Cervical plexus block has been evaluated clinically for surgery of the anterior neck in 13 patients during the 10 months(from July 1981 to April 1982) at the Department of Anesthesiology in Capital Armed Forces General Hospital. We have assessed CPB for technique, onset, anesthetized area, duration, complication and supplimentary agents, and reviewed the anatomical aspects of cervical plexus. The distribution of injected local anesthetics was demonstrated under radiography using Urographin. We experienced incomplete block in 9 cases which needed substitution with Thalamonal. The incidence of complications was few and most significant complication seen in this study was respiratory difficulty. However, There was no evidence for phrenic nerve paralysis. Cervical plexus block was performed safely and effectively for surgery of the anterior neck.
Incidence

The purpose of this study was to elucidate the effects of Hwangyun, Hwangyunhaedogtang, and Kumeunhwa on the lymphocyte activity in allergic contact dermatitis induced by contact allergen 1-chloro-2,4-dinitrobenzene (DNCB) of Balb/c mouse. For examination of a contact hypersensitivity, MEST (mouse ear swelling test) and lymphocyte proliferation assay measured by [(3)H]-methylthymidine incorporation were done. Cytokine mRNA in the draining lymph node cells were examined by RT-PCR. Contact hypersensitivity was more effectively induced by 0.25% DNCB treatment than 1% DNCB treatment. Local lymph node cell proliferation from DNCB-sensitized mouse was most highly elicitated with 100 ug/ml DNBS stimulation in vitro. The cytokine profiles of lymph node cells from DNCB-sensitized and DNBS-stimulated mouse were strong expression of IL-2 and IFN-r, weak expression of LT and IL-4, and no expression of IL-6 and IL-10. This lymphocyte proliferation was significantly inhibited in mice administered Korean medical drug for 10 days and sensitized with DNCB at day 5 (88.22%, 65.14%, and 52.29% in Hwangyun, Hwangyunhaedogtang, and Kumeunhwa, respectively). But Kumeunhwa was not effective in the inhibition of lymphocyte proliferation when administered after DNCB-sensitization. The cytokine expressions were also inhibited especially IL-2 and IFN-r in Hwangyun administered- mice. These inhibitions of lymphocyte activity by Korean medical drugs were also observed when stimulated with ConA (1 ug/ml). Conclusively, immune responses of contact hypersensitivity induced by DNCB are involved in local lymph node T cells mainly Th1 type cells, and Korean medical drugs especially Hwangyun suppressed allergic contact dermatitis via inhibition of the activity of these cells.
Animals ; Cell Proliferation ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dinitrochlorobenzene ; Ear ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Lymph Nodes ; Lymphocytes* ; Mice ; RNA, Messenger ; T-Lymphocytes

Phase-partitioning with Triton X-114 (TX114) was applied to the TSP antigen, which may be preferentially associated with the cell wall of M. tuberculosis. The hydrophilic protein components of the TSP antigen were successfully separated from integral hydrophobic macromolecules. To further characterize and examine the cellular immune response of the aqueous fraction of the TSP antigen (TSPa), the in vitro properties of the antigen were measured by lymphoproliferation; surface expression of IL-2 Ra on T lymphocytes was analyzed by flow cytometry; and the cytokine mRNA expression pattern was determined by RT-PCR. Significant lymphoproliferative responses to the TSPa antigen were observed in healthy tuberculin reactive donors after a 5 day in vitro stimulation. TSPa treatment of PBMCs from healthy tuberculin positive subjects for 5 days resulted in progressive augmentation of IFN-r, II 2, and IL-2Ra mRNA expression, as measured by RT-PCR, but considerably reduced IL-4 mRNA expression. In addition, the TSPa antigen stimulated more IL-12 p40 mRNA production than did the PPD antigen, and graduaBy suppressed IL- 10 mRNA expression. Moreover, the CD3' T cells of tuberculin positive subjects displayed a profound increase in their expression of the II 2Ru protein (39.0%) in response to the TSPa antigen. Proliferation was correlated with IL-2 and IL-2Ra mRNAs, but not correlated with distinct IFN-r or IL-12 p40 mRNA production. These findings strongly suggest that the TSPa antigen preferentially evokes the generation of a Thl-like immune response in healthy tuberculin reactors.
Cell Wall ; Flow Cytometry ; Humans* ; Immunity, Cellular* ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune ; RNA, Messenger ; T-Lymphocytes ; Tissue Donors ; Tuberculin ; Tuberculosis

No abstract available.
Embryonic Development* ; Female ; Humans* ; Pregnancy ; Serum Albumin*

In the olfactory bulb, normal and transected olfactory axons are able to enter, regenerate, and reestablish lost synaptic contacts with their targets, throughout the lifetime of the organism. It was expected that studies of olfactory bulb ensheathing glia will provide important advances for the field of neural regeneration. Purpose of this study is to analyze morphologically the effects of olfactory bulb transplants into the cord after complete transection. Forty Sprague-Dawley rats were used in this study. Spinal cord of the rats were transected after laminectomy followed by insertion of chopped olfactory bulb tissues immediately and 3 weeks after the operation. In this study, transplants of olfactory bulb were successfully used to promote functional and structural recovery after complete spinal cord transection. The area of damaged spinal cord was greatly diminished after olfactory bulb transplantation. Nearly normal anterior horn cells were observed immediately distal to the transected region. Tyrosine hydroxylase immunoreactive descending fibers were observed in the distal region beyond transected area.
Animals ; Anterior Horn Cells ; Axons ; Immunohistochemistry ; Laminectomy ; Neuroglia ; Olfactory Bulb* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Spinal Cord Injuries* ; Spinal Cord* ; Tyrosine 3-Monooxygenase

Present study was aimed to investigate the immunological activities of the 47 kDa protein antigen from Treponema pallidum and conducted on 12 patients with syphilis (early, late, spontaneously healed, congenital and treated patients) followed by therapy. Peripheral blood mononuclear cells (PBMC) were obtained three times from each patient, on admission before the initiation of therapy, 1 and 6 months later. Eleven (96.7%) of the patients prior to therapy, showed depressed lymphoproliferative responses to the 47 kDa antigen (stimulation index <4) by 3H-thymidine incorporation assay. However, these T cell responses were seemed to be transient because most of the patients (63.6%) exhibited significantly higher lymphoproliferation after therapy. Before therapy, PBMC from spontaneously healed syphilis patients resulted in significantly increased gene expression of IFN- and proinflarnmatory cytokines, such as TNFa, IL-1B and IL-6, in response to the 47 kDa. Patients with late latent and late congenital syphilis exhibited lower IFN-r and proinflammatory cytokine mRNA expression than spontaneously healed syphilis group did. After therapy, IFN-r and proinflammatory cytokine mRNA expressions were gradually reduced in these groups. On the other hand, IFN- and proinflammatory cytokine gene expressions were considerably depressed in early syphilis patients, but these patients went on to express prominent IFN-r and proinflamrnatory cytokine mRNA with treatment. These data suggest that the pattern of cellular immune response in response to the 47 kDa antigen may be involved in the evaluation of the clinical course and outcome of syphilis followed by therapy.
Cytokines ; Flow Cytometry ; Follow-Up Studies* ; Gene Expression ; Hand ; Humans ; Immunity, Cellular ; Interleukin-6 ; RNA, Messenger ; Syphilis ; Syphilis, Congenital ; Treponema pallidum* ; Treponema*

OBJECTIVE: This study was designed to evaluate the effect of functional electrical stimulation on swallowing function in stroke patients with dysphagia. METHOD: The subjects were 22 stroke patients with dysphagia. Functional electrical stimulation was applied to skin over anterior neck for thirty minutes and then, the patients were trained to swallow at the time of maximal stimulation. Swallowing function was evaluated by functional dysphagia scale using videofluoroscopic swallowing study with semisolid material before and 2 weeks after electrical stimulation. RESULTS: There were no significant differences in oral phase scores, the scores of triggering of pharyngeal swallow, residue in piriform sinuses, and coating of pharyngeal wall after swallow of pharyngeal phase. However, the scores of laryngeal elevation and epiglottic closure, residue in valleculae and pharyngeal transit time were significantly decreased (p<0.05). The score of pharyngeal phase was negatively correlated with the pulse intensity. The score of oral phase was negatively correlated with the cognitive function. CONCLUSION: The results of this study showed that the functional electrical stimulation can be used as an additional treatment method for stroke patients with dysphagia.
Deglutition Disorders* ; Deglutition* ; Electric Stimulation* ; Humans ; Neck ; Pyriform Sinus ; Skin ; Stroke*

BACKGROUND: The gut is an important area for inflammatory responses. Gut manipulation during open laparotomy compared with laparoscopic surgery, increases the inflammatory responses. Laparoscopic assisted colectomy (LC) with less bowel manipulation might minimize the inflammatory responses and oxidative stress, and offer a faster postanesthetic recovery than an open colectomy (OC). This study evaluated the effect of N-acetyl-cysteine (NAC), an antioxidant, on the recovery after colectomy. METHODS: 116 colorectal tumor patients were reviewed retrospectively. The patients were divided into 3 groups; LC by surgeon A (A - L), OC by surgeon A (A - O) and OC by surgeon B (B - O). The postanesthetic recovery scores (PARS) were compared. In the prospective randomized controlled trial, the colorectal tumor patients were assigned to one of four groups; laparoscopic assisted colectomy (L - N) with NAC infusion (L + N), open colectomy (O - N) with NAC infusion (O + N). In the NAC groups, NAC (5 mg/kg/h) was infused after intubation to extubation. The PARS were compared. RESULTS: In the retrospective study, the time to reach 10 points, which satisfies the discharge criteria in the PACU, was significantly lower in the A-L group than in the other groups. In the prospective study, the time to 10 points was shorter in the O + N group than in the O-N group. NAC offered no added benefits to the L + N and L-N groups. CONCLUSIONS: NAC offered faster recovery in the OC group but not in the LC group.
Colectomy ; Colorectal Neoplasms ; Colorectal Surgery* ; Humans ; Intubation ; Laparoscopy ; Laparotomy ; Oxidative Stress ; Prospective Studies ; Retrospective Studies

PURPOSE: An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. METHODS: We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. RESULTS: Among the clinical manifestations, fever was the most frequent (96.1%), followed by diarrhea (93.2%), abdominal pain (76.7%), headache (71.8%), vomiting (65.0%), and nausea (41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common (69%) followed by mucoid (26%), and bloody stool (5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows: 100% (9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9% (5/72) to cefdinir, 0% (0/8) to ceftriaxone, 12.5% (1/8) to ceftizoxime, 0% (0/ 8) to TMP/SMX, 42.9% (3/7) to ampicillin/sulbactam, 20% (1/5) to amoxicillin/clavulanic acid, and 68.8 % (11/16) to imipenem/cilastatin. CONCLUSION: It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.
Abdominal Pain ; Anti-Bacterial Agents ; Azithromycin ; beta-Lactamases* ; Ceftizoxime ; Ceftriaxone ; Ciprofloxacin ; Diarrhea ; Dysentery* ; Dysentery, Bacillary ; Enteritis ; Fever ; Headache ; Humans ; Korea ; Leukocytosis ; Nausea ; Occult Blood ; Retrospective Studies ; Sequence Analysis, DNA ; Shigella sonnei* ; Shigella* ; Vomiting

Solitary juvenile polyps are the most common benign hamartomatous polyps in childhood presenting with painless rectal bleeding. It is rare in solitary juvenile polyps with adenomatous change which is associated with increased risk for gastrointestinal cancer. We report a rare case of a solitary juvenile polyp with adenomatous change and causing colonic intussussection in a 6 year old girl, who presented symptoms of lower abdominal pain, vomiting, and hematochezia. The colonic intussussception was reduced during the colon barium study and a polypoid round mass shadow at the splenic flexure was formed. On colonoscopy, it was seen as a single huge polyp impacted to the splenic flexure lumen. Endoscopic polypectomy was performed. The histologic evaluation revealed the characteristic features of a juvenile poloyps with adenomatous change.
Abdominal Pain ; Barium ; Child ; Colon* ; Colon, Transverse ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Neoplasms ; Hemorrhage ; Humans ; Intussusception* ; Polyps* ; Vomiting