Sustained downgaze mostly occurs in association with lesions affecting the dorsal midbrain. We report sustained downgaze in a patient with hepatic encephalopathy. The sustained downgaze existed for seven more days after she regained her consciousness. The persistent downgaze even after regaining full consciousness indicates localized pretectal dysfunction rather than diffuse encephalopathy as the mechanism of sustained downgaze in our patient. The ocular motor dysfunction in hepatic encephalopathy may be due to localized dysfunction of the brainstem

BACKGROUND: Although exact mechanism of adult respiratory distress syndorme (ARDS) is not known, many evidences suggest that inflammatory mediators such as protease and oxygen radicals may be the final common pathway to the endothelial injury. It is gradually accepted that activated neutrophils play a major role in the process. Pentoxifylline is a methylated xanthine with a wide range of actions that make it theoretically useful in the treatment of ARDS. Studies show that it decreases neutrophil phagocytosis and superoxied production. The aim of this experiment is to determine whether pentoxifylline has a preventive effect on oleic acid-induced lung injury. METHODS: Oleic acid (0.08 ml/kg) was infused in 10 mongrel dogs in order to induce acute lung injury. Pentoxifylline (20 mg/kg) was administered 40 mins before oleic acid injection. The author made a comparative studies on the effects of pentoxifylline on hemodynamics and gas exchange before oleic acid injection and at 15, 30, 45, 60, 90 mins after oleic acid injection. RESULTS: There were not significant changes in mean arterial pressure, cardiac output, systemic vascular resistence, pulmonary wedge pressure intrapulmonary shunt in both groups. There were statistical significance in arterial oxygen tension, pulmonary artery pressure, pulmonary vascular resistance between both groups (p<0.05). CONCLUSIONS: Pentoxifylline is a noteworthy drug that could be a candidate as a therapy to help prevent effect in lung injuries that share a common mechanism with oleic acid-induced lung injury.
Acute Lung Injury ; Adult ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs ; Hemodynamics ; Humans ; Lung Injury* ; Lung* ; Neutrophils ; Oleic Acid ; Oxygen ; Pentoxifylline* ; Phagocytosis ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reactive Oxygen Species ; Vascular Resistance ; Xanthine

OBJECTIVE: The purpose of this study was to investigate the relationship between the enamel thickness of proximal surfaces and the morphologic features of mandibular incisors. METHODS: Mesiodistal/faciolingual (MD/FL) index, MD width, and height of contour width/cervical width ratio were measured in 40 incisors extracted from Koreans. For determining the height of contour width/cervical width ratio, the cervical width was measured as the distance between proximal cementoenamel junctions. Then, the labial surface was ground to the height of the contour level to measure enamel thickness. Pearson correlation analysis was used to investigate the correlation between enamel thickness and morphologic features. RESULTS: Enamel thickness was 0.75 +/- 0.07 mm per side, and MD width was 5.56 +/- 0.40 mm. Enamel thickness and MD width were significantly correlated. However, a significant relationship was not observed between enamel thickness and MD/FL index or the height of contour width/cervical width ratio. CONCLUSIONS: The results suggest that enamel thickness is affected only by MD width. Therefore, if the MD width is the same for mandibular incisors with a large MD/FL index or triangular shape and mandibular incisors with normal shape, then the limit of enamel reduction for reproximation will be the same.
Dental Enamel ; Incisor ; Tooth Cervix

BACKGROUND: The aim of this study was to examine the cardiac function and transcriptional response of the heart to propofol after ischemia-reperfusion. METHODS: Rat hearts were Langendorff-perfused using the modified Krebs-Henseleit buffer, and took 20 min stabilizing periods, 40 min ischemia periods, and then 120 min reperfusion period. The hearts were divided into 5 groups; Control: 180 min perfusion after stabilization, Ischemic: 40 min global ischemia after stabilization, followed by 120 min reperfusion, Pre: 2 micrometer propofol treatment was preformed only before ischemia, Post: 2 micrometer propofol treatment was performed only during reperfusion after ischemia, Pre/Post: 2 micrometer propofol treatment was performed both before and after ischemia. The measurement for cardiac performances, such as left ventricular developed pressure (LVDP), rate of left ventricular pressure generation (dP/dt), heart rate, and coronary flow were obtained. The expression profiles of isolated mRNA were determined by using Agilent microarray and real time-polymerase chain reaction (RT-PCR) was used to confirm the microarray results for a subset of genes. RESULTS: The Post group showed better LVDP and dP/dt than the Ischemic group. But there were no significant differences in heart rate and coronary flow among the groups. On the results of RT-PCR, the expressions of Abcc9, Bard1, and Casp4 were increased, but the expressions of Lyz, Casp8, and Timp1 were decreased in the Post group compared with the Ischemic group. CONCLUSIONS: This study suggests that 2 micrometer propofol may provide cardioprotective effect, and modulate gene expression such as apoptosis, and K(ATP) ion channel related-genes during reperfusion in the isolated rat hearts.
Animals ; Apoptosis ; Gene Expression ; Glucose ; Heart ; Heart Rate ; Ion Channels ; Ischemia ; Perfusion ; Propofol ; Rats ; Reperfusion ; RNA, Messenger ; Tromethamine ; Ventricular Pressure

BACKGROUND: The aim of this study was to examine the cardiac function and transcriptional response of the heart to propofol after ischemia-reperfusion. METHODS: Rat hearts were Langendorff-perfused using the modified Krebs-Henseleit buffer, and took 20 min stabilizing periods, 40 min ischemia periods, and then 120 min reperfusion period. The hearts were divided into 5 groups; Control: 180 min perfusion after stabilization, Ischemic: 40 min global ischemia after stabilization, followed by 120 min reperfusion, Pre: 2 micrometer propofol treatment was preformed only before ischemia, Post: 2 micrometer propofol treatment was performed only during reperfusion after ischemia, Pre/Post: 2 micrometer propofol treatment was performed both before and after ischemia. The measurement for cardiac performances, such as left ventricular developed pressure (LVDP), rate of left ventricular pressure generation (dP/dt), heart rate, and coronary flow were obtained. The expression profiles of isolated mRNA were determined by using Agilent microarray and real time-polymerase chain reaction (RT-PCR) was used to confirm the microarray results for a subset of genes. RESULTS: The Post group showed better LVDP and dP/dt than the Ischemic group. But there were no significant differences in heart rate and coronary flow among the groups. On the results of RT-PCR, the expressions of Abcc9, Bard1, and Casp4 were increased, but the expressions of Lyz, Casp8, and Timp1 were decreased in the Post group compared with the Ischemic group. CONCLUSIONS: This study suggests that 2 micrometer propofol may provide cardioprotective effect, and modulate gene expression such as apoptosis, and K(ATP) ion channel related-genes during reperfusion in the isolated rat hearts.
Animals ; Apoptosis ; Gene Expression ; Glucose ; Heart ; Heart Rate ; Ion Channels ; Ischemia ; Perfusion ; Propofol ; Rats ; Reperfusion ; RNA, Messenger ; Tromethamine ; Ventricular Pressure

No abstract available.
Cartilage* ; Rabbits* ; Ribs*

PURPOSE: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. MATERIALS AND METHODS: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. RESULTS: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. CONCLUSION: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.
Brachytherapy* ; Humans ; Mouth Neoplasms ; Mouth* ; Radiotherapy ; Recurrence ; Retrospective Studies

Background: Lead, which is widely used in various industrial settings, is a major health hazard for manufacturing workers. Therefore, control of lead exposure has been implemented in an effort to prevent lead-related health problems. In this study, our aim was to evaluate temporal trends in occupational lead exposure in Korean lead workers using data from monitoring of workplace exposure. Methods: A nationwide work environment monitoring database, data from a work environment monitoring institution, and data extracted from a review paper were utilized. Different versions of standard industrial classification codes were aligned with the 10th Korean Standard Industrial Classification, which is generally consistent with the 4th revision of the International Standard Industrial Classification. The multiple data sources were combined and temporal trends over the period from 1994–2021 were estimated. In addition, separate estimation of temporal trends in the storage battery manufacturing industry over the period from 1987–2021 was also performed. Results: A total of 444,296 personal airborne lead measurements were used for the estimation process. The temporal trends in occupational exposure to lead declined by −6% annually over the study period. In particular, levels of lead exposure in the storage battery manufacturing industry showed a steeper decline of −12% annually. Conclusions Findings of our study showed that occupational exposure to lead declined over the period from 1994 to 2021 in Korea. However, adverse effects of exposure to lead on health should be regarded with caution. The results will be useful in conduct of epidemiological studies examining lead-related effects on health.

No abstract available.
Dopamine ; Parkinson Disease

BACKGROUND: Rocuronium administration is associated with a severe burning pain during injection in 50-80% patients. The purpose of this study was to evaluate mixtures of saline, lidocaine, sodium bicarbonate (NaHCO3) and lidocaine-NaHCO3 with rocuronium to reduce injection pain and withdrawal movement. METHODS: One hundred and twenty patients were randomly assigned to one of four groups in a double blinded, prospective study; Group S (0.9% normal saline 5 ml mixed with rocuronium 50 mg/5 ml, n = 30), Group L (2% lidocaine 5 ml mixed with rocuronium 50 mg/5 ml, n = 30), Group B (8.4% NaHCO3 5 ml mixed with rocuronium 50 mg/5 ml, n = 30) and Group LB (4% lidocaine 2.5 ml and 8.4% NaHCO3 2.5 ml mixed with rocuronium 50 mg/5 ml, n = 30). After all patients had received an intubating dose (0.6 mg/kg) of premixed rocuronium over 5 seconds, we investigated the incidence and severity of pain and withdrawal movement. We measured the onset and duration of muscle relaxation using train-of-four (TOF) and the pH values and osmolalities of each mixture. RESULTS: The incidence and severity of pain during injection were significantly reduced in Groups B and LB compared with Group S. The withdrawal movement was observed 8 patients (26.7%) in Group S, but in no patient in Groups B or LB. No significant difference in the incidence of pain or withdrawal response was observed between Groups S and L. CONCLUSIONS: We conclude that premixed NaHCO3 with rocuronium is effective at reducing injection pain and withdrawal movement whereas the addition of lidocaine has little effect.
Burns ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Lidocaine* ; Muscle Relaxation ; Osmolar Concentration ; Prospective Studies ; Sodium Bicarbonate