No abstract available.
Cesarean Section* ; Female ; Pregnancy

BACKGROUND: Since its introduction in 1987, the laparoscopic cholecystectomy has become the treatment of choice for most patients with symptomatic cholelithiasis. However, about 20% of the patients requiring a cholecystectomy present with acute cholecystitis, and the safety of a laparoscopic cholecystectomy in these patients has been questioned. With increasing experience, many studies have reported that a laparoscopic cholecystectomy in patients with acute cholecystitis is safe and cost effective. This study was to review retrospectively the results of laparoscopic cholecystectomies in patients with acute inflamed gallbladders. METHODS: From July 1993 through Fabruary 1997, laparoscopic cholecystectomies were attempted in 250 patients with or without symptomatic gallbladder disease. Acute cholecystitis, confirmed by clinical, laboratory, operative, and histological findings, was present in 61 patients. The preoperative factors that may be useful in predicting conversion to an open operation were analyzed. RESULTS: The frequency of conversion to an open operation was 19.7% for acute inflammation and 3.2% for chronic inflammation. Patients who had a laparoscopic cholecystectomy done within 72 hours of the onset of symptoms had a lower rate of conversion to open procedures. Patients who had a laparoscopic cholecystectomy done and who had a white blood cell count over 15 10(9)/L, persistant high fever (>38.0degrees C) over 3 days, and managed diabetes mellitus for over 3 years had a high rate of conversion to open procedures. There were no bile-duct injuries and no mortalites. CONCLUSIONS: Laparoscopic intervention appears to be a safe and beneficial option in the management of patients with acute cholecystitis. Surgeons should have extensive experience with both routine laparoscopic cholecystectomy and conventional open biliary tract surgery. A greater number of patients with inflammation require conversion to an open operation compared with the number of patients with no obvious inflammation who require conversion. Conversion to an open operation was frequent for patients with empyema, with symptoms that had lasted for longer than 72 hours prior to the operation, with white blood cell counts over 15 10(9)/L, with persistant high fever (>38.0degrees C) over 3 days and with managed diabetes mellitus for over 3 years, suggesting that once this diagnosis of acute cholecystitis is made, excessive time should not be spent in a laparoscopic trial dissection before conversion to an open operation.
Biliary Tract ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Cholecystitis, Acute* ; Cholelithiasis ; Diabetes Mellitus ; Diagnosis ; Empyema ; Fever ; Gallbladder ; Gallbladder Diseases ; Humans ; Inflammation ; Leukocyte Count ; Retrospective Studies

PURPOSE: To determine the best routes of administration of Tobramycin, the intracameral concentrations was assessed as time progressed after administering identical amounts and concentrations of tobramycin through various methods. METHODS: 40 eyes from 20 house rabbits were administered the same amount (200 micro liter) of 0.3% tobramycin. The first group was administered topically, and the second group was administered by subconjunctival injection. Contact lenses were soaked in tobramycin for 30 minutes and were covered over the corneas of the third group. While amniotic membranes were transplanted onto the corneas and tobramycin was topically administered in the fourth group. 100 micro liter of aqueous fluid was extracted 30 min, 1 hr, 2 hr and 3 hr after the administration and intracameral concentrations of tobramycin were measured using FPIA (fluorescence polarization immunoassay). RESULTS: After topical administration and subconjunctival injection, statistically significant decreases of average concentrations were observed after 2~3 hours. The group that was covered with flexible hydrophilic contact lenses showed high concentrations after 30 minutes, and a statistically significant increases of concentration was observed after 2 hours. The group that was topically administered with 0.3% tobramycin after amniotic transplantation on the cornea, showed a gradual increase of concentration as time progressed, and statistically significant increase of concentration was observed after 1~2 hours. CONCLUSIONS: Topical administrations with more frequent instillations increased intracameral concentrations, exceeding the MIC90 concentration of Staphylococcus aureus. while low concentration (0.3%) of subconjunctival injections did not significantly increases intracameral concentrations. Using flexible contact lenses, high concentrations were observed in the early stages, exceeding the MIC90 concentrations of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. Concentrations exceeded MIC90 concentration of Staphylococcus epidermidis 30 minutes after amniotic membranes transplantation, and continued to increases after 3 hours, Therefore, we can conclude that amniotic membrane can be used as a reservoir for transferring drugs.
Administration, Topical ; Amnion ; Aqueous Humor* ; Contact Lenses ; Contact Lenses, Hydrophilic ; Cornea ; Pseudomonas aeruginosa ; Rabbits ; Staphylococcus aureus ; Staphylococcus epidermidis ; Tobramycin*

Medicinal mushrooms have been used worldwide to treat cancer and modulate the immune system. Over the last several years, there has been increasing interest in isolating bioactive compounds from medicinal mushrooms and evaluating their health beneficial effects. Fomes fomentarius is used in traditional oriental medicine and is known to possess antioxidant, anti-inflammatory, antidiabetic, and antitumor effects. In the present study, we isolated fomentariol from Fomes fomentarius and investigated its anti-inflammatory effect in murine macrophages (RAW264.7 cells) stimulated with lipopolysaccharides. Fomentariol inhibited the production of nitric oxide and intracellular reactive oxygen species triggered by lipopolysaccharides. Interestingly, fomentariol differentially regulated cytokine production triggered by lipopolysaccharides. Fomentariol effectively suppressed the production of interleukin-1beta and interleukin-6 but not tumor necrosis factor-alpha. The inhibitory effect of fomentariol against nitric oxide, interleukin-1beta, and interleukin-6 production was possibly mediated by downregulation of the extracellular signal-regulated kinase signaling pathway. Taken together, our results suggest that fomentariol differentially modulated inflammatory responses triggered by lipopolysaccharides in macrophages and is one of the bioactive compounds that mediate the physiological effects of Fomes fomentarius.
Agaricales ; Coriolaceae ; Down-Regulation ; Immune System ; Interleukin-1beta ; Interleukin-6 ; Lipopolysaccharides ; Macrophages ; Medicine, East Asian Traditional ; Nitric Oxide ; Phosphotransferases ; Reactive Oxygen Species ; Tumor Necrosis Factor-alpha

Fomes fomentarius is a fungus of the Polyporaceae family and is used in traditional oriental therapies. Although the anti-inflammatory activities of this species have been previously reported, the identity of the bioactive compounds responsible for this activity remains unknown. Here, we investigated whether methyl 9-oxo-(10E,12E)-octadecadienoate (FF-8) purified from F. fomentarius exerts anti-inflammatory activity in murine macrophages stimulated with lipopolysaccharide (LPS). FF-8 suppressed secretion of nitric oxide (NO) and prostaglandin E2 through downregulation of inducible NO synthase and cyclooxygenase-2 expression induced by LPS. In addition, pretreatment of cells with FF-8 led to a reduction in levels of secreted inflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6 in macrophages stimulated with LPS. Conversely, FF-8 did not affect nuclear factor kappaB, p38, c-Jun NH2-terminal kinase, and extracellular signal-regulated kinase pathways. Instead, FF-8 specifically interfered with signal transducer and activator of transcription 3 (STAT3) phosphorylation induced by LPS. Collectively, this study demonstrated that FF-8 purified from F. fomentarius suppresses inflammatory responses in macrophages stimulated with LPS by inhibiting STAT3 activation. Further studies will be required to elucidate the anti-inflammatory effect of FF-8 in vivo.
Coriolaceae* ; Cyclooxygenase 2 ; Cytokines ; Dinoprostone ; Down-Regulation ; Fungi ; Humans ; Interleukin-6 ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase ; Phosphorylation* ; Phosphotransferases ; Polyporaceae ; STAT3 Transcription Factor ; Tumor Necrosis Factor-alpha

Omental pregnancy is an extremely rare form of abdominal pregnancy that may cause life threatening massive hemorrhage in case of rupture. It may occur by primary implantation of the fertilized ovum in the omentum. The diagnosis is very difficult, but prompt surgical intervention is required when it is suspected, because perinatal mortality and maternal mortality in abdominal pregnancy were 85~95% and 0.5~6%. We experienced a case of omental pregnancy in the first times and reported it with brief review of literature.
Diagnosis ; Female ; Hemorrhage ; Maternal Mortality ; Omentum ; Perinatal Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Rupture ; Zygote

A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with alpha and beta blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.
Catecholamines ; Headache ; Humans ; Hypertension ; Mediastinum ; Pheochromocytoma ; Thorax

PURPOSE: To study the effect of topical autologous serum in the treatment of recurrent punctate corneal erosions. METHODS: A total of 10 eyes from recurrent corneal erosion patients, who had suffered from recurrence after initial treatment with conventional therapy were treated using topical autologous serum from October 2001 to April 2003. We investigated the efficacy of this method over conventional therapy by retrospective review of their medical records. RESULTS: The recurrence rate of erosions before treatment with autologous serum eyedrops ranged from once every 2months to twice a month. Mean follow-up time was 11.0 +/- 4.6 months (range, 6~19 months). There was one case of recurrence 3 months after first treatment with autologous serum eyedrops which was effectively cured with autologous serum eyedrops. No side effects were noted in any of the treated patients. CONCLUSIONS: Topical autologous serum application may be considered as an effective and safe treatment modality in recurrent corneal erosions.
Follow-Up Studies ; Humans ; Medical Records ; Ophthalmic Solutions ; Recurrence ; Retrospective Studies

OBJECTIVES: Quality of life (QoL) was a important factor of treatment outcome in alcoholics. This study was to examine the relationship between family support and quality of life among alcoholics, to explore the moderating effect of abstinence self-efficacy on those relationship and to suggest practical implications for intervention services. METHODS: Data for this study were collected through the use of a survey instrument completed by 771 alcohol dependent admitted to inpatient treatment from 20 psychiatric hospital. Subjects were screened using the Family support, Drug Taking Confidence Questionnaire-8, World Health Organization Quality of Life Assessment Instrument. Collected data were analysed by moderated multiple regression and simple slope analysis. RESULTS: Family support was directly associated with QoL. Also the abstinence self-efficacy had moderating effects on relationship between family support and QoL. Simple slope analysis showed that the effects of family support on QoL were significant at low and high levels of abstinence self-efficacy and especially the effects of family support on QoL were more higher at the high levels of abstinence self-efficacy. CONCLUSION: This findings suggest that abstinence self-efficacy is an important factor to QoL among alcohol dependents. Increasing self-efficacy, family support will be improve the QoL and recovering process. Based on these findings suggest practical intervention.
Alcoholics ; Alcoholism ; Hospitals, Psychiatric ; Humans ; Inpatients ; Quality of Life ; Treatment Outcome ; World Health Organization

Background: Cognitive impairment is the second most common clinical manifestation in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). However, understanding of cognitive impairment in CADASIL has been hampered by lack of consensus on diagnosis of vascular cognitive impairment (VCI). We used vascular impairment of cognition classification consensus study principles (VICCCS-1) and protocols (VICCCS-2) to assess the cognitive impairment in CADASIL. We also evaluated the impact of MRI markers on major and mild VCI in CADASIL. Methods: We prospectively recruited 64 patients who underwent standardized brain MRI and detailed neuropsychological test. MRI analysis included number of lacunes, number of cerebral microbleeds (CMB), normalized volume of white-matter hyperintensities (nWMH), and brain parenchymal fraction (BPF). BPF has been used to measure brain atrophy. The patients were divided into three groups: those with normal cognition (CADASIL-NC, n=14), those with mild VCI (CADASIL-mild VCI, n=38), and those with major VCI (CADASIL-major VCI, n=11). Results: The three groups differed according to age, with the major VCI group being older. The major VCI group had more lacunes, more CMB, more extensive white matter lesions and lower BPF than NC group. There were no significant differences between NC and mild VCI groups in BPF. BPF and age were the independent predictors of major VCI. There was a tendency that women were at higher risk for mild VCI, though it did not reach statistical significance. Women were older than men, but had lower number of lacunes in mild VCI. Conclusions These findings suggest that brain atrophy and age are the main predictors of major VCI in CADASIL.