No abstract available.

OBJECTIVES: To evaluate the effects on the formation of benzidine-hemoglobin, and benzidine metabolite-hemoglobin adducts, caused by pretreatment with the known xenobiotic metabolism effectors, ethanol and phenobarbital, in rats administered Direct Black 38 dye. METHODS: The experimental rats were divided into three groups: a control group, an ethanol group and a phenobarbital group. Rats were pretreated with ethanol (1g/kg) or phenobarbital (80mg/kg) 24 hours prior to the oral administration of Direct Black 38 (0.5mmol/kg), with the control group being administered the same amount of distilled water. Blood samples were obtained from the vena cava of 5 rats from each group prior to, and at 30 min, 3 h, 6 h, 9 h, 12 h, 24 h, 48 h, 72 h, 96 h, and 144 h following the oral administration of Direct Black 38. Directly after sampling the blood was separated into hemoglobin and plasma, with the adducts being converted into aromatic amines by basic hydrolysis. Hydrolyzed benzidiene, monoacetylbenzidine and 4-aminobiphenyl were analyzed by reverse-phase liquid chromatography with an electrochemical detector. The quantitative amount of the metabolites was expressed by the hemoglobin binding index (HBI). RESULTS: In the ethanol group, benzidine-, monoacetylben-zidine-, and 4-aminobiphenyl-HBI were increased to a greater extent than those in the control group. These results were attributed to the ethanol inducing N-hydroxylation, which is related to the formation of the hemoglobin adduct. In the phenobarbital group, all the HBIs, with the exception of the benzidine-HBI, were increased to a greater extent than those of the control group. These results were attributed to the phenobarbital inducing N-hydroxylation related to the formation of the hemoglobin adduct. The N-acetylation ratio was only increased with the phenobarbital pretreatment due to the lower benzidine-HBI of the phenobarbital group compared to those of the control and ethanol groups. The N-acetylation ratios for all groups were higher than 1 for the duration of the experimental period. Although the azo reduction was unaffected by the ethanol, it was inhibited by the phenobarbital. The ratio of the benzidine-HBI in the phenobarbital group was lower than those of the ethanol the control groups for the entire experiment. CONCLUSION: Our results indicate that both ethanol and phenobarbital increase the formation of adducts by the induction of N-hydroxylation, but also induced N-acetylation. Phenobarbital decreased the formation of benzidine-HBI due to the decrease of the azo reduction. These results suggest that the effects of ethanol and phenobarbital need to be considered in the biochemical monitoring of Direct Black 38.
Administration, Oral ; Amines ; Animals ; Chromatography, Reverse-Phase ; Ethanol* ; Hydrolysis ; Metabolism ; Phenobarbital* ; Plasma ; Rats* ; Water

Reduction of displaced diaphyseal fractures of the radius and ulna in adult must be nearly anatomical for restoration of mormal function. Most of the fractures require operative management, and various methods of open reduction and internal fixation have been recommended. Because we believe that anatomical reduction followed by rigid internal fixation provides the most satisfactory results for these injuries, dynamic compression plating method is frequently used in our hos pi tal. We studied 52 diaphyseal fractures of the forearm bone in 33 patients treated at the S.R.C.H. from May 1980 to December 1985. Of the 33 patients, 20 had fractures of the radius and ulna; 6, fractures of the radius only; and 7, fractures of the ulna only. The fractures of both bones were treated with plate and screws in 19 patients. In another one, the ulna was treated with plate and screws and the radius was treated by screw fixation only. The results were as follows: l. Of the 52 fractures, 51(98.1%) were united after the initial operation within 23 weeks. 2. The average time for radiological union of the fracture, excluding those complicated by infection or non-union, was 11.1 weeks for 24 radii and 10.9 weeks for 25 ulnae. 3. Only one patient(3.0%) was complicated by infection and only one(1.9%) non-union of radius occurred. 4. The functional results were excellent or satisfactory in 25 patients(83.3%). 5. We have found that in adults the auto compression plating is a successful method for the diaphyseal fractures of the forearm.
Adult ; Diaphyses ; Forearm ; Humans ; Methods ; Radius ; Retrospective Studies ; Ulna

No abstract available.
Humans ; Lymphocytes* ; Stomach Neoplasms* ; Stomach*

No abstract available.
Protein-Losing Enteropathies*

No abstract available.
Snake Bites* ; Snakes*

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.
Delayed Diagnosis ; Esophagoscopy ; Humans ; Laryngoscopy ; Larynx ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Retrospective Studies ; Tolnaftate

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed by overproduction of plasminogen activator inhibitor-1 (PAI-1). Intermittent sequential pneumatic compression (ISPC) is an effective method to prevent deep vein thrombosis. Its action is explained by the mechanical effect on blood flow, as well as by the enhancement of fibrinolysis by the reduction of PAI-1. The aim of this study was to determine the effects of ISPC on coagulation and fibrinolysis after multiple trauma. METHODS: Thirty-nine trauma patients were either treated with ISPC (ISPC group, 20 patients) or without ISPC (control group, 19 patients). We measured the plasma levels of the thrombin antithrombin III complex (TAT), the plasmin alpha 2 plasmin inhibitor complex (PIC), the tissue plasminogen activator (t-PA), and the plasminogen activator inhibitor-1 (PAI-1) on admission and at 1, 2, 3, 6, 12, and 24 hours after admission. RESULTS: The TAT was higher than normal in both groups, with no significant difference between the two groups throughout the study period. The PIC level of ISPC group was significantly higher than that of the control group. In the ISPC group, the PIC level increased gradually, reaching a peak at 3 hours and decreasing thereafter. In the control group, the PIC level increased to a peak level at 2 hours. The TAT/PIC ratio dropped in the first two hours and increased at 3 hours, dropping again thereafter. In the ISPC group, the ratio dropped gradually without an intermittent fluctuation. At 3 and 6 hours, the control group showed a significantly greater ratio compared to the ISPC group. PAI-1 was higher than normal in bothgroups, with a significantly lower level in the ISPC group from 2 hours to 24 hours. For the t-PA level, no difference was noted between the two groups, with the peak level occurring at 1 hour. The PAI-1/t-PA ratio was significantly greater in the control group from 2 hours to 12 hours than in the ISPC group, but the difference was not significant at 24 hours. CONCLUSIONS: In multiple trauma patients, ISPC does not seem to affect coagulation, but enhances fibrinolysis through suppressed PAI-1 production. This effect of ISPC may be maintained for 12 hours.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Thrombin ; Tissue Plasminogen Activator ; Venous Thrombosis

No abstract available.
Abdomen, Acute* ; Aged* ; Geriatrics* ; Humans

In evaluating the early state of shock patients and their response to treatment, generally vital signs or additional hemodynamic values were used. Vital signs are easily obtained and repetitious values or continous monitoring is possible, whereas it cannot evaluate the patient's status properly nor is it a good prognostic factor. Meanwhile, additional hemodynamic values are obtained from pulmonary artery catheterization. But this procedure is difficult to proceed in the emergency room. Since central venous oxygen saturation has the advantage of being easily obtained and acts as a good prognostic factor for shock patients, we intended to prove its efficacy. From 1997 May to October, 50 patients admitted to Yonsei University Young Dong Severance Hospital in shock state, with systolic blood pressure below 90mmHg, were evaluated. Central venous catheter was inserted to obtain central venous oxygen saturation, serum lactate, base excess value, and its' initial value compared with the prognosis. The central venous oxygen saturation and base excess were low, while serum lactate value was high in the nonsurvival group. And in ROC(relative operating characteristic) curve, the AUC(area under curve) of central venous oxygen saturation was larger than the others. In comparing the MOF(multi-organ failure) group with the non-MOF group, the MOF group had a lower central venous oxygen saturation and base excess, and a higher serum lactate level, whereas in ROC curve, the AUC of base excess was larger than the others. Therefore, in estimating the prognosis of shock patients, the early central venous oxygen saturation proved to be a good prognostic factor.
Area Under Curve ; Blood Pressure ; Catheterization, Swan-Ganz ; Central Venous Catheters ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Lactic Acid ; Oxygen* ; Prognosis ; ROC Curve ; Shock* ; Vital Signs