BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*

We described a case of well differentiated papillary mesothelioma (WDPM) of the peritoneum in a 68-year-old man because of its rarity. It was incidentally found during operation for renal cell carcinoma. Grossly, the tumor appeared as multiple small granules or nodules on the entire peritoneal surface, including serosa of the intestine, omentum and mesentery. Microscopically, characteristic features are papillary, tubulopapillary or solid architecture lined by single layer of uniform, cytologically bland, cuboidal or polygonal mesothelial cells. The tumor cells were positive for EMA, cytokeratin and vimentin, but negative for CEA on immunohistochemical staining. Ultrastructural study showed characteristic long slender microvilli on the surface and intercellular junctions.
Male ; Humans

Drug-induced interstitial nephritis is one cause of acute kidney injury. Although traditional remedies have been widely used in South Korea, Corni fructus-induced interstitial nephritis has not been reported in the general population. A 65-year-old female patient was admitted with sudden onset of gross hematuria after ingesting Corni fructus tea for 2 weeks. Her initial lab findings showed a blood urea nitrogen level of 35.1 mg/dL, creatinine level of 1.7 mg/dL, albumin level of 4.5 g/dL, and hemoglobin level of 10.3 g/dL. Urinalysis revealed SG (1.025), blood (many), protein (+), and WBC (0-3/HPF). Her 24-hour total protein level was 1,120 mg/day. No specific abnormalities were found on serum and urine protein electrophoresis. Kidney biopsy demonstrated severe mononuclear cell infiltration into the renal interstitium with mild tubular atrophy and pericapsular fibrosis. Immediate withdrawal of Corni fructus, appropriate education, and conservative management resulted in gradual restoration of her renal function. This case implies that Corni fructus may be a causative allergen that induces acute interstitial nephritis in some patients.
Acute Kidney Injury ; Aged ; Atrophy ; Biopsy ; Blood ; Blood Urea Nitrogen ; Cornus ; Creatinine ; Education ; Electrophoresis ; Female ; Fibrosis ; Hematuria ; Hemoglobins ; Humans ; Kidney ; Nephritis, Interstitial* ; Pyridines ; Republic of Korea ; Tea ; Thiazoles ; Urinalysis ; Urine

Drug-induced interstitial nephritis is one cause of acute kidney injury. Although traditional remedies have been widely used in South Korea, Corni fructus-induced interstitial nephritis has not been reported in the general population. A 65-year-old female patient was admitted with sudden onset of gross hematuria after ingesting Corni fructus tea for 2 weeks. Her initial lab findings showed a blood urea nitrogen level of 35.1 mg/dL, creatinine level of 1.7 mg/dL, albumin level of 4.5 g/dL, and hemoglobin level of 10.3 g/dL. Urinalysis revealed SG (1.025), blood (many), protein (+), and WBC (0-3/HPF). Her 24-hour total protein level was 1,120 mg/day. No specific abnormalities were found on serum and urine protein electrophoresis. Kidney biopsy demonstrated severe mononuclear cell infiltration into the renal interstitium with mild tubular atrophy and pericapsular fibrosis. Immediate withdrawal of Corni fructus, appropriate education, and conservative management resulted in gradual restoration of her renal function. This case implies that Corni fructus may be a causative allergen that induces acute interstitial nephritis in some patients.
Acute Kidney Injury ; Aged ; Atrophy ; Biopsy ; Blood ; Blood Urea Nitrogen ; Cornus ; Creatinine ; Education ; Electrophoresis ; Female ; Fibrosis ; Hematuria ; Hemoglobins ; Humans ; Kidney ; Nephritis, Interstitial* ; Pyridines ; Republic of Korea ; Tea ; Thiazoles ; Urinalysis ; Urine

Purpose: We evaluated changes in the tear film parameters of the corneal surface, and their correlations with Munk scores,based on corneal topographic scans of patients with nasolacrimal duct obstructions who underwent dacryocystorhinostomy(DCR). We explored whether tear parameters can serve as useful indicators of functional surgical success. Methods: We assessed 72 eyes of 45 patients diagnosed with nasolacrimal duct obstruction who underwent DCR. Tear film parameterswere measured via corneal topography (Keratograph® 5M) once before, and three times after surgery, and includedtear meniscus height (TMH), and the initial and average keratographic tear break-up time (NIKBUT-first and NIKBUT-average,respectively; measured noninvasively). Results: The three postoperative TMH values were 0.31 ± 0.20, 0.30 ± 0.22, and 0.29 ± 0.15 mm, all of which were significantlylower than the preoperative value of 0.48 ± 0.29 mm (all, p < 0.001). Three months after surgery, the NIKBUT-first (6.90 ± 3.39seconds) was significantly shorter than the preoperative value (8.39 ± 5.34 seconds; p = 0.030). The preoperative NIKBUT-averagedid not differ significantly from the values at the three postoperative timepoints (p = 0.756, p = 0.753, and p > 0.999).Changes in the Munk score after surgery correlated significantly with changes in the TMH (r = 0.46, p < 0.001). When functionalsuccess was defined as a Munk score ≤ 1, the area under the curve (AUC) value corresponding to the ability of TMH to definefunctional success of 0.995, was statistically significant (cut-off of 0.31 mm; p < 0.001). Conclusions The TMH DCR correlated significantly with the Munk score, which is a quantitative measure of clinical symptomseverity. The ability of TMH to define functional surgical success was excellent.

PURPOSE: The aim of this study was to assess changes in neuropeptide Y (NPY) immunoreactivity in the hypothalamus and interstitial cells of Cajal (ICC) in the small intestine of rats fed high-fat diets (HFD). METHODS: Male Sprague-Dawley rats (200~250 g body weight) were randomly divided into two groups, which were the control group (normal chow diet for 6 weeks), and the HFD group (rodent diet with 60% kcal fat for 6 weeks). The immunoreactivity of NPY in the hypothalamus and ICC in the small intestine was evaluated after every feed for 6 weeks. RESULTS: NPY immunoreactivity was observed strongly in the hypothalamic nuclei in the HFD group compared to the control group. The numbers of NPY-immunoreactive (IR) cells were significantly higher in the paraventricular hypothalamic nucleus in the HFD group than in the control group. In the region of Auerbach's plexus (AP) of small intestine, the staining intensity of the ICC-IR cells was reduced in the HFD group compared to the control group. The numbers of ICC in the small intestine with HFD, including ICC in the inner circular and outer longitudinal muscle were significantly lower than in the control group. CONCLUSION: This study suggested that increasing NPY-IR cells in the hypothalamus may reflect resistance of NPY action after a HFD, and decreasing ICC-IR cells in the small intestine after a HFD is functionally significant in gastrointestinal motility.
Animals ; Diet ; Diet, High-Fat ; Gastrointestinal Motility ; Humans ; Hypothalamus ; Interstitial Cells of Cajal ; Intestine, Small ; Male ; Muscles ; Myenteric Plexus ; Neuropeptide Y ; Neuropeptides ; Paraventricular Hypothalamic Nucleus ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Chronic myelogenous leukemia is a chronic myeloproliferative disorder characterized by leukocytosis with myeloid elements at all stages of differentiation, t(9;22)(q34;q11) and bcr/abl rearrangement. We studied hydroxyurea induced apoptotic changes such as externalization of phosphatidylserine, caspase activities on human chronic myelogenous leukemic cell line, K562 cells. METHODS: K562 cells were grown in RPMI 1640 supplemented with 10% fetal bovine serum and treated hydroxyurea. Viability was examined by MTT assay. Apoptosis were examined by annexin V stain, caspase (such as caspase-, caspase-, caspase-, caspase-, and caspase-) activities, and DNA fragmentation. RESULTS: The viability of K562 cells were markedly decreased in a dose dependent manner of hydroxyurea. Phosphatidylserine externalization was detected by annexin V stain after 3 hours in hydroxyurea treated K562 cells and the value of lactate dehydrogenase was not significantly changed in their culture media. The upstream effector of caspase- was slightly increased and had influenced on caspase-. And downstream acting caspase protease of caspase- was markedly increased in a time dependent manner at hydroxyurea treated K562 cells. In addition, however the activities of caspase- and caspase- were not increased. We also found DNA fragmentation at hydroxyurea treated K562 cells between 48 hours and 72 hours on agarose gel electrophoresis. CONCLUSIONS: Hydroxyurea induces apoptotic change in K562 cells via externalization of phosphatidylserine, activations of caspase-, caspase-, caspase- proteases, and DNA fragmentation.
Annexin A5 ; Apoptosis ; Cell Line* ; Culture Media ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Humans ; Hydroxyurea* ; K562 Cells* ; L-Lactate Dehydrogenase ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukocytosis ; Myeloproliferative Disorders ; Peptide Hydrolases

Infertility due to ejaculatory failure and poor semen quality is a main problem for sexual dysfunction of spinal cord injured (SCI) men. A 27-year-old paraplegic man who wished to father children was induced to repeated ejaculations for eight times with a rectal probe electrical stimulation at one or two weekly interval. For the 4th to 8th stimulations, the subject took pseudoephedrine 20 mg, three times a day orally to improve the semen quality. We report a triplet childbirth between the SCI man and his healthy wife through the ejaculatory stimulations in conjuction with advanced reproductive techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
Adult ; Child ; Ejaculation ; Electric Stimulation ; Fathers ; Fertilization in Vitro ; Fertilization* ; Humans ; Infertility ; Male ; Parturition* ; Pseudoephedrine ; Reproductive Techniques ; Semen Analysis ; Sperm Injections, Intracytoplasmic ; Spinal Cord* ; Spouses ; Triplets

Two series of 15 patients who undersent cesarean section with general anesthesia were given either 0.5% halothane (Group I ) or 0.75% isoflurane (Group II) as supplements of 50%, nitrous oxide in oxygen used for maintenance. In Group II, recovery was slower than in group I, but there was no intraoperative awareness and neither uterine relaxation assessed by visual analogue scale nor bleeding assessed by postoperative hemoglobin and hematocrit value presented difficulty. Infant well-being, as judged by Apgar score and cord blood gas analysis, was not affected.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Apgar Score ; Cesarean Section* ; Female ; Fetal Blood ; Halothane* ; Hematocrit ; Hemorrhage ; Humans ; Infant ; Intraoperative Awareness ; Isoflurane* ; Nitrous Oxide ; Oxygen ; Pregnancy ; Relaxation

OBJECTIVES: Mild cognitive impairment (MCI) is distinguished from mild dementia by an absence of global intellectual deterioration and the preservation of activities of daily living (ADL). Recently, however, it became apparent that impairment of instrumental activities of daily living (IADL) is present before the threshold of dementia is reached. Thus, we want to examine whether IADL are impaired in patients with MCI, and which items of IADL are particularly involved. We divided the MCI group into amnestic (aMCI) and non-amnestic MCI (naMCI), and compared to the cognitively normal controls. In this study, we focused on the instrumental activities of daily living (IADL). METHODS: The sample consisted of 69 community-dwelling older adults from a welfare center for the aged in Korea. The subjects were divided into three diagnostic groups; aMCI [N=19, memory domains below -1.5 standard deviation (SD)], naMCI (N=19, other cognitive domains below -1.5 SD, except memory domains) and cognitive normal controls (N=31). Subjects were assessed both on IADL and the cognitive function. In order to assess the IADL, we used the Seoul -Instrumental Activities of Daily Living (S-IADL). Included measures of cognitive tests are as follows; Seoul Verbal Learning Test (SVLT), Rey Complex Figure Test (RCFT), Korean-Boston Naming Test (K-BNT), Stroop test, and Korean-Mini Mental Status Examination (K-MMSE). Groups were compared on the S-IADL and the cognitive tests. RESULTS: The three groups did not differ in the mean age, gender distribution and years of education. S-IADL were shown to be different between the groups in this study. Subjects with aMCI were significantly more impaired in S-IADL in comparison to the controls [F(2,50)= 4.251, p=0.020]. And on four items of S-IADL (shopping, transportation, medication and talking about recent events), subjects with aMCI showed higher impairment compared to the controls. However, the S-IADL did not differ between the subjects with naMCI and controls. CONCLUSION: In this study, impairment of S-IADL was shown in subjects with aMCI. And S-IADL of naMCI was not significantly differed from aMCI and controls. The results suggest that naMCI would be distinguished from aMCI in characteristics and prognosis.
Activities of Daily Living ; Adult ; Aged ; Dementia ; Humans ; Korea ; Memory ; Mild Cognitive Impairment ; Prognosis ; Stroop Test ; Transportation ; Verbal Learning