Chronic alcohol intake can profoundly modify the neuronal activity and the morphologic structure of hypothalamic nucleus in the rat brain. The aim of the present study is to observe the effects of chronic alcohol intake on expression of vasopressin and oxytocin in the paraventricular and supraoptic nucleus in the rat hypothalamus. Experimental rats (n=14) were divided into control group and chronic alcohol group. Chronic alcohol group was induced via daily liquid alcohol intake for 6 months beginning at 8 weeks of age. As a result, the number of vasopressin and oxytocin-containing neurons was decreased in the paraventricular and supraoptic nucleus in chronic alcohol group. Especially, the number of vasopressin-containing neurons of chronic alcohol group was significantly decreased in the paraventricular nucleus. Chronic alcohol intake produced significant changes in the volume of the cell bodies and their nucleus in neurons of the paraventricular and supraoptic nucleus. Particularly, the size of nucleus of vasopressin-containing neurons in chronic alcohol group was larger than in control group. These results show that chronic alcohol intake may affect the synthesis of vasopressin and oxytocin in the neurons of hypothalamic nuclei. Whereas, chronic alcohol intake induces an enlargement of the cell size of surviving neuron to compensate.
Animals ; Brain ; Cell Size ; Hypothalamus* ; Neurons* ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Rats* ; Supraoptic Nucleus* ; Vasopressins*

Two external quality assessment trials were conducted on 13 test proteins spanning 4 test categories, in 2013. The first trial was initiated on May 6, 2013, and the second trial of immunoassay tests was conducted on November 12, 2013. The trials analysed tumour markers, thyroid hormones, bone marker carboxy-terminal collagen crosslinks (CTX), and the cardiac marker troponin (troponin T [Tn-T] or troponin I [Tn-I]) used in standard immunoassay testing. Three new markers, i.e., thyroglobulin, CTX, and Tn-T/Tn-I were introduced in 2013 to replace 5 existing marker immunoproteins (immunoglobulin G, immunoglobulin M, immunoglobulin A, complement (C)3, and C4). External quality surveys of 13 immunoassay test items were conducted with the aid of 8 control materials. The tested markers included 6 tumour markers (alpha-fetoprotein, carcinoembryonic antigen, carcinoma antigen 125, carbohydrate antigen 19-9), human chorionic gonadotrophin, and prostate specific antigen), 5 thyroid markers (thyroid hormone 3 [T3], T4, thyroid stimulating hormone, free T4, and thyroglobulin), and 1 bone resorption marker CTX. The newly adopted cardiac marker troponin was also included in this study. Five homemade pooled sera and 3 commercial sera were used as the control sera. The thyroid hormones, novel bone marker CTX, and troponin controls were analysed using the MAS Tri-point Liquimmune level 3 (Medical Analysis System, Inc., USA), Elecsys PreciControl Varia, and Elecsys PreciControl Troponin (Roche, Germany), respectively. The external quality assessment was analyzed by the Immunoassay Subcommittee in 685 institutions in the first trial survey (response rate 97.9%) and 678 institutions in the second survey (95.9%). A consistent improvement was observed in the quality of the participating laboratories, particularly in the peer group results. In addition, three new immunoassay markers, thyroglobulin, CTX, and Tn-T/Tn-I, were introduced to the standard assay systems by the Immunoassay Subcommittee.
Bone Resorption ; Carcinoembryonic Antigen ; Chorion ; Collagen ; Complement System Proteins ; Data Collection ; Humans ; Immunoassay* ; Immunoglobulin A ; Immunoglobulin M ; Immunoproteins ; Korea ; Peer Group ; Prostate ; Thyroglobulin ; Thyroid Gland ; Thyroid Hormones ; Thyrotropin ; Troponin ; Troponin I

In 2014, two external quality assessment trials were performed on 13 test items grouped in four categories. The laboratories procured the materials for the first and second trials on 13 May 2014 and 11 November 2014, respectively. The trials were performed on 13 test items, including tumour markers, thyroid hormones, cardiac marker troponin (troponin T or troponin I), and procalcitonin as a new biomarker for immunoassay methods. The bone marker carboxy-terminal collagen crosslinks (CTX) has been replaced by procalcitonin this year because only a limited number of institutions used it. External quality surveys of the 13 immunoassay test items with 8 control materials were performed as scheduled. The 13 control materials included six tumour markers, alpha-fetoprotein, carcinoembryonic antigen, carcinoma antigen 125, carbohydrate antigen 19-9, human chorionic gonadotrophin, and prostate specific antigen, as well as five thyroid markers, thyroid hormone 3 (T3), T4, thyroid stimulating hormone, free T4, and thyroglobulin. This year, procalcitonin has been introduced as a new biomarker in addition to troponin, which was introduced last year. Five homemade pooled sera and three commercial control sera were used as survey materials. The MAS Tri-point Liquimmune level 3 (Medical Analysis Systems Inc., USA) was used for controls of thyroid hormones, while Elecsys PreciControl Varia and Elecsys PreciControl Troponin (Roche, Germany) were used for controls of the new biomarkers procalcitonin and troponin, respectively. In the external quality assessment by the Immunoassay Subcommittee, 712 institutions participated in the first trial survey (response rate 97.9%), while 715 participated in the second survey (response rate 97.9%). The quality of the participating laboratories seems to be continuously improving compared to the results of their peers. Additionally, this year procalcitonin has been introduced as a new biomarker instead of the CTX, which was used in 2013, while thyroglobulin and troponin-T/troponin-I, which were used for the 2013 samples, continue to be used in surveys by the Immunoassay Subcommittee.
alpha-Fetoproteins ; Biomarkers ; Carcinoembryonic Antigen ; Chorion ; Collagen ; Humans ; Immunoassay* ; Korea* ; Prostate-Specific Antigen ; Thyroglobulin ; Thyroid Gland ; Thyroid Hormones ; Thyrotropin ; Troponin

BACKGROUND: Intra-operative hypothermia adversely affects hemodynamics and post-operative recovery in cardiac surgery patients. This study evaluated the efficacy of active warming during the preanesthetic period on the prevention of intraoperative hypothermia in cardiac surgery patients. METHODS: After gaining the approval of Institutional Review Board and informed consent from the patients, sixty patients undergoing cardiac surgery were divided into control and prewarming group. The control group (n = 30) were managed with warm mattresses and cotton blankets, whereas the prewarming group (n = 30) were actively warmed with a forced-air warming device before anesthesia. Hemodynamic variables and temperature were recorded before anesthesia (Tpre) and at 30 min intervals after anesthesia (T30, T60, and T90). RESULTS: Before anesthesia, skin temperature was significantly higher in the prewarming group than in the control group. At T90, core temperature was significantly higher in the prewarming group than in the control group. Intraoperative hypothermia (core temperature < 35.5oC) developed by T90 in 78% of patients in the control group and 44% of patients in the prewarming group. Moreover, temperatures below 35oC developed in 58% of the conrol group and 17% of the prearming group. CONCLUSIONS: Active warming just before anesthesia reduced the incidence and degree of hypothermia in patients undergoing cardiac surgery, with no delay of anesthesia.
Anesthesia* ; Beds ; Ethics Committees, Research ; Hemodynamics ; Humans ; Hypothermia* ; Incidence ; Informed Consent ; Skin Temperature ; Thoracic Surgery*

BACKGROUND: There has been no report about the effects of blood pressure (BP) on the change of blood flow (BF) to major organs when pump flow is maintained during cardiopulmonary bypass (CPB). We evaluated the changes of the BF and oxygen consumption of major organs when BP was controlled by vasopressors or vasodilators during CPB. METHODS: Carotid, femoral, hepatic and renal arteries and veins were exposed and arteries were cannulated for pressure monitoring, except the hepatic artery and arteries on the opposite side were exposed for the measurement of BF in 7 dogs. Temperature was lowered to 30oC after initiation of CPB and phenylephrine or sodium nitroprusside was infused to increase or decrease BP about 30% under the same pump flow. BP and BF were measured before CPB, before the infusion of drugs and when BP was changed by vasoactive drugs. Blood gas analyses were performed from the artery and each vein while the BF was measured. RESULTS: The change of BP didn't affect carotid and renal BF. However, hepatic BF decreased about 50% when BP was reduced and femoral BF changed in the opposite way of BP change. Oxygen consumption of each organ wasn't influenced by BP. CONCLSIONS: When pump flow was constantly maintained, changes in BP redistributed BF to major organs but didn't affect oxygen consumption. The brain and kidney have the ability of autoregulation of BF unlike the liver or legs. Hepatic BF was dependent on perfusion pressure and a decrease in BP by vasodilators during CPB may be not good for the liver.
Animals ; Arteries ; Blood Gas Analysis ; Blood Pressure ; Brain ; Cardiopulmonary Bypass* ; Dogs ; Hepatic Artery ; Homeostasis ; Kidney ; Leg ; Liver ; Nitroprusside ; Oxygen Consumption ; Perfusion* ; Phenylephrine ; Renal Artery ; Vasodilator Agents ; Veins

In this case, a successful mitral valve repair was confirmed by transesophageal echocardiography (TEE) at the end of a cardiopulmonary bypass. The left ventricular vent was placed through the mitral valve to remove the air after the TEE examination, and on its way out, the left ventricular vent damaged the anterior mitral leaflet (AML). Re-examination of the valve with TEE detected the new mitral valve insufficiency. The CPB was reinstituted, and tearing of the lateral third part of the anterior mitral leaflet was found. This case emphasizes the importance of TEE in the operating room as a continuous monitor, not only to evaluate the result of the cardiac surgery, but also to detect any unpredictable events during the surgery.
Mitral Valve Insufficiency/*surgery/*ultrasonography ; Mitral Valve/*injuries/surgery ; Middle Aged ; Intraoperative Complications/surgery ; Humans ; Female ; *Echocardiography, Transesophageal ; Cardiopulmonary Bypass/*adverse effects

BACKGROUND AND OBJECTIVES: This examined the association of cognitive function with self-care and major adverse cardiac events (MACE) among heart failure (HF) patients. SUBJECTS AND METHODS: In this prospective study, 86 outpatients with HF completed face-to-face interviews including neuropsychological testing to evaluate cognitive function and the use of the Self-Care of Heart Failure Index to measure self-care. Functional status was assessed with the New York Heart Association (NYHA) classification. Follow-up data on MACE were obtained at 24 months after enrollment. RESULTS: Compared with the Korean norm values, more than half of the HF patients had cognitive deficits in global function (33.0%), immediate recall (65.1%), delayed recall memory (65.1%), and executive function (60.5%). Patients with symptomatic HF (> or =NYHA class II) had the higher risk for substantially poor cognitive function in all areas of cognitive function than asymptomatic HF patients (NYHA class I, p<0.05). Most patients demonstrated poor self-care adequacy in maintenance (84.9%), management of symptoms (100%), and confidence (86.0%). After adjustment for age and gender, memory function was significantly associated with self-care confidence (odds ratio 1.41, 95% confidence interval 1.03-1.92, p=0.033). No relationship was found between cognition and self-care maintenance. There were 19 MACE's during the 24-month follow-up. Patients without MACE had a significantly higher global cognitive function (p=0.024), while no cognitive domains were significant predictors of MACE when adjusted for age and gender. CONCLUSION: HF patients with memory loss have poorer self-care confidence. Studies are warranted to examine the functional implication of cognitive deficits and adverse outcomes in a larger sample.
Classification ; Cognition ; Executive Function ; Follow-Up Studies ; Heart ; Heart Failure* ; Humans ; Memory ; Memory Disorders ; Memory, Short-Term ; Neuropsychological Tests ; Outpatients ; Prospective Studies ; Self Care*

Behcet's syndrome has been known as a disease which has the triple symptoms such as recurrent orogenital ulceration and eye inflammation. The syndrome is now recogninized as a multisystem disease involving mucocutaneaous, cardiovascular, central nervous system, renal, articular and gastrointestinal system. The vascular involvement in Behcet's disease has been reported since Mischima first described the case in 1961, four types of vascular lesion are recognized ; arterial occlusion ; aneurysm ; venous occlusion ; and varices. Venous occlusion are frequently observed, most commonly in the inferior or superior vena cava. We report a case of Behcet's disease manifested as superior vena cava syndrome due to thrombus on both brachiocephalic veins.
Aneurysm ; Behcet Syndrome* ; Brachiocephalic Veins ; Central Nervous System ; Inflammation ; Superior Vena Cava Syndrome* ; Thrombosis ; Ulcer ; Varicose Veins ; Vena Cava, Superior*

Medical students’ career choices hold significant importance at both individual and national levels. Therefore, Chungnam National University College of Medicine aimed to systematize its revised career fair in 2022, basing its efforts on a career planning process model. Chungnam National University College of Medicine sought to formalize the design process by utilizing the ADDIE model (analysis design, development, implementation, evaluation model) in developing programs for the career fair program. Throughout the entire process, the student support center and student council actively collaborated, striving to incorporate students’ requests and opinions. They designed and developed a program for all stages of the career planning process. However, a new stage (“review & reflection”) was added to the existing 4-phase model, creating a transformed framework where this stage interacts with the original 4 phases. Each stage involved portfolios, career aptitude tests, career-related lectures, posters with introductory information about majors, and booths for each major. The revised career fair attracted double the expected participants (N=589). The program evaluation survey showed overall positive responses (N=135). Additionally, some factors in the Specialty Indecision Scale showed significant differences between before and after the career fair. The success of the newly developed career fair at Chungnam National University College of Medicine can be attributed to its systematic framework and the active involvement of students throughout the process. However, for aspects with long-term implications, such as “understand yourself” and “choose your specialty,” there may be a need for supplementary programs.

Postoperative atrial arrhythmia after thoracotomy is relatively common, with a reported incidence ranging from 8% to 30%. These arrhythmias may cause hypotension, congestive heart failure and lengthen the period of postoperative hospitalization. The most important precipitating factor is atrial dilation and identified risk factor is an advanced age of the patient. The effect of various prophylactic regimens to reduce atrial arrhythmias is controversial. We report a case of postoperative atrial fibrillation in a 73 year-old female patient undergoing repair of esophageal hiatal hernia.
Aged ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Female ; Heart Failure ; Hernia, Hiatal* ; Hospitalization ; Humans ; Hypotension ; Incidence ; Precipitating Factors ; Risk Factors ; Thoracotomy