No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

We examined the fibronectin (FN) secretion of cultured trabecular meshwork (TM) cells in a normal human eye by indirect immunofluorescent technique using mouse anti-human FN monoclonal antibody and FITC-conjugated goat anti-mouse IgG. To localize FN on frozen sections of normal TM, which were obtained from 7 enucleated eyes owing to traumatic eyeball rupture, the same indirect immunofluorescent method was used. Immunoelectron microscopy was applied to demonstrate the distribution pattern of FN in the normal TM of 2 human eyes using an avidin-biotin-peroxidase complex method. In the tissue culture of TM, the TM cell walls and extracellular matrices showed an intense staining with antibody to FN. Indirect immunofluorescent staining of FN on frozen sections of TM showed strong positive reactions in the subendothelial region. There was no reaction in the central core of the trabecular beam. Immunoelectron microscopy revealed the reaction products to FN in the areas lining the trabecular endothelial cells.
Adolescent ; Adult ; Antibodies, Monoclonal ; Cells, Cultured ; Fibronectins/biosynthesis/*metabolism ; Fluorescent Antibody Technique ; Humans ; Male ; Microscopy, Immunoelectron ; Trabecular Meshwork/*metabolism/ultrastructure

The authors experienced a case of anterior uneitis associated with secondary glaucoma caused by a cycitsercosis cellulosae in the anterior chamber of the left eye of a 39-year-old Korean male. The cyst appeared from the posterior surface of the iris through the pupillary margin of 10-o'clock position and grew larger and larger with automatic active movements, filling finally the nasal upper one third of the anterior chamber, but the cyst did not change the position to the 6-o'clock chamber angle. The cysticercus grown for almost four months was extracted successfully with a teethless, serrated, curved forceps with some resistance after opening the anterior chamber from 7~11-o'clock position without iris prolapse and any damage to the anterior lens capsule. The extracted cyst with the size of 8 mm X 6 mm X 3 mm was confirmed as a cysticercus cellulosae by parasitological examinations (Fig. 2,3). After the extraction of the cysticercus the uveitis and the increased intraocular tension subsided completely, remaining some brownish fine keratic precipitates, pigment masses on the anterior surface of the lens and irregularly somewhat dilated pupil due to partial posterior synechia. The naked vision O.S., however, was 20/25 using pin hole, and the eye has been still quiet during last 3 and half years following surgical extraction. In addition the authors have recently seen three cases of subconjunctival cystiticercosis cellulosae. In the first case the cysticercus with the size of 8 mm X 7 mm X 4 mm appeared at the nasal superior part of the bulbar conjunctiva O.D. of a three-year-old Korean male. In the second case the cyst with the size of 7 mm X 5 mm X 3 mm was seen at the nasal inferior part of the bulbar conjunctiva O.S. of a 12-year old Korean female. In the last case the cyst with the size of 10 mm X 8 mm X 5 mm was located beneath the plica semilunaris of 3-o'clock position O.D. of a 58-year-old Korean female. All the cysts were extracted successfully without any rupture, and they were confirmed as the cysticercus cellulosae histologically.
Adult ; Anterior Chamber* ; Child ; Conjunctiva ; Cysticercosis* ; Cysticercus* ; Female ; Glaucoma ; Humans ; Iris ; Male ; Middle Aged ; Prolapse ; Pupil ; Rupture ; Surgical Instruments ; Uveitis

To elucidate the effect of splenectomy on the development of experimental primary amoebic meningoencephalitis in mice, the death rate and survival time of mice infected intranasally with Naegleria fowleri trophozoites 5 x 10(4) cultivated in CGVS medium were compared according to the age when splenectomy was done, and post-operation until experimental infection. Immunodiffusion was undergone to detect the presence of serum antibody due to N. fowleri infection in mice. Polyacrylamide gel electrophoresis was done to compare the protein fractions of mouse serum in each experimental groups. In experiment I, splenectomy was done 3 weeks and infection 4 weeks after birth, the death rate of control, sham operated and splenectomized group were 100 percent, 85 percent and 95 percent, and the mean survival time after infection 7.3 days, 7.5 days and 7.8 days, respectively. In experiment II, splenectomy was undergone 3 weeks and infection 6 weeks after birth, the death rate of control, sham operated and splenectomized group were 95 percent, 95 percent and 95 percent , and the mean survival time after infection 12.1 days, 11.5 days and 11.5 days, respectively. In experiment III, splenectomy was done 5 weeks and infection 6 weeks after birth, the death rate of control, sham operated and splenectomized group were 95 percent, 90 percent and 95 percent, and the mean survival time after infection 8.1 days, 8.3 days and 8.5 days, respectively. By Ouchterlony immunodiffusion, anti-N. fowleri antibody in the serum of mouse with primary amoebic meningoencephalitis was detected against a N. fowleri antigen, which was prepared by ultrasonication of N. fowleri trophozoites, each reacting two lines of precipitation. The patterns of serum fractions by polyacrylamide gel electrophoresis were different between control and sham operated groups from splenectomized group in fraction II, III and V, the sera of which were collected after N. fowleri infection. This results may be summarized as that splenectomy has no effect on the development of primary amoebic meningoencephalitis in mice.
parasitology-protozoa ; Naegleria fowleri ; meningoencephalitis ; brain ; immunology ; spleen ; brain

In order to assess the extracellular matrix(ECM) secretion of corneal epithelial cells inoculated with herpes simplex virus-1 in vitro the indirect immunofluorescent technique was used. In this study, ECM such as fibronectin, type IV collagen and laminin were rich in cultured rabbit corneal epithelial cells under the normal condition, while those became poor after inoculation with herpes simplex virus-1. This result suggested that herpes simplex virus-1 inhibit ECM secretion of the corneal epithelial cells. These findings mean that delayed epithelial wound healing after herpes simplex virus-1 infection is due to suppressed secretion of ECM which is the principal component of corneal epithelial wound healing.
Collagen Type IV ; Epithelial Cells* ; Extracellular Matrix* ; Fibronectins ; Herpes Simplex ; Herpesvirus 1, Human* ; Laminin ; Simplexvirus ; Wound Healing

This study was performed to observe the retinal changes in rabbits by intravitreal inoculation of HSV-1. The solution of HSV-1 virus(Kos strain) was inoculated into the vitreous cavity in 5 eyes. All the eyes were checked with a slit lamp and an indirect ophthalmoscope. Two eyes that showed the retinal lesion were enucleated for the histopathologic examination. The focal infiltration of inflammatory cells was marked around the retinal vessels in one eye and there was the diffuse infiltration of plasma cells and lymphocytes in the choroid and the retina in the other eye. The pattern of proliferation and migration of retinal pigment epithelial cells was observed at the outer retina. The virus-infected nuclei were evident in the photoreceptor cells and ganglion cells. The viral particles and intranuclear inclusion were prominent in the deformed nuclei and free-floating viral particle was shown at the extracellular space of the necrotic retina. These results suggest that the intravitreal inoculation of HSV-1 might induce retinal necrosis. The inflammatory reactions was initiated at the vitreoretinal interface and perivascular area. Virus might be propagated through axons or infected cell from free-flating virus.
Axons ; Choroid ; Epithelial Cells ; Extracellular Space ; Ganglion Cysts ; Herpes Simplex* ; Herpesvirus 1, Human ; Intranuclear Inclusion Bodies ; Lymphocytes ; Necrosis* ; Ophthalmoscopes ; Photoreceptor Cells ; Plasma Cells ; Rabbits ; Retina ; Retinal Vessels ; Retinaldehyde* ; Simplexvirus ; Virion

We examined the fibronectin(FN) secretion by cultured trabecular meshwork(TM) cells from a normal human eye by indirect immunofluorescent technique using mouse anti-human FN monoclonal antibody and FITC-conjugated goat anti-mouse IgG. To localize FN on frozen sections of normal TM which were obtained from 7 enucleated eyes owing to traumatic eyeball rupture, the same indirect immunofluorescent method was used. Immunoelectron microscopy was applied to demonstrate the distribution pattern of FN in the normal TM of 2 human eyes using an avidin-biotin-peroxidase complex method. In tissue culture of TM, TM cell walls and extracellular matrices showed an intense staining with antibody to FN. Indirect immunofluorescent staining of FN on frozen sections of TM showed strong positive reactions in the subendothelial region. There was no reaction in the central core of the trabecular beam. Immunoelectron microscopy revealed the reaction products to FN in the areas lining the trabecular endothelial cells.
Animals ; Cell Wall ; Endothelial Cells ; Extracellular Matrix ; Fibronectins* ; Fluorescent Antibody Technique, Indirect ; Frozen Sections ; Goats ; Humans ; Immunoglobulin G ; Mice ; Microscopy, Immunoelectron ; Rupture ; Trabecular Meshwork*

BACKGROUND: The spinal opioid is one of the excellent analgesic methods for acute postoperative pain and intractable terminal cancer pain, but some side effects limit its use. Many studies had been continued to decrease the frequency and severity of these side effects and to reinforce the analgesic potency of spinal opioid by administering of other drugs. METHODS: Ninety healthy patients who received perianal surgery were divided into 3 groups randomly and we observed VAS, sedation score, blood pressure, pulse rates and SpO2 after epidural clonidine (Group 1), fentanyl (Group 2) and combination of two drugs (Group 3) were injected. The ED50 of epidural clonidine and fentanyl were evaluated from VAS of Group 1 and 2 using the linear regression on log dose versus %MPE(Percent Maximal Possible Effect). We injected epidurally 1/4, 1/2, full dosage of ED50 to Group 3 patients and isobologram was constructed for evaluating the interaction of two drugs. RESULTS: The ED50 and 95% confidence limit of clonidine were 119 mcg, 78~161 mcg and those of fentanyl were 105 mcg, 68~204 mcg. At the ED95 level, the isobologram is nearly straight, suggesting additive interaction. At the lower level, the isobologram was bent toward the origin, a sign of synergy, the interaction below the ED80 was synergistic. CONCLUSION: At the large dose(ED95) to achieve nearly complete pain relief, epidural fentanyl and clonidine showed additive interaction and the other hand, at the smaller dose(below the ED80)which relieves most pain but not all pain, they showed synergistic interaction.
Analgesics ; Blood Pressure ; Clonidine* ; Fentanyl* ; Hand ; Heart Rate ; Humans ; Linear Models ; Pain, Postoperative

A coronary arteriovenous fistula consists of a communication between a coronary artery and a cardiac chamber, a great artery or the vena cava. It is the most common anomaly that can affect coronary perfusion. Bilateral involvement of coronary fistula, however, constitutes an uncommon subgroup of coronary arteriovenous fistulas. We report a case which shows a rare occurrence of bilateral coronary arteriovenous fistula coexistent with atrial septal defect and pulmonic stenosis.
Arteries/abnormalities ; Arteriovenous Fistula/complications* ; Case Report ; Coronary Vessel Anomalies/complications* ; Heart Septal Defects, Atrial/complications* ; Human ; Male ; Middle Age ; Pulmonary Valve Stenosis/complications* ; Veins/abnormalities