RESUMEN
The aim of this study was to compare the prognosis of separated and non-separated tooth autotransplantation of the upper first and second molars with complete root formation undertaken at dental clinics. The participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. This study analysed 35 separated teeth and 22 non-separated teeth of 47 participants ranging from 27 to 76 years of age (mean age: 55·0 years) after data screening and elimination. The cumulative post-transplantation survival rate at 10 years was 77·1% for separated teeth and 63·6% for non-separated teeth as calculated with the Kaplan-Meier method. There were no significant differences between separated teeth and non-separated teeth in a log rank test (P = 0·687). Separated-tooth autotransplantation can help fill narrow recipient sites and increase occlusal supporting zones, but the clinical success rate was only 48·6%. Although transplantation of teeth with complete root formation has limited prognosis, transplantation of upper first and second molars, whether separated or non-separated, is a viable option to replace missing teeth.
Asunto(s)
Arcada Parcialmente Edéntula/cirugía , Diente Molar/trasplante , Procedimientos Quirúrgicos Orales/métodos , Raíz del Diente/trasplante , Adulto , Anciano , Femenino , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Pronóstico , Trasplante Autólogo/métodosRESUMEN
Gender-related risk factors in the survival of transplanted teeth with complete root formation have not yet been identified. The purpose of this study was to investigate gender differences in tooth autotransplantation at dental clinics. We asked participating dentists to provide information on transplantations they had undertaken from 1 January 1990 to 1931 December 2010. The data were screened to exclude patients who underwent more than one transplantation, smokers or those whose smoking habits were unknown, patients under 30 or who were 70 years old and over, cases where the transplanted teeth had incomplete root formation or multiple roots and those with fewer than 20 present teeth post-operation. We analysed 73 teeth of 73 males (mean age, 47.2 years) and 106 teeth of 106 females (mean age, 45.3 years) in this study. The cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method. The cumulative survival rate for males was 88.3% at the 5-year mark, 64.8% at 10 years and 48.6% at 15 years; for females, it was 97.2% at the 5-year mark, 85.9% at 10 years and 85.9% at 15 years. A log-rank test indicated the difference between males and females to be significant (P = 0.011). There was also a significant difference in the main causes for the loss of transplanted teeth: males lost more transplanted teeth due to attachment loss than females (P < 0.05). These results indicate that males require more attention during the autotransplantation process, particularly at the stage of pre-operation evaluation and that of follow-up maintenance.
Asunto(s)
Raíz del Diente/anatomía & histología , Diente/trasplante , Adulto , Anciano , Diente Premolar/patología , Diente Premolar/trasplante , Femenino , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Diente Molar/patología , Diente Molar/trasplante , Odontogénesis/fisiología , Pérdida de la Inserción Periodontal/complicaciones , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Factores de Tiempo , Pérdida de Diente/etiología , Trasplante Autólogo , Resultado del TratamientoRESUMEN
The aim of this study was to investigate risk factors with age in the long-term prognosis of autotransplantation of teeth with complete root formation at dental clinics. Participating dentists were asked to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. The data were screened to exclude patients who were under 25 or 70 years of age and over, those who were smokers or whose smoking habits were unknown, those whose transplanted teeth had incomplete root formation or multiple roots and those with fewer than 25 present teeth post-operation. The participants in this study were 71 men (74 teeth) and 100 women (107 teeth) ranging from 25 to 69 years of age. Third molars were used as donor teeth in 89·0% of the cases. The participants were divided into three age groups of 25-39, 40-54 and 55-69. Survival analysis was conducted using the Kaplan-Meier method, and a log-rank test revealed that there were no significant differences in age groups for men or women. Cox regression analysis indicated that the survival of transplanted teeth was not influenced by age. However, although not statistically significant, the clinical success rate was lower in the 55-69-year-old group than that in the younger groups. These results indicate that if suitable donor teeth are available and the conditions are right, autotransplantation is a viable treatment for missing teeth regardless of the age of the patient.
Asunto(s)
Raíz del Diente/crecimiento & desarrollo , Diente/trasplante , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Tercer Molar/trasplante , Pronóstico , Modelos de Riesgos Proporcionales , Trasplante AutólogoRESUMEN
The aim of this study was to investigate the usage of tooth autotransplantation in dental clinics which offer the treatment and evaluate its practicality. Participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. A total of 614 teeth from 552 patients (37 dentists) ranging in age from 17 to 79 (mean age: 44·1) were examined. Cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method, and log rank test was used for analysis of factors. The mean number of autotransplantation patients per clinic per year was 1·4. Upper third molars constituted 36·8% of donor teeth, while 37·1% were lower third molars. The lower first molar region was the most common recipient site at 32·6%, followed by the lower second molar region (28·0%). Prosthodontic treatment of transplanted teeth involved coverage with a single crown (72·5%) and abutment of bridge (18·9%). A total of 102 transplanted teeth were lost owing to complications such as attachment loss (54·9%) and root resorption (25·7%). The cumulative survival rate in cases where donor teeth had complete root formation was 90·1% at 5 years, 70·5% at 10 years and 55·6% at 15 years. The mean survival time was 165·6 months. Older age was a significant risk factor (P < 0·05) for survival. In cases where suitable donor teeth are available, autotransplantation of teeth may be a plausible treatment option for dealing with missing teeth in dental clinics.
Asunto(s)
Procedimientos Quirúrgicos Orales/estadística & datos numéricos , Diente/trasplante , Adolescente , Adulto , Anciano , Clínicas Odontológicas , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trasplante Autólogo/estadística & datos numéricos , Resultado del Tratamiento , Adulto JovenRESUMEN
The aim of this study was to investigate the risk factors affecting long-term prognosis of autotransplantation of third molars with complete root formation in males at dental clinics. Participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. After data screening and elimination, participants of this study consisted of 183 teeth of 171 males ranging from 20 to 72 years of age (mean age, 44·8 years). The cumulative survival rate was 86·0% at the 5-year mark, 59·1% at 10 years and 28·0% at 15 years. The mean survival time was 134·5 months, as calculated by the Kaplan-Meier method. Single factor analysis using the log-rank test showed that the following factors had significant influence (P < 0·05) on survival of transplanted teeth: periodontal disease as the reason for recipient site tooth extraction, fewer than 25 present teeth and Eichner index Groups B1 to C. Cox regression analysis examined five factors: age, smoking habit, recipient site extraction caused by periodontal disease, fewer than 25 present teeth and Eichner index. This analysis showed that two of these factors were significant: fewer than 25 present teeth was 2·63 (95% CI, 1·03-6·69) and recipient site extraction caused by periodontal disease was 3·80 (95% CI, 1·61-9·01). The results of this study suggest that long-term survival of transplanted teeth in males is influenced not only by oral bacterium but also by occlusal status.
Asunto(s)
Tercer Molar/trasplante , Adulto , Factores de Edad , Anciano , Coronas , Pilares Dentales , Caries Dental/etiología , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/etiología , Periodontitis/complicaciones , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Riesgo , Tratamiento del Conducto Radicular , Resorción Radicular/etiología , Factores Sexuales , Fumar , Análisis de Supervivencia , Anquilosis del Diente/etiología , Extracción Dental , Fracturas de los Dientes/etiología , Raíz del Diente/lesiones , Alveolo Dental/cirugía , Trasplante Autólogo , Resultado del Tratamiento , Adulto JovenRESUMEN
Dehydrogenation of cyclohexane over Pt/alumite and Pt/activated carbon catalysts has been carried out for hydrogen storage and supply to fuel cell applications. An unsteady state has been created using spray pulsed injection of cyclohexane over the catalyst surface to facilitate the endothermic reaction to occur efficiently. Higher temperature of the catalyst surface is more favorable for the reaction, thus the heat transfer phenomena and temperature profile under alternate wet and dry conditions created using spray pulsed injection becomes important. IR thermography has been used for monitoring of temperature profile of the catalyst surface simultaneously with product analysis. The heat flux from the plate-type heater to the catalyst has been estimated using a rapid temperature recording and thermocouple arrangement. The estimated heat flux under transient conditions was in the range of 10-15 kW/m(2), which equates the requirement for endothermic reactions to the injection frequency of 0.5 Hz, as used in this study. The analysis of temperature profiles, reaction products over two different supports namely activated carbon cloth and alumite, reveals that the more conductive support such as alumite is more suitable for dehydrogenation of cyclohexane.
RESUMEN
We hypothesized that depression of liver function by norepinephrine can be improved by prostaglandin E1. Isolated perfused rat liver was selected as an experimental model, since the flow rate can be regulated in it. Twenty-one rats were randomly allocated to three groups: control, norepinephrine, and norepinephrine and prostaglandin E1 groups. The liver was perfused in a recirculating system at a constant flow rate of 20 ml/min. After administration of two milligrams of lidocaine in each group, lidocaine and monoethylglycinexylidide concentrations in the recirculating system were measured. Lidocaine pharmacokinetics were analyzed using the SAAM II program, including metabolic rate from lidocaine to monoethylglycinexylidide using time-concentration curves. Norepinephrine significantly increased perfusion pressure and the area under the time-concentration curve for lidocaine. Norepinephrine decreased the clearance and the elimination rate constant of lidocaine compared with those in the control group. Although administration of prostaglandin E1 after infusion of norepinephrine did not significantly change perfusion pressure, it significantly (p < 0.05) improved metabolic rate, clearance and the elimination rate constant of lidocaine in the isolated rat liver model.
Asunto(s)
Alprostadil/farmacología , Lidocaína/análogos & derivados , Lidocaína/farmacocinética , Hígado/metabolismo , Norepinefrina/farmacología , Animales , Interacciones Farmacológicas , Técnicas In Vitro , Lidocaína/metabolismo , Masculino , Modelos Biológicos , Perfusión , Presión Portal/efectos de los fármacos , Presión Portal/fisiología , Ratas , Ratas Sprague-DawleyRESUMEN
We hypothesized that changes in the pharmacokinetics of lidocaine might reveal changes in portal circulation induced by catecholamines. Isolated perfused rat liver (IPRL) was selected as an experimental model, since experimental conditions in this model could be regulated. The liver was perfused with a recirculating system at a constant flow rate of 20 ml/min. Two milligrams of lidocaine was administered along with one of three drugs, dopamine, norepinephrine or adenosine triphosphate. The fractional transfer rate constants, k21 and k12, from medium to liver and liver to medium, respectively, and ke, the elimination rate constant, were calculated using a two-compartment model with the SAAM II program. Curves of decay of lidocaine from the recirculating medium consisted of a fast and a slow component. Norepinephrine and high-dose dopamine significantly increased k12, while low-dose dopamine significantly increased k21 and ke compared with control values. Thus, norepinephrine and high-dose dopamine increased lidocaine transfer rate from liver to medium, while low-dose dopamine increased the transfer rate from medium to liver and the rate of elimination from liver. These findings suggest that norepinephrine and high-dose dopamine inhibit hepatic drug uptake and that low-dose dopamine improves uptake in IPRL.
Asunto(s)
Anestésicos Locales/farmacocinética , Catecolaminas/farmacología , Lidocaína/farmacocinética , Hígado/metabolismo , Animales , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Técnicas In Vitro , Hígado/efectos de los fármacos , Masculino , Modelos Biológicos , Consumo de Oxígeno/efectos de los fármacos , Ratas , Ratas Sprague-DawleyRESUMEN
This report describes a case of ventricular fibrillation resulting from coronary vasospasm during intracranial operation under general anesthesia. An autonomic response associated with the intracranial procedure caused a coronary spasm, which was worsened by alpha-agonists. Nitroglycerin effectively resolved the coronary spasm and co-complications persisted.
Asunto(s)
Vasoespasmo Coronario/etiología , Craneotomía/efectos adversos , Reflejo/fisiología , Nervio Trigémino/fisiopatología , Nervio Vago/fisiopatología , Agonistas alfa-Adrenérgicos/efectos adversos , Agonistas alfa-Adrenérgicos/uso terapéutico , Sistema Nervioso Autónomo/efectos de los fármacos , Sistema Nervioso Autónomo/fisiopatología , Bradicardia/etiología , Vasoespasmo Coronario/tratamiento farmacológico , Electrocardiografía/efectos de los fármacos , Humanos , Hipotensión/etiología , Masculino , Persona de Mediana Edad , Nitroglicerina/uso terapéutico , Hueso Petroso/cirugía , Reflejo/efectos de los fármacos , Taquicardia Ventricular/etiología , Nervio Trigémino/efectos de los fármacos , Nervio Vago/efectos de los fármacos , Vasodilatadores/uso terapéutico , Fibrilación Ventricular/etiologíaRESUMEN
Clonidine, an alpha2 agonist, was administered through a nasogastric tube for the treatment of hypertension in a head-injury patient with elevated plasma catecholamines. Haemodynamic parameters were stabilized with a reduction in sympathetic nervous activity. The plasma clonidine concentration, measured by radioimmunoassay, rapidly increased following the administration. After cessation of oral administration of clonidine, mean arterial blood pressure gradually increased. So clonidine was again administered orally and good blood pressure control was achieved and no change in consciousness level was observed. Oral clonidine was useful and effective for hypertension in this head injury patient.
Asunto(s)
Agonistas alfa-Adrenérgicos/administración & dosificación , Clonidina/administración & dosificación , Traumatismos Craneocerebrales/complicaciones , Hipertensión/tratamiento farmacológico , Administración Oral , Anciano , Humanos , Hipertensión/etiología , Intubación Gastrointestinal , Masculino , Resultado del TratamientoRESUMEN
Clonidine has both analgesic and sedative actions, and it has been used in a variety of settings as a sedative, or both. We administered oral clonidine with intravenous ketamine to a burn patient to control severe pain. Clonidine produced good analgesia and sedation. In addition, clonidine counterbalanced the sympathetic stimulation of ketamine by virtue of its action in reducing sympathetic outflow. The combination of these two drugs may be useful for burn patients with hypertension or myocardial ischemia.
Asunto(s)
Analgésicos/uso terapéutico , Quemaduras/tratamiento farmacológico , Clonidina/uso terapéutico , Hipnóticos y Sedantes/uso terapéutico , Administración Oral , Quemaduras/fisiopatología , Clonidina/administración & dosificación , Humanos , Ketamina/uso terapéutico , Masculino , Persona de Mediana EdadRESUMEN
A 45-year-old pregnant woman with cerebral palsy was scheduled for cesarean section at 37 weeks' gestation due to the risk of athetotic reaction. Spinal anesthesia appeared difficult to perform due to maintenance position, and because maternal respiratory depression due to athetotic reaction to mechanical stimulation might cause fetal hypoxia. We therefore selected general anesthesia. Propofol and succinylcholine were intravenously (i.v.) administered for induction, and additional propofol was administered i.v. for hemodynamics stabilization. Neonatal Apgar scores were 8 at one minute and 10 at five minutes. No maternal respiratory depression was observed postoperatively, and a healthy baby was successfully delivered.
Asunto(s)
Anestesia General , Anestesia Obstétrica , Anestésicos Intravenosos/farmacología , Parálisis Cerebral/fisiopatología , Complicaciones del Embarazo/fisiopatología , Propofol/farmacología , Cesárea , Femenino , Humanos , Persona de Mediana Edad , EmbarazoRESUMEN
We studied the effect of amrinone on portal perfusion pressure, perfusion flow, and tissue blood flow using an isolated perfused rat liver model. In the constant perfusion flow model, amrinone effectively decreased perfusion pressure in the precontracted state by adenosine triphosphate (ATP) or norepinephrine. Amrinone dose-dependently decreased portal perfusion pressure increased by calcium chloride. Similarly, amrinone dose-dependently increased portal perfusion flow decreased by ATP in the constant perfusion pressure model. Amrinone effectively increased tissue blood flow decreased by ATP or norepinephrine measured by laser-Doppler flowmetry. A specific inhibitor of the biosynthesis of nitric oxide, N omega-nitro-L-arginine, did not affect the hemodynamic effect of amrinone, suggesting that nitric oxide is not involved in the portal vasodilating effect of amrinone. We conclude that amrinone increases portal blood flow by decreasing perfusion pressure and contributes to increasing tissue blood flow of the liver without the involvement of nitric oxide.
Asunto(s)
Amrinona/farmacología , Inhibidores de Fosfodiesterasa/farmacología , Sistema Porta/efectos de los fármacos , Animales , Hemodinámica/efectos de los fármacos , Técnicas In Vitro , Circulación Hepática/efectos de los fármacos , Masculino , Perfusión , Presión , Ratas , Ratas Sprague-DawleyRESUMEN
To characterize the deficit in random number generation in schizophrenia with respect to control of sensory information processing, the present study employed a random number generation task using 10 digits (0 to 9) and compared two response modes (oral and written) with different amounts of sensory availability about the previous choices of the subject. Analysis indicated that the increased availability of previous information in the written response mode may exacerbate an aspect of the deficit in random number generation in schizophrenia reflecting the disturbance in control of sensory information processing. The comparison of performance in written and oral response modes may be useful in assessing schizophrenic psychopathology.
Asunto(s)
Atención , Solución de Problemas , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Conducta Verbal , Escritura , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Recuerdo Mental , Persona de Mediana EdadRESUMEN
A 46-year-old man involved in a traffic accident was admitted to our university hospital for treatment of acute subdural hematoma of the brain, multiple rib fractures and hemothorax. On admission, he manifested disturbance of consciousness, and his left upper and lower extremities were paralyzed. Blood gas analysis revealed hypoxia, and he was nasotracheally intubated. He was mechanically ventilated with 10 cmH2O positive end-expiratory pressure for treatment of rib fractures following surgical removal of the subdural hematoma and insertion of a sensor into the epidural space for measurement of intracranial pressure. Despite continuous intravenous infusion of midazolam and buprenorphine, he was agitated and thrashed from side to side, probably due to severe chest pain caused by rib fractures. Agitation was effectively controlled by continuous thoracic epidural administration of morphine and bupivacaine. Intracranial pressure did not increase, and epidural analgesia was without sequelae. The patient's level of consciousness gradually improved, rib fractures were treated and he was extubated on the 25th hospital day. These findings indicate that epidural analgesia is useful for controlling pain-related agitation caused by head and chest injuries if increased intracranial pressure is not present.
Asunto(s)
Analgesia Epidural , Analgésicos Opioides/administración & dosificación , Traumatismos Craneocerebrales/complicaciones , Fracturas Óseas/fisiopatología , Dolor/tratamiento farmacológico , Costillas/lesiones , Accidentes de Tránsito , Bupivacaína/administración & dosificación , Buprenorfina/administración & dosificación , Fracturas Óseas/etiología , Hematoma Subdural/etiología , Hematoma Subdural/cirugía , Humanos , Presión Intracraneal , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Morfina/administración & dosificaciónRESUMEN
We studied the effects of ATP and epinephrine on distribution of ischemic hepatic tissue flow in the isolated perfused rat liver. Five minutes after clamping both the portal vein and hepatic artery, perfusion was started. Lidocaine was infused into the portal vein, and the concentration of lidocaine in hepatic outflow was measured with FPIA. The oxygen extraction ratio was also measured. Tissue surface blood flow was measured with laser-Doppler flowmetry. We measured the tissue flow at 2 points: one where flow was more than 10 ml.min-1.100 gm liver weight-1 (R), and the other where flow was less than 10 ml.min-1.100 gm liver weight-1 (P). After perfusion pressure had become stable, ATP or epinephrine was infused for 15 minutes. Perfusion pressure increased, and tissue flow of R decreased significantly, while that of P increased (not significantly). The extraction ratio of lidocaine decreased significantly by epinephrine, and that of oxygen decreased (not significantly). We conclude that in the ischemic liver, vasoconstriction results in changes in the distribution of tissue blood flow and alters drug metabolism.
Asunto(s)
Isquemia/fisiopatología , Circulación Hepática/efectos de los fármacos , Hígado/irrigación sanguínea , Vasoconstrictores/farmacología , Adenosina Trifosfato/farmacología , Animales , Biotransformación , Epinefrina/farmacología , Técnicas In Vitro , Lidocaína/farmacocinética , Hígado/metabolismo , Masculino , Perfusión , Ratas , Ratas Sprague-Dawley , Vasoconstrictores/farmacocinéticaRESUMEN
The Airway Scope™, a novel videolaryngoscope used for tracheal intubation, is minimally invasive and can be used in conscious patients. The parturient with a potentially difficult airway should sometimes be intubated while awake, without anaesthesia or neuromuscular block. Two pregnant women who experienced massive postpartum haemorrhage during caesarean section underwent unscheduled intraoperative tracheal intubation using the Airway Scope. They were conscious and were intubated with minimal local anaesthesia so as to prevent cardiovascular compromise. We believe the Airway Scope is useful for anaesthetic procedures in the parturient who has haemodynamic instability.
Asunto(s)
Cesárea/métodos , Intubación Intratraqueal/métodos , Laringoscopios , Adulto , Anestesia Obstétrica , Estado de Conciencia , Femenino , Humanos , Periodo Intraoperatorio , Laringoscopía , Hemorragia Posparto/terapia , Embarazo , Embolización de la Arteria UterinaRESUMEN
BACKGROUND: Netherton syndrome (NS) is a severe autosomal recessive disorder characterized by ichthyosiform erythroderma, bamboo hair and atopy. The disease is caused by mutations in the SPINK5 gene, which encodes a putative serine protease inhibitor, LEKTI (lymphoepithelial Kazal-type-related inhibitor). Previous studies have clearly shown a crucial role for LEKTI in skin barrier formation. OBJECTIVES: To identify pathogenic mutations in two Japanese siblings with NS, and further to investigate the consequences of the mutations at the protein level. METHODS: To screen for mutations in the SPINK5 gene, all of its exons and splice junctions were amplified by polymerase chain reaction and directly sequenced. In addition, immunohistochemical staining of LEKTI, desmoglein (Dsg) 1 and elafin was performed with their specific antibodies. RESULTS: Mutation analysis resulted in the identification of compound heterozygous mutations, Q713X and R790X, in the SPINK5 gene of both patients. The former one is a novel mutation. Immunohistochemical studies in one patient demonstrated a complete absence of LEKTI and a strong expression of elafin in the patient's skin. Dsg1 was normally expressed in our patient. CONCLUSIONS: In this report, we describe compound heterozygous mutations in the SPINK5 gene in two Japanese siblings with NS. The result of immunohistochemistry shows LEKTI deficiency and upregulation of elafin in the skin of one patient. Furthermore, our data indicate that degradation of Dsg1 does not always occur in NS.
Asunto(s)
Proteínas Portadoras/genética , Proteínas Portadoras/metabolismo , Eritrodermia Ictiosiforme Congénita/genética , Mutación , Preescolar , Epidermis/metabolismo , Cabello/anomalías , Humanos , Eritrodermia Ictiosiforme Congénita/metabolismo , Eritrodermia Ictiosiforme Congénita/patología , Lactante , Masculino , Linaje , Proteínas Inhibidoras de Proteinasas Secretoras , Inhibidor de Serinpeptidasas Tipo Kazal-5 , SíndromeRESUMEN
Spasm of the sphincter of Oddi still occurs during cholecystectomy. Some reports indicate that the spasm, induced by morphine, can be reversed by injection of naloxone, nalbuphine, and glucagon. Others maintain that nitroglycerin or nifedipine can relax the sphincter of Oddi muscle. We recently encountered spasm of the sphincter of Oddi during a laparoscopic cholecystectomy and treated it successfully with intravenous nitroglycerin.