Succinylcholine (Sch) has long been used to facilitate laryngoscopy and endotracheal intubation for general anesthesia, because of a rapid onset of intense but brief paralysis. However, exaggerated potassium (K+) release following Sch, sufficient to cause ventricular dysrhythmias and cardiac arrest, has sporadically been reported in susceptible conditions, including spinal cord injury, severe burn, massive trauma and neuromuscular disorder. And diazepam has been shown to attenuate the increase in serum K+ following Sch administration. The purpose of this study was to assess the effect of Sch on serum K+ in patients with spinal cord lesions, and to assess the effect of pretreatment with diazepam (0.05 mg/kg IV) on potassium flux. The results were as follows: 1) Baseline K+ values were not significantly different among the groups. 2) The time to peak increases in K+ was 3 minutes following Sch in all groups. 3) The magnitude of maximum increases in K' following Sch were 0.32 Eq/l, 0.63 mEq/l, 0.06 mEq/I and 1,10 mEq/I in group 1, group 2A, group 2B, and group 3, respectively. 4) Diazepam pretreatment attenuated the increases in K+ following Sch. From the above results, it can be concluded that Sch may safely be used to facilitate intubation in paraplegic patients, provided that they are normokalemic and pretreated with diazepam.
Anesthesia, General ; Burns ; Diazepam ; Heart Arrest ; Humans ; Hypnotics and Sedatives ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Paralysis ; Potassium* ; Spinal Cord Injuries ; Spinal Cord* ; Succinylcholine*

BACKGROUND: Recently, according to many studies, variable factors have been known to be associated with physical fitness. The factors such as obesity and inactivity are associated with poor physical fitness, but regular exercise is associated with good physical fitness. In our country, these studies are not yet reported. And so, this study was designed to investigate the factors associat,ed with physical fitness. METHODS: From May 1st, until July 30th 1996, we recruited the 411 subjects who visited the Health Promotion Center at Seoul National University Hospital. Data related to sex, age, exercise, job, cigarette smoking, alcohol consumption were obtained by self-administered Questionnaire. Obesity index was calculated by the percentage of standard body weight. And VO2max were obtained by submaximal bicycle ergometer test. High level exercise group was defined as the persons who had taken exercise more than 3 times a week and 20 minutes per session, and moderate exercise group was defined as the persons who had taken exercise one or two times a week and 20 minutes per session, and sedentary group was defined as the persons who had taken exercise more than 20 minutes less than one time per week. RESULTS: The subjects were 230 males(56%), total numbers were 411. The results were as follows. Compaired to women and nonexercise group, men and exercise group had high VO2max(p<0.005). The relationship between VO2max and age showed negative, and the VO2max of obese group(obesity index>_120) was greater than that of nonobese group. Any significant relationships between VO2max and job, disease were not found. In multiple regression analysis, significant relationships between VO2max and age, sex, exercise type, and obesity index were observed(p<0.01). CONCLUSIONS: We concluded that there were significant relationships between VO2max and obesity index, exercise group.
Alcohol Drinking ; Body Weight ; Female ; Health Promotion ; Humans ; Male ; Obesity ; Physical Fitness* ; Seoul ; Smoking ; Surveys and Questionnaires

The purpose of this study was to investigate the speech characteristics and speech therapy of Parkinson disease (PD). This study selected 28 papers published in Korea from 1998 to 2018 after searching the terms ‘Parkinson voice’ and ‘Parkinson speech therapy.’ Literature review had been conducted in the two aspects of speech characteristics and speech therapy. The speech characteristics were divided into respiration, phonation, articulation, prosody, vowel production, and voice questionnaire. Speech therapy was divided into Lee Sliverman voice treatment (LSVT) and other voice therapy. PD patients did not differ in respiration function compared to normal elderly people, but their speech and articulation function were poorer. There was also a difference in the speech rate, frequency of pause, and accuracy of vowel production compared with normal elderly people. PD had a lower VHI score and their voice related quality of life was a little poorer. The LSVT was typically used in speech therapy for PD. The methods of speech therapy for PD have been shown to improve respiration and phonation. It is necessary to establish voice norms in PD patients and develop effective speech therapy in the following study.

In order to evaluate the efficacy of adenosine triphosphate (ATP) in the reduction of left ventricular afterload, we studied the hemodynamic and intrapulmonary shunt effects of intravenous ATP during ethrane-N2O anesthesia. Hemodynamic measurements and arterial and mixed venous blood gas analyses were made in ten patients before (baseline) and 10 min after. ATP infusion at 80,60,120 and 250 mcg/kg/min, respective. The results were as follows: 1) ATP produced a rapid and stable reduction in mean arterial pressure resulting from a marked decrease in systemic vascular resistance. 2) Cardiac index increased significantly by 14, 47 and 72% from baseline value after intravenous infusion of ATP at rates of 60, 120 and 250 mcg/kg/min, respectively. 3) Stroke volume index, heart rate, mean pulmonary arterial pressure, pulmonary capillary wedge pressure and central venous pressure increased significantly, whereas systemic vasular resistance and pulmonary vascular resistance decreased significantly in a dose related fashion during ATP infusion. 4) Intrapulmonary ehunt fraction increased from 5.67% to 6.73, 8.28, 9.85 and 13.38% after intra- venous infusion of ATP at rates of 30, 60, 120 and 250 mcg/kg/min, respectively. 5) Arterial oxygen tension decreased significantly after ATP infusion. These results suggest that ATP might be of value in augmentation of cardiac performance in patients with low cardiac output with high peripheral vascular resistance.
Adenosine Triphosphate* ; Adenosine* ; Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Cardiac Output, Low ; Central Venous Pressure ; Enflurane* ; Heart Rate ; Hemodynamics* ; Humans ; Infusions, Intravenous ; Lung ; Oxygen ; Pulmonary Wedge Pressure ; Stroke Volume ; Vascular Resistance

Portal vein gas and pneumatosis cystoides intestinalis are uncommon conditions and have been associated with poor prognosis. They are most commonly caused by necrotizing enterocolitis but may have other causes, and they can be associated with necrotizing and ischemic colitis, intra-abdominal abscess, small bowel obstruction, diverticulitis, colon cancer, and acute pancreatitis. With the more frequent use of computed tomography (CT) scans, portal vein gas and pneumatosis cystoides intestinalis have been increasingly detected in recent years. Because of its high mortality rate, necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis may be treated with emergent exploratory laparotomy. We report a case of necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis in a 47-year-old man treated with intensive medical management and delayed operation due to unstable condition and surgical mortality. He had good clinical results without complications after the delayed operation.
Abdominal Abscess ; Colitis, Ischemic ; Colonic Neoplasms ; Diverticulitis ; Enteritis* ; Enterocolitis, Necrotizing ; Humans ; Laparotomy ; Middle Aged ; Mortality ; Pancreatitis ; Pneumatosis Cystoides Intestinalis* ; Portal Vein* ; Prognosis

Endothelin(ET), is the most potent endogenous vasoconstrictor. Myocardial ischemia and chemical stimuli including calcium ionophores are known to release ET-1. Recently, halothane has been shown to block calcium channel. Thus, halothane might attenuate coronary endothelial ET-1 production during myocardial ischemia-reperfusion. To test this hypothesis, we measured plasma ET-1 level continuously in open chest dogs subjected to 15 min of left anterior coronary arterial occlusion and 1 hour of reperfusion during fentanly(n=8) or halothane(n=7) anesthesia. The results were as follows. I) Baseline ET-1 levels of both femoral artery and great cardiac vein in the halothane group were lower than in the fentanly group(NS). 2) ET-1 level of femoral artery and great coronary vein in both halothane and fentanyl group remained unchanged 10 min into ischemia. 3) Coronary blood flow increased by 325, 250% in the halothane group and by 315, 258% in the fentanly group 2, 5 min into reperfusion, respectively. 4) ET-1 production increased from baseline of -2.9+/-1.7 pg/min to 66.0+/-21.5(p<0.05), 20.8+/-5.1 (p<0.01), 13.2+/-6.2(p<0.05) pg/min 5, 15, 30 min into reperfusion, respectively in the fentanyl group, but it remained unchanged from baseline of 0.8+/-3.1 pg/min in the halothane group. These findings suggest that ET-1 production or release is diminished by halothane during myocardial ischemia-reperfusion. Thus, halothane provides an advantage over fentanyl in patients with myocarial ischemic episodes.
Analgesics ; Anesthesia* ; Anesthetics ; Animals ; Calcium Channels ; Calcium Ionophores ; Coronary Vessels ; Dogs* ; Endothelin-1* ; Endothelins ; Femoral Artery ; Fentanyl* ; Halothane* ; Humans ; Ischemia ; Myocardial Ischemia ; Plasma ; Reperfusion ; Thorax ; Veins

Leiomyosarcoma of the penis is an extremely rare disease. We have encountered a case of leiomyosarcoma of the penis in a 45 year old man. On staging work up. local invasion to corpus cavernosum. but no evidence of lymph node metastasis was evident. After the confirmation of leiomyosarcoma by excisional biopsy, the patient underwent partial penectemy. Herein we report this case with the review of literatures.
Biopsy ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Penis* ; Rare Diseases

Spinal alpha-2 adrenoceptors and cholinergic receptors are involved in the regulation of acute nociception and the facilitated processing. The aim of this study was to examine the pharmacological effect of an intrathecal alpha-2 agonist and a cholinesterase inhibitor on the facilitated pain model induced by formalin injection and to determine the nature of drug interaction using an isobolographic analysis. Both intrathecal clonidine and neostigmine dose-dependently suppressed the flinching during phase 1 and phase 2. Intrathecal pretreatment with atropine reversed the antinociceptive effects of clonidine and neostigmine in both phases. Pretreatment with intrathecal yohimbine attenuated the effect of clonidine. The antinociception of clonidine and neostigmine was not reversed by mecamylamine. Isobolographic analysis showed that intrathecal clonidine and neostigmine acted synergistically in both phase 1 and 2. Intrathecal pretreatment with atropine and yohimbine antagonized the effect of the mixture of clonidine and neostigmine in both phases, but no antagonism was observed with mecamylamine pretreatment. These data indicate that spinal clonidine and neostigmine are effective to counteract the facilitated state evoked formalin stimulus, and these two drugs interact in a synergistic fashion. In addition, the analgesic action of intrathecal clonidine is mediated by spinal muscarinic receptors as well as alpha-2 adrenoceptors.
Adrenergic alpha-Agonists/*pharmacology ; Analgesics, Non-Narcotic/*pharmacology ; Animal ; Cholinesterase Inhibitors/*pharmacology ; Clonidine/administration & dosage/*pharmacology ; Dose-Response Relationship, Drug ; Drug Synergism ; Formaldehyde ; Injections, Spinal ; Male ; Neostigmine/administration & dosage/*pharmacology ; Pain/drug therapy ; Rats ; Rats, Sprague-Dawley

The purpose of the present study was to compare prapofol, newly introduced anesthetic agnet, & thiopental as to the characteristics of induction & recovery as well as the safety of both anents. Fifty patients who presented for termination of pregnancy were allocated at random to recieve either propofol 2 mg/kg IV or thiopental 4 mg/kg IV. In addition all patients recevied fentanyl, 1 ug/kg IV, one minute befor the induction. Repeated bolus doses of either propofol 20 mg or thiopental 50 mg were given, if the patient respond to surgical stimulation by moving. The result were as follows. 1) Both propofol and thiopental produced smooth and rapid induction, but caused significant respiratory depression. 2) There was more cardiovascular depression with propofol than with thiopental. 3) Postoperative recovery(time to ambulation) was faster with propofol than with thiopental (36.5+/-1.4 vs 72.9+/-5.1 min, p<0.001). 4) Propofol was associated with less side effects(Nausea, vomithing, and dizziness) than thiopental. These results suggest 1) that propofol has significant advantage over thiopental in outpatient surgery, where early ambulation and discharge is desirable, and 2) that both propofol and thiopental should be administered by expert anesthesiologist only when ventiatory assistant device with oxygen is immediately available.
Ambulatory Surgical Procedures* ; Anesthesia* ; Depression ; Early Ambulation ; Fentanyl ; Humans ; Oxygen ; Pregnancy ; Propofol* ; Respiratory Insufficiency ; Thiopental*

The aim of this study was to investigate the characteristics of mandibular premolars regarding size and morphology in Koreans. Moreover, comparisons of gender difference in mandibular premolars were examined to expand anatomical database in Koreans. Data was obtained from students in School of Dentistry, Chonnam National University, Gwangju, Korea. The total number of participants was 66 (33 men and 33 women) and dental casts were fabricated. A total of nine items was investigated using a digital measuring software. Five measurements were performed including intercuspal distance (ID), buccolingual diameter (BL), mesiodistal diameter (MD), total crown area, and each cusp area. One item as each cusp area ratio was calculated, and three items were observed including the number of lingual cusp, occlusal groove patterns, and mesiolingual developmental groove. Comparison measurements were analyzed using paired t-tests, independent t-tests and Pearson correlation tests. Average values in mandibular second premolars were larger than first premolars in most of measurements with a significance with the exception of mesiodistal diameter (p=0.223). Overall average values were significantly higher in male than in female except intercuspal distance (p=0.607) and lingual cusp area (p=0.070) in mandibular premolars. The presence of mesiolingual developmental grooves in the first premolars was 59.1% (male 51.5%, female 66.7%). The most common occlusal groove patterns of the second premolar were a Y pattern, followed in order by H and U patterns. These results provide valuable morphological characteristics of mandibular premolars in Koreans.
Asian Continental Ancestry Group ; Bicuspid* ; Crowns ; Dentistry ; Female ; Gwangju ; Humans ; Jeollanam-do ; Korea ; Male