No abstract available.
Emergencies* ; Emergency Service, Hospital*

Pulsatilla koreana is a member of the buttercup familly(Ranuculaceae) which contains the unsaturated lactone, protoanemonin(C3H4O2), formed after injury to the plant by the breakdown of the glycoside ranunculin. It has been prescribed as a herbal medicine or a folk medicine for antipyretic, analgesic, anti-inflammatory, astringent and hemostatic effects in Korea. A 20 year-old famale patient presented with confluent vesicobullae on the erythematous base with a burning sensation on her upper back. This was caused by contact with crushed Pulsatilla koreana, a folk medicine for the treatment of left facial nerve palsy, that had occurred 10 days before her visit. A provocation patch test with Pulsatilla koreana upon a heathy male volunteers upper back showed strong positive reactions with the stalk and leaf in fresh and frozen stat.e and after thaw ing resptively. However no reaction was seen when the folk medicine was used in a dried form or with the root in any state. This case indicates that misadvice and ignorant folk remedies could cause misfortunate results to innocent people.
Burns ; Dermatitis, Irritant* ; Facial Nerve ; Herbal Medicine ; Humans ; Korea ; Male ; Medicine, Traditional ; Paralysis ; Patch Tests ; Plants ; Pulsatilla* ; Sensation ; Volunteers ; Young Adult

BACKGROUND: Combined spinal epidural anesthesia (CSE) is used for obtaining adventages of both spinal and epidural anesthesia. But it might be suspected that epidural volume load affect spinal sensory blockade level during CSE. METHODS: Eighty patients undergoing lower abdominal and lower extremity operation were involved in our study. Subarachnoid block with 12mg of tetracaine was established in all patients. Four groups were studied. Group 1 (n=20), the control, received only spinal anesthesia. Group 2 (n=20), group 3 (n=20) and group 4 (n=20) received 10, 15 and 20 ml of epidural saline immediately after spinal anesthetic administration. Sensory blockade level was checked by pinprick test at 5, 10, 15, 20, 25, 30, 40, 60 and 90 minutes. Blood pressure, heart rate and incidence of complications such as hypotension, bradycardia, nausea and high block were measured. RESULTS: The sensory blockade level of groups 3 and 4 was higher than group 1 (p<0.05). Blood pressure and heart rate were not different compared with each other. The incidence of complications, except that higher block above T4 in group 4 was more than in group 1 (p<0.05), were not different when compared with each other. CONCLUSIONS: Epidural saline above 15 ml may affect sensory blockade level of spinal anesthesia during CSE.
Anesthesia, Epidural* ; Anesthesia, Spinal ; Blood Pressure ; Bradycardia ; Heart Rate ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Nausea ; Tetracaine

BACKGROUND: Cytokines such as TNF-a, and IL-1, 6, 8 are thought to mediate many host responses in patients with sepsis through the release of many kinds of inflammatory mediators. Vibrio vulnificus is a virulent, halophilic, marine, and Gram-negative bacterium causing wound infections or primary sepsis with fulminant course. It has been known to produce many exocellular factors, such as cytolysin and exozymes, which are possible causes of shock and tissue damage. OBJECTIVE: Our purpose was to investigate the changes of cytokines(TNF-a, Il-l p, and IL-6) after intravenous administration of V. vulnificus cytolysin which have known to be a major virulent factor for elucidating pathogenesis of septic shock. METHODS: After administration of V. vulnificus cytolysin(20 hemolytic units) and physiologic saline through a mouse tail vein, we obtained blood samples from the heart according to a time course(0, 30, 60, 90, 120, 240, and 360 minutes). We measured serum concentrations of circulating TNF- a, IL-1 p, and IL-6 using commercially available immunoassay kits. RESULTS: The serum concentration of TNF- a peaked at 60 min (1894 pg/ml, as compared with 829 pg/ml after saline administration), began to decrease at 90 min and fell to baseline at 360min. Concentration of IL-6 rose significantly at 90 min(>3,839 pg/ml) and began to decrease at 120 min, whereas the level of IL-1 0 increased slightly and the peaked around 90min(117 pg/ml) after the cytolysin injection. CONCLUSION: We conclude that the host response to cytolysin is associated with a brief pulse of circulating cytokines in the early stage of sepsis caused by V. vulnipcus infection.
Administration, Intravenous ; Animals ; Cytokines* ; Heart ; Humans ; Immunoassay ; Interleukin-1 ; Interleukin-6* ; Mice* ; Perforin* ; Sepsis ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha* ; Veins ; Vibrio vulnificus* ; Vibrio* ; Wound Infection

No abstract available.
Colon* ; Diverticulitis* ; Laparoscopy*

Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.
Airway Management ; Congenital Abnormalities ; Glossectomy ; Macroglossia* ; Malocclusion ; Malocclusion, Angle Class III ; Open Bite ; Tongue*

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.
Adult ; Alleles ; Apolipoproteins E ; Blood Glucose ; Cholesterol ; Diet Therapy ; Diet* ; Diet, Vegetarian ; Fasting ; Genotype ; Hand ; Humans ; Hyperlipidemias ; Lipoprotein(a) ; Male* ; Triglycerides

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

GH concentration in plasma decline with age. GH and GH response to GHRH are influenced by sex hormones, thereby changing around the menopause. In several aspects, features of aging resemble those of a state of GH deficiency. It has been argued the declining GH function, along with other factors, might be a causal factor in osteoporosis. The purpose of this study was to investigate that postmenopausal osteoporosis in ovariectomized rat could be prevented by rhGH. Fifty-four Sprague-Dawley rats(weight 140-200g) were devided 3 groups. Group 1(n=18) was sham operation; Group 2(n=18) was ovariectomized and received subcutaneous injection with 0.05 cc normal saline; Group 3(n=18) was ovariectomized and received subcutaneous injection with 0.2 IU rhGH. Group 2 and 3 were injected daily, 6 day per week. Each group was devided three subgroups(n=6) and were sacrificed at 6 week, 10 week, 14 week, respectively. Group 2 showed a significant increase in body weight, femur length, serum IGF-1 level, serum PICP and ICTP level at 6 weeks, 10 weeks, 14 weeks and a significant decrease in ash weight of tibia, width of bony spicules, at 14 weeks than Group 1. Group 3 demonstrated a significant increase in body weight, femur length, serum IGF-1, serum PICP and ITCP levels and a insignificant decrease in ash weight of tibia and width of bony spicules, at 6 weeks, 10 weeks, 14 weeks than Group 1. At 14 weeks, Group 3 showed a significant increase in serum IGF-1, Serum PTH, Serum PICP. From these data, we conclude that although rhGH administration leads to an activation of bone turnover and more stimulation of bone formation, it does not prevent a bone loss in ovariectomized rat.
Aging ; Animals ; Body Weight ; Female ; Femur ; Gonadal Steroid Hormones ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor I ; Menopause ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Tibia

Authors concluded an experimental study in order to find out what the effects of parathyroid hormone on cells derived from human Trabecular bone in vitro are on terms of proliferation of cells, adenylate cyclase activity and production of small substances such as osteocalcin and collagen type I. The results were as follows; 1. 3H-thymidine incorporation into cultured osteoblast was initially low (day 1–2), increased by exponential curve from day 3 till day 11. The uptakes of 3H-thymidine by osteoblasts, when bovine parathyroid hormone was added, increased dose-dependently. Greater increments were seen at concentrations of bovine PTH higher than 5.0 X10-8 mole. 2. Intracellular c-AMP accumulation was stimulated by bovine PTH in a dose-dependent manner and greater production was seen at concentrations of bovine PHT higher than 5.0 X10-8 mole. Maximal stimulation was observed at 1 X10-7 mole of bovine PTH. The concentrations of c-AMP were observed significantly higher in the presence of bovine PTH in a dose-dependent manner when compared to those of bovine PTH-absent culture condition. 3. Treatment with bovine parathyroid hormone of cultured osteoblasts resulted in increase of alkaline phophatase activity and synthesis of osteocalcin in the cultured media in a dose-dependent manner. Greater productions were observed at concentrations of bovine PTH higher than 5.0 X10-8 mole. 4. Synthesis of type I collagen by cultured osteoblasts in bovine PTH-added media was inversely proportional to their concentration, whereas control group showed minimal increments of no significance. These in vitro findings may suggest that PTH has a stimulatory effect on proliferation of osteoblast, c-AMP production and alkaline phosphatase activity in a direct manner.
Adenylyl Cyclases ; Alkaline Phosphatase ; Cell Proliferation ; Collagen Type I ; Humans ; In Vitro Techniques ; Osteoblasts ; Osteocalcin ; Parathyroid Hormone