Foreign Bodies ; Humans ; Male ; Middle Aged ; Skull Base

Objective To explore the changes and clinical significance of levels of serum vascular endothelial growth factor(VEGF)and endostatin in smokers. Methods In a case-control study,levels of serum VEGF and endostatin were determined in 82 smokers with lung cancer,82 pair-matched smokers without lung cancer and 20 healthy non-smokers by enzyme-linked immunoabsent assay(ELISA) or competitive enzyme immunoassay.Results The level of serum VEGF in smokers with lung anncer[(16.1±7.9)ng/ml]was markedly higher than that in the other two groups(both P＜0.01).The level of serum VEGF in smokers without lung cancer was significantly higher than that in healthy non-smokers(P＜0.05).The level of serum endostatin in smokers with lung cancer was significantly higher than that in healthy nonsmokers(P＜0.01),but was not significantly different from that in smokers without lung cancer(P＞0.05),and that in smokers without lung cancer was significantly higher than that in healthy non-smokers (P＜0.05).Notably,the ratio of endostatin to VEGF in smokers with lung cancer(1.3±0.5)was significantly lower than that in the other two groups(both P＜0.01).However.there was no significant difference in it between smokers without lung cancer and healthy non-smokers(P＞0.05).The level of serum VEGF correlated significantly to that of endostatin in smokers both with and without lung cancer(P＜0.01).Conclusions These findings suggest that smoking may result in imbalance of levels of serum endostatin and VEGF leading to tumorigenesis.The ratio of endostatin to VEGF can be used as an early diagnostic indicator for lung cancer in smokers.Periodic determination of levels of serum VEGF and endostatin as well as the ratio of endostatin to VEGF is of clinical importance.

· AIM: To compare the measurement of anterior chamber depth (ACD) and axial length (AL) by IOLMaster and contact ultrasonic (US) axial scan (A-scan).· METHODS: Measurements of ACD and AL were prospectively obtained in 137 eyes of 121 subjects with the IOLMaster compared with measurements with the US.· RESULTS: There was an excellent correlation between IOLMaster and US measurements for the ACD (r=0.823;P＜0.001) and AL (r=0.996;P＜0.001). The mean values of the parameters measured by IOLMaster and US were,respectively, as follows: ACD, 2.94±0.49mm, 2.58±0.51mm;AL, 24.37±3.04mm, 23.81±2.83mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0.36 ±0.30mm, 0.56 ±0.34 mm respectively, and they proved to be statistically significant (P＜0.001), With the 95%limits of agreement (LoA) from -0.08mm to +0.38mm for ACD and from -0.09mm to +0.69mm for AL.· CONCLUSION: As noncontact biometry, IOLMaster provides accurate values. A high degree of agreement between US and IOLMaster was noted. It not only has the advantage of performing noncontact examinations, but also produces various additional data simultaneously and may thus obviate the need for multiple examinations. Further studies are needed to assess the interchangeability of measurements in clinical practice.

ObjectiveTo evaluate the safety and feasibility of the tracheal stent implantation for treatment of malignant tracheal stenosis under general anaesthesia. Methods Eighteen patients with malignant tracheal stenosis underwent preoperative 64-slice spiral CT scan and airway reconstruction. The stenotic sites were located in main tracheal trunk(5 patients),in right main bronchus( 1 patient),in trachea and left main bronchus (4 patients),in trachea and right main bronchus (3 patients),in main tracheal trunk and bilateral main bronchus(5 patients).The degree of stenosis was rated 51％ to 70％ in 7 cases,71％ to 90％ in 11 cases.All patients,17 patients of ASA grade 1V and 1 patient of grade Ⅲ,presented with severe dyspnea. Under general anaesthesia,implantation of metallic stent was performed through the sputum aspiration hole of the connecting tubing with DSA guidance.The NBP,ECG,RR,SaO2 of the patients were recorded and compared with t test during the entire procedure. At the end of the procedure,relief of dyspnea,complications related to anesthesia and operation were recorded. Results The success rate of stent placement was 18/18,and dyspnea was significantly relived in all patients. Slightly bloody sputum occurred in 7 cases.The stent was obstructed by sputum in 1case,and the patient was treated with medication.There were no severe complications.The operative course were rated 11 to 9 in 17 cases,and 6 to 8 in 1 case.All 18 patients were cooperative during the procedure.Sixteen patients rated the procedure as very comfortable and 2 rated the procedure as comfortable.Respiratory rate (RR) and heart rate (HR) decreased in all patients after the operation [ ( 37.1 ± 2.8 )/min and ( 106.5 ± 14.2 ) bpm before the operation respectively,( 18.6 ± 1.4)/min and ( 73.2 ± 7.6) bpm after the operation respectively ],t =17.81 and 3.80,P ＜ 0.01.Pulse oxygen saturation ( SaO2 ) during the operation [ ( 91.2 ± 1.8 ) ％ ]increased [ (76.3 ± 8.6 )％ before the operation ] and increased further after the operation [ (94.5 ±4.3 ) ％ ],t =2.06 and 2.26,P ＜ 0.01.Blood pressure (BP) showed no changes throughout the operation (P ＞ 0.05 ).The conprehensive assessment of operation were favorable in all patients. Conclusion With careful preoperative evaluation and planning, tracheal stent implantation under general anaesthesia in patients with malignant tracheal stenosis is feasible and safe.

Objective To observe effects and mechanisms of insulin on reperfusion injury after cerebral ischemia.Methods Sixty-six male Wistar rats were used in this study.All rats were divided into 3 groups as treated group(A),control group(B) and random sham-operated group(C).Four-vessel occlusion was used to establish global cerebral ischemia reperfusion model in study groups.The treated group were divided into 5 groups(A1-A5) and intraperineally injected with biosynthetic human insulin 2 IU/(kg?d) and 50%glucose 2 g/(kg?d) for 7 days,the blood glucose was monitored in preoperative and postoperative 3,6,12,24 h,and the blood glucose was maintained between 3.5-6.5 mmol/L.These animals of control group were given with saline 2 mL/(kg?d) for 7 days in abdominal cavity.All the rats were killed in the seventh day,brain homogenate was collected for detection of neuron specific enolase(NSE)and nitric oxide(NO).The hippocampus was separated for observation of electronic microscope.Results Concentration of NSE in brain tissue in group C was significantly higher than that of group A and group B,while the level in group A was higher than that of group B.Concentration of NO in group C was lower than that of group A and group B while the level of NO in group A was significantly lower than that of group B.Electron microscope showed that the ultrastructure of sham-operated group was nearly normal,damage degree of hippocampal neuron and gliacyte and capillary was gradually worse from group A1,A2 to A4,the damage degree of group B1,B2 and B4 was serious and there was no difference among them.Conclusion Insulin can really promote recovery of the cerebral injury after ischemia reperfusion.

OBJECTIVETo observe the color changes of nickel-titanium (Ni-Ti) orthodontic wires induced by fluoride.

METHODSEach 40 samples of 4 kinds of nickel-titanium orthodontic wires (IMD, SL, TP, YY) were put into artificial saliva with sodium fluoride at different F concentrations (0.05%, 0.10%, 0.15%) and artificial saliva, separately. Dislodged the species and immersed them into artificial saliva with sodium fluoride for 3 minutes, then washed them with deionized water, and put back to artificial saliva, this course should be repeated 3 times per day. The whole immersion test lasted for 28 days. The color and micro-morphous changing were observed.

RESULTSThe color changes came to be more serious as the F- concentration growing (P < 0.05). At the same F- concentration, the color changes of IMD and YY were higher than SL and YP (P < 0.01), while there were no significant difference between IMD and YY, SL and TP (P > 0.05).

CONCLUSIONFluoride can change the color of Ni-Ti wire. Different Ni-Ti wires get different changes at the same F- concentration.

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.
Apgar Score ; Bronchopulmonary Dysplasia ; Counseling ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Incidence ; Infant, Newborn ; Length of Stay ; Maternal Age ; Parity ; Parturition ; Pregnancy ; Pregnancy, Triplet ; Pregnancy, Twin* ; Reproductive Techniques, Assisted* ; Seizures ; Triplets*

OBJECTIVES: The study is to test reliability and validity of the Korean version of spiritual well being scale which is devised by Paloutzian and Ellison. METHODS: The spiritual well being scale was translated into Korean by two psychiatrist and 131 Christians rated the Korean version of spiritual well being scale. For test-retest reliability, 80 telephone counsellor trainee rated it again after one week interval and statistical analysis was done with the collected data. RESULT: Correlation coefficients were regarded to have good test-retest reliability. Cronbach alpha value of total score, and religious well being subscale and existential well being subscale were significantly high. Among demographic factors, health(healthier) factors, is related with significantly high score of spiritual well-being scale(SWS). Period(over 30year) of christianity showed significant discriminative score of SWS. Factor analysis for validity showed 5 subgroups which were correlated with religious well-being scale(RWS) and existential well-being scale(EWS). 1st subgroup of RWS is related with educational factor, 2nd subgroup of RWS is related with health foactor, 3rd subgroup of RWS is related with personal relationship with God especially, 4th subgroup of EWS is related with health factor and 5th subgroup of EWS is related with reality oriented view. CONCLULSION: The Korean version of SWS which is consisted of RWS and EWS was proved to be a reliable and valid instrument of assessment of spirituality.
Christianity ; Demography ; Humans ; Psychiatry ; Reproducibility of Results* ; Spirituality ; Telephone

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics of "fake bad" and "fake good" patients with traumatic head injury in neuropsychological tests. METHODS: We measured subjective symptoms by SCL-90-R and objective symptoms by McBride obstacle-valuation measure. The patient was divided into three groups according to differences between subjective and objective symptoms. We also examined their intelligence, memory, clinical characteristics, using K-WAIS, K-MAS, MMPI. RESULTS: The group who overly expressed their subjective symptoms has its psychotic symptom exaggeratingly measured, so it will be helpful to be careful to such over-expressed symptoms in those who present a psychotic symptom in a clinical view-point. An K-WAIS measurement among those who exaggerated their subjective symptoms showed less value than the actual one, which weakens the reliability of this intelligent test. Rather, for that group, the result of K-MAS can be used with a confidence in the estimation of their severity of symptoms. CONCLUSION: MMPI and neuropsychological tests are helpful to understand characteristics between subjective symptoms and objective disabilities of patients with traumatic head injury.
Craniocerebral Trauma* ; Head* ; Humans ; Intelligence ; Memory ; MMPI* ; Neuropsychological Tests*

There has been a considerable controversy on the prognosis of the mucinous gastric adenocarcinoma(MGC). In this study we analyzed the clinicopathologic differences between MGC and non-mucinous gastric carcinoma(NMGC). In addition, the relationship between mucin content and other clinicopathologic variables, including prognosis in MGC was examined. We reviewed 2118 patients with pathologically confirmed gastric cancer who had underwent gastrectomy at the department of surgery of Yonsei University College of Medicine, during the period between Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric cancer with extracellular mucin(MGC) and 1988 patients had gastric carcinoma without extracellular mucin(NMGC). We studied the MGC patients into two groups according to mucin content: mucin content involving over 50% of the tumor(dominant type, n=94) and mucin content involving less than 50% of the tumor area(partial type, n=36). The results are as follows: The MGC was more common in male then NMGC. The size of tumor in MGC was larger than that of NMGC. The patients with MGC had higher incidence of Borrmann type IV, more frequent serosal invasion, lymph nodes metastasis and peritoneal metastasis than the patients with NMGC. The patients with MGC had more advanced stage at the time of diagnosis and worse overall 5-year survival rate than the patients with NMGC. But the 5-year survival rate according to the stage of MGC was similar to that of NMGC. There were no significant differences between the mucin content and other pathologic variables including prognosis. So we suggested that MGC has worse prognosis than NMGC and it is reasonable to consider the carcinoma with mucin content involving less than 50% of the tumor area as MGC.
Adenocarcinoma* ; Diagnosis ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Male ; Mucins* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms ; Survival Rate