Bone formation by osteoblast may be closely related to the increase in intracellular Ca2+ activity of osteoblast. In order to study the effects of changes in Ca2+ activity of osteoblast-like cell on fracture healing, we changed intracellular Ca2+ activity of osteoblast-like cells by vanadate and verapamil. And the process of fracture healing was observed after injection of the treatment osteoblast-like cells into the fracture site by hematoxylin-eosin (H-E) stain and bromodeoxyuridine (BrdU) stain. The results were as follow: 1) The most effective range of concentration which could facilitate bone formation was 10-6 to 10-5 M. 2) H-E stain showed more abundant osteoblast and osteoid tissues, more active mitotic division of osteoblast, and earlier appearance of chondroblast and chondroid tissue, making the maturation of woven bone faster in the vanadate-treated group than in the control group. The opposite was true in the verapamil-treated group compared with the control group. 3) BrdU labeling index showed more active osteoblastic proliferation in the vanadate-treated than in the control group. The opposite was observed in the verapamil-treated group compared with the control group. From these results, the fracture healing appears to be facilitated and decelerated by vanadate which apparently increase intracellular Ca2+ activity of osteoblast and verapamil which decreases it, repectively. Therefore the change of intracellular Ca2+ activity of osteoblast can be considered to be one of fracture healing mechanisms and expected to be applied for clinical purpose.
Bromodeoxyuridine ; Chondrocytes ; Fracture Healing ; Osteoblasts ; Osteogenesis ; Vanadates ; Verapamil

PURPOSE: This study was done to examine the association between body mass index (BMI) and any type of clinical dementia. METHODS: Participants were 60,321 people over 60 years of age enrolled in the Seoul Dementia Management Project in 2011. K-MMSE was used to classify participants as having a cognitive impairment and the Clinical Dementia Rating or DSM-IV by psychiatrists or neurologists to determine whether participants were in the dementia group or the non-dementia group. Descriptive statistics, chi-square test, and binary logistic regression analysis were performed. RESULTS: In the univariate analysis, age, education level, living with spouse, BMI, alcohol consumption, and exercise were significantly associated with dementia. In multivariable analysis, increasing age was positively associated with dementia, and educational level was negatively associated with dementia. The exercise group had a lower prevalence of dementia than the non-exercise group. The odds ratio of dementia in the over-weight and obese groups compared to the normal group was 0.85 (95% CI 0.60, 0.98) and 0.64 (95%CI 0.46, 0.75), respectively. CONCLUSION: Results indicate that dementia is negatively associated with increasing BMI in people aged 60 years or older, but a prospective cohort study is needed to elucidate the causal effect relationship between BMI and dementia.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Body Mass Index ; Cross-Sectional Studies ; Dementia/*epidemiology ; Exercise ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Residence Characteristics ; Risk Factors ; Smoking

Maple syrup urine disease (MSUD) is an autosomal recessive disease caused by a deficiency in subunits of the branched-chain alpha-ketoacid dehydrogenase complex (BCKDH). The disease is characterized by the accumulation of the branched-chain amino acids leucine, isoleucine, valine, alloisoleucine, and their corresponding alpha-ketoacid in blood and urine. MSUD is a heterogenous disorder, and classic, intermittent, intermediate and thiamine-responsive phenotypes have been identified. We experienced a case of Maple syrup urine disease (classic type) in a female neonate, who suffered from lethargy, poor feeding, apnea, alternating periods of hypertonicity and flaccidity, generalized convulsions, and a peculiar burned sugar smell from the body and urine. She died of respiratory failure 22 days after the birth. The brief review of the literature was made.
Acer* ; Amino Acids, Branched-Chain ; Apnea ; Burns ; Female ; Humans ; Infant, Newborn ; Isoleucine ; Lethargy ; Leucine ; Maple Syrup Urine Disease* ; Oxidoreductases ; Parturition ; Phenotype ; Respiratory Insufficiency ; Seizures ; Smell ; Valine

BACKGROUND: The focus of this study is the effects of thiopental sodium, etomidate and propofol on systemic vascular resistance and venous capacitance during cardiopulmonary bypass with constant pump flow. METHODS: Thirty patients (ASA III) scheduled for open heart surgery were randomly divided into three groups. Anesthesia was induced with thiopental sodium 5 mg/kg, fentanyl 5 microgram/kg and vecuronium 1 mg/kg. CPB was conduced with a membrane oxygenator using non-pulsatile flow and moderate hypothermia. When rectal temperature and pump flow had been stable for 5 min, patients randomly received thiopental sodium 4 mg/kg, etomidate 0.3 mg/kg and propofol 2 mg/kg. Perfusion pressure and pump flow were measured 0, 1, 3, 5, 10, 15, 20 and 30 min after administration. RESULTS: The systemic vascular resistance index (SVRI) decreased to 84.3% of the control values after thiopental sodium 4 mg/kg, to 74.7% of the control after etomidate 0.3 mg/kg and to 79.8% of the control after propofol 2 mg/kg. SVRI returned to control value levels 3 min after the administration of thiopental sodium, 20 min after etomidate, and 5 min after propofol. Thiopental sodium, etomidate and propofol reduced venous reservoir volume 1 min after injection and the reduction was sustained throughout the all period of the cardiopulmonary bypass. CONCLUSIONS: The results indicate that thiopental sodium, etomidate and propofol dilate both resistance and capacitance vessels, but there was no correlation between the two vessels.
Anesthesia ; Cardiopulmonary Bypass* ; Etomidate* ; Fentanyl ; Humans ; Hypothermia ; Oxygenators, Membrane ; Perfusion ; Propofol* ; Thiopental* ; Thoracic Surgery ; Vascular Access Devices ; Vascular Resistance* ; Vecuronium Bromide

BACKGROUND: Spinal anesthesia for cesarean section is regaining popularity because it can prevent pulmonary aspiration, failure of endotracheal intubation, depression of neonate by anesthetic agent in general anesthesia. Meperidine is unique in having significant local anesthetic properties that differentiate with morphine and fentanyl. Therefore, we compared the effects of adding meperidine 25 mg to intrathecal bupivacaine with fentanyl mixture. METHODS: Sixty parturients were allocated (n = 30 per group) to group 1; 0.5% hyperbaric bupivacaine 7.5 mg plus meperidine 25 mg and group 2; 0.5% hyperbaric bupivacaine 10 mg plus fentanyl 25 microgram in random order. Time to reach T4 sensory level, starting time of surgery, maximal spread of sensory block, incidence of complications, duration of motor block, perioperative analgesic effects, duration of postoperative analgesia were evaluated. We observed Apgar score and umbilical cord blood gas analysis for evaluation of the status of neonate. RESULTS: There were no significant differences in Time to reach T4 sensory level, starting time of surgery, maximal spread of sensory block, incidence of hypotension, perioperative analgesic effects, duration of motor block and neonatal status between two groups. The incidence of intraoperative nausea was greater in group 1 (60%) compared to the group 2 (20%) but the incidence of postoperative nausea and vomiting were not significantly different between two groups. Duration of postoperative analgesia was longer in group 1 (576.4 +/- 197.8 min) compared to the group 2 (192.6 +/- 75.5 min). CONCLUSIONS: Addition of meperidine 25 mg to intrathecal bupivacaine for Cesarean section improves intraoperative analgesia and also provides postoperative analgesia without significant adverse effects on the mother and neonate.
Analgesia ; Anesthesia, General ; Anesthesia, Spinal* ; Apgar Score ; Bupivacaine ; Cesarean Section* ; Depression ; Female ; Fentanyl ; Fetal Blood ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Intubation, Intratracheal ; Meperidine ; Morphine ; Mothers ; Nausea ; Postoperative Nausea and Vomiting ; Pregnancy

Renal agenesis is a disorder characterized by the congenital absence of one or both kidneys due to complete failure of the kidney to form. The syndrome of renal agenesis is severe oligohydramnios, amnion nodosum, flattened face, low-set and floppy ears, and bilateral pulmonary hypoplasia. Bilateral renal agenesis occurs in 0.1 to 0.3 per 1000 births and unilateral involvement occurs in 1 in 500 to 1 in 1300 live births.1,2 Bilateral renal agenesis is an invariably lethal condition, and is associated in more than half of the affected individuals with malformations of the genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus.2 Accurate diagnosis in the mid-trimester permits the parents to allow elective termination. However, the nearly absent amniotic fluid makes an accurate assessment of fetal kidney difficult. We present a case of unilateral renal agenesis with contralateral renal hypoplasia, diagnosed by ultrasonography after amnioinfusion at 21 weeks gestation.
Amnion ; Amniotic Fluid ; Cardiovascular System ; Diagnosis ; Ear ; Female ; Humans ; Kidney ; Oligohydramnios ; Parents ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography

We investigated the pulpal response to direct pulp capping in rat molar teeth using mineral trioxide aggregate (MTA) and calcium hydroxide (CH). A palatal cavity was prepared in rat maxillary molar teeth. Either MTA or CH was placed on the exposed pulp and all cavities were restored with composite. Rats were sacrificed for histological evaluation after 12 hours and at 2, 7, 14 and 21 days. In both the MTA and CH groups, reparative dentin formation was clearly observed on histology after 14 days. The MTA-capped pulps were found to be mostly free from inflammation, and hard tissue of a tubular consistent barrier was observed. In contrast, in CH-capped teeth, excessive formation of reparative dentin toward residual pulp was evident. The pulpal cell response beneath the reparative dentin layer was examined by immunofluorescence using antibodies against DSP. After 2 days, a few DSP immunopositive cells, most of which showed a cuboidal shape, appeared beneath the predentin layer. At 7 days, DSP-immunopositive cells with columnar odontoblast-like cells were seen beneath the newly formed hard tissues. At 14 and 21 days, DSP was more abundant in the vicinity of the odontoblastic process along the dentinal tubules than in the mineralized reparative dentin. The CH group showed strong expression patterns in terms of DSP immunoreactivity. Our results thus indicate that MTA may be a more effective pulp capping material as it induces the differentiation of odontoblast-like cells and the formation of reparative dentin without the loss of residual pulp functions.
Aluminum Compounds ; Animals ; Antibodies ; Calcium ; Calcium Compounds ; Calcium Hydroxide ; Dental Pulp Capping ; Dentin ; Drug Combinations ; Fluorescent Antibody Technique ; Glutamates ; Guanine ; Hydroxides ; Inflammation ; Molar ; Odontoblasts ; Oxides ; Pemetrexed ; Rats ; Silicates ; Tooth

BACKGROUND: Laparoscopy with peritoneal carbon dioxide insufflation is a standard procedure in many gynecological departments. And more prolonged gynecological laparoscopic operations are being performed in recent years, and a steeper head-down position is required. Despite laparoscopic operations have many advantages, peritoneal insufflation of CO2 to create the pneumoperitoneum necessary for laparoscopy induces intraoperative hemodynamic changes that complicate anesthetic management of laparoscopy.The purpose of this study is to evaluate the effect of general anesthesia on hemodynamics during loparoscopic hysterectomy. METHODS: Twenty six women undergoing laparoscopic hysterectomy were randomly allocated to either a propofol (Group 1, n=13) intravenous anesthesia or a enflurane (Group 2, n=13) anesthesia with fentanyl-N2O/O2-vecuronium. Hemodynamic parameters were measured before induction (T1), 5 min after induction (T2), 5 min after head-down (T3), 5, 10, 15, 20 min after pneumoperitoneum (T4, T5, T6, T7), 5, 10 min after deflation (T8, T9). The MAP, HR, CI, SVRI, SI were measured by transthoracic electrical bioimpedence method and automated blood pressure device. RESULTS: The mean arterial pressure were increased during pneumoperitonem in both groups and heart rate were increased in Group 2. The cardic index were decreased in both groups after induction by 27.4 % in Group 1 and 25.7% in Group 2. The systemic vascular resistanace index were increased in both groups from head-down to after deflation by 68.3% in Group 1, 73.1% in Group 2 maximally. No significant changes of stroke index were observed during surgery in Group 1. CONCLUSIONS: Laproscopy with CO2 insufflation induces significant hemodynamic changes includig increases of MAP, SVR and a reduction of CI. And usual intraoperative hemodynamic monitoring; the blood pressure and heart rate give no information on the reduction in cardic output.
Anesthesia ; Anesthesia, General* ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Enflurane ; Female ; Heart Rate ; Hemodynamics* ; Humans ; Hysterectomy* ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Propofol ; Stroke

This study was performed to investigate the effect of vitamin C and E supplementation on blood pressure, plasma lipids, folate, and homocysteine levels in smokers and non-smokersof college male students in Gyeonggi Area. The nutrient intakes were determined by a 24hr-recall method. The subjects were divided into six groups: vitamin C supplementation group (n: smokers = 10, nonsmokers = 10), vitamin E supplementation group (n: smokers = 10, nonsmokers = 10), vitamin C and E supplementation group (n: smokers = 10, nonsmokers = 10), respectively. There were no significant differences between the smokers and nonsmokers in terms of anthropometric measurements. Systolic and diastolic blood pressure were significantly higher (p < 0.05) in smokers than that of non-smokers. There was no significant difference in energy and other nutrients intakes between smokers and non-smokers. In plasma lipids levels, smokers had higher plasma triglyceride, LDL-cholesterol, VLDL-cholesterol, total cholesterol concentration than that of non-smokers (p < 0.05). HDL-cholesterol level of smokers had a tendency to be lower than that of nonsmokers. In smokers, AI, TPH, LPH were significantly higher than that of non-smokers (p < 0.01). Plasma folate, homocysteine levels were not significantly different between smokers and non-smokers. The effect of antioxidant vitamins supplementation in smokers: In vitamin C supplementation group, HDL-cholesterol level was significantly increased (p < 0.01) and AI, TPH, LPH were significantly decreased (p < 0.01). In vitamin E supplementation group, HDL-cholesterol level was significantly increased (p < 0.05). In vitamin C and E supplementation group, LPH was significantly decreased (p < 0.05). The effect of antioxidant vitamins supplementation in non-smokers: HDL-cholesterol level was significantly increased (p < 0.05) and AI, TPH, LPH were significantly decreased (p < 0.05) by vitamin C supplementation group. Plasma homocysteine level was decreased by vitamin E supplementation group in non-smokers p < 0.01). The results of this study showed that smoking had a tendency to increase plasma lipids levels that factor into the risk of coronary heart disease. It is considered that antioxidant vitamin supplementation in smokers had a tendency to decrease cardiovascular disease than in nonsmokers.
Ascorbic Acid ; Blood Pressure* ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Folic Acid* ; Gyeonggi-do* ; Homocysteine* ; Humans ; Male ; Plasma* ; Smoke ; Smoking ; Triglycerides ; Vitamin E ; Vitamins*

Epidural block is one of the most effective methods of intrapartum pain relief in current practice. This is a case of a scalding burn resulting from a sitz bath long enough after epidural block for vaginal delivery. The patient received 7 ml of 0.25% bupivacaine mixed with 1 : 300,000 epinephrine and fentanyl 50 microgram for epidural block. Following delivery, the patient started complaining of voiding difficulty without any motor weakness 6 hours after the epidural block occured. At that time, the patient did not feel any hot or pain sensations during the 15 minutes of unintentional hot water application for sitz bath. Consequently, an approximately 5~10% superficial second degree burn developed on her perineal and inner thigh region.
Baths* ; Bupivacaine ; Burns* ; Epinephrine ; Fentanyl ; Humans ; Sensation ; Thigh ; Water