The purpose of this study is to investigate the effects of doxapram on the rates of spontaneous and neostigmine-induced recovery from neuromuscular block with vecuronium and atracurium. Following intravenous injection of either vecuronium (40 patients) or atracurium (40 patients), recovery index (RI) was measured without administering either doxapram or neostigmine (Group 1), or after administration of a combination of neostigmine 40 ug/kg and doxapram 1 mg/kg (Group 2), neostigmine 40 ug/kg (Group 3) or doxapram 1 mg/kg (Group 4) when twitch tension returned to 25% block of train of four response, each of the four group had 10 patients. The results were such that RI was significantly prolonged after vecuronium in the presence of doxapram compared with Group 1 (13.5 min vs 8.2 min). There was no significant difference in the RI after atracurium in the presence of doxapram compared with Group 1 (7.0 min vs 7.1 min). There was rapid recovery which was significant when neostigmine was administered with or without doxapram (2.4 min vs 2.3 min respectively after vecuronium; 2.3 min vs 2.4 min respectively after atracurium). The authors conclude that administration of doxapram in situation where neuromuscular block with vecuronium is not adequately antagonized does not contribute to rapid recovery from neuromuscular block.
Atracurium* ; Doxapram* ; Humans ; Injections, Intravenous ; Neostigmine ; Neuromuscular Blockade ; Vecuronium Bromide*

Wolf-Hirschhorn syndrome (WHS) is a malformation associated with a hemizygous deletion of the distal short arm of chromosome 4. Herein we report a fetal autopsy case of WHS. A male fetus was therapeutically aborted at 17(+0) weeks gestational age, due to complex anomaly and intrauterine growth retardation, which were found in prenatal ultrasonography. His birth weight was 65 g. Mild craniofacial dysmorphism, club feet, bilateral renal hypoplasia, edematous neck, and left diaphragmatic hernia of Bochdalek were found on gross examination. On GTG-banding, the fetus revealed 46,XY,add(4p) karyotype and the mother revealed 46,XX,t(4;18)(p16;q21.1), with normal karyotype of the father. Array comparative genomic hybridization performed on the autopsied lung tissue revealed loss of 4p16.2-->4pter and gain of 18q21.1-->18qter, suggesting 46,XY,der(4)t(4;18)(p16.2;q21.1)mat of fetal karyotype. This suggested deletion of 4p, compatible with WHS inherited from the mal-segregation of a maternal translocation t(4;18)(p16.2;21.1). Therefore, our fetus was both genotypically and phenotypically compatible with WHS.
Arm ; Autopsy ; Birth Weight ; Chromosomes, Human, Pair 4 ; Comparative Genomic Hybridization ; Fathers ; Fetal Growth Retardation ; Fetus ; Foot ; Gestational Age ; Hernia, Diaphragmatic ; Humans ; Karyotype ; Karyotyping ; Lung ; Male ; Mothers ; Neck ; Ultrasonography, Prenatal ; Wolf-Hirschhorn Syndrome

OBJECTIVES: This study is aimed to quantify the complex dynamics of beat-to-beat fetal heart rate(FHR) fluctuations by using approximate entropy(ApEn) which is a recently developed mathematical formula quantifying regularity and also to determine the differences between normal fetuses and growth retarded fetuses. BACKGROUND: Recently, some measures of heart rate variability and nonlinear "complexity" of heart rate dynamics have been used as indicators fetal well-being. Approximate entropy is a new mathematical approach and formula to quantify regularity in data. It has been shown to provide new information in fetal heart rate analysis. Because growth retarded fetus accounts for a significant increase in perinatal morbidity and mortality, than normal fetus, we postulated that there existed important differences between normal fetuses and growth retarded fetuses. METHODS: We analyzed FHR tracings for 40 minutes, and approximately 5,000 points in normal fetuses(n=315) and growth retarded fetuses(n=76). The overall "complexity" of each FHR time series was quantified by its approximate entropy, measure of regularity derived from nonlinear dynamics, "chaos theory". RESULTS: Mean baseline FHR increased in growth retarded fetuses than normal fetuses. And the FHR ApEn significantly decreased in growth retarded fetuses(ApEn=0.623) compared to that of the normal fetuses(ApEn=0.868) throughout all gestational ages(p < 0.001). CONCLUSIONS: The ApEn of FHR decreased in growth retarded fetuses throughout all gestational ages. These findings indicated that decreased ApEn values of FHR are associated with sickness and the greater perinatal morbidity risks. Therefore ApEn quantifies subtle changes in FHR regularity and promises for new information in FHR analysis.
Entropy* ; Female ; Fetal Heart* ; Fetus* ; Gestational Age ; Heart Rate ; Heart Rate, Fetal* ; Mortality ; Nonlinear Dynamics ; Pregnancy

Tumor necrosis factor-n (TNF - alpha) involved in the pathogenesis of multiple sclerosis and contribute to the degeneration of oligodendrocytes as well as neurons. TNF - alpha is produced by miocroglia and astrocytes, which also produce hormones and cytokines that influence its biological activity. Astrocytes, the major glial cells in the CNS, are capable of producing TNF - alpha at both the mRNA and protein levels in response to interleukine-1 (IL-1) or TNF - alpha. Two immunosuppressive cytokines, transforming growth factor - beta (TGF - beta) and IL-10, have been shown to influence glial cell function. TGF - beta can modulate the activity of glial cells by inhibiting interferon-gamma (IFN - gamma) induced expression of class II major histocompatibility complex (MHC) molecules on astrocytes and microglia. To explore the role of astrocytes in the production of TNF - alpha, astrocytes were pretreated with IL-10 or TGF - beta and then stimulated with IL-1p to determine their effects on TNF - alpha production. The secretion of TNF - alpha by human fetal astrocytes was markedly inhibited by TGF - beta at a low concentration. In contrast IL-10 had no effect on TNF - alpha mRNA level. These results show that TGF - beta may regulate the expression of TNF - alpha in activated human fetal astrocytes.
Astrocytes* ; Cytokines ; Gene Expression* ; Humans* ; Interferon-gamma ; Interleukin-10 ; Major Histocompatibility Complex ; Microglia ; Multiple Sclerosis ; Necrosis ; Neuroglia ; Neurons ; Oligodendroglia ; RNA, Messenger ; Transforming Growth Factors

No Abstract Available.
Astrocytes* ; Humans*

No abstract available.
Astrocytes* ; Humans*

No abstract available.
Astrocytes* ; Gene Expression* ; Humans* ; Polymerase Chain Reaction*

Background : The approximate entropy of heart rate variability has recently been used as a tool in evaluating cardiovascular health and physiology and in diagnosing pertubated physiologic status, by quantifying the irregularity and the pattern of the heart rate variability. Therefore approximate entropy of the fetal heart rate variability will be used as an important tool in studying the fetal cardiovascular health and disease, but unfortunately there have been no previous systematic studies of the approximate entropy in normal fetuses. This study's aim has been to present the normal approximate entropy values of the fetal heart rate variability according to the gestational age, to demonstrate the developmental maturation of physiology of the control systems of the heart rate, and to quantify the evolution of the pattern of fetal heart rate variability. METHODS: Three hundred and thirty seven mothers with normal singleton pregnancies, who were 20 weeks or more of gestational age, were randomly chosen. For more than 40 minutes fetal heart rates and fetal movements were recorded and were downloaded to a computer. From each heart rate data, 5000 points ('total') of heart rate during which fetal movements occured and 1200 points ('rest') during which no fetal movement occured were selected and the approximate entropy was calculated, and then 2 weeks' average of the approximated entropy of the heart rate were calculated and compared to find the maturational differences of them. RESULTS: The approximate entropy of the rest period showed a tendency to increase with advancing gestation (p=0.0001). It was significantly higher between the 41st-42nd week (0.987 +/-0.017) than the period before the 24 th week (0.864+/-0.032) and between the 25th-26th week (0.868+/-0.022). (p<0.05). The approximate entropy of the total period showed another tendency (p<0.05): from a low level before the 24 th week (0.788+/-0.067) it increased to reach its peak at the 29th-30 th week (0.963+/-0.041) then it gradually decreased again to significantly (p<0.05) lower levels at the 37th-38th week (0.776+/-0.046) and the 39th-40th week (0.786+/-0.047). CONCLUSIONS: Normal value of approximate entropy, which is bound to be used as an index in evaluating the fetal well-being, has been presented from 20th to 42th week of gestation with an interval of two weeks. The systems that control the heart rate seem to mature consistently as gestation advances, but before the 26th week it is significantly more immature than at term. Fetal heart rate variability evolves from an immature oscillating pattern into a transitional patternless pattern during the second trimester and finally consolidates into a mature accelerational pattern during the third trimester.
Entropy* ; Female ; Fetal Heart* ; Fetal Movement ; Fetus ; Gestational Age ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Mothers ; Physiology ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Reference Values

No abstract available.
Body Weight* ; Diet* ; Exercise Therapy* ; Humans

This study was designed to assess the iron nutritional status and anemia of high school students. 383 female subjects in Ulsan Metropolitan city were evaluated using a questionnaire, and a measurement of hematological indices. The average height and weight of the respondents were 161.24+/-4.90 cm and 53.12+/-6.37 kg, repectively. The average BMI(body mass index) was 20.43+/-2.26 which was in the normal ramge. The average hemoglobin(Hb) concentration of the subjects was 13.14+/-0.97g/dl, and the average hematocrit(Hct) level was 40.84+/-17.40%. Transferrin saturation{TS(%)} was 20.86+/-10.32%, and the ferritin by Hct(<36%), 27.2%by TS(<14%),26.6% by ferritin(<12 ng/ml). As for clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concectrate'. Mean daily intakes of iron were 14.89+/-4.48 mg and heme iron intakes were 5.04+/-2.13 mg, which was 29.6% of total iron intake. The total iron binding capacity(TIBC) was negatively correlated with Hb concentration(r= -0.222, p<0.01). Serum ferritin was positively correlated with Hb concentration(r= - 0.323, p<0.05) and negatively correlated with TIBC(r= -0.367, p<0.01). TS(%) was positively correlated with Hb concentration(r= 0.402, p<0.01) and positively correlated with serum ferritin(r=0.413, p<0.01). As for the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'shortening of breath when going upstairs(p>0.05)' and 'cold hands and feet' significantly(r= -0.109, p<0.05). The level of Mean corpuscular volume(MCV) was negatively correlated with 'feel dizzy when standing up', 'tired out easily', and 'decrease ability to concentrate' significantly(p<0.05). In particular, the level of Fe was negatively correlated with 'shortening of breath when going upstairs' and 'feeling blue' significantly(p<0.01). These results suggest That the prevalence of iron deficiency of female high school students is very high, therefore guidelin......
Anemia* ; Biochemistry ; Surveys and Questionnaires ; Female* ; Ferritins ; Hand ; Heme ; Humans ; Iron* ; Nutritional Status ; Prevalence ; Transferrin ; Ulsan*