Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

BACKGROUND: Desflurane has some cardiovascular effects similar to isofl-urane. Desflurane has decreased systemic vascular resistance and demonstrated a myocardial depressant property in vivo animal stulies. The purpose of this study was to compare the myocardial and coronary effects of desflurane and isoflurane. METHODS: Cardiac effects were examinated in 24 rat hearts perfused with modified Krebs solution containing 1 MAC and 2 MAC desflurane or isoflurane for 10 min. at each concentration in a retrograde manner. Left ventricle pressure, heart rate and rate of change of ventricular pressure (dp/dt) were mea-sured, as were coronary flow and partial oxygen pressure. Oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated by each measurement. RESULTS: Heart rate, left ventricle pressure and dp/dt decreased each anesthetic similarly in a concentration-dependent manner. Heart rate decreased by 243.86 15.7 beats/min at 1 MAC and 219.14 15.8 beats/min at 2 MAC with isoflurane (control: 262.99 2.35 beats/min.) and by 250 23 beats/min at 1 MAC and 223.89 23 beats/min at 2MAC with desflurane (control 266.94 22.30 beats/min). Coronary flow increased by 13.72 0.99 ml/g/min at 1 MAC and 14.30 1.05 ml/g/min at 2 MAC with isoflurane (control :12.04 0.84 ml/g/min) and by 12.80 1.63 ml/g/min at 1 MAC and 13.71 1.46 ml/g/min at 2 MAC with desflurane (control 14.04 1.22 ml/g/min). Oxygen delivery increased proportionally with coronary flow. The increase in MVO2 was accompanied by a decrease in heart rate and pressure but there were no significant differences. Percent oxygen extraction decreased in a concentration dependent manner. CONCLUSIONS: This study shows that desflurane and isoflurane decreased heart rate, myocardial depression and coronary vasodilating effects, resulting in improved oxygen perfusion effects.
Animals ; Depression ; Heart Rate ; Heart Ventricles ; Heart* ; Isoflurane* ; Oxygen ; Oxygen Consumption ; Perfusion ; Rats ; Rats, Sprague-Dawley* ; Vascular Resistance ; Ventricular Pressure

BACKGROUND/AIMS: Anisakiasis is a well known parasitosis resulted from eating raw seafoods and there were many reports of cases. However, its endoscopic and clinical characteristics have not been reviewed well. The aim of this study was to clarify the gastric mucosal changes and influencing factors of upper gastrointestinal (UGI) anisakiasis. METHODS: We analyzed retrospectively the endoscopic and clinical characteristics of 141 cases with UGI anisakiasis diagnosed during UGI endoscopy, based on the review of medical records. The patients' data were collected consecutively from October 1999 through September 2006. RESULTS: In the 141 patients with UGI anisakiasis, the peak age was the 40s (44.7%). The female to male ratio was 1.82:1. The most prevailed season was winter (41.1%). The most frequent symptom was acute epigastric pain and 76.6% of the patients developed symptoms within 12 hours after the ingestion of raw seafoods. The greater curvature of body was the most preferred site of anisakid larvae. The median time from meal to symptom onset was shortest in esophageal location and longest in fundus location (3 vs. 18.7 hours). The various mucosal changes were observed and the most frequent mucosal change was edema (90.8%). Submucosal tumor was also found in 31.9% of the patients. The severity of mucosal change was related inversely with the time interval from meal to endoscopy (p=0.048). CONCLUSIONS: Anisakiasis presented various mucosal changes depending on the time interval from ingestion of raw seafood to endoscopy. Delayed endoscopy may lead chronic mucosal change and cause difficulty in the detection of anisakiasis. Therefore, the prompt endoscopic examination is required for the patients presenting acute gastrointestinal symptoms after taking raw fish.
Adult ; Aged ; Animals ; Anisakiasis/*diagnosis/parasitology ; Edema/etiology ; Esophageal Diseases/*parasitology/pathology ; Female ; Gastric Mucosa/parasitology/*pathology ; Gastroscopy ; Humans ; Male ; Medical Records ; Middle Aged ; Retrospective Studies ; Seafood ; Stomach Diseases/*parasitology/pathology ; Time Factors ; Upper Gastrointestinal Tract/parasitology/*pathology

BACKGROUND: Although there are controversies regarding the benefit of fluoropyrimidine-based adjuvant chemotherapy in patients with microsatellite instability-high (MSI-H) colorectal cancer (CRC), the pathologic features affecting postchemotherapeutic prognosis in these patients have not been fully identified yet. METHODS: A total of 26 histopathologic and immunohistochemical factors were comprehensively evaluated in 125 stage II or III MSI-H CRC patients who underwent curative resection followed by fluoropyrimidine-based adjuvant chemotherapy. We statistically analyzed the associations of these factors with disease-free survival (DFS). RESULTS: Using a Kaplan- Meier analysis with log-rank test, we determined that ulceroinfiltrative gross type (p=.003), pT4 (p<.001), pN2 (p=.002), perineural invasion (p=.001), absence of peritumoral lymphoid reaction (p=.041), signet ring cell component (p=.006), and cribriform comedo component (p=.004) were significantly associated with worse DFS in patients receiving oxaliplatin-based adjuvant chemotherapy (n=45). By contrast, pT4 (p<.001) and tumor budding-positivity (p=.032) were significant predictors of poor survival in patients receiving non-oxaliplatin-based adjuvant chemotherapy (n=80). In Cox proportional hazards regression model-based univariate and multivariate analyses, pT category (pT1-3 vs pT4) was the only significant prognostic factor in patients receiving non-oxaliplatin-based adjuvant chemotherapy, whereas pT category, signet ring cell histology and cribriform comedo histology remained independent prognostic factors in patients receiving oxaliplatin-based adjuvant chemotherapy. CONCLUSIONS: pT4 status is the most significant pathologic determinant of poor outcome after fluoropyrimidine-based adjuvant chemotherapy in patients with stage II/III MSI-H CRC.
Cellular Structures ; Chemotherapy, Adjuvant* ; Colorectal Neoplasms* ; Disease-Free Survival ; Humans ; Microsatellite Instability ; Microsatellite Repeats ; Multivariate Analysis ; Pathology ; Prognosis*

No abstract available.
Hypercalcemia* ; Incidence*

Angioleiomyoma (AL) is a very rare benign tumor that originates from smooth muscle cells and has thick walled vessels. It may be found throughout the body but more frequently occurs in the lower extremities and rarely develops in the head and other parts of the body. This paper presents a case report of giant AL detected in a 33-year-old woman who complained of severe anemia, menorrhagia, and palpable lower abdominal mass. The patient underwent myomectomy and was diagnosed with AL based on the pathological report of mass. The effective treatment for AL is either simple hysterectomy or angiomyomectomy depending on the patient's desire to preserve fertility and symptom.
Adult ; Anemia ; Angiomyoma* ; Female ; Fertility ; Head ; Humans ; Hysterectomy ; Immunohistochemistry ; Leiomyoma ; Lower Extremity ; Menorrhagia ; Myocytes, Smooth Muscle ; Uterus*

PURPOSE: We created an 'AAPM TG18 Evaluation Tool' and we determined its usefulness for the quality control of a diagnostic monitor. MATERIALS AND METHODS: We created an evaluation tool (the AAPM TG18) for conducting quality control of a diagnostic monitor, and we evaluated the measurement items of the AAPM TG18 evaluation tool. The measurement items were geometric distortion, fixed quantity assessment and visual assessment of the veiling glare, and we carried out adjustment for the luminance meter 0% calibration, which was used to revise the diagnostic monitor DICOM LUT. RESULTS: With the AAPM TG18 Evaluation Tool, we measured the 2-dimensional length when evaluating the quantitative geometric distortions in the TG18-QC test pattern, and we measured the veiling-glare ring response function, which provided information regarding the spatial extent of the luminance spread, and this measurement of the can be performed using the TG18-GV pattern. Additionally, the AAPM TG18 Evaluation Tool can be used for sensor calibration to standardize the basic rate of 0% luminance when performing periodic calibration. CONCLUSION: The evaluation tool is a very useful for easily evaluating many of the examination items of the AAPM TG18 for performing quality control of a diagnostic monitor.
Calibration ; Computer Terminals ; Glare ; Organothiophosphorus Compounds ; Quality Control ; Radiology Information Systems ; Total Quality Management

No abstract available.
Hepacivirus ; Hepatitis C* ; Hepatitis*

OBJECTIVES: We examined the effect of commercial plum beverages on dental erosion and whether the addition of calcium to these beverages would inhibit dental erosion. METHODS: We analyzed three groups as follows: Maesil 1 group (Chorok Maesil), Maesil 2 group (Sunkist plum), both of which were selected from commercially-available plum beverages, and Calcium-added maesil group (addition of 3% calcium to Chorok Maesil). For negative and positive control groups, Jeju Samdasoo and Coca Cola were selected, respectively. The characteristics of the experimental beverages were analyzed, and the specimens were immersed in the experimental beverage. The degree of erosion was measured by Vickers hardness number (VHN) and scanning electron microscope images. RESULTS: Positive control group had the lowest pH (2.50±0.03), followed by Maesil 2 (pH 2.59±0.01), Maesil 1 (pH 2.81±0.02), calcium-added maesil (pH 4.19±0.01), and negative control group (pH 7.57±0.06). Significant differences were found in surface microhardness between positive control, Maesil 1, Maesil 2 and calcium-added maesil group before immersion and at 30 minutes after immersion (P<0.05), and change in VHN (positive control group, −80.94±20.63; Maesil 1 group, −69.33±24.88; and Maesil 2 group, −78.49±18.60 in comparison with negative control group, −6.57±26.73). There was no significant difference (P<0.05) in change in VHN between calcium-added maesil (−13.02±17.33) and negative control group. CONCLUSIONS: Plum beverages can potentially induce dental erosion due to their low pH. However, adding calcium to these beverages can reduce the risk of dental erosion. Therefore, the risk of dental erosion must be considered during consumption of plum beverages, and the addition of calcium into plum beverages may be considered as a way to prevent dental erosion.
Beverages ; Calcium ; Coca ; Cola ; Hardness ; Hydrogen-Ion Concentration ; Immersion ; Prunus domestica

PURPOSE: The purpose of the study is to find whether there is any effect on shortening the length of stay of long term patients due to issuing of hospitalization sheets by emergency department. METHODS: For the investigation, 27,948 patients who resided in hospitals over 6 hours from 2006 to 2007 were chosen as the subjects. The main materials for the investigation were various time variables according to the medical records. For the verification of each factor, Student's t-test and Pearson' correlation coefficient were used. RESULTS: There was statistically significant difference in regard to length of stay (p<0.01). The departments related to internal medicine showed that they required longer times in every aspect compared to those of non-internal medicine. There were statistically significant differences (p<0.01) in regard to the time of patients' length of stay and the time of issuing sheets for hospitalization according to the numbers of related department. However, there was no meaningful difference in regard to the waiting time for hospitalization. CONCLUSION: In conclusion, in the cases of long term patients who stayed over 6 hours in 2007 when the random sheets for hospitalization were issued by emergency department, the length of stay was significantly reduced. It was found that the time was more increased in the departments of internal medicine than the departments of noninternal medicine and when the related sub departments increased.
Emergencies ; Emergency Medicine ; Hospitalization ; Humans ; Internal Medicine ; Length of Stay ; Medical Records