PURPOSE: Neuronal apoptotic events induced by aging and hypoxic/ischemic conditions is an important risk factor in neurodegenerative diseases such as ischemia stroke and Alzheimer's disease. The peel of Citrus sunki Hort. ex Tanaka has long been used as a traditional medicine, based on multiple biological activities including anti-oxidant, anti-inflammation, and anti-obesity. In the current study, we examined the actions of fermented C. sunki peel extract against cobalt chloride (CoCl2)-mediated hypoxic death in human neuroblastoma SH-SY5Y cells. METHODS: Cell viability was measured by trypan blue exclusion. Expression of apoptosis related proteins and release of cytochrome c were detected by western blot. Production of intracellular reactive oxygen species (ROS) and apoptotic morphology were examined using 2',7'-dichlorofluorescin diacetate (DCF-DA) and 4',6-diamidino-2-phenylindole (DAPI) staining. RESULTS: Exposure to CoCl2, a well-known mimetic agent of hypoxic/ischemic condition, resulted in neuronal cell death via caspase-3 dependent pathway. Extract of fermented C. sunki peel significantly rescued the CoCl2-induced neuronal toxicity with the cell viability and appearance of apoptotic morphology. Cytoprotection with fermented C. sunki peel extract was associated with a decrease in activities of caspase-3 and cleavage of poly (ADP ribose) polymerase (PARP). In addition, increase in the intracellular ROS and release of cytochrome c from mitochondria to the cytosol were inhibited by treatment with extract of fermented C. sunki peel. CONCLUSION: Based on these data, fermented C. sunki peel extract might have a protective effect against CoCl2-induced neuronal injury partly through generation of ROS and effectors involved in mitochondrial mediated apoptosis.
Aging ; Alzheimer Disease ; Anoxia ; Apoptosis ; Blotting, Western ; Caspase 3 ; Cell Death ; Cell Survival ; Citrus* ; Cobalt ; Cytochromes c ; Cytoprotection ; Cytosol ; Humans ; Ischemia ; Medicine, Traditional ; Mitochondria ; Neuroblastoma ; Neurodegenerative Diseases ; Neurons* ; Reactive Oxygen Species ; Risk Factors ; Stroke ; Trypan Blue

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

The causes of pneumomediastinum during perioperative period are trauma to the airway from intubation or other manipulation, raised airway pressure during anesthesia, rupture of a bleb or other intrapulmonary lesion, upper airway damage during neck surgery, infiltration of the tonsillar fossa or adenoid bed with air under pressure, increased airway pressure after nausea and vomiting, and coughing during awakening. This paper is represents and discusses a case of pneumomediastinum, pneumothorax, extensive subcutaneous and retroperitoneal emphysema which occurred suddenly a few minute after several times of bucking and straining in the intubated state with oxygen catheter after tonsillectomy and adenoidectomy at recovery room. The complieation was thought to be a infiltration of air through tonsillar fossa under pressure or alveolar rupture due to increased airway pressure after coughing. The patient was treated with high concentration of oxygen and recoverd uneventfully.
Adenoidectomy ; Adenoids ; Anesthesia ; Blister ; Catheters ; Cough ; Emphysema ; Humans ; Intubation ; Mediastinal Emphysema* ; Nausea ; Neck ; Oxygen ; Perioperative Period ; Pneumothorax ; Recovery Room ; Rupture ; Subcutaneous Emphysema* ; Tonsillectomy* ; Vomiting

The diffuse large B-cell lymphoma category of the Revised European American Classification of Lymphoid Neoplasms (REAL) encompasses different morphologic lymphoma subtypes in a single entity, especially the diffuse large cell (DLC) and the immunoblastic (IBL) subtypes by Working Formulation (WF). The aim of this study is to determine the influence of the morphologic subdivision within this category with respect to clinical outcome and proliferative index using Ki-67 immunostainig combined with image analysis. We retrospectively reviewed 74 patients from 1990 to 1996, who were diagnosed with diffuse large B-cell lymphoma. All cases were reclassified according to REAL and Working Formulation (WF), and Ki-67 immunostaining was performed in all the cases. Fifty-eight cases (78.4%) were classified as DLC and 16 cases (21.6%) as IBL, according to WF. Twenty one cases (28.4%) showed nodal involvement and 53 cases (71.6%), extranodal involvement. All cases were found to display a variable degree of nuclear Ki-67 staining. A proliferative index of 50% or higher identified a group of patients (77%) who had poor clinical results. Overall survival was significantly reduced in these patients displaying high Ki-67 associated proliferative index compared to those with a low proliferative index (p=0.007). 5-year survival estimates were 93% in the low proliferative index group and 55% in the high proliferative index group. A multivariate regression analysis incorporating commonly used clinical prognostic factors confirmed the independent effect of proliferation index on survival. Moreover, all of the 16 IBL cases showed Ki-67 positivity of 50% or higher, which correlates with the poor clinical outcome compared to 70.7% of DLC (p=0.014). We conclude that subdivision of the diffuse large B-cell lymphoma category of the REAL classification is necessary in terms of prognostic significance in correlation with Ki-67 proliferative index.
B-Lymphocytes* ; Classification ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Retrospective Studies

A 35-year-old man was admitted with a 20 day history of generalized edema and muscular weakness of the lower extremities. He was alert with a pale puffy face and an ejection murmur was heard at the cardiac apex. The electrocardiogram disclosed low voltage, first degree atrioventricular block, and a right bundle branch block. During the hospitalization an intractable diastolic hypotension developed, which measured 0 mmHg at the lowest point. At that time the echocardiogram revealed a dilated, akinetic right ventricle. Eventually a multiorgan failure developed and an autopsy following his death presented a fibrofatty replacement of the right ventricular myocardium. This might be a case of an arrhythmogenic right ventricular dysplasia/cardiomyopathy, which is usually characterized clinically by a ventricular tachycardia and may cause a sudden death in young adults.
Adult ; Atrioventricular Block ; Autopsy* ; Bundle-Branch Block ; Death, Sudden ; Edema ; Electrocardiography ; Heart Ventricles ; Hospitalization ; Humans ; Hypotension ; Lower Extremity ; Muscle Weakness ; Myocardium ; Systolic Murmurs ; Tachycardia, Ventricular ; Young Adult

Annular pancreas is a rarely found gastrointestinal tract malformation, and is frequently associated with Down syndrome. Endocardial cushion defect is a type of congenital heart disease, commonly also related to Down syndrome. However, a combination of endocardial cushion defect with annular pancreas has not been reported previously. We recently experienced such a case in 2 month old boy. Moreover Down syndrome was excluded through physical examination and a chromosomal study. We think it difficult to obtain a complete explanation for this condition through the currently known pathogenesis of annular pancreas and endocardial cushion defect.
Down Syndrome* ; Endocardial Cushion Defects ; Endocardial Cushions* ; Gastrointestinal Tract ; Heart Defects, Congenital ; Humans ; Infant ; Male ; Pancreas* ; Physical Examination

BACKGROUND: To evaluate the effects of thoracic epidural anesthesia, with or without bilateral vagotomy, epinephrine-induced arrhythmias were studied in 31 rabbits anesthetized with 1 MAC enflurane. METHODS: Logdose protocol was used for the infusion of epinephrine; its arrhythmic dose being defined as the smallest infusion rate produced four or more continuous or intermittent arrhythmias within 15 seconds. RESULTS: The values (geometric mean) of arrhythmic doses and the plasma concentration of epinephrine during arrhythmia were as follows: 10.21 g.kg 1.min 1 and 83.16 ng/ml in epidural control group; 118.90 g.kg 1.min 1 and 677.76 ng/ml in epidural lidocaine group (p<0.05); 6.34 g.kg-1.min 1 and 96.42 ng/ml in intravenous lidocaine group; 8.65 g.kg 1.min-1 and 44.64 ng/ml in vagotomized-epidural control group; and 12.03 g.kg 1.min 1 and 95.35 ng/ml in vagotomized- epidural lidocaine group. CONCLUSIONS: The data suggest that thoracic epidural anesthesia raises the threshold for enflurane- epinephrine arrhythmias in rabbits and that this effect is eliminated by bilateral vagotomy.
Anesthesia, Epidural* ; Arrhythmias, Cardiac* ; Enflurane ; Epinephrine ; Lidocaine ; Plasma ; Rabbits* ; Vagotomy*

A clinical study was performed of the respiratory care of 1309 critically ill patients who had been admitted to respiratory intensive care units (RICU) in 1986 and 1987. 1) The number of patients who needed respiratory care was 691 and the mortality in RICU was 1.45% (10 case) in 1986, and 618 and 2.59% (16 cases) in 1987, respectively. 2) The average duration of ventilatory support was 2.1 days in 1986, and 1.9 days in 1987. The patients of thoracic surgery needed respiratory support for 2.6 days in 1986, and 2.3 days in 1987. 3) The mortalities according to department were:1.42% (6 of 424 cases) in thoracic surgery, 1.89% (2 of 107 cases) in general surgery, 20% (1 of 5 cases) in pediatry surgery, and 7.14% (1 of 14 cases) in gynecology in 1986. In 1987, 2.56% (8 of 312 cases) in thoracic surgery, 4.0% (6 of 150 cases) in neurosurgery, 0.96% (1 of 104 cases) in general surgery, and 7.69% (1 of 13 cases) in urology. 4) The most frequently used ventilator was Bear II, followed by Benett MA-I. 5) The major causes of death in RICU were low cardiac output syndrome, sepsis, respiratory failure, and brain damage.
Brain ; Cardiac Output, Low ; Cause of Death ; Critical Illness* ; Gynecology ; Humans ; Intensive Care Units ; Critical Care* ; Mortality ; Neurosurgery ; Respiratory Insufficiency ; Sepsis ; Thoracic Surgery ; Urology ; Ventilators, Mechanical

Of all the aeromedical treats to flying safety, G-induced loss of consciousness (G-LOC) must be one of the most important. The present study is undertaken to acquire the physiological normative data (including lifestyle and physical fitness) of KAF pilots and to investigate the factors that will be related with G-LOC. From 15 May through 27 Nov 2000, 464 KAF pilots underwent high G training and flight performance tests at the Aeromedical Research and Training Center are checked CBC, total cholesterol, PFT, physical fitness battery tests-muscular strength, muscular endurance, power, and flexibility. High G training and 2 kinds (before and after the G-training) of questionnaire were tried. Pilot's attitude for health promotion was relatively passive and the proportions as of high and borderline risk for atherosclerosis in total cholesterol level were 4.98% and 22.1%, respectively. 17.6% of the pilots had G-LOC and three quarters of them fell into G-LOC within the first 5 seconds. Variables showing significant correlation (p<0.05) with G-LOC were as follows; height, age, total flying time, and high G-training times. Trunk extension had positive correlation and curls ups had negative correlation, but the reasons are needed more following study. Also, the judgments of pilots and a supervisor in skillfulness of L1 maneuver were significant with G-LOC.
Atherosclerosis ; Cholesterol ; Diptera ; Health Promotion ; Judgment ; Life Style ; Physical Fitness ; Pliability ; Risk Factors* ; Unconsciousness ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to examine the long-term effects of Hospital Information System(HIS) on nurses' job pattern and satisfaction, and attitudes toward electronic medical record system. METHODS: Prospective survey using repeated measures design was performed to compare the changes between 2 years and 4 years after introduction of HIS in a tertiary hospital. Participants were 374 nurses working in the target hospital. Questionnaire was developed by researchers based on Walker, Eyman, Krall, Prophet, and Flanagan(1996)'s study and consisted of 21 questions about job pattern, job satisfaction, and attitudes toward computerization and paper record system. RESULTS: Overall time for documentation, shift reporting, communication with other departments were reduced. Otherwise, direct nursing time was not increased after HIS. Nurses showed positive responses on changes of job pattern after HIS while job satisfaction has been decreased. In addition, nurses' attitudes toward hospital information system and paper medical record system showed they were accepting computerized information system. CONCLUSION: This study identified the long-term positive effects of HIS and the need for nursing sensitive hospital information system.
Electronic Health Records ; Hospital Information Systems* ; Information Systems ; Job Satisfaction ; Medical Records ; Nursing ; Prospective Studies ; Surveys and Questionnaires ; Tertiary Care Centers