No abstract available.
Congenital Hypothyroidism*

N, N-dimethylformamide (DMF) is a solvent which is widely used in the industrial workplace. It causes the liver damages to the chronically exposed workers and is also well known as the harzadous material to generate occupational malignancies. DMF is mainly metabolized into N-hydroxymethyl-N-methylformamide (HMMF) by the microsomal cytochrome p-450. HMMF breaks down to NMF. However, the detailed mechanism of its toxicity are unknown. In this experiment, the metabolism and the toxicity of DMF was investigated using an isolated perfumed liver model. DMF (0, 10, 25mM) were added into recirculating perfusate of the isolated perfused rat liver. Samples were collected at 0, 30, 45, 60, 75, 90 minutes from inferior vena cava. The gas-chromatography was used to analyze the metabolite of DMF, The changes in the oxygen consumption rate by DMF were monitored during perfusion. The enzyme activity (AST, ALT, LDH) in the perfusate were treasured to find out whether DMF causers hepatotoxicity. As perfusion continued, DMF concentration in the perfusate decreased, and NMF 1.16mM was detected. The oxygen consumption rate increased both at 10mM and 25mM DMF concentration. However, when SKF 525A, a known inhibitor of cytochrome p-450, had been pretreated (300uM before DMF addition, the oxygen consumption rate was significantly inhibited, indicating that cytochrome p-450 system is responsible for the conversion to NMF. With DMF addition, the activity of AST, ALT, and LDH significantly increased time dependently and dose dependently. However, the pretreatment of perfused liver with SKF 525A shoved that the release of AST, ALT and LDH was inhibited. In summary, it is found that DMF is metabolized to NMF in liver, and that cytochrome p-450 mono-oxygenase is suggested to play a role in the biotransformation of NMF. The time course of BMF toxicity in relation to NMF formation is compatible with hypothesis that the hepatotoxicity of DMF is mediated via NMF. Further study combined with in vivo experiment through the toxicological approaches is expected.
Animals ; Biotransformation ; Cytochrome P-450 Enzyme System ; Liver* ; Metabolism* ; Oxygen Consumption ; Perfusion ; Rats ; Vena Cava, Inferior

High peak inspiratory pressure during control-mode ventilation (CMV) with volume cycled ventilator is associated with increased risk of barotrauma. Pressure controlled ventilation can reduce peak inspiratory pressure and barotrauma, and provide for adequate gas exchange. We present a case of the patient of status asthmaticus in whom we used pressure controll ventilation of lower inspiratory pressure (initially 45 cmH2O) with good outcome during midazolam infusion. At the admission to the ICU, the peak inspiratory pressure was 80 cmH2O with control- mode ventilation of volume cycled ventilator and respiratory acidosis developed (pH: 7.20, PaCO2: 64.1 mmHg). After changing the volume control mode to pressure controlled mode, the peak inspiratory pressure could be reduced from 80 cmH2O to 45 cmH2O with improvement of respiratory acidosis. From our experience, we recommend the application of pressure control ventilation safely to the patients in whom peak inspiratory pressure is high enough to induce barotrauma, if expired tidal volume is monitored.
Acidosis, Respiratory ; Barotrauma ; Humans ; Midazolam ; Status Asthmaticus* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

The coronary vasospasm has usually been readily reversible by sublingual, intravenous or intracoronary nitroglycerin. Relief of spasm, either spontaneous or following nitrate therapy, results in reperfusion. Occurence of ventricular tachyarrhythmia during release of coronary spasm is attractive as a possible cause of sudden death because of significant proportion of sudden death victims do not have acute myocardial infarction. Recently, we experienced a 36 year old man who developed spontaneous coronary vasospasm, and the patients suffered from repetitive reperfusion ventricular tachyarrhythmia, and died suddenly in spite of administration of isosorbide dinitrate, lidocaine and several trials of cardioversion and cardiopulmonary resuscitation, and we report.
Adult ; Cardiopulmonary Resuscitation ; Coronary Vasospasm ; Death, Sudden* ; Electric Countershock ; Humans ; Isosorbide Dinitrate ; Lidocaine ; Myocardial Infarction ; Nitroglycerin ; Reperfusion* ; Spasm ; Tachycardia*

OBJECTIVE: To determine optimal follow-up time of BAEP for the infants with abnormal BAEP at the initial screening test. METHOD: Control group consisted of 85 infants with normal BAEP and experimental group consisted of 41 infants with abnormal BAEP at the first examination but normalized on regular follow-up examinations. Gestational age (correctional age), intrauterine period, birth weight, delivery method, presence of perinatal asphyxia, Apgar score after 1 minute, the highest serum bilirubin level, and the results of cranial ultrasonography were recorded. The above parameters, peak and interpeak latencies of BAEP were compared between both groups. RESULTS: Lower correctional age at the first BAEP, shorter intrauterine period, and lower birth weight were noted in experimental group (p<0.001). The average correctional age when BAEP had normalized in experimental group was 45.0+/-5.8 weeks, which was much later than 40.2+/-2.8 weeks in control group (p<0.001). 90.2% of infants among experimental group revealed normalized BAEP within 48 weeks, and 95.1% within 51 weeks according to correctional age, or within 12 weeks after initial examination. CONCLUSION: We recommend that BAEP should be rechecked after 48 weeks by correctional age for the high risk infants who were abnormal with initial screening BAEP.
Apgar Score ; Asphyxia ; Bilirubin ; Birth Weight ; Brain Stem* ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies* ; Gestational Age ; Humans ; Infant ; Mass Screening ; Ultrasonography

Pancreatic metastasis from papillary thyroid cancer (PTC) is extremely rare; only 18 cases have been reported in the literature. However, several reviews have highlighted similar characteristics between metastatic and primary pancreatic tumors. The patient was a 51-year-old male with a history of total thyroidectomy, modified radical neck dissection, and radioactive iodine ablation for PTC in 2014. Nodules suspected of metastasis were found in both lungs on chest computed tomography (CT). However, after 6 months, a follow-up chest CT showed no increase in size; thus, a follow-up observation was planned. Six years after his initial diagnosis, abdominal CT and pancreas magnetic resonance imaging revealed a 4.7 cm cystic mass with a 2.5 cm enhancing mural nodule in the pancreas tail. We diagnosed the pancreatic lesion as either metastatic cancer or primary pancreas cancer. The patient underwent distal pancreato-splenectomy. After surgery, the pathological report revealed that the mass was metastatic PTC. Pancreatic metastasis from PTC indicates an advanced tumor stage and poor prognosis. However, pancreatectomy can increase the survival rate when the lesion is completely resectable. Therefore, surgical resection should be considered as a treatment for pancreatic metastasis from PTC.

OBJECTIVE: This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). METHODS: CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. RESULTS: Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was 56.7 +/- 19.3 mmHg (Mean +/- SD) and 7.4 +/- 3.3 mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. CONCLUSION: CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.
Carpal Tunnel Syndrome ; Catheters ; Cytidine Triphosphate ; Electrodiagnosis ; Humans ; Wrist

OBJECTIVES: This study aimed to assess the relationship between musculoskeletal symptoms and non-fatal injuries in construction workers. METHODS: This was a cross-sectional study involving 1,836 male construction workers in petrochemical plants in Korea. For this study, a structured self-reported questionnaire(KOSHA CODE H-30-2003) was used. Musculoskeletal symptoms were defined as symptoms that affect the operation of the musculoskeletal system, for longer than one week or a frequency of more than once per month. To evaluate the association between musculoskeletal symptoms and non-fatal occupatioanl injuries, multiple logistic-regressions were used after adjusting for age, exercise, smoking status, alcohol consumption, work time, work duration, and income. RESULTS: A total of 140 workers were involved in non-fatal injuries cases, representing 7.6% prevalence. After adjusting for confounding variables, the logistic regression analyses indicated the group with musculoskeletal symptoms(OR 1.73 95% CI:1.21~2.47) and intensity criteria of musculoskeletal symptoms as related to 'moderate' criteria(OR 1.82 95% CI:1.18~2.81) or 'severe' criteria(OR 2.57 95% CI:1.43~4.63). This identified group was more likely to experience non-fatal occupational injuries. However, a 'mild' criteria(OR 1.00 95% CI:0.51~1.99) was not associated with non-fatal occupational injuries. CONCLUSIONS: The results indicated a possible association between musculoskeletal symptoms and non-fatal injuries. Hence, strengthening of laws and regulations, effective ergonomic programs and training is necessary to prevent musculoskeletal symptoms.
Alcohol Drinking ; Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Humans ; Jurisprudence ; Korea ; Logistic Models ; Male ; Multiple Trauma ; Musculoskeletal System ; Occupational Injuries ; Prevalence ; Smoke ; Smoking ; Social Control, Formal

BACKGROUND: Fibroblast growth factor 21 (FGF21) was originally identified as a paroxysm proliferator activated receptor-alpha target gene product and is a hormone involved in metabolic regulation. The purpose of this study was to investigate the diurnal variation of serum FGF21 concentration in obese and non-obese healthy volunteers. METHODS: Blood samples were collected from five non-obese (body mass index [BMI] < or =23 kg/m2) and five obese (BMI > or =25 kg/m2) healthy young men every 30 to 60 minutes over 24 hours. Serum FGF21 concentrations were determined by radioimmunoassay. Anthropometric parameters, glucose, free fatty acid, insulin, leptin, and cortisol concentrations were also measured. RESULTS: The serum FGF21 concentrations displayed various individual oscillation patterns. The oscillation frequency ranged between 6 and 12 times per day. The average duration of oscillation was 2.52 hours (range, 1.9 to 3.0 hours). The peaks and troughs of FGF21 oscillation showed no circadian rhythm. However, the oscillation frequency had a diurnal variation and was lower during the light-off period than during the light-on period (2.4 vs. 7.3 times, P<0.001). There was no difference in the total frequency or duration of oscillations between non-obese and obese subjects, but obese individuals had increased numbers of larger oscillations (amplitude > or =0.19 ng/mL). CONCLUSION: Various oscillation patterns in serum FGF21 concentration were observed, and reduced oscillation frequencies were seen during sleep. The oscillation patterns of serum FGF21 concentration suggest that FGF21 may be secreted into systemic circulation in a pulsatile manner. Obesity appeared to affect the amplitude of oscillations of serum FGF21.
Circadian Rhythm ; Fibroblast Growth Factors ; Fibroblasts ; Glucose ; Humans ; Hydrocortisone ; Insulin ; Leptin ; Male ; Obesity ; Radioimmunoassay

STUDY DESIGN: Retrospective analysis to evaluate predictive factors of low back pain after discectomy in lumbar disc herniation. OBJECTIVE: We analysed clinical and radiological predictive factors which possibly contribute to postoperative low back pain in herniated lumbar disc disease. SUMMARY OF LITERATURE REVIEW: There was no statistically significant factors which contribute to postoperative low back pain. MATERIALS AND METHODS: Ninety two patients with herniated lumbar disc who were treated by one level simple discectomy from June 1995 to June 2000 were included in this study. They were divided into two groups by severity of postoperative low back pain, back pain group and no back pain group. We analyzed clinical and radiological factors retrospectively in each group by medical records, preoperative radiographs and telephone interview. Then statistical analysis was performed with Chi-square test and logistic regression analysis. Confidence interval was 95%. RESULTS: Eighteen patients (19.6%) were in back pain group and seventy four patients (80.4%) were in no back pain group. Among patients over 50 years old and below 50 years old, the ratio of low back pain after discectomy was 33% and 13.8% respectively (Odds ratio=3.1, confidence interval 1.07~9.03). It was proved statistically that except age factor, such factors as follows did not affect postoperative lower back pain. Sex, smoking, preceeding low back pain before discectomy, level of discectomy, disc space narrowing, bony spur, grade of disc degeneration, presence of high intensity zone of disc. CONCLUSIONS: There was no other significant predictive factors of post-discectomy low back pain than the age over 50 years old.
Age Factors ; Back Pain ; Diskectomy* ; Humans ; Intervertebral Disc Degeneration ; Interviews as Topic ; Logistic Models ; Low Back Pain* ; Medical Records ; Middle Aged ; Retrospective Studies ; Smoke ; Smoking