No abstract available.

After the clinical introduction of halothane, the problem of hepatotoxicity and mechanism has major implications for the practice of anesthesiology. This study was undertaken to investigate the liver function change after halothane anesthesia in 22 cases of electric burn patient. In this study, all cases had a great elevation of SGOT and SGPT levels, and previous experience of inhalation anesthesia, jaundice and who had not been transfused during this study. The following results were obtained: 1) Elevation of the SGOT and SGPT in electric burn patients may be influenced by damage of skeletal muscle and transaminase released into systemic circulation. 2) In the electric burn patients, elevation of the SGOT and SGPT does not enhance the susceptibility of the liver to injury by halothane.
Alanine Transaminase ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesiology ; Aspartate Aminotransferases ; Burns, Electric* ; Halothane* ; Humans ; Jaundice ; Liver* ; Muscle, Skeletal

BACKGROUND: The valve area derived from the Gorlin formula has been used clinically for decades as an index of severity on the assessiment of valve stenosis, in spite of some limitations on Gorlin formula studied in aortic stenosis and mitral bioprostheses. It had been shown that Gorlin valve area varied if the hemodynamic conditions during measurement are changed. Valve resistance has been proposed as an alternative hemodynamic indicator, but initially this index was not used because it was unlikely to remain constant at different flow rates. Recently valve resistance provided a better indices of hemodynamic obstruction than mitral valve area, and these stenotic indices usually estimated by angiographic method and we studied the valve resistance by Doppler echocardiographic measurement. METHOD AND RESULT: To compare the clinical implication about these stenotic indices measured by echcoardiography and cardiac catheterization, we studied 41 patients of mitral stenosis with normal sinus rhythm. The results were as follows ; 1) In catheterization, increased heart rate, mean pressure gradient and decreased diastolic time was observed, but mitral area, resistance, cardiac output and mitral flow was not different. 2) Linear regression analysis showed negative correlation of mitral valve resistance and Gorlin mitral area(echocardiography r=-0.84, catheterization r=-0.84)(p<0.001). 3) Correlation coefficeint of mitral valve area and mitral valve resistance between echocardiography(r=0.87) and catheterization(r=0.82) showed positive correlation(p<0.001). CONCLUSION: These results suggest that mitral valve resistance by echocardiography is a useful method in the evaluation of the severity of mitral stenosis.
Aortic Valve Stenosis ; Bioprosthesis ; Cardiac Catheterization* ; Cardiac Catheters* ; Cardiac Output ; Catheterization ; Catheters ; Constriction, Pathologic ; Echocardiography ; Echocardiography, Doppler* ; Heart Rate ; Hemodynamics ; Humans ; Linear Models ; Mitral Valve Stenosis* ; Mitral Valve*

No abstract available.
Coronary Vessels* ; Myocardial Infarction* ; Perfusion*

No abstract available.
Polymerase Chain Reaction*

BACKGROUND: Platelet refractoriness has been reported to occur in 30-70% of multitransfused patients. This can result by either immune or nonimmune mechanisms. The predominant immune cause of platelet refractoriness is alloimmunization to HLA class I antigens. Recently, acid-treated platelets have been used in a few patients with platelet refractoriness due to HLA alloantibodies. However, the effect of acid-treated platelets has not been consistent. The aim of this study was to evaluate the in vivo survival of acid-treated, HLA-eluted platelets in HLA-immunized rabbits. METHODS: For in vivo survival test, 14 New Zealand White rabbits were studied. Four rabbits were in the nonimmunized control and 10 were immunized by weekly transfusions of human pooled platelets for six weeks. The HLA-immunized group was separated into two groups with transfusion of acid-treated platelets and untreated platelets. The survival of transfused platelets in rabbits with immunization and control group was estimated by a flow cytometer using FITC-labeled anti-CD42a. We also examined the HLA re-expression in acid-treated platelets due to regeneration and adsorption of HLA from human plasma. RESLUTS: The half-life of untreated platelets in nonimmunized rabbits was 11.8 +/- 3.7 hr. The half-life of acid-treated platelets in rabbits with HLA antibodies was 9.5 +/- 5.5 hr and the half-life of untreated platelets in rabbits with HLA antibodies was 5.9 +/- 2.9 hr. The difference between untreated platelets in the nonimmunized control group and acid-treated platelets in rabbits with HLA antibodies was statistically insignificant (p=0.221). Re-expression of HLA-A,B,C by endogenous resynthesis occurred continuously, and after 24 hrs it reached 84% of pre-elution level. Adsorption of HLA antigens from human plasma was completed within four hrs. CONCLUSIONS: Acid-treated, HLA-eluted platelets may be applicable for the patients with refractoriness to platelet transfusion, especially, in case of unavailability of HLA-compatible donors and fatal bleeding such as intracranial hemorrhage and pulmonary hemorrhage. However, the post-transfusion increment of the platelet count could not be maintained over 24 hrs because of the endogenous resynthesis of HLA antigens.
Adsorption ; Antibodies ; Blood Platelets ; Half-Life ; Hemorrhage ; Histocompatibility Antigens Class I ; HLA Antigens ; Humans ; Immunization ; Intracranial Hemorrhages ; Isoantibodies ; Plasma ; Platelet Count ; Platelet Transfusion ; Rabbits* ; Regeneration ; Tissue Donors

PURPOSE: The purpose of this study was to identity the relationships among self reported health behaviors, menopausal symptoms, and sexual satisfaction in middle-aged women. METHOD: The subjects of this study were 155 women from 40 to 60 years. The data was analyzed using SPSS program for frequency, percentage, mean, t-test, ANOVA, Duncan and Pearson's correlation coefficients. RESULTS: 1. The mean score of health behaviors was 3.10 out of maximum 4. 2. The mean score of self-reported menopausal symptoms was 1.73 out of maximum 2. 3. The mean score of sexual satisfaction was 2.73 out of maximum 4. 4. Women's degree of menopausal symptoms had negative correlations with the degree of health behaviors(r=-0.437, p<.001) and the degree of sexual satisfaction(r=-0.439, p<.001). The degree of health behaviors had a positive correlation with the degree of sexual satisfaction (r=0.470, p<.001). CONCLUSION: In conclusion, menopausal symptoms-based complaints by middle-aged women were negatively correlated to health behavior and sexual satisfaction. Therefore, health behavior should be considered when developing nursing strategies for middle- aged women, especially when dealing with menopausal symptoms and sexual satisfaction.
Female ; Health Behavior* ; Humans ; Nursing ; Self Report

BACKGROUND: This study was performed to evaluate the effects of intercostal nerve block added in intravenous patient-controlled analgesia (IV-PCA; PCA) on pain, pulmonary function and the movement of the ipsilateral arm after a thoracotomy. METHODS: Forty five patients undergoing elective thoracotomy were randomly allocated into one of three groups. The groups were divided as follows: PCA, ICB-PCA (PCA and intercostal nerve blocks by direct injection of 5 ml of 0.2% bupivacaine into the intercostal spaces of two upper and two lower segments around the surgical incision) and IM groups. For the PCA, the patients that received PCA, were administered IV bolus of 0.1 mg/kg of nalbuphine followed by PCA with 0.1% nalbuphine (basal rate 0.5 ml/hr, bolus dose 1 mg and lockout interval 8 minutes). In each group, VAS score, the inspiratory capacity and the movement of the ipsilateral arm were checked postoperatively at 6, 24, 48 and 72 hours. RESULTS: Inspiratory capacity was decreased less in ICB-PCA group (P<0.05) at 6 hour, but after 24 hour, there were no differences between the groups. The analgesic effect was significantly better in ICB-PCA group as compared to the PCA or IM groups (P<0.05). Furthermore, arm motion limitation after operation was the least in ICB-PCA group (P<0.01). CONCLUSION: Intraoperative intercostal nerve blocks added in PCA has a transient improvement of pulmonary function, and also provide better analgesia and improved ipsilateral arm motion after a thoracotomy than in PCA or IM analgesia. The authors recommend adding intercostal nerve block for patients undergoing thoracotomy who receive IV-PCA.
Analgesia ; Analgesia, Patient-Controlled ; Arm ; Bupivacaine ; Humans ; Inspiratory Capacity* ; Intercostal Nerves* ; Nalbuphine ; Passive Cutaneous Anaphylaxis ; Thoracotomy*

BACKGROUND/OBJECTIVES: Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS: This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing “very difficult” or “difficult”, were combined to form the chewing difficulty group. Similarly, those who found chewing “moderately difficult”, “easy”, and “very easy” were combined to form the normal chewing group. RESULTS: Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS: The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.
Aged* ; Ascorbic Acid ; Calcium ; Diet ; Female ; Fruit ; Humans ; Korea* ; Life Style ; Male ; Malnutrition ; Mastication* ; Miners ; Niacin ; Nutrition Surveys* ; Nutritional Status ; Phosphorus ; Potassium ; Prevalence ; Recommended Dietary Allowances ; Riboflavin ; Sodium ; Vegetables ; Vitamins

Somatostatinoma is a rare form of neuroendocrine tumor that was first described in 1977. Most tumors have involved the pancreas, and gastrointestinal tract involvement is rare. Somatostatinomas of the ampulla of Vater are extremely rare and present distinct clinical and pathologic differences. Pancreatic somatostatinoma has been associated with a clinical syndrome of dyspepsia, mild diabetes, cholelithiasis, steatorrhea, and hypochlorhydria, but duodenal somatostatinoma, in general, has been clinically silent. A further contrast is that duodenal carcinoid tumors, mainly gastrinoma, tended to be benign, whereas ampullary carcinoid tumors, mainly somatostatinoma, exhibited malignant behavior. Therefore, definite diagnosis is important for treatment and prognosis, and is performed by image study, immunohistochemistry and electron microscopic examination. We report a case of somatostatinoma of the ampulla of Vater in a 51-year-old male. He complained of generalized abdominal pain for a few days. Gastrofiberscopically, a 1.2 cm sized bulging mass was observed on the ampulla of Vater. Radiologically, on abdomen CT, a protruding enhancing mass was revealed in the duodenum. In octreoscan, there was an abnormal focus off increased radiouptake in the infrahepatic area. He underwent a pancreatoduodenectomy. Grossly, the mass was an intraluminary protruding polypoid submucosal mass with focal ulceration in the ampulla of Vater. Histologically, it showed well-differentiated nonpleomorphic tubular cell nest and psammoma bodies. Immunohistochemically, the tumor cells showed a neuroendocrine nature with synaptophysin immunostain and intense staining only for somatostatin.
Abdomen ; Abdominal Pain ; Achlorhydria ; Ampulla of Vater* ; Carcinoid Tumor ; Cholelithiasis ; Diagnosis ; Duodenum ; Dyspepsia ; Gastrinoma ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neuroendocrine Tumors ; Pancreas ; Pancreaticoduodenectomy ; Prognosis ; Somatostatin ; Somatostatinoma* ; Steatorrhea ; Synaptophysin ; Ulcer