No abstract available.
Endocarditis*

Adult* ; Humans ; Respiratory Distress Syndrome, Adult*

No abstract available.
Malingering*

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

No abstract available.
Humans ; Otitis Media* ; Otitis*

Capnogram, monitoring of end-tidal CO2, has been a popular tool for assessment of ventilatory status during modern anesthesia. A normal curve on capnogram suggests normal CO2 production, adequate circulation, and adequate ventilation. Level of end-tidal CO2. is different from that of arterial CO2 even in normal individual. The difference is originated from alveolar dead space gas which dilute concentration of CO2 from normal alveoli. In clinical situation, the major factor which determines alveolar dead space is low pulmonary blood flow. Decrease of alveolar capillary perfusion from low cardiac output is the most important cause of low measure of end-tidal CO and large difference between arterial CO2 and end-tidal CO2 concentration in perioperative period. To understand the effect of cardiac output on end-tidal CO2 tension and the difference between arterial CO2 tension and end-tidal CO2 tension, We measured cardiac output before and dutiag administration of nitroglycerine and sodium nitropruside for relieve of myocardial load before aortic clamping in 30 male patients undergoing aortic recontructive surgery under endotracheal anesthesia for repair of infrarenal aortic obstruction. We also measured arterial CO2 tension, and end-tidal CO2 tension at the time of 10% decrease(phasel), 15% decrease(phase2)and 20% decrease(phase3) of cardiac output respectively. Measured values were statistically analyzed to evaluate correlation between cardiac output and end-tidal CO2 tension. The results are as follows: 1) Decreases of cardiac output brought about significant decrease in end-tidal CO2 in all phases compared to control value(p<0,05). 2) Decreases of cardiac output brought about significant increase in the difference between arterial- end-tidal CO2. tension in all phases compared to control value(p<0.05). 3) Changes in cardiac ourput correlated with changes in end-tidal CO2 tension significantly(p=0.0001, r=0.61, slope=2.01). 4) Changes in cardiac ourput correlated with changes in differences between arterial-end-tidal CO2 tension significantly(p=0.0001, r=-0.59, slope=-1.63). In conclusion we suggest that measurement of end-tidal CO2 tension, especially difference between arterial and end-tidal CO2 tension, may be a useful indicator for detection of cardiac output change during operation.
Anesthesia ; Capillaries ; Cardiac Output* ; Cardiac Output, Low ; Constriction ; Humans ; Male ; Nitroglycerin ; Perfusion ; Perioperative Period ; Sodium ; Ventilation

The role of the periosteum on osteointegration of Bio-Oss(R)(Geistlich, Wolhusen/Switzerland) was studied in rabbit calvarial defect. 12 New Zealand white male rabbits between 2.8 and 4 kg were included in this randomized, blinded, prospective study. Each rabbit was anesthetized with Ketamine HCl(5 mg/kg) and Xylazine HCl(1.5 ml/kg). An incision was made to the bony cranium and the periosteum was reflected. Using a 6-mm trephine bur(3i. USA), four 8-mm defects were created with copious irrigation. The defects were classified into barrier membrane(Tefgen(R), Lifecore Biomedical, Inc, U.S.A.) only group as a control, Bio-Oss(R) with barrier membrane group, Bio-Oss(R) with periosteum covering group, and Bio-Oss(R) without periosteum covering group. There were 2 rabbits in each group. The wound was closed with resorbable suture materials. Rabbits were sacrificed using phentobarbital(100 mg/kg) intravenously at 1, 2, and 4 weeks after surgery. The samples were fixed in 4% paraformaldehyde, and decalcified in hydrochloric acid decalcifying solution(Fisher Scientific, Tustin, CA) at 4degrees C for 2-4 weeks. It was embedded in paraffin and cut into 6 micrometer thickness. The sections were stained with H & E and observed by optical microscope. The results were as follows; 1. The periosteum played an important role in osteointegration of Bio-Oss(R) in bone defects. 2. When the periosteum remained intact and Bio-Oss(R) was placed on the defect, Bio-Oss(R) with periosteum covering has been incorporated into the newly formed bone from 2-week postoperatively. 3. When the periosteum was removed at the surgical procedure, invasion of connective tissue took place among the granules, and new bone formation was delayed compared to periosteum covering group. Therefore, when the bone grafting was performed with periosteal incision procedure to achieve tension-free suture, the integrity of the overlying periosteum should be maintained to avoid fibrous tissue ingrowth.
Bone Regeneration* ; Bone Transplantation ; Connective Tissue ; Humans ; Hydrochloric Acid ; Ketamine ; Male ; Membranes ; New Zealand ; Osteogenesis ; Paraffin ; Periosteum* ; Prospective Studies ; Rabbits ; Skull ; Sutures ; Wounds and Injuries ; Xylazine

Cardiopulmonary dysfunction in deformity of the spine had been recognized and complicated with surgical risk. The deformity of the bony thoracic cage reduces its capacity and also impairs the action of the inspiratory muscles will increase work of breathing. Progression of the deformity, the work of breathing and arterial desaturation were further increased. Primary alveolar hypoventilation will produce hypoxemia and resulting in polycythemia and increased pulmonary vascular resistance, and causespulmonary hypertension and congestive heart failure. The end result is similar to the cardiopulmonary failure of primary alveolar hypoventilation and of chronic obstructive bronchitis. Two cases of severe kyphoscoliosis were anesthetised for appendectomy and caesarean section. Anesthetic management of the severe kyphoscoliosis should be focused on the cardiopulmonary dysfunction. In this respect, for the surgical patient with kyphoscoliosis, it is very important to detect the reduced cardiopulmonary function and to consider the prevention or treatment of postoperative pulmonary complication by use an antibiotics, IPPB with oxygen, tracheobronchial toilet, venesection, digitalization and diuretics.
Anoxia ; Anti-Bacterial Agents ; Appendectomy ; Bronchitis ; Cesarean Section ; Congenital Abnormalities ; Diuretics ; Female ; Heart Failure ; Humans ; Hypertension ; Hypoventilation ; Intermittent Positive-Pressure Breathing ; Muscles ; Oxygen ; Phlebotomy ; Polycythemia ; Pregnancy ; Spine ; Vascular Resistance ; Work of Breathing

To clarify the mechanism of the protective effect of hemodialysis on lipid peroxidation in RBC membrane structures, the level of malondialdehyde (MDA) which is the lipid peroxidation product, and the activities of antioxidant enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) were determined before and after hemodialysis in the RBCs from 20 patients with end stage renal disease (ESRD), and from 14 healthy subjects. Before dialysis, MDA levels in the RBCs from the patients with ESRD were higher than those from healthy controls. SOD and catalase activities in the RBCs were lower. After hemodialysis, MDA, SOD, and catalase in the RBCs from the patients with ESRD were normalized. These results indicate that hemodialysis treatment is helpful to protect the peroxidative darnage through normalizing the activities of antioxidant enzymes.
Catalase ; Dialysis ; Erythrocytes* ; Glutathione Peroxidase ; Humans ; Kidney Failure, Chronic* ; Lipid Peroxidation ; Malondialdehyde* ; Membranes ; Renal Dialysis* ; Superoxide Dismutase

No abstract available.
Spinal Muscular Atrophies of Childhood*