BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Objectives: Dental caries and periodontal disease are infectious and chronic diseases. The aim of the study was to investigate the antimicrobial effect of mentha extracts against Streptococcus mutans (S. mutans ) and Porphyromonas gingivalis (P. gingivalis ). Methods: This activity of mentha extracts were confirmed by the disk diffusion test and minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and colony forming unit (CFU) assays. Results: S. mutans and P. gingivalis showed the highest antimicrobial activity within the inhibition zones. The antimicrobial activity was interrupted as the MIC and MBC of the herbal extracts against the two bacteria were 1 mg/ml and 10 mg/ml, respectively. The antimicrobial effect was determined by the CFU assay. Conclusions Mentha herb extract demonstrated potential antimicrobial activity against S. mutans and P. gingivalis that cause dental caries and periodontal disease.

Tubulointerstitial nephritis and uveitis (TINU) syndrome is defined as the occurrence of tubulointerstitial nephritis and uveitis in the absence of other systemic diseases. Three pediatric cases have been reported in the Republic of Korea, and we now report a fourth case. A 15-year-old girl presented to the ophthalmology department with a 1-week history of bilateral ocular discomfort that worsened on the day of presentation with redness and pain in both eyes. She was diagnosed with bilateral uveitis, and her baseline examination revealed moderate renal dysfunction and mild proteinuria. A renal biopsy was performed and confirmed the diagnosis of TINU syndrome. She was started on steroid eye drops and a 12-week course of oral steroids at a dose of 40 mg/m2/day, which completely resolved the proteinuria and mild renal function to an estimated glomerular filtration rate of 60 mL/min/1.73 m2. However, the uveitis did not improve, and despite the addition of oral methotrexate as a second-line treatment, the uveitis remains unresponsive to treatment over 21 months. Further evaluation and treatment are ongoing, and active therapeutic intervention is suggested even at a pediatric age, considering the lack of improvement in renal function and uveitis to date.

No abstract available.
Gastrointestinal Tract* ; Radionuclide Imaging*

Although various functions of CD99 have been reported, such as apoptosis and homotypic aggregation of thymocyte and transendothelial migration of immune cells, biochemical/molecular natures of CD99 are still elusive. Using mouse CD99 gene, we show that CD99 forms homodimer through its extracellular domain. Expression of mouse CD99 is up-regulated on T cells after CD3-mediated activation, like the case for human CD99. The potential of CD99 to form homodimer was tested with a recently developed bimoleular fluorescence complementation analysis (BiFC). In BiFC analysis, the dimerization-induced fluorescence was strong near the perinuclear region and was faded at the cell membrane. However, surface expression of CD99 was still detected by flow cytometry, suggesting that CD99 either in monomer form or in association with other molecules exists on the cell surface. In BiFC analysis using CD99 mutants with its extracellular, transmembrane, or cytosolic domains changed to corresponding human CD4 domains, the mutant replaced with human CD4-extracellular domain did not produce fluorescence. Purified soluble CD99-Fc fusion proteins bound to CD99-Fc immobilized onto the gold sensor chip in surface plasmon resonance analysis, confirming that the extracellular domain was responsible for dimer formation. Intracytoplasmic staining for CD99 expression in the thymocytes and mature T cells showed that most of the cells, even the cells with low surface level of CD99, contained the molecule inside the cell. Our results suggest that majority of CD99 homodimers may exit in the cell and be exported to the cell surface, dissociating from each other, after a certain regulatory signal is delivered.
Animals ; Antigens, CD/chemistry/*isolation & purification ; Cell Adhesion Molecules/chemistry/*isolation & purification ; Flow Cytometry ; *Fluorescence ; Luminescent Measurements/*methods ; Mice ; Molecular Biology/*methods ; T-Lymphocytes/immunology

PURPOSE: The purpose of this study is to describe the imaging characteristics of oligodendroglioma in childhood. MATERIALS AND METHODS: Eight CT scans and 12 MR images were retrospectively reviewed in 12 children (mean age, 9.5 years) with pathologically-proven oligodendroglioma. The most frequent symptoms were seizure and headache, with a mean duration before diagnosis of 21 months. Location, MR signal intensity, calcification,intratumoral hemorrhage, cystic change, peritumoral edema and contrast enhancement were retrospectively analyzed. RESULTS: The supratentorial location was most frequent (9/12, 75%) and the majority of tumors were located peripherally or subcortically (7/9, 78%). On MR, most tumors demonstrated low signal intensity on T1WI and high signal intensity on T2WI ; cystic change was frequent (10/12, 83%). Tumor enhancement was seen in 60% of cases (6/10), with various enhancement patterns. Intratumoral hemorrhage was seen in two cases. On CT, the tumors were usually hypodense and calcification was noted in two cases (2/8, 25%). Peritumoral edema and mass effect of the tumor were seen in five (5/12,42%). Hydrocephalus was associated in two cases. CONCLUSION: In childhood, most oligodendrogliomas demonstrate a peripherally located supratentorial mass, with frequent cystic change. Calcification or intratumoral hemorrhage were less frequent than in previously reported adult series.
Adult ; Child ; Diagnosis ; Edema ; Headache ; Hemorrhage ; Humans ; Hydrocephalus ; Oligodendroglioma* ; Retrospective Studies ; Seizures ; Tomography, X-Ray Computed

PURPOSE: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural-cutaneous fistula developed after undergoing lobectomy for lung cancer. METHODS: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleuralcutaneous fistula. RESULTS: The patient has remained healed for 14 months without any postoperative complications or recurrent infection or fistula. CONCLUSION: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.
Cutaneous Fistula ; Drainage ; Empyema ; Fistula ; Free Tissue Flaps ; Humans ; Lung ; Muscles ; Postoperative Complications ; Rectus Abdominis ; Thoracic Wall ; Thorax

BACKGROUND: Recently, the prevalence of obesity and socioeconomic costs stemming from obesity are increasing steeply. Obesity, in particular, has a highly polarization caused by income levels. Obesity in low-income patients is expected to become a serious social problem in the future. This study aims to observe the effects of consistent consultation and drug therapy during a six months period, and to develop the treatment process of obesity for low-income people. METHODS: The body weight, waist circumference, body mass index (BMI), and blood pressure (BP) was measured every 2 weeks, and laboratory blood tests with a survey including Beck Depression Inventory (BDI) and eating behavior index was checked at 0, 3, and 6 months. Paired t-test and linear mixed model was done to evaluate the difference between pre-treatment data and post-treatment data. RESULTS: Twenty-one patients (2 males, median age [interquartile range] of 39 years [29-46]) were analyzed. There were statistically significant reductions of body weight (P<0.01), BMI (P<0.01), waist circumference (P<0.01), low-density lipoprotein (P=0.01), BDI-I (P<0.01), eating behavior index (P<0.01). There was no statistically significant difference of safety outcome of the BP and blood tests. CONCLUSIONS: Proper obesity treatment of obese patients of low socioeconomic status was meaningful enough to affect depression and eating patterns as well as reducing body weight and decreased waist circumference.
Blood Pressure ; Body Mass Index ; Body Weight ; Depression ; Drug Therapy ; Eating ; Feeding Behavior ; Hematologic Tests ; Humans ; Korea* ; Lipoproteins ; Male ; Obesity ; Prevalence ; Prospective Studies* ; Social Class* ; Social Problems ; Socioeconomic Factors ; Waist Circumference

PURPOSE: Brain injury due to hanging leads has a high mortality rate and severe neurological sequelae. Serum S100B for predicting brain injury in hanging injury has not been evaluated. The aim of this study is to review the characteristics and the prognosis of hanging patients and to determine the usefulness of S100B as a predicting factor. METHODS: A single center, retrospective study was conducted from January 2011 to December 2014. A total of 102 patients visited the emergency department (ED) with hanging injuries and 70 resuscitated patients were enrolled. RESULTS: Of all patients, 56 (54.9%) patients were male and 96 (94.1%) patients committed suicide by hanging; 61 (59.8%) patients visited the ED with cardiac arrest. In arrest patients, all survived patients showed a Cerebral Performance Category (CPC) score of 4. Although 16 (39.0%) had the initial mental status as stupor or coma in non-arrest patients, 1 (2.4%) remained as CPC 4. Among the resuscitated patients, comatose mental status, absence of pupil light reflex (PLR), and diffuse swelling on brain computed tomography (CT) tended to show relation to high mortality rate. Only PLR tended to show relation to CPC score in non-arrest patients. The elevated level of serum S100B was related to the mortality in arrest patients, whereas it was not related to CPC score in non-arrest patients. CONCLUSION: The prognosis of hanging patients was related to PLR irrespective of the presence of cardiac arrest. The serum S100B level for prediction of prognosis is not sufficient in non-arrest patients with hanging.
Asphyxia ; Brain ; Brain Injuries ; Coma ; Emergency Service, Hospital ; Heart Arrest* ; Humans ; Male ; Mortality ; Neck Injuries ; Prognosis ; Pupil ; Reflex ; Retrospective Studies ; Staphylococcal Protein A* ; Status Epilepticus ; Stupor ; Suicide

BACKGROUNDS: Recent studies of population trends demonstrate massive increases in both absolute numbers and percentage of our aging population. A large proportion of the population older than 65 years has age-related sensory losses that impair food intakes, overall health, self-sufficiency, and quality of life. Thus, this study was performed investigate the subjective and objective changes of taste perception in Korean elderly. METHODS: The subjects were 22 male and 109 female normal elderly persons aged 55 to 81(mean: 70+4.5) years without diabetes mellitus. They were recruited from senior citizen centers in Northern area of Seoul. The agents used for taste measurements are; sodium chloride for salt taste ; sucrose, for sweet; Glacial acetic acid, for sour; and Quinine hemisulfate for buffer. Taste threshold was measured by determining detection and recognition thresholds for all 4 taste qualities by a forced-choice, three-stimulus drop technique. Taste threshold was obtained by dropping solutions on the right sides of the tip of the tongue for salt taste, anterior lateral side for sweet, posterior lateral side, for sour taste, and back of the tongue for buffer taste. RESULTS: Among subjects, 52(40%) had hypertension, 12(9%) heart disease, and 18(14%) hypercholesterolemia. Male subjects had lower detection threshold for salt taste compared to that of females. The subjects with hypercholestrolemia had higher detection threshold for buffer taste(p<0.05). Male subjects had higher recognition threshold for buffer taste compared to that of females(p<0.05). The subjects with hypertension, heart problems, history of smoking, drinking, or medication had no significant changes in detection and recognition taste threshold of 4 different taste. Twenty one(16%) subjects experienced symptoms of dysgeusia, thirty(23%) hypogeusia. None of them reported symptoms of phantogeusia, cacogeusia, or heterogeusia. The subjects with dysgeusia had higher detection threshold for sweet taste(p<0.05). CONCLUSION: Male subjects had lower detection threshold for salt taste and higher recognition threshold for buffer taste compared to those of females in Korean elderly(p<0.05). The subjects with hypercholesterolemia had higher detection threshold for buffer taste(p<0.05), and the subjects with dysgeusia had higher detection threshold for sweet taste(p<0.05). Thus, sex-related salty and buffer taste perception were observed in the elderly and dysgeusia had an effect on sweet taste. These results suggest that these taste perception changes seem to have an influence on nutritional and health status of the elderly and we should consider these taste perception changes to prepare the dietary guidelines for healthy life of the elderly.
Acetic Acid ; Aged* ; Ageusia ; Aging ; Diabetes Mellitus ; Drinking ; Dysgeusia ; Female ; Heart ; Heart Diseases ; Humans ; Hypercholesterolemia ; Hypertension ; Male ; Nutrition Policy ; Quality of Life ; Quinine ; Seoul ; Smoke ; Smoking ; Sodium Chloride ; Sucrose ; Taste Perception* ; Taste Threshold ; Tongue