BACKGROUND: The use of anesthesia during assisted reproductive technology (ART) such as TEST (Tubal Embryo Stage Transfer) may expose early embryo to anesthetics in tubal fluid. The effects of anesthetic agents on the development of early embryo in ART are yet unclear. The purpose of this study was to evaluate the effects of narcotics on mouse two-cell embryo development using in vitro growth model of mouse embryo. METHODS: Mouse two-cell embryos were exposed to narcotics, fentanyl (6.0 nM; 30.0 nM) and meperidine (1.0 M; 3.6 M) respectively. Mouse two-cell embryos unexposed to any drugs were served as controls. In vitro developmental patterns were observed on the third and fifth day of culture. RESULTS: There were no significant differences in the rates of embryos arrested at 2~8 cell stage on the third day after culture and blastocysts development and their hatching on the fifth day after culture among three groups. CONCLUSION: We conclude that fentanyl and meperidine in clinical therapeutic concentration have no detrimental effects on the in vitro two-cell mouse embryo development. But further investigations are required to determine whether narcotics have any adverse toxic effects in human reproductive medicine.
Anesthesia ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development* ; Embryonic Structures* ; Female ; Fentanyl ; Humans ; Meperidine ; Mice* ; Narcotics* ; Pregnancy ; Reproductive Medicine ; Reproductive Techniques, Assisted

Background: Positive end-expiratory pressure(PEEP) ventilation causes reduction in cardiac output and increase of intra-thoracic pressure, hence reduction of hepatic blood flow. The purpose of this study is to evaluate the changes of hepatic venous oxygen saturation, tension and content during increase and removal of PEEP and to evaluate hemodynamic variable which has the greatest effect on hepatic oxygenation. Method: Eight dogs were anethetised with 1.0 vol% isoflurane and 100% oxygen. After 30 minutes of stabilization of vital signs, PEEP were increased from 0 cmH2O to 5 cmH2O and 10 cmH2O and lowered to 0 cmH2O again, and hemodynamic data (heart rate, arterial blood pressure, central venous pressure(CVP), pulmonary arterial pressure, pulmonary arterial occlusion pressure and cardiac output(CO)) and hepatic venous oxygenation data (hepatic venous oxygen saturation(ShvO2), tension(PhvO2) and content(ChvO2)) were measured at each step. Results: CO, ShvO2, PhvO2 and ChvO2 decreased significantly at 10 cmH2O PEEP compared to the baseline and 5 cmH2O PEEP and CO, ShvO2 and ChvO2 increased signicantly with removal of PEEP. CVP increased significantly at 10 cmH2O PEEP and decreased significantly with PEEP removal. PEEP showed close correlationship with CO and CVP considering all steps of PEEP and PEEP removal. ShvO2 and PhvO2 showed most close correlationship with CO considering all steps of PEEP and PEEP removal. Conclusion: ShvO2 with PEEP therapy is dependent upon CO. Therefore cardiac output maintenance is essential during PEEP therapy. For exact evaluation of hepatic oxygenation, it is valuable to monitor ShvO2.
Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Hemodynamics ; Isoflurane ; Oxygen* ; Positive-Pressure Respiration* ; Ventilation ; Vital Signs

No abstract available.
Hepatitis B Surface Antigens* ; Interferons* ; Lymphocytes*

BACKGROUND: The purpose of this study is to compare the clinical effects of isobaric 0.5% bupivacaine 8 mg and hyperbaric 0.5% bupivacaine 8 mg on sensory and motor block in aged patients undergoing spinal anesthesia. METHODS: Thirty patients, aged 65 years or more, undergoing orthopedic surgical operation of the lower extremities were randomly assigned to two groups for spinal anesthesia. In the isobaric group (n = 15), isobaric 0.5% bupivacaine 8 mg was administered and in the hyperbaric group (n = 15), hyperbaric 0.5% bupivacaine 8 mg was administered. We measured the maximal sensory level, the time to maximal sensory block, the duration of sensory block, the time to complete motor block, degree of motor block and hemodynamic variables every 2 minutes for 10 minutes in lateral decubitus position and then every 5 minutes for 20 minutes in supine position after spinal anesthesia. RESULTS: The maximal sensory block level and the duration of sensory block were not significantly different between the two groups. The time to maximal sensory block was significantly shorter in the hyperbaric group than in the isobaric group in both lower extremities. The time to complete motor block was significantly longer in the hyperbaric group than in the isobaric group in the nondependent extremity. CONCLUSIONS: These results suggest that isobaric 0.5% bupivacaine 8 mg for spinal anestheisa is more suitable for orthopedic operations requiring rapid and complete motor block than hyperbaric 0.5% bupivacaine 8 mg and that it can be performed in lateral decubitus position with the operating site up.
Anesthesia, Spinal* ; Bupivacaine* ; Extremities ; Hemodynamics ; Humans ; Lower Extremity* ; Orthopedics ; Supine Position

BACKGROUND: It is generally accepted that propofol does not inhibit hypoxic pulmonary vasoconstriction (HPV). However, because the previous studies for the effects of propofol on HPV were established in vivo, the effects of physiologic variables could not be ruled out. Therefore, we investigated the effects of various concentrations of propofol on HPV at isolated rat lungs and the relationship of these effects of propofol on HPV and endothelium-derived relaxing factor (EDRF) and an ATP-dependent K+ channel which were candidates as the mechanism of HPV. METHODS: In 30 isolated rat lungs, after three hypoxic challenges for 5 minutes, we administered saline in the control group, N(G)-nitro-L-arginine methyl ester (L-NAME) in the L group and glibenclamide in the G group followed by three hypoxic challenges for 5 minutes. In addition, we studied the effects of various concentrations of propofol on HPV in the three groups. RESULTS: L-NAME and glibenclamide did not alter baseline pulmonary arterial pressure but L-NAME significantly enhanced HPV. Clinical concentrations of propofol did not affect HPV and high concentrations of propofol inhibited HPV. The pretreatment of L-NAME and glibenclamide did not alter the inhibition of HPV even at high concentrations of propofol. CONCLUSIONS: The EDRF and ATP-dependent K+ channel did not largely contribute to baseline pulmonary arterial tone but EDRF might be released and downregulate HPV. Clinical concentrations of propofol did not inhibit HPV but high concentrations of propofol inhibited HPV. In addition, the mechanism of inhibition of HPV at high concentrations of propofol did not relate to the EDRF pathway and ATP-dependent K+ channel.
Animals ; Arterial Pressure ; Endothelium-Dependent Relaxing Factors ; Glyburide* ; Lung* ; NG-Nitroarginine Methyl Ester* ; Propofol* ; Rats* ; Vasoconstriction*

A new intravenous anesthetic agent, propofol reduces arterial blool pressure and reduces cardiovascular changes of tracheal intubation. The purpose of this study is to evaluate the effects of administration of thiopental 5 mg/kg and propofol 2.5 mg/kg on cardiovascular changes of tracheal intubation. Systolic arterial presure, diastolic arterial pressure, mean arterial pressure, heart rate and rate-pressure product were determined in healthy patients seheduled for tracehal intubation for general anesthesia before induction, after induction, 1, 3, and 5 minute after tracheal intubation. 1) After induction of anesthesia, above cardiovascular measurements except heart rate decreased significantly in both groups, but more profoundly in the propofol group. Heart rate did not change significantly in both groups. 2) Systolic arterial pressure, diastolic arterial pressure and mean arterial pressure increased significantly in the thiopental group after tracheal intubation, but decreased significantly in the thiopental group after tracehal intubation, but decreased significantly in the propofol group. After tracheal intubation, heart rate and rate-pressure product increased significantly in both groups, but the propofol group returned to the control value faster than the thiopental groups. In conclusion, in healthy adult patients, rise in the arterial blood pressure and heart rate after tracheal intubation decreased significantly in the propofol group compared with the thiopental group.
Adult ; Anesthesia ; Anesthesia, General ; Arterial Pressure ; Heart Rate ; Humans ; Intubation* ; Propofol* ; Thiopental

The effects of morphine in bringing sleep and an end to pain have been known from the beginning of recorded history. But the existence of endogenous opiates(endorphin) has been demonstrated only in the last decade. Endorphin bind to opiate receptors and exhibit potent opiate-like activity. In the corticotroph cells of the anterior lobe of pitultary, ACTH and beta-endorphin are synthesized simultaneously. There is a hypothalamic releasing factor which causes the secretion both beta-endorphin and ACTH, but ACTH and beta-endorphine are also released simultaneously by stress. Endorphins adversely affect the circulatory status and these effects are reversed by the intravenous injection of the narcotic antagonist, naloxone. The author studied Dirksen's hypothesis that endorphins may be involved in the pathophysiology of hemorrhagic shock. In this experiment, the author divided in the pathophysiology of hemorrhagic shock. In this experiment, the author divided laboratory animals into 3 groups and administered normal saline, salicylate or hyprocortisone, respectively. l. normal saline pretreated group. ll. salicylate pretreated group. lll. hydrocortisone pretreated group. Each group was then divided into 4 subgroups and treated as follows: 1) hypovolemic shock + normal saline. 2) hypovolemic shock + naloxone. 3) hypovolemic shock + hydrocortisone. 4) hypovolemic shock + PGE1. The following results were obtained: 1) MAP was significantly increased after naloxone and PGE1 adminitration in the normal saline pretreated group. 2) MAP was not changed in the salicylate pretreated group. 3) MAP was significantly increased after naloxone and PGE1 administration in the hydrocortisone pretreated group. 4) Pulse pressure was significantly increased after anloxone, hydrocortisone and PGE1 administration in the normal saline and hydrocortisone pretreated groups. From the above experiment, it may be inferred that endorphins and prostaglandin may play a role in the pathophysiology of hypovolemic shock.
Adrenocorticotropic Hormone ; Alprostadil ; Animals ; Animals, Laboratory ; beta-Endorphin ; Blood Pressure ; Corticotrophs ; Endorphins ; Hydrocortisone ; Hypovolemia* ; Injections, Intravenous ; Morphine ; Naloxone* ; Pituitary Hormone-Releasing Hormones ; Rats* ; Receptors, Opioid ; Shock* ; Shock, Hemorrhagic

Riboflavin is a constituent of coenzyme, FMN, FAD and its content varies according to the physiological and nutritional status. However, the measurement of its content is so disputable that a new technique to determine its content has been developed, done by determination of glutathione reductase activity in red blood cell hemolysate. With this technique, the effect of various anesthetic agents (ether, halothane, tetracaine) upon riboflavin metabolism has been studied by the authors. In conclusion, the effects of anesthetics upon riboflavin metabolism are insignificant.
Anesthetics ; Erythrocytes* ; Flavin Mononucleotide ; Flavin-Adenine Dinucleotide ; Glutathione Reductase ; Glutathione* ; Halothane ; Metabolism ; Nutritional Status ; Riboflavin

A clinical study was made on 14 cases of coronary sinus rhythm and 17 cases of left atrial rhythm seen at the Kyungpook University Hospital during the past 13 years. The incidence of coronary sinus rhythm among 23, 137 electrocardiograms was 0.07% and that of left atrial rhythm was 0.08%. Among the various types of left atrial rhythm as diagnosed by Mirowski's criteria, type III, posterior type and inferior type were far more common than others. The most common underlying diseases were heart diseases in both coronary sinus rhythm and left atrial rhythm: five cases out of 14 in the former and 11 cases out of 17 in the latter were cardiac cases, respectively.
Coronary Sinus* ; Electrocardiography ; Gyeongsangbuk-do ; Heart Diseases ; Incidence

BACKGROUND: The incidence of hip fractures in the elderly is increasing because of the expanding elderly population. These patients usually have accompanying chronic illness. We have reviewed 108 cases for hip fracture surgery to determine the factors which influence the intraoperative and postoperative outcome. METHODS: One hundred eight patients, aged 65 year or more, undergoing surgery for hip fracture were reviewed retrospectively according to age, sex, preoperative laboratory findings, pre-existing concomittent disease, type of anesthesia, amount of estimated blood loss during operation, changes of blood pressure, heart rate during anesthesia and postanesthesia care unit, one month morbidity and mortality. RESULTS: Seventy-one patients had pre-existing concomittent disease. Decrease in mean arterial pressure and tachycardia were less frequent in combined spinal epidural anesthesia than spinal anesthesia. Increase in mean arterial pressure was less frequent in combined spinal epidural anesthesia than epidural and general anesthesia during surgery. There was a significantly high postoperative morbidity among patients with concomittent disease. One month mortality increased with increasing age. CONCLUSIONS: We recommend the combined spinal epidural anesthesia in patients who could aggravate the pre-existing concomittent disease when hypotension, hypertension or tachycardia occurs during operation. One month morbidity was related to pre-existing concomittent disease, whereas mortality was related to age. More studies are needed to focus on well-defined risk groups in the elderly patients.
Aged* ; Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Arterial Pressure ; Blood Pressure ; Chronic Disease ; Heart Rate ; Hip Fractures ; Hip* ; Humans ; Hypertension ; Hypotension ; Incidence ; Mortality ; Retrospective Studies ; Tachycardia