OBJECTIVE: To evaluate the effects of the reactive oxygen species (ROS) generated with a xanthine(X) and xanthine oxidase (XO) system on sperm function, the change of sperm characteristics, lipid peroxidation, and DNA fragmentation in bovine spermatozoa. MATERIALS AND METHODS: ROS were produced using a combination of 100 micrometer X and 50 mU/ml XO. The ROS scavengers: superoxide dismutase (SOD)(200mu/ml) and catalase (500mu/ml) were also tested. Spermatozoa were incubated for 2 hours in BWW medium with a combination of X-XO supplemented with or without ROS scavengers at 37degrees C under 5% CO2 incubator. Sperm movement characteristics by CASA (computer-aided sperm analysis), HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, malondialdehyde formation for the analysis of lipid peroxidation, the percentage of DNA fragmentation using the method of TdT-mediated nick end labelling (TUNEL) by flow cytometry were determined after 2 hours incubation. RESULTS: The action of ROS on bovine spermatozoa resulted in a decreased in capacity for sperm motility, Ca-ionophore induced acrosome reaction and membrane integrity, an increased in malondialdehyde formation and the percentage of sperm with DNA fragmentation. In the effects of antioxidant, catalase completely alleviated the toxic effects induced by the ROS in terms of sperm function and characteristics, however SOD exhibited no capacity to reduce the toxic effects. CONCLUSION: The ROS can induce significant damages to sperm functions and characteristics. The useful ROS scavengers can minimized the defects of sperm function and various damages of spermatozoa.
Acrosome Reaction ; Catalase ; DNA Fragmentation* ; DNA* ; Flow Cytometry ; Incubators ; Lipid Peroxidation* ; Malondialdehyde ; Membranes ; Reactive Oxygen Species* ; Sperm Motility ; Spermatozoa* ; Superoxide Dismutase ; Xanthine Oxidase

BACKGROUND: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. METHODS: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. RESULTS: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). CONCLUSIONS: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
Coma ; Embolization, Therapeutic ; Emergency Service, Hospital ; Humans ; Incidence ; Liver* ; Mortality* ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies ; Time Factors

Neurofibromatosis also referred to as von Recklinghausen`s disease, is an autosomal dominant disease, which is characterized by cutaneous neurofibromas, cafe-au-lait spot, and axillary freckles. Although neruofibromatosis is a congenital disorder, the pulmonary manifestation become evident in adulthood. Approximately 15percent of patients with cutaneous lesions have intrathoracic neurofibromas. In some patients with neurofibromatosis, the lungs are the seat of interstitial fibrosis, leiomyoma, and bullous lesion, meningocele or less commonly lung cancer. The association of neurofibromatosis and lung cancer is rare, A 47-year-old man, who was a heavy smoker, was admitted to our hospital because of hemoptysis. Since cafe-au-lait sopts, diffuse pigmentation and multiple neurofibromatosis were observed on the skin, he was considered to have von Recklinghausen`s disease. Chest X-ray film showd extensive hazy density affecting all of his lung field, and minimal peribronchial infiltratin in his left lower lung field. Chest CT showed that near total consolidative lesions were present of right middle lobe. Also, some patchy infiltration were present in his right lower lobe and some of left lower lobe. Histoathological examination of the percutaneous lung biopsy specimen demonstrated that he had undifferentiated large cell carcinoma. The Authors have experienced a case of neurofibromatosis combined with undifferntiated large cell carcinoma. A brief review of related literature was conducted.
Biopsy ; Blister ; Cafe-au-Lait Spots ; Carcinoma, Large Cell* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Fibrosis ; Hemoptysis ; Humans ; Leiomyoma ; Lung Neoplasms ; Lung* ; Melanosis ; Meningocele ; Middle Aged ; Neurofibroma ; Neurofibromatoses* ; Pigmentation ; Skin ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

OBJECTIVE: To demonstrate the efficacy of first trimester embryofetoscopy for prenatal diagnosis of congenital anomalies in continuing pregnancies. METHODS: Under ultrasound guidance, six patients at 12+6-14+6 weeks of gestation underwent endoscopic procedures. Indications included history of 2 recurrent major genetic syndromes, history of cleft lip/palate in 2 cases, each one of the patient itself and the previous fetus and each family history of syndactyly and polydactyly. A 1 mm semirigid fiberoptic endoscope with a 18 gauge examination sheath and a single-chip digital camera were used for transabdominal embryofetoscopy. RESULTS: Excellent visualization of the external fetal anatomy was obtained in 83% of cases (5/6) with the duration of procedures ranging 15 to 40 minutes. A diagnosis of Meckel-Gruber syndrome was made at 13+1 weeks of gestation by visualizing postaxial polydactyly and an occipital encephalocele. Subsequently the pregnancy was terminated. Three full-term infants were delivered with no gross limb or facial abnormalities. Amniotic fluid leakage after the procedure occurred in 2 cases resulting in termination of pregnancy. CONCLUSION: Our experiences confirm the efficacy of embryofetoscopy for early diagnosis in the first trimester of pregnancy. Procedure-related risks are to be established by multicenter studies.
Amniotic Fluid ; Diagnosis ; Early Diagnosis ; Encephalocele ; Endoscopes ; Extremities ; Female ; Fetus ; Humans ; Infant ; Polydactyly ; Pregnancy ; Pregnancy Trimester, First* ; Prenatal Diagnosis* ; Syndactyly ; Ultrasonography

BACKGROUND: Postoperative residual curarization subsequent to the use of neuromuscular blocking drugs can cause respiratory problems. This study examined the incidence of postoperative residual curarization on the arrival of patients in the recovery room. METHODS: Two-hundred-fifty-nine patients were enrolled in the study. The neuromuscular blockade was maintained with vecuronium or rocuronium and all subjects were reversed with pyridostigmine. The train of four ratios (TR) was quantified by acceleromyography immediately upon their arrival in the recovery room. The residual curarization was defined as a TR of < 0.9. RESULTS: The incidence of residual curarization was 32.8% (84 patients). The time from the last dose of muscle relaxants to the TR assessment in the recovery room was significantly different between those with a TR <0.9 (74.9 +/- 35.3 min) and a TR > 0.9 (104.5 +/- 51.1 min) patients. The total dose of muscle relaxants corrected by the ED95 was significantly different between TR < 0.9 and TR > or = 0.9 patients. The total dose of vecuronium or rocuronium, and the dose of pyridostimine was similar in the TR < 0.9 and TR > or = 0.9 patients. CONCLUSIONS: Significant postoperative residual curarization waspresent in the majority of patients, even with the use of intermediate- acting neuromuscular blocking drugs. In addition, the time from the last dose of muscle relaxants to the TR assessment in the recovery room is a major factor that affects the residual curarization.
Humans ; Incidence ; Neuromuscular Blockade ; Pyridostigmine Bromide ; Recovery Room* ; Vecuronium Bromide*

OBJECTIVE: To analyze both differentially expressed genes and the Bcl-xL protein expression after acute and chronic treatment with fluoxetine in rat C6 glioma cells. METHODS: C6 glioma cells were cultured for 24 h or 72 h after treatment with 10 microM fluoxetine, and gene expression patterns were observed using microarray and qRT-PCR. Then, cells were cultured for 6 h, 24 h, 72 h or 96 h after treatment with 10 microM fluoxetine, and the expression of Bcl-xL protein was measured using western blot. RESULTS: As determined by microarray, treatment with fluoxetine for 24 h up-regulated 33 genes (including Bcl-xL and NCAM140) and down-regulated 7 genes (including cyclin G-associated kinase). Treatment with fluoxetine for 72 h up-regulated 53 genes (including Gsalpha and Bcl-xL) and down-regulated 77 genes (including Galphai2 and annexin V). Based on the qRT-PCR results, there was an increase in Gsalpha mRNA and a decrease in Galphai2 mRNA at 72 h in fluoxetine-treated cells as compared to control, a result that was consistent with microarray. We also observed an increase in Bcl-xL mRNA (both at 24 h and at 72 h) in fluoxetine-treated cells as compared to control, demonstrating a tendency to increase gradually. Bcl-xL protein expression increased as the duration of fluoxetine treatment increased. CONCLUSION: These results suggest that chronic treatment with fluoxetine not only initiates the cAMP pathway through inducing Gsalpha expression but also induces Bcl-xL expression, thus inhibiting apoptosis.
Animals ; Apoptosis ; bcl-X Protein ; Cyclins ; Fluoxetine ; Gene Expression ; Glioma ; Rats ; RNA, Messenger

Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.
Acidosis, Respiratory ; Aged, 80 and over ; Animals ; Benzodiazepines ; Bradycardia ; Drug Combinations ; Female ; Flumazenil ; Hematologic Tests ; Humans ; Hyperkalemia ; Hypotension ; Ketamine ; Korea ; Naloxone ; Nuclear Family ; Stupor ; Tiletamine ; Vital Signs ; Zolazepam

BACKGROUND: Head lift (HL) for 5 seconds and tongue depressor (TD) test have been used for diagnosis of the residual block after using the nondepolarizing muscle relaxants. We investigated validity and reliability of HL, TD, and both of them (HLTD). METHODS: Four-hundred-thirteen patients were enrolled in this study. Neuromuscular blockade was maintained with rocuronium and reversed with pyridostigmine and glycopyrrolate. TOF ratio was quantified by acceleromyograph in the recovery room. HL and TD test were performed in the patients who could respond to verbal command of the investigator. We analyzed the sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, area under the cure (AUC) from ROC analysis and kappa statistics. RESULTS: Prevalences of residual block were 13%, 32% and 78% at 0.7, 0.9 and 1.0 of TOF ratio cutoff value, respectively. Specificity was good for HL (79.7-86.8%), TD (94.2-97.8%) and HLTD (77.8-85.7%), but sensitivity was not. Positive predictive value was higher in TD than HL and HLTD, and negative predictive value was similar among them. Positive and negative likelihood ratio was higher in TD than HL and HLTD. AUC had no difference among HL, TD and LTD. Kappa statistics were showed minimal or moderate relationship between clinical test and train of four responses. CONCLUSIONS: We concluded that HL, TD and HLTD were not good tools for diagnosis of the residual block in a view of validity and reliability.
Androstanols ; Area Under Curve ; Glycopyrrolate ; Head ; Humans ; Muscles ; Neuromuscular Blockade ; Prevalence ; Pyridostigmine Bromide ; Recovery Room ; Reproducibility of Results ; Research Personnel ; ROC Curve ; Tongue

OBJECTIVES: The ginsenoside Rg1 and Rb1, the major components of ginseng saponin, have neurotrophic and neuroprotective effects including promotion of neuronal survival and proliferation, facilitation of learning and memory, and protection from ischemic injury and apoptosis. In this study, to investigate the molecular basis of the effects of ginsenoside on neuron, we analyzed gene expression profiling of SH-SY5Y human neuroblastoma cells treated with ginsenoside Rg1 or Rb1. METHODS: SH-SY5Y cells were cultured and treated in triplicate with ginsenoside Rg1 or Rb1(80micrometer, 40micrometer, 20micrometer). The proliferation rates of SH-SY5Y cells were determined by MTT assay and microscopic examination. We used a high density cDNA microarray chip that contained 8K human genes to analyze the gene expression profiles in SH-SY5Y cells. We analyzed using the Significance Analysis of Microarray(SAM) method for identifying genes on a microarray with statistically significant changes in expression. RESULTS: Treatment of SH-SY5Y cells with 80microliter ginsenoside Rg1 or Rb1 for 36h showed maximal proliferation compared with other concentrations or control. The results of the microarray experiment yielded 96 genes were upregulated(> or =3 fold) in Rg1 treated cells and 40 genes were up-regulated(> or =2 fold) in Rb1 treated cells. Treatment with ginsenoside Rg1 for 36h induced the expression of some genes associated with protein biosynthesis, regulation of transcription or translation, cell proliferation and growth, neurogenesis and differentiation, regulation of cell cycle, energy transport and others. Genes associated with neurogenesis and neuronal differentiation such as SCG10 and MLP increased in ginsenoside Rg1 treated cells, but such changes did not occur in Rb1- group. CONCLUSION: Our data provide novel insights into the gene mechanisms involved in possible role for ginsenoside Rg1 or Rb1 in mediating neuronal proliferation or cell viability, which can elicit distinct patterns of gene expression in neuronal cell line. Ginsenoside Rg1 have more broad and strong effects than ginsenoside Rb1 in gene expression and related cellular physiology. In addition, we suggest that SCG10 gene, which is known to be expressed in neuronal differentiation during development and neuronal regeneration during adulthood, may have a role in enhancement of activity dependent synaptic plasticity or cytoskeletal regulation following treatment of ginsenoside Rg1. Further, ginsenoside Rg1 may have a possible role in regeneration of injured neuron, promotion of memory, and prevention from aging or neuronal degeneration.
Aging ; Apoptosis ; Cell Cycle ; Cell Line ; Cell Proliferation ; Cell Survival ; Gene Expression Profiling* ; Gene Expression* ; Humans* ; Learning ; Memory ; Negotiating ; Neuroblastoma* ; Neurogenesis ; Neurons ; Neuroprotective Agents ; Oligonucleotide Array Sequence Analysis ; Panax ; Physiology ; Plastics ; Protein Biosynthesis ; Regeneration ; Saponins ; Transcriptome

Objective: Frequent emergency department (ED) visit is a global public health problem that can delay proper management and reduce the quality of medical services. While many researches were done on adult frequent ED users, studies lack on pediatric patients. This study was designed to identify the characteristics of the frequent pediatric ED users and risk factors related to pediatric frequent ED visits. Methods: This was a retrospective observational study using ED-based data derived from pediatric patients at a tertiary university hospital. The main exposure variable was frequent pediatric ED visits, which were defined as more than 4 visits within a year (January 1-December 31, 2019). Characteristics and risk factors for frequent pediatric ED users were evaluated using forward stepwise regression analysis. Results: During the study period, 10,050 pediatric ED visits (8,313 patients) were identified. Of which, 550 (5.5%) were frequent ED visits (114 patients, 1.4%). The independent risk factors for frequent pediatric ED visits were age <1 year (adjusted odds ratio [AOR], 2.79; 95% confidence interval [CI], 1.32-5.93), visiting during spring and winter (AOR, 5.72; 95% CI, 3.36-9.75) and visiting due to medical problem (AOR, 1.66; 95% CI, 1.02-3.08). Primary diagnosis of unspecified convulsions, acute lower respiratory infection, other specified medical care, and arrhythmia were associated with frequent pediatric ED visits. Conclusion Age <1 year, visiting ED during spring and winter, visiting ED due to medical problem can increase the risk of frequent ED visit by pediatric patients.