Herein is a review of eigthy six surgical cases from March to August, 1986 with recieved tetracaine hrdrochloride spinal anesthesia. In an attempt to relieve postoperative pain, 0.5 mg morphine sulfate was administrated into the lumbar Subarachnoid space. Pruritus, a side effect of intraSpinal morphine, was explored in detail. The results were as follows : 1) The incidence of Pruritus was 67.4%, 65.5% in man find 71.0% in Woman. 2) The time of onset of pruritus was between 30 and 120 minutes with an average of 79.1 minutes. 3) Pruritus primary occurred on the face(87.9%). especially on the nasal, perinasal and periocular areas. Other sites included the scalp, neck, chest, abdomen, shoulder, hip, thigh, flank, and whole body. 4) The severity of pruritus was classified as mild and moderate, but 4 cases(6.9%) were regarded as severe and were treated with naloxone. 5) The duratiun of pruritus was from 15 minutes to 19 hours with an average of 4.7 hours. 6) There was no significant difference in the prevention of pruritus between the group recieving diphenhydramine and the one which received normal saline.
Abdomen ; Anesthesia, Spinal ; Diphenhydramine ; Female ; Hip ; Humans ; Incidence ; Morphine* ; Naloxone ; Neck ; Pain, Postoperative ; Pruritus* ; Scalp ; Shoulder ; Subarachnoid Space ; Tetracaine ; Thigh ; Thorax

Cerebral autoregulation is the mainternance of a constant cerebral blood flow over a wide range of cerebral perfusion pressure. But irreversible hypoxic brain damage may occur as a consequence of such diverse conditions as lung and heart disease, shock, seizure or an episode of severe hypotension, and is potential hazard to any patient undergoing general anesthesia. The ultimate degree of neurological recovery may range from brain death and vegetative state to minor psychiatric disturbance and even normality, and is determined by the severity of the initial stress and wheather or not adequate resuscitation was commenced before irreversible brain damage. We performed an experiment to determine the protective effect of the calcium channel blocker nimodipine on the neuronal injury following cerebral ischemia in a rat model. The result were as follows: 1) Mean arterial pressure decreased more significantly in the nimodipine-treated group than the saline-treated group (p<0.01). 2) With respect to the degree of neuronal damage following cerebral ischemia, it decreased more significantly in the nimodipine-treated group than the saline-treated group (p<0.01).
Anesthesia, General ; Arterial Pressure ; Brain ; Brain Death ; Brain Ischemia* ; Calcium Channels ; Heart Diseases ; Homeostasis ; Humans ; Hypotension ; Hypoxia, Brain ; Lung ; Models, Animal ; Neurons* ; Nimodipine* ; Perfusion ; Persistent Vegetative State ; Resuscitation ; Seizures ; Shock

BACKGROUND: Obesity can be considered as hyperaccumulation of body fat. Therefore, the aim to treat obesity is to decrease body fat. Abdominal total fat calculated in computed tomography is thought to be the most accurate index measuring body fat. The body mass index (BMI) and body fat mass are the representative indices also. Leptin is a protein hormone expressed by obesity gene in adipose tissue. It inhibits food intake and increases energy consumption, thereby controls obesity. With a study of relationship between plasma leptin level and body mass index and abdominal total fat area, we tried to find the usefulness of leptin as an index of adiposity. METHODS: The adiposity level was approximated by BMI, computed tomography and bioelectical impedence. To further explore the relationship with body composition, body fat distribution was determined by computed tomograph. To quantify the relationship between serum leptin level and adiposity, correlation analyses have been conducted. RESULTS: The subjects were 32 females with a BMI of over 25 kg/m2. The mean plasma leptin level was 14.2 5.9 ug/L. We investigated the correlation of plasma leptin level with subcutaneous and visceral fat. The plasma leptin level showed a significant correlation with BMI and body fat mass, and was significantly correlated with subctaneous fat (P<0.01), but not with abdominal visceral fat. CONCLUSION: A significant correlation between plasma leptin level and body fat mass was observed. The distribution of subcutaneous fat showed differences in plasma leptin level. Therefore, the plasma leptin level may be used as an index of change of body fat mass, especially subcutaneous fat.
Adipose Tissue ; Adiposity* ; Body Composition ; Body Fat Distribution ; Body Mass Index ; Eating ; Female ; Humans ; Intra-Abdominal Fat ; Leptin* ; Obesity* ; Plasma* ; Subcutaneous Fat ; Subcutaneous Fat, Abdominal

BACKGROUND: Although rare, paralysis secondary to spinal cord ischemia after aortic aneurysm surgery is a devastating complication. Many papers have been published on this topic but without a clear consensus on the best way of minimizing the problem. Mild hypothermia and lamotrigine have been neuroprotective in several models of cerebral ischemia. In this study we compared the effects of mild hypothermia and the lamotrigine on neurologic and histopathologic outcomes, and inflammatory gene expression in transient spinal ischemia. METHODS: Rats were anesthetized with halothane, and divided into 4 groups; the Sham-operated (S) group; the Normothermic ischemic (N) group; the Hypothermic ischemic (H) group; and the Lamotrigine- treated (L) group. Spinal ischemia was produced by induced hypotension and thoracic aortic cross clamping. After spinal ischemia neurologic scores were assessed at 1, 2, 3, 24, and 48 hours after reperfusion. After 48 hours the rats were euthanized and their spinal cords were removed for histopathologic assessment. Also, spinal cords were removed at 1, 3, and 48 hours after reperfusion for the assay of TNF-alpha, IL-1 mRNA. RESULTS: The neurologic scores of the H group were significantly lower than from the N group. There was no significant difference between the L group and the N group. The histopathologic scores in the H and L groups were significantly lower than in the N group, and the histopathologic scores of the L group were higher than those of the H group. The TNF-alpha and IL-1 gene expression was increased in the N group. In the H group, the gene expression was significantly less than in the N group. The L group was not significantly different than N group in gene expression. CONCLUSIONS: The inflammatory gene expressions were increased in transient spinal ischemia. Hypothermia was neuroprotective in transient spinal ischemia. However, the lamotrigine showed only partial neuroprotective effects in transient spinal ischemia.
Animals ; Aortic Aneurysm ; Brain Ischemia ; Consensus ; Constriction ; Gene Expression* ; Halothane ; Hypotension ; Hypothermia* ; Interleukin-1 ; Ischemia* ; Neuroprotective Agents* ; Paralysis ; Rats* ; Reperfusion ; RNA, Messenger ; Spinal Cord ; Spinal Cord Ischemia ; Tumor Necrosis Factor-alpha

We evaluated therapeutic and preventive properties of dehydroepiandrosterone (DHEA), a weak androgenic steroid, against isoproterenol-induced cardiomyopathy. The cardiomyopathy was induced by daily i.p. administration of isoproterenol to rats for five days. One group of rats were given with daily s.c. for 5 days during isoproterenol and the other group with daily s.c. DHEA for total 10 days, including 5 days before and during isoproterenol. The animals were killed after each treatment, and cardiac muscle failure was evaluated using histopathologic examination and biochemical indices. DHEA was found to reduce the damaged area and inhibit the elevation in the serum levels of glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), skeletal muscle creatine kinase (CK) and heart creatine kinase (CK-MB) induced by isoproterenol. We also assayed widely used oxidative stress parameters, including thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase and glutathion peroxidase (GPx). DHEA decreased the escalated level of TBARS and enhanced the anti oxidant defense reaction with an increase in Mn-SOD and Cu/Zn-SOD. On the other hand, the treatment with DHEA did not affect catalase and GPx activity. The present study indicates that DHEA has a therapeutic and preventive effect against isoproterenol-induced cardiomyopathy and its effects may depend largely on the increase in SOD activity.
Animals ; Aspartate Aminotransferases ; Cardiomyopathies* ; Catalase ; Creatine Kinase ; Dehydroepiandrosterone* ; Hand ; Heart ; Isoproterenol ; L-Lactate Dehydrogenase ; Muscle, Skeletal ; Myocardium ; Oxidative Stress ; Peroxidase ; Rats* ; Superoxide Dismutase ; Thiobarbituric Acid Reactive Substances

BACKGROUND: LKB1(STK11) is a serine/threonine kinase that functions as a tumor growth suppressor. The functions of LKB1 in lung cancer are not completely understood. This study evaluated the relationship between LKB1 protein expression and the clinicopathological features in lung cancer tissues. METHODS: The expression of LKB1 was studied in paraffin-embedded tumor blocks, which were obtained from 77 patients who had undergone surgery at Wonkwang University Hospital. The expression of the LKB1 protein was considered positive if the staining intensity in the tumor tissue adjacent to the normal airway epithelium was >30%. RESULTS: The LKB1 expression was positive in 31 (40%) of samples. Loss of LKB1 expression was significantly associated with being male, smoking history, and squamous cell carcinoma. In the peripheral sites, the loss of LKB1 expression was strongly associated with a smoking history. A loss of LKB1 expression was more frequently associated with progression according to TNM staging, particularly more than T2, N progression. CONCLUSION: There was a significant relationship between the loss of the LKB1 protein and gender, smoking history, and histological type in primary lung cancer. Although LKB1 expression was not found to be a significant prognostic factor, further studies with a larger cohort of patient's lung cancer tissue samples will be needed to confirm this.
Carcinoma, Squamous Cell ; Cohort Studies ; Epithelium ; Humans ; Lung ; Lung Neoplasms ; Male ; Neoplasm Staging ; Phosphotransferases ; Smoke ; Smoking

BACKGROUND: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. METHODS: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. RESULTS: The mean plasma G-CSF levels were 12.2+/-0.3 pg/mL and 46.0+/-3.8 pg/mL (mean+/-SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Adrenal Glands ; Biomarkers ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Granulocyte Colony-Stimulating Factor ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Plasma ; Recurrence ; Research Personnel ; Small Cell Lung Carcinoma