BACKGROUND: There are cases in which shoulder pain persists long after shoulder joint surgery and this pain can not be reduced by intravenous patient controlled analgesia (IVPCA). Our purpose was to evaluate the effect of stellate ganglion block (SGB) on postoperative shoulder pain and also to investigate the effect of preventive SBG on complex regional pain syndrome (CRPS). METHODS: Forty patients, who were evaluated to ASA class 1 and 2 and who were scheduled for shoulder joint surgery under general anesthesia, were randomly divided into 2 groups. The experimental group of patients (n = 20) received SGB with 0.5% mepivacaine 8 ml after induction of general anesthesia. The control group of patients (n = 20) received only general anesthesia. Their postoperative pain was assessed using the visual analog scale (VAS) at 30 min, 1, 2, 6, 12, 24 and 48 hours postoperatively. Whenever patients wanted supplemental analgesia, diclofenac sodium 75 mg was injected intramuscularly and the need for supplemental analgesia was recorded. RESULTS: The experimental group of patients had significantly lower pain scores at 30 min, 1, 2 and 6 hours and also significantly lower analgesic requirement at 1, 2 and 6 hours. CONCLUSIONS: We found SGB was effective for controlling postoperative pain after shoulder joint surgery. Also, we could expect that SGB reduced the incidence of CRPS.
Analgesia ; Analgesia, Patient-Controlled ; Anesthesia, General ; Diclofenac ; Humans ; Incidence ; Mepivacaine ; Pain, Postoperative* ; Shoulder Joint* ; Shoulder Pain ; Shoulder* ; Stellate Ganglion* ; Visual Analog Scale

The effect of praziquantel on P. westermani exposed in vitro was observed by stereomicroscope, light microscope and scanning electron microscope. Following results were found. The worms incubated in 0.01 micro-g/ml praziquantel were moving after 26-hour incubation. However, all of them were immobilized immediately after incubation in solutions over 0.1 micro-g/ml concentration. All of the exposed worms showed severe vacuolization not only in tegument but in subtegument, intestine, ovary, testis, Mehlis' gland and excretory bladder. Vacuoles in tegument burst out to form craters. As incubation time went on, tegumental structure was disintegrated severely. The worms exposed to praziquantel were observed to be immobilized and be vacuolized of all tissues. Disintegration of reproductive organs suggests that praziquantel have suppressive effect on egg production when the flukes are not killed. The drug effects were found more related with incubation time than with drug concentration.
parasitology-helminth-trematoda ; Paragonimus westermani ; electronmicroscopy ; chemotherapy ; praziquantel

A nationwide survey was performed to know the distribution and prevalence of human Gymnophalloides seoi infection on western and southern coastal islands in the Republic of Korea. A total of 4,178 fecal specimens were collected from residents on 45 (24 western and 21 southern) islands, and examined by Kato-Katz and formalin-ether sedimentation techniques. Eggs of G. seoi were detected from 160 (3.8%) people living on 22 (13 western and 9 southern) islands. The prevalence varied by the location of islands; higher on western islands than on southern islands. The highest prevalence was found on Amtaedo (25.3%), followed by Cheungdo (25.0%), and Anchwado (20.9%) (Shinan-gun). A little lower prevalence was observed on Munyodo (13.3%), Shinshido (12.9%), and Sonyudo (10.3%) (Kunsan-shi). Of the remaining islands, the regions showing the prevalence greater than 5% included Kohado, Dallido (Mokpo-shi), Pyeongildo, Kogumdo (Wando-gun), and Keogumdo (Kohung-gun). A strong age predilection was noted (P < 0.05); 95% of the infected people were over 40 years old. Females showed a little higher prevalence than males. The results indicate that human G. seoi infection is more widely distributed than previously considered. Nine of 11 islands (excluding the 2 known areas Munyodo and Sunyudo) that showed greater prevalence than 5% are regarded as new endemic foci of G. seoi.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Animals ; Child ; Child, Preschool ; Female ; Human ; Infant ; Intestinal Diseases, Parasitic/*epidemiology ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Sex Factors ; Support, Non-U.S. Gov't ; Trematode Infections/*epidemiology

The metacercariae of Echinostoma cinetorchis (Trematoda: Echinostomatidae) were found infected in the loaches (Misgurnus anguillicaudatus) purchased from two local markets in Korea. Identification of the metacercariae was done after obtaining adult worms from experimentally infected albino rats. Brief course of worm development in rats was also observed up to 28th post-infection day. The results are as follows: The metacercariae of E. cinetorchis were detected from 5 (10.9 percent) out of 46 loaches examined and the average metacercarial burden per infected loach was 34.4. They were always found from the posterior abdominal wall. The worm recovery rate from 8 rats was 24.6 percent in average. It was observed that the rate decreased according to age of infection; from 40.7 percent after 6 days to 15.0 percent after 28 days. The adult worms were morphologically characterized by the presence of head crown with dorsally uninterrupted collar spines, 37-38 in number, and the tendency of migration or disappearance of testes. So that they were identified as Echinostoma cinetorchis Ando et Ozaki, 1923. The development of worm was very rapid during 6-10 days after infection and became much slower thereafter. During the rapid worm growth the development of genital organs was more prominent than that of non-genital organs. From the results it is concluded that the loach is involved in the life cycle of E. cinetorchis in this country and may take a role for infection source to animals and man. It is also confirmed that migration or loss of testes is the distinct specific character of this echinostomatid fluke.
parasitology-helminth-trematoda ; Echinostoma cinetorchis ; metacercaria ; mouse ; development

Hepatocellular carcinoma (HCC) involving the inferior vena cava (IVC) and/or right atrium (RA) is a rare and intractable disease. A standard treatment has not been established yet, owing to the rarity of disease and difficulties in the therapeutic treatment. Herein, we report the case of a patient who had recurrent HCC (after a prior lobectomy) involving both IVC and RA and underwent multimodality treatments including external beam radiotherapy and transarterial chemotherapy, followed by sorafenib treatment. The disease was well controlled with local treatments and sustained for 7 years until last follow-up after the systemic treatments. Our case shows a possibility of long-term survival for patients affected by HCC involving IVC and/or RA, after a rigorous multimodality treatment strategy.
Carcinoma, Hepatocellular ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Heart Atria ; Humans ; Liver Neoplasms ; Radiotherapy ; Vena Cava, Inferior

No abstract available.
Ultrasonography*

Avian influenza (AI) virus infects both animal and human. Low pathogenic AI virus infections (some H7 and H9 subtypes) have been reported all over the world and pose a potential threat to the poultry industry. Vaccination is the most effective way to prevent virus infection. However, vaccination makes it difficult to differentiate between vaccinated chickens and infected chickens. In order to differentiate vaccinated chickens from naturally infected chickens, we adopted synthetic peptide-based enzyme-linked immunosorbent assay (ELISA) using the peptide sequences from nonstructural protein 1 (NS1) of H9N2. Five synthetic peptides were designed using Protein Variability Sever (http://imed.med.ucm.es/PVS/) and synthesized. NS1-1 ~ NS1-4 peptides failed to detect serum antibodies from both vaccinated and naturally infected chickens. NS1-5 peptide from the C-terminal NS1 protein detected serum antibody from naturally infected chickens but not vaccinated chickens. These results imply that NS1-5 peptide may be a useful tool to differentiate naturally infected chicken from vaccinated chicken as being used in the synthetic peptide-based ELISA.
Animals ; Antibodies ; Chickens ; Enzyme-Linked Immunosorbent Assay ; Humans ; Influenza in Birds ; Peptides ; Poultry ; Vaccination ; Viruses

BACKGROUND: Hip replacement arthroplasty (HRA) is highly traumatic and performed in a lateral position for several hours and dead-space ventilation may increase. So, the difference between arterial and end-tidal PCO2 was investigated depending on the changes in the patient's posture during HRA in elderly patients. METHODS: Forty-three patients scheduled for a HRA were divided into two groups; Adult Group (n = 21, A-Group) and Elderly Group (n = 22, E-Group). Mean arterial pressure (MAP), heart rate (HR), PaO2, PaCO2, and end-tidal carbon dioxide tension (P(ET)CO2) were simultaneously measured at 10 min after anesthesia in a supine position (S[10]), at 30 min intervals from 30 min (L[30]) to 180 min (L[180]) in a lateral position and at 10 min in a supine position after the end of surgery (ES[10]) in both groups. The PaCO2-P(ET)CO2 gradient (P[a-ET]CO2) and dead space ventilation (Vd/ Vt) were calculated. RESULTS: At S(10), P(a-ET)CO2 in the A- and E-Groups was 7.0 +/- 5.0 and 7.2 +/- 3.3 mmHg respectively. From L(30) to ES(10), the P(a-ET)CO2 and the ratio of Vd/Vt in both groups increased significantly and progressively (P < 0.05 vs the control value) and the slope in the E-Group rose two times as compared to that in the A-Group. The correlation coefficient between P(a)CO2 and P(ET)CO2 was very significant from S(10) to L(90) and ES(10) in the A-Group, and from S(10) to L (60) in the E-Group (P < 0.01). CONCLUSIONS: For maintaining adequate ventilation of the elderly patient during HRA, PaCO2 should be measured intermittently along with the position changes after anesthesia in addition to the constant monitoring of PETCO2.
Adult ; Aged* ; Anesthesia ; Arterial Pressure ; Arthroplasty, Replacement, Hip* ; Carbon Dioxide ; Heart Rate ; Hip* ; Humans ; Posture ; Supine Position ; Ventilation

PURPOSE: Renal cell carcinoma has been characterized by an abnormality on the short arm of chromosome 3, which suggests the presence of a tumor suppressor gene at this location. The aim of study was to investigate the role of tumor suppressor genes on the short arm of chromosome 3 in the mechanism of tumorigenesis in sporadic renal cell carcinoma. MATERIALS AND METHODS: The DNA from normal and tumor tissue from 48cases with renal cell carcinoma was analyzed for allele loss on chromosome 3p by polymerase chain reaction using microsatellite marker. RESULTS: A total of 37 of 48 informative tumors(77%) showed loss of heteroxygosity(LOH) at one or more loci. Detailed analysis of the pattern of LOH on the chromosome 3p suggested that mutations of other genes in chromosome 3p13-p24, in addition to VHL gens in chromosome 3p25, are required for malignant tumor growth. There was the statistically significant correlation between the extent of LOH and cancer cell type(clear vs. others)(p=value 0.048, Fisher's exact test). A total of 26 of 37 clear cell types(70%)revealed LOH on chromosome 3p, but all of 11 non clear cell types including 2 granular cell types, 3 chromophobe types, 1 sarcomatoid cell type and 5 mixed cell types showed LOH. There was no correlation between LOH and other clinico-pathological factors including patients age, sex, symptom, tumor size, stage of disease and tumor cell grade. CONCLUSIONS: Our data suggest that, in addition to VHL gene, at least one tumor suppressor gene for the genesis of sporadic remal cell carcinoma exists on the short arm of chromosome 3.
Alleles* ; Arm ; Carcinogenesis ; Carcinoma, Renal Cell* ; Chromosomes, Human, Pair 3 ; DNA ; Genes, Tumor Suppressor ; Humans ; Loss of Heterozygosity ; Microsatellite Repeats ; Molecular Biology* ; Polymerase Chain Reaction

BACKGROUND: We were interested in getting feedback from physical therapists practicing in individualized home health programs about the present situation and the problems of home-based rehabilitation therapy services. METHODS: We recruited 110 physical therapists practicing in individualized home-visiting health programs offered at health centers. They each completed a 15-item self-administered questionnaire including personal information, therapy environments, characteristics of patients, treatment outcomes and suggestions. RESULTS: Of the 110 respondents, 66 (60%) were engaged in home-based rehabilitation therapy services with other duties. Sixty (54.5%) indicated that >25% of patients improved with home-based therapy and 90% of patients were satisfied with the services they received. Eighty-three (75.5%) respondents indicated that the amount of therapy provided was insufficient, 82 (74.5%) thought that there were no measurement tools to use except for the rehabilitation therapy services records and 27 (24.6%) had evaluation meetings with other medical service members for >50% of their patients. CONCLUSION: The majority of the physical therapists in our study indicated that the home-based rehabilitation therapy services satisfied the needs of patients and improved their functional abilities. However, amount of therapy, use of measurement tools for outcome evaluations and comprehensive team approach were indicated as insufficient. We conclude that increasing the number of physical therapists and systematizing the home-based rehabilitation therapy services would improve the present situation.
Surveys and Questionnaires ; Humans ; Physical Therapists