 with mean level of T6. The onset of motor weakness at the knee was 4.1 +/- 1.9 min, and the duration was 108 +/- 10.5 min.

A case of coagulation factor V deficiency complicated with intracranial hemorrhage

Factor V deficiency is a relatively uncommon disorder, inherited as an autosomal recessive trait that manifests clinically only in individuals who inherit the defective gene from both parents. The hemorrhage of nasal and oral cavity and ecchymosis are common but intracranial hemorrhage is very rare. We experienced a 53 year old male patient with intracranial hemorrhage due to factor V deficiency. The laboratory tests showed prolongation of APTT and PT, normal bleeding time and normal thrombin time. The levels of the coagulation profiles on the patient revealed a significant decrease factor V, below 1% of normal range (60-140%). Other coagulation factors were normal. He was treated with fresh frozen plasma and completely recovered 3 weeks after treatment.

Normal bronchial and pulmonary arterial diameters measured by thin section CT

OBJECTIVE

We undertook this study to evaluate the normal values of the artery-bronchus ratio (ABR) and the bronchial lumen ratio (BLR) at subsegmental levels and to determine whether these values can be used as objective parameters for evaluation of various diseases involving the bronchovascular trees.

MATERIALS AND METHODS

We analyzed high-resolution CT of 30 patients without cardiopulmonary diseases. The CT studies were performed with 5 mm collimation at 5 mm intervals from the carina to the level of the inferior pulmonary vein and with 1.5 mm collimation at 10 mm intervals through the remainder of the lung. Both ABR, defined as the outer diameter of the pulmonary artery were divided by the outer diameter of its accompanying bronchus, and BLR, defined as the inner diameter of the bronchus divided by its outer diameter, were measured at the subsegmental level on the display console.

RESULTS

The mean ABR was 0.98 +/- 0.14 (range, 0.53-1.39), and the mean BLR was 0.66 +/- 0.06 (range, 0.51-0.86). Although BLR revealed no statistical differences between segments, lobes, and lungs, there were statistically significant differences between the ABRs of segments and between those of lobes.

CONCLUSION

There was a wide range of normal values of ABR and BLR. This wide range of values would make these parameters of less value in the evaluation of bronchovascular bundles.

Rib counting on CT using the sternal approach

To devise a new method for counting ribs on CT scan, we evaluated the CT anatomy of the costal cartilages and the proximal xiphoid in 20 control patients without rib pathology. The sternal end of costal cartilages seen on the same image as the proximal xiphoid was always the seventh (n = 20). These costal cartilages were located anterolateral (n = 13) or lateral (n = 7) to the proximal xiphoid. In fifteen patients with rib pathology, 23 abnormal ribs were localized by our method. All of these ribs correlated with those seen on chest radiographs and rib cage views or with resected ribs on postoperative films.