PURPOSE: To evaluate the effect of anti-interleukin-33 (anti-IL-33) on a mouse model of ovalbumin (OVA)-induced acute kidney injury (AKI). METHODS: Twenty-four female BALB/c mice were assigned to 4 groups: group A (control, n=6) was administered sterile saline intraperitoneally (i.p.) and intranasally (i.n.); group B (allergic, n=6) was administered i.p./i.n. OVA challenge; group C (null treatment, n=6) was administered control IgG i.p. before OVA challenge; and group D (anti-IL-33, n=6) was pretreated with 3.6 µg of anti-IL-33 i.p. before every OVA challenge. The following were evaluated after sacrifice: serum blood urea nitrogen and creatinine levels, Kidney injury molecule-1 gene (Kim-1) and protein (KIM-1) expression in renal parenchyma, and expression of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), phosphorylated endothelial NOS (p-eNOS), and phosphorylated AMP kinase (p-AMPK) proteins in renal parenchyma. RESULTS: After OVA injection and intranasal challenge, mice in groups B and C showed significant increases in the expression of Kim-1 at both the mRNA and protein levels. After anti-IL-33 treatment, mice in group D showed significant Kim-1 down-regulation at the mRNA and protein levels. Group D also showed significantly lower COX-2 protein expression, marginally lesser iNOS expression than groups B and C, and p-eNOS and p-AMPK expression at baseline levels. CONCLUSIONS: Kim-1 could be a useful marker for detecting early-stage renal injury in mouse models of OVA-induced AKI. Further, anti-IL-33 might have beneficial effects on these mouse models.
Acute Kidney Injury ; Adenylate Kinase ; Animals ; Blood Urea Nitrogen ; Creatinine ; Cyclooxygenase 2 ; Down-Regulation ; Female ; Humans ; Immunoglobulin G ; Interleukin-33 ; Kidney* ; Mice ; Nitric Oxide Synthase Type II ; Ovalbumin ; Ovum ; RNA, Messenger

OBJECTIVE: To investigate the normal data of pain-related evoked potentials (PREP) elicited with a concentric surface electrode among normal, healthy adults and the relationship between PREP and pain intensity. METHODS: Sixty healthy volunteers (22 men and 38 women; aged 36.4+/-10.7 years; height, 165.4+/-7.8 cm) were enrolled. Routine nerve conduction study (NCS) was done to measure PREP following electrical stimulation of hands (C7 dermatome) and feet (L5 dermatome). Negative peak (N), positive peak (P) latencies, peak to peak (NP) amplitudes, conduction velocity (CV), and verbal rating scale (VRS) score were obtained. Linear regression analysis tested for significant relevance between variables of PREP and VRS score. RESULTS: Normal NCS results were obtained in all subjects. N latency of hand PREP was 163.8 +/-40.0 ms (right) and 161.0+/-39.9 ms (left). N latency of foot PREP was 178.0+/-43.9 ms (right), 180.4+/-43.4 ms (left). NP amplitude of hands was 20.6+/-10.6 microV (right) and 21.9+/-11.6 microV (left). NP amplitude of feet was 18.8+/-8.3 microV (right) and 19.0+/-8.4 microV (left). The calculated CV was 13.2+/-4.7 m/s and VRS score was 3.8+/-1.0. A highly significant positive correlation was evident between VRS score and NP amplitude (y=0.1069x+1.781, r=0.877, n=60, p<0.0001). CONCLUSION: PREP among normal, healthy adults revealed a statistically significant correlation between PREP amplitude and VRS score.
Adult* ; Electric Stimulation ; Electrodes ; Evoked Potentials* ; Female ; Foot ; Hand ; Healthy Volunteers ; Humans ; Linear Models ; Male ; Neural Conduction ; Nociceptive Pain ; Pain Measurement

OBJECTIVE: To examine the neurophysiologic status in patients with idiopathic facial nerve palsy (Bell's palsy) and Ramsay Hunt syndrome (herpes zoster oticus) within 7 days from onset of symptoms, by comparing the amplitude of compound muscle action potentials (CMAP) of facial muscles in electroneuronography (ENoG) and transcranial magnetic stimulation (TMS). METHODS: The facial nerve conduction study using ENoG and TMS was performed in 42 patients with Bell's palsy and 14 patients with Ramsay Hunt syndrome within 7 days from onset of symptoms. Denervation ratio was calculated as CMAP amplitude evoked by ENoG or TMS on the affected side as percentage of the amplitudes on the healthy side. The severity of the facial palsy was graded according to House-Brackmann facial grading scale (H-B FGS). RESULTS: In all subjects, the denervation ratio in TMS (71.53+/-18.38%) was significantly greater than the denervation ratio in ENoG (41.95+/-21.59%). The difference of denervation ratio between ENoG and TMS was significantly smaller in patients with Ramsay Hunt syndrome than in patients with Bell's palsy. The denervation ratio of ENoG or TMS did not correlated significantly with the H-B FGS. CONCLUSION: In the electrophysiologic study for evaluation in patients with facial palsy within 7 days from onset of symptoms, ENoG and TMS are useful in gaining additional information about the neurophysiologic status of the facial nerve and may help to evaluate prognosis and set management plan.
Action Potentials ; Bell Palsy ; Denervation ; Facial Muscles ; Facial Nerve ; Facial Paralysis ; Herpes Zoster ; Herpes Zoster Oticus ; Humans ; Muscles ; Paralysis ; Prognosis ; Transcranial Magnetic Stimulation

BACKGROUND: A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. METHODS: One hundred patients receiving upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled in this study. The infraclavicular brachial plexus block was performed using the vertical technique with 30 ml of 0.5% ropivacaine. The supraclavicular brachial plexus block was performed using the plumb bob technique with 30 ml of 0.5% ropivacaine. The block performance-related pain was evaluated. This study observed which nerve type was stimulated, and scored the sensory and motor block. The quality of the block was assessed intra-operatively. The duration of the sensory and motor block as well as the complications were assessed. The patient's satisfaction with the anesthetic technique was assessed after surgery. RESULTS: There were no significant differences in the block performance-related pain, frequency of the stimulated nerve type, evolution of sensory and motor block quality, or the success of the block. There were no significant differences in the duration of the sensory and motor block. There was a significant difference in the incidence of Horner's syndrome. Two patients had a pneumothorax in the supraclavicular approach. There were no significant differences in the patient's satisfaction. CONCLUSIONS: Both infraclavicular and supraclavicular brachial plexus block had similar effects. The infraclavicular approach may be preferred to the supraclavicular approach when considering the complications.
Amides ; Brachial Plexus ; Double-Blind Method ; Horner Syndrome ; Humans ; Incidence ; Pneumothorax ; Prospective Studies ; Upper Extremity

BACKGROUND: Postoperative nausea and vomiting (PONV) are common problems in patients undergoing general anesthesia. Ondansetron is widely used for this problems. But, some patients treated with ondansetron do not respond to therapy. We hypothesized that patients with genetic variation in 5-HT3b receptor and CYP2D6 gene might respond differently to ondansetron treatment. METHODS: 135 patients undergoing gynecologic surgery were given 4 mg ondansetron 15 min before extubation. The assessment of PONV was performed during < 2 hours and 2-24 hours. DNA was extracted from blood and was analyzed by using restriction fragment-length polymorphism (RFLP) and site-specific PCR. RESULTS: In 5-HT3b AAG deletion mutation, the incidence of nausea and vomiting < 2 hr were 25% and 12.5% for wild, 23.4% and 12.2% for heteromutant. The incidence of nausea and vomiting 2-24 hr were 3.2% and 1.1% for wild, 4.9% and 2.4% for heteromutant. This showed no significant differences between two groups. In CYP2D6*10 mutation, the incidence of nausea and vomiting < 2 hr were 28.6% and 19.6% for wild, 22.8% and 8.8% for heteromutant and 23.5% and 5.9% for homomutant. The incidence of nausea and vomiting 2-24 hr were 5.4% and 1.8% for wild, 3.2% and 1.6% for heteromutant, 0% and 0% for homomutant. This showed no significant differences among three groups. CONCLUSIONS: The incidence of PONV were not different among the genotype of CYP2D6*10 and 5HT3b AAG mutation.
Anesthesia, General ; Cytochrome P-450 CYP2D6 ; DNA ; Female ; Genetic Variation ; Genotype ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Nausea ; Ondansetron* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Postoperative Nausea and Vomiting ; Sequence Deletion* ; Vomiting

PURPOSE: To determine the extent to which magnetic resonance(MR) imaging findings can help differentiate between tuberculous arthritis (TA) and rheumatoid arthritis(RA). MATERIALS AND METHODS: This study involved sixteen patients with pathologically proven arthritis of the knee. In eight patients(mean age, 29.6 years; M:F=4:4) this was of the tuberculous variety, while eight (mean age, 47.5 years; M:F=2:6) suffered from the rheumatoid variety, which was monoarticular. For 14 patients, contrast enhancement studies were available. We retrospectively analyzed MR findings according to the demonstrated pattern of synovial thickening (regular and even, or irregular and nodular), bone erosion or abscess,bone marrow(BM) edema, the sites at which bursae were present, para-articular mass formation, and lymphadenopathy. RESULTS: In five of eight TA cases (62.5 %), irregular and nodular enhanced synovial thickening was present, while in six of eight RA cases (75%), thickening was regular and even. Bone erosions or subarticular abscesses were found in six TA cases (75%) and small erosions in three cases (37.5%) of RA. BM edema surrounding the erosion was found in four cases of TA (50%) and two of RA (25 %). In TA, edema was more extensive. In both TA and RA, all suprapatella bursae were distended while popliteal bursae were present in two cases of TA(25 %) and four of RA (50%). Para-articular masses with rim like enhancement were found in six cases of TA (75%) and in one case of RA (12.5 %). In particular, para-articular lymphadenopathy was seen in six cases of TA(75%), but not in RA. CONCLUSION: MR findings of irregular and nodular synovial thickening, extensive bone erosion, extensive BM edema, particular, para-articular abscess formation and ymphadenopathy, may help differentiate tuberculous arthritis of the knee from the rhumatoid variety.
Abscess ; Arthritis* ; Arthritis, Rheumatoid* ; Diagnosis, Differential* ; Edema ; Humans ; Knee* ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Retrospective Studies

Diffuse skin thickening of the breast is produced by lymphedema usually secondary to obstruction of theaxillary lymphatics. On physical examination, the affected breast is, due to increased fluid content, larger,heavier, and of higher overall density. Mammography reveals an increased coarse reticular pattern. Thickening ofthe skin can have many causes. It may be a result of tumor invasion or a tumor in the dermal lymphatics; orbecause of lymphatic congestion through obstruction of lymphatic drainage within the breast, in the axilla, orcentrally in the mediastinum. Further causes may be congestive heart failure, benign inflammation, primary skinprocesses such as psoriasis, or systemic diseases which involve the skin. Mammographic appearance is known to benonspecific. Ultrasound can demonstrate skin thickening directly, but despite some reports suggesting that thecause of skin thickening can be inferred from the results of ultrasound, this is not usually of practicalimportance. The purpose of this study is to review the causes of skin thickening of the breast and to usemammography and US to differentiate the causes.
Axilla ; Breast Diseases* ; Breast* ; Diagnosis, Differential* ; Drainage ; Estrogens, Conjugated (USP) ; Heart Failure ; Inflammation ; Lymphedema ; Mammography* ; Mediastinum ; Physical Examination ; Psoriasis ; Skin* ; Ultrasonography*

PURPOSE: To analyze the radiologic findings of metastatic tumors of the breast. MATERIALS AND METHODS: We retrospectively analyzed the findings of mammography (n=12), ultrasonography (n=9) and CT (n=4) of 13 patients with metastatic tumors of the breast. Methods for confirmation were biopsy (n=8) and clinical follow-up (n=5). The patient's ages ranged from 24 to 63 (mean 43) years. RESULTS: Primary malignancies were contralateral breast cancer (n=3), non-Hodgkin's lymphoma (n=3), stomach cancer (n=2), uterine cervix cancer (n=1), laryngeal cancer (n=1), esophageal melanoma (n=1), malignant thymoma (n=1), and lung cancer (n=1). Patterns of metastasis from contralateral breast cancer and the stomach cancer were diffuse and infiltrative, while metastasis from other cancers was of the focal massforming type. The radiologic findings of metastasis from contralateral breast cancer (n=3) were diffuse skin thickening and increased density or echogenicity in the medial aspect of the breast, while in cases involving metastasis from stomach cancer (n=2) radiographs revealed extensive skin thickening, increased density or echogenicity, lymphedema and ipsilateral lymphadenopathy in the left breast. In cases of metastatic tumors to the breast in which focal masses were seen on mammography (n=7), marginal spiculation or microcalcification of the tumors was not present. In six such cases, ultrasonography revealed well-defined margin, posterior acoustic shadowing or an irregular thick echogenic boundary was not seen. In two patients who underwent CT scanning, well-defined masses with moderate contrast enhancement were present. CONCLUSION: Radiographs of metastatic tumors to the breast from contralateral breast cancer and stomach cancer showed diffuse infiltration. The metastatic tumors with focal masses showed oval to round, smooth-marginated, well-defined masses without spiculation or microcalcification on mammography, and a well-defined mass without posterior acoustic shadowing or irregular thick echogenic boundary on ultrasonography.
Acoustics ; Biopsy ; Breast Neoplasms ; Breast* ; Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; Lung Neoplasms ; Lymphatic Diseases ; Lymphedema ; Lymphoma, Non-Hodgkin ; Mammography ; Melanoma ; Neoplasm Metastasis ; Retrospective Studies ; Shadowing (Histology) ; Skin ; Stomach Neoplasms ; Thymoma ; Tomography, X-Ray Computed ; Ultrasonography

Kaposi's sarcoma accounts for more than 3 % of neoplasms occurring in patients who have undergone atransplant. An epidemiologic study showed that in renal transplanted patients, the incidence of Kaposi's sarcomawas 400 to 500 times higher than in controls of the same ethnic origin. We report a case of Kaposi's sarcomainvolving the lung and skin after immunosuppressive therapy in a patient with renal transplant. A plain chestradiograph showed diffusely increased interstitial opacity with multiple, ill-defined small nodules in both lungfields. HRCT revealed multiple small nodules, predominantly in the peribronchovascular regions, and ill-definedareas of ground-glass opacity and consolidation in both lungs.
Humans ; Incidence ; Lung ; Sarcoma* ; Sarcoma, Kaposi ; Skin

PURPOSE: To evaluate the usefulness of venous dialysis pressure(VDP) and urea recirculation rate(URR) for theearly detection of venous stenoses, the most common cause of hemodialysis fistular failure. To correlate theoutcome of early percutaneous transluminal angioplasty(PTA) with VDP and URR after PTA. MATERIALS AND METHODS: Eighty one chronic hemodialysis patients were monitored for VDP and URR during each session of hemodialysistreatment. Twenty-eight patients with elevated VDP and URR underwent fistulography, and the results wereprospectively analysed. PTA was performed in twelve discrete stenoses(>70% reduction of the lumen) in sixpatients. Following PTA, VDP and URR were reevaluated. RESULT: Fistulogramas showed that 15 of 28 patients had 22stenoses. All of these lesions occurred in the proximal vein of an arteriovenous fistula, showing less than 50%reduction of the lumen in six stenoses, 50-70% in four, more than 70% in twelve, and no complete occlusion.Stenosis length was less than 1cm in twelve lesions, 1-3cm in seven, and 3-6cm in three. In 11 of 12 stenoses,angioplasty was successful with no significant residual stenosis remaining. After PTA, mean VDP and URR fellsignificantly : 117.8+/-20.6 mmHg to 99.8+/- 8.2 mmHg (p=0.025), and 22.9+/-16.1 to 7.6+/-7.2(p=0.014), respectively. CONCLUSION: Early detection and early PTA of venous stenoses led to a high initial patency rate when used inconjuction with elective measurement of VDP and URR. After PTA, VDP and URR fell significantly, and there wasclose correlation with the outcome of PTA.
Angioplasty* ; Arteriovenous Fistula ; Constriction, Pathologic* ; Dialysis* ; Fistula* ; Humans ; Renal Dialysis* ; Urea* ; Veins