No significant difference was noted in canine hookworm infection due to hormone influence between the control group and the gonadectomized rats which were sacrificed 17 days after gonadectomy and 7 days after the infection. However in the rats which were infected 20 days after oophorectomy a significant difference was thought to be present in this group(176 +- 12.9 larvae/rat) compared with the control group (138 +- 21.2 larvae/rat). On the other hand, in the castrated group the number of larvae (138 +- 37.1 larvae/rat) was less than that in the control group (208 +- 43.4 larvae/rat). In the estrogen-injected male and female groups, there were no difference compared to the control, but the testosterone-injected groups of males and females showed more susceptibility to infection by A. caninum than in the control group. The Capillaria hepatica infection to the castracted host showed no significant difference between the gonadectomized and the control group. (oophorectomy; 214 +- 28.0), castration; 250 +- 36.5 and control; 191 +- 58.2 and 270 +- 30.1 adults/rat). Concerning the influence of the host's sex hormone on egg production of canine hookworm, there was a significantly decreased egg production in castrated dogs(6,578 +- 664.0 egg per gram) compared to the control dogs(9,711 +- 1,322.3 egg per gram). The same results were observed in vitro test. In the host, the susceptibility to hookworm infection was reduced in castrated rats, while oophorectomy group had a little or no effect. In the favorable or unfavorable hosts, testosterone gave the tendency of increasing susceptibility of the host to infection, while estrogen did a little or no effect.
parasitology-helminth-nematoda ; hookworm ; estrogen ; testosterone ; rat ; dog Ancylostoma caninum ; Capillaria hepatica ; gonadectomy ; estrogen ; testosterone

OBJECTIVE: This study was designed to clarify the phasic changes and distinctive spectral features of the brain abscess in the in vivo proton MR spectroscopy during the processes of abscess formation in rats, in relation to MR images. METHODS: Staphylococcus aureus was stereotactically inoculated into the predetermined location of the right frontal brain of SPF controlled Sprague-Dawley female rats(200-250gm). T1 weighted image(WI), T2WI and gadolinium enhanced image(CEMR) were obtained serially prior to each MR spectroscopy in order to visualize the infected lesions. RESULT: Three characteristic peaks, from proton MR spectroscopy, were found. A dominant peak was shown at 1.3ppm, which was due to the high concentration of mobile lipid or lactate, and smaller two peaks were shown at 0.8-1.0ppm and 1.9ppm, due to the small concentration of aminoacid(leucine, isoleucine. valine) and acetate, respectively. The lactate peak has increased during the stage of cerebritis and started to decrease in its early capsulation stage, finally invisible in its late capsulation stage(p=0.0001). The change of lactate peak was conspicuous at the early stage of cerebritis while the change of MR image was rather subtle. The aminoacids peak remained small throughout all stages. The acetate peak was shown in the late stage of cerebritis. However, it's peak area of integration was not exactly measured because of overlapping on the N-acetylaspartate peak. On the other hand, the peak of N-acetylaspartate and creatines, which could be observed in normal brain, remained at low level after sharp decrease in the early stage of cerebritis(p=0.004, p=0.005). The cholines peak decreased in the early stage of cerebritis, but it was not statistically significant(p=0.124). CONCLUSION: From this study, we were able to observe the characteristic MR spectroscopic features of each stage even from such a small volume of abnormal lesions with a 2X2X3mm 3 voxel size. Furthermore, based on our results that inflammatory change could be detected earlier by MR spectroscopy than by MR images, MR spectroscopy may be applied for early diagnosis of the brain abscess.
Abscess ; Animals ; Brain Abscess* ; Brain* ; Early Diagnosis ; Female ; Gadolinium ; Hand ; Humans ; Isoleucine ; Lactic Acid ; Magnetic Resonance Spectroscopy ; Protons* ; Rats* ; Rats, Sprague-Dawley ; Staphylococcus aureus

A newer atypical antipsychotic, aripiprazole has been shown to be effective in the treatment of schizophrenia and other psychotic disorders. A 44-year-old woman who developed psychotic symptoms and parkinsonism a month after carbon monoxide poisoning and did not respond to other atypical antipsychotics, was successfully treated with aripiprazole. This case suggests that aripiprazole may be helpful to those developed psychotic symptoms and movement disorders associated with toxic brain injury such as carbon monoxide poisoning.
Adult ; Antipsychotic Agents ; Brain Injuries ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Female ; Humans ; Movement Disorders ; Parkinsonian Disorders* ; Psychotic Disorders ; Schizophrenia ; Aripiprazole

Sclerotic fibroma is a rare fibrous tumor of the skin associated with Cowden’s disease. In 1989, Rapini described sclerotic fibroma without Cowden’s disease as solitary sclerotic fibroma of the skin. It is a solid, well-circumscribed, slow-growing nodular tumor and it looks similar to a keloid scar. Consequently, it is extremely difficult to make a differential diagnosis of solitary sclerotic fibroma with keloid scar based on clinical findings only. The authors report a case of solitary sclerotic fibroma arising at the left lateral thigh of a 25-year-old man.

Diabetes has been associated with more severe outcomes and higher mortality in coronavirus disease 2019 (COVID-19) patients compare to morbidity and mortality in patients without diabetes. Several mechanisms may play a role in this greater morbidity and mortality, especially uncontrolled hyperglycemia, an impaired immune system, pre-existing proinflammatory states, multiple comorbidities, and dysregulated angiotensin-converting enzyme 2 signaling. Thus, the diabetes medical community emergently needs to know about COVID-19 and its effects on patients with diabetes, as they must take precautions to carefully manage these patients during the COVID-19 pandemic. The Korean Diabetes Association provides some guidance and practical recommendations for the management of diabetes during the pandemic. This report provides insight into the association between diabetes and COVID-19, proper management of diabetes in patients with COVID-19 and an official suggestion by the Korean Diabetes Association for managing the COVID-19 outbreak.

BACKGROUND: Pain after laparoscopy is multifactorial and different treatments have been proposed to provide pain relief. Multimodal analgesia is now recommended to prevent and treat post-laparoscopy pain. Dexmedetomidine, an alpha2 agonist, has well-known anesthetic and analgesic-sparing effects. We evaluated the analgesic effect of perioperative dexmedetomidine infusion during laparoscopic cholecystectomy with multimodal analgesia. METHODS: Forty-two patients aged 20 to 60 years old were allocated randomly into one of 2 groups (n = 21, in each). All patients underwent laparoscopic cholecystectomy under multimodal analgesia. The patients in group P received dexmedetomidine 1 microg/kg during 10 min before induction and then 0.5 microg/kg/h continuously until the removal of the gall bladder while the patients in the group C received saline by the same methods as group P. Total analgesic consumption and VAS score were recorded for the first 24 hr. RESULTS: There were no significant differences in VAS scores between group P and group C during 24 hr after laparoscopic cholecystectomy. VAS scores of group P were lower than that of group C during the 1st hr after operation. The amount of ketorolac required during the 24 hr after the operation was significantly less in group P compared to group C. CONCLUSIONS: The administration of dexmedetomidine during laparoscopic cholecystectomy with multimodal analgesia has minimal benefits on the reduction of the postoperative pain score. The amount of ketorolac requirements during 24 hr after the operation showed significant difference. Dexmedetomidine might be helpful for the postoperative pain after laparoscopic cholecystectomy with multimodal analgesia.
Aged ; Analgesia ; Cholecystectomy, Laparoscopic ; Dexmedetomidine ; Humans ; Ketorolac ; Laparoscopy ; Pain, Postoperative ; Urinary Bladder

BACKGROUND: Rocuronium has a high incidence of vascular pain when injected intravenous by, and diverse methods have been examined to reduced this pain. The aim of this study was to evaluate the effect of ketamine pretreatment on vascular pain during the injection of rocuronium in pediatric patients. METHODS: Sixty ASA physical status 1 patients scheduled for elective surgery were randomly divided into three groups; a control group (placebo: normal saline, n = 20), group 1 (ketamine 0.5 mg/kg pretreatment, n = 20), and group 2 (ketamine 1 mg/kg pretreatment, n = 20). The ketamine pretreatment was injected in the preanesthetic room. After being moved into the operation room, general anesthesia was induced using thiopental sodium 5 mg/kg in control group. All groups were followed during and after injecting rocuronium 0.9 mg/kg IV. Vascular pain was graded using a 4-point scale. RESULTS: The incidence of vascular pain diminished significantly in the ketamine pretreated group, as follows: 17 (85%) in control group, 4 (20%) in group 1 and 7 (35%) in group 2. CONCLUSIONS: Intravenous ketamine pretreatment at 0.5-1 mg/kg may effectively reduce or prevent vascular pain on injecting rocuronium in pediatric patients.
Anesthesia, General ; Humans ; Incidence ; Ketamine* ; Thiopental

Toxic epidermal necrolysis (TEN) is one of the most dramatic, life-threatening cutaneous drug reaction. TEN is characterized by extensive detachment of the epidermis due to full-thickness necrosis. Because of extensive epidermal loss, these patients are vulnerable to infection, fluid loss, electrolyte imbalance, and heat loss. Anesthesiologist should attempt to prevent further skin damage and reduce complications such as pulmonary edema, renal failure, and sepsis. A 30-year-old male patient was admitted with fever and myalgia. 1 day after admission, scale, erosion, ulceration, eruption on skin and mucosa were developed. Symptoms progressed to TEN after 5 days of admission. 6 days after admission, he developed panperitonitis due to duodenal ulcer perforation, and underwent laparotomy under general anesthesia. We report a case of a patient with TEN who received general anesthesia for laparotomy due to panperitonitis.
Adult ; Anesthesia, General ; Body Temperature Regulation ; Duodenal Ulcer ; Epidermis ; Fever ; Humans ; Laparotomy ; Male ; Mucous Membrane ; Myalgia ; Necrosis ; Pulmonary Edema ; Renal Insufficiency ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Ulcer

It is uncommon that anesthesiologists experience patients with thyroid storms. In our case, the patient had been medicated for 5 years, however, she developed agranulocytosis. Anti-thyroid drugs were stopped and hyperthyroidism progressed. Her symptoms and laboratory results revealed manifestation of thyroid storm: TSH of < 0.005 IU/L, free T4 of > 7.77 ng/dl, T3 of 403.1 ng/dl, and T4 of 22.15 microg/dl. The euthyroid state had not been achieved before the surgery. From the judgment of difficulty controls of hyperthyroidism, the surgeon requested for an emergency operation. We report a case of total intravenous anesthesia with propofol and remifentanil which achieved hemodynamic stability.
Agranulocytosis ; Anesthesia, Intravenous* ; Emergencies ; Hemodynamics ; Humans ; Hyperthyroidism ; Judgment ; Propofol ; Thyroid Crisis ; Thyrotoxicosis*

BACKGROUND: Hypothermia is common during arthroscopic shoulder surgery under general anesthesia, and anesthetic-impaired thermoregulation is thought to be the major cause of hypothermia. This prospective, randomized, double-blind study was designed to compare perioperative temperature during arthroscopic shoulder surgery with interscalene brachial plexus block (IBPB) followed by general anesthesia vs. general anesthesia alone. METHODS: Patients scheduled for arthroscopic shoulder surgery were randomly allocated to receive IBPB followed by general anesthesia (group GB, n = 20) or general anesthesia alone (group GO, n = 20), and intraoperative and postoperative body temperatures were measured. RESULTS: The initial body temperatures were 36.5 ± 0.3℃ vs. 36.4 ± 0.4℃ in group GB vs. GO, respectively (P = 0.215). The body temperature at 120 minutes after induction of anesthesia was significantly higher in group GB than in group GO (35.8 ± 0.3℃ vs. 34.9 ± 0.3℃; P < 0.001). The body temperatures at 60 minutes after admission to the post-anesthesia care unit were 35.8 ± 0.3℃ vs. 35.2 ± 0.2℃ in group GB vs. GO, respectively (P < 0.001). The concentrations of desflurane at 0, 15, and 120 minutes after induction of anesthesia were 6.0 vs. 6.0% (P = 0.330), 5.0 ± 0.8% vs. 5.8 ± 0.4% (P = 0.001), and 3.4 ± 0.4% vs. 7.1 ± 0.9% (P < 0.001) in group GB vs. GO, respectively. CONCLUSIONS: The present study demonstrated that preoperative IBPB could reduce both the intraoperative concentration of desflurane and the reduction in body temperature during and after arthroscopic shoulder surgery.
Anesthesia ; Anesthesia, General ; Arthroscopy ; Body Temperature ; Body Temperature Regulation ; Brachial Plexus Block* ; Brachial Plexus* ; Double-Blind Method ; Humans ; Hypothermia ; Prospective Studies ; Shoulder*