LPS and IFN-r induce nitric oxide synthase in macrophages and the resultant NO causes apoptotic cell death in the activated macrophages. NO production and apoptosis were inhibited by N-monomethyl L-arginine (NMMA), a competitive inhibitor of NO synthase. To study the role of BCL-X proteins, RAW 264.7 cells were transfected with the expression vectors with human bcl-Xl or bcl-Xs cDNAs, respectively. Stable transfectants were selected and confirmed by RT-PCR. NO production in response to LPS and IFN-r caused apoptosis in RAW 264.7 cells and vector transfected control cells within 24 hr. Both NO production and apoptosis were inhibited by N(G)-monomethyl L-arginine (NMMA). In contrast, bcl-Xs transfectant appeared slightly susceptible and bcl-X(L)< transfectant appeared slightly resistant, although NO production was similar to control cells. These results suggest that bcl-X proteins play roles in both positive and negative regulation of apoptosis induced by NO.
Apoptosis* ; Arginine ; bcl-X Protein* ; Cell Death ; DNA, Complementary ; Humans ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase

BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans.
Animals ; Bony Callus ; Fractures, Open ; Humans ; Maxillary Sinus ; Models, Animal ; Mucous Membrane ; New Zealand ; Orbit ; Polyethylene ; Rabbits ; Regeneration ; Silicones ; Tissue Fixation ; Transplants ; Wound Healing

No abstract available.
Humans ; Multiple Birth Offspring ; Twins*

BACKGROUND: There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. METHODS: M.tuberculosis, differentiated MOTT (Tycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-1β, IL-12, *1 IFNγ and *2 TNFαblood levels were measured. All patients were regularly followed for 18 months after treatment. RESULTS: There was no correlation between the RFLP patterns of M.tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/ml. Most of the 53 cases on neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. CONCLUSION: A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.
Humans ; Interleukin-12 ; Korea ; Male ; Neck* ; Polymorphism, Restriction Fragment Length ; Treatment Failure* ; Tuberculosis* ; Tuberculosis, Pulmonary

Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

Sixty healthy adult patients undergoing general anesthesia for elective surgery were randomly allocated to three group(n = 20), and their EMG response(twitch height) of the adductor digiti mini muscle(hypothena) to TOF stimulation of ulnar nerve by Datex relaxograph was monitored. The patients were received a bolus injection of vecuronium(0.1mg/kg) alone in group I, vecuronium(0.1 mg/kg) after 25-50% recovery from SCh(l mg/kg) in group II, and the mixed injection of SCh(1 mg/kg) and vecuronium(O.I mg/kg) in group III. The onset time(mean SEM) of effect of vecuronium(0.1 mg/kg) in group II(2.2+/-0.4 min) and group III(1.7+/-0.2 min) significantly was shorten when compared with a bolus injection of vecuronium alone in group(4.4+/-0,4 min)(p<0.05). The duration(mean+/-SEM) of vecuronium(0.1 mg/kg), however, had no significant differences among three group. It was 33+/-2 min in group I, 39+/-3 min in group II, and 34+/-2 min in group III. The potency of twitch height depression of vecuronium(0.1 mg/kg) was increased significantly following preinjection of SCh(1 mg/kg) and at the mixed injection of SCh and vecuronium The intensity of fasciculation induced by SCh was not affected at the mixed injection of vecuronium in group III. The peak increases in arterial pressare and heart rate on the endotracheal intubation were attenuated significantly at the mixed injection of SCh (1 mg/kg) and vecuronium(0.1 mg/kg) when compared with its effect of SCh (1 mg/kg) in group II(p<0.05).
Adult ; Anesthesia, General ; Depression ; Fasciculation ; Heart Rate ; Humans ; Intubation, Intratracheal ; Neuromuscular Blockade* ; Succinylcholine* ; Ulnar Nerve ; Vecuronium Bromide*

OBJECTIVES: This study explored the reuse of data captured by nurses to support nursing decisions related to pressure-ulcer care. METHODS: To examine the existence of coded data in an electronic nursing record system for the identified concepts, we used the electronic nursing documents of a teaching hospital in Gyeonggi-Do, in Korea. A surgical intensive care unit (SICU) was selected as the test unit due to the high incidence of pressure ulcers. The concepts were identified from literature review and refined through the involvement of staff nurses. RESULTS: We found that 93.4% of the necessary concepts were matched semantically with data items at the input level of the electronic medical record system. Eighteen concepts (60%) were directly matched with the data variables of structured electronic nursing records. Five concepts (16.7%) were matched into more than two items. Including the standard nursing statements coded in Nurses' notes, five concepts were mapped more. CONCLUSIONS: More than 90% of the concepts were matched successfully, which suggests that the secondary use of the routine data collected in an EMR system could be used to develop an automated risk assessment tool for pressure ulcers.
Electronic Health Records ; Electronics ; Electrons ; Hospitals, Teaching ; Incidence ; Critical Care ; Korea ; Medical Records Systems, Computerized ; Nursing Records ; Pressure Ulcer ; Risk Assessment

A massive pulmonary embolism occurring during surgery is a fatal complication. Therefore, early detection and subsequent treatment of pulmonary emboli are important clinical challenges. In this report, an acute pulmonary embolism associated with cardiac arrest occurred during the surgical reduction of a femur fracture. It was diagnosed by echocardiography and treated with urokinase successfully. Therefore, we recommend the use of urokinase for the treatment of a intraoperative massive pulmonary embolism.
Echocardiography ; Femur* ; Heart Arrest ; Pulmonary Embolism* ; Urokinase-Type Plasminogen Activator*

PURPOSE: The purpose of this study was to explore the parenting image of modern Korean society through modern novels published during in the stage of modern change in Korea. METHOD: The data were analyzed through latent content analysis. Modern Korean novels (N=138) written during the Korean modernization stage were chosen for analysis. Five categories and seventeen meaningful sub-categories were drawn out from 636 significant sentences. RESULTS: The parenting images expressed in modern Korean society were as follows: From the category of [Devotional love], 5 sub-categories were drawn: Hedgehog's love, Lavish love, Sacrificial care, Exertion of the mind, and Prayer for the future of their children. From the category of [Stern father and affectionate mother], 3 sub-categories were drawn: Stern and Strict father, Tender and loving mother, and Strong maternal love. From the category of [Enthusiasm for their children's education], 3 sub-categories were drawn: Sense of duty to provide good education for their children, Zeal for their children's education, and Satisfaction with their hard-working children. From the category of [The head of family], 3 sub-categories were drawn: Person who has the right to make decisions, Reliable protector, and Object of filial devotion. From the category of [sexual discrimination], 3 sub-categories were drawn: Preference and favoritism to sons, Attaching importance to education of sons, Regarding daughters as those who help support the family. CONCLUSIONS: The results of this study will help to improve the basic understanding the parenting image and parent-child relationship in present day Korea.
Child ; Education ; Fathers ; Head ; Humans ; Korea ; Love ; Mothers ; Nuclear Family ; Parent-Child Relations ; Parenting* ; Parents* ; Religion ; Social Change ; Child Health