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

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

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

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: 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*

BACKGROUND: Intravenous injection of rocuronium is associated with withdrawal responses which are attributable to the pain from the injection of rocuronium. Several methods have been proposed to abolish and attenuate rocuronium-induced pain. We hypothesized priming dose of rocuronium could reduce withdrawal responses associated with administering a second large dose of rocuronium for tracheal intubation. We compared the efficacy of the priming dose technique of rocuronium with intravenous lidocaine as a pre-treatment for the prevention of withdrawal responses associated with rocuronium injection. METHODS: We recruited 150 patients aged between 18 and 60 years, ASA physical status 1 or 2, who were going to undergo elective surgery requiring general anesthesia. Patients were allocated into three groups. Group C received normal saline, Group L received lidocaine 1 mg/kg, and Group P received rocuronium 0.06 mg/kg 2 minutes before administering a second large dose of rocuronium for tracheal intubation. After the loss of consciousness, rocuronium 0.6 mg/kg was administered intravenously over 10 seconds for tracheal intubation. The withdrawal responses to the injection of rocuronium were evaluated. RESULTS: The incidence of withdrawal responses associated with rocuronium injection for tracheal intubation was 56, 50, 24% in group C, group L, and group P, respectively. The incidence of withdrawal responses was lower in group P than group C and group L, but there was no difference between group L and group C. CONCLUSIONS: Priming dose technique is a useful clinical method to alleviate withdrawal responses associated with rocuronium injection.
Administration, Intravenous ; Aged ; Androstanols ; Anesthesia, General ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Lidocaine ; Unconsciousness

A 53 year old man with gastric cancer was admitted for radical subtotal gastrectomy. The patient received general anesthesia with epidural analgesia. Epidural catheterization was performed using an 18-gauge Tuohy needle at the T10-11 interspace, and the epidural space was confirmed after a repeated attempt. An epidural catheter was then advanced smoothly 5 cm in cephalad direction without bleeding or CSF leakage. The patient received a test dose of lidocaine and epinephrine and continuous infusion with morphine and lidocaine 30 minutes before operation finished. Vital signs during the operation were stable. Two days after the operation, the patient complained of an orthostatic headache, and relieved ketolorac. On the seventh day, the patient complained of bilateral diplopia. Diffuse pachymeningeal gadolonium enhancement was seen on the brain MRI, and his CSF pressure was 0 mmHg by spinal tapping. We suspected abducent nerve palsy due to CSF hypovolemia and performed an epidural blood patch with 15 ml of autologus blood at the previous puncture site. The patient is receiving regular examinations at the Neurology and Opthalmology department. Abducent nerve palsy completely recovered by the Hess Screen test 6 months after operation, and diplopia disappeared 10 months after the operation.
Abducens Nerve ; Analgesia, Epidural ; Anesthesia, General ; Blood Patch, Epidural ; Brain ; Catheterization* ; Catheters* ; Diplopia* ; Epidural Space ; Epinephrine ; Gastrectomy ; Headache ; Hemorrhage ; Humans ; Hypovolemia ; Lidocaine ; Magnetic Resonance Imaging ; Middle Aged ; Morphine ; Needles ; Neurology ; Pain, Postoperative* ; Paralysis ; Punctures ; Spinal Puncture ; Stomach Neoplasms ; Vital Signs

BACKGROUND: Lidocaine is used for suppressing circulatory responses to endotracheal intubation. In this study the investigated changes of middle cerebral artery blood flow velocity (Vmca) before and after intravenous lidocaine injection by transcranial doppler. METHODS: Fifteen healthy volunteers received a bolus dose of intravenous lidocaine 1.5 mg/kg. Vmca's were measured on the temple using a bidirectional 2-MHz transcranial doppler probe before and after lidocaine injection. Vmca's were recorded continually every 10 sec for 10 minutes after lidocaine injection. RESULTS: Mean Vmca was 67.6 +/- 7.6 cm/sec before lidocaine injection. Maximal Vmca's (70.7 +/- 7.5 cm/sec, P<0.05) occurred 35 +/- 16 sec after lidocaine injection, and then the Vmca decreased gradually. Minimal Vmca's (56.6 +/- 7.4 cm/sec, P<0.05) were measured at 164 +/- 40 sec after lidocaine injection. CONCLUSIONS: We suggest that lidocaine generally causes the decreases in Vmca, excepting the temporarily increase in Vmca about 35 sec after a single bolus administration of intravenous lidocaine.
Blood Flow Velocity* ; Healthy Volunteers ; Injections, Intravenous* ; Intubation, Intratracheal ; Lidocaine* ; Middle Cerebral Artery*

BACKGROUND: There was a difference between the past and the present in distance from the upper incisor to the carina in children. This study was performed to evaluate the distance from the upper incisor to the carina and correlation of it with age, the weight and height in korean children from 2 to 8 years old. METHODS: Two hundred twenty two children from 2 to 8 years old scheduled for receiving tonsillectomy or adenoidectomy were evaluated for the study by age groups (every 6 months from 2 to 8 years old). The X-ray was used for evaluation of distance from the incisor to the carina. The distance from the upper incisor to C7 was calculated on neck lateral view and distance from C7 to the carina was calculated on chest PA. Both distance were added and served as the distance from upper incisor to the carina. RESULTS: The coefficient of determination of the distance from the upper incisor to the carina was highest according to height. The regression equation of the distance from the upper incisor to the carina using height was Y (cm) = 0.15 X (cm) and R2 = 0.70 (Y: the upper incisor to the carina, X: the height). CONCLUSIONS: We found that the distance from the upper incisor to the carina in children correlated with both the weight and height in children and the height was the highest correlation with distance.
Adenoidectomy ; Child* ; Humans ; Incisor* ; Neck ; Thorax ; Tonsillectomy