BACKGROUND: It has been shown that L-type calcium channel blockers increase the muscle relaxation effects of non-depolarizing neuromuscular blocking agents whereas the potentiated neuromuscular blocking effects by L-type calcium channel blocker are resistant to reversal by neostigmine. The aims of this study were 1) to see whether the pretreatment of L-type calcium channel blocker, such as verapamil, aggravates the pipecuronium-induced muscle relaxation, 2) if so, to see whether these effects are reversed by anticholinesterase, such as neostigmine and edrophonium or potassium channel blocker, such as 4-aminopyridine. METHODS: The rat-phrenic nerve-hemidiaphragms (n=60) were prepared. Twenty microgram of pipecuronium was administered to all organ bath. All samples were divided into two groups according to the administration of 10uM of verapamil i.e. verapamil pretreated, non-pretreated group. The amounts of administered pipecuronium were gradually increased by 4ug until the force of twitch decreased to 10% of control value in both groups. Each group was subdivided into three groups according to the administration of 0.75 M of neostigmine, 12.4 uM of edrophonium or 40uM of 4-aminopyridine. RESULTS: The dose of pipecuronium required for the decrease of contractile force to 10% of control value was less in verapamil pretreated group than in non-pretreated group. And, the decrease of contractile force in both groups was more effectively reversed by 4-aminopyridine than neostigmine and edrophonium. CONCLUSIONS: Verapamil potentiates the pipecuronium-induced neuromuscular blockade and 4-aminopyridine is more effective to reverse verapamil pretreated, pipecuronium induced neuromuscular blockade.
4-Aminopyridine* ; Baths ; Calcium Channels, L-Type ; Edrophonium* ; Muscle Relaxation ; Neostigmine* ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Pipecuronium* ; Potassium Channels ; Verapamil*

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

PURPOSE: The aim of the present study was to investigate the effect of single dose imipramine on nocturnal urine output in patients with nocturnal enuresis. METHODS:A total of 6 monosymptomatic enuretic patients of more than 5 years of age were enrolled in this study. We measured nocturnal urine output, urine osrnolality, creatinine clearance, osmolal clearance, excretion rate of solutes, fractional excretion of sodium and potassium, and plasma vasopressin with and without a single oral dose of imipramine(lmg/kg of body weight) at 8 p.m. RESULTS: The administration of imipramine was followed by a significant decrease in noctumal urine output(P=0.02). Urine osmolality was not significantly increased(P>0.05), but osmolal clearance was significantly decreased during imipramine medication(P=0.03). Urinary excretion rate of sodium and potassium showed a statistically insignificant trend toward lower values during imipramine administration in nocturnal enuretics. Fractional urinary excretion of sodium and potassium was significantly decreased during imipramine medication(P<0.05). There was no significant difference in plasma vasopressin level and creatinine clearance in nocturnal enuretics after imipramine. CONCLUSION: Imipramine has a vasopressin independent antidiuretic effect in patients with nocturnal enuresis. The antidiuretic effect of imipramine can be attributed prirnarily to increased a-adrenergic stimulation in the proximal tubules with secondary increased urea and water reabsorption more distally in the nephron. (J Korean Pediatr Soc 2000;43:792 - 797)
Antidiuretic Agents ; Creatinine ; Enuresis ; Humans ; Imipramine* ; Nephrons ; Nocturnal Enuresis* ; Osmolar Concentration ; Plasma ; Potassium ; Sodium ; Urea ; Vasopressins

Using the avidin-biotin-peroxidase complex(ABC) technique, 36 skin specimens from 30 patients with primary and secondary syphilis and a gastric mucosal specimen from a patient with secondary syphilis which were confirmed by clinical history, physical examination, the VDRL, FTA-ABS, TPHA, and 19s(IgM)-FTA test, were examined. The results were compared with that of the indirect mmunoperoxidase technique which was done by authors previously with same specimens. The following results were obtained. 1. Of the 37 specimens, 35(95%) were positive in ABC technique and 33 of the 37 specirnens(89%) were positive in the indirect immunoperoxidase technique. 2. The ratio of agreement of the results between the ABC and the indirect immunoperoxidase technique was 89%. 3. Most of the treponemes were located in the upper dermis, epidermis, and blood vessel walls in the arder named, and rarely in the lower dermis of the syphilitic skin lesions. There was no remarkable difference in histologic distribution of treponemes between the clinical stages and types of syphilitic skin lesions. :From the results, the ABC technique is considered to be an excellent method for detecting the treponemes in the suspected syphilitic lesions.
Avidin* ; Biotin* ; Blood Vessels ; Dermis ; Epidermis ; Humans ; Immunoenzyme Techniques ; Peroxidase* ; Physical Examination ; Skin ; Syphilis ; Treponema pallidum* ; Treponema*

Using the indirect immunoperoxidase and FTA ABS complement techniques, 36 skin specimen: from 30 patients with primary and secondary syphilis and a gastric mucosal specimen from a patient with secondary syphilis which were confirmed by elinical history, physical examination, VDRL, FTA ABS, TPHA, and 19s(IgM)-FTA test, were examined. The follwing results were obtained. l. Of the 37 specimens, 33(89%) were positive in the indirect immunoperoxidase techique and 26 of the 37 specimens(70g) were positive in the FTA ABS complement technique. Of the 17 specimens, 12(71%) were positive in the darkfield examination. 2. The ratio of agreement of the results between the indirect immunoperoxidase and FTA ABS complement techniques was 81%, The ratio of agreement of the results between the indirect immunoperoxidase technique and darkfield examination was 82%. 3. Most, of the treponemes were located in the upper dermis, epidermis, and blood vessel walls in the order named, and rarely in the lower dermis of the syphilitic skin lesion. There was no remarkable difference in histologic clistribution of treponemes between the clinical stages and types of syphilitic skin lesions. From the results, the indirect immunoperoxidase technique is considered a superior method than the FTA ABS complement technique and darkfield examination for detecting the treponemes in the suspected syphilitic lesions.
Blood Vessels ; Complement System Proteins* ; Dermis ; Epidermis ; Humans ; Immunoenzyme Techniques* ; Physical Examination ; Skin ; Syphilis ; Treponema pallidum* ; Treponema*

No abstract available.
Humans ; Token Economy*

The exact etiology and pathogenesis of myopia are not known yet, although various studies of the development of myopia in experimental animals have been made. Authors attemtped whether rabbits developed axial myopia by fusing their lids at birth in one eye, or not. The monocular vision was deprived by suture of upper and lower lids in 12 rabbits which were 5 day-old. The other eye was unsutured as the control. Ten months later, we assessed refractive error, corneal curvature, axial length, and intraocular pressure and enucleation was done. We observed the histologic change of sclera with light microscope. The eyes with lid suture were more myopic(-3.35 +/- 0.99D) than the controlled eyes(-0.21 +/- 0.46D) (p<0.01). The corneal curvature and intraocular pressure were not significantly different between two groups. The axial lengths of the sutured eves were increased(21.27 +/- 1.70mm) in comparison with those of the controlled(17.39 +/- 1.83mm)(p<0.01). We conclude the difference in axial length was caused by the elongation of the posterior segment of eyeball. since lens thickness, depth of anterior chamber, and corneal curvature were identical in both groups. These were correlated with histologic change that showed thinner posterior parts of sclera of the sutured eyes than those of the controlled eyes. The results of this study demonstrate that monocular lid fusion in rabbits produced an expenmental axial myopia.
Animals ; Anterior Chamber ; Eyelids* ; Intraocular Pressure ; Myopia* ; Parturition ; Rabbits* ; Refractive Errors ; Sclera ; Sutures* ; Vision, Monocular

A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient’s vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

No abstract available.
Cholesterol* ; Granuloma*

Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin