No abstract available.
Blood Flow Velocity* ; Fetus* ; Gases*

Pseudo-kaposi's sarcoma is a vasoproliferative disorder that may resemble Kaposi's sarcoma, clinically and histologically. In most cases, it has been associated with congenital or iatrogenic arteriovenous fistula and chronic venous insuffiency. We present a 36-year-old male patient with pseudo-Kaposi's sarcoma caused by a deed vein thrombosis in the absence of any detectable underlying etiologic factors.
Adult ; Arteriovenous Fistula ; Humans ; Male ; Sarcoma ; Sarcoma, Kaposi* ; Thrombosis ; Veins ; Venous Thrombosis*

OBJECTIVES: There are emerging evidences suggest that the development of tardive dyskinesia (TD) is related to the oxidative stress, excitotoxicity, and immune activation. The purpose of this study is to investigate whether single-nucleotide polymorphisms (SNPs) of tumor necrosis factor (TNF)-alpha genes are associated with the susceptibility of TD and schizophrenia. METHODS: We investigated two hundred and eighty Korean schizophrenic patients. The schizophrenic participants consisted of patients with (n=105) and without (n=175) TD who were matched for antipsychotic drug exposure and other relevant variables. The TNF-alpha gene -308G/A SNPs were analyzed by polymerase chain reaction (PCR)-based methods. RESULTS: The frequencies of genotype (chi2=0.33, p=0.848) of the TNF-alpha gene -308 G/A SNP did not differ significantly between schizophrenic patients with and without TD. The difference of allele frequencies (chi2=0.28, p=0.594) of the TNF-alpha gene between the schizophrenic patients with and without TD were not significant. CONCLUSION: These results suggest that the TNF-alpha gene -308 G/A SNPs are not associated with TD and schizophrenia in a Korean population. Further association studies of TD with other candidate genes for cytokines would help us understand the pathophysiological mechanisms of TD.
Cytokines ; Gene Frequency ; Genotype ; Humans ; Movement Disorders ; Oxidative Stress ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Schizophrenia ; Tumor Necrosis Factor-alpha

OBJECTIVES: The management of disaster should be immediate and sustainable. Further, it is hard to predict where the disaster will occur, using pre-exists governmental and non-governmental organizations are important. In this study, we tried to investigate the associated activities of organizations performed in Ansan city, in Sewol ferry accident. METHODS: A total 121 workers in 25 organizations were surveyd about organizations which they worked with, kind of works performed, frequency of meetings, satisfaction in activities and factors associated with dissatisfaction in usual state and in Sewol ferry accident state, respectively. The differences between those two situations were analyzed using paired t-test for continuous variables and Chi-square test or McNemar test for categorical variables. RESULTS: The total number of linkage of institutions were decreased(from n=397 to n=251) and the mean scores of rating satisfaction were significantly lower in most of organizations in disaster state. The rigid policy in performance evaluation was more likely associated with dissatisfaction in disaster state than usual state(p=0.045). CONCLUSIONS: For effective linkage of institutions, preparedness, such as understanding the capability of organizations in the communities and developing the protocol for associated activities, is important. The unnecessary and effortful performance evaluation should be sublated.
Disasters* ; Gyeonggi-do*

BACKGROUND: The i-gel™ (i-gel) and Laryngeal Mask Airway Supreme™ (LMA Supreme) have been safely used in children. We compared the airway performance of the i-gel and LMA Supreme in infants undergoing general anesthesia. METHODS: Sixty infants with American Society of Anesthesiologists physical status I or II were randomly assigned to place either the i-gel or the LMA Supreme. The size 1 or 1.5 of each airway was selected by the weight of infants. The primary outcome variable was oropharyngeal leak pressure (OLP). We also assessed insertion success rate, insertion time, fiberoptic view of the larynx, airway quality, airway manipulations, and perioperative complications. RESULTS: Demographic data did not differ between the two groups. Insertion success rate was similar in both groups. OLP for the i-gel (26.0 ± 3.8 cmH2O) was higher than for the LMA Supreme (23.7 ± 3.2 cmH2O) (P = 0.016). Insertion time for the i-gel (16.4 ± 2.8 s) was shorter than for the LMA Supreme (18.5 ± 2.7 s) (P = 0.002). There were no differences in fiberoptic view of the larynx, airway quality, airway manipulations, and complications between the two groups. CONCLUSIONS This study demonstrated that the i-gel and LMA Supreme provided a similar performance of airway in infants. Compared with the LMA Supreme, the i-gel provided shorter insertion time and higher OLP in infants.

BACKGROUND: The i-gel™ (i-gel) and Laryngeal Mask Airway Supreme™ (LMA Supreme) have been safely used in children. We compared the airway performance of the i-gel and LMA Supreme in infants undergoing general anesthesia. METHODS: Sixty infants with American Society of Anesthesiologists physical status I or II were randomly assigned to place either the i-gel or the LMA Supreme. The size 1 or 1.5 of each airway was selected by the weight of infants. The primary outcome variable was oropharyngeal leak pressure (OLP). We also assessed insertion success rate, insertion time, fiberoptic view of the larynx, airway quality, airway manipulations, and perioperative complications. RESULTS: Demographic data did not differ between the two groups. Insertion success rate was similar in both groups. OLP for the i-gel (26.0 ± 3.8 cmH2O) was higher than for the LMA Supreme (23.7 ± 3.2 cmH2O) (P = 0.016). Insertion time for the i-gel (16.4 ± 2.8 s) was shorter than for the LMA Supreme (18.5 ± 2.7 s) (P = 0.002). There were no differences in fiberoptic view of the larynx, airway quality, airway manipulations, and complications between the two groups. CONCLUSIONS: This study demonstrated that the i-gel and LMA Supreme provided a similar performance of airway in infants. Compared with the LMA Supreme, the i-gel provided shorter insertion time and higher OLP in infants.
Anesthesia, General ; Child ; Humans ; Infant ; Laryngeal Masks ; Larynx

The vertebrate neuromuscular junction (NMJ) is considered as a “tripartite synapse” consisting of a motor axon terminal, a muscle endplate, and terminal Schwann cells that envelope the motor axon terminal. The neuregulin 1 (NRG1)-ErbB2 signaling pathway plays an important role in the development of the NMJ. We previously showed that Grb2-associated binder 1 (Gab1), a scaffolding mediator of receptor tyrosine kinase signaling, is required for NRG1-induced peripheral nerve myelination. Here, we determined the role of Gab1 in the development of the NMJ using muscle-specific conditional Gab1 knockout mice. The mutant mice showed delayed postnatal maturation of the NMJ. Furthermore, the selective loss of the gab1 gene in terminal Schwann cells produced delayed synaptic elimination with abnormal morphology of the motor endplate, suggesting that Gab1 in both muscles and terminal Schwann cells is required for proper NMJ development. Gab1 in terminal Schwann cells appeared to regulate the number and process elongation of terminal Schwann cells during synaptic elimination. However, Gab2 knockout mice did not show any defects in the development of the NMJ. Considering the role of Gab1 in postnatal peripheral nerve myelination, our findings suggest that Gab1 is a pleiotropic and important component of NRG1 signals during postnatal development of the peripheral neuromuscular system.
Animals ; Mice ; Mice, Knockout ; Motor Endplate ; Muscle, Skeletal* ; Muscles ; Myelin Sheath ; Neuregulin-1 ; Neuromuscular Junction ; Peripheral Nerves ; Presynaptic Terminals ; Protein-Tyrosine Kinases ; Schwann Cells* ; Synapses* ; Vertebrates

Purpose: Critically ill patients often require multidisciplinary treatment for both acute illnesses and pre-existing medical conditions. Since different medical conditions are managed in the intensive care unit (ICU), consultation is often required. This study aimed to identify the frequency and type of consultation required and analyze changes in consultation patterns after the introduction of intensivist-directed care in the surgical ICU (SICU). Methods: Between June 2006 and December 2013, a retrospective cohort study was conducted to identify the frequency and type of consultation at 3 different ICUs. Consultations for patients who were admitted to the ICUs for more than 48 consecutive hours were included. The pattern of consultations in each ICU was investigated. In addition, the pattern of consultations before and after the implementation of intensivist-directed care in the SICU was compared. Results: During the study, 11,053 consultations were requested for 7,774 critically ill patients in a total of 3 ICUs. Consultations with the Departments of Cardiology, Infectious Diseases, and Pulmonology were requested most frequently in the SICU. However, after the implementation of the intensivist-directed care approach, there was an increase in the frequency of consultation requests to the Department of Neurology, followed by the Departments of Cardiology, and Infectious Diseases. Conclusion Analysis of consultation patterns is an important method of assessing the complexity and severity of illnesses, and of evaluating the needs of available health system resources. Based on our findings, we suggest the development of an appropriate protocol for frequently consulted services.

The aim of this study was to analyze the relationship between serum pro-hepcidin concentration and the anemia profiles of rheumatoid arthritis (RA) and to estimate the pro-hepcidin could reflect the disease activity of RA. RA disease activities were measured using Disease Activity Score 28 (DAS28), tender/swollen joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Anemia profiles such as hemoglobin, iron, total iron binding capacity (TIBC), ferritin, and transferrin levels were measured. Serum concentration of pro-hepcidin, the prohormone of hepcidin, was measured using enzyme-linked immunosorbent assay (ELISA). Mean concentration of serum pro-hepcidin was 237.6+/-67.9 ng/mL in 40 RA patients. The pro-hepcidin concentration was correlated with rheumatoid factor, CRP, ESR, and DAS28. There was a significant correlation between pro-hepcidin with tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6. The pro-hepcidin concentration was significantly higher in the patients with active RA (DAS28>5.1) than those with inactive to moderate RA (DAS28< or =5.1). However, the pro-hepcidin concentration did not correlate with the anemia profiles except hemoglobin level. There was no difference of pro-hepcidin concentration between the patients with anemia of chronic disease and those without. In conclusion, serum concentration of pro-hepcidin reflects the disease activity, regardless of the anemia states in RA patients, thus it may be another potential marker for disease activity of RA.
Adult ; Aged ; Anemia/*blood ; Anti-Bacterial Agents/blood ; Antimicrobial Cationic Peptides/*blood ; Arthritis, Rheumatoid/*blood/immunology/*physiopathology ; Biological Markers/blood ; Female ; Humans ; Interleukin-1beta/blood/immunology ; Interleukin-6/blood/immunology ; Male ; Middle Aged ; Protein Precursors/*blood ; *Severity of Illness Index ; Tumor Necrosis Factor-alpha/blood/immunology

The histologically confirmed endothelial damage (HCED) may lead to vasospasm, which increases the failure rate of microvascular anastomosis. Recently, vascular freezing has been reported to be the most effective and lasting method of alleviating or preventing vessel constriction in virgin microvessels. We question whether the application of freezing designed to relieve vasospasm is possible in microvessels accompanying with underlying acute endothelial damages without any harmful effects. We produced an experimental model with histologically confirmed endothelial damage and vasospasm in Sprague-Dawley rat. In crush injury group(group I, n = 15), the determined crushing load (0.07 J) was applied to femoral artery. In crush injury-freezing group(group II, n = 15), crushed arteries was frozen with ethyl chloride at 30 minutes after applying the crush injury. Gross and scanning electron microscopic appearances were inspected in both experimental groups on the 2nd, 14th and 30th day after the operation. In group I, vasospasm around the crushed segments were continued but in group II, the vasospasm disappeared immediately after vascular freezing, maintained its expansion even at postoperative 2, 14 and 30 days. On scanning electron microscopic examination, endothelium in group II showed slightly slower regeneration velocity but near complete regeneration was achieved at postoperative day 30. Regenerated endothelial cell in group II was more atypically shaped but arranged longitudinally at postoperative day 30. In conclusion, freezing with ethyl chloride could be a useful tool to reliably revert vasospasm without inducing thrombus even in acute endothelial damaged vessels after crush injury.
Animals ; Arteries ; Constriction ; Endothelial Cells ; Endothelium ; Ethyl Chloride ; Femoral Artery ; Freezing* ; Microvessels ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Thrombosis