BACKGROUND AND OBJECTIVES: Oxygen radical scavengers and inhibitors are known to have protective functions (or roles) against hypoxia and noise exposure in the cochlea and brain. The purpose of this study was to examine the toxic effect of oxygen radicals (xanthine oxidase and hypoxanthine) on cultured mouse facial nerve Schwann cells, and determine if antioxidants (TPEN and DFO) might ptotect Schwann cells from oxidant-induced neurotoxicity. MATERIALS AND METHODS: Dissociated cell cultures were prepared from the facial nerve of a mouse. After dissociation of Schwann cells, isolated cells were washed, resuspended in feeding medium, and plated onto poly-L-lysine-coated Aclar plastic cover slips (12 mm diameter) in petri dishes or in 96 well multichambers at cell density of 2X105 ceIls/coverslip or lX10(5) ceIls/we11. The feeding medium consisted of Eagle's minimum essential medium (MEM) containing 5% horse serum, 5 mg/ml D-glucose, and 25 ng/ml gentamicin. Cultures were grown in 5% CO2/95% atmosphere at 37degreesC, and the medium was renewed twice a week. Cultures grown for 4-5 days were utilized for experiments. Oxygen radical exposure was done using XO and HX, and antioxidant pretreatment was carried out using tetrakis (2-pyridylmethyl) ethylenediamine (TPEN) and desferrioxamine (DFO). Cytotoxicity assay was performed by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cytotoxic assay and inverted microscopy. RESULTS: Cell viability of cultured mouse Schwann cells treated with markedly decreased in a dose-dependent manner. Cultured mouse Schwann cells exposed to XO/HX for 4 hours showed degenerative changes such as the decrease of cell number and process. Pretreatment of 80 uM TPEN for 2 hours increased remarkably the cell viability of cultured Schwann cells exposed to 20 mU/ml XO/0.1 mM HX, while DFO did not show any protective effects on oxidant-induced neurotoxicity in these cultures. CONCLUSION: It is suggested that oxygen radicals induce neurotoxic effect on cultured mouse Schwann cells, and that selective antioxidants such as TPEN is very effective in blocking oxidant-induced neurotoxicity.
Animals ; Anoxia ; Antioxidants* ; Atmosphere ; Brain ; Cell Count ; Cell Culture Techniques ; Cell Survival ; Cochlea ; Deferoxamine ; Facial Nerve ; Gentamicins ; Glucose ; Horses ; Mice* ; Microscopy ; Noise ; Oxidoreductases ; Oxygen* ; Plastics ; Reactive Oxygen Species* ; Schwann Cells*

Most intussusceptions occur in children under 1 year of age whereas 5%~10% occurs in adults. Although intussusception has an acute occurrence in children, symptoms in adults may be subacute or chronic, and the diagnosis is often delayed. In contrast to adults, intussusception in children is the most common cause of intestinal obstruction, and one of the most frequent causes of surgical emergencies. While idiopathic cases account for more than 90% of those seen in children, many cases in adults are generally related to neoplasm. However, intussusception due to a primary malignant lymphoma of the small intestine is a rare clinical condition. There is little information on the role of colonoscopy in colonic intussusception. Two cases are herein reported, of malignant lymphoma in the ileocecal region causing intussusceptions in which the diagnosis and reduction of intussusception were made by colonoscopy. Colonoscopy plays a useful role in the diagnosis and management of intussusception. The clinical, radiographic, endoscopic, and pathologic findings are described with brief reviews of related literature.
Adult ; Child ; Colon ; Colonoscopy* ; Diagnosis* ; Emergencies ; Humans ; Ileum* ; Intestinal Obstruction ; Intestine, Small ; Intussusception* ; Lymphoma*

BACKGROUND: Awakebruxism is defined as an oral parafunctional activity that includes clenching and grinding of teeth during wakefulness. Confirming the possible related anatomy and the clinical significance of awake bruxism in Yong-in Hyoja Geriatric Hospital is the aim of this study. METHODS: We analyzed the medical records of 503 patients who were admitted in hospital from April to June 2005. After the recognition of bruxism, the clinical, brain imaging studies and statistical parametric mapping(SPM) of Brain SPECT were done. RESULTS: (1) In each disease group, 5 among 125 Alzheimer's disease(AD) patients(4.0%, 5/125), 3 among 11 frontotemporal dementia(FTD) patients(27.3%; 3/11), 7 among 230 stroke patients(including two patients related with citalopram, 3.0%; 7/230), 1 among 45 Parkinson's disease patients(2.2%; 1/45), and 4 hydrocephalus patient(23.5%; 4/ 17) had bruxism. (2) Even though awake bruxism occurred in early stage after stroke onset, it occurred in late stage after AD and FTD onset. This occurred in far advanced stage of AD, while it occurred in moderately advanced stage of FTD and stroke. (3) SPM analysis in AD and FTD patients with awake bruxism revealed significant hypoperfusion in frontotemporal and other subcortical structures. CONCLUSIONS: This study suggests that awake bruxism is encountered in various diseases in geriatric hospital. It is closely related frontotemporal lobe dysfunction in degenerative dementia like FTD and AD. Therefore it can be regarded as one of marker of frontal or related subcortical neurological sign in degenerative dementia.
Alzheimer Disease ; Brain ; Bruxism* ; Citalopram ; Dementia ; Frontotemporal Dementia ; Gyeonggi-do ; Humans ; Hydrocephalus ; Medical Records ; Neuroimaging ; Parkinson Disease ; Stroke ; Tomography, Emission-Computed, Single-Photon ; Tooth ; Wakefulness

BACKGROUND: Dobutamine and amrinone, phosphodiesterase-III inhibitor, are known to have both inotropic and vasodilatory properties. We evaluated the effects of both drugs on systemic and pulmonary hemodynamics in patients with pulmonary hypertension (PH). METHODS: With Institutional Review Board approval, 45 patients whose mean pulmonary arterial pressure was greater than 30 mmHg were studied. After sternotomy under the steady state of anesthesia and controlled ventilation (30 mmHg < PaCO2 < 40 mmHg), patients recieved one of following drugs for 30minutes (min); dobutamine 5.0ug/kg/min (Group I), low dose amrinone (loading dose 1.0 mg/kg, followed by infusion 7.5 g/kg/min, Group II) or high dose amrinone (loading dose 2.0 mg/kg, followed by infusion 10 g/kg/min, Group III). Hemodynamic variables were measured at 10 min and 30 min after start of infusion. RESULTS: Dobutamine didn't decrease pulmonary arterial pressure (PAP) and cause no hemodynamic change while low and high dose amrinone reduced PAP and especcially decrease of PAP in low dose amrinone group was statistically significnat. High dose amrinone increased cardiac index (CI) and decreased both systemic vascular resistance index (SVRI) and central venous pressure (CVP) more significantly than control value. CONCLUSIONS: In patients with chronic right ventricular failure associated with PH, amrinone may decrease the PAP and improve cardiac performance more effectively than dobutamin does. Increment of dosage of amrinone may not result in significant reduction of PAP.
Amrinone* ; Anesthesia ; Arterial Pressure ; Central Venous Pressure ; Dobutamine* ; Ethics Committees, Research ; Hemodynamics* ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Sternotomy ; Vascular Resistance ; Ventilation

There are several reports suggesting Helicobacter pylori can initiate and perpetuate idiopathic thrombocytopenic purpura (ITP) and eradication of H. pylori can increase the platelet counts, however, the prevalence of H. pylori infection in patients with ITP is similar to that found in the general population and a recovery of thrombocytopenia after H. pylori eradication therapy has not been identified reliably. We report three different cases of H. pylori infected patients with ITP who recovered completely after eradication of H. pylori. The first case was refractory, the second was recurred after conventional treatment for ITP, and the third was treated with H. pylori eradication on first line treatment. We believe that the eradication of H. pylori is useful in some patients with ITP in Korea and well controlled randomized study is necessary for further identification of such population.
Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Platelet Count ; Prevalence ; Purpura, Thrombocytopenic, Idiopathic ; Thrombocytopenia

In situ follicular lymphoma is a newly defined entity among the lymphoid neoplasms and is defined as architecturally normal-appearing lymph nodes and other lymphoid tissues that have one or more follicles that demonstrate bcl-2 overexpressing centrocytes and centroblasts, with or without a monomorphic cytologic appearance suggestive of follicular lymphoma. Here we present a case of in situ follicular lymphoma diagnosed during the follow-up after a complete response to the treatment of lymphocyte-rich classical Hodgkin's lymphoma. In our case, because only a few germinal centers contained bcl-2 overexpressing cells, we missed the diagnosis of in situ follicular lymphoma in the initial histological examination. We could establish the diagnosis only after performing bcl-2 immunostaining in the sequential biopsy. Therefore, we recommend that careful histological examination along with bcl-2 immunostaining is needed in patients with suspicious clinical findings.
Biopsy ; Follow-Up Studies ; Germinal Center ; Hodgkin Disease ; Humans ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, Follicular ; Precancerous Conditions

The reverse doming of the anterior mitral leaflet by two-dimensional echocardiography was shown in 39 patients(83%) among 47 patients with aortic regurgitation. The reverse doming was noted in 21(80%) of 26 patients with mild AR and in 15(83%) of 18 patients with moderate AR and in all(100%) of 3 patients with severe AR. Thus observing the reverse doming of the anterior mitral leaflet by two-dimensional echocardiography may be an important auxiliary diagnostic aid in conjunction with well known other echocardiographic findings.
Aortic Valve Insufficiency* ; Echocardiography ; Humans

Several noninfectious pulmonary complications can be associated with chronic graft versus host disease (GVHD). Obstructive airway disease can be a clinical feature of chronic GVHD and the histopathology reveals characteristic lesions of bronchiolitis obliterans. Bronchiolitis obliterans is an obstructive pulmonary disorder affecting the small airways, and it was first described as a late complication of allogeneic bone marrow transplantation (BMT). Spontaneous pneumomediastinum and subcutaneous emphysema can occur in the setting of severe bronchiolitis obliterans and only rarely are they the first sign of such disease. We describe here a case of a 27-year old woman who developed recurrent pneumomediastinum and subcutaneous emphysema that were secondary to the bronchiolitis obliterans that complicated chronic GVHD after allogeneic BMT.
Adult ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchiolitis Obliterans ; Female ; Graft vs Host Disease* ; Humans ; Mediastinal Emphysema* ; Subcutaneous Emphysema* ; Transplants*

Coincident Hodgkin's disease and pregnancy is rare and optimal management requires special consideration because usual treatment modalities are associated with significant risk to the developing fetus. We have experienced a 20 weeks pregnant woman with Hodgkin's disease. Combination chemotherapy with ABV (Adriamycin, Bleomycin, Vinblastine) 3 cycles were given during 2nd and 3rd trimester. She was delivered of a baby the 40 weeks of pregnancy without any problem. After delivery, she received additional 3 cycles of combination chemotherapy with ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine). Then, radiation treatment with Mantle technique, total 3,600cGy was performed. Finally, she reached the complete remission. After 12 months from the end of treatment, there was no evidence of recurrence and the baby are developing without any anomaly.
Bleomycin ; Drug Therapy, Combination* ; Female ; Fetus ; Hodgkin Disease* ; Humans ; Pregnancy ; Pregnant Women ; Recurrence ; Vinblastine

BACKGROUNDS: In this study, we assessed nasotracheal intubation conditions following an inhalation induction using 8% sevoflurane and nitrous oxide with fentanyl and evaluated the effect of 0.1 mg/kg dexamethasone on postoperative nausea and vomiting (PONV) in pediatric ambulatory patients. METHODS: Forty-two pediatric patients requiring nasotracheal intubation were scheduled for ambulatory procedures. Anesthesia was induced with sevoflurane 8% in a nitrous oxide and oxygen mixture, and after an end-expiratory concentration of sevoflurane of at least 4.5% had been reached, the trachea was intubated. Intubating conditions were graded as excellent, good, poor or impossible according to Good Clinical Research Practice criteria, and the incidence of adverse events during induction were also noted. Patients were randomly allocated to receive normal saline (control group, n = 20) or dexamethasone 0.1 mg/kg (dexamethasone group, n= 22) after the induction of anesthesia. RESULTS: Nasotracheal intubation was accomplished successfully in 100% of the patients and clinically acceptable intubating conditions were obtained in 38 patients (25 excellent and 13 good). There were no significant differences between the two groups in age, sex, and operation time. In the 0 to 6 hour postoperative period, the incidences of PONV were 15% and 9% in the control and dexamethasone groups respectively, but this was not significantly different. CONCLUSIONS: Induction with sevoflurane in nitrous oxide and oxygen provided ideal conditions for nasotracheal intubation. Intraoperative dexamethasone did not significantly reduce PONV after inhalation induction and maintenance with sevoflurane during the first 6 hour postoperative period in pediatric patients.
Ambulatory Surgical Procedures* ; Anesthesia* ; Dexamethasone* ; Fentanyl ; Humans ; Incidence ; Inhalation* ; Intubation* ; Nitrous Oxide ; Oxygen ; Pediatrics ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Trachea