Ventriculoperitoneal(VP) shunting has been associated with a variety of complications. CSF ascites secondary to VP shunting is very rare. We report a case of 68-year-old man with VP shunt in whom subclinical peritoneal infection presented with ascites. The patient was treated successfully with antibiotics and removal of the shunt. CSF ascites complicating VP shunt is reviewed and the pathogenesis of this condition is discussed.
Aged ; Anti-Bacterial Agents ; Ascites* ; Humans ; Ventriculoperitoneal Shunt*

G protein-coupled receptor 119 (GPR119) is expressed in the pancreas and gastrointestinal tract, and its activation promotes insulin secretion in the beta cells of the pancreatic islets as well as the secretion of glucagon-like peptide-1 (GLP-1) in intestinal L cells, consequently improving glucose-stimulated insulin secretion. Due to this dual mechanism of action, the development of small-molecule GPR119 agonists has received significant interest for the treatment of type 2 diabetes. We newly synthesized 1,2,4-triazolone derivatives of GPR119 agonists, which demonstrated excellent outcomes in a cyclic adenosine monophosphate (cAMP) assay. Among the synthesized derivatives, YH18968 showed cAMP=2.8 nM; in GLUTag cell, GLP-1secretion=2.3 fold; in the HIT-T15 cell, and insulin secretion=1.9 fold. Single oral administration of YH18968 improved glucose tolerance and combined treatment with a dipeptidyl peptidase 4 (DPP-4) inhibitor augmented the glucose lowering effect as well as the plasma level of active GLP-1 in normal mice. Single oral administration of YH18968 improved glucose tolerance in a diet induced obese mice model. This effect was maintained after repeated dosing for 4 weeks. The results indicate that YH18968 combined with a DPP-4 inhibitor may be an effective therapeutic candidate for the treatment of type 2 diabetes.
Adenosine Monophosphate ; Administration, Oral ; Animals ; Diabetes Mellitus, Type 2* ; Diet ; Dipeptidyl Peptidase 4 ; Enteroendocrine Cells ; Gastrointestinal Tract ; Glucagon-Like Peptide 1 ; Glucose ; GTP-Binding Proteins* ; Insulin ; Islets of Langerhans ; Mice ; Mice, Obese ; Pancreas ; Plasma

OBJECTIVE: Contrast-induced nephropathy (CIN) frequently occurs after percutaneous intervention. Objective of this study was to investigate the usefulness of serum cystatin C, neutrophil gelatinase-associated lipocalcin (NGAL), urinary kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) as early predictors for CIN after percutaneous coronary intervention (PCI). METHODS: In 53 patients who underwent PCI were enrolled. Serum creatinine and cystatin C level were measured immediately before, and 24 hours and 48 hours after catheterization. Serum NGAL, urinary KIM-1, and IL-18 were measured immediately before, and 4 hours, 24 hours, and 48 hours after catheterization. CIN was defined as a rise in creatinine 0.5 mg/dL or 25% above baseline. RESULTS: CIN occurred in four patients (7.5%). Serum cystatin C levels were higher at 24 hours and 48 hours in CIN patients than in those without CIN (P<0.05). Serum NGAL levels were higher at 48 hours in CIN patients than in those without CIN. Urinary KIM-1 levels were higher at 48 hours in CIN patients than in those without CIN. There were no significant markers of CIN on multi-variate analysis. CONCLUSION: In this study, the occurrence of CIN after PCI was 7.5%. Although there were some time-course changes in serum cystatin C and urinary KIM-1 after PCI, there was no significant predictor for CIN after PCI.
Catheterization ; Catheters ; Contrast Media ; Creatinine ; Cystatin C ; Humans ; Interleukin-18 ; Kidney ; Neutrophils ; Percutaneous Coronary Intervention*

BACKGROUND: Thiopental and propofol are the most widely used intravenous anesthetics as induction agents in general anesthesia. Thiopental is a very strong alkaline drug, and when it is extravasated, it can cause pain and skin necrosis. Propofol also can cause pain on injection in many populations. Therefore, we planed this study to compare inflammatory reactions of skin tissues after subdermal injections of thiopental and propofol in rabbits. METHODS: Four rabbits were divided into 2 groups: Standard dose (S) group and double dose (D) group. In the S group, thiopental 0.4 ml and propofol 0.4 ml were injected subcutaneously on each side of the posterior proximal ear. In the D group, the dose was doubled to 0.8 ml of each drug and injection was done in the same manner. Skin tissue at the injection sites were excised after 1 day, 3 days, and 7 days. Then each skin tissue slide was examined under an optical microsccpe. RESULTS: In the S group, the inflammatory reaction after the subdermal injection of 2.5% thiopental revealed a more progressed and more severe pattern than 1% propofol. In the D group, the inflammatory reaction after a subdermal injection of 2.5% thiopental revealed a more progressed and more severe pattern than 1% propofol at 3 days, but there was no significant difference in the degree of progression and severity between the 2 drugs at 7 days. CONCLUSIONS: When propofol is extravasated during continuous infusion for maintenance of anesthesia, it can cause distinct inflammatory reaction; though the inflammatory reaction is milder and the possibility of complications is lower than with thiopental.
Anesthesia ; Anesthesia, General ; Anesthetics, Intravenous ; Ear ; Inflammation ; Necrosis ; Propofol* ; Rabbits* ; Skin ; Thiopental*