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

PURPOSE: To report a case of eccrine spiradenoma that presented as an eyelid nodule. CASE SUMMARY: A 61-year-old female presented with a mass in the right upper lid margin; the onset time was unknown. An ophthalmic examination revealed no abnormalities except the eyelid nodule. The nodule was 3 mm in size with a firm, smooth surface and light pinkish color, and was located near the lid margin. Excision and biopsy of the nodule was performed. The pathological findings of the specimen obtained showed islands of 2 types of lobular cells. Larger, paler cells were grouped around the central area, darker and smaller cells on the periphery. These findings were compatible with eccrine spiradenoma. CONCLUSIONS: Eccrine spiradenoma should be considered a differential diagnosis of a solitary eyelid tumor.
Biopsy ; Diagnosis, Differential ; Eyelids* ; Female ; Humans ; Islands ; Middle Aged

The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enchance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk+education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk+education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk+education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk+education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk+education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk+education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model R2=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk+education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducting drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.
Aged* ; Ascorbic Acid ; Calcium ; Candy ; Counseling ; Diet ; Eating ; Education* ; Female ; Food Habits ; Gyeonggi-do ; Humans ; Korea ; Male ; Meals ; Milk ; Motivation ; NAD ; Niacin ; Potassium ; Riboflavin ; Vegetables ; Vitamin A ; Yogurt

A 25 years old woman was adrnitted to the department of neurosurgery for a right hemifacial spasm. She was undertaken microvascular decompression in the Fukushima lateral position. Following completion of operation, she began to complain of dyspnea, but the phonation was not changed. Mild weakness and paresthesia on left upper extremity was complained, too. Severe swelling on the left side of face and neck expending to left shoulder was noted simultaneously. Immediate computerized tomography was taken to reveal the cause of respiratory distress, which suggested that venous and/or lymphatic congestion on the left side of neck. As respiratory distress was getting more severe, emergent tracheostomy was taken. The cause of above symptoms was suspected to an extreme rotation and flexion of the head resulting in direct contact of mandibular body to clavicle. A month after operation, there was still remained mild paresthesia on left thumb and index finger.
Adult ; Airway Obstruction* ; Brachial Plexus* ; Clavicle ; Dyspnea ; Estrogens, Conjugated (USP) ; Female ; Fingers ; Head ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery* ; Neck ; Neurosurgery ; Paresthesia ; Phonation ; Shoulder ; Thumb ; Tracheostomy ; Upper Extremity

Motor evoked potentials(MEP) have been recently introduced as intraoperative monitoring of descending motor pathways. Transcranial electrical or magnetic MEP have been using clinically, but there are still some limitations of using in operating room. Furthermore, according to anesthetic regimens, MEP responses vary significantly. The authors observed the effects of the various anesthetics (thiopental, fentanyl, ketamine, nitrous oxide and isoflurane) on electocortical MEP in a patient who had been previously undertaken electrocortico-graphic grid insertion operation for seizure monitoring. Electromyographic responses were recorded from contralateral arm flexor and extensor using needle type electrode. Most anesthetics except ketamine decreased the amplitude of MEPs reversibly and there were differences in electromyographic responses according to measuring compound muscles.
Anesthetics* ; Arm ; Efferent Pathways ; Electrodes ; Evoked Potentials, Motor ; Fentanyl ; Humans ; Isoflurane ; Ketamine ; Monitoring, Intraoperative ; Muscles ; Needles ; Nitrous Oxide ; Operating Rooms ; Seizures ; Thiopental

BACKGROUND: Studies in animals suggest that pipecuronium dose not induce hemodynamic chan-ges related to histamine release or to an effect on the autonomic nervous system. Therefore the effects of bolus administration of large doses of pipecuronium, up to 0.20 mg/kg, on the intubation condition, onset and duration of neuromuscular blockade, heart rate and blood pressure were studied during fentanyl- nitrous oxide anesthesia. METHOD: Forty adults were randomly assigned to receive a bolus injection of either 0.05, 0.10, 0.15, 0.20 mg/kg of pipecuronium. Neuromuscular blockade was measured using mechanomyographic activity of the adductor pollicis muscle after supramaximal stimulation of the ulnar nerve. Four subgroups of 10 patients received pipecuronium doses of 0.05, 0.10, 0.15 and 0.20 mg/kg, respectively, as an intubating dose. RESULTS: The times of onset and clinical duration (mean sem) after each dose were as follows: 0.05 mg/kg, 2.98 0.42 and 41.5 2.42 min; 0.10 mg/kg, 1.54 0.06 and 82.9 7.48 min; 0.15 mg/kg, 1.41 0.14 and 124.8 13.1 min; 0.20 mg/kg, 1.12 0.05 and 187.1 12.8 min. The intubation condition, time of onset and duration after doses of 0.05 mg/kg were significantly different from values after the higer doses. The duration was increased with dose-increments. No dose-related changes in heart rate or blood pressure were observed. CONCLUSION: The authors conclude that dose of 0.10 mg/kg and over has good intubation condition clinically and large bolus dose of pipecuronium can be safely used with a significantly prolonged duration of action without hemodynamic change.
Adult* ; Anesthesia ; Animals ; Autonomic Nervous System ; Blood Pressure ; Heart Rate ; Hemodynamics ; Histamine Release ; Humans ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Nitrous Oxide ; Pipecuronium* ; Ulnar Nerve