No abstract available.
Succimer* ; Thymoma*

We investigated the effects of panretinal photocoagulation (PRP)on macular microcirculation in diabetic retinopathy. PRP using argon blue green laser was performed in 23 eyes of 15 patients with early proliferative diabetic etinopathy and very severe nonproliferative diabetic retinopathy without significant macular edema. The changes in volume, flow, velocity of macular microcirculation were measured before PRP, 1 hour, 1 day, 1 week, and 1 month following PRP, using Heidelberg Retina Flowmeter(HRF). Mean volume, flow, velocity of macular microcirculation decreased to a maximal degree 1 hour following PRP, from 14.87+/-0.40, 387.45 +/-101.40, 1.40+/-0.28(before PRP)to 12.44+/-1.39, 347. 33+/-100.39, 1.27+/-0.34(p<0.05). From 1hour to 1 month after PRP, macular microcirculation gradually increased. However, throughout this period, all parameters of macular microcirculation remained lower than pre-PRP level(p<0.05). Our study suggests that panretinal photocoagulation reduces the macular microcirculation in diabetic retinopathy.
Argon ; Diabetic Retinopathy ; Humans ; Light Coagulation* ; Macular Edema ; Microcirculation* ; Retina ; Retinaldehyde*

Hepatoblastoma is a rare malignant liver tumor found in children. Its biological characteristics and prognostic factors have not been well known. We investigated 29 cases of hepatoblastoma, registered in university hospitals in Seoul from 1984 to 1996. By the immunohistochemical method, p53, Waf-1 (p21), bcl-2, heat shock protein 70 (hsp70), c-jun, transforming growth factor-alpha (TGF-alpha) expressions were studied. Those data were compared with clinico-pathologic features; age, sex, tumor size, tumor stage and histologic subtypes. Expression of p53 and bcl-2 were each observed separately in single cases. Expression of c-jun was more frequently noted in patients at higher stages. Expression of TGF-alpha decreased in the order of pure fetal, mixed, embryonal and small cell anaplastic subtypes. Cumulative survival rate was lower in females than in males and in patients with a higher tumor stage. According to histologic subtypes, survival rates decreased in the order of pure fetal, mixed, embryonal and small cell anaplastic subtypes. Survival rate was lower in patients with c-jun expression. Group of TGF-alpha labelling index under 19 showed a lower survival rate than that over 19. In conclusion, we found that tumor associated proteins, c-jun and TGF-alpha, are closely related to the prognosis of hepatoblastoma but p53 and bcl-2 may not be related to it.
Child ; Female ; Hepatoblastoma* ; Hospitals, University ; HSP70 Heat-Shock Proteins ; Humans ; Liver ; Male ; Population Characteristics ; Prognosis ; Seoul ; Survival Rate ; Transforming Growth Factor alpha

Eight patients in the state of ASA classification l, ll were investigate. Blood samples were collected before, just after, 30 minutes after and 60 minutes after induction of anesthesia. Glucose and electrolyte changes in relation to maintenance fluids in balanced and halothane anesthesia were as follows. 1) In both anesthetic techniques blood sugar level showed increasing tendency according to duration of anesthesia. 2) There were no specific changes in serum electrolytes related to type of anesthesia. 3) The administration of D/S and H/D showed a little increase in Na+ and Cl- level compared to the administration of just DsW. 4) The administration of H/d showed less increase in K+ level than the administration of DsW or D/S. 5) Just after induction of anesthesia the K+ level increased a little and decreased gradually thereafter.
Anesthesia ; Anesthesia, General* ; Blood Glucose* ; Classification ; Electrolytes* ; Glucose ; Halothane ; Humans

Even though Neptunea contricta appears similar to Batilus cornutus and Rapana venosa, they are different in tetramine content which inhibits the neuronal calcium channel. Therefore, mistaking Neptunea contricta for Batilus cornutus or Rapana venosa, can result in the occurrence of toxic symptoms. Three patients developed nausea, epigastric pain, chest pain, dizziness, blurred vision, dyspnea, hypertension and tachycardia after eating Neptunea contricta. Moreover, consumption of one only piece was sufficient to cause symptoms because each Neptunea contricta has 17.3 mg of tetramine. Accordingly, care should be taken when patients are consuming more than 5 pieces because toxic symptoms such as dyspnea can occur. Moreover, correct species identification is important because the quantity of tetramine varies among sea snail species. Finally, it is important to educate people to remove the salivary glands completely before consuming Neptunea contricta.
Calcium Channels ; Chest Pain ; Dizziness ; Dyspnea ; Eating ; Gastropoda ; Humans ; Hypertension ; Nausea ; Neurons ; Poisoning ; Salivary Glands ; Snails ; Tachycardia

OBJECTIVE: University hospitals nationwide are experiencing a shortage of neurology residents and excessive workloads; new measures are required because a lack of neurologists in the emergency department (ED) leads to ED overcrowding. This study examined the effects of emergency medicine doctors taking over the role of neurologists in the treatment of primary headache patients visiting the ED. METHODS: A study group of primary headache patients, who visited a single university hospital ED between 1 June and 31 October 2017 and were treated by an emergency medical doctor, was selected. The control group consisted of patients who met the same conditions as the study group and visited the ED during the same period in 2016 but were treated by a neurologist. The following variables between the two groups were compared: length of stay in the ED, medical expenses in the ED, and the time taken to decide on neuroimaging tests. RESULTS: This study was conducted on 300 patients in the control group and 94 patients in the study group. The study group showed a shorter time to decide on neuroimaging tests (64.4%, 95% confidence interval [CI], P<0.001), shorter length of stay in the ED (15.2%, 95% CI, P<0.001), and lower medical expenses (12.8%, 95% CI, P=0.011). CONCLUSION When emergency medicine doctors take over the neurologic medical care of primary headache patients in ED, it can be expected to reduce ED overcrowding and medical expenses.

Kounis syndrome is defined as the occurrence of acute coronary syndrome associated with vasoactive mediators, such as histamines in the setting of hypersensitivity and allergic reactions or anaphylactic insults. The condition can be caused by various drugs, foods, or environmental factors that cause allergic reactions. A 35-year-old male visited the emergency room with anaphylaxis accompanied by chest pain approximately 20 minutes after taking zaltoprofen, a nonsteroidal anti-inflammatory drug. After acute treatment for the anaphylaxis, the patient was stabilized and all symptoms disappeared, but the ischemic changes in the electrocardiogram and elevation of the cardiac enzymes were observed. The emergency cardiac angiography and echocardiography were all normal. The allergic reaction of this patient to zaltoprofen was believed to cause a temporary coronary arterial vasospasm, inducing Type 1 Kounis syndrome. Thus far, there have been case reports of Kounis syndrome caused by a range of nonsteroidal anti-inflammatory drugs, but there are no reports of the condition being caused by zaltoprofen. According to the pathophysiology, both cardiac and allergic symptoms must be solved simultaneously, so rapid treatment and diagnosis are needed. Doctors treating acute allergic reactions and anaphylaxis patients must check the cardiovascular symptoms thoroughly and consider the possibility of Kounis syndrome.
Acute Coronary Syndrome ; Adult ; Anaphylaxis ; Angiography ; Chest Pain ; Diagnosis ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Hypersensitivity ; Male

PURPOSE: The fibrates are ligands for peroxisome proliferator-activated receptor (PPAR) alpha and used clinically as hypolipidemic drugs. The fibrates are known to cause peroxisome proliferation, enhance superoxide dismutase (SOD) expression and catalase activity. The antioxidant actions of the fibrates may modify radiation sensitivity. Here, we investigated the change of the radiation sensitivity in two cervix cancer cell lines in combination with fenofibrate (FF). MATERIALS AND METHODS: Activity and protein expression of SOD were measured according to the concentration of FF. The mRNA expressions were measured by using real time reverse-transcription polymerase chain reaction. Combined cytotoxic effect of FF and radiation was measured by using clonogenic assay. RESULTS: In HeLa cells total SOD activity was increased with increasing FF doses up to 30 microM. In the other hand, the catalase activity was increased a little. As with activity the protein expression of SOD1 and SOD2 was increased with increasing doses of FF. The mRNAs of SOD1, SOD2, PPARalpha and PPARgamma were increased with increasing doses of FF. The reactive oxygen species (ROS) produced by radiation was decreased by preincubation with FF. The surviving fractions (SF) by combining FF and radiation was higher than those of radiation alone. In Me180 cells SOD and catalase activity were not increased with FF. Also, the mRNAs of SOD1, SOD2, and PPARalpha were not increased with FF. However, the mRNA of PPARgamma was increased with FF. CONCLUSION: FF can reduce radiation sensitivity by ROS scavenging via SOD induction in HeLa. SOD induction by FF is related with PPARalpha.
Catalase ; Cell Line ; Fenofibrate ; Fibric Acids ; Hand ; HeLa Cells ; Humans ; Hypolipidemic Agents ; Ligands ; Peroxisomes ; Polymerase Chain Reaction ; PPAR alpha ; PPAR gamma ; Radiation Tolerance ; Reactive Oxygen Species ; RNA, Messenger ; Superoxide Dismutase ; Superoxides ; Uterine Cervical Neoplasms

PURPOSE: Non-cement total hip arthroplasty for unstable intertrochanteric fracture in elderly patients is regarded as another surgical technique preventing complications such as non-union, long term limitation of weight bearing, pressure sore, pulmonary thromboembolism after open reduction or closed reduction with intramedullary nailing, or plate fixation. We would like to announce the short-term results of primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fracture in elderly patients. MATERIALS AND METHODS: All of the 20 patients admitted to the hospital between April 2010 and February 2012 who underwent non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fractures were evaluated. The mean age was 71.1(57-86), there were nine males, and 11 females, with an average follow up period of six months. The post-operative state was evaluated by Harris hip score. RESULTS: The mean operation time was 95 min, and the average blood loss was 800 cc. Mean Harris hip score at the last available follow-up was 92.7, and, among the patients, 15 had all functions of daily life without limitation of walking distance, one had hip dislocation, one had breakage of strands. Pressure sore, deep vein thrombosis, and pulmonary thromboembolism were absent. Radiography at the last available follow-up showed no loosening of the femoral stem in any of the patients, and 13 patients had osteogenesis around the fracture site, and there was no osteolysis. CONCLUSION: Primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring in elderly patients with unstable intertrochanteric fractures showed satisfactory results. These results are expected to be useful for further studies with a long-term follow-up and in development of a reduction method.
Aged ; Arthroplasty ; Female ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Dislocation ; Hip Fractures ; Humans ; Male ; Osteogenesis ; Pressure Ulcer ; Pulmonary Embolism ; Venous Thrombosis ; Walking ; Weight-Bearing

The purpose of this study was to determine the factors which were responsible for delaying early diagnosis and optimal management of rheumatoid arthritis (RA) in Korea. We interviewed 109 outpatients diagnosed as RA being treated by rheumatologists, and we eventually analyzed 98 patients' data. The median length of time from symptom onset to the first visit to a medical doctor, to diagnosis, and visiting a rheumatologist were 8 weeks, 23 weeks, and 42 months respectively. The subspecialist with whom the patients consulted with for the longest time before visiting a rheumatologist were an orthopaedic surgeon for 51 patients, a Chinese herbal doctor for 19 patients, and a pharmacist for 16 patients. For early diagnosis and optimal management of RA in Korea, we believe that it is necessary to reduce the use of unconventional medical services such as Chinese herbal medicine and nonprescribed medication, and to emphasize rheumatologic and rehabilitative care in the early stage.
Adult ; Alternative Medicine/utilization ; Arthritis, Rheumatoid/therapy* ; Arthritis, Rheumatoid/rehabilitation ; Female ; Health Services/utilization* ; Human ; Korea ; Male ; Middle Age ; Rheumatology/methods