PURPOSE: The purpose of this study was to observe and compare the changes in the patterns of hemodynamic and blood profiles on the circuit of Extra-corporeal life support system (ECLS) by using a dual pulsatile pump (T-PLS). METHODS: An acute heart failure model using partial pulmonary artery banding was constructed in 12 piglets (20 -25kg). The animals were divided into centrifugal (n=6) and dual pulsatile pump (n=6) group. Each animal was placed on an ECLS system with a membrane oxygenator bypassing the right atrium and the aorta for 2 hours under general anesthesia. The parameters mainly observed were intra-circuit pressure changes, arterial pulsatility (pulse pressure), plasma free hemoglobin, hemodynamic changes, and other blood profiles. The parameters obtained just prior to the bypass were compared with the corresponding parameters obtained two hours after the bypass. RESULTS: Before bypass, the parameters were statistically the same between the groups. Two hours after the bypass, no significant differences were observed between the groups in ABGA, VBGA, AST/ALT, BUN/Cr, and electrolytes; the plasma free hemoglobin was 14.8+/-4.7 g/dl in the dual pulsatile group and 19.1+/-9.1 g/dl in the centrifugal group (p=NS). The pulse pressure was higher in the dual pulsatile pump than in the centrifugal pump group (35+/-8 vs. 11+/-7 mmHg, p=0.0253 mmHg). The highest circuit pressure was generated at the inlet of the membrane oxygenator and was higher in the dual pulsatile group than in the centrifugal group (173+/-12 mmHg vs. 222+/-8 mmHg, p=0.0000). CONCLUSION: The results demonstrate that a dual pulsating mechanism lessens blood cell trauma while providing physiologic pulsatile blood flow. The ECLS system using a dual pulsatile pump (T-PLS) can be useed as an effective and safe driving motor for an ECLS.
Anesthesia, General ; Animals ; Aorta ; Bays ; Blood Cells ; Blood Pressure ; Cardiopulmonary Resuscitation ; Electrolytes ; Heart Atria ; Heart Failure ; Hemodynamics ; Life Support Systems* ; Oxygenators, Membrane ; Plasma ; Pulmonary Artery

OBJECTIVES: The purpose of this study was to investigate the clinical utility of the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV) and General Ability Index (GAI) in children with attention-deficit hyperactivity disorder (ADHD). METHODS: The GAI and Full Scale IQ (FSIQ) in K-WISC-IV were compared for a group of 79 children with ADHD and 234 normal children. The mean differences within each group were testified by the t-test and Cohen's d. The Wechsler's descriptive classifications for each GAI and FSIQ score were analyzed in the children with ADHD. Additionally, the critical value for the difference between the means of the FSIQ and GAI was calculated in the normal children. RESULTS: The score on the GAI was higher than that on the FSIQ in the children with ADHD, with a mean difference of 2.19 points. The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. According to Wechsler's descriptive classification, the application of the GAI showed a lower (7.59%), equal (61.65%) or higher (60.76%) prevalence of ADHD compared to the application of FSIQ. CONCLUSION: The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. The GAI reflecting the attention and behavioral problems in children with ADHD could be utilized as an alternative global intelligence estimate that considers their potential for development.
Child ; Classification ; Humans ; Intelligence* ; Prevalence ; Problem Behavior

One of the least frequently encountered nongliomatous intraspinal neoplasm is the teratoma. Tumors that are not dermoid or epidermoid cyst have been reported as being teratomatous or teratoid when they do not have tissue derived from all three germ layers and when they are clearly most closely related to the trigerminal teratoma. Authors described an illustrated case report of teratoid cyst of the spinal cannal, summarized the previous report cases, and discuss the classification and origin of these tumors.
Classification ; Dermoid Cyst ; Epidermal Cyst ; Germ Layers ; Lumbosacral Region* ; Teratoma

In children, primary tumors of the third ventricle are uncommon. The majority of the lesion were infiltrating astrocytoma of the anterior portion of the third ventricle. Tumors within the third ventricle were benign, encapsulated, and respectable with good prognosis. But most surgerns have considered this tumors to be inoperable;accordingly shunting procedures followed by radiotherapy has been the treatment of choice. We recently experienced a case of astrocytoma which entirely filled the third ventricle with hemorrhage and reviewed the literatures.
Astrocytoma* ; Child ; Hemorrhage ; Humans ; Prognosis ; Radiotherapy ; Third Ventricle*

Thanks to recent progress in availability of molecular and functional techniques it became possible to search for the basic molecular and cellular processes that mediate and control HCO3- and fluid secretion by the pancreatic duct. The coordinated action of various transporters on the luminal and basolateral membranes of polarized epithelial cells mediates the transepithelial HCO3- transport, which involves HCO3- absorption in the resting state and HCO3- secretion in the stimulated state. The overall process of HCO3- secretion can be divided into two steps. First, HCO3- in the blood enters the ductal epithelial cells across the basolateral membrane either by simple diffusion in the forms of CO2 and H2O or by the action of an Na+-coupled transporter, a Na+-HCO3- cotranporter (NBC) identified as pNBC1. Subsequently, the cells secrete HCO3- to the luminal space using at least two HCO3- exit mechanisms at the luminal membrane. One of the critical transporters needed for all forms of HCO3- secretion across the luminal membrane is the cystic fibrosis transmembrane conductance regulator (CFTR). In the resting state the pancreatic duct, and probably other HCO3- secretory epithelia, absorb HCO3-. Interestingly, CFTR also control this mechanism. In this review, we discuss recent progress in understanding epithelial HCO3- transport, in particular the nature of the luminal transporters and their regulation by CFTR.
Absorption ; Cystic Fibrosis Transmembrane Conductance Regulator ; Diffusion ; Epithelial Cells ; Membranes ; Pancreas ; Pancreatic Ducts ; Phenobarbital

The multidrug resistance protein 2 (MRP2, ABCC2) gene may determine individual susceptibility to adverse drug reactions (ADRs) in the central nervous system (CNS) by limiting brain access of antiepileptic drugs, especially valproic acid (VPA). Our objective was to investigate the effect of ABCC2 polymorphisms on ADRs caused by VPA in Korean epileptic patients. We examined the association of ABCC2 single-nucleotide polymorphisms and haplotype frequencies with VPA related to adverse reactions. In addition, the association of the polymorphisms with the risk of VPA related to adverse reactions was estimated by logistic regression analysis. A total of 41 (24.4%) patients had shown VPA-related adverse reactions in CNS, and the most frequent symptom was tremor (78.0%). The patients with CNS ADRs were more likely to have the G allele (79.3% vs. 62.7%, p = 0.0057) and the GG genotype (61.0% vs. 39.7%, p = 0.019) at the g.-1774delG locus. The frequency of the haplotype containing g.-1774Gdel was significantly lower in the patients with CNS ADRs than without CNS ADRs (15.8% vs. 32.3%, p = 0.0039). Lastly, in the multivariate logistic regression analysis, the presence of the GG genotype at the g.-1774delG locus was identified as a stronger risk factor for VPA related to ADRs (odds ratio, 8.53; 95% confidence interval, 1.04 to 70.17). We demonstrated that ABCC2 polymorphisms may influence VPA-related ADRs. The results above suggest the possible usefulness of ABCC2 gene polymorphisms as a marker for predicting response to VPA-related ADRs.
Alleles ; Anticonvulsants ; Brain ; Central Nervous System ; Drug Resistance, Multiple ; Drug Toxicity* ; Drug-Related Side Effects and Adverse Reactions ; Epilepsy ; Genetic Variation* ; Genotype ; Haplotypes ; Humans ; Logistic Models ; Polymorphism, Genetic ; Risk Factors ; Tremor ; Valproic Acid*

Dermatomyositis is rare inflammatory condition of the skin and muscles that the incidence is 5 cases per million population per year. This disease was strongly associated with malignant disease, particularly ovarian, lung, pancreatic, stomach and colorectal cancers, and non-Hodgkins lymphoma. A 56-year-old female patient had a ovarian tumor, thereafter she presented with typical skin lesions and muscle weakness. And then we found she had a colon cancer. Here we present the case with brief review of literature.
Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Dermatomyositis* ; Female ; Humans ; Incidence ; Lung ; Lymphoma, Non-Hodgkin ; Middle Aged ; Mucins* ; Muscle Weakness ; Muscles ; Skin ; Stomach

BACKGROUND: Real-time PCR for quantification of JAK2 V617F has recently been introduced and used to evaluate the importance of mutant allele burden in both diagnosis and disease progression in myeloproliferative diseases (MPDs). We evaluated the usefulness of JAK2 MutaScreen(TM) kit that uses a real-time semiquantitative PCR method and has been designed to screen JAK2 V617F mutant allele burden. METHODS: Forty MPD patients were included in this study. We screened JAK2 V617F and determined the mutant allele burden using JAK2 MutaScreen(TM) kit. The mutant allele burden was estimated by six-scaled standards of JAK2 V617F mutant allele (2%, 5%, 12.5%, 31%, 50%, and 78%). For evaluation of test performance, an allele-specific PCR (AS-PCR) was carried out in all samples by using Seeplex JAK2 Genotyping kit. We assessed the clinical differences in distinct disease entities of MPDs according to JAK2 V617F mutant allele burden. RESULTS: JAK2 V617F mutation was detected in 30 cases, including 10 of 11 cases (91%) of polycythemia vera (PV), 13 of 20 cases (65%) of essential thrombocythemia (ET), and 2 of 3 cases (67%) of chronic idiopathic myelofibrosis (CIMF). The concordance rate between the two tests was 95% (38/40). JAK2 V617F mutant allele burden was greater than 50% in 17 cases, and 10 of them (59%) were PV. In contrast, mutant allele burden was less than 50% in 13 cases and 11 of them (85%) were ET. CONCLUSIONS: JAK2 MutaScreen(TM) kit that utilizes a real-time semi-quantitative PCR method is a useful tool for diagnosing MPDs precisely. It can be used to assess the grade of mutant allele burden as well as to screen JAK2 V617F simultaneously.
Adult ; Aged ; *Alleles ; Amino Acid Substitution ; DNA Mutational Analysis ; Disease Progression ; Female ; Humans ; Janus Kinase 2/*genetics ; Male ; Middle Aged ; Mutation ; Myeloproliferative Disorders/*diagnosis/genetics ; Polymerase Chain Reaction/*methods ; Reagent Kits, Diagnostic

PURPOSE: This study was done to assess the effects of Transdermal testosterone gel(Testogel(R)) in late onset hypogonadism (LOH) patients and the correlation of AMS(aging males' symptoms) scale with serum testosterone concentration. MATERIALS AND METHODS: We reviewed 73 medical records of LOH patients with low serum testosterone level (<3.5 ng/ml) who had been prescribed 1% Testogel(R) 5 g for over 3 months. The changes in serum testosterone level and AMS scores after application of Testogel(R) were statistically analyzed. RESULTS: Mean age and duration of therapy were 56.0+/-11.1 years and 195.4+/-102.9 days, respectively. Compared to before treatment, Testogel(R) significantly increased the level of serum total testosterone, free testosterone, and bioavailable testosterone at 3, 6, and 9 months after treatment, and there were no significant differences in each of these parameters at the 3 time points. Testogel(R) also significantly improved AMS scores related to sexual dysfunction, somatic function, and psychological function at 3, 6, and 9 months. Among various parameters, serum total testosterone level was highly correlated with the AMS score (r=0.422, p<0.01). The more severe the complaints were before treatment, the greater the relative improvement. There were no severe systemic adverse reactions in any patients. CONCLUSIONS: Testogel(R) effectively elevated serum testosterone level and improved AMS scores. The improvement of AMS score was correlated with serum total testosterone concentration. Treatment was more effective in patients with more severe symptoms. Large prospective studies are needed to identify the long-term effects of Testogel(R) in LOH patients.
Aging* ; Humans ; Hypogonadism* ; Medical Records ; Testosterone*

Ulnar neuropathy at the wrist is an uncommon disease and pure ulnar sensory neuropathy at the wrist is even rarer. It is difficult to diagnose pure ulnar sensory neuropathy at the wrist by conventional methods. We report a case of pure ulnar sensory neuropathy at the hypothenar area. The lesion was localized between 3 cm and 5 cm distal to pisiform using orthodromic inching test of ulnar sensory nerve to stimulate at three points around the hypothenar area. Ultrasonographic examination confirmed compression of superficial sensory branch of the ulnar nerve. Further, surgical exploration reconfirmed compression of the ulnar nerve. This case report demonstrates the utility of orthodromic ulnar sensory inching test.
Diagnosis* ; Electrodiagnosis ; Neural Conduction* ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies ; Wrist