Succinylcholine-induced prolonged neuromuscular blockade may occur in patients with either a low level of plasma cholinesterase activity or genotypically abnormal form of that enzyme. We experienced a case of succinylcholine-induced prolonged apnea due to a low level of plasma cholinesterase activity. A 31-year-old woman, full term primigravida, underwent cesarean section for breech presentation under general anesthesia. Familial and past medical history were nonspecific and preoperative physical and laboratory findings were within normal range. After operation, delayed apnea was detected and lasted for about one hour. We performed controlled and assisted ventilation for two and half hours. Plasma cholinesterase activity measured 30.00 IU/L (colorimetric method, normal value: 1130~1960 IU/L) at the first postoperative day. She was discharged on 7th postoperative day without any sequelae. From follow-up study after six months, it measured 1.02 U/ml (EIA, normal value: 7~9 U/ml).
Adult ; Anesthesia, General ; Apnea* ; Breech Presentation ; Cesarean Section* ; Cholinesterases* ; Female ; Follow-Up Studies ; Humans ; Neuromuscular Blockade ; Plasma* ; Pregnancy ; Reference Values ; Ventilation

No abstract available.
Prostate* ; Testis*

No abstract available.
Salivary Ducts*

No abstract available.
Immunoglobulins* ; Lactoglobulins* ; Milk*

The purpose of the present was devalopment of a new pain assessment model that recorded in free moving rats to eliminte of anesthetic agents in orofacial area. Antinociceptive effects and mechanisms of tricyclic antidepressants is also investigated. Fifty-five male Wistar rats (400-500gm) were anesthetized with an intraperitoneal injection of urethane (500microgram/kg) and pentobarbital sodium ((20microgram/kg). Anesthetized rats mounted in a sterotaxic instrument and a guide cannula was implanted in the lateral ventricle. The Cordinates were 0.8mm posterior to bregma, 1.5mm lateral from midline and 0.4mm ventral from the skull. Stimulating electrodes implanted in the incisor plup and recording electrodes were inserted into the belly of digastric musle. Stimulating and recording eletodes were led subcutaneously to miniature cranial connector sealed on the top of the skullwhit acrylic resin. Jaw opening reflex (JOP) was used a pian assessment. Jaw opening reflex is elicted by noxious stimulation of the incisor and is quantified by the magnitude of electromyogram of digastric muscle(dEMG). After a 48hours recovery period from surgery. JOR was recorded in free moving rats. Electrcal shock (200 sec duration, 0.5-2mA intensity, 0.5Hz) were delivered to the dental plup. Twenty subsequent electromyograms were recorded from digastric music in free moving rats. After intraperitioneal injection of 15microgram/kg impramine or nortriptyline dEMG was suppressed to 64+/-6 or 56+/-8% of the control. Intraperitioneal injection of 30microgram/kg desipramine, impramine or nortriptyline dEMG respectively to 44+/-9, 15+/-4, or 16+/-3% of the control. After intravenous injection of 12microgram/kg desipramine, imipramine or nortriptyline, dEMG was suspressed to 73 7, 50 4, or 66 7% of the control. Intravenous injection of 18microgram/kg desipramine, imipramine or nortriptyline suppressed dEMG respectively to 57+/-6, 12+/-3 or 6+/-2% of the control. To investigate the central mechanisms of antinociception of nortriptyline, naloxne, opioid receptor antagonist, methysergide, and phentolamine inhibited suppression of dEMG by intravenous injection of 18microgram/kg notriptyline from 7+/-2 to 47+/-9, from 4+/-2 to 24+/-6, and from 4+/-1 to 51+/-7% of the control resectively. these results suggest that antidepressant agents be to modulate pain transmission in orofacial area. The analgesia produced by intraperitioneal and intraventous injection of antidepressants seems to be mediated by multipule pathways such as descending pain inhibitory system.
Analgesia ; Anesthetics ; Animals ; Antidepressive Agents* ; Antidepressive Agents, Tricyclic ; Catheters ; Desipramine ; Electrodes ; Humans ; Imipramine ; Incisor ; Injections, Intraperitoneal ; Injections, Intravenous ; Jaw ; Lateral Ventricles ; Male ; Methysergide ; Music ; Nortriptyline ; Pain Measurement ; Pentobarbital ; Phentolamine ; Rats* ; Rats, Wistar ; Receptors, Opioid ; Reflex* ; Shock ; Skull ; Urethane

No abstract available.
Child* ; Humans ; Immunoglobulins ; Infant, Newborn* ; Lactoglobulins ; Milk Proteins* ; Milk* ; Mothers* ; Postpartum Period*

BACKGROUND: The risk for a hand injury was increased according to industrial structure and lifestyle change. This study investigated the post traumatic stress (PTS) and related factors in some hand replantation patients. METHODS: Total 150 hand replantation patients in one hospital were selected using convenience sampling methods. General characteristics of patients, characteristics of injured hand, self-esteem and PTS were collected using self-reported questionnaires. And clinical characteristics of injured hand were obtained from a review of medical records. Descriptive analysis, t-test, ANOVA and multiple regression analysis were performed to determine the associated factors with the score of PTS. RESULTS: Among 150 patients, 80% were male and 94% had a job. The mean score of PTS was 22.2±16.9. In simple analysis, PTS score were associated with smoking status, injury day of the week, pain score and self-esteem. Finally, the subjects who injured in weekdays had significantly higher PTS score compared to subjects who injured in weekend (β=0.185, P=0.021) and pain score was positively associated with PTS score (β=0.181, P=0.027) in multiple regression analysis. CONCLUSIONS: Injury day of the week and pain score were associated with PTS score in some hand replantation patients. Considering these results will help to management and improve quality of life of hand replantation patients.
Amputation ; Hand Injuries ; Hand* ; Humans ; Life Style ; Male ; Medical Records ; Quality of Life ; Replantation* ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Parkinson's Disease (PD) is a progressive neurodegenerative disorder characterized by resting tremor, rigidity, and bradykinesia. L-3,4-dihydroxyphenylalanine (L-dopa) has been used for over last 3 decades to treat this disorder, however, its usage is limited due to the reducing effectiveness on time and severe side effects. The best strategy for treating this disorder without serious side effects would be to keep a constant level of dopamine in the brain. This could be achieved by gene or cell therapy using gene(S) involved in dopamine biosynthesis or cells from other individual. For Parkinson's gene therapy, however, there still are controversies on which gene In what combination will yield the best result. In this report, we propose a biochemical background for using GTP cyc]ohydrolase I (GTPCH I) in addition to TH for higher and/or more stable expression of TH. METHODS: TH and GTPCH I cDNA were subcloned into retroviral vectos and resulting recombinant retrovirus packaged in BOSC 23 cells were used to infect NIH-3T3. Confirming successful infections by westers blot analysls, the new cell lines were used to examine steady state TH expression level and TH activity. Furthermore, the effect of ectopic expression of BH4 to the proliferation of these cells were studied. RESULTS: NIH-3T3 cells expressing both TH and GTPCH I showed approximately 10 fold higher expression of TH protein than the cells expressing TH alone. The activity of KNTH2GC6 was approximately 4-6 fold higher than that of striatal tissue and 60 fold higher than KNTH2. Furthermore, growth rate of KNTH2GC6 was strikingly reduced by inhibiting the biosynthesis of BH4. CONCLUSIONS: We showed that the use of GTPCH I in addition to TH not only increased the stability and/or expression of TH protein but also the activity of the enzyme. These improved characteristics of TH protein are very likely due to the expression of BH4 and should be very seriously considered for Parkinson's gene therapy.
Brain ; Cell Line ; Cell- and Tissue-Based Therapy ; DNA, Complementary ; Dopamine ; Genetic Therapy ; GTP Cyclohydrolase* ; Guanosine Triphosphate* ; Hypokinesia ; Levodopa ; Neurodegenerative Diseases ; NIH 3T3 Cells ; Parkinson Disease ; Retroviridae ; Tremor ; Tyrosine 3-Monooxygenase* ; Tyrosine* ; Zidovudine

BACKGROUND: The dysfunction of the proteasome system has been implicated in neuronal degeneration. Apocynin, a specific inhibitor for nicotinamide adenine dinucleotide phosphate oxidase, has anti-inflammatory and anti-oxidant effects. However, the effect of apocynin on the neuronal cell death induced by proteasome inhibition has not been studied. METHODS: Using differentiated PC12 cells, in the respect of cell death process the suppressive effect of apocynin on the proteasome inhibition-mediated apoptosis was examined. RESULTS: The proteasome inhibitors MG132 and MG115 induced a decrease in Bid and Bcl-2 protein levels, an increase in Bax and p53 levels, mitochondrial depolarization, efflux of cytochrome c into cytosol and increase in caspases (-8, -9 and -3) activities. Treatment with apocynin attenuated the proteasome inhibitor-induced changes in the apoptosis-related protein levels, formation of reactive oxygen species, glutathione (GSH) depletion and cell death. CONCLUSIONS: Apocynin may attenuate the proteasome inhibitor-mediated apoptosis in differentiated PC12 cells by inhibiting the activation of the mitochondria-mediated pathway and the caspase-8- and Bid-dependent pathways. The preventive effect of apocynin appears to be attributed to inhibition of the production of reactive oxygen species and the depletion of cellular GSH contents.
Animals ; Antioxidants ; Apoptosis* ; Caspases ; Cell Death ; Cytochromes c ; Cytosol ; Glutathione ; NADP ; Neurons ; Oxidoreductases ; PC12 Cells* ; Proteasome Endopeptidase Complex* ; Proteasome Inhibitors ; Reactive Oxygen Species

Calcifying aponeurotic fibroma is a very rare benign soft tissue tumor with predilection for the fingers and palms of children and adolescents. We describe an unusual case of a calcifying aponeurotic fibroma in old age that circumferentially involved the dorsal and palmar side of the third metacarpal head.We performed a wide excision using two incisions, resulting in satisfactory clinical result. A calcifying aponeurotic fibroma must be considered in the differential diagnosis of a calcifying soft tissue lesion occuring in the hand of old age.
Adolescent ; Child ; Diagnosis, Differential ; Fibroma ; Fingers ; Hand ; Humans