PURPOSE: To evaluate the severity of tissue necrosis of liver according to various kinds of contrast materials used in percutaneous transhepatic procedure. MATERIALS AND METHODS: Four kinds of commercially available contrast material were used in the this study :meglumine ioxithalamate (ionic monomer, Telebrix 30, Guerbet, France), meglumine ioglicinate (ionic dimer, Rayvist 300, Schering, Germany), iopromide (nonionic monomer, Ultravist 300, Schering, Germany), and iotrolan (nonionic dimer, Isovist 300, Schering, Germany). The same amount(0.1 ml) of each contrast material was directly injected into the liver of Sprongue-Dawley rats. After two days and four weeks, the histopathologic findings of resected liver were assessed and analysed with special emphasis on the difference in the area of tissue necrosis between each group. RESULTS: In the liver resected 48 hours later, the area of necrosis was related to the osmolality and ionicity of contrast material used :the higher the osmolality, the wider the area of necrosis and ionic contrast material exhibited wider area of necrosis than nonionic contrast material. In the liver resected four weeks later, almost complete recovery was seen at the site of necrosis in all groups. CONCLUSION: Nonionic contrast materials caused less tissue necrosis than ionic contrast materials in percutaneous transhepatic procedure because of their lower osmolality.
Animals ; Contrast Media* ; Liver* ; Meglumine ; Necrosis ; Osmolar Concentration ; Rats*

This study was performed to investigate the mechanism of the clozapine-induced seizures in partially restrained rats by concomitant treatment with drugs affecting monoaminergic systems. Partially restrained rats treated with acute single doses of 10mg/kg clozapine exhibited myoclonic jerks(MJs). Drugs affecting the monoaminergic systems, including 2mg/kg haloperidol, 5mg/kg propranolol, 2mg/kg ritanserin, 20mg/kg fluoxetine, and 20mg/kg imipramine, were concomitantly treated with clozapine to observe the effects of these drugs on the MJs. The drugs were given intraperitoneally either as acute single doses(haloperidol, propranolol, ritanserin, and fluoxetine) or as chronic doses for 21 days(haloperidol, imipramine, ritanserin, and fluoxetine). The effects of the concomitant treatment of other drugs on the clozapine-induced MJs were evaluated by comparison of the total numbers of the MJs between the clozapine-treated and concomitantly treated groups. The results were as follows. 1) Concomitant treatment with acute single doses of haloperidol, propranolol, and fluoxetine reduced the total numbers of the clozapine-induced MJs, while concomitant treatment with ritanserin did not. 2) Concomitant treatment with chronic doses of imipramine and ritanserin increased the total numbers of the MJs, while concomitant treatment with fluoxetine reduced them. Concomitant chronic treatment with haloperidol did not affect the numbers of the MJs. These results suggest that dopamine and serotonin, not noradrenalin may be involved in the clozapine-induced MJs in partially restrained rats. Future research needs to study the function of each subtype of monoaminergic receptors on the mechanism of the clozapine-induced seizure.
Animals ; Clozapine ; Dopamine ; Fluoxetine ; Haloperidol ; Imipramine ; Myoclonus* ; Propranolol ; Rats* ; Ritanserin ; Seizures ; Serotonin

OBJECTIVE: We evaluate the cerebral protective effect of thiopental, propofol and dantrolene in middle cerebral artery occlusion(MCAO) model of rats, which ventilated spontaneously and showed definitely decreased EEG activities which is compatible with cerebral focal ischemia. METHODS: Sprague-Dawley rats were anesthetized with halothane. In control group, halothane(1-1.3 vol%) was inhaled by mask. In thiopental and propofol group, halothane was switched to each drug about 20 minutes before MCAO. In dantrolene group, dantrolene was administered 20 minutes before MCAO with halothane inhalation. Middle cerebral artery was occluded for 120 minutes. The focal ischemic proess was confirmed by ipsilateral suppression of EEG, expressed by compressed spectral array. The volume percentage of infarcted brain was measured. RESULTS: The percentage of infarct volume in thiopental group(13.7+/-4.6%) was significantly smaller than other groups(control group : 28.4+/-4.2%, propofol group:32.3+/-6.7%, dantrolene group : 31.9+/-5.4%). But, there was no statistically meaningful difference between control group, propofol group, and dantrolene group. CONCLUSION: The results of this study indicate that only thiopental has brain protective effect against focal cerebral ischemia.
Animals ; Brain ; Brain Ischemia* ; Dantrolene* ; Electroencephalography ; Halothane ; Infarction, Middle Cerebral Artery* ; Inhalation ; Ischemia ; Masks ; Middle Cerebral Artery* ; Propofol* ; Rats* ; Rats, Sprague-Dawley ; Thiopental*

BACKGROUND: The use of intraoperative brainstem auditory evoked potential (BAEP) has reduced the incidence of sensorineural hearing loss (SNHL) after microvascular decompression (MVD). This complication occurs due to direct compressive and/or stretching injury of the cochlear nerve or to indirect compression of the perineural vasculature during cerebellar retraction. The aim of this study was to evaluate the effect of thiopental sodium on SNHL after MVD for hemifacial spasm. METHODS: 94 hemifacial spasm patients with normal hearing function preoperatively and who underwent MVD under intraoperative BAEP monitoring were enrolled in this study. Patients were randomly divided into two groups. 52 patients were administered placebo (control group) and 42 patients were administered thiopental sodium 5 mg/kg intravenously 5 minutes before cerebellar retraction (thiopental group). The effects of thiopental on intraoperative BAEP changes and postoperative hearing functional outcomes were sought. Incidence and degree of postoperative SNHL were evaluated by pure tone audiometry threshold analysis. RESULTS: Maximal changes in intraoperative BAEP parameters did not differ between the two groups, and neither did the incidence nor degree of SNHL. In the control group, 4 transient and 4 permanent postoperative SNHL, including 2 deaf patients, occurred with an overall incidence of 15.4%. In the thiopental group, 2 transient and 1 permanent postoperative SNHL occurred, with an overall incidence of 7.1%. CONCLUSIONS: Thiopental sodium administered prior to cerebellar retraction might reduce the incidence of postoperative hearing loss.
Audiometry ; Cochlear Nerve ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing* ; Hemifacial Spasm ; Humans ; Incidence ; Microvascular Decompression Surgery* ; Thiopental*

Femoral artery pseudoaneurysm, a very uncommon disease, is usually reported trauma, iatrogenic vascular intervention, and nail fixation in the treatment of fracture. The femoral artery is a major vessel for blood supply to the lower extremities. If the femoral artery is injured, the patient will experience cardiovascular collapse and hypovolemic shock due to massive hemorrhage. We report on the case of a 49-year-old male patient who had been diagnosed with systemic lupus erythematosus (SLE), who was admitted to our hospital with progressive swelling of the right thigh without any trauma history. A computed tomographic scan with arterial enhancement showed a large pseudoaneurysm of the right femoral artery, which was then treated successfully with great saphenous vein graft surgery.
Aneurysm ; Aneurysm, False* ; Femoral Artery* ; Hemorrhage ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic* ; Male ; Middle Aged ; Rupture* ; Saphenous Vein ; Shock ; Thigh ; Transplants

A type I Arnold-Chiari malformation (ACM1) is characterized by herniation of cerebellar tonsils at least 3 mm below the plane of the foramen magnum and can present with various clinical symptoms, frequently occipital headache, lower cranial nerve palsy, or ataxia. However, syncope has rarely been described as an initial manifestation of ACM1. An 18-year-old girl experienced a falling to the ground with a loss of consciousness for a minute. The fall occurred with a sensation of vertigo when she was extending her neck to pick up a shuttlecock. Electroencephalography, autonomic function tests, and echocardiography did not demonstrate abnormalities. An magnetic resonance image showed a ACM1. A second-degree atrioventricular block was noted on the initial 24-hour EKG, but not on the second and the third ones taken after neck movement had been restricted by a brace. The initiation of syncope with a sensation of vertigo during excessive head movement and the absence of any other common causes of syncope except for the transient second-degree atrioventricular block disappearing after restriction of neck movement raise the possibility that the syncope was due to the ACM1. Therefore, we recommend that a differential diagnosis of syncope should include ACM1 on the initial evaluation.
Adolescent ; Arnold-Chiari Malformation* ; Ataxia ; Atrioventricular Block ; Braces ; Cranial Nerve Diseases ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Electroencephalography ; Female ; Foramen Magnum ; Head Movements ; Headache ; Humans ; Magnetic Resonance Imaging ; Neck ; Palatine Tonsil ; Sensation ; Syncope* ; Unconsciousness ; Vertigo

No abstract available.
Aging* ; Endocrine Cells* ; Neurons*

PURPOSE: We explored whether a gender difference was evident in terms of the associations of snoring with hemoglobin A1c (HbA1c) and homeostatic model assessment-insulin resistance (HOMA-IR) levels in a healthy population without type 2 diabetes mellitus (DM). MATERIALS AND METHODS: We analyzed 2706 males and 4080 females who participated in the baseline survey of the Namwon Study. In terms of self-reported snoring frequency, participants were classified as non-snorers or occasional (1–3 days/week), frequent (4–6 days/week), or constant (7 days/week) snorers. Participants with DM, defined as a fasting blood glucose level ≥126 mg/dL and/or use of insulin or hypoglycemic medication, were excluded from the analysis. RESULTS: In females, the fully adjusted mean (95% confidence interval) HbA1c levels in non-snorers and in occasional, frequent, and constant snorers were 5.53% (5.47–5.59%), 5.53% (5.47–5.59%), 5.57% (5.49–5.64%), and 5.57% (5.51–5.64%), respectively, reflecting a dose-response relationship (p trend=0.004). Compared with female non-snorers, the risk of an elevated HbA1c level (top quintile, ≥5.9%) in constant snorers remained significant (odds ratio 1.30, 95% confidence interval 1.02–1.66) after full adjustment. In addition, in females, a significant linear trend in HbA1c level odds ratio by increased snoring frequency was apparent (p trend=0.019 in model 3). In contrast, no significant association between snoring frequency and HbA1c level was identified in males. No significant association between snoring frequency and HOMA-IR was detected in either gender. CONCLUSION: We discovered a gender-specific association between snoring and HbA1c level in a healthy, community-dwelling population free of DM.
Blood Glucose ; Diabetes Mellitus, Type 2* ; Fasting ; Female ; Hemoglobin A ; Humans ; Insulin ; Insulin Resistance ; Jeollabuk-do ; Male ; Odds Ratio ; Snoring* ; Surveys and Questionnaires

PURPOSE: On November 8, 2013, Typhoon Haiyan attacked the Philippines, causing damage to many houses and trees as well as loss of many lives. A medical team from our hospital and university was sent to Philippines in order to provide medical assistance. We wish to describe our experiences of disaster medicine and discuss problems and improvement points. METHODS: We analyzed the characteristics of patients who received medical treatment administered by us at Tagobon city in the Philippines for five days. RESULTS: We provided medical services to 951 patients for five days. Most patients visited us for medical treatment not trauma. Almost all chief complaints were associated with respiratory, gastrointestinal, dermatologic, and ophthalmologic symptoms. We mainly treated the patients with medications. CONCLUSION: During the subacute period after the disaster, most patients complained of medical and dermatologic problems due to lack of sanitation rather than traumatic complications. Medical assistance for disaster should be administered appropriately according to the types of diseases that occurduring each period after disaster.
Cyclonic Storms* ; Disaster Medicine ; Disasters* ; Humans ; Medical Assistance* ; Philippines* ; Sanitation

This study evaluated the association between falls and the fear of falling (FOF) with the risk of all-cause mortality in Korean adults. The study enrolled 4,386 subjects aged 50 years and over who participated in the Dong-gu Study. Falls in the past year were categorized as yes or no. Injurious falls were defined as falls that resulted in fractures, head injuries, sprains or strains, bruising or bleeding, or other unspecified injuries. FOF was classified as low or high. The associations of falls and fall-related characteristics with mortality were assessed using Cox proportional hazards models. The average follow-up was 7.8 years. During this period, 255 men and 146 women died. In a fully adjusted model, falls in the past year were not associated with an increased risk of all-cause mortality (hazard ratio [HR] 1.16, 95% confidence interval [CI] 0.85–1.58), but a history of injurious falls was associated with an increased risk of mortality (HR 1.36, 95% CI 1.04–1.79). Compared with subjects without a FOF, subjects who were moderately or very afraid of falling had a higher mortality rate (HR 1.26, 95% CI 0.97–1.63). In conclusion, injurious falls and a high FOF increased the risk of all-cause mortality in Koreans. This study suggests that injurious falls and FOF can predict mortality in the general population.
Accidental Falls ; Adult ; Cause of Death ; Cohort Studies ; Craniocerebral Trauma ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Mortality ; Proportional Hazards Models ; Sprains and Strains