Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

Infantile spasms (IS) is a type of epileptic encephalopathy with poor developmental outcomes. The goal of treatment is complete control of spasms, improvement of hypsarrhythmia, and rapid reversal of delayed development. Improvements in diagnosis can result in the selection of appropriate therapy, which can improve a patient's developmental outcomes. However, there is no consensus on the best initial treatment for IS. Here, we describe 6-month-old boy with severe periventricular leukomalacia, developmental regression, and hypsarrhythmic pattern on electroencephalography, who was successfully treated with intravenous methylprednisolone.
Consensus ; Electroencephalography ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular ; Methylprednisolone ; Spasm ; Spasms, Infantile

PURPOSE: With an accumulation of surgical experience for endoscopic or video-assisted thyroidectomy and improvements in surgical techniques and endoscopic instruments, these procedures have become a valid option for patients with benign thyroid nodules. These applications are now being expanded even to selected patients with low risk thyroid carcinomas. This study was performed to suggest new modified methods of approach on the use of a gasless endoscopic thyroidectomy via an axillary approach and to evaluate the short-term outcomes. METHODS: Between May 2004 and March 2007, 66 female patients underwent a gasless endoscopic thyroidectomy via an axillary approach. Surgical outcomes were evaluated in terms of surgical time, length of hospital stay, the incidence of perioperative complications, and patient opinion at two and four months after surgery. RESULTS: No cases required conversion to open surgery. The mean surgical time was 136.5±31.8 minutes, and the mean length of hospital stay was 4.2±1.1 days. There were two transient recurrent laryngeal nerve palsies, two minor tracheal injuries without air leakage, and two postoperative hemorrhages that required a second surgery. Only one patient (1.9%) and five patients (9.4%) complained of slight hypesthesia or paresthesia in the neck and anterior chest wall, respectively, and only three patients (5.7%) complained of discomfort while swallowing 4 months after surgery. CONCLUSION: Gasless endoscopic thyroidectomy via an axillary approach is a feasible and safe procedure and providesa minimal degree of postoperative complaints. This procedure is now a valid option for the surgical treatment of benign thyroid disease and its applications will broaden in the near future.
Conversion to Open Surgery ; Deglutition ; Female ; Humans ; Hypesthesia ; Incidence ; Length of Stay ; Neck ; Operative Time ; Paralysis ; Paresthesia ; Postoperative Hemorrhage ; Recurrent Laryngeal Nerve ; Thoracic Wall ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy*

The biological activities of PDGF include stimulation of mitogenesis, chemotaxis, and differentiation. In nervous system, previous studies have shown that PDGF has an important role in the generation of cells of a glial lineage. However, several studies demonstrated that mature and immature neurons could also synthesize PDGF-alphaR. In the present study, to analyze the distributional pattern of PDGF-alphaR during postnatal development of the canine cerebellum, we used immunohistochemistry. We found that neurons of cerebellum, including Purkinje cells and granules cells, showed immunoreactivity to PDGF-alphaR (IRPDGF-alphaR) as early as postnatal day 0. Whereas IRPDGF-alphaR immunoreactivity in the Purkinje cells were maintained at all postnatal ages. Our data support that PDGF may have the important roles during development and survival of neurons.
Animals ; Cerebellum* ; Chemotaxis ; Dogs ; Immunohistochemistry ; Nervous System ; Neurons ; Platelet-Derived Growth Factor* ; Purkinje Cells

BACKGROUND: Rescently, the immunotherapy against infectious disease and cancer is being actively studied, and high yield of pure CD14+ monocytes is a key of concern. In this study, we optimized the percoll gradient method to increase the purity and yield of monocytes from peripheral mononuclear cells. METHODS: We separated mononuclear cells (MNC) from healthy donors, and monocytes from MNC were separated with the various density of percoll gradient. After centrifugation, we determined the most efficient density of the percoll gradient to get the highest yield and purity of monocytes. We also obtained monocytes by the plastic absorption method. Monocytes were differentiated into dendritic cells (DC) and the efficacy of differentiation to DC is confirmed and compared by morphological characteristics and using a flowcytometer. RESULTS: The purity of monocytes was 51.3+/-8.3% by the 35% percoll gradient method and the purity was improved to 82.9+/-4.2% with 100% of yield by repeating the same method. Therefore, the yield of mature dendritic cells was 3.6+/-0.9% of the total input MNC by the 35% percoll repetition method, which was 1.7 times higher than the plastic adherent method (2.1+/-0.5%). CONCLUSION: This study shows a cost-effective method to isolate CD14+ monocytes and these cells demonstrate high differentiation rate to DC. This process will be valuable for obtaining a sufficient number of DC.
Absorption ; Centrifugation ; Communicable Diseases ; Dendritic Cells ; Humans ; Immunotherapy ; Monocytes ; Plastics ; Povidone ; Silicon Dioxide ; Tissue Donors

PURPOSE: To evaluate the clinical results of corneal triple procedure, as well as the causes and the risk factors for graft failure. METHODS: Indications, survival period of graft, causes of graft failure, and risk factors for failure in 29 patients (29 eyes) who had undergone penetrating keratoplasty combined with cataract surgery and intraocular lens (IOL) implantation were retrospectively analyzed. RESULTS: The most common primary indication of corneal triple procedure was bacterial keratitis (24%), followed by corneal trauma, herpes simplex keratitis, and graft failure. The average survival period of corneal graft in corneal triple procedure was 29.2+/-23.2 months. The most common cause of graft failure was allograft rejection (56.3%). The risk factors of graft failure by an univariate analysis were preoperative unfavorable diagnosis (bullous keratopathy, corneal ulcer, and trauma), corneal neovasculization, intraoperative additional procedure (anterior vitrectomy, synechiolysis, and anterior chamber irrigation), immune rejection, and postoperative glaucoma, but were unrelated to methods of cataract surgery, graft size, or IOL position. In a multivariate analysis, graft rejection and corneal neovascularization were identified as risk factors for graft failure in patients undergoing triple procedure. CONCLUSIONS: Corneal graft in corneal triple procedure had various success rates according to the many factors. Risk factors for graft failure included graft rejection and corneal neovascularization.
Allografts ; Anterior Chamber ; Cataract ; Corneal Neovascularization ; Corneal Ulcer ; Diagnosis ; Glaucoma ; Graft Rejection ; Humans ; Keratitis ; Keratitis, Herpetic ; Keratoplasty, Penetrating ; Lenses, Intraocular ; Multivariate Analysis ; Retrospective Studies ; Risk Factors* ; Transplants* ; Vitrectomy

No abstract available.
Acupuncture Therapy ; Ampicillin/pharmacology/therapeutic use ; Ankle/ultrasonography ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Cellulitis/complications/diagnosis/drug therapy/*microbiology ; Diabetes Mellitus, Type 2/complications ; Gram-Negative Bacterial Infections/complications/diagnosis/drug therapy/*microbiology ; Humans ; Hypertension/complications ; Magnetic Resonance Imaging ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Prevotella nigrescens/drug effects/*genetics/isolation & purification ; RNA, Ribosomal, 16S/*analysis ; Sulbactam/pharmacology/therapeutic use ; Tomography, X-Ray Computed

The objective of this study was to compare early child care center teachers' attitudes for meal and snack guidance between Sweden and Korea. Participants were 251 early child care center teachers (Sweden: 134, Korea: 117) working in Goetebory, Sweden, and Seoul, Korea. The survey was conducted from December in 2003 to February in 2004. SPSS programme was used for statistical analysis. Sixty five point eight percent of the Korean early child care center teachers provided a certain amount of foods for children. But 20.9% of Swedish provided a certain amount of foods for children, 79.1% of them provided the amount a child wanted. Sixty one point seven percent of Korean teachers allowed a child leave foods on the plate, but 95.5% of Swedish teachers asked a child eat all food on the plate. When a child didn't want to eat, 61.1% of the Korean teachers fed him/her, but 11.0% of the Swedish teachers did. Only 42.4% of the Swedish teachers allowed a children eat sweets, but 92.9% of Korean did. The Swedish teachers' perception for food guidance were eating by child himself/herself > washing hands before eating > having appropriate table manner > eating as talking with friends > not playing during the meal time, while the Korean teachers' was taking various food > having appropriate table manner > eating by child himself/herself, not playing during the meal time > washing hands before eating. The Swedish teachers thought 'eating as talking with friends' and 'eating by child himself/herself' is important, where as the Korean's did 'eating without making noise', 'not playing during the mealtime' in the eating behavior. For 'brushing teeth after meal' the Swedish teachers' score (1.5) was lower than the Korean (4.2). The results is necessary to improve meal and snack guidance for Korean early child care center teachers' education.
Child ; Child Care* ; Child* ; Eating ; Education ; Feeding Behavior ; Friends ; Hand ; Humans ; Korea* ; Meals* ; Seoul ; Snacks* ; Sweden* ; Tooth

PURPOSE: To evaluate the incidence and type of low attenuation seen on high resolution computed tomography (HRCT) performed after artificially induced pulmonary embolism. MATERIALS AND METHODS: Using permanent embolic materials, pulmonary embolism was induced in ten Yorkshire pigs. Pre- and postembolic pulmonary angiography was performed, and HRCT was performed immediately and 1, 3, and 6 weeks after embolization. The incidence and type of low attenuation of all segments, as seen on HRCT, was evaluated. Low attenuation was classified as mottled, lobular, segmental, or peripheral. The pigs were sacrified after 6 weeks and contact radiographs were obtained. RESULTS: Low attenuation developed in eight of ten pigs. Pulmonary angiography revealed arterial occlusion in 15 large and 19 small segmental arteries (34 of 45 segments). In the remaining 11 segments, follow-up HRCT demonstrated areas of low attenuation. This was present in 25 of 35 segments (71%) as seen on HRCT images obtained immediately; in 16 of 41 segments (39 %) on images obtained 1 week after embolization; in 17 of 41 segments (41 %) on those acquired at 3 weeks; and in 25 of 45 segments (56 %) on those acquired at 6 weeks. The overall incidence of low attenuation was 83/166 (50 %). The types of low attenuation were mottled in 32/83 cases, lobular in 13/83, segmental in 13/83, and peripheral in 25/83. In large segmental arterial occlusion, the incidence of low attenuation on HRCT was 100% immediately, 57% at 1 week, 60% at 3 weeks, and 80 % at 6 weeks. In small segmental arterial occlusion, the incidence was 47%, 25 %, 11 %, and 21 % respectively. The overall incidence of low attenuation was 40/55 (73 %) in large segmental arterial occlusion and 18/71 ( 25%) in small segmental arterial occlusion. CONCLUSION: Low attenuation on HRCT is a finding of pulmonary embolism and is more common on HRCT performed immediately after embolization (71%) and in large segmental arterial occlusion (73%). Low attenuation on HRCT is an ancillary finding and may be useful in the diagnosis of pulmonary embolism.
Angiography ; Arteries ; Diagnosis ; Follow-Up Studies ; Incidence ; Pulmonary Embolism* ; Swine*

PURPOSE:To analyze the clinical aspects and risk factors for recurrent herpes simplex keratitis (HSK) after penetrating keratoplasty (PKP). METHODS: Records from 78 eyes of 41 patients who underwent PKP for HSV keratitis with a mean follow-up duration of 31.83+/-21.35 months (24~97 months) were reviewed. The clinical aspects of recurrent keratitis, rejection, and survival rate were evaluated. Previous operation history, preoperative inflammation and neovascularization, graft size, suture methods, and antiviral use were analyzed to elucidate the risk factor for recurrent HSK after PKP. RESULTS: HSK recurred in 47.4% of the patients at a mean time of 18.36+/-21.02 months after PKP. The mean duration of keratitis was 2.16+/-1.71 months and the mean frequency of recurrence was 1.41+/-0.69 times. Epithelial keratitis developed in 46.2% of the patients, and epithelial keratitis combined with stromal inflammation developed in 36.5%. Previous graft failure due to recurrent HSK and preoperative inflammation were significant risk factors for recurrent HSK after PKP (p=0.019, p=0.006). There were no statistically significant differences in graft rejection and survival rate between the two groups with and without recurrent HSK. CONCLUSIONS: The majority of cases of recurrent HSK after PKP were epithelial keratitis or epithelial keratitis combined with stromal inflammation, and risk factors for the recurrence of HSK were previous graft failure due to recurrent HSK and preoperative inflammation.
Eye ; Follow-Up Studies ; Graft Rejection ; Herpes Simplex ; Humans ; Inflammation ; Keratitis ; Keratitis, Herpetic ; Keratoplasty, Penetrating ; Methylmethacrylates ; Polystyrenes ; Recurrence ; Rejection (Psychology) ; Risk Factors ; Survival Rate ; Sutures ; Transplants