OBJECTIVES: This study was performed to identify genes regulated by electroconvulsive shock (ECS) and to observe the pattern of expression of genes according to different developmental stages and brain regions. METHODS: ECS(130V, 0.5 sec) was given to male Sprague-Dawley rats with age of postnatal day 7 and 21(P7, P21 respectively). After screening genes regulated by ECS with mRNA differential display-PCR(DD-PCR), we selected one clone among them and observed the induction of this gene after ECS by time-dependent Northern blot analysis of rat brain of P7, P21 and adult rat cortex and hippocampus. RESULTS: By DD-PCR method, we have identified four clones whose expression was regulated by ECS. Among them, one(CP 10-2) was proved to be a new gene by sequencing and BLAST search. Its expression was increased after ECS in P7, P21, and adult rat brain. The expression of CP 10-2 reached peak level at 180 minutes after ECS in P7 rat brain, but was further increased until 360 minutes after ECS in P21 and adult rat brain. CONCLUSION: In this study, a new gene was identified in rat brain which showed up-regulated expression in response to ECS. Cloning and characterization of this new gene would be helpful to elucidate the effect of ECS in rat brain.
Adult ; Animals ; Blotting, Northern ; Brain* ; Clone Cells ; Cloning, Organism ; Electroshock* ; Hippocampus ; Humans ; Male ; Mass Screening ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger

Usually FEV1 lower than 1 liter is considered as a contraindication to pneumonectomy. Therefore sometimes, the curative operations of the resectable lung cancer can not be performed in case of poor pulmonary functions. The usual criteria on the performance of pneumonectomy on high risk patients based on the preoperative assessment of pulmonary function may not predict the operative outcome with accuracy in the postoperative period. Nowadays, there are some arguing points about applying the values of preoperative PFTs to pulmonary resection surgery. We performed a right pneumonectomy for stage IIIb lung cancer in a patient with poor lung function test; FVC 2.17 L, FEV1 0.97 L, FEV1/FVC 44%, FEF 25~75% 0.42 L/sec, MVV 28 L/min, TLC 5.18 L, RV 2.99, DLCO 13.46. After the temporary ligation of right main pulmonary artery during 30 minutes, arterial blood gas and percutaneous oxygen saturation with the controlled ventilation with room air (FiO2=0.21) confirmed the hemodynamic and oxygenation stabilities, twice. After successful surgery, the patient was tolerated for 4 months. And the follow up PFTs at postoperative 3 months and 18 days showed as follows; FVC 1.20 L, FEV1 0.63 L, FEV1/FVC 53%, FEF 25~75% 0.31 L/sec, MVV 25 L/min, TLC 3.80 L, RV 2.33 L, DLCO 8.04. Through the intraoperative re-evaluation of pulmonary function in a patient with poor preoperative PFTs,had been conventionally considered as a contraindication to pneumonectomy, we report a successful surgery and anesthetic management with the literatures reviewed.
Anesthesia ; Follow-Up Studies ; Hemodynamics ; Humans ; Ligation ; Lung Neoplasms* ; Lung* ; Oxygen ; Pneumonectomy* ; Postoperative Period ; Pulmonary Artery ; Respiratory Function Tests* ; Ventilation

Midazolam, a benzodiazepine derivatives, is widely used in intensive care unit for sedation of patients who require mechanical ventilation. Although midazolam has a short acting time, it might cause a prolonged sedation, especially in patients with renal failure. We report the case of a 76-year-old man who received peritoneal dialysis and showed prolonged sedation after stopping continuous infusion of midazolam. The patient who has received maintenance hemodialysis for five months admitted in intensive care unit to manage pneumonia and severe congestive heart failure. In ICU, hemodialysis was transferred to peritoneal dialysis due to severe cardiac dysfunction. He was treated with mechanical ventilation under sedation with midazolam. However, even though stopping midazolam, deep sedation by midazolam was not restored. The patient completely recovered from sedation after 280 hours.
Aged ; Benzodiazepines ; Deep Sedation ; Heart Failure ; Humans ; Intensive Care Units ; Kidney Failure, Chronic ; Midazolam ; Peritoneal Dialysis ; Pneumonia ; Renal Dialysis ; Renal Insufficiency ; Respiration, Artificial

Arteriovenous vascular access infection associated with S. aureus bacteremia may cause metastatic complications, which relate to a poor outcome especially if proper diagnosis and treatment are delayed. We report a case of a 61-year-old male patient on maintenance hemodialysis who developed multiple metastatic infections associated with arteriovenous graft infection caused by methicillin-resistant Staphylococcus aureus (MRSA). At 7th hospital day, multiple metastatic infections, including osteomyelitis of clavicle, vertebral osteomyelitis, and tendinitis of the 5th finger proximal interphalangeal joint, were diagnosed by CT of chest, ultrasonography of hands, and whole body bone scan. Infected arteriovenous graft was removed and antibiotics was administrated for 18 weeks. Thereafter, MRSA bacteremia and clinical symptoms and signs related to metastatic infections were improved.
Anti-Bacterial Agents ; Bacteremia ; Clavicle ; Fingers ; Hand ; Humans ; Joints ; Kidney Failure, Chronic ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Osteomyelitis ; Polymethacrylic Acids ; Renal Dialysis ; Tendinopathy ; Thorax ; Transplants

PURPOSE: To determine the clinical utility of coronary CT angiography (CCTA) with low-dose chest CT in the evaluation of patients with atypical chest pain. MATERIALS AND METHODS: Ninety-six patients (mean age 60.2 years; age range, 41-68 years; 70 males) were referred for CCTA with low-dose chest CT (16-slice MDCT, Siemens) for an evaluation of atypical chest pain. When significant stenoses (lumen diameter reduction > 50%) were detected on CCTA, invasive coronary angiography (CA) was performed as the standard of reference. In all patients, medical chart review or telephone contact with patients was used to evaluate the contribution of CCTA with low-dose chest CT to the final clinical diagnosis, at least 6 months after performing CCTA. RESULTS: Among 96 patients, seven patients (7%) had significant stenoses as detected on CCTA, whereas two patients (2%) had significant stenoses and five patients had insignificant stenoses or no stenosis, as detected on conventional catheter angiography. In 18 (19%) of the 89 patients without significant stenosis detected on CCTA, this protocol provided additional information that suggested or confirmed an alternate clinical diagnosis. CONCLUSION: In patients with atypical chest pain, CCTA with low-dose chest CT could help to exclude ischemic heart disease and could provide important ancillary information for the final diagnosis.
Angiography ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Myocardial Ischemia ; Telephone ; Thorax ; Tomography, X-Ray Computed

Spontaneous rupture with internal bleeding of solid tumors has rarely been described at the time of diagnosis or during chemotherapy. This rare event must be regarded as a life threatening condition. In these emergency situations, control of hemorrhage, which is life-saving, can be achieved by transcatheter arterial embolization (TAE) and/or surgical resection. This report describes two infants presenting with acute hemorrhagic shock due to spontaneous tumor rupture of hepatoblastoma and neuroblastoma during chemotherapy. TAE successfully arrested the tumor bleeding and a visibly reduced the tumor size in both children. Spontaneous rupture of solid tumors occur infrequently in children, but is a life threatening situation. Careful monitoring for the occurrence of this rare event especially in very young children presenting with a large tumor mass.
Child ; Diagnosis ; Drug Therapy ; Emergencies ; Hemorrhage ; Hepatoblastoma ; Humans ; Infant ; Neuroblastoma ; Rupture ; Rupture, Spontaneous ; Shock, Hemorrhagic

Purpose: To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests. Materials and Methods: We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stentgraft patency was evaluated using serial CT angiography images. Results: All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28–1766 days). Follow-up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases. Conclusion Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.

Purpose: To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests. Materials and Methods: We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stentgraft patency was evaluated using serial CT angiography images. Results: All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28–1766 days). Follow-up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases. Conclusion Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.

The most important molecular mechanisms of intraneuronal signal transduction are those mediated by calcium and reversible protein phosphorylation. Although many studies pursued the activation of the protein kinases in the nervous system, there are only few reports focused on the protein phosphatases. In this article, the authors report the effects of cyclosporin A (CSA), an inhibitor of calcineurin, on the calcium signaling-related molecules such as ERKs, calmodulin-dependent kinase II (CaMKII) and CREB in the rat hippocampus. The authors also report the effects of cyclosporin A on the electroconvulsive shock (ECS)-induced seizure and the activation of ERKs. Calcineurin is a protein phosphatase that is abundant in the brain and regulated by calcium and calmodulin. It is proposed that calcineurin plays central roles in the synaptic plasticity and neuronal apoptosis. CSA (50 mg/kg) increased the phosphorylation of ERK, CaMKII and CREB. The treatment of of CSA increased the duration of tonic phase of seizure induced by ECS and augmented the phosphorylation of ERKs after ECS. These results suggested the protective role of calcineurin against the excessive electrical and molecular activities in the brain.
Animals ; Apoptosis ; Brain* ; Calcineurin ; Calcium ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; Calmodulin ; Cyclosporine* ; Electroshock ; Hippocampus ; Nervous System ; Neurons ; Phosphoprotein Phosphatases ; Phosphorylation ; Phosphotransferases ; Plastics ; Protein Kinases ; Rats* ; Seizures ; Signal Transduction*

OBJECTIVES: The composition of gallstones is very variable depending on many factors such as diet, sex, race, genetic background, and so on. The compositional changes of gallstones have been reported in Korean people. Author studied the compositional characteristics of gallstones in Pusan area to see geographical difference. MATERIAL AND METHODS: Gas chromatography and Mass spectrophotometry was performed on the gallstones obtained from the 34 patients who had been taken cholecystectomy because of acute or chronic cholecystitis. Cholesterol gallstone was defined as the composition of the cholesterol is more than 50%. RESULTS: The cholesterol gallstone was 67.6% (23/34) in the 34 patients. There was sexual difference in the cholesterol gallstone group, which the ratio of male and female was 1:2.3(7/16), while there was no difference in the non-cholesterol stone(5:6). The cholesterol stone consisted with cholesterol, bilirubin, bile acid, and palmitic acid and the propotion of them was 75.6%, 4.6%, 15.0%, and 1.8% respectively. While the proportion of non-cholesterol stone was 30.2%, 26.8%, 37.5%, and 5.5% respectively. CONCLUSIONS: The cholesterol stone was major fraction of gallstone of the patients in Pusan area. There was no difference on the compostion of gallstones between those of patients in Pusan area and in the other area of Korea.
Bile ; Bilirubin ; Busan* ; Cholecystectomy ; Cholecystitis ; Cholesterol ; Chromatography, Gas ; Chromatography, High Pressure Liquid ; Continental Population Groups ; Diet ; Female ; Gallstones* ; Gyeongsangnam-do* ; Humans ; Korea ; Male ; Palmitic Acid ; Soil ; Spectrophotometry