Evaluation of the Toxicity of Sugammadex in Zebrafish Larvae

BACKGROUND@#Sugammadex is a new neuromuscular blockade reversal agent. Recently, it has been used in patients under general anesthesia. However, sugammadex could be toxic to fetuses and pediatric patients under 3 years of age. In this study, we demonstrated the safety of sugammadex in fetuses, using zebrafish larvae. Furthermore, its neurotoxicity was evaluated using neuronal cell lines.@*METHODS@#We used SH-SY5Y cells to determine the viability of neuronal cells treated with sugammadex. Zebrafish larvae were used to determine the teratogenic effects of sugammadex.@*RESULTS@#Sugammadex showed no adverse effects on neuronal cells and zebrafish larvae. The survival rates of neuronal cells were not different in all concentrations. In addition, the heart formation of zebrafish embryos, which were exposed to various concentrations of sugammadex, were not different.@*CONCLUSION@#This study demonstrated the feasibility of using sugammadex during pregnancy. However, further clinical studies will be required to extrapolate these results to humans.

Evaluation of the Toxicity of Sugammadex in Zebrafish Larvae

BACKGROUND: Sugammadex is a new neuromuscular blockade reversal agent. Recently, it has been used in patients under general anesthesia. However, sugammadex could be toxic to fetuses and pediatric patients under 3 years of age. In this study, we demonstrated the safety of sugammadex in fetuses, using zebrafish larvae. Furthermore, its neurotoxicity was evaluated using neuronal cell lines.METHODS: We used SH-SY5Y cells to determine the viability of neuronal cells treated with sugammadex. Zebrafish larvae were used to determine the teratogenic effects of sugammadex.RESULTS: Sugammadex showed no adverse effects on neuronal cells and zebrafish larvae. The survival rates of neuronal cells were not different in all concentrations. In addition, the heart formation of zebrafish embryos, which were exposed to various concentrations of sugammadex, were not different.CONCLUSION: This study demonstrated the feasibility of using sugammadex during pregnancy. However, further clinical studies will be required to extrapolate these results to humans.

Evaluation of the Toxicity of Sugammadex in Zebrafish Larvae

BACKGROUND@#Sugammadex is a new neuromuscular blockade reversal agent. Recently, it has been used in patients under general anesthesia. However, sugammadex could be toxic to fetuses and pediatric patients under 3 years of age. In this study, we demonstrated the safety of sugammadex in fetuses, using zebrafish larvae. Furthermore, its neurotoxicity was evaluated using neuronal cell lines.@*METHODS@#We used SH-SY5Y cells to determine the viability of neuronal cells treated with sugammadex. Zebrafish larvae were used to determine the teratogenic effects of sugammadex.@*RESULTS@#Sugammadex showed no adverse effects on neuronal cells and zebrafish larvae. The survival rates of neuronal cells were not different in all concentrations. In addition, the heart formation of zebrafish embryos, which were exposed to various concentrations of sugammadex, were not different.@*CONCLUSION@#This study demonstrated the feasibility of using sugammadex during pregnancy. However, further clinical studies will be required to extrapolate these results to humans.

Clinical Outcome of Veterans with Acute Coronary Syndrome Who Had Been Exposed to Agent Orange / 전남의대학술지

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), one of the components of Agent Orange, has been reported to be a deadly poison despite its presence at extremely small doses. TCDD is reported to cause various kinds of cancers and other harmful effects on humans. However, a correlation between exposure to TCDD and acute coronary syndrome (ACS) is not yet proven. Thus, we examined the correlation between exposure to TCDD and ACS through an analysis of coronary angiograms from veterans of the Vietnam War. Two hundred fifty-one consecutive men undergoing coronary angiograms owing to ACS between April 2004 and May 2009 at Gwangju Veterans Hospital were analyzed. Included subjects were between 50 and 70 years of age. The patients were divided into two groups: 121 patients who had been exposed to TCDD (Group I) and 130 patients who had not been exposed to TCDD (Group II). Clinical and coronary angiographic findings were evaluated. Baseline clinical characteristics, inflammatory markers, and echocardiographic parameters were not significantly different between the two groups. The incidence of hypertension (71.1% vs. 60.0%, p=0.039) and hyperlipidemia (27.3% vs. 16.9%, p=0.038) was higher in Group I than in Group II. Total occlusion, stent length, stent use, and coronary lesion characteristics were not significantly different between the two groups. The rate of major adverse cardiovascular events (MACE) had no relationship with exposure to TCDD. Exposure to TCDD might not affect severity or the rate of MACE in persons with ACS.

Reverse Controlled Antegrade and Retrograde Subintimal Tracking in Chronic Total Occlusion of Right Coronary Artery

Passage failure of guidewire is still remained most common reason for percutaneous coronary intervention (PCI) failure in chronic total occlusion (CTO). Intravascular ultrasound study (IVUS) and cardiac CT angiography can help identify features that most influence current success rates of PCI. We report our experience using the reverse controlled antegrade and retrograde subintimal tracking technique under the aid of IVUS, cardiac CT angiography for an ambiguous CTO of proximal right coronary artery.

Below the Knee Intervention Using Multidisciplinary Methods Including an Antegrade, Retrograde Approach Without the Use of a Sheath but With a Plaque Excision Device

Below the knee (BTK) interventions are increasing in patients with rest pain or critical limb ischemia, and these interventions are frequently successful in facilitating limb salvage. New intervention techniques and devices allow successful recanalization of occluded BTK arteries. Here, we report a case of successful recanalization of BTK arteries using multidisciplinary methods, including an antegrade approach and retrograde approach without the use of a sheath, but with simple balloon angioplasty, and plaque excision using Silverhawk atherectomy device.

Clinical Outcome of Veterans with Acute Coronary Syndrome Who Had Been Exposed to Agent Orange / 전남의대학술지

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), one of the components of Agent Orange, has been reported to be a deadly poison despite its presence at extremely small doses. TCDD is reported to cause various kinds of cancers and other harmful effects on humans. However, a correlation between exposure to TCDD and acute coronary syndrome (ACS) is not yet proven. Thus, we examined the correlation between exposure to TCDD and ACS through an analysis of coronary angiograms from veterans of the Vietnam War. Two hundred fifty-one consecutive men undergoing coronary angiograms owing to ACS between April 2004 and May 2009 at Gwangju Veterans Hospital were analyzed. Included subjects were between 50 and 70 years of age. The patients were divided into two groups: 121 patients who had been exposed to TCDD (Group I) and 130 patients who had not been exposed to TCDD (Group II). Clinical and coronary angiographic findings were evaluated. Baseline clinical characteristics, inflammatory markers, and echocardiographic parameters were not significantly different between the two groups. The incidence of hypertension (71.1% vs. 60.0%, p=0.039) and hyperlipidemia (27.3% vs. 16.9%, p=0.038) was higher in Group I than in Group II. Total occlusion, stent length, stent use, and coronary lesion characteristics were not significantly different between the two groups. The rate of major adverse cardiovascular events (MACE) had no relationship with exposure to TCDD. Exposure to TCDD might not affect severity or the rate of MACE in persons with ACS.

A Case of Gastric Intramural Hematoma after an Epinephrine Injection for Gastric Ulcer Bleeding in a Patient Medicated with Aspirin / 대한소화기내시경학회지

An intramural hematoma of the stomach usually results from trauma. Gastric intramural hematomas may also occur in patients with bleeding disorders who are receiving anticoagulation therapy or after an endoscopic procedure. Here, we describe a case of a gastric intramural hematoma after endoscopic hemostasis for gastric ulcer bleeding in a patient medicated with aspirin.

Diastema closure with direct composite: architectural gingival contouring / 대한치과보존학회지

One of the most challenging task in closing anterior diastema is avoiding "black triangle" between the teeth. This paper reports a case that the closure of diastema in anterior teeth could be successfully accomplished using direct adhesive restorations and gingival recontouring. The traditional technique using Mylar strip was modified to increase the emergence profile with natural contours at the gingival-tooth interface. Mylar strip was extended out of the sulcus by approximately 1 mm high from the gingival margin, and a small cotton pellet was used to provide the emergence contour. This modified approach is acceptable for the clinical situation.

Hypertensive Heart Failure Associated with Middle Aortic Syndrome Reversed Dramatically by Endovascular Management

A 42-year-old male patient presented with refractory hypertension and congestive heart failure. He had taken hydrochlorthiazide 50 mg, carvedilol 25 mg, diltiazem 180 mg, and losartan 100 mg per day. Aortogram revealed a severe luminal narrowing in the distal thoracic aorta with a peak systolic pressure gradient of 60 mmHg across the lesion. Endovascular management was performed with 22 x 80 mm self-expandable Nitinol-S stent after predilation with 10 x 40 mm balloon. After endovascular management, the patient's blood pressure, left ventricular ejection fraction (LVEF) and dilated LV dimension were remarkably improved.

Physical Health Status, Depression and Activities of Daily Living of the Low-income Elderly Living Alone in Metropolitan Areas

PURPOSE: This study was conducted to investigate physical health status. depression. activities of daily living (ADL & IADL) of the low-income elderly who live alone in urban areas. METHOD: The subjects were the 400 low-income elders who live alone in Daegu city and the following instruments were used: 1. The number of self-reported physical health problems and present diseases: 2. CES-D scale for depression by Jo Nam-Oak et al. (1998): and 3. ADL scale by Katz (1989) and IADL scale by Lawton and Brody (1969). RESULTS: 1. Visual difficulty was the most prevailing problem (55.3%) among physical problems. the second bowel elimination and the third hearing disturbance. As for present diseases. arthritis (26.5%), hypertension(24.3%) and DM (11.8%) were the most common diseases. 2. There were significant differences in physical health status according to age (t=3.115. p=.045). kind of medical security (t=-1.973. p=.049). perceived life satisfaction (F=4.966. p=.007) and the number of present diseases (F=2.937. p=.033). 3. There were significant differences in depression according to sex (t=-3.758. p=.000) . kind of medical security (t=-4.368. p=.000). perceived life satisfaction (F=35.743. p=.000) and the number of present diseases (F=4.246. p=.006). 4. There were significant differences in ADL according to sex (t=-2.136. p=.033) and age (F=4.863. p=.008). and in IADL according to sex (t=4.552, p=.000), age (F=3.090. p=.047) and kind of medical security (t=-3.306. p=.001). 5. Physical health state was correlated positively with both the number of present diseases (r=.140. p=.005) and depression (r=.352. p=.000), and negatively with ADL (r=-.176. p=.000) and IADL (r=-.230. p=.000). Depression was correlated positively with the number of present diseases (r=.169. p=.001) and negatively with both ADL (r=-.139. p=.005) and IADL (r=-.203. p=.000). CONCLUSION: The results of this study suggest that general characteristics are important factors for physical health status, depression. ADL and IADL of the low-income elderly who live alone and there are close relations among physical health status, the number of diseases, depression, ADL and IADL. Therefore, these results must be reflected in community health programs for the low-income elderly who live alone. In addition, this kind of study must be extended to the low-income elderly who live alone in rural areas.

A Study on Modes of Transmission and Role of Nasal Carriage to Subsequent Infection with Methicillin-Resistant Staphylococcus aureus in Medical ICU Using PFGE / 병원감염관리

BACKGROUND: In Korea, methicillin-resistant Staphylococcus aureus (MRSA) is the most common nosocomial pathogen, which is particularly prevalent in ICU. We performed this study to investigate the modes of transmission of MRSA and the role of nasal carriage of11RSA to subsequent MRSA infections in medical ICU. METHODS: All patients admitted to the medical lCU during 10 months were studied prospectively. Nasal swabs were done in all patients within 24 hours of admission and weekly thereafter. For patients who developed MRSA infections, additional cultures were done before start of antibiotics. Surveillance cultures of nostril, hands of health care workers and environment were done once at the end of the study. Bacterial typing was performed with pulsed-field gel electrophoresis (PFGE) using Smal. RESULTS: Among 138 patients enrolled, 24 patients (17.4 %) were nasal colonizers, and 9 patients (6.5%) were already infected with MRSA prior to admission. New nasal colonization among patients, in whom follow up nasal cultures were done at the interval of 3 days or more, developed at 36.2 % (21/58 patients). New infections of MRSA in patients who were admitted for more than 3 days, developed at 11.7 % (13/111 patients). Patients in isolation room were infected with MRSA less frequently (P <0.05). No other risk factors for nasal colonization of MRSA or MRSA infections were found. There were no significant differences between nasal colonizers and non-colonizers in the incidence of MRSA infections. PFGE analysis of MRSA isolates from patients showed several major patterns, which were similar in both MRSA isolates obtained prior to admission and those acquired after admission. PFGE patterns of MRSA isolates from health care workers and environment were different from those of patients. CONCLUSION: Patients who were infected or colonized with MRSA seemed to be a major source for transmission of MRSA in medical ICU. In medical lCU, where MRSA were prevalent, nasal colonization was not related to the increased incidence of MRSA infections.