Background: This study evaluated the difference in brain metabolite profiles between normothermia and hypothermia reaching 25°C in humans in vivo. Methods: Thirteen patients who underwent thoracic aorta surgery under moderate hypothermia were prospectively enrolled. Plasma samples were collected simultaneously from the arteries and veins to estimate metabolite uptake or release. Targeted metabolomics based on liquid chromatographic mass spectrometry and direct flow injection were performed, and changes in the profiles of respective metabolites from normothermia to hypothermia were compared. The ratios of metabolite concentrations in venous blood samples to those in arterial blood samples (V/A ratios) were calculated, and log 2 transformation of the ratios [log2 (V/A)] was performed for comparison between the temperature groups. Results: Targeted metabolomics were performed for 140 metabolites, including 20 amino acids, 13 biogenic amines, 10 acylcarnitines, 82 glycerophospholipids, 14 sphingomyelins, and 1 hexose. Of the 140 metabolites analyzed, 137 metabolites were released from the brain in normothermia, and the release of 132 of these 137 metabolites was decreased in hypothermia. Two metabolites (dopamine and hexose) showed constant release from the brain in hypothermia, and 3 metabolites (2 glycophospholipids and 1 sphingomyelin) showed conversion from release to uptake in hypothermia. Glutamic acid demonstrated a distinct brain metabolism in that it was taken up by the brain in normothermia, and the uptake was increased in hypothermia. Conclusion Targeted metabolomics demonstrated various degrees of changes in the release of metabolites by the hypothermic brain. The release of most metabolites was decreased in hypothermia, whereas glutamic acid showed a distinct brain metabolism.

BACKGROUND/AIMS: Sofosbuvir plus ribavirin is a standard treatment for patients infected with chronic hepatitis C virus (HCV) genotype 2 in Korea. The purpose of this study was to examine the efficacy and safety of this treatment in Korean patients with chronic HCV genotype 2 infection. METHODS: We retrospectively analyzed clinical data of patients treated with sofosbuvir plus ribavirin for chronic HCV genotype 2 from May 2016 to December 2017 at eight hospitals located in the Daejeon-Chungcheong area. RESULTS: A total of 172 patients were treated with sofosbuvir plus ribavirin. Of them, 163 patients completed the treatment, and 162 patients were tested for sustained virologic response 12 weeks after treatment discontinuation (SVR12). Mean age was 59.6±12.3 years (27–96), and 105 (64.4%) patients were female. Of the total patients, 49 (30.1%) were diagnosed with cirrhosis, and 31 of them were treated for 16 weeks. Sofosbuvir plus ribavirin was the first-line treatment for 144 (88.3%) patients. Eleven (6.7%) patients were intolerant to previous interferon-based treatment. Eight (5.0%) patients relapsed after interferon-based treatment. HCV RNA non-detection rate at 4, 8, and 12 weeks was 97.5%, 99.1%, and 99.3%, respectively, and SVR12 was 98.8% (161/163). During treatment, 18 (11.0%) patients had to reduce their administrated dose of ribavirin because of anemia. One patient stopped the treatment because of severe anemia. Other adverse events, including dizziness, indigestion, and headache, were found in 26 (16.0%) patients. CONCLUSIONS: A 12-16 week treatment with sofosbuvir plus ribavirin is remarkably effective and well tolerated in Korean patients with chronic HCV genotype 2 infection.
Anemia ; Dizziness ; Dyspepsia ; Female ; Fibrosis ; Genotype ; Headache ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic ; Hepatitis* ; Humans ; Korea ; Retrospective Studies* ; Ribavirin* ; RNA ; Sofosbuvir*

Nephrotic syndrome is associated with a hypercoagulable state, which results in thromboembolism as one of its main complications. Various pathogenetic factors that cause the hypercoagulable state in nephrotic syndrome have been recognized. We report on a 19-year-old female with a minimal-change disease who developed pulmonary thromboembolism combined with intracardiac thrombus while on tapering steroid. Our patient showed hypoalbuminemia with an episode of shock, and was successfully treated with thrombolysis and anticoagulation therapy.
Female ; Humans ; Hypoalbuminemia ; Nephrotic Syndrome* ; Pulmonary Embolism* ; Shock ; Thromboembolism ; Thrombosis* ; Young Adult

BACKGROUND: Nefopam has been known as an inhibitor of the reuptake of monoamines, and the noradrenergic and/or serotonergic system has been focused on as a mechanism of its analgesic action. Here we investigated the role of the spinal dopaminergic neurotransmission in the antinociceptive effect of nefopam administered intravenously or intrathecally. METHODS: The effects of intravenously and intrathecally administered nefopam were examined using the rat formalin test. Then we performed a microdialysis study to confirm the change of extracellular dopamine concentration in the spinal dorsal horn by nefopam. To determine whether the changes of dopamine level are associated with the nefopam analgesia, its mechanism was investigated pharmacologically via pretreatment with sulpiride, a dopaminergic D2 receptor antagonist. RESULTS: When nefopam was administered intravenously the flinching responses in phase I of the formalin test were decreased, but not those in phase II of the formalin test were decreased. Intrathecally injected nefopam reduced the flinching responses in both phases of the formalin test in a dose dependent manner. Microdialysis study revealed a significant increase of the level of dopamine in the spinal cord by intrathecally administered nefopam (about 3.8 fold the baseline value) but not by that administered intravenously. The analgesic effects of intrathecally injected nefopam were not affected by pretreatment with sulpiride, and neither were those of the intravenous nefopam. CONCLUSIONS: Both the intravenously and intrathecally administered nefopam effectively relieved inflammatory pain in rats. Nefopam may act as an inhibitor of dopamine reuptake when delivered into the spinal cord. However, the analgesic mechanism of nefopam may not involve the dopaminergic transmission at the spinal level.
Analgesia ; Animals ; Dopamine ; Microdialysis ; Nefopam* ; Pain Measurement ; Rats* ; Spinal Cord ; Spinal Cord Dorsal Horn ; Sulpiride ; Synaptic Transmission

BACKGROUND: Dermoscopy has been suggested as a useful tool for diagnosing various skin diseases. Recently, the possibility of using dermoscopy to predict the response to treatment has emerged. OBJECTIVE: The purpose of this study was to determine whether dermoscopic findings corresponded to clinical acne scar types. This study also aimed to discover which dermoscopic findings predict the response to acne scar treatment. METHODS: The dermoscopic findings of 39 participants undergoing atrophic acne scar treatment with fractional photothermolysis were evaluated. Patients were divided into two groups according to the duration of acne scar persistence. RESULTS: Patients with a relatively short duration of acne scar persistence usually achieved better treatment outcomes. Dermoscopic findings showed no obvious differences according to clinical acne scar type. But high hair follicle density can be considered a predictive factor of treatment effects. CONCLUSION: Our study indicated that acne scar improvements can be predicted by dermoscopically observing hair follicle density.
Acne Vulgaris* ; Cicatrix* ; Dermoscopy ; Hair Follicle ; Humans ; Pilot Projects* ; Skin Diseases

Childhood granulomatous periorificial dermatitis (CGPD) is a distinctive granulomatous form of perioral dermatitis. It is characterized by papular eruptions located around the mouth, nose, and eyes, and rarely present eczematous patches or plaques. Histopathologic examination shows upper dermal and perifollicular granulomatous infiltrates. Herein, we report two cases of CGPD that were presented with erythematous plaques. One patient was treated with 0.03% topical tacrolimus and the other patient with oral metronidazole. The patients responded well to their respective therapies, showing resolution of the lesions.
Dermatitis* ; Dermatitis, Perioral ; Humans ; Metronidazole ; Mouth ; Nose ; Tacrolimus

Childhood granulomatous periorificial dermatitis (CGPD) is a distinctive granulomatous form of perioral dermatitis. It is characterized by papular eruptions located around the mouth, nose, and eyes, and rarely present eczematous patches or plaques. Histopathologic examination shows upper dermal and perifollicular granulomatous infiltrates. Herein, we report two cases of CGPD that were presented with erythematous plaques. One patient was treated with 0.03% topical tacrolimus and the other patient with oral metronidazole. The patients responded well to their respective therapies, showing resolution of the lesions.
Dermatitis* ; Dermatitis, Perioral ; Humans ; Metronidazole ; Mouth ; Nose ; Tacrolimus

No abstract available.
Exanthema* ; Humans ; Infant* ; Leukemia* ; Leukemia, Myeloid, Acute

No abstract available.
Histiocytosis*

BACKGROUND: The aim of this in vitro study was to determine the effect of zoledronate, which is frequently used to treat osteoporosis, on osteoarthritis by analyzing zoledronate-induced expression of vascular endothelial growth factor-A (VEGF-A) in chondrocytes and synovial cells. METHODS: After chondrocytes and synovial cells were separated and cultured, zoledronate was added, and VEGF-A and pigment epithelium-derived factor (PEDF) expression were quantified by real-time polymerase chain reaction and Western blotting. RESULTS: There was no significant difference in the expression of VEGF-A mRNA in chondrocytes between the zoledronate group and the control group on the 8th day of culture. The expression of both VEGF-A and PEDF mRNA in synovial cells was significantly decreased in the zoledronate group (P<0.05). CONCLUSIONS: Zoledronate decreases the expression of VEGF-A in synovial cells and may affect the development and progression of osteoarthritis.
Blotting, Western ; Chondrocytes* ; Osteoarthritis ; Osteoporosis ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Vascular Endothelial Growth Factor A*