To combat the cardiovascular depression in blood pressure and palserate induced by halothane anesthesia in healthy persons after administration of propranolol(1.0mg) by the intravenous route, atropnie sulfate(0.5mg), ephedrine Hcl(20mg) and aramine(1.0mg) were administered respectively i.v. The results were as follows: 1) After i.v. administration of atropine sulfate, systolic blood pressure was elevated by 15 mmHg, diastolic blood pressure was elevated by 13mmHg, and pulse rate was increased by 24 per minute. 2) After i.v. administration of ephedrine, systolic blood pressure was elevated by 27 mmHg, diastolic blood pressure was elevated by 17mmHg, but significant pulse rate change was not observed. 3) After i.v. administration of aramine, systolic blood pressure was elevated by 29mmHg, diastolic blood pressure was elevated by 19mmHg, but pulse rate was decreased by 8 per minute. 4) As shown in the above results, in the cardiovascular depression due to halothane anesthesia after propranolol intravenous administration, blood pressure and pulse rated were corrected by treatment with atropine sulfate. Ephedrine and aramine effected elevation of the blood pressure, but not the pulse rate.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure* ; Depression ; Ephedrine ; Halothane* ; Heart Rate* ; Humans ; Metaraminol ; Propranolol*

1) The author investigated whether presynaptic alpha-adrenoceptors exist in the cardioaccelerator nerves of cold-blooded animals(frog, tortoise) as in ones of in mammals. 2) Each atrial preparation of a frog, tortoise and guinea-pig produced the positive chronotropic and inotropic responces to field stimulation. Each ventricular muscle preparation of frog and tortoise produced positive inotropic responces to field stimulation. 3) Both the responces of frog atrium and the inotropic response of frog ventrice to the stimulation were abolished or markedly inhibited by the presence of tetrodotoxin, guanethidine and proparanolo. Both responses of tortoise atrium to the stimulation were markedly inhibited by propranolol and the inotropic response ventricle to the stimulation was markedly inhibited by tetrodotoxin. 4) Both responses of frog and tortoise atrium, and the inotropic response of frog and tortoise ventricle to the stimulation were not affected by clonidine and yohimbine. 5) Both responses of guinea-pig atrium to the stimulation were markedly inhibited in the presence of clonidine and this clonidine-induced inhibition was not observed in the presence of yohimbine. 6) The above results suggest that presynaptic alpha-adrenoceptors do not exist in the cardioaccelerator nerves of frog and tortoise, being different from those of mammalisn animals.
Animals* ; Clonidine ; Guanethidine ; Mammals ; Propranolol ; Tetrodotoxin ; Yohimbine

No abstract available.
Breast Neoplasms* ; Tamoxifen*

Left ventricular mural thrombi can occur in setting of acute myocarditis. Major thromboembolism may occur according to the echocardiographic characteristics of the thrombi. Mobile, irregular and protruding thrombi are known to raise systemic embolism more easily than immobile laminar clot. We experienced a case of a hypermobile pedunculated left ventricular thrombus complicated to acute myocarditis in a 49-year-old woman. Mobility of it increased day by day in spite of the proper anticoagulation. Surgical removal of the thrombus was performed to prevent major thromboembolism.
Echocardiography ; Embolism ; Female ; Heart Ventricles ; Humans ; Middle Aged ; Myocarditis* ; Thromboembolism ; Thrombosis*

We used in situ hybridization histochemistry with synthetic oligonucleotide probes to examined the effects of unilateral 6-hydroxydopamine lesions (which eliminated tyrosine hydroxylase mRNA containing cells in mesencephalon) on enkephalin, dynorphin, and substance P mRNA exprssion in the striatum. The expression of tyroxine hydroxylase mRNA on ipsilateral substantia nigra pars compacta, which reflect dopamine activity, totally decreased for 2weeks after lesioning. After lesioning 1week, 2weeks, and 4weeks, a significant increase of the expression of enkephalin mRNA in ipsilateral to the lesioned striatum was observed (p<0.05). Substance P mRNA expressions were depressed significantly in ispsilateral to the lesioned striaturm, whereas enkephalin mRNA expressions were elevated in consecutive sections from striatal aresas in all rat model. The effect of lesions on dynorphin mRNA expressions in ipsilateral to the lesioned striatum less robust, but significant decreased tendency was observed (p<0.05). These data show that the expression of enkephalin, dynorphin and substance P mRNA is differentially regulated by mesostriatal dopaminergic system.
Animals ; Basal Ganglia* ; Dopamine ; Dynorphins ; Enkephalins ; In Situ Hybridization ; Models, Animal* ; Neuropeptides* ; Oligonucleotide Probes ; Oxidopamine ; Rats* ; RNA, Messenger ; Substance P ; Substantia Nigra ; Tyrosine 3-Monooxygenase

BACKGROUND: c-Jun along with JunB, JunD, and the Fos group proteins comprise the core members of the activator protein 1 (AP1) family of transcription factors. Recently, many studies have demonstrated the key roles of AP1 in regulating a wide spectrum of biological processes, including tumorigenesis. We therefore hypothesized that c-Jun and JunB influence the differentiation and malignant change of various skin tumors. OBJECTIVE: We measured the expression levels of c-Jun and JunB in different skin tumors. METHODS: The expressions of c-Jun and JunB were examined by performing the immunohistochemical staining of 55 specimens of skin tumors, including 13 cases of seborrheic keratosis, 4 cases of keratoacanthoma, 9 cases of actinic keratosis, 4 cases of Bowen's disease, 4 cases of basal cell carcinoma, 16 cases of squamous cell carcinoma, and 5 cases of malignant melanoma. RESULTS: Immunohistochemical analysis of the skin tumor tissue samples revealed a significantly higher expression of c-Jun in malignant skin tumors (basal cell carcinoma, squamous cell carcinoma, malignant melanoma) than in benign (seborrheic keratosis, keratoacanthoma) or premalignant skin tumors (actinic keratosis, Bowen's disease). The expression of JunB, however, was significantly lower in malignant skin tumors than in benign skin tumors. CONCLUSION: These findings showed that c-Jun has a positive association with skin malignancies, while JunB has a negative association with skin malignancies. The role of AP1 as key regulators of cell proliferation and epidermal tumor progression is suggested.
Biological Processes ; Bowen's Disease ; Carcinogenesis ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cell Proliferation ; Humans ; Keratoacanthoma ; Keratosis ; Keratosis, Actinic ; Keratosis, Seborrheic ; Melanoma ; Skin* ; Transcription Factor AP-1 ; Transcription Factors

No abstract available.
Melanosis* ; Tranexamic Acid*

BACKGROUND/AIMS: The early diagnosis of acute hepatitis A (AHA) is hindered because serum IgM against hepatitis A virus (HAV) can yield false-negative results during the window period. This study evaluated the diagnostic accuracy of a polymerase chain reaction (PCR) kit for HAV RNA for the diagnosis of AHA. METHODS: Samples were collected from 136 patients with acute severe hepatitis at their admission to Asan Medical Center between June 2010 and July 2010. Samples were analyzed for serum IgM anti-HAV using an immunoassay test and for qualitative HAV RNA using the Magicplex HepaTrio PCR test kit. The diagnostic accuracies of these methods were tested on the basis of clinical and laboratory diagnoses of AHA. RESULTS: The concordance rate and kappa value between IgM anti-HAV and HAV RNA PCR were 88.2% and 0.707, respectively. For the diagnosis of AHA, the sensitivity and specificity of IgM anti-HAV were 90.7% and 100%, respectively, when an "equivocal" result was regarded as positive; and 79.1% and 100%, respectively, when an "equivocal" result was regarded as negative. The sensitivity and specificity of HAV RNA PCR were 81.4% and 100%, respectively. All four patients with negative IgM anti-HAV and positive HAV RNA PCR results and all four patients with equivocal IgM anti-HAV RNA and positive HAV RNA PCR results were eventually diagnosed with AHA. CONCLUSIONS: The qualitative HAV RNA PCR test has an equivalent diagnostic accuracy for AHA compared to IgM anti-HAV and may be more sensitive during the window period.
Acute Disease ; Adult ; Aged ; Female ; Hepatitis A/*diagnosis ; Hepatitis A virus/genetics/immunology ; Humans ; Immunoassay ; Immunoglobulin M/blood ; Male ; Middle Aged ; *Multiplex Polymerase Chain Reaction ; Prospective Studies ; RNA, Viral/*blood ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is a difficult procedure to perform on patients who have undergone a Billroth II gastrectomy, Whipple's operation or Roux-en-Y gastrobypass surgery. Our study was designed to evaluate the clinical usefulness of cap-assisted ERCP for beginner endoscopists in cases of surgically altered anatomy. METHODS: From April 2008 to March 2010, 16 patients with biliary diseases and who had previously undergone abdominal surgery such as Billroth II gastrectomy or Roux-en-Y operation were analyzed. A single endoscopist performed all the procedures using a cap-assisted gastroscope, after ERCP training. RESULTS: Cap-assisted ERCP was attempted in 24 sessions of 16 patients. Afferent loop intubation and selective bile duct cannulation was successfully achieved in 19 sessions (79.1%). Among the patients who had undergone a Billroth II gastrectomy, 19 out of 20 sessions were successfully conducted. Only 4 patients who had undergone a previous Roux-en-Y operation failed afferent loop intubation. Duodenal free wall perforation developed in one case. There were no cases of mortality. CONCLUSIONS: Therapeutic cap-assisted ERCP was useful in patients who had previously undergone a Billroth II gastrectomy and this may be helpful for inexperienced endoscopists.
Anastomosis, Roux-en-Y ; Bile Ducts ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Gastrectomy ; Gastroenterostomy ; Gastroscopes ; Humans ; Intubation

BACKGROUND: We investigated hepatitis B virus (HBV) infection cases, who were HBsAg negative by radioimmunoassay (RIA) and HBV DNA positive for their clinical characteristics, the S gene mutation of hepatitis B virus (HBV), and usefulness of other HBsAg immunoassay. METHODS: Among the patients requested for HBV DNA quantification, 16 patients positive in HBV DNA but negative in HBsAg RIA (BNIBT HBsAg Kit, China) were enrolled. The "a" determinant of HBV S gene was sequenced and clinical characteristics were reviewed. Additional HBsAg assay was performed using Architect HBsAg kit (Abbott laboratories, USA) employing chemiluminescent immunoassay method. RESULTS: Eleven of the 16 patients showed multiple mutations in the "a" determinant. These patients received liver transplantation several years ago and have been treated with hepatitis B immune globulin (HBIG) and antiviral drugs. G145R mutation was found in 8 patients and G145K, D144G, and D144A were also frequently found. Among 9 of the 11 patients tested for HBsAg by Architect HBsAg kit, 8 showed positive results. Among 4 of the remaining 5 patients, only 2 showed weak positive results (< or =1 IU/mL) in Architect HBsAg kit. CONCLUSIONS: HBV DNA-positive/HBsAg RIA-negative results were mostly observed in the patients treated with HBIG after liver transplantation, in whom HBIG escape mutations were found. Majority of these cases were positive in Architect HBsAg assay, and it is recommended to use other HBsAg immunoassay methods that are more sensitive than RIA in the detection limit as well as in the detection of escape mutant in hospitals performing liver transplantation.
Adolescent ; Adult ; Aged ; Amino Acid Sequence ; Antiviral Agents/therapeutic use ; DNA, Viral/analysis ; Female ; Hepatitis B/*diagnosis/drug therapy/virology ; Hepatitis B Surface Antigens/*analysis/genetics ; Hepatitis B virus/*genetics/isolation & purification ; Humans ; Immunoassay ; Immunoglobulins/therapeutic use ; Immunologic Factors/therapeutic use ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation ; Radioimmunoassay