Pseudocholinesterase is an essential enzyme for hydrolysis of succinylcholine and some people has low activity. The pseudocholinesterase from a normal individual has a greater apparent affinity for the cholinester substrate than the enzyme from succinylcholine-sensitive individuals, who has genetic variants. The ideal situation would be one in which a single, simple test would detect and identify all the variant forms of enzyme, but no such test currently exsits. The inhibitors frequently used to identify variants are dibucaine, fluoride, chloride, urea or succinylcholine as inhibition numbers. The authors found that dibucaine, fluoride and chloride numbers in Korean adults (mean+/-SD, %) are 85.8+/-1.83, 46.5+/-2,05 and 3.53+/-1.64, respectively (substrate is butyrylthiocholine).
Adult* ; Dibucaine ; Fluorides ; Humans ; Hydrolysis ; Pseudocholinesterase* ; Succinylcholine ; Urea

Accessory cervical thymic tissue has been rarely reported. However, it should be included in the differential diagnosis of neck masses in children, along with branchial anomalies, lymph nodes and other tumors. This lesion occurs along the descending line of the thymus between the angle of mandible and superior mediastinum. A 2-month-old infant presented with an asymptomatic left sided neck mass. MRI revealed a well defined homogeneous mass in the deep lobe of left parotid gland. At operation, an easily identified soft tissue mass was found in the left submandibular area, measuring 3 x 1.5 cm. It was completely excised. Microscopic examination revealed normal thymic tissue.
Child ; Diagnosis, Differential ; Humans ; Infant ; Lymph Nodes ; Mandible ; Mediastinum ; Neck ; Parotid Gland ; Thymus Gland

No abstract available.
Humans ; T-Lymphocytes*

A 4 day old male neonate with severe dehydration, uremia, and hyperbilirubinemia presented with bilateral renal vein thrombosis. Following exchange transfusion and peritoneal dialysis renal function returned to normal without nephrectomy. The importance of adequate and prompt management of renal failure to expect the spontaneous recanalization is stressed. Because of the high mortality rate associated with the nephrectomy in neonates, adequate and prompt medical management including peritoneal dialysis or exchange transfusion, if indicated, with expectation of spontaneous recovery is considered the treatment of choice in this age group.
Dehydration ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Male ; Mortality ; Nephrectomy ; Peritoneal Dialysis ; Renal Insufficiency ; Renal Veins* ; Thrombosis* ; Uremia

Hypoxia is one of the major causes of neonatal mortality. Hypoxia-induced tissue injuries are resulted from complex mechanisms such as DNA damage and apoptosis. In this study, we aimed to elucidate the changes in the expression of DNA repairing enzymes such as 8-hydroxyguanine glycosylase 1 (OGG1) and apurinic/apyrimidinic endonuclease 1 (APE1) and brain derived neurotrophic factor (BDNF) in the fetal cerebral tissue after intrauterine hypoxic injury. For this study, pregnant Sprague-Dawley rats were exposed to hypoxic gas (10% O2, 5% CO2, 85% N2) for 2 or 4 hours at postconception day 14.5 and 15.5. After 24 hours, the animals were anesthetized with ethyl ether and fetuses were obtained by laparatomy. Hematoxylin-eosin stain, immunohistochemical stain, and western blot were employed for analysis. The caspase-3 immunolabeled cells were significantly increased within the cerebral cortex after hypoxic injury. The expressions of OGG1, APE1, and BDNF were also increased in the cerebral tissue after hypoxic injury at post-conception day 14.5, in a dose-dependent manner. However, the expression of BDNF was significantly decreased in the cortical tissue exposed to hypoxic injury at postconception day 15.5. These results demonstrate that fetal hypoxic injury induces apoptosis of the nerve cells and promotes the expressions of the DNA repairing enzymes and neurotrophic factors. In addition, these results suggest that protection mechanisms against hypoxic injury alter along the progression of the fetal development.
Animals ; Anoxia ; Apoptosis ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; Caspase 3 ; Cerebral Cortex ; DNA ; DNA Damage ; DNA Repair ; Ether, Ethyl ; Fetal Development ; Fetus ; Guanine ; Humans ; Infant ; Infant Mortality ; Nerve Growth Factors ; Neurons ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Therapeutic plasma exchange (TPE) is a procedure by which plasma is removed from whole blood and this can be used in the treatment of some renal diseases. METHODS: We reviewed the medical records for the chief complaints, underlying diseases, clinical courses and treatment outcomes of 23 patients who had been treated with TPE at the Renal Division of Chungnam National University Hospital from January 1995 to June 2005. RESULTS: Patients with thrombotic thrombocytopenic purpura (TTP), microcopic polyangitis, lupus nephritis, hyperacute humoral rejection after kidney trasnplantation and rapidly progressive glomerulonephritis (RPGN) secondary to subacute bacterial endocarditis were included in this study. Among the 11 patients with TTP, six patients improved and two patients progressed to end-stage renal disease (ESRD). Three patients with TTP died. Seven patients with microscopic polyangitis and two patients with lupus nephritis had pulmonary hemorrhage at the time of TPE. Eight of the 11 TTP patients showed improvement of their pulmonary hemorrhage after TPE. One of the two patients with hyperacute humoral rejection after kidney transplantation and one patient with secondary RPGN were improved after TPE. Hypotension (three cases) was the most common adverse effect of TPE, followed by two cases of itching sensation and one case of fever with chills. CONCLUSIONS: Therapeutic plasma exchange was an effective treatment for patients with TTP, microscopic polyangitis, lupus nephritis with pulmonary hemorrhage and hyperacute humoral rejection after kidney transplantation.
Chills ; Chungcheongnam-do ; Endocarditis, Subacute Bacterial ; Fever ; Glomerulonephritis ; Hemorrhage ; Humans ; Hypotension ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Lupus Nephritis ; Medical Records ; Plasma Exchange* ; Plasma* ; Pruritus ; Purpura, Thrombotic Thrombocytopenic ; Sensation

Allopurinol decreases serum uric acid levels in hyperuricemic patients and may slow the progression of renal diseases, Allopurinol-induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome, which was called allopurinol hypersensitivity syndrome previously, is very rare and can be associated with serious complications characterized by fever, skin rash, acute hepatocelluar injury, renal insufficiency, leukocytosis, and eosinophilia. We report four cases of allopurinol-induced DRESS syndrome in patients with chronic kidney disease who had been taking allopurinol as a dose of 100 mg daily for 5 to 10 weeks. They presented with skin rash and eosinophilia. Blood chemistry showed acute aggravation of renal dysfunction. All of the patients recovered from DRESS syndrome and renal function of them were returned to the basal levels in several weeks.
Allopurinol* ; Chemistry ; Drug Hypersensitivity Syndrome* ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Uric Acid

BACKGROUND: Desflurane depresses the contractile function of the myocardium. It also causes direct coronary vasodilation. Milrinone, a phosphodiesterase III inhibitor, usually increases myocardial contractility and also has vasodilatory activity. Some inhalation anesthetic agents, such as isoflurane, are safely combined with phosphodiesterase III inhibitors clinically, but milrinone sometimes causes significant hypotension by reducing systemic vascular resistance. The purpose of this study was to evaluate the effect of the combined use of desflurane and milrinone on the function of the isolated rat heart. METHOD: Thirty isolated rat hearts were divided into two groups. [Group 1 (n = 15): desflurane, Group 2 (n = 15): desflurane and milrinone] They were perfused continuously with modified Krebs' solution in a Langendorff retrograde perfusion apparatus. After measuring the control values of the hemodynamic and oxygenation parameters in each group, we administered 6.6 vol% of desflurane to both groups and added sequential perfusion of modified Krebs' solution containing 0.5, 1.0, and 1.5mug/ml of milrinone in Group 2 and then measured the parameters and analyzed them statistically. RESULTS: Baseline measurements in both groups were not statistically different. In Group 1, desflurane significantly decreased LVP (55+/-5 mmHg), dp/dt (557+/-65 mmHg/sec) and MVO2 (71.2+/-16.3 ml/g/min) after 15 minutes. CF (13.9+/-3.1 ml/g/min) and DO2 (176.7+/-43.4 ml/g/min) were increased after 15 minutes. There was no further change after this. In Group 2, desflurane decreased LVP (53+/-18 mmHg), dp/dt (558 90 mmHg/sec) and MVO2 (72.0+/-11.0 ml/g/min) and increased CF (14.2+/-1.9 ml/g/min) and DO2 (175.3+/-29.1 ml/g/min). But, there was no significant difference in the effects of desflurane between the two groups. Milrinone restored LVP, dp/dt and MVO2 to the baseline level, but not with dose-dependency. Desflurane-induced elevated CF and DO2 did not show further changes. CONCLUSIONS: These findings suggest that milrinone increased myocardial contractility and restored the desflurane-induced myocardial depression of the isolated rat heart without further increase of oxygen consumption from the baseline control value. In addition, no additive effects was observed on coronary blood flow when these two agents were used in combination.
Anesthetics ; Animals ; Cyclic Nucleotide Phosphodiesterases, Type 3 ; Depression ; Heart* ; Hemodynamics ; Hypotension ; Inhalation ; Isoflurane ; Milrinone* ; Myocardium ; Oxygen ; Oxygen Consumption ; Perfusion ; Rats* ; Vascular Resistance ; Vasodilation

One of the major risk factors of renal cell carcinoma is acquired cystic kidney disease (ACKD) developed in course of end-stage renal failure (ESRF) and the incidence of ACKD increases with the duration of dialysis. Moreover, the overall incidence of renal cell carcinoma after renal transplantation has been reported to be being more than 8 times higher compared with that of general population. But renal cell carcinomas occurred in native kidneys before and after renal transplantation in ESRF patient with ACKD are very rare. We experienced a case of renal cell carcinoma occurred in native kidneys 14 months before and 5 months after renal transplantation in an ESRF patient with ACKD.
Carcinoma, Renal Cell ; Dialysis ; Humans ; Incidence ; Kidney ; Kidney Diseases, Cystic ; Kidney Failure, Chronic ; Kidney Transplantation ; Risk Factors

PURPOSE: We investigated the effects of recombinant human erythropoietin (EPO) and N-acetylcysteine (NAC) in the prevention of radiocontrast-induced nephrotoxicity in patients with underlying renal dysfunction, who are regarded as a high risk group. METHODS: This study included 77 individuals with renal insufficiency, defined by a serum creatinine concentration above 1.2 mg/dL or creatinine clearance of more than 15 mL/min/1.73m2 and less than 60 mL/min/1.73m2. These patients who needed radiologic interventions including the use of radiocontrast materials from August 2006 to May 2007 were randomly assigned to one of four groups, which were treated with EPO only, NAC only, EPO plus NAC and placebo respectively. The serum creatinine and cystatin-C were measured before, 24 hours and 48 hours after the intervention. The creatinine clearance was obtained using the Cockcroft-Gault equation. RESULTS: The serum level of creatinine in EPO plus NAC group was not significantly elevated 24 and 48 hours after radiocontrast exposure compared to control group (p=0.012). Also, the creatinine clearance of EPO plus NAC group was not significantly decreased after radiocontrast exposure compared to control group (p=0.046). The serum level of creatinine in EPO and NAC group increased less than control group, but there were no significant differences between the groups. Also, the creatinine clearance in EPO and NAC group decreased less than control group, but there were no significant differences between the groups. CONCLUSION: EPO plus NAC showed a renoprotective effect on radiocontrast study in patients with underlying renal dysfunction.
Acetylcysteine* ; Contrast Media ; Creatinine ; Erythropoietin* ; Humans* ; Renal Insufficiency