Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.20
no.1
/
pp.1-7
/
2014
Background: As the increase of forward head position, we studied the change of thickness of deep cervical flexor (DCF) compared of with sternocleidomastoid (SCM). we measured and analysed the change of thickness of the neck flexor for forward head position and cranio-cervical flexion exercise (CCFE). Methods: Using a cross-sectional design, we conducted the study selecting 35 healthy adults (12 males, 23 females). We measured the craniovertebral angle (CVA), instructed them to perform the CCFE, and measured the DCF and SCM using ultrasonography during the contraction and relaxation period. Results: Intra-reliability of SCM is .96, longus capitis is .92 and longus coli is .97. we compared according to the change of forward head position, Correlation of DCF is .841, and DCF/SCM is .754 by significant positive correlation. At the comparison of CCFE and Resting muscle thickness, SCM and DCF is .00, DCF/SCM is .68. Conclusion: There is a strong positive correlation between the change amount of DCF and DCF/SCM as the increase of CVA.
Abnormal distribution of the enteric nerves such as adrenergic, cholinergic and peptidergic nerves may cause the functional obstruction in Hirschsprung's disease (HD). Although the sustained contraction of the aganglionic segment is the main pathophysiology of HD, the etiology and pathogenesis is not thoroughly understood, With the recent progress of molecular biology and genetics,a more detailed approach to the pathogenesis of the HD can be undertaken. In this review, the roles of the nitric oxide, nitric oxide synthase and interstitial cells of Cajal on smooth muscle relaxation, the effects of extracellular matrix, cell adhesion molecules, neurotrophic factors on the migration and maturation of the neural crest cells are described. In the section of genetic factors, familial occurrences, association of chromosomal abnormalities, RET gene, glial cell line-derived neurotrophic factor gene, endothelin-3 gene and endothelin-B receptor gene and their r elationships to HD is briefly reviewed.
The purposes of this study were to examine the effect of two different pelvic alignments and the Valsalva maneuver on electromyographic (EMG) activity of the erector spinae during squat lifting and lowering, and to find an efficient method for squat lifting and lowering. Twenty hea1thy men in their twenties lifted and lowered loads using four different methods: 1) anterior pelvic tilt position with the Valsalva maneuver, 2) anterior pelvic tilt position without the Valsalva maneuver, 3) posterior pelvic tilt with the Valsalva maneuver, 4) posterior pelvic tilt without the Valsalva maneuver. The EMG activity of erector spinae was recorded during both lifting and lowering with each method. The EMG activity of each individual was normalized to EMG activity produced by muscle during maximal voluntary contraction. Two-way analysis of variance for repeated measures ($2{\times}2$) was used to analyze the effect of the two factors: 1) pelvic tilt position (anterior pelvic tilt, posterior pelvic tilt), 2) the Valsalva maneuver (with and without). Analysis was performed separately for the lifting and lowering. The results were as follows: 1) EMG activity of erector spinae was greater when the pelvis was tilted anteriorly than when the pelvis was tilted posteriorly during squat lifting and squat lowering. 2) There was no difference between EMG activity of erector spinae with the Valsalva maneuver and EMG activity of erector spinae without the Valsalva maneuver during squat lifting and squat lowering. These results suggest that the greater EMG activity of erector spinae with an anterior pelvic tilt position during squat lifting and squat lowering may ensure optimal muscular support for the spine while handling loads, but the Valsalva maneuver may have less effect on erector spinae.
Kim, Min-Jeong;Jeong, Su-Min;Park, Seong-Kwon;Park, Du-Jin
PNF and Movement
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v.14
no.2
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pp.113-120
/
2016
Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey's multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.
Kim, Hae-Won;Park, Mi-Young;Lee, Eun-Hee;Cho, Hyoung-Jin;Lee, Hee-Ran
The Korean Journal of Physiology and Pharmacology
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v.3
no.3
/
pp.329-337
/
1999
Thyroid hormone-induced cellular dysfunctions may be associated with changes in the intracellular $Ca^{2+}$ concentration. The ryanodine receptor, a $Ca^{2+}$ release channel of the SR, is responsible for the rapid release of $Ca^{2+}$ that activates cardiac muscle contraction. In the excitation-contaction coupling cascade, activation of ryanodine receptors is initiated by the activity of sarcolemmal $Ca^{2+}$ channels, the dihydropyridine receptors. In hyperthyroidism left ventricular contractility and relaxation velocity were increased, whereas these parameters were decreased in hypothyroidism. The mechanisms for these changes have been suggested to include alterations in the expression and/or activity levels of various proteins. In the present study, quantitative changes of ryanodine receptors and the dihydropyridine receptors, and the functional consequences of these changes in various thyroid states were investigated. In hyperthyroid hearts, $[^3H]ryanodine$ binding and ryanodine receptor mRNA levels were increased, but protein levels of ryanodine were not changed significantly. However, the above parameters were markedly decreased in hypothyroid hearts. In case of dihydropyridine receptor, there were a significant increase in the mRNA and protein levels, and [3H]nitrendipine binding, whereas no changes were observed in these parameters of hypothyroid hearts. Our findings indicate that hyperthyroidism is associated with increases in ryanodine receptor and dihydropyridine receptor expression levels, which is well correlated with the ryanodine and dihydropyridine binding. Whereas opposite changes occur in ryanodine receptor of the hypothyroid hearts.
Haloperidol, a butyrophenone, was synthetized by Janssen and introduced for the treatment of psychosis. Although structurally different from the phenothiazines, the butyrophenones share many of their pharmacological properties, such as inhibition of conditioned avoidance response, blocking effect of amphetamine reaction, producing catalepsy, antishock effect and protection against the lethal effects of catecholalmines. Chlorpromazine can lower the arterial blood pressure through its adrenergic blocking activity, its direct effect in relaxing vascular smooth muscle, its direct effect in depressing the myocardium and its action in a complex manner on the central nervous system. In the case of haloperidol, however, was not clarified the mechanism of lowering the blood pressure. The present paper describes the effects of haloperidol on cardiovascular system to investigate the mechanisms of its actions on the arterial blood pressure. The results are followings; 1. In anesthetized cats, intravenous administration of haloperidol and chlorpromazine in the dose of 0.1mg/kg produced a slight decrease in the blood pressure, which followed by complete recovery within $30{\sim}60$ minutes. In the dose of 3mg/kg, however, both produced an abrupt and marked decrease of the blood pressure, which followed by delayed recovery. 2. Haloperidol in the dose ranges of 0.1mg to 3.0mg/kg tended to produce the heart rate slowing in the cats, while chlorpromazine has no effect on the rate. 3. Following administration of haloperidol or chlorpromazine, epinephrine reversal in the arterial blood pressure was observed in the cat, however the responses of norepinephrine and acetylcholine were little affected. 4. In the isolated rabbit atrium the contractility was depressed by haloperidol in the doses over 0.5mg per 100ml, but the rate was not affected. In contrast, the epinephrine-induced contractility was not depressed after haloperidol treatment. However, the increased rate of atrium by epinephrine was partially blocked after haloperidol. 5. In the isolated rabbit aortic strip, epinephrine-induced contraction was blocked by haloperidol. With the above results, it may be concluded that the hypotensive effect of haloperidol was largely due to ${\alpha}$-adrenergic blocking properties and the direct effect in depressing the myocardium as well as its action on central nervous system.
The purpose of this study was to investigate influence of wrist position on the electromyographic(EMG) activities of the flexor digitorum superficialis (FDS) and extensor digitorum (ED) during drilling and pinch grip. Eighteen healthy subjects had been recruited and each subject performed two tasks (drilling and pinch grip) at three different wrist positions ($30^{\circ}$ flexion, neutral, $30^{\circ}$ extension). The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary contraction (MVC). Repeated one-way ANOVA was used to compare the differences of EMG across wrist positions. The FDS EMG activity in both drilling and pinch grip was lowest at $30^{\circ}$ wrist extension and the highest at $30^{\circ}$ wrist flexion. The ED EMG activity was lowest when the wrist was neutral in both tasks. From the results of this study, we can conclude that the desirable wrist positions for drilling and pinch grip tasks are slightly extended or neutral position. Therefore, flexed wrist position should be avoided to reduce the excessive work load on the finger muscles during the tasks.
Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.
To examine whether salt stress would alter or not contractility of isolated rat aorta, under anesthesia with sodium pentobarbital(50 mg kg-1 i.p.), male Sprague Dawley rats(300-330 g) were subjected to 0, 50, and 150 mM of sodium chloride at 37$^{\circ}C$ for 60 min. where as the sham group was left at modified Krebs-bicarbonate solution. To measure contractile response of vascular ring preparation isolated from rat was determined in organ bath and was recorded on physiograph connected to isometric transducer. And the strip was checked for expression of heat shock protein(Hsp) by Western blotting. One, three and eight hours later, we measured vascular contractility of isolated rat aorta treated with KCI, phenylephrine from organ bath study. The dose-vascular responses of potassium chloride and phenylephrine showed a little augmentation by NaCl concentration in the strips exposed to NaCl for 8 hours. And the response of relaxation induced by nitroprusside and acetylcholine was not influenced by NaCl stress in isolated aorta ring for 8 hours, respectively. Expression pattern of Hsp 70 of vascular muscle in isolated rat aorta showed a little increase in 150 mM NaCl group at 8 hours after NaCl treatment but not at 3 hours, and Hsp 60 expression of rat aorta was markedly increased in 50 mM NaCl group at 8 hours after NaCl treatment. Taken together, NaCl induced dose-and time dependent accumulation of the Hsp but not affected contraction of rat aorta. These data suggest that short term high salt stress was not sufficient to induce hypertension of rat aorta.
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