This study was designed to investigate the effect of diazepam on the spontaneous contraction and oxytocin induced contraction of the isolated rat uterus. Female rat (Sprague-Dawley) pretreated with oophorectomy and 4 days administration of estrogen. Weighing about 200 g, was sacrificed by cervical dislocation, and the uteruses were isolated. A longitudinal muscle strip was placed in temperature controlled (37℃) muscle chamber containing Locke's solution and myographied isometrically. Diazepam inhibited the spontaneous contraction and oxytocin induced contraction of the isolated rat uterus in a concentration-dependent manner. GABA, muscimol, a GABA A receptor agonist, bicuculline, a competitive GABA A receptor antagonist, picrotoxin, a non competitive GABA A receptor antagonist, baclofen, a GABA B receptor agonist, and delta-aminovaleric acid, a GABA B receptor antagonist, did not affect on the spontaneous and oxytocin induced contraction of the isolated rat uterus. The inhibitory actions of diazepam on the spontaneous and oxytocin induced contraction were not affected by all the GABA receptor agonists and antagonists, but exceptionally potentiated by bicuculline. This potentiation-effect by bicuculline was not antagonized by muscumol. In normal calcium PSS, addition of calcium restored the spontaneous contraction preinhibited by diazepam and recovered the contractile of oxtrocin preinhibited by diazepam. A23187, a calcium inophore, enhanced the restoration of both the spontaneous and oxytocin induced contraction by addition of calcium. In calcium-free PSS, diazepam suppressed the restoration of spontaneous motility by addition of calcium but allowed the recovery of spontaneous motility to a considerable extent. Diazepam could not inhibit some development of contractility by oxytocin in calcium-free PSS, but inhibited the increase in contractility by subsequent addition of calcium. These results suggest that the inhibitory action of diazepam on the rat uterine motility does not depend on or related to GABA receptors and that diazepam inhibits the extracellular calcium influx to suppress the spontaneous and oxytocin induced contractilities.
Animals ; Baclofen ; Bicuculline ; Calcimycin ; Calcium ; Diazepam* ; Dislocations ; Estrogens ; Female ; GABA Agonists ; GABA-A Receptor Agonists ; GABA-A Receptor Antagonists ; GABA-B Receptor Agonists ; GABA-B Receptor Antagonists ; gamma-Aminobutyric Acid ; Humans ; Muscimol ; Ovariectomy ; Oxytocin* ; Picrotoxin ; Rats* ; Receptors, GABA ; Uterus*

Purpose: We evaluated the clinical manifestations and risk factors of fungal keratitis after penetrating keratoplasty (PKP). Methods: Eighteen patients who experienced fungal keratitis after PKP between January 2005 and January 2020 were included in this retrospective study. Clinical characteristics including sex, age, underlying disease, indication for PKP, symptom duration, visual acuity, graft state before infection, suture-related problems, size of epithelial defect, depth of infiltration, presence of hypopyon, use of eyedrops before infection, and the results of microbiological tests were analyzed. Patients were classified into the treatment success or failure group, and the risk factors were evaluated accordingly. Results: The mean age at diagnosis was 63.94 ± 15.53 years. Fungal infection occurred a mean of 55.31 ± 44.72 months after PKP. The mean symptom duration was 10.33 ± 7.36 days. Of the 18 patients, 5 (27.8%) and 13 (72.2%) were in the treatment success and failure groups, respectively. Of the treatment failure group, seven patients (38.9%) underwent surgical management. The graft state before infection, symptom duration, and size of epithelial defects had significant correlations with treatment failure (all p < 0.05). Multivariate analysis identified graft state (p = 0.046) as a significant risk factor for treatment failure. Conclusions Graft state before infection, symptom duration, and size of epithelial defects were associated with the prognosis of fungal keratitis after PKP. Graft state before infection was a significant risk factor for treatment failure.

Purpose: To evaluate the clinical efficacy of preservative-free 0.15% sodium hyaluronate eye drops on the ocular surface after upper eyelid surgery. Methods: This study included 43 patients who underwent upper eyelid surgery between December 2018 and May 2019. Patients were randomly assigned to group A (those treated with preservative-free 0.15% sodium hyaluronate eye drops) and group B (the control group). Ocular surface disease index score (OSDI), tear break up time (TBUT), Schirmer’s test, corneal staining score (CSS), meibomian gland (MG) quality, MG expressibility, and meiboscore were evaluated before surgery and at 1 week, 1 month, and 2 months after surgery. Results: In group A, OSDI and TBUT showed a significant increase at 1 week after surgery compared with baseline values (all p < 0.05). In group B, OSDI, TBUT, and CSS were significantly higher at 1 week and 1 month after surgery (all p < 0.05), whereas there were no significant changes at 2 months after surgery compared with baseline values. At 1 month after surgery, OSDI (p = 0.03) and CSS (p < 0.01) showed significant changes between group A and group B; however, there was no significant change in the TBUT. There were no significant within-group differences in Schirmer’s test values, MG quality, MG expressibility, or meiboscore, and there were no significant between-group differences over time. Conclusions Preservative-free 0.15% sodium hyaluronate eye drops were shown to be an effective treatment for early dry-eye symptoms and ocular surface damage after upper eyelid surgery.

Purpose: We evaluated the clinical manifestations and risk factors of fungal keratitis after penetrating keratoplasty (PKP). Methods: Eighteen patients who experienced fungal keratitis after PKP between January 2005 and January 2020 were included in this retrospective study. Clinical characteristics including sex, age, underlying disease, indication for PKP, symptom duration, visual acuity, graft state before infection, suture-related problems, size of epithelial defect, depth of infiltration, presence of hypopyon, use of eyedrops before infection, and the results of microbiological tests were analyzed. Patients were classified into the treatment success or failure group, and the risk factors were evaluated accordingly. Results: The mean age at diagnosis was 63.94 ± 15.53 years. Fungal infection occurred a mean of 55.31 ± 44.72 months after PKP. The mean symptom duration was 10.33 ± 7.36 days. Of the 18 patients, 5 (27.8%) and 13 (72.2%) were in the treatment success and failure groups, respectively. Of the treatment failure group, seven patients (38.9%) underwent surgical management. The graft state before infection, symptom duration, and size of epithelial defects had significant correlations with treatment failure (all p < 0.05). Multivariate analysis identified graft state (p = 0.046) as a significant risk factor for treatment failure. Conclusions Graft state before infection, symptom duration, and size of epithelial defects were associated with the prognosis of fungal keratitis after PKP. Graft state before infection was a significant risk factor for treatment failure.

Purpose: To evaluate the clinical efficacy of preservative-free 0.15% sodium hyaluronate eye drops on the ocular surface after upper eyelid surgery. Methods: This study included 43 patients who underwent upper eyelid surgery between December 2018 and May 2019. Patients were randomly assigned to group A (those treated with preservative-free 0.15% sodium hyaluronate eye drops) and group B (the control group). Ocular surface disease index score (OSDI), tear break up time (TBUT), Schirmer’s test, corneal staining score (CSS), meibomian gland (MG) quality, MG expressibility, and meiboscore were evaluated before surgery and at 1 week, 1 month, and 2 months after surgery. Results: In group A, OSDI and TBUT showed a significant increase at 1 week after surgery compared with baseline values (all p < 0.05). In group B, OSDI, TBUT, and CSS were significantly higher at 1 week and 1 month after surgery (all p < 0.05), whereas there were no significant changes at 2 months after surgery compared with baseline values. At 1 month after surgery, OSDI (p = 0.03) and CSS (p < 0.01) showed significant changes between group A and group B; however, there was no significant change in the TBUT. There were no significant within-group differences in Schirmer’s test values, MG quality, MG expressibility, or meiboscore, and there were no significant between-group differences over time. Conclusions Preservative-free 0.15% sodium hyaluronate eye drops were shown to be an effective treatment for early dry-eye symptoms and ocular surface damage after upper eyelid surgery.

BACKGROUND: To diagnose paroxysmal nocturnal hemoglobinuria (PNH), the conventional methods such as sucrose lysis test and Ham's test have been used. But their sensitivities were so low that it has been difficult to confirm the diagnosis of PNH. And it has been reported that during the follow up of aplastic anemia patients, PNH clones were developed. So, we investigated the usefulness of newly introduced CD55 and CD59 tests for the diagnosis of PNH compared with conventional tests and the significance of previous history of aplastic anemia in PNH patients. METHODS: We performed the flow cytometric measurements with indirect immunofluorescence method using monoclonal antibodies to each CD55 or CD59 on the surface of red cells or neutrophils. Among fifty one patients who were requested of CD55 and CD59 tests, we reviewed the medical records of ten patients who showed the defective expression of CD55 and/or CD59 expression. RESULTS: Of ten patients who showed the defective expression of CD55 and/or CD59 expression on red cells or neutrophils, six patients were requested of sucrose lysis test also and seven patients Ham's test. Only three of six (50%) showed positive results in sucrose lysis test and two of seven (29%) in Ham's test. One showed detective CD59 expression on only neutrophils. Four (40%) had the history of aplastic anemia and two (20%) were diagnosed as aplastic anemia and PNH at the same time. Another one had the refractory anemia of excess blasts and another acute mixed lineage leukemia at the time of CD55 and CD59 tests. Two were diagnosed as PNH in the course of cytopenia workup and had no previous history of hematologic diseases. CONCLUSION: CD55 and CD59 tests are considered to be the most useful and specific tests to diagnose PNH. During the follow up of patients with aplastic anemia, CD55 and CD59 tests are valuable to detect the development of complicated PNH clones.
Anemia, Aplastic ; Anemia, Refractory ; Antibodies, Monoclonal ; Clone Cells ; Diagnosis ; Diagnostic Tests, Routine* ; Fluorescent Antibody Technique, Indirect ; Follow-Up Studies ; Hematologic Diseases ; Hemoglobinuria, Paroxysmal* ; Humans ; Leukemia ; Medical Records ; Neutrophils ; Sucrose

Renin-Angiotensin system (RAS) has been suggested as one of important factors in stress-related responses, and also suggested to be a pro-oxidant in mammals. Studies about antioxidant activity changes in brain by systemic administration of angiotensin II (Ang II) may be valuable data in the clarification of pathogenesis and development of treatment modalities for the psychologic stress-induced somatic disease, such as stress-induced hypertension. We examined, therefore, antioxidant defense changes in the brain induced by Ang II. Antioxidant enzyme activities including superoxide dismutase (SOD), contents of glutathione (GSH), and lipoperoxidation (LPO) were measured in the dissected specimens of the brain regions after subcutaneous injection of human Ang II. In this study, peripheral administration of Ang II decreased LPO in the cerebral cortex, hippocampus, striatum, hypothalamus of Sprague-Dawley rats. Ang II increased activities of SOD, glutathione peroxidase, and glutathione reductase in the hippocampus and striatum. Borderline-hypertensive rats (BHR), a well-known animal model for stress-induced hypertension, showed some differences in the Ang II-induced antioxidant activity changes, comparing with SD rats. In the BHR, peripheral administration of Ang II significantly decreased the activities of antioxidant enzymes and contents of GSH, increased LPO contents in the various regions of brain. These results suggested that oxidative stress on the brain due to Ang II may be greater in the BHR than SDs, and RAS may be one of important pathophysiologic factors for stress-induced hypertension in BHR.
Angiotensin II ; Animals ; Brain* ; Cerebral Cortex ; Glutathione ; Glutathione Peroxidase ; Glutathione Reductase ; Hippocampus ; Humans ; Hypertension ; Hypothalamus ; Injections, Subcutaneous ; Mammals ; Models, Animal ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Renin-Angiotensin System ; Superoxide Dismutase

Coronary artery fistula (CAF) is a rare form of congenital anomalies of the coronary arteries, and this is usually discovered by chance during coronary angiography. However, this type of fistula can cause important coronary morbidity and mortality leading to angina, syncope, congestive heart failure, myocardial infarction and sudden death. Bilateral CAFs are even rarer, and especially when combined with valvular heart disease. The coincidence of CAF with aortic regurgitation is relatively rare and this might sometimes cause myocardial ischemia. We present here a case of bilateral coronary-pulmonary artery fistulas that arose from the first diagonal branch of the left anterior descending artery and the conal branch of the right coronary artery combined with severe aortic regurgitation, and this all caused myocardial ischemia.
Aortic Valve Insufficiency ; Arteries ; Arteriovenous Fistula ; Coronary Angiography ; Coronary Vessels ; Death, Sudden ; Fistula ; Heart Failure ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Pulmonary Artery ; Syncope

Background: Plasma cell myeloma (PCM) is caused by immune dysregulation. We evaluated the expression of immune checkpoint programmed cell death protein-1 (PD-1) on T cell subsets in PCM patients according to disease course and cytogenetic abnormalities.This study aimed to find a target group suitable for therapeutic use of PD-1 blockade in PCM. Methods: A total of 188 bone marrow (BM) samples from 166 PCM patients and 32 controls were prospectively collected between May 2016 and May 2017. PD-1 expression on BM T cell subsets was measured using flow cytometry. Results: At diagnosis, the median PD-1 expression on CD4+ T cells was 24.6%, which did not significantly differ from that in controls. After stem cell transplantation, PD-1 expression on CD4+ T cells was higher than that at diagnosis (P < 0.001), regardless of residual disease. PD-1 expression on CD4+ T cells in patients with residual disease after chemotherapy was significantly higher than that at diagnosis (P = 0.001) and after complete remission following chemotherapy (P = 0.044). PD-1 expression on CD8+ T cells was higher in PCM patients with cytogenetic abnormalities, including monosomy 13, 1q gain, complex karyotype, and hypodiploidy. Conclusions PD-1 blockade might have therapeutic potential in refractory PCM patients after chemotherapy, especially in those with high- or intermediate-risk cytogenetic abnormalities.

Nonspecific interstitial pneumonia (NSIP) was first described as a new category of idiopathic interstitial pneumonia in 1994. This is a disease with a more insidious onset and has a chronic course. The histological findings are unusual for other idiopathic interstitial pneumonia cases (usual interstitial pneumonia, diffuse interstitial pneumonia, and acute interstitial pneumonia). In contrast to NSIP, acute interstitial pneumonia (AIP) has an acute onset and a fulminant course with the rapid development of respiratory failure. A pathological examination demonstrated characteristic diffuse interstitial fibrosis, hyaline membranes, thrombi, and architectural derangement. Here we report a 48-year-old woman who was diagnosed pathologically NSIP, but with a rapid progressive course similar to AIP.
Female ; Fibrosis ; Humans ; Hyalin ; Idiopathic Interstitial Pneumonias ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Respiratory Insufficiency