BACKGROUND: The effects of a newly synthesized potassium channel opener, KR-30816((-)(nitro-2-hydroxymethyl-2-methy-2H-1-benzopyran-4-y1)pyridine oxide) on the action potential of papillary muscles of guinea pigs and the ATP-sensitive potassium channel current(IKATP) of single ventricular muscle cells of rats were examined to make clear its action mechanism of the KATPchannel. METHODS: We used the conventional microelectrode and the excised inside-out patch configuration. RESULTS: KR-30816 caused a shortening of the action potential duration in dose-dependent manner, which was inhibited by glibenclamide(3microM). Before run-down of the K+channel, KR-30816 activated the cardiac ATP-sensitive K+ channel only in the presence of ATP and shifted the dose-response relation curve between [ATP]i and the channel activity to the right in parallel. After run-down of the KATP channel, KR-30816 did not after the channel opening either in the absence or in the presence of UDP. CONCLUSION: These results suggest that KR-30816 antagonizes the inhibitory effect of ATP on the KATPchannel in a competitive manner, thereby enhancing the channel openings.
Action Potentials ; Adenosine Triphosphate ; Animals ; Guinea Pigs ; Heart ; Microelectrodes ; Muscle Cells ; Papillary Muscles ; Potassium Channels* ; Potassium* ; Rats ; Uridine Diphosphate

PURPOSE: Snowboarding accidents may cause severe injury due to the advanced skills required of Olympic athletes and the faster speed compared to many other sports. The aim of this study was to describe environmental characteristics of snowboarding injuries and to determine the level of medical support using injury analysis. METHODS: A descriptive epidemiology study was conducted with collection of data from the Federation Internationale de Ski (FIS) Snowboard Competition from January 14 to 24 in 2009. Data from the Competition Operation Committee records, medical records and competition regulations were selected for analysis. RESULTS: In this study, 31/524 competitors reported injuries, predominantly sprains and contusions (21 cases), including eight fractures. Analysis of the physical distribution of these injuries indicated ten injuries of an upper extremity (32%), seven of a lower extremity (23%), six in the head/neck region (19%), and five spinal injuries (16%). The majority (23/31) of these injuries occurred during the snowboard cross (SBX) events. Environmental factors including the course visibility and slope conditions impacted the frequency of injury during the competition. In addition, the arrival times of medical teams were longer for the SBX events (260+/-92 sec) than for the Parallel Giant Slalom (202+/-54 sec) and other snowboarding events (<60 sec). CONCLUSION: The frequency and severity of injuries were highest in the SBX competition. For injury prevention, we recommend increased focus on safety on the SBX course, consideration of weather and other environmental conditions, and a rapid emergency medical support response for injury management.
Athletes ; Contusions ; Emergencies ; Epidemiology ; Humans ; Lower Extremity ; Medical Records ; Medical Staff ; Skiing ; Social Control, Formal ; Spinal Injuries ; Sports ; Sprains and Strains ; Upper Extremity ; Weather ; Wounds and Injuries

BACKGROUND: Patients on continuous ambulatory peritoneal dialysis (CAPD) have increased risk of low-turnover bone disease and relative hypoparathyroidism. Recently, it has been believed that magnesium plays an important role in regulating secretion of parathyroid hormone (PTH). The aim of this study was to evaluate the relationship between serum PTH and serum magnesium as a factor increasing the frequency of relative hypoparathyroidism. METHODS: We analyzed the data of 56 patients who had been on CAPD for more than 6 months without any significant problems. No patient had been previously treated with vitamin D or aluminum hydroxide. The patients had used peritoneal dialysate with the magnesium concentration of 0.5 mEq/L. Biochemical parameters, such as BUN, creatinine, alkaline phosphatase bony isoenzyme, total protein, albumin, total calcium, ionized calcium and intact parathyroid hormone level were measured. RESULTS: The mean serum magnesium level was 1.99 +/- 0.36 mEq/L. Among total 56 patients, 15 patients (26.8%) showed hypermagnesemia (serum magnesium > 2.2 mEq/L) and 5 patients (8.9%) showed hypomagnesemia (serum magnesium < 1.6 mEq/L). Among all 56 patients, serum iPTH (intact PTH) level was not correlated with serum magnesium level. However, it was inversely correlated with serum total calcium and ionized calcium levels, respectively (r=-0.365, p=0.006; r=-0.515 p < 0.001). Among 49 patients whose serum iPTH level was less than 300 pg/mL, serum iPTH level was inversely correlated with serum magnesium level (r=-0.295, p=0.039) and inversely correlated with serum total calcium and ionized calcium levels, respectively (r=-0.546, p < 0.001; r=-0.572 p < 0.001). Among 49 patients whose serum iPTH level was less than 300 pg/mL, lower iPTH group (serum iPTH < 120 pg/mL) showed higher serum magnesium level (p=0.037), higher serum total calcium level (p < 0.001) and lower bone isoenzyme of alkaline phosphatase level (p < 0.001) than those of higher iPTH group (120 pg/mL Adult ; Alkaline Phosphatase/blood ; Calcium/blood ; Dialysis Solutions ; Female ; Human ; Kidney Failure, Chronic/complications/therapy ; Magnesium/*blood ; Male ; Middle Age ; Parathyroid Hormones/*blood ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects/methods ; Phosphates/blood ; Renal Osteodystrophy/etiology

PURPOSE: Current clinical data support a safe warm ischemia time (WIT) limit of 30 minutes during laparoscopic partial nephrectomy (LPN) or robot-assisted partial nephrectomy (RPN). We evaluated independent factors predicting prolonged WIT (more than 30 minutes) after LPN or RPN. MATERIALS AND METHODS: A retrospective data review was performed for 317 consecutive patients who underwent LPN or RPN performed by the same surgeon from October 2007 to May 2013. Patients were divided into two groups: group A was defined as prolonged WIT (> or =30 minutes) and group B as short WIT (<30 minutes). We compared clinical factors between the two groups to evaluate predictors of prolonged WIT. RESULTS: Among 317 consecutive patients, 80 were in the prolonged WIT group. Baseline characteristics were not significantly different between the groups. In the univariable analysis, PADUA (preoperative aspects and dimensions used for an anatomical) score (p=0.001), approach method (transperitoneal or retroperitoneal approach; p<0.001), and surgeon experience (p<0.001) were significantly associated with prolonged WIT. In the multivariable analysis, PADUA score (p=0.032), tumor size (> or =25 mm; odds ratio, 2.98; 95% confidence interval, 1.48-5.96; p=0.002), and surgeon experience (p<0.001) were independent predictors of prolonged WIT. CONCLUSIONS: Surgeon experience, tumor size, and PADUA score predicted prolonged WIT after RPN or LPN. Among these factors, increasing surgical experience with LPN or RPN is the most important factor for preventing prolonged WIT.
Adult ; Aged ; Carcinoma, Renal Cell/pathology/*surgery ; Clinical Competence ; Female ; Humans ; Intraoperative Period ; Kidney Neoplasms/pathology/*surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Nephrectomy/*methods ; Pneumoperitoneum, Artificial/*methods ; Retrospective Studies ; Risk Factors ; Robotic Surgical Procedures/methods ; Warm Ischemia/*methods

OBJECTIVES: This study was purposed to determine the levels of PCBs and DDE in adipose tissue and serum and to evaluate the relations with factors affecting these levels. METHODS: We analyzed adipose tissues and sera from 52 gynecologic benign disease patients aged 27-78 years, except hormonal diseases such as breast cancer and endometriosis. We also surveyed age, education, occupation, body mass index (BMI), smoking, drinking, number of children, and duration of breastfeeding by questionnaires. Tissue and serum levels of PCBs and DDE were measured using gas chromatography. RESULTS: The median and geometric mean levels of PCBs were 48. 29 ng/g, 56. 78 ng/g for adipose tissue and 4. 67 uc/L, 4. 85 m/L for serum, and those of DDE were 142.89 ng/g, 117.06 ng/g for adipose tissue and l. 75 m/L, 2.09 ua/L for serum, respectively. Adipose tissue and serum levels for DDE showed high correlation (r=0. 310, p=0. 0002), but those of PCBs didn' t (r=0.029, p=0.2582). In analyses of the differences of the means of log transformed adipose tissue and serum PCBs and DDE levels for groups of potential covariates, only adipose tissue DDE levels were significantly associated with number of children (p=0.015), age at first birth (p=0.014) and BMI (p=0.035). In multiple regression analysis, adipose tissue DDE levels were significantly increased with decreasing number of children and increasing age at first birth. CONCLUSIONS: This study suggested that parity and adiposity were associated with levels of DDE in adipose tissue, and adipose tissue is a better biomarker than serum for evaluating the long-term exposure of organochlorines.
Adipose Tissue* ; Adiposity ; Birth Order ; Body Mass Index ; Breast Feeding ; Breast Neoplasms ; Child ; Chromatography, Gas ; Dichlorodiphenyl Dichloroethylene* ; Drinking ; Education ; Endometriosis ; Female ; Humans ; Occupations ; Parity ; Polychlorinated Biphenyls* ; Questionnaires ; Smoke ; Smoking

Left ventricular inflow obstruction can be caused by a persistent left superior vena cava (SVC) and a dilated coronary sinus. A 31-day-old male infant with secondum atrial septal defect (ASD) and bilateral SVC underwent an operation for treating his uncontrollable congestive heart failure. The preoperative 2-dimensional echocardiography showed a normally sized mitral valve shrouded by a dilated coronary sinus. The operation consisted of pericardial patch closure of the ASD, coronary sinus unroofing and left SVC transfer to the right atrial auricle. The postoperative course was complicated by persistent chylothorax, which was controlled by thoracic duct ligation. He was discharged to home at the postoperative day 39. He has been followed up for 9 months and has displayed normal development.
Chylothorax ; Coronary Sinus* ; Echocardiography ; Heart Failure ; Heart Septal Defects, Atrial ; Humans ; Infant ; Ligation ; Male ; Mitral Valve ; Thoracic Duct ; Vena Cava, Superior*

BACKGROUND: One of the most common complications in patients with end stage renal disease is renal osteodystrophy and parathyroid hormone (PTH) plays a key role in the pathogenesis of renal osteodystrophy. It is known that patients undergoing CAPD (continuous ambulatory peritoneal dialysis) have increased risk of low turnover bone disease and relative hypoparathyroidism is related to its pathogenesis. Factors related to relative hypoparathyroidism are increased in extracellular calcium level, accumulation of aluminum, vitamin D treatment, good control of serum phosphate, diabetes mellitus, and old age. Recently it has been believed that magnesium plays an important role in regulating secretion of PTH. The aim of this study was to evaluate the relationship between serum PTH and serum magnesium as a factor increasing the frequency of relative hypoparathyroidism. METHODS: Author studied 56 patients who had undergone CAPD for more than 6 months without any significant problems and had been followed by Chonnam National University Hospital. No patient had been previously treated with vitamin D or aluminum hydroxide. The patients had used peritoneal dialysate with the magnesium concentration of 0.5 mEq/L. Biochemical parameters were checked. RESULTS: 1. The mean serum magnesium level was 1.99+/-0.36 mEq/L. Among total 56 patients, 15 patients (26.8%) showed hypermagnesemia (serum magnesium > 2.2 mEq/L), and 5 patients (8.9%) showed hypomagnesemia (serum magnesium < 1.6 mEq/L)2. On all 56 patients, serum iPTH level was not correlated with serum magnesium level. But, it was inversely correlated with serum total calcium and ionized calcium levels, respectively (r=-0.365, p=0.006; r=-0.515 p<0.001).3. Among the 49 patients whose serum iPTH level was less than 300 pg/mL, serum iPTH level was inversely correlated with serum magnesium level (r=-0.295, p=0.039), and inversely correlated with serum total calcium and ionized calcium levels, respectively (r=-0.546, p<0.001; r=-0.572 p<0.001).4. Among the 49 patients whose serum iPTH level was less than 300 pg/mL, lower iPTH group (serum iPTH<120 pg/mL) showed higher serum magnesium level (p=0.037), higher serum total calcium level (p<0.001), and lower bone isoenzyme of alkaline phosphatase level (p<0.001) than those of higher iPTH group (120 pg/mL serum< or =iPTH<300 pg/mL). CONCLUSION: Among the CAPD patients whose serum iPTH level was less than 300 pg/mL, there was a significantly inverse correlation between serum iPTH level and serum magnesium level. This study indicates that not only serum calcium level, but also serum magnesium level are important in the regulation of serum iPTH levels of CAPD patients who have been dialyzed by low-magnesium peritoneal dialysate.
Alkaline Phosphatase ; Aluminum ; Aluminum Hydroxide ; Bone Diseases ; Calcium ; Diabetes Mellitus ; Humans ; Hypoparathyroidism ; Jeollanam-do ; Kidney Failure, Chronic ; Magnesium* ; Parathyroid Hormone* ; Peritoneal Dialysis, Continuous Ambulatory* ; Receptors, Calcium-Sensing ; Renal Osteodystrophy ; Vitamin D

BACKGROUND: This study was performed to analyze the risk factors for ventriculostomy-related infections (VRIs) in the neurosurgical intensive care unit (NSICU) and the relationship between these risk factors and the patients' outcomes. METHODS: We collected demographic, clinical, laboratory and microbiological data from all 146 consecutive adult patients who underwent ventriculostomy in the NSICU from January 2007 to December 2008. We excluded patients with ventriculostomy performed for the draining of intraventricular abscess, infection of ventriculoperitoneal shunt (V-P shunt) or previous ventriculitis. VRI was defined by positive culture from cerebrospinal fluid (CSF) obtained via the ventricular catheter. RESULTS: VRIs were diagnosed in 26 (17.8%) of 146 patients. On average, the patients with VRIs stayed longer in the NSICU than patients without VRIs (mean duration 20 days vs. 11.9 days). All VRIs occurred in patients who had a low Acute Physiology and Chronic Health Evaluation (APACHE) IV score. In addition, the duration required to maintain ventriculostomy was longer in patients with VRIs. However, sex, mortality, the cause of ventriculosotmy, the level of consciousness, combined systemic infections, number of catheters, and performing urokinase irrigation or antibiotics irrigation via the ventriculostomy catheter were not associated with VRIs. CONCLUSIONS: VRIs were associated with longer ICU stay. However, VRIs did not influence the overall mortality rate of patients undergoing ventriculostomy in the NSICU. Because the long duration required for maintaining ventriculostomy was the risk factor of VRI, early removal of ventriculostomy catheter must be considered.
Abscess ; Adult ; Anti-Bacterial Agents ; APACHE ; Catheters ; Consciousness ; Humans ; Critical Care ; Intensive Care Units ; Risk Factors ; Urokinase-Type Plasminogen Activator ; Ventriculoperitoneal Shunt ; Ventriculostomy

Purpose: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with a poor prognosis and a lack of targeted therapy. Overexpression of FRAT1 is thought to be associated with this aggressive subtype of cancer. Here, we performed a comprehensive analysis and assessed the association between overexpression of FRAT1 and TNBC. Methods: First, using different web-based bioinformatics platforms (TIMER 2.0, UALCAN, and GEPIA 2), the expression of FRAT1 was assessed. Then, the expression of the FRAT1 protein and hormone receptors and HER2 status were assessed by immunohistochemical analysis. For samples of tumors with equivocal immunoreactivity, we performed silver in situ hybridization of the HER2 gene to determine an accurate HER2 status. Next, we used the R package and bc-GenExMiner 4.8 to analyze the relationship between FRAT1 expression and clinicopathological parameters in breast cancer patients.Finally, we determined the relationship between FRAT1 overexpression and prognosis in patients. Results: The expression of FRAT1 in breast cancer tissues is significantly higher than in normal tissue. FRAT1 expression was significantly related to worse overall survival (P < 0.05) and was correlated with these clinicopathological features:T stage, N stage, age, high histologic grade, estrogen receptor status, progesterone receptor status, Her-2 status, TNBC status, basal-like status, CK5/6 status, and Ki67 status. Conclusion FRAT1 was overexpressed in breast cancer compared to normal tissue, and it may be involved in the progression of breast cancer malignancy. This study provides suggestive evidence of the prognostic role of FRAT1 in breast cancer and the therapeutic target for TNBC.

BACKGROUND: Simian virus 40 (SV40), a polyomavirus, was discovered as a contaminant of a human polio vaccine in the 1960s. It is known that malignant mesothelioma (MM) is associated with SV40, and that the virus works as a cofactor to the carcinogenetic effects of asbestos. However, the reports about the correlation between SV40 and MM have not been consistent. The purpose of this study is to identify SV40 in MM tissue in Korea through detection of SV40 protein and DNA. METHODS: We analyzed 62 cases of available paraffin-blocks enrolled through the Korean Malignant Mesothelioma Surveillance System and performed immunohistochemistry for SV40 protein and real-time polymerase chain reaction (PCR) for SV40 DNA. RESULTS: Of 62 total cases, 40 had disease involving the pleura (64.5%), and 29 (46.8%) were found to be of the epithelioid subtype. Immunostaining demonstrated that all examined tissues were negative for SV40 protein. Sufficient DNA was extracted for real-time PCR analysis from 36 cases. Quantitative PCR of these samples showed no increase in SV40 transcript compared to the negative controls. CONCLUSIONS: SV40 is not associated with the development of MM in Korea.
Asbestos ; DNA ; Humans ; Immunohistochemistry ; Korea ; Mesothelioma ; Pleura ; Poliomyelitis ; Polymerase Chain Reaction ; Polyomavirus ; Real-Time Polymerase Chain Reaction ; Simian virus 40 ; Viruses