Sodium nitrorusside (SNP) is used for induced hypotension to decrease bleeding in operation site by direct relaxation of vascular smooth muscles. It is known that the infusion of SNP increases plasma renin activity (PRA) and this activation of renin-angiotensin system is one of physiologic mechanism opposing the hypotensive action. Captopril, the renin-angiotensin converting enzyme inhibitor, could reduced the dose of SNP during induced hypotension through blocking of the cardiovascular effect of renin-angiotensin system. The present study investigates the effect of captopril on PRA, aldosterone, elecholamines and electroytes and whether the pretreatment with captoril can reduce the dose of SNP. Forty patients who needed the induced hypotension for maxillofacial reconstructive surgery were studied. They were pertained to ASA class I and II and classified to 4 groups. Ten patients were pretreated with captopril 3 mg/kg, 10 min. before induction. And ten patients were 1 mg/kg, the other ten patients were 0.5 mg/kg and remainder served as control group. Blood samples for analysis were drawn according to the time sequence of SNP infusion; Stage 1; after the induction and before SNP infusion Stage 2; 30 min. after SNP (when mean arterial pressure was 60-70 torr) infusion Stage 3; before stopping infusion of SNP Stage 4; 30 min. after stopping infusion of SNP The results were as follows: 1) The duration of anesthesia were not stastically different among four groups. 2) Total dose of SNP were significantly decreased in each captopril group. 3) PRA and each value of control group were significantly increased compared with stage l. But there were no significant increase in stages 2, 3, 4 compared with control group PRA. 4) Aldosterone level of all captopril groups were decreased in all stage compared with control group. 5) Epinephrine and norepinephrine were significantly incerased in control group and returned to control level after stopping of SNP infusuon. In captopril group 3 mg/kg, norepinephrine of stage 2.3.4 were not significantly increased than stage l. Epinephrine in captopril 3 mg/ kg group, there were no significant changes except for stage 2. 6) While sodium was decreased in stage 3,4 compared with stage 1 in control group, potassium and chloride were not changed. In summary, captopril can reduce significantly the total dose of SNP required to produce induced hypotension during operation.
Aldosterone* ; Anesthesia ; Arterial Pressure ; Captopril* ; Catecholamines* ; Electrolytes* ; Epinephrine ; Hemorrhage ; Humans ; Hypotension* ; Muscle, Smooth, Vascular ; Nitroprusside* ; Norepinephrine ; Plasma* ; Potassium ; Relaxation ; Renin* ; Renin-Angiotensin System ; Sodium*

We investigated the effect of low dose radiation on diabetes induced suppression of neurogenesis in the hippocampal dentate gyrus of rat. After 0.01 Gy, 0.1 Gy, 1 Gy and 10 Gy radiation was delivered, the dentate gyrus of hippocampus of streptozotocin (STZ)-induced diabetic rats were evaluated using immunohistochemistry for 5-bromo-2-deoxyuridine (BrdU), caspase-3, and terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) staining. The number of BrdU positive cells in the non-diabetic rats, diabetic rats without radiation, diabetic rats with 0.01 Gy radiation, diabetic rats with 0.1 Gy radiation, diabetic rats with 1 Gy radiation and diabetic rats with 10 Gy radiation were 55.4+/-8.5/mm2, 33.3+/-6.4/mm2, 67.7+/-10.5/mm2, 66.6+/-10.0/mm2, 23.5+/-6.3/mm2 and 14.3+/-7.2/mm2, respectively. The number of caspase-3 positive cells was 132.6+/-37.4/mm2, 378.6+/-99.1/mm2, 15.0+/-2.8/mm2, 57.1+/-16.9/mm2, 191.8+/-44.8/mm2 and 450.4+/-58.3/mm2, respectively. The number of TUNEL-positive cells was 24.5+/-2.0/mm2, 21.7+/-4.0/mm2, 20.4+/-2.0/mm2, 18.96+/-2.1/mm2, 58.3+/-7.9/mm2, and 106.0+/-9.8/mm2, respectively. These results suggest low doses of radiation paradoxically improved diabetes induced neuronal cell suppression in the hippocampal dentate gyrus of rat.
Rats, Sprague-Dawley ; Rats ; Radiotherapy/methods ; Neurons/*metabolism ; Male ; In Situ Nick-End Labeling ; Hippocampus/*cytology/metabolism/radiation effects ; Diabetes Mellitus, Experimental/radiotherapy ; Dentate Gyrus/drug effects/*radiation effects ; Cell Proliferation ; Caspase 3/metabolism ; Bromodeoxyuridine/pharmacology ; Apoptosis ; Animals

Meningitis associated with tsutsugamushi is not a rare disease and simple, effective treatments are available. However, the diagnosis of meningitis is important since it is potentially associated with significant mortality rates. Case 1 : A 47-year-old woman had a headache and high fever with chills for 3 days. She fell into a stupor, and her blood pressure dropped to 80/60 mmHg on the fifth day of admission to the hospital. The patient was treated with 200 mg of doxycycline given intravenously. Case 2 : A 48-year-old woman was admitted with a 7-day history of fever with chills, severe headache, vomiting, and a generalized non-pruritic erythematous maculopapular rash. The patient was treated with 200 mg of doxycycline given orally. CSF examinations revealed predominantly lymphocytic pleocytosis in all cases. The indirect immunofluorescent antibody titer for Orientia tsutsugamushi were 1:20,480 in case 1 and 1:5, 120 in case 2. We report two cases of meningitis associated with tsutsugamuschi disease.
Blood Pressure ; Chills ; Diagnosis ; Doxycycline ; Exanthema ; Female ; Fever ; Headache ; Humans ; Leukocytosis ; Meningitis* ; Middle Aged ; Mortality ; Orientia tsutsugamushi ; Rare Diseases ; Stupor ; Vomiting

PURPOSE: To investigate the effect of low dose radiation on neuronal cell proliferation in diabetic rats. MATERIALS AND METHODS: A group of rats (first group) were divided into three subgroups (nondiabetic control, nondiabetic 0.1 Gy and nondiabetic 10 Gy groups) to determine the effect of radiation on normal hippocampal neuronal cell proliferation. A further group of rats (second group) were divided into six subgroups (nondiabetic control, diabetic control, diabetic 0.01 Gy, diabetic 0.1 Gy, diabetic 1 Gy and diabetic 10 Gy groups) to determine the effect of radiation on hippocampal neuronal cell proliferation under diabetic conditions. Using immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), the number of neuronal cells in the dentate gyrus of all the groups was counted. RESULTS: The number of BrdU-positive cells in the dentate Gyrus of the nondiabetic control, nondiabetic 0.1 Gy and nondiabetic 10 Gy subgroups of the first group were 45.96+/-3.42, 59.34+/-5.20 and 19.26+/-2.98/mm2, respectively. The number of BrdU-positive cells in the dentate gyrus of the diabetic control, diabetic 0.01 Gy, diabetic 0.1 Gy, diabetic 1 Gy and diabetic 10 Gy subgroups of the second group were 55.44+/-8.57, 33.33+/-6.46, 67.75+/-10.54, 66.63+/-10.05, 23.59+/-6.37 and 14.34+/-7.22/mm2, respectively. CONCLUSION: Low dose radiation enhances cell proliferation in the dentate gyrus of STZ-induced diabetic rats.
Animals ; Bromodeoxyuridine ; Cell Proliferation* ; Dentate Gyrus ; Hippocampus ; Immunohistochemistry ; Neurons* ; Rats*

PURPOSE: To investigate the effect of low dose radiation on neuronal cell proliferation in diabetic rats. MATERIALS AND METHODS: A group of rats (first group) were divided into three subgroups (nondiabetic control, nondiabetic 0.1 Gy and nondiabetic 10 Gy groups) to determine the effect of radiation on normal hippocampal neuronal cell proliferation. A further group of rats (second group) were divided into six subgroups (nondiabetic control, diabetic control, diabetic 0.01 Gy, diabetic 0.1 Gy, diabetic 1 Gy and diabetic 10 Gy groups) to determine the effect of radiation on hippocampal neuronal cell proliferation under diabetic conditions. Using immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), the number of neuronal cells in the dentate gyrus of all the groups was counted. RESULTS: The number of BrdU-positive cells in the dentate Gyrus of the nondiabetic control, nondiabetic 0.1 Gy and nondiabetic 10 Gy subgroups of the first group were 45.96+/-3.42, 59.34+/-5.20 and 19.26+/-2.98/mm2, respectively. The number of BrdU-positive cells in the dentate gyrus of the diabetic control, diabetic 0.01 Gy, diabetic 0.1 Gy, diabetic 1 Gy and diabetic 10 Gy subgroups of the second group were 55.44+/-8.57, 33.33+/-6.46, 67.75+/-10.54, 66.63+/-10.05, 23.59+/-6.37 and 14.34+/-7.22/mm2, respectively. CONCLUSION: Low dose radiation enhances cell proliferation in the dentate gyrus of STZ-induced diabetic rats.
Animals ; Bromodeoxyuridine ; Cell Proliferation* ; Dentate Gyrus ; Hippocampus ; Immunohistochemistry ; Neurons* ; Rats*

The purpose of this study is to investigate the mechanism of alternative responses to low dose irradiation for neuronal cell proliferation in the dentate gyrus of rats. To determine the effect of a single exposure to radiation, rats were irradiated with a single dose of 0.1, 1, 10 or 20 Gy. To determine the effect of the cumulative dose, the animals were irradiated daily with 0.01 Gy or 0.1 Gy from 1 to 4 days. The neuronal cell proliferation was evaluated using immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), Ki-67 and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining. Four consecutive daily irradiations with a 0.01 Gy/fraction increased the number of BrdU-positive and Ki-67-positive cells in a dose dependent manner, but this did not affect the number of TUNEL-positive cells. However, there was not a dose dependent relationship for the 0.1 Gy/fraction irradiation with the number of BrdU, Ki-67 and TUNEL positive cells. Our data support the explanation that the adaptive response, induced by low-dose radiation, in the hippocampus of rats is more likely a reflection of the perturbations of cell cycle progression.
Rats, Sprague-Dawley ; Rats ; Radiation Dosage ; Neurons/*cytology/*radiation effects ; Neuronal Plasticity/*radiation effects ; Male ; Dose-Response Relationship, Radiation ; Dentate Gyrus/*cytology/*radiation effects ; Cell Survival/radiation effects ; Cell Proliferation/*drug effects ; Animals ; Adaptation, Physiological/radiation effects

In a series of 375 bilateral carotid angiographies, two accessory middle cerebral arteries, one duplication of the middle cerebral artery demonstrated on the angiography were reviewed relative to the pertinent literature. These anomalous middle cerebral arteries are very rare. We reported a case of duplication of the middle cerebral artery at 1993 which was first one to be reported in Korea. At present, we report two additional anomalous accessory middle cerebral arteries. Among these, one was accessory middle cerebral artery originated from the horizontal portion of the anterior cerebral artery, and the other originated from the A2 segment of the anterior cerebral artery. Both of these gave rise to some perforating arteries.
Angiography ; Anterior Cerebral Artery ; Arteries ; Korea ; Middle Cerebral Artery*

The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index > or =25 kg/m2 in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5% to 10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity.
Adult ; Body Mass Index ; Comorbidity ; Female ; Humans ; Incidence ; Korea ; Male ; Natural History ; Obesity* ; Overweight* ; Prevalence ; Risk Factors ; Weight Loss