BACKGROUND: As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important 13 prevent pleural fibrosis, entrapment and depression of lung function Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the Predictors of effeotiveness of intrapleural urokinase in treatment of loculated pleural effusion METHOD: Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleura1 cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. RESULT: Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in sucess group (11.8α6.9day) than in failure group (26.62α16.5day) (P<0.05). Amount of drained fluid during urokinsse therapy was larger in success group (917.1α392.7ml) than in failure group (613.8α259.7ml) (P<0.05). Pleural fluid glucose was higher in success group (89.7 α35.9mg/dl) than in failure group (41.2α47.1mg/dl) (P<0.05). Pleural fluid LDH was lower in success group (878.4α654.31U/L) than in failure group (2711.1α973.1IU/L) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group(P<0.05). CONCLUSION: Longer duration of symptoms before admission smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination and honeycomb septation pattern on chest ultrasonography were predictors for failure group of intrapleural urokinase instillation therapy.
Biomarkers ; Catheters ; Depression ; Drainage ; Empyema ; Fibrosis ; Follow-Up Studies ; Gelatin ; Glucose ; Humans ; Inflammation ; Lung ; Pleural Effusion* ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

BACKGROUND: The photsensitizing effect of quinolones has been recognized since their introdulation as an antibacterial agents. Recently several new second eneration antibacterial agents of this pharmacological class have become available for therapy, and are gaining increasing impotance. OBJECTIVE: To reveal the phototoxic potentials of some new quinolones by photohemolysis test, estimation of fluorescenc spectra, and Candida albicans test. METHODS: Nalidixic acid and four second-generation quinolones(ciprofloxacin, enoxacini, norfloxacin, and ofloxacitid were examined by fluorescence spertra which measured t.he phototoxc potentials by photochemial instability, photohemolsis test for the phototoxic properties against cell membranes and Candida tlbicans test for phototoxic properties against DNA. RESULTS: All drugs showed a fluorescence spectra within 360 nm to 450 nm, and in the photohemolysis test, all studied drug except ofloxacin got above 5% hemolytic value, and all drugs showed clear zone. in Candida albicans test after 48hours. CONCLUSION: These results suggested that all tested drugs were photochemically unstable. According to the mechanisris of cellular phototoxicity, ciprofloxacin, enoxacin, and norfloxacin was phtototoxic to nucleus and cell membrane, whereas ofloxacin was phototoxic to nucleus only.
Anti-Bacterial Agents* ; Candida ; Candida albicans ; Cell Membrane ; Ciprofloxacin ; Dermatitis, Phototoxic ; DNA ; Enoxacin ; Fluorescence ; Nalidixic Acid ; Norfloxacin ; Ofloxacin ; Quinolones

No abstract available.

The gene encoding E7 oncoprotein of human papillomavirus type 16 was cloned and expressed in Escherichia coli, and the monoclonal antibodies (Mabs) against this expressed protein were generated. For the efficient immunization, two kind of recombinant E7 protein in fusion form were produced. One was maltose binding protein (MBP) fusion type (MBP-E7) and the other was T7 phage gene 10 product fusioa type (gene 10-E7). Immunization with these two fusion protein to mice, finally two Mabs (VD6 and IB10) were obtained. VD6 and IB10 showed reactivities with E7 protein in CaSki cell but not in HeLa by Western blot analysis. In addition, the Mab, VD6, reacted with COS-7 cell transfected with E7 gene majorly in cytoplasm by immunofluorescence test. Also VD6 could detect E7 protein in cytoplasm and nucleus of CaSki ceU by immunogold electron microscopy. Based on these results, the Mab VD6 was could be used for various E7 detection system such as Western blot analysis and immunohistochemical methods.
Animals ; Antibodies, Monoclonal* ; Bacteriophage T7 ; Blotting, Western ; Clone Cells ; COS Cells ; Cytoplasm ; Escherichia coli ; Fluorescent Antibody Technique ; Humans* ; Immunization ; Maltose-Binding Proteins ; Mice ; Microscopy, Electron

CT and portographic findings of 63 patients with hepatoma, undergone hepatic angiography and superiormesenteric portography for evaluation of tumor and thrombosis of portal vein and determination of indication oftranscatheter arterial embolization for palliative treatment of hepatoma from April,85 to June, 86 in Hanyanguniversity hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis wasdetected during portography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the livershowed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liverrevealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2.Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence ofportal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal veinthrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did notreveal contrast enhancement. 4. CT revealed well the evidences of obstructions in the cases of portal veinthrombosis and the findings were well-corresponded to the findings of the superior mesenteric portography. 5. Fiveof the cases of the portal vein thrombosis were missed in the CT and the casuses were considered as due to partialvolume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases withocclusion of main portal vein showed cavernous transformation and they were noted as multiple small enhancedvascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a usefulmodality to detect the changes of the portal veins in the patients of the hepatoma.
Angiography ; Carcinoma, Hepatocellular ; Humans ; Incidence ; Palliative Care ; Portal Vein ; Portography ; Thrombosis ; Veins ; Venous Thrombosis

Autologous Transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs in very limited, however, because of concern over the possibility of inducing premature labor or causing fetal distress by blood volume change or vasovagal reactions. We describe our experience with pregnant women in this program. The incidence of vagovagal reactions of autologous donation was 9.5% (2.21). After entry into this program, 17pastients received a total 37pints, which consist of 19 Autologous and 18 Homologous. Homologous transfusion was avoided in 30% of patients receiving blood. The values of the mean hematocrits before and after hpebotomy were 34.1% and 31.8% respectively. It was stastically significant (p<0.01). We recommended that autologous blood donation by pregnant women in third trimester is safe for mothers or infants and it should be strongly encouraged for patient with placenta previa and repeated cesarean section.
Blood Donors ; Blood Volume ; Cesarean Section ; Female ; Fetal Distress ; Hematocrit ; Hemorrhage* ; Humans ; Incidence ; Infant ; Mothers ; Obstetric Labor, Premature ; Placenta Previa ; Pregnancy ; Pregnancy Trimester, Third ; Pregnant Women* ; Surgical Procedures, Operative

Anticancer effect and complications were evaluated after transcatheter arterial embolization(TAE) in 12patients with hepatocellular carcinoma until 2 weeks and 4 weeks after TAE, respectively. The results were asfollows: 1. Serum alpha-fetoprotein value decreased in 7 out of 9 patients wih high value prior to TAE. 2. Loss ofenhancement and better definition on enhanced CT were seen in the tumors in all cases, and low-density areas in9/10 . Gas bubbles were seen in low-density areas in 4/10 and highdensity area caused by lipiodol in 6/10. 3.Post-embolization syndrome was develped in most patients but improved clinically within a week after TAE. 4. Onlaboratory examination, impairment of liver function was developed in most patients but improved within 4 weeksafter TAE. 5. Complications on CT included splenic infarction and thickening of wall of the gallbladder, whichdidn't require specific treatment. The authors conclude that TAE for hepatocellular carcinoma reveals apparentanticancer effect on shortterm evaluation, and resultant complications are transient and improved by conservativetreatment.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Ethiodized Oil ; Gallbladder ; Humans ; Liver ; Splenic Infarction

One of the most common mechanisms of failure of epidural anesthesia is the misplacement of a catheter. We present two cases of transforaminal escape of catheter which occurred accidentally during lumbar epidural anesthesia. Epidural catheter was inserted to a depth of 4.5 cm and 3.5 cm respectively, then 2% lidocaine 25 ml were injected slowly into the catheter. No analgesia was found except anterior knee area, so Iohexol dye was injected through the catheter for X-ray determination. The epidurogram showed the catheter, which passed through the intervertebral foramen, was to lie outside the epidural space in the paravertebral tissue. Because of the random direction and migration of epidural catheter, we suggest an epidural catheter should be inserted 3cm into the epidural space. Epidurogram with a small dose of contrast material is advisable in the cases of unsatisfactory effect of epidural block, or when some adverse reactions are noted after block.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Catheters* ; Epidural Space ; Iohexol ; Knee ; Lidocaine ; United Nations*

No abstract available.
Adenocarcinoma* ; Neurofibromatoses* ; Pancreas*

In this work we have measured the dose distribution and the percent depth dose of 20 MeV electron beam using the X-OMAT films in order to verify the effects of transverse magnetic field on high energy elecrtron beam in a phantom. The result shows about 30% increase of the percent depth dose at 4.5 cm depth under the transverse magnetic field of 1.5 Tesla at 7.5 cm depth. We have verified that these were in an agreement with other theoretical results.
Magnetic Fields*