Apodemus agrarius has been using for experimental purpose to identifying the route of infection and pathogenesis of korean hemorrhagic fever. However, despite the increasing amount of information being published at present about the physiologic and ecologic characteristics of Apodemus, few data are availalle about the morphologic findings in the brain. The NADPH-diaphorase[NADPH-d] positive neurons, uniquely resistant to toxic insults and neurodegenerative diseases, have been colocalized with neurons in the brain and peripheral tissue containing nitric oxide synthase, which generates nitric oxide, a recently identified neuronal messenger molecule. In this study we used NADPH-d histochemistry to evaluate the distribution of neuropeptide Y-immunoreactive[NPY-IR] cells within neurons which contain nitric oxide synthase. In the cerebral cortex of Apodemus agrarius, NADPH-d positive and NPY-IR neurons were observed in all cortical layers, but they were concentrated in two bands layer II/III and V/VI extending into the subcortical white matter. Double labeling for NADPH-d and NPY showed colocalization of NPY with NADPH-d in numerous neurons of the cerebral cortex. The data obtained showed that about 74-79% of NPY-IR neurons contained NADPH-d in the neocortex and that 77-89% in the allocortex. The number of NPY-IR/NADPH-d positive neurons was about 10-13 per unit area [2,500,000 micrometer] in the neocortex and about 11-25 in the allocortex except retrosplenial cortex. In the retrosplenial cortex, the number of double labeled neurons was about 5 per unit area. NPY-IR and NADPH-d positive neurons were predominantly medium-sized with extended, multipolar or bipolar dendritic branches which belong to fusiform or stellate cell types. A moderately dense network of fine, varicose NADPH-d positive fibers was present throughout all cortical layers.
Animals ; Brain ; Cerebral Cortex* ; Hemorrhagic Fever with Renal Syndrome ; Murinae* ; Neocortex ; Neurodegenerative Diseases ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Nitric Oxide ; Nitric Oxide Synthase

No abstract available.
Mitral Valve*

BACKGROUND: In TIVA, it was controversy which was more appropriate to increase the concentration of the analgesic or of the hypnotic according to the intensity of the surgical stimulus. We used preset infusion dose of propofol and fentanyl mixed with pancuronium through a single syringe for expected better control of hemodynamics. METHODS: Vital signs and recovery scores were observed in thirty patients undergoing total abdominal hysterectomy using one-syringe TIVA in which we used premixed fentanyl(150mcg), propofol(450mg) and pancuronium(2 mg) in one syringe. Induction of anesthesia was performed by injection of propofol 1.5~2 mg/kg, fentanyl 1.5~2 mcg/kg, pancuronium 0.1 mg/kg and ventilated with 100% oxygen after endotracheal intubation. Infusion was started by 1 ml/kg/hr of mixed solution immediately after intubation. If the vital sign changed more than 15% compared with preoperative value, flow rate either increased or decreased by 50%. If stable vital signs were maintained for more than 15 minutes, the flow rate decreased by 20% every 15 min, but were maintained above 0.5 ml/kg/hr. Two to four minutes before skin incision and peritoneal traction, an additional 10 ml of mixed solution was infused. Solution without fentanyl and pancuronium was infused after peritoneal closure for early recovery. Ten to fifteen minutes before the operation was completed, infusion was discontinued and neuromuscular block was reversed. RESULTS: Blood pressure and pulse rate were stable and did not significantly change even after intubation or peritoneal traction compared with preoperative value. And, recovery from anesthesia was prompt 15 min after extubation except 2 cases of respiratory depression. CONCLUSIONS: One-syringe TIVA may be an feasible alternative method to replace conventional multi-syringe TIVA.
Anesthesia ; Anesthesia, Intravenous* ; Blood Pressure ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hysterectomy ; Intubation ; Intubation, Intratracheal ; Neuromuscular Blockade ; Oxygen ; Pancuronium ; Propofol ; Respiratory Insufficiency ; Skin ; Syringes* ; Traction ; Vital Signs

BACKGROUND: Morphine for the intravenous patient controlled analgesia (IV-PCA) provides effective postoperative pain control, but it has side effects such as itching, nausea and vomiting. Meanwhile, butorphanol, a synthetic potent agonist-antagonist narcotic with low incidence of adverse side effects and minimal addiction, produce adequate analgesia for postoperative pain. The purpose of this study was to compare the suitability of butorphanol combining with or without morphine with that of morphine in terms of relieving postoperative pain and incidence of side effects. METHODS: Sixty ASA physical status I or II female patients undergoing total abdominal hysterectomy were randomly allocated into one of three groups according to type of drug used (n=20 for each group). The groups were divided to group M (morphine 100 mg), group M B (morphine 50 mg+butorphanol 10 mg) and group B (butorphanol 20 mg). Drugs for each group mixed with 90 ml of normal saline (total amount: 100 ml) for infusion. Loading dose, PCA dose, lockout interval, mode of infusion was 0.05 ml/kg, 0.02 ml/kg, 8 minute, and PCA only, respectively. In each group, visual analog scale (VAS), pain score, sedation score, degree of satisfaction, total amount of drug used, history of attempt/injetion and incidence of side effects were checked. RESULTS: There were no significant differences in analgesic effects and degree of satisfaction among three groups, but incidence of side effects (especially pruritis) were less in group M+B and B compared with group M (p<0.05). CONCLUSIONS: Butorphanol showed comparable postoperative pain relief and marked less side effects compared with morphine. Butorphanol was considered as a useful drug for postoperative pain relief using IV-PCA.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Butorphanol* ; Female ; Humans ; Hysterectomy ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis ; Pruritus ; Visual Analog Scale ; Vomiting

No abstract available.
Sarcoma, Synovial*

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting

In parentage testing DNA profiles are used to link the alleged father with paternity by matching their patterns. The probative value of a match is often calculated by multiplying together the estimated frequencies with which each particular VNTR or STR pattern occurs in a reference population. When this calculating method applies to the motherless case of paternity disputes, a calculation must usually be based on types determined for the child and the alleged father. In such case, the first consideration is to exclude a man from paternity of a child when the man did not have the child's paternal allele at some loci, or if the paternal allele cannot be determined, when the man had neither of the child s alleles. The second is to evaluate the DNA evidence when a man is not excluded by the paternal allele. This work is to provide theories of paternity analysis with three approach methods for the motherless case, and to evaluate their efficiency compared to the trio case when the man tested is not excluded. Consequently, the motherless case offers lower probability exclusion and questionable cumulative paternity index than those of the trio case as being typed with 14 STR loci(CSF1PO, TH01, TPDX, vWA, D5S818, D13S317, D7S820, D16S539, FGA, D21S11, FES/FPS, F13A1, D18S80, D17S5). Since the motherless case in paternity disputes is less efficient for paternity exclusion of the child, the use of genetic maker systems with the higher value of mean exclusion chance(MEC) and exact levels of the relative probability of paternity must be of importance considered in the analysis of such deficiency cases.
Alleles ; Child ; Dissent and Disputes ; DNA ; Fathers ; Humans ; Paternity*

No abstract available.

PURPOSE: Detrusor overactivity is frequently associated with bladder outlet obstruction, which may be related with increased electrical coupling. The effects of connexin 43(Cx43) and connexin 26(Cx26) mRNA expressions on the detrusor over activity were studied. MATERIALS AND METHODS: 36 male patients, with a bladder outlet obstruction due to benign prostatic hyperplasia(BPH), were subdivided into those with and without detrusor overactivity(DO) based on urodynamic studies: DO(+) and DO(-) group. All patients underwent a bladder biopsy during TUR-P. The symptoms, International Prostate Symptom Score (IPSS), prostate size, serum prostatic specific antigen(PSA) value and urodynamic parameters were compared between the two groups. The expressions of Cx43 and Cx26 mRNA in each group were analyzed by a reverse transcriptase polymerase chain reaction(RT-PCR). RESULTS: There were no differences in age, IPSS score, prostate volume, PSA and free Qmax between the DO(+) and DO(-) groups. The expressions of Cx43 and Cx26 mRNA in the DO(+) group were significantly increased compared with those in the DO(-) group. CONCLUSIONS: Our results show there is a change in the expressions of the Cx43 and Cx26 according to the bladder function, which may be related to detrusor overactivity in patients with a bladder outlet obstruction.
Biopsy ; Connexin 43 ; Connexins ; Humans ; Male* ; Prostate ; Prostatic Hyperplasia* ; RNA, Messenger ; RNA-Directed DNA Polymerase ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urodynamics

Neurologic complications after open-heart surgery are not only relatively common but also often fatal. In order to know the clinical characteristics and causative risk factors, we carried out the retrospective study on 655 patients who had been admitted and undergone OHS at Seoul National University Children's Hospital during 2-year period from July 1990 to June 1992. The results were as follows; 1) The incidence of neurologic complications after OHS was 4.7% (31 cases) of the total 655 cases. 2) In the viewpoint of the pre-op diagnosis, neurologic complications developed in 20 cases (7.8%) among cyanotic congenital heart disease and in 11 cases (2.9%J among acyanotic CHD. 3) In the viewpoint of the type of operation, the incidence of neurologic complications was 33.3% in Jatene procedure and 12.1% in Fontan procedure. 4) Compared with the group who didn't develp neurologic complications (624 cases), cardiopulmonary bypass time, aorta cross clamp time, and total arrest time were longer and the degree of hypothermia was lower in the group who had neurologic complications (31 cases), which are statistically significant each other(p<0.01). 5) In 25 cases (80.6%), neurologic complications occurred within 72 hours after OHS. 6) Clinical manifestations of neurologic complications were seizures (26 cases, 84%), consciousness change (13 cases, 42%), hemiplegia (1 case), and decreased muscle tone (1 case). 7) Of the 31 cases, 16 cases showed more than one abnormal finding among EEG, Brain CT, or Brain MRI. 8) The possible etiologies of neurologic complications were diffuse hypoxic ischemic encephalopathy (16 cases, 51.6%), focal or multiple ischemic stoke that was thought to be due to microembolisms (3 cases, 9.7%), electrolyte or acid-base imbalance (8 cases, 25.8%), and the remainders were unknown (4 cases. 12.9%) 9) In the course of neurologic complications, 11 cases (35.5%) expired, 14 cases(45.2%) recovered at discharge, 3 cases (9.7%) were controlled at discharge, and 2 cases (6.5%) had long-term sequela(one spastic quadriplegia and one hemiparesis). 10) The cause of death among mortality cases were mainly due to brain damage (7 cases), while 4 cases had other direct causes such as heart failure, respiratory failure, or sepsis.
Acid-Base Imbalance ; Aorta ; Brain ; Cardiopulmonary Bypass ; Cause of Death ; Child* ; Consciousness ; Diagnosis ; Electroencephalography ; Fontan Procedure ; Heart Defects, Congenital ; Heart Failure ; Hemiplegia ; Humans ; Hypothermia ; Hypoxia-Ischemia, Brain ; Incidence ; Magnetic Resonance Imaging ; Mortality ; Muscle Hypotonia ; Quadriplegia ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors ; Seizures ; Seoul ; Sepsis