No abstract available.
Pancytopenia*

PURPOSE: In adriamycin(ADR)-induced cardiomyopathy, several different mechanisms are suggested. However, little information is available regarding the role of apoptosis. In the present study, we examined the induction of apoptosis on ADR treatment and anti-apoptotic effects of probucol, a lipid-lowering drug, and we also studied the changes of bcl-2 expression in order to see the molecular mechanisms underlying the effect of probucol. METHODS: Cardiac myocytes were isolated from 3-day-old rats, and cultured in low(1 pM) or high doses(10pM) of ADR for 24 hours. Probucol(50 pM) was added 30 minutes before ADR administration. Apoptosis was determined by TUNEL staining, and bcl-2 expression was estimated by immunocytochemistry. RESULTS: The number of TUNEL-positive cells significantly increased in both groups treated with ADR. However, anti-apoptotic effect of probucol was evident only in low dose. In addition, the expression of bcl-2 was significantly increased only in the low-dose ADR treatment group and its expression was inhibited by pretreatment of probucol. CONCLUSION: These results suggest that apoptosis might play an important role in ADR-induced cardiotoxicity, and ADR-induced apoptosis was partially prevented by pretreatment of probucol. And ADR-induced apoptosis was not related with depression of bcl-2. Additionally, inhibition of bcl-2 gene expression of low-dose ADR treatment group by probucol suggests that another cell survival mechanism could be implicated in the action of probucol. (J Korean Pediatr Soc 2000;43:746-754)
Animals ; Apoptosis* ; Cardiomyopathies ; Cell Survival ; Depression ; Doxorubicin ; Genes, bcl-2 ; Immunohistochemistry ; In Situ Nick-End Labeling ; Myocytes, Cardiac* ; Probucol* ; Rats*

BACKGROUND: It has been known that arterial carbon dioxide tension is 4~5 mmHg higher than end-tidal carbon dioxide tension in healthy adults during general anesthesia. But negative arterial to end-tidal PCO2 difference was reported in pregnant patients undergoing cesarean section. The purpose of this study was to elucidate the difference between arterial and end-tidal PCO2 in anesthetized patients with reduced functional residual capacity. METHODS: 90 patients were divided into 3 groups i.e. control group (n=30), obese group (n=20, body weight more than 20% greater than ideal weight), pregnant group (n=40). All patients had no cardiac or respiratory abnormalities and never smoked. Arterial blood gas analysis and measurement of end-tidal PCO2 were done 20 minutes after induction of anesthesia in control and obese group and just before uterine incision and 20 minutes after fetal delivery in pregnant group. RESULTS: There were significant correlations between arterial and end-tidal PCO2 in all groups. The incidences of negative arterial to end-tidal PCO2 difference were 10% in control group, 40% in obese group, 42.5% in pregnant group (p<0.05). CONCLUSION: From this study, it is concluded that patients with reduced functional residual capacity have more incidences of negativity than normal patients in the values of arterial to end-tidal PCO2 difference during general anesthesia. So when the tight control of PaCO2 is required in patients with reduced FRC, we recommend to measure PaCO2 for better anesthetic management.
Adult ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Body Weight ; Carbon Dioxide* ; Carbon* ; Cesarean Section ; Female ; Functional Residual Capacity* ; Humans ; Incidence ; Pregnancy ; Smoke

We report three cases of neuroendocrine tumors of the lung characterized by large pleomorphic cell with frequent mitosis, which show neuroendocrine differentiation by both light microscopy or electron microscopy and iminunohistochemistry. These tumors have been categorized as large cell neuroendocrine carcinoma by Travis et al.(1991) in contrast with non-small cell lung cancer with neuroendocrine differentiation. In the latter, neuroendocrine differentiation is not evident by light microscopy and must be demonstrated by imunohistochemstry or by electron microscopy. The prognosis of large cell neuroendocrine carcinoma, together with non-small cell lung cancer with neuroendocrine differentiation, appears to be worse than cancer without neuroendocrine differentiation and intermediate between atypical carcinoid and small cell lung cancer. Larger numbers of patients will be needed to demonstrate significant differences in survival.
Lung Neoplasms

No abstract available.
Neuroblastoma*

No abstract available.

PURPOSE: The purpose of this study was to identify the effects of structured information provided on self care knowledge, self care performance, and functional status. METHOD: The data were collected using self care knowledge and performance assessment tool, and functional status assessment tool from both group hospitalized patients at D hospital in Busan. RESULTS: There was a significant improvement(p=.032) in self care knowledge in experimental group compared to the control group. But there were not improvement in self care performance and functional status in experimental group compared to the control group. But comparing to pretest and posttest in experimental group, There were significant improvement in self care performance (p=.003) and functional status(p=.013). CONCLUSION: Structured information provided showed increased in the degree of knowledge, self care performance, and functional status. But the effect size of program which had been developed in this study was estimated small, so there is needed to modify this program and to research repeatedly.
Busan ; Humans ; Liver Cirrhosis* ; Liver* ; Self Care*

Supravalvular aortic stenosis is an uncommon, congenital narrowing of the ascending aorta which originates just distal to the level of the ostium of the coronary artery. We conducted a successful surgical treatment in a 39 year- old female patient with a congenital supravalvular aortic stenosis and aortic regurgitation who did not show signs of William's syndrome. After we performed an inverted Y-shaped aortotomy toward the noncoronary sinus and right coronary sinus, pantaloon shaped prosthetic patch(Vascutek, Ino, USA) was used to repair the narrowing sinotubular junction. The aortic valve was replaced concommittently using Sorin Bicarbon 19mm. Her postoperative course was uneventful. The patient discharged at 9th postoperative day in good health.
Aorta ; Aortic Stenosis, Supravalvular* ; Aortic Valve ; Aortic Valve Insufficiency* ; Coronary Sinus ; Coronary Vessels ; Female ; Humans

Combid is a compound of Compaxine, which is a phenothiazine derivative, and Darbid that is a long acting anticholinergic synthetic. This medicant was originally intended for use in physical and emotional peptic ulcer cases. Because of it's pharmacological action, writers decided to consider the medicant as a preanesthetic medication. From a record of 2800 patients in the hospital for the year 1975 was administered as a premedicant at random, even though some contraindication did occur and is discussed later in this article, the following results were observed. 1. Because of the characteristics of a long acting effect of Combid Spansule, it can be administered orally with sips of water, 2~3 hours prior to operation, eliminating needless preanesthetic shots, without affecting the N.P.O. rule. 2. Sedative and antisialogue effects of the drug have been also satisfactory, therefore it is recommended to use as a premedicant especially in Korea because ether is commonly used. 3. The drug has an additional antiemetic effect to prevent vomiting from ether anesthesia. 4. Some side effects were observed such as dry mouth, tachycardia, fever and extrapyramidal action that occur from overdosage. 5. The contraindications to be considered when using Combid Spansule as a premedicant include dehydration, fever, tachycardia and parkinsonism. 6. Please note the writers do not recommend this application for short procedure such as closed reduction of Colles fracture and simple spinal anesthesia due to the long lasting drying effect.
Anesthesia ; Anesthesia, Spinal ; Antiemetics ; Colles' Fracture ; Dehydration ; Ether ; Fever ; Humans ; Korea ; Mouth ; Parkinsonian Disorders ; Peptic Ulcer ; Preanesthetic Medication ; Tachycardia ; Trimeprazine* ; Vomiting ; Water

Many cases have been reported indicating that postspinal headache can be relieved immediately by an epiduralinjection of saline: also autologous blood has recently been used successfully instead of saline. C.S.F. changes in 20 cases were observed in the support of the concept; that a continuous leakage in association with hypovolemia and hypotension of C.S.F is the primary cause of postspinal headache. Subarachnoid pressure increased immediately with Xylocaine injection into lumbar epidural space. A spinal needle was inserted into the subarachnoid space at the level Ll-L2 and opening pressure of C.S.F. was read, epidural Tuohy needle was inserted at the 4~5. Twenty-five ml of Xylocaine was injected into epidural space and C.S.F. pressure changes were observed. This procedure was performed on 10 patients in lateral position and another 10 patients were tested in the sitting position. Sitting position: Condition Highest pressure change Lowest pressure change Average pressure change Average opening pressure Horizontal position: Highest pressure change Lowest pressure change Average pressure' change Average opening pressure .Pressure rise 350 mm H2O 60 mm HO 191 mm H2O 369 mm H2O .290 mm H2O 40 mm H2O 14Z mm H2O 165 mm H2O .These pressure changes responded almost simultaneously as xylocaine was injected. The immediate relief of postspinal headache by injecting fluid into epidural space is simultaneous with the increase of C.S.F. pressure. In summary, the direct cause of postspinal headache is probably hypotension of C.S.F. pressure resulting from continuous leakage from spinal tap.
Epidural Space* ; Headache ; Humans ; Hypotension ; Hypovolemia ; Intracranial Pressure ; Lidocaine* ; Needles ; Spinal Puncture ; Subarachnoid Space