BACKGROUND: The present study was aimed (1) to assess the effects of nitric oxide (NO) synthesis inhibitor on regional myocardial function and systemic and pulmonary hemodynamics; (2) to determine whether the blockade of the cyclo-oxygenase (COX) pathway modifies these effects on the variables, and (3) to investigate the mechanism of cardiac depression following NO synthesis inhibition in an open-chest canine model. METHODS: Twenty-five dogs of either sex were acutely instrumented under 1.6% ethrane anesthesia to measure aortic, pulmonary arterial and left ventricular pressure, pulmonary (cardiac output) and left circumflex coronary flow, and subendocardial segment length. NG-nitro-L-arginine methyl ester (L- NAME) at doses of 0.3, 1.0, 3.0, or 10.0 mg/kg i.v. was administered alone (control dogs, n = 10) or in the presence of COX inhibitor, indomethacin (10 mg/kg i.v., n = 10). Seven dogs (n = 7) received phenylephrine at doses of 0.1, 0.3, 1.0, or 3.0 microgram/kg/min i.v. to compare its hemodynamic effects with those of L-NAME. The preload recruitable stroke work slope (Mw) and percent systolic shortening (%SS) as an index of regional myocardial contractility, and the maximum segment lengthening rate (dL/dt max) and percent post-systolic shortening (%PSS) as an index of regional diastolic function, were evaluated. RESULTS: L-NAME dose-dependantly attenuated both regional systolic (Mw and %SS) and diastolic functions (dL/dt max and %PSS), whereas it caused an increase of coronary flow. L-NAME dose- dependently increased systemic blood pressure and vascular resistance as well as pulmonary arterial pressure and vascular resistance. L-NAME also reduced cardiac and stroke volume indices. Pretreatment with indomethacin did not affect the regional myocardial and systemic hemodynamic responses to L-NAME, but did blunt the coronary flow and pulmonary pressure responses. The magnitude of decreases in cardiac and stroke volume indices and Mw was greater with L-NAME than with phenylephrine (P <0.05), despite the comparable blood pressure increases. CONCLUSIONS:These results suggest (1) that NO plays a significant role in cardiac function as well as in systemic and pulmonary but not coronary, vasomotor activities, and (2) that COX products are involved in pulmonary hemodynamic responses to NO synthesis inhibition. It is also suggested that the decline in cardiac output following the NO synthesis inhibition results from a direct myocardial depressant effect of the drug.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Depression ; Dogs* ; Enflurane ; Hemodynamics* ; Indomethacin ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Stroke ; Stroke Volume ; Vascular Resistance ; Ventricular Pressure

The retraction of anterior teeth could be performed more easier by inducing of skeletal anchorage system rather than by conventional method on orthodontic treatment. But, we wonder how effective the system draws well without anchorage loss and draws anterior teeth aside posteriorly, and if the system can reduce the time, in comparison with the anchorage of posterior teeth. For that reason we have studied on the subject of patients, who were required the maximum anchorage on orthodontic treatment and the cases without crowding. The subjects of the experimental group are 35 areas of 20 people who were inserted miniscrews after Mx or Mn 1st premolar extracted. Also, the subjects of the control group are 81 areas of 45 people who were not inserted miniscrews. Compared the anchorage loss of experimental group with control one, we could get the result that the anchorage loss of experimental group is 1.034+/-0.891mm and control group is 2.790+/-1.882mm(P<0.01). Compared the space closing time of experimental group with control one, we could get the result that the space closing time of experimental group is 369.40+/-110.81days and control group is 406.56+/-231.63days. But the result of comparing space closing time has no significance in statistics. We recognized that the experimental group is more faster than the control group in the canine retraction velocity from the result ; the speed of a experimental group has as much as 0.60+/-0.23mm/30days while the speed of a control group has 0.44+/-0.35mm/30days(P<0.05). So, we could convince that orthodontic miniscrew is used effectively in the cases required the maximum anchorage.
Bicuspid ; Crowding ; Humans ; Tooth*

BACKGROUND: Cytosolic Ca2+ overload and oxygen derived free radicals may contribute to stunned myocardium. The pnt study was aimed to investigate the effects of nicardipine and sodium nitroprusside (SNP) on the functional recovery of postischemic reperfused myocardium. METHODS: Fifty-seven halothane-anesthetized dogs were subjected to 15 minutes of 1eft anterior descending coronary artery (LAD) occlusion and 3 hours of reperfusion. They were randomly assigned to receive either intracoronary nicardipine (n=11) or SNP (n=10) alone or both (nicardipine plus SNP, n=10). Eleven dogs that received saline i.c. served as the controL Regional myocardial contractility was evaluated by systolic shortening (%SS), the preload recruitable stroke work slope (Mw), and intramyocardial pressure (IMPs). Diastolic function was assessed by time constant of myocardial relaxation (IMP-tau) and postsystolic shortening (%PSS), LAD blood flow was measured by a Doppler flowmeter as well. RESULTS: LAD occlusion produced a significant reduction in systolic as well as diasto1ic functions to similar degrees in all groups. However, %SS was significantly higher in the nicardipine, SNP and nicardipine-SNP groups (67%, 56%, and 68% of baseline values, respectively) than in the controls (20%) at 3 hours of reperfusion. Furthermore, Mw recovered to the baseline with the onset of reperfusian in the three experimental groups. IMP-tau was restored to the baseline during early nperfusion in the SNP-treated groups but was significantly prolonged in the control and nicardipine poups throughout the seperfusion. LAD blood flow during reperfusion was higher in the SNP-treated groups in comparison to the control group. CONCLUSIONS: Treatment with either nicardipine or SNP enhances the recovery of mgional contractile function in the canine model of myocardial stunning. SNP not nicardipine is also beneficial in attenuation of early diastolic dysfunction. Nicardipine combined with SNP improved systolic as well as early diastolic functions more significantly when compared to either nicardipine or SNP alane.
Animals ; Coronary Vessels ; Cytosol ; Dogs* ; Flowmeters ; Free Radicals ; Heart ; Myocardial Stunning* ; Myocardium ; Nicardipine* ; Nitroprusside* ; Oxygen ; Pharmacology ; Relaxation ; Reperfusion ; Sodium* ; Stroke

Heterotopic ossification in abdominal incision is a rare post-surgical sequala and a subtype of myositis ossificans traumatica. Recognition of this rare condition is important because it may be misinterpreted as a retained foreign body or incisional neoplastic recurrence. We report a case involving a 59-year-old man who presented with a palpable epigastric mass and pronounced fatigability.
Foreign Bodies ; Humans ; Middle Aged ; Myositis ; Myositis Ossificans ; Ossification, Heterotopic* ; Recurrence

PURPOSE: The purpose of this study was to identify the factors influencing parenting stress in primiparas. METHOD: The participants in this study were 198 primiparas of infants aged 1-6 months who visited well baby clinics in 5 hospitals. The data were collected from April 15 to June 15, 2003. RESULTS: The mean score for parenting stress was 2.4 of a possible 5 and thus considered average. The score for parenting stress was significantly correlated with the level of maternal perception of the infant and the level of social support. The score for parenting stress was significantly different according to the education level of the primiparas and prenatal management. For the primiparas, social support(20%) and maternal perception of the infant(9%) were significant predictors explaining parenting stress. CONCLUSIONS: Nursing interventions to improve maternal perception of the infant and increase social support should be provided for primiparas in order to reduce parenting stress.
Education ; Humans ; Infant ; Nursing ; Parenting* ; Parents* ; Child Health

No abstract available.
Arthritis, Rheumatoid* ; Depression* ; Humans

Most acinic cell carcinomas arise within the parotid gland: extraparotid origin is rare. We encountered three cases of extraparotid acinic cell carcinoma arising in the buccal or palatal region, or the submandibular gland. All three tumors presented as a painless, slow-growing mass. CT imaging indicated that they were well defined, homogeneously enhanced, round masses. In one case, sonography demonstrated relatively homogeneous low echogenicity.
Acinar Cells* ; Carcinoma, Acinar Cell* ; Parotid Gland ; Salivary Glands ; Submandibular Gland

BACKGROUND: Effects of fentanyl, sufentanil, meperidine, and morphine on the spontaneous contractility of isolated human pregnant uterine muscle strips were determined. METHODS: Uterine specimens were obtained from normal full-term parturients undergoing elective lower-segment cesarean section. Longitudinal muscle strips were made and mounted individually and vertically in tissue chambers to record their isometric tension. After establishment of rhythmic contractions in the buffer solution, opioid concentration-response curves were constructed. The responses to opioids were repeated in the presence of opioid receptor blocker, nitric oxide synthase inhibitor, beta-adrenoceptor blocker, or cyclo-oxygenase inhibitor. RESULTS: Fentanyl and meperidine caused concentration-dependent decreases of the uterine contractility, their IC50 (concentration which causes 50% inhibition of the amplitude of spontaneous contractions) being 6.8 x 10(-6) M and 2.2 x 10(-3) M, respectively. On the contrary, sufentanil and morphine were without significant effects on the contractility. Pretreatment with either naloxone, N(G)-nitro-L-arginine methyl ester, atenolol, or indomethacin did not affect the uterine responses to opioids. CONCLUSIONS: These results demonstrate that fentanyl and meperidine may have direct inhibitory effects on the contractility of the human uterus. However, the opioid concentrations needed to significantly reduce the uterine contractility were at a supraclinical range.
Analgesics, Opioid* ; Animals ; Atenolol ; Cesarean Section ; Female ; Fentanyl ; Humans* ; Indomethacin ; Inhibitory Concentration 50 ; Meperidine ; Mice ; Morphine ; Myometrium* ; Naloxone ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Pregnancy ; Prostaglandin-Endoperoxide Synthases ; Receptors, Opioid ; Sufentanil ; Uterus

INTRODUCTION: The present study was aimed to investigate the hemodynamic effects of protamine and to determine whether the increases of pulmonary arterial pressure (deltaPAP) after protamine is related to development of systemic hypotension in heparinized dogs. METHODS: Nineteen mongrel dogs were acutely instrumented during 1.5% halothane anesthesia. All dogs then received protamine 3 mg.kg (-1) over a period of 30 s given through right atrium 5 minutes after heparin (300 IU.kg (-1), iv). Animals were retrospectively assigned into two groups, control (deltaPAP<6 mmHg, n=9) and pulmonary hypertensive (PHT, deltaPAP<6 mmHg, n=10) groups. Mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), left ventricular pressure, heart rate (HR), and cardiac output and left circumflex coronary flow (LCX flow) via Doppler flowmeter were continuously recorded throughout the experiments. Changes in MPAP were related to changes in MAP using standard regression analysis. RESULTS: MPAP (66% in PHT vs 7% in control group) and pulmonary vascular resistance index (5.1- vs 3.0-fold) increased more markedly immediately after protamine administration in PHT group than in control group. However, protamine caused similar reductions of MAP (-40 vs -46%), cardiac index (-60 vs -59%), and left ventricular end- diastolic pressure (-47 vs -53%) in both groups. No correlation was found between deltaPAP and deltaMAP in either group. LCX flow increased significantly but similarly immediately after protamine in both groups (183 vs 238%), indicating rapid release of potent vasodilator. CONCLUSIONS: These results suggest that, in heparinized dogs, protamine produces transient severe hypotension but does not consistently elevate pulmonary arterial pressure and, that acute pulmonary vasoconstriction does not play a major role in protamine-induced hypotension.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Control Groups ; Dogs* ; Flowmeters ; Halothane ; Heart Atria ; Heart Rate ; Hemodynamics ; Heparin* ; Hypertension, Pulmonary* ; Hypotension* ; Retrospective Studies ; Vascular Resistance ; Vasoconstriction ; Ventricular Pressure

Succinylcholine induces a small increase in serum K+ (0.3~0.5mEq/l) in normal patients, but it may produce fatal increases in sensitive conditions, including severe burn, massive trauma, tetanus and neuromuscular disorders. Recently, interest has been focussed on the role of the adrenergic system in extrarenal potassium hemeostasis. According to this concept, beta-adrenergic stimulation enhances and conversely a blockade imparis celluar uptake of potassium. Meanwhile propranolol, a beta-adrenergic blocker, is an incresingly, common drug among surgical patients. Therefore, the present experiment was carried out on 66 patients in order to determine whether propranolol augments or prolongs the increases in serum K+ following succinylcholine injection(2mg/kg, I.V.). Serum K+ and Na+ levels were measured just prior to induction and at 3,5,10,30,60,90 minutes following succinylcholine administration. The patients were divided into three groups: Group 1: 26 patients without propranolol treatment, Group 2: 20 patients pretreat with divided doses of propranolol (320 mg b.i.d. p.o.). and Group 3: 20 patients on chronic propranolol therapy. The results were as follows. 1) Baseline K+ valuses were significantly higher in propranolol treated patients(Groups 2 and 3) than in non-treated patients(Group 1). 2) The magnitude of maximum increases in serum K+ following succinylcholine was 0.19mEq/l, 0.16mEq/l and 0.21mEq/l in group 1,2 and 3, respectively. 3) The time to peak increases in K+ was 30min, 5min and 3 min following succinylcholine in group 1,2 and 3, respectively. 4) Serum Na+ decreased significantly following succinylcholine administration in all groups, but there was no significant difference among the groups at other times. These results indicate that propranolol neither augments nor prolongs increases in serum K+ following succinylcholin injection. Thus succinylcholine can be used safely in the presence of a beta-adrenergic blockade.
Burns ; Humans ; Potassium ; Propranolol* ; Succinylcholine* ; Tetanus