The present study was designed to establish comparatively the inhibitory effects of cilnidipine (CNP), nifedipine (NIF), and omega-conotoxin GVIA (CTX) on the release of CA evoked by cholinergic stimulation and membrane depolarization from the isolated perfused model of the rat adrenal medulla. CNP (3 micrometer), NIF (3 micrometer), and CTX (3 micrometer) perfused into an adrenal vein for 60 min produced greatly inhibition in CA secretory responses evoked by ACh (5.32 x 10(-3) M), DMPP (10(-4) M for 2 min), McN-A-343 (10(-4) M for 2 min), high K+ (5.6 x 10(-2) M), Bay-K-8644 (10(-5) M), and cyclopiazonic acid (10(-5) M), respectively. For the CA release evoked by ACh and Bay-K-8644, the following rank order of potency was obtained: CNP > NIF > CTX. The rank order for the CA release evoked by McN-A-343 and cyclopiazonic acid was CNP > NIF > CTX. Also, the rank orders for high K+ and for DMPP were NIF > CTX > CNP and NIF > CNP > CTX, respectively. Taken together, these results demonstrate that all voltage-dependent Ca2+ channels (VDCCs) blockers of cilnidipine, nifedipine, and omega-conotoxin GVIA inhibit greatly the CA release evoked by stimulation of cholinergic (both nicotinic and muscarinic) receptors and the membrane depolarization without affecting the basal release from the isolated perfused rat adrenal gland. It seems likely that the inhibitory effects of cilnidipine, nifedipine, and omega-conotoxin GVIA are mediated by the blockade of both L- and N-type, L-type only, and N-type only VDCCs located on the rat adrenomedullary chromaffin cells, respectively, which are relevant to Ca2+ mobilization. It is also suggested that N-type VDCCs play an important role in the rat adrenomedullary CA secretion, in addition to L-type VDCCs.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla* ; Animals ; Calcium Channels ; Calcium Channels, L-Type ; Calcium Channels, N-Type ; Chromaffin Cells ; Dimethylphenylpiperazinium Iodide ; Membranes ; Nifedipine* ; omega-Conotoxin GVIA* ; omega-Conotoxins* ; Rats* ; Veins

BACKGROUND: To manage the EMS(emergency medical services) system effectively, departments, such as fire stations, emergency information centers, hospitals, and The Ministry of Health and Welfare, should exchange information that they own and/or gather during patient care and/or transportation. Medical records and information are very important for continuing the patient's care and for deciding on a treatment plan, but medical information is not exchanged fully in spite of its importance. METHOD: We analyzed the transfer medical reports that were written by medical doctors who transferred emergency patients to our hospital. The contents and the accuracy of the transfer medical records were analyzed and graded into 4 groups. Group A was fully described and was equipped with diagnosis, laboratory data, X-ray films; group B had a diagnosis and full laboratory data; group C had a diagnosis, but only partial laboratory data; and group D had only a diagnosis. RESULTS: Among 38,214 patients who visited our hospital from Jan. 2001 to Jun. 2001, 7,031 cases were transferred from other hospitals with transfer medical records. According to the accuracy and important contents of the transfer records, Group A occupied 1.9%, group B 5.2%, group C 32.5%, and group D, with only a diagnosis, 60.4%. In the case of our hospital, we delivered all emergency medical information by written paper(transfer note), E-mail, and web-based information system(cyber-AMC) to the doctors concerned with managing the patient. However, 93% of the medical records of patients transferred from other hospital contained insufficient information to adequately care for the emergency patients. In addition, most of the transferred patients had been transorted without prior information about transportation. CONCLUSION: Within the near future, a medical information center equipped with a computerized system should be operated to exchange medical data. As most general hospitals are operating the OCS(order communication system), EMR(electronic medical record), telemedicine, and PACS(picture-archiving communication system), medical information can be exchanged freely in real time if a code standard and HL7(Health Level 7) can be established.
Clinical Laboratory Techniques ; Diagnosis ; Electronic Mail ; Emergencies* ; Fires ; Hospitals, General ; Humans ; Information Centers ; Medical Records ; Patient Care ; Telemedicine ; Transportation ; X-Ray Film

BACKGROUND & OBJECTIVES: It is widely believed that the post-lumbar puncture headache(PLPH) is related to CSF leakage through the dural hole made by needle tract. So it is accepted that PLPH is prevented by at least 4 hour bed rest after lumbar puncture (LP). If bed rest was unneccessary, the administrative and nursing advantages would be obvious,, especially in neurologic units, whereLP has been done frequently. Therefore, we evaluate the incidence of PLPH in the ambulant and bed-rest patients prospectively and compared the incidence difference between two group. METHODS: Eighty-eight patients without preceding headache who were done lumbar puncture for diagnostic purpose were selected prospectively. We compared the incidence of PLPH between the ambulant (50 patients) and bed-rest group (38 patient,) at 6 hour and 24 hours. We also evaluated the effect of the CSF profile (count of RBC and WBC, protein level and opening pressure) on PLPH. RESULTS: The PLPH was found in 11 cases(12.5%) among bed-rest and ambulant groups. The frequency of each group was 8% (3/38) in bed-rest group and 16%(8/50) in ambulant group, but there is no significant difference between two groups (p-vaIue = 0.26). The frequency of PLPH is also not correlated to the CSF profiles; count of RBC and WBC, protein level, and opening pressure. CONCLUSIONS: There is no significant difference between the ambulant and bed rest group in the frequency of the PLPH. We conclude that the bed rest after LP is unnecessary for the prevention of the PLPH.
Bed Rest* ; Headache ; Humans ; Incidence ; Needles ; Nursing ; Post-Dural Puncture Headache* ; Prospective Studies ; Punctures ; Spinal Puncture

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

The incidence of thymolipoma or thynuc cyst is very rare among the tumors of thymic origin, which are usually benign or invasive thymoma. Thymic tumor has been found among 10 to 15% of the patients with myasthenia gravis(MG). However the patients with thymolipoma or thynuc cyst rarely manifestated as MG. Moreover the case of MG with thymolipoma and thymic cyst is extremely rare ; Only one case has been reported hitherto. We hereby report a 41-year-old woman presenting as ocular MG with thymolipoma and thymic cyst. She complained diplopia, ptosis and headache, which had begun 3 months prior to admission and have been fluctuating thereafter. Ocular MG was confirmed by positive Tensilon and Jolly test. Her chest CT showed an enlarged thymus which turned out to be thymolipoma with thymic cyst on the pathologic examination. Although rare, thymolipoma and/or thymic cyst should be considered in the differential diagnosis of thymic tumor in MG.
Adult ; Diagnosis, Differential ; Diplopia ; Edrophonium ; Female ; Headache ; Humans ; Incidence ; Mediastinal Cyst* ; Myasthenia Gravis* ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed

The aim of the present study was to examine the effects of platycodin D and D3, which are active components derived from the roots of Platycodon grandiflorum A. DC., on the contractile force of the i3olated rat aorta and blood pressure of the anesthetized rat, and also to elucidate its mechanism of action. Both phenylephrine (an adrenergic alpha1-receptor agonist) and high potassium (a membrane- depolarizing agent) caused great contractile responses in the isolated aortic strips. Platycodin D at high concentration (24microgram/ml) inhibited contractile responses induced by phenylephrine (10 (-5) M) and high potassium (5.6x10 (-2) M), while low concentrations of platycodin D (4~8microgram/ml) did not affect those responses. However, platycodin D3 (8~32microgram/ml) did not alter the contractile responses evoked by phenylephrine and high K+. Interestingly, the infusion of platycodin D3 (1.0 mg/kg/30 min) significantly reduced the pressor responses induced by intravenous norepinephrine. However, platycodin D3 (1.0 mg/kg/30 min) did not affect them. Taken together, these results show that intravenously administered platycodin D depresses norepinephrine-induced pressor responses in the anesthetized rat, at least partly through the blockade of adrenergic alpha1-receptors. Platycodin D also caused vascular relaxation in the isolated aortic strips of the rat via the blockade of adrenergic alpha1-receptors, in addition to an unknown direct mechanism. However, platycodin D3 did not affect both norepinephrine-induced pressor responses and the isolated rat aortic contractile responses evoked by phenylephrine and high potassium. Based on these results, there seems to be much difference in the mode of action between platycodin D and platycodin D3.
Animals ; Aorta ; Blood Pressure ; Norepinephrine ; Phenylephrine ; Platycodon ; Potassium ; Rats* ; Relaxation

Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents.Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed. Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age £15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance. Conclusion For DTC of children and adolescents (£18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.

Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents.Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed. Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age £15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance. Conclusion For DTC of children and adolescents (£18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.

BACKGROUND: Limited exercise capacity is common in the elderly. Kinetics of recovery oxygen consumption plays an important role in determining exercise capacity. This study was performed to evaluate the kinetics of recovery oxygen consumption as well as peak oxygen consumption during exercise and recovery in the elderly. METHODS: Thirty healthy volunteers were included for this study. They were divided into three groups according to their ages(20 to 39; 40 to 59; and over 60). All subjects performed symptomlimited maximal treadmill exercise. RESULTS: Peak oxygen consumption(pVO2, ml/min/kg) was gradually decreased with the age. Half-recovery time of peak oxygen consumption(T1/2VO2) was maintained from third to sixth decades without significant changes, and then rapidly delayed in the elderly. CONCLUSION: Kinetics of recovery oxygen consumption was rapidly and markedly delayed in the elderly and this may result in the exercise intolerance.
Aged* ; Healthy Volunteers ; Humans ; Kinetics* ; Oxygen Consumption* ; Oxygen*

BACKGROUND/AIMS: It is recommended that duodenal ulcer patients who are infected with H. pylori should be treated with eradication therapy, whether the ulcer is active or in remission. However, there has been no report on the effect of eradication treatment in patients with incidentally found S-2 stage duodenal ulcer scar. METHODS: We prospectively enrolled 80 H. pylori-positive patients with S-2 stage duodenal ulcer scar who have no past history of ulcer treatment. Treatment group received triple therapy consisted of omeprazole, amoxicillin, and clarithromycin for 2 weeks, whereas control group received no treatment. The follow-up endoscopy was performed every 1 year and when the patients have symptoms of ulcer disease. Fifty-three patients were followed up for more than 1 year. RESULTS: The eradication rate of the treatment group was 92.9%. During the follow-up period of 14.7 months, 20% (5/25) of patients in the control group (2 gastric ulcers and 3 duodenal ulcers) and 3.6% (1/28) of patients in the treatment group (1 duodenal ulcer) developed active or healing stage peptic ulcers (p=0.089). CONCLUSIONS: Our results suggest that H. pylori eradication may he effective in preventing peptic ulcers in patients with S-2 stage duodenal ulcer scar.
Amoxicillin ; Cicatrix* ; Clarithromycin ; Duodenal Ulcer* ; Endoscopy ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Omeprazole ; Peptic Ulcer ; Prospective Studies ; Stomach Ulcer ; Ulcer