BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

The present study examined cortical cerebral microinfarcts (CMIs) on a 3T magnetic resonance imaging and investigated the impact of CMIs on the comprehensive functional outcomes during the post-stroke rehabilitation period. Patients with acute phase of firstever ischemic stroke were retrospectively recruited (n = 62) and divided into 2 groups with and without CMIs. Clinical parameters including age, sex, stroke lesion laterality, location, the National Institutes of Health Stroke Scale score, as well as history of hypertension, dyslipidemia, diabetes mellitus, and smoking were obtained. Functional outcomes were assessed twice at baseline and one month later with the Korean version of the MiniMental State Examination, the Berg balance scale (BBS), and the functional independence measure. Partial correlation and multiple linear regression analyses were used to examine the relationship between the presence of CMIs and the change in functional outcomes. At least one CMI was reported in 27 patients, who were older (p = 0.043). The presence of CMIs was significantly associated with functional impairment in all 3 functional outcomes, after controlling for confounding factors (p < 0.05). CMIs might contribute to poor functional outcomes during the post-stroke rehabilitation period. These results suggest that CMIs should be considered when establishing rehabilitation treatment strategies or making a prognosis.

The relationship between respiratory infections and exacerbations of wheezing in patients with wheezy bronchitis or asthma has been described. Most respiratory infections were viral or Mycoplasma pneumoniae. This study was performed to evaluate the effect of Mycoplasma pneumoniae infection on bronchial reactivity and atopic background. 106 patients with Mycoplasma pneumoniae pneumonia who were admitted to the department of pediatrics, Fatima Hospital, Taegu during the period of two years from January 1989 to December 1990 were involved in this study. The results were as follows 1) Out of 106 cases, 69 were male,37 were female and 34.9% of the cases were between 5~6 years of age. 35 cases(33.0%) had wheezing and the incidence of wheezing were higher in male than in female. 2) The incidence of wheezing was high in the patients with serum IgE level higher than 200IU/ml, patients with past and family history of allergy and the patients fed with formula feeding in infancy. 3) Eosinophils and the associated maxillary sinusitis had no effect on the incidence of wheezing. 4) The recurrence of wheezing was higher in Mycoplasma pneumoniae pneumonia with wheezing(26.8%) than in patients without wheezing(3.8%).
Asthma ; Bronchitis ; Child* ; Daegu ; Eosinophils ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E ; Incidence ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pediatrics ; Pneumonia* ; Pneumonia, Mycoplasma* ; Recurrence ; Respiratory Sounds* ; Respiratory Tract Infections

No abstract available.
Anemia, Hypoplastic, Congenital*

BACKGROUND: Cardiac troponin T (cTnT) is a new serological marker for use as a diagnostic toots for acute myocardial infarction (AMI). This study was designed to evaluate tee diagnostic efficiency of troponin T in AMI. METHODS: We determined the reference range of troponin T in 20 healthy adults without previous cardiovascular diseases and chest pain. We evaluated troponin-T, CK, LD, AST and CK-MB in serum of 13 AMI and 5 angina pectoris patients. The patients were arrived at the hospital within 3 hours after onset of (most recent) acute symptoms. Samples were drawn individually at the times of 0, 1, 3, 7, 18 and 24 hours after admission and continued at 6-h intervals for 2 days and 24-h intervals fort 2 weeks. Troponin T was determined by an enzyme-linked immuno-sorbent assay (one step sandwich assay) on an ES-300 analyzer. RESULTS: We found that serum troponin-T concentrations in healthy control adults were below 0.07microgram/L. The peak level of troponin-T concentration of patients with AMI was 22.0microgram/L, mean value, at 7 hours after admission and showed 110 times its discrimination limit value (0.2microgram/L). CK-MB value was normalized within 3 days after admission, but cTnT value remained high above its discrimination limit value until 2 weeks after admission during this study. CONCLUSIONS: The data indicate that the measurement of serum cTnT improves efficiency of serological testings of AMI as compared with conventionally used cardiac enzymes.
Adult ; Angina Pectoris ; Cardiovascular Diseases ; Chest Pain ; Discrimination (Psychology) ; Humans ; Myocardial Infarction* ; Reference Values ; Serologic Tests ; Troponin T* ; Troponin*

LPS and IFN-r induce nitric oxide synthase in macrophages and the resultant NO causes apoptotic cell death in the activated macrophages. NO production and apoptosis were inhibited by N-monomethyl L-arginine (NMMA), a competitive inhibitor of NO synthase. To study the role of BCL-X proteins, RAW 264.7 cells were transfected with the expression vectors with human bcl-Xl or bcl-Xs cDNAs, respectively. Stable transfectants were selected and confirmed by RT-PCR. NO production in response to LPS and IFN-r caused apoptosis in RAW 264.7 cells and vector transfected control cells within 24 hr. Both NO production and apoptosis were inhibited by N(G)-monomethyl L-arginine (NMMA). In contrast, bcl-Xs transfectant appeared slightly susceptible and bcl-X(L)< transfectant appeared slightly resistant, although NO production was similar to control cells. These results suggest that bcl-X proteins play roles in both positive and negative regulation of apoptosis induced by NO.
Apoptosis* ; Arginine ; bcl-X Protein* ; Cell Death ; DNA, Complementary ; Humans ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase

Intravenous lidocaine has been used for attenuating cardiovascular responses to endotracheal intubation. To determine the optimal time of administration of lidocaine for attenuating hemodynamic changes induced by intubation, 100 patients were allocated randomly to a control group (without lidocaine) or four treated groups (with lidocaine). Lidocaine 1.5 mg/kg was administered intravenously at 60 (Group 2), 90 (Group 3), 120 (Group 4) and 180 seconds (Group 5) before intubation. Arterial pressure (systolic, mean and diastolic), heart rate and rate-pressure product (RPP) were measured before induction, after lidocaine injection, immediatly before intubation, immediately and 5 minutes after intubation. After intubation, arterial pressure, heart rate and RPP increased significantly in every study groups. In group 2 and 3, however, such changes were attenuated significantly, Postintubation elevation of systolic blood pressure, mean arterial pressure and RPP were effectively prevented in group 2 and 3. Lidocaine effect on diastolic pressure was observed only in group 3. Changes of heart rate were not affected with lidocaine adminiistration. In Group 4 and Group 5, this effect was not observed. In diastolic pressure, suppressive effect of lidocaine in increasing of blood pressure and RPP was observed in Group 3 significantly, but not in Group 2, Group 3 and Group 5. Changes of heart rate show that in all groups injected lidocaine (Group 2,3,4,5) significantly suppressive effect was not observed as compared with control group. These results suggest that intravenous lidocaine (1.5 mg/kg), 60-90 second prior to intubation attenuate hemodynamic responses induced by intubation.
Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal* ; Lidocaine*

Erythropoietic protoporphyria (EPP) is an autosomal dominant condition due to decreased activity of ferrochelatase. The disease is characterized by a wide range of photocutaneous changes and occasionally by liver disease. The level of protoporphyin is raised in erythkocytes and it may also be increased in the feces. We report herein a case of EPP present in a family which was diagnosed by a high free erythrocyte protoporphyrin (FEP) count.
Erythrocytes ; Feces ; Ferrochelatase ; Humans ; Liver Diseases ; Protoporphyria, Erythropoietic*

Erythropoietic protoporphyria (EPP) is an autosomal dominant condition due to decreased activity of ferrochelatase. The disease is characterized by a wide range of photocutaneous changes and occasionally by liver disease. The level of protoporphyin is raised in erythkocytes and it may also be increased in the feces. We report herein a case of EPP present in a family which was diagnosed by a high free erythrocyte protoporphyrin (FEP) count.
Erythrocytes ; Feces ; Ferrochelatase ; Humans ; Liver Diseases ; Protoporphyria, Erythropoietic*

Sixty healthy adult patients undergoing general anesthesia for elective surgery were randomly allocated to three group(n = 20), and their EMG response(twitch height) of the adductor digiti mini muscle(hypothena) to TOF stimulation of ulnar nerve by Datex relaxograph was monitored. The patients were received a bolus injection of vecuronium(0.1mg/kg) alone in group I, vecuronium(0.1 mg/kg) after 25-50% recovery from SCh(l mg/kg) in group II, and the mixed injection of SCh(1 mg/kg) and vecuronium(O.I mg/kg) in group III. The onset time(mean SEM) of effect of vecuronium(0.1 mg/kg) in group II(2.2+/-0.4 min) and group III(1.7+/-0.2 min) significantly was shorten when compared with a bolus injection of vecuronium alone in group(4.4+/-0,4 min)(p<0.05). The duration(mean+/-SEM) of vecuronium(0.1 mg/kg), however, had no significant differences among three group. It was 33+/-2 min in group I, 39+/-3 min in group II, and 34+/-2 min in group III. The potency of twitch height depression of vecuronium(0.1 mg/kg) was increased significantly following preinjection of SCh(1 mg/kg) and at the mixed injection of SCh and vecuronium The intensity of fasciculation induced by SCh was not affected at the mixed injection of vecuronium in group III. The peak increases in arterial pressare and heart rate on the endotracheal intubation were attenuated significantly at the mixed injection of SCh (1 mg/kg) and vecuronium(0.1 mg/kg) when compared with its effect of SCh (1 mg/kg) in group II(p<0.05).
Adult ; Anesthesia, General ; Depression ; Fasciculation ; Heart Rate ; Humans ; Intubation, Intratracheal ; Neuromuscular Blockade* ; Succinylcholine* ; Ulnar Nerve ; Vecuronium Bromide*