PAF itself induces the non-specific bronchial hyperreactivity(NSBH) in asthma. NSBH induced by PAF is nearly as same as that by the sensitized allergen inhalation even though PAF never provokes the late asthmatic response. Usually the amount of allergen for BPT inversely correlated with the severity of asthma, but in PAF, nothing was clarified about that, yet. usually eosinophil is the main effector cell in PAF-induced NSBH. So we want to declare whether PAF inhalation affects the NSBH differently according to the severity of asthma or not in this study and eosinophil is the main effector cell in asthmatics. Single dose PAF(400microgram/microliter) inhalation challenge was done by the Cockcroft' s method but that of methacholine by Chai's method before and after PAF until NSBH returned the basal value. From that, we calculated PC20. Also we checked the eosinophil and platelet count in peripheral blood before and after PAF until those returned the baseline. All these were done in two groups, mild asthmatics and moderate asthmatics classified by the PFT and their PC20. The Bronchoconstriction started at the 3 minutes after PAF inhalation and then relieved completely 30 minutes after inhalation but in mild asthmatics bronchi constricted much more than moderate asthmatics. The fall of NSBH also persisted much longer in mild asthmatics. But the decrease in peripheral eoslnophil counts was nearly same in both groups. None of asthmatics showed the changes in platelet counts in peripheral blood. The degree of bronchoconstriction and decrease in eosinophil counts didn't have any correlation with the persistence of the NSBH. Taken together, PAF inhalation affected the NSBH inversely according to the severity of asthma in this study but eosinophil might not be the only effector cell in PAF-induced NSBH.
Asthma* ; Bronchi ; Bronchial Hyperreactivity* ; Bronchoconstriction ; Eosinophils ; Inhalation* ; Methacholine Chloride ; Platelet Count

No abstract available.
Female ; Ovulation*

OBJECTIVE: Cerebral vasospasm still remains a major cause of the morbidity and mortality, despite the developments in treatment of aneurysmal subarachnoid hemorrhage. The authors measured the utility and benefits of external lumbar cerebrospinal fluid (CSF) drainage to prevent the clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage in this randomized study. METHODS: Between January 2004 and March 2006, 280 patients with aneurysmal subarachnoid hemorrhage were treated at our institution. Among them, 107 patients met our study criteria. The treatment group consisted of 47 patients who underwent lumbar CSF drainage during vasospasm risk period (about for 14 days after SAH), whereas the control group consisted of 60 patients who received the management according to conventional protocol without lumbar CSF drainage. We created our new modified Fisher grade on the basis of initial brain computed tomography (CT) scan at admission. The authors established five outcome criteria as follows : 1) clinical vasospasm; 2) GOS score at 1-month to 6-month follow-up; 3) shunt procedures for hydrocephalus; 4) the duration of stay in the ICU and total hospital stay; 5) mortality rate. RESULTS: The incidence of clinical vasospasm in the lumbar drain group showed 23.4% compared with 63.3% of individuals in the control group. Moreover, the risk of death in the lumbar drain group showed 2.1% compared with 15% of individuals in the control group. Within individual modified Fisher grade, there were similar favorable results. Also, lumbar drain group had twice more patients than the control group in good GOS score of 5. However, there were no statistical significances in mean hospital stay and shunt procedures between the two groups. IVH was an important factor for delayed hydrocephalus regardless of lumbar drain. CONCLUSION: Lumbar CSF drainage remains to play a prominent role to prevent clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage. Also, this technique shows favorable effects on numerous neurological outcomes and prognosis. The results of this study warrant clinical trials after endovascular treatment in patients with aneurysmal SAH.
Aneurysm ; Brain ; Drainage ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Length of Stay ; Prognosis ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial

No Abstract Available.
Depression* ; Primary Health Care*

Foreign body aspiration into the airway causes airway obstruction that may be acutely life-threatening or if undected result in severe lung damage. In case of bilateral bronchial obstruction, the impairment of gas exchange is usually severe enough to threaten the patient's life. And the gas exchange will become worsen during bronchoscopy. So, anesthesia and bronchoscopy for removal of the foreign body should be carried out by skilled personel with appropriate equipment, especially in case of bilateral bronchial obstruction. A 16 month old, cyanotic and dyspneic female infant was brought to operating room for removal of bronchial foreign bodies . The anesthesia was induced and maintained with enflurane(1-2%) -oxygen(100%)- vecuronium using Jackson- Rees breathing system which was connecting to the side arm of ventilating brochoscope. Foreign bodies (peanut), which were two pieces of peanut 4X4X6 mm sized from right and 4X8X12 mm sized from left main bronchus, were sucessfully removed.
Airway Obstruction ; Anesthesia* ; Arm ; Bronchi* ; Bronchoscopes ; Bronchoscopy ; Female ; Foreign Bodies* ; Humans ; Infant ; Lung ; Operating Rooms ; Respiration ; Vecuronium Bromide

No Abstract Available.
Depression* ; Primary Health Care*

The purpose of this study is to investigate the protective role of esmolol during cross-clamping of descending thoracic aorta on the ischemic myocardium induced by the ligation of the left anterior descending coronary artery(LAD) in dogs. LAD was ligated for 15 min followed by reperfusion. Nitroglycerin with or without esmolol were continuously infused throughout procedure and the thoracic aorta was cross-clamped for 45 mins. Eighteen dogs were divided into three groups; group C-no drug administerd, group N-nitroglycerin(5 ug/kg/min), and group NE-nitroglycerin(5 ug/kg/min) with esmolol(0.5 mg/kg as loading dose following 50 ug/kg/min as maintenance dose). Heart rate(HR), mean arterial pressure(MAP), stroke volume(SV), cardiac index(CI), left ventricular stroke work index(LVSWI), pulmonary capillary wedge pressure(PCWP), triple index(TI), mixed venous oxygen tension of great cardiac vein(PgvO2), Ca-vDO2(carotid arterial oxygen content-great cardiac vein oxygen content) and lactate were measured three times in each group before ligation of LAD(stage 1), 15 minutes after LAD ligation(stage 2) and 45 minutes after cross-clamping of descending thoracic aorta(stage 3). The results were as follows: 1) MAP of group NE at stage 3 was significantly high compared with group C but low compared with group N (P<0.05). 2) SV of group NE at stage 3 was significantly high compared with group C and group N. A significant change was observed between group C and group N(P<0.05). 3) CI, LVSWI, PgvO2 of group NE at stage 3 were significantly high compared with group C but not significantly high compared with group N(P<0.05). 4) HR, PCWP, Lactate level of group NE at stage 3 were significantly low compared with group C and group N. A significant change was also observed between group C and group N(P<0.05). 5) TI, Ca vDO2 of group NE at stage 3 were significantly low compared with group C and group N, but no significant change was observed between group C and group N(P<0.05). These results suggest that esmolol could protect ischemic myocardium from progressive damage via reduction of myocardial oxygen consumption without decrease of cardiac output and left ventricular stroke work index.
Animals ; Aorta, Thoracic* ; Capillaries ; Cardiac Output ; Dogs ; Heart* ; Hemodynamics* ; Lactic Acid ; Ligation ; Myocardium ; Nitroglycerin* ; Oxygen Consumption ; Oxygen* ; Reperfusion ; Stroke ; Veins

BACKGROUND: Neostigmine, a cholinesterase inhibitor, is known to reverse the neuromuscular blocking action induced by nondepolarizing muscle relaxants at the end of general anesthesia. Some authors, however, reported that neostigmine has the properties of a neuromuscular block in skeletal muscles while others reported that neostigmine caused the smooth muscles such as the diaphragm to relax rather than to contract. The purpose of this study was to evaluate the effect of neostigmine at different doses on the tracheal smooth muscle in rabbits. METHODS: Isolated tracheal ring preparation in rabbits was used. Groups were divided into 7 groups; acetylcholine group (acetylcholine cumulative administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), neostigmine group (neostigmine cumulative administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), acetylcholine 10 6 M + neostigmine group (acetylcholine 10 6 M prior to neostigmine administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), acetylcholine 10 4 M + neostigmine group (acetylcholine 10 4 M prior to neostigmine administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), neostigmine 10 5, 10 4 and 10 3 M groups (neostigmine administered at doses of 10 5, 10 4 and 10 3 M). Smooth muscle contraction was evaluated in isometric tension per gram of tissue. RESULTS: In the acetylcholine group, the contractions increased as the dosage increased (10 8 10 3 M). In the neostigmine group, the contractions increased as the dosage increased (10 8 10 4 M), but at 10 3 M of neostigmine, contractions suddenly decreased. In addition when acetylcholine 10 6 M was given as a pretreatment, there was a sudden decrease in muscle contractions induced by neostigmine at 10 3 M. Also the contractions induced by 10 3 M neostigmine were less than that of 10 4 and 10 5 M. CONCLUSIONS: We concluded that neostigmine caused smooth muscle contraction at low concentrations by blocking acetylcholine metabolism, but at high concentrations, smooth muscle contractions were decreased and this might be due to direct action at the acetylcholine receptor.
Acetylcholine ; Anesthesia, General ; Cholinesterases ; Diaphragm ; Metabolism ; Muscle Contraction ; Muscle, Skeletal ; Muscle, Smooth* ; Neostigmine* ; Neuromuscular Blockade ; Rabbits*

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation