No abstract available.
Nortriptyline* ; Pharmacokinetics*

PURPOSE: Escalator-related injuries have been considered uncommon and most likely to occur to children. We set out to describe the epidemiology of these injuries with focus on the aging population in order to determine whether or not escalators are safe for the aged, and in order to obtain information to help in preventing escalator-related injuries. METHODS: A prospective survey was undertaken to identify the number and nature of these injuries from May 2004 to June 2006. We enrolled patients who had sustained escalated- related injuries and a standard list of questions and answers were recorded by the emergency physician. A total of 54 Such questionnaires were completed during the study period. Data were analyzed using SPSS 12.0K. RESULTS: The average patient age 63.40+/-20.92 years (range 3-94). There were 18 (33.3%) males. Only 4 (7.4%) were younger than their sixteen year, but 36 (66.7%) were over age 65 and 17 of those were injured from standing on escalators. However of 18 patients younger than age 65, 13 were injured from walking on moving escalators. CONCLUSION: Escalator-related injuries are not as uncommon as previously believed and the aged population over 65 years old is the highest risk group. Additionally, walking on moving escalator was a cause of injuries. Therefore, two orimary prevention strategies are needed. Provision of alternatives to escalators for people over 65 and keeping passengers from walking on escalators.
Aged ; Aging ; Child ; Elevators and Escalators ; Emergencies ; Humans ; Male ; Prospective Studies ; Surveys and Questionnaires ; Walking

This study evaluated the pharmacokinetic profile and therapeutic efficacy of piroxicam (PX), a long acting non-steroidal anti-inflammatory drug for the treatment of arthritis, following intra-articular (IA) injection in comparison to the pharmacokinetic profile and therapeutic efficacy of PX after intramuscular (IM) injection. In the pharmacokinetic study in rats, systemic exposure and pharmacokinetic parameters of PX after a single IA dose were compared with systemic exposure and pharmacokinetic parameters of PX after administration of the same dose IM (0.6 mg/kg). The anti-inflammatory and analgesic effects of IA PX were evaluated simultaneously in a monoiodoacetate-induced osteoarthritis rat model. The plasma PX concentration rapidly rose following IA injection, and it was comparable to the plasma PX concentration following IM injection, suggesting the rapid efflux of the drug molecule from the joint cavity. However, in the efficacy study, the IA PX administration significantly reduced the knee swelling by reducing the level of prostaglandin E2 in the joint, compared to that following administration of IA vehicle and after administration of the IM PX dose. In addition, we found that the anti-inflammatory and anti-nociceptive efficacies of IA PX were synergistically increased upon co-treatment with hyaluronic acid (HA), a potent agent for the treatment of osteoarthritis, at the weight ratio of 1:1 or 1:2, and these effects were more pronounced than those following administration of HA or PX alone. In conclusion, this study demonstrated the efficacy of the IA use of PX alone and/or in combination with HA in osteoarthritis.
Animals ; Arthritis ; Dinoprostone ; Hyaluronic Acid ; Injections, Intra-Articular ; Joints ; Knee ; Models, Animal ; Osteoarthritis ; Pharmacokinetics* ; Piroxicam* ; Plasma ; Rats*

BACKGROUND: Alcohol intake induces complex changes in the human body. However, there has not been much investigation on the interaction between alcohol and human skin. OBJECTIVE: The aim of this study is to investigate the effects of alcohol intake on the skin's physiology. METHODS: A total 16 Korean males was enrolled in this study and they were divided into two groups (group A and group B). Each group included 8 people. Group A drank alcohol (20.1%, 360 ml) for 90 min and Group B drank 360 ml of normal saline. The body temperature, the skin erythema index, the transepidermal water loss (TEWL), the skin hydration, the skin pH and skin sebum were measured before and 30 min and 120 min after alcohol intake. RESULTS: In group A, the skin erythema index, TEWL, skin hydration and skin pH significantly increased 30 min after alcohol intake, while the body temperature and sebum decreased. All the measurements except sebum recovered 120 min after alcohol intake. However, in group B, all the measurements were not significantly changed. CONCLUSION: Alcohol intake affects thermoregulation, the skin barrier function and the skin pH. This study showing that physiologic changes are induced by alcohol intake may help investigate the interaction between alcohol and skin disease.
Body Temperature ; Body Temperature Regulation ; Erythema ; Human Body ; Humans ; Hydrogen-Ion Concentration ; Male ; Sebum ; Skin ; Skin Diseases ; Skin Physiological Phenomena

For the pharmacokinetic analysis of isoniazid transfer into CSF, steady-state isoniazid concentrations of plasma and CSF were measured in eleven tuberculous meningitis patients confirmed with findings of CSF and neuroimazing. Peak plasma levels (4.17-21.5 micrograms/mL) were achieved at 0.25 to 3 hours after multiple isoniazid dose (600 mg/day). Terminal half-life, total clearance (CI/F) and volume of distribution (Vd/F) were 1.42 +/- 0.41 hr, 0.47 +/- 0.22 L/kg/hr and 0.93 +/- 0.48 L/kg, respectively. Isoniazid concentrations in CSF collected intermittently were highest at 3 hr (Mean, 4.18 micrograms/mL) and were 0.54 +/- 0.21 micrograms/mL at 12 hrs after the last dose of isoniazid 10 mg/kg/day. CSF/plasma partitioning of isoniazid and equilibration rate were estimated using modified pharmacokinetic/pharmacodynamic model. Disposition rate constant from CSF to plasma and CSF/plasma partitioning ratio of isoniazid were estimated to be 0.39 h-1 and 1.17, respectively.
Administration, Oral ; Humans ; Isoniazid/*cerebrospinal fluid ; Metabolic Clearance Rate ; Models, Biological ; Tuberculosis, Meningeal/*cerebrospinal fluid

Osmotic demyelination syndrome (ODS) is a demyelinating disorder related to the rapid correction of hyponatremia. It usually affects the pontine area; hence, the name central pontine myelinolysis (CPM). However, it rarely occurs with the correction of hypernatremia and hyperosmolarity and involves extrapontine areas. A 56-year-old chronic alcoholic had been admitted with a history of confusion. He had been in alcohol withdrawal for 4 days. Laboratory examinations showed severe hypernatremia and hyperosmolarity. After serum sodium level was normalized; however, his clinical course did not improve and deteriorated to semicoma progressively. Magnetic resonance imaging (MRI) revealed abnormal signal intensity in the pontine and extrapontine areas, including the basal ganglia, thalamus, and cerebral cortices. This is the first case report of combined central pontine and extrapontine demyelination after alcohol withdrawal and correction of hypernatremia in a chronic alcoholic.
Alcoholics* ; Basal Ganglia ; Cerebral Cortex ; Demyelinating Diseases ; Humans ; Hypernatremia* ; Hyponatremia ; Magnetic Resonance Imaging ; Middle Aged ; Myelinolysis, Central Pontine* ; Sodium ; Thalamus

Captopril tablets of two different producers were tested for bioequivalence as well as therapeutic equivalence. The pharmacokinetics, the time course of plasma angiotensin-converting enzyme inhibition, and the changes of systolic and diastolic blood pressure after administration of drugs were studied. In a balanced, randomized two-way crossover design, two single doses of 50mg each of captopril were administered orally to twelve male volunteers. Peak blood levels of free captopril were observed about 0.85 hour after the dose, and practically free captopril could not be detected in blood within 8 hours. Peak free captopril levels of both compounds were almost identical(Capoten(R), 464.3ng/ml ; Capril(R), 504.6ng/ml). No statistically significant difference was identified between two compounds when area und the concentration time curve, peak level, time to peak were compared. Inhibition of plasma angiotensin-converting enzyme to blood free captopril concentration showed the hyperbolic concentration-response relationship with IC50 value of 7.4ng/ml. The area under the percent angiotensin-converting enzyme inhibition versus time curve were quite similar after administration of both drugs. The compounds were also found to be equivalent on the premise that no significant difference was detected when the time courses of systolic and diastolic blood pressure reduction were compared.
Biological Availability* ; Blood Pressure ; Captopril* ; Cross-Over Studies ; Humans ; Inhibitory Concentration 50 ; Male ; Pharmacokinetics ; Plasma* ; Tablets* ; Therapeutic Equivalency ; Volunteers

Subcutaneous panniculitic T-cell lymphoma(SPTCL) is categorized as a rare subtype of peripheral T-cell lymphoma. It is characterized by primary involvement of the subcutaneous fat in a manner mimicking panniculitis with/without hemophagocytic syndrome. They share a generally aggressive course and are highly associated with Epstein-Barr virus infection. EBV infection plays an important role in the tumorigenesis and may be related to cutaneous lymphoma with hemophagocytic manifestations. We have seen a patient, a 67-year-old woman with tender erythematous nodules on both upper extremities and abdomen. With time, the skin lesion showed ulcerative change on her right thigh. She has also suffered from fever, weight loss, arthralgia, and general weakness without hepatosplenomegaly or lymphadenopathy for 4 months. During the admission, she complained of nausea, vomiting and dysarthria. On the MRI examination, we found a multi-focal solid lesion on her brain. The histopathological findings of the biopsy from her abdominal skin lesion showed a septal and lobular, histiocytic panniculitis with bean bag cells and atypical lymphoid cells identified as NK like T-cells and also dense diffuse infiltrates localized in the lower dermis and subcutaneous tissue, with minimal epidermal and upper dermal infiltrates without destructive change of blood vessels. The infiltrating atypical lymphoid cells expressed the phenotype of LCA, CD45RO, CD3, CD8, CD56 and also positive for EBV by in situ hybridization. Our case showed a clonal TCR gamma gene rearrangement by polymerase chain reaction. She was subjected to a course of treatment(cyclophosphamide, vincristine, prednisolone and radiation therapy) under the diagnosis of SPTCL. but died of sepsis due to urinary tract infections after 2 months.
Abdomen ; Aged ; Arthralgia ; Biopsy ; Blood Vessels ; Brain ; Carcinogenesis ; Central Nervous System* ; Dermis ; Diagnosis ; Dysarthria ; Epstein-Barr Virus Infections ; Female ; Fever ; Genes, T-Cell Receptor gamma ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Lymphatic Diseases ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Peripheral ; Magnetic Resonance Imaging ; Nausea ; Panniculitis ; Phenotype ; Polymerase Chain Reaction ; Prednisolone ; Sepsis ; Skin* ; Subcutaneous Fat ; Subcutaneous Tissue ; T-Lymphocytes* ; Thigh ; Ulcer ; Upper Extremity ; Urinary Tract Infections ; Vincristine ; Vomiting ; Weight Loss

Severe tricuspid regurgitation resulting from a flail leaflet is a rare cause of neonatal cyanosis. We report a neonate with profound cyanosis and severe tricuspid regurgitation caused by a rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. Ductal patency could not be established. The repair of the tricuspid valve was performed after initial stabilization by using extracorporeal membrane oxygenation.
Cyanosis ; Extracorporeal Membrane Oxygenation ; Heart ; Humans ; Infant, Newborn* ; Papillary Muscles* ; Rupture ; Tricuspid Valve ; Tricuspid Valve Insufficiency*

BACKGROUND: The Damus-Kaye-Stansel (DKS) procedure is a method for mitigating the risk of systemic ventricular outflow tract obstruction (SVOTO). However, there have been few reports on which surgical technique shows a better outcome. The objective of this study was to compare the outcome of the DKS procedure according to the surgical technique used. METHODS: We retrospectively reviewed 12 consecutive patients who underwent the DKS procedure from March 2004 to April 2013. When the relationship of the great arteries was anterior-posterior, the double-barrel technique (group A) was performed. If the relationship was side-by-side, the ascending aortic flap technique (group B) was performed. RESULTS: There was no early mortality and 1 late mortality in group B. There was no statistically significant difference in the median peak pressure gradient of preoperative subaortic stenosis in both groups: 14 mmHg (range, 4 to 53 mmHg) in group A and 15 mmHg (range, 0 to 30 mmHg) in group B (p=0.526). Further, a significant postoperative pressure gradient was not observed in either group A or group B. More than moderate postoperative neoaortic regurgitation was observed in 1 patient of group B; this patient underwent neoaortic valve replacement 66 months after the DKS procedure. No one had a recurrent SVOTO during follow-up. CONCLUSION: The DKS procedure is an effective way to minimize the risk of SVOTO, and there is little difference in the outcomes of the DKS procedure according to the surgical technique used.
Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Fontan Procedure ; Humans ; Mortality ; Retrospective Studies