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Effect of temperature on pharmacokinetics of nalidixic acid, piromidic acid and oxolinic acid in olive flounder Paralichthys olivaceus following oral administration (넙치, Paralichthys olivaceus에 nalidixic acid, piromidic acid, oxolinic acid의 경구투여 약물동태에 미치는 수온의 영향)

  • Jung, Sung-Hee;Kim, Jin-Woo;Seo, Jung-Soo;Choi, Dong-Lim;Jee, Bo-Young;Park, Myoung-Ae
    • Journal of fish pathology
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    • v.23 no.1
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    • pp.57-67
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    • 2010
  • Effects of temperature ($13{\pm}1.5^{\circ}C$, $23{\pm}1.5^{\circ}C$) on the pharmacokinetic properties of nalidixic acid (NA), piromidic acid (PA) and oxolinic acid (OA) were studied after oral administration to cultured olive flounder, Paralichthys olivaceus. Serum concentrations of these antimicrobials were determined after oral administration of a single dosage of 60 mg/kg body weight (average 700 g). At $23{\pm}1.5^{\circ}C$, the peak serum concentrations of NA, PA and OA, which attained at 10 h, 24 h and 30 h post-dose, were 11.55, 3.79 and $1.12{\mu}g/m\ell$, respectively. At $13{\pm}1.5^{\circ}C$, the peak serum concentrations of NA, PA and OA, which attained at 10 h, 15 h and 30 h post-dose, were 6.36, 1.4 and $1.01{\mu}g/m\ell$, respectively. Better absorption of NA and PA was noted at $23{\pm}1.5^{\circ}C$ compared to $23{\pm}13^{\circ}C$. The elimination of NA from serum of olive flounder was considerably faster at $23{\pm}1.5^{\circ}C$ than at $13{\pm}1.5^{\circ}C$. However, both absorption and elimination of OA were not affected significantly by temperature. The kinetic profile of absorption, distribution and elimination of these antimicrobials in serum were analyzed by fitting to a one- and two compartment model, with WinNonlin program. In the one compartment model for NA, AUC, Tmax and Cmax at $23{\pm}1.5^{\circ}C$ were $258.26{\mu}g{\cdot}h/m\ell$, 10.67 h and $8.91{\mu}g/m\ell$, respectively. The AUC, $T_{max}$ and $C_{max}$ at $13{\pm}1.5^{\circ}C$ were $341.45 {\mu}g{\cdot}h/m\ell$, 7.72 h and $6.23{\mu}g/m\ell$, respectively. In the one compartment model for PA, AUC, $T_{max}$ and $C_{max}$ at $23{\pm}1.5^{\circ}C$ were $248.12{\mu}g{\cdot}h/m\ell$, 21.15 h and $3.09{\mu}g/m\ell$, respectively. The AUC, $T_{max}$ and $C_{max}$ at $13{\pm}1.5^{\circ}C$ were $103.89{\mu}g{\cdot}h/m\ell$, 12.89 h and $1.22{\mu}g/m\ell$, respectively. In the two compartment model for OA, AUC, $T_{max}$ and $C_{max}$ at $23{\pm}1.5^{\circ}C$ were $138.20{\mu}g{\cdot}h/m\ell$, 23.95 h and $1.06{\mu}g/m\ell$, respectively. The AUC, $T_{max}$ and $T_{max}$ at $13{\pm}1.5^{\circ}C$ were $159.10{\mu}g{\cdot}h/m\ell$, 28.03 h and $1.02{\mu}g/m\ell$, respectively.

Varietal and Locational Variation of Grain Quality Components of Rice Produced in Hilly and High Altitude Areas in Korea (중산간지와 고냉지산 쌀 형태 및 이화학적특성의 품종 및 산지간 변이)

  • Choi, Hae-Chune;Chi, Jeong-Hyun;Lee, Chong-Seob;Kim, Young-Bae;Cho, Soo-Yeon
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.39 no.1
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    • pp.27-37
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    • 1994
  • To catch the relative importance of varietal and environmental variation in various grain quality components associated with palatability of cooked rice, grain appearance, milling recovery, several physicochemical properties of milled rice and texture or eating quality of cooked rice for rice materials of five japonica cultivars, produced at four locations of the mid-mountainous and alpine area of Korea in 1989, were evaluated and analyzed the obtained data. Highly significant varietal and locational variations were detected in 1000-grain weight, amylose content, K/Mg ratio, gelatinization temperature, peak viscosity, breakdown and setback viscosities as compared with variety x location interaction variation. Also, marked locational variations were recongnized in milling recovery from rough to brwon rice, alkali digestibility and protein content, and significant varietal variation was caught in stickiness /hardness ratio of cooked rice. The variety x location interaction variation was especially large in quality components of grain appearance and ripening, palatability of cooked rice and consistency viscosity. One thousand kernel weight was heaviest in Jinbuolbyeo and Odaebyeo, and the unfilled grain ratio was lowest in Jinbuolbyeo. Odaebyeo showed slightly' lower ratio of intact and clear milled rice because of more chalky rice kernels compared with other cultivars. Amylose content of Jinbuolbyeo and Sobaegbyeo was about 1% lower than that of others and K/Mg ratio of Odaebyeo was the lowest one among rice materials. Odaebyeo, Sobaegbyeo and Jinbuolbyeo revealed significantly low gelatinization temperature and setback viscosity while high peak and breakdown viscosities. Cholwon rice showed the greatest kernel weight, good grain filling but lowest ratio of intact and clear milled rice while Jinbu rices exhibited the highest milling recovery from rough to brown rice and ratio of sound milled rice. Amylose content of milled rice in Jinbu rices was about 2-3% lower than those in other locations. Protein content of polished rice was about 1% lower in rice materials of middle zone than those of southern part of Korea. K/Mg ratio of milled rice was highest in Jinbu rice and potassium content was slightly higher in the rice materials of middle region than in those of southern region. Alkali digestion value and gelatinization temperature of polished rice was markedly high in Jinbu rices as compared with other locations. Breakdown viscosity was hightest in Chlown rices and next higher with the order of Hwaso>Unbong>Jinbu rices, and setback viscosity was the quite contrary tendency with breakdown. The stickiness /hardness ratio of cooked rice was relatively higher value in Cholwon rices than in the others and the palatability of cooked rice was a little better in Unbong and Cholwon rices than in Jinbu and Hwaso rices, although variety x location interaction variation was large. The rice materials can be classified largely into two groups of Jinbu and the others by the distribution on the plane of 1st and 2nd principal components (about 60% of total informations) contracted from twelve grain quality properties closely associated with eating quality of cooked rice. Also, Jinbu and the other rices were divided into two and three rice groups respectively. Varietal variation of overall rice quality was smallest in Hwaso. The most superior rice group in overall quality evaluation included Odaebyeo produced at Cholwon, Unbong and Hwaso, and Sobaegbyeo grown at Unbong

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A Clinical and Pathological Analysis of Children with Membranoproliferative Glomerulonephritis According to the Clinical Manifestations at Presentation (발견 양상에 따른 소아 막증식성 사구체신염의 임상적 및 병리조직학적분석)

  • Jeon Chang-Ho;Kang Mi-Seon;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.186-194
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    • 2004
  • Purpose: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. Methods: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. Results: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and $C_3$ levels in the S group were significantly lower than those levels of the A group, respectively($4.9{\pm}1.2\;g/dL,\;vs\;7.0{\pm}0.5\;g/dL\;P=0.002,\;2.8{\pm}0.9\;g/dL\;vs.\;4.1{\pm}0.3\;g/dL\;P=0.002,\;63.9{\pm}36.4\;mg/dL\;vs.\;100.8{\pm}39.5\;g/dL\;P=0.041$). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group($3684.0{\pm}2601.3\;mg/m^2\;vs.\;559.4{\pm}4.6.9\;mg/m^2$, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy. as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. Conclusion: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum $C_3$ level when urinary abnormalities are found by school urinary screening test.

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Study of nosocomial rotavirus infection in neonates admitted to a postpartum-care center (서울시내 1개 산후 조리원에서 시행한 로타바이러스 선별검사에 대한 분석)

  • Park, Ji Young;Kim, Dong Hwan;Bae, Seung Young;Choi, Chang Hee;Cho, Eun Young;Choi, Jeong Hoon;Kim, Sun Mi
    • Pediatric Infection and Vaccine
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    • v.14 no.2
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    • pp.145-154
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    • 2007
  • Purpose : Rotavirus is one of the most important etiologic agents of nosocomial infections among the neonates. This study was designed to investigate nosocomial rotavirus infection in neonates who were admitted to a postpartum-care center after birth. Methods : From March 2005 to September 2006, 957 healthy neonates were examined for rotavirus antigen in stool by immunochromatographic method and 216 neonates were rotavirus antigen positive within 24 hours after admitted to a postpartum-care center. We reviewed the nursing charts retrospectively such as characteristics, monthly distribution, birth hospitals, delivery methods, feeding types and clinical manifestations. Results : Among 957 neonates, 216 neonates (22.6%) were rotavirus antigen positive and there were no differences in sex, birth weight, gestational age. Monthly positive rate of rotavirus antigen showed diversity from 10% to 36%. According to birth hospitals, positive rate showed diversity from 3.5% to 53.6%. Out of 957 neonates, 655 cases (68.4%) were born of vaginal delivery and mean hospitalized duration was 2.4 days, 302 cases (31.6%) were born of cesarean section and mean hospitalized duration was 5.7 days. 17.6% of vaginal delivery and 33.4% of cesarean section were rotavirus antigen positive. The positive rate was higher in neonates by cesarean section than vaginal delivery (P<0.001). According to feeding types, positive rate of rotavirus antigen was lower in breast-fed group than formula-fed group (P<0.001). Proportion of symptomatic case among rotavirus antigen positive was 34.7%. Most common clinical manifestation was diarrhea (61.3%), following poor feeding (45.3%), fever (40.0%), vomiting (25.3%), delayed weight gain (12.0%), and decreased urine amount (5.3%). Conclusion : Some neonates were already infected before admission to a postpartum-care center. Without meticulous management, nosocomial rotavirus infection would transmit rapidly in a postpartum-care center spreading to the community. Recommendation of breast-feeding, routine rotavirus screeing test with or without symptom, and isolation of all rotavirus antigen positive neonates in a postpartum-care center seem to be necessary. Also attentive hygiene education and further investigations of rotavirus infection in a postpartum-care center would be needed.

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Studies on absorption of ammonium, nitrate-and urea-N by Jinheung and Tongil rice using labelled nitrogen (중질소(重窒素)를 이용(利用)한 진흥(振興)과 통일(統一)벼의 암모니움, 질산(窒酸) 및 요소태(尿素態) 질소(窒素)의 흡수특성(吸收特性) 연구(硏究))

  • Park, Hoon;Seok, Sun Jong
    • Korean Journal of Soil Science and Fertilizer
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    • v.10 no.4
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    • pp.225-233
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    • 1978
  • Uptake and distribution of labelled urea, $NH{_4}^+$, and $NO{_3}^-$ by Tongil and Jinheung rice grown with each nitrogen source until ear formation stage under water culture system were as follows. 1. When the previous nitrogen source was same as one tested the uptake rate ($mg^{15}N/g$ d.w. root 2hrs, at $28^{\circ}C$ light) was great in the order of $NH_4$ >urea> $NO_3$ and higher (especially $NH_4$) in Tongil than in Jinheung. Rate limiting step (slowest) seems to be exist at R (root)${\rightarrow}$LS(leaf sheath) for urea, LS${\rightarrow}$LB(leaf blade) for $NH_4$ and M(medium)${\rightarrow}$R for $NO_3$. The fast step of translocation appeare to be at M${\rightarrow}$R for urea R${\rightarrow}$LS for $NH_4$ and LS${\rightarrow}$LB for $NO_3$. 2. The uptake rate of $NH_4$ by the urea-fed plant increased almost linearly from $18^{\circ}C$ via $28^{\circ}C$ to $38^{\circ}C$ in Tongil ($Q_{10}$=1.21 and 1.32 respectively) while no change in Jinheung ($Q_{10}$=0.99 and 1.00 respectively). It decreased by 12% in Jinheung under dark but uo change in Tongil. 3. The uptake rate of nitrogen source by different source-fed plant was great in the order of $NH_4{\rightarrow}^{15}NO_3$ $NO_3{\rightarrow}^{15}NH_4$, $urea{\rightarrow}^{15}NO_3$ and higher (especially $NH_4{\rightarrow}^{15}NO_3$) in Tongil. In the case of $urea{\rightarrow}^{15}NH_4$ it was same in $NH_4{\rightarrow}^{15}NO_3$ for Tongil and slightly lower than that in $NO_3{\rightarrow}^{15}NH_4$ for Jinheung. It was lower (especially Tongil) in $NH_4{\rightarrow}^{15}NO_3$ than in $NH_4{\rightarrow}^{15}NH_4 $ 4. The uptake rate (in $NH_4{\rightarrow}^{15}NO_3$) was higher during 15 minutes than during 2 hours and always higher in Tongil. 5. $^{15}N$ excess % and content in each part, and uptake rate of root seems to have their own significance relatling with metabolism and translocation respectively. The change of nitrogen nutritional environment and source preference of varieties were discussed in relation to field condition and efficient use of nitrogen fertilizer.

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Comparison of the Uptakes of Tc-99m MIBI and Tc-99m Tetrofosmin in A549, an MRP-expressing Cancer Cell, In Vitro and In Vivo (MRP발현 인체 비소세포 폐암 A549에서 Tc-99m MIBI와 Tc-99m Tetrofosmin섭취의 비교)

  • Yoo, Jeong-Ah;Jeong, Shin-Young;Seo, Myung-Rang;Bae, Jin-Ho;Ahn, Byeong-Cheol;Lee, Kyu-Bo;Choi, Sang-Woon;Lee, Byung-Ho;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.6
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    • pp.382-392
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    • 2003
  • Purpose: Uptakes of Tc-99m MIBI (MIBI) and Tc-99m tetrofosmin (tetrofosmin) in human non-small cell lung cancer A549, multidrug-resistance associated protein (MRP) expressing cell, were investigated in vitro and in vivo. Materials and Methods: Western blot analysis and immunohistochemistry were used for detection of MRP in A549 cells with anti-MRPr1 antibody. Cellular uptakes of two tracers were evaluated at $100{\mu}M$ of verapamil (Vrp), $50{\mu}M$ of cyclosporin A (CsA) and $25{\mu}M$ of butoxysulfoximide (BSO) after incubation with MIBI and tetrofosmin for 30 and 50 min at $37^{\circ}C$, using single cell suspensions at $1{\times}10^6cells/ml$. Radioactivities in supernatants and pellets were measured with gamma well counter. A549 cells were inoculated in each flanks of 24 nude mice. Group 1 (Gr1) and Gr3 mice were treated with only MIBI or tetrofosmin, and Gr2 and Gr4 mice were treated with 70mg/kg of CsA i.p. for 1 hour before injection of 370KBq of MIBI or tetrofosmin. Mice were sacrificed at 10, 60 and 240 min. Radioactivities of organs and tumors were expressed as percentage injected dose per gram of tissue (%ID/gm). Results: Western blot analysis of the A549 cells detected expression of MRPr1 (190 kDa) and immunohistochemical staining of tumor tissue for MRPr1 revealed brownish staining in cell membrane but not P-gp. Upon incubating A549 cells for 60 min with MIBI and tetrofosmin, cellular uptake of MIBI was higher than that of tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetrofosmin. Percentage increase of MIBI was higher than that of tetrofosmin with Vrp by 623% and 427%, CsA by 753% and 629% and BSO by 219% and 140%, respectively. There was no significant difference in tumoral uptakes of MIBI and tetrofosmin between Gr1 and Gr3. Percentage increases in MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively higher by the time up to 240 min with CsA. Conclusion: These results indicate that MIBI and tetrofosmin are suitable tracers for imaging MRP-mediated drug resistance in A549 tumors. MIBI may be a better tracer than tetrofosmin for evaluating MRP reversal effect of modulators.

Influence of Age on The Adenosine Deaminase Activity in Patients with Exudative Pleural Effusion (연령의 증가가 삼출성 흉수 Adenosine Deaminase 활성도에 미치는 영향)

  • Yeon, Kyu-Min;Kim, Chong-Ju;Kim, Jeong-Soo;Kim, Chi-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.530-541
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    • 2002
  • Background : Pleural fluid adenosine deaminase (ADA) activity can be helpful in a differntial diagnosis of an exudative pleural effusion because it is increased in a tuberculous pleural effusion. The ADA activity is determined mainly by the lymphocyte function. Age-associated immune decline is characterized by a decrease in T-lymphocyte function. For that reason, the pleural fluid ADA level would be lower in older patients with exudative pleural effusion. This study focused on the influence of age on the pleural fluid ADA activity in patients with exudative pleural effusion. Methods : A total of 81 patients with exudative pleural effusion were enrolled in this study. In all patients, the pleural fluid ADA activity was measured using an automated kinetic method. Results : The mean age of the patients was $52.7{\pm}21.2$ years. In all patients with exudative pleural effusion, the pleural fluid ADA activity revealed a significant difference between young patients (under 65 years of age) and old patients (p<0.05), and showed a negative correlation with age (r=-0.325, p<0.05). In the 60 patients with a tuberculous pleural effusion, the pleural fluid ADA activity revealed a significant difference between the young and older patients : $103.5{\pm}36.9$ IU/L in young patients Vs. $72.2{\pm}31.6$ IU/L in old patients (p<0.05), and showed a negative correlation with age (r=-0.384, p<0.05). In the 21 patients with non-tuberculous exudative pleural effusion, the pleural fluid ADA activity of the young patients and old patients was similar : $23.7{\pm}15.3$ IU/L in young patients Vs. $16.1{\pm}10.2$ IU/L in old patients (p>0.05), and did not show any correlation with age (r=-0.263, p>0.05). The diagnostic cutoff value of pleural fluid ADA activity for tuberculous pleural effusion was lower in the older patients (25.9 IU/L) than in the younger patients (49.1 IU/L) or all patients (38.4 IU/L) with exudative pleural effusion. Conclusion : Tuberculous pleural effusion is an important possibility to consider in older patients with a clinical suspicion of a tuberculous pleural effusion, although no marked increase in the pleural fluid ADA activity is usually detected. For a diagnosis of a tuberculous pleural effusion in old patients, the cutoff for the pleural fluid ADA activity should be set lower.

Evaluation of Korean Native Ducks on Production Efficiency Factor, Carcass Yield, Partial Meat Ratio and Meat Quality with Weeks (토종오리 대형종의 주령별 생산지수, 도체 수율, 부분육 비율 및 육질 평가)

  • Heo, Kang-Nyeong;Kim, Hak-Kyu;Kim, Chong-Dae;Kim, Sang-Ho;Lee, Myeong-Ji;Choo, Hyo-Jun;Son, Bo-Ram;Choi, Hee-Cheol;Lee, Sang-Bae;Hong, Eui-Chul
    • Korean Journal of Poultry Science
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    • v.40 no.2
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    • pp.121-127
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    • 2013
  • This work was carried to evaluate production efficiency factor, carcass yield and meat quality with weeks of Large-type Korean native ducks. Korean native ducks (n = 90) from National Institute of Animal Science (RDA, Korea) were used in this work. Ninety ducks were divided into 6 groups (15 birds/group) and were fed with meat-type duck diets for 8 wk old. When ducks grew at specific wk (6, 7 and 8 weeks), 2 ducks per group were slaughtered at 6, 7 and 8 wk old. Production efficiency factor, carcass yield, partial meat and meat quality were researched in this work. There was no significant difference on livability with weeks, but body weight at 7 and 8 wk old was higher than that at 6 wk old (P<0.05). Feed conversion ratio at 6, 7 and 8 wk old were 2.25, 2.69 and 3.21, respectively, so there was significant difference with weeks (P<0.05). Production efficiency factor at 6, 7 and 8 wk old were 256.6, 199.8 and 153.0, respectively, so there was significant difference with weeks (P<0.05). Carcass yield at 8 wk old was higher than that at 6 and 7 wk old as 73.5% (P<0.05). Lightness at 6, 7 and 8 wk were 41.8, 39.0 and 38.1, respectively, and that at 6 wk old was the higher than other weeks (P<0.05). There was no significant difference on redness at 6, 7, and 8 wk old (P>0.05) and yellowness at 8 wk old was higher compared to other weeks (P<0.05). Cooking loss was the highest at 6 wk old as 31.6%, but water holding capacity was the highest at 8 wk old (P<0.05). There was no significant difference on shear force among weeks. pH at 6 wk old was the lower than that of other weeks as 5.84. Moisture content significantly decreased with weeks (P<0.05) and fat content at 8 wk was the highest as 1.88% (P<0.05). Protein content significantly increased with weeks until 20.9% at the age of 8 wk (P<0.05). Ash content at 7 and 8 wk old was the higher than that at 6 wk old (P<0.05). There was no significant difference on juiciness, tenderness, and flavor with weeks. Finally, these results may provide that shipping time at 7 wk old preferred to that at 6 and 7 wk old, but further research was needed because of deficiency of data.

Effect of Repetitive Transcranial Magnetic Stimulation in Drug Resistant Depressed Patients (치료 저항성 우울증 환자에서 반복적 경두개 자기자극후 국소뇌혈류 변화)

  • Chung, Yong-An;Yoo, Ie-Ryung;Kang, Bong-Joo;Chae, Jeong-Ho;Lee, Hye-Won;Moon, Hyun-Jin;Kim, Sung-Hoon;Sohn, Hyung-Sun;Chung, Soo-Kyo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.9-15
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    • 2007
  • Purpose: Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Materials and Methods: Twelve patients with drug-resistant depression (7 male, 5 female; age range: $19{\sim}52$ years; mean age: $29.3{\pm}9.3$ years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected p<0.01, voxel=100). Results: Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in: the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Conclusion: Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant depressed patients.

The Clinical Effects of Normocapnia and Hypercapnia on Cerebral Oxygen Metabolism in Cardiopulmonary Bypass (체외순환 시 뇌대사에 대한 정상 탄산분압과 고 탄산분압의 임상적 영향에 관한 비교연구)

  • 김성룡;최석철;최국렬;박상섭;최강주;윤영철;전희재;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.712-723
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    • 2002
  • Substantial alterations in cerebral blood flow(CBF) are known to occur during cardiopulmonary bypass(CPB). Many investigators have speculated that these changes may be responsible for both minor and major cerebral damages after CPB. More recently, these changes in CBF have been observed to be intimately related to the arterial carbon dioxide tension(Pa$CO_2$) maintained during CPB. The present study was prospectively designed to investigate the clinical effects of normocapnic and hypercapnic CPB on the cerebral oxygen metabolism in cardiac surgery Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to either normocapnic group (Pa$CO_2$35~40 mmHg, n=18) or hypercapnic group(Pa$CO_2$, 45~55 mmHg, n=18) with moderately hypothermic nonpulsatile CPB(nasopharyngeal temperature of 29~3$0^{\circ}C$). In each patient, middle cerebral artery blood flow velocity( $V_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v) $O_2$), cerebral oxygen extraction(COE), cerebral metabolic rate for oxygen(CMR $O_2$), cerebral oxygen transport( $T_{E}$ $O_2$), $T_{E}$ $O_2$/CMR $O_2$ ratio, cerebral desaturation(internal jugular bulb blood oxygen saturation $\leq$ 50%), and arterial and jugular bulb blood gas were evaluated throughout the operation. Postoperative neuropsychologic complications were assessed in all patients. All variables were compared between the two groups. Result: VMCA(169.13 $\pm$ 8.32 vs 153.11 $\pm$8.98%), TE $O_2$(1,911.17$\pm$250.14 vs 1,757.40$\pm$249.56), $T_{E}$ $O_2$,/CMR $O_2$ ratio(287.38$\pm$28.051 vs 246.77$\pm$25.84), $O_2$ tension in internal jugular bulb (41.66$\pm$9.19 vs 31.50$\pm$6.09 mmHg), and $O_2$saturation in internal jugular bulb(68.97$\pm$10.96 vs 58.12$\pm$12.11%) during CPB were significantly lower in normocapnic group(p=0.03), whereas hypercapnic group had lower C(a-v) $O_2$(3.9$\pm$0.3 vs 4.9$\pm$0.3 mL/dL), COE(0.3$\pm$0.03 vs 0.4$\pm$0.03), CMR $O_2$(5.8 $\pm$0.5 vs 6.8$\pm$0.6), and arterial blood pH(7.36$\pm$0.09 vs 7.46$\pm$0.07, p=0.04) during CPB. Hypercapnic group had lower incidence of cerebral desaturation than normocapnic group(3 vs 9 patients, p=0.03). Duration of the neuropsychologic complication(delirium) were shorter in hypercapnic group than in normocapnic group(36 vs 60 hrs, p=0.009). Conclusion: These findings suggest that hypercapnic CPB may have salutary effects on the cerebral oxygen metabolism and postoperative neurologic outcomes in cardiac surgery.surgery.