Epidemiologic assessment of mortality, building collapse pattern, and medical response after the 1992 earthquake in Turkey. Disaster Reanimatology Study Group (DRSG).

Background: Post-earthquake engineering and epidemiologic assessments are important for the development of injury prevention strategies. This paper describes mortality and its relationship to building collapse patterns and initial medical responses following the 1992 earthquake in Erzincan, Turkey.

Methods: The study consisted of: 1) background data collection and review; 2) design and implementation of a field survey; and 3) site inspection of building collapse patterns.

Changes in serum CPK, LDH, and their isoenzymes in the perioperative period in patients undergoing craniotomy.

The perioperative changes in the serum concentration of creatine phosphokinase (CPK) and its isoenzymes MM, MB, and BB and of lactic dehydrogenase (LDH) and its isoenzymes LDH1 to LDH5 were determined during craniotomy in order to distinguish operation-induced changes in these enzymes from those due to acute myocardial infarction and malignant hyperthermia. Twenty-eight male patients, 29 to 76 years of age (mean +/- SD = 58 +/- 13.2 years), undergoing craniotomy for tumor reseaction (n = 26) or cerebral artery aneurysm clipping (n = 2) were included in this study.

Effects of bupivacaine on the membrane properties of nerve cell soma.

While the effects of local anaesthetics on axonal conduction and axonal membrane have been extensively studied, there is little information about the actions of these agents on nerve cell soma. Therefore, the effects of the amide local anaesthetic bupivacaine on the electrophysiologic properties of the nerve cell soma were studied on isolated superfused superior cervical ganglia of rats. Administration of 100-200 nM of bupivacaine to the preparation produced marked changes in membrane properties of the cell soma.

Serum creatine phosphokinase, lactic dehydrogenase, and their isoenzymes in the perioperative period.

The purpose of the present investigation was to determine the normal perioperative variations in the serum concentration of creatine phosphokinase (CPK) and its isoenzymes MM, MB, and BB, and of lactic dehydrogenase (LDH) and its isoenzymes LDH1 to LDH5 to distinguish operation-induced changes in these enzymes from those due to acute myocardial infarction or malignant hyperthermia. In 30 patients, 52 to 75 years of age undergoing elective orthopedic operations, 10 serial blood samples were obtained in the perioperative period: two samples before skin incision and eight samples after the incision over a time span of 70 hours. The preinduction mean serum CPK level of 141 U/L increased gradually and significantly and reached a maximum mean concentration of 809 U/L 34 hours after incision (p less than 0.

Bilateral Horner's syndrome and hoarseness complicating lumbar epidural anesthesia.

A case of bilateral Horner's syndrome associated with hoarseness resulting from single-dose lumbar epidural analgesia for relief of low back pain in a 57-year-old man is reported. The pathophysiology of Horner's syndrome and hoarseness is discussed.

Transurethral prostatectomy complicated by intraperitoneal extravasation of irrigating fluid.

A patient underwent transurethral resection of the prostate (TURP), which was complicated at the outset of the procedure by an inadvertent puncture wound of the dome of the bladder and the peritoneum. Shortly after resection was initiated, the patient developed shoulder pain and a tensely distended abdomen, although at this time the serum sodium concentration remained normal. Over the next several hours the patient developed significant hyponatremia.

Unrecognized tracheo-oesophageal fistula.

A patient with a retropharyngeal carcinoma was anaesthetized for laryngoscopy, oesophagoscopy and biopsy. Suggestive symptoms of a tracheo-oesophageal fistula were absent and a barium swallow did not demonstrate its presence. Sign of an abnormal communication appeared for the first time after the patient had been intubated and positive airway pressure applied.

Reaction to indigo carmine.

The commonly encountered cardiovascular effects of intravenous indigo carmine administration is transient alpha-receptor stimulation, namely increased total peripheral resistance, diastolic and systolic blood pressure, and central venous pressure with decreased cardiac output, stroke volume and heart rate. These usually cause no problems and frequently go undetected unless the patient is monitored closely during that brief interval. However, significant problems occur occasionally and its use is not totally without risks.

Hazards in use of anode endotracheal tube a case report and review.

While the design and manfacture of plastic tubes have been greatly improved in recent years, spiral-metal-bound latex tubes are still subject to a number of hazards, among them herniation of the intramural cuff-inflating tube into the lumen of the anode tube, preventing entry or exit of gases through the anode tube after cuff inflation. Problems may also occur at the bevel and at juctions. Until better-designed anode tubes are available, extra care is required in their use.