No abstract available.

To evaluate the second gas effect during induction of clinical anesthesia, the ratios of the end-tidal to the inspired concentration of halothane (FET/F1) were measured in 21 children in ASA class 1. The children were divided into three groups: gorup I received 100 % O2 and 1% halothane, group II received 70% N2O, 30% O2 and 1% halothane simultaneously, and group III received 1% halothane and 100% O2 for 5 min, followed by 70% N2O, 30% O2 and 1% halothane. With or without N2O, the increases of FET/F1 were significant 3min after inhalation of halothane. The increase in FET/F1 compared with the previous value, was insignificant in gorup I, and significant for 7min and 5min in groups II and III respectively. Compared with gorup I, the remarkable second gas effect in gorup II was noticed 7 min after induction and continued during the study, but in group III, it was noticed only 9 min after induction, and disappeared rapidly. The second gas effect in this study might be due to the concentrating effect by the uptake of N2O.
Anesthesia* ; Child* ; Halothane ; Humans ; Inhalation ; Nitrous Oxide

This research was performed to find out the adaptation patterns of maxillary and mandibular posterior teeth to the changes in relationships of vertical skeletal components, which constitute the skeletofacial complex. For this research, 61 adult malocclusion patients were chosen as subjects according to the Hellman's dental age with normally ranged FMN-A-B angle. These subjects were divided into 4 groups in maxilla and 3 groups in mandible according to mesiodistal inclinations of teeth. Following results were obtained after studying the relationships of the vertical skeletal components between each group. 1. Inspire of the fact that the FMN-A-B angle was within a normal range, the degree of mesiodistal inclinations of maxillary and mandibular posterior teeth showed differences in relation to the anteroposterior relationships of maxilla and mandible. In case where the FMN-A-B angle was large, the mesial inclinations of maxillary posterior teeth showed more increase from the posterior to the anterior, whereas in mandible it showed overall decrease. 2. The degrees of mesial inclinations of mandibular posterior teeth were increased when the angulations of lower facial height, occlusal plane angle and mandibular plane angle were greater. 3. The patterns of mesial inclinations of maxillary posterior teeth were varied according to the angulation of lower facial height. If relatively large, it showed more increase from the posterior to the anterior and it was decreased nearly consistent when the angulation was small. 4. The degrees of mesial inclinations of maxillary posterior teeth were decreased as the lower facial height, palatal plane angle, occlusal plane angle and the mandibular plane angle became greater.
Adult ; Dental Occlusion ; Humans ; Malocclusion* ; Mandible ; Maxilla ; Reference Values ; Tooth

BACKGROUND AND OBJECT: Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. METHODS AND RESULTS: We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. CONCLUSION: When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.
Brain Stem ; Fingers ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Migraine Disorders ; Mouth ; Neurologic Examination ; Rabeprazole ; Stroke ; Thalamus

BACKGROUND: Several investigations have studied hypoxic pulmonary vasoconstriction (HPV) during endotoxemia and there is an increase in nitric oxide (NO) in pulmonary vessels. However, these studies yielded conflicting or at times contradictory results, since reference has been made to both enhancement and inhibition of HPV. Our objective was to determine the changes of hypoxic pulmonary vasoconstriction on the isolated blood-perfused lung of endotoxemic rats. METHODS: Pulmonary arterial pressure (PAP) was measured in a blood-perfused lung preparation from Sprague-Dawley rats in normoxia (21% O2, 5% CO2, balanced N2) and hypoxia (5% O2, 5% CO2, balanced N2). We studied the effect of normoxia and hypoxia in a control group, Escherichia coli lipopolysaccharide group (LPS) and LPS with N omega-nitro-L-arginine methyl ester group (L-NAME). RESULTS: The Baseline PAP was higher in LPS (15.0+/-4.0 mmHg) compared with control group (10.9+/-2.9 mmHg) and L-NAME (11.1+/-3.6 mmHg). In hypoxia, HPV was higher in L-NAME (109.6+/-100.2%) compared with control group (59.9+/-31.6%) and LPS (58.8+/-33.8%)(P<0.05). CONCLUSIONS: We conclude that NO is an important factor to impair HPV during endotoxemia.
Animals ; Anoxia ; Arterial Pressure ; Endotoxemia ; Escherichia coli ; Lung* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Rats* ; Rats, Sprague-Dawley ; Vasoconstriction*

Thirty six pediatric patients who were diagnosed as pulmonary atelectasis by chest radiography were managed with one of the following techniques for the treatment of atelectasis: 1) intermittent positive pressure breathing (IPPB) with extrathoracic chest percussion and vibration, 2) IPPB and intrapulmonary percussive ventilation (IPV) and 3) IPV only. Chest X-ray films and arterial pH, Pco, and Po, were obtained for all patients in the morning and the afternoon. And systolic and diastolic blood pressure and heart rate were measured at that time. Alveolar arterial oxygen tension difference was calculated from inspired oxygen fracton and arterial oxygen tension. The rate of treatment of atelectasis was significantly low in the patients with IPPB and chest physiotherpy. But the durations for the treatment were not significantly different among the three groups. There were no significant differences in blood pressures, heart rates and artrial blood gases between pre-treatment and post- treatment states in all groups.
Blood Pressure ; Critical Illness* ; Gases ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Intermittent Positive-Pressure Breathing ; Oxygen ; Percussion ; Pulmonary Atelectasis* ; Radiography ; Thorax ; Ventilation* ; Vibration ; X-Ray Film

The clinical utility of thallium-201 SPECT combined dwith pharmacologic vasodilation induced by oral dipyridamole as an alternatiove to intravenous dipyridamole was incestigated in 21 patients who had concomitant coronary arteriography. Tomographic images were assessed visually. Sensitivity & specificity for overall detection of coronary artery disease were 93.7% and 80% respectively. Sensitivity & specificity for identification of indevidual diseased vessels were 84.6% and 87.5% for the left anterior descending artery, 75% and 84.6% for the right coronary artery, 60% and 100% for the left circumflex artery, respecitively. Of the 26 patients unergoing thallium scintigraphy 11 patients(42.3%) had some adverse effects between 20 and 50 minutes after oral dipyrdamole ingestion, including headache(26.9%), chest pain(26.9%), electrocardiographic changes(19.2%), and nausea(11.5%). Intravenous aminophylline was used to resolve these adverse effects in 8 patients & most of the adverse effects were subsided within 10 minutes. There was no ventricular arrhythmias, myocardial infarctions or deaths. In conclusion, oral dipyridamole thallium-201 SPECT is safe and accurate test for the overall detection of coranary artery disease and identification of disease in individual arteries. Furthermore it is useful for determining the necessities of coronary reperfusion and prognstically stratiofying the patients with coronary artery disease.
Aminophylline ; Angiography ; Arrhythmias, Cardiac ; Arteries ; Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole* ; Eating ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocardial Perfusion Imaging* ; Myocardial Reperfusion ; Radionuclide Imaging ; Sensitivity and Specificity ; Thallium ; Thorax ; Tomography, Emission-Computed, Single-Photon* ; Vasodilation

For the purpose of recommending appropriate fraction of inspired oxygen(F1O2) for long term mechanical ventilation support by evaluating the effect of changes in F1O2 on pulmonary shunt ratio in respiratory intensive care, the effects of various F1O2 on pulmonary shunt ratio were investigated and analysed with 20 pediatric intensive care patients who had received open heart surgeries for their congenital heart diseases in the department of Pediatrics, Seoul National University Hospital. The results were as follows ; 1. Through the whole process of control of mechanical ventilation the arterial CO2 tension(PaCO2) showed hyperventilation with the average of 31-34mmHg and pH showed pure respiratory alkalosis with the average of 7.45-7.51. As the fraction of inspired oxygen decreased, the arterial oxygen tension decreased. 2. Inspite of the change of F1O2, analysis of central venous blood gas showed no significant change. 3. The alveolar-arterial oxygen tension difference(AaDO2) was positively related to F1O2. 4. The pulmonary shunt ratio(Q's/Q'T) showed no significant difference in the F1O2 range of 0.6 to 1.0. But the Q's/Q'T in the F1O2 range of 0.3 to 0.4 decreased significantly comparing to that of 0.6 to 1.0 F1O2 range. Linear regression analysis of Q's/Q'T showed that the Q's/Q'T was positively related to F1O2 and AaDO2, respectively.
Alkalosis, Respiratory ; Heart ; Heart Diseases ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Critical Care* ; Linear Models ; Oxygen ; Pediatrics ; Respiration, Artificial ; Seoul

Background: Reduced lipid content in the stratum corneum is a major cause of skin-barrier dysfunction in various pathological conditions. Promoting lipid production is a potential strategy to improve skin-barrier function. Recent evidence supports the beneficial effects of adiponectin on lipid metabolism and senescence in keratinocytes. Objective: This study aimed to investigate whether plant extracts can enhance skin-barrier function. Methods: We screened fruit and herb extracts that enhance the lipid synthesis of keratinocytes via AMP-activated protein kinase (AMPK) activation and SIRT1 signaling in the adiponectin pathway. The levels of major lipid synthesis enzymes and transcription factors as well as epidermal barrier lipids involved in adiponectin-associated epidermal barrier formation were evaluated in the herbal extracts- or adiponectin-treated human epidermal keratinocyte and equivalent models. The mRNA expression of major lipid synthesis enzymes increased following treatment with Lycii Fructus, Prunus tomentosa, and Melia toosendan extracts. Results: The expression of transcription factors SIRT1, liver X receptor α, peroxisome proliferator-activated receptors (PPARs), and sterol regulatory element-binding proteins (SREBPs) were upregulated. Levels of free fatty acids, cholesterol, and ceramides were elevated. The expression of keratinocyte differentiation markers increased. In particular, among fruit extracts with a detectable effect, Melia toosendan induced the highest expression of lipid synthase. Conclusion These results indicate that Melia toosendan is a promising candidate for improving skin-barrier function.

Although ERCP has been widely used to diagnose and occasionally treat chronic pancreatitis, it is not always easy to differentiate between malignancy and benign disease by ERCP alone. So peroral pancreatoscopy(PPS) using mother and baby type scopes was developed and several types of peroral pancreatoscopes with various diameters have been used at several institutes. To assess the clinical usefulness of ultrathin-caliber pancreatoscopy on diagnosis of various pancreatic diseases, we performed peroral pancreatoscopy with PF 8P (Olympus, external diameter: 0.8 mm) in 12 cases(6 cases of chronic pancreatitis, 5 cases of pancreatic tumor, and 1 case of mucinous ductal ectasia) of pancreatic diseases. The pancreatoscope was successfully inserted into main pancreatic duct in 11 cases and permitted satisfactory endoscopic observation. The endoscopic findings of chronic pancreatitis were smooth stenosis, protein plug, and stones in pancreatic duct. Peroral pancreatoscopic findings of pancreatic cancer were characteristically seen as stenosis with irregular mucosal protrusion. In the mucin-producing tumor cases, the lesions were generally not clearly visualized due to the presence of copious amount of mucin. We conclude that pancreatoscopy is a valuable alternative or supplementary procedure to diagnostic imaging method of arriving at a more definite diagnosis in difficult cases. But several limitations, such as poor visual field, absence of biopsy channel and controllable tip, and poor durability of endoscope will be overcomed to serve as essential diagnosic tool for pancratic diseases.
Academies and Institutes ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Diagnosis* ; Diagnostic Imaging ; Endoscopes ; Humans ; Mothers ; Mucins ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis, Chronic ; Visual Fields