No abstract available.
Activities of Daily Living* ; Humans ; Stroke*

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

Laryngoscopy and endotracheal intubation are potent stimuli that increase heart rate and blood pressure. These transient stress responses are probably not harmful in healthy individuals. However hypertensive patients are more prone to have significant increase in heart rate and blood pressure whether they have been treated beforehand or not and these responses also can lead to fstal complications. A randomized double-blind study was csrried out on 40 ASA physical status II-III adult elective surgical patients with hypertension to assess the effects of continuous intravenous infusion of esmolol, ultrashortacting cardioselective beta blocker, on hemodynamic responses to laryngoscopy and endotracheal intubation. Patients received a continuous infusion of esmolol(500mcg/kg/min for 1 minute, followed by 200mcg/kg/min for 12minutes) or an equal volume of saline before and throughout the induction periods of anesthesia. Using noninvasive automatic blood pressure monitor, blood pressure( systolic, diastolic and mean arterial pressure) and heart rate were measured at 6 points: 1) as the control value, on arrival to operating room, 2) just after IV loading dose of saline or esmolol, 3) just after IV thiopental, 4) 1 minute after intuhation, 5) 3 minutes after intubation, and 6) 5 minutes after intubation. The rate-pressure product was calculated in each time. During this study, anesthesia was maintained with enflursne-N2O-O2 vecuronium and controlled ventilstion. In patients given esmolol, systolic pressure, diasolic pressure, mean arterial pressure, heart rate, and rate pressure product at 1 minute, 3 minutes, 5 minutes after intubation were less increased than control group. And the heart rste response was more effectively blunted than the blood pressure response. The continuous infusion of esmolol can blunt hemodynamic changes caused by laryngoscopy and endotracheal intubation in hypertensive patients, yet it is needed to find out the optimal dosage of esmolol for complete blocking of the sympathetic response without the adverse effects.
Adult ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Blood Pressure Monitors ; Double-Blind Method ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension* ; Infusions, Intravenous ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Operating Rooms ; Thiopental ; Vecuronium Bromide

No abstract available.
Humans

Basal Cell Nevus Syndrome ; Family Characteristics ; Female ; Follow-Up Studies ; Genetic Counseling ; Humans ; Mandible ; Mass Screening ; Mothers ; Odontogenic Cysts ; Recurrence ; Siblings ; Skin ; Young Adult

PURPOSE: Surface antigen 3 (SAG3) of Toxoplasma gondii is very similar in structure to the major surface antigen 1 (SAG1). Although numerous studies have supported the importance of SAG1 in protection against T. gondii infection, few reports exist on SAG3. MATERIALS AND METHODS: Glutathione-S-transferase (GST)-fused SAG3 of T. gondii (rSAG3) were immunized into BALB/c mice alone or in combination with Quil A (rSAG3/Quil A), and then evaluated the protective immunity in vivo and in vitro against murine toxoplasmosis. RESULTS: Immunization with rSAG3 or rSAG3/Quil A resulted in significantly more survival days and fewer brain cysts after challenge with T. gondii compared to an infected control group. Mice immunized with rSAG3 alone or in combination with Quil A produced significantly more specific IgG2a antibody, whereas specific IgG1 antibody titers did not increase. The percentage of CD8+ T cells, IFN-gamma mRNA expression, and nitric oxide production significantly increased in rSAG3- and rSAG3/Quil A-immunized mice. CONCLUSION: These results indicate that vaccination with Toxoplasma rSAG3 results in partial protective immunity against T. gondii infection through induction of a Th1-type immune response, and that protective immunity is accelerated by the modulating effects of Quil A.
Animals ; Antigens, Protozoan/genetics/*immunology/metabolism ; Bacterial Proteins/genetics/immunology/metabolism ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Immunoglobulin G/immunology ; Interferon-gamma/metabolism ; Mice ; Mice, Inbred BALB C ; Nitric Oxide/metabolism ; Protozoan Proteins/genetics/immunology/metabolism ; Recombinant Fusion Proteins/genetics/immunology/metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Saponins/*immunology ; Toxoplasma/growth & development/*immunology ; Toxoplasmosis, Animal/*immunology/metabolism/microbiology ; Vaccination/*methods

PURPOSE: Surface antigen 3 (SAG3) of Toxoplasma gondii is very similar in structure to the major surface antigen 1 (SAG1). Although numerous studies have supported the importance of SAG1 in protection against T. gondii infection, few reports exist on SAG3. MATERIALS AND METHODS: Glutathione-S-transferase (GST)-fused SAG3 of T. gondii (rSAG3) were immunized into BALB/c mice alone or in combination with Quil A (rSAG3/Quil A), and then evaluated the protective immunity in vivo and in vitro against murine toxoplasmosis. RESULTS: Immunization with rSAG3 or rSAG3/Quil A resulted in significantly more survival days and fewer brain cysts after challenge with T. gondii compared to an infected control group. Mice immunized with rSAG3 alone or in combination with Quil A produced significantly more specific IgG2a antibody, whereas specific IgG1 antibody titers did not increase. The percentage of CD8+ T cells, IFN-gamma mRNA expression, and nitric oxide production significantly increased in rSAG3- and rSAG3/Quil A-immunized mice. CONCLUSION: These results indicate that vaccination with Toxoplasma rSAG3 results in partial protective immunity against T. gondii infection through induction of a Th1-type immune response, and that protective immunity is accelerated by the modulating effects of Quil A.
Animals ; Antigens, Protozoan/genetics/*immunology/metabolism ; Bacterial Proteins/genetics/immunology/metabolism ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Immunoglobulin G/immunology ; Interferon-gamma/metabolism ; Mice ; Mice, Inbred BALB C ; Nitric Oxide/metabolism ; Protozoan Proteins/genetics/immunology/metabolism ; Recombinant Fusion Proteins/genetics/immunology/metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Saponins/*immunology ; Toxoplasma/growth & development/*immunology ; Toxoplasmosis, Animal/*immunology/metabolism/microbiology ; Vaccination/*methods

Emergency surgical patients are more frequently in critical state than elective patients and they have not enough time for physical and laboratory examinations. The evaluation of perio-perative data will improve the outcome of emergency operation. We analyzed 1053 anesthesias for emergency operation which were performed at the department of anesthesiology, Anam Hospital from September 1992 to August 1993 clinically and statistically according to age, sex, physical status, department, anesthetic duration, method and agent, types of trauma, amount of transfusion, etc. The results were as follows; 1) The percent of emergency surgery cases was 13.6 of total surgical patients. 2) The ratio of male to female was 1.15:1. 3) About 61.1% of all emergency patients were in the 21-40 years age group. 4) According to the ASA classification of physical status, the percent of patients in emergency class 1 and 2 was 86.2 of the total patients. 5) The most common operation was Cesarean section (19.9%), and appendectomy (13.8%) the next. 6) The most common anesthetic method for emergency operation was general anesthesia with enflurane. 7) The obstetric cases were most common and the general surgery cases were the next. 8) The percent of the cases which took less than 2 hours duration was 82.4 of total operation. 9) The transfusion was done in 108 cases (10.3%) and less than 2 units was transfused most frequently. 10) The transference to ICU was done in 144 (13.7%) cases and the patients of general surgery were transfered to ICU most frequently. 11) The majority of injuries were classified as blunt trauma (86.6%) while 13.4% were classified as penetrating trauma. 12) The lagest number of injuries involved the upper extremity (47.8%) and the next was the head & neck (31.9%).
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Appendectomy ; Cesarean Section ; Classification ; Emergencies* ; Enflurane ; Female ; Head ; Humans ; Male ; Neck ; Pregnancy ; Upper Extremity

BACKGROUND: Postoperative pruritus following the administration of epidural narcotics is a very common and undesirable side effect. Therefore, we evaluated the use of a combination of naloxone and sufentanil via patient controlled epidural analgesia to determine if the incidence of pruritus was decreased when compared to the use of sufentanil alone. METHODS: Patients scheduled for subtotal gastrectomy under general anesthesia were enrolled in a prospective, double-blinded and randomized trial. All patients received a 20 microgram epidural bolus of sufentanil in 5 ml of 0.2% ropivacaine. Following administration of the epidural, patients in the sufentanyl group (S) received a continuous epidural comprised of sufentanil (0.75 microgram/ml) in 0.2% ropivacaine, whereas patients in the naloxone group (N) received an epidural infusion comprised of naloxone (4 microgram/ml) and sufentanil (0.75 microgram/ml) in 0.2% ropivacaine. The infusion rate, demand dose and lockout interval were 5 ml/hr, 0.5 ml and 15 minutes respectively. Next, the occurrence of postoperative analgesia and side effects were evaluated by blinded observers. RESULTS: The incidence of pruritus (47.4% versus 20.0%, P = 0.013) and nausea (42.1% versus 20.0%, P = 0.043) were lower in group N than in group S. In addition, there were no significant differences observed in the visual analogue scale, the incidence of vomiting or the incidence of sedation. Furthermore, epidural infusion of naloxone at 0.25-0.4 microgram/kg/hr did not affect the requirement for postoperative sufentanil. CONCLUSIONS: Epidural naloxone reduces epidural sufentanil induced pruritus and nausea without reversing its analgesic effects.
Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Anesthesia, General ; Gastrectomy ; Humans ; Incidence ; Naloxone* ; Narcotics ; Nausea ; Prospective Studies ; Pruritus* ; Sufentanil* ; Vomiting

In this paper, the real-time telemedicine system based on multimedia data was designed. In order to describe patients to medical specialists, the system included multimedia data. The prototype system designed in this paper effectively integrated multimedia components in a single computer, as well as compromise the compression, interface, medical imaging standards and modular software architectures. The mobile bed was manufactured to improve the movement of the system. Two experiments had been conducted to evaluate the technical functionality and clinical usability. Using the data compression and priority control, the telemedicine system transmitted multimedia data in real-time at the internet and the ethernet network. Inter-hospital experiments and Sang-Am World-Cup Stadium experiments demonstrate the feasibility to be effectively used.
Data Compression ; Diagnostic Imaging ; Emergencies* ; Humans ; Internet ; Multimedia* ; Specialization ; Telemedicine*