Succinylcholine-induced prolonged neuromuscular blockade may occur in patients with either a low level of plasma cholinesterase activity or genotypically abnormal form of that enzyme. We experienced a case of succinylcholine-induced prolonged apnea due to a low level of plasma cholinesterase activity. A 31-year-old woman, full term primigravida, underwent cesarean section for breech presentation under general anesthesia. Familial and past medical history were nonspecific and preoperative physical and laboratory findings were within normal range. After operation, delayed apnea was detected and lasted for about one hour. We performed controlled and assisted ventilation for two and half hours. Plasma cholinesterase activity measured 30.00 IU/L (colorimetric method, normal value: 1130~1960 IU/L) at the first postoperative day. She was discharged on 7th postoperative day without any sequelae. From follow-up study after six months, it measured 1.02 U/ml (EIA, normal value: 7~9 U/ml).
Adult ; Anesthesia, General ; Apnea* ; Breech Presentation ; Cesarean Section* ; Cholinesterases* ; Female ; Follow-Up Studies ; Humans ; Neuromuscular Blockade ; Plasma* ; Pregnancy ; Reference Values ; Ventilation

BACKGROUND: The proto-oncogene c-met encodes the tyrosine kinase receptor for hepatocyte growth factor (HGF), which is a pleiotropic cytokine that controls growth, survival, motility, invasive migration, and differentiation of epithelial cells. Like several other epithelial neoplasms, thyroid carcinomas have been found to overexpress the c-met oncogene. We presently examine the expression of c-met protein in thyroid tumors and the correlation of c-met protein expression with prognostic factors in thyroid cancers. METHOD: We have examined the expression of the c-met oncogene in 62 paraffin-embedded thyroid cancer specimens (54 papillary carcinomas, 5 follicular carcinomas, 2 medullary carcinomas, and 1 anaplastic carcinoma), 20 benign tumors and 20 normal tissues using immunohistochemistry. We measured both the proportion and the intensity of stained cells and then calculated the staining index by multiplying the proportion and intensity scores. The staining index were categorized to be negative/low (staining index < or = 5) or high(staining index >5). The most important prognostic factors were age (over 45), tumor size (over 1.5 cm), lymph node metastasis, capsular invasion, vascular invasion and peripheral metastasis. RESULT: 1) The rate of expression of the c-met oncogene were 100%, 100% and 60% in thyroid cancer, benign tumors and normal thyroid tissue respectively. The expression of the c-met oncogene was restricted to the membrane. 2) The staining index of normal tissue, benign tumors and thyroid carcinomas was 1.8, 4.3 and 5.8 respectively. In malignancies, the staining index of papillary carcinoma was 5.7, follicular carcinoma 5.4, medullary carcinoma 7.5, and anaplastic cancer 9. 3) A high expression of c-met was not correlated with prognostic factors in papillary, follicular carcinomas or medullay carcinomas. CONCLUSION: The c-met oncogene might not play a role in the pathogenesis of thyroid neoplasia. There was no correlation between the high expression rate of the c-met oncogene and prognostic factors in papillary and follicular carcinomas.
Carcinoma, Medullary ; Carcinoma, Papillary ; Epithelial Cells ; Hepatocyte Growth Factor ; Immunohistochemistry ; Lymph Nodes ; Membranes ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Oncogenes* ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Thyroid Gland* ; Thyroid Neoplasms

BACKGROUND: Many oncogenes have been recently identified in human thyroid carcinomas, but the molecular mechanisms that lead to thyroid neoplasia are not well understood. To assess whether oncogene- encoded proteins can be regarded as useful prognostic indicators, we have evaluated the expressions of c-met, c-Ha-ras, c-myc oncogenes in patients with papillary thyroid cancer (PTC) in relation to the prog nostic factors. METHODS: We used immunohistochemistry to examine the expressions of c-met, c-Ha-ras, and c-myc oncogenes in 54 paraffin-embedded PTC specimens. We measured both the proportion (scale of 0-3) and the intensity (scale of 0-3) of the stained cells and then calculated the staining index (scale of 0-9) by multiplying the proportion and the intensity scores. The staining index was thus categorized as negative/low (staining index < or =5) or high (staining index >5). The considered prognostic factors were age (over 45), tumor size (over 1.5 cm), lymph node metastasis, capsular invasion, vascular invasion, and distant metastasis. RESULTS: 1) The rates of expression of c-met, c-Ha-ras, c-myc oncogenes were 100%, 81.5%, and 70.3% in papillary thyroid cancer and 100%, 30%, and 10% in benign tumors and 60%, 10%, and 0% in normal thyroid tissue, respectively. The expression of c-met oncogene was restricted to the membrane the expression of c-Ha-ras was stromal in 95.5% of the specimens, and that of c-myc was stromal in 94.7%. 2) High expression (staining index >5) of c-met, c-Ha-ras and c-myc were not associated with the prognostic factors such as age, tumor size, lymph node metastasis, capsular invasion, vascular invasion and distant metastasis. CONCLUSION: Although the rates of expression of c-met, c-Ha-ras, and c-myc oncogenes were high in papillary carcinomas (100%, 81.5%, and 70.3%, respectively), there was no relationship between the high expression rates of the oncogenes and prognostic factors.
Carcinoma, Papillary ; Humans ; Immunohistochemistry ; Lymph Nodes ; Membranes ; Neoplasm Metastasis ; Oncogenes* ; Thyroid Gland* ; Thyroid Neoplasms

Truncus arteriosus is a rare congenital heart disease which is diagnosed in from 1 to 2 percent of congenital cardiac birth. Whithout surgical intervention, survival beyond infancy is unusual. Unoperated patients who survive to adult life have associated pulmonary stenosis or have developed pulmonary arteriolar disease. We report a case of truncus arteriosus in a 17-year-old man with a review of literature.
Adolescent ; Adult ; Heart Defects, Congenital ; Humans ; Parturition ; Pulmonary Valve Stenosis ; Truncus Arteriosus*

BACKGROUND: Smoking is closely related to pulmonary diseases, especially pulmonary function. Past studies were defective in that pulmonary function was not included for ex-smokers and the study population being too small. This study attempted to show the change of pulmonary function parameters according to post-smoking years of ex-smokers and pack-years of current smokers. METHODS: We analyzed the results of parameters derived from the forced expiratory spirogram in 3,713 adults who visited Kyungpook National University Hospital Health Screening Center between May 1997 and March 1998. Independent variables used were age, sex, height, weight and smoking status. Dependent variables were pulmonary function parameters. Multiple regression analysis was used. RESULTS: 1.Overall, there was a significant change in pulmonary function parameters among the subjects studied. Significant variables shown were age, sex, height and pack-years. Weight and post-smoking years turned out to be relatively less significant variables. 2. Positive correlation was seen in both FEV1/FVC and FEF25-75% in ex-smokers with longer post-smoking years. 3. There was negative correlation in all the parameters of current smokers with longer pack-years. CONCLUSION: The results of this test show that smoking slowly reduce pulmonary function and even those smokers who quit smoking can not be expected to have normal pulmonary function as healthy nonsmokers. However, ex-smokers can expect some improvement in certain pulmonary function parameters as the post-smoking years become longer.
Adult ; Gyeongsangbuk-do ; Humans ; Lung Diseases ; Mass Screening ; Smoke* ; Smoking*

We correct a typo in the title.

PURPOSE: We evaluated the accuracy of death certificates for persons who registered in the Central Cancer Registry in 1993 and died from 1993 to 1995. MATERIALS AND METHODS: The study consisted of 27,058 cases which were classified into five groups. according to the possibility of accuracy of the underlying causes of death. We compared the distribution of five groups according to several demographic factors. Also we calculated the detection rate and the confirmation rate for a selected 23,858 persons reported to die of a cancer. RESULTS: Among the 27,058 deaths, only 64.4% was included in the group which had reported the same cancer site with registry as underlying cause of death. The accuracy decreased with increasing age and was worse for women and rural residence. And physicians certification was an important factor to improve the accuracy. Cancers of stomach, lung, esophagus and breast were included into the high accuracy group, cancers of the colon, rectum and gallbladder and extrahepatic biliary tract into the low accuracy group. Cancers of the colon, pancreas, liver and lung were overreported, varied from 1.2 to 1.4 times, and cervical cancer was severely underreported, about 0.5 times. CONCLUSION: These results suggest that the caution in the use and interpretation of cancer certificate data would be required.
Biliary Tract ; Breast ; Cause of Death* ; Certification ; Colon ; Death Certificates* ; Demography ; Diagnosis* ; Esophagus ; Female ; Gallbladder ; Humans ; Korea* ; Liver ; Lung ; Pancreas ; Rectum ; Stomach ; Uterine Cervical Neoplasms

BACKGROUND: The aim of this study was to compare the difference in hemodynamic change and in sensory or motor block between hyperbaric tetracaine and bupivacaine in spinal anesthesia. METHODS: The sixty-three patients, belonged to ASA class 1 and 2, were divided into tetracaine group and bupivacaine group. The patients were administered 0.5% hyperbaric tetracaine(Pantocaine ) in tetracaine group and 0.5% hyperbaric bupivacaine(Marcaine ) in bupivacaine group, intrathecally. After intrathecal injection of the agents, we measured the change of sensory block level according to pinprick test, the motor block by the modified Bromage score until fixations was achieved, and the blood pressure and heart rate. RESULTS: The two groups did not differ significantly with loss of sensory level and onset time. Bupivacaine group was revealed a slower fixations of motor block than tetracaine group(p<0.05). Changes of systolic blood pressure and mean arterial blood pressure of bupivacaine group were less than tetracaine group(p<0.05) in 2~25 minutes and 6~15 minutes, respectively. Diastolic blood pressure and heart rate were not different statistically in two groups. CONCLUSION: Spinal anesthesia with hyperbaric bupivacaine was revealed less changes of systolic blood pressure and mean arterial blood pressure than hyperbaric tetracaine, although fixation of motor block was delayed onset. Therefore, we thought that spinal anesthesia with hyperbaric bupivacaine may be used more safe than hyperbaric tetracaine in hemodynamical troublesome case.
Anesthesia, Spinal* ; Arterial Pressure ; Blood Pressure ; Bupivacaine* ; Heart Rate ; Hemodynamics ; Humans ; Injections, Spinal ; Tetracaine*

OBJECTIVE: To investigate the kinematic and kinetic characteristics of stair ascent in patients with knee osteoarthritis. METHOD: Twenty patients with knee osteoarthritis and twenty healthy controls were recruited. The kinematic and kinetic data were obtained through a three dimensional motion analyzer. The kinematic and kinetic data during stair ascent were compared between two groups. RESULTS: The total required time of stair ascent was significantly longer in the osteoarthritis group than that of the control group (p<0.05). In comparison with the control group, the angle of maximal pelvis anterior tilting, minimal and maximal hip flexion and minimal knee flexion were significantly increased (p<0.05). However, the angle of knee flexion and ankle dorsiflexion at initial contact were significantly decreased in the osteoarthritis group (p<0.05). The maximal moment and power of knee extension and ankle plantarflexion were significantly decreased in the osteoarthritis group (p<0.05). Sixteen patients (80.0%) in the osteoarthritis group showed flexion arc after initial contact. "W" sign was shown in 16 patients (80.0%). CONCLUSION: We found the unique kinematic and kinetic patterns during stair ascent in patients with knee osteoarthritis, and that knee osteoarthritis influence not only kinematic and kinetic patterns of knee but also those of hip and ankle.
Ankle ; Hip ; Humans ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee* ; Pelvis

Stroke is one of the common causes of death and disability. Despite extensive efforts in stroke research, therapeutic options for improving the functional recovery remain limited in clinical practice. Experimental stroke models using genetically modified mice could aid in unraveling the complex pathophysiology triggered by ischemic brain injury. Here, we optimized the procedure for generating mouse stroke model using an intraluminal suture in the middle cerebral artery and verified the blockage of blood flow using indocyanine green coupled with near infra-red radiation. The first week after the ischemic injury was critical for survivability. The survival rate of 11% in mice without any treatment but increased to 60% on administering prophylactic antibiotics. During this period, mice showed severe functional impairment but recovered spontaneously starting from the second week onward. Among the various behavioral tests, the pole tests and neurological severity score tests remained reliable up to 4 weeks after ischemia, whereas the rotarod and corner tests became less sensitive for assessing the severity of ischemic injury with time. Further, loss of body weight was also observed for up 4 weeks after ischemia induction. In conclusion, we have developed an improved approach which allows us to investigate the role of the cell death-related genes in the disease progression using genetically modified mice and to evaluate the modes of action of candidate drugs.
Animals ; Anti-Bacterial Agents ; Body Weight ; Brain Injuries ; Brain Ischemia ; Cause of Death ; Disease Progression ; Indocyanine Green ; Ischemia ; Mice* ; Middle Cerebral Artery ; Stroke* ; Survival Rate ; Sutures ; Therapeutic Human Experimentation