BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

No abstract available.

A twenty four-year-old female patient had suffered progressive dyspnea for 6 years until death. She denied any symptoms suggestive of connective tissue disease, or deep vein thrombosis. She suffered an episode of pontine infarct in 1995. Four years after diagnosis of primary pulmonary hypertension, she died of sudden death during hospitalization. Gross features of pulmonary arteries at autopsy were as follows: left main pulmonary artery showed dilation of the lumen and thickening of the wall, and right main pulmonary artery was markedly dilated and contained fresh thrombus. Hematoxylin and eosin-stained sections of lung tissue showed plexiform lesions of pulmonary arteries, complete luminal obliteration of pulmonary arterioles and dilated lesion of pulmonary arterioles, and capillaries. This patient represents a typical case with a primary pulmonary arteriopathy with plexiform lesions with thrombotic lesion, demonstrating the importance of thrombosis in situ in the pathogenesis of primary pulmonary hypertension. To our knowledge, this is the first autopsy report on the primary pulmonary hypertension in Korea.
Arterioles ; Autopsy ; Capillaries ; Connective Tissue Diseases ; Death, Sudden ; Diagnosis ; Dyspnea ; Female ; Hematoxylin ; Hospitalization ; Humans ; Hypertension, Pulmonary* ; Korea ; Lung ; Phenobarbital ; Pulmonary Artery ; Thrombosis ; Venous Thrombosis

BACKGROUND: The analysis of the papers on the primary care quality assessment in Korea was performed to summarize existing papers, estimate the level of primary care quality, and suggest the directions and areas of the future research. METHODS: Primary care quality-related papers were selected via internet web search engines which were Korean Journal of Family Medicine homepage, KMbase, and KoreaMed. Further papers were added after consultation to primary care quality assessment specialists in Korea. RESULTS: The number of related papers was 29. Data collection was done mostly via mail or telephone questionnaire to suppliers, primary care physicians. Papers on resource capacity area were 11, on services delivery 4, on outcome by service 2, and on clinical performance 12. The total primary care score was low. The themes of clinical performance studies were common diseases in Korea. CONCLUSION: Research volume on primary care quality assessment was poor, especially on outcome area. Data collection methods and quality indicators are needed to diverse. Future researches using OECD health care quality indicators are needed to make international comparison possible, which finally contributes to primary care quality improvement in Korea.
Data Collection ; Humans ; Internet ; Korea ; Physicians, Primary Care ; Postal Service ; Primary Health Care ; Quality Improvement ; Quality Indicators, Health Care ; Quality of Health Care ; Republic of Korea ; Search Engine ; Specialization ; Telephone

Researchers have an ethical responsibility to report the results of research involving human subjects. Dissemination of results ensures that patient care is based on good science and that the field of medicine advances based on complete and accurate knowledge. However, current evidence suggests that publication is often neglected or substantially delayed, especially in the case of negative and inconclusive results. Researchers, editors and reviewers should value all high-quality research regardless of the conclusiveness of the results and ensure that all research involving human subjects is registered in a publicly accessible database.
Clinical Trials as Topic/*ethics ; *Ethics, Research ; Human Experimentation/*ethics ; Publishing/*ethics ; Republic of Korea ; *Research Report ; Research Subjects

No abstract available.
Drainage* ; Prognosis*

Background: Esmolol is rapid hydrolyzed by plasma esterase but may inhibit plasma cholinesterase activity based on its structure. This study was designed to evaluate the interactions between esmolol and succinylcholine or mivacurium which are metabolized by plasma cholinesterase and to determine the inhibitory effect of esmolol on human plasma cholinesterase. Methods: Neuromuscular effects of succinylcholine (1.0 mg/kg) and mivacurium (0.15 mg/kg) with or without esmolol (0.5 mg/kg or 1.0 mg/kg) were compared in 57 adult patients (ASA class I) during O2-N2O-isoflurane anesthesia. Neuromuscular block was monitored by recording the compound electromyogram of the hypothenar muscle resulting from supramaximal train of four stimuli applied to the ulnar nerve. Also plasma cholinesterase activity was measured before and 5, 10 minutes after injection of esmolol. Results: Time from injection to onset of over 95% block, clinical duration from injection to 25% recovery of control twitch, and recovery index defined as from 25% to 75% twitch recovery of succinylcholine or mivacurium were not altered by pretreatment of esmolol. Plasma cholinesterase activity was not decreased after injection of esmolol 0.5 mg/kg, but decreased by 5% after injection of 1.0 mg/kg (p<0.05). Conclusions: It is unlikely that neuromuscular blocking effects of succinylcholine and mivacurium are prolonged by administration of clinical doses of esmolol (0.5~1.0 mg/kg) due to inhibition of plasma cholinesterase activity in human.
Adult ; Anesthesia ; Cholinesterases ; Humans ; Neuromuscular Agents ; Neuromuscular Blockade ; Plasma ; Succinylcholine* ; Ulnar Nerve

Nodular fat necrosis is a rare and often overlooked sign of pancreatic disease. It is manifested as painful subcutaneous erythematous nodules, often found on the legs. We report a case of nodular fat necrosis associated with pancreatitis. The patient was a 14-year-old girl who presented with erythema nodosum-like tender subcutaneous nodules on both her lower extremities. The serum amylase and lipase levels were markedly elevated. The change of serum calcium and eosinophils were not so remarkable. Histopathological findings showed diffuse subcutaneous fat necrosis and ghost-like cells with thick shadowy walls and no nuclei. The lesions involuted gradually without any specific treatment and the underlying pancreatitis was followed up in the department of medicine.
Adolescent ; Amylases ; Calcium ; Eosinophils ; Erythema ; Fat Necrosis* ; Female ; Humans ; Leg ; Lipase ; Lower Extremity ; Necrosis ; Pancreatic Diseases ; Pancreatitis* ; Subcutaneous Fat

BACKGROUND: Almost all STD(sexually tranamitted diseases) have been increasing worldwide since the 1960s. In Korea, the occurrence of STD from recent trends of sexual openness and development in the pleasure-seeking industry is becoming a social issue. However, epidemiological studies and reports concerning the incidence of STD are lacking in Korea, especially in the sexually aetive young age group. OBJECTIVE: We evaluated the incidence of YTD and sexual behavior of recruits in a Korean arrny training center to contribute to the management of STD in Korea. METHODS: We studied 1304 recruits in a Korean army training center by questionnaire, physical examination and laboratory data. The subjects were divided into 3 groups: group 1(1072 persons), those who visited the hospital for evaluation of STD; group 2(641 persons), a control group for coitus rate; and group 3(1304 persons; group 1 plus 232 persons out of group 2), those who had coital experiences. RESULTS: 1. The incidence of STD in group 1 was 65.7%(704/1072) and that of the total number of recruits was 0.43%(704/164,134). 2. Among the 704 cases of STD, the most frequently observed STD was non-gonococcal urethritis, 292 cases(41.5%) and the second was gonorrhea, 236 cases(33.5%). The others were, 68 cases(9.7%) of pediculosis pubis, 41 cases(5.8%) of condyloma acuminatum, 29 cases(4.1%) of syphilis, 20 cases(2.8%) of combined STD, 14 cases(2%) of herpes progenitalis, 2 cases(0.28%) of molluscum cohtagiosum and 2 cases(0.28%) of chancroid. 3. The coitus rate in group 2 was 36.2%(232/641). 4. The incidence of previous STD in group 3 was 20.9%(273/1304). 5. The mn;t common form of STD which the patients experienced previously was urethritis(82.8%) and the others were pediculosis pubis(7.3%), syphilis(3.3%), condylcena acuminahun and herpes progenitalis. 6. The group with more sexual partners tended to have a lower educational level. 7. The experience rate of drug abuse was higher in the group with more sexual partners. 8. The experience rate of oral and anal sex was higher in the group with experiences of clrug abuse than in the ather one. CONCLUSION: In this study, urethritis was the most common form of STD(75% of all STD) and non-gonococcal urethritis showed a greater incidence than gonorrhea. The incidence of STD is thought to be closely related to the factors associated with social or behavioral science, such as the number of sexual partners, grade of education, drug abuse, experience of oral and anal sex. To accomplish more effective management of STD, therefore, the improvement of current social problems involving sexual openness, the pleasure-seeking industry and drug abuse should be achieved.
Behavioral Sciences ; Chancroid ; Coitus ; Education ; Epidemiologic Studies ; Gonorrhea ; Humans ; Incidence ; Korea ; Lice Infestations ; Physical Examination ; Sexual Behavior* ; Sexual Partners ; Sexually Transmitted Diseases* ; Social Problems ; Substance-Related Disorders ; Syphilis ; Urethritis ; Surveys and Questionnaires

No abstract available.
Anemia, Hypoplastic, Congenital*