BACKGROUND: Core hypothermia after induction of anesthesia results from an core-to-peripheral redistribution of body heat and a loss of body heat to environment. The purpose of this study is finding body temperatures during operation by either general of epidural anesthesia and evaluates content of total body heat. METHODS: We measured tympanic membrane temperature, 4 point skin temperature (mid calf, mid thigh, upper extremity, nipple). And we calculate mean skin temperature, mean body temperature, total body heat content changes based on tympanic membrane temperature and 4 point skin temperature. RESULTS: Tympanic membrane temperature of the first group decreased significantly after 10 minutes of induction (p<0.005), the second group decreased after 45 minutes of induction. Although upper extremity temperature has continuously increased as time passed, there was no significant difference in both group. Lower extremity temperature has significantly increased after 30 minutes of induction in the first group, and the second group has significantly increased after 10 minutes of induction (p<0.05). Mean skin temperature hasdecreasd temperaturily in both group after 10 minutes of induction and increased as time passed. Mean body temperature of the first group has significantly decreased after 10 minutes of induction (p<0.05) and second group has no significant changes. Total body heat content has continuously decreased after induction with no significance. CONCLUSIONS: General anesthesia reveals more significant decrease than epidural anesthesia. Both groups show significant decrease of body temperature after induction. We think that we need to close attention to temperature changes after induction for preventing possible side effects due to core hypothermia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General* ; Body Temperature Changes* ; Body Temperature* ; Hot Temperature ; Hypothermia ; Lower Extremity ; Skin Temperature ; Thigh ; Tympanic Membrane ; Upper Extremity

The several Chinese herbs such as Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, So-Hap-Hyang-Won and O-Yak-Soon-Ki-San were extracted with water and then lyophilized. For identification of the effect of extracted herbs, they were medicated to 103 patients of cerebrovascular accident for 4 week. They were hospitalized in D-Oriental Medical Hospital from April to August in 1999. The herbs were extracted with water and lyophilized and then, used as samples. The medical history of each patient was detected and analyzed from their medical records. The results were as follows: 1) Each sample (Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, and O-Yak-Soon-Ki-San) was statistically significant differences of systolic blood pressure(t=4.22, P=0.0004: t=3.44, P=0.0028: t=2.11. P=0.0463: t=3.23, P=0.0052). The statistically significant difference of diastolic blood pressure showed by medicated with Soon-Ki-Hwal-Hyal-Tang, Seong-HyangJeong-Ki-San, and O-Yak-Soon-ki-San(t=2.13, P= 0.0459: t=2.68, P=0.0136: t=3.12, P=0.0066). 2) The statistically significant difference of the arm/leg-ROM showed by medicated with Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O Tang, So-Hap-Hyang-Won(t =4. 74/4. 95, P=0.0002/0.0001: t=2.25/2.44, P=0.0368/0.0248: t=585/6.76, P=0.0001/0.0001). 3) In the verbal disorder, Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang had statistically significant differences(t=4.50, P=0.0002: t=3.32, P=0.0036) 4) In the conscious disorder, Soon-Ki-HwalHyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang =-Jeong-Kj-San, and So-Hap-Hyang-Won had statistical1y significant differences(t =6.32, P = 0,0001: t=8.32, P=0.000l: t=3.74, P=0.0012: t=5.14, P=0.0001). 5) Bovine aortic endothelial cell (BAEC) were cultured in DMEM treating 0.01mg/ml. and 0.1mg/ml of each lyophilized samples for 24 hours, In BAECs were treated by 5 kinds of samples, the effect of So-Hyap-Hyang-Won induced syncytium of adjacent endothelial cells. It may induce the recovering of the damaged blood vessels in cerebrovascular accidental patient by angiogensis of endothelial cells. Therefore, it suggests that the medication of So-Hap-Hyang-Won will help to nursing care for cerebrovascular accidental patients.
Asian Continental Ancestry Group ; Blood Pressure ; Blood Vessels ; Endothelial Cells ; Giant Cells ; Humans ; Medical Records ; Nursing Care ; Stroke* ; Water

No abstract available.
Cisplatin* ; Drug Therapy* ; Ovarian Neoplasms*

No abstract available.
Cisplatin* ; Drug Therapy* ; Ovarian Neoplasms*

Recently, it has been postulated that diabetic autonomic neuropathy is caused by reduction in availability of nerve growth factor (NGF) in enteric nervous system. This experiments were performed to determine the changes of the distribution of enteric neuropeptide by diabetes and these changes could be prevented by administration of NGF. Sprague Dawley rats (200~250gm) were made diabetic by a single intraperitoneal injection of streptozotocin 65 mg/kg in saline. Recombinant human NGF (Sigma, Co., Ltd.) were administered at a dose of 500ng/kg subcutaneously every day for consecutive 4 weeks after streptozotocin administration. After 4 weeks, rats were anesthetized with ether and perfused with 4% paraformaldehyde. ileum was dissected and prepared by whole mount preparation method. Prepared segments were immunostained for substance p, calcitonin gene-related peptide, vasoactive intestinal peptide, and galanin by PAP technique. For the observation of the interstitial cells of Cajal, segments were immersed in Champy-Maillet solution for 2 days Results obtained were as follows: 1. In myenteric plexus of diabetic rats, substance P-like and VIP-like immunoreactivity were not changed compared with that of the control group. CGRP-like and galanin-like immunoreactivity were decreased in diabetic group and immunoreactive cells for CGRP and galanin were also decreased 18.1% (P<0.01) and 43.7% (P<0.01) respectively. 2. In NGF administerd diabetic group, immunoreactivity of substance p, VIP, galanin in myenteric plexus were slightly increased and immunoreactive cells for substancre p, VIP, galanin were almost the same as that of the control group. However, immunoreactive cells for CGRP of myenteric plexus were not changed by NGF. 3. In submucous plexus of diabetic rats, immunoreactivity of all four neuropeptides(substance p, CGRP, VIP, galanin) were decreased compared with that of the control group. Immunoreactive cells for substance p, CGRP, VIP, and galanin were also decreased in 38.8%, 77.6%, 33.0%, and 35.7%, respectively (P<0.01). 4. In NGF administered diabetic group, immunoreactivities of substance p, VIP and galanin in submucous plexus were increased and the immunoreactive cells were increased significantly compared to diabetic group. However, immunoreactive cells for CGRP of submucous plexus were not changed by NGF. 5. Interstitial cells of Cajal of diabetic group were decreased 7.4% ovoidal cells (A type) and 28.3% round cells (B type) In NGF administered group, the morphology and the number of ICC were not different to the control group. With the above results, it could be assumed that NGF prevent the damage of neurotransmitter and ICC in enteric nervous system.
Animals ; Calcitonin Gene-Related Peptide ; Diabetic Neuropathies ; Enteric Nervous System ; Ether ; Galanin ; Humans ; Ileum ; Injections, Intraperitoneal ; Interstitial Cells of Cajal ; Myenteric Plexus ; Nerve Growth Factor* ; Neuropeptides ; Neurotransmitter Agents ; Peristalsis* ; Rats* ; Rats, Sprague-Dawley ; Streptozocin ; Submucous Plexus ; Substance P ; Vasoactive Intestinal Peptide

The expression of c-fos and c-jun in the brain of the rat after capsaicin treatment was investigated by in situ hybridization, dot blot hybridization and immunocytochemical methods. Adult male Sprague-Dawley rats[200g] were used for this study. The first set of rats received a single subcutaneous injection of capsaicin[50mg/Kg] dissolved in 10% Tween-80 and 10% ethanol in saline. The rats were decapitated 1, 3, 5, 10, 24, 72 hours and 1 week after capsaicin treatment. The control set of rats were treated with saline instead of capsaicin. In situ hybridization and dot blot hybridization were carried out. O1igonucleotide probe complimentary to c-fos mRNA sequences were used for this study and labeling of oligonucleotides was accomplished using the DNA tailing kit. The expression of c-fos mRNA on the nucleus of neurons in in situ hybridization was observed throughout the brain, and was especially abundant in the olfactory cortex, nucleus of diagonal band of Broca, habenular nuclei, periaqueductal gray, parabrachial nucleus, entopeduncular nucleus, ventral posterolateral nucleus of the thalamus and cerebellum. Compared to the control rats, c-fos mRNA were increased 24 hours after capsaicin injection and gradually decreased after 72 hours, returning to the normal control level 1 week after capsaicin injection. c-fos mRNA was detected only 1 week after capsaicin injection in the various areas of the brain. The fos protein-like immunoreactivity was initially somewhat decreased at 24 hours, but increased at 72 hours and reactions was maximally observed at 1 week after capsaicin treatment. But Jun protein immunoreactivity was not increased, on the contrary, it was even decreased both in numbers of reactive cells and immunoreactivity 1 week after capsaicin injection. From the above results, c-fos gene expression was pronounced in the nucleus concerned with pain, olfaction and taste such as VPL nucleus of the thalamus, olfactory cortex and parabrachial nucleus, in the limbic system concerned with stress and emotion such as nucleus of diagonal band of Broca, periaqueductal gray and habenular nucleus, in the structure concerned with somatic motor function such as entopeduncular nucleus and cerebellum. Also, the c-fos gene was activated by the capsaicin early in the course of effects, then the fos protein increased as a results of c-fos activation. On the other hand, c-jun did not respond to capsaicin treatment early in the course, but Jun protein decreased late in the course of capsaicin effects.
Adult ; Animals ; Brain* ; Capsaicin* ; Cerebellum ; DNA ; Entopeduncular Nucleus ; Ethanol ; Genes, fos ; Habenula ; Hand ; Humans ; In Situ Hybridization ; Injections, Subcutaneous ; Limbic System ; Male ; Neurons ; Olfactory Pathways ; Oligonucleotides ; Periaqueductal Gray ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Septal Nuclei ; Smell ; Thalamus ; Ventral Thalamic Nuclei

Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.

Disodium cromoglycate(DSCG) has been widely used in the treatment of bronchial asthma and has become the prophylactic drug of choice in patients with mild-to-moderate asthma, because it has anti-allergic, anti-inflammatory and mast cell stabilizing properties. DSCG has been considered one of the safest medications among drugs for asthma treatment. The most common side effects are irritation of throat and dry mouth. Bronchospasm and chest tightness have been reported, but they were usually experienced by patients using spinhaler powdered capsules rather than metered dose inhalers (MDI). In this report, we presented a case of recurrent DSCG-induced bronchoconstriction with brief review of the literature. He had had an aspirin-induced asthma and had been well controlled with steroid inhalers and DSCG-MDI. After aspirin-bronchopro vocation test, he complained of chest discomfort and tightness immediately after inhaling DSCG-MDI. On serial monitoring of peak expiratory flow rate (PEER), there was a significant decline of PEER after two puffs inhalation of DSCG-MDI. Thus we performed DSCG-inhalation broncho provocation test with the nebulizer solution, which was pure DSCG without any addition of ingradients or propellants. This produced an early asthmatic reaction with more than 40% decline of FEV,. He was diagnosed as DSCG-induced bronchoconstriction and his clinical conditions were improved after avoidance of DSCG-MDI.
Asthma* ; Asthma, Aspirin-Induced ; Bronchial Spasm ; Bronchoconstriction* ; Capsules ; Humans ; Inhalation ; Mast Cells ; Metered Dose Inhalers ; Mouth ; Nebulizers and Vaporizers ; Occupations ; Peak Expiratory Flow Rate ; Pharynx ; Thorax

Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Diagnosis ; Epidural Abscess* ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Myelitis* ; Neck ; Paresis ; Sensation ; Spinal Cord ; Spine

To keep the patent airway during a general anesthetic procedure or when handling an unconscious patient is the most important concern as well as responsibility and/or duty of the anesthesiologist. Many delicate operations could and can be performed because of the development of anesthetic techniques aad methods, especially through the introduction of endotracheal intubations. However, at times, an endotracheal tube can unfortunately be a hazardous instrument-lethal instead of lifesaving. The authors experienced a case of left main bronchial obstruction with a thick mucus plug immediately following the completion of oro-endotracheal intubation. This was successfully remedied by direct bronchoscopic aspiration under transtracheal spray. In such a circumstance as this, the newly designed instrument, namely; a bronchofiberscope, is a real necessity.
Humans ; Intubation ; Intubation, Intratracheal* ; Mucus*