The objective of this study was to clarify the different inhibitory effects against necrosis according to the injection time of hydrocortisone on adriamycin extravasated wounds. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Thus, many studies on the prevention and alleviation of this tissue injury have been made. However, a comparative study on the inhibitory effect of antidots according to the injection time after extravasation of chemotherapeutic agents has not yet been made. We compared the effect of hydrocortisone succinate on adriamycin-induced tissue necrosis according to its injection time. Sixty mature male Sprague-Dawley rats were divided into 6 groups and each group contained 10 rats. Administration of adriamycin(1.0mg/ml) 0.5ml by subcutaneous injection on the dorsal side of the rats was followed by injection of hydrocortisone succinate(20mg/ml) 0.5ml on the same site according to a time protocol. Group 1(the co-ntrol group): adriamycin injection only; gorup 2(the normal saline group): injection of normal saline 30 minutes after adriamycin injection; group 3: injection of hydrocortisone 30 minutes after adriamycin injection; group 4: injection of hydrocortisone 6 hours after adriamycin injection; group 5: injection of hydrocortisone one day after adriamycin injection; group 6: injection of hydrocortisone 3 days after adriamycin injection. Mean areas of ulcer, measured in mm2, which developed 4 week after adriamycin injection were as follows; group 1 (the control group): 67.3; group 2(the normal saline group):44.8; group 3: 12.9; group 4: 18.9; group 5: 46.7; group 6:72.0. Significant differences among the groups were noted. The groups which received hydrocortisone injection showed smaller ulcers compared to the control group or the normal saline group. As well, earlier injection time correlated with smaller ulcer formation. These findings showed the inhibitory effect of hydrocortisone succinate on tissue damage caused by adriamycin, as well as the increased effectiveness of the inhibitory effect when earlier injections were made. An analysis of this study can be applied in clinical situations for extravasation of adriamycin by administering proper agents such as hydrocortisone succinate. The administration of these agents will also help to minimize tissue necrosis.
Animals ; Doxorubicin ; Humans ; Hydrocortisone* ; Injections, Subcutaneous ; Male ; Necrosis* ; Rats ; Rats, Sprague-Dawley ; Skin ; Succinic Acid ; Ulcer ; Wounds and Injuries

No abstract available.
Animals ; Nephrons* ; Population Characteristics* ; Rats*

BACKGROUND: In recent days, the prevalence of childhood metabolic syndrome (MS) has increased substantially due to the increasing rate of childhood obesity on a global scale. The aims of this study were to detect the important parameters and provide the screening system to prevent cardiovascular disease in adolescents with MS. METHODS: Ninety one male adolescents were divided into two groups based on the presence or absence of MS. Anthropometric measurement and laboratory study were studied. Intimal medial thickness and pulse wave velocity were estimated. Left ventricular mass index (LVMI), ejection fraction, myocardial velocity, strain and strain rate were measured by tissue Doppler imaging and strain rate imaging. RESULTS: The prevalence of MS was 7.7%. Weight, body mass index (BMI), waist circumference (WC), glucose, insulin, homeostasis model assessment of insulin resistance, triglyceride and LVMI were significantly increased in the MS group. High density lipoprotein-cholesterol (HDL-C), peak early diastolic myocardial velocity (e'), systolic myocardial velocity (s') and global longitudinal strain were significantly lower in the MS group. In univariant analysis, LVMI was significantly correlated with BMI, WC, fat %, fat mass, systolic blood pressure, alanine aminotransferase, total cholesterol (TC) and low density lipoprotein-cholesterol. e' was significantly correlated with BMI, fat %, fat mass, and HDL-C. Global circumferential strain had significant correlation with glucose and TC. Basal anterolateral strain rate was significantly correlated with weight, BMI, WC, fat %, and fat mass. CONCLUSION: LVMI, strain and strain rate are practical and accurate parameters for assessment of left ventricular function in adolescents with MS.
Adolescent* ; Alanine Transaminase ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Mass Screening* ; Pediatric Obesity ; Prevalence ; Pulse Wave Analysis ; Triglycerides ; Ventricular Function, Left ; Waist Circumference

OBJECTIVE: To evaluate differences in skeletal maturity in relation to vertical facial types and to compare differences in the skeletal maturity of the cervical vertebrae and hand-wrist in females. METHODS: This study included 59 females aged 7 to 9 years with skeletal Class I malocclusion. The participants were categorized into three groups (low, normal, and high) according to the mandibular plane angle. Skeletal maturity was measured using skeletal maturity indicators (SMIs) and the Tanner–Whitehouse III (TW3) method on hand-wrist radiographs and by using cervical vertebrae maturation indicators (CVMIs) on lateral cephalometric radiographs. RESULTS: The SMI was higher in the high-angle group than in the low-angle group (p = 0.014). The median TW3 bone age was 11.4 months higher in the high-angle group than in the low-angle group (p = 0.032). There was no significant difference in CVMI among the three groups. Skeletal maturity showed a weakly positive correlation with the mandibular plane angle (SMI, r = 0.391; TW3, r = 0.333; CVMI, r = 0.259). CONCLUSIONS The skeletal maturity of the hand-wrist in females with a high mandibular plane angle was higher than that in females with a low mandibular plane angle. Obtaining additional hand-wrist radiographs may facilitate evaluation of skeletal maturity of females. In females with a high mandibular angle, the time to commence orthodontic treatment may be earlier than that in females with a low mandibular angle.

To define the postnatal changes in ANP secretion in response to mechanical stretch and atrial compliance, experiments have been done in perfused nonbeating rabbit atria with different ages: 1-day, 1-, 2-, 3-, 4-, and 8-wk-old. In 1-day-old-rabbits, an increase in intraatrial pressure resulted in an increase in atrial volume, which was higher than that in 1-wk-old rabbits. Increases in atrial volume stimulated the secretion of ANP with concomitant translocation of extracellular fluid (ECF) into the atrial lumen. However, mechanically stimulated ECF translocation was lower in 1-day-old rabbits than that in 1-wk-old rabbits. Therefore, positive relationship between mechanically stimulated ECF translocation and ANP secretion was shifted upward in 1-day-old rabbits, as compared to 1-wk-old rabbits. Changes in atrial volume and ECF translocation were gradually increased with aging and reached the peak value at 4 wk. The stretch-induced ANP secretion in terms of ECF translocation (the interstitial ANP concentration) was also increased with aging and reached the peak value at 4 wk. The interstitial ANP concentration was dependent on the atrial content of ANP. These data suggest that the higher level of atrial ANP secretion is related to the postnatal changes in atrial volume and unidentified factor.
Aging ; Atrial Natriuretic Factor* ; Atrial Pressure ; Compliance* ; Extracellular Fluid ; Rabbits*

To investigate the changes in renal function during the halothane, enflurane and thalamonal anesthesia and elective surgery, the authors measured urine flow rate, creatinine clearance(Ccr, GFR), excreted amounts of sodium, potassium and chloride ions, fractional excretion of sodium (FeNa), free water clearnace (C H2O) at preanesthesia (control), 20 minute after the induction of anesthesia, during operation (3 times), 1 hour after surgery, respectively, and obtained the results as follows: 1) Changes in renal function was not significant after the induction of anesthesia compared to preanesthesia in halothane, enflurane and thalamonal anesthesia. 2) Renal function decreased signifi-cantly during the operation under anesthesia with halothane or enfiurane. 3) There was a tendency of renal function to be decreased compared to preanesthesia in the 1st postoperative day in patients anesthetized with halothane or enflurane, but tendency of it to be increased in thalamonal anesthesia. Therefore, it is suggested that thalamonal anesthesia is a good choice in patients with renal dysfunc-tion.
Anesthesia* ; Creatinine ; Enflurane* ; Halothane* ; Humans ; Ions ; Kidney ; Potassium ; Sodium ; Water

Background: Point-of-care testing (POCT) coagulometers are increasingly used for monitoring warfarin therapy. However, in high international normalized ratio (INR) ranges, significant discrepancy in the INR between POCT and conventional laboratory tests occurs. We compared the INR of POCT (CoaguChek XS Plus; Roche Diagnostics, Mannheim, Germany) with that of a conventional laboratory test (ACL TOP 750; Instrumentation Laboratory SpA, Milan, Italy) and explored possible reasons for discrepancy. Methods: Paired POCT and conventional laboratory test INRs were analyzed in 400 samples from 126 patients undergoing warfarin therapy after cardiac surgery. Coagulation factor and thrombin generation tests were compared using the Mann–Whitney U test. Correlations between coagulation factors and INRs were determined using Pearson correlation coefficients. Results: The mean difference in the INR between the tests increased at high INR ranges. Endogenous thrombin potential levels were decreased at INR <2.0 for CoaguChek XS Plus and 2.0< INR <3.0 for ACL TOP 750 compared with those at INR <2.0 for both tests, indicating a better performance of ACL TOP 750 in assessing thrombin changes. The correlation coefficients of coagulation factors were stronger for ACL TOP 750 INR than for CoaguChek XS Plus INR. Vitamin K-dependent coagulation factors were found to contribute to the INR discrepancy. Conclusions Decreases in vitamin K-dependent coagulation and anticoagulation factors can explain the significant discrepancy between the two tests in high INR ranges. Since conventional laboratory test INR values are more reliable than POCT INR values, a confirmatory conventional laboratory test is required for high INR ranges.

Purpose: Frequent neutropenia hinders uninterrupted palbociclib treatment in patients with hormone receptor (HR)–positive breast cancer. We compared the efficacy outcomes in multicenter cohorts of patients with metastatic breast cancer (mBC) receiving palbociclib following conventional dose modification or limited modified schemes for afebrile grade 3 neutropenia. Materials and Methods: Patients with HR-positive, human epidermal growth factor receptor 2–negative mBC (n=434) receiving palbociclib with letrozole as first-line therapy were analyzed and classified based on neutropenia grade and afebrile grade 3 neutropenia management as follows: group 1 (maintained palbociclib dose, limited scheme), group 2 (dose delay or reduction, conventional scheme), group 3 (no afebrile grade 3 neutropenia event), and group 4 (grade 4 neutropenia event). The primary and secondary endpoints were progression-free survival (PFS) between groups 1 and 2 and PFS, overall survival, and safety profiles among all groups. Results: During follow-up (median 23.7 months), group 1 (2-year PFS, 67.9%) showed significantly longer PFS than did group 2 (2-year PFS, 55.3%; p=0.036), maintained across all subgroups, and upon adjustment of the factors. Febrile neutropenia occurred in one and two patients of group 1 and group 2, respectively, without mortality. Conclusion Limited dose modification for palbociclib-related grade 3 neutropenia may lead to longer PFS, without increasing toxicity, than the conventional dose scheme.

BACKGROUND/AIMS: beta2-microglobulin (beta2-MG) is freely filtered at the glomerulus and subsequently reabsorbed and catabolized by proximal renal tubular cells. Urinary beta2-MG is an early and sensitive biomarker of acute kidney injury; however, its utility as a biomarker of immunoglobulin A nephropathy (IgAN) is unclear. METHODS: We included urinary beta2-MG levels in the routine laboratory examination of all inpatients with biopsy-proven IgAN at our hospital from 2006 to 2010. We retrospectively analyzed the correlation between beta2-MG levels and clinical parameters as a prognostic biomarker of IgAN. RESULTS: A total of 51 patients (30 males, 21 females; mean age, 33.01 +/- 12.73 years) with IgAN were included in this study. Initial demographic, clinical, and laboratory data for all patients are listed. The mean initial estimated glomerular filtration rate and 24-hour urine protein levels were 94.69 +/- 34.78 mL/min/1.73 m2 and 1.28 +/- 1.75 g/day, respectively. The mean level of urinary beta2-MG was 1.92 +/- 7.38 microg/mg creatinine. There was a significant correlation between initial serum creatinine (iSCr), urine protein creatinine ratio (UPCR), and the level of beta2-MG (r = 0.744, r = 0.667, p < 0.01). There was also a significant correlation between renal function tests and the level of urinary beta2-MG (p < 0.01). Cox regression analysis showed that albumin, beta2-MG, iSCr, and UPCR were significant predictors of disease progression in IgAN. CONCLUSIONS: Urinary beta2-MG levels showed a significant correlation with renal function and proteinuria in IgAN. Thus, we propose that urinary beta2-MG may be an additional prognostic factor in patients with IgAN.
Adult ; Biological Markers/blood/urine ; Biopsy ; Creatinine/blood/urine ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/blood/diagnosis/physiopathology/*urine ; Humans ; Inpatients ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Proteinuria/blood/diagnosis/physiopathology/*urine ; Risk Factors ; Young Adult ; beta 2-Microglobulin/*urine

We report the first case of Ramsay Hunt syndrome (RHS) diagnosed after kidney transplantation in Korea. RHS is a disease caused by latent varicella-zoster characterized to involve geniculate ganglion of the seventh cranial nerve. Patients who have undergone kidney transplantation can be easily affected by viral infections because of their immune-compromised status. A 35-year-old man with hypertensive end-stage renal disease underwent kidney transplantation. Two months after surgery, the recipient was diagnosed with RHS and treated with antivirals and steroids. However, after using the antiviral agents for the recommended duration, facial paralysis occurred as a new presentation and he required further treatment. Otalgia and periauricular vesicles improved, but the facial palsy remained.
Adult ; Antiviral Agents ; Earache ; Facial Nerve ; Facial Paralysis ; Geniculate Ganglion ; Herpes Zoster Oticus* ; Herpesvirus 3, Human ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Korea ; Steroids