Objective To investigate the protective effect of ulinastatin on erythrocyte in patients undergoing open heart surgery with cardiopulmonary bypass (CPB) .Methods Twenty NYHA class Ⅱ-Ⅲ patients (10 male, 10 female) aged 16-66 yr undergoing elective valve replacement under CPB were randomly divided into two groups: ulinastatin group (U, n = 10) and control group (C, n = 10) . Patients with hepato-renal disease, hyperlipoproteinemia, respiratory dysfunction, blood diseases or pulmonary hypertension were excluded. The patients were premedicated with intramuscular morphine 0.08 mg ? kg-1 and scopolamine 0.006 mg?kg-1 . Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10 ?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with intravenous midazolam and fentanyl. In group U the patients received ulinastatin 12000 U?kg-1 , of which half was given i.v. before CPB and the other half was added to the priming solution. In control group the patients received normal saline instead of ulinastatin. Blood samples were taken from radial artery before operation (T1), 15 min after initiation of CPB (T2), 15 min (T3) and 30 min (T4) after aortic declamping and 24 h after operation (T5) , for determination of plasma and erythrocyte MDA (P-MDA, E-MDA) levels and erythrocyte SOD (E-SOD) , Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activities.Results The levels of P-MDA and E-MDA were significantly increased at T2_5 in group C but only at T3 and T4 in group U compared to the baseline at T1 . The levels of P-MDA and E-MDA at T2-5 were significantly higher in group C than in group U. The E-SOD, Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activities significantly increased at T2 compared to baseline at T1 , then gradually decreased in both groups. They were significantly higher at T3-5 in group U than in group C. Conclusion Ulinastatin can alleviate erythrocyte lipid peroxidation and protect erythrocyte during CPB.

No abstract available.
Bone and Bones* ; Dental Implants*

PURPOSE: The purpose of this study was to compare differences in the time when bowel sounds were heard and gas was passed in women who had an abdominal hysterectomy and were treated for 5 minutes (experimental group A) or 10 minutes (experimental group B) with San-Yin-Jiao (SP-6) acupressure. METHOD: The design of this study was a nonequivalent control group non-synchronized post test only design. The participants included 142 women, 39 in experimental group A, 30 in experimental group B, and 73 in the control group. Data was collected using a structured questionnaire which included items on general characteristics and a self report of time when gas was passed. Differences for the three groups as to time when bowel sounds were heard and gas was passed were analyzed using ANOVA. RESULT: The time when bowel sounds were heard was statistically significantly shorter in both experimental groups compared to the control group(F=10.29, p=.000). The time when gas was passed was statistically significantly shorter in experimental group B(10 min) compared to the control group(F=4.68, p=.011). CONCLUSION: It could be concluded that SP-6 acupressure of 10 minutes was effective in shortening the time until bowel sounds were heard and gas was passed for women who had had an abdominal hysterectomy. Replication of the study with a larger number of participants is necessary in order to be able to generalize the results.
*Acupressure ; Adult ; *Auscultation ; Female ; *Flatulence ; *Gastrointestinal Motility ; Humans ; *Hysterectomy ; Middle Aged ; Postoperative Complications/*therapy

Usual interstitial pneumonia (UIP) is one type of idiopathic interstitial pneumonia, characterized by its poor prognosis and gradual deterioration of clinical course. So it is important to distinguish UIP from other interstitial pneumonia. Defi nitive histological diagnosis of UIP requires lung biopsy. The criteria for diagnosis of UIP in the absence of a surgical lung biopsy were recently defi ned. We report a case of 75-year-old man who was diagnosed as bronchopneumonia with chief complaint of fever, dyspnea on fi rst visit, then fi nally diagnosed as UIP through the remaining of chest abnormality after treatment.
Aged ; Biopsy ; Bronchopneumonia ; Dyspnea ; Fever ; Humans ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Lung ; Lung Diseases, Interstitial ; Prognosis ; Thorax

BACKGROUND/AIMS: This study aimed to investigate the prevalence of chronic kidney disease (CKD) and associated risk factors in a high-risk population in Korea. METHODS: A total of 6,045 participants aged ≥ 65 years (mean age, 73.0 ± 5.5) with diabetes or hypertension were enrolled. Participants were screened for CKD, which was defined as the presence of albuminuria (urine albumin-to-creatinine ratio ≥ 30 mg/g) or an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². RESULTS: The prevalence of CKD was 39.6% (women, 40.3%; men, 38.4%). Albuminuria was detected in 22.6% of participants, whereas eGFR < 60 mL/min/1.73 m² was found in 24.6% of participants. The prevalence of CKD by stage was 4.4% for stage 1, 10.4% for stage 2, 23.4% for stage 3, 0.9% for stage 4, and 0.3% for stage 5. Older age, concomitant diabetes and hypertension, higher body mass index, higher systolic and diastolic blood pressure, and higher hemoglobin A1c levels were independently associated with the presence of CKD in multivariate-adjusted analyses that included with age, sex, body mass index, hypertension, diabetes, and smoking. CONCLUSIONS: The prevalence of CKD was very high in the present high-risk Korean population. Our results suggest that a screening method for early detection of CKD in high-risk populations is needed in Korea.
Albuminuria ; Blood Pressure ; Body Mass Index ; Cross-Sectional Studies* ; Epidemiology ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Diseases ; Korea* ; Male ; Mass Screening ; Methods ; Prevalence ; Renal Insufficiency, Chronic* ; Risk Factors ; Smoke ; Smoking

Renal sodium and water reabsorption occurs through epithelial sodium transporters and aquaporin (AQP) water channels in various segments of tubules. We have demonstrated altered regulation of these transporters and channels in various pathophysiological conditions. In nephrotic syndrome and liver cirrhosis, expression of epithelial sodium channels (ENaC) was increased in the late distal convoluted tubule, connecting tubule, and collecting duct. In spontaneously hypertensive rats, the expression of Na,K-ATPase as well as that of ENaC was increased. In contrast, AQP1-3 and sodium transporters was decreased in the kidney from deoxycorticosterone acetate-salt hypertension. In two-kidney, one clip hypertension, the expression of Na,K-ATPase, NHE3, NKCC2 and ENaC subunits was decreased in the clipped kidney while remained unchanged in the contralateral kidney. We have also shown an increased activity of renal atrial natriuretic peptide system in postobstructive natriuresis/ diuresis. In acute kidney injury (cisplatin-, gentamicin- and ischemia/reperfusion-induced), the expression of Na,K-ATPase, NHE3, NKCC2 and AQP1-3 was decreased. The altered regulation of sodium transporters and AQP may be causally related with various kidney diseases and hypertension.
Acute Kidney Injury ; Aquaporins ; Desoxycorticosterone ; Diuresis ; Epithelial Sodium Channels ; Hypertension ; Kidney ; Kidney Diseases ; Liver Cirrhosis ; Nephrotic Syndrome ; Rats, Inbred SHR ; Sodium

Renal sodium and water reabsorption occurs through epithelial sodium transporters and aquaporin (AQP) water channels in various segments of tubules. We have demonstrated altered regulation of these transporters and channels in various pathophysiological conditions. In nephrotic syndrome and liver cirrhosis, expression of epithelial sodium channels (ENaC) was increased in the late distal convoluted tubule, connecting tubule, and collecting duct. In spontaneously hypertensive rats, the expression of Na,K-ATPase as well as that of ENaC was increased. In contrast, AQP1-3 and sodium transporters was decreased in the kidney from deoxycorticosterone acetate-salt hypertension. In two-kidney, one clip hypertension, the expression of Na,K-ATPase, NHE3, NKCC2 and ENaC subunits was decreased in the clipped kidney while remained unchanged in the contralateral kidney. We have also shown an increased activity of renal atrial natriuretic peptide system in postobstructive natriuresis/ diuresis. In acute kidney injury (cisplatin-, gentamicin- and ischemia/reperfusion-induced), the expression of Na,K-ATPase, NHE3, NKCC2 and AQP1-3 was decreased. The altered regulation of sodium transporters and AQP may be causally related with various kidney diseases and hypertension.
Acute Kidney Injury ; Aquaporins ; Desoxycorticosterone ; Diuresis ; Epithelial Sodium Channels ; Hypertension ; Kidney ; Kidney Diseases ; Liver Cirrhosis ; Nephrotic Syndrome ; Rats, Inbred SHR ; Sodium

Acute renal failure is mainly caused by ischemia/reperfusion (I/R) injury or nephrotoxic drugs, in which reactive oxygen species (ROS) may play an important role. Therefore, antioxidants are expected to decrease the vulnerability of renal injury associated with oxidative challenges. alpha-Lipoic acid (alpha-LA), potent antioxidant, could act as ROS scavengers, iron chelators and enzyme modulators. In rats with acute renal injury, dysregulation of aquaporin (AQP) water channels and sodium transporters has been noted. I/R injury or cisplatin induced marked down-regulation of AQP1, AQP2 and AQP3 water channels, and type-3 Na-H exchanger, Na,K-ATPase, and Na-K-2Cl cotransporters, in association with impairment of urinary concentration and tubular sodium reabsorption. Treatment with alpha-LA prevented the dysregulation of AQP channels and sodium transporters, along with improved urinary concentrating capability and renal sodium reabsorption.
Acute Kidney Injury* ; Animals ; Antioxidants ; Aquaporins ; Chelating Agents ; Cisplatin ; Down-Regulation ; Iron ; Rats* ; Reactive Oxygen Species ; Reperfusion Injury ; Sodium ; Thioctic Acid

Nitric oxide (NO) and atrial natriuretic peptide (ANP) may induce vascular relaxation by increasing the production of cyclic guanosine monophosphate (cGMP), an important mediator of vascular tone during sepsis. This study aimed to determine whether regulation of NO and the ANP system is altered in lipopolysaccharide (LPS)-induced kidney injury. LPS (10 mg.kg-1) was injected in the tail veins of male Sprague-Dawley rats; 12 hours later, the kidneys were removed. Protein expression of NO synthase (NOS) and neutral endopeptidase (NEP) was determined by semiquantitative immunoblotting. As an index of synthesis of NO, its stable metabolites (nitrite/nitrate, NOx) were measured using colorimetric assays. mRNA expression of the ANP system was determined by real-time polymerase chain reaction. To determine the activity of guanylyl cyclase (GC), the amount of cGMP generated in response to sodium nitroprusside (SNP) and ANP was calculated. Creatinine clearance decreased and fractional excretion of sodium increased in LPS-treated rats compared with the controls. Inducible NOS protein expression increased in LPS-treated rats, while that of endothelial NOS, neuronal NOS, and NEP remained unchanged. Additionally, urinary and plasma NOx levels increased in LPS-treated rats. SNP-stimulated GC activity remained unchanged in the glomerulus and papilla in the LPS-treated rats. mRNA expression of natriuretic peptide receptor (NPR)-C decreased in LPS-treated rats, while that of ANP and NPR-A did not change. ANP-stimulated GC activity reduced in the glomerulus and papilla. In conclusion, enhancement of the NO/cGMP pathway and decrease in ANP clearance were found play a role in the pathogenesis of LPS-induced kidney injury.
Animals ; Atrial Natriuretic Factor ; Creatinine ; Guanosine Monophosphate ; Guanylate Cyclase ; Humans ; Immunoblotting ; Kidney ; Male ; Neprilysin ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Nitroprusside ; Plasma ; Rats ; Real-Time Polymerase Chain Reaction ; Receptors, Peptide ; Relaxation ; RNA, Messenger ; Sepsis ; Sodium ; Veins

Purpose: We report a conjunctival myxoid stromal tumor (CMST), which is a rare benign conjunctival mass.Case summary: A 70-year-old man with a history of hypertension and cerebral infarction visited our hospital with a clear mass ofthe conjunctiva in the left eye. His visual acuity was normal, and no other abnormal findings were noted. A transparent, yellowish,jelly-like, 4 × 3 mm mass with a clear border between it and the surrounding tissue was found at the lower temporal part of theconjunctiva. The mass was mobile and there was no pain or tenderness. Excisional biopsy was performed on the mass.Histopathological examination showed reticular fibers located in an abundant mucus-like matrix with fusiform, astrocytic andscattered inflammatory cells. Immunologic examination revealed CD34 positive and SMA negative findings and we diagnosedthe mass as a CMST. Conclusions When there is a clear pale yellow to light pink mass with a clear border and a distinct vascular distribution or pigmentationin the conjunctiva, the possibility of a CMST must be considered. Histopathologic and immunologic examinationshould be performed through biopsy and evaluation for systemic disease should be performed as necessary.