Characteristics of blood tests in patients with acute cerebral infarction who developed symptomatic intracranial hemorrhage after intravenous administration of recombinant tissue plasminogen activator

OBJECTIVE: Patients suspected as having acute ischemic stroke usually undergo blood tests, including coagulation-related indexes, because thrombocytopenia and coagulopathy are contraindications for recombinant tissue plasminogen activator (rtPA) administration. We aimed to identify blood test indexes associated with symptomatic intracranial hemorrhage (sICH) in patients with acute ischemic stroke who received intravenous rtPA.METHODS: This retrospective observational study included patients diagnosed with acute ischemic stroke who were treated with intravenous rtPA at the emergency department of a tertiary hospital in Seoul between February 2008 and January 2018. Blood test indexes were compared between the sICH and non-sICH groups. Logistic regression and receiver-operating characteristic curve analyses were performed.RESULTS: In this study, 375 patients were finally included. Of 375 patients, 42 (11.2%) showed new intracranial hemorrhage on follow-up brain computed tomography, of whom 14 (3.73%) had sICH. Platelet count, aspartate aminotransferase and lactate dehydrogenase levels were significantly different between the sICH and non-sICH groups, and platelet count showed statistical significance in the regression analysis. Significantly lower platelet counts were observed in the sICH group than in the non-sICH group (174,500 vs. 228,000/mm³, P=0.020). The best cutoff platelet count was 195,000/mm³, and patients with platelet counts of < 195,000/mm³ had a 5.4- times higher risk of developing sICH than those with platelet counts of ≥195,000/mm³.CONCLUSION: Platelet count was the only independent parameter associated with sICH among the blood test indexes. Mild thrombocytopenia may increase the risk of sICH after intravenous administration of rtPA.

Is current cardiopulmonary resuscitation guideline recommending same chest compression depth between men and women appropriate?

OBJECTIVE: This study examined whether the depth of chest compression (CC) recommended by current cardiopulmonary resuscitation guidelines is equally appropriate to both men and women. METHODS: Retrospective analysis of the chest computed tomography (CT) findings was performed. The anteroposterior diameter (APD), internal compressible depth (ICD), and anterior chest wall thickness were measured at the midpoint of the lower half of the sternum. The residual diameter (RD) for simulated CC was also obtained. If the RD was less than 20 mm, it was assumed that a potential injury would occur. RESULTS: A total of 319 adults (173 men, 141 women), who underwent chest CT at the emergency room, were enrolled. A statistically significant difference was observed between the mean APD and ICD between men and women. The mean APD and IPD were 8 mm shorter and 9.5 mm shorter, respectively, in women than in men. When adjusted for age, height, weight, and body mass index (BMI), the differences in the value of these parameters increased even more. In simulated CC with a 60 mm depth, the predictors of RD of less than 20 mm were weighed (odds ratio [OR], 0.888; 95% confidence interval [CI], 0.826–0.954; P=0.001) and BMI (OR, 0.706; 95% CI, 0.579–0.862; P=0.001), and all cases with RD of less than 20 mm were women. CONCLUSION: Chest compression of more than 60 mm may increase the potential risk of injury, particularly in women. The maximum allowable chest compression depth of less than 60 mm should be emphasized for women.

Ultrasonography-guided Fine-needle Aspiration for Solid Thyroid Nodules Less than 5 mm in the Largest Diameter: Comparison in Diagnostic Adequacy and Accuracy According to Nodule Size

PURPOSE: This study assessed the adequacy and accuracy of ultrasonography (US)-guided fine-needle aspiration (US-FNA) of solid thyroid nodules, less than 5 mm in maximum diameter. MATERIALS AND METHODS: From January to December 2009, US-FNA was performed for small solid thyroid nodules in 201 patients. Each thyroid nodule was classified into group A and B according to the largest diameter (1 mm or = 3 mm in the largest diameter, were higher than those of US-FNA for very small nodules, < 3 mm in the largest diameter.

Use of Point-of-Care Blood gas Analyzer for Potassium Measurement in Cardiac Arrest Cases

PURPOSE: The aim of this study was to assess agreement of potassium test results between the point-of-care-testing (POCT) blood gas analyzer and central laboratory (CL) biochemistry analysis associated with cardiopulmonary resuscitation (CPR) cases. METHODS: This was a prospective, comparative study of 108- paired results conducted between January 2009 and December 2010. Blood specimens were collected within 5 minutes of arrival to the emergency department from the femoral artery of cardiac arrest patients, and specimens were used for both arterial blood gas and routine laboratory analysis. Arterial blood gas analysis samples were immediately analyzed using a POCT blood gas machine [GEM Premier 3000 analyzer (Instrumentation Laboratory, Lexington, MA)]. Potassium levels obtained from the POCT arterial blood gas analyzer and subsequent CL biochemistry analysis were then compared. RESULTS: Mean values of potassium measured were 5.17+/-1.72 mmol/l using POCT and 5.37+/-1.79 mmol/l using CL. The mean difference+/-SD between simultaneous POCT and CL measurements was 0.19+/-0.66 mmol/l, with 95% limits of agreement of -1.48 to 1.10 mmol/l. The sensitivity, specificity, positive predictive value, and negative predictive value of POCT in diagnosing life threatening hyperkalaemia (> 6.5 mmol/l) were 85%, 97%, 85%, and 97%, respectively. CONCLUSION: The mean difference between the results obtained from the POCT blood gas analyzer and CL analysis were small. POCT is a thus a useful method for rapidly detecting life-threatening hyperkalaemia during CPR. However, due to wide limits of agreements, caution in interpretation of POCT results is necessary.

The Effects of 5-alpha Reductase Inhibitor on Contr action of Erectile Tissue and Secretion of Seminal Fluid in Male Rabbits: Preliminary Study / 대한남성과학회지

PURPOSE: Adverse sexual experiences such as erectile dysfunction (ED), loss of libido, and ejaculation disorders have been consistent side effects of 5-alpha reductase inhibitors (5ARI). The aim of this study was to evaluate the effects of 5ARI (finasteride) treatment on semen parameters and contraction of the corpus cavernosum and seminal vesicles in male rabbits. MATERIALS AND METHODS: Adult male New Zealand White rabbits (n=10) were randomized into 2 groups: finasteride-treatment (5ARI) group and vehicle-treatment (control) group. The 5ARI group received daily oral finasteride (10 mg/day) by gavage for 4~6 weeks, and the control group received the same concentration of the vehicle. The semen volume and semen parameters between the 2 groups were compared; thereafter, contraction or relaxation responses of smooth muscle strips of the corpus cavernosum and seminal vesicles were observed in an organ bath. RESULTS: Semen magnesium (14.2 vs 5.1 mg/dl) and protein (2.2 vs 1.6 g/dl) concentrations were significantly lower in the 5ARI group than in the control group. The concentrations of other parameters such as electrolytes (Na/K/Cl), fructose, and citrate did not differ between the 2 groups. The contractile responses to norepinephrine (NE) significantly increased in the 5ARI group compared to the control group and the relaxation responses to acetylcholine (ACh) or sodium nitroprusside (SNP) also increased in the 5ARI group. The contractile responses of the seminal vesicular strips to NE significantly decreased in the 5ARI group compared with the control group. CONCLUSIONS: The results suggest that finasteride may decrease contraction of seminal vesicle tissue and alter semen parameters. The effect of finasteride on erectile tissue was double-faced; enhancing both contraction and relaxation. Further study is needed in this respect.

Cytotoxicity and Hypersensitivity Test of Toothash

A study of comparing life stress between suicide attempters anddepressed patients

No abstract available.

The Effect of the Antioxidant on the Tyxidty of Paraquat in Rat / 대한산업의학회지

This study was designed to examine the influences of antioxidants on toxicity of paraquat in male rats. Paraquat and ascorbic acid were given orally ad libitum with tap water containing paraquat 30 ppm and 100 ppm and ascorbic acid 1000ppm for 10 days, respectively, alpha-tocopherol(60 mg/kg) was administered orally by sonde at 2 days intervals for 10 days. Paraquat at given doses produced markedly a dose-related reduction in water-intake, ratio of liver weight/body weight and glutathione along with the increased aspartate aminotransferase, alkaline phosphatase, serum lipid and ratio of lung weight/body weight. However the combined administration of ascorbic acid and paraquat did not affect the toxic effects of paraquat, whereas combined administration of paraquat and alpha-tocopherol showed relative reduction in the toxicities of paraquat. From these experimental results, it could be concluded that alpha-tocopherol has detoxifying effect on paraquat poisoning as the antioxidant, meanwhile ascorbic acid, one of the antioxidance, does not exert any detoxifying effects.