Methoxyflurane, a new anesthetic agent, was administered to one hundred surgical patients. The following are the results of clinical observation and liver function tests. (1) Methoxyflurane is easily administered with a relatively simple vaporizer such as Heidbrink No.8 ether vaporizer in semi-closed system. (2) Blood pressure, pulse rate and cardiac rhythm are remarkably stable if deep anesthesia is avoided. (3) Excellent muscle relaxation is produced at intermediate levels of anesthesia without producing apnea. To avoid overdose it is recommended, however, to use muscle relaxants for operations which require highest degree of muscle relaxation such as upper abdominal procedures. (4) Assisted respirstion is advocated since methoxyflurane tends to depress respiration. (5) Depth of anesthesia is easily controlled with growing experience so that overdose can be avoided. (6) Analgesia extends into the recovery phase, minimizing the need for narcotics in the immediate postoperative period. (7) lnduction of and recovery from anesthesia is relatively prolonged. However, nausea, vomiting or delirium is less frequent than after ether anesthesia. (8) Hepatotoxicity, as determined by bromsulphalein, retention is of the same magnitude as that determined for diethyl ether.
Analgesia ; Anesthesia ; Apnea ; Blood Pressure ; Delirium ; Ether ; Heart Rate ; Humans ; Liver Function Tests ; Methoxyflurane* ; Muscle Relaxation ; Narcotics ; Nausea ; Nebulizers and Vaporizers ; Postoperative Period ; Respiration ; Sulfobromophthalein ; Vomiting

The glucose uptake rate by plerocercoid of Diphyllobothrium sp. was a mean value of 5.35+/-0.80 micro-mole/hr/g of wet wt, and total CO(2) production rates by the plerocercoid larva averaged 7.54+/-0.73 micro-mole/hr/g of wet wt. The relative specific activity into respiratory CO(2) showed a mean value of 7.30 +/-0.90 per cent. The rate of CO(2) production derived from medium C(14)-glucose was a mean of 0.58+/-0.13 micro-mole/hr/g of wet wt. Therefore, the average value of 1.92+/-0.38 per cent of glucose utilized by the larvae from the medium C(14)-glucose was oxidized to respiratory CO(2). The tissue concentration of glycogen in plerocercoid larva was a mean of 46.28 +/-2.23 mg/g or 4.63+/-0.22 per cent/g of wet wt., and the turnover rate of glycogen pool was a mean of 0.049 +/- 0.012 %/hr or 0.010 +/- 0.003 mg/hr/g of wet wt. The average value of 2.76+/-1.00 per cent of glucose utilized by the larvae from the medium C(14)-glucose was incorporated to the glycogen. These data accounts for that only 5 per cent of the utilized glucose by the plerocercoid larvae participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen.
parasitology-helminth-cestoda ; Diphyllobothrium sp. ; sparganum ; plerocercoid ; biochemistry ; autoradiography ; glucose ; metabolism ; CO(2)

The adult trematodes, Fasciola hepatica, Eurytrema pancreaticum and Paramphistomum cervi, employed in this experiment were obtained from the cattle slaughtered at the local abbatoir. The worms selected and washed several times in normal sterilized saline solution. Each about ten of intact F. hepatica, fourty of E. pancreaticum, and twenty of P. cervi were incubated in 50 cc volume of special incubation flasks with incubation medium consisting of 10 cc. of Krebs-Ringer phosphate buffer(pH 7.4) The incubation medium was added C(14)-1-acetate and non-radioactive carrier Na-acetate so as to contain acetate concentration of 50 mg per cent . The worms were allowed to incubate for 5 hours in the Dubnoff metabolic shaking incubator at 38 C. After incubation period, respiratory CO(2) samples from central well of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). The lactate and pyruvate appearance rates were determined by analyzing the lactate and pyruvate concentration in a medium after incubation. The glycogen samples isolated from worms were analyzed for the tissue concentration and their radioactivities in order to determine the turnover rate of glycogen pool. Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-acetate utilized by F. hepatica, E. pancreaticum and P. cervi were compared and discussed in this report. According to these data of the experiment, it is suggested that the fatty acid such as acetate may play a part of their oxidative process into the respiratory CO2 and the synthetic process into glycogen in the above species of trematodes.
parasitology ; helminth ; trematoda ; Fasciola hepatica ; Eurytrema pancreaticum ; Paramphistomum cervi ; acetate ; metabolism ; biochemistry ; CO(2) ; glycogen ; Krebs-Ringer phosphate buffer

Generally, most cases of diabetes mellitus (DM) are classified as either type 1 DM or type 2 DM based on their pathophysiolgic features. However, it is not always possible to classify this disease clearly according to current diagnostic criteria. Recently, the existence of non-typical diabetes has been found in patients with simultaneous features of both type 1 and type 2 DM. In these patients, obvious evidence of insulin resistance, positivity of islet autoantibody, and progressive beta cell loss are observed concurrently. Moreover, this non-typical diabetes that usually occurs among children and adolescents has been defined as 'double diabetes', and its worldwide incidence has been on the increase as of late. Thus, there has been heightened interest among researchers about this ambiguous condition.
Adolescent ; Autoimmunity ; Biomarkers ; Child ; Diabetes Mellitus ; Genetic Predisposition to Disease ; Humans ; Incidence ; Insulin Resistance

Peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM) exhibits broad clinical characteristics and various consequences and is known as one of the major macrovascular complications of T2DM. Atherosclerosis is recognized as the most direct and important cause of PAD, but acute or chronic limb ischemia may be the result of various risk factors. In light of the increasing number of patients who undergo peripheral vascular procedures, the number of subjects who are exposed to the risks for PAD and related complications is increasing. In this review, we will discuss the clinical and epidemiological characteristics of PAD, as well as the clinical significance of PAD in T2DM subjects.
Atherosclerosis ; Diabetes Mellitus, Type 2* ; Extremities ; Humans ; Ischemia ; Korea ; Peripheral Arterial Disease* ; Risk Factors

The glucose uptake rate by Fasciola hepatica was a mean value of 9.62 +/- 0.54 micro-mole/hr/g, and total CO(2) production rate by the flukes averaged 24.28 +/- 4.26 micro-mole/hr/g wet wt. The relative specific activity of respiratory CO(2) showed a mean value of 79.89 +/- 1.78 per cent. The rate of CO(2) production derived from medium C(14)-glucose was a mean of 19.55 +/- 3.56 micro-mole/hr/g of we wt. Therefore, the average value of 32.72 +/- 4.8 percent of glucose utilized by the flukes from the medium C(14)-glucose was oxidized to respiratory CO(2). The tissue concentration of glycogen in F. hepatica was a mean of 38.36 +/- 2.91 mg/g or 3.84 +/- 0.29 %/g of wet wt, and the turnover rate of glycogen pool was a mean of 1.6+/-0.22 %/hr or 0.65 +/- 0.13 mg/hr/g. The average value of 37.26 +/- 3.86 per cent of glucose utilized by the fluke from the medium C(4)-glucose was incorporated to the glycogen. These data account for that approximately 70 per cent of the utilized glucose by the flukes participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen.
parasitology-helminth-trematoda-Fasciola hepatica ; glucose ; biochemistry ; autoradiograhy ; glycogen ; CO(2)

In cases of chronic hyperglycemia, advanced glycation end-products (AGEs) are actively produced and accumulated in the circulating blood and various tissues. AGEs also accelerate the expression of receptors for AGEs, and they play an important role in the development of diabetic vascular complications through various mechanisms. Active interventions for glucose and related risk factors may help improve the clinical course of patients by reducing AGEs. This review summarizes recent updates on AGEs that have a significant impact on diabetic vascular complications.
Diabetes Complications ; Diabetic Angiopathies* ; Glucose ; Glycosylation End Products, Advanced* ; Humans ; Hyperglycemia ; Risk Factors

PURPOSE: The purpose of this study was to evaluate the suitability (convenience, objectiveness, and satisfaction) of ubiquitous-based testing (UBT) as a medical education evaluation tool. METHODS: UBT was administered using a smart pad in our medical school in May 2012. A questionnaire was given twice. The pre-UBT questionnaire examined possession of a tablet computer, skillfulness of smart devices, the convenience of UBT, and the usefulness of a medical educational assessment tool. The post-UBT questionnaire evaluated the satisfaction, convenience, and preference of UBT and the usefulness of a medical educational assessment tool, as in the pre-UBT test. The survey was measured on a 4-point scale: 1 is "strongly disagree" and 4 is "strongly agree." RESULTS: One hundred three students (male, 55.3%) participated in the UBT. The mean age was 29.2+/-2.4 years. In the pre-UBT questionnaire analysis, students responded affirmatively to the items about the skillfulness of smart devices, clinical skill assessment, and achievement of educational objectives. The responses to the items on the convenience and satisfaction with the UBT were positive in the post-UBT. The factors that affected the post-UBT questionnaire were as follows: knowledge assessment (p=0.041) and achievement of educational objectives (p=0.015) were significant, based on gender, and satisfaction with the UBT (p=0.002) was significant, based on possession of a tablet computer. The relationship between the ranks of this UBT and the average ranks of the three previous semesters was statistically significant (p<0.001). CONCLUSION: Convenience, objectiveness, knowledge assessment, and composition and completion were useful items in the UBT.
Achievement ; Adult ; *Clinical Competence ; *Computers ; Consumer Behavior ; *Education, Medical ; Educational Measurement/*methods ; Female ; Goals ; Humans ; Male ; Ownership ; Sex Factors ; *Smartphone ; Surveys and Questionnaires

BACKGROUND/AIMS: This study was conducted to examine the relationship between family history of type 2 diabetes (T2DM) and risk of developing gestational diabetes mellitus (GDM) in Korean women. METHODS: We performed a 100-g oral glucose tolerance test in 858 pregnant women who had abnormal glucose tolerance in 50-g oral glucose challenge. In addition, we reviewed the incidence of T2DM in the parents and siblings and analyzed the association between the familial history of T2DM and the risk of GDM. RESULTS: Of the 858 subjects, 427 were normal, and 431 were diagnosed with GDM. Compared with women with no family history of T2DM, women with first degree family history of T2DM displayed higher risk of T2DM (odd ratio: parent only 1.91, sibling only 6.24, any 2.27). CONCLUSIONS: The risk of developing GDM was significantly increased in Korean women with a family history of T2DM in first-degree relatives.
Adult ; Cluster Analysis ; Diabetes Mellitus, Type 2/*genetics ; Diabetes, Gestational/diagnosis/*genetics ; Female ; Genetic Predisposition to Disease ; Glucose Tolerance Test ; Humans ; Korea ; Male ; Parents ; Pregnancy ; Risk Factors ; Siblings

BACKGROUND: Recently, a hemoglobin A1c (HbA1c) level of 6.5% has been determined to be a criterion for diabetes mellitus (DM), and it is a widely used marker for the diagnosis of DM. However, HbA1c may be influenced by a number of factors. Anemia is one of the most prevalent diseases with an influence on HbA1c; however, its effect on HbA1c varies based on the variable pathophysiology of anemia. The aim of this study was to determine the effect of anemia on HbA1c levels. METHODS: Anemic subjects (n=112) and age- and sex-matched controls (n=217) who were drug naive and suspected of having DM were enrolled. The subjects underwent an oral glucose tolerance test and HbA1c simultaneously. We compared mean HbA1c and its sensitivity and specificity for diagnosing DM between each subgroup. RESULTS: Clinical characteristics were found to be similar between each subgroup. Also, when glucose levels were within the normal range, the difference in mean HbA1c was not significant (P=0.580). However, when plasma glucose levels were above the diagnostic cutoff for prediabetes and DM, the mean HbA1c of the anemic subgroup was modestly higher than in the nonanemic group. The specificity of HbA1c for diagnosis of DM was significantly lower in the anemic subgroup (P<0.05). CONCLUSION: These results suggest that the diagnostic significance of HbA1c might be limited in anemic patients.
Anemia ; Blood Glucose ; Diabetes Mellitus* ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Humans ; Prediabetic State ; Reference Values ; Sensitivity and Specificity