No abstract available.
Knee*

BACKGROUND: Glidescope(R) is a video-assisted intubation device.It offers a clear view and is easy to use, giving it several advantages over conventional intubation devises.This study was designed to compare the hemodynamic effects and POGO scores between conventional and video laryngoscopic intubation. METHODS: Sixty adult patients with ASA 1 or 2 were randomly allocated into two groups; Glidescope(R) (group G) or Macintosh (group M).Anesthesia was induced with propofol and remifentanil.Blood pressure and heart rate were recorded just prior to intubation and 1, 3, and 5 minutes after intubation.POGO scores, intubation time and the severity of sore throat were also recorded. RESULTS: There were no significant differences in SBP, MBP, DBP, HR, POGO score, intubation time and the severity of sore throat between two groups. CONCLUSIONS: The POGO scores and hemodynamic changes associated with tracheal intubation using the Glidescope(R) were almost the same as that of the Macintosh group.
Adult ; Blood Pressure ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Pharyngitis ; Propofol

PURPOSE: Currently, no studies have examined the diurnal variation of sex hormones in Korean men. We realized that accurate models of the diurnal variation of the sex hormones in Korean males are needed to evaluate and manage patients in urology. Therefore diurnal variation of testosterone and related sex hormones were investigated in young Korean men. MATERIALS AND METHODS: Healthy Korean men from 20 to 25 years old who had evident secondary growth were enrolled. We drew blood from each subject 12 times at 2-hour intervals for 24 hours. The concentrations of total testosterone, estradiol, luteinizing hormone, sex hormone binding globulin and albumin were measured. The free and bioavailable testosterone were calculated by Vermeulen's equation. To analyze the rhythmicity of diurnal variation in sex hormones, 24-hr cosine regression analysis was used for the statistical analysis. RESULTS: Total testosterone, free testosterone, estradiol, and testosterone estradiol ratio demonstrated a significant diurnal cosinor rhythm. The diurnal variation of bioavailable testosterone did not demonstrate a statistically significant cosinor rhythm. CONCLUSIONS: The diurnal variations of serum total and free testosterone concentration in Korean young men were similar to those found in studies of Caucasian men. Our study provides basic data for future studies of Korean male sex hormones. Furthermore, additional studies targeted toward various male age groups are needed to make the standard models of sex hormones in Korean men.
Adult ; Circadian Rhythm* ; Estradiol* ; Gonadal Steroid Hormones ; Humans ; Lutein* ; Luteinizing Hormone* ; Male ; Periodicity ; Sex Hormone-Binding Globulin* ; Testosterone* ; Urology

BACKGROUND: Cryopreservation can cause mechanical and chemical stress, ultimately leading to the formation of reactive oxygen species (ROS) and oxidative stress. ROS inhibits the expression of antioxidant enzymes in cells, resulting in increased DNA fragmentation and apoptosis. In this paper, we used a vitrification method that has the advantage of producing less ice crystal formation, cost-effectiveness, and time efficiency during cryopreservation. The objective of this paper is to evaluate the degree of protection of ovarian tissue against oxidative stress when N-acetylcysteine (NAC) and Klotho proteins are treated in the vitrification process of ovarian tissue. METHODS: The control group and the cryopreservation groups were randomly assigned, and treated NAC, Klotho, or the combination (NAC ? Klotho). The cell morphological change, DNA damage, senescence, and apoptosis of each group after the freeze–thaw process were compared using transmission electron microscopy, immunohistochemistry, and western blot analysis. RESULTS: Both NAC and Klotho were found to be more effective at protecting against DNA damage than the control;however, DNA damage was greater in the NAC ? Klotho group than in the group treated with NAC and Klotho, respectively. DNA damage and cellular senescence were also reduced during the vitrification process when cells were treated with NAC, Klotho, or the combination (NAC ? Klotho). NAC increased apoptosis during cryopreservation, whereas Klotho inhibited apoptosis and NAC-induced apoptosis. CONCLUSION This study highlights Klotho’s benefits in inhibiting DNA damage, cell senescence, and apoptosis, including NAC-induced apoptosis, despite its unclear role in vitrification.

OBJECTIVES: This study aimed to investigate the associations between physical disorders and prevalent/incident insomnia in a community dwelling older population. METHODS: 1,204 people aged 65 or over evaluated at baseline. Insomnia was defined as difficulty in initiation or maintenance of sleep on at least three nights per week over the last month. Reported physical disorders covering 11 common and generally chronic health problems were ascertained. Covariates included were age, gender, education, housing, past occupation, current employment, and depression. Of 879 without insomnia at baseline, 651 (74%) were followed 2 years later, and incident insomnia was evaluated. RESULTS: Prevalent insomnia was significantly associated with 10 of 11 physical disorders. Incident insomnia was associated with 2 physical disorders: eyesight problems and hearing difficulty. Both prevalent and incident insomnia were significantly associated with increased number of physical disorders. CONCLUSION: Certain physical disorders were comorbid and precipitating factors of insomnia in elders.
Aged ; Aging ; Depression ; Employment ; Hearing ; Housing ; Humans ; Occupations ; Precipitating Factors ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

Recently, there have been many changes in the area of healthcare. There is no certainty how these changes will affect the healthcare system and public health. However, to at least have these changes positively implemented, it is clear that evaluation through continuous monitoring is necessary. The enforcement of the Medical Institution Accreditation and Medical Dispute Mediation Law as well as legal revisions regarding the public healthcare system are changes to improve the quality of healthcare, while at the same time, provide penalties for infractions of the new law such as medicine/medical device rebates; moreover, legal revisions regarding telemedicine are anticipated to impartially vitalize technical development as well as the pharmaceutical industry. For these changes to have a positive effect on the medical field and people's lives, an accurate comprehension of the system and understanding of the details is necessary to be able to respond sensitively to any changes in the future. Therefore, this paper examined the background information on the current discussion on the changes in the healthcare system, examined the detailed content of the system, and reviewed the areas that were in dispute as well as the main issues to contemplate the expected effects of the changes and future tasks that may be generated as a result. These considerations will act as foundation for an in depth understanding of recent trends in the healthcare system.
Accreditation/legislation & jurisprudence ; Delivery of Health Care/*legislation & jurisprudence ; Health Care Reform ; Humans ; Quality of Health Care ; Telemedicine

PURPOSE: We'd like to evaluate the relationship between the degree of cardiac damage and that of cardiac function according to the total injected dose of doxorubicin. METHODS: 12 rabbits(body weight : 2.0-3.2 kg) were used and 30 mg/m2/week of doxorubicin hydrochloride was injected intravenously. The cardiac function was checked under anesthesia, after which the thorax was opened and cardiac samples were evaluated with light and electron microscopics. RESULTS: Regardless of total injected dose of doxorubicin, there was no difference between the general appearance, sizes and thickness of both atria and ventricles of doxorubicin injected rabbits and those of normal control. The rabbits with total cumulative dose <180 mg/m2 showed no differences with the rabbits of normal control in the cardiac histology. The rabbits with cumulative doses of 210 mg/m2 had an increased number of vacuoles in the interspaces of the myofibrils and glucogen granules in myocytes. The rabbits with the cumulative dose of 240 mg/m2 had focal necrosis and degeneration of myocytes with fibrous cells infiltration. The rabbits with cumulative doses of 300 mg/m2 demonstrated severe and diffuse degenerations with markedly decreased numbers of myocytes and increased intracellular vacuoles. All the rabbits with total cumulative doses <240 mg/m2 showed no difference in the aortic pressure, left ventricular(LV) maximal dP/dt and left ventricular end diastolic pressure(LVEDP) compared to normal control. The rabbit with total cumulative doses of 300 mg/m2 showed no difference in the aortic pressure and LV maximal dP/ dt, but revealed significantly elevated LVEDP compared to normal control. CONCLUSION: These results showed doxorubicin induced cardiotoxicity is dose related and may be certain at total cumulative dose >200 mg/m2, although cardiac function is normal.
Anesthesia ; Arterial Pressure ; Doxorubicin* ; Muscle Cells ; Myofibrils ; Necrosis ; Rabbits* ; Thorax ; Vacuoles ; Ventricular Function, Left*

Multiple primary cancers are the occurrence of more than two cancers of different origin in an individual. Penile cancer is a rare disease, and finding it combined with other cancers is even rarer. A 64-year-old man with a painful penile mass was referred to us from a primary urological clinic. We performed a biopsy of the penile mass and the histology revealed a well-differentiated squamous cell carcinoma. Abdominal computed tomography showed a localized bladder tumor with inguinal lymphadenopathy. The patient underwent a partial penectomy, transurethral resection of the bladder tumor and inguinal lymph node dissection. The histology of the bladder tumor was high-grade papillary carcinoma, and that of the lymph node was squamous cell carcinoma. The penile and bladder tumors were in stage II (T1N1M0) and stage I (T1N0M0), respectively. We successfully treated the patient with adjuvant radiotherapy and systemic chemotherapy.
Biopsy ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Male ; Middle Aged ; Penile Neoplasms ; Radiotherapy, Adjuvant ; Rare Diseases ; Urinary Bladder ; Urinary Bladder Neoplasms

During the last decade the issue of therapy-related myelodysplasia (t-MDS) and acute myeloid leukemia (t-AML) following high-dose chemotherapy (HD-CT) and autologous stem cell transplantation (ASCT) or conventional chemotherapy, radiotherapy for malignant diseases has become increasingly important. The number of patients with hematologic malignancies and chemosensitive or radiosensitive solid tumors undergoing this new type of treatment has expanded dramatically. Recently, we experienced a case of 35-year-old female patient with therapy-related acute lymphoblastic leukemia (t-ALL) after 131I treatment for thyroid papillary carcinoma. Total 131I dose the patient received was 900mCi and patient was diagnosed as having ALL 11 months after last 131I treatment. Although the prognosis of therapy-related acute leukemia/myelodysplastic syndrome is poor, the patient is alive in complete remission after allogeneic bone marrow transplantation from HLA-matched sibling donor. Given the rarity of this case, we report the case with literature reviews.
Adult ; Bone Marrow Transplantation ; Carcinoma, Papillary* ; Drug Therapy ; Female ; Hematologic Neoplasms ; Humans ; Leukemia, Myeloid, Acute ; Neoplasms, Second Primary ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Radiotherapy ; Siblings ; Stem Cell Transplantation ; Thyroid Gland* ; Thyroid Neoplasms ; Tissue Donors

We report a case of torsion of a benign cyst arising from the parietal layer of the tunica vaginalis, which presented on an acute scrotum. Physical examination revealed a tender swelling of the left hemiscrotum. Surgical, we happened to find torsion of a cyst originating from the parietal layer of the tunica vaginalis. The pedicle of the cyst was twisted about 360 degrees.
Physical Examination ; Rabeprazole ; Scrotum*