Nowadays the importance of respiratory therapy is increasing with the development of modern medicine. Especially effective respiratory care in the field of anesthesia and intensive care unit has close relationship to the decrease of mortality or morbidity of the critically ill patients. Compared with spontaneous respiration, so various physiological changes related to these methods can occur. Because most modernized ventilations can choose the various respiratory patterns according to the patients' respiratory condition, it is ideal to select the respiratory mode which is least hazardous and most effective to the patients. To confirm the effects of respiratory therapy on the cardiovascular system and arterial blood gas in one-lung ventilation and in pulmonary edema, we made one-lung ventilation by deep right endobronchial intubation and ppulmonary edema was induced by oleid acid (0.05g/kg. IV) to 12 mongrel dogs. And we observed the cardiovascular changes and arterial blood gas analysis in the situation of applying the inspiratory pause(0.25sec. and 0.5sec) and positive end-expiratory pressure(5cm H2O and 10cm H2O). The results were as follows: 1) One-lung Ventilation. (i) Inspiratory pause-There were no changes of cardiovascular system and arterial blood gas in the inspiratory pause of 0.25 and 0.5 sec. (ii)PEEP-In 5cmH2O of PEEP there was no change of cardiovascular system, but there was decrease in PCO2(p<0.01) on arterial blood gas. In 10cmH2O of PEEP there was increase in heart rate(p<0.05) and decrease in cardiac output(p<0.05). There was decrease in PCO2(p<0.01), but there were no changes of pH and PO2 on arterial blood gas. 2) Pulmonary edema. (i) Inspiratory pause-There was increase in heart rate(p<0.01), but there was no change of arterial blood gas in the 0.25 and 0.5sec. inspiratory pause. (ii) PEEP- In 5cmH2O PEEP there was increase in heart rate(p<0.01), but there was no change of arterial blood gas in the 0.25 and 0.5 sec. inspiratory pause. In 10cmH2O PEEP there were decrease in sBP, dBP, MAP, increase in heart rate(p<0.05) and decrease in cardiac output(p<0.01). There were increase in pH(p<0.05) and PO2(p<0.01), decrease in PCO2. According to the above results in the condition of one-lung ventilation mechanical ventilation with inspiratory pause(0.25 or 0.5 sec) was not helpful to respiratory care. 5cmH2O PEEP could improve the pulmonary ventilation without ay changes of cardiovascular system, but 10cmH2O PEEP increased heart rate and decrease cardiac output. In the condition of pulmonary edema, mechanical ventilation with inspiratory pause(0.25 or 0.5 sec) could not improve the pulmonary ventilation with depression of cardiovascular system. PEEP (5 or 10 cmH2O) could improve the pulmonary condition in proportion to PEEP, but it also depressed the cardiovascular system. Therefore we concluded that mild degree PEEP (5cmH2O) may be helpful to the one-lung ventilation or pulmonary edema.
Anesthesia ; Animals ; Blood Gas Analysis ; Cardiac Output ; Cardiovascular System* ; Critical Illness ; Depression ; Dogs ; Edema ; Heart ; Heart Rate ; History, Modern 1601- ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Intubation ; Mortality ; One-Lung Ventilation* ; Positive-Pressure Respiration ; Pulmonary Edema* ; Pulmonary Ventilation ; Respiration ; Respiration, Artificial ; Respiratory Therapy ; Ventilation

OBJECTIVES: The purpose of this study is to examine the effects of venlafaxine, one of novel antidepressant drugs, on neurite growth in PC12 cells. METHODS: PC12 cells were cultured with NGF for eight days. Then different concentrations(0micrometer, 1micrometer, 5micrometer) of venlafaxine were mixed with cultured PC12 cells. After 24 hours and 48 hours of culture, we compared the effects of venlafaxine on the total length of neurites of cultured PC12 cells between no venlafaxine treated group(0micrometer) and venlafaxine treated groups(1micrometer and 5micrometer). Additionally, we studied the concentration-dependent effect of venlafaxine on differentiation in PC12 cells. RESULTS: Experimental results showed that 1) the mean length of neurites in 1micrometer and 5micrometer venlafaxine treated group was more increased than no venlafaxine treated group(p=0.002). 2) the length of neurite in 5micrometer venlafaxine treated group was more elongated than 1micrometer venlafaxine treated group(p=0.046). 3) the length of neurite in 6micrometer venlafaxine treated group was more elongated than all the other concentrations in our experiment. Above 6micrometer, the length of neurite was shortened in inverse proportion to the concentration of venlafaxine. CONCLUSIONS: This results suggest that venlafaxine, one of novel antidepressant drugs, promotes the differentiation of neuron. This study is believed to be a first step toward understanding the molecular and cellular mechanisms of antidepressant treatment.
Animals ; Antidepressive Agents ; Nerve Growth Factor ; Neurites* ; Neurons ; PC12 Cells* ; Venlafaxine Hydrochloride

The parasitic infection patterns of the Joseon period have begun to be revealed in a series of paleoparasitological studies. However, parasitism prevailing during or before the Three Kingdom period is still relatively unexplored. In the present study, we therefore conducted parasitological examinations of soil and organic-material sediments precipitated upon human hipbone and sacrum discovered inside an ancient Mokgwakmyo tomb dating to the Silla Dynasty (57 BCE–660 CE). Within the samples, we discovered ancient Ascaris lumbricoides (eggs per gram [EPG], 46.6–48.3) and Trichuris trichiura (EPG, 32.8–62.1) eggs, the species commonly detected among Korean populations until just prior to the 1970s. These findings show that soil-transmitted parasitic infection among the Silla nobility might not have been uncommon. This is the first-ever report on the presence of ancient parasite eggs in the samples obtained from a Three Kingdom period tomb; and it also presents the earliest positive results for any of the ancient South Korean tombs paleoparasitologically examined to date.
Ascaris lumbricoides ; Eggs ; Humans ; Ovum ; Parasites ; Sacrum ; Soil ; Trichuris

We analyzed Clonorchis sinensis ancient DNA (aDNA) acquired from the specimens of the Joseon mummies. The target regions were cytochrome C oxidase subunit 1 (CO1), internal transcribed spacer 1 (ITS1), nicotinamide adenine dinucleotide hydrogen (NADH) dehydrogenase subunits 2 (NAD2) and 5 (NAD5). The sequences of C. sinensis aDNA was completely or almost identical to modern C. sinensis sequences in GenBank. We also found that ITS1, NAD2 and NAD5 could be good markers for molecular diagnosis between C. sinensis and the other trematode parasite species. The current result could improve our knowledge about genetic history of C. sinensis.
Clonorchis sinensis ; Cytochromes c ; Cytochromes ; Databases, Nucleic Acid ; Diagnosis ; DNA ; Electron Transport Complex IV ; Hydrogen ; Mummies ; NAD ; Niacinamide ; Oxidoreductases ; Parasites ; Republic of Korea

Objective: This study examined whether the preventive effects of the safety belt on traumatic brain injury (TBI) from motor vehicle collisions (MVCs) differ according to the occupants’ age. Methods: This study was a retrospective, observational study. This study evaluated the crash data from 2011 to 2016 obtained from the Emergency Department-based Injury In-depth Surveillance registry. The injured occupants were categorized by age into young adults (age, 18-35 years; n=35,032), middle-aged adults (age, 36-55 years; n=34,507), and older adults (aged older than 55 years, n=21,895). The primary (TBI), secondary (intensive care unit [ICU] admission), and tertiary endpoint (mortality) were set. Multivariate logistic regression analysis was performed, and the adjusted odds ratios (aORs) of subgroups were calculated for study outcomes adjusted for any potential confounders. Results: Among 91,434 patients, 61,205 used seat belts at the time of the crashes. Compared to the unbelted group, the belted group was less likely to have a TBI. A comparison of the aOR of subgroups for TBI revealed the odds ratio reduction to be the highest in young adults (aOR, 0.39; 95% confidence interval [CI], 0.32-0.47), followed by middle-aged adults (aOR, 0.39; 95% CI, 0.33-0.47) and older adults (aOR, 0.49; 95% CI, 0.42-0.56). In addition, seat belt use had a preventive effect on ICU admission and mortality at all subgroups, the effect of which decreased with age. Conclusion The protective effects of seat belts on TBI, ICU admission, and mortality from MVCs were reduced with age.

Objective: This study examined whether the preventive effects of the safety belt on traumatic brain injury (TBI) from motor vehicle collisions (MVCs) differ according to the occupants’ age. Methods: This study was a retrospective, observational study. This study evaluated the crash data from 2011 to 2016 obtained from the Emergency Department-based Injury In-depth Surveillance registry. The injured occupants were categorized by age into young adults (age, 18-35 years; n=35,032), middle-aged adults (age, 36-55 years; n=34,507), and older adults (aged older than 55 years, n=21,895). The primary (TBI), secondary (intensive care unit [ICU] admission), and tertiary endpoint (mortality) were set. Multivariate logistic regression analysis was performed, and the adjusted odds ratios (aORs) of subgroups were calculated for study outcomes adjusted for any potential confounders. Results: Among 91,434 patients, 61,205 used seat belts at the time of the crashes. Compared to the unbelted group, the belted group was less likely to have a TBI. A comparison of the aOR of subgroups for TBI revealed the odds ratio reduction to be the highest in young adults (aOR, 0.39; 95% confidence interval [CI], 0.32-0.47), followed by middle-aged adults (aOR, 0.39; 95% CI, 0.33-0.47) and older adults (aOR, 0.49; 95% CI, 0.42-0.56). In addition, seat belt use had a preventive effect on ICU admission and mortality at all subgroups, the effect of which decreased with age. Conclusion The protective effects of seat belts on TBI, ICU admission, and mortality from MVCs were reduced with age.

Malaria is a reemerging infectious disease in Korea. We experienced a case of asymptomatic P. vivax malaria accompanied by thrombocytopenia, mimicking immune thrombocytopenic purpura. The patient was exposed to mosquito 12 weeks ago. She experienced a characteristic febrile episode lasting for 2 weeks and remained asymptomatic thereafter. It was 7 weeks after the characteristic febrile episode when the diagnosis was established by the parasitemia. Malaria should be considered in the differential diagnosis of thrombocytopenia in Korea, especially in patients with febrile episodes.
Communicable Diseases, Emerging ; Culicidae ; Diagnosis ; Diagnosis, Differential ; Humans ; Korea ; Malaria ; Malaria, Vivax* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Purpura, Thrombocytopenic, Idiopathic* ; Thrombocytopenia

PURPOSE: Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for T2, T3 distal rectal carcinoma. MATERIALS AND METHODS: From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 T2 and 8 T3 tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was performed 4~6 weeks after the completion of radiotherapy. Median follow-up was 22 months (range : 16~37 months). RESULTS: One patient (6.7%) had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients (73.3%) and N1 stages occurred in 2 of 5 patients (40%). No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed. CONCLUSION: Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for T2, T3 distal rectal cancer.
Classification ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Particle Accelerators ; Radiotherapy* ; Rectal Neoplasms* ; Recurrence ; Tumor Burden

BACKGROUND: Remifentanil is a new member of fentanyl family and a short-acting, esterase-metabolized opioid.This study compared the perioperative characteristics of a remifentanil infusion with those of fentanyl bolus administration as an adjuvant to propofol infusion for the anesthetic management of patients undergoing ureteroscopic lithotripsy. METHODS: Eighty patients were randomly assigned to receive either remifentanil target controlled infusion (R group, effect-site concentration of 4.0 ng/ml for induction followed by 2.0 ng/ml) or fentanyl bolus (F group, 2.0microgram/kg before induction).All patients received propofol infusion as the part of the induction and maintenance.We investigated recovery profiles, adverse events and the ease of insertion of laryngeal mask airway (LMA) between the two groups.Heart rate (HR) and mean blood pressure (MBP) were also compared at baseline (T0), loss of consciousness (T1), insertion of LMA (T2), beginning and end of operation (T3, T4) and removal of LMA (T5). RESULTS: The time from the end of anesthesia to spontaneous respiration, eye opening and LMA removal were significantly shorter for patients receiving remifentanil than for those receiving fentanyl.HR at T3 and T4 were lower in the R group than in the F group.Aldrete recovery score, time to discharge from recovery ward, the ease of insertion of the LMA, MAP and adverse events did not differ significantly between the two groups. CONCLUSIONS: Target controlled infusion of remifentanil combined with propofol can significantly shorten the early recovery time than fentanyl bolus administration without increasing adverse events in patients undergoing ureteroscopic lithotripsy.
Anesthesia ; Blood Pressure ; Eye ; Fentanyl ; Humans ; Laryngeal Masks ; Lithotripsy ; Piperidines ; Propofol ; Respiration ; Unconsciousness

A study was carried out to figure the cases and to observe the endemic status of clonorchiasis and metagonimiasis in endemic areas in Korea. Total 13,373 inhabitants living in 40 villages along 7 main rivers and 9 small streams were subjected to stool examination. They were selected randomly among the riverside population. Their specimens were examined both by cellphane thick smear method and Stoll's egg countung technique. This study was performed during the period from May 1979 to April 1980. The results obtained are as follows: The egg positive rate of any kind of helminths was 58.7% out of 13,373 examned cases, and the egg positive rates by each helminth were; Clonorchis sinensis 21.5%, Metagonimus yokogaqai 4.8%, large type Metagonimus eggs 0.4%, Ascaris lumbricoides 22.9%, Trichuris trichiura 35.2%, hookworm 0.2%, Taenia sp. 0.5%, Hymenolepis nana 0.07%, Paragonimus westermani 2 cases, Fasciola sp. 4 cases, Echinostoma sp. 1 case and Hymenolepis diminuta 1 case respectively. Many endemic foci of clonorchiasis were revealed along the 7 major rivers. The egg positive rates of each river basin differed from each other significantly; Nagdonggang 40.2%, Yeongsangang 30.8%, Seomjingang 17.3%, Hangang 15.7%, Tamjingang 15.9%, Geumgang 12.0% and Mangyeonggang 8.0%. The cases of clonorchiasis were estimated in range 830,000 to 890,000 in riverside areas of the 7 rivers. By grading the infection intensity, 64.7% was in Grade I(EPG 0-900), 28.6% in Grade II (EPG 1000-9,900), 5.5% in Grade III (EPG 10,000-29,900) and 1.3% in Grade IV (EPG over 30,000). The proportion of the cases in Grade III and IV was 6.8% among positive cases. Therefore 60,000 cases at least were regarded to suffer from it clinically. Males of 30-60 years of age showed higher positive rate and heavier burden of infection. This makes clonorchiasis more important socially because the patients lose their social productivity. A few endemic foci of metagonimiasis were detected newly by egg detection; Samcheong 28.5% egg positive rate, Uljin 21.3%, Yeuongdeog 46.3%, Milyang 6.7%, Yeongil 9.2% and Geoje 18.2%. The mean EPG values were in range of 320-7, 120 by the focus. The egg positive rate and proportion of EPG Grade varied greatly by the area, and mean proportion of the positive cases were 69.7% in Grade I, 24.1% in Grade II, 5.0% in Grade III and 1.2% in Grade IV. Males of 30-60 years were infected in higher rate also. The large sized eggs of Metagonimus were found also in upper basin of Hangang and Geumgang mainly. They were regarded as eggs of M. takahashii which is mediated by the cyprinid fishes. Its significance should be studied further. Clonorchiasis and metagonimiasis should be realized as important public health problems in Korea by their wide distribution, high prevalence rate and heavy infection intensity. Comprehensive measures against them are needed urgently.
parasitology-helminth-trematoda ; clonorchiasis ; metagonimiasis ; Clonorchisis sinensis ; Metagonimus yokogawai ; epidemiology