No abstract available.

Hypothalamic suprachiasmatic nucleus (SCN) is a circadian pacemaker which controls diurnal behavioral and hormonal rhythms in mammals. The SCN receives environmental light signals through the retinohypothalamic tract, and glutamate is the major excitatory neurotransmitter in the retinohypothalamic tract. In the present study, we investigated the developmental expression of the mRNAs for N-methyl-D-aspartate type glutamate receptor (NR)1, NR2A, NR2B and NR2C subunits in the rat SCN using in situ hybridization with specific riboprobes. At postnatal day 2 (P2), P8, Pl5 and P45, the high level of NRI transcripts was observed in both ventrolateral and dorsomedial subdivisions of the SCN, and the distinct expression of NR2C mRNA was principally found in the dorsomedial SCN. The weak NR2B mRNA expression was clearly found in both subdivisions of the SCN at P2 and P8, whereas specific NR2B hybridization signals were not found at Pl5 and P45. There was no specific hybridization signal of NR2A in the SCN throughout the postnatal life. These findings implicate that NR may play an important role in the neonatal SCN. In addition, this study suggests that NR1, NR2B and NR2C might be the major NR subunits in the developing SCN, whereas NRI and NR2C could be the subunit components of NR in the adult SCN.
Adult ; Animals ; Glutamic Acid ; Humans ; In Situ Hybridization ; Mammals ; N-Methylaspartate* ; Neurotransmitter Agents ; Rats* ; Receptors, Glutamate ; RNA, Messenger* ; Suprachiasmatic Nucleus

OBJECTIVE: A retrospective review of premedication method and drug resistance of aspirin and clopidogrel in association with thromboembolic events during and after coil embolization of an unruptured intracranial aneurysm was conducted. METHODS: Our premedication policy for coil embolization of an unruptured intracranial aneurysm has changed from administration of the loading dose before the procedure (i.e. loading group) to repeated administration of the maintenance dose for several days (i.e. preparation group). The loading group (27 patients with 29 aneurysms) and the preparation group (30 patients with 35 aneurysms) were compared for identification of the effect of premedication method on periprocedural thromboembolic events. The results of drug response assays of the preparation group were analyzed with respect to periprocedural thromboembolic events. RESULTS: No statistically significant difference in incidence of thromboembolic events was observed between the loading group and the preparation group. Analysis of the results of the drug response assay showed high prevalence (56.7%, 73.3%) of clopidogrel resistance and relatively low prevalence (6.7%) of aspirin resistance. Patients who had thromboembolic events tended to have lower responsiveness to both aspirin and clopidogrel than patients without it. CONCLUSION: The method of antiplatelet premedication does not affect the rate of periprocedural thromboembolic events in coil embolization for treatment of an unruptured intracranial aneurysm. Nevertheless, considering the high prevalence of drug resistance, it is reasonable to premedicate antiplatelet agents in the preparation method for the drug response assay. Use of a higher dose of aspirin and clopidogrel or addition of an alternative drug (cilostazol or triflusal) can be applied against antiplatelet agent resistance. However, because the hemorrhagic risk associated with this supplementary use of antiplatelet agent has not been well-documented, the hemorrhagic risk and the preventive benefit must be weighed.
Aspirin ; Drug Resistance ; Humans ; Incidence ; Intracranial Aneurysm ; Platelet Aggregation Inhibitors ; Premedication ; Prevalence ; Retrospective Studies ; Ticlopidine

OBJECTIVE: Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. METHODS: Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. RESULTS: There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. CONCLUSION: Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.
Accidents, Traffic* ; Adjustment Disorders* ; Depression ; Diagnosis, Differential ; Hypochondriasis ; Hysteria ; Memory Disorders ; Memory* ; MMPI ; Paranoid Disorders ; Prognosis ; Schizophrenia ; Stress Disorders, Post-Traumatic*

Spinal and epidural anesthesia were performed with a 26 gauge, long spinal needle through a 17 gauge Tuohy needle in thirty patients undergoing elective Caesarian section. To study the effects of subarachnoid local anesthetic solution, the thirty patients were classified into 3 groups on the anesthetics used respectively; a group treated with 0,5% hyperbaric tetracaine 10 mg alone (group I), a group treated 0.5% hyperbaric tetracaine 10 mg and fentanyl 10 mg (group II), a group treated 0.5% hyperbaric tetracaine 10 mg, fentanyl 10 ug and epinephrine 0.3 mg (group III). Each group contained 10 patients. The results were as follows. 1) Onset time of analgesia to T10 sensory level was significantly longer in group IlI than in remained groups and that to T4 sensory level was significantly shorter in group II than in other groups (p<0.05). 2) The time recovered from motor and sensory block was significantly longer in group III than in other groups (p<0.05). 3) The time requiring fentanyl from postoperative pain was significantly longer in group III than in other groups (p<0.05). 4) Complications after postoperative pain block were as follows; delayed awakening (3 cases), itching (3 cases), and one was nausea and vomiting. However serious complications such as respiratory depression did not occurred. In summary, We can concluded that use of needle-through-needle method of anesthesia for elective Caesarian section has benifits not only of spinal anesthesia but also of facilitating postoperative pain block.
Analgesia ; Anesthesia ; Anesthesia, Conduction* ; Anesthesia, Epidural ; Anesthesia, Spinal ; Anesthetics ; Epinephrine ; Fentanyl ; Humans ; Nausea ; Needles ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Tetracaine ; Vomiting

For anesthesia of sixty children undergoing elective tonsillectomy, we randomly assigned the patients as 2 groups, intravenous propofol for induction and 6-12 mg/kg/hr propofol infusion with 66% nitrous oxide for maintenance(propofol group) or intravenous 4 mg/kg thiopental for induction and inhalation of enflurane with 66% nitrous oxide for maintenance(enflurane group). We compared the effects of two groups for induction time, hemodynamic change, recovery time, and side effects. The results were as follows. 1) Time for loss of eyelid reflex was significantly shorter in enflurane group than in propofol group(P <0.05). 2) Heart rate was increased significantly in both groups at 1 min after intubation, 1 min after operation, 5min after end of operation(P< 0.05). But there were no significant differences between groups. 3) Systolic and diastolic arterial pressure were increased significantly in both groups at 1 min after intubation(P<0.05). But there were no siginificant differences between groups. 4) The recovery time was shorter siginificantly in propofol group than in enflurane group(P< 0.05), and recovery scores according to modified Steward coma scale were higher in propofol group than in enflurane group until 25 min after end of anesthesia(P< 0.05). 5) Pain on injection at induction was siginificantly more frequent in propofol group than in enflurane group(P< 0.05), and excitatory effect during emergence was significantly more frequent in enflurane group than in propofol group(P< 0.05).
Anesthesia ; Arterial Pressure ; Child* ; Coma ; Enflurane* ; Eyelids ; Heart Rate ; Hemodynamics ; Humans ; Inhalation ; Intubation ; Nitrous Oxide ; Propofol* ; Reflex ; Thiopental ; Tonsillectomy*

In a placebo-controlled trial, we have studied the vasodilator properties of bolus dose of nitroglycerin, isosorbide dinitrate and chlorpromazine in 38 patients during cardiopulmonary bypass with a constant pump flow. Mean arterial pressure and blood volume of the venous reservoir were recorded for 10 min after drug administration to detect changes in arteriolar resistance and venous capacitance, respectively. Nitroglycerin, 2.5 ug/kg, decreased arterial pressure, but the effect lasted for 3 minutes. Chlorpromazine, 0.1 mg/kg, decreased arterial pressure for 9 minutes. Isosorbide dinitrate, 20 ug/kg, had no significant change on arterial pressure. The venous capacitance-increasing effects of nitroglycerin and chlorpromazine were significant for 4 minutes after the bolus. Thereafter the effect of nitroglycerin began to decline, while that of chlorpromazine significantly continued. Isosorbide dinitrate had no significant change on venous reservoir level. The SVR reduction effects of nitroglycerin was significant for 3 minutes, chlorpromazine decreased SVR for over 10 minutes. In conclusion chlorpromazine effect on arterial pressure and venous capacitance was more potent and longer than nitroglycerin and isosorbide dinitrate. Nitroglycerin and chlorpromazine effect on preload and afterload were significant after bolus dose.
Arterial Pressure ; Blood Volume ; Cardiopulmonary Bypass ; Chlorpromazine* ; Humans ; Isosorbide Dinitrate* ; Isosorbide* ; Nitroglycerin* ; Vascular Access Devices

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

Systemic lupus ertthematosus(SLE) is a prototypic autoimmune disease characterized by the production of antibodies to components of the cell nucleus in association with a diverse array of clinical manifestations. Infection is a major source of morbidity and mortality in parients whth SLE. Although the most frequent etiologic agents are pyogenic organisms such as Staphylococcus species and Echerichia coli, opportunistic pathogens such as uncommon bacteria, fungal organisms, viruses and protozoans have been described. Cases of osteomyelitis due to Salmonella have been reported worldwide, however, it has never been reported in the Korean literature. A 35-year-old female patient with SEL, who has treated with corticosteroid was complicated by osteomyelitis on the life distar femur. A computerized tomography guided aspiration showed greenish yellow pus. Salmonella enteritidis was cultured from the pus. Incision and pus drainage was performed. After 6weeks of antiboitic theraphy, fever, local heat, and swelling improved and she was discharged. We report this patient with a review of relevant literatures.
Adult ; Antibodies ; Autoimmune Diseases ; Bacteria ; Cell Nucleus ; Drainage ; Female ; Femur ; Fever ; Hot Temperature ; Humans ; Lupus Erythematosus, Systemic* ; Mortality ; Osteomyelitis* ; Salmonella enteritidis ; Salmonella* ; Staphylococcus ; Suppuration

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*