This study aimed to investigate the mechanism of action of baclofen on the detrusor muscle isolated from rat. Rats (Sprague-Dawley) were sacrificed by decapitation and exsanguination. Horizontal muscle strips of 2 mm x 15mm were prepared for isometric myography in isolated muscle chamber bubbled with 95% / 5%-OZ / CO2 at 371C, and the pH was maintained at 7.4 Detrusor strips. contracted responding to the.. electrical field stimulation (EFS) by 2 Hz, 2U msec, monophasic square wave of 60 VDC. The initial peak of EFS-Induced contraction was tended to be suppresed by a,p-methylene-adenosine 5'-triphosphate (mATP), a partial agonist of purinergic receptor, and baclofen, a GABAB receptor agonist (statistically nonsignificant). The late sustained contraction by EFS was suppressed significantly (p < 0.05) by additions of atropione, a cholinergic muscarinic receptor antagonist and baclofen. The adenosine 5'-triphosphate-induced contraction was completely abolished by mA TP but not by baclofen. In the presence of atropine, the subsequent addition of acetylcholine could not contract the muscle strips: but the addition of acetylcholine in the presence of baclofen evoked a contraction to a remarkable extent.
Acetylcholine ; Adenosine ; Animals ; Atropine ; Baclofen* ; Decapitation ; Exsanguination ; Hydrogen-Ion Concentration ; Myography ; Rats* ; Receptors, Muscarinic

PURPOSE: This is to examine the neurodevelopmental outcomes of very low birth weight (VLBW) infants by Korean infant developmental screening test. METHODS: 29 VLBW infants and 39 normal term infants, at their corrected age of 1 to 3 years, were included for the study. Risk factors which influence neurodevelopmental outcomes were analyzed. RESULT: The mean levels of developmental quotients for VLBW infants were lower than those of term infants (P<0.001); gross motor 99.3+/-27.28 vs. 121.3+/-19.08, fine motor 95.9+/-27.22 vs. 118.3+/-17.77, social-personality 100.2+/-28.01 vs. 126.3+/-21.31, language 99.5+/-27.34 vs. 120.1+/-18.82, cognitive-adaptive 101.4+/-28.60 vs. 122.7+/-19.59, and total developmental quotient is 99.3+/-27 vs. 121.7+/-19.18. Nevertheless, the mean levels of the individual developmental quotients for VLBW infants were in normal range. There were five VLBW infants (17%) those who scored lower than 80, also showed neurologic sequelae. The infants who had the more risk factors during hospitalization scored the less developmental quotient (R(2)=0.35, P=0.01). CONCLUSION: Although the mean levels of the individual developmental quotient for VLBW infants, assessed by Korean infant developmental screening test, were lower than those of term infants, they are in normal range.
Child ; Child Development* ; Hospitalization ; Humans ; Infant* ; Infant, Very Low Birth Weight* ; Mass Screening* ; Reference Values ; Risk Factors

Enterobacter cloacae, a gram negative bacillus is an increasingly frequent cause of nosocomial pediatric infection. It can cause infection of postsurgical wounds, meningitis, and infection of the gastrointestinal, urinary, and respiratory tracts. Newborn infants often are colonized by Enterobacter species in the gastrointestina tract or respiratory tract soon after birth, and a acquisition of hospital strains in immunocompromised newborn infants is common. Neonatal pneumonia has been associated with many infectious agents. Pneumatocele, a cyst-like lesion that develops within the lung parenchyma, is an unusual complication of pneumonia in the neonate, especially in the preterm neonate. Pneumatocele has been reported to occur with Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, and Pseudomonas aeruginosa infections. We describe 2 cases of premature neonates with pneumonia and subsequent pneumatocele formation caused by Enterobacter cloacae.
Bacillus ; Colon ; Enterobacter cloacae* ; Enterobacter* ; Escherichia coli ; Humans ; Infant, Newborn* ; Klebsiella pneumoniae ; Lung ; Meningitis ; Parturition ; Pneumonia ; Pseudomonas aeruginosa ; Respiratory System ; Staphylococcus aureus ; Streptococcus pneumoniae ; Wounds and Injuries

PURPOSE: The purpose of this study was to investigate the welfare status of nurses and the status of fixed night shifts and flexible work arrangements in both general hospitals and advanced general hospitals in Korea. METHODS: A total of 167 hospitals participated in this study, done from April to October 2018. RESULTS: There were 103 hospitals utilizing the fixed night shift system, 22 in the two-shift system, 3 in the fixed holiday shift, 79 in the fixed shift system, and 39 in the short-time working system. The average welfare benefits for nurses increased to 33.02 million won on average. However, welfare services for the nurses were poor: 41.8% of the respondents had a nurses' lounge, 81.7% were given dormitory space at their place of employment, 41.8% had access to welfare facilities, and 56.4% were provided with welfare support countermeasures. CONCLUSION: The results show an increasing trend of hospitals to utilize fixed night shift and flexible work arrangements. An institutional strategy at the national policy level should be established to implement flexible work arrangements including the fixed night shift system, which has a poor level of welfare.
Employment ; Holidays ; Hospitals, General ; Korea ; Surveys and Questionnaires

Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S. aureus. A 62-year-old man with type 2 diabetes was admitted with fever, increased urinary frequency, and left flank pain. He was diagnosed with acute pyelonephritis caused by S. aureus. His fever and flank pain subsided after 3 days of intravenous antibiotics. Evaluation of bladder obstruction and metastatic infection were not performed, as he declined further evaluation. The patient was discharged with oral antibiotics and was requested to attend weekly appointments but was lost to follow-up. One month later, the patient presented at the outpatient clinic with similar symptoms. Computed tomography showed recurrent pyelonephritis and a distended bladder. His flank pain persisted despite administration of an opioid agent. Therefore, magnetic resonance imaging was performed, revealing epidural and paraspinal abscesses. Ultrasound-guided aspiration of the paraspinal muscle layer was performed, and blood and percutaneous aspirated fluid cultures revealed S. aureus growth. The pattern of antimicrobial sensitivity was identical to that at his first admission. Following more than 4 weeks of antibiotics, magnetic resonance imaging showed the abscesses had decreased in size. The patient was discharged without neurologic sequelae and was provided with oral antibiotics.
Abscess* ; Ambulatory Care Facilities ; Anti-Bacterial Agents ; Appointments and Schedules ; Diagnosis ; Epidural Abscess ; Fever ; Flank Pain ; Heart ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Middle Aged ; Paraspinal Muscles ; Pyelonephritis* ; Spine ; Staphylococcus aureus* ; Staphylococcus* ; Urinary Bladder ; Urinary Tract Infections

The use of lower extremity tourniquets for procedures of the lower leg is considered routine in orthopedic surgery, yet, lower extremity tourniquets are not benign. While the tourniquet is inflated, metabolic changes such as increased PaCO2, lactic acid, and serum potassium and decreased level of PaO2. and pH occur in the ischemic limb. Deflation of tourniquet results in release of anaerobic metabolic products during ischemia into systemic circulation. In this ischemia/reperfusion situation, oxygen free radicals could potentially be produced during the reperfusion period by several mechanisms. One of these mechanisms is release of intracellular superoxide or hydrogen peroxide by activated neutrophils in the area. These reactive oxygen species(ROS) could be a causative factor for the postreperfusion no-flow, lung injury, induction of tourniquet shock, etc, The purpose of this clinical study was to investigate the effect of tourniquet deflation on the hemodynamic changes, changes of blood gas analysis, and hydrogen peroxide production using flow cytometric analysis of fluorescent DCF(Dichlorofluorescein). Quantitative Analysis of fluorescent DCF was performed in resting and fMLP(N-formyl-methyonyl-leucyl-phenylalanine) or PMA(phorbol myristate acetate) stimuliated neutrophils. The results were as follows: 1)The hemodynamic changes (systolic and diastolic BP, pulse rate) did not show any significant difference before and after tourniquet release(P>0.05). 2)Arterial pH deceased significantly until 10min and PaC was increased significantly until Smin after toumiquet release(P<0.05). 3) Arterial PO2, bicarbonate, base excess showed no significant change before and after tour- niquet release(P>0.05). 4) Hydrogen peroxide production which was estimated by fluorescent DCF in neutrophils did not show any significant change before and after tourniquet release(P>0.05). These results indicate that tourniquet application(400mmHg, less than 2hours) could not release significant hydrogen peroxide during reperfusion period after tourniquet release.
Blood Gas Analysis ; Extremities ; Flow Cytometry ; Free Radicals ; Hemodynamics ; Hydrogen Peroxide* ; Hydrogen* ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Leg ; Lower Extremity ; Lung Injury ; Myristic Acid ; Neutrophils* ; Orthopedics ; Oxygen ; Potassium ; Reperfusion ; Shock ; Superoxides ; Tourniquets*

Primaquine was approved for treatment of malaria in 1952 by the United States Food and Drug Administration (FDA). It has remained the only FDA-licensed drug capable of clearing the intra-hepatic schizonts and hypnozoites of Plasmodium vivax. It is associated with serious hazards and side effects, such as hemolytic anemia and methemoglobinemia. However, there is no report of primaquine causing liver injury in Korea. We describe a case of acute liver failure following primaquine overdose in a 19-year-old man.
Anemia, Hemolytic ; Drug-Induced Liver Injury ; Humans ; Korea ; Liver ; Liver Failure, Acute* ; Malaria ; Methemoglobinemia ; Plasmodium vivax ; Primaquine ; Schizonts ; United States Food and Drug Administration ; Young Adult

Preventive and therapeutic effects of egg yolk antibody, immunoglobulin Y (IgY), against canine parvovirus (CPV) was evaluated in 25 pups orally challenged with CPV-2a. Oral administration of IgY using powder, paste and coated paste delivery systems was compared. Each type of IgY was administered orally for 17 days from 3 days before challenge. The group of pups administered coated IgY showed mild symptoms such as a moderate decrease in total white blood cell count, no depression, vomiting and diarrhea when compared with other groups. The overall clinical score of the group of pups administered coated IgY was significantly lower than that of the challenge control group. However, mortality did not differ among groups because not all pups received symptomatic treatment. These results implied that oral treatment of coated IgY could improve therapeutic effects against CPV challenge if pups received symptomatic treatment.
Administration, Oral ; Chickens* ; Depression ; Diarrhea ; Egg Yolk* ; Enteritis* ; Immunoglobulins ; Immunotherapy ; Leukocyte Count ; Mortality ; Parvovirus, Canine ; Vomiting

Acromegaly is a slowly progressing condition resulting from excess growth hormone (GH), generally caused by a GH-secreting pituitary adenoma. Cancer is the third most common cause of mortality in patients with acromegaly, and insulin-like growth factor 1 (IGF-1) is known to influence tumor formation by increasing cell proliferation and inhibiting apoptosis. Multiple myeloma (MM) is a plasma cell neoplasm, and previous studies have suggested the possible role of IGF-1 in its development of MM. However, no cases of acromegaly accompanied with MM have been reported in Asia to date. We here report the case of a 58-year-old woman with acromegaly accompanied with MM who presented with longstanding acromegalic manifestations resulting from a GH-secreting pituitary adenoma and also exhibited anemia, a reversed albumin/globulin ratio, and plasmacytosis on bone marrow examination. Because IGF-1 has been suggested to play an important role in the development and progression of MM, the patient promptly underwent surgical removal of the pituitary adenoma via a transsphenoidal approach. Since there is currently no consensus on therapeutic guidelines and suggested prognosis for MM with acromegaly, long-term follow-up of such cases is needed.
Acromegaly* ; Anemia ; Apoptosis ; Asia ; Bone Marrow Examination ; Cell Proliferation ; Consensus ; Female ; Growth Hormone ; Growth Hormone-Secreting Pituitary Adenoma ; Humans ; Insulin-Like Growth Factor I ; Middle Aged ; Mortality ; Multiple Myeloma* ; Neoplasms, Plasma Cell ; Pituitary Neoplasms ; Prognosis

PURPOSE: The purpose of this study is to show the total survival rate of implants with maxillary sinus floor elevation and the effects that reach the survival rate by classifying types of graft materials, implant surface, operation method, bone height. METHODS: In a total of 131 patients, 251 implants with sinus floor elevation were installed simultaneously or after regular healing. Various bone grafts (autograft, xonograft, allograft, alloplast) and implant surface (MTX-HA implant, chemical etching implant, Titanium oxide surface implant, resorbable blasting media implant, resorbable blast texturing implant, HA-coated implant) were used. All implants were investigated clinically and radiographically, being with 1 to 5 years follow-up period after installation. RESULTS: The survival rate of 251 implants with maxillary sinus floor elevation was 94%. The types of implant, surface, graft material, bone height have no statistically signi-ficant differencies. CONCLUSIONS: It can be suggested that maxillary sinus floor elevation may have predictable result with various bone graft materials and implant surface.
Dental Implants ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Retrospective Studies ; Survival Rate ; Titanium ; Transplantation, Homologous ; Transplants