No abstract available.
Graft vs Host Disease*

OBJECTIVE: It is known that mouse embryos before implantation develop in a low oxygen environment of 3- 8% concentration and with antioxidant materials such as vitamins, antioxidant enzymes, ferrous binding proteins, and albumin in follicular and tubal fluids. However, the 20% oxygen culture condition with chemically defined media might be produce an abundance of ROS, and leads to developmental delay or developmental block in vitro. In this study, we attempt to elucidate the relationship between intracellular H2O2 production and embryo development in different oxygen culture conditions of mouse embryos. METHODS: Prenuclear embryos from C57BL/CBA Fl hybrid and ICR mouse were cultured in incubators which provided 5% carbon dioxide, 20% oxygen and 5% carbon dioxide, 5% oxygen. Measurement of H2O2 level in a embryo was performed with DCHFDA(2, 7 -dichlorodihydroflourescein diacetate)and analyzed with Quanti-cell 700, and the number of blastomeres was counted with DAPI( 4, 6'-diamidino-2-phenylindole). RESULTS: Oxygen concentration of the culture medias was significantly higher in the 20% oxygen environment compared to that of 5% oxygen environment. Culture of mice embryos in high oxygen condition leads to high HO concentrations at 2 cell stage and developmental delay or ""2-cell block"" regardless of the strain. But in a 5% oxygen environment, which is similar to in-vivo conditions HO production was suppressed continuously through out culture and development of embryos was definitely improved. CONCLUSION: These results suggest that there is a difference in the production of ROS or protective mechanism according to the mouse strains and stage of development, and it is thought that in-vitro culture in 5% oxygen environment provides stable in vivo equilibrium but in a 20% oxygen environment there is production of ROS which overcome the protective mechanism which leads to cellular damage and embryo developmental delay.
Animals ; Blastomeres ; Carbon Dioxide ; Carrier Proteins ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Female ; Incubators ; Mice* ; Mice, Inbred ICR ; Oxygen* ; Pregnancy ; Vitamins

Eisenmenger syndrome (ES) is characterized by pulmonary arterial hypertension and right-to-left shunting. The signs and symptoms of ES include cyanosis, shortness of breath, fatigue, hemoptysis, and sudden death. In patients with ES, it is important that the systemic and pulmonary circulations be properly distributed and maintained. General dental treatment is not known to be particularly dangerous. To control pain and anxiety, local anesthetics without epinephrine are usually recommended. However, in cases of difficulty of cooperation, general anesthesia for dental treatment makes the condition worse. In the present case, intravenous deep sedation with propofol and remifentanil was administered for behavioral management during dental treatment successfully.
Anesthesia, General ; Anesthetics, Local ; Anxiety ; Cyanosis ; Death, Sudden ; Deep Sedation* ; Down Syndrome* ; Dyspnea ; Eisenmenger Complex* ; Epinephrine ; Fatigue ; Hemoptysis ; Humans ; Hypertension ; Propofol

Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an α-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.
Conscious Sedation ; Dexmedetomidine* ; Humans ; Infusion Pumps* ; Respiratory Insufficiency

BACKGROUND: An understanding of the features of postoperative pain is essential for optimal analgesic dosing strategies. Using a visual analogue scale (VAS) score and patient controlled analgesia (PCA) infusion pattern analysis, an anesthesiologist can estimate when and how severely patients suffer from pain. Several reports have been published about circadian changes in the pain threshold. Postoperative pain was analyzed retrospectively in 250 patients who underwent orthognathic surgery. METHODS: A total of 250 patients were allocated into two groups according to the time of recovery from anesthesia. Patients in the early group (group E) recovered from anesthesia before 06:00 p.m. Patients in the late group (group L) recovered from anesthesia after 06:00 p.m. All patients received intravenous patient controlled analgesia (IV PCA) at the end of the operation. The VAS score of pain intensity was measured. Self-administration of bolus analgesic from the IV PCA device was also analyzed according to actual time and elapsed time. RESULTS: VAS scores showed no difference between the two groups except 36 hours after recovery from anesthesia. On POD1, there were two peaks for self-administration of bolus analgesics in group L and one peak in the morning for group E. Two peaks each in the morning and in the afternoon were shown in both groups on POD2. CONCLUSIONS: Diurnal variance in pain should be considered for effective dosing strategies.
Analgesia, Patient-Controlled ; Analgesics ; Anesthesia ; Humans ; Orthognathic Surgery* ; Pain Threshold ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis* ; Retrospective Studies*

BACKGROUND: An understanding of the features of postoperative pain is essential for optimal analgesic dosing strategies. Using a visual analogue scale (VAS) score and patient controlled analgesia (PCA) infusion pattern analysis, an anesthesiologist can estimate when and how severely patients suffer from pain. Several reports have been published about circadian changes in the pain threshold. Postoperative pain was analyzed retrospectively in 250 patients who underwent orthognathic surgery. METHODS: A total of 250 patients were allocated into two groups according to the time of recovery from anesthesia. Patients in the early group (group E) recovered from anesthesia before 06:00 p.m. Patients in the late group (group L) recovered from anesthesia after 06:00 p.m. All patients received intravenous patient controlled analgesia (IV PCA) at the end of the operation. The VAS score of pain intensity was measured. Self-administration of bolus analgesic from the IV PCA device was also analyzed according to actual time and elapsed time. RESULTS: VAS scores showed no difference between the two groups except 36 hours after recovery from anesthesia. On POD1, there were two peaks for self-administration of bolus analgesics in group L and one peak in the morning for group E. Two peaks each in the morning and in the afternoon were shown in both groups on POD2. CONCLUSIONS: Diurnal variance in pain should be considered for effective dosing strategies.
Analgesia, Patient-Controlled ; Analgesics ; Anesthesia ; Humans ; Orthognathic Surgery* ; Pain Threshold ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis* ; Retrospective Studies*

OBJECTIVE: In the human body the embryo initially gmws in the fallopian tube which is maintained in an 3-8% O2 concentration environment, and various substances such as growth factors and antioxidants present in tbe tubal fluid assists in maintaining a healthy environment for embryo development. But in IVF programs embryo cultures are conducted in incubators with 21.9% O2 and 5% CO2 condition, and such high oxygen concentrations have been reported to increase the production of oxygen free radicals within the embryo and is detrimental to the growth and development of the embryo. The objective of this study, therefore, is to determine the culture conditions which will decrease oxygen free radical production and thereby minimize the injury to the embryo. METHODS: Six to eight week old ICR strain mice embryos were cultured in 5% or 21.9% O2 conditions and in culture media to which inaement concentrations of superoxide dismutase (SOD) had been and the H2O2 concentration within the embryo, embryo developmental rate, and degree of fragmentation of the embryos was investigated. RESULTS: The control gmup embryos which were cultured in 21.9% O2 condition without addition of SOD showed developmental arrest at the 2-cell stage or fragmentation, while those cultured in 21.9% O2 condition with addition of SOD showed development to the blastocyst stage with deaeased fragmentation. In particular, the blastulation and fragmentation rates were the lowest in the group to which 500 IU/ml of SOD was added, but in the 5% O2 enviranment group many embryos reached the blastocyst stage and with no difference in frapnentation with or without addition of SOD. The HO relative intensity (120.5+/-20.2) within the embryos cultured in 21.9% O2 environment without SOD was significantly higher than that (56.8+/-10.8) of group with SOD (p<0.05). As showing that in the 5% O2 environment group without SOD it was 43.8+/-7.8 and in the group with SOD it was 37.3+/-5.4, the H2O2 concentration within embryos cultured in 5% 02 condition was significantly lower those that of 21,9% 02 environment regardless of SOD addition (p<0.05). CONCLUSION: The optimal oxygen concentration in incubator for mice embryo cultures is that which is similar to the 5% 0 concentration in vivo. When 20% 02 incubators are routinely used, the addition of SOD to the culture media will decrease the H2O2 concentration within the embryos with subsequent improvement in development. The optimal concentration which should be used is thought to be 500 IU/ml. It is suggested that the use of the above method in human IVF-ET programs will lead to improved embryo quality and enhanced pregnancy rates.
Animals ; Antioxidants ; Blastocyst ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Fallopian Tubes ; Female ; Free Radicals ; Growth and Development ; Human Body ; Humans ; Incubators ; Intercellular Signaling Peptides and Proteins ; Mice* ; Oxygen* ; Pregnancy ; Pregnancy Rate ; Superoxide Dismutase* ; Superoxides*

PURPOSE: To evaluate the CT findings of tumor in the pyriform sinus, and to assess by functional study of thelarynx the extent the extent to which its characteristic findings differ from those of supraglottic tumor. MATERIALS AND METHODS: CT scans of 14 patients with tumor in the pyriform sinus were reviewed and compared withthose of 17 patients with supraglottic tumor. In all cases, spiral CT scanning linvolved both quiet breathing andmodified breath holding; we evaluated the images and analysed the primary site of tumors and the displacement ofair in the pyriform sinus. Extra and intralaryngeal extension of the tumors was also assessed. RESULTS: In tumorsin the pyriform sinus, CT findings were thickening of more than two walls in 14, the displacement of air in 9,extralaryngeal extension in 13, extension to the post-cricoid space in 11, invasion of the pre-epiglottic space in13, and widening of the cricothyroid space in 8 patients. In supraglottic tumors, CT findings were thickening ofthe medial wall in 17, extralaryngeal extension in 1, extension to the post-cricoid space in 1, invasion of theipsilateral paralaryngeal space in 17, and of the contralateral paralaryngeal space in 6, invasion of thepre-epiglottic space in 11, and widening of the cricothyroid space in 9 patienhts. In this type of tumor thedisplacement of air was not seen. CONCLUSION: The characteristic CT findings of tumor in the pyriform sinus werethickening of more than two walls of the pyriform sinus and the anterior or medial displacement of air. To assessthe site at which a tumor originates, spiral CT scanning is needed, together with functional study.
Breath Holding ; Humans ; Larynx* ; Pyriform Sinus* ; Respiration ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS™), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS™ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min..
Adult ; Anesthesia ; Anesthesia, General ; Anoxia ; Blood Pressure Monitors ; Conscious Sedation ; Deep Sedation ; Dental Anxiety ; Electrocardiography ; Electroencephalography ; Female ; Humans ; Intellectual Disability ; Oximetry ; Oxygen ; Patient Safety ; Propofol

OBJECTIVES: This study was designed to quantify symptoms in the upper extremities and to identify the pain related factors among hospital workers using video display terminals. METHODS: The subject-group consisted of 138 employees working at a hospital using video display terminals. A structured questionnaire was used to estimate the participants' general characteristics, and job contents. Job stress was measured using Karaseks JCQ(Job Content Questionnaire). Pain in the upper extremities was identified according to the NIOSH symptoms survey criteria. Quantification was measured using Kim Chul's method. Pearson's Correlation analysis was used to identify validity in quantification. VAS(visual analog scale) was used to compare with this method. Multiple regression analyses elucidated the relationship between quantified pain and various work factors, such as job stress. Data were analysed with SAS 6.12 program. RESULTS: First, in quantification using Kim Chul's method, the correlation between modified PRS(pain rating score) and VAS was extremely high by 0.60(P<0.01), indicating the high validity of PRS. Second, the groups of high job demand, high job control, and females were related to an increased pain level. CONCLUSIONS: These results suggest that the self pain assessment method, PRS, is valuable and useful in analyzing occupational musculoskeletal symptoms. High demand, job control and gender may influence the levels of pain. Prospective studies about musculoskeletal disorder are required.
Computer Terminals* ; Female ; Humans ; National Institute for Occupational Safety and Health (U.S.) ; Pain Measurement ; Questionnaires ; Upper Extremity*