BACKGROUND: One of prominent cardiovascular effects of imipramine is postural hypotension. The present study was to verify whether imipramine has a central hypotensive action and futher to investigate its mechanism of action. METHODS: Rats(male, Sprague-Dawley) weighing 250-300g were anesthetized with pentobarbital sodium(50mg/kg, ip). Imipramine was administered into the left lateral cerebral ventricle. Mean arterial pressure(MAP) and heart rate(HR) were continuously monitored from the right femoral artery. RESULTS: Intracerebroventricular(icv) imipramine(3micromol/kg) caused decrease in MAP without significant alterations in HR, of which safety dose-range was very narrow. 1micromol/kg did not affect MAP and 10micromol/kg caused deaths of animals within 10min. Intravenous infusion of the same dose(3micromol/kg) of imipramine caused only a transient hypotension within 5min. Hexamethonium-treated(1mg/kg/min) rats did not respond to icv imipramine. Regitine pretreatment(2mg/kg, iv) prevented the hypotensive response to icv imipramine. Yohimbine pretreatment(500microg/kg, icv) not only blocked the hypotensive effect, but it caused a transient pressor response to icv imipramine. CONCLUSIONS: These results indicate that imipramine has a separate hypotensive effect which is mediated through central alpha2-adrenoceptors.
Animals ; Blood Pressure ; Cerebral Ventricles ; Femoral Artery ; Heart ; Hypotension ; Hypotension, Orthostatic ; Imipramine* ; Infusions, Intravenous ; Pentobarbital ; Phentolamine ; Rats* ; Yohimbine

No abstract available.
Colon* ; Humans* ; Morphine* ; Naloxone* ; Perfusion*

No abstract available.

No abstract available.
Asthma* ; Asthma, Exercise-Induced ; Bronchoconstriction* ; Child* ; Humans

The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9+/-5.6 yr, mean parity was 0.6+/-0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, 47%). The mean operating time was 85.6+/-38.9 min, and the mean diameter of the largest myoma was 9.3+/-1.8 cm. The mean change in hemoglobin concentration was 2.1+/-1.2 g/dL. Histopathological diagnosis included 49 patients of leiomyoma (96.1%) and 2 patients of leiomyoma with adenomyosis (3.9%). Postoperatively, a transfusion was done in 7 patients, and a case of subcutaneous emphysema was noted. None of the operations was switched to laparotomy. With the newly-developed screw and the port placement system that was modified from the Choi's 4-trocar method to obtain better surgical vision, LM of large myomas proved to be one of the efficient and feasible methods.
Adult ; Feasibility Studies ; Female ; Humans ; Laparoscopy/adverse effects/*methods ; Leiomyoma/pathology/*surgery ; Length of Stay ; Postoperative Complications/etiology ; Reproducibility of Results ; Subcutaneous Emphysema/etiology ; Treatment Outcome ; Uterine Neoplasms/pathology/*surgery

BACKGROUND AND OBJECTIVES: The status of cervical lymph node is important factor influencing the prognosis of patients with oral cavity squamous cell carcinoma. There has been some controversy regarding the treatment of clinical N0 neck in oral cavity squamous cell carcinoma, and the purpose of this study is to analyze the outcomes and efficacy of the elective neck dissection. SUBJECTS AND METHOD: Authors analyzed outcomes of elective neck dissection by a retrospective study with a review of medical records of 41 oral cavity squamous cell carcinoma patients who had clinical N0 neck. RESULTS: The overall rate of occult neck metastasis was 27%, and the rate of occult metastasis beyond T2 stage was 45%. The occult metastasis rates of the primary sites in the oral tongue, floor of mouth and retromolar trigon were 26.7%, 40% and 33.3%, respectively. Three cases had bilateral occult metastasis and other three had nodal recurrence after elective neck dissection. CONCLUSION: Because there were high occult neck metastasis rate but no significant postoperative complications in using the elective neck dissection, it could be used in T2, T3 or T4 oral cavity squamous cell carcinoma with clinical N0 neck.
Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Medical Records ; Mouth ; Mouth Floor ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Tongue

Hepatocellular carcinoma (HCC) is one of the most common malignant cancers closely associated with chronic infection by the hepatitis B virus (HBV) or the hepatitis C virus (HCV) throughout the world. In this study, the genetic associations of 20 known polymorphisms in eight candidate genes, including angiotensinogen (AGT), cadherin 1 (CDH1), cyclooxygenase 2 (COX2), monocyte chemotactic protein-1 (MCP1), multidrug resistance 1 (MDR1), chemokine ligand 5 (RANTES), thrombospondin 2 (THBS2), and thrombospondin 4 (THBS4), were analyzed in a large chronic hepatitis B cohort (n=1,095) recruited from the Korean population. In addition, three polymorphisms in chemokine receptor 4 (CXCR4) and vimentin (VIM) identified in this study were also genotyped. Using logistic regression analysis controlling possible confounding factors, one common (freq.=0.367) promoter polymorphism of MCP1 (MCP1-2518G>A) among analyzed polymorphisms was significantly associated with clearance of HBV infection. The frequency of homozygotes for the MCP1-2518A allele (MCP1-2518A/A) among chronic hepatitis B virus (HBV) carrier patients was significantly higher than that among spontaneously recovered (SR) subjects (17.7% vs. 10.4%)(OR=1.78, P=0.004). Our findings imply a plausible explanation for the contribution of host genetic determinants to the variable outcome of HBV infection, which might provide valuable information for future genetic study in this area.
Promoter Regions (Genetics)/*genetics ; Polymorphism, Genetic/*genetics ; Middle Aged ; Male ; Humans ; Hepatitis B virus/*physiology ; Hepatitis B/complications/*genetics/therapy/*virology ; Haplotypes/genetics ; Female ; Chemokine CCL2/*genetics ; Carcinoma, Hepatocellular/epidemiology/etiology/genetics/virology ; Aged, 80 and over ; Aged ; Adult

We recently experienced a case of spontaneous perforation of infected necrosis into the colon and duodenum during the course of acute pancreatitis in a 63 year-old male patient. Enteric perforations or fistulas in the setting of acute pancreatitis implicate severe underlying pathology and have substantial morbidity and mortality. In the meantime it has generally been accepted that infected pancreatic or peripancreatic necrosis should be managed surgically as soon as possible. Enteric perforations in the present case contributed to transient improvement of the patient's infection sign and condition, and thus an early operation was able to be avoided. Delayed surgical management resulted in complete recovery of the patient without postoperative morbidity. Herein we report an unusual complication of acute pancreatitis.
Acute Disease ; Case Report ; Human ; Intestinal Perforation/*etiology ; Male ; Middle Age ; Pancreatitis/*complications

OBJECTIVE: To assess the feasibility and clinical efficacy of laparoscopic myomectomy (LM). METHODS: We analyzed retrospectively the data for 110 LM preformed at Kangbuk Samsung Hospital between July 2003 and July 2006. We reviewed their clinical charts and the operative and anesthetic records, and analyzed data on the patients' age, parity, previous operative history, preoperative indication, the diameter of the largest myoma, operating time, number of the removed myoma, hospital stay, change of the hemoglobin concentration from preoperative to postoperative day 1, concomitant procedures, histopathological reports, and complications. RESULTS: The mean age of the patients was 35.7+/-5.8 years, the mean parity was 0.8+/-0.9, and 26 (23%) patients had a previous operative history. The most common operative indication was a palpable abdominal mass (46 patients, 41.9%), followed by chronic pelvic pain (32 patients, 29.0%), abnormal uterine bleeding (24 patients, 21.8%), urinary frequency (7 patients, 6.4%), and infertility (1 patient, 0.9%). The mean operating time was 82.9+/-30.8 minutes, and the mean diameter of the largest myoma was 7.1+/-2.3 cm. The heaviest of the removed myoma weighed 795 gm. The mean change of the hemoglobin concentration was 2.2+/-1.1 g/dL, and the mean hospital stay was 3.5+/-1.4 days. Postoperatively, transfusions were done 10% (11 cases) of patients, and 2 cases of paralytic ileus and a case of subcutaneous emphysema were noted. Conversion rate to laparotomy was 0.9% (1 case). CONCLUSION: LM for various sized myomas can be performed successfully and effectively by decreasing laparoconversion, if the surgical team and the laparoscopic surgeon are experienced and enhanced equipment is available.
Female ; Humans ; Infertility ; Intestinal Pseudo-Obstruction ; Laparotomy ; Length of Stay ; Myoma* ; Parity ; Pelvic Pain ; Retrospective Studies ; Subcutaneous Emphysema ; Uterine Hemorrhage

Cytochrome P450 2E1 (CYP2E1) is a member of the cytochrome P450 superfamily, and it is a key enzyme responsible for the metabolic activation of many smallmolecular-weight compounds such as alcohol, which is classified as a human carcinogen. In this study, we identified 19 single nucleotide polymorphisms (SNPs) in CYP2E1 in Korean population. In these SNPs, we examined possible genetic association of CYP2E1 polymorphisms with HBV clearance and the risk of hepatocellular carcinoma (HCC). Five common polymorphic sites were selected, CYP2E1 polymorphisms at rs381-3867, rs3813870, rs2070673, rs2515641 and rs2480257 , considering their allele frequencies, haplotype-tagging status and LDs for genotyping in larger-scale subjects (n=1,092). Statistical analysis demonstrated that CYP2E1 polymorphisms and haplotypes show no significant association with HBV clearance, HCC occurrence and onset age of HCC (p>0.05). Previous studies, however, have shown contradictory findings on associations of CYP2E1 polymorphisms with CYP2E1 activities and HCC risk. Comparing the contrasting results of previous researches suggest that CYP2E1 polymorphism is associated with CYP2E1 activity induced by ethanol, but is not directly associated with HCC risk. CYP2E1 variation/haploype information identified in this study will provide valuable information for future studies on CYP2E1.
Age of Onset ; Biotransformation ; Carcinoma, Hepatocellular ; Cytochrome P-450 CYP2E1 ; Cytochrome P-450 Enzyme System ; Ethanol ; Gene Frequency ; Haplotypes ; Humans ; Polymorphism, Single Nucleotide