The isolated rabbit kidney was perfused with 4 kinds of perfusates which had different ionic compositions, in order to investigate the effects of divalent cations, Mg and Ca, on the renal autoregulation. Four kinds of perfusates are full-balanced perfusate (FBP), perfusate subtracted both CaCl2and MgCI2 from FBP, perfusate subtracted only CaCI, from FBP, and perfusate subtracted only MgCl2 from FBP. The composition of FBP is 6% hydroxyethyl starch in 0.9% NaCl (McGaw Lab. USA) containing Na-acetate 5.0, K2HPO4 5.0, CaCls 1.2, MgCl2 0.5, and glucose 5.O mM/L. Renal Perfusate Flow (RPF) as related to various renal arterial perfusion pressure (RAP) was directly measured with flow-meter attached to the perfusion system. Total renal resistance (Rr) was calculated from RAP & RPF (RT=RAP/RPF). Alterations in renal autoregulation, when different perfusates were perfused, were estimated by pressure-flow curve in every run of perfusion experiments. The results obtained were as follows: 1) Kidney perfused with FBP revealed autoregulation within the range of 100~180 mmHg RAP. Renal Perfusate Flow in the autoregulation zone was 5.0 ml,min/gm. 2) The autoregulation was not appeared in the experiments perfused with the solution subtracted both CaCl2 and MgCI2 from FBP. 3) Kidney perfused with FBP-CaCI2 revealed the autoregulation, which had the autoregulation zone of 110~180 mmHg RAP, and 5. 5 m1/min/gm RPF. However, it was not present in the kidney perfused with FBP-MgCl2. 4) The time course of autoregulation was observed on the pressure-flow curve; autoregulation was continued approximately for 15 minutes, and then deteriorated rapidly. 5) Total renal resistance calculated was proportionately increased as the RAP increased within the regulation zone. Below and above the zone, it was almost inversely related to the RAP. From the above results, it was concluded that Mg is the essential factor in the renal autoregulation and suggested that Mg could have a key role on the neuromuscular transmission, excitability of muscular cell membrane, or the process of intracellular contraction.
Cations, Divalent ; Cell Membrane ; Glucose ; Homeostasis* ; Ions* ; Kidney* ; Magnesium Chloride ; Perfusion ; Starch

The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.
Aged ; Carcinoma, Pancreatic Ductal/physiopathology/surgery/therapy ; Digestive System/physiopathology ; *Enteral Nutrition/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Nutritional Status ; Pancreatic Neoplasms/physiopathology/surgery/therapy ; *Pancreaticoduodenectomy/adverse effects ; *Parenteral Nutrition, Total ; Postoperative Care/*methods ; Postoperative Period ; Prospective Studies ; Time Factors ; Treatment Outcome ; Weight Gain

BACKGROUND: We studied the time course of gene expression of dynorphin, enkephalin, c-fos, and the changes of allodynia, and the effect of chemical sympathectomy on the gene expression and allodynia in neuropathic rat. METHODS: In two groups of rat (Sprague-Dawley), the left L5 and L6 spinal nerves were tight ligated. In gene expression group (N=25), behavioral tests for mechanical allodynia and cold allodynia were perfomed for the next two weeks. After the test of allodynia, the expression of dynorphin, enkephalin, c-fos were assessed by Northern blot hybridization. In chemical sympathectomy group (N=16), after chemical sympathectomy (guanethidine 70 mg/kg intraperitoneally, from postoperative 7 days to 9 days), the changes of allodynia and the gene expression of enkephalin, c-fos were tested. RESULTS: Mechanical allodynia and cold allodynia was developed on the postoperative 3, 5, 7, 14 days. Preprodynorphin mRNA expression was reached peak level at the postoperative 8 hrs, sustained increase by the postoperative 3 days, but preproenkephalin mRNA expression increased slightly after operation. c-Fos mRNA expression was increased immediately at the postoperative 30 min, 1 hr, returned to normal level thereafter, and increased again on the postoperative 3, 5, 7 days that neuropathic pain was developed. Mechanical allodynia and cold allodynia were decreased by chemical sympathectomy. The increased c-fos mRNA expression and pain at postoperative 7 days was reduced by chemical sympathectomy. CONCLUSION: These results suggest that the transient gene expression of dynorphin and c-fos after tight ligation of L5 and L6 spinal nerves induces the development neuropathic pain, and late c-fos expression is related to neuropathic pain.
Animals ; Blotting, Northern ; Dynorphins* ; Enkephalins* ; Gene Expression* ; Hyperalgesia ; Ligation ; Neuralgia ; Rats* ; RNA, Messenger ; Spinal Nerves ; Sympathectomy, Chemical

Lysosomal acid lipase (LAL) plays a central role in the intracellular degradation of neutral lipids derived from plasma lipoproteins. In this study, we investigated the missense mutation within exon 2 of human LAL gene changing of codon -6 of prepeptide from threonine to proline. The Thr-6Pro mutation was detected by the Hae III restriction fragment length polymorphism (RFLP) and single-strand conformation polymorphism (SSCP). We analyzed the mutation in subjects with 221 unrelated randomly selected control samples and 86 patients with familial hypercholesterolemia (FH) in Korea. We observed that mutation is present with high frequency in Korea compared to other populations studied previously. The frequency of PP homozygote in the FH group was observed considerably higher than that of control. However, there was no significant difference of genotype frequency between two groups. These results, together with the fact that plasma lipids and lipoproteins levels between genotypes showed no statistical difference, suggest that the Thr-6Pro mutation in the LAL gene may have no association with the increased risk of FH development.
Codon ; Exons ; Genotype ; Homozygote ; Humans* ; Hyperlipoproteinemia Type II* ; Korea* ; Lipoproteins ; Mutation, Missense* ; Plasma ; Polymorphism, Restriction Fragment Length ; Proline ; Sterol Esterase* ; Threonine

BACKGROUND: Cord blood (CB) is a useful source of hematopoietic stem cells. In public CB banks, only CB units with good hematopoietic potential are processed and stored because the processing and storage of CB are cost-consuming and labor-intensive procedures. Presently, we sought to determine factors correlated with, and influential to, hematopoietic parameters of CB units donated from Korean neonates and their mothers. METHODS: A total of 1,696 CB units that were donated and processed from August 1 - December 31, 2007 were enrolled. Donated CB volume, total nucleated cells (TNC), total mononucleated cells (MNC), CD34+ cells after processing, and cell viability before and after processing were analyzed according to sex and delivery method. We also determined whether maternal age, neonatal factors (gestational age, birth weight, sex, delivery method), CB volume, and processing time were correlated with hematopoietic parameters of CB. RESULTS: CB of female neonates had significantly higher mean TNC and CB obtained from vaginal delivery had significantly higher mean TNC, MNC, and CD34+ cells. The counts of TNC, MNC, and CD34+ cells were significantly positively correlated with CB volume, gestational age, and birth weight. Counts of TNC, MNC, and CD34+ cells, and pre- and post-viability of CB were significantly negatively correlated with processing time. CONCLUSION: The present data provide a baseline for standard methods of collection, processing, and storage in cord blood banking.
Birth Weight ; Cell Survival ; Female ; Fetal Blood ; Gestational Age ; Hematopoietic Stem Cells ; Humans ; Infant, Newborn ; Maternal Age

A 38-year-old man presented with typical squeezing-type anterior chest pain. An initial electrocardiogram (ECG) showed prominent ST-segment elevation (V1-V4 lead, 3 mm). Suddenly, the patient fell unconscious and had no pulse. At that time, the ECG showed polymorphic ventricular fibrillation (VT). After direct current (DC) cardioversion, the patient regained vital signs and defibrillation converted the VT into an accelerated idioventricular rhythm with resolution of the ST-segment elevation. The patient was referred to our hospital for close observation and further evaluation. At our hospital, an ECG showed normal sinus rhythms and cardiac enzymes were within normal limits. We diagnosed the patient with variant angina rather than ST elevation myocardial infarction (STEMI), because his clinical manifestations were quite distinct; ST-segment elevations disappeared slowly at the reperfusion stage. However, the patient's final diagnosis was STEMI because coronary angiography showed severe eccentric tubular stenosis (85%) with remnant thrombus in the middle left anterior descending artery. Defibrillation likely removed the thrombus, which led to STEMI.
Accelerated Idioventricular Rhythm ; Adult ; Angina Pectoris, Variant ; Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Electric Countershock ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocardial Revascularization ; Reperfusion ; Thrombosis ; Unconscious (Psychology) ; Ventricular Fibrillation ; Vital Signs

Alagille syndrome is characterized by chronic cholestasis, posterior embryotoxon, skeletal abnormalities, cardiovascular abnormalities, and a typical face with prominent forehead and pointed chin. Its histological feature includes paucity of interlobular bile ducts. We experienced a 49-day-old female infant presenting with frequent upper respiratory tract infection and persistent jaundice. She had a typical face and chronic cholestasis. Echocardiograms revealed peripheral pulmonary stenosis. The histological examination of liver revealed paucity of interlobular bile ducts.
Alagille Syndrome* ; Cardiovascular Abnormalities ; Chin ; Cholestasis ; Female ; Forehead ; Humans ; Infant ; Jaundice ; Liver ; Pulmonary Valve Stenosis ; Respiratory Tract Infections

In vivo 31P NMR spectra were obtained in eight infant brain at 4.7T. Each phosphorus metabolite and its ratio were analyzed to evaluate the brain damage and maturity, and compared with the reported data obtained at the lower field strength. Measurement of T1 relaxation time at 4.7T was done in an infant and a cat brain in vivo. PCr/Pi and PCr/β-ATP ratio were used as a marker of brain damage. PME/PDE revealed higher values than those of the reported data obtained at the lower field strength and the difference was partly attributed to the long T1 relaxation time of PME rather than the brain immaturity. Although the resolution of the spectrum was improved at 4.7T, a long repetition time is recommended to minimize T1difference of phosphorus metabolites of brain at 4.7T.
Animals ; Brain* ; Cats ; Humans ; Infant ; Magnetic Resonance Spectroscopy* ; Phosphorus ; Relaxation

Acinar cell carcinoma (ACC) is a very rare type of pancreatic cancer that makes up less than 1% of all pancreatic cancers. The prognosis of ACC is very poor and the mean survival interval is only 18-19 months. The only effective treatment is currently early radical resection. MATERIALS AND METHODS: To determine ACC`s clinical characteristics and the treatment efficacy, we conducted a retrospective chart review to study the clinical characteristics, laboratory findings, pathology and treatment responses of 10 ACC patients among 3042 pancreatic cancer patients who were diagnosed in Severance Hospital and Kangnam Severance Hospital of Yonsei University, College of Medicine from 1988.01.01 to 2008.12.31. RESULTS: The 10 ACC patients were 6 males and 4 females. The mean age of the 10 ACC patients was 53.2 years. The most of the patients (7/10) complained the pain on the epigastric area and there was no jaundice in 8 patients (80%). Unfortunately, regional or distant metastases were founded in 8 patients (80%) at the time of the first diagnosis. The initial mean CA19-9 level was increased to 73.5 U/ml (range: 0.1~350.0 U/ml). Six of 10 patients underwent radical surgery and 4 of 10, including 1 with open and closure, were treated with conservative treatment. The median survival interval was 22.4 months with operative treatment and 1.5 months with conservative treatment. The median overall survival interval was 19.4 months. The median disease free survival was 17 months. The liver was the most common recurrent site (3 cases). CONCLUSIONS: An early radical resection is currently the best and only treatment for ACC, but in rare cases, post-operative adjuvant chemotherapy shows hopeful results and so this requires more study.
Acinar Cells ; Carcinoma, Acinar Cell ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Jaundice ; Liver ; Male ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To evaluate the efficacy of botulinum toxin type A in the treatment of spasticitc and dystonic upper limbs in a group of cerebral palsy children METHOD: Eighteen children with cerebral palsy who did not have fixed contractures in the wrist and hand were enrolled (mean age 9.0 years; range 6~15). Measurements were obtained before and at 1 and 3 months after botulinum toxin A injections. Assessments included spasticity (modified Ashworth scale), range of motion of thumb and functional assessments including Melbourne assessment of unilateral upper limb function and Jebsen Taylor hand function test. Hand and forearm muscles were injected with 1~3 u/kg botulinum toxin. RESULTS: Spasticity measured by modified Ashworth scale decreased by 1 month and diminished spasticity continued for 3 months. Range of motion of thumb increased by 1 and 3 months. In Jebsen hand function test, patients showed functional improvements in item 6 (lifting light weight object) and item 7 (lifting heavy object). Melbourne assessment of unilateral upper limb function scores improved from a mean value of 92 at baseline to a mean value of 101 at 1 month and a mean value of 105 at 3 months. CONCLUSION: Botulinum toxin A would be helpful in some selected cerebral palsy patients with upper limb dysfunction. But further research including randomized controlled study is needed on the use of botulinum toxin A to improve function.
Botulinum Toxins* ; Botulinum Toxins, Type A ; Cerebral Palsy* ; Child* ; Contracture ; Forearm ; Hand ; Humans ; Muscle Spasticity ; Muscles ; Range of Motion, Articular ; Thumb ; Upper Extremity* ; Wrist