Immunogenicity and Reactogenicity of Ad26.COV2.S in Korean Adults: A Prospective Cohort Study

Background@#As the coronavirus disease 2019 (COVID-19) pandemic continues, there are concerns regarding waning immunity and the emergence of viral variants. The immunogenicity of Ad26.COV2.S against wild-type (WT) and variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) needs to be evaluated.Method: This prospective cohort study was conducted between June 2021 and January 2022 at two university hospitals in South Korea. Healthy adults who were scheduled to be vaccinated with Ad26.COV2.S were enrolled in this study. The main outcomes included anti-spike (S) IgG antibody and neutralizing antibody responses, S-specific T-cell responses (interferon-γ enzyme-linked immunospot assay), solicited adverse events (AEs), and serious AEs. @*Results@#Fifty participants aged ≥ 19 years were included in the study. Geometric mean titers (GMTs) of anti-S IgG were 0.4 U/mL at baseline, 5.2 ± 3.0 U/mL at 3–4 weeks, 55.7 ± 2.4 U/mL at 5–8 weeks, and 81.3 ± 2.5 U/mL at 10–12 weeks after vaccination. GMTs of 50% neutralizing dilution (ND50) against WT SARS-CoV-2 were 164.6 ± 4.6 at 3-4 weeks, 313.9 ± 3.6 at 5–8 weeks, and 124.4 ± 2.6 at 10–12 weeks after vaccination. As for the S-specific T-cell responses, the median number of spot-forming units/10 6 peripheral blood mononuclear cell was 25.0 (5.0–29.2) at baseline, 60.0 (23.3–178.3) at 5-8 weeks, and 35.0 (13.3–71.7) at 10–12 weeks after vaccination. Compared to WT SARS-CoV-2, ND50 against Delta and Omicron variants was attenuated by 3.6-fold and 8.2-fold, respectively. The most frequent AE was injection site pain (82%), followed by myalgia (80%), fatigue (70%), and fever (50%). Most AEs were grade 1–2, and resolved within two days. @*Conclusion@#Single-dose Ad26.COV2.S was safe and immunogenic. NAb titer and S-specific T-cell immunity peak at 5–8 weeks and rather decrease at 10–12 weeks after vaccination.Cross-reactive neutralizing activity against the Omicron variant was negligible.

A Case of Segmental Vitiligo Occurring Where Herpes Zoster Occurred Previously as an Isotopic Response / 대한피부과학회지

Wolf's isotopic response is defined as the occurrence of a new skin disorder at the site of another unrelated skin disease that has already healed. In most cases of isotopic response, the initial dermatosis is herpes infection, and the most frequent second dermatoses are granulomatous reactions. Various interpretations of this phenomenon have been attempted. However, the exact mechanism has not been identified yet. Herein, we report a case in which the secondary disease was segmental vitiligo that appeared over the same dermatomes of herpes zoster. A 71-year-old woman presented with well-defined, depigmented patches on the left chest and back. She had been diagnosed with herpes zoster on the same dermatomes and treated with an antiviral agent 3 years ago. Histological examination showed decreased basal melanin pigments and melanocytes. Consequently, the patient was diagnosed with segmental vitiligo based on the clinical and histological findings.

Serologic Response to Treatment in Human Immunodeficiency Virus-Negative Syphilis Patients Using Automated Serological Tests: Proposals for New Guidelines

BACKGROUND: Automated analyzer-based nontreponemal serological tests for syphilis (STS) have been used for several decades. OBJECTIVE: In this study, we evaluated serological responses to treatment and proposed clinical guidelines for automated STS. METHODS: This retrospective cohort study analyzed human immunodeficiency virus-negative syphilis patients who were diagnosed with automated rapid plasma reagin (auto RPR) tests as a nontreponemal STS, and who also received the fluorescent treponemal antibody-absorption test as a confirmatory test. The ratio of auto RPR values after treatment against those at baseline was defined as the auto RPR ratio for the analysis of the serological response to treatment. The cutoff value for reliable seroreversion prediction was assessed with receiver-operating-characteristic curves. RESULTS: Overall, 89.7% of participants (78/87) seroreverted and 10.3% of participants (9/87) remained serofast during the two-year follow-up period. We were unable to describe trends in the changes among auto RPR values within six months after treatment because of high variation. All of the patients who had an auto RPR ratio ≥1.0 after six months continuously had positive serologic results during their 24-month follow-up and were classified as a serofast group. The receiver-operating-characteristic curves revealed a 25% reduction in auto RPR values nine months after treatment and predicted seroreversion with a sensitivity of 96.2% and a specificity of 100%. CONCLUSION: The most important primary checkpoint for syphilis treatment response is an increase in automated nontreponemal STS six months after treatment. Thus, we recommend monitoring the treatment response with an auto RPR.

A case of generalized argyria presenting with muscle weakness

BACKGROUND: Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness. CASE PRESENTATION: A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids. CONCLUSIONS: Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.

Metabolic Complications among Korean Patients with HIV Infection: The Korea HIV/AIDS Cohort Study

Currently, metabolic complications are the most common problem among human immunodeficiency virus (HIV)-infected patients, with a high incidence. However, there have been very few studies regarding metabolic abnormalities published in Asia, especially in Korea. This cross-sectional study was performed to investigate the prevalence of and risk factors for metabolic abnormalities in 1,096 HIV-infected patients of the Korea HIV/AIDS cohort study enrolled from 19 hospitals between 2006 and 2013. Data at entry to cohort were analyzed. As a result, the median age of the 1,096 enrolled subjects was 46 years, and most patients were men (92.8%). The metabolic profiles of the patients were as follows: median weight was 63.8 kg, median body mass index (BMI) was 22.2 kg/m², and 16.4% of the patients had a BMI over 25 kg/m². A total of 5.5% of the patients had abdominal obesity (waist/hip ratio ≥ 1 in men, ≥ 0.85 in women). Increased levels of fasting glucose, total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides were present in 10.4%, 6.0%, 5.5%, and 32.1% of the patients. Decreased high-density lipoprotein (HDL) cholesterol levels were observed in 44.2% of the patients. High systolic blood pressure was present in 14.3% of the patients. In multivariate analysis, high BMI and the use of protease inhibitors (PIs) were risk factors for dyslipidemia in HIV-infected patients. In conclusion, proper diagnosis and management should be offered for the prevalent metabolic complications of Korean HIV-infected patients. Further studies on risk factors for metabolic complications are needed.

The Prevalence and Risk Factors of Renal Insufficiency among Korean HIV-Infected Patients: The Korea HIV/AIDS Cohort Study / 감염과화학요법

BACKGROUND: Renal disease is one of the leading causes of morbidity and mortality among people infected with human immunodeficiency virus (HIV). However, there are very few published studies about renal insufficiency in HIV-infected persons in Asia, especially in South Korea. MATERIALS AND METHODS: A cross-sectional study was performed to investigate the prevalence and risk factors of renal insufficiency, defined as <60 mL/min/1.73 m², in subjects in the Korea HIV/AIDS Cohort Study enrolled from 19 institutions between December 2006 and July 2013. Data at entry into the cohort were analyzed. RESULTS: Of 454 enrolled subjects, 24 (5.3%) showed renal insufficiency at entry into the cohort. The mean age of patients in the renal insufficiency group was 5.28 years and the majority were male subjects (91.7%). All the patients were receiving antiretroviral agents, mostly protease inhibitor-based regimens (76.4%), for an average of 19 months. In univariate analysis, older age (P = 0.002), diabetes mellitus (DM) (P = 0.0002), unknown route of transmission (P = 0.007), and taking indinavir (P = 0.0022) were associated with renal insufficiency. In multivariable analysis, older age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.03–1.12, P = 0.002], DM [OR 3.03, 95% CI 1.17–7.82, P = 0.022], unknown route of transmission [OR 6.15, 95% CI 1.77–21.33, P = 0.004], and taking indinavir [OR 3.07, 95% CI 1.17–8.05, P = 0.023] were independent risk factors of renal insufficiency. CONCLUSION: The prevalence of renal insufficiency in HIV-infected subjects in this study was relatively low, similar to that in other countries. Aging, DM, and taking indinavir were significantly associated with decreased glomerular filtration rate. Furthermore, unknown route of transmission was an independent risk factor, which was interpreted as a reflection of patient compliance. Further studies on the incidence and risk factors of renal insufficiency during HIV infection using follow-up cohort data are necessary.

Causes of HIV Drug Non-Adherence in Korea: Korea HIV/AIDS Cohort Study, 2006-2015 / 감염과화학요법

We aimed to determine the initial adherence of HIV cohort patients to ART (antiretroviral therapy), and reasons for non-adherence. Patients who received ART at the time of enrollment in the Korea HIV/AIDS Cohort were included in this study. Treatment adherence was determined at the baseline interview by self-reported questionnaire. Eight-hundred thirty two HIV-infected patients received ART. Of these, 253 (30.4%) patients skipped ART more than once a month. The most common reason of skipping medication was “simply forgot” (60.4%).

Human Immunodeficiency Virus (HIV) and Hepatitis Virus Coinfection among HIV-Infected Korean Patients: The Korea HIV/AIDS Cohort Study / 감염과화학요법

BACKGROUND: Despite declines in mortality and morbidity rates of patients with human immunodeficiency virus (HIV) infection as the result of highly active antiretroviral therapy, liver diseases due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a leading cause of death among HIV-infected patients. However, HIV and HBV or HCV coinfection is still poorly documented, and more information is needed to better understand the characteristics of HIV-infected patients in Korea. MATERIALS AND METHODS: A cross-sectional study was performed to investigate clinical characteristics and prevalence of HBV and HCV infection in HIV patients enrolled in the Korea HIV/acquired immune deficiency syndrome (AIDS) cohort study from 17 institutions between December 2006 and July 2013. RESULTS: Among the 1,218 HIV-infected participants, 541 were included in this study. The prevalence of HBV-HIV and HCV-HIV coinfection was 5.0% (27/541) and 1.7% (9/541), respectively. There was no patient who was positive for both HBs antigen and HCV antibody. In multivariate logistic regression analysis, HBV unvaccinated status was a significant risk factor for HBV-HIV coinfection (odds ratio = 4.95, 95% confidence interval = 1.43–17.13). CONCLUSIONS: HBV and HCV infection was more common in HIV-infected persons enrolled in the Korean HIV/AIDS cohort, than in the general population in Korea.

Trend of CD4+ Cell Counts at Diagnosis and Initiation of Highly Active Antiretroviral Therapy (HAART): Korea HIV/AIDS Cohort Study, 1992-2015 / 감염과화학요법

BACKGROUND: CD4+ cell counts reflect immunologic status of human immunodeficiency virus (HIV) patients. Recommended CD4+ cell counts for the initiation of highly active antiretroviral therapy (HAART) has increased over the past several years in various HIV treatment guidelines. We investigated the trend of CD4+ cell counts at diagnosis and treatment start using data from the Korea HIV/acquired immune deficiency syndrome (AIDS) Cohort Study. MATERIALS AND METHODS: The Korea HIV/AIDS Cohort Study started in 2006 and enrolled HIV patients from 21 tertiary and secondary hospitals in South Korea. The data for CD4+ cell counts at diagnosis and HAART initiation from these HIV patients were analyzed by three-year time intervals and presented by number of CD4+ cells (≤100, 101-200, 201-350, 351-500 and >500 cells/mm³). The HIV-RNA titer at diagnosis and HAART initiation were presented by 3-year intervals by groups ≤50,000, 50,001-100,000, 100,001-200,000, 200,001-1,000,000, and >1,000,000 copies/mL. RESULTS: Median values of CD4+ cell count and HIV-RNA titer at initial HIV diagnosis were 247 cells/mm³ and 394,955 copies/mL, respectively. At time of initiating HAART, median values of CD4+ cell count and HIV-RNA were 181 cells/mm³ and 83,500 copies/mL, respectively. Patients with low CD4+ cell count (CD4+ cell count ≤200 cells/mm³) at diagnosis (31-51%) and initiation of HAART accounted for the largest proportion (30-65%) over the three-year time intervals. This proportion increased until 2010-2012. CONCLUSION: CD4+ cell count at initiation of HAART was found to be very low, and the increase in late initiation of HAART in recent years is of concern. We think that this increase is primarily due to an increasing proportion of late presenters. We recommend early detection of HIV patients and earlier start of HAART in order to treat and prevent spread of HIV infection.

Efficacy of Punch Reduction Prior to Cryotherapy in Patients with Viral Warts: A Case-Control Study in a Single Tertiary Center

BACKGROUND: Cutaneous warts are a common complaint to visit dermatologic clinic and its course is variable, ranging from spontaneous resolution to a chronic condition refractory to treatment. OBJECTIVE: To evaluate the efficacy and safety of punch biopsy for cutaneous warts. METHODS: Thirty-nine patients who received punch biopsy for warts were reviewed through charts and photos. Among them, 15 were matched with cryotherapy-only controls in terms of size and location of the wart. We compared the number and cost of treatments between the two groups. RESULTS: Eleven of the total 39 patients were treated with cryotherapy in addition to punch biopsy and the average number of treatments was 4.1±3.3 (mean±standard deviation). In a case-control study, the ratio value of cost was 2.9±3.6 in the experimental group and was 5.9±4.1 in controls (p<0.05). CONCLUSION: Punch biopsies can decrease the number and cost of treatment by reducing the size of warts and inducing local inflammation to accelerate resolution. Therefore, punch reduction should be considered as a viable measure to treat warts.

Mitochondria-Targeted Vitamin E Protects Skin from UVB-Irradiation

Mitochondria-targeted vitamin E (MVE) is designed to accumulate within mitochondria and is applied to decrease mitochondrial oxidative damage. However, the protective effects of MVE in skin cells have not been identified. We investigated the protective effect of MVE against UVB in dermal fibroblasts and immortalized human keratinocyte cell line (HaCaT). In addition, we studied the wound-healing effect of MVE in animal models. We found that MVE increased the proliferation and survival of fibroblasts at low concentration (i.e., nM ranges). In addition, MVE increased collagen production and downregulated matrix metalloproteinase1. MVE also increased the proliferation and survival of HaCaT cells. UVB increased reactive oxygen species (ROS) production in fibroblasts and HaCaT cells, while MVE decreased ROS production at low concentration. In an animal experiment, MVE accelerated wound healing from laser-induced skin damage. These results collectively suggest that low dose MVE protects skin from UVB irradiation. Therefore, MVE can be developed as a cosmetic raw material.

Identifying Skin Type using the Baumann Skin Type Questionnaire in Korean Women Who Visited a Dermatologic Clinic / 대한피부과학회지

BACKGROUND: Skin types vary, making it difficult to identify them at a glance. To effectively understand skin type, analysis based on a questionnaire could be helpful. OBJECTIVE: The purpose of this study was to identify the accuracy and effectiveness of the Baumann skin type questionnaire (BSTQ) compared with an interview with a dermatologic specialist. In addition, we aimed to identify differences in skin type proportions according to age and develop a modified BSTQ. METHODS: Subjects included 202 women (19~64 years of age) who visited the dermatologic clinic of our hospital. They completed both the BSTQ and an interview with a dermatologic specialist. A modified BSTQ was developed by removing similar and racial questions and adjusting grading scores. RESULTS: The agreement between skin type proportions analyzed by the BSTQ and an interview was not reasonable (κ=0.428, 95% confidence interval [CI]: 0.363~0.493). There was a correlation between the proportion of dryness and age (R2=0.029, p<0.05). However, other skin type proportions (sensitivity, pigmentation, and wrinkles) were not significantly correlated with age. The modified BSTQ showed substantial agreement with the BSTQ in skin type proportions (κ=0.691, 95% CI: 0.641~0.740). CONCLUSION: We identified the skin types of Korean women of various ages using the BSTQ and an interview. Furthermore, the modified BSTQ might be helpful for accurately recognizing skin types.

Lupus Miliaris Disseminatus Faciei with Extrafacial Involvement

No abstract available.

Effects of Music Therapy on Pain, Anxiety and Length of Stay of Patients with Laparoscopic Hysterectomy in the Postanesthesia Care Unit

PURPOSE: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). METHODS: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, chi2-test, Fisher's exact test, and independent t-test using SPSS version 21.0. RESULTS: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. CONCLUSION: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.

Antiretroviral Genotypic Resistance Mutations in HIV-1 Infected Korean Patients with Virologic Failure

Resistance assays are useful in guiding decisions for patients experiencing virologic failure (VF) during highly-active antiretroviral therapy (HAART). We investigated antiretroviral resistance mutations in 41 Korean human immunodeficiency virus type 1 (HIV-1) infected patients with VF and observed immunologic/virologic response 6 months after HAART regimen change. Mean HAART duration prior to resistance assay was 45.3+/-27.5 months and commonly prescribed HAART regimens were zidovudine/lamivudine/nelfinavir (22.0%) and zidovudine/lamivudine/efavirenz (19.5%). Forty patients (97.6%) revealed intermediate to high-level resistance to equal or more than 2 antiretroviral drugs among prescribed HAART regimen. M184V/I mutation was observed in 36 patients (87.7%) followed by T215Y/F (41.5%) and M46I/L (34%). Six months after resistance assay and HAART regimen change, median CD4+ T cell count increased from 168 cells/microliter (interquartile range [IQR], 62-253) to 276 cells/microliter (IQR, 153-381) and log viral load decreased from 4.65 copies/mL (IQR, 4.18-5.00) to 1.91 copies/mL (IQR, 1.10-3.60) (P<0.001 for both values). The number of patients who accomplished viral load <400 copies/mL was 26 (63.4%) at 6 months follow-up. In conclusion, many Korean HIV-1 infected patients with VF are harboring strains with multiple resistance mutations and immunologic/virologic parameters are improved significantly after genotypic resistance assay and HAART regimen change.

Coronary Artery Bypass Grafting under Thoracic Epidural Anesthesia in the Awake Patient: Initial Experiences of 12 Cases / 대한마취과학회지

.7 days, respectively. CONCLUSIONS: Our initial experience confirms the feasibility of performing ACAB under TEA. However, high rate of conversion to general anesthesia and development of pneumotorax should be considered. Therefore, the actual and potential risks of ACAB under TEA should not be underestimated.

Heparin-Induced Thrombocytopenia during Continuous Veno-Venous Hemodiafiltration after Total Aortic Arch Replacement: A case report / 대한마취과학회지

Heparin-induced thrombocytopenia (HIT) is an immunologically mediated complication of heparin therapy resulting in the consumption of platelets and a catastrophic thromboembolism. Both the clinical and laboratory features are important for a diagnosis of HIT. There have been 3 case reports of suspected HIT in Korea. However none have satisfied the laboratory features. We experienced a case of HIT, which satisfied both clinical and laboratory features, in a patient who received heparin during continuous veno-venous hemodiafiltration (CVVHD) used to treat acute renal failure that developed after a total aortic arch replacement with a cardiopulmonary bypass. The decreased platelet count and obstruction of extracorporeal filter of CVVHD by the blood clot was observed while receiving unfractionated heparin. The serum from the patient contained the anti heparin-platelet factor 4 antibody, and the condition was thus diagnosed as HIT. Argatroban, which is a direct thrombin inhibitor, was used to treat the thrombosis.

Validity and Reliability of Korean Version of the Female Sexual Distress Scale (FSDS) / 대한남성과학회지

PURPOSE: The Female Sexual Distress Scale(FSDS) was developed to measure sexually-related personal distress in women. We performed this study to assess the reliability and validity of FSDS-Korean version in Korean women. MATERIALS AND METHODS: The original 20-item FSDS was translated into Korean. One-hundred four healthy, married women were recruited and given the survey. A second survey was done two weeks later for test-retest reliability. Validity, internal consistency reliability, and test-retest reliability were evaluated. RESULTS: The test-retest coefficient of stability over a 2-week period was 0.99(p<0.01). The 20 items of the FSDS have good internal consistency, with an alpha of 0.96. The FSDS discriminated between women with and without sexually related distress(t=-7.34, p<0.01). The optimal cut-off score was 20(sensitivity 71.4%, specificity 92.2%). CONCLUSIONS: The Korean version of FSDS might be a useful tool to screen for sexually distressed women in Korea.

Evaluation of LMA Insertion with Sevoflurane 8% and N2O after Midazolam Administration / 대한마취과학회지

BACKGROUND: Sevoflurane is characterized by the lack of an unpleasant odor, airway irritation and its low blood/gas partition coefficient (0.68), which provides rapid and smooth induction. Inhaled induction with sevoflurane is commonly used in pediatric patients, but not in adult patients. This study was designed to investigate the time to completion of LMA insertion and end-tidal sevoflurane concentration during induction with sevoflurane 8% and N2O 50%, after midazolam administration, in adults. METHODS: Twenty eight patients, aged 20(-60) years, were administered intravenous midazolam 30 microgram/kg and after one minute, sevoflurane 8% and N2O 50% were inhaled with tidal-volume breathing. One minute after loss of consciousness, jaw thrust and mouth opening were checked and an LMA was inserted. The end-tidal concentration of sevoflurane, and the times to loss of consciousness and completion of insertion were recorded. The mean arterial pressure and heart rate were also recorded. RESULTS: From initiation of sevoflurane and N2O inhalation, it took 48 +/- 14 seconds until loss of consciousness, and 143 +/- 19 seconds until the completion of LMA insertion. The end-tidal sevoflurane concentration was 4.1 +/- 0.6% at loss of consciousness, 5.0 +/- 0.7% at one min after loss of consciousness, and 4.1 +/- 0.5% after LMA insertion. In all patients LMA insertion was successful and satisfactory. After LMA insertion, compared to baseline, the mean arterial pressure was reduced and the heart rate increased. CONCLUSIONS: After small-dose of midazolam, inhaled induction with sevoflurane 8% and N2O 50% allowed successful and satisfactory LMA insertion in adults.

Changes of Respiratory Mechanics in Pregnant Woman under General Anesthesia for Cesarean Section / 대한마취과학회지

BACKGROUND: In pregnant woman, the respiratory system is influenced by the hormonal environment and an enlarged gravid uterus. After delivery of the fetus, and contraction of the uterus, changes in the respiratory system produced by the mechanical effect of the gravid uterus may decrease or be reversed. We designed this study to observe changes in the respiratory mechanics in pregnant woman under general anesthesia for cesarean section. METHODS: 15 pregnant women at term, ASA 1 were studied. Induction was performed with thiopental/succinylcholine and maintained with O2, N2O and enflurane until delivery. Just before delivery, enflurane was discontinued. Vecuronium was given at 0.1 mg/kg iv 4 min after induction, and after delivery, 1 mg was given as needed. Inspired tidal volume, expired tidal volume, inspired minute ventilation, expired minute ventilation, airway peak pressure, plateau pressure, expired volume during the first 1 second/expired tidal volume (V1.0), dynamic compliance and end-tidal CO2 were continuously measured just after induction, at delivery and 5, 10, 15, 20, 25, 30, 40 and 50 min after delivery. Blood pressure, heart rate and oxygen saturation were also measured. RESULTS: Compared to the value after induction, values after delivery showed no significant changes in inspired tidal volume or minute volume, but significantly increased in expired tidal volume and minute volume and dynamic compliance, and a significant decrease in airway peak pressure, plateau pressure, V1.0 and end-tidal CO2. Blood pressure and heart rate increased significantly after induction, compared to before induction. Oxygen saturation was maintained at 99-100%. CONCLUSIONS: After delivery, the effects of the gravid uterus on the respiratory system rapidly disappeared, in particular changes of pressure in the airway preceded the respiratory volume changes.