No abstract available.
Reye Syndrome*

No abstract available.
Intussusception*

BACKGROUND: Bag and mask devices are used frequently to provide patients with positive-pressure-assisted ventilation. One of the disadvantages is the fact that they do not deliver high concentrations of oxygen without special adaptors or attention to technique. In order to investigate the variables affecting oxygen delivery, we designed a study to determine the fractions of delivered oxygen (FDO2) under varying ventilating techniques and conditions. METHODS: We designed special wooden box, in which the Laerdal resuscitator bag had been. We measured the fractions of delivered oxygen with or without reservoir bag in various tidal volumes, respiration rates and oxygen flows. RESULTS: Without reservoir bag, the fractions of delivered oxygen were increased up to only 73% in spite of 15 l/min oxygen flow. With reservoir bag, the fractions of delivered oxygen were increased up to nearly 96% in 5-7.5 l/min oxygen flow. CONCLUSIONS: While using the Laerdal resuscitator bag, it is desirable to adapt reservoir bag and supply 5 l/min oxygen in conventional ventilation and 7.5 l/min in hyperventilation minimally for higher fraction of delivered oxygen.
Humans ; Hyperventilation ; Masks ; Oxygen* ; Respiratory Rate ; Tidal Volume ; Ventilation

BACKGROUND: Methylmethacrylate monomer (MMA) bone cement has been associated with sudden systemic hypotension. The present study was aimed to explore the mechanism of direct myocardial depressant actions of MMA. METHODS: The isometric contraction of isolated guinea pig's right ventricular papillary muscle was measured. Normal and slow action potentials were evaluated by a conventional micro-electrode technique. The effects of MMA on sarcoplasmic reticulum (SR) function were evaluated by its effect on: rapid cooling contractures, rested state contraction of rat papillary muscle in normal Tyrode's solution and of guinea pig's papillary muscle in low Na+ Tyrode's solution. To measure the inward calcium currents (ICa), whole cell patch clamp techniques were applied. RESULTS: MMA caused a dose-dependent depression of the peak force (PF) and maximal rate of peak force (dF/dt-max). About a 30% depression of PF was shown at rested state (RS) contraction in rat myocardium and under low Na+ Tyrode's solution in guinea pig myocardium, respectively. In the 26 mM K+ Tyrode's solution, MMA caused dose-dependent depression of late force development without alteration in early force development. MMA depressed rapid cooling contracture accompanied by prolongation of time to peak contracture. MMA did not alter the amplitude or maximum depolarization rate of normal and slow action potentials. Action potential durations were significantly reduced. In patch clamp studies, MMA reduced ICa in a dose-dependent manner. CONCLUSIONS: MMA depressed cardiac contractility in a dose-dependent manner and may be partly related to the depression of Ca2+ influx through the cardiac membrane. SR Ca2+ release seems to be mildly inhibited by MMA. Based on common clinical concentrations, the direct myocardial depressant effect of MMA may not be a main cause of hypotension during an operation.
Action Potentials ; Animals ; Calcium ; Contracture ; Depression ; Guinea ; Guinea Pigs ; Hypotension ; Isometric Contraction ; Membranes ; Methylmethacrylate* ; Myocardium ; Papillary Muscles ; Patch-Clamp Techniques ; Rats ; Sarcoplasmic Reticulum

BACKGROUND: Propofol inhibits postoperative bronchospasm. Ketamine prevents bronchospasm in asthmatic patients. The present study was designed to evaluate the effects and mechanisms of propofol and ketamine on tracheal smooth muscles. METHODS: After isolating guinea-pig tracheal preparations, the maximal tracheal tones were induced by smooth muscle constrictors(2 10 7 M carbachol, 10 5 M histamine, 30 mM K+ Krebs solution, 124 mM K+ Krebs solution). When tracheal tones stabilized, propofol or ketamine was added cumulatively to obtain the concentration-relaxation curves, and calculated the ED50 and ED95. RESULTS: Propofol and ketamine decreased maximal tracheal tones in the concentration-dependent manners. The ED50 and ED95 of propofol were lowest in the histamine group, highest in the 30 mM K+ Krebs solution group. The ED50 and ED95 of ketamine were lowest in the 124 mM K+ Krebs solution group, highest in the histamine group. CONCLUSIONS: The relaxant effects of propofol and ketamine involve with all receptors in nonspecific way. However, propofol may inhibit more strongly the histamine mediated mechanism of tracheal contraction and ketamine may involve more strongly with Ca++ channel.
Bronchial Spasm ; Carbachol ; Histamine ; Humans ; Ketamine* ; Muscle, Smooth* ; Propofol*

PURPOSE: Colorectal cancer (CRC) has a high risk for postoperative thromboembolic complications such as venous thromboembolism (VTE) compared to other surgical diseases, but the relationship between VTE and CRC in Asian patients remains poorly understood. The present study examined the incidence of symptomatic VTE in Korean patients who underwent surgery for CRC. We also identified risk factors, incidence and survival rate for VTE in these patients. MATERIALS AND METHODS: The patients were identified from the CRC database treated from January 2011 to December 2012 in a single institution. These patients were classified into VTE and non-VTE groups, their demographic features were compared, and the factors which had significant effects on VTE and mortality between the two groups were analyzed. RESULTS: We analyzed retrospectively a total of 840 patients and the incidence of VTE was 3.7% (31 patients) during the follow-up period (mean, 17.2 months). Histologic subtype (mucinous adenocarcinoma) and previous history of VTE affected the incidence of VTE on multivariate analysis. There was a statistically significant difference in survival rate between the VTE and non-VTE group, but VTE wasn't the factor affecting survival rate on multivariate analysis. Comparing differences in survival rate for each pathologic stage, there was only a significant difference in stage II patients. CONCLUSION: Among CRC patients after surgery, the incidence of VTE was approximately 3% within 1 year and development of VTE wasn't a significant risk factor for death in our study but these findings are not conclusive due to our small sample size.
Asian Continental Ancestry Group ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Mortality ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sample Size ; Survival Rate ; Venous Thromboembolism*

Mesenchymal stem cells (MSCs) of human origin have been frequently applied to experimental animal models to evaluate their immunomodulatory functions. MSCs are known to be activated by cytokines from T cells, predominantly by interferon-gamma (IFN-gamma), in conjunction with other cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interlukin-1beta. Because IFN-gamma is not cross-reactive between human and mouse species, the manner in which human MSCs administered in experimental animals are activated and stimulated to function has been questioned. In the present study, we established MSCs from human adipose tissue. They successfully suppressed the proliferation of not only human peripheral blood mononuclear cells but also mouse splenic T cells. When these human MSCs were stimulated with a culture supernatant of mouse T cells or recombinant murine TNF-alpha, they expressed cyclooxygenase-2 (COX-2), but not indoleamine 2,3-dioxygenase. The dominant role of COX-2 in suppressing mouse T cell proliferation was validated by the addition of COX-2 inhibitor in the co-culture, wherein the suppressed proliferation was almost completely recovered. In conclusion, human MSCs in a murine environment were activated, at least in part, by TNF-alpha and mainly used COX-2 as a tool for the suppression of in vitro T cell proliferation. These results should be considered when interpreting results for human MSCs in experimental animals.
Adipose Tissue ; Animals ; Cell Proliferation* ; Coculture Techniques ; Cyclooxygenase 2* ; Cytokines ; Humans* ; Immunomodulation ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; Interferon-gamma ; Mesenchymal Stromal Cells* ; Mice ; Models, Animal ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

Traumatic asphyxia is a clinical symptom complex characterized by craniofacial cyanosis, subconjunctival hemorrhage, and head and neck vascular engorgement due to sudden compressive injury on the thoracic cage. It is occasionally combined with mental deterioration, lung contusion, and edema. It is considered due to increased intrathoracic pressure in state of closed epiglottis. Recently, we had experienced three cases of traumatic asphyxia of which clinical courses were somewhat different. The first case developed by a compression between a elevator and the ground while the victim did not realized the accident happening, and the patient showed nonspecific facial edema and ecchymosis but mental deterioration and ultimate respiratory failure. The second case by a compression between cars, while the impending accident was noticed by the victim, showed full-blown asphyxia without mental or respiratory symptoms. The last case by forceful coughing and vomiting showed facial edema and ecchymosis without any other symptoms. Hospital courses of all cases were uneventful. We believe that 'fear response' or 'closure of the epiglottis' might be an important mechanism on developing symptom of traumatic asphyxia.
Asphyxia* ; Contusions ; Cough ; Cyanosis ; Ecchymosis ; Edema ; Elevators and Escalators ; Epiglottis ; Head ; Hemorrhage ; Humans ; Lung ; Neck ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Many strategies to reduce pain during propofol injection have been investigated. Inhibitors of cyclooxygenase are frequently used to provide post operative pain relief in patients undergoing minor gynecologic surgery. Therefore, in this study, we have investigated whether ketorolac injected intravenously reduces pain during propofol injection. METHODS: Fifty healthy female patients scheduled for minor gynecological surgery were randomly allocated to one of four groups. All patients were inserted 20 G Angiocatheter into the veins on the dorsum of the hands. After applying an arm tourniquet at an inflation pressure of 40-45 mmHg, the control group received 2 ml of 0.9% saline, and those in groups I, II, and III received ketorolac 0.5, 0.75, and 1.0 mg/kg mixed with 2 ml of 0.9% saline respectively. The tourniquet was released 2 minutes later. 2 mg/kg of 1% propofol bolus was then injected with an infusion pump intravenously. After 50 mg of propofol were injected, patients were assessed for visual analogue scale (VAS) scores and pain grades. RESULTS: VAS scores during propofol injection diminished significantly in group II (0.75 mg/kg ketorolac) and group III (1 mg/kg ketorolac) compared with the control (saline) group. CONCLUSIONS: Pretreatment with intravenous ketorolac more than 0.75 mg/kg during the 2 minutes tourniquet time can reduce pain elicited by profofol injection.
Arm ; Female ; Gynecologic Surgical Procedures ; Hand ; Humans ; Inflation, Economic ; Infusion Pumps ; Ketorolac* ; Propofol* ; Prostaglandin-Endoperoxide Synthases ; Tourniquets ; Veins

BACKGROUND: Hemodynamic derangement during the displacement of the beating heart in off-pump coronary artery bypass graft surgery (OPCAB) might be related with right ventricular (RV) dysfunction. This study evaluated the influence of displacing and stabilizing the heart, for the anastomosis of coronary arteries, on hemodynamic alterations and RV function in patients undergoing OPCAB. METHODS: Twenty patients with triple vessel coronary artery disease underwent OPCAB using single pericardial sutures: a tissue stabilizer was included. The hemodynamic variables and right ventricular ejection fraction (RVEF) were obtained using a right-heart ejection fraction thermodilution pulmonary artery catheter after the induction of anesthesia, before and after anastomosis of each coronary artery and after sternal closure. RESULTS: No significant hemodynamic changes were observed during the displacement of the heart or the placement of a stabilizer on all of the coronary arteries, except the obtuse marginal artery (OM) before anastomosis. RVEF, left ventricular stroke work index (LVSWI), stroke volume index and cardiac index (CI) decreased and mean pulmonary artery pressure increased significantly whist positioning the graft to the OM. Right ventricular volumes were not significantly changed, although central venous pressure and pulmonary capillary wedge pressure increased. Changing CI had a close relationship with LVSWI (r2 = 0.537, P <0.05) but not with RVEF (r2 = 0.118). These hemodynamic compromises recovered to baseline values after sternal closure. CONCLUSIONS: The displacement of the beating heart for positioning during anastomosis of the graft to the OM caused significant hemodynamic instability and LV functional changes in addition to RV functional changes seemed to be responsible for hemodynamic derangements.
Anesthesia ; Arteries ; Catheters ; Central Venous Pressure ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease ; Coronary Vessels ; Heart* ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Stroke ; Stroke Volume ; Sutures ; Thermodilution ; Thoracic Surgery* ; Transplants ; Ventricular Function, Right*