No abstract available.
Neurons* ; Reflex*

No abstract available.

A preparation of water soluble components(EA) was made from carpophores of Elfvingia applanata(Pers.) Karst and its in vitro antibacterial activity on a number of bacterial species was examined by macrobroth dilution assay. Among 16 species of bacteria tested, the most potent antibacterial activity was observed against Staphylococcus epiderrnidis and Proteus vulgaris, of which MICs were 1.25 mg/ml. To investigate the antibacterial effects in combinations of EA with quinolone antibiotics, such as ciprofloxacin, enoxacin, lomefloxacin, norfloxacin, and ofloxacin, the fractional inhibitory concentrations(FICs) and the fractional inhibitory concentration indices(FICIs) for four bacterial strains were determined by macrobroth dilution checkerboard assay. Combinations of EA and quinolones exhibited either additive or indifferent effects of antibacterial activity in most instances. However, both synergistic and antagonistic effects were not observed in any cases.
Anti-Bacterial Agents ; Bacteria ; Ciprofloxacin ; Enoxacin ; Norfloxacin ; Ofloxacin ; Proteus vulgaris ; Quinolones* ; Staphylococcus

BACKGROUND: Routine management of postoperative pain have been changed as a result of technological advances in drug delivery systems. The purpose of this study was to compare the effect of continuous epidural analgesia(CEA) system and intravenous patient controlled analgesia (IV-PCA) system for pain relief after cesarean delivery. METHODS: Sixty adult women were randomly assigned to receive analgesics either IV-PCA or CEA after cesarean delivery with general anesthesia for operation. IV-PCA group was received 30 mg intramuscular injection of ketorolac after awakening, followed by IV-PCA. PCA unit was filled with 60 ml; mixed with morphine 10 mg, fentanyl 1000 microgram, ketorolac 180 mg, and normal saline. It had a flow rate of 0.5 ml/hr and lockout interval was 15minutes. CEA group was received a bolus of epidural morphine 3mg and 8ml of 0.25% bupivacaine before the end of operation, followed by CEA. CEA unit was filled with 100 ml; mixed with morphine 4 mg, fentanyl 500 microgram, 0.5% bupivacaine 20 ml, and normal saline. It had a flow rate of 2ml/hr. The degree of analgesia was subjectively evaluated by a visual analogue scale(VAS). Patients were evaluated 0, 1, 2, 6, 12, 24, and 48hours after operation for pain relief, sedation, nausea, vomiting, pruritus, and respiratory rate. RESULTS: VAS pain score were significantly lower in CEA group than IV-PCA group at 0(8.0+/-1.4 vs 3.9+/-0.7), 1(4.4+/-1.3 vs 3.3+/-0.9) and 2hours(3.9+/-1.2 vs 3.3+/-0.8)(p<0.05). There were no apparent cases of respiratory depression and motor weakness of lower extrimity. Nausea or vomiting occurred in 7 patients(23%) of IV-PCA group, and occurred in 3 patients(10%) of CEA group. Pruritus occurred in 6 patients(20%) of IV-PCA group, and occurred in 11 patients (37%) of CEA group. Sedation occurred in 9 patients(30%) of IV-PCA group. Conculsions: We conclude that the CEA with small dose of morphine, fentanyl and bupivacaine is an easy and effective method for pain control after cesarean delivery.
Adult ; Analgesia ; Analgesia, Epidural* ; Analgesia, Patient-Controlled* ; Analgesics ; Anesthesia, General ; Bupivacaine ; Drug Delivery Systems ; Female ; Fentanyl ; Humans ; Injections, Intramuscular ; Ketorolac ; Morphine ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Pruritus ; Respiratory Insufficiency ; Respiratory Rate ; Vomiting

BACKGROUND: The potent bronchodilatory effects of ketamine on airway smooth muscle tone are important in the management of patients with asthma, but its mode of action is unclear. In the present study we evaluated that effects on isolated guinea pig tracheal smooth muscle. METHODS: Changes of isometric contraction of strip were measured. (1) Serial stimulation with acetylcholine(ACh) in Krebs solution or with A23187, nifedipine, ketamine were evaluated. After that, ACh stimulation was induced in Ca2+ free solution. (2) In Ca2+ free solution, ACh contraction was obtained(L1) and emptied by repetitive ACh stimulation. Internal stores were refilled by Ca2+ with ACh stimulation. During the incubation period, A23187, nifedipine, ketamine, cyclopiazonic acid + ketamine was added and tested for their ability to inhibit refilling. Refilling was evaluated by ACh produced contraction (L2) with ratio (L2/L1). (3) Effects of ketamine on the contraction induced by caffeine were also checked. RESULTS: Ketamine inhibited amplitude dose-dependently by successive application of ACh in modified Krebs solution and Ca2+ free solution. Ca2+ influx through voltage gated channels were inhibited with nifedipine but not with A23187. ACh sensitive internal store were different when A23187, nifedipine and ketamine were applied in Ca2+ free solution. Refilling of internal store were potentiated by A23187, but decreased by nifedipine and ketamine. Caffeine produced contractions in the presence of ketamine were not significantly different from control. CONCLUSION: We concluded that the inhibitory effects of ketamine in guinea pig trachea were by acting through voltage and receptor gated channels in dose-depedent manner and these effects may be interferences of intracellular second messengers system.
Animals ; Asthma ; Caffeine ; Calcimycin ; Guinea Pigs* ; Guinea* ; Humans ; Isometric Contraction ; Ketamine* ; Muscle, Smooth ; Nifedipine ; Second Messenger Systems ; Trachea*

Sixty-two patients with primary liver cancer were treated by surgical resection during a period of 10 years. There were 41 hepatocellular carcinomas, 19 cholangiocellular carcinomas, one mixed hepatocellular and cholangiocellular carcinoma, and one hepatoblastoma. Liver cirrhosis and positive hepatitis B surface antigen were noted in 78.0% and 75.7%, respectively, of the patients with hepatocellular carcinomas. In cholangiocellular carcinomas, clonorchiasis and hepatolithiasis were common associated diseases. The tumor was larger than 5 cm in 61.3% of the patients, and was multiple in 21.0%. Multiplicity of the tumor was more common in hepatocellular carcinomas, and regional lymph node metastases were present in 47.4% of the cholangiocellular carcinomas. The types of surgical procedures were a trisegmentectomy in one patient, an extended lobectomy in four, a lobectomy in 24, a segmentectomy in 12, a subsegmentectomy in 11, and a partial resection in 10. A curative resection with a negative resection margin was obtained in 75.8% of the patients. Operative morbidity developed in 29 patients (46.8%), and pulmonary problems, wound infection, and intra-abdominal abscess were common complications. The operative mortality was 3.2% (two out of 62 patients). The overall cumulative 5-year survival rate was 24.6%, and the median survival time was 14.0 months. The cumulative 5-year survival rate for hepatocellular carcinomas and cholangiocellular carcinomas were 28.2% and 20.0%, respectively. The presence of capsule formation, the absence of vascular invasion, a tumor-free resection margin, and the absence of associated liver cirrhosis were favorable prognostic factors. In patients with hepatocellular carcinomas, a high level of serum alpa -fetoprotein and a large tumor (over 5 cm) were significantly related to a shorter survival time.
Abdominal Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Clonorchiasis ; Hepatectomy ; Hepatitis B Surface Antigens ; Hepatoblastoma ; Humans ; Liver Cirrhosis ; Liver Neoplasms* ; Liver* ; Lymph Nodes ; Mastectomy, Segmental ; Mortality ; Neoplasm Metastasis ; Survival Rate ; Wound Infection

BACKGROUND: The MK1 strain, a novel bacterial isolate from soft-rotten tissue of the Neungee mushroom, produces copious amounts of exopolysaccharide (EPS) in a dextrose minimal medium. This study examined the molecular characteristics and immunomodulatory activity of MK1 EPS. METHODS: The EPS in the culture supernatant was purified by cold ethanol precipitation, and characterized by SDS-PAGE/silver staining and Bio-HPLC. The immunomodulatory activities of the EPS were examined using the mouse monocytic cell line, RAW 264.7 cells. RESULTS: The molecular weights of the purified EPS were rather heterogeneous, ranging from 10.6 to 55 kDa. The EPS was composed of glucose, rhamnose, mannose, galactose, and glucosamine at an approximate molar ratio of 1.00:0.8:0.71:0.29:0.21. EPS activated the RAW cells to produce cytokines, such as TNF-alpha and IL-1beta, and nitric oxide (NO). EPS also induced the expression of co-stimulatory molecules, such as B7-1, B7-2 and ICAM-1, and increased the phagocytic activity. The macrophage-activating activity of EPS was not due to endotoxin contamination because the treatment of EPS with polymyin B did not reduce the macrophage-activating activity. CONCLUSION: The EPS produced from the MK1 strain exerts macrophage-activating activity.
Agaricales ; Animals ; Cell Line ; Cold Temperature ; Cytokines ; Ethanol ; Galactose ; Glucosamine ; Glucose ; Intercellular Adhesion Molecule-1 ; Macrophages ; Mannose ; Mice ; Molar ; Molecular Weight ; Nitric Oxide ; Rhamnose ; Sprains and Strains ; Tumor Necrosis Factor-alpha

An outbreak of nosocomial infections caused by Serratia marcescens is described. There were 40 bacterial isolates from 21 patients during a 3 month period at pediatric ward and sick baby room. Bacterial cultures from blood revealed positive in 19 patients out of 21, but one from urine and the other from bronchial secretions. 16 cases among 19 Serratia septicemia were completely recovered, but 3 patients were discharged without adequate treatment. We lost two patients in spite of vigorous medical treatment. Factors associated with Serratia infections were previous multiple and ?road-spectrum antimicrobial therapy and underlying chronic debilitating disese. Indwelling intravenous catheter and previously instrumented urinary tract were the most frequent portals of entry. The isolated strains were resisant to most antibiotics, but most frequently sensitvive to gentamicin, amikacin and chloramphenicoI. It is recommended that until specific antibiotic sensitivities can be obtained, patients with Serratia septicemia should be treated with chloramphenciol in combination with gentamicin or amikacin. Dust collection of the sick baby room, the incubators of the pediatric ward and the nurse room were contaminated with serratia marcescens. The distilled water of the cold steam and incubator were also contaminated. The culture of the specimens from the hands of doctors and nurses revealed many Serratia organisms. The control measures were instituted and the outbreak stopped. These data demonstrate that the organism can become pathogenic for man in certain clinical situations, especially in patients with chronic debilitating disease who have been treated with multiple antibiotics. These experience emphasized the problems in recognition of hospital associated infections.
Amikacin ; Anti-Bacterial Agents ; Catheters ; Cross Infection ; Dust ; Gentamicins ; Hand ; Humans ; Incubators ; Sepsis ; Serratia Infections ; Serratia marcescens* ; Serratia* ; Steam ; Urinary Tract ; Water

When tracheal invasion of a malignant tumor or tracheal stenosis of a benign origin exists at the lower or anterior part of the trachea, tracheal intubation or conventional tracheostomy may be difficult, and in these cases a modified tracheostomy through the lower or lateral part of the trachea would be necessary. We present 6 cases of modified tracheostomy performed with satisfactory results in severe tracheal stenosis that developed in the lower or anterior part of the trachea.
Intubation ; Trachea ; Tracheal Stenosis* ; Tracheostomy*

OBJECTS: We developed the Korean version of Hasegawa Dementia Scale(HDS-K) by translating the revised Hasegawa Dementia Scale(HDS-R) which is known to be a useful brief screening instrument for dementia. MATERIALS AND METHODS: The translation was carried out keeping the basic structure of Revised Hasegawa Dementia Scale(HDS-R). HDS-K, along with MMSE-KC, SBT-K and CDR, were administered to 174 dementia patients and 160 elderly control subjects. Cronbach alpha coefficient, inter-rator reliability, and test-retest reliability of HDS-K were examined. The correlations of MMSE-KC, SBT-K and CDR with HDS-K were also examined to confirm the validity of HDS-K. Cut-off scores for dementia were estimated by Receiver Operator Characteristic(ROC) curve anslyses. By comparing Area Under Curve(AUC), the diagnostic efficiency of HDS-K was compared with those of MMSE-KC and SBT-K. RESULTS: 1) HDS-K was found to have significantly high internal consistency(Cronbach alpha coefficient=0.948, <0.01), inter-rater reliability(Pearson correlation coefficient=0.999, <0.01) and test-retest reliability(Pearson correlation coefficient=0.848, <0.01). 2) All the correlations of HDS-K with MMSE-KC, SBT-K and CDR were significant indicating that HDS-K has good concurrent validity. Its optimal cut-off point for dementia was estimated as 15/16, where the sensitivity and specificity were 0.950 and 0.902, respectively. 3) The ROC curve analysis indicated that the diagnostic efficiency of HDS-K(AUC=0.972) was comparable with MMSE-KC(AUC=0.951) and SBT-K(AUC=0.963). CONCLUSION: We conclude that HDS-K is a reliable, valid, and useful screening instrument for dementia.
Aged ; Dementia* ; Humans ; Mass Screening* ; Reproducibility of Results* ; ROC Curve ; Sensitivity and Specificity ; Translating