No abstract available.
Male ; Penis* ; Xanthogranuloma, Juvenile*

No abstract available.
Sciatic Nerve*

BACKGROUND: Epinephrine is commonly used to reduce bleeding by constriction of nasal vessels in endoscopic sinus surgery. However, when it absorbs to other organs systemically, tachycardia and hypertension may occur and result in more bleeding. This study is performed to evaluate the dose response effects of remifentanil infusion to suppress these adverse responses without delaying emergence. METHODS: Sixty healthy patients who scheduled for endoscopic sinus surgery were randomly allocated into three groups by the dose of remifentanil infusion. For induction and maintenance of anesthesia, 0.05, 0.15, 0.25microgram/kg/min of remifentanil and 3.5microgram/ml of intravenous propofol by TCI were infused to each group. Systolic and diastolic blood pressure, heart rate and bispectral index were measured for 15 minutes at the 1 minute intervals after nasal packing of epinephrine. RESULTS: Systolic and diastolic blood pressure in R0.15 and R0.25 group were significantly lower compared to R0.05 group during 9 to 12 minutes after epinephrine packing, but heart rate and bispectral index were not significantly different among the groups. The frequency of hypotension and bradycardia were significantly higher in R0.25 than R0.05 and R0.15. CONCLUSIONS: Continuous infusion of 3.5microgram/ml of propofol with 0.15microgram/kg/min of remifentanil attenuate hypertension and tachycardia induced by epinephrine with little side effects.
Anesthesia ; Blood Pressure ; Bradycardia ; Constriction ; Epinephrine* ; Heart Rate ; Hemodynamics* ; Hemorrhage ; Humans ; Hypertension ; Hypotension ; Propofol ; Tachycardia

OBJECTIVE: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%-6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. METHODS: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was > or =5.7% or <5.7%. Lipid levels, blood pressure, BMI (kg/m2), total abdominal, and visceral fat levels were measured by computed tomography. RESULTS: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, 6.03+/-0.8% and 5.88+/-0.72%(p<0.05). Only the mean values of age and visceral fat area were different between HbA1c> or =5.7% and <5.7% in both male and female group (p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c > or =5.7% (odds ratio=1.005, 95% CI 1.002~1.008). CONCLUSIONS: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is > or =5.7%. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs.
Adult ; Blood Pressure ; Cardiovascular Diseases ; Diabetes Mellitus ; Female ; Health Education ; Hemoglobins ; Humans ; Intra-Abdominal Fat ; Male ; Prediabetic State ; Risk Factors

BACKGROUND: Mivacurium is a new, short acting, nondepolarizing muscle relaxant of the benzylisoquinolinium type. Enflurane produces relaxation and augments the neuromuscular blockade from muscle relaxation, but propofol does not produce muscle relaxation. We compared maintenance infusion rates, recovery index and correlations of recovery index to maintenance infusion rates and infusion duration after mivacurium during enflurane or propofol anesthesia in children. METHODS: Maintenance infusion rates, and the recovery index after mivacurium were studied in 30 pediatric patients in enflurane anesthesia (n = 15) and propofol anesthesia (n = 15). The ulnar nerve was stimulated at the wrist by repeated single twitch (1Hz) stimulus using the peripheral nerve stimulator (Model ST5 MaxiStimTM, Life-Tech , Inc, Texas, USA). We recorded the contraction of adductor pollicis longus via mechanomyography (MYOTRACE, Life-Tech, Inc, Texas, USA). RESULTS: The infusion rates of mivacurium for the maintenance of muscle relaxation (below 10% of control) were 9.6 0.80 microgram/kg/min in the enflurane anesthesia, and 11.04 1.22 microgram/kg/min in the propofol anesthesia. There was a significant difference between the groups. The recovery index was shorter in the propofol anesthesia, but regarding this index, there was no significant difference between both groups. The correlation between the recovery index and the infusion duration was significantly different in the enflurane anesthesia. CONCLUSIONS: We conclude that maintenance infusion rates are significantly lower in the enflurane anesthesia, the recovery index is insignificantly shorter in the propofol anesthesia, that there is a significant correlation between the maintenance infusion rates and recovery index in the enflurane anesthesia.
Anesthesia* ; Child* ; Enflurane* ; Humans ; Muscle Relaxation ; Neuromuscular Blockade ; Peripheral Nerves ; Propofol* ; Relaxation ; Texas ; Ulnar Nerve ; Wrist

BACKGROUND: Rapid-sequence intubation is a common technique to reduce anesthetic complication. Due to side effects of succinylcholine, nondepolarizing muscle relaxants have been tried. Rocuronium is a new nondepolarizing muscle relaxant with a brief onset of action, but devoid of the adverse reaction associated with succinylcholine. Most local anesthetics decrease neuromuscular transmission and pontentiate neuromuscular blocks of muscle relaxants. The purpose of this study was to examine the effect of lidocaine on the onset time of rocuronium-induced neuromuscular blockade in adults. METHODS: Fourty five patients, ASA physical status I or II, were randomly divided into three groups. Anesthetic induction with thiopental 5 mg/kg was made. Succinylcholine (1.0 mg/kg) was administered intravenously in group 1. Rocuronium (0.6 mg/kg) was given in group 2, additional lidocaine (1.0 mg/kg) was given intravenously 1 minute prior to the administration of rocuronium in group 3. Neuromuscular blockade was assessed by train-of-four at the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve (2 Hz, 0.2 msec) every 10 seconds. The condition of intubation, the appearance of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods. RESULTS: The onset time of group 1 (55.1 14.9 sec) was faster than that of group 2 (137.8 46.0 sec) and group 3 (139.3 41.0 sec), but there was no difference between the onset time of group 2 and that of group 3. Intubating conditions were good or excellent in all groups, but group 1 and 3 were better than group 2. There was no difference between the three groups in hemodynamics. More adverse effects were observed in group 1, that of group 2 and 3 were observed in only one case. CONCLUSIONS: The authors concluded that lidocaine is not effective on the onset time of rocuronium, but improves the intubating condition. Rocuronium is devoid of side effects of succinylcholine, but not a alternative to succinylcholine because its onset time is too slow when compared with succinylcholine.
Adult* ; Anesthetics, Local ; Arrhythmias, Cardiac ; Arterial Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Lidocaine* ; Neuromuscular Blockade* ; Succinylcholine ; Thiopental ; Ulnar Nerve

BACKGROUND: Rapid-sequence intubation is a common technique to reduce anesthetic complication. Due to side effects of succinylcholine, nondepolarizing muscle relaxants have been tried. Rocuronium is a new nondepolarizing muscle relaxant with a brief onset of action, but devoid of the adverse reaction associated with succinylcholine. Most local anesthetics decrease neuromuscular transmission and pontentiate neuromuscular blocks of muscle relaxants. The purpose of this study was to examine the effect of lidocaine on the onset time of rocuronium-induced neuromuscular blockade in adults. METHODS: Fourty five patients, ASA physical status I or II, were randomly divided into three groups. Anesthetic induction with thiopental 5 mg/kg was made. Succinylcholine (1.0 mg/kg) was administered intravenously in group 1. Rocuronium (0.6 mg/kg) was given in group 2, additional lidocaine (1.0 mg/kg) was given intravenously 1 minute prior to the administration of rocuronium in group 3. Neuromuscular blockade was assessed by train-of-four at the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve (2 Hz, 0.2 msec) every 10 seconds. The condition of intubation, the appearance of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods. RESULTS: The onset time of group 1 (55.1 14.9 sec) was faster than that of group 2 (137.8 46.0 sec) and group 3 (139.3 41.0 sec), but there was no difference between the onset time of group 2 and that of group 3. Intubating conditions were good or excellent in all groups, but group 1 and 3 were better than group 2. There was no difference between the three groups in hemodynamics. More adverse effects were observed in group 1, that of group 2 and 3 were observed in only one case. CONCLUSIONS: The authors concluded that lidocaine is not effective on the onset time of rocuronium, but improves the intubating condition. Rocuronium is devoid of side effects of succinylcholine, but not a alternative to succinylcholine because its onset time is too slow when compared with succinylcholine.
Adult* ; Anesthetics, Local ; Arrhythmias, Cardiac ; Arterial Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Lidocaine* ; Neuromuscular Blockade* ; Succinylcholine ; Thiopental ; Ulnar Nerve

Purpose: Insulin is known to induce relaxation in various vasculatures by increasing the release of nitric oxide or the expression of nitric oxide synthase. However, its action mechanisms on the corpus cavernosum remain to be uncovered. This study aimed to investigate the relaxative responses and the mechanism of normal cavernous smooth muscles to insulin. Methods and Materials: Rabbit corpus cavernous tissues were prepared in 2x2x8 mm sized strip for isotonic tension recording. The dose-dependent relaxation responses of norepinephrine (10(-4)M)-precontracted strips to insulin (10(-6)M)were measured. The relaxation responses of NE (10(-4)M)-precontracted strips to insulin (10(-6)M) were measured under low to high glucose concentrations (0, 0.1, 1 and 11mM) in physiological solution. The relaxation responses of the NE-precontracted strips to insulin (10(-6)M) were also observed after endothelial denudation, 30-minute preincubation with L-NAME (5mM) or 30-minute preincubation with indomethacin (10(-4)M). Results: The cavernosal strips were relaxed by insulin in a dose-dependent manner. The insulin-induced relaxation was dose-dependently increased by glucose. The endothelial denudation or indomethacin pretreatment almost abolished the insulin-induced relaxation, but L-NAME rarely affected the relaxation. Conclusions: Insulin induces an endothelium-dependent relaxation of rabbit cavernous smooth muscles, which is mostly NO-independent, but seems to be related with prostaglandins or their metabolites.
Glucose ; Indomethacin ; Insulin ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Norepinephrine ; Prostaglandins ; Relaxation*

PURPOSE: This study was designed to investigate the effects of polyamines on rabbit seminal vesicular contractility. MATERIALS AND METHODS: The polyamines; putrescine, spermidine and spermine, were added to deepithelized and precontracted seminal vesicle strips, with either 10 4M norepinephrine (NE), 10 4M acetylcholine (ACh) or 70mM KCl, in organ chambers to obtain cumulative concentration response curves. A whole cell mode patch clamp study was also performed to observe the effects of the polyamines on the L-type calcium channel activities. RESULTS: The polyamines elicited concentration-dependent relaxations of the precontracted strips with the NE, ACh and KCl. The spermine showed the most potent relaxation response. Both extracellular and intracellular application of the spermine decreased the L-type calcium channel currents. CONCLUSIONS: Spermine more potently inhibited the seminal vesicle contraction than putrescine or spermidine, which suggests the polyamines may play a role in maintaining the basal tonicity of seminal vesicle in a flaccid state. The spermine-induced relaxation response seems to be related with an inhibition of the L-type calcium channel activities.
Acetylcholine ; Calcium Channels, L-Type ; Norepinephrine ; Polyamines* ; Putrescine ; Relaxation* ; Seminal Vesicles* ; Spermidine ; Spermine

BACKGROUND AND OBJECTIVES: The recurrence rate of patients with Graves' disease (GD) is estimated to be 50-55% after withdrawal of antithyroid drug therapy, and relapse is frequent in the first year after discontinuing the medication. Follow-up examination of these patients frequently reveals laboratory findings consistent with subclinical thyrotoxicosis in the first year after stopping the antithyroid agents. We investigated the risk of recurrence of GD among patients with resurfacing subclinical thyrotoxicosis state after remission of initial GD with antithyroid treatments. MATERIALS AND METHODS: We reviewed the patients diagnosed with GD who visited the Department of Endocrinology at two tertiary medical centers: Wonju Severance Christian Hospital and Gangneung Asan Hospital. We enrolled patients whose GD was completely treated after initial treatment with antithyroid agents who then developed subclinical thyrotoxicosis after discontinuation of antithyroid agents. RESULTS: We reviewed a total of 44 patients (29 females, 15 males; age, 48.93±18.04; range, 17-85 years). The recurrence rate was 27.3% (12/44 patients), and recurrence occurred 3 months to 12 months later resurfacing of subclinical thyrotoxicosis. Patients with recurred GD was significantly older than non-recurred patients (44.63±17.75 years vs. 58.58±15.48 years, p=0.02). Other clinical parameters measured at the time of initial diagnosis were not different between the two groups. CONCLUSION: The recurrence rate of GD in patients with resurfacing subclinical thyrotoxicosis after initial remission of the disease was less than 30%. A close monitoring is recommended in these subgroup patients, especially in older patients.
Antithyroid Agents* ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Endocrinology ; Female ; Follow-Up Studies ; Gangwon-do ; Graves Disease* ; Humans ; Male ; Recurrence* ; Thyrotoxicosis*