BACKGROUND: It has been suggested that diabetic patients are under high oxidative stress and plasma MDA concentration is a reliable marker for oxidative stress. However, some studies showed that plasma MDA is not a good marker for oxidative stress. Reeently, the total radical-trapping antioxidant parameter (TRAPc) has been proposed as a marker for the overall antioxidant property of plasma samples. Therefore, in this study, we tried to evaluate whether MDA and TRAPc are reliable markers of the oxidative stress-antioxidant system or not. METHODS: The plasma samples from 67 type 2 diabetic patients and 31 normal subjects were collected. The plasma MDA, protein-bound SH groups, uric acid and vitamin C were determined by fluorophotometry or spectrophotometry. Plasma vitamin E concentration was analyzed by HPLC. Calculated TRAP (TRAPc) were determined by the proposed calculation methods. RESULTS: 1. Diabetic patients had significantly lower TRAPc, compared with normal subjects. 2. SH groups, uric acid, vitamin C and vitamin E were not different between the two groups. 3. MDA and MDA/TG were significantly higher in diabetic subjects. CONCLUSION: From the results of this study, TRAPc seems to be a reliable parameter of overall plasma antioxidant system and the plasma MDA may be used as a marker of oxidative stress, but further long-term logitudinal studies are needed.
Ascorbic Acid ; Chromatography, High Pressure Liquid ; Fluorophotometry ; Humans ; Oxidative Stress ; Plasma ; Spectrophotometry ; Uric Acid ; Vitamin E ; Vitamins

No abstract available.

BACKGROUND: Status epilepticus (SE) shows stereotyped progression of electroencephalogram (EEG) and behaviors in human and some SE models. We analysed semiologic features with the electroencephalographic characteristics of kainic acid (KA)-induced SE which showed different patterns from the previously reported patterns of SE. METHODS: Seventeen male Sprague-Dawley rats weighing 150~220 grams were used. SE was induced 5~7 days after the place-ment of epidural electrodes on the rats, using 13 mg/kg kainic acid I.p.. EEGs were recorded and behaviors were contin-uously observed until the end of SE. RESULTS: After the initial akinesia which was apparent within minutes of the KA injection, limbic motor seizure (LMS) composed of facial clonus, head nodding, and akinesia were repeated. Each LMS progressed into more vigorous patterns composed of facial clonus, head nodding, bilateral upper extremity clonus and rearing, without akinesia. Each cycle was repeated as the SE progressed. Severe LMS made up of facial clonus, head nodding, bilateral upper extremity clonus, rearing, falling, and jumping was followed and reiterated. After severe LMS, rats entered subtle SE. In the EEG, repeated discrete seizures mostly consisted of low voltage regular sharp waves and spikes with flat periods. After entering into the LMS, discrete seizure, merging seizure, continuous ictal discharges & periodic epileptiform discharges (PEDs) appeared sequentially in a single cycle and also reiterated. Even during subtle SE, rhythmic cycles were composed of alternating continuous ictal discharges and PEDs. PEDs were gradually replaced by sharp waves or spikes and rats recovered from SE. CONCLUSIONS: Semiologic features and the EEG sequence of KA-induced SE were composed of a series of rhythmic cycles, which have separate EEG patterns in a single cycle. Late EEG patterns of SE were more prominent as the SE progressed.
Animals ; Electrodes ; Electroencephalography ; Head ; Humans ; Kainic Acid ; Male ; Rats* ; Rats, Sprague-Dawley ; Seizures ; Status Epilepticus* ; Upper Extremity

Neonatal herpes simplex virus(HSV) infections result in significant morbidity and mortality. Although acyclovir treatment has improved survival, severe neurological sequelae can occur in the majority of survivors. HSV infections limited to the skin, eyes and mouth(SEM) can cause neurologic impairment. A direct correlation exists between the development of neurologic deficits and the frequency of cutaneous HSV recurrences. National Institutes of Allergy and Infectious Diseases(NIAID) Collaborative Antiviral Study Group conducted a phase I/II trial of continuous oral acyclovir therapy for the suppression of cutaneous recurrences. We describe a preterm infant who had two recurrences after neonatal SEM disease had been treated with intravenous acyclovir, and there were no more recurrences after continuous oral acyclovir suppressive therapy for six months. We report this case with a review of related literature.
Academies and Institutes ; Acyclovir* ; Herpes Simplex* ; Humans ; Hypersensitivity ; Infant, Newborn ; Infant, Premature* ; Mortality ; Neurologic Manifestations ; Recurrence ; Simplexvirus* ; Skin ; Survivors

We report a case of colonic metastasis from ovarian cancer presented as an intraluminal fungating mass mimicking primary colon cancer 8 years after surgery for ovarian cancer. A 70-year-old woman presented with constipation. She had undergone an extended total abdominal hysterectomy with bilateral salpingo-oophorectomy for an ovarian papillary serous cystadenocarcinoma 8 years earlier. Colonoscopy showed a large fungating mass 10 cm from the anal verge that was suspected to be colorectal cancer. A computed tomography scan showed a bulky intraluminal fungating mass in the rectosigmoid junction. After a lower anterior resection and a pathologic diagnosis, a diagnosis of a papillary serous adenocarcinoma due to metastasis from an ovarian tumor was made for this patient.
Adenocarcinoma ; Aged ; Colon* ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Constipation ; Cystadenocarcinoma, Serous ; Diagnosis ; Female ; Humans ; Hysterectomy ; Neoplasm Metastasis* ; Ovarian Neoplasms*

BACKGROUND: Immediate early gene (IEG) is supposed to be linked in the continuous seizure induced long-term changes of specific neurons. We tried to investigate the effects of focal interictal epileptiform discharges on the c-JUN expression in the rat brain which is not clearly understood. METHODS:Epidural electrodes were placed on a male Sprague-Dawley weighing 150~230 g and benzathine penicillin (Pc) was applied cortically. After focal interictal epileptiform discharges were successfully identified, EEG was recorded regularly. Cardiac perfusion and extraction of the brain was done at 2, 4, 24 hours and 1 week after the Pc application. Sixteen rats were evenly distributed into 4 groups. Immunocytochemical staining with specific antisera (Santa Cruz) was performed. RESULTS: The epileptiform discharges were induced within an hour after topical Pc applications. At 2 hours after Pc application, c-JUN was moderately expressed in the dentate gyrus (DG) and weakly expressed in the CA3 pyramidal cell, amygdala, pyriform cortex, thalamus, and neocortex. At 4 hours, c-JUN was minimally expressed in DG and other regions. Whereas, at 24 hours, c-JUN was maximally expressed in the DG and also in the CA3 pyramidal cell, amygdala, pyriform cortex, thalamus, and neocortex. One week after Pc application, c-JUN was moderately expressed in the DG and weakly expressed in the CA3 pyramidal cell, amygdala, pyriform cortex, and neocortex. CONCLUSIONS: This data showed that even focal interictal epileptic activity can induce IEG encoded c-JUN protein in the specific distant brain regions of a rat until a late period and the expression pattern showed a synchronous and bimodal pattern.
Amygdala ; Animals ; Brain* ; Dentate Gyrus ; Electrodes ; Electroencephalography ; Humans ; Immune Sera ; Male ; Neocortex ; Neurons ; Penicillin G ; Penicillin G Benzathine ; Perfusion ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley ; Seizures ; Thalamus

We have already reported good effect of meperidin and pentazocin as the sole agent for spinal anesthesia. The present study was undertaken to examine toxic effects of pentazocin and meperidine on peripheral nerve tissue. 11 rats were divided into three groups i.e. pentazocine, meperidine and control group. The sciatic nerves of adult rats were exposed and injected with pentazocin 0.5ml(15mg) or meperidine 0.5ml (25mg). Two specimens of normal nerve and another two specimens injected with normal saline 0.5 ml were used as the controIs. The nerve was examined under electron microcopy at 24 hours, 48 hours, 1 week and 4 weeks after the injection of each of the drugs. A total of twenty injections were carried out in 11 rats. The results were as follows: The pentazocien group revealed hydropic changes in the mitochondria and ER of axon and Schwann cell but the degree of injury was not significant and was reversible. The meperidine group showed hydropic changes that were not significant but the specimen taken at one week revealed severe axonal and myeline changes, admixed with fat globules and Schwann cell with severe fatty changes in the cytoplasm. Although most of the above mentioned changes may reverse, it is not certain yet that pentazocin and meperidine are free of toxicity on nerve cells until further study is done to find the causes of the severe histolgical changes which were shown in the one week specimen with demerol.
Adult ; Anesthesia, Spinal ; Animals ; Axons ; Cytoplasm ; Humans ; Meperidine ; Mitochondria ; Myelin Sheath ; Narcotics* ; Neurons ; Pentazocine ; Peripheral Nerves* ; Rats* ; Sciatic Nerve

OBJECTIVES: To understand the current status of the opening, closing and relocation of primary medical institutes in Korea and identify the underlying decision factors. METHODS: Sources of analyzed data included the medical institutional master file at the National Health Insurance Corporation (1998, 2000) and Regional Statistic Annual Bulletins. To investigate changes including the opening, closing and relocation, a total of primary medicalinstitutions (16,757 in 1998, 19,267 in 2000) were analysed. RESULTS: Between 1998 and 2000, there was a 15.0% (2,510) increase in the number of primary medical institutions and the rate of increase in the rural area was higher than the urban area, and higher for specialty clinics than primary practice. However, these findings did not suggestany improvement in the maldistribution of primary medical institutions. During the time period studied, newly opened and closed primary medical institutions numbered 4,085 and 1,573, respectively. Additionally, institutions thatrelocated numbered 2,729, or 16.3%of all primary medical institutions in operation in 1998. These openings and closings were more frequent among young doctors. As a result of our analysis on the underlying regional factors forrelocation, the factors that were statistically significant were local per capita tax burden and the number of schools per ten thousand persons. In the case of institutional factors, movements were significantly associated with gender and the location of primary medical institutions. CONCLUSIONS: In order to establish effective long-term intervention for primary medical institutions, further study and monitoring of primary medical institutions and the dentification of factors influencing opening location and relocation is necessary.
Academies and Institutes ; Humans ; Korea* ; National Health Programs ; Taxes

With growing accounts of inflammatory diseases such as sepsis, greater understanding the immune system and the mechanisms of cellular immunity have become primary objectives in immunology studies. High mobility group box 1 (HMGB1) is a ubiquitous nuclear protein that is implicated in various aspects of the innate immune system as a damage-associated molecular pattern molecule and a late mediator of inflammation, as well as in principal cellular processes, such as autophagy and apoptosis. HMGB1 functions in the nucleus as a DNA chaperone; however, it exhibits cytokine-like activity when secreted by injurious or infectious stimuli. Extracellular HMGB1 acts through specific receptors to promote activation of the NF-kappaB signaling pathway, leading to production of cytokines and chemokines. These findings further implicate HMGB1 in lethal inflammatory diseases as a crucial regulator of inflammatory, injurious, and infectious responses. In this paper, we summarize the role of HMGB1 in inflammatory and non-inflammatory states and assess potential therapeutic approaches targeting HMGB1 in inflammatory diseases.
Amino Acid Sequence ; HMGB1 Protein/chemistry/metabolism/*physiology ; Humans ; Immunity, Innate/*physiology ; *Models, Immunological ; Molecular Sequence Data ; Protein Structure, Tertiary ; Signal Transduction

BACKGROUND: The antinociceptive action of intrathecal midazolam is well documented and the administration of midazolam by centroneuraxis route has been shown to produce segmental antinociception. This study was designed to evaluate the duration of sensory block and BIS sedation score of intrathecal midazolam-bupivacaine mixture in patients undergoing knee arthroscopy. METHODS: In this double-blind prospective study, one hundred twenty seven patinets were randomly assigned to receive 4.5 ml of one of the following intrathecal solutions: 15 mg of 0.5% isobaric bupivacaine plus 1.5 ml of 0.9% saline (Group C; n = 34); 15 mg of 0.5% bupivacaine plus 0.5 ml of 0.1% midazolam and normal saline 1 ml mixture (Group 0.5; n = 28); 15 mg of 0.5% bupivacaine plus 1 ml of 0.1% midazolam and normal saline 0.5 ml mixture (Group 1; n = 27); 15 mg of 0.5% bupivacaine plus 1.5 ml of 0.1% midazolam (Group 1.5; n = 38). Time of sensory block until L5-S1 level regression occurred and sedation score using BIS, duration of effective analgesia connecting IV-PCA pump, blood pressure, heart rate, oxygen saturation and nausea/vomiting were recorded and observed. RESULTS: A significantly longer sensory block duration was seen in group 0.5, 1, 1.5 patients compared with group C (P < 0.01). Correlation coefficent of midazolam dose and sensory block duration was 0.95. Duration of effective analgesia was also prolongated in midazolam-bupivacaine mixture groups (P < 0.01). Blood pressure, heart rate, oxygen saturation and nausea/ vomiting showed no differences among the groups. Sedation score was slightly decreased in only group 1.5, but not to the level of unconsciousness. CONCLUSIONS: The results suggest that addition of midazolam 1.5 mg to 0.5% bupivacaine intrathecally provided prolongation of sensory block without any adverse effects.
Analgesia ; Anesthesia, Spinal ; Arthroscopy ; Blood Pressure ; Bupivacaine* ; Heart Rate ; Humans ; Knee ; Midazolam* ; Oxygen ; Prospective Studies ; Unconsciousness ; Vomiting