We recently had a patient(51 year-old man) who was to undergo resection of pheochromocytoma under general ansthesia. The patient was treated with phenoxybenzamine for 10 days preoperatively. Following induction of anesthesia with intravenous thiopental sodium, endotracheal intubation was performed with vecuronium and anesthesia was maintained with isoflurane. Following intubation, tachycardia controlled by intravenous injection of small dose of propranolol. The course of anesthesia was rather stormy reflected by hypertension, arrhythmia and hypotension. But the patient tolerated long anesthesia and operation relatively well with appropriate use of nitroglycerine, lidocaine, etc. Importance of preoperative preparation, sufficient sedation, smooth induction, complete analgesia, and good muscular relaxation, adequate alveolar ventilation and stable cardiovascular control has been discussed. Blood pressure during manipulation of tumor was 150/100 mmHg without arrhythmia, but gradually was controlled to the range of 120/80 mmHg after intravenous infusion of nitroglycerine at the rate of 0.5-5 pg/kg/min. To our surprise, the blood pressure and pulse and pulse rate was controlled very well with nitroglycerine and isoflurane. After removal of tumor, the blood pressure dropped 100/70 mmHg, so, blood pressure was controlled by LV fluid(Hartmans dextrose, normal saline, plasmanate, low molecular weight dextran), packed red blood cell, whole blood, fresh frozen plasma, vasopressor of small amount was used. There was no marked hypertension, hypotension, tachycardia, arrhythmia during anesthesia. Thus, we anticipate that nitroglyecerine with beta-blocker may be good intraoperative antihypertensive regimen for pheochromocytoma.
Analgesia ; Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Erythrocytes ; Glucose ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Infusions, Intravenous ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal ; Isoflurane ; Lidocaine ; Molecular Weight ; Nitroglycerin* ; Phenoxybenzamine ; Pheochromocytoma* ; Plasma ; Propranolol ; Relaxation ; Tachycardia ; Thiopental ; Vecuronium Bromide ; Ventilation

Background: Coffee is one of the most commonly consumed beverages in the world. There is evidence that the consumption of coffee has a strong influence on health outcomes. However, the relationship between coffee consumption and serum uric acid in the Korean population is unclear. In this study, we investigated the relationship between coffee consumption and serum uric acid levels in Korean adults. Methods: This study included 2,966 adults aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2016. The participants were divided into four groups according to the amount of coffee consumed and serum uric acid level. Linear regression analysis was used to analyze the relationship between coffee consumption and serum uric acid level. Results: Serum uric acid level increased with increasing coffee consumption (P<0.001). After adjusting for all confounding factors, serum uric acid level was higher in the groups that consumed coffee daily, at more than four teaspoons, than in the groups that did not consume coffee (P<0.001). Conclusion The findings of this study suggest that coffee consumption has a positive relationship with serum uric acid level.

Many fungi including Penicillium, Aspergillus, Gliocladium, and Thermoascus produce an epipolythiodioxopiperazine class of fungal metabolite, gliotoxin, which contirbutes the pathogenesis of fungal infection as an immunomodulator and cytotoxic agent. This study is designed to define the mechanism by which gliotoxin exerts the cytotoxic effect of gliotoxin on human promyelocytic leukemic cells, HL-60. Gliotoxin induces the apoptosis of HL-60 cells which is characterized by the ladder pattern fragmentation of DNA. Gliotoxin induces the activation of DEVD-specific cysteine protease in a time- and dose-dependent rnanner. It also increases the phosphotransferase activities of c-Jun N-terminal kinase1 (JNK1) and p38 in gliotoxin-treated HL-60 cells. Furthermore, gliotoxin decreases the activation of transcriptional activator, actiating protein (AP-1) and NF-kB. These results suggest that gliotoxin induces the apoptotic death of HL-60 cells via activation of DEVD- specific caspase as well as mitogen activated protein kinases (MAP kinases) including JNK1 and p38, and inhibition of transcriptional activators, AP-1 and NF-kB.
Apoptosis* ; Aspergillus ; Caspase 3 ; Cysteine Proteases ; DNA ; Fungi ; Gliocladium ; Gliotoxin* ; HL-60 Cells* ; Humans ; Mitogen-Activated Protein Kinases ; NF-kappa B ; Penicillium ; Thermoascus ; Transcription Factor AP-1 ; Transcription Factors

BACKGROUND: This study aimed to investigate the relationship between leisure time physical activities (LTPA) and metabolic syndrome (MS). METHODS: Five thousand seven hundred and thirty two adults 40 years old or older were enrolled in the study from April 2009 to December 2010. National Cholesterol Education Program's Adult Treatment Panel III was used for the criteria of MS, and Minnesota Leisure Time Physical Activity Questionnaire was used to measure LTPA. After adjusted covariates (age, hypertension, smoking, drinking, education level, household income level, work time physical activities, and menopause for females), the relationship between LTPA and MS was analyzed using logistic regression analysis. RESULTS: The prevalence of MS was 22.8% in men, and 14.1% in women. Average LTPA was 1,498 kcal/wk in men, and 1,308 kcal/wk in women. After adjustment for covariates, the odds ratios of middle and low LTPA compared with high LTPA were 1.06 (0.87-1.34), 1.54 (1.08-1.75), for women, this same association was not seen in men. The prevalence of MS was 22.8% in men and 14.1% in women, and their LTPA burned 1,498 and 1,308 kcal/wk, respectively. When the odds ratio of MS for the high LTPA group was set at 1.0, the odds ratio of MS was 1.06 (0.87-1.34) in the middle LTPA group and 1.54 (1.08-1.75) in the low LTPA group in women, which showed that the MS risk increased when the LTPA was lower. This same association was not seen in men. CONCLUSION: LTPA was independently associated with metabolic syndrome, but only for women.
Adult ; Burns ; Cholesterol ; Drinking ; Education ; Family Characteristics ; Female ; Health Behavior ; Humans ; Hypertension ; Leisure Activities* ; Logistic Models ; Male ; Menopause ; Minnesota ; Motor Activity* ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Smoke ; Smoking

No abstract available.
Hemorrhage* ; Kidney Transplantation*

No abstract available.
Cause of Death* ; Kidney Transplantation* ; Kidney*

PURPOSE: This study is to examine the painful dysesthesia of lip & gingiva followed after implant surgeries and to evaluate the prognosis of microsurgical epineurotomy & tubulization with e-PTFE tubes. METHOD: Three patients who had been suffered from painful anesthesia and dysesthesia following dental implant surgeries were examined periodically and followed for over 1 year after epineurotomy and e-PTFE tubulization. Neurosensory dysfunctions were examined by Static Light Touch Threshold, Moving Direction Discrimination. Two Point Discrimination, Pin-Prick Nociception. Visual Analog Scales and Tinel sign. The subjective symptoms were confirmed by SSEP and DITI prior to surgical exploration. RESULT: Two patients complained of continuous tearing and lancinating pain disclosed complete avulsion of IAN and degenerative changes with neuroma. One patient complained of mild painful dysesthesia revealed partial adhesion & fibrous epineural changes. Two patients whose IAN were explored after over 1 year resulted in only mild improvement in sensory recovery and moderate reduction of pain score. While the patient to whom decompression & epineural repair were given in 3 months after nerve injuries resulted in satisfactory improvement in sensory function and pain reduction. CONCLUSION: Painful dysesthesias occurred after implant placement were resulted from neurotmesis and disclosed degenerative neuropathy. Therefore, the micro-surgical explorations and repairs (epineurotomy, decompression neurolysis, and neurorrhaphy) can be recommended for known injuries as early as possible. For the delayed painful dysesthesia lasted over year, however, epineurotomy & tubulization could be an option to improve the painful discomfort but not satisfactory.
Anesthesia ; Decompression ; Dental Implants ; Discrimination (Psychology) ; Gingiva ; Humans ; Lip ; Mandible* ; Neuroma ; Nociception ; Paresthesia* ; Prognosis* ; Sensation ; Visual Analog Scale

PURPOSE: To demonstrate the anatomy of the female pelvic floor and to determine the anatomic differences between normal controls and women with stress urinary incontinence, using MRI. MATERIALS AND METHODS: Five healthy, young, nulliparous women and 12 with stress urinary incontinence un-derwent MR imaging. We obtained FSE T2-weighted axial images, 3mm thick, of the region extending from the urethrovesical junction to the perineal membrane. The following parameters were determined : angle, asymmetry and signal intensity of the levator ani muscles, the distance between the urethra and symphysis, and the presence, shape and angulation of urethropelvic ligament. RESULTS: In contrast to normal controls, frequent findings in women with stress incontinence were as follows : increased angle(43%), asymmetry(43 %) and higher signal intensity(67%) of the levator ani muscles; increased distance between the urethra and symphysis; loss(43 %), discontinuity (60 %) and dorsal angulation(43%) of the urethropelvic ligament. CONCLUSION: In women with stress urinary incontinence, MRI clearly demonstrates the anatomy of the female pelvic floor, changes in the levator ani muscles, the distance between the urethra and symphysis, and the ure-thropelvic ligament. The modality can therefore be used to evaluate the anatomical changes occurring in cases of stress urinary incontinence.
Female ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Membranes ; Muscles ; Pelvic Floor* ; Urethra ; Urinary Incontinence*

Taxol, an anticancer drug, blocks cell division by stabilizing microtubules. However, taxol has distinct cell-cycle-independent effects. For example, taxol and bacterial LPS induce strikingly similar responses in murine microglial cells. Here, we report that taxol, like LPS, provides a ""second"" signal for murine microglial cell activation to induce tumoricidal activity. Tumoricidal activity determined by MTT assay appeared that taxol or LPS alone weakly activated microglial cells to kill P815 mastocytoma cells, whereas combinations of taxol or LPS with IFN-r synergized to activate macrophages to lyse tumor cells in a dose dependent manner. Secretion of nitric oxide (NO) correlated with tumor cell killing, and the activated microglial cells failed to kill tumor cell targets in the presence of N'-monomethyl-L-arginine (N'MMA), a competitive inhibitor of NO synthase (NOS). Treatment of the cells with anti-TNF-a neutralizing antibodies clearly blocked taxol plus IFN-r induced tumoricidal activity as well as NO production. Collectively, the data illustrate the potential for taxol to activate microglial cell mediated-antitumor mechanisms in addition to its better characterized role as an anti-mitotic agent.
Antibodies, Neutralizing ; Cell Division ; Homicide ; Macrophages ; Mastocytoma ; Microglia ; Microtubules ; Nitric Oxide Synthase ; Nitric Oxide* ; Paclitaxel*

STUDY DESIGN: A retrospective study. OBJECTIVES: The aim of this study was to examine the usefulness of axial and sagittal-reconstructed CT images in the evaluation of spinal canal encroachment by thoracolumbar burst fractures. SUMMARY OF LITERATURE REVIEW: The dimensions of spinal canal encroachment by burst fractures have been described using axial CT images in the thoracolumbar region and sagittal-reconstructed images in the lower cervical region. However, the validity and reliability, depending on the measuring method, have not been fully evaluated. MATERIALS AND METHODS: A hundred and ninety-nine patients, who had diagnosed as a thoracolumbar burst fracture, were included in this study. Three orthopedic surgeons independently measured the canal encroachment of the burst fragment in the axial CT images and the sagittal-reconstructed images using the ratio of spinal length (method 1) and the ratio of area (method 2). The validity for the evaluation of the deformity and fracture stability was evaluated. In addition, the reliability of each method was assessed. RESULTS: Sixty-seven stable burst fractures and 132 unstable burst fractures were assessed. The mean kyphotic angle of stable and unstable burst fracture were 11.89 +/- 8.49degreesand 15.90 +/- 9.63degrees(P=0.005). The mean canal encroachment ratios of stable fracture were 17.21 +/- 15.82 % (axial-method 1), 16.71 +/-16.49 % (axial-method 2), 19.54 +/- 17.03 % (sagittal reconstructed-method 1), and 11.75 +/- 12.33 % (sagittal reconstructed-method 2). The mean canal encroachment ratios of unstable fracture were 31.54 +/- 17.10 % (axial-method 1), 29.67 +/- 18.47 % (axial-method 2), 28.53 +/- 18.60 % (sagittal reconstructed-method 1), and 21.20 +/- 15.11 % (sagittal reconstructed-method 2). There was no relationship between the fracture deformity and the canal encroachment ratio in all 4 methods. All ratios in the 4 method showed significant differences in the evaluation of fracture stability. All methods except method 1 in the sagittal-reconstructed images showed significant differences in the assessment of neurologic compromise. CONCLUSIONS: The measurement of a canal encroachment area using axial and sagittal-reconstructed images was valid in the description of fracture stability.
Congenital Abnormalities ; Humans ; Orthopedics ; Reproducibility of Results ; Retrospective Studies ; Spinal Canal