No abstract available.
Animals ; Cell Adhesion* ; Female ; Leiomyoma* ; Mice ; Myometrium* ; Neural Cell Adhesion Molecules*

There is still controversy over applying enflurane anesthesia to cesarean sections in obstetrics. Clinical experience has suggested that the uterine depressant effects of halothane and enflurane are dose-dependent. In low concentrationss both agents have been used successfully as anesthetics for Cesarean section, whereas in higher concentrations, both have been employed when indicated to produce ceseation of uterine activity. The purpose of this clinical research is to investigate the impact of enflurane in low concentrations on neonates and parturients during Cesarean section. Sixty parturients for elective Cesarean section were divided into two groups. One group of parturients(l) were anesthetised with N2O-O2-thiopental-Thalamonal.The other group(ll) were anesthetised as the first group, except enflurane in low concentration added to the inhalation agent. Then group(l) was compared with the group(ll). Common aspects between the two groups are as follows: 1) No difference in blood gas status of maternal artery, umbilical vein or umbilical artery was identified. 2) Mean Apgar scores were above 8 point both 1 minute and 5 minutes after birth. 3) Mean neonatal neurological and adaptive capacity scores(NACS) were high both 15 minutes and 2 hours after birth. 4) Blood loss and administration of oxytocia during wurgery were almost the same. The results suggest that enflurane in low concentrations does not cause significant perinatal depression, and that fetoplacental exchange is well maintained during anesthesis. The anesthetic was well tolerated by the mothers and there were no instances of factual recall, no cardiac arrhythmia was observed, no significant hypotension was encountered and blood loss was not excessive. In conclusion, it is thought to be safe to add enflurane in low concentrations to general anesthesia in Cesarean section.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Cesarean Section* ; Depression ; Enflurane* ; Female ; Halothane ; Humans ; Hypotension ; Infant, Newborn* ; Inhalation ; Mothers ; Obstetrics ; Parturition ; Pregnancy ; Umbilical Arteries ; Veins

Cytomegalovirus (CMV) is potentially the most important pathogen affecting organ transplant recipients. The overall incidence of documented CMV infection after liver transplantation ranges from 23% to 85%. Approximately 15~40% of infected patients develop CMV disease such as pneumonia, hepatitis, gastrointestinal involvement, central nervous system involvement, retinitis, or nephritis. The gastrointestinal tract is one of the least common sites of CMV disease and usually presents as fever, diarrhea, and abdominal pain. We report a case of a 45-year-old man with end-stage liver disease who developed CMV colitis 6 weeks after deceased donor whole liver transplantation with a review of the relevant literature.
Abdominal Pain ; Central Nervous System ; Colitis* ; Cytomegalovirus* ; Diarrhea ; Fever ; Gastrointestinal Tract ; Hepatitis ; Humans ; Incidence ; Liver Diseases ; Liver Transplantation* ; Liver* ; Middle Aged ; Nephritis ; Pneumonia ; Retinitis ; Tissue Donors ; Transplants

BACKGROUND: High glucose in peritoneal dialysis solution has been implicated in the pathogenesis of peritoneal fibrosis. Macrophages in peritoneal cavity seem to participate in the process of peritoneal fibrosis through the production of various cytokines and growth factors. Monocyte chemoattractant protein-1(MCP-1) plays a key role in the recruitment of monocytes toward the peritoneal cavity. Vascular cell adhesion molecule-1(VCAM-1) is assumed to be important in the transmigration of monocytes. MCP-1 and VCAM-1 can be induced by various cytokines and growth factors in human peritoneal mesothelial cells(HPMC). However, effect of high glucose on the expression of MCP-1 and VCAM-1 in HPMC has not been known well. METHODS: Cultured HPMC were conditioned with glucose(5-100mM) or mannitol for varying periods up to 7 days. Cell proliferation and mRNA expression of MCP-1 and VCAM-1 were assessed by MTT assay and Northern blot analysis respectively. MCP-1 protein was measured using ELISA. Chemotactic activity of high glucose-conditioned culture supernant were evaluated by chemotactic assay. Effect of protein tyrosine kinase(PTK) inhibitor on the high glucose-induced MCP-1 mRNA expression was examined. RESULTS: Glucose inhibited the cell proliferation in a time and dose dependent manner. Northern blot analysis showed that high glucose increased the MCP-1 mRNA expression in a time(2-7days) and dose(15-100mM) dependent manner, but not VCAM-1 mRNA expression. MCP-1 protein in cell culture supernant was also increased. Equivalent osmotic concentration of mannitol had no significant effect. High glucose-conditioned supernant had an increased chemotactic activity for monocyte, which was neutralized by specific anti-MCP-1 antibody. PTK inhibitors such as genistein and herbimycin A suppressed the high glucose-induced MCP-1 mRNA expression in a dose dependent manner. CONCLUSION: High glucose induced MCP-1 expression in HPMC partly via pathways involving PTK.
Blotting, Northern ; Cell Adhesion ; Cell Culture Techniques ; Cell Proliferation ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Genistein ; Glucose* ; Humans* ; Intercellular Signaling Peptides and Proteins ; Macrophages ; Mannitol ; Monocytes ; Peritoneal Cavity ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Protein-Tyrosine Kinases ; RNA, Messenger ; Tyrosine ; Vascular Cell Adhesion Molecule-1*

OBJECTIVES: We aimed to evaluate the efficacy of biofeedback-assisted autogenic training for chronic tension-type headache, and to determine the relationship among the changes in electromyography (EMG) activity, headache activity, and mood states according to the psychophysiological treatment. METHODS: Chronic tension-type headache patients aged from 20 to 40 years (n=35) were randomized to the treatment group receiving biofeedback-assisted autogenic training (8 sessions) or the monitoring-only control group. EMG activities, headache index, and various psychological variables were examined. RESULTS: We found greater treatment response rate (> or =50% reduction in headache index) in patients with biofeedbackassisted autogenic training than in the monitoring group (61% vs. 18%; chi-square=6.882, df=1, p=0.01). There were no significant changes in the mean values of the pretreatment EMG activities across the sessions in either group (all p's>0.1). Mood states including anxiety and depression improved over time in the both groups, with the improvements being more prominent in the treatment group. Moreover, the reduction in depression level predicted treatment outcome in terms of headache index (95% confidence interval: 0.272-0.966, p=0.039). CONCLUSION: These results show that biofeedback-assisted autogenic training is effective for the treatment of chronic tension-type headache in a Korean population. Changes in mood states may be closely associated with the clinical outcome in the treatment of chronic tension-type headache using biofeedback-assisted autogenic training.
Aged ; Anxiety ; Autogenic Training ; Biofeedback, Psychology ; Depression ; Electromyography ; Headache ; Humans ; Tension-Type Headache ; Treatment Outcome

OBJECTIVE: There have been much effort to find reliable indicators predicting treatment response in panic disorder. This study aimed to find the effect of pharmacotherapy on biofeedback measurement variables in panic disorder patients. METHOD: We recruited 38 panic disorder patients (M:25, F:13) in the Samsung Medical Center, who were diagnosed by the ADIS-IV (Anxiety Disorder Interview Schedule-IV), and 33 normal control subjects (M:21 F:12). Panic patients were treated with paroxetine for 3 months. All subjects were assessed on forearm and frontal electromyography (EMG), electrodermal response (EDR), and skin temperature in baseline, stress, recovery phases using the Procomp & Biograph biofeedback instrument. Psychological measures such as Hamilton anxiety rating scale (HAM-A), Hamilton depression rating scale (HAM-D), Beck depression inventory (BDI), Spielberger state-trait anxiety inventory (STAI-S, STAI-T), and Anxiety sensitivity index (ASI) were also assessed. All measurements were performed at the beginning of the study and after 3 months of paroxetine treatment. RESULT: Panic patients had significantly higher scores on psychological measures such as HAM-A, HAM-D, BDI, STAI-S, STAI-T, and ASI (all p values<0.001) before treatment. After 3months of treatment, panic patients showed significant improvement on baseline EDR (z=-2.824, p=0.005), stress EDR (z=-2.691, p=0.007), and recovery EDR (z=-3.416, p=0.001). They also showed significant improvement on HAM-A, HAM-D, BDI, STAI-S, STAI-T, and ASI (all p values<0.001) after treatment. CONCLUSION: Electrodermal response, one of the biofeedback measurement variables, was suggested to be the possible indicator predicting treatment response in panic disorder.
Anxiety ; Biofeedback, Psychology* ; Depression ; Drug Therapy* ; Electromyography ; Forearm ; Galvanic Skin Response ; Humans ; Panic Disorder* ; Panic* ; Paroxetine* ; Skin Temperature

Malignant epithelial neoplasm usually occurs in postmenopausal women, with less than 10% of cases occurring in women under the age of 20. In patients below this age, the majority of ovarian tumors are of germ cell origin and malignant ovarian epithelial tumors are uncommon. We report US & CT imaging in a case of mucinous cystadenocarcinoma in a 17-year-old nullipara who complained of amenorrhea for 45 days and a palpable mass.
Adolescent* ; Amenorrhea ; Carcinoma ; Cystadenocarcinoma, Mucinous* ; Female* ; Germ Cells ; Humans ; Mucins*

Esmolol is a cardioselective beta-blocker with a very rapid onset of action and a short half-life. Labetalol is a combined alpha- and beta-adrenoceptor blocking agent. It is a nonselective antagonist at beta-adrenoceptors and a competitive antagonist of postsynaptic alpha 1-adrenoceptors. A 51 year old female patient was transferred to the operating room for performing spinal fusion under general anesthesia. She had no operation and medication history. The initial heart rate was 150 beats/min. Despite administering several bolus injections of esmolol, the heart rate was not decreased to under 130 beats/min. But the heart rate was decreased to 100 beats/min after the administration of labetalol 5 mg and this rate was maintained without an additional injection. The vital signs were stable until the operation was finished and the patient recovered uneventfully in the recovery room. The postoperative laboratory findings revealed that she had hyperthyroidism. We report here on an anesthetic experience of effective labetalol treatment for esmolol-resistant tachycardia in a patient who was under general anesthesia.
Anesthesia, General ; Female ; Half-Life ; Heart Rate ; Humans ; Hyperthyroidism ; Labetalol ; Operating Rooms ; Propanolamines ; Recovery Room ; Spinal Fusion ; Tachycardia ; Vital Signs

OBJECTIVE: To determine whether triple arterial phase acquisition via a combination of Contrast Enhanced Time Robust Angiography, keyhole, temporal viewsharing and parallel imaging can improve arterial phase acquisition with higher spatial resolution than single arterial phase gadoxetic-acid enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: Informed consent was waived for this retrospective study by our Institutional Review Board. In 752 consecutive patients who underwent gadoxetic acid-enhanced liver MRI, either single (n = 587) or triple (n = 165) arterial phases was obtained in a single breath-hold under MR fluoroscopy guidance. Arterial phase timing was assessed, and the degree of motion was rated on a four-point scale. The percentage of patients achieving the late arterial phase without significant motion was compared between the two methods using the χ2 test. RESULTS: The late arterial phase was captured at least once in 96.4% (159/165) of the triple arterial phase group and in 84.2% (494/587) of the single arterial phase group (p < 0.001). Significant motion artifacts (score ≤ 2) were observed in 13.3% (22/165), 1.2% (2/165), 4.8% (8/165) on 1st, 2nd, and 3rd scans of triple arterial phase acquisitions and 6.0% (35/587) of single phase acquisitions. Thus, the late arterial phase without significant motion artifacts was captured in 96.4% (159/165) of the triple arterial phase group and in 79.9% (469/587) of the single arterial phase group (p < 0.001). CONCLUSION: Triple arterial phase imaging may reliably provide adequate arterial phase imaging for gadoxetic acid-enhanced liver MRI.
Angiography* ; Artifacts ; Ethics Committees, Research ; Fluoroscopy ; Humans ; Informed Consent ; Liver ; Magnetic Resonance Imaging* ; Retrospective Studies

The iliopsoas bursa is a normal anatomical structure that lies deep to the iliopsoas tendon in the region of the hip joint. Iliopsoas bursitis is a relatively rare condition, so it is often overlooked as a cause of signs and symptoms involving the inguinal area and lower extremity. The clinical manifestation related to iliopsoas bursitis can vary due to compression of the adjacent structures such as the common and superficial femoral vessels, nerve, and bladder. We report here on rare cases of iliopsoas bursitis with compression of the superficial femoral artery and common femoral vein.
Bursitis* ; Femoral Artery ; Femoral Vein ; Hip Joint ; Lower Extremity ; Tendons ; Urinary Bladder