BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation

No abstract available.
Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory*

This study investigated the epidemiology (prevalence, risk factors, and impact on quality of life) of knee pain and its severity in elderly Koreans. The subjects (n=3,054) were participants aged > or =50 yr from the fifth Korea National Health and Nutrition Examination Survey, conducted in 2010. Knee pain was defined as pain in the knee lasting > or =30 days during the most recent 3 months; severity was categorized as mild, moderate, or severe. EQ-5D was used to measure quality of life. The prevalence of knee pain was 23.1% (11.7% in men, 31.9% in women). The prevalences of mild, moderate, and severe knee pain were 4.3%, 9.1%, and 9.7%, respectively (2.8%, 5.4%, and 3.5% in men and 5.4%, 12.0%, and 14.4% in women). Old age, female gender, a low level of education, a manual occupation, obesity, and radiographic osteoarthritis were risk factors for knee pain, and were associated with increased severity of knee pain. Excluding men with mild knee pain, people with knee pain had significantly lower quality of life than those without knee pain. Early interventional approaches are needed to reduce the medical, social, and economic burden of knee pain in elderly Koreans.
Age Factors ; Aged ; Asian Continental Ancestry Group ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Obesity/complications ; Odds Ratio ; Osteoarthritis, Knee/complications/epidemiology/radiography ; Pain/*epidemiology/etiology ; Prevalence ; *Quality of Life ; Questionnaires ; Republic of Korea ; Risk Factors ; Severity of Illness Index ; Sex Factors

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

PURPOSE: The purpose of this study was to identify family resiliency, ADL in elders with dementia, and symptom for families with an elder with dementia. METHOD: The participants were 102 people who were caregivers to elders with dementia and who visited the out-patient department at S. hospital for follow up care. Data were collected from August to October 2003 using a questionnaire. The collected data were analyzed using descriptive statistics and t-test aided by the SPSS/PC. RESULT: Family resiliency for the whole sample was within normal limits but when the sample was quarter-divided by good and poor family resiliency, based on established cut-off scores, there were differences for some characteristics according to good/poor family resiliency. These differences were for perceived health state of caregivers (t=-2.78, p=.008), economic state of family (t=-3.34, p=.002), and ADL (t=-2.56, p=.014). CONCLUSION: Future research should focus on the way in which family resiliency can be enhanced and on the effects of interventions for those caregivers who report poor family resiliency.
Activities of Daily Living* ; Caregivers ; Dementia* ; Follow-Up Studies ; Humans ; Outpatients ; Surveys and Questionnaires

No abstract available.
Teratoma*

One of the reasons for insertion of endotracheal tube is to provide a patent airway. Unfortunately, the tube itself may become the cause of airway obstruction. Especially, armored tube is known to be most effective in maintenance of airway patency. However, airway obstruction has been reported by a varity of causes even though armored tube was used. We experienced airway obstruction with armored tracheostomy tube by swelling of inner layer near the cuff. The tube was reused one and had been disinfected with ethylene oxide. Therefore, to prevent complication such as airway obstruction by use of armored tubes, it is desirable to avoid reusal of armored tube and to examine the lumen as well as cuff before intubation when reused.
Airway Obstruction* ; Ethylene Oxide ; Intubation ; Tracheostomy*

Glycopyrrolate, a synthetic quarternary ammonium compound, has a similar pharmacologic property to that of scopolamine, a belladonna alkaloid. Since glycopyrrolate, a quarternary ammonium compound, dose not readily cross the blood brain barrier, it has less central effect than that of scopoiamine a tertiary-amine compound. The authors administered a small dose of scopolamine and glycopyrrolate to human volunteers, and examined the effect on the heart rate ofr both drugs. The results were as follows: 1) A small dose of scopolamine(0.1mg) showed significnat decrease in the heart rate. 2) A small dose of gylcopyrrolate(0.1mg) indeced little change in the heart rate. 3) A small dose of gylcopyrrolate(0.1mg), 10minutes after glycopyrrolate(0.1mg), showed marked increase in the heart rate. 4) A small dose of scopolamine(0.1mg), given 10 minutes after glycopyrrolate (0.1mg), showed tendency for decrease in heart kate. 5) A small dose of gylcopyrrolate(0.1mg), 10 minutes afterscopolamine(0.1mg), showed significant increases in the heart rate. 6) Scopolamine induced bradycardia was suppressed by an additional dose of glycopyrrolate and a preceding dose of glycopyrrolate.
Humans

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*