The objectives of this study were to investigate the efficacy and dose-effect relationship for glycopyrrolate in the suppression of the oculocardiac reflex, and to compare glycopyrrolate with the reported equivalent dose of atropine. Glycopyrrolate 5 and 7.5ug/kg and atropine 10 and 15ug/kg were studied in 40 paediatric patients to assess more fully the dose of glycopyrrolate required for adequate prevention of the oculocardiac reflex. The results obtained were summarized as follows: 1) The increase in the mean heart rate 5 min after the test drug was statistically significant in all of the four groups. 2) Both drugs showed a dose-related response for reduction in slowing of heart rate after rectus muscle traction. 3) There is great individual variation in response to muscle traction within each group, no group being fully protected from marked slowing in heart rate. 4) The frequency of arrhythmias with low doses of both drugs was more than in high doses with both drugs.
Anesthesia* ; Arrhythmias, Cardiac ; Atropine* ; Child* ; Glycopyrrolate* ; Heart Rate* ; Heart* ; Humans ; Reflex, Oculocardiac ; Traction

No abstract available.
Arachnoid* ; Arachnoiditis* ; Magnetic Resonance Imaging* ; Tuberculosis*

No abstract available.
Arachnoid* ; Arachnoiditis* ; Magnetic Resonance Imaging* ; Tuberculosis*

1. The intracranial pressure (ICP) was raised by the extradural balloon method in urethane-anesthetized rabbits, and change of the arterial blood pressure (BP) with change of ICP was studied. 2. In the control rabbit group raising ICP resulted in marked increase in BP. 3. In the reserpine-treated group raising ICP did not induce the increase in BP but the decrease in BP. 4. In the tetrabenazine-treated group raising ICP did not cause change in BP. 5. After the administration of norepinephrine through the lateral ventricle to the reserpine-treated and tetrabenazine-treated rabbits, raising ICP resulted in marked increase in BP. 6. These results indicate that the existence of norepinephrine in the brain is essential for the BP increase by raising ICP.
Arterial Pressure ; Blood Pressure* ; Brain* ; Intracranial Pressure* ; Lateral Ventricles ; Norepinephrine* ; Rabbits

We report four cases of unilateral pulmonary vein atresia without associated congenital intracardiac anomalies to illustrate a part of the clinical and radiological characteristics and its diagnosis. Pulmonary vein atresia was in right side in all cases. Narrowing of contralateral pulmonary vein and pure red cell anemia were combined in one cases. In four cases, initial presentations were hemoptysis and lower respiratory tract infection. The simple chest X-ray revealed loss of volume, increased reticular interstitial markings of the involved lung and the shift of mediastinal structures to the involved side, and hilar prominency in the contralateral side. Lung perfusion scan revealed no visualization of involved lung. Cardiac Catheterization revealed pulmonary artery hypertension 2/4 and pulmonary artery wedge pressure 1/2. On pulmonary angiogram, nonvisualiaztion of pulmonary vein in the involved side in 3: partial visualization of pulmonary vein not connected to atrium in 1: dysmorphic pulmonary artery on the contralateral side in 1. Right pneumonectomy was done without specific problems in two cases. In conclusion, Unilateral pulmonary vein atresia should be suggested when the clinical and radiological characteristics are present.
Anemia ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Hemoptysis ; Hypertension ; Hypertension, Pulmonary ; Lung ; Perfusion ; Pneumonectomy ; Pulmonary Artery ; Pulmonary Veins* ; Pulmonary Wedge Pressure ; Respiratory Tract Infections ; Thorax

BACKGROUND: It is known that air borne particulates are closely related with the respiratory symptoms and peak expiratory flow (PEF) in patients with respiratory diseases. In Korea, concentrations of airborne dust and inhalable particulates are dramatically increased by the Yellow sand phenomenon, especially in springtime. OBJECTIVE: This study was performed to evaluate the effect of Yellow sand-related airborne dust on the respiratory symptoms and pulmonary function of patients with bronchial asthma. METHOD: 21 non-smoking, tree pollen non-sensitized subjects with bronchial asthma in Seoul were included in this study. For each subject, asthma and rhinoconjunctivitis symptoms were recorded by self-administered standardized questionnaire and by monitoring PEF between April and May 2000. Symptom score and diurnal variability of PEF were compared with the levels of inhalable particulate matter (PM10) checked in that time at 25 points in Seoul. RESULTS: 15 (71.4%) of the enrolled subjects successfully finished this study. There was no statistically significant relationship between the increment of Yellow sand-related PM10 and respiratory symptom or PEF variability. Of the 15 subjects, there were increased symptoms for the eye in 2 (13.3%) subjects, nose in 3 (20.0%), and sinus in 1 (6.7%), which were associated with Yellow sand-related increase of airborne dust levels. 5 (33.3%) subjects showed changes of PEF variability proportional to the change of PM10. CONCLUSION: Meteorological phenomenon related with Yellow sand has a potential risk of aggravating the upper respiratory tract symptoms and of deteriorating pulmonary functions in patients with asthma.
Asthma* ; Dust ; Humans ; Korea ; Nose ; Particulate Matter ; Pollen ; Respiratory System ; Seoul ; Silicon Dioxide* ; Surveys and Questionnaires

Bronchial carcinosarcoma is a very rare malignant tumor that is composed of carcinomatous and sarcomatous elements. We describe the first case in which digital tomosynthesis was useful for the evaluation of airway obstruction by bronchial carcinosarcoma that was overlooked on initial chest radiography.
Airway Obstruction* ; Carcinosarcoma* ; Radiography ; Thorax

PURPOSE: We conducted this study to determine the efficacy of conventional treatments for patients with Hodgkin's disease and identify the patients who have poor prognosis and need high-dose chemotherapy and autologous stem cell transplantation. MATERIALS AND METHODS: Between Jun. 1989 and Dec. 1997, 50 patients were enrolled and 39 patients were evaluable. Patients were treated with radiotherapy (5 patients) or combination chemotherapy (21 patients) or combined chemotherapy and radiotherapy (13 patients) according to their disease stage. Chemotherapy regimens were C-MOPP (cyclo- phosphamide, vincristine, procarbazine, and prednisone), MOPP (mechlorethamine, vin- cristine, procarbazine, and prednisone), ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), alternating C-MOPP/ABVD, and MOPP/ABV hybrid. Radiation therapy was performed when there was residual tumor after chemotherapy or bulky disease. The response to treatments was analyzed by clinical stage I-II and stage III-IV patients group, respectively. RESULTS: The complete response rate was 76.9% for total patients, 83.3% for stage I-II patients, and 71.4% for stage III-IV patients. Of the 30 patients achieving complete response, four (13.3%) relapsed at 6, 12, 22, and 28 months after complete response, respectively. The median follow-up duration was 24 months. Nine patients died. Four patients died of Hodgkins disease. Three-year overall survival rate was 72.9% for total patients, 72.5% for stage I-II patients, and 70% for stage III-IV patients. Two-year disease- free survival rate was 77.6% for total patients, 79% for stage I-II stage patients, and 73.9% for stage III-IV patients. The prognostic factor analysis showed that performance status affected the disease-free survival rate. CONCLUSION: Conventional treatments in patients with Hodgkins disease showed results comparable to previous studies. But we were unable to identify the patients, who need high-dose chemotherapy and autologous stem cell transplantation, because of small number of study patients and short follow up duration.
Bleomycin ; Dimethoate ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Hodgkin Disease* ; Humans ; Neoplasm, Residual ; Procarbazine ; Prognosis ; Radiotherapy ; Stem Cell Transplantation ; Survival Rate ; Vinblastine ; Vincristine

Veno-occlusive disease (VOD) of the liver is a clinical syndrome characterized by hyperbilirubinemia, painful hepatomegaly, and fluid retention. In the bone marrow transplantation (BMT) setting, VOD is caused by dose-intensive chemotherapy and/or radiotherapy used to prepare patients for transplant. VOD occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. Until recently, there was no proven effective medical therapy for this condition once it was clinically apparent. We report here on the frequency and treatment result of VOD with rt-PA in our allogeneic BMT patients. Eight patients (median age 28.5 years) underwent allogeneic BMT from December, 1993 to June, 1995 in Asan Medical Center. Six leukemia patients were prepared for BMT with busulfan and cyclophosphmide, while two aplastic anemia patients received cyclophosphamide and antithymocyte globulin. VOD was defined as having two of the following features before day 20 posttransplant: jaundice (bilirubin > or = 2 mg/dL), tender hepatomegaly and/or right upper quadrant pain, ascites and/or unexplained weight gain (> 2% from baseline). All patients who were diagnosed with VOD received rt-PA (10-20 mg/day) and heparin (10,000 U/day). Three (37.5%) of the eight patients developed VOD that occurred between 6 and 10 days posttransplant. All three patients developed jaundice, weight gain, and tender hepatomegaly. Ascites and renal insufficiency occurred in two patients and pleural effusion in one patient. rt-PA and heparin were begun 6 to 26 days posttransplant and rt-PA was administered for 7 to 14 days. All three patients responded to the therapy; bilirubin levels began to decrease at 4 to 13 days from the start of therapy. They are all alive at day 111, 316, and 548 days posttransplant. None of the patients had significant hemorrhagic complications after rt-PA treatment. Prolonged administration of rt-PA was feasible without bleeding episode and it seems that rt-PA may alter the natural course of VOD.
Adolescent ; Adult ; Bone Marrow Transplantation/*adverse effects ; Drug Therapy, Combination ; Female ; Heparin/therapeutic use ; Hepatic Veno-Occlusive Disease/*drug therapy/etiology/physiopathology/prevention & control ; Human ; Immunosuppressive Agents/*adverse effects ; Male ; Preoperative Care/adverse effects ; Radiotherapy/*adverse effects ; Risk Factors ; Tissue Plasminogen Activator/*therapeutic use ; Treatment Outcome

Low molecular proteins (LMPs) which are smaller than 20 kDa are difficult to visible on a standard two-dimensional SDS-polyacrylamide gel electrophoresis (2-D SDS-PAGE) map. LMPs must be enriched appropriately to be analyzed. We isolated LMPs of Helicobacter pylori 26695 from 1-D polyacrylamide gel and digested by pepsin. Pepsin-digested LMPs were separated by HPLC and each fraction was analyzed by hybrid tandem mass spectrometer. Seventy nine peptides, representing 27 genes, including copper ion binding protein (CopP, 7 kDa), thioredoxin (TrxA, 11.9 kDa) and ribosomal protein L23 (Rpl23, 10.5 kDa) were identified. Some proteins larger than 40 kDa including Omp2, Omp21, Omp27, Omp30, Omp32, catalase and HP1083 were also identified. This work may give researchers a useful way to analyse the expressed LMPs which could not be identified on the conventional 2-D SDS-PAGE.
Acrylic Resins ; Carrier Proteins ; Catalase ; Chimera ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Copper ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Helicobacter pylori ; Molecular Weight ; Pepsin A ; Peptides ; Proteins ; Proteome ; Ribosomal Proteins ; Thioredoxins