Tri- and tetra-cyclic antidepressants are known to cause dry mouth among other several major complications. The present study was designed to compare the degree of reduced salivation due to antidepressants and to explore whether intracellular calcium-increasing agents ameliorate the salivation. Effects of antidepressants and agents increasing intracellular calcium on the cholinergic submandibular secretion and blood flow induced by the chorda stimulation or intra-arterial acetylcholine were observed in anesthetized cats. Effects of antidepressants and calcium-mobilizing agents on K+ efflux were also observed in excised gland slices. The results obtained were as follows: 1. Salivary secretion in response to the chorda stimulation (3 V, 20 Hz, 1 msec) was significantly attenuated by antidepressants in a dose-dependent manner, whereas the blood flow was not affected. 2. Salivary secretion and increased blood flow evoked by intra-arterial acetylcholine (20 microgram/kg) were markedly diminished by antidepressants, the magnitude of which was amitryptyline>imipramine >mianserin in order. 3. Cholinergic salivation was significantly decrease by cyclopiazonic acid, a calcium pump inhibitor of the endoplasmic reticulum, or by BAPTA/AM, a specific intracellular calcium chelator. 4. Caffeine and ryanodine potentiated the cholinergic salivation and ameliorated the depressed salivary secreation due to antidepressants. 5. Calcium ionophore A 23187 ameliorated the depressed salivation due to antidepressants. 6. Antidepressants inhibited the K+ efflux, which were restored by caffeine or A 23187. These results suggest that the depressed salivary secreation due to antidepressants is ameliorated by increasing intracellular calcium levels.
Acetylcholine ; Animals ; Antidepressive Agents ; Caffeine ; Calcimycin ; Calcium* ; Cats ; Endoplasmic Reticulum ; Mouth ; Ryanodine ; Salivation*

PURPOSE: The most common complication of Kawasaki disease(KD) is the development of coronary artery aneurysm. Other cardiac complication include myocarditis, pericarditis, mitral or aortic insufficiency, congestive failure, and arrhythmia. These non- coronary cardiac problems have important role on clinical course in acute phase of KD. Extensive researches have been performed about the pathogenesis, natural course and treatment of coronary artery lesion. But the studies about non-coronary cardiac complication have been limited, so we aimed to study the manifestation, incidence, and clinical predictor of carditis. METHODS: The retrospective studies was performed to the 48 KD patients diagnosed in Chungnam National University Hospital from May 1998 to September 2004. The patients were divided into two groups. Patients with carditis(11 patients) and without carditis(37 patients) before receiving the IVGG infusion were analyzed. RESULTS: There were no differences in age and sex between two groups. Patients with long duration of fever and high Harada score had the significant increase in the incidence of carditis before the initial IVGG infusion. No significant differences were not shown between the two groups in terms of WBC count, hemoglobin, hematocrit, platelet count, total protein, AST/ALT, LDH, CPK, troponin I, total cholesterol, and triglyceride before the initiL IVGG infusion. The incidence of carditis was high in patient with high CRP, low albumin, and high cholesterol and triglyceride. CONCLUSION: The possibility of significant carditis should be considered before the infusion of high dose IVIG, which may worse the caridac dysfunction. Some predictors of significant carditis such as long duration of fever, high Harada score, high levels of CRP, and low levels of albumin can be suggested.
Aneurysm ; Arrhythmias, Cardiac ; Child* ; Cholesterol ; Chungcheongnam-do ; Coronary Vessels ; Estrogens, Conjugated (USP) ; Fever ; Hematocrit ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis* ; Pericarditis ; Platelet Count ; Retrospective Studies ; Risk Factors* ; Triglycerides ; Troponin I

Endogenous nitric oxide (NO) has been known to regulate the salivary secretion and glandular blood flow. However, the distribution of nitric oxide synthase (NOS) responsible for NO synthesis has not been well studied in salivary glands. The present study was aimed to investigate the distribution of nitric oxide synthase isoforms (endothelial, neuronal, and inducible NOS). Immunohistochemistry, using monoclonal mouse anti-endothelial NOS, anti-neuronal NOS, and anti-inducible NOS, was performed in 3 major salivary glands (parotid, submandibular and sublingual gland) of the rat. Endothelial NOS (eNOS)-positive immunoreactivity was observed in arterial endothelium, striated duct, granular convoluted duct of the submandibular gland, intercalated duct, and mucous acinar cells of the sublingual gland. The eNOS-positive immunoreactivity was most prominent in the arterial endothelial layer and that of the striated and granular convoluted duct was well concentrated in columnar epithelial layer. In the intercalated duct and mucous acinus, eNOS-positive immunoreactivity was weakly detected. Neural NOS (nNOS)-positive immunoreactivity was observed in submandibular ganglion, autonomic postganglionic fiber, striated duct, granular convoluted duct, and intercalated duct. nNOS-positive immunoreactivity of the submandibular ganglion and autonomic postganglionic fiber was most prominent and that of the ductal system was well concentrated in the epithelial layer. eNOS-positive immunoreactivity was not detected either in excretory ducts or in serous acinar cells. Inducible NOS-positive immunoreactivity was not detected. There results reveal the presence of eNOS and nNOS in the salivary gland, which may be related with regulation of the glandular secretion and blood flow through synthesis and secretion of NO.
Acinar Cells ; Animals ; Endothelium ; Ganglia, Autonomic ; Ganglion Cysts ; Immunohistochemistry ; Mice ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Protein Isoforms ; Rats ; Salivary Glands* ; Sublingual Gland ; Submandibular Gland

A 49-year-old female presented with severe dyspnea. She was diagnosed with cardiac tamponade combined with ascending aortic pseudoaneurysm and rupture, which was caused by Klebsiella pneumoniae infection. This extremely rare condition was managed by an emergency pericardiostomy and two separate aortic operations. Antibiotics active for the K. pneumoniae isolate were used throughout. The patient was well for nine months after discharge and continues to be followed up for signs of possible reinfection.
Aneurysm, False ; Anti-Bacterial Agents ; Aortic Aneurysm ; Aortic Rupture* ; Cardiac Tamponade ; Dyspnea ; Emergencies ; Female ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Middle Aged ; Pericardial Window Techniques ; Pericarditis* ; Pneumonia ; Rupture

To evaluate the role of capsular polysaccharide (CPS) as a virulence factor, the interaction of V. vulnificus with mouse peritoneal macrophages and serum, which are involved in the clearance of bacteria from blood and other tissues, were examined. In this study, MO6-24/0 (wild strain; hemolysin- and capsule-positive), MO6-24/I' (acapsular spontaneous mutant), CVD 752 (acapsular transposon mutant), and CVD 707 (hemolysin-negative and capsule-positive mutant) were used. The strain with CPS (MO6-24/0 and CVD 707) were more resistant to phagocytosis by mouse peritoneal macrophages compared with acapsular strains (MO6-24/T and CVD 752), and the resistance to phagocytosis was not changed by serum opsonin in the capsular strains. Acapsular strains were more susceptible to serum bactericidal activity than the capsular strains through the classical complement pathway. MO6-24/0 strain were detected in blood, spleen, liver and lung at 4 hours after intraperitoneally infection, whereas CVD 752 were not detected. All tested strains could induced the transcription of inflammatory cytokine gene such as IL-1, IL-6, IL-10 and TNF-u, and their inductions were not decreased by cytochalasin B treatment. This results demonstrate that CPS of V. vulnificus plays an important role in V. vulnificus infection through interfering nonspecific host defense system such as blood clearance and phagocytosis.
Animals ; Bacteria ; Complement Pathway, Classical ; Cytochalasin B ; Interleukin-1 ; Interleukin-10 ; Interleukin-6 ; Liver ; Lung ; Macrophages, Peritoneal ; Mice ; Phagocytosis ; Spleen ; Vibrio vulnificus* ; Vibrio* ; Virulence*

OBJECTIVES: Despite remarkable development of pharmacotherapy for schizophrenia, some patients continuously have had violence problems. The violence of psychotic patients is recently becoming the focus of the attention. The aim of this study is to investigate the influence of Cognitive Behavioral Therapy (CBT) on patients with schizophrenia having violence related history. METHODS: 15 Patients with schizophrenia spectrum disorder of crime history were treated with individual CBT for 12 sessions, and assessed with 4 scales (Korean version of Aggression Questionnaire, Korean version of the Barratt Impulsiveness Scale-11-Revised, Beck Cognitive Insight Scale and Positive and Negative Syndrome Scale) to evaluate anger, impulse, insight and clinical symptoms respectively at baseline and post treatment. The comparison group consisted of 15 patients with schizophrenia spectrum disorder of crime history. They were also assessed with the same scales during the same period. RESULTS: Although impulsivity is not changed significantly after treatment, but there was significant improvement in clinical symptom, insight and aggression, especially self-reflectiveness and anger respectively. CONCLUSION: CBT can be one of the good therapeutic tools for patients with schizophrenia having violence problems in that it reduces aggression and enhances insight of patients with schizophrenia spectrum disorder.
Aggression ; Anger ; Case-Control Studies* ; Cognitive Therapy* ; Crime* ; Drug Therapy ; Humans ; Impulsive Behavior ; Surveys and Questionnaires ; Schizophrenia* ; Violence ; Weights and Measures

No abstract available.
Nitric Oxide Synthase* ; Nitric Oxide*

BACKGROUND: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4–6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. METHODS: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed. RESULTS: Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively). CONCLUSION: We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.
Arteriovenous Fistula* ; Cerebrovascular Disorders ; Forearm* ; Humans ; Polytetrafluoroethylene* ; Retrospective Studies ; Transplants*

Cryosupernatant which is the residual plasma fraction after removing cryoprecipitate has been used for plasma exchange in thrombotic thrombocytopenic purpura and hemolytic uremic syndrome replacing the fresh frozen plasma. Recently, the unusually large yon Willebrand factor multireefs (ULvWFM) has been observed in patients with refractory or chronic relapsing hemolytic uremic syndrome as well as thrombotic thrombocytopenic purpura which disappeared by infusion or plasma exchange with cryosupernatant, and infusion of fresh frozen plasma, the largest multimers of yon Willebrand factor were replenished that it might be a cause of refractoriness. This study was conducted to investigate the characteristics of home-made cryosupernatant from thawed fresh frozen plasma and its thehrapeutic effect in a hemolytic uremic syndrome patient. The level of fibrinogen, coagulation factor VIII, vWF antigen, and ristocetin cofactor activity was decreased and yon Willebrand factor multimers were barely seen in cryosupernatant than those of in fresh frozen plasma. A hemolytic uremic syndrome patient tried with exchange and infusion of cryosupernatant showed excellent recovery. It is concluded that home-made cryosupernatant shares many of the features of fresh frozen plasma except factor VIII, especially von Willebrand factor multimers, and thus it could be a useful alternative to fresh frozen plasma in case of refractory hemolytic uremic synydrome.
Factor VIII ; Fibrinogen ; Hemolytic-Uremic Syndrome ; Humans ; Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic ; von Willebrand Factor

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins