Background: Peripheral nerve injury is a complication that can occur after general anesthesia. It significantly impairs the patient’s quality of life and may lead to permanent disability. Nerves in several areas can be damaged during the perioperative period, but it is very rare that numbness of the lower lip is caused after general anesthesia. Case: A 73-year-old man with diabetes mellitus underwent urological surgery under general anesthesia. The day after surgery, he complained of numbness on the right lower lip caused by a mental nerve injury. Diabetic mononeuropathy or neurapraxia related to mechanical compression was considered a possible cause. The symptoms resolved spontaneously after six weeks. Conclusions Mental nerve injury is a rare perioperative complication in surgical patients under general anesthesia. In this case, patients should be reassured and advised to avoid injuries to the mouth and lips. However, specific treatment is not required.

Background: Peripheral nerve injury is a complication that can occur after general anesthesia. It significantly impairs the patient’s quality of life and may lead to permanent disability. Nerves in several areas can be damaged during the perioperative period, but it is very rare that numbness of the lower lip is caused after general anesthesia. Case: A 73-year-old man with diabetes mellitus underwent urological surgery under general anesthesia. The day after surgery, he complained of numbness on the right lower lip caused by a mental nerve injury. Diabetic mononeuropathy or neurapraxia related to mechanical compression was considered a possible cause. The symptoms resolved spontaneously after six weeks. Conclusions Mental nerve injury is a rare perioperative complication in surgical patients under general anesthesia. In this case, patients should be reassured and advised to avoid injuries to the mouth and lips. However, specific treatment is not required.

Benign prostate hyperplasia (BPH) is a common disease in old-age males, accounting for approximately 77% of morbidity within the age range of 40 to 70 years. It has been shown that morbidity increases with social graying. Quisqualis indica linn (QI) has been used to treat inflammation, stomach pain, and digestion problems. In this study, we evaluated the symptom-regulating effects of QI extract on a testosterone-induced BPH rat model. After inducing BPH in rats using testosterone propionate (TP) injection, we assessed basal intraurethral pressure (IUP) and increments of IUP elicited by electrical field stimulation (5 V, 5, 10, or 20 Hz) or phenylephrine (Phe) (0.01, 0.03, 0.1 mg/kg IV). To induce BPH, 8-week-old rats were subjected to a daily subcutaneous TP (3 mg/kg) injection for 4 weeks. Finasteride (Fina) (10 mg/kg PO) was administered to the rats in the first treatment, while QI (150 mg/kg PO) was administered to those in the second group. Blood pressure was measured together with IUP, after which low urinary tract (LUT), ventral prostate (VP), testicle, and corpus spongiosum were isolated and weighed. Basal IUPs for the Fina- and QI-treated groups were 87.6 and 86.8%, respectively.LUT and VP organ weights in the QI group were lower than those in the Fina group. However, the QI group showed significantly reduced electrical stimulated or Phe-induced IUP increment compared to the Fina and BPH groups. These results proved that QI can be beneficial for BPH symptoms by inhibiting 5α-reductase and consequently decreasing prostate and releasing urinary pressure.

BACKGROUND: Among the many Vibrio species that can cause infections in humans, several species can cause a fatal outcome. Therefore, accurate identification of Vibrio species is very important. Since some species show atypical phenotypic features, selecting an appropriate molecular method is necessary to avoid misdiagnosis. METHODS: Vibrio clinical isolates (N=53) and reference strains (N=8) were used in this study. We analyzed the following sequences for identification: dnaJ gene, 16S rDNA, gyrase B (gyrB) V. vulnificus-specific sequence, gyrB V. navarrensis-specific sequence, and V. vulnificus hemolysin gene PCR (Vvh PCR). We performed phylogenetic analysis of the 16S rDNA, dnaJ, and gyrB sequences. Final identification was based on the combined results of all tests described above. Concordance of the 16S rDNA and dnaJ sequence analysis was measured using the Chi-square test. RESULTS: The 61 Vibrio strains were identified as follows, in descending order: V. vulnificus (78.69%), V. parahaemolyticus (6.56%), V. navarrensis (4.92%), V. mimicus (1.64%), V. cholera (1.64%), V. furnissii (1.64%), V. alginolyticus (1.64%), and Grimontia hollisae (1.64%). The accuracy rates of the dnaJ gene and 16S rDNA sequence for identification were 91.80% and 86.89%, respectively. The 16S rDNA and dnaJ sequences showed a concordance rate of 0.45, which indicates moderate agreement. CONCLUSIONS: Our results suggest that analysis of the dnaJ sequence may be a useful method for the identification of clinical isolates of Vibrio species, especially for distinguishing between closely related Vibrio species.
Cholera ; Diagnostic Errors ; DNA, Ribosomal ; Fatal Outcome ; Humans ; Methods ; Polymerase Chain Reaction ; Sequence Analysis ; Vibrio

BACKGROUND: Tigecycline resistance has emerged recently and has shown diverse mechanisms. The aim of this study was to assess the role of efflux activity in tigecycline resistance in 120 clinical isolates of A. baumannii using two methods: the H33342 accumulation assay and adeB real-time reverse transcriptase polymerase chain reaction. In addition, we analyzed the correlation between the expression level of adeB and H33342 accumulation level. METHODS: A. baumannii clinical isolates was divided into tigecycline-resistant (49 strains), intermediate (40 strains), and susceptible (31 strains) groups. The H33342 accumulation was measured in the absence or presence of the efflux pump inhibitor carbonyl cyanide 3-chlorophenylhydrazone (CCCP). Real-time RT-PCR was performed to determine the relative expression of the adeB gene in A. baumannii clinical isolates. RESULTS: The level of H33342 accumulation in the resistant group was relatively lower than those in the other groups. The addition of CCCP caused a significantly increased fold change in H33342 accumulation in the tigecycline-resistant group. Significant difference in the fold change level in H33342 accumulation was found between tigecycline-susceptible and resistant isolates. Those findings support the role of efflux pumps of which substrates are H33342 in the resistance of tigecycline. Significant differences in the relative expression levels of adeB were shown between tigecycline-susceptible and resistant groups also. CONCLUSION: The results showed that several efflux pumps of which substrates were H33342 can contribute to tigecycline resistance. The adeB overexpression can also contribute to tigecycline resistance. It is possible that efflux pumps other than adeB efflux pumps contribute to tigecycline resistance because there was no correlation between fold change level in H33342 accumulation and adeB expression level.
Acinetobacter baumannii* ; Acinetobacter* ; Carbonyl Cyanide m-Chlorophenyl Hydrazone ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND: Lung cancer is the leading cause of cancer death in South Korea since the year 2000 and it is more common in elderly patients, with a peak incidence at around 70~80 years of age. However, these elderly patients receive treatment less often than do the younger patients because of organ dysfunction related to their age and their comorbidities, and they show poor tolerance to chemotherapy. The aims of this study were to analyze the clinical characteristics and treatment-related survival of elderly patients with lung cancer. METHODS: In this retrospective study, we analyzed the clinical data of 706 lung cancer patients who were diagnosed at hospitals in Daegu and Gyeongsangbukdo from January 2005 to December 2005. We compared the clinical characteristics and outcomes of the patients who were aged 70 years and older (elderly patients) with those clinical characteristics and outcomes of the younger individuals. RESULTS: The median age of the patients was 68 years (from 29 to 93) and the elderly patients were 38.7% (n=273) of all the study's patients. Squamous cell carcinoma was the most common type of lung cancer in both the elderly and younger patient groups. Elderly patients had more symptoms of dyspnea and chronic obstructive pulmonary disease (COPD) than the younger patients (p<0.001 and p<0.001, respectively). A good performance status (ECOG 0-1) was less common for the elderly patients (p<0.001). The median survival of the non-small cell lung cancer (NSCLC) patients was significantly higher in the younger patient group than in the elderly patient group (962 days vs 298 days, respectively, p=0.001). However, the median survival of the NSCLC patients who received any treatment showed no significant difference between the younger patient group and the elderly patient group (1,109 days vs 708 days, respectively, p=0.14). CONCLUSION: Our data showed that appropriate treatment for selected elderly patients improved the survival of patients with NSCLC. Therefore, elderly NSCLC patients with a good performance status should be encouraged to receive appropriate treatment.
Aged ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Comorbidity ; Dyspnea ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Prognosis ; Pulmonary Disease, Chronic Obstructive ; Republic of Korea ; Retrospective Studies

PURPOSES: An overactive bladder is highly prevalent in middle-aged woman, especially during the postmenopausal period. We evaluated the relationship between detrusor overactivity and postmenopausal state and the effects of estrogen replacement for detrusor overactivity caused by the ovariectomy in rat. MATERIAL AND METHODS: Thirty female Sprague Dawley rats were divided into three groups: the control, the ovariectomy group and the estrogen replacement group after the ovariectomy. The ovariectomy and estrogen replacement groups had the bilateral ovariectomies at 12 weeks of age. After 2 weeks, the control and ovariectomy groups were injected weekly with saline, while the estrogen replacement group was injected with estradiol benzoate (500 migrogram/kg) weekly. After 12 weeks, the voiding frequency study was recorded and a cystometrogram was performed while awake. The harvested bladders were used in the carbachol-induced detrusor muscle contraction study and the distribution of estrogen, M2 and M3 muscarinic receptors in the rats' bladder. RESULTS: The ovariectomy group voided more frequently than the others (p=0.005). During the awake cystometrogram, the detrusor characteristics of the ovariectomy group were a higher mean intervoiding pressure and smaller bladder capacity than the others (p=0.000). There was no significant statistical difference between the control and estrogen replacement group. The other cystometric parameters were not statistically different either. The detrusor muscle contraction study showed no difference between three groups. There was a significant difference in the distribution of M2 and M3 receptors of bladder mucosa between the control and ovariectomy group. CONCLUSIONS: This study suggested that the detrusor overactivity resulted from increased connective tissue ratio and decreased M2, M3 receptor in the bladder mucosa. Moreover, estrogen replacement in the postmenopausal state had the effect of reversing the physiological and morphological changes caused by an estrogen deficiency in the bladder.
Animals ; Benzoates ; Connective Tissue ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Mucous Membrane ; Muscle Contraction ; Ovariectomy* ; Physiology* ; Postmenopause ; Rats* ; Rats, Sprague-Dawley ; Receptors, Muscarinic ; Urinary Bladder* ; Urinary Bladder, Overactive

OBJECTIVE: Exercise may contribute to alteration in cancer in many ways. The major cell in cellular immunity to defense against cancer cell is natural killer [NK] cell. So this study is aimed to investigate the effects of exercise on NK cell cytotoxic activity (NKCA) in breast cancer patients who underwent mastectomy. METHOD: Thirty-one breast cancer patients who had undergone curative surgery were randomly assigned to an exercise group (n=16) and a non-exercise group (n=15). Exercise therapy was consisted of aerobic activity such as bicycle ergometer for 30 minutes, twice a day, five times each week for 2 weeks. The venous blood samplings were obtained on postoperative days 1, 7 and 14. NKCA was assayed by cytotoxic response against K562 cells. The venous blood samplings were obtained on postoperative days 1, 7 and 14. NKCA was assayed by cytotoxic response against K562 cells. RESULT: The baseline study did not show any statistical difference between exercise group and non-exercise group. Mean NKCA of day 7 decreased in both groups compared with that at postoperative day 1 (p<0.05). At day 14, the difference of the mean NKCA between two groups was not significant, but the mean NKCA of the exercise group without metastasis demonstrated a significant increase compared with that of the non-exercise group without metastasis (p<0.05). CONCLUSION: This study suggested that early moderate exercise had a beneficial effect on the function of NK cells in early stage of breast cancer patients after curative surgery. A further study will be needed to evaluate long-term effect of exercise on NK cell.
Breast Neoplasms* ; Breast* ; Exercise Therapy* ; Humans ; Immunity, Cellular ; K562 Cells ; Killer Cells, Natural* ; Mastectomy ; Neoplasm Metastasis

A lymphatic cyst of the stomach is rare benign tumor which is composed of thin-walled lymphatic space lined by benign-appearing endothelial cells. It rarely manifests clinical symptoms, so it is found incidentally in most cases. Recently, a case of submucosal lymphatic cyst associated with early gastric cancer was experienced. An endoscopy revealed a slightly elevated, edematous lesion adjacent to the malignant ulcer. This case is herein reported with a brief review of related literature.
Endoscopy ; Endothelial Cells ; Lymphocele* ; Stomach ; Stomach Neoplasms* ; Ulcer

Hemorrhagic fever with renal syndrome (HFRS) in Korea is caused by 2 serotypes of hantavirus, Hantaan and Seoul. Even though the number of peripheral CD8' T-lymphocytes is markedly elevated in the acute phase of HFRS, the pathogenetic role of this phenomena is not clear. To elucidate the role of cell-mediated immune response in HFRS, we measured concentrations of cytokines, such as IL-1, IL-2, IL-4, IL-6, IL-10 and IFN-r in plasma samples obtained from 15 patients (15 men, 20-24 years old) at various phase of illness. Cytokines were measured by ELISA in plasma samples. The plasma concentration of IL-10 was elevated in 13/15 patients. The median maximum value, during days 4-8, was 23 ng/L (range, 0-70.2). The maximum values were significantly higher(p=0.005) than the baseline. IL-1 and IL-6 was detected in 6 patients. Other cytokine responses (IL-2, IL-4, IFN-r ) were negligible. There was no significant correlation between maximum levels of IL-10 and maximum serum concentration of creatinine (r=0.118, p=0.675), and lowest plate#let count (r=-0.088, p=0.765). Kinetics of IL-10 were quite similar in HFRS patients with maximum creatinine values >3 mg/dL and in those with values <3 mg/dL. In conclusion, plasma IL-10 levels, but not IL-2, IL-4 or INF-r were elevated in acute phase of HFRS, and it suggests that the systemic immunosuppressive activities of IL-10 might have some pathogenetic role in HFRS.
Creatinine ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Kinetics ; Korea ; Male ; Plasma* ; Seoul ; T-Lymphocytes