No abstract available.
Cell Cycle*

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Only a few patients reach adulthood without surgical correction. Unrepaired TOF patients with mild to moderate right ventricular outflow tract (RVOT) obstruction may be clinically silent until adulthood. TOF with hypoxic spells present as periods of profound cyanosis that occur because of almost total RVOT obstruction. So, hypoxic spell typically occurs in a crying infant but is rare in an adult. In this report, we presented a case of a 75-year-old patient with uncorrected TOF presenting with hypoxic spell, consequent pulmonary hypertension and chronic heart failure. This is the oldest case of natural survivor with uncorrected TOF in Korea and the oldest patient presenting hypoxic spell worldwide.
Adult ; Aged* ; Anoxia ; Crying ; Cyanosis ; Heart Defects, Congenital ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Infant ; Korea ; Survivors* ; Tetralogy of Fallot*

Eisenmenger syndrome is defined as pulmonary hypertension at or close to systemic values, with an intracardiac or aortopulmonary communication resulting a bidirectional or right-to-left shunt.Patients with Eisenmenger syndrome require a close monitoring while undergoing non-cardiac surgery because these patients are very vulnerable to alteration in hemodynamics induced by anesthetics or surgery.Therefore we report the successful management of a patient with Eisenmenger syndrome undergoing a dacryocystorhinostomy under desflurane and ketamine based general anesthesia.
Anesthesia, General ; Anesthetics ; Dacryocystorhinostomy ; Eisenmenger Complex ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Isoflurane ; Ketamine

Viagra has been prescribed worldwide to treat men with erectile dysfunction. Clinical trials have shown that Viagra may cause various kinds of adverse effects include some central nervous system (CNS) adverse effects. Although extremely rare, toxic encephalopathy also can be one of those effects. This report presents a case of encephalopathy caused by Viagra in correlation with its radiologic findings. Its pharmacologic mechanism and potential effects on the biochemistry of the CNS are reviewed.
Biochemistry ; Brain Diseases ; Central Nervous System ; Erectile Dysfunction ; Humans ; Male ; Neurotoxicity Syndromes* ; Sildenafil Citrate*

No abstract available.
Magnetic Resonance Imaging ; Pulmonary Artery ; Pulmonary Embolism* ; Radionuclide Imaging

BACKGROUND: Postoperative nausea and vomiting (PONV) frequently develops in patients undergoing thyroidectomy, and propofol-based total intravenous anesthesia (TIVA) has been reported to reduce the incidence of PONV. The present study was undertaken to compare the effects of ramosetron on PONV in women following total thyroidectomy under TIVA. METHODS: One hundred and thirty women scheduled for thyroidectomy were allocated to either a control group (n = 65) or a ramosetron group (n = 65). Propofol in combination with remifentanil was used for TIVA in all patients. 2 ml of either intravenous saline (control group) or 0.3 mg of ramosetron (ramosetron group) were administered at the end of the surgery. Fentanyl-based patient-controlled analgesia was implemented for 48 h after surgery in all patients. The incidences and severities of PONV, pain scores, administrations of rescue antiemetics, and the side effects of the antiemetics were documented during the first 48 h after surgery. RESULTS: The incidences of complete response (no PONV, no rescue) in the control and ramosetron groups were 71% and 88%, respectively, during the first 6 h (P = 0.029), 85% and 94% during the next 6 to 24 h period (P = 0.155), and 97% and 95% during the last 24 to 48 h period (P = 1.00). During the first 6 h, the severity of nausea and the use of rescue antiemetic medication were significantly lower in the ramosetron group. CONCLUSIONS: Ramosetron was found to be effective at reducing the incidence and severity of postoperative nausea in women that underwent total thyroidectomy with propofol-based TIVA, especially during the first 6 hours postoperatively.
Analgesia, Patient-Controlled ; Anesthesia, Intravenous ; Antiemetics ; Benzimidazoles ; Female ; Humans ; Incidence ; Nausea ; Piperidines ; Postoperative Nausea and Vomiting ; Propofol ; Thyroidectomy

BACKGROUND: Protamine sulfate has been found to produce systemic hypotension secondary to acute pulmonary vasoconstriction and subsequent right heart failure in pigs and sheep. Nitric oxide (NO) is a potent pulmonary vasodilator. The present study was aimed to determine whether NO inhalation prevents hypotension in an open-chest canine model. METHODS: With IRB approval, 29 mongrel dogs were acutely instrumented during 1.5% enflurane anesthesia. All animals then received protamine 3 mg/kg over 30 s given through right atrium, 5 min after heparin (300 IU/kg, iv). NO inhalation was done for 20 min beginning 10 min before protamine infusion (NO group, n = 10). Control group was without NO inhalation (n = 19), which was retrospectively divided into two groups according to the magnitude of pulmonary arterial pressure (PAP) increase: normal PAP group (increase in PAP less than 6 mmHg, n = 9) and pulmonary hypertensive group (increase in PAP more than 6 mmHg, n = 10). Mean arterial pressure (MAP), PAP, left ventricular end-diastolic pressure (LVEDP), heart rate (HR), and cardiac output and left circumflex (LCX) coronary flow via a Doppler flowmeter were continuously monitored. Calculated parameters included cardiac index (CI), and systemic and pulmonary vascular resistance indices (SVRI and PVRI). RESULTS: Protamine increased PAP (66 vs 7%) and PVRI (5.1- vs 3.0- fold) more pronouncedly in pulmonary hypertensive than in normal group. However, protamine caused similar reductions of MAP (-40 vs -46%), CI (-60 vs -59%), and LVEDP (-47 vs -53%) in pulmonary hypertensive and normal groups. SVRI showed a biphasic response in both groups, an initial decrease (-15 vs -14%), followed by an increase (48 vs 25%, P<0.05). Continuous inhalation of NO at 80 ppm did not affect the protamine-induced reductions in MAP (-40%), CI (-55%), and LVEDP (-46%) and increases in PAP (45%) and PVRI (4.1-fold). LCX flow increased immediately after the protamine treatment in all groups to a similar magnitude (83-130%), indicating a rapid release of potent vasodilators. CONCLUSIONS: Protamine produces profound hypotension, which may not be causally related to an acute pulmonary vasoconstriction in the dog. It is unlikely that exogenous NO treatment affects hypotension.
Anesthesia ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Enflurane ; Ethics Committees, Research ; Flowmeters ; Heart Atria ; Heart Failure ; Heart Rate ; Heparin ; Hypotension* ; Inhalation ; Nitric Oxide* ; Protamines ; Retrospective Studies ; Sheep ; Swine ; Vascular Resistance ; Vasoconstriction ; Vasodilator Agents

OBJECTIVES: This study was conducted to examine the preferences and needs of typical Korean females adults for food and nutrition information provided by the mass media. METHODS: A total of 343 females (77 in their 20s, 85 in their 30s, 88 in their 40s and 93 in their 50s) residing in the Seoul/Gyeonggido area was surveyed on general characteristics, main sources of food and nutrition information and needs for sources and contents of nutrition information. RESULTS: The survey showed that typical Korean females obtained knowledge of food and nutrition mainly through the Internet (30.4%) and broadcasting (29.0%). Typical Korean females were interested in 'dietary management for weight control' (21.9%), 'the prevention and treatment of disease' (20.0%), 'food safety' (16.8%), 'proper dietary habits' (14.6%), 'cookery' (11.8%), 'functional foods' (9.6%), 'restaurant details' (3.5%) and 'life-cycle-specific dietary guideline' (1.6%). Needs for food and nutrition program forms on TV were 'educational programs' (34.3%), 'documentaries' (20.8), 'expert lecture-style' (13.0%), 'entertainment programs' (11.9%), 'expert conversation' (11.4%), 'news-style' (4.6%) and 'public campaign advertisements' (4.0%). On the Internet, 38.6% of the respondents preferred to get information provided by food and nutrition-related institutions (38.6%) while 26.1% preferred webtoons for nutritional information. The favored forms in mobile applications were 'monitoring their diets' (29.5%), 'data-based texts information' (21.4%), 'experts feedback' (20.6%), 'communities' (15.1%) and 'games' (13.1%). The rates of the preference to obtain information from experts such as nutritionists and dietitians and doctors - or dietitian turned reporters increased markedly with older ages. CONCLUSIONS: Since the mass media is a main source of food and nutrition information for the general public, the effectiveness and accuracy of the information provided should be enhanced by taking the needs of the public into account. The quality of information should be improved by involving more nutrition experts.
Adult* ; Surveys and Questionnaires ; Female ; Humans ; Internet ; Mass Media* ; Mobile Applications ; Nutritionists

Omega-3 polyunsaturated fatty acids are essential fatty acids because humans cannot synthesize them de novo and must obtain them in their diet. Fish and fish oil are rich sources of omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Significant evidence of the beneficial role of dietary intake of omega-3 fatty acids in blood flow has been reported and putative mechanisms for improvement of blood flow include anti-thrombotic effects, lowered blood pressure, improved endothelial function, and anti-atherogenic effects. Edible oils containing omega-3 fatty acids were registered as functional ingredients in the Korea Health Functional Food Code. Although omega-3 fatty acids have been evaluated by the Korea Food and Drug Administration (KFDA) based on scientific evidence, periodic re-evaluation may be needed because emerging data related to omega-3 fatty acids have accumulated. Therefore, in this study, we re-evaluated scientific evidence for the effect of omega-3 fatty acids as a functional ingredient in health functional food on improvement of blood flow. A comprehensive literature search was conducted for collection of relevant human studies using the Medline and Cochrane, KISS, and IBIDS databases for the years 1955-2012. Search keywords were used by combination of terms related to omega-3 fatty acids and blood flow. The search was limited to human studies published in Korean, English, and Japanese. Using the KFDA's evidence based evaluation system for scientific evaluation of health claims, 112 human studies were identified and reviewed in order to evaluate the strength of the evidence supporting a relation between omega-3 fatty acids and blood flow. Among 112 studies, significant effects on improvement of blood flow were reported in 84 studies and the daily intake amount was ranged from 0.1 to 15 g. According to this methodology of systematic review, we concluded that there was possible evidence to support a relation between omega-3 fatty acid intake and blood flow. However, because inconsistent results have recently been reported, future studies should be monitored.
Asian Continental Ancestry Group ; Blood Pressure ; Diet ; Eicosapentaenoic Acid ; Fatty Acids, Essential ; Fatty Acids, Omega-3 ; Fatty Acids, Unsaturated ; Functional Food ; Humans ; Korea ; Oils ; United States Food and Drug Administration

The clinical manifestations related to iliopsoas bursitis can vary due to compression of the adjacent structure such as the common femoral vein, nerve and bladder. We report here on a rare case of iliopsoas bursitis with compression of the common femoral vein that resulted in acute lower leg edema.
Bursitis* ; Edema* ; Femoral Vein* ; Leg* ; Urinary Bladder