No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction*

No abstract available.
Toluene* ; Xylenes*

BACKGROUND: Ozone (03) induces airway inflammation and hyperresponsiveness which are characteristic features of asthma. There have been few studies observing O3-induced increase in responsiveness of rat airway muscle. Objectives: The aims of this study were to develop an O3-induced nonallergic asthma model using rat tracheal smooth muscle (TSM) and to evaluate the role of airway epithelium on the modulation of muscle responsiveness. METHOD: Five groups of 20 male Sprague-Dawley(SD) rats were exposed to filtered air including 0.12, 0.5, 1.0, or 2.0 ppm 03 for 1 hour. Thirty minutes after the exposure, bronchoalveolar lavage (BAL) and isometric contractile responses of the isolated tracheal ring segments to KCI, acetylcholine (ACh), and electrical field stimulation (EFS) were measured. RESULTS: The percent age of neutrophils was significantly higher and that of alveolar macro-phages in BAL fluid was significantly lower in 2.0 ppm O3-exposed rats than in the control. There were no significant differences in the maximal contractile responses of TSM to KC1, ACh, EFS and in the sensitivity to ACh (ACh-EC50) and EFS (EFS-EC50) between the control group and the ozone exposed group. ACh-EC50 and EFS-EC50 were correlated positively with the percent age of neutrophils and inversely with that of macrophages. Removal of epithelium significantly increased the sensitivity to ACh in O3-exposed group, but not in the control group. CONCLUSION: These findings indicate that O3 induces neutrophilic airway inflammation, but not an increased sensitivity of TSM to ACh or EFS in SD rats. However, O3-induced epithelial damage may be associated with increased muscle response.
Acetylcholine ; Animals ; Asthma ; Bronchoalveolar Lavage ; Epithelium ; Humans ; Inflammation ; Macrophages ; Male ; Muscle, Smooth* ; Neutrophils ; Ozone ; Rats* ; Trachea

BACKGROUND: Local anesthetics depress smooth muscle contractions in the intact bowel and in strips of isolated intestine, and also relax bronchial smooth muscle. Following systemic absorption, local anesthetics act on the cardiovascular system. Their primary site of action is the myocardium, where decreases in electrical excitability, conduction rates, and contraction force occur. In addition, most local anesthetics cause arteriolar dilation. METHODS: The ability of bupivacaine to elicit a direct relaxant effect on vascular smooth muscle was studied using isolated rat thoracic aortic rings contracted by phenylephrine (PE). Each thoracic aorta ring was suspended on wire supports in a 20 ml tissue bath under 2 g of resting tension. All tissues were bathed in Tris Tyrode solution at 37 degrees C and 100% oxygen was supplied. RESULTS: 1. Bupivacaine (10(-5) M) inhibited PE induced contractions of aortic rings significantly (P < 0.05). 2. Relaxation of aortic rings by bupivacaine (10(-5) M) was reversed by L-NAME pretreatment. 3. Relaxation of aortic rings by bupivacaine (10(-5) M) was not recovered by methylene blue. 4. Indomethacine enhanced the contraction of aortic rings by bupivacaine (10(-5) M). 5. Bupivacaine (10(-5) M) inhibited both the influx of extracellular Ca+2 and intracellular Ca+2 release. 6. Relaxation of aortic rings by bupivacaine 10(-5) M was recovered by tetraethylammonium. CONCLUSIONS: From the results obtained, it is concluded that the relaxation effects of bupivacaine are related with endothelium dependent, and that cyclooxygenase and not guanylate cyclase participates in this relaxation. Bupivacaine inhibited both intracellular calcium release and extracelluar calcium influx. In addition, the potassium channel was also found to be related to this relaxation effect.
Absorption ; Anesthetics, Local ; Animals ; Aorta, Thoracic ; Baths ; Bupivacaine* ; Calcium ; Cardiovascular System ; Endothelium ; Guanylate Cyclase ; Indomethacin ; Intestines ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Myocardium ; NG-Nitroarginine Methyl Ester ; Oxygen ; Phenylephrine ; Potassium Channels ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Relaxation ; Tetraethylammonium

PURPOSE: To evaluate the role of the MRI after the stereotactic radiofrequency ventralis intermedius nucleus (VIM) thalamotomy for the treatment of tremor. MATERIALS AND METHODS: 156 cases of the postthalamotomy MR findings were analized retrospectively. The sagittal T1 weighted image(WI), axial and coronal Proton and T2WI were obtained by using 0.38 T(Resonex Sunnyvale, U. S. A) machine. The interval between thalamotomy and MR examination was from 3 days to 2 months. The MR characteristics and complications related to thalamotomy were reviewed. In 16 cases, a follow-up MR was done 3 to 13 months after the initial MR study. We also reviewed the follow-up MR findings. RESULTS: The mean size of the thalamus lesion was 16 mm. The thalamus lesions were noted as a single layer in 23 cases and as layers of different signal intensity in 100 cases;(2 layers in 84 cases, and 3 or more layers in 16 cases). In 74 cases of the 84 cases with 2 layers, the inner layer was isointense with gray matter on T1WI, hypointense on T2WI, and the outer layer was hypointense on T1WI, hyperintense on T2WI. There were extrathalamic lesions that were related to mistargetting of stereotactic radiofrequency. The locations of the extrathalamic lesions were the posterior limb of the internal capsule(119 cases), the posterior limb of the internal capsule and the midbrain(39 cases), the posterior limb of the internal capsule and the basal ganglia(11 cases), and the midbrain(9 cases). In 5 cases of the mistargetting, double radiofrequency lesions were visualized because of the repeated coagulation. The other complications were intracerebral hemorrhage(2 cases), subdural hemorrhage(2 cases), epidural hemorrhage(1 case), and intraventricular hemorrhage(1 case). On the follow up MR studies(16 cases), 2 cases showed the hemosiderin deposition in periphery of the lesion. CONCLUSION: The MRI was useful for the evaluation of the thalamic lesions and complications after the stereotactic radiofrequency VIM-thalamotomy for the treatment of tremor.
Extremities ; Follow-Up Studies ; Hemosiderin ; Internal Capsule ; Magnetic Resonance Imaging ; Protons ; Retrospective Studies ; Thalamus ; Tremor

PURPOSE: It is well known that 1/3 - 1/2 of Atrioventricular septal defect(AVSD) patients also have Down syndrome which may influence the clinical course of AVSD. To know the anatomic type of AVSD and the effect of Down syndrome on the clinical course of AVSD, we studied 37 cases( Down group: 14 cases, non Down group: 23 cases) who were diagnosed and followed at Department of Pediatrics, Kyungpook National University Hospital between Jan. 1987 and Dec. 1994. METHODS: Patients were diagnosed to have AVSD by 2D-echocardiography and Down syndrome by chromosome study. In 17 cases we catheterizes, Qp/Qs, Rp/Rs and Pp/Ps were compared according to the group. In 14 cases we operated on, the durations of ventilator therapy, ICU stay, and hospital admission were also compared. RESULTS: Of the 36 cases with AVSD, Down syndrome were 14 cases(38%). In Down group(14 cases), complete type of AVSD were 6 cases(43%, Rastelli A: 4 cases, Rastelli B: 1, Rastelli C: 1) and incomplete type of AVSD were 8 cases(57%, Atrial septal defect only: 4 cases, Ventricular septal defect only: 4). In non Down group(23 cases), complete type of AVSD were 10 cases(42%, Rastelli A: 7 cases, Rastelli B: 2, Rastelli C: 1) and incomplete type of AVSD were 13 cases(58%, Atrial septal defect only: 10 cases, Ventricular septal defect only: 3). Of the 17 cases we catheterized(Down group: 9 cases, mean age: 2.1+/-2.0 years, non Down group: 8 cases, mean age: 2.7+/-3.9 years), Qp/Qs was significantly high in non Down group(1.42+/-0.60 vs 2.61+/-1.31, p<0.05) but Rp/Rs and Pp/Ps were significantly high in Down group(Rp/Rs: 0.34+/-0.31 vs 0.10+/-0.06, Pp/Ps: 0.68+/-0.28 vs 0.31+/-0.09, P<0.05 respectively). Of the 14 cases we operated on(Down group: 6 cases, non Down group: 8 cases), the duration of ventilator therapy, ICU stay and hospital admission were not significantly different between both groups but tended to be long in Down syndrome(ventilator therapy: 5.3+/-2.5 days vs 4.3+/-6.7, ICU stay: 9.0+/-6.1 days vs 3.0+/-2.3, hospital admission: 29.4+/-25.9 days vs 21.9+/-27.4). CONCLUSIONS: Down syndrome may adversely influencd the course of atrioventricular septal defect hemodynamically and clinically.
Catheters ; Down Syndrome* ; Gyeongsangbuk-do ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Pediatrics ; Ventilators, Mechanical

PURPOSE: It is well known that 1/3 - 1/2 of Atrioventricular septal defect(AVSD) patients also have Down syndrome which may influence the clinical course of AVSD. To know the anatomic type of AVSD and the effect of Down syndrome on the clinical course of AVSD, we studied 37 cases( Down group: 14 cases, non Down group: 23 cases) who were diagnosed and followed at Department of Pediatrics, Kyungpook National University Hospital between Jan. 1987 and Dec. 1994. METHODS: Patients were diagnosed to have AVSD by 2D-echocardiography and Down syndrome by chromosome study. In 17 cases we catheterizes, Qp/Qs, Rp/Rs and Pp/Ps were compared according to the group. In 14 cases we operated on, the durations of ventilator therapy, ICU stay, and hospital admission were also compared. RESULTS: Of the 36 cases with AVSD, Down syndrome were 14 cases(38%). In Down group(14 cases), complete type of AVSD were 6 cases(43%, Rastelli A: 4 cases, Rastelli B: 1, Rastelli C: 1) and incomplete type of AVSD were 8 cases(57%, Atrial septal defect only: 4 cases, Ventricular septal defect only: 4). In non Down group(23 cases), complete type of AVSD were 10 cases(42%, Rastelli A: 7 cases, Rastelli B: 2, Rastelli C: 1) and incomplete type of AVSD were 13 cases(58%, Atrial septal defect only: 10 cases, Ventricular septal defect only: 3). Of the 17 cases we catheterized(Down group: 9 cases, mean age: 2.1+/-2.0 years, non Down group: 8 cases, mean age: 2.7+/-3.9 years), Qp/Qs was significantly high in non Down group(1.42+/-0.60 vs 2.61+/-1.31, p<0.05) but Rp/Rs and Pp/Ps were significantly high in Down group(Rp/Rs: 0.34+/-0.31 vs 0.10+/-0.06, Pp/Ps: 0.68+/-0.28 vs 0.31+/-0.09, P<0.05 respectively). Of the 14 cases we operated on(Down group: 6 cases, non Down group: 8 cases), the duration of ventilator therapy, ICU stay and hospital admission were not significantly different between both groups but tended to be long in Down syndrome(ventilator therapy: 5.3+/-2.5 days vs 4.3+/-6.7, ICU stay: 9.0+/-6.1 days vs 3.0+/-2.3, hospital admission: 29.4+/-25.9 days vs 21.9+/-27.4). CONCLUSIONS: Down syndrome may adversely influencd the course of atrioventricular septal defect hemodynamically and clinically.
Catheters ; Down Syndrome* ; Gyeongsangbuk-do ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Pediatrics ; Ventilators, Mechanical

The Shy-Drager syndrome is a very rare chronic progressive disease characterised by autonomic failure and multiple system atropy. The main clinical manifestations of this syndrome are orthostatic hypotension, urinary and bowel dysfunction, impaired sexual potency and parkinsonean symptoms. A key in the management of anesthesia is the maintenance of cardiovascular atability. These patient are suffered from defective baroreceptor regulation of the blood pressure as a result of autonomic failure. We report a successful epidural anesthesia for vwicolithotomy in a female patient with Shy-Drager syndrome.
Anesthesia ; Anesthesia, Epidural ; Blood Pressure ; Female ; Humans ; Hypotension, Orthostatic ; Pressoreceptors ; Shy-Drager Syndrome

The Shy-Drager syndrome is a very rare chronic progressive disease characterised by autonomic failure and multiple system atropy. The main clinical manifestations of this syndrome are orthostatic hypotension, urinary and bowel dysfunction, impaired sexual potency and parkinsonean symptoms. A key in the management of anesthesia is the maintenance of cardiovascular atability. These patient are suffered from defective baroreceptor regulation of the blood pressure as a result of autonomic failure. We report a successful epidural anesthesia for vwicolithotomy in a female patient with Shy-Drager syndrome.
Anesthesia ; Anesthesia, Epidural ; Blood Pressure ; Female ; Humans ; Hypotension, Orthostatic ; Pressoreceptors ; Shy-Drager Syndrome

Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, is a chronic condition characterized by relapsing and remitting inflammation of the gastrointestinal tract. The pathogenesis involves a complex interplay of genetic, environmental, and immune factors. Treatment paradigms have evolved significantly over the past few decades, with the introduction of biologics, particularly anti-TNF (tumor necrosis factor) agents, marking a significant advancement. Anti-TNF therapies, including infliximab, adalimumab, golimumab, and certolizumab pegol, have efficacy in inducing and maintaining remission, promoting mucosal healing, and improving the quality of life in moderate to severe IBD patients. The early and appropriate use of these agents can mitigate disease progression and reduce the dependency on corticosteroids, enhancing long-term patient outcomes. Nevertheless, these therapies are expensive and are associated with potential adverse effects, including increased risk of infections and malignancies. This review discusses the mechanisms, clinical efficacy, safety profiles, and therapeutic positioning of anti-TNF agents in IBD management, integrating current Korean treatment guidelines.