BACKGROUND: One of the most common side effects of antidepressant medication is orthostatic hypotension, which can be caused by impaired vasoconstriction. This study was designed to compare the inhibitory effects of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), on the contractile responses to alpha1-adrenergic receptor activation and depolarization in isolated rat aorta. METHODS: Vascular rings were suspended for the measurement of isometric tension in a water-jacketed bath filled with Tyrode solution. After pretreatment with antidepressant for 20 min, vasoconstriction induced by norepinephrine (NE) or 35 mM K+ was measured and compared to the control response. RESULTS: Whereas trazodone and tricyclic antidepressants (TCAs) selectively inhibited NE-induced vasoconstriction, SSRIs inhibited depolarization-induced vasoconstriction more potently. The IC50 value of fluoxetine on depolarization- induced vasoconstriction was 3.29 microM, which is consistent with the previous results on L-type Ca2+ currents of cardiac myocyte. Moclobemide, a monoamine oxidase inhibitor, had no effect on vasoconstriction induced by either alpha- adrenergic receptor activation, or depolarization. CONCLUSION: These results suggest that SSRIs, different from TCAs and trazodone, have potent inhibitory actions to depolarization-induced contraction that may be due to blocking Ca2+ entry through L-type Ca2+ channel.
Animals ; Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Aorta* ; Baths ; Fluoxetine ; Hypotension, Orthostatic ; Inhibitory Concentration 50 ; Moclobemide ; Monoamine Oxidase Inhibitors ; Myocytes, Cardiac ; Norepinephrine ; Rats* ; Receptors, Adrenergic ; Serotonin Uptake Inhibitors* ; Trazodone ; Vasoconstriction*

Serious complications involving the alimentary tract are commonly reported following cardiac transplantation and may be associated with significant morbidity and mortality. Between April 1994 and April 1996, 17 patients underwent orthotopic cardiac transplantation at the Buchon Sejong General Hospital. Recipients comprised 15 males and 2 females with a mean age of 33-years old. Basic immunosuppressive therapy was accomplished with immuran and cyclosporine and prednisolone. Gastrointestinal complications developed in 10 patients(58.8%), including gastritis[n=4(23.5%)], nonspecific enteritis[n=3(17.6%)], cholecystitis[n=1(5.8%)], perianal abscess[n=1(5.8%)] and panperitonitis due to mesenteric infarction[n=1(5.8%)]. Among them three patients required surgical procedures and one is dead due to sepsis and multiple organic failure(surgical mortality:33.3%). Gastrointestinal complications in cardiac transplantation are frequent cause of postoperative morbidity and mostly step benign courses, they should be detected as soon as possible and be managed with aggressive intervention. Early, aggressive surgical intervention may reduce subsequent mortality.
Adult ; Azathioprine ; Cyclosporine ; Female ; Heart Transplantation* ; Hospitals, General ; Humans ; Male ; Mortality ; Prednisolone ; Sepsis

Thyroid nodules are the most common endocrine disease requiring surgical management. Various techniques for evaluating thyroid nodules have been developed and are being utilized, but it is difficult to differentiate the few malignant lesions from the numerous benign nodules. We reviewed 187 patients with thyroid nodules who were admitted to and operated on at the Department of General Surgery, Buchon Sejong General Hospital, from January 1990 to December 1996. The results are summarized as follows: 1) The incidence of benign nodules was 83.9%, and that of malignant nodules was 16.0% among the 187 cases of thyroid nodules. 2) The sexual distribution revealed female preponderance of 6.5:1 for benign nodules and 14:1 for malignant nodules. 3) The peak-incidence was in the 4th decade to both patients with benign nodules and patients with malignant nodules. 4) As to the duration of illness, 39.6% of cases were resolved within 3 months, 77.5% of cases within 1 year. 5) The most common subjective symptoms were a palpable mass (100%), fatigue, palpitation, and headache, in order of frequency. 6) Eight four percent (84%) of the nocules were unilateral, 46.5% were on the right, 37.4% were on the left, and 12.8% were bilateral. 7) The most common (36.9%) nodule size was 2~3 cm. 8) There was a single nodule in 142 (75.9%) cases and multiple nodules in 45 (24.1%) cases. There was no difference in the incidence of cancer between single and multiple nodules. Also, 35.7% of the benign tumors and 80.0% of the malignant ones were solid. 9) On thyroid scanning, 86.0% of the benign nodules and 93.3% of the malignant nodules were cold nodules. 10) The histopathologic classifications of the benign nodules in decreasing order of frequency were adenomatous goiter, 121 cases (77.1%); follicular adenoma, 20 cases (12.7%); Graves' disease, 6 cases (3.8%); Hashimoto's thyroiditis, 6 cases (3.8%), cyst, 3 cases (1.9%); and subacute thyroiditis, 1 case (0.6%). The malignant diseases were papillary carcinoma, 26 cases (86.7%); follicular carcinoma, 3 cases (10.0%); and medullary carcinoma, 1 case (3.3%). 11) Benign nodules were treated with a lobectomy (69.4%), a lobectomy with isthmectomy (17.8%), a near total thyroidectomy (11.5%) or a total thyroidectomy (1.3%). Malignant nodules were treated with a lobectomy (23.3%), a lobectomy with isthmectomy (20.0%), a total thyroidectomy (20%), a total thyroidectomy with radical neck dissection (20%) a near total thyroidectomy (13.3%), or a near total thyroidectomy with radical neck disection(RND) or modified RND (3.3%). 12) The postoperative complications were transient hypocalcemia (6.4%), permanent hypocalcemia (2.1%), transient hoarseness (1.6%), permanent hoarseness (0.5%), and hematoma (0.5%).
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Classification ; Endocrine System Diseases ; Fatigue ; Female ; Goiter ; Graves Disease ; Headache ; Hematoma ; Hoarseness ; Hospitals, General ; Humans ; Hypocalcemia ; Incidence ; Neck ; Neck Dissection ; Postoperative Complications ; Thyroid Gland* ; Thyroid Nodule* ; Thyroidectomy ; Thyroiditis ; Thyroiditis, Subacute

Thyroid nodules are the most common endocrine disease requiring surgical management. Various techniques for evaluating thyroid nodules have been developed and are being utilized, but it is difficult to differentiate the few malignant lesions from the numerous benign nodules. We reviewed 187 patients with thyroid nodules who were admitted to and operated on at the Department of General Surgery, Buchon Sejong General Hospital, from January 1990 to December 1996. The results are summarized as follows: 1) The incidence of benign nodules was 83.9%, and that of malignant nodules was 16.0% among the 187 cases of thyroid nodules. 2) The sexual distribution revealed female preponderance of 6.5:1 for benign nodules and 14:1 for malignant nodules. 3) The peak-incidence was in the 4th decade to both patients with benign nodules and patients with malignant nodules. 4) As to the duration of illness, 39.6% of cases were resolved within 3 months, 77.5% of cases within 1 year. 5) The most common subjective symptoms were a palpable mass (100%), fatigue, palpitation, and headache, in order of frequency. 6) Eight four percent (84%) of the nocules were unilateral, 46.5% were on the right, 37.4% were on the left, and 12.8% were bilateral. 7) The most common (36.9%) nodule size was 2~3 cm. 8) There was a single nodule in 142 (75.9%) cases and multiple nodules in 45 (24.1%) cases. There was no difference in the incidence of cancer between single and multiple nodules. Also, 35.7% of the benign tumors and 80.0% of the malignant ones were solid. 9) On thyroid scanning, 86.0% of the benign nodules and 93.3% of the malignant nodules were cold nodules. 10) The histopathologic classifications of the benign nodules in decreasing order of frequency were adenomatous goiter, 121 cases (77.1%); follicular adenoma, 20 cases (12.7%); Graves' disease, 6 cases (3.8%); Hashimoto's thyroiditis, 6 cases (3.8%), cyst, 3 cases (1.9%); and subacute thyroiditis, 1 case (0.6%). The malignant diseases were papillary carcinoma, 26 cases (86.7%); follicular carcinoma, 3 cases (10.0%); and medullary carcinoma, 1 case (3.3%). 11) Benign nodules were treated with a lobectomy (69.4%), a lobectomy with isthmectomy (17.8%), a near total thyroidectomy (11.5%) or a total thyroidectomy (1.3%). Malignant nodules were treated with a lobectomy (23.3%), a lobectomy with isthmectomy (20.0%), a total thyroidectomy (20%), a total thyroidectomy with radical neck dissection (20%) a near total thyroidectomy (13.3%), or a near total thyroidectomy with radical neck disection(RND) or modified RND (3.3%). 12) The postoperative complications were transient hypocalcemia (6.4%), permanent hypocalcemia (2.1%), transient hoarseness (1.6%), permanent hoarseness (0.5%), and hematoma (0.5%).
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Classification ; Endocrine System Diseases ; Fatigue ; Female ; Goiter ; Graves Disease ; Headache ; Hematoma ; Hoarseness ; Hospitals, General ; Humans ; Hypocalcemia ; Incidence ; Neck ; Neck Dissection ; Postoperative Complications ; Thyroid Gland* ; Thyroid Nodule* ; Thyroidectomy ; Thyroiditis ; Thyroiditis, Subacute

No abstract available.
Cell Line* ; Humans* ; Interferon-gamma* ; Matrix Metalloproteinases* ; Tumor Necrosis Factor-alpha* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Cell Line* ; Humans* ; Interferon-gamma* ; Matrix Metalloproteinases* ; Tumor Necrosis Factor-alpha* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Five medical students in the fourth-year took anatomy as their elective courses for 1 month. They dissected one cadaver, and investigated Digital Report, under the course subjects as follows; (1) the shape of thyroid gland and the location of its isthmus, (2) the branches of left and right coronary arteries, (3) the number of blood vessels and bronchi on the hilum of lung, (4) topographical relationship of the renal vessels and ureter, and the shape of the renal pelvis, (5) the location and attachment of the appendix, (6) the penetration of median nerve through the pronator teres, (7) the sensory nerves and the extensor tendons on the dorsum of hand, (8) the branches of deep femoral artery. The pancreatic and live samples were processed and stained with H&E, for LM observation, since the individual had suffered from pancreatic cancer and got a Pylorus preserving pancreatico-duodenectomy (PPPD). At the last step of the elective course, students wrote small articles following the conventional method for writing manuscript. From the viewpoint of professor, the anatomy course for the fourth-year students were definitely different from that for first-year students, and had many positive effects in terms of anatomy education.
Appendix ; Blood Vessels ; Bronchi ; Cadaver ; Coronary Vessels ; Education ; Femoral Artery ; Hand ; Humans ; Kidney Pelvis ; Lung ; Median Nerve ; Pancreatic Neoplasms ; Pylorus ; Students, Medical* ; Tendons ; Thyroid Gland ; Ureter ; Writing

OBJECTIVE: The purpose of this study was to investigate the effects of haloperidol on [Ca2+]i in hamster insulinoma cells (HIT T-15). METHODS: [Ca2+]i levels were measured by calcium imaging techniques, and membrane potential ionic currents were recorded using conventional patch-clamp methods. RESULTS: Haloperidol induced a transient [Ca2+]i increase, which was abolished by the removal of extracellular Ca2+ or pretreatment with Ca2+ channel blockers (nimodipine and mibefradil). Haloperidol depolarized the membrane potential and inhibited the ATP-sensitive K+ (KATP) channels. Sigma receptor agonists, (+)-SKF10047 and ifenprodil, induced a transient [Ca2+]i increase similar to haloperidol. BD1047, a sigma receptor antagonist, completely blocked the [Ca2+]i increase induced by haloperidol. Haloperidol inhibited the KCl-induced [Ca2+]i increase and voltage-dependent Ca2+ currents. Sigma receptor agonists [(+)-SKF10047, ifenprodil] also inhibited the KCl-induced [Ca2+]i increase. CONCLUSION: Our results suggest that haloperidol induces depolarization, which increases [Ca2+]i by voltage-gated Ca2+ currents via the closing of KATP channels. Haloperidol also inhibits KCl-induced [Ca2+]i increases in the same manner. These effects of haloperidol seemed to be mediated by sigma receptors, which might be linked to the pathogenesis of haloperidol-induced diabetes mellitus.
Animals ; Calcium ; Cricetinae ; Diabetes Mellitus ; Haloperidol* ; Insulinoma* ; KATP Channels ; Membrane Potentials ; Receptors, sigma

BACKGROUND: Cough and hyperdynamic reaction cause considerable discomfort, and they may lead to postoperative surgical complication. To reduce coughing and hemodynamics during emergence, the efficacy of laryngotracheal spraying with lidocaine before intubation is not clear, particularly, in children. We investigated such effect during emergence from general anesthesia, in children. METHODS: Children were studied in a double blind manner: 105 ASA physical status I-II, aged 2-16 yrs, undergoing tonsillectomy and adenoidectomy. Patients were randomly grouped into three (A, B, and C) by the lidocaine spray before endotracheal intubation: 4% lidocaine to the group A (n = 32), 10% lidocaine to the group B (n = 36), and normal saline to the group C (n = 37). The same dose (2 mg/kg) of lidocaine was applied. During emergence, patients were observed their cough and hemodynamics. RESULTS: Lidocaine spray, irrespective of concentration, did not significantly diminish the cough and the hemodynamic reaction across the groups before and after the extubation as well as in the recovery room (P value = 0.44, 0.86, 0.17). CONCLUSIONS: These findings support that the laryngotracheal spraying with lidocaine (2 mg/kg of 4% and 10%) before endotracheal intubation does not reduce the cough and hemodynamic reactions during emergence from general anesthesia in children.
Adenoidectomy ; Anesthesia, General ; Child* ; Cough* ; Hemodynamics* ; Humans ; Incidence* ; Intubation ; Intubation, Intratracheal* ; Lidocaine* ; Recovery Room ; Tonsillectomy

Leukemic infiltration of the penis is an extremely rare entity. A case involving the penile shaft is described, and the relevant evaluation and treatment are discussed. Only 3 other documented cases of penile leukemia have been found in the literature. The identification and treatment of the underlying etiology are important aspects with this unusual disease entity.
Leukemia ; Leukemic Infiltration* ; Male ; Penis*