The caudal subnucleus of the spinal trigeminal nucleus (medullary dorsal horn; MDH) receives direct inputs from small diameter primary afferent fibers that predominantly transmit nociceptive information in the orofacial region. Recent studies indicate that reactive oxygen species (ROS) is involved in persistent pain, primarily through spinal mechanisms. In this study, we aimed to investigate the role of xanthine/xanthine oxidase (X/XO) system, a known generator of superoxide anion (O₂(·−)), on membrane excitability in the rat MDH neurons. For this, we used patch clamp recording and confocal imaging. An application of X/XO (300 µM/30 mU) induced membrane depolarization and inward currents. When slices were pretreated with ROS scavengers, such as phenyl N-tert-butylnitrone (PBN), superoxide dismutase (SOD), and catalase, X/XO-induced responses decreased. Fluorescence intensity in the DCF-DA and DHE-loaded MDH cells increased on the application of X/XO. An anion channel blocker, 4,4-diisothiocyanatostilbene-2,2-disulfonic acid (DIDS), significantly decreased X/XO-induced depolarization. X/XO elicited an inward current associated with a linear current-voltage relationship that reversed near −40 mV. X/XO-induced depolarization reduced in the presence of La³⁺, a nonselective cation channel (NSCC) blocker, and by lowering the external sodium concentration, indicating that membrane depolarization and inward current are induced by influx of Na⁺ ions. In conclusion, X/XO-induced ROS modulate the membrane excitability of MDH neurons, which was related to the activation of NSCC.
Animals ; Catalase ; Facial Pain ; Fluorescence ; Ions ; Membranes ; Neurons* ; Oxidoreductases ; Posterior Horn Cells* ; Rats* ; Reactive Oxygen Species* ; Sodium ; Spinal Cord Dorsal Horn* ; Superoxide Dismutase ; Superoxides ; Trigeminal Nucleus, Spinal ; Xanthine Oxidase

Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionnaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The major results were as follows. First, physicians were more prevalent 35~44 group (38.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization, city (78.0%) in geographical location. Age group of 35-54 and specialist were more prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatient load of all physician were 77.1 persons on average. Age group of 35~44 had the most outpatient load (90.3 persons) among all age group, 6~10 years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factorsnumber of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.
Efficiency* ; General Practitioners ; Health Manpower ; Humans ; Male ; Outpatients ; Surveys and Questionnaires ; Specialization

In order to prepare the fundamental data for preventing the hazardous effects at toluene exposure in many kinds of industry, the authors determined the level of urinary hippuric acid on 592 toluene exposed women(exposed group) and 102 unexposed women(control group) in Pusan area, from April 1 to October 31, 1986. Hippuric acid was measured by high performance liquid chromatography. The results were summarized as follows; 1. The mean value of urinary hippuric acid concentration of the control group was 0.44+/-0.21g/l(0.11-0.89g/l). The distribution of urinary hippuric acid concentration of the control group was not fit to the normal distribution. 2. The mean value of urinary hippuric acid concentration of the exposed group was 1.56+/-0.95g/l(0.44-4.57g/l). The distribution of urinary hippuric acid concentration of control group was not fit to the normal distribution. 3. The urinary hippuric acid concentration by age group was not statistically significant in the control group, but in the exposed the urinary hippuric acid concentration was highest in women between 20-29 years old(1.71+/-0.95g/l) and was statistically significant(p<0.01). 4. The urinary hippuric acid concentration by duration of working hours was not statistically significant(p>0.1).
Busan ; Chromatography, Liquid ; Female ; Humans ; Toluene*

Skin burn injury from light cables is a rare complication of laparoscopic surgery. We report the case of a 57-year-old female who underwent laparoscopic-assisted right hemicolectomy under general anesthesia. During surgery, the anesthesiologist discovered that the tip of the light cable, with the light source powered on, penetrated the surgical drape and was positioned on the right forearm of the patient, where a bulla measuring 2.0× 2.5 cm in size and a second-degree burn were identified. All medical personnel participating in laparoscopic and arthroscopic procedures should always be aware that the light cable can cause burns to the patient. Additionally, after connecting the light cable to the scope, the light source should be activated. The light cable should not be placed around the patient or on the surgical drape while the light source is active. Immediately after completing the surgery, the power to the light source should be turned off, and the light cable should be placed in a safe place.

BACKGROUND: The loss of resistance (LOR) method is most commonly used to identify the epidural space. This method is thought to rely on the penetration of the ligamentum flavum. Unfortunately the exact morphology of the ligamentum flavum is variable at different vertebral levels. Especially, it has been pointed out that the lower cervical ligamentum flavum may be discontinuous in the midline in up to 50% of patients. Thus, the LOR method may be inaccurate to confirm the cervical epidural space. The aim of this study is to determine which method is the safest and most exact for confirming the cervical epidural space. METHODS: 100 adult, chronic renal failure patients who were undergoing an arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. During the cervical epidural puncture, we identified the cervical epidural space by subjectively feeling the resistance with using a finger just through the ligamentum flavum, and we also used the drip infusion method, the loss of resistance method using air, and the hanging drop method. By using 5 grades, we classified the extent of whether or not the techniques were effective. RESULTS: Using the drip infusion method, we identify the epidural space in all the patients as +/++ grade. The catheter insertion method was also successful in identifying those epidural spaces over a +/- grade. The pseudo LOR was over micro grade in 47 patients. CONCLUSIONS: The combined LOR/hanging drop with drip infusion method is useful for confirming the cervical epidural space.
Adult ; Anesthesia, Epidural ; Arm ; Catheters ; Epidural Space ; Fingers ; Humans ; Infusions, Intravenous ; Kidney Failure, Chronic ; Ligamentum Flavum ; Punctures ; Renal Dialysis ; Transplants

BACKGROUND AND OBJECTIVES: Nasal polyp (NP) and antrochoanal polyp (ACP) are soft tissue masses, featuring chronic inflammation and tissue remodeling. To elucidate the mechanism of tissue remodeling, we investigated the expressions of matrix metalloproteinase-2 (MMP-2) and MMP-9 in ACP and NP and compared them with normal inferior turbinate mucosa. SUBJECTS AND METHOD: Nasal samples, obtained from controls (n=10), from ACP (n=10) and from NP (n=13), were analysed by immunohistochemistry. MMP-2/-9 expression was identified in epithelial, endothelial, gland, inflammatory cells. We assessed MMP-2/-9 immunoreactivity of ACP and NP in comparison with the normal inferior turbinate. The number of immunostained inflammatory cells were determined. RESULTS: In ACP, compared with controls, the MMP-2 expression was increased in vessel endothelium, while the MMP-9 expression was increased in vessel endothelium and inflammatory cells. In NP, compared with controls, increased expression of MMP-9 was observed in gland and inflammatory cells. CONCLUSION: ACP showed increased expression of MMP-2/-9, while NP showed increased expression of MMP-9. It is concluded that MMP-2/-9 in ACP and MMP-9 in NP may play a role in tissue remodeling.
Endothelium ; Immunohistochemistry ; Inflammation ; Matrix Metalloproteinase 2 ; Mucous Membrane ; Nasal Polyps* ; Polyps* ; Turbinates

OBJECTIVE: This study was aimed to investigate the disease free interval and feasibility of FDG-PET for following up the patients with no evidence of cervical cancer after primary treatment. METHODS: From May, 1998 to February, 2003, 406 patients with no evidence of cervical cancer by FDG-PET were investigated retrospectively. They underwent primary treatment and FDG-PET between 3 to 16 months after treatment. All of them were monitored closely after FDG-PET scanning. RESULTS: Of the 406 patients with no evidence of cervical cancer by FDG-PET after treatment, recurrence was detected in 17 patients. The recurrence sites were lymph nodes (7), lung (6), liver (1), central lesion (1) and others (2). The Mean disease free interval (DFI) in patients with No evidence of disease (NED) was 27 months, DFI with recurrence was 35 months, and the mean DFI in all patients were 28 months (p=0.051). FIGO stage, initial tumor size, status of lymph node metastasis and cell type had no effect on the recurrence rate of NED patients by FDG-PET. Our study also shows high false positive rate and low sensitivity in the conventional imaging and tumor marker. CONCLUSION: The FDG-PET is proved to be a useful imaging study for following up cervical cancer patients after primary treatment. If there is no evidence of disease by the first FDG-PET after primary treatment, we can expect the average disease free interval to be about 28 months. And it is suggested that the patients should undergo the FDG-PET every one or two years to detect possible early recurrence.
Follow-Up Studies* ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Uterine Cervical Neoplasms

PURPOSE: This study set out to identify the association between the intraperitoneal CO₂ concentrations and postoperative pain by dividing the participants into a control group and 2 experimental groups receiving irrigation (1 L and 2 L), and directly measuring their intraperitoneal CO₂ concentrations with a CO₂ gas detector. METHODS: A total of 101 patients, American Society of Anesthesiologists physical status classification I and II patients aged 18–65 years were enrolled in the study. Group 1 did not receive irrigation with normal saline, while groups 2 and 3 were administered irrigation with 1 L and 2 L of normal saline, respectively, after laparoscopic cholecystectomy. Intraperitoneal CO₂ concentrations were measured with a CO₂ gas detector through the port, and postoperative pain was assessed on a visual analogue scale at 6, 12, and 24 hours after surgery. RESULTS: The intraperitoneal CO₂ concentrations were 1,016.0 ± 960.3 ppm in group 1, 524.5 ± 383.2 ppm in group 2, and 362.2 ± 293.6 ppm in group 3, showing significantly lower concentrations in groups 2 and 3. Postoperative pain was significantly lower in group 3 at 6 hours after surgery, and in groups 2 and 3 at 12 hours after the surgery. However, there was no significant difference between the 3 groups in postoperative pain 24 hours after the surgery. CONCLUSION: This study found a causal relationship between the amount of normal saline used for irrigation and the intraperitoneal CO₂ concentrations in that irrigation with normal saline reduces pain on the day of the surgery.
Cholecystectomy, Laparoscopic* ; Classification ; Humans ; Pain, Postoperative* ; Saline Waters

Cytomegalovirus (CMV) pneumonia is one of the major causes of morbidity and mortality in immunocompromised patients such as transplant recipients. But CMV pneumonia is unusually reported among adults with leukemia who have not undergone transplantation. Because it is a cause of life-threatening pneumonia in adults with leukemia receiving potent immunosuppressive therapies, CMV has emerged as an important pathogen. We report a case of CMV pneumonia and invasive pulmonary aspergillosis in a patient with acute leukemia who have not undergone transplantation. A 31-year-old man with acute myelogenous leukemia developed high fever on day 9 of second consolidation chemotherapy. Six days later, chest radiography showed patchy consolidation with central cavity on right upper lung. Considering fungal pneumonia, amphoterin B was started, then fever was subsided. Chest CT showed necrotizing pneumonia with cavity formation in posterior segment of right upper lobe. Because of several episodes of hemoptysis, lobectomy was performed. Grossly, the area of focal necrosis with central cavity formation and multiple small interstitial nodules were observed. In the area of interstitial nodules, giant cells with intranuclear inclusion and perinuclear halo were found. In the area of focal necrosis, fungal hyphae with acute branching and septation were found. Ganciclovir and immunoglobulin were administered for CMV pneumonia. On day 62 of the chemotherapy, the patient discharged with improved symptoms. After several weeks, unrelated HLA-matched allogeneic stem cell transplantation was performed. On day 14 of transplantation, the patient died due to septic shock of unknown cause.
Adult ; Aspergillosis ; Consolidation Chemotherapy ; Cytomegalovirus* ; Drug Therapy* ; Fever ; Ganciclovir ; Giant Cells ; Hemoptysis ; HMGB1 Protein ; Humans* ; Hyphae ; Immunocompromised Host ; Immunoglobulins ; Intranuclear Inclusion Bodies ; Invasive Pulmonary Aspergillosis ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Mortality ; Necrosis ; Pneumonia* ; Pulmonary Aspergillosis* ; Radiography ; Shock, Septic ; Stem Cell Transplantation ; Thorax ; Tomography, X-Ray Computed ; Transplantation