No abstract available.
Animals ; Brain* ; Pineal Gland* ; Rats*

Soft-tissue sarcomas account for 1% of all solid tumors. Of these, less than 15% will occur in the retroperitoneum. Late diagnosis and large tumor size make retroperitoneal sarcomas difficult to resect. Resection with wide margins in all directions is rarely possible owing to proximity to vital structures. Radiation therapy is limited in dosage and, as with chemotherapy, has only been successful in a limited number of cases. These problems result in a poor prognosis. A series of patients with retroperitoneal sarcoma was reviewed with a focus on issues of surgical management and prognostic factors. A retrospective analysis of 12 patients with retroperitoneal sarcomas who had undergone operations at the Department of Surgery, Inje University Paik Hospital, Seoul, from 1980 through 1996 was performed. The mean age of the 10 adult patients was 51 years; the male-to-female ratio was 2:1. Eighty-three percent of the patients presented with an abdominal mass. The mean diameter of the tumors was 18.3 cm. Leimyosarcomas(33%) and liposarcomas(25%) comprised the majority of the histologic types. The tumor grades were I, II, and III in 3 cases each. Resection of the tumor was possible in 75%(9/12) of the cases, although 17% of the resections were incomplete. Resection of adjacent organs was required in 66% of the cases. The resectability rose from 60% in 80s to 86% in 90s, with no statistical significance, possibly due to the small number of cases in this series. There was no postoperative morbidity or mortality. Actuarial 1-, 3-, and 5-year survival rates after resection were 75%, 60%, and 30%, respectively. Four of the 7(57%) patients who underwent complete resections had recurrence 3 to 33 months after surgery; this was notable for grade II or III tumors only. Two patients with grade I tumors are alive 65 and 102 months respectively after complete resection and show no evidence of the disease. One patient who underwent an incomplete resection of the tumor died 50 months after the operation. Only the tumor grade was a significant prognostic factor(p=0.0207). In conclusion, a wide en-bloc resection of a retroperitoneal sarcoma with a clear margin in all directions is a prerequisite for long-term survival. Aggressive follow-up for the first 3 years after a complete resection of a high-grade tumor is justified.
Adult ; Delayed Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Mortality ; Prognosis ; Recurrence ; Retrospective Studies ; Sarcoma* ; Seoul ; Survival Rate

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Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs.
Acetylcholine ; Anesthesia ; Anesthesia, Obstetrical ; Anesthetics ; Cholinesterases ; Diffusion ; Drug Interactions ; Emergencies ; Humans ; Metabolism ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Neuromuscular Junction ; Neuromuscular Monitoring ; Pharmacokinetics ; Plasma ; Receptors, Nicotinic ; Receptors, Presynaptic ; Respiration

Urotensin II (UII) is a mitogenic and hypertrophic agent that can induce the proliferation of vascular cells. UII inhibition has been considered as beneficial strategy for atherosclerosis and restenosis. However, currently there is no therapeutics clinically available for atherosclerosis or restenosis. In this study, we evaluated the effects of a newly synthesized UII receptor (UT) antagonist, KR-36996, on the proliferation of SMCs in vitro and neointima formation in vivo in comparison with GSK-1440115, a known potent UT antagonist. In primary human aortic SMCs (HASMCs), UII (50 nM) induced proliferation was significantly inhibited by KR-36996 at 1, 10, and 100 nM which showed greater potency (IC₅₀: 3.5 nM) than GSK-1440115 (IC₅₀: 82.3 nM). UII-induced proliferation of HASMC cells was inhibited by U0126, an ERK1/2 inhibitor, but not by SP600125 (inhibitor of JNK) or SB202190 (inhibitor of p38 MAPK). UII increased the phosphorylation level of ERK1/2. Such increase was significantly inhibited by KR-36996. UII-induced proliferation was also inhibited by trolox, a scavenger for reactive oxygen species (ROS). UII-induced ROS generation was also decreased by KR-36996 treatment. In a carotid artery ligation mouse model, intimal thickening was dramatically suppressed by oral treatment with KR-36996 (30 mg/kg) which showed better efficacy than GSK-1440115. These results suggest that KR-36996 is a better candidate than GSK-1440115 in preventing vascular proliferation in the pathogenesis of atherosclerosis and restenosis.
Animals ; Atherosclerosis ; Carotid Arteries ; Humans ; In Vitro Techniques ; Ligation ; Mice ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Neointima ; Phosphorylation ; Reactive Oxygen Species

The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement. Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot. The end point of loading response was located at the 1.92+/-1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27+/-1.96 frame distal to the maximal pressure points of metatarsal head. Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.
Adult ; Foot* ; Gait* ; Head ; Humans ; Metatarsal Bones

The purposes of this study are to investigate the effect of the cold air application in the skin and intraarticular temperature changes and to observe the rebound temperature changes after cooling. We recorded the changes of the skin surface and intraarticular temperatures of knees during and after the cold air application. The intraarticular temperature was measured by a temperature probe inserted into the knee joint cavity and the skin temperature by the infrared system. Eighteen healthy subjects were examined. The knee was cooled by a 5-minutes application of CRAis (Kyung-won Century, Korea) machine and the intraarticular and skin temperatures of knees were measured at every 0.5-minute during and after the cold therpy, then at every minute for 5 minutes, and every 5-minute for the next 110 minutes. We also evaluated the variables that might affect the skin and intraarticular temperature changes. Results showed that the mean skin temperature dropped from 31.8oC to 10.5oC immediately after the cold air application for 5-minutes. The mean intraarticular temperature dropped from 33.9oC to 30.0oC after the cold air application for 5-minutes. Two hours after the initiation of treatment with cold air, the mean intraarticular temperatures did not recover to the baseline values(p<0.01). No significant correlations were found between the body mass index with the intraarticular and surface temperatures of knees. A highly significant correlation was noted between the baseline skin surface and intraarticular temperatures(p<0.01). In conclusion, the reduction of the joint temperature by the cold air application using CRAis machine can be a useful treatment method for the synovitis of knees.
Body Mass Index ; Cryotherapy ; Joints ; Knee Joint ; Knee* ; Skin Temperature* ; Skin* ; Synovitis

OBJECTIVE: Dopamine transporter is member of family of Na/Cl dependent neurotransmitter transporter, 12 transmembrane domain that has high substrate specificity, affinity. It is related with dopamine reuptake in presynaptic vesicle. DAT has a VNTR in its 3'-untranslated region(UTR), 3'-UTR VNTR polymorphism is related with modification of dopamine transmission. The association between with VNTR polymorphism and neuropsychiatric disorders such as alcohol dependence, and low activity ALDH has been studied but their relationship is unclear. We study about association of 3'-UTR VNTR of DAT gene and G2319A and alcohol dependence. METHOD: Group of Korea subjects were studied with alcohol dependence(n=49 male) compared to mentally healthy controls(n=53 male). The peripheral blood sample was acquired. and Polymerase Chain Reaction(PCR) amplification, Mspl procedure was done. RESULT: There was a significant difference between alcohol dependence group and normal control(genotype frequency p<0.05 allele frequency p<0.05) Allele A frequency and genotype(GG,GA) frequency was a significant difference between alcohol dependence group and normal control(p<0.05) CONCLUSION: Our study showed that genetic polymorphism of DAT1 G2319A had relation with alcohol dependence.
Alcoholism* ; Alleles ; Dopamine Plasma Membrane Transport Proteins ; Dopamine* ; Gene Frequency ; Humans ; Korea ; Neurotransmitter Agents ; Polymorphism, Genetic* ; Substrate Specificity

Purpose of this study is to evaluate the temperature lowering effects of the local cold air application on the skin surface and the muscle of different depth, and to observe whether the rebound rise of the temperature occurs after the cold air application. Subjects were prepared in a relaxed prone position. Cold air of CRAis(Kyung-won Century, Korea) was applied to the gluteal area of 20 healthy subjects for 5 minutes. The skin and intramuscular temperatures were measured by a thermogram(Infrared system, Sweden) and digital thermometers(Barnant company, USA). The temperatures were measured before and 30 seconds after the cold air application, and then every 5 minutes for the next 110 minutes. The few variables were considered that might affect the temperature changes. The thermometer-probes were inserted into the outer quadrant of the gluteal muscle below 5 cm from the iliac crest with the depth of 2 cm, 4 cm, and 6 cm respectively. ANOVA was used for the analysis of the data. The resting temperature of the skin surface was 32.6+/-1.2oC, and the lowest temperature was 12.9+/-3.3oC after 5 minutes of cold air application. The resting intramuscular temperatures with 2 cm, 4 cm, and 6 cm depth were 36.5+/-0.2oC, 36.9+/-0.2oC, and 37.1+/-0.2oC respectively (p<0.05). The lowest temperature in 2 cm, 4 cm, and 6 cm depth was 35.1+/-0.7oC, 36.2+/-0.4oC, and 36.9+/-0.3oC respectively(p<0.05). The mean duration to reach the lowest temperature was 20, 25, and 45 minutes respectively. The temperatures in the skin and the muscle with the depth of 2 cm, 4 cm, and 6 cm after 2 hours on cold air application were 32.2+/-1.1oC, 36.2+/-0.5oC, 36.6+/-0.3oC, and 36.9+/-0.3oC(p<0.05) respectively. The temperatures in the skin and the muscle were significantly lower after 2 hours than before the cold air application(p<0.05). The change of skin surface temperature was more rapid than that of the muscle and the deeper the muscle was the lesser the temperature change. In conclusion, the effect of cold air application for 5 minutes lasts up to 2 hours and the rebound rise of the temperature due to reactive vasodilatation seems not to occur in the gluteal muscle.
Cryotherapy ; Prone Position ; Skin Temperature ; Skin* ; Vasodilation