Mast cells are an effector cell that plays a pivotal role in type I hypersensitive immune responses. Mast cells exist in connective tissues, such as skin and mucosal tissue, and contain granules which contain bioactive substances such as histamine and heparin in cells. The granules of mast cells are secreted by antigen stimulation to cause the type I allergic hypersensitivity. In addition, stimulated by antigen, mast cells synthesize and secrete various eicosanoids and cytokines. While AT9283 is known to have anticancer effects, the therapeutic effect of AT9283 on allergic disorders is completely unknown. In this study, it was found that AT9283 reversibly inhibited antigen-IgE binding-induced degranulation in mast cells (IC50, approx. 0.58 μM) and suppressed the secretion of the inflammatory cytokines IL-4 (IC50, approx. 0.09 μM) and TNF-α (IC50, approx. 0.19 μM). For a mechanism of mast cell inhibition, while not inhibiting Syk phosphorylation, AT9283 suppressed the activation of LAT, a downstream substrate protein of Syk, in a dose-dependent manner. As expected, AT9283 also inhibited the activation of PLCγ1 and Akt, downstream signaling molecules of Syk/LAT, and MAP kinases such as JNK, Erk1/2, and P38. In an in vitro protein tyrosine kinase assay, AT9283 directly inhibited Syk activity. Next, AT9283 dose-dependently inhibited passive cutaneous anaphylaxis (PCA), an IgE-mediated allergic acute response, in mice (ED50, approx. 34 mg/kg, p.o.). These findings suggest that AT9283 has potential to use as a new drug for alleviating the symptoms of IgE-mediated allergic disorders.

Background/Aims: Although prolonged post-operative ileus (PPOI) is an important factor for the prolonged length of post-operative hospital stay, there is still a lack of effective predictive and therapeutic methods for PPOI. Previous studies reported that increased inflammatory markers, such as C-reactive protein (CRP) level and neutrophil to lymphocyte ratio (NLR), are associated with malignancies. The aim of our study is to elucidate the association between peri-operative inflammatory markers and PPOI after gastrectomy for gastric cancer. Methods: We enrolled patients who received gastrectomy for gastric cancer from June 2013 to January 2016 at a single tertiary referral center in Seoul, Korea. We evaluated peri-operative inflammatory markers, including CRP level, NLR, and platelet to lymphocyte ratio (PLR) of enrolled patients. We compared these data between control group and PPOI group. Results: A total of 390 subjects were enrolled in this study, and 132 patients (33.8%) showed PPOI. In univariate analysis, preoperative CRP level and NLR, post-operative day (POD) 1 CRP level, NLR, and PLR, and POD3 CRP level, NLR, and PLR were significantly associated with PPOI. In multivariate analysis, preoperative NLR (P = 0.014), POD1 NLR (P = 0.019), POD3 CRP (P = 0.004), and POD3 NLR (P = 0.008) were independent risk factors for PPOI. Conclusions Peri-operative inflammatory markers, such as CRP level and NLR, are useful predictive factors for PPOI who received gastrectomy for gastric cancer. Moreover, prophylactic antibiotics and anti-inflammatory drugs can be preventive and therapeutic agents for PPOI.

Background/Aims: Although prolonged post-operative ileus (PPOI) is an important factor for the prolonged length of post-operative hospital stay, there is still a lack of effective predictive and therapeutic methods for PPOI. Previous studies reported that increased inflammatory markers, such as C-reactive protein (CRP) level and neutrophil to lymphocyte ratio (NLR), are associated with malignancies. The aim of our study is to elucidate the association between peri-operative inflammatory markers and PPOI after gastrectomy for gastric cancer. Methods: We enrolled patients who received gastrectomy for gastric cancer from June 2013 to January 2016 at a single tertiary referral center in Seoul, Korea. We evaluated peri-operative inflammatory markers, including CRP level, NLR, and platelet to lymphocyte ratio (PLR) of enrolled patients. We compared these data between control group and PPOI group. Results: A total of 390 subjects were enrolled in this study, and 132 patients (33.8%) showed PPOI. In univariate analysis, preoperative CRP level and NLR, post-operative day (POD) 1 CRP level, NLR, and PLR, and POD3 CRP level, NLR, and PLR were significantly associated with PPOI. In multivariate analysis, preoperative NLR (P = 0.014), POD1 NLR (P = 0.019), POD3 CRP (P = 0.004), and POD3 NLR (P = 0.008) were independent risk factors for PPOI. Conclusions Peri-operative inflammatory markers, such as CRP level and NLR, are useful predictive factors for PPOI who received gastrectomy for gastric cancer. Moreover, prophylactic antibiotics and anti-inflammatory drugs can be preventive and therapeutic agents for PPOI.

BACKGROUND: This study was designed to compare the hemodynamic changes in response to direct laryngoscopy of the McCoy blade and the Macintosh blade. METHODS: Sixty patients scheduled for elective gynecologic surgery were randomly allocated into two groups. The induction of anesthesia was done with thiopental sodium 5 mg/kg, fentanyl 2 mcg/kg, vecuronium 0.1 mg/kg. When the train of four arrived came at 0/4, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade for 10 seconds. Heart rate and blood pressure were recorded at 1 minute intervals for 5 minutes. RESULTS: Laryngoscopy caused significant increases in arterial blood pressure in both groups, while it had no effect on heart rate in either group. There were no significant differences in blood pressure and heart rate responses to laryngoscopy in the blades. CONCLUSIONS: The McCoy and the Macintosh blade show similar changes in heart rate and blood pressure after laryngoscopy.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Laryngoscopes* ; Laryngoscopy ; Thiopental ; Vecuronium Bromide ; Vocal Cords

BACKGROUND: In patient-controlled analgesia (PCA), ketorolac tromethamine has been mixed with nalbuphine HCL in the same PCA balloon or syringe. The compatibility of mixed drugs is an important factor in determining the effects of the administered drugs, so we examined the compatibility of the mixed solution of the both drugs in various dilutions. METHODS: Ketorolac tromethamine (K1, 3, 7, 19 group; n = 10/group) or nalbuphine HCl (N1, 3, 7, 19 group; n = 10/group) was diluted 1: 1, 3, 7, or 19 with normal saline and then the other drug was added. The presence of precipitates, turbidity by visual and spectrophotometric methods, and the pH of the mixed solutions were evaluated 0, 1, 6, 12 and 24 hours later. RESULTS: Precipitates were observed in all studied solutions except in solutions of nalbuphine HCl diluted 1 : 19 with normal saline plus ketorolac tromethamine at the observed intervals. Turbid changes were observed in N1, 3, K1, 3, and 7, but significantly decreased from 6 hours after mixing. The pH of the K groups were significantly lower than those of the N groups. CONCLUSIONS: The mixed solutions of ketorolac tromethamine with nalbuphine HCl were visually incompatible in almost all studied cases, so careful considerations are needed in mixing ketorolac tromethamine with nalbuphine HCl.
Analgesia, Patient-Controlled ; Hydrogen-Ion Concentration ; Ketorolac Tromethamine* ; Ketorolac* ; Nalbuphine* ; Passive Cutaneous Anaphylaxis ; Syringes

PURPOSE: To evaluate the prevalence of esophageal reflux-induced symptoms after gastrectomy owing to gastric cancer and assess the relationship between esophageal reflux-induced symptoms and quality of life. MATERIALS AND METHODS: From January 2012 to May 2012, 332 patients were enrolled in this cross-sectional study. The patients had a history of curative resection for gastric cancer at least 6 months previously without recurrence, other malignancy, or ongoing chemotherapy. Esophageal reflux-induced symptoms were evaluated with the GerdQ questionnaire. The quality of life was evaluated with the European Organization for Research and Treatment QLQ-C30 and STO22 questionnaires. RESULTS: Of the 332 patients, 275 had undergone subtotal gastrectomy and 57 had undergone total gastrectomy. The number of GerdQ(+) patients was 58 (21.1%) after subtotal gastrectomy, and 7 (12.3%) after total gastrectomy (P=0.127). GerdQ(+) patients showed significantly worse scores compared to those for GerdQ(-) patients in nearly all functional and symptom QLQ-C30 scales, with the difference in the mean score of global health status/quality of life and diarrhea symptoms being higher than in the minimal important difference. Additionally, in the QLQ STO22, GerdQ(+) patients had significantly worse scores in every symptom scale. The GerdQ score was negatively correlated with the global quality of life score (r=-0.170, P=0.002). CONCLUSIONS: Esophageal reflux-induced symptoms may develop at a similar rate or more frequently after subtotal gastrectomy compared to that after total gastrectomy, and decrease quality of life in gastric cancer patients. To improve quality of life after gastrectomy, new strategies are required to prevent or reduce esophageal reflux.
Cross-Sectional Studies ; Diarrhea ; Drug Therapy ; Gastrectomy* ; Gastroesophageal Reflux ; Humans ; Prevalence ; Quality of Life* ; Recurrence ; Stomach Neoplasms* ; Weights and Measures ; Surveys and Questionnaires

In recent years, there appears to have been an increased incidence or recognition of sebaceous carcinomas of the ocular adnexa, which had been previously believed very rare. A 55-year-old male visited our hospital in April 1973 with a large lump in the right lower eyelid which had showed progressive enlargement of one year's duration. A biopsy was carried out and the histopathological examination revealed sebaceous carcinoma. He was treated with a total dosage of 6,000 rads of electron-beam by LINAC machine in October 1973, and the result was excellent.
Biopsy ; Eyelids ; Humans ; Incidence ; Male ; Middle Aged

PURPOSE: This study was done to evaluate the usefulness of preoperative computed tomography (CT) and intraoperative laparoscopic ultrasound to facilitate treatment of gastric submucosal tumors. MATERIALS AND METHODS: The feasibility of laparoscopic wedge resection as determined by CT findings of tumor size, location, and growth pattern was correlated with surgical findings in 89 consecutive operations. The role of laparoscopic ultrasound for tumor localization was analyzed. RESULTS: Twenty-three patients were considered unsuitable for laparoscopic wedge resection because of large tumor size (N=13) or involvement of the gastroesophageal junction (N=9) or pyloric channel (N=1). Laparoscopic wedge resection was not attempted in 11 of these patients because of large tumor size. Laparoscopic wedge resection was successfully performed in 65 of 66 (98.5%) patients considered suitable for this procedure. Incorrect interpretation of preoperative CT resulted in a change of surgery type in seven patients (7.9%): incorrect CT diagnosis on gastroesophageal junction involvement (N=6) and on growth pattern (N=1). In 18 patients without an exophytic growth pattern, laparoscopic ultrasound was necessary and successfully localized all lesions. CONCLUSIONS: Preoperative CT and laparoscopic ultrasound are useful for surgical planning and tumor localization in laparoscopic wedge resection.
Esophagogastric Junction ; Humans

PURPOSE: This study was done to evaluate the usefulness of preoperative computed tomography (CT) and intraoperative laparoscopic ultrasound to facilitate treatment of gastric submucosal tumors. MATERIALS AND METHODS: The feasibility of laparoscopic wedge resection as determined by CT findings of tumor size, location, and growth pattern was correlated with surgical findings in 89 consecutive operations. The role of laparoscopic ultrasound for tumor localization was analyzed. RESULTS: Twenty-three patients were considered unsuitable for laparoscopic wedge resection because of large tumor size (N=13) or involvement of the gastroesophageal junction (N=9) or pyloric channel (N=1). Laparoscopic wedge resection was not attempted in 11 of these patients because of large tumor size. Laparoscopic wedge resection was successfully performed in 65 of 66 (98.5%) patients considered suitable for this procedure. Incorrect interpretation of preoperative CT resulted in a change of surgery type in seven patients (7.9%): incorrect CT diagnosis on gastroesophageal junction involvement (N=6) and on growth pattern (N=1). In 18 patients without an exophytic growth pattern, laparoscopic ultrasound was necessary and successfully localized all lesions. CONCLUSIONS: Preoperative CT and laparoscopic ultrasound are useful for surgical planning and tumor localization in laparoscopic wedge resection.
Esophagogastric Junction ; Humans

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis