Glycopyrrolate is frequently administered in combination with neostigmine to reverse a neuromus- cular blockade. The dosage was well established at 1/5 of neostigmine. But the authers have often observed a delayed manifestation of relative bradycardia after such a recommended dosage. This is not mentioned in the literature, but this may be due to an insufficient observation period. The authors monitored the change of pulse rate for 1 hour after the administration of the recom. mended dose. Further, the data wIns compared with that obtained after studies of lower and higher doses. The doses were 0.004, 0.008 and 0.012mg/kg of glycopyrrolate with 0.04mg/kg of neostigmine. 1) At all doses, bradycardia relative to the pre-reversal pulse rate was progressive until 30 minutes after injection. 2) As the glycopyrrate dose was increased the degree of bradycardia decreased (-24.7, -20.5, - 15.0 at 30 min.). 3) There was no difference in the immediate change in the pulse rate between the dcsages of 0.008 and 0.012 mg/kg. Change occured at 9 mins. 4) At dosages of 0.004 and 0.008 mg/kg, the pulse rates at 60 min were comparable to their ward pulses, but at a dosage of 0.012 mg/kg, the pulse rate was 8.5 beats/min higher.
Bradycardia ; Glycopyrrolate* ; Heart Rate* ; Neostigmine*

No abstract available.
Methylprednisolone* ; Purpura, Thrombocytopenic, Idiopathic*

A 35 year old woman, gravid 5, multiparous, was admitted to our department at 6 weeks and 5 days of gestation after being diagnosed with cervical pregnancy. Before the evacuation, the uterine arteries were embolized using angiographic techniques. As a result, dilatation and curettage were performed with minimal hemorrhage. We report one case of cervical pregnancy managed, successfully with preoperative uterine artery embolization and evacuation.
Adult ; Dilatation and Curettage ; Female ; Hemorrhage ; Humans ; Pregnancy* ; Uterine Artery Embolization* ; Uterine Artery*

To evaluate the predictive value of serum fibronectin and roll-over test for pregnancy induced hypertension (PIH), we studies 79 patients between the twenty-eighth and thirty-second week of gestation from October 1995 to May 1996. The results were as follows . 1) There was no significant difference of mean diastolic pressure difference in roll-over test and serum fibronectin levels between 13 PIH patients and 66 controls. Between two groups of patients, mean diastolic blood pressure differences were 14.3+/-3.9mmHg, 12.0+/-4.4mmHg and mean serum fibronectin levels were 231.2+/-90.8 pg/ml, 196.5+/-61.2 pg/ml respectively(p> 0.1). 2) For prediction of PIH, the sensitivity, the positive predictive value and the negative predictive value of roll-over test were 8%, 14% and 83%.
Blood Pressure ; Female ; Fibronectins* ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy*

The purpose of this study was to evaluate the changes of cancellous and cortical bone and the effect of estrogen in ovariectomized rats. Fifty female rats, 250gm in body weight, were divided into three groups : ovariectomized group(OVE), ovariectomized and estrogen-injected group(OVE-EST), and sham operated and estrogen-injected group(EST), Bilateral ovariectomy was performed at the onset of the experiment. In OVE-EST group and EST group, estrogen was injected 50microgram/kg B.W. every other days from 3 weeks after surgery to sacrifice Each five rats were sacrificed after 5, 6, 7 weeks. One side of mandibular body was radiographed with a soft x-ray apparatus (Hitex Co., Ltd., Japan). Thereafter the obtained microradiographs were used for the morphometric analysis using a Image analyzer. The morphometric analysis was performed for parameters such as total bone area, cortex bone area and medullary one area. The other side of the mandibular bone was decalcified and embedded in paraffin as using a general method. The specimens were sectioned and stained with Mallory`s anilline blue and observed light microscopically. The results were as follows. 1. In all groups, the proportion of cortex to total bone area was not significantly different. 2. In ovarietomized(OVE) group, the proportion of marrow cavity to medullary bone area increased significantly from 5 to 7 weeks(p<0.05). In ovariectomized and estrogen-injected (OVE-EST) group, it decreased significantly at 7 weeks, and in estrogen-injected(EST) group, it decreased significantly from 6 week(p<0.05). 3. Microradiogram and histopathologic findings revealed that marrow cavity was enlarged and osteoclasts were observed around irregular bone surface in OVE group. In OVE-EST group, the size of marrow cavity at 7 weeks was similar to that of control group, as dense trabecular bone increased from 5 to 7 weeks, marrow cavity decreased.
Animals ; Body Weight ; Bone Marrow ; Estrogens* ; Female ; Humans ; Mandible* ; Osteoclasts ; Ovariectomy* ; Paraffin ; Rats*

BACKGROUND: Iron deficiency still remains the most common single nutrient deficiency disorder in the world, especially among young children and adolescent girls. As little is recently known about iron deficiency in infants and preschool children in Korea, this study is aimed to determine the prevalence of iron deficiency in healthy population and to determine the proportion of children in whom iron deficiency goes undetected using the current screening technique. METHODS: We collected venous samples from 410 apparently healthy preschool children during March to June, 1997, as a part of a regular health check-up program. We measured hemoglobin, hematocrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), serum ferritin, serum iron, and total iron binding capacity(TIBC). RESULTS: A total of 410 infants and preschool children aged 1~6 years were included in this study. The prevalence of anemia was 7.9%(3/38) in infants and children aged 1~2 years, 6.3%(12/190) in 3~4 years and 1.6%(3/182) in 5~6 years. The prevalence of iron deficiency(ferritin <10 ng/mL or transferrin saturation <10%) was 31.6%(12/38) in 1~2 years, 23.7%(45/190) in 3~4 years and 14.3%(26/182) in 5~6 years. The prevalence of IDA was 5.3% (2/38) in 1~2 years, 1.1% (2/190) in 3~4 years and 0.5%(1/182) in 5~6 years. Microcytic anemia was found in only 2 cases, both of which is included in 1~2 years of age. CONCLUSION: The prevalence of iron deficiency and IDA was relatively high in 1~2 years of age, critical period for neurologic development. Nutritional education including iron fortification for mothers having caring babies especially of this age group should be warranted.
Adolescent ; Anemia ; Anemia, Iron-Deficiency ; Child ; Child, Preschool* ; Critical Period (Psychology) ; Education ; Female ; Ferritins ; Hematocrit ; Humans ; Infant ; Iron* ; Korea ; Mass Screening ; Mothers ; Prevalence* ; Transferrin

BACKGROUND AND OBJECTIVES: Controversy exists regarding the role of endogenous ouabain in the pathogenesis of DOCA-salt induced hypertension. The purpose of this study was to investigate the role of endogenous ouabain in the development of hypertension in DOCA-salt rats. MATERIALS AND METHODS: The mean blood pressure and heart rate were recorded in 1, 2 and 4 week old control and DOCA-salt treated rats. The endogenous levels of ouabain in the plasma, hypothalamus, pituitary and adrenal glands of the 1, 2 and 4 week old control and DOCA-salt treated rats were also measured using a radioimmunoassay. RESULTS: The mean blood pressures in the 2 and 4 week old DOCA-salt treated rats were significantly higher than those of the controls. There was no significant change in the heart rate between the DOCA-salt treated and control groups. In the 4 week old DOCA-salt treated rats, the endogenous level of ouabain in the adrenal glands was higher than that in the control rats, but this was only weakly significant. The endogenous level of ouabain in the hypothalamus was significantly higher in the 1 week old DOCA-salt treated rats than in the control, but this significance disappeared in the 2 and 4 week old DOCA-salt treated rats. CONCLUSION: These results suggest that the endogenous level of ouabain contributes to the development and maintenance of high blood pressure in DOCA-salt rats. Further studies will be required to elucidate the relationship between the endogenous level of ouabain and DOCA-salt hypertension.
Adrenal Glands ; Animals ; Blood Pressure ; Heart Rate ; Hypertension ; Hypothalamus ; Ouabain* ; Plasma ; Radioimmunoassay ; Rats*

An anomalous origin of the left coronary artery (LCA )from the pulmonary artery (ALCAPA syndrome )or Bland-White-Garland syndrome is a rare congenital cardiac anomaly. We report a 65-year old female patient who presented with atypical chest discomfort. Coronary angiography and three-dimensional multidetector computed tomography coronary angiography demonstrated the ectatic right coronary artery (RCA )arising from the aorta, rich collaterals from the RCA to LCA and the ectatic tortuous LCA that originated from the pulmonary trunk.
Aged* ; Aorta ; Bland White Garland Syndrome ; Collateral Circulation ; Coronary Angiography* ; Coronary Vessel Anomalies ; Coronary Vessels* ; Female ; Humans ; Multidetector Computed Tomography ; Pulmonary Artery* ; Thorax

BACKGROUND: The interest of patients with chest pain and normal coronary arteries has been increased since 1960. From the year 1973, the syndrome representing these characteristics has been classified as syndrome X. Treadmill test and exercise TI-201 SPECT are important in the diagnosis of syndrome X. This study was designed to evaluate the clinical value of exercise TI-201 SPECT and the difference of clinical characteristics between exercise TI-201 SPECT positive(Group A) and negative (Group B) in patients with chest pain and normal coronary angiogram. METHODS: Twenty seven patients with chest pain and normal coronary angiogram underwent echocardiogram and exercise TI-201 SPECT. Patients received 2 mCi of thallium intravenously during exercise, redistribution images were performed 4 hour later and second dose of 1 mCi of thallium was injected at rest immediately thereafter. These three sets of image(stress, redistribution and reinjection) were analyzed. RESULTS: 1) 12 of 16 patients in Group A, none of 11 patients were positive on exercise treadmill test(p<0.005). 2) The incidence of systemic hypertension in Group A was significant greater than Group B(p<0.05). 3) The left ventricular end diastolic pressure was significantly higher in Group A than in Group B (p<0.05). CONCLUSION: The exercise TI-201 SPECT is a useful method to evaluate the patients with chest pain and normal coronary angiogram and the reversible perfusion defects on the exercise TI-201 SPECT might be related to systemic hypertension and elevated left ventricular end diastolic pressure.
Blood Pressure ; Chest Pain* ; Coronary Vessels ; Diagnosis ; Exercise Test ; Humans ; Hypertension ; Incidence ; Perfusion ; Thallium ; Thorax* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: To identify fetal gender using fetal DNA in maternal plasma. METHODS: DNA from maternal plasma of 55 pregnant women(47: inpatients, 8: outpatients) underwent a sensitive Y-PCR assay to identify gender. RESULTS: Of the inpatients, fetus-derived Y sequences were detected in 26(80.6%) of the 31 maternal plasma samples from women bearing male fetuses. None of the 16 women bearing female fetuses had positive results from plasma DNA. Eighteen weeks is earliest gestation of gender identification. Of the outpatients(GA 8-11 weeks), fetus-derived Y sequences were detected in 7 of the 8 maternal plasma. Only one patient's fetal gender(GA 9 weeks) was identified. The others were not identified at this moment. CONCLUSION: We identified fetal DNA in maternal plasma. The sensitivity of Y-PCR was 80.6% in women bearing male fetus and the specificity was 100% in women bearing female fetus.
DNA* ; Female ; Fetus ; Humans ; Inpatients ; Male ; Plasma* ; Pregnancy ; Sensitivity and Specificity