BACKGROUND: The 5-hydroxytryptamine type 3 (5-HT3) receptor is a member of the Cys-loop superfamily of ligand-gated ion channels (LGICs) and modulated by pharmacologic relevant concentrations of volatile anesthetics or n-alcohols like most receptors of LGICs. The goal of this study was to reveal whether the site-directed single mutations of E-106, F-107 and R-222 in 5-HT3 receptor may affect the anesthetic modulation of halothane known as positive modulator. METHODS: The wild-type and mutant receptors, E106D, F107Y, R222F, R222V, were expressed in Xenopus Laevis oocytes and receptor function was assessed using two electrode voltage clamp techniques. RESULTS: E106D, F107Y, R222F, R222V mutant 5-HT3A receptors were functionally expressed. F107Y mutant 5-HT3A receptors displayed decreased sensitivity to 5-HT compared to the wild type 5-HT3A receptor (P < 0.05). Halothane showed positive modulation in both wild and F107Y mutant 5-HT3A receptors but F107Y mutant 5-HT3 receptor showed greater enhancing modulation comparing to wild-type receptor. Meanwhile, R222F and R222V mutant 5-HT3 receptor lost positive modulation with 1 and 2 MAC of halothane. Most interestingly, positive modulation by halothane was converted into negative modulation in E106D mutant 5-HT3A receptor. CONCLUSIONS: The present study implicate the amino acid residues known for agonist binding and linking agonist binding to channel gating might also have important role for anesthetic modulation in 5-HT3A receptor.
Anesthetics ; Electrodes ; Electrophysiology ; Halothane ; Ligand-Gated Ion Channels ; Oocytes ; Patch-Clamp Techniques ; Receptors, Serotonin, 5-HT3 ; Serotonin ; Xenopus laevis

Low energy intakes, poor nutritional quality, and low food diversity are among the factors affecting the nutritional status of elderly in Korea. Therefore, a nutrition counseling and education program was conducted to promote dietary change and to improve nutritional status of elderly. The 7 step program consisted of a individual nutrition counseling and weekly or biweekly group nutrition education programs. Pre- and post-test measurings of dietary behaviors, attitudes, nutrition knowledge, and 24-hour dietary recall data were collected. Positive changes in the attitude related to diet were noted, whereas nutritional knowledge scores were not improved. Significant increases were noted in the frequency of vegetable consumption in female and diversity of food consumption in male. The densities of vitamin C(male & female), B1, B2, and niacin, calculated using the INQ(Index of Nutritional Quality), were significantly improved by nutrition counseling and education programs. These results suggest the appropriateness of nutrition intervention programs for the improvement of elderly nutrition.
Aged* ; Community Health Centers* ; Counseling* ; Diet ; Education* ; Female ; Humans ; Korea ; Male ; Niacin ; Nutritional Status ; Nutritive Value ; Vegetables ; Vitamins

The elderly are the most rapidly growing segment of the population in Korea and the largest consumers of expensive medical care. It is reasonable to believe that improving the nutritional status would be beneficial to reducing morbidity and to improving the quality of their lives. This study was conducted to assess the health status and the Nutritional Risk Index of the elderly, and to provide the basic data for the Elderly Nutrition Improvement Program at the Public Health Center. One hundred and forty seven(76 males. 71 females) aged 60 years and over living in Suwon, were assessed with anthropometric measurements, body fat analysis, blood pressure measurements, and a set of about health and other related variables. Over half of them had less than a junior middle school education and were considered low income. The percentage of overweight and obese subjects was 33% by the BMI(Body Mass Index), and the prevalence of hypertension was 28%(males) and 31%(females). They had a lot of self-recognized health problems, the male elderly complained about more than the female elderly. In the case of psychological health status, however, the female elderly showed a higher proportions of depression than the male elderly(p<0.05). In social health status, the elderly had good relationships with friends and collegues, whereas they had poor relationships with their families. They had many nutritional risk factors, and smoking was the most prevalent risk factor for the male elderly and anemia was for the female elderly. The results of this study suggest that Elderly Nutrition Improvement Programs should be planned that can be easily followed. It would be helpful to design a program focusing on individual phychological and social health status, this would increase the efficiency of the program.
Adipose Tissue ; Aged* ; Anemia ; Blood Pressure ; Depression ; Education ; Female ; Friends ; Gyeonggi-do ; Humans ; Hypertension ; Korea ; Male ; Nutritional Status ; Overweight ; Prevalence ; Public Health ; Risk Factors ; Smoke ; Smoking ; Surveys and Questionnaires

No abstract available.
Brain Injuries*

BACKGROUND: Postoperative nausea and vomiting (PONV) is the most frequent and discomforting side effect following general anesthesia. Most volatile anesthetics have a potent effect on serotonin (5-hydroxydtryptamine, 5-HT) type 3 receptor mediating PONV, and their antagonists have been currently used effectively to prevent and/or reduce the incidence and severity of PONV. The authors reported previously that ginsenosides have inhibitory effect on 5-HT3A receptor. In this study we intended to elucidate the inhibitory effect of ginsenosides on the potentiated 5-HT3A receptor by desflurane. METHODS: After in vitro transcription of the recombinant mouse 5-HT3A receptor in the Xenopus laevis oocyte, we examined the effects of ginsenosides (g-Rb1, g-Rg1, g-Rd, g-Rg2) as well as ginsenoside metabolite, compound K on the modulation of desflurane by measuring currents flowing through 5-HT3A receptor using two-electrode voltage clamp technique. RESULTS: Although normalized inhibitory responses of ginsenosides were same regardless of desflurane, some ginsenosides such as g-Rd, g-Rg2, and g-Rg1 showed potential inhibition to the enhanced 5-HT induced current of 5-HT3A receptor by desflurane. CONCLUSIONS: Although ginsenosides have substantial inhibitory effect on 5-HT3A receptor, the effects of ginsenoside on potentiation by desflurane of 5-HT induced current via recombinant 5HT3A receptor may depend on the types of ginsenoside, which suggesting that ginsenoside might have an antagonistic action to nausea and vomiting associated with volatile anesthetics.
Anesthesia, General ; Anesthetics ; Animals ; Ginsenosides ; Incidence ; Isoflurane ; Mice ; Nausea ; Negotiating ; Oocytes ; Postoperative Nausea and Vomiting ; Serotonin ; Vomiting ; Xenopus ; Xenopus laevis

Continuous assessment of arterial oxygenation is important in the clinical management of critically ill patients. Analysis of arterial blood gas is reliable but is invasive and only provides intermittent informations. In order to determine the accuracy of pulse oximeters in ICU patients, arterial oxygen saturation was measured in 58 patients in ICU using two kinds of pulse oximeters (Ohmeda, CSI), while simutaneously analyzing arterial blood gases. The relationship between the pulse oximeters saturation (SpO2) and arterial oxygen saturation (SaO2) was evaluated, Group l consisted of 102 samples of SpO2 using an Ohmeda pulse oximter in 45 of 72 patients. Group ll included 102 samples of SpO2 using a CSl pulse oximeter in 45 of 72 patients. Both Ohmeda and CSI pulse oximeters were applied to 32 patients. Group lll had 204 samples, thE Sum of Groups l and ll. The results were as follow ; 1) The correlation coefficients of SpO2 to SaO2 in Groups l, ll and lll were 0.97, 0.90 and 0.96 (p < 0.775). 2) Mean difference between SaO2 and SpO2 in Groups l, ll and lll were almost within the limit of 1%. 3) The correlation coefficient of SpO2 between Ohmeda andcsr pulse oximeter was 0.79, and there was no mean difference between them in the 32 patients who were tested with both the Ohmeda and the CSI pulse oximeters. In conclusion, a pulse oximter is an accurate noninvasive device which assesses arterial oxygenation and provides information continuously. Wider clinical indication will follow.
Critical Illness ; Gases ; Humans ; Oximetry* ; Oxygen

Inhalation induction of anesthesia is seldom used in a routine adult practice because of the long induction time and the prolonged excitement phase with the risk of laryngospasm and vomiting. So in modern practice, anesthesia is usually administered intravenously and produces unconsclousness pleasantly. However there are situaions where intravenous induction may not be ideal, and where rapid induction is still desired. The author wanted to evaluate the clinical application of inhalation induction of halothane using a vital capacity breath as a substitute for intravenous induction of anesthesia. The patients in this study had an ASA physical status of l or ll and presented no cardiopulmonary disease or abnormal laboratory data. The patients were divided into two group: a control group(n=30) and an experimental group(n=30). Control group: Intravenous induction with thiopental sodium. Experimental group: Inhalation induction with halothane using a vital capacity breath. The results are as follows: 1) The control group consisted of 14 males and 16 females. The mean age was 37.8+/-11.5years, and the ages ranged from 16 to 65 years. The mean body weight was 59.8+/-8.0kg, and body weights ranged from 44 to 75kg. in the experimental group, there were 17 males and 13 females. The mean age was 28.9+/-13.7 years, and the ages ranged from 18 to 65 years. The mean body weight was 57.4+/-8.1 kg, and body weight ranged from 43+/-75kg. 2) In the experimental group, the apnea time ranged from 20 to 105 sec, with a mean of 44.5+/-20.4 sec. The mean induction time was 76.7+/-32.1sec. and induction time ranged from 20 to 150 sec. There was no relationship between apnea time and induction time. 3) The hemodynamic changes were as follows: a. There were significantly greater changes in blood pressure and pulse rate during intubation and postintubation in the control group than in the experimental group(p<0.05). b. There were significant changes in blood pressure and pulse rate in the control group(p<0.05), but seemed not to be hazardous clinically. 4) Induction was impossible in two patients in the experimental group due to profuse secretion or excitement. 5) The side effects in the experimental group included coughs(5 cases), arrythmias(4), excitements(4) and secretion(1), respectively. 6) Postanesthetic comments in the experimental group:27 of the 28 patients remembered the anesthetic smells: 3 pleasantly, 20 moderately and 4 unpleasantly. In conclusion, inhalation induction of halothane using a vital capacity breath is a safe, acceptable and practical alternative to intravenous induction in cooperative adult patients.
Adult ; Anesthesia ; Apnea ; Blood Pressure ; Body Weight ; Female ; Halothane* ; Heart Rate ; Hemodynamics ; Humans ; Inhalation* ; Intubation ; Laryngismus ; Male ; Smell ; Thiopental ; Vital Capacity* ; Vomiting

The retrograde microorganismal colonization in the pharynx from stomach may cause the nosocomial pneumonia and that may be more likely when the gastric pH is relatively high. We tried to find out the relationships between the gastric pH and the incidence of nosocomial pneumonia with twenty patients intubated for longer than 48 hours at ICU. We achieved following results: 1) The incidence of the nosocomial pneumonia was twenty percent. 2) All the patients developed nosocomial pneumonia showed the gastric pH above 4.0. 3) In the patients intubated for longer than 5 days, the incidence of nosocomial pneumonia was 33.3% in contrast to 9.0% for less than 5 days. 4) With the sputum culture, the incidence of colonization was higher in the patients with gastric pH above 4.0 than that in the patients with gastric pH below 4.0(84.6% vs 58.1%). 5) With regard to the duration of intubation, the incidence of colonization was higher in the patients intubated for longer than 4 days than that in the patients intubated for less than 4 days(90% vs 50%). 6) The most common pathognomic organisms were astreptoccus and Pseudomonas aeroginosa. It is conculded that the nosocmial pneumonia might develop more frequently in the patients with gastric pH above 4.0 than in the patients with gastric pH below establishment of the relationship between the treatment of the stress ulcer and the nosocomial pneumonia.
Colon ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Intubation ; Pharynx ; Pneumonia* ; Pseudomonas ; Sputum ; Stomach ; Ulcer

This study investigated the method to adjust acquisition time(a) and injection dose(i) to make the best basal and subtraction images in consecutive SPECT. Image quality was assumed to be mainly affected by signal to noise ratio(S/N). Basal image was subtracted from the second image consecutively acquired at the same position. We calculated S/N ratio in basal SPECT images(S1/N1) and subtraction SPECT images(Ss/Ns) to find a(time) and i(dose) to maximize S/N of both images at the same time. From phantom images, we drew the relation of image counts and a(time) and i(dose) in our system using fanbeam-high-resolution collimated triple head SPECT. Noise by imaging process depended on Poisson distribution. We took maximum tolerable duration of consecutive acquisition as 30 minutes and maximum injectible dose as 1,850MBq(50 mCi)(sum of two injections) per study. Counts of second-acquired image(S2), counts(Ss) and noise(Ns) of subtraction SPECT were as follows. C1 was the coefficient of measurement with our system.
Acetazolamide* ; Brain* ; Head ; Noise ; Perfusion* ; Signal-To-Noise Ratio ; Tomography, Emission-Computed, Single-Photon*

Subarachnoid hemorrhage from a ruptured intracranial aneurysm during pregnancy is rare but results in significant maternal and fetal mortality. The authors report 5 cases of anesthetic experience with pregnant patients undergoing a surgical aneurysmal clipping out of 2,100 patients with subarachnoid hemorrhages due to a ruptured cerebral aneurysm from 1972 until May 2001. All of the patients were diagnosed with a subarachnoid hemorrhage by a brain CT and cerebral angiography. Anesthetic modality and surgical timing should be adjusted by gestational age and the physiologic changes which accompany the pregnancy and the potential risks to the fetus from investigating and treating the mother. Anesthetic goals for this patient include maintenance of uteroplacental perfusion, and fetal as well as maternal well-being. We gave a general anesthesia with isoflurane-nitrous oxide and fentanyl. The patients were monitored with standard monitorings for surgical repair of a cerebral aneurysm and perioperative fetal heart monitoring. All of the five patients recovered well from the surgical aneurysmal repair. After surgical aneurysmal repair, 4 patients maintained their pregnancies and had their babies delivered at term through a cesarean section in 3 patients and transvagina in 1 patient. However, 1 patient who presented persisting hypertension experienced an intrauterine fetal death at 25 weeks of gestational age.
Anesthesia, General ; Aneurysm ; Brain ; Cerebral Angiography ; Cesarean Section ; Female ; Fentanyl ; Fetal Death ; Fetal Heart ; Fetal Mortality ; Fetus ; Gestational Age ; Humans ; Hypertension ; Intracranial Aneurysm* ; Mothers ; Perfusion ; Pregnancy* ; Rupture* ; Subarachnoid Hemorrhage