No abstract available.
Anesthetics, Intravenous*

BACKGROUND: It has been shown that L-type calcium channel blockers increase the muscle relaxation effects of non-depolarizing neuromuscular blocking agents whereas the potentiated neuromuscular blocking effects by L-type calcium channel blocker are resistant to reversal by neostigmine. The aims of this study were 1) to see whether the pretreatment of L-type calcium channel blocker, such as verapamil, aggravates the pipecuronium-induced muscle relaxation, 2) if so, to see whether these effects are reversed by anticholinesterase, such as neostigmine and edrophonium or potassium channel blocker, such as 4-aminopyridine. METHODS: The rat-phrenic nerve-hemidiaphragms (n=60) were prepared. Twenty microgram of pipecuronium was administered to all organ bath. All samples were divided into two groups according to the administration of 10uM of verapamil i.e. verapamil pretreated, non-pretreated group. The amounts of administered pipecuronium were gradually increased by 4ug until the force of twitch decreased to 10% of control value in both groups. Each group was subdivided into three groups according to the administration of 0.75 M of neostigmine, 12.4 uM of edrophonium or 40uM of 4-aminopyridine. RESULTS: The dose of pipecuronium required for the decrease of contractile force to 10% of control value was less in verapamil pretreated group than in non-pretreated group. And, the decrease of contractile force in both groups was more effectively reversed by 4-aminopyridine than neostigmine and edrophonium. CONCLUSIONS: Verapamil potentiates the pipecuronium-induced neuromuscular blockade and 4-aminopyridine is more effective to reverse verapamil pretreated, pipecuronium induced neuromuscular blockade.
4-Aminopyridine* ; Baths ; Calcium Channels, L-Type ; Edrophonium* ; Muscle Relaxation ; Neostigmine* ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Pipecuronium* ; Potassium Channels ; Verapamil*

Monitoring of the central venous pressure is a simple, relatively inexpensive method of assessing a patient's cardiac status, circulating blood volume, and vasomotor tone. The simplest way of checking the intrathoraeic location of the catheter tip is by observing oscillation of 2~4cmH2O in the manometer column, synchronous with respiratory cycle. Inaccurate measurements are often obtained by the misplacement of the central venous catheter tip, in addition to the other well-known complications. Radiographic identification of the catheter tip is essential to eliminate these problems. We experienced a case of arrhythmia which appeared upon misplacement of the central venous catheter tip, and confirmed its misplacement by radiographic study.
Arrhythmias, Cardiac ; Blood Volume ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Methods

OBJECTIVE: Propofol and volatile anesthesia have been associated with metabolic acidosis induced by increased lactate. This study was designed to evaluate changes in pH, base excess (BE), and lactate in response to different anesthetic agents and to characterize propofol infusion-associated lactic acidosis. METHODS: The medical records of patients undergoing neurosurgical anesthesia between January 2005 and September 2012 were examined. Patients were divided into 2 groups : those who received propofol (total intravenous anesthesia, TIVA) and those who received sevoflurane (balanced inhalation anesthesia, BIA) anesthesia. Propensity analysis was performed (1 : 1 match, n=47), and the characteristics of the patients who developed severe acidosis were recorded. RESULTS: In the matched TIVA and BIA groups, the incidence of metabolic acidosis (11% vs. 13%, p=1) and base excess (p>0.05) were similar. All patients in the TIVA group who developed severe acidosis did so within 4 hours of the initiation of propofol infusion, and these patients improved when propofol was discontinued. CONCLUSIONS: The incidence of metabolic acidosis was similar during neurosurgical anesthesia with propofol or sevoflurane. In addition, severe acidosis associated with propofol infusion appears to be reversible when propofol is discontinued.
Acidosis* ; Acidosis, Lactic ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Anesthetics ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Lactic Acid ; Medical Records ; Neurosurgery ; Propofol* ; Retrospective Studies*

The individual onset of action of pancuronium and vecuronium has been examined with a priming dose of same or the other agent or two times priming. Measurement of changes in the Tl% of TOF ratio of the adductor pollicis muscle were performed by Accelograph (Biometer). Sixty adult patients were administered Vecuronium(V) 0.015mg/kg (group 1), V 0.005mg/kg 3 minutes after 0.01mg/ kg(group 2), Pancuronium(P) 0. 015 mg/kg(group 3,4) as a priming agents. After 5 minutes, the intubating dose of V 0.085mg/kg (group 1,2,3), P 0.085 mg/kg (group 4) were administered with the induction agent, thiopental sodium 5 mg/kg. All sixty patients underwent orotracheal intubation at 60 seconds after the injection of intubating dose. Intubation condition, reduction of Tl% at 60 seconds, the onset time of maximal blockade (Tl 0%) were evaluated. There was no difficulty in intubation. Fifty-two (86%) patients were distributed in exellent and satisfactory grade of largest in group 2. While group 3 showed more rapid than group 4, group 2 showed the most rapid onset time significantly. These results indicate that the twicely divided dose of vecuronium for priming agent may be adequate and vecuronium after priming with pancuronium is more rapid than priming with same agent.
Adult ; Humans ; Intubation ; Intubation, Intratracheal* ; Pancuronium* ; Thiopental ; Vecuronium Bromide*

PURPOSE: To evaluate changes of pancreatic size with aging in control subjects and in non-insulin-dependent diabetic patients. MATERIALS AND METHODS: Two groups of non-insulin-dependent diabetic patients were examined; one had been treated with an oral hypoglycemic agent(n=59), and the other with insulin(n=56). The CT findings of 175 patients without clinical evidence of pancreatic disease were included as a normal control. RESULTS: In control subjects, pancreatic size and age correlated. The pancreas was smaller in non-insulin-dependent diabetics than incontrol subjects and smaller in insulin- treated non-insulin-dependent diabetics than in non-insulin treated patients. CONCLUSION: The pancreas was smaller in non-insulin-dependent diabetic patients than in control subjects within the same age range.
Aging ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Humans ; Pancreas* ; Pancreatic Diseases

The purpose of this study was to identify nursing interventions performed by neonatal nursing unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification(NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The new 58 nursing interventions was translated into Korean, and then modified by pannel group, which consist of clinical experts and nursing scholars and finally the 419 nursing interventions was selected. The data were collected from 112 nurses. 168 nursing interventions were performed at least monthly by 50% or more of the nurses. The high frequency of performed nursing interventions were Family domain. 37 nursing interventions were performed at least once a day. The nursing interventions receiving the highest item mean score were neonatal care, neonatal monitoring, phototherapy; neonate, bottle feeding and temperature regulation. 56 nursing interventions were rarely performed by 90% or more of the nurses. Most of them were in the behavioral domain. The rarely used interventions were urinary bladder training, art therapy, religious addiction prevention, religious ritual enhancement and bladder irrigation. Therefore, neonatal nursing units nurses used interventions in the Physiological: basic domain most often on a daily basis and the interventions in the behavioral domain least often. These findings will help in building of a standardized language for the neonatal nursing units and enhance the quality of nursing care. Further study will be needed to classify each intervention class and nursing activity and validate NIC in pediatric care unit.
Art Therapy ; Bottle Feeding ; Classification ; Data Collection ; Humans ; Infant, Newborn ; Neonatal Nursing* ; Nursing Care ; Nursing* ; Phototherapy ; Urinary Bladder ; Child Health

We report an autopsy case of secondary hemochromatosis associated with multiple frequent blood transfusion for the treatment of aplastic anemia. A 23-year-old man had been diagnosed as having aplastic anemia at the age of 13. He received a whole blood transfusion, about 1280 ml, every month during the past 10 years. Recently he developed diabetes mellitus and a congestive heart failure. The autopsy revealed that multiple organs were affected by secondary hemochromatosis, including the liver, heart, pancreas, spleen, bone marrow, stomach, thyroid gland, adrenal glands, and testes. The lungs and liver showed gross and microscopic findings consistent with a congestive heart failure in addition to hemochromatosis. The details are presented. This is a case of rare secondary hemochromatosis occurring in a young man and presenting the classic histopathologic changes indistinguishable from those of primary hemochromatosis.
Adrenal Glands ; Anemia ; Anemia, Aplastic* ; Autopsy* ; Blood Transfusion ; Bone Marrow ; Diabetes Mellitus ; Heart ; Heart Failure ; Hemochromatosis* ; Humans ; Liver ; Lung ; Pancreas ; Spleen ; Stomach ; Testis ; Thyroid Gland ; Young Adult

BACKGROUND: The aims of this study were to test if amrinone or milrinone reverses cardiac depression induced by the exposure to isoflurane in the isolated heart and to determine whether amrinone or milrinone dilates the coronary artery directly. METHODS: Using the isolated Sprague-Dawley rat hearts, heart rate, left ventricular pressure, dp/dt (differentiated rate of pressure development), O2 delivery(DO2), myocardial oxygen consumption(MVO2), and percent O2 extraction were measured. After the isolated hearts were exposed to isoflurane at 1.2 vol% during 10 min, amrinone(10, 50, 100 M) or milrinone(1, 5, 10 M) was separately given to six groups. RESULTS: Amrinone and milrinone reversed, not statistically significant, the depression of cardiac contractility induced by isoflurane, while the isoflurane-induced bradycardia substantially returned to normal by amrinone 100 M. And amrinone and milrinone elevated coronary flow, DO2, MVO2, while isoflurane increased in coronary flow and DO2, except MVO2. CONCLUSIONS: These results suggest that amrinone and milrinone did not counteract the isoflurane-induced cardiac depression and indirectly increased in coronary blood flow through the elevation of cardiac work.
Amrinone* ; Animals ; Bradycardia ; Coronary Vessels ; Depression ; Heart Rate ; Heart* ; Isoflurane ; Milrinone* ; Myocardium* ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Ventricular Pressure

PURPOSE: The objectives of the study were to examine university students' health behavior, depression, and ego-resilience in order to understand the relationship between these variables, and to identify factors influencing ego-resilience. METHODS: Data were collected from a sample of 302 students attending G University. The data collection period was from October 28, 2015 to December 21, 2015. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression with the SPSS Statistics version 23 Program. RESULTS: The number of close friends was weakly correlated with depression and ego-resilience: specifically, the number of close friends had a weak negative correlation with depression, and a weak positive correlation with ego-resilience. Factors significantly influencing the students' ego-resilience were depression, type of residence, frequency of exercise, and gender, with a total explanatory power of 18%. CONCLUSION: These findings indicate that intervention programs to improve ego-resilience should be developed. Research into ego-resilience should be replicated with students from a variety of cultural background and diverse study areas.
Data Collection ; Depression* ; Friends ; Health Behavior* ; Humans