Halothane, in common use today, sensitizes the myocardium to endogenous and exogenous sympathomimetic amines arid induces cardiac arrhythmia, sometimes life threatening. Sympatbomimetic amines, however, are frequently injected subcutaneously for hemostasis or intravenously far cardiovascular stability. Therefore, this study was performed to investigate the effect of lidocaine 1 mg/kg, pro-pranolol 0.02 mg/kg, and droperidol 0.1 mg/kg pretreatment on arrhythmias(A.R.) and changes in heart ramie(H.R.), systolic bood pressure(T.B.P ) and diastolic blood pressure (D.B.P.) Induced by lV administered ephedrine 0.2 mg/kg. Patients were divided into 5 groups: 20 cases without pretreatment(Group l ), 10 cases with lidocaine prtreatment(Group ll), 10 cases with propranolol pretreatment(Group lll), 20 eases with lidocaine-propranolol pretreatment(Group lV) and 20 cases with droperidol pretreatment(Group V ). The results were as follows: 1) In Group l, ephedrine produced A.R. in 16 cases(80%) and significant increase in H.R.(d~11 bpm, p<0.001) and S.B.P. (8~22 torr, p<0.001), but D.B.P. increased insignif-icantly(2~10 torr, NS). 2) In Group ll, ephedrine produced A.R. in 5 cases(57%) and 5.B.p.(10~17 terr, p<0, 01) increased significantly, but H.R. remained unaltered. 3) In Group lll, ephedrine produced A.R. in 3 cases(30%) and H.R. (6~8 bpm, p<0.05) decreased, but S.B.P.(12~21 torr, p<0.01) and D.B.P (8~16 torr, p<0.01) increased signi-ficantle. 4) In Group lV, ephedrine produced A.R. in 2 cases(10.%) and H.R.(3~6 bpm, p<0.05) decreased, but S.B.P (4~11 torr, p<0.05) and D.B.P.(3~9 torr, p<0.01) increased signific-antly. 5) In Group V. ephedrine produced A.R. in 2 cases(10%) and H.R.(9~13 bum, p<0.001) increased siginificantly, but S.B.P. and D.B.P. remained unaltered. From the above results, it is concluded that lidocaine and propranolol mixture or droperidol protects most effectively against ventricular arrhythmias induced by ephedrine during halothane-N2O anesthesia in human volunteers.
Amines ; Anesthesia* ; Arrhythmias, Cardiac* ; Blood Pressure ; Droperidol* ; Ephedrine* ; Halothane ; Healthy Volunteers ; Heart ; Hemostasis ; Humans ; Lidocaine* ; Myocardium ; Propranolol* ; Sympathomimetics

Cryopreservation is able to store the surplus pre-embryos for freezing and furthermore thawing and transfer in a subsequent cycle. Cryopreserving cells which are maintaining their viability are the very complex process. This study has been carried out in order to find the effects of cryopreservation steps, freezing media and embryonic stages on the rates of viability and development of cryopreserved mouse embryos. Female ICR mice (6~8 weeks old) were induced to superovulate by sequential intraperitoneal injection of 5 IU PMSG and 5 IU hGC 48h apart. Mouse embryos were collected according to its developmental stage after the injection of hCG. Embryos were cryopreserved not only by cryoprotectant step (1 step~ 4 step) but also in a variety of media (HTF, IVF medium, D-PBS) and cell stage. The results were as follows: There is no clear advantage in these freezing media of rapid method, but 4 cell and 8 cell of slow method (2, 3, 4 step) have advantage in D-PBS. The development of embryos according to cell stage become greater in 8 cell stage. In the treatment steps of cryopreservation, the development of embryo to blastocyst was similar among rapid method, but the development of 4 cell and 8 cell embryos to blastocyst according to slow method was better than rapid method.
Animals ; Blastocyst ; Cryopreservation* ; Culture Media* ; Embryonic Structures* ; Female ; Freezing ; Humans ; Injections, Intraperitoneal ; Mice* ; Mice, Inbred ICR

Spontaneous intracranial hypotension (SIH) is a rare disease with a symptom of a postural headache, which is aggravated by the erect position and relieved by the supine position. This persistent headache is dramatically improved with an epidural blood patch. C6-7 is the most common site of leakage of cerebrospinal fluid (CSF) from the subarachnoid space in SIH. The diagnosis of SIH is based on a typical history. It is supported by low CSF pressure in a lumbar puncture and diffuse dural enhancement on a brain MRI, and confirmed by a CSF leakage site on a radioisotope cisternography or on a myelography. However, we had two patients of SIH whose CSF leakage site was not found on cisternography. We tried an epidurogram just before an injection of autologous blood for an epidural blood patch, and found specific finding on the epidurogam suggesting the CSF leakage site, such as a filling defect on C6-7 during dye injection, and delayed washout of dye around the filling defect on the epidurogram performed at C7-T1/C6-7. Therefore, we suggest that an epidurogram is occasionally a useful diagnostic tool when looking for the site of CSF leakage in SIH.
Blood Patch, Epidural ; Brain ; Cerebrospinal Fluid ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Rare Diseases ; Spinal Puncture ; Subarachnoid Space ; Supine Position

Purpose: To report a case of ischemic optic neuropathy caused by iron deficiency anemia (IDA) accompanied by ethambutol-induced toxic optic neuropathy.Case summary: A 64-year-old female patient presented with declining visual acuity. Four months prior, she had been taking ethambutol daily for tuberculosis. Corrected visual acuity was 0.3 in both eyes and a central visual field defect was revealed in visual field tests. In the color vision test, the right eye scored three and the left eye scored two. Ethambutol was stopped immediately under suspicion of toxic optic neuropathy; however, the corrected visual acuity gradually worsened to 0.05 in the right eye and the finger count was 50 cm in the left eye. The patient’s blood test showed signs of IDA. After 5 months of IDA treatment, the blood test results returned to the normal range and corrected visual acuity improved to 0.5 in both eyes. However, focal atrophy of the ganglion cell-inner plexiform layer was observed, requiring close monitoring of optical coherence tomography findings. Conclusions Ischemic optic neuropathy due to IDA may occur in a short period of time and may be difficult to diagnose if accompanied by ethambutol-induced toxic optic neuropathy. In the case of patients with progressive vision loss, prompt diagnosis and careful monitoring in follow-up evaluations are required.

BACKGROUND: As indicators of obesity, waist circumference (WC), body mass index (BMI), and adiponectin are well known risk factor for diabetes mellitus. The objectives of this study were to measure the independent association between these obesity indicators and diabetes and to examine the combined effect of these indicators on diabetes in a Korean population. METHODS: The WC, BMI, and serum adiponectin were measured in 6,505 healthy Koreans and were classified into tertile groups for men and women. The independent and combined associations of the obesity indicators with diabetes were measured using logistic regression analyses. Diabetes was defined as fasting serum glucose greater than 126 mg/dL or taking medication. RESULTS: Levels of adiponectin were inversely associated with BMI and WC and directly associated with age and high density lipoprotein cholesterol (HDL) cholesterol (P <0.001). After adjusting for age, WC, and other lifestyle factors, low levels of adiponectin were associated with an increased prevalence of diabetes. Further adjustment for HDL cholesterol and triglyceride attenuated this association in both men and women. The best cut-off value of adiponectin in terms of identifying the presence of diabetes was 5.5 /ml with a sensitivity and specificity of 46.7% and 63.9% for men and 9.5 /ml with a sensitivity and specificity of 68.2% and 55.2 for women. CONCLUSIONS: These results suggest that adiponectin was associated with diabetes. The association was independent of WC and was partly modified by HDL and triglyceride. There were no effect modifications of adiponectin with WC on diabetes.
Adiponectin* ; Blood Glucose ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus ; Fasting ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Obesity ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference

Purpose: To report a case of ischemic optic neuropathy caused by iron deficiency anemia (IDA) accompanied by ethambutol-induced toxic optic neuropathy.Case summary: A 64-year-old female patient presented with declining visual acuity. Four months prior, she had been taking ethambutol daily for tuberculosis. Corrected visual acuity was 0.3 in both eyes and a central visual field defect was revealed in visual field tests. In the color vision test, the right eye scored three and the left eye scored two. Ethambutol was stopped immediately under suspicion of toxic optic neuropathy; however, the corrected visual acuity gradually worsened to 0.05 in the right eye and the finger count was 50 cm in the left eye. The patient’s blood test showed signs of IDA. After 5 months of IDA treatment, the blood test results returned to the normal range and corrected visual acuity improved to 0.5 in both eyes. However, focal atrophy of the ganglion cell-inner plexiform layer was observed, requiring close monitoring of optical coherence tomography findings. Conclusions Ischemic optic neuropathy due to IDA may occur in a short period of time and may be difficult to diagnose if accompanied by ethambutol-induced toxic optic neuropathy. In the case of patients with progressive vision loss, prompt diagnosis and careful monitoring in follow-up evaluations are required.

BACKGROUND: Hantaan (HTN) and Seoul (SEO) viruses, harbored by the striped-field mouse(Apodemus agrarius) and the Norway or common rat (Rattus rattus & Rattus norvegicus), respectively, were known to cause hemorrhagic fever with renal syndrome(HFRS) in Korea. We evaluated the seroepidemiologic patterns of hantaviral infections and detect the hantaviral antigens from patients' sera. METHODS: Total 8,102 HFRS patients' sera were collected from 1994 to 1996, and examined by indirect immunofluorescent antibody technique (IFA), hemagglutination inhibition test (HI), IgM emzyme-linked immunosorbent assay (IgM-ELISA) and nested reverse transcription-polymerase chain reaction(RT-PCR). RESULTS: The seropositive rate against hantaviral antigen was 12.0% (973/8102) with the high incidence rate (68.3%) in the period from October to January, and males in the thirties were mostly affected. HTN viral infections were detected 3.5 and 5.2 times higher than SEO viral infections by HI and RT-PCR, respectively, and patients in the fifties were the mostly affected age-group in SEO viral infections, IgM antibodies were detected in the 717 sera of the 905 IFA positive cases (79.2%), and the antigen detection rate of HTN and SEO viruses was 7.7% (56/724). Interestingly, 40 sera (4.4%), showed higher antibody titers against the Puumala (PUU) virus than those against HTN or SEO viruses. CONCLUSION: The results showed HTN and SEO viruses were the main causative agents of HFRS in Korea, and also suggested the possible presence of PUU-related hantaviral infections.
Animals ; Antibodies ; Fever ; Hantaan virus ; Hantavirus ; Hemagglutination Inhibition Tests ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Immunoglobulin M ; Incidence ; Korea ; Male ; Norway ; Puumala virus ; Rats ; Seoul ; Seoul virus ; Seroepidemiologic Studies

BACKGROUND: The principal acute febrile diseases reported in autumn, Korea, have been hemorrhagic fever with renal syndrome (HFRS), scrub typhus, murine METHODS: To evaluate the seroepidemiologic patterns of acute febrile illness in Korea, sera were collected from 5330 patients from 1994 to 1995, and examined for antibodies against Hantaan virus, Orientia tsutsuga-mushi, Rickettsia typhi, and Borrelia burgdorf eri by indirect immunofluorescent antibody technique(IFA) and by macroscopic agglutination test for Leptosp ira intero-gans. RESULTS: Of 640 seropositive cases against O. tsutsu-gamushi, 60% were female; age group of the seventh decade occupied 30%; 89% were reported during October and November. By IFA test, the seropositive rate of murine typhus was 3.5% (187/5330) with high incidence rate (44%) in the period from October to December, and males in their forties and fifties were mostly affected. Cases seropositive for leptospirosis consisted 1% of 5330 acute febrile illness cases. Of 55 seropositive cases, 71% were male; 71% were in their sixties; 78% occurred during the period from August to October. Hantavirus seropositive rate was 12.2% (649/5330) with a high incidence rate (70%) in the period from October to January and males in the thirties were mostly infected. No seropositive case of Lyme disease was present. CONCLUSION: The above results indicate that hantavirus, O. tsutsugamushi, R. typhi, and L. interogans were the main causative agents of acute febrile diseases during autumn season in Korea.
Agglutination Tests ; Antibodies ; Borrelia ; Female ; Hantaan virus ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Korea* ; Leptospirosis ; Lyme Disease ; Male ; Rickettsia typhi ; Scrub Typhus ; Seasons ; Typhus, Endemic Flea-Borne

To discover genetic markers for autism spectrum disorder (ASD), we previously applied genome-wide BAC array comparative genomic hybridization (array-CGH) to 28 autistic patients and 62 normal controls in Korean population, and identified that chromosomal losses on 8p23.1 and on 17p11.2 are significantly associated with autism. In this study, we developed an 8.5K ASD-specific BAC array covering 27 previously reported ASD-associated CNV loci including ours and examined whether the associations would be replicated in 8 ASD patient cell lines of four different ethnic groups and 10 Korean normal controls. As a result, a CNV-loss on 8p23.1 was found to be significantly more frequent in patients regardless of ethnicity (p<0.0001). This CNV region contains two coding genes, DEFA1 and DEFA3, which are members of DEFENSIN gene family. Two other CNVs on 17p11.2 and Xp22.31 were also distributed differently between ASDs and controls, but not significant (p=0.069 and 0.092, respectively). All the other loci did not show significant association. When these evidences are considered, the association between ASD and CNV of DEFENSIN gene seems worthy of further exploration to elucidate the pathogenesis of ASD. Validation studies with a larger sample size will be required to verify its biological implication.
Autistic Disorder ; Cell Line ; Child ; Clinical Coding ; Coat Protein Complex I ; Comparative Genomic Hybridization ; Ethnic Groups ; Genetic Markers ; Humans ; Sample Size ; Autism Spectrum Disorder

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before 131I administration. RESULTS: The median iodine intake was 290 µg/day on the usual diet and 63.2 µg/day on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.
Dairy Products ; Diet Records ; Diet* ; Education ; Energy Intake ; Humans ; Iodine* ; Milk ; Seaweed ; Seoul ; Sodium ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Vegetables