• The Korean Journal of Nuclear Medicine
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• v.33 no.2
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• pp.143-151
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• 1999

Purpose: Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphos-cintigraphy in patients with lower extremity lymphedema. Materials and Methods: The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphosintigraphic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. Results: There were 20 episodes of DLA in 12 extremities during clinical follow-up (19 :6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance fore confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Conclusion: Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.

• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.308-312
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• 2015

This study was aimed to evaluate the effects of tramadol hydrochloride on the minimum alveolar concentration of isoflurane ($MAC_{ISO}$) in dogs. Six healthy, female German shepherd dogs (aged 1-2 years) were used in this study. Anesthesia was induced by mask induction and maintained with isoflurane in oxygen. Mechanical ventilation maintained the end-tidal $CO_2$ partial pressure ($P_{ET}CO_2$) from 35 to 45 mmHg throughout the study. A baseline $MAC_{ISO}$ ($MAC_{ISO}B$) was determined starting 45 minutes after induction of anesthesia by clamping a pedal digit until gross purposeful movement was detected. After $MAC_{ISO}B$ determination, dogs received a tramadol loading dose of 3 mg/kg followed by a continuous rate infusion (CRI) of 2.6 mg/kg/h. The determination of $MAC_{ISO}$ after administration of tramadol ($MAC_{ISO}T$) began 20 min after the start of the CRI. Arterial blood pressure and heart rate were recorded continuously and arterial blood samples for blood gas analysis were collected at the end of the equilibration period. Mean ${\pm}$ SD values for the $MAC_{ISO}B$ and $MAC_{ISO}T$ were $1.33{\pm}0.04%$ and $1.23{\pm}0.04%$, respectively. The $MAC_{ISO}B$ decreased significantly by $7.5{\pm}0.2%$ (P < 0.05) after administration of tramadol. The mean heart rate and arterial blood pressure of six dogs were not changed significantly after tramadol administration. The blood gas levels remained constant during the study. In conclusion, tramadol could significantly reduce $MAC_{ISO}$ without depression of cardiorespiratory function. Thus, the use of tramadol on inhalation anesthesia with isoflurane in dogs can improve the stability of anesthesia and the quality of recovery.