No abstract available.
Neurons* ; Reflex*

BACKGROUND: Pregabalin is an antiepileptic drug that is effective for treating postoperative pain, neuropathic pain, anxiety, and hemodynamic instability. The aim of this study was to investigate the effect of a single preoperative dose of pregabalin in patients with opioid-induced hyperalgesia (OIH). METHODS: Ninety ASA I-II patients undergoing laparoendoscopic single-site urologic surgery were randomly assigned to one of the following three groups that received either pregabalin or placebo 1 h before anesthesia and an intraoperative remifentanil infusion. Group plL received placebo and 0.05 microgram/kg/min remifentanil, group plH received placebo and 0.3 microgram/kg/min remifentanil, and group prH received 300 mg pregabalin plus 0.3 microgram/kg/min remifentanil. The primary endpoint was pain intensity upon movement 1, 6, 12, and 24 h after surgery. Secondary endpoints were the area of hyperalgesia and mechanical hyperalgesia threshold 24 h after surgery, time to first postoperative analgesic requirement, and cumulative postoperative volume of morphine administered via a patient-controlled analgesia (PCA) pump over 24 h. RESULTS: The time to first postoperative analgesic requirement in group plH was significantly shorter than that in group plL. The injected PCA volume was significantly greater in group plH than that in the other two groups. Postoperative pain intensity in group plH was significantly greater than that in the other two groups at 6, 12, and 24 h after surgery. The mechanical hyperalgesia threshold and the area of hyperalgesia around the surgical incision 24 h after surgery in group plH differed significantly from those in the other two groups, which were not significantly different. Adverse effects were comparable among groups. CONCLUSIONS: High-dose remifentanil induced hyperalgesia, including increased pain intensity, increased area of hyperalgesia, and decreased mechanical hyperalgesia threshold. These effects were attenuated by oral administration of a single preoperative dose of pregabalin (300 mg) in patients undergoing laparo-endoscopic single-site urologic surgery.
Administration, Oral ; Analgesia, Patient-Controlled ; Anesthesia ; Anxiety ; gamma-Aminobutyric Acid ; Hemodynamics ; Humans ; Hyperalgesia ; Morphine ; Neuralgia ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Piperidines ; Pregabalin

The fMRI signals are composed of many various signals. It is very difficult to find the accurate parameter for the model of fMRI signal containing only neural activity, though we may estimating the signal patterns by the modeling of several signal components. Besides the nose by the physiologic motion, the motion of object and noise of MR instruments make it more difficult to analyze signals of fMRI. Therefore, it is not easy to select an accurate reference data that can accurately reflect neural activity, and the method of an analysis of various signal patterns containing the information of neural activity is an issue of the post-processing methods for fMRI. In the present study, fMRI data was analyzed with the Independent Component Analysis(ICA) method that doesn't need a priori-knowledge or reference data. ICA can be more effective over the analytic method using cross-correlation analysis and can separate the signal patterns of the signals with delayed response or motion related components. The Principal Component Analysis (PCA) threshold, wavelet spatial filtering and analysis of a part of whole images can be used for the reduction of the freedom of data before ICA analysis, and these preceding analyses may be useful for a more effective analysis. As a result, ICA method will be effective for the analysis of signal patterns in fMRI and the pre-filtering may be necessary for the reduction of the degree of freedom of the data.
Freedom ; Magnetic Resonance Imaging* ; Noise ; Nose ; Principal Component Analysis

BACKGROUND: Escherichia coli and Klebsiella pneumoniae resistant to 3rd generation cephalosporin have been reported with increasing frequency in tertiary-care hospital in Korea. MicroScan Neg Combo Panel Type 21 (Type 21) contains a 1 microgram/mL cepfodoxime (POD) in addition to other screen wells containing ceftazidime, cefotaxime, ceftriaxone, and aztreonam, which are designed for detecting extended-spectrum beta-lactamase (ESBL)-producing E. coli and Klebsiella species. We evaluated the Type 21 panel for its ability to detect ESBL. METHODS: From November to December in 1998, 496 E. coli and 326 K. pneumoniae strains isolated from clinical specimens were tested with Type 21 panel The isolates flagged as ESBL producers by the panel were confirmed by the double disk synergy test (DDS). To evaluate the specificity of POD, n-lactamases of 54 E, coli and 20 K. pneumoniae strains that were flagged by, POD only from January to May 1999 were analyzed by isoelectric focusing(IEF). RESULTS: 75/496(15%) E. coli and 68/326(21%) K. pneumoniae were flagged as ESBL producers by Type 21 panel. Of those, 94 isolates including 38/75 (51%) of E. coli and 56/68 (82%) of K. pneumoniae were positive for DDS. Among the 94 ESBL producers, all were detected by POD, 84% by cefotaxime, 85% by ceftazidime, 84% by ceftriaxone, and 86% by aztreonam. The 74 strains that were flagged as ESBL producers by POD screen well only were mostly DDS-negative, cefoxitin- resistant and showed beta-lactamases with pls of 5.4 and 7.6 or no band, which could be interpreted as the presence of TEM-1 or SHV-1 type beta-lactamases and/or basal AmpC beta-lactamases, not ESBL. CONCLUSION: MicroScan Neg Combo Panel Type 21 was able to detect a greater number of ESBL producers by inclusion of POD in its screening well. However, the specificity of POD was compromised by flagging a significant number of DDS negative strains. We conclude that the isolates with reduced susceptibility to 3rd generation cephalosporins as well as POD can be reported as ESBL-producers and those resistant to POD only should be confirmed by DDS.
Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Cephalosporins ; Escherichia coli ; Klebsiella ; Klebsiella pneumoniae ; Korea ; Mass Screening ; Pneumonia ; Sensitivity and Specificity

Background: The anti-oxidative, anti-inflammatory, and anti-apoptotic effects of erythropoietin may provide neuroprotective effects. Erythropoietin also modulates autophagy signaling that may play a role in anesthesia-induced neurotoxicity (AIN). Herein, we investigated whether AIN can be attenuated by the neuroprotective effect of erythropoietin in the Caenorhabditis elegans (C. elegans). Methods: Synchronized worms were divided into the control, Iso, EPO, and EPO-Iso groups. The chemotaxis index (CI) was evaluated when they reached the young adult stage. The lgg-1::GFP-positive puncta per seam cell were used to determine the autophagic events. The erythropoietin-mediated pathway of autophagy was determined by measuring the genetic expression level of let-363, bec-1, atg-7, atg-5, and lgg-3. Results: Increased lgg-1::GFP puncta were observed in the Iso, EPO, and EPO-Iso groups. In the Iso group, only the let-363 level decreased significantly as compared to that in the control group (P = 0.009). bec-1 (P < 0.001), atg-5 (P = 0.012), and lgg-3 (P < 0.001) were expressed significantly more in the EPO-Iso group than in the Iso groups. Repeated isoflurane exposure during development decreased the CI. Erythropoietin could restore the decreased CI by isoflurane significantly in the EPO-Iso group. Conclusions Erythropoietin showed neuroprotective effects against AIN and modulated the autophagic pathway in C. elegans. This experimental evidence of erythropoietin-related neuroprotection against AIN may be correlated with the induced autophagic degradation process that was sufficient for handling enhanced autophagy induction in erythropoietin-treated worms.

Xanthogranulomatous pyelonephritis (XGP) is an uncommon, severe, chronic infection of the kidney, which results in the normal renal parenchyma being replaced by characteristic lipid-laden macrophages (foam cells). It can occur at any age, but is extremely rare in children. Herein, the case of a 6-month-3-week-old girl with XGP, pre-operatively diagnosed with a Wilms' tumor, is reported. This is the youngest age of any patient with such a condition reported in the Korean literatures. Excretory urography, abdominal sonogram, computed tomogram and magnetic resonance imaging revealed a right renal round mass, without any calcifications. Her pathological findings after a radical nephrectomy revealed XGP.
Child ; Female ; Humans ; Infant* ; Kidney ; Macrophages ; Magnetic Resonance Imaging ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous* ; Urography ; Wilms Tumor

PURPOSE: To explore the effect of recombinant human EGF on the proliferation and survival of human fibroblast cell lines following irradiation. MATERIALS AND METHODS: Fibroblast was originated human skin and primary cultured. The trypan blue stain assay and MTT assay were used to study the proliferative effects of EGF on human fibroblast cell lines in vitro. An incubation of fibroblasts with rhEGF for 24 hours immediately after irradiation was counted everyday. Cell cycle distributions were analyzed by FACS analysis. RESULTS: Number of fibroblast was significantly more increased rhEGF (1.0 nM, 10 nM, 100 nM, 1,000 nM) treated cell than control after 8 Gy irradiation. Most effective dose of rhEGF was at 160 nM. These survival differences were maintained at 1 week later. Proportion of S phase was significantly increased on rhEGF treated cells. CONCLUSION: rhEGF cause increased fibroblast proliferation following irradiation. We expect that rhEGF was effective for radiation induced wound healing.
Cell Cycle ; Cell Line* ; Epidermal Growth Factor* ; Fibroblasts* ; Humans* ; S Phase ; Skin ; Trypan Blue ; Wound Healing

The cystic teratoma is the most common germ cell tumors in reproductive age women. The malignant change of cystic teratoma is rare, about 1~2%, and mostly change to squ-amous cell carcinoma. We experienced 4 cases of squamous cell carcinoma arising in cystic teratoma and re- port our cases with a brief review of the literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

Tophus due to gout is most commonly found in the toes and ankles, but can also be found in the auricle. Although small nodules on the helix are sometimes found in gout patients, a large mass lesion on the back side of the auricle is rare. We report a patient who visited the otology clinic due to an auricular mass lesion, which was diagnosed as a large auricular tophus. A 17-year-old male patient who suffered from gout complained of a right side auricular mass. A 3 cm sized solid mass lesion was detected on the back side of the right canvum conchal cartilage. The mass was soft, non-tender, and well-circumscribed. The lesion was first found 1-2 years earlier. The size of the lesion had been slowly increasing, but had recently stopped growing. The mass was surgically removed for pathologic confirmation and cosmetic reasons. Specimens were composed of 2 irregularly shaped pieces of soft-gray tan and yellowish tissue. The upper larger tophus was attached to the cartilage and the lower smaller tophus was embedded inside the auricular cartilage. Pathologic findings suggested tophus with amorphous deposits and subepithelial tissue.
Adolescent ; Animals ; Ankle ; Cartilage ; Cosmetics ; Ear Cartilage ; Gout ; Humans ; Male ; Otolaryngology ; Toes ; Triacetoneamine-N-Oxyl

The Heterotopic pancreas is defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of pancreas. Heterotopic pancreas or ectopic pancreas is found in 0.55% to 13.7% of autopsy series and also found one in approximately every 500 operations in abdominal surgery. The most common sites are the antrum of stomach, duodenum, and proximal jejunum. Most masses of heterotopic pancreas in stomach were encountered in the distal one third, usually within 5 or 6 cm of pylorus. We have recently experienced a case of hetertopic pancreas that was located in fundus which is not the usual site. Gastrofiberscopy revealed a 2 2.5 cm sized protruding mass on the fundus. There was apperared an umbilical shaped dimple on the center with a relatively normal mucosa. Endoscopic ultrasonography revealed a 2.5 cm sized hypoechoic mass of fundus, originating from submucosal and muscular layer. It was considered a submucosal tumor, such as leiomyoma, and subsequently wedge resection was performed. Histologic finding showed pancreatic acni.
Autopsy ; Duodenum ; Endosonography ; Jejunum ; Leiomyoma ; Mucous Membrane ; Pancreas* ; Pylorus ; Stomach*