We had experience of 464 cases of anesthesia for repair of cleft lip and cleft palate under 10 years of age. The analyzed results are as follows: 1) The 464 cases were divided into 5 age groups and 165 cases(35.6%) were in the under 2 years age group. Sex distribution was 291 males(66.2%) and 173 females(37.3%) 2) 377 cases(81.3%) were under 20kg of body weight. 3) There were 229 cleft lip cases (29.3%), 233 cleft palate cases, and 1 case each of (50.2%), of naso-ocular fistular correction and oro-ocular correction. 4) There were 386 cases elective surgery and 2 were emergency cases. 5) All cases had general anesthesia by means of endotracheal intubation 377 cases(81.3%) with a non-rebreathing system and 87 cases(18.8%) had a semi-closed absorption system. 6) The main anesthetic was halothane in 462 cases(99.6%) and Valium-Demerol and ether was 1 case each. 7) The mean blood loss in palatoplastry was 10ml/kg of body weight but it was 13.7ml/kg in the 5~10kg of body weight group, 11.6ml/kg in the 10kg~20kg of body weight group and 7.5ml/kg in the 20~30kg of body weight group. 8) Incidence of cleft lip combined with cleft palate was 211 cases(45.5%) among 464 cases and 149 cases(51.2%) were males and 62 cases(35.8%) were females. 9) The most common type of cleft lip was left incomplete lip(30.1%) and of cleft palate it was left complete palate(30.5%). 10) Familial history was found in 56 cases(12%).
Absorption ; Anesthesia* ; Anesthesia, General ; Body Weight ; Child* ; Cleft Lip ; Cleft Palate ; Emergencies ; Ether ; Female ; Halothane ; Humans ; Incidence ; Intubation, Intratracheal ; Male ; Sex Distribution

We performed the interscalene technic of brachial plexus block for an operation of the upper extremity in 94 patients. We used 1%, 1.5% or 2% lidocaine solution with or without 1:200,000 epinephrine. There were paresthesias in all cases of needle puncture with the interscalene approach. The resutls were as follows: 1) Onset of anesthesia was observed in 3~10 minutes(average: 5 min.) 2) Complete anesthesia was observed in 10~30 minutes(average: 18 min.) 3) The mean interval of anesthesia to operation was 22 minutes. 4) We observed satisfactory blocks in 81 cases, unsatisfactory block in 8 cases and failure in 5 cases. 5) There were not any complications such as pneumothorax, dyspnea, convulsions, subarachnoid or epidural injection, etc.
Anesthesia ; Brachial Plexus* ; Dyspnea ; Epinephrine ; Humans ; Injections, Epidural ; Lidocaine ; Needles ; Paresthesia ; Pneumothorax ; Punctures ; Seizures ; Upper Extremity

BACKGROUND: Several abnormalities of the autonomic regulation of the heart have been noted after acute myocardial infarction(AMI). Measurement of heart rate(HR) variability has been reported to provide indirect, noninvasive estimate of the cardiac efferent parasympathetic activity. The purposes of this study were to get the information on heart rate variability after AMI and to determine its relation to clinical and hemodynamic data. METHODS: We measured HR variability in 28 patients(23 men and 5 women : mean age, 56.6+/-10.4 years) 3-15days after AMI, in 25 patients with unstable angina and in 21 normal subjects by using triangular interpolation of the frequency distribution histogram om normalto-normal RR intervals from Holter tapes. RESULTS: HR variability was lower in AMI than unstable angina patients(357.9+/-118.6 versus 426.1+/-122.5 msec : p<0.05) and normal subjects(525.1+/-137.4 msec : p<0.025). There was no difference for infarct site, thrombolytic therapy, presence of Q-wave. HR variability was significantly related to mean 24-hour HR, left ventricular ejection fraction(all p<0.0001), left ventricular end diastolic diameter(p<0.05). HR varability was lower in patients belonging to Killip class 2-4 and who reqired the use of diuretics or digitalis(all p<0.05). CONCLUSION: After AMI, HR variabillity was reduced and significantly related to clinical and hemodynamic indexes of severity. Measurement of HR variability early after AMI may offer important clinical information for the early high stratification of patients.
Angina, Unstable ; Autonomic Nervous System ; Diuretics ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Infarction* ; Thrombolytic Therapy

Cosmetics are primarily applied to the skin; therefore, the association of cosmetic dyes with skin diseases or inflammation is a topic of great interest. Thymic stromal lymphopoietin (TSLP) is an interleukin 7-like cytokine that activates dendritic cells to promote Th2 inflammatory immune responses. TSLP is highly expressed in keratinocytes under inflammatory conditions, which suggests that it may play a critical role in the development of skin diseases, such as atopic dermatitis. Therefore, we investigated whether cosmetic dyes influenced the production of TSLP by keratinocytes. Phloxine O, also known as D&C Red No.27, is one of the most common red synthetic pigments and is widely used in colored cosmetics. Our results showed that Phloxine O downregulated phorbol 12-myristate 13-acetate-induced production of TSLP in a murine keratinocyte cell line (PAM212). Phloxine O also suppressed TSLP expression in KCMH-1 cells, which are mouse keratinocytes that constitutively produce high levels of TSLP. To investigate the in vivo effects of Phloxine O, we induced TSLP expression in mouse ear skin by topically applying MC903, a vitamin D3 analogue that is a well-known inducer of atopic dermatitis-like symptoms. Topical application of Phloxine O prevented MC903-induced TSLP production in mouse ear skin, attenuated the acute dermatitis-like symptoms and decreased serum IgE and histamine levels in mice. Suppression of TSLP expression by Phloxine O correlated with reduced expression of OX40 ligand and Th2 cytokines in mouse ear skin. Our results showed that Phloxine O may be beneficial to prevent dermatitis by suppressing the expression of TSLP and Th2 cytokines in skin.
Animals ; Cell Line ; Cholecalciferol ; Coloring Agents ; Cytokines ; Dendritic Cells ; Dermatitis* ; Dermatitis, Atopic ; Dilatation and Curettage ; Ear ; Female ; Histamine ; Immunoglobulin E ; Inflammation ; Interleukins ; Keratinocytes ; Mice* ; OX40 Ligand ; Skin ; Skin Diseases

PURPOSE: Esophageal cancer patients have a difficulty in the intake of meals through the blocked esophageal lumen, which is caused by an ingrowth of cancer cells and largely influences on the prognosis. It is reported that esophageal cancer has a very low survival rate due to the lack of nourishment and immunity as the result of this. In this study a new radioactive stent, which prevents tumor ingrowth and restenosis by additional radiation treatment, has been developed. MATERIALS AND METHODS: Using HANARO research reactor, the radioactive stent assembly (166Ho-SA) was prepared by covering the metallic stent with a radioactive sleeve by means of a post-irradiation and pre-irradiation methods. RESULTS: Scanning electron microscopy and autoradiography exhibited that the distribution of 165/166Ho (NO3) compounds in polyurethane matrix was homogeneous. A geometrical model of the esophagus considering its structural properties, was developed for the computer simulation of energy deposition to the esophageal wall. The dose distributions of 166Ho-stent were calculated by means of the EGS4 code system. The sources are considered to be distributed uniformly on the surface in the form of a cylinder with a diameter of 20 mm and length of 40 mm. As an animal experiment, when radioactive stent developed in this study was inserted into the esophagus of a Mongrel dog, tissue destruction and widening of the esophageal lumen were observed. CONCLUSION: We have developed a new radioactive stent comprising of a radioactive tubular sleeve covering the metallic stent, which emits homogeneous radiation. If it is inserted into the blocked or narrowed lumen, it can lead to local destruction of the tumor due to irradiation effect with dilatation resulting from self-expansion of the metallic property. Accordingly, it is expected that restenosis esophageal lumen by the continuous ingrowth and infiltration of cancer after insertion of our radioactive stent will be decreased remarkably.
Animal Experimentation ; Animals ; Autoradiography ; Computer Simulation ; Dilatation ; Dogs ; Esophageal Neoplasms* ; Esophagus ; Humans ; Meals ; Microscopy, Electron, Scanning ; Polyurethanes ; Prognosis ; Stents ; Survival Rate

PURPOSE: Organophosphorus (OP) pesticides are differentiated into 3 groups according to their toxicity. The differences in chemical composition of each OP pesticide determines its toxicokinetic characteristics. There are few human studies that address the clinical results of poisoning according to the OP pesticide. In this study, we aimed to examine the differences in clinical features among self-poisoning from 4 highly toxic OP pesticides. METHODS: The 4 kinds of OP poisonings included 17 cases of Dichlorvos, 17 cases of EPN, 17 cases of methidathion, and 13 cases of phosphamidon. We set primary outcomes as GCS, atropine dose required, duration of patient need for atropine, proportion who required ventilation, duration on ventilation, and the interval from ingestion to ventilation. Secondary outcomes were the proportion of OP-induced delayed neuropathy, duration of ICU stay, and proportion who required additional infusion of pralidoxime chloride (PAM). RESULTS: The EPN group required the largest amount of atropine, the longest duration of atropine use, the longest duration for support of mechanical ventilation, and the longest ICU stay. Furthermore the proportion who required additional PAM and neuropathy were in the EPN group. However, the EPN group had the longest interval from ingestion to ventilatory support. Meanwhile, the Dichlorvos group exhibited comparatively mild clinical features. CONCLUSION: Throughout this study, we found different clinical features to each OP pesticide poisoning. It can be explained by differences in chemical composition, which determined the speed of aging, the reactivation rate of OPenzyme, the metabolism, the fat solubility, and other characteristics of the pesticides.
Aging ; Atropine ; Dichlorvos ; Eating ; Humans ; Organophosphorus Compounds ; Organothiophosphorus Compounds ; Pesticides ; Phosphamidon ; Pralidoxime Compounds ; Respiration, Artificial ; Solubility ; Ventilation

Histone deacetylase (HDAC) inhibitors are considered novel agents for cancer chemotherapy. We previously investigated MHY219, a new HDAC inhibitor, and its potent anticancer activity in human prostate cancer cells. In the present study, we evaluated MHY219 molecular mechanisms involved in the regulation of prostate cancer cell migration. Similar to suberanilohydroxamic acid (SAHA), MHY219 inhibited HDAC1 enzyme activity in a dose-dependent manner. MHY219 cytotoxicity was higher in LNCaP (IC50=0.67 muM) than in DU145 cells (IC50=1.10 muM) and PC3 cells (IC50=5.60 muM) after 48 h of treatment. MHY219 significantly inhibited the HDAC1 protein levels in LNCaP and DU145 cells at high concentrations. However, inhibitory effects of MHY219 on HDAC proteins levels varied based on the cell type. MHY219 significantly inhibited LNCaP and DU145 cells migration by down-regulation of matrix metalloprotease-1 (MMP-1) and MMP-2 and induction of tissue inhibitor of metalloproteinases-1 (TIMP-1). These results suggest that MHY219 may potentially be used as an anticancer agent to block cancer cell migration through the repression of MMP-1 and MMP-2, which is related to the reduction of HDAC1.
Cell Movement ; Down-Regulation ; Drug Therapy ; Histone Deacetylase Inhibitors* ; Histone Deacetylases* ; Histones* ; Humans* ; Matrix Metalloproteinases ; Prostate* ; Prostatic Neoplasms* ; Repression, Psychology

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

PURPOSE: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. MATERIALS AND METHODS: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. RESULTS: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). CONCLUSION: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.
Acceleration ; Artifacts ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Signal-To-Noise Ratio