No abstract available.
Amnion* ; Cell Line* ; Cyclooxygenase 2* ; Protein Kinases*

This study was performed to examine the combined effects of gamma linolenic acid and isoflavone supplementation on menopausal symptoms and serum lipids in 73 postmenopausal women. A total subjects were randomly assigned to isoflavone (30 mg) + gamma-linolenic acid (110 mg) group or placebo group. We measured menopausal symptoms by modified Kupperman Index (KI) and oxidized LDL, lipid peroxides, blood components and anthropometric parameters before and after the 12 week intervention period. After the 12 weeks of supplementation, supplement group and placebo group showed a significant reduction of modified kupperman index (p < 0.001). Isoflavone (30 mg) + gamma-linolenic acid (110 mg) supplement group showed a significant reduction of oxidized LDL cholesterol concentration (p = 0.006) whereas placebo group did not show significant change. Isoflavone and gamma-linolenic acid consumption did not significantly affect plasma concentrations of total, LDL, HDL cholesterol, triglyceride, apo A1, B and blood components. The result of present study demonstrated the supplementation of 30 mg isoflavone and 110 mg gamma-linolenic acid per day for 12 weeks may protect LDL cholesterol from oxidative stress.
Apolipoprotein A-I ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; gamma-Linolenic Acid ; Humans ; Lipid Peroxides ; Lipoproteins, LDL ; Oxidative Stress ; Plasma

BACKGROUND: Anesthesiologist must be aware of the common problems that occur in pediatric anesthesia. The purpose of this survey was to collect information to help improve the quality of pediatric anesthesia by comparing the opinions of anesthesiologists that treat children and those that do not treat children. METHODS: A questionnaire surveying the attitudes of 103 anesthesiologists with regard to pediatric problems was analyzed. The questionnaire inquired about the number of years worked in field, the form of work and the responsibilities with regard to the pediatric anesthesia. Each question was rated from 1 (very infrequent) to 5 (very common) for the frequency of problems and from 1 (not importance) to 5 (very important) for the importance of the problem. Then we calculated the average of each item and combined the scores to obtain an average frequency and an average importance. RESULTS: The list of problems had high combined scores for preoperative anxiety (10.62), incision pain (9.59), postoperative agitation (9.53), hypothermia (9.40), and vomiting (9.30) for the pediatric anesthesiologist group. In addition, the problem list had high combined scores for propofol injection pain (11.25), preoperative anxiety (10.92), vomiting (10.17), hypothermia (9.44), and postoperative agitation (9.42) for the non-pediatric anesthesiologist group. CONCLUSIONS: The results of this study showed a difference in the pediatric and non pediatric anesthesiologist groups for propofol injection pain. Differences were noted for the average importance (2.34 : 2.80) compared to the average frequency (3.93 : 4.01). The pediatric anesthesiologists regarded propofol injection pain to be less of a problem than did the anesthesiologists who did not care for pediatric patients.
Anesthesia ; Anxiety ; Child ; Dihydroergotamine ; Humans ; Hypothermia ; Propofol ; Vomiting ; Surveys and Questionnaires

Isaacs' syndrome consists of spontaneously occurring muscle activity of peripheral nerve origins. This syndrome arises in association with/without polyneuropathy and rarely with malignancy. A 63-year-old man was admitted to our hospital due to generalized painful muscle stiffness. He complained of difficulty with standing and with finger exten-sion after grasping. Chvostek's and Trousseau's signs were noticed. Electrolytes, calcium, CK, and LDH were in the normal range. Small cell lung cancer was diagnosed by a needle biopsy. Electrophysiological testing revealed normal nerve conduction studies with the exception of a grossly abnormal EMG. Continuous neuromyotonic discharges with firing rates of 120-200 Hz were seen at rest. The amplitude of the response typically waned with 0.5-1.5 seconds of duration. The discharges persisted throughout sleep, after diazepam injection, and with brachial plexus blockage.Muscle stiffness improved with the administration of oral phenytoin. Under chemotherapy and radiotherapy, tumor remission was partially achieved and neurological symptoms markedly improved.
Biopsy, Needle ; Brachial Plexus ; Calcium ; Diazepam ; Drug Therapy ; Electrolytes ; Fingers ; Fires ; Hand Strength ; Humans ; Isaacs Syndrome* ; Middle Aged ; Neural Conduction ; Peripheral Nerves ; Phenytoin ; Polyneuropathies ; Radiotherapy ; Reference Values ; Small Cell Lung Carcinoma*

Tracheobronchopathia osteochondroplastica is a rarely reported disease, and the clinical course is usually benign. But it may cause significant tracheal stenosis. Although it is usually found by autopsy, with the development of bronchoscopic examination and computed tomography, antemortem diagnosis is increasing. We experienced a case of tracheobronchopathia osteochondroplastica which caused severe dyspnea, we did laryngoscopic examination, biosy and treated with tracheostomy.
Airway Obstruction* ; Autopsy ; Diagnosis ; Dyspnea ; Tracheal Stenosis ; Tracheostomy

It is known that many renal transplantation candidates with end stage renal disease have bladder dysfunction. Before 1966, these patients were considered poor candidates for renal transplantation because of their many bladder problems. But it has recently been reported that renal transplantation with an ileal conduit could solve these problems. Herein, we report on a patient with Hinman's syndrome and this patient underwent renal transplantation using a pre-existing cutaneous ureterostomy.
Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Ureterostomy ; Urinary Bladder ; Urinary Diversion

BACKGROUND: The early and accurate diagnosis of leptomeningeal metastasis (LM) has become important because of introduction of new therapeutic strategies for LM and increasing incidence of LM along with longer survival of cancer patients. We aimed to evaluate the role of cerebrospinal fluid (CSF) CYFRA 21-1 as a diagnostic indicator for LM in patients with cancer. METHODS: CSF CYFRA 21-1 level was analyzed using electro-chemiluminescent immunoassay. The difference in concentration of CSF CYFRA 21-1 between 91 patients with LM and 339 control groups (patients with other neurological disease or healthy controls) was investigated. The cut-off value of CSF CYFRA 21-1 as a diagnostic indicator for LM and its diagnostic performance were evaluated. RESULTS: The CSF CYFRA 21-1 was significantly higher in LM patients than control groups (p<0.001). A cut-off value of diagnosis for LM in patients with cancer was 1.59 ng/mL. The sensitivity, specificity, accuracy, and positive and negative predictive values of CSF CYFRA 21-1 were 80.2%, 96.2%, 92.8%, 84.9%, 94.8% for diagnosis of LM. CONCLUSIONS: These results suggested that CSF CYFRA 21-1 can be an additional diagnostic indicator for cancer patients with LM.
Cerebrospinal Fluid ; Diagnosis ; Humans ; Immunoassay ; Incidence ; Neoplasm Metastasis ; Sensitivity and Specificity

Background: Liver cirrhosis is advanced stage of hepatic brosis caused by viral hepatitis. Mac-2 binding protein glycosylation isomer (M2BPGi) is a serum marker to diagnose and evaluate hepatic brosis progression. In this study, we evaluated the efficacy of serum M2BPGi to predict chronic hepatitis B (HBV)-mediated cirrhosis by liver biopsy. Methods: M2BPGi cut-off index (COI) was evaluated from 312 patients with chronic HBV-mediated hepatocellular carcinoma and 105 healthy controls. Comparative analysis was performed with conventional hepatic brosis markers such as brosis index based on four factors (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and Fibroscan. Results: Korean Study Group for Pathology of Digestive Diseases classified 165 (52%) patients with histological stage F4 liver cirrhosis. Comparison of cases with stage F4 cirrhosis and stage F3 septal brosis revealed significant difference between M2BPGi, platelet count, APRI, FIB-4, and Fibroscan prediction. M2BPGi 2+ (COI ≥3) was found to be 8% in patients with F4 cirrhosis and 1% in patients with F3 brosis. In multi-regression analysis, M2BPGi showed higher odds ratio than that of other serum markers while M2BPGi 2+ showed comparable odds ratio to Fibroscan F3 and F4 assessment. Conclusions In patients with chronic HBV-mediated hepatocellular carcinoma, M2BPGi was neither comprehensive nor as effective as Fibroscan in assessing liver cirrhosis and brosis progression.

Background: Hypertrophic cardiomyopathy (HCM) needs careful differentiation from other cardiomyopathies. Current guidelines recommend genetic testing, but genetic data on differential diagnoses and their relation with clinical outcomes in HCM are still lacking.This study aimed to investigate the prevalence of genetic variants and the proportion of other cardiomyopathies in patients with suspected HCM in Korea and compare the outcomes of HCM according to the presence of sarcomere gene mutation. Methods: We enrolled 1,554 patients with suspected HCM having left ventricular hypertrophy on transthoracic echocardiography between April 2012 and February 2023. Patients who declined genetic testing or who had pure apical HCM without a familial history were excluded. Genetic testing was performed using a next-generation sequencing panel or wholeexome sequencing for cardiomyopathies. We performed cardiovascular magnetic resonance if the diagnosis was inconclusive. Genotype-positive HCM was defined as sarcomere gene mutations of pathogenic or likely pathogenic variants. Adverse clinical outcomes were defined as a composite of all-cause death, resuscitated cardiac arrest, heart failure-related admission, appropriate implantable cardioverter defibrillator shocks, and stroke. Results: Of 492 patients (mean age 49.6 ± 14.7 years, 29.4% women) who underwent genetic testing, 214 (43.5%) had disease-causing gene mutations. After combining gene tests, multi-imaging modality, and clinical information, 447 (90.9%) had HCM, and 27 (5.5%) had Fabry disease. Among the HCM patients, 182 (40.7%) were genotype-positive, and 265 (59.3%) were genotype-negative. Kaplan–Meier curve analysis showed that genotype-positive HCM patients experienced more composite outcomes (log-rank, P < 0.001). In multivariable Cox analysis, non-sustained ventricular tachycardia (NSVT) (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.17–3.12; P = 0.010), left ventricular ejection fraction (LVEF) < 50% (HR, 5.50; 95% CI, 2.68–11.27; P < 0.001), LA reservoir strain (HR, 0.96; 95% CI, 0.93–0.99;P = 0.037), and positive sarcomere gene mutation (HR, 1.70; 95% CI, 1.04–2.78; P = 0.034) were significantly association with composite outcomes. Sarcomere gene mutation had incremental value for predicting adverse outcomes added on NSVT and LVEF < 50%. Conclusion Genetic testing is helpful in diagnosing HCM, and sarcomere gene mutations in HCM are significantly associated with clinical outcomes.

Background: Hypertrophic cardiomyopathy (HCM) needs careful differentiation from other cardiomyopathies. Current guidelines recommend genetic testing, but genetic data on differential diagnoses and their relation with clinical outcomes in HCM are still lacking.This study aimed to investigate the prevalence of genetic variants and the proportion of other cardiomyopathies in patients with suspected HCM in Korea and compare the outcomes of HCM according to the presence of sarcomere gene mutation. Methods: We enrolled 1,554 patients with suspected HCM having left ventricular hypertrophy on transthoracic echocardiography between April 2012 and February 2023. Patients who declined genetic testing or who had pure apical HCM without a familial history were excluded. Genetic testing was performed using a next-generation sequencing panel or wholeexome sequencing for cardiomyopathies. We performed cardiovascular magnetic resonance if the diagnosis was inconclusive. Genotype-positive HCM was defined as sarcomere gene mutations of pathogenic or likely pathogenic variants. Adverse clinical outcomes were defined as a composite of all-cause death, resuscitated cardiac arrest, heart failure-related admission, appropriate implantable cardioverter defibrillator shocks, and stroke. Results: Of 492 patients (mean age 49.6 ± 14.7 years, 29.4% women) who underwent genetic testing, 214 (43.5%) had disease-causing gene mutations. After combining gene tests, multi-imaging modality, and clinical information, 447 (90.9%) had HCM, and 27 (5.5%) had Fabry disease. Among the HCM patients, 182 (40.7%) were genotype-positive, and 265 (59.3%) were genotype-negative. Kaplan–Meier curve analysis showed that genotype-positive HCM patients experienced more composite outcomes (log-rank, P < 0.001). In multivariable Cox analysis, non-sustained ventricular tachycardia (NSVT) (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.17–3.12; P = 0.010), left ventricular ejection fraction (LVEF) < 50% (HR, 5.50; 95% CI, 2.68–11.27; P < 0.001), LA reservoir strain (HR, 0.96; 95% CI, 0.93–0.99;P = 0.037), and positive sarcomere gene mutation (HR, 1.70; 95% CI, 1.04–2.78; P = 0.034) were significantly association with composite outcomes. Sarcomere gene mutation had incremental value for predicting adverse outcomes added on NSVT and LVEF < 50%. Conclusion Genetic testing is helpful in diagnosing HCM, and sarcomere gene mutations in HCM are significantly associated with clinical outcomes.