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

Diagnostic ultrasound has become one of the most useful tools in the practice of obstetics. It has been ofparticular utility in the placental localization. We analyzed 34 patients of placenta previa scanned byultrasound. The reults were as follows; 1. The age of patient ranged from 22 to 39 years, showing the highestincidence in 26 to 30 years. 2. The accuracy of correct localization was 70.6%. 3. Among 13 cases diagnosed byultrasound as total placenta previa, 2 cases were partial placenta previa and 1 was low-lying placenta at the timeof delivery. 4. Among 9 cases diagnosed by ultrasound as partial placenta previa, 1 case was total palcenta previaand 1 case was low-lying placenta and 1 case was upper segment placenta. 5. Among 10 cases diagnosed by utrasoundas low-lying placenta, 2 cases were partial placenta previa. 6. Among 2 cases diagnosed by utlrasound as uppersegment placenta, 1 case was total placental previa and 1 case was partial placenta previa. 7. Among 9 cases doneserial ultrasoud, 3 cases revealed that the placenta migrates toward fundus in the course of pregnancy, Therefore,the palcental scanning should be repeated in the last month before term to decide the mode of delivery.conclusively, ultrasonography is the imaging modality of choice in the evaluation of placental localization becuseit provides speedy and repeatable way without any known risk to both mother and fetus itself. Careful performanceand accurate interpretation shold be needed for more correct palcental localization.
Fetus ; Humans ; Mothers ; Placenta Previa ; Placenta ; Pregnancy ; Ultrasonography

Objective: To investigate imaging biomarkers of microperfusion in contrast-induced nephropathy (CIN) using contrastenhanced ultrasound (CEUS). Materials and Methods: The CIN model was fabricated by administering indomethacin (10 mg/kg), L-NAME (15 mg/kg), and iopamidol (10 mL/kg) to Sprague-Dawley rats. After 24 hours, CEUS was performed on CIN (n = 6) and control (n = 6) rats with sulphur hexafluoride microbubbles (SonoVue). From time-intensity curves obtained from the kidney arriving time (AT), acceleration time (AC), time to peak (TTP), and peak enhancement (PE) were measured and compared between the groups. After CEUS, the rats were sacrificed, and cell apoptosis markers were evaluated to confirm the development of CIN. Results: Among CEUS parameters, AT (7.8 ± 1.6 vs. 4.2 ± 0.5 s, p = 0.002), AC (4.7 ± 1.4 vs. 2.0 ± 0.4 s, p = 0.002), and TTP (12.5 ± 2.9 vs. 6.2 ± 0.6 s, p = 0.002) were significantly prolonged in the CIN group compared to controls. PE was significantly higher in the control group than in the CIN group (17.1 ± 1.9 vs. 12.2 ± 2.0 dB, p = 0.004). In kidney tissue, mRNA and protein levels of the apoptotic makers were significantly higher in the CIN group than in the control group (p = 0.003 and p = 0.002). Conclusion CEUS parameters can be used as imaging biomarkers for microperfusion in CIN. In rats with CIN, AT, AC, and TTP were significantly prolonged, while PE was significantly lower compared to controls.

Objective: To investigate imaging biomarkers of microperfusion in contrast-induced nephropathy (CIN) using contrastenhanced ultrasound (CEUS). Materials and Methods: The CIN model was fabricated by administering indomethacin (10 mg/kg), L-NAME (15 mg/kg), and iopamidol (10 mL/kg) to Sprague-Dawley rats. After 24 hours, CEUS was performed on CIN (n = 6) and control (n = 6) rats with sulphur hexafluoride microbubbles (SonoVue). From time-intensity curves obtained from the kidney arriving time (AT), acceleration time (AC), time to peak (TTP), and peak enhancement (PE) were measured and compared between the groups. After CEUS, the rats were sacrificed, and cell apoptosis markers were evaluated to confirm the development of CIN. Results: Among CEUS parameters, AT (7.8 ± 1.6 vs. 4.2 ± 0.5 s, p = 0.002), AC (4.7 ± 1.4 vs. 2.0 ± 0.4 s, p = 0.002), and TTP (12.5 ± 2.9 vs. 6.2 ± 0.6 s, p = 0.002) were significantly prolonged in the CIN group compared to controls. PE was significantly higher in the control group than in the CIN group (17.1 ± 1.9 vs. 12.2 ± 2.0 dB, p = 0.004). In kidney tissue, mRNA and protein levels of the apoptotic makers were significantly higher in the CIN group than in the control group (p = 0.003 and p = 0.002). Conclusion CEUS parameters can be used as imaging biomarkers for microperfusion in CIN. In rats with CIN, AT, AC, and TTP were significantly prolonged, while PE was significantly lower compared to controls.

Lipoma is a common tumor throughout the body, but occurrence in the deep neck space is very rare, and only some cases have been reported by otolaryngologist and pathologist for the last century. In head and neck area, as elsewhere, the lipoma is mainly originated from the subcutaneum. But in deeper tissues, its characteristics are different from those of other sites of lipoma. Submucosal lipoma in the head and neck area usually occur in oral cavity and hypopharynx. Recently we hae experienced 3 cases of deep neck space lipoma, so we report our clinical experiences with brief review of literature.
Head ; Hypopharynx ; Lipoma* ; Mouth ; Neck*

BACKGROUND: To determine whether multiple short-term surveillances are as effective as long-term surveillance for estimating the incidence rates of nosocomial infections (NIs), we prospectively performed 9-month surveillance in four intensive care units (ICUs). METHODS: NI surveillance was performed prospectively from November 2002 through July 2003, with long-term surveillance performed over the 9-month period, and short-term surveillance performed during the middle 3 weeks of each calendar quarter. The incidence rate of NIs or device-associated infections was calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We observed no significant differences between the incidence rates of total NIs determined from these two methods (9.6 [CI95 8.2-11.3] vs 10.4 [CI95 7.5-14.4], P=.66). In addition, these two methods did not differ significantly in estimating the rates of ventilator-associated pneumonia (5.1 [CI95 3.4-7.6] vs 7.5 [CI95 3.8-15.0], P=.35), catheter-associated urinary tract infection (2.4 [CI95 1.7-3.4] vs 1.7 [CI95 0.7-4.1], P=.47), and central line-associated bloodstream infection (2.2 [CI95 1.4-3.4] vs 3.7 [CI95 1.9-7.4], P=.21). Plotting of the NI rates showed that the trends in multiple short-term surveillances were similar to those in long-term surveillance, except in one ICU. CONCLUSION: Our findings suggest that multiple short-term surveillances could replace long-term surveillance in estimating the baseline incidence rates of NIs in the circumstances of the relatively large number of patients in the ICUs, which would be especially useful in countries with limited resources.
Cross Infection* ; Epidemiology ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Tract Infections

A molecularly cloned human cellular H-ras (c-H-ras) oncogene(pbc N1 plasmid) was treated with N-acetoxyacetylaminofluorene (AAAF) in vitro and subcloned into E.coli. This was done to identify the mutational changes at specific codons of the gene. Guanine nucleotides were identified as the major AAAF binding site of the DNA adduct formed. Base changes in codons 12 and 61 were determined by the analysis of restriction fragment length polymorphism (RFLP) and site specific oligonucleotide hybridization. RFLP was observed due to the loss of the Hpall recognition site at codon 11 and 12 of AAAF-treated c-H-ras gene. Hybridization of AAAF treated c-H-ras with 32P-labeled oligonucleotide probes for the mutant alleles of codon 61 showed no substitutions at codon 61. From these results, it is assumed that AAAF treatment in vitro caused mutation at codon 12 but not at codon 61 of the c-H-ras oncogene and that codon 12 is the primary target of mutation by AAAF
Acetoxyacetylaminofluorene/*pharmacology ; Chromatography, Thin Layer ; Codon ; *DNA Damage ; Electrophoresis, Agar Gel ; Genes, ras/*drug effects/genetics ; Human ; Mutagenesis, Site-Directed ; Oligonucleotide Probes ; Plasmids/drug effects/genetics ; Polymorphism, Restriction Fragment Length

BACKGROUND AND OBJECTIVES: The incidence of inflammatory heart diseases is not yet as high as those of other cardiovascular diseases; however, inflammatory heart diseases do have relatively high mortality rate. Therefore, update information on the economic burden of inflammatory heart diseases are necessary in order to appropriate policy making on these diseases. MATERIALS AND METHODS: This study used a number of resources to obtain data, national health insurance statistics, the Korean Health Panel, and the causes of death report by the Korean National Statistical Office. The total costs of inflammatory heart diseases were estimated as the sum of direct medical care costs, direct non-medical care and indirect costs. RESULTS: The total direct cost of inflammatory heart disease was higher in Korean men than that of Korean women and cost due to inpatient was higher than that of outpatients cost. The costs to cover premature death were highest among all of the components used to determine the total costs for inflammatory heart disease, representing 66.3% of these costs in Korea. CONCLUSION: Inflammatory heart disease has a relatively high mortality rate, and the costs that are associated with premature deaths consume the greatest proportion of the costs associated with this disease. In spite of some limitations of study, this could be a reliable evidence of economic burden of inflammatory heart disease.
Cause of Death ; Cost of Illness ; Endocarditis ; Female ; Health Care Costs ; Heart ; Heart Diseases ; Humans ; Incidence ; Inflammation ; Inpatients ; Korea ; Male ; Mortality, Premature ; National Health Programs ; Outpatients ; Policy Making

An experiment was designed to investigate the reaction mechanism of AP (apurinic or apyrimidinic) DNA endonucleases (APcI, APcII, APcIII) purified from rat liver chromatin. Sulfhydryl compounds (2-mercaptoethanol, dithiothreitol) brought about optimal activities of AP DNA endonucleases and N-ethylmaleimide or HgCl2 inhibited the enzyme activities, indicating the presence of sulfhydryl group at or near the active sites of the enzymes. Mg2+ was essential and 4mM of Mg2+ was sufficient for the optimal activities of AP DNA endonucleases. Km values of APcI, APcII and APcIII for the substrate (E. coli chromosomal AP DNA) were 0.53, 0.27 and 0.36 microM AP sites, respectively. AMP was the most potent inhibitor among adenine nucleotides tested and the inhibition was uncompetitive with respective to the substrate. The Ki values of APcI, APcII and APcIII were 0.35, 0.54 and 0.41mM, respectively. The degree of nick translation of AP DNAs nicked by APcI, APcII and APcIII with Klenow fragment in the presence and absence of T4 polynucleotide kinase or alkaline phosphatase were the same, suggesting that all 3 AP DNA endonucleases excise the phosphodiester bond of AP DNA strand to release 3-hydroxyl nucleotides and 5-phosphomonoester nucleotides.
Animals ; Binding Sites ; Chromatin/*enzymology ; DNA Damage/physiology ; DNA Repair/physiology ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; Deoxyribonuclease IV (Phage T4-Induced) ; Endodeoxyribonucleases/antagonists & inhibitors/drug effects/*metabolism ; Kinetics ; Liver/drug effects/*enzymology ; Magnesium/pharmacology ; Rats ; Sulfhydryl Compounds/pharmacology

Three kinds of apurinic/apyrimidinic (AP) DNA endonuclease, APcI, APcII, APcIII, were purified from rat liver chromatin through 1M KCl extraction, DEAE-trisacryl ion exchange chromatography. Sephadex G-150 gel filtration and AP DNA cellulose affinity chromatography. Activities of the purified APcI, APcII and APcIII were 62.5, 83.3 and 52.0 EU/mg of protein, respectively. Molecular weights of APcI, APcII and APcIII, each consisting of a single polypeptide, were 30,000, 42,000 and 13,000, and isoelectric points of them were 7.2, 6.3 and 6.2, respectively. Three enzymes showed different substrate specificities; APcI acted only on AP DNA, and APcII acted on both AP DNA and UV DNA, while APcIII acted on 3'-methyl-4-monomethylaminoazobenzene (3'-Me MAB) DNA adduct as well as AP DNA and UV DNA. These results indicate that three kinds of AP DNA endonuclease present in rat liver chromatin have structural and functional diversities.
Animals ; Carcinogens ; Chromatin/*enzymology ; DNA Damage/*physiology ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; Deoxyribonuclease IV (Phage T4-Induced) ; Electrophoresis, Polyacrylamide Gel ; Endodeoxyribonucleases/*isolation & purification/metabolism ; Isoelectric Focusing ; Liver/drug effects/*enzymology ; Male ; Rats ; Rats, Inbred Strains ; Substrate Specificity ; p-Dimethylaminoazobenzene