BACKGROUND: It has been known that arteries of hypertensive animals and patients are generally thicker and more rigid than those of normal subjects, resulting from the morphological changes induced by an increased stress on the vessel wall. Factors proposed to be responsible for these changes are smooth muscle hypertrophy, increased amount of collagen, hyperplasia of smooth muscle cell and changes in cross-linkages of the fibrous proteins. The present study was conducted to define whether enalapril, a converting enzyme inhibitor of angiotensin II generation from angiotensin I, can restore the structural alterations of aortic media in spontaneously hypertensive rat(SHR). METHODS: For this purpose, SHR were treated for 22 weeks with 2mg/kg/day enalapril and morphologic changes were compared between enalapril-treated SHR and normotensive Wistar-Kyoto rats. RESULTS: The increased thickness of the aortic media in SHR was reduced and intervening elastic laminae were narrowed by enalapril treatment. Subcellular analysis of cytoplasmic composition and nucleus in the aorta of hypertensive rats revealed some modification with enalapril. Some irregularly arranged collagen fibrils in aortic media of SHR were regularly distributed and the periodic bands of the fibrils which were the fragmented were clearly apparent by enalapril treatmed SHR group. CONCLUSIONS: From the above experimental results, it is concluded that subcellular changes of smooth muscle cells and collage fibrils of aortic media in SHR could be repaired by long-term treatment with enalapril.
Angiotensin I ; Angiotensin II ; Animals ; Aorta ; Arteries ; Collagen ; Cytoplasm ; Enalapril* ; Humans ; Hyperplasia ; Hypertrophy ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Rats ; Rats, Inbred SHR* ; Scleroproteins

BACKGROUND: Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in humans. Paraquat especially leads to irreversible progressive pulmonary fibrosis, which is related to oxygen free radicals. However, its biochemical mechanism is not clear. Natural mechanisms that prevent damage from oxygen free radicals include changes in glutathione level, G6PDH, superoxide dismutase(SOD), catalase, and glutathione peroxidase. The authors think catalase is closely related to paraquat toxicity in the lungs METHOD: The effects of 3-amino-1,2,4-triazole(aminotriazole), a catalase inhibitor, on mice administered with paraquat were investigated. We studied the effects of aminotriazole on the survival of mice administered with paraquat, by comparing life spans between the group to which paraquat had been administered and the group to which a combination of paraquat and aminotriazole had been administered. We measured glutathion level, glucose 6-phosphate dehydrogenase(G6PDH), superoxide dismutase(SOD), catalase, and glutathione peroxidase(GPx) in the lung tissue of 4 groups of mice: the control grouts, group A(aminouiazole injected), group B(paraquat administered), group C(Paraquat and aminotriazole administered). RESULTS: The mortality of mice administered with paraquat which were treated with aminotriazole was significantly increased compared with those of mice not treated with aminotriazole. Glutathione level in group B was decreased by 20%, a significant decrease compared with the control group. However, this level was not changed by the administration of aminotriazole(group C). The activity of G6PDH in all groups was not significantly changed compared with the control group. The activities of SOD, catalase, and glutathione peroxidase(GPx) in the lung tissue were significantly decreased by paraquat administration(group B); catalase showed the largest decrease. Catalase and GPX were significantly decreased by aminotriazole treatment in mice administered with paraquat but change in SOD activity was not significant.(group C). CONCLUSION: Decrease in catalase activity by paraquat suggests that paraquat toxicity in the lungs is closely related to catalase activity. Paraquat toxicity in mice is enhanced by aminotriazole administration, and its result is related to the decrease of catalase activity rather than glutathione level in the lungs. Production of hydroxyl radicals, the most reactive oxygen metabolite, is accelerated due to increased hydrogen peroxide by catalase inhibition and the lung damage probably results from nonspecific tissue injury of hydroxyl radicals.
Amitrole* ; Animals ; Catalase ; Free Radicals ; Glucose ; Glutathione ; Glutathione Peroxidase ; Humans ; Hydrogen Peroxide ; Lung* ; Mice* ; Mortality ; Multiple Organ Failure ; Oxygen ; Paraquat* ; Pulmonary Fibrosis ; Superoxides

BACKGROUND: The aim of this study was to compare the cardiovascular changes followed by laryngoscopy with the McCoy laryngoscope blade with those followed by laryngoscopy with the Macintosh laryngoscope blade. METHODS: Forty eight patients were randomly divided into two groups. Following induction with fentanyl 2 mcg/kg and thiopental 5 mg/kg, and muscle relaxation with vecuronium 0.1 mg/kg, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, then tracheal intubation was performed. Heart rate and arterial blood pressure were measured just before and after laryngoscopy, and 1, 3 and 5 min later. RESULTS: There was a significant increase in both heart rate and arterial blood pressure after tracheal intubation using the Macintosh laryngoscope. Also, use of the McCoy blade resulted in a significant increase in both heart rate and arterial blood pressure. CONCLUSIONS: There was no significant difference on arterial pressure and heart rate to laryngoscopy and tracheal intubation with either the McCoy blade or the Macintosh.
Arterial Pressure ; Blood Pressure* ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Laryngoscopy ; Muscle Relaxation ; Thiopental ; Vecuronium Bromide ; Vocal Cords

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

Early detection of neoplastic disese and metastatic spred is very important. Carcinoma of the breast is knownto readily metastasize to the bone. The use of Tc-99m-phophate as bone imaging agent has been shown to demonstrate early evidence of bone metastasis well before radiographic evidence is visualized and as thus become a very usefultechnique for establishing and monitoring the bony metastatic element of breast cancer. In this study, serial boneimaging studies were performed to monitor the management of 84 breast cancer patients before and after mastectomyand biopsy. We attempted to analyse bone scans of breast cancer and to correlated the scan findings with theclinical stage, status of lymphnodes, distanat metastasis, bone pain, and laboratory datas. The following useful patterns were emerged: 1. Postive bone scan rate was definitely higher in clinical stage III and IV (42, 57%) thatin stage I and II(4, 18%) in initital studies. However, no correlation between positive bone scan rate andclinical stage was found in follow up studies. 2. Positive bone scan rate was high in both groups with locallyadvanced tumor(T3 & T4) and distant metastasis. 3. No correlation between postive bone scan and status oflymphnode involvement was noted. 4. Positive bone scan rate was also very high in patients with bone pain andabnomral laboratory data.
Biopsy ; Breast Neoplasms ; Breast ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radionuclide Imaging

BACKGROUND: Tracheal intubation by direct laryngoscopy induces frequently transient hypertension, tachycardia and arrhythmia. The purpose of this study was to examine the effect of esmolol and clonidine in attenuating the changes of blood pressure and heart rate by tracheal intubation. METHODS: Eighty patients were randomly divided into four groups: Group 1 (control , n=20), Group 2 (esmolol 0.5 mg/kg IV, n=20), Group 3 (clonidine 4 mcg/kg PO, n=20) and Group 4 (clonidine 4 mcg/kg PO and esmolol 0.5 mg/kg IV, n=20). The clonidine premedication were given orally with a sip of water 90 minutes before induction of anesthesia. Anesthesia was induced with thiopental 5 mg/kg, vecuronium 0.1 mg/kg, 50% nitrous oxide in oxygen and 2 vol % enflurane. After 5 minutes, tracheal intubation was performed. Patients in the group 2 and group 4 were given esmolol 0.5 mg/kg 90 seconds prior to tracheal intubation. Blood pressure and heart rate were measured at ward, preinduction, preintubation, immediately after intubation, 1, 3 and 5 minutes after intubation. RESULTS: After tracheal intubation, the increase in systolic blood pressure was supressed significantly in the clonidine-treated patients (Group 3, Group 4) compared with control group (p<0.05). The attenuating effect on increase of mean arterial pressure(MAP) was sustained longer in group 4 than group 3. Heart rate increased after tracheal intubation in all groups, but were markedly increased in the control group (p<0.05). The differences of MAP which measured at preinduction and immediately postintubation were smaller in group 4 than control group (p<0.05). The differences of heart rate which measured at preinduction and immediately postintubation were smaller in group 4 than group 1 or group 3 (p<0.05). CONCLUSIONS: Esmolol 0.5 mg/kg given as bolus, is effective for controlling the increase of heart rate but not in attenuating increase of blood pressure. Oral clonidine is effective for controlling the increase of blood pressure but not in attenuating increase of heart rate. Therefore esmolol combined with oral clonidine results in effective control of both heart rate and blood pressure.
Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Clonidine* ; Enflurane ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation* ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Premedication* ; Tachycardia ; Thiopental ; Vecuronium Bromide ; Water

BACKGROUND: Post-CPB bleeding diathesis remains one of main causes of morbidity in open heart operation since it requires significant amount of homologous transfusion. Many approaches have been studied to reduce the amount of postoperative blood loss and blood use. Aprotinin is known to reduce postoperative bleeding. Therefore, hemostatic effects of aprotinin have been searched in open heart surgery. METHODS: Adult patients for open heart opeartion were randomly allocated to two groups, control group and study group. All anesthetic, surgical and bypass techniques were standardized. After induction, 10,000 KIU given for testing and then 2,000,000 KIU of aprotinin was infused for 20~30 minutes before sternotomy, and followed by at rate of 500,000 KIU/hr. Additional 2,000,000 KIU of aprotinin was mixed to pump prime of heart-lung machine. Aprotinin infusion was ended by the time of skin closure. Amount of postoperative bleeding as well as homologous blood requirement were measured. Urine output and serum creatinine were also documented during postoperative period. RESULTS: Postoperative-36hr summation of blood loss differed significantly(1858.4 1182.9 ml vs. 1256.7 688.4 ml, p<0.1). Postoperative homologous blood requirements were also reduced in the requirement of packed RBCs use(3.0 2.5 units vs. 1.0 0.8 units, p<0.01) and of fresh frozen plasma use(6.6 4.4 units vs. 3.9 2.6 units, p<0.05). Postoperative measurement of urine output and serum creatinine showed insignificant difference between groups while remained within normal range. CONCLUSIONS: High-dose aprotinin seems to have beneficial effect in reducing postoperative blood loss and blood use without renal complication.
Adult* ; Aprotinin* ; Blood Platelets ; Cardiopulmonary Bypass ; Control Groups ; Creatinine ; Disease Susceptibility ; Heart ; Heart-Lung Machine ; Hemorrhage ; Humans ; Pharmacology ; Plasma ; Postoperative Hemorrhage ; Postoperative Period ; Reference Values ; Skin ; Sternotomy ; Thoracic Surgery*

Dilutional hyponatremia as one of the postoperative complications shows around 0.34% in pediatric patients, of which iatrogenic administration of salt-free water is the major cause. Aggressive management should be performed if neurologic symptoms and signs coexist. He/she may be expired of respiratory arrest in severe cases, or permanent neurologic sequelae might persist. We report a case of female pediatric surgical patient who received general anesthesia for Salter innominate osteotomy and had generalized convulsions following 5% dextrose administration. Sodium concentration at immediate postconvulsive period revealed 122 mEq/L, appropriate fluid & electrolyte therapy was performed, then sodium level was successfully restored without any sequelae found. We emphasize that it should be checked out prudently whether postoperative free water is administered in the case of postoperative convulsion, while surgical stimuli and anesthesia itself elevate serum antidiuretic hormone level.
Anesthesia ; Anesthesia, General ; Female ; Glucose ; Humans ; Hyponatremia ; Neurologic Manifestations ; Osteotomy ; Postoperative Complications ; Seizures* ; Sodium ; Water ; Water Intoxication

PURPOSE: The Epstein-Barr Virus (EBV) is associated with a variety of human lymphocytic and epithelial malignancies. EBV is thought to display exclusive tropism for B lymphocytes, follicular dendritic cells, and pharyngeal epithelia via specific receptors (C3d receptors, CR2, CD21). Recent evidence, however, challenged this belief. We designed this experiment to determine the incidence of EBV receptor in various malignant tumor cell lines and normal lymphocyte subsets. MATERIALS AND METHODS: We have examined the incidence of EBV receptor, CD21 on the 10 healthy adult peripheral blood (PB), 10 umbilical cord blood (CB), 4 immortalized lymphoblastoid B cells by EBV infection (CSUP-1, CSUP-2, CSUP-3, CSUP-4), 3 EBV-positive B cell lymphoma cell lines (Jiyoye, IM-9, PTLC-1), 1 EBV-negative B cell lymphoma cell line (JeKo-1), 3 T cell lymphoma and leukemia cell lines (CCRF-CEM, H9, CEM-CM3), one histiocytic lymphoma cell line (U-937) and 5 gastric cancer cell lines (KATO III, AGS, SNU-1, SNU-5, and SNU-16). EBV receptor, C3d receptor was identified by flow cytometry (FACSCalibur) using FITC-conjugated or PE-conjugated CD21 monoclonal antibody. Also we investigated the expression of CD3, CD5, CD7, CD19, CD20, IgM, IgG, Ig and Ig by using FITC-conjugated or PE-conjugated monoclonal antibody, on above cell lines. RESULTS: The expressions of CD21 molecule were 10.99 3.84% and 9.22 5.39% in adult PB lymphocytes and CB lymphocytes, respectively. The anti-human CD21 antibody was positive for CD19-positive or CD20-positive B lymphocytes. The CD3-positive or CD7-positive T lymphocytes were negative for anti-human CD21 antibody in PB and CB. But, CD21 antibody was weakly positive for CD5-positive lymphocytes. EBV-positive cell lines expressed variable ranges from 0.9% to 5.2% for CD21 antigen, while EBV-negative lymphoma cell line, JeKo-1 expressed 5.5%. All T lymphoma and leukemia cell lines and gastric cancer cell lines did not express CD21 antigen. But U-937 expressed 14.4% for CD21 antigen. CONCLUSION: These results suggested that the CD21 antigen was expressed in CD20 or CD19-positive mature B cells, CD5-dim positive lymphocytes, some EBV-positive and negative B cell lymphoma cell lines, and a histiocytic lymphoma cell line. Further evaluation on the nature of CD5-dim positive cells, which was expressing CD21 molecule, is revealed, especially in reference to EBV association in some peculiar subtypes of peripheral T cell lymphoma.
Adult ; B-Lymphocytes ; Cell Line ; Cell Line, Tumor ; Dendritic Cells, Follicular ; Epstein-Barr Virus Infections ; Fetal Blood ; Flow Cytometry ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Leukemia ; Lymphocyte Subsets ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Receptors, Complement 3d ; Stomach Neoplasms ; T-Lymphocytes ; Tropism*

Up to 5% of all small cell carcinomas develop at extrapulmonary sites. Primary small cell carcinomas originating in the kidney are extremely rare neoplasms. Here we report a case of primary small cell carcinoma of the kidney. A nephrectomy was performed on a 52-year-old female patient to remove a large tumor located in the right kidney. The histology and immunohistochemistry of the resected tumor revealed a pure small cell carcinoma with invasion into the renal capsule. The patient received postoperative adjuvant chemotherapy with etoposide and cisplatin. The patient has been monitored with regular check ups and remains stable with no recurrence at 28 months after the initial diagnosis.
*Nephrectomy ; Middle Aged ; Kidney Neoplasms/*diagnosis/drug therapy/surgery ; Humans ; Female ; Carcinoma, Small Cell/*diagnosis/drug therapy/surgery