No abstract available.

BACKGROUND: The neuromuscular blocking effects of a nondepolarizing neuromuscular blocker (NDNM) during a nitroglycerin (NTG) infusion were significantly potentiated and prolonged. NTG reduced the requirement of a NDNM in surgical patients. We investigated the influence of a NTG single bolus injection on a mivacurium nuromuscular blockade. METHODS: We studied 36 adult surgical patients, ASA physical status I or II, between 15 and 53 years old. Neuromuscular monitoring was measured by TOF-GUARD (Biometer Co., Denmark). Anesthesia was induced by thiopental sodium 3-5 mg/kg and fentanyl 3 microgram/kg, and maintained with 3 L/min N2O, 2 L/min O2 and 1 vol.% isoflurane. Patients were randomly assigned to 3 groups: 1) Control group (mivacurium 0.16 mg/kg), 2) N100 group (mivacurium 0.16 mg/kg, NTG 100 microgram), 3) N200 group (mivacurium 0.16 mg/kg, NTG 200 microgram). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch. RESULTS: NTG produced a prolongation of the neuromuscular blocking effect by mivacurium. T1 (contro group: 12.1 +/- 0.5, N100 group: 15.8 +/- 0.4 and N200 group: 11.6 +/- 0.4 min), T25 (16.4 +/- 0.4, 20.5 +/- 0.5 and 14.9 +/- 1.0 min), T75 (22.5 +/- 0.9, 29.4 +/- 0.7 and 20.1 +/- 1.0 min), T95 (27.3 +/- 0.6, 39.6 +/- 0.7 and 24.6 +/- 1.5 min) and the recovery index (6.1 +/- 0.6, 9.0 +/- 0.4 and 5.3 +/- 0.7 min) were significantly prolonged in the N100 and N200 groups (P < 0.05). CONCLUSION: These results suggest that a NTG bolus injection prolonged the neuromuscular blocking effect of mivacurium, dose relatively.
Adult ; Anesthesia ; Fentanyl ; Humans ; Isoflurane ; Middle Aged ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Nitroglycerin* ; Thiopental

No abstract available.
Antibodies, Monoclonal* ; Humans* ; Interleukins*

PURPOSE: The purpose of this study is to examine the frequency of posterior element injury in patients with traumatic thoraco-lumbar burst fractures and to evaluate the correlation between the MR imaging and CT findings. MATERIALS AND METHODS: The MR images of 38 patients with 39 thoraco-lumbar burst fractures and the results of the CT examinations of 28 patients with 29 fractures were retrospectively analyzed. Both procedures were performed within two weeks of injury. Twenty-one males and 17 females were included ; their average age was 51.3 (range, 11-75) years. MR images were evaluated for injury to the posterior ligamentous complex, comprising the supraspinous ligament(SSL), the interspinous ligament(ISL), the flaval ligament(FL), and the capsule of facets. Analysis of the CT findings focused on the posterior bony elements of the lamina, pedicle, spinous process, and facet joint. RESULTS: MR imaging revealed posterior ligamentous injuries in 18(46.2%) of 39 burst fractures ; there was tearing of the ISL in 15 cases(38.5%), of the SSL in 11(28.2%), of the capsule of facets in 11(28.2%), and of the FL in nine(23.1%). Among the 29 burst fracture cases examined by CT, posterior bony injuries were detected in 13(44.8%). Lamina and facet joint fractures were detected in six cases(20.7%), facet separation or dislocation in six(20.7%), and spinous process and pedicle fracture in one(3.4%). In 29 burst fracture cases, both MRI and CT were performed. Among the 18 cases in which MR imaging revealed posterior ligamentous injuries, CT failed to demonstrate posterior element fractures in seven. On the other hand, among the 13 cases in which CT indicated posterior bony fractures, MR failed to reveal posterior ligamentous injuries in two. CONCLUSION: Posterior element injury is frequently found in patients with traumatic thoraco-lumbar burst fractures demonstrated by MR imaging(46.2%) and CT(44.8%). Both MRI and CT are useful tools for the evaluation of posterior element injury, which determines the degree of instability of traumatic burst fracture.
Dislocations ; Female ; Hand ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Zygapophyseal Joint

We present an unusual case of a complete type II first branchial cleft fistula that communicates between the external auditory canal and the skin near the angle of the mandible. The incomplete branchial fistula is not an uncommon congenital anomaly of branchial apparatus but a complete one is rare. It was successfully treated with complete surgical excision without facial nerve injury. It was diagnosed as the type II first branchial cleft anomaly by histological finding. We discuss the classification of first branchial cleft anomalies, with emphasis on the complete type fistula and the facial nerve.
Branchial Region ; Craniofacial Abnormalities ; Ear Canal ; Facial Nerve ; Facial Nerve Injuries ; Fistula ; Mandible ; Pharyngeal Diseases ; Skin

Pelvic pain syndrome or pelvic congestion syndrome, with no apparent organic cause, is a common gynecologicaldisorder. Ovarian varix, one of the causes of this syndrome, presents a difficult diagnostic and therapeuticproblem, though surgical ligation of the ovarian vein is an effective method of treatment. Although ovarian veinembolization has been recently developed as a useful alternative, no previous reports have described thisprocedure in Korea. We report a case of pelvic pain syndrome successully treated by ovarian vein embolization.
Estrogens, Conjugated (USP) ; Korea ; Ligation ; Pelvic Pain* ; Varicose Veins ; Veins*

PURPOSE: To determine the relative accuracy of barium enema findings of Hirschsprung's disease (HD) and to calculate a level of probability for three signs combined. MATERIAL AND METHODS: Barium enema findings in 45 patients who had undergone rectal biopsy to prove or exclude the diagnosis of HD were retrospectively analyzed by evaluating the presence of a transition zone, irregular contractions and delayed evacuation of barium. Seventeen were neonates (group 1) and the other 28 were infants and children (group 2). The sensitivity, specificity, and positive and negative predictive values of the findings were compared. RESULTS: In visualization of a transition zone, sensitivity, specificity and positive predictive value were 76.5%, 72.7% and 89.7%, respectively. Sensitivity for irregular contractions and delayed evacuation of barium was 76.5% and 91.7%, respectively, whereas for specificity, the corresponding values were 63.6% and 40%. Sensitivities for radiologic signs were higher in group 1 than in group 2, but, the specificities were lower. If two or three findings were positive, the level of probability was 85 - 100%. If two findings were negative, however, the corresponding value was 30%. CONCLUSION: We conclude that the most reliable HD finding is the presence of a transition zone. Irregular contractions and the delayed evacuation of barium are not specific. Two or three positive findings may suggest a higher probability of HD than any single positive finding alone.
Barium* ; Biopsy ; Child ; Diagnosis* ; Enema* ; Hirschsprung Disease* ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies ; Sensitivity and Specificity

Emerging evidence has emphasized the importance of cancer therapies targeting an abnormal metabolic state of tumor-initiating cells (TICs) in which they retain stem cell-like phenotypes and nicotinamide adenine dinucleotide (NAD⁺) metabolism. However, the functional role of NAD⁺ metabolism in regulating the characteristics of TICs is not known. In this study, we provide evidence that the mitochondrial NAD⁺ levels affect the characteristics of glioma-driven SSEA1⁺ TICs, including clonogenic growth potential. An increase in the mitochondrial NAD⁺ levels by the overexpression of the mitochondrial enzyme nicotinamide nucleotide transhydrogenase (NNT) significantly suppressed the sphere-forming ability and induced differentiation of TICs, suggesting a loss of the characteristics of TICs. In addition, increased SIRT3 activity and reduced lactate production, which are mainly observed in healthy and young cells, appeared following NNT-overexpressed TICs. Moreover, in vivo tumorigenic potential was substantially abolished by NNT overexpression. Conversely, the short interfering RNA-mediated knockdown of NNT facilitated the maintenance of TIC characteristics, as evidenced by the increased numbers of large tumor spheres and in vivo tumorigenic potential. Our results demonstrated that targeting the maintenance of healthy mitochondria with increased mitochondrial NAD⁺ levels and SIRT3 activity could be a promising strategy for abolishing the development of TICs as a new therapeutic approach to treating aging-associated tumors.
Glioblastoma* ; Lactic Acid ; Metabolism ; Mitochondria ; NAD ; NADP Transhydrogenases ; Phenotype ; Tics ; Up-Regulation*

Genus Phellinus taxonomically belongs to Aphyllophorales and some species of this genus have been used as a medicinal ingredients and Indian folk medicines. Especially, P. linteus and morphological-related species are well-known medicinal fungi that have various biological activities such as humoral and cell-mediated, anti-mutagenic, and anti-cancer activities. However, little is known about the rapid detection for complex Phellinus species. Therefore, this study was carried out to develop specific primers for the rapid detection of P. linteus and other related species. Designing the species-specific primers was done based on internal transcribed spacer sequence data. Each primer set detected specifically P. linteus (PL2/PL5R) and P. baumii (PB1/PB4R). These primer sets could be useful for the rapid detection of specific-species among unidentified Phellinus species. Moreover, restriction fragment length polymorphism analysis of the ITS region with HaeIII was also useful for clarifying the relationship between each 5 Phellinus species.
Fungi ; Phylogeny ; Polymorphism, Restriction Fragment Length ; Polyporales

PURPOSE:The objective of this study was to evaluate the indications, effectiveness and complications associated with uterine arterial embolization as an alternative treatment of obstetrical hemorrhage. METHODS:From January 2006 to December 2008, 25 patients who underwent angiographic embolization for the obstetrical hemorrhage that was not responsive to conventional treatments, like obstetric maneuvers and uterotonic drugs, were included in our study. All medical records were reviewed and detailed clinical data such as clinical status, underlying conditions, amount of transfusion, embolized arteries, hospital stay, the success rate and the complications were collected. RESULTS:We have experienced clinically successful embolization in 22 (88%) of 25 patients with obstetrical hemorrhage resulting from various causes. After embolization, the patients' vital signs were stabilized. The causes of hemorrhage were atony of uterus (n=10), myomectomy during cesarean section (n=6), abnormal placentation (n=5), arterio-venous malformation (n=3), and cervical pregnancy (n=1). The average amount of blood transfusion was 7.2 units (range; 0~39 units). The average length of the time for the procedure was 55 minutes (range: 25~96 minutes). The average duration of hospitalization was 5.5 days (range: 2~14 days). In 22 patients, menses resumed spontaneously after procedures. The main complications after embolization were numbness and pain on lower extremities (n=1), and hypomenorrhea (n=1). CONCLUSION:The atrerial embolization is one of the safe and effective procedures that offers patients an alternative to hysterectomy for the treatment of intractable postpartum hemorrhage.
Arteries ; Blood Transfusion ; Cesarean Section ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hypesthesia ; Hysterectomy ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation Disturbances ; Placentation ; Postpartum Period ; Pregnancy ; Uterus ; Vital Signs