We analyzed the mRNA expression patterns of major potassium channel genes to determine the mechanism of hypokalemia in familial hypokalemic periodic paralysis. We used quantitative RT-PCR to examine the mRNA levels of both inward (KCNJ2, KCNJ6, and KCNJ14) and delayed rectifi er (KCNQ1 and KCNA2) potassium channel genes in skeletal muscle cells from both normal and patient groups, prior to and after exposure to 4 mM and 50 mM potassium buffers. Quantitative RT-PCR analysis revealed no changes in the mRNA levels of these genes in normal and patient cells on exposure to 4 mM potassium buffer. However, after exposure to 50 mM potassium buffer, which was used to induce depolarization, normal cells showed a signifi cant decrease in KCNJ2, KCNJ6, and KCNJ14 expression, but no change in KCNQ1 and KCNA2 expression. In contrast, patient cells showed no change in KCNJ2 and KCNJ6 expression, but an increase in KCNJ14 expression. Furthermore, KCNQ1 and KCNA2 showed decreased expression. We found that the expression levels of both inward and delayed rectifi er potassium channel genes in patient cells differ from those in normal cells. Altered potassium channel gene expression in patient cells may suggest a possible mechanism for hypokalemia in familial hypokalemic periodic paralysis.

Moyamoya is a chronic cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal parts of both intermal carotid arteries with telangiectatic vascular network of collateral circulation at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. Although the idiopathic presentattion is the commonest, moyamoya disease has also been reported in several hereditary or acquired clinical conditions including neurofibromatosis, sickle cell anemia, tuberculous meningitis, atherosclerosis, and following radiation therapy to the head. The term moyamoya disease should be reserved for those cases in which the characteristic angiogrphic pattern is idiopathic; moyamoya syndrome is used when the underlying condition is known. We have experienced a case of coexistence of moyamoya syndrome and hereditary spherocytosis in a 6-year-8-month-old girl who presented with right-sided hemiparesis and pallor. A cerebral angiogram revealed occlusion of proximal portion of left middle cerebral artery and abnormal collateral network. The peripheral blood smear and osmotic fragility test disclosed hereditary spherocytosis. To our knowledge, the coexistence of moyamoya syndrome and hereditary spherocytosis has not been documented. We report here the case and the brief review of related literatures. Further studies are needed to clarify the intimate relationship between the two diseases.
Anemia, Sickle Cell ; Arteries ; Atherosclerosis ; Brain ; Carotid Arteries ; Collateral Circulation ; Constriction, Pathologic ; Female ; Head ; Humans ; Middle Cerebral Artery ; Moyamoya Disease* ; Neurofibromatoses ; Osmotic Fragility ; Pallor ; Paresis ; Tuberculosis, Meningeal

An inferior vena cava (IVC) filter is a useful treatment to prevent a pulmonary embolism (PE) in patients with DVT. Since the introduction of IVC filters more than 30 years ago, there has been a steady improvement in the design, ease and safety of the delivery system. The use of a temporary filter has also increased as performing thrombolysis and thrombectomy has increased. Today all of the commonly used filters can be placed via a peripheral vein by using the standard percutaneous Seldinger (Ed note: check the spelling) technique. However this typically requires fluoroscopy, intravenous contrast agents, radiation exposure and transport of the patient to the interventional or operating suite. As the multiple trauma injured or critically-ill intensive care unit patients often require inotropic and ventilator support, transporting these patients to these facilities can be hazardous. The following report describes two cases of VTE patients who underwent percutaneous placement of an IVC filter with using duplex ultrasound guidance. Identification of the renal vein and artery is important to decide the infrarenal level. The first case was an 84 years female with right ilio-femoral DVT and pulmonary embolism. To prevent recurrence of PE, we decided to insert an IVC filter. The second case was a 47 years female with right femoral DVT together with left pulmonary embolism and infarction. She also had thrombocytopenia, which is a contraindication for anticoagulation. IVC filter insertion can be safely performed under ultrasound guidance. This technique will reduce the risk and complexity of inserting an IVC filter in selected multiple injured trauma patients.
Arteries ; Contrast Media ; Female ; Fluoroscopy ; Humans ; Infarction ; Intensive Care Units ; Multiple Trauma ; Pulmonary Embolism ; Recurrence ; Renal Veins ; Thrombectomy ; Thrombocytopenia ; Veins ; Vena Cava Filters ; Vena Cava, Inferior ; Ventilators, Mechanical

The purpose of this study was to regenerate human dental pulp tissues similar to native pulp tissues. Using the mixture of type I collagen solution, primary cells collected from the different tissues (pulp, gingiva, and skin) and NIH 3T3 (1 x 10(5) cells/ml/well) were cultured at 12-well plate at 37degrees C for 14 days. Standardized photographs were taken with digital camera during 14 days and the diameter of the contracted collagen gel matrix was measured and statistically analyzed with student t-test. As one of the pulp tissue engineering, normal human dental pulp tissue and collagen gel matrix cultured with dental pulp cells for 14 days were fixed and stained with Hematoxyline & Eosin. According to this study, the results were as follows: 1. The contraction of collagen gel matrix cultured with pulp cells for 14 days was significantly higher than other fibroblasts (gingiva, skin) (p < 0.05). 2. The diameter of collagen gel matrix cultured with pulp cells was reduced to 70.4% after 7 days, and 57.1% after 14 days. 3. The collagen gel without any cells did not contract, whereas the collagen gel cultured with gingiva and skin showed mild contraction after 14 days (88.1% and 87.6% respectively). 4. The contraction of the collagen gel cultured with NIH 3T3 cells after 14 days was higher than those cultured with gingival and skin fibroblasts, but it was not statistically significant (72.1%, p > 0.05). 5. The collagen gel matrix cultured with pulp cells for 14 days showed similar shape with native pulp tissue without blood vessels. This approach may provide a means of engineering a variety of other oral tissue as well and these cell behaviors may provide information needed to establish pulp tissue engineering protocols.
Blood Vessels ; Collagen ; Collagen Type I* ; Dental Pulp* ; Eosine Yellowish-(YS) ; Fibroblasts ; Gingiva ; Hematoxylin ; Humans ; NIH 3T3 Cells ; Skin ; Tissue Engineering*

A 46-year old woman presented with progressive limb weakness and fatigue. Laboratory tests showed abnormalities consistent with autoimmune hepatitis and she was diagnosed with biopsy-proven inflammatory myopathy. The patient was commenced on immunosuppressive therapy with azathioprine 50 mg and prednisolone 1 mg/kg. At the six-month follow up, her symptoms subsided and aminotransferase and muscle enzymes were normalized. This case presents rare case of concomitant development of polymyositis and autoimmune hepatitis.
Autoimmunity ; Azathioprine ; Extremities ; Fatigue ; Female ; Follow-Up Studies ; Hepatitis ; Hepatitis, Autoimmune* ; Humans ; Myositis ; Polymyositis* ; Prednisolone

The obturator bypass operation is not a common procedure. In 1963, Shaw and Baue first described performing bypass surgery through the obturator foramen as a technique to deal with infected arterial prostheses in the groin. This operation has been used to reconstruct patients with groin infection, irradiation ulcer, mycotic aneurysm, trauma and excessive scar tissue in the femoral region. We experienced one case of transobturator foramen bypass surgery from a Dacron iliac limb to the popliteal artery.
Aneurysm, Infected ; Cicatrix ; Extremities ; Groin ; Humans ; Polyethylene Terephthalates ; Popliteal Artery ; Prostheses and Implants ; Ulcer

Accurate estimation of the exposure-response relationship between ambient urban particulate matters (PM) and public health is important for regulatory perspective of ambient urban particulate matters (PM). Ambient PM contains various transition metals and organic compounds. PM10 (aerodynamic diameter less than 10 microgram) is known to induce diverse diseases such as chronic cough, bronchitis, chest illness, etc. However, recent evaluation of PM2.5 (aerodynamic diameter less than 2.5 microgram) against health outcomes has suggested that the fine particles may be more closely associated with adverse respiratory health effects than particles of larger size. This study was performed to evaluate PM2.5-induced oxidative stress in rat lung epithelial cell in order to provide basic data for the risk assessment of PM2.5. PM2.5 showed higher cytotoxicity than PM10. Also, PM 2.5 induced more malondialdehyde (MDA) formation than PM10. In Hoechst 33258 dye staining and DNA fragmentation assay, apopotic changes were clearly detected in PM2.5 treated cells in compared to PM10. Expression of catalase mRNA was increased by PM2.5 rather than PM10. PM2.5 induced higher Mth1 mRNA than PM10. In pBR322 DNA treated with PM2.5, production of single strand breakage of DNA was higher than that of PM10. In Western blot analysis, PM2.5 induced more Nrf-2 protein, associated with diverse transcriptional and anti-oxidative stress enzymes, compared to PM10. Our data suggest that PM2.5 rather than PM10 may be responsible for PM-induced toxicity. Additional efforts are needed to establish the environmental standard of PM2.5.
Air Pollutants/chemistry/*toxicity ; Animals ; Apoptosis/physiology ; Benzimidazoles/metabolism ; Blotting, Western ; Cell Line ; Cell Survival/physiology ; DNA Fragmentation/physiology ; DNA Repair Enzymes/genetics/metabolism ; DNA-Binding Proteins/metabolism ; Epithelial Cells/drug effects/enzymology/pathology ; Formazans/metabolism ; GA-Binding Protein Transcription Factor ; Lipid Peroxides/metabolism ; Lung Diseases/*chemically induced/enzymology/pathology ; Oxidative Stress/*physiology ; RNA, Messenger/chemistry/genetics ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Tetrazolium Salts/metabolism ; Transcription Factors/metabolism

BACKGROUND: According to domestic studies, patients visiting the emergency departments (ED) with acute toxic exposure comprise 0.68%–5.5% of all ED patients, with various causes and motives. The purpose of this study is to investigate the clinical and social characteristics of patients with toxic exposure visiting the ED. METHODS: This study spanned a period of five years, from January 1, 2009 to December 31, 2013. The data were extracted using the National Emergency Department Information System (NEDIS) and The Korea Health Insurance Review and Assessment Service (HIRA). RESULTS: From the HIRA database, during the study period (2009–2013); 310,159 (2009), 289,829 (2010), 288,906 (2011), 285,514 (2012), and 279,575 (2013) patients, respectively, visited EDs with diagnoses related to exposure to toxic substances. The number of patients who presented with acute toxic exposure compared to all ED visits significantly decreased consistently (7.8%, 6.9%, 6.0%, 5.0%, 4.1%) over 5 years. Regarding the cause of toxic exposure, substances other than drugs accounted for the largest percentage, and increased annually. Acetylcysteine was the most commonly prescribed antidote, and patients in their 40s and 50s showed the most frequent visits. The monthly distribution was highest in July-September, and higher in January than in other months. CONCLUSION: This study found that the percentage of patients visiting the ED is decreasing, the exposure to quasi-drugs was the most common, and the exposure to antipsychotic drugs was the most frequent.
Acetylcysteine ; Antipsychotic Agents ; Diagnosis ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Epidemiology ; Humans ; Information Systems* ; Insurance, Health* ; Korea* ; Poisoning ; Sociological Factors

PURPOSE: Sometimes, there are endograft shortenings during endovascular aneurysm repair (EVAR). They are associated with various changes of endograft position in a 3-dimensional (3D) space. The purpose of this study is to evaluate the accuracy of central luminal line (CLL) measurements and understand the degree of endograft shortenings. METHODS: Preoperative 3D computed tomographic (CT) scans were evaluated for every EVAR case. Preoperative working lengths were measured with computerized software that allowed for centerline measurements on 3D reconstructions based on CT data. We compared preoperative CLL measurements and used the endograft length. In this study, the ipsilateral limb length comparisons were excluded, because the overlapped stent-graft length can influence the total ipsilateral limb length. Hence, only the contralateral limb lengths were compared with each other. RESULTS: Preoperative contralateral lengths in the 9 limbs were studied. There was no large difference (below 10 mm) in almost all cases except for one (15 mm shortening), which was very tortuous aortoiliac anatomy. The mean difference between preoperative CLL measurements and the used stent-graft length was 4.48 mm. CONCLUSION: Although these shortenings can be overcome with the deployment technique, the operator should prepare various length extensions in tortuous anatomy.
Aneurysm ; Aortic Aneurysm, Abdominal ; Extremities ; Phenobarbital

Tortuousity of the vertebral artery is clinically uncommon because it rarely causes symptoms. We described a patient with pain in the neck and both upper extremities in whom diagnosis of intervertebral foraminal widening and deformity of the vertebral artery were suggested by results of radiography and magnetic resonance. We confirmed the tortuous vertebral artery by results of computed tomography angiography. Correlation of the patient's symptoms and abnormalities was not clear; conservative treatment was administered.
Angiography ; Congenital Abnormalities ; Humans ; Magnetic Resonance Spectroscopy ; Neck ; Upper Extremity ; Vertebral Artery