No abstract available.

Leader peptidase is a novel serine protease in Escherichia coli, which catalyzes the cleavage of amino-terminal signal sequences from exported proteins. It is an integral membrane protein containing two transmembrane segments with its carboxy-terminal catalytic domain residing in the periplasmic space. Recently, the x-ray crystal structure of signal peptidase-inhibitor complex showed that Asp 280, a highly conserved consensus sequence of E. coli leader peptidase is the closest charged residue in the vicinity of two catalytic dyad, Ser 90 and Lys 145, and it is likely held in place by a salt bridge to Arg 282. Possible roles of Asp 280 and Arg 282 in the structure-catalytic function relationship were investigated by the site-directed mutagenesis of Asp 280 substituted with alanine, glutamic acid, glycine, or asparagine and of Arg 282 with methionine. All of mutants purified with nickel affinity chromatography were inactive using in vitro assay. It is surprising to find complete lose of activity by an extension of one carbon units in the mutant where Asp 280 is substituted with glutamic acid. These results suggest that Asp 280 and Arg 282 are in a sequence which constitutes catalytic crevice of leader peptidase and are essential for maintaining the conformation of catalytic pocket.
Aspartic Acid/chemistry* ; Bacterial Outer Membrane Proteins/metabolism ; Blotting, Western ; Escherichia coli/enzymology* ; Escherichia coli/chemistry ; Micrococcal Nuclease/metabolism ; Mutagenesis, Site-Directed ; Oligonucleotides ; Protein Precursors/metabolism ; Serine Endopeptidases/metabolism* ; Serine Endopeptidases/genetics ; Serine Endopeptidases/chemistry* ; Structure-Activity Relationship

No abstract available.
Chlamydia* ; Humans ; Infant* ; Pneumonia*

No abstract available.
Bacteria* ; Tetracycline*

No abstract available.
Bacteria* ; Tetracycline*

Tetralogy of Fallot constitutes the highest proportion of cyanotic congenital heart disease and has four basic abnormal anatomical pictures including ventricular septal defect, pulmonary stenosis, aortic overriding and right ventricular hypertrophy. The work of Edward, et al(1965), Guntheroth, et al(1965) and Lev and Eckner(1964) has shown that the anatomical picture in a combination of just first two morphological characteristics, the aortic overriding and right ventricular hypertrophy being a consequence of the ventricular septal defect and pulmonary stenosis. Basic signs involve two categories, one is change of shunt rate depending on pulmonary stenosis, ventricular septal defect and systemic vascular resistance, and the other is physiological response to the chronically lowered PaO2. Thus the pathophysiological status presents to us more problems than other congenital heart disease in the care of patients during operation and anesthesia. Therefore, the anesthesiologist must understand the basic pathophysiology, various findings of examination, symptoms and signs, the problems during anesthesia and postoperative care. The purpose of this study was to evaluate the anesthetic management in total corrective surgery of tetralogy of Fallo which was performed at Severance Hospital. Out of consecutive 160 cases of tetralogy of Fallot in our past ten years experiences from 1971 to 1980, we selected the clinical results on anesthetic care of 12 cases which received total corrective surgery under hypothermia and extracorporeal circulation. The results were as follows: 1) Out of 121 cases, 82 cases were male(67.8%) and female was 39 cases(32.2%). The group aging from 6 to 10 year old was the highest proportion (44.6%) and the next proportion was the group aging from 11 to 15(22.3%). 2) Out of 121 cases, 91 cases were cyanotic(75.2%). On the diagnostic distribution, tetralogy of Fallot without any other anomaly was the most common(66.9%). 3) As for premedicants, secobarbital was the highest proportion(28.1%). For anesthetic maintenance, methoxyflurane with nitrous oxide was the most common(43.8%). 4) During cardio-pulmonary bypass, high flow perfusion was commonly used and the highest mean arterial pressure was 89.09+/-1.21 mmHg and the lowest mean arterial pressure was 36.33+/-1.21mmHg. 5) The major complications after operation and anesthesia were dysrhythmia(13.1%), pleural effusion(10.3%), main wound infection(10.3%), hemorrhage(8.3%), acute renal failure(8.3%), heart failure(6.9%), low output syndrome(4.1%) and cerebral infarction due to air emboliam(2.7%). 6) Out of 121 cases were expired and hospital mortality was 23.1%. The causes of death were heart failure(50%), acute renal failure(14.3%) and cerebral infarction(14.3%). in conclusion, anesthetic care for total corrective surgery of teralogy of Fallot should be based upon the understanding of the pathophysiology of disorder itself.
Female ; Humans ; Mortality

At present, spinal anesthesia is often recommanded for a safe operation and the management of pain. However the complications from the spinal anesthesia, such as hypotension, dyspnes, nauses and vomiting, pulmonary embolism, headache, auditory and visual disturbances, lumbago, urinary difficulty and neurologic sequelae have often reported from time to time. Thus an attempt to study the complications of spinal anesthesia, particularly the differences of complications between needle sizes(22 gauge and 25 gauge), has been done by our department. The following results were observed: 1) The most common sequelae of spinal anesthesia was hypotension(35.6%) and in order frequency, urinay difficulty(23.3%), headache(16.7%), lumbago(15.3%), nauses of and vomiting(12.8%), dyspnes(8.9%), auditory and visual disturbances(0.83%) and minor neurologic sequelse(0.56%). 2) The incidence of headache and lumbago was more frequent in the 22G, group, but there were no statistically significant differences(p>0.05). 3) The incidence of headache was higher in the females than the males and there were statistically significant differences(p<0.01). 4) The incidence of lumbago was higher in the fourth decade (21.7%), and females showed a higher incidence than in males and there were statistically significant differences(p<0.05). 5) The incidence of lumbago and headache and the degree of headache was without correlation to the number of punctures in both groups(22G group and 26G group). 6) The time to postoperative urination had no correlation to the level of anesthesia.
Anesthesia ; Anesthesia, Spinal* ; Female ; Headache ; Humans ; Hypotension ; Incidence ; Low Back Pain ; Male ; Needles ; Pulmonary Embolism ; Punctures ; Urination ; Vomiting

Postoperative muscle pain is well known to occur in man following intravenous administration of succinylcholine. The mechanism of muscle pain is yet unknown. A number of methods for preventing muscle pains or decreasing their severity have been suggested, including nondepolarizing relaxants prior to succinylcholine (Churchill-Davidson, 1954: Cullen, 1971: Wig and Bali, 1979) or lidocaine(Usubiaga et al., 1967: Haldia et al., 1973: Fry, 1975), use of vitamin C (Gupte & Savant, 1971), procaine chloride(Morris & Dunn, 1957), thiopental sodium (Craign, 1964) or diazepam (Verma et al., 1978) and the use of a "self-taming" method of succinylcholine by prior injection of a small dose(Baraka, 1977). To investigate methods of preventing muscle pains or decreasing their severity after intravenous injection of succinylcholine, we studied four groups, a control group and three experimental groups (a lidocaine group, a d- Tubocurarine group and a succinylcholine self-taming group). The following results were obtained: 1) In the lidocaine group, the incidence of muscle pain was lower than in the control group, but there was no significant difference between the two groups. However the incidence of muscle pain in the d-Tubocurarine group or the succinylcholine self-taming group were lower than in the control group and there were statistically significant differences(p<0.0005). 2) In most of the patients of each group, the degree of postoperative muscle pain was mild and a difference of degree of muscle pain was not found in each group (p>0.05).3) The muscle pain usually appeared in the first day after operation and disappeared usually within three days. 4) The degree of muscle fasciculation showed a significant decrease with lidocaine, d-Tubocurarine or the succinylcholine self-taming group over the control group(p<0.0005), but there was no significant relationship between the degree of muscle fasciculation and the incidence of postoperative muscle pain(p>0.05). 5) The degree of muscle relaxation during intubation in the d-Tubocurarine group was less complete than in the other 3 groups and it was statistically significant(Zi>1.96). It is suggested from the above results that d-Tubocurarine(0.05~0.06mg/kg) prior to succinylcholine or the method of self-taming of succinylcholine(prior use of succinylcholine 0.15mg/kg) can be used as methods to prevent muscle pain after intravenous administration of succinylcholine, but lidocaine(2mg/kg) prior to succinylcholine is not effective in preventing muscle pain following succinylcholine administration.
Administration, Intravenous ; Ascorbic Acid ; Diazepam ; Fasciculation ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Lidocaine ; Methods ; Muscle Relaxation ; Myalgia* ; Procaine ; Succinylcholine ; Thiopental ; Tubocurarine

No abstract available.

No abstract available.
Infant, Newborn ; Jaundice, Neonatal* ; Radionuclide Imaging* ; Technetium Tc 99m Disofenin*