ABSTRACT
Sedation plays a crucial role in successful pediatric imaging, and chloral hydrate is commonly used for this purpose. However, the challenges associated with chloral hydrate administration, such as its unpleasant taste and potential induction of vomiting, remain a concern. Sweet oral solutions have emerged as potential solutions for reducing distress and providing analgesia. This study compared the efficacy of dextrose combined with chloral hydrate with that of conventional sedation methods. This prospective, double-blind, randomized controlled clinical study enrolled 160 pediatric outpatients scheduled for echocardiography. Chloral hydrate syrup (100 mg/mL) was supplemented with a dextrose solution (dextrose group) or distilled water (control group) in a 1:10 volume ratio. The sedation achievement time, Skeie scale score, revised Face, Legs, Activity, Cry, and Consolability (FLACC) score, and side effects (nausea, vomiting, hypoxia, and respiratory depression) were assessed. No significant difference in average time to achieve sedation was observed between the dextrose and control groups (24.4±17.8 vs. 24.7±17.1 min, p=0.92). Both groups demonstrated similar levels of sedation according to the Skeie scale and mean revised FLACC score. Although the occurrence rates of nausea and vomiting had no significant differences, the dextrose group had no cases of vomiting in children aged >24 months compared to the control group, which had three cases (30%). In conclusion, the addition of dextrose to chloral hydrate did not significantly affect sedation time, anxiety, pain reduction, or occurrence of gastrointestinal complications during sedation.
ABSTRACT
Sodium butyrate (SB) has various metabolic actions. However, its effect on dipeptidyl peptidase 4 (DPP-4) needs to be studied further. We aimed to evaluate the metabolic actions of SB, considering its physiologically relevant concentration. We evaluated the effect of SB on regulation of DPP-4 and its other metabolic actions, both in vitro (HepG2 cells and mouse mesangial cells) and in vivo (high fat diet [HFD]-induced obese mice). Ten-week HFD-induced obese C57BL/6J mice were subjected to SB treatment by adding SB to HFD which was maintained for an additional 16 weeks. In HepG2 cells, SB suppressed DPP-4 activity and expression at sub-molar concentrations, whereas it increased DPP-4 activity at a concentration of 1,000 µM. In HFD-induced obese mice, SB decreased blood glucose, serum levels of insulin and IL-1β, and DPP-4 activity, and suppressed the increase in body weight. On the contrary, various tissues including liver, kidney, and peripheral blood cells showed variable responses of DPP-4 to SB. Especially in the kidney, although DPP-4 activity was decreased by SB in HFD-induced obese mice, it caused an increase in mRNA expression of TNF-α, IL-6, and IL-1β. The pro-inflammatory actions of SB in the kidney of HFD-induced obese mice were recapitulated by cultured mesangial cell experiments, in which SB stimulated the secretion of several cytokines from cells. Our results showed that SB has differential actions according to its treatment dose and the type of cells and tissues. Thus, further studies are required to evaluate its therapeutic relevance in metabolic diseases including diabetes and obesity.
Subject(s)
Animals , Mice , Blood Cells , Blood Glucose , Body Weight , Butyric Acid , Cytokines , Diet , Dipeptidyl Peptidase 4 , Hep G2 Cells , In Vitro Techniques , Insulin , Interleukin-6 , Kidney , Liver , Mesangial Cells , Metabolic Diseases , Mice, Obese , Obesity , RNA, Messenger , SodiumABSTRACT
PURPOSE: The purpose of this study is to compare the accuracy of the CT guided implant template that was produced by using an intraoral scanner according to the edentulous distance. MATERIALS AND METHODS: Five maxillary casts were fabricated using radiopaque acrylic resin with the second premolars, first molars, and second molars missing. Then a virtual cast was acquired by scanning each resin cast. Implant treatment was planned on the missing sites by superimposing the presurgical CT DICOM file and the virtual cast. Then the implants were placed using a surgical template followed by postsurgical CT scan. The distance and angle of the platform and apex between the presurgical implant and postsurgical implant were measured using the X, Y, and Z axis of the superimposed presurgical CT and postsurgical CT via software followed by statistical analysis using Kruskall-Wallis test and Mann-Whitney test. RESULTS: The implant placement angle error increased towards the second molars but there was no statistically significant difference. The implant placement distance error at the platform and apex also increased towards the second molars and there was a statistically significant error at the second molars. CONCLUSION: Although the placement angle had no statistically significant difference between the presurgical implant and postsurgical implant, the placement distance at the platform and apex showed a larger error and a statistically significant difference at the second molar implant.
Subject(s)
Bicuspid , Molar , Tomography, X-Ray ComputedABSTRACT
Accuracy is the most important thing in implant prosthesis, for this reason it is essential procedure to check the accuracy of impression taking. However, impression material has its own error and the error occurs in model-making procedure. As an alternative way to this, using intraoral scanner can be suggested and many studies were issued reporting that there's no statistically significant difference in accuracy between intraoral scanner and conventional impression. Therefore, the purpose of this study is to report the process of making of implant prosthesis using intraoral scanner, which is more convenient, fast, accurate compared with conventional method.
Subject(s)
Prostheses and ImplantsABSTRACT
Caplan's syndrome is characterized by multiple small distinct nodules with progressive massive fibrosis and rheumatic arthritis in pneumoconiosis. Although pleural effusions occur infrequently as an extra-articular manifestation, pleuritis can develop without joint involvement in patients with rheumatoid arthritis. We treated an 81-year-old man who had been diagnosed with silicosis with progressive massive fibrosis. He suffered from progressive dyspnea, and chest computed tomography (CT) and echocardiography revealed pleural and pericardial effusions. We speculated that the multiple serositis was related to a rheumatic disorder because the rheumatic factor was elevated in both the pleural and pericardial effusions. After corticosteroid treatment, the serositis improved. We suggest that this case is an atypical pattern of Caplan's syndrome presenting as serositis without arthritis. Rheumatoid serositis should be considered as the cause of pleural or pericardial effusions in patients with pneumoconiosis.
Subject(s)
Humans , Arthritis , Arthritis, Rheumatoid , Caplan Syndrome , Dyspnea , Echocardiography , Fibrosis , Joints , Pericardial Effusion , Pericarditis , Pleural Effusion , Pleurisy , Pneumoconiosis , Rheumatic Fever , Serositis , Silicosis , ThoraxABSTRACT
No abstract available.
Subject(s)
Hemiarthroplasty , Hemorrhage , Hip , Hypotension , Retrospective StudiesABSTRACT
We describe a 64-year-old male patient with panhypopituitarism who experienced polymorphic ventricular tachycardia (VT) associated with long QT intervals. The panhypopituitarism developed as a sequelae of radiation therapy administered 20 years prior to his current presentation and was recently aggravated by urinary tract infection with sepsis. In this case, polymorphic VT was resistant to conventional therapy (including magnesium infusion), and QT prolongation and T wave inversion were normalized after the administration of steroid and thyroid hormones. Thyroid hormone is generally known to be associated with torsades de pointes (TdP), but steroid or other hormones may also provoke TdP. Hormonal disorders should be considered as a cause of polymorphic VT with long QT intervals. Some arrhythmias can be life-threatening, and they can be prevented with supplementation of the insufficient hormone.
Subject(s)
Humans , Male , Arrhythmias, Cardiac , Hypopituitarism , Long QT Syndrome , Magnesium , Sepsis , Tachycardia, Ventricular , Thyroid Gland , Thyroid Hormones , Torsades de Pointes , Urinary Tract InfectionsABSTRACT
Cronkhite-Cadana syndrome is a rare non-familial disease. This syndrome is characterized by multiple hamartomatous polyps on the entire gastrointestinal tract except esophagus, nail dystrophy, alopecia and hyperpigmentation. Taste disturbance, abdominal pain, diarrhea and weight loss are common symptoms of it. The pathogenesis and causes of Cronkhite-Canada syndrome remain unknown until now. Although various treatment strategies including steroid therapy have been tried, their prognosis is poor. We report a 68 years old man who were diagnosed Cronkhite-Canada syndrome with esophageal candidiasis. After using combination of steroids and anti-fungal drugs, both Cronkhite-Canada syndrome and esophageal candidiasis were cured.
Subject(s)
Abdominal Pain , Alopecia , Candidiasis , Diarrhea , Esophagus , Gastrointestinal Tract , Hyperpigmentation , Intestinal Polyposis , Nails , Polyps , Prognosis , Steroids , Weight LossABSTRACT
Amiodarone is a highly effective antiarrhythmic agent. It is commonly used to treat ventricular and supraventricular arrhythmias. However, amiodarone has been found to be associated with a variety of adverse effects. Amiodarone causes toxicity to organs such as lung, gastrointestinal tract, liver, eye, thyroid gland, skin, and neuromuscular system. Among these side effects, pulmonary toxicity is one of the most serious ones. The prevalence of amiodarone-induced pulmonary toxicity is not known precisely, but recent studies have reported that incidence rates range from 1% to 13%. The risk factors associated with the development of pulmonary toxicity are age, duration of treatment, cumulative dosage, history of cardiothoracic surgery, and use of high oxygen mixture. Amiodarone use has been rarely related to development of acute respiratory distress syndrome (ARDS), which is often in association with surgery or pulmonary angiography. We experienced a case of amiodarone-induced ARDS which developed after an increase of amiodarone dosage.
Subject(s)
Amiodarone , Angiography , Arrhythmias, Cardiac , Eye , Gastrointestinal Tract , Incidence , Liver , Lung , Oxygen , Prevalence , Respiratory Distress Syndrome , Risk Factors , Skin , Thyroid GlandABSTRACT
Selective intestinal decontamination (SID) with norfloxacin has been widely used for the prophylaxis of spontaneous bacterial peritonitis (SBP) because of a high recurrence rate and preventive effect of SID for SBP. However, it does select resistant gut flora and may lead to SBP caused by unusual pathogens such as quinolone-resistant gram-negative bacilli or gram-positive cocci. Enterococcus hirae is known to cause infections mainly in animals, but is rarely encountered in humans. We report the first case of SBP by E. hirae in a cirrhotic patient who have previously received an oral administration of norfloxacin against SBP caused by Klebsiella pneumoniae and presented in septic shock.
Subject(s)
Humans , Male , Middle Aged , Administration, Oral , Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Ascitic Fluid/microbiology , Enterococcus/isolation & purification , Gram-Positive Bacterial Infections/complications , Microbial Sensitivity Tests , Peritonitis/diagnosis , Sepsis/etiologyABSTRACT
Anterior mediastinal hematoma is often reported as a complication of cardiopulmonary resuscitation (CPR). CPR can be performed as a result of myocardial infarction, and early percutaneous coronary intervention (PCI) and anticoagulant, antiplatelet agent can improve outcome. As use of antiplatelet agents, like glycoprotein IIb/IIIa inhibitors, becomes more widespread, occurrence of complications such as bleeding may be increased. The mediastinal hematoma usually resolves itself without complications; however, a large amount of hematoma can cause cardiac tamponade. Therefore, rapid diagnosis is very important. We describe a case of anterior mediastinal hematoma detected by echocardiography after CPR and PCI.
Subject(s)
Angioplasty , Antibodies, Monoclonal , Cardiac Tamponade , Cardiopulmonary Resuscitation , Echocardiography , Glycoproteins , Hematoma , Hemorrhage , Immunoglobulin Fab Fragments , Mediastinum , Myocardial Infarction , Percutaneous Coronary Intervention , Platelet Aggregation InhibitorsABSTRACT
Flank Pain is a leading indicator of renal and upper urinary tract disease or trauma, and rarely results from pelvic congestion syndrome. Although pelvic congestion syndrome occurs commonly in multi-parous women, pelvic congestion syndrome should also be considered as the cause of flank pain in an adolescent girl. We report the first case of pelvic congestion syndrome presenting with chronic left flank pain in an adolescent girl.
Subject(s)
Adolescent , Female , Humans , Estrogens, Conjugated (USP) , Flank Pain , Urologic DiseasesABSTRACT
Menkes disease, so called kinky-hair syndrome, is a rare, genetic and progressive neurodegenerative disorder. It is caused by a mutation in the ATP7A gene, which codes for the copper transporting ATPase in the cell organelles. The dysfunction of many copper-dependent enzymes results in low concentration of copper in some tissues and accumulation of copper in others. We report a boy presented with kinky hairs, developmental delay, hypotonia and connective tissue abnormalities at the age of 4 months. Despite the treatment with various antiepileptic drugs, atonic seizures still persisted. At the age of 7 months, his atonic seizures was changed into extensor spasms with modified hypsarrhythmia for some years. The seizure were controlled by topiramate and vigabatrin. At the age of 22 months, serum copper and ceruloplasmin rechecked as 17 ug/dL(80-150 ug/dL) and 7.3 mg/dL(20-46 mg/ dL) respectively. The gene study showed ATP7A mutation and the patient was diagnosed as Menkes disease so that copper-histidine was daily injected. We experienced a case of a 4-month-old boy with Menkes disease and infantile spasm, confirmed by ATP7A mutation.
Subject(s)
Humans , Infant , Infant, Newborn , Male , Adenosine Triphosphatases , Anticonvulsants , Ceruloplasmin , Connective Tissue , Copper , Hair , Menkes Kinky Hair Syndrome , Muscle Hypotonia , Neurodegenerative Diseases , Organelles , Seizures , Spasm , Spasms, Infantile , VigabatrinABSTRACT
BACKGROUND: The endothelium-dependent vasorelaxation has been largely accounted for by the release of nitric oxide (NO). Three distinct isoforms of NO synthases (NOS) have been characterized, i.e., brain(bNOS), inducible (iNOS), and endothelial constitutive (ecNOS). Although hypertension hasbeen associated with a vascular endothelial dysfunction, changes in the vascular expression of NOS isoforms have not been established. The present study was aimed at exploring the vascular expression of NOS isozymes in hypertension. MATERIAL AND METHOD: Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were induced in rats. The expression of different NOS isozymes in the thoracic aorta was determined by Western blot analysis. The vascular tissue contents of nitrites were measured by colorimetric assay. RESULT: Arterial blood pressure was significantly higher in experimental groups of 2K1C and DOCA-salt rats compared with their corresponding control rats. The vascular expression of bNOS as well as that of ecNOS was decreased in both models of hypertension. iNOS was not changed in DOCA-salt hypertension, but was also decreased in 2K1C hypertension. The vascular contents of nitrites were significantly decreased in DOCA-salt as well as in 2K1C hypertension. CONCLUSION: These results suggest that 2K1C and DOCA-salt hypertension are associated with decreases in the vascular expression of NOS isozymes and nitrite contents.
Subject(s)
Animals , Rats , Aorta, Thoracic , Arterial Pressure , Blotting, Western , Desoxycorticosterone , Hypertension , Isoenzymes , Nitric Oxide Synthase , Nitric Oxide , Nitrites , Protein Isoforms , VasodilationABSTRACT
OBJECTIVES: The present study was aimed at exploring whether the pathogenesis of hypertension is related with an altered expression of nitric oxide synthase (NOS) isozymes, i.e., bNOS, iNOS and ecNOS. METHOD: By Western blot analysis, the expression of NOS isozymes were determined in the kidney isolated from spontaneously hypertensive rats (SHR) and their normotensive control, Wistar-Kyoto rats (WKY). The NOx (nitrite/nitrate) contents were also determined in the kidney and plasma. RESULTS: The plasma NOx was significantly increased in SHR compared with that in WKY. The basal level of NOx was higher in the medulla and cortex of the kidney in SHR compared with that in WKY rat. bNOS proteins were expressed higher in the outer medulla and cortex, and iNOS proteins were higher in the inner medulla, outer medulla and cortex in SHR. ecNOS expression did not significantly differ between the SHR and WKY. CONCLUSIONS: These results indicate that the NO generation may not be impaired, but rather increased. It is likely that the increased expression of NOS isozymes is a counter-reactive phenomenon secondary to the increased blood pressure in this model of hypertension.
Subject(s)
Male , Rats , Animals , Hypertension/physiopathology , Hypertension/enzymology , Isoenzymes/metabolism , Kidney/enzymology , Nitrates/metabolism , Nitrates/blood , Nitric Oxide/biosynthesis , Nitric Oxide Synthase/metabolism , Nitrites/metabolism , Nitrites/blood , Rats, Inbred SHR , Rats, Inbred WKYABSTRACT
PURPOSE: The gastric cancer is most frequent malignant disease in Korea. With increase of GNP and social welfare, lot of people pay attention to that. But many of gastric cancer patients who were diagnosed, are advanced -stage III or more- case and produces poor result of treatment. Nowadays many surgeons report that the resection of cancer mass and radical lymph node dissection, which called systematic lymph node dissection, can increase the longterm survival rate and curability of patients. For this purpose Maruyama and his colleagues made a program to predict the 5 year survival rate, cause of death, and the status of lymph node metastases. We put the basic datas of pateints in AGC into Maruyama's program and compare its result to final histologic reports. We would check sesitivity, specificity, positive predictive value, negative predictive values between Maruyamas program and hitologic reports. MATERIALS AND METHODS: From Sep. 1995 to Sep. 1996, We operated 55 patients with gastric cancer with this program in GNUH. We checked the histopathologic reports and put the data into the prediction program. The datas were sex, age, maximal size of tumor, differentiation, gross type and location. We compared status of lymph node metastases, TNM stages between the reports of histopathology and that of predictive program. RESULTS: In early stages the sensitivity and specificity of the program showed poor result but in advanced stages did not. The distribution of lymph node metastasis showed a same pattern. The patterns of perigastric lymph node metastasis were somewhat different according to the location of tumor. But its significance was not confirmed. We analysed the metastaic rate between lymph node groups and compared with the results between two reports. The sensitivity, and negative predictive value were 100% in each groups, and positive predictive value was also high. CONCLUSION: The systematic lymph node dissection is an effective and safe procedure in the surgical treatment of gastric cancer. We suggest that the techniques should be standardized and popularized in Korea. This procedure will improve the survival rate of gastric cancer patients and decrease the local recurrence of gastric cancer.