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

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

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

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*

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

Kernicterus is a neurologic syndrome, resulting from the preferential deposition of unconjugated bilirubin in the globus pallidus, subthalamus, hippocampus, and brain stem. The characteristic finding of kernicterus revealed by T2-weighted MR imaging is irreversible, bilaterally symmetrical high signal intensities in the globus pallidus. We report an atypical case of kernicterus, in which follow-up MR imaging of the globus pallidus demonstrated reversible signal intensity.
Bilirubin ; Brain Stem ; Follow-Up Studies ; Globus Pallidus ; Hippocampus ; Humans ; Infant, Newborn ; Kernicterus* ; Magnetic Resonance Imaging* ; Subthalamus

BACKGROUND: A brief period of coronary artery occlusion followed by reperfusion is known to produce prolonged period of ventricular dysfunction without necrosis (myocardial stunning). The present study was aimed to investigate the effects of propofol on regional myocardial functions and metabolism in postischemic stunned myocardium in an open-chest canine model. METHODS: Twenty-two dogs were acutely instrumented under halothane anesthesia to measure aortic and left ventricular pressure, pulmonary, left anterior descending (LAD) and circumflex (LCX) coronary artery flow, and subendocardial segment length in both the regions supplied by LAD and LCX. All animals were then subjected to a 15 min of LAD occlusion and subsequent reperfusion. In the expermental group (n=12), after 30 min of reperfusion halothane was replaced by a bolus of 5 mg.kg 1 of propofol followed by a continuous infusion for 30 min at 0.2 (baseline), 0.3, 0.4, and 0.5 mg.kg 1.min 1, whereas halothane was maintained without propofol infusion throughout the reperfusion period in the control group (n=10). Percent segment shortening (%SS) and the preload recruitable stroke work slope (Mw), as an index of regional myocardial contractility, and peak lengthening rate (dL/dtmax) and percent post-systolic shortening (%PSS), as an index of regional diastolic function, were evaluated. Metabolic data were determined from simultaneous arterial and coronary venous measurements of oxygen and lactate. RESULTS: Significant and dose-dependent decreases in both %SS (8.8 +/- 1.7 at 0.2 to 6.5 +/-1.6% at the 0.5 mg.kg 1.min 1 infusion) and Mw (1.45 +/- 0.15 at 0.2 to 0.87 +/- 0.07 erg.cm 3.104 at the 0.5 mg.kg 1.min 1) in the LAD region were observed. Concomitant decrease in dL/dtmax (52.4 +/- 3.9 at 0.2 to 40.2 +/- 3.6 mm.sec 1 at the 0.5 mg.kg 1.min 1 infusion) in the LAD region was also observed. In contrast, %SS, Mw, and dL/dtmax in the LCX region as well as %PSS in both regions remained unchanged throughout the infusion period. Propofol infusion was accompanied by progressive Although propofol produced progressive decreases in coronary blood flow and myocardial oxygen consumption in both regions, its administration was not associated with any changes in oxygen and lactate extraction ratios. CONCLUSION: The results indicate that propofol produces a greater depression on both regional systolic and diastolic functions in stunned myocardium than those in normal myocardium. However, propofol does not impair myocardial aerobic metabolism in both stunned and normal myocardium.
Anesthesia ; Animals ; Coronary Vessels ; Depression ; Dogs ; Halothane ; Lactic Acid ; Metabolism* ; Myocardial Stunning* ; Myocardium ; Necrosis ; Oxygen ; Oxygen Consumption ; Propofol* ; Reperfusion ; Stroke ; Ventricular Dysfunction ; Ventricular Pressure

BACKGROUND: Fatigue is one of the common chief complaints in primary care setting. It causes disability in daily activity and lowers quality of life. This study was intended to investigate the information about fatigue useful in outpatient clinic. METHODS: The data was obtained from the Korean Health and Nutrition Survey 2001. Logistic regression analysis was performed to examine the association between self- reported fatigue and several factors including sociodemographic factors, life style factors, stress, depression, and worry about health. RESULTS: The prevalence of fatigue was low in unmarried status, more significantly in men when compared with those in married status. No significant association was found between fatigue and occupation, education level, monthly income, smoking, and alcohol consumption. The risk of fatigue in the exercising group more than 4 times per week was significantly low in women. The risk of fatigue in the group of sleeping duration less than 5 hours was significantly higher than the group of sleeping more than 9 hours. Compared with unemployed state, the daily working duration of more than 9 hours increased the risk for fatigue significantly. Stress perception, sadness or depression during the past 1 year and worry about health were strongly associated with fatigue. CONCLUSION: When evaluating and managing patients with fatigue, we should search for information about the patients' lifestyle such as exercise, daily work hours, sleeping as well as stress perception and depressive mood. Especially among the lifestyle, inquiring about regular exercise and promoting it may be important in order to manage patients with fatigue.
Alcohol Drinking ; Ambulatory Care Facilities ; Depression ; Education ; Fatigue* ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Nutrition Surveys* ; Occupations ; Prevalence ; Primary Health Care ; Quality of Life ; Single Person ; Smoke ; Smoking