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BACKGROUND: Vasoconstrictors have been used as an adjunct to local anesthetics to prolong the duration of spinal anesthesia. Recently, clonidine, an 2-receptor agonist has been shown to prolong the duration of spinal anesthesia following intrathecal administration. Bupivacaine has been used for spinal anesthesia and compared with tetracaine in recent studies. We have undertaken this study to further evaluate the effect of clonidine in hyperbaric 0.5% bupivacaine spinal anesthesia. METHODS: Thirty patients who were scheduled for lower limb or urologic operation were divided into 2 groups: Group A (hyperbaric bupivacaine 13 mg, 2.6 ml + N/S 1 ml), Group B (hyperbaric bupivacaine 13 mg, 2.6 ml + clonidine 150 g, 1 ml). We used standardized techniques and injected above drugs to group A and B intrathecally for spinal anesthesia. We investigated the onset and the duration of spinal anesthesia along with hemodynamic changes (blood pressure and heart rate) in patients. RESULTS: There were no significant differences in the onset of spinal anesthesia and hemodynamic changes between two groups. The time taken to recover from the nerve block was more prolonged in the group B (touch 225, pain 262, foot dorsiflexion 271, knee flexion 290 minutes) than group A (touch 154, pain 188, foot dorsiflexion 198, knee flexion 216 minutes). There were no significant differences in sedation, and in experiencing dry mouth and other side effects between two groups. CONCLUSION: Intrathecal clonidine 150 g has been proved to prolong the duration of hyperbaric 0.5% bupivacaine spinal anesthesia without neurotoxicity or dangerous hemodynamic depression. Therefore, clonidine can be used as an effective adjunct in hyperbaric bupivacaine spinal anesthesia.
Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine* ; Clonidine* ; Depression ; Foot ; Heart ; Hemodynamics ; Humans ; Knee ; Lower Extremity ; Mouth ; Nerve Block ; Tetracaine ; Vasoconstrictor Agents

There is a dearth of Korean studies on dehydration, one of the health risks for adult women. This study analyzed the subjects of the 2016∼2018 National Health and Nutrition Examination Survey (KNHANES) to investigate the relationship between nutrient intake ratios and sedentary time in dehydrated women. Body mass index and waist circumference in the dehydrated group (DG) were significantly higher than the normal group (NG). Intake of other liquids in the DG was significantly higher than in the NG, but total water intake in the DG was significantly lower than in the NG. Compared to the 600 sedentary minutes or more per day group, the odds ratio of dehydration was significantly higher in the less than 300 sedentary minutes per day group (1.871 [95% CI: 1.579∼2.215], P＜0.001). Compared to the drinking over 6.0 cups of water per day group, the odds ratio of dehydration was significantly higher in the 3 cups or fewer per day (OR [95% CI] is 1.198 times [1.019 to 1.408], P＜0.05), and 6.0 cups or fewer group (OR [95% CI] is 1.162 times [1.018 to 1.326], P＜0.05). The results of this study showed that the total water intake was relatively lower in the ≥600 sedentary minutes per day group compared to the 300 sedentary minutes per day group, making them more vulnerable to dehydration. The nutrient intake ratios were higher in the dehydration group than in the normal group. In conclusion, emphasis should be placed on the importance of hydration and nutrition education for adult women in the workplace.

OBJECTIVE: To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: The blood samples of patients with recurrent spontaneous abortion were tested by PCR-RFLP method. RESULTS: Of 51 cases of study group, 14 (27.5%) were normal, 25 (49.0%) were heterozygosity, and 12 (23.5%) were homozygosity. Of 58 cases of control group, 20 (34.5%) were normal, 30 (51.7%) were heterozygosity, and 8 (13.8%) were homozygosity. But the difference between two groups was not significant (p=0.190). CONCLUSION: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the study for MTHFR mutation should be included in the workup of recurrent spontaneous abortion.
Abortion, Spontaneous* ; Female ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

BACKGROUND: Dapagliflozin is an oral selective inhibitor of sodium-glucose cotransporter 2(SGLT2), the kidney transporter chiefly responsible for glucose reabsorption from the glomerular filtrate. Because this mechanism does not require the action of insulin, dapagliflozin rarely causes hypoglycemia. Dapagliflozin may affect blood glucose control as well as blood pressure and the body weight which are one of the cardiovascular disease risk factors. However, dehydration and ketoacidosis are reported as the side effects of the dapagliflozin treatment and the safety issues have been occurred. The aim of this study is to analyze the effectiveness and adverse events of dapagliflozin in Korean patients. METHODS: From December 2014 to August 2015, we retrospectively reviewed the electronic medical records of type 2 diabetes patients who were prescribed dapagliflozin at Severance Hospital. RESULTS: A total of 202 Korean patients were enrolled in this study. The effectiveness in the reduction of blood glucose was statistically significant(p < 0.001). Dapagliflozin decreased 0.74% of HbA1c after 24 weeks. Significantly more participants achieved the target HbA1c level(HbA1c < 7%) after 24 weeks(n=42, 35.3%) than before taking dapagliflozin(n=21, 17.6%). Blood pressure decreased 5.7 mmHg s ystolic b lood p ressure(SBP), 1.9 mmHg d iastolic b lood p ressure(DBP) a fter 24 weeks. M ore than o ne q uarter of participants(n=35, 29.4%) experienced weight loss. Most common adverse event was genitourinary symptoms. CONCLUSION: In this study, the effectiveness of dapagliflozin in improving glycemic control, blood pressure control, and weight loss was statistically significant. However, elderly and female patients, who have higher incidence of adverse events, should use dapagliflozin cautiously.

BACKGROUND: The FimA of Porphyromonas gingivalis is a crucial pathogenic component of the bacteria and has been implicated as a target for vaccine development against the periodontal diseases. METHODS: In this study, the purified fimbriae (FimA subunit polymers) protein was used for immunization in their native form and B hybridoma clones producing antibodies specific to FimA were established. RESULTS: The monoclonal antibodies prepared from selected two clones, designated #123 (IgG2b/ kappa) and #265 (IgG1/kappa), displayed different patterns of binding activity against the cognate antigen. Both antibodies reacted with conformational epitopes expressed by partially dissociated oligomers, but not with monomer as elucidated by Western blot analysis. Ascites fluid containing the monoclonal antibodies showed the inhibitory activity against P. gingivalis to saliva-coated hydroxyapatite beads, an in vitro model for the pellicle-coated tooth surface. CONCLUSION: These results suggest that the monoclonal antibodies could be used as vaccine material against the periodontal diseases through passive immunization.
Antibodies ; Antibodies, Monoclonal ; Ascites ; Bacteria ; Blotting, Western ; Clone Cells ; Durapatite ; Epitopes ; Hybridomas ; Immunization ; Immunization, Passive ; Periodontal Diseases ; Porphyromonas ; Porphyromonas gingivalis ; Tooth

A number of brain imaging and human lesion studies suggest an involvement of the cerebellum in various cognitive functions. A 60-year-old woman developed dizziness due to cerebellar infarction. One month later, she developed cognitive decline, delusion, irritability, impulsive and violent behavior. Cognitive and behavioral symptom onset, neuroimaging findings and neuropsychological test led us to the diagnosis of cerebellar cognitive affective syndrome.
Arteries ; Behavioral Symptoms ; Cerebellum ; Delusions ; Dizziness ; Female ; Humans ; Infarction ; Middle Aged ; Neuroimaging ; Neuropsychological Tests

Purpose: The concept of hidden hearing loss can explain the discrepancy between a listener’s perception of hearing ability and hearing evaluation using pure tone audiograms. This study investigated the utility of the suprathreshold auditory brainstem response (ABR) for the evaluation of hidden hearing loss in noise-exposed ear with normal audiograms. Materials and Methods: A total of 15 patients (24 ears) with normal auditory thresholds and normal distortion product otoacoustic emissions were included in a retrospective analysis of medical records of 80 patients presenting with histories of acute noise exposure. The control group included 12 subjects (24 ears) with normal audiograms and no history of noise exposure. Pure tone audiometry and suprathreshold ABR testing at 90 dB peSPL were performed. The amplitudes and latencies of ABR waves I and V were compared between the noise-exposed and control groups. Results: We found no significant difference in the wave I or V amplitude, or the wave I/V ratio, between the two groups. The latencies of ABR wave I, V, and I–V interpeak interval were compared, and no significant intergroup difference was observed. Conclusion The results suggest that either hidden hearing loss may not be significant in this cohort of patients with acute noise exposure history, or the possible damage by noise exposure is not reflected in the ABRs. Further studies are needed to inquire about the role of ABR in identification of hidden hearing loss.

Purpose: The concept of hidden hearing loss can explain the discrepancy between a listener’s perception of hearing ability and hearing evaluation using pure tone audiograms. This study investigated the utility of the suprathreshold auditory brainstem response (ABR) for the evaluation of hidden hearing loss in noise-exposed ear with normal audiograms. Materials and Methods: A total of 15 patients (24 ears) with normal auditory thresholds and normal distortion product otoacoustic emissions were included in a retrospective analysis of medical records of 80 patients presenting with histories of acute noise exposure. The control group included 12 subjects (24 ears) with normal audiograms and no history of noise exposure. Pure tone audiometry and suprathreshold ABR testing at 90 dB peSPL were performed. The amplitudes and latencies of ABR waves I and V were compared between the noise-exposed and control groups. Results: We found no significant difference in the wave I or V amplitude, or the wave I/V ratio, between the two groups. The latencies of ABR wave I, V, and I–V interpeak interval were compared, and no significant intergroup difference was observed. Conclusion The results suggest that either hidden hearing loss may not be significant in this cohort of patients with acute noise exposure history, or the possible damage by noise exposure is not reflected in the ABRs. Further studies are needed to inquire about the role of ABR in identification of hidden hearing loss.

Atopic dermatitis (AD) is a common inflammatory skin disorder mediated by inflammatory cells, such as macrophages and mast cells. Rifampicin is mainly used for the treatment of tuberculosis. Recently, it was reported that rifampicin has anti-inflammatory and immune-suppressive activities. In this study, we investigated the effect of rifampicin on atopic dermatitis in vivo and in vitro. AD was induced by treatment with 2, 4-dinitrochlorobenzene (DNCB) in NC/Nga mice. A subset of mice was then treated with rifampicin by oral administration. The severity score and scratching behavior were alleviated in the rifampicin-treated group. Serum immunoglobulin E (IgE) and interleukin-4 (IL-4) levels were also ameliorated in mice treated with rifampicin. We next examined whether rifampicin has anti-atopic activity via suppression of mast cell activation. Rifampicin suppressed the release of β-hexosaminidase and histamine from human mast cell (HMC)-1 cultures stimulated with compound 48/80. Treatment with rifampicin also inhibited secretion of inflammatory mediators, such tumor necrosis factor-α (TNF-α) and prostaglandin D₂ (PGD₂), in mast cells activated by compound 48/80. The mRNA expression of cyclooxygenase 2 (COX-2) was reduced in the cells treated with rifampicin in a concentration-dependent manner. These results suggest that rifampicin can be used to treat atopic dermatitis.
Administration, Oral ; Animals ; Cyclooxygenase 2 ; Dermatitis, Atopic ; Histamine ; Humans ; Immunoglobulin E ; Immunoglobulins ; In Vitro Techniques* ; Interleukin-4 ; Macrophages ; Mast Cells ; Mice ; Necrosis ; Rifampin* ; RNA, Messenger ; Skin ; Tuberculosis