No abstract available.
Glomerulonephritis, IGA* ; Immunoglobulin A*

BACKGROUND: Oxidative stress contributes to vascular diseases in patients with diabetes. As the mechanism of development and progression of diabetic vascular complications is poorly understood, this study was aimed to assess the potential role of hyperglycemia-induced oxidative stress and to determine whether the oxidative stress is a major factor in hyperglycemia-induced migration of vascular smooth muscle cells (VSMCs). METHODS: We treated primary cultured rat aortic smooth muscle cells for 72 hours with medium containing 5.5 mM D-glucose (normal glucose), 30 mM D-glucose (high glucose) or 5.5 mM D-glucose plus 24.5 mM mannitol (osmotic control). We measured the migration of VSMCs and superoxide production. Immunoblotting of PKC isozymes using phoshospecific antibodies was performed, and PKC activity was also measured. RESULTS: Migration of VSMCs incubated under high glucose condition were markedly increased compared to normal glucose condition. Treatment with diphenyleneiodonium (DPI, 10 micromol/L) and superoxide dismutase (SOD, 500 U/mL) significantly suppressed high glucose-induced migration of VSMCs. Superoxide production was significantly increased in high glucose condition and was markedly decreased after treatment with DPI and SOD. High glucose also markedly increased activity of PKC-delta isozyme. When VSMCs were treated with rottlerin or transfected with PKC-delta siRNA, nitro blue tetrazolium (NBT) staining and NAD(P)H oxidase activity were significantly attenuated in the high glucose-treated VSMCs. Furthermore, inhibition of PKC-delta markedly decreased VSMC migration by high glucose. CONCLUSION: These results suggest that high glucose-induced VSMC migration is dependent upon activation of PKC-delta, which may responsible for elevated intracellular ROS production in VSMCs, and this is mediated by NAD(P)H oxidase.
Acetophenones ; Animals ; Antibodies ; Benzopyrans ; Diabetic Angiopathies ; Glucose ; Humans ; Immunoblotting ; Isoenzymes ; Mannitol ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; NADPH Oxidase ; Onium Compounds ; Oxidative Stress ; Oxygen ; Protein Kinase C ; Rats ; RNA, Small Interfering ; Superoxide Dismutase ; Superoxides ; Vascular Diseases

Dermatofibroma is a common fibrohistiocytic tumor of the skin. It generally occurs as a solitary lesion. However, some cases of multiple dermatofibromas in immune-compromised patients or patients with abnormal immune status have been reported, hence this phenomenon has been thought to be associated with altered immunity. We present a case of multiple dermatofibromas which developed in a patient with systemic lupus erythematosus, plus a review of the literature.
Histiocytoma, Benign Fibrous* ; Humans ; Lupus Erythematosus, Systemic* ; Skin

BACKGROUND: It is difficult to choose the appropriate drug when hypotension develops in patients with pulmonary hypertension (PH). There is no known drug to increase the systemic blood pressure (BP) without an increase of pulmonary arterial pressure (PAP). We observed the effects of phenylephrine (PE) and norepinehrine (NE) on systemic and pulmonary hemodynamics when hypotension was treated in patients with PH. METHODS: Patients with PH (mean PAP > or = 25 mmHg, n = 28) were studied. When hypotension occurred (systolic BP < or = 100 mmHg, T1) after the induction of anesthesia, PE or NE was randomly infused to raise the systolic BP above 130 mmHg (T2) and 150 mmHg (T3). Hemodynamic variables were measured at T1, T2 and T3, and the ratio (RBP) of mean PAP to mean BP was calculated. The measurements were performed before skin incision to avoid the effects of surgical stimulation. RESULTS: NE increased BP concomitantly with relatively small increase of PAP, meaning a decrease of RBP (P < 0.05) without any other changes of hemodynamic variables in all patients. However, PE could not raise BP above 130 mmHg in one third of patients, and decreased the cardiac index without a significant decrease of RBP. CONCLUSIONS: NE increased BP and decreased RBP without tachycardia or any other hemodynamic disturbances. NE is considered to be a proper and safe drug to raise BP when hypotension occurs in patients with PH.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Hemodynamics* ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Hypotension ; Norepinephrine* ; Phenylephrine* ; Skin ; Tachycardia

No abstract available.
Hair* ; Hypopigmentation* ; Scalp* ; Ureter*

To investigate the effect of intrathecal fentanyl,36 ASA physieal status 1 or 2 parturients who underwent cesarean section with apinal anesthesis using 0.25% bupivacaine in 5.0% dextroae with 0.25mg morphine were studied. Patients were randomly allocated to receive either saline 0.2ml (group 1, n=17) or fentanyl 10ug(group 2, n=19) in 3.525ml volume mixed with the bupivacaine with morphine. Spinal anesthesia was performed in sitting position using a 25 guage spinal needle. At the completion of injection, patients immediately turned supine with left uterine diaplacement. There was no statistically significant difference in the incidence of the hypotension between groups. The progress of sensory and motor blocks was similar in the two groups. The times from drug injection ta the onset to maximal sensory blockade and complete motor blockade, complete recovery of sensation and motor power were not different between groups. post delivery,the incidence of visceral pain were significantly less in group 2, as 2 of 19 patients(10%) in group 2 compared to 8 of 17 patients(47%) in group 1(p< 0.05). The effective analgesia time was no significant different: 31.7+/-2.5 hour in group 1 compared to 28.6+/-5.6 hour in Group 2. The ineidence of patients not requiring narcotics until discharge was similar in two groups. No patient showed any evidence of respiratory depression. The incidence of other side effects,such as nausea,vomiting and pruritus was not different between groups. No neonate had an Apgar score below 7.
Analgesia ; Anesthesia, Spinal ; Apgar Score ; Bupivacaine* ; Cesarean Section* ; Female ; Fentanyl* ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Morphine* ; Narcotics ; Needles ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Sensation ; Visceral Pain

To investigate the effect of intrathecal fentanyl,36 ASA physieal status 1 or 2 parturients who underwent cesarean section with apinal anesthesis using 0.25% bupivacaine in 5.0% dextroae with 0.25mg morphine were studied. Patients were randomly allocated to receive either saline 0.2ml (group 1, n=17) or fentanyl 10ug(group 2, n=19) in 3.525ml volume mixed with the bupivacaine with morphine. Spinal anesthesia was performed in sitting position using a 25 guage spinal needle. At the completion of injection, patients immediately turned supine with left uterine diaplacement. There was no statistically significant difference in the incidence of the hypotension between groups. The progress of sensory and motor blocks was similar in the two groups. The times from drug injection ta the onset to maximal sensory blockade and complete motor blockade, complete recovery of sensation and motor power were not different between groups. post delivery,the incidence of visceral pain were significantly less in group 2, as 2 of 19 patients(10%) in group 2 compared to 8 of 17 patients(47%) in group 1(p< 0.05). The effective analgesia time was no significant different: 31.7+/-2.5 hour in group 1 compared to 28.6+/-5.6 hour in Group 2. The ineidence of patients not requiring narcotics until discharge was similar in two groups. No patient showed any evidence of respiratory depression. The incidence of other side effects,such as nausea,vomiting and pruritus was not different between groups. No neonate had an Apgar score below 7.
Analgesia ; Anesthesia, Spinal ; Apgar Score ; Bupivacaine* ; Cesarean Section* ; Female ; Fentanyl* ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Morphine* ; Narcotics ; Needles ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Sensation ; Visceral Pain

BACKGROUND: The aim of this study was to evaluate whether continuous infusion of remifentanil during propofol anesthesia could produce opioid-induced hyperalgesia (OIH) and whether an intravenous bolus of fentanyl could control OIH in the management of postoperative pain. METHODS: One hundred fifty-nine women undergoing gynecologic surgery were randomly divided into four groups. Group C: nitrous oxide and propofol infusion (3-4 microg/ml, n = 40), Group F: propofol infusion and intravenous bolus administration of fentanyl (1 microg/kg) after suturing the peritoneum (n = 40), Group R: propofol and remifentanil infusion (2-4 ng/ml, n = 40) and Group RF: propofol, remifentanil infusion and intravenous bolus administration of fentanyl (n = 39). Patient controlled analgesia was started after the operation. The postoperative visual analog scale (VAS) was measured in the recovery room, then at 2 h, 6 h, 12 h, and 24 h after the operation. RESULTS: The VAS scores for Groups R and F in the recovery room were lower than for group C (P < 0.05), but there were no differences 2 h after the operation. The VAS scores for Group RF 6 h and 12 h after the operation were higher than those for group C (P < 0.05). CONCLUSIONS: Our results suggest that low dose (2-4 ng/ml) continuous infusion of remifentanil during propofol anesthesia does not produce marked hyperalgesia. However, an intravenous bolus of fentanyl can aggravate OIH induced by remifentanil.
Analgesia, Patient-Controlled ; Anesthesia ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Humans ; Hyperalgesia ; Nitrous Oxide ; Pain, Postoperative ; Peritoneum ; Piperidines ; Propofol ; Recovery Room

BACKGROUND: The aim of this study was to evaluate whether continuous infusion of remifentanil during propofol anesthesia could produce opioid-induced hyperalgesia (OIH) and whether an intravenous bolus of fentanyl could control OIH in the management of postoperative pain. METHODS: One hundred fifty-nine women undergoing gynecologic surgery were randomly divided into four groups. Group C: nitrous oxide and propofol infusion (3-4 microg/ml, n = 40), Group F: propofol infusion and intravenous bolus administration of fentanyl (1 microg/kg) after suturing the peritoneum (n = 40), Group R: propofol and remifentanil infusion (2-4 ng/ml, n = 40) and Group RF: propofol, remifentanil infusion and intravenous bolus administration of fentanyl (n = 39). Patient controlled analgesia was started after the operation. The postoperative visual analog scale (VAS) was measured in the recovery room, then at 2 h, 6 h, 12 h, and 24 h after the operation. RESULTS: The VAS scores for Groups R and F in the recovery room were lower than for group C (P < 0.05), but there were no differences 2 h after the operation. The VAS scores for Group RF 6 h and 12 h after the operation were higher than those for group C (P < 0.05). CONCLUSIONS: Our results suggest that low dose (2-4 ng/ml) continuous infusion of remifentanil during propofol anesthesia does not produce marked hyperalgesia. However, an intravenous bolus of fentanyl can aggravate OIH induced by remifentanil.
Analgesia, Patient-Controlled ; Anesthesia ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Humans ; Hyperalgesia ; Nitrous Oxide ; Pain, Postoperative ; Peritoneum ; Piperidines ; Propofol ; Recovery Room

BACKGROUND: The aim of the study was to evaluate the biochemical effects of recombinant human thyroid stimulating hormone (rhTSH) as an adjunct to radioiodine (RI) treatment of a differentiated thyroid carcinoma (DTC). We retrospectively reviewed the clinical response rates of DTC patients treated with RI after thyroid hormone withdrawal and compared with those after rhTSH stimulation. METHOD: We included the patients treated with RI for locally recurrent DTC from February 1, 2002 to August 31, 2005 and followed with diagnostic studies at our hospital. Forty totally (or near totally) thyroidectomized adults were included in this study. Nine patients underwent RI treatment after rhTSH stimulation while euthyoid on L-thyroxine (LT4), and 31 patients were treated with RI after thyroid hormone withdrawal. The clinical response was defined as >25% decrease in serum thyroglobulin (Tg) level on LT4 3 months after the RI treatment. RESULTS: In each group, serum Tg levels were significantly decreased 3 months after the RI treatment. And we found that 77.8 and 71.0% of those prepared by rhTSH and LT4 withdrawal, respectively, had clinical responses 3 months after the RI treatment by our criteria and there was no significant difference in response rates between two groups (P=0.238). CONCLUSIONS: Given the biases that exist in retrospective studies, at the current time we cannot recommend the routine use of rhTSH to prepare RI treatment of DTC. However, our study provided preliminary evidence that rhTSH effectively aided RI treatment of DTC at least to an equivalent degree as LT4 withdrawal.
Adult ; Bias (Epidemiology) ; Humans* ; Retrospective Studies* ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin ; Thyrotropin Alfa ; Thyroxine