It has been known that halothane potentiates the effect of muscle relaxants. We electrophysically studied the atterations by halothane in the rat diaphragm. The diaphragm -phrenic nerve preparation was dissected out of the anesthetized rat. In 1% and 2% halothane groups, control determinations were measured on infusion of simple Ringer's solution. Following infusion of halothane-saturated Ringer's solution for 10 minutes, determinations studied were recorded. Transmembrane currents were elucidated using the standard two microelectrode voltage clamp. To determine the mean MEPC amplitude and , 30 MEPC's were first gotten. A series of EPC's were elicited by stimulation of phrenic nerve at 0.4 Hz and 40 Hz. EPC's of both frequencies were used to evaluate the amplitude and quantum content (QC) of EPC. With tetanic stimulation, the degree of rundown was calculated. 1) MEPC amplitudes were reduced under 1% and 2% halothane, to 80.9% and 71.6% respec- tively. of MEPC shortened to 84.1% and 70.7%. 2) Amplitudes of EPC lowered to 65.9% and 49.4% at 0.4 Hz, and 70.7% and 52.2% at 40 HZ. 3) QC of EPC diminished to 81.5% and 70.1% at 0.4 Hz, and 87.2% and 74.1% at 40 Hz. 4) THe degrees of rundown by the tetanic stimulation were augmented to 119.1% and 136.1%. It is concluded that halothane reduced the amplitude and time constant of decay of MEPC, and the amplitude and QC of EPC, and augmented the degree of rundown at tetanic stimulation.
Animals ; Control Groups ; Diaphragm* ; Halothane* ; Microelectrodes ; Phrenic Nerve ; Rats* ; Synaptic Transmission*

No abstract available.
Humans

PURPOSE: We examined the clinical and pathologic findings of small renal masses that were suspected to be malignant. We investigated the prevalence and the predictors of benign tumors. MATERIALS AND METHODS: We retrospectively reviewed the medical records of the patients who underwent surgeries for renal lesions between September 1994 and June 2007. We analyzed the pathologic reports and medical records of 586 patients who had a renal mass that was 4cm or less. The mean patient age was 53 years(age range: 15-82). There were 418 male patients(71.3%) and 168 females(28.7%). Multiple logistic regression analysis was done to determine the clinical factors associated with benign renal masses, including the radiological tumor size, a cystic versus solid appearance, gender, age and the presenting symptoms. RESULTS: Of the 586 renal masses, 62(10.6%) were benign, 520(88.7%) were renal cell carcinoma and 4(0.7%) were other malignancies. The proportion of benign lesions was significantly higher in the females than that in the males(21.4% vs. 6.2%, respectively, p<001) and the proportion of benign lesions was significantly higher for the smaller masses(0-2cm) than for the 2.1-4cm sized tumors(14.7% vs. 9.1%, respectively, p=0.048). On multivariate analysis, gender and tumor size were significantly associated with malignant histology with the males having an odds ratio(OR) of 4.16 (95% CI 2.41-7.19, p<0.001) and the tumor size more than 2cm having an OR of 1.93(95% CI 1.08-3.44, p=0.03). CONCLUSIONS: A considerable number(10.6%) of benign lesions 4cm or less in the radiological diameter were operated on based on suspicious preoperative imaging. The results of this study seem to help not only for counseling the patients, but also for deciding on a therapeutic modality preoperatively.
Carcinoma, Renal Cell ; Counseling ; Female ; Humans ; Kidney Neoplasms ; Logistic Models ; Male ; Medical Records ; Multivariate Analysis ; Nephrectomy ; Prevalence ; Retrospective Studies

Concurrent presentation of acute hepatitis A virus (HAV) infection and Graves' disease has not been reported in literature worldwide. Although there is no well-established mechanism that explains the induction of Graves' disease by HAV to date, our case suggests that HAV infection may be responsible for inducing Graves' disease. A healthy 27-year-old female presented fever, palpitation, and diarrhea, and she was subsequently diagnosed as acute HAV infection. Concurrently, she showed hyperthyroidism, and the diagnosis was made as Graves' disease. She had never had symptoms that suggested hyperthyroidism, and previous thyroid function test was normal. Acute HAV infection was recovered by conservative management, however, thyroid dysfunction was maintained even after normalization of liver enzymes. Methimazole was used to treat Graves' disease. We report a case of concurrent acute HAV infection and Graves' disease in a patient without preexisting thyroid disease. This suggests that HAV infection may be a trigger for an autoimmune thyroid disease in susceptible individuals.
Adult ; Diagnosis ; Diarrhea ; Female ; Fever ; Graves Disease* ; Hepatitis A virus* ; Hepatitis A* ; Hepatitis* ; Humans ; Hyperthyroidism ; Liver ; Methimazole ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland

Chloroma is an invasive extramedullary tumor composed of immature myeloid cells, which complicates the clinical course in a minority of patients with acute myeloid leukemia (AML). The presence of myeloid sarcoma is known to be a poor prognostic indicator in patients with AML. However, the optimal treatment of AML with concurrent chloroma has not been determined. We report four patients with AML accompanied by concurrent chloroma from the time of initial diagnosis. All of the patients underwent hematopoietic stem cell transplantation after complete remission. We also present a review of the literature.
Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Leukemia, Myeloid, Acute ; Myeloid Cells ; Sarcoma, Myeloid

The occurrence of granulocytic sarcoma as a pattern of relapse after allogenic bone marrow transplantation (allo-BMT) is rare. We report two AML1/ETO positive patients with granulocytic sarcoma as a pattern of relapse after allo-BMT. The first case is 39-year-old woman who had lower back pain without any abnormal peripheral blood exam. MRI showed a paraspinal mass, and the pathologic report was granulocytic sarcoma. The second case is 34-year-old woman who had breast humps without any abnormal peripheral blood exam. CT showed multiple breast masses, and the pathologic report was granulocytic sarcoma. We believe that this is the first cases report of extramedullary relapse after allo-BMT in AML1/ETO positive AML in Korea. These cases suggest that we should be aware of the possibility of an extramedullary relapse in bone marrow transplant recipients with AML1/ETO positive AML.
Adult ; Bone Marrow ; Bone Marrow Transplantation ; Breast ; Female ; Humans ; Korea ; Low Back Pain ; Magnetic Resonance Imaging ; Recurrence* ; Sarcoma, Myeloid ; Transplantation

We present cases of post traumatic infarction after head injury. Two patients were admitted to our emergency room after traffic accidents. They developed neurological deficiency after a few hours to days after the accidents. In both cases, an initial computed tomography scan of the head was normal. A follow-up computed tomography obtained later revealed a hypodense lesion at cerebral hemisphere and a diffusion-weighted magnetic resonance imaging disclosed an area of infarction. The patients were conservatively medicated. One patient died due to a medical complication and the other patient fully recovered in several weeks. Hospital admission, careful observation and early diffusion-weighted magnetic resonance examination should be considered for patients with persistent neurological deficits.
Accidents, Traffic ; Cerebral Infarction ; Cerebrum ; Craniocerebral Trauma ; Emergencies ; Follow-Up Studies ; Head ; Humans ; Infarction ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy

Fetus in fetu is an extremely uncommon cause of abdominal mass in the neonate with an incidence of 1 in 500,000 births. This is thought to occur when a monozygotic, diamniotic twin is incorporated into the body of its sibling early in embryonic development. A case of retroperitoneal fetus in fetu in a 3 day old male infant is reported, the excised round mass contained the vertebral column, 2 feet, 2 arms, small penis and testis. The presence of vertebral axis and organogenesis differentiates it from a teratoma. More than 100 cases of fetus in fetu have been reported, most of which have been in the abdomen. We report a case of a well developed fetus in the retroperitoneal area of a neonate delivered at term.
Abdomen ; Arm ; Axis, Cervical Vertebra ; Embryonic Development ; Female ; Fetus* ; Foot ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Organogenesis ; Parturition ; Penis ; Pregnancy ; Siblings ; Spine ; Teratoma ; Testis

H. pylori produces urease abundantly amounting to 6% of total protein of bacterial mass. Urease genes are composed of a cluster of 9 genes of ureC, ureD, ureA, ureB, ureI, ureE, ureF, ureG, ureH. Production of H. pylori urease in E. coli was studied with genetic cotransformation. Structural genes ureA and ureB produce urease apoprotein in E, coli but the apoprotein has no enzymatic activity. ureC and ureD do not affect urease production nor enzyme activity ureF, ureG, and ureH are essential to produce the catalytically active H. pylori urease of structural genes (ureA and ureB) in E.coli. The kinetics of activation of H. pylori urease apoprotein were examined to understand the production of active H. pylori urease. Activation of H. pylori urease apoprotein, pH dependency, reversibility of CO2 binding, irreversibility of CO2 and Ni2+ incorporation, and CO2 dependency of initial rate of urease activity have been observed in vitro. The intrinsic reactivity (ko) for carbamylation of urease apoprotein coexpressed with accessory genes was 17-fold greater than that of urease apoprotein expressed without accessory genes. It is concluded that accessory genes function in maximizing the carbamylating deprotonated E-amino group of Lys 219 of urease B subunit and metallocenter of urease apoprotein is supposed to be assembled by reaction of a deprotonated protein side chain with an activating CO2 molecule to generate ligands that facilitate productive nickel binding.
Apoproteins* ; Helicobacter pylori* ; Helicobacter* ; Hydrogen-Ion Concentration ; Kinetics ; Ligands ; Nickel ; Urea ; Urease*

BACKGROUND: Double autologous stem cell transplantation (ASCT) seems to be superior to a single ASCT, at least in the patients who did not achieve a 90% response after the first transplant. An allogeneic SCT with a dose-reduced conditioning regimen after ASCT and as part of the initial therapy, might be a feasible and highly effective approach. The aim of this study was to determine the prognostic factors that are associated with the outcome of multiple myeloma (MM) patients who had received a second transplant. METHODS: From April 1996 to December 2004, 38 MM patients, who had previously received high-dose melphalan (200 mg/m2) with autologous stem cell support, underwent a second transplant. Following the 1(st) ASCT, 24 patients received a second ASCT and 14 received a tandem reduced-intensity conditioning allogeneic stem cell transplantation (RIST) from their HLA-matched siblings. RESULTS: The 3-year estimated PFS and overall survival (OS) from the time of the first ASCT were 25.2% and 77.6%, respectively. The median PFS and OS were 26 months (95% CI, 23~29) and 60 months (95% CI, 44~76), respectively. The disease status (a CR vs. PR or less) at the second transplant was be the most powerful factor for improving the PFS (P=0.001, hazard ratio 5.8, 95% CI 2.1~16.1). CONCLUSION: Patients whose disease is sensitive to chemotherapy and who obtain a CR after a single transplantation might benefit the most from a second transplant.
Drug Therapy ; Humans ; Melphalan ; Multiple Myeloma ; Siblings ; Stem Cell Transplantation* ; Stem Cells*