BACKGROUND: The toxicity of paraquat has been known to be caused by oxygen free radicals which leads to the lipid peroxidation and multiple organ failure. Although vitamin C has been known to be a potent antioxidant, recently there are numerous data which have shown that a low dose of vitamin C may act as a prooxidant due to the stimulation of the Fenton reaction with metal ions, which produces hydroxyl radicals. It has been reported that a deferoxamine in paraquat intoxication could reduce the production of the hydroxyl radicals by the inhibition of the Fenton reaction through the reduction of iron ion in tissue. The aim of this study was to evaluate the effect of the high and low dose of vitamin C and deferoxamine on lipid peroxidation and plasma TNF-alpha in paraquat intoxication. METHODS: Female Sprague-Dawley rats were divided into seven groups: control group which was not given paraquat(20mg/kg), P group which was given paraquat only, PVH group given paraquat and high dose of vitamin C(100mg/kg), PVL group given paraquat and low dose of vitamin C(10mg/kg), PVHD given paraquat, high dose of vitamine C and deferoxamine(100mg/kg), PVLD given paraquat, low dose of vitamin C and deferoxamine, and PD given paraquat and deferoxamine. Animals were killed at 6 and 24 hours after treatment. Malondialdehyde(MDA), superoxide dismutase(SOD) and glutathione(GSH) contents, catalase activity, plasma TNF-alpha, and histologic changes in the lung and liver tissue were measured. RESULTS: The lung histology in the PVH and PD or PVHD groups showed the significant decreases in the alveolar edema and interstitial thickness compared to the P group. The liver histology in the PVH and PVHD groups demonstrated marked differences in the central venous and sinusoidal dilatation compared to that of the P group. While the MDA levels of the lung and liver in the PVH and PD groups showed the significant reduction compared to that of the P group at 6 hours after treatment, all groups showed the significant changes compared to the P group at 24 hours. There was no significant change of the SOD levels of the lung and liver at 6 hours among all groups. At 24 hours, the SOD levels of the lung in PVH, PVL, and PVHD groups showed the significant increases compared to the P group. The increase of the SOD level in groups combined with deforoxamine, however, revealed a little reduction. The SOD level of the liver in PVH group only significantly increased compared to the P group at 24 hours. There was no significant change of the GSH level of the lung and liver among all groups at 6 hours. At 24 hours, the GSH level of the lung and liver were significantly increased in both PVH and PD group and PVH group, respectively, compared to the P group. Although the catalase activity of the lung was not significantly increased, that of liver was significantly increased in both PVHD and PD groups compared to the P group at 6 hours. The catalase activities of the lung and liver were significantly increased in PVH, PD, and PVHD at 24 hours. The concentrations of the Plasma TNF-alpha were slightly decreased at 6 hours and slightly increased at 24 hours compared to that of the P group, but they were not significant. CONCLUSION: This study showed that although the low dose of vitamin C had no effect, the high dose of vitamin C revealed a decrease of the MDA level and an increase of SOD, GSH, and catalase activity in the lung and lung and liver tissues, and the effect of the high dose of vitamin C increased with time. The administration of the deferoxamine with or without high dose of vitamin C, however, significantly showed the inhibition of the lipid peroxidation and antioxidant effect and low dose vitamin C decreased the effect of deferoxamine. The effects of the vitamin C and deferoxamine on plasma TNF-alpha were not clearly shown.
Animals ; Antioxidants* ; Ascorbic Acid* ; Catalase ; Deferoxamine* ; Dilatation ; Edema ; Female ; Free Radicals ; Humans ; Ions ; Iron ; Lipid Peroxidation* ; Liver ; Lung ; Multiple Organ Failure ; Oxygen ; Paraquat* ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Superoxides ; Tumor Necrosis Factor-alpha ; Vitamins*

No abstract available.
Heart Arrest* ; Resuscitation*

No abstract available.
Contusions*

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancy, but it has been increased. Ectopic pregnancy is associated with significant mortality if not promptly diagnosed. Careful pelvic examination combined serial beta-hCG determinations and transvaginal sonography to evaluation the adnexal region are necessary prerequisites for early diagnosis. We report a case of discovery of heterotopic pregnancy after elective abortion with brief review of literature.
Early Diagnosis ; Female ; Gynecological Examination ; Incidence ; Mortality ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic*

The Echocardiography is a useful non-invasive diagnostic tool for cardiac evaluation without known risk, and its application in the diagnosis and management of congenital heart disease in infants and children has become indispensable. Especially left ventricular echocardiogram appears to be a effective technique for determination of left ventricular dimensions and volume, other echocardiographic index of left ventricular function. There are numerous echocardiographic studies for normal and abnormal heart of adult, but few in Korean infants and children. Echocardiographic studies were performed on 103 normal infants and children to obtain the normal value of stroke volume, cardiac index, ejection fraction, cardiac out put, percent of fractional shortening which were related to left ventricular function. The result obtained were as follows: 1) Normal mean stroke volume was 39.2314.49ml. 2) Normal mean cardiac index was 4.111.20L/min./m2. 3) Normal mean ejection fraction was 69.4411.31%. 4) Normal mean cardiac output was 3.481.10L. 5) Normal mean percent of fractional shortening was 38.908.07%. The normal values of stroke volume, cardiac output were increased by aging,but no significant differences were found in cardiac index, ejection fraction, percent of fractional shortening.
Adult ; Cardiac Output ; Child* ; Diagnosis ; Echocardiography* ; Heart ; Heart Defects, Congenital ; Humans ; Infant* ; Reference Values ; Stroke Volume ; Ventricular Function, Left*

No abstract available.
Central Venous Catheters* ; Emergencies* ; Emergency Service, Hospital* ; Pericardiocentesis*

BACKGROUND: In korea, significant proportion of victims with out-of-hospital cardiac arrest have no change to survive because some physicians regard the victim with cardiac arrest outside the hospital as the dead and they do not attempt cardiopulmonary resuscitation(CPR). And we cannot expect bystander-initiated CPR and emergency medical system in resuscitating the victims with cardiac arrest. We studies the outcome of resuscitation attempts and the factor associated with survival in patients with out-of-hospital cardiac arrest in current situation of emegency medical system. Method: We attempted cardiopulmonary resuscitation(by standard guidelines) in 74 consecutive victims with non-traumatic out-of-hospital cardiac arrest in emergency department. RESULTS: Of 74 victims with cardiac arrest 35(47%) had no any restoration of spotaneous circulation(ROSC), 26(35%) had transient ROSC but died within 24 hours,6(8%) survived over 24 hours but died in the hospital, and 7(10%) discharged alive. Factors associated with survival were cardiac origin as a cause of cardiac arrest, ventricular fibrillation as a initial ECG rhythm, and short circulatory arrest time. CONCLUSION: Survival rate of victims with non-traumatic out-of-hospital cardiac arrest was 10%. Considering the feasibility to survive, CPR should be attempted in patients with out-of-hospital cardiac arrest if do-no-resusciate(DNR) is not indicated.
Cardiopulmonary Resuscitation ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest* ; Resuscitation* ; Survival Rate ; Ventricular Fibrillation

Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.
Anterior Cruciate Ligament ; Artifacts ; Cartilage ; Knee Joint ; Knee* ; Pathology ; Protons ; Relaxation ; Water

Not infrequently, we meet urgent situations that emergency cardiac pacing is inevitable. Paricularly, in patients with impending brady-asystole cardiac arrest, we cannot but introduce pacing cartheter without fluroscopic guidance in emergency department if transcutaneous pacing is not available. There is little report about emergency transvenous cardiac pacing without fluoroscopic guidance in patients with impending cardiac arrest in korea. We report our experiences of temporary transvenous pacing by blind approach performed in patients with impending bradyasystolic cardiac arrest in emergency department. Among 10 patients who blind pacing were performed. 7 were successfully paced and 3 were not. 5 of 7 patients with successful pacing died of underlying diseases. 2 patients wiere alive. A hematoma around the puncture site was developed in a patient receiving thrombolytic therapy. We concluded that temporary transvenous pacing withoup fluoroscopy should be tried in the emergency situations if fluoroscopy or transcutaneous pacemaker is not avialable.
Emergencies* ; Emergency Service, Hospital ; Fluoroscopy* ; Heart Arrest* ; Hematoma ; Humans ; Korea ; Punctures ; Thrombolytic Therapy

No abstract available.
Death, Sudden, Cardiac* ; Resuscitation*