No abstract available.
Diskectomy ; Ear Cartilage ; Temporomandibular Joint ; Transplants

OBJECTIVE: We analyzed 200 cases of prenatal amniocentesis and compared them with other reported studies. Thus we propose the necessity of metanalysis for prenatal amniocentesis. METHOD: We analyzed 200 cases that have undergone amniocentesis at Masan Samsung hospital from January 1996 to December 1997. The results of our study was compared with other reported studies of amniocentesis by indication and maternal age. The proportion of age-class and indication are compared between previous study subjects and our 200 cases. RESULTS: Triple marker abnormality was the most common indication of amniocentesis(51%) and the most common age distribution was 25-29 years (43.5%). Chromosomal aberration was diagnosed in 20 cases (10%) of which the numerical aberration was 9 cases (4.5%) and the structural aberration was 11 cases (5.5%). 5 cases (2.5%) out of ll cases of the structural aberration were normal variant. There were 7 cases (trisomy 21) of autosomal aberration and 2 cases (Turner syndrome) of sex chromosome aberration. Arnong the structural aberration, there was only one reported case of 46, t(7:10) reciprocal translocation. There were no cases of fetal death except for a little self limited preterm labor. There were no neonatal complications. In the comparison of indication and maternal age with other studies, abnormal triple test was the most common indication of amniocentesis. The number of young pregnant women under 35 years old who underwent genetic amniocentesis was increased year by year. CONCLUSION: Triple maker screening test and genetic amniocentesis become popular method of antenatal diagnosis in Korea. Now, it is the proper time to establish standard indication of prenatal amniocentesis in this country by systemic and objective statistic examination. So we address the need for metanalysis in our country as comparing with other studies.
Adult ; Age Distribution ; Amniocentesis* ; Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Korea ; Mass Screening ; Maternal Age ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Prenatal Diagnosis ; Sex Chromosome Aberrations

Animals ; Bone Matrix ; Hardness ; Methylprednisolone ; Rats

No abstract available.
Gynecology* ; Laparoscopy*

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

A 75-year-old male patient with a left intertrochanteric fracture underwent emergency total hip arthroplasty under spinal anesthesia. He had an operation for laryngeal cancer about 10 years ago. Bronchiectasis and atelectasis were noticed in his preoperative roentgenogram. He underwent spinal anesthesia with 13 mg of 0.5% isobaric tetracaine. The level of spinal anesthesia was T7. The SpO2 (oxygen saturation of pulse oxymeter) decreased to 55% at 1 hour after start of operation. Breath sounds on the right lung were diminished. Tracheal intubation was performed for endotracheal suction. A large amount of yellowish secretion was aspirated through suction catheter. The SpO2 returned to 98%. We report a case of severe hypoxemia due to inability of expectoration in patient with bronchiectasis who underwent spinal anesthesia.
Aged ; Anesthesia, Spinal* ; Anoxia* ; Arthroplasty, Replacement, Hip ; Bronchi* ; Bronchiectasis* ; Catheters ; Emergencies ; Humans ; Intubation ; Laryngeal Neoplasms ; Lung ; Male ; Pulmonary Atelectasis ; Suction ; Tetracaine

Recently halothane and enflurane are commonly used inhalational anesthetic agents in our country. However, it is a controversial matter whether these agents are a potential threat to the liver. Therefore, in order to evaluate the effects of halothane and enflurane on the hepatic function, we divided a anesthetized patients into the following 4 groups. 1st group; low spinal anesthesia. 2nd group; single inhalational anesthesia with halothane.3rd group; repeated secondary inhalational anesthesia with halothane. 4th group; secondary inhalational anesthesia with enflurane following halothane. On postoperative 1st, 3rd, 5th, 7th, 10th day, we checked the levels of SGOT, SGPT and ALP. The results are as follows. group 1. Low spinal anesthesia(10 cases) ;SGOT and SGPT levels-no change or recovered in 9 cases (90%) ALP level-no change in all cases. group 2. Single inhalational anesthesia with halothane (14 cases) ;SGOT and SGPT levels-no change or recovered in 13 cases(92%) severely changed in 1 case. ALP level-no change or recovered in 13 cases (92%) group 3. Repeat 2ndary halothane anesthesia following previous halothane anesthesia. (14cases) ; SGOT level-no-change or recovered in 11 cases (79%), severely changed in 2 cases. SGPT level-no-change or recovered in 11 cases (79%), severely changed in 3 cases. ALP level-no-change or recovered in 11 cases (79%), severely changed in 1 case group 4. Repeated 2ndary enflurane anesthesia following previous halothane anesthesia. (11 cases) ; SGOT level-no-change or recovered in 8 cases (72%), severely changed in 2 cases SGPT level-no-change or recovered in 8 cases (63%), severely changed in 2 cases ALP level-no-change or recovered in 5 cases (45%), severely changed in 1 case From the above results, more cases of elevated SGOT, SGPT and ALP levels and slower recovery rate were noted in the repeated anesthesia group than in the one time anesthesia group. Not only the anesthetics themselves but also other variables such as disease severity coincidental illness, transfusion, duration of operation and so on are probably responsible for these alterations.
Alanine Transaminase* ; Anesthesia* ; Anesthesia, Spinal ; Anesthetics ; Aspartate Aminotransferases* ; Enflurane ; Halothane ; Humans ; Liver

Two patients with respiratory paralysis by cervical(C) injury were treated by sequential four-pole stimulation of the phrenic nerves to pace the diaphragm. With sequential four-pole nerve stimulator, full-time bilateral electroventi-lation were achieved and the conditioning of the diaphragm have been performed in 72 hours. According to other papers using unipolar or bipolar electrode, conditioning of the hypotrophic diaphragm took 2 to 1l months, and full-time electroventilation was possible in only about half of the patients, so part-time mechanical ventilation was needed in remained half of the patients. These results suggest that the conditioning time in patients with high quadriplegia could be significantly shortened and it should be possible to achieved independence from the mechani-cal ventilator when sequential four-pole stimulator was used.
Diaphragm* ; Electrodes* ; Humans ; Phrenic Nerve* ; Quadriplegia* ; Respiration, Artificial ; Respiratory Paralysis ; Ventilators, Mechanical

The purpose of this study is to observe histopathologic changes in the bilateral craniomandibular joints after allowing 6 weeks of consolidation by varying the amount of distraction in rabbit mandible. Eight rabbits weighing about 2 to 3kg were used. After corticotomy was performed on the left mandibular body between the first premolar and the second premolar region, a unilateral fixation device was placed. Then, a 7-day period was allowed without distraction of the device. The mandible was lengthened 0.5mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 6-week-consolidation period was allowed. Then, the rabbits were sacrificed, and histologic examination of the craniomandibular joints was performed. Proliferative changes were observed in the craniomandibular joints in all groups. With the increasing amount of distraction, hypertrophy of the cartilage layer became more severe, bone formed was dense and enchondral ossification was clearly shown in subchondral bone. Hypertrophy of the cartilage layer was also seen in the non-distracted side as the distracted side in the experimental group. These results indicate that when physical force is applied constantly to joints, the proliferation of articular cartilage and bone formation are present. When more than 6 weeks of consolidation period is allowed at the time of performing distraction for more than 5mm, articular changes, especially, in the contralateral side should also be noted.
Bicuspid ; Cartilage ; Cartilage, Articular ; Hypertrophy ; Joints* ; Mandible ; Osteogenesis ; Osteogenesis, Distraction* ; Rabbits*

BACKGROUND: EGF and TGF-a are ligands for the EGF-receptor and act as mitogens for a variety of tissues. TGF-a, in particular, has been implicated as an autocrine growth factor for several cancer cell lines. TGF-B exerts an inhibitory effect on the growth of most epithelial cell types, and the loss of responsiveness to this growth inhibition has been implicated in the development of a variety of human cancers. In the present study, we evaluate whether EGF, TGF-a and TGF-B modulate apoptosis and cell cycle progression in cervical cancer cell lines. MATERIALS & METHODS: The effect of EGF, TGF-a and TGF-B on apoptosis and cell cycle such as CaSki and HeLa cell lines was analysed by flow cytometry RESULTS: 1. TGF-B did not induce apoptosis in CaSki and HeLa cell lines. 2. TGF-B as well as EGF, TGF-a, did not affect the process of apoptosis significantly. 3. The time to occur apoptosis was different between CaSki and HeLa cells treated by growth factots. 4. G1 phase was the checkpoint in CaSki and HeLa cells treated with TGF-B. CONCLUSION: These results suggest that TGF-B as well as EGF, TGF-a does not induce apoptosis and cell growth inhibition.
Apoptosis* ; Cell Cycle Checkpoints* ; Cell Cycle* ; Cell Line* ; Epidermal Growth Factor* ; Epithelial Cells ; Flow Cytometry ; G1 Phase ; HeLa Cells ; Humans ; Ligands ; Mitogens ; Uterine Cervical Neoplasms*