Halothane, in common use today, sensitizes the myocardium to endogenous and exogenous sympathomimetic amines arid induces cardiac arrhythmia, sometimes life threatening. Sympatbomimetic amines, however, are frequently injected subcutaneously for hemostasis or intravenously far cardiovascular stability. Therefore, this study was performed to investigate the effect of lidocaine 1 mg/kg, pro-pranolol 0.02 mg/kg, and droperidol 0.1 mg/kg pretreatment on arrhythmias(A.R.) and changes in heart ramie(H.R.), systolic bood pressure(T.B.P ) and diastolic blood pressure (D.B.P.) Induced by lV administered ephedrine 0.2 mg/kg. Patients were divided into 5 groups: 20 cases without pretreatment(Group l ), 10 cases with lidocaine prtreatment(Group ll), 10 cases with propranolol pretreatment(Group lll), 20 eases with lidocaine-propranolol pretreatment(Group lV) and 20 cases with droperidol pretreatment(Group V ). The results were as follows: 1) In Group l, ephedrine produced A.R. in 16 cases(80%) and significant increase in H.R.(d~11 bpm, p<0.001) and S.B.P. (8~22 torr, p<0.001), but D.B.P. increased insignif-icantly(2~10 torr, NS). 2) In Group ll, ephedrine produced A.R. in 5 cases(57%) and 5.B.p.(10~17 terr, p<0, 01) increased significantly, but H.R. remained unaltered. 3) In Group lll, ephedrine produced A.R. in 3 cases(30%) and H.R. (6~8 bpm, p<0.05) decreased, but S.B.P.(12~21 torr, p<0.01) and D.B.P (8~16 torr, p<0.01) increased signi-ficantle. 4) In Group lV, ephedrine produced A.R. in 2 cases(10.%) and H.R.(3~6 bpm, p<0.05) decreased, but S.B.P (4~11 torr, p<0.05) and D.B.P.(3~9 torr, p<0.01) increased signific-antly. 5) In Group V. ephedrine produced A.R. in 2 cases(10%) and H.R.(9~13 bum, p<0.001) increased siginificantly, but S.B.P. and D.B.P. remained unaltered. From the above results, it is concluded that lidocaine and propranolol mixture or droperidol protects most effectively against ventricular arrhythmias induced by ephedrine during halothane-N2O anesthesia in human volunteers.
Amines ; Anesthesia* ; Arrhythmias, Cardiac* ; Blood Pressure ; Droperidol* ; Ephedrine* ; Halothane ; Healthy Volunteers ; Heart ; Hemostasis ; Humans ; Lidocaine* ; Myocardium ; Propranolol* ; Sympathomimetics

The purpose of this study was to evaluate the effects of verapamil on hemodynamics and pulmonary gas exchanges during isoflurane-N2O-O2(FIO2, 50%) anesthesia. Hemodynamic measurements and arterial and mixed venous blood gas analyses were made in thirteen healthy patients immediately before (control) and at 1, 5,10min after 5mg of intravenous verapamil administration as single bolus. 1) Verapamil produced a rapid and transient reduction of 15% in mean arterial pressure resulting from a decrease in systemic vascular resistance. 2) Heart rate and cardiac index increased by 14%, 9% respectively only immediately after i.v. verapamil injection and restored thereafter toward control values. 3) SVI, MPAP, PCWP, PVR and CVP revealed only minor changes. 4) Verapamil did not cause any significant changes in intrapulmonary shunt. These findings suggest that during isoflurane-N2O-O2(50%) anesthesia verapamil might safely be used, even in the presence of ventilation/perfusion inequalities, (i.e. lung disease, one lung anesthesia) provided patient has good cardiovascular reserve.
Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Heart Rate ; Hemodynamics* ; Humans ; Isoflurane ; Lung ; Lung Diseases ; Socioeconomic Factors ; Vascular Resistance ; Verapamil*

The cystic teratoma is the most common germ cell tumors in reproductive age women. The malignant change of cystic teratoma is rare, about 1~2%, and mostly change to squ-amous cell carcinoma. We experienced 4 cases of squamous cell carcinoma arising in cystic teratoma and re- port our cases with a brief review of the literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

Sodium nitroprusside hart become increasingly popular as a vasodilator due to its high potency, rapid onset and reversibility. However, it has some untoward effects including cyanide toxicity, tachyphylaxis, and rebound phenomenon. Accordingly, several attempts to dimmish such complications have been tried including the use propranolol, a possible direct cardiovascular depressant. Therefore, to determine whether propranolol makes a deleterious contribution to hemodynamic responses and impaired in pulmonary gas exchange during SNP in patients anesthetized with halothane-N2O (FiO2; 0.5), experiments were performed on 25 patients with deliberate hypotension scheduled for elective surgery. Thirteen patients were pretreated with divided doses of propranolo (320mg, b.i.d po) and the other twelve were controls. The results were as follows. 1) Cardiac index was significantly lower in pretreated with propranolol than the untreated control in the hypotensive period (3.45+/-0.16 vs 2.97+/-7.141/min/m2, p<0.05). 2) Heart rate increased by 20% in control group during the hypotensive period, but it remained unaltered in propranolol group at all times. 3) Hypotension induced by SNP, resulted from a marked decrease in systemic vascular resistance in both groups. 4) MPAP, PCWP, CVP, SVR, PVR significantly decreased after SNP infusion in both groups, but , they did not differ significantly between the groups at all times. 5) SNP caused a significant increase in intrapulmonary shunt fraction from 8.26+/-0.51 to 10.11+/-0.92%, but propranolo prevented it. 6) Mixed venous oxygen tension was significantly lower in propranolol group than in untreated control group at all times. 7) Patients who .received propranolo required less SNP than the untreated control. (2.51+/-0.22 vs 5.95+/-0.75 mcg/kg/min, p<0.001) These results indicate that propranolol required does not produce any unfavorable hemodynamic event and, furthermore, prevents impairment of pulmonary gas exchange during SNP induced hypotension in patients anesthetized with halothane and nitrous oxide. Therefore, premfdication with propranolol should be considered for patients who are supposed to receive SNP for deliberate hypotension.
Halothane* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension* ; Nitroprusside ; Nitrous Oxide* ; Oxygen ; Propranolol* ; Pulmonary Gas Exchange ; Sodium* ; Tachyphylaxis ; Vascular Resistance

Sodium nitroprusside hart become increasingly popular as a vasodilator due to its high potency, rapid onset and reversibility. However, it has some untoward effects including cyanide toxicity, tachyphylaxis, and rebound phenomenon. Accordingly, several attempts to dimmish such complications have been tried including the use propranolol, a possible direct cardiovascular depressant. Therefore, to determine whether propranolol makes a deleterious contribution to hemodynamic responses and impaired in pulmonary gas exchange during SNP in patients anesthetized with halothane-N2O (FiO2; 0.5), experiments were performed on 25 patients with deliberate hypotension scheduled for elective surgery. Thirteen patients were pretreated with divided doses of propranolo (320mg, b.i.d po) and the other twelve were controls. The results were as follows. 1) Cardiac index was significantly lower in pretreated with propranolol than the untreated control in the hypotensive period (3.45+/-0.16 vs 2.97+/-7.141/min/m2, p<0.05). 2) Heart rate increased by 20% in control group during the hypotensive period, but it remained unaltered in propranolol group at all times. 3) Hypotension induced by SNP, resulted from a marked decrease in systemic vascular resistance in both groups. 4) MPAP, PCWP, CVP, SVR, PVR significantly decreased after SNP infusion in both groups, but , they did not differ significantly between the groups at all times. 5) SNP caused a significant increase in intrapulmonary shunt fraction from 8.26+/-0.51 to 10.11+/-0.92%, but propranolo prevented it. 6) Mixed venous oxygen tension was significantly lower in propranolol group than in untreated control group at all times. 7) Patients who .received propranolo required less SNP than the untreated control. (2.51+/-0.22 vs 5.95+/-0.75 mcg/kg/min, p<0.001) These results indicate that propranolol required does not produce any unfavorable hemodynamic event and, furthermore, prevents impairment of pulmonary gas exchange during SNP induced hypotension in patients anesthetized with halothane and nitrous oxide. Therefore, premfdication with propranolol should be considered for patients who are supposed to receive SNP for deliberate hypotension.
Halothane* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension* ; Nitroprusside ; Nitrous Oxide* ; Oxygen ; Propranolol* ; Pulmonary Gas Exchange ; Sodium* ; Tachyphylaxis ; Vascular Resistance

The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.
Asthma ; Bronchi ; Bronchoscopy* ; Delayed Diagnosis ; Dyspnea ; Early Diagnosis ; Incidence ; Lung ; Lung Abscess ; Membranes ; Pneumonia ; Pulmonary Atelectasis ; Rib Fractures ; Rupture* ; Thorax* ; Trees

PURPOSE: Currently, no studies have examined the diurnal variation of sex hormones in Korean men. We realized that accurate models of the diurnal variation of the sex hormones in Korean males are needed to evaluate and manage patients in urology. Therefore diurnal variation of testosterone and related sex hormones were investigated in young Korean men. MATERIALS AND METHODS: Healthy Korean men from 20 to 25 years old who had evident secondary growth were enrolled. We drew blood from each subject 12 times at 2-hour intervals for 24 hours. The concentrations of total testosterone, estradiol, luteinizing hormone, sex hormone binding globulin and albumin were measured. The free and bioavailable testosterone were calculated by Vermeulen's equation. To analyze the rhythmicity of diurnal variation in sex hormones, 24-hr cosine regression analysis was used for the statistical analysis. RESULTS: Total testosterone, free testosterone, estradiol, and testosterone estradiol ratio demonstrated a significant diurnal cosinor rhythm. The diurnal variation of bioavailable testosterone did not demonstrate a statistically significant cosinor rhythm. CONCLUSIONS: The diurnal variations of serum total and free testosterone concentration in Korean young men were similar to those found in studies of Caucasian men. Our study provides basic data for future studies of Korean male sex hormones. Furthermore, additional studies targeted toward various male age groups are needed to make the standard models of sex hormones in Korean men.
Adult ; Circadian Rhythm* ; Estradiol* ; Gonadal Steroid Hormones ; Humans ; Lutein* ; Luteinizing Hormone* ; Male ; Periodicity ; Sex Hormone-Binding Globulin* ; Testosterone* ; Urology

BACKGROUND: It is regarded that contemporary Korean diet, the combination of carbohydrates-based Korean traditional diet and the Western eating patterns, increases the vulnerability to chronic diseases such as coronary vascular disease, diabetes mellitus, and hypertension. Therefore, there is a rising interest in carbohydrate sources with low glycemic index; many researches have proven the medical benefits of low glycemic index diet. Barley has recently drawn attention and various benefits of barley, such as improvements of obesity and bowel function, have been suggested. It seems that the beta-glucan, a content of barley helps to lower blood sugar level. This study aimed to evaluate the advantages of barley consumption compared to wheat consumption in blood sugar and blood lipid profile levels. METHODS: Twenty-four healthy Korea University students were randomly assigned to two groups: 12 of barley bread consumption group (treatment group) and 12 of wheat bread consumption group (control group). Both groups took bread on an empty stomach and the changes of their blood sugar and lipid levels were measured, compared, and analyzed every hour for four hours. RESULTS: The blood sugar level one hour later in the barley bread consumption group was statistically low. In addition, the area under curve of the barley bread intake group was found to be statistically smaller. However, the blood lipid profiles between the two groups did not show meaningful difference. CONCLUSION: This study suggests that the consumption of food containing barley could bring various medical benefits to one's health by lowering blood sugar.
Area Under Curve ; Blood Glucose ; Bread ; Chronic Disease ; Diabetes Mellitus ; Diet ; Eating ; Glycemic Index ; Hordeum ; Humans ; Hypertension ; Korea ; Lipid Metabolism ; Obesity ; Stomach ; Triticum ; Vascular Diseases

The mechanism of apoptosis was first discovered at the end of the 19th century, but it was only recently that its importance was recognized. Not only in a pathologic environment but also in a normal environment, apoptosis has an important role in homeostasis. The number of cells is restricted by apoptosis which is controlled by several SlgBS lll VlVO. In pregnancy, the placenta regulates the maternal-fetal exchange of molecules and functions as a barrier for the protection of the fetus. As the pregnancy proceeds, changes occur in the number and components of placental cells. Observing the placental tissues, apoptosis was found in the syncytiotrophoblasts of early and late pregnancy. In particular, the fact that apoptosis observed in the placenta of late pregnancy supports the hypothesis that pmgrammed cell death is a normal sequence. Pregnancy-induced hypertension is usually accompanied by abnormal placenta and intrauterine growth restriction. In this study, using the TdT-FragEL DNA fragmentation detection kit, the changes in the nucleus by apoptosis in the placental tissues of 23 to 40 gestational weeks in preeclampsia and eclampsia were compared with normal placenta. Apoptosis was observed in the normal term placenta and in pregnancy-induced hypertension patients, regardless of whether vasculopathy was observed in Doppler ultrasound or confirmed by pathology, more apoptoses were observed aside from the number of gestational weeks.
Apoptosis ; Cell Death ; DNA Fragmentation ; Eclampsia ; Female ; Fetus ; Homeostasis ; Humans ; Hypertension, Pregnancy-Induced* ; Maternal-Fetal Exchange ; Pathology ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Trophoblasts ; Ultrasonography

Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition: trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.
Abdominal Pain* ; Adult ; Bezoars* ; Child* ; Deglutition ; Female ; Hair ; Hemorrhage ; Humans ; Intellectual Disability ; Intussusception ; Mortality ; Nausea* ; Pica ; Stomach ; Stomach Ulcer ; Stroke ; Trichotillomania ; Vomiting*