The investigation of systolic time intervals and hemodynamics was performed in 42 patients with liver cirrhosis by noninvascive methods. The patients were divided into four groups according to the presence or absence of anemia and/or ascites: i.e. group I; cirrhosis without anemia and ascites, group II; cirrhosis with ascites only, group III; cirrhosis with anemia only, and group IV; cirrhosis with ascites and anemia. In the resting state of the patients, the systolic time intervals and hemodynamic data were measured by the high speed simultaneous recordings of electrocardiogram, phonocardiogram, carotid and femoral arterial pulse tracings, and compared with those obtained from 155 normal adult subjects. 1. The pulse were increased considerably in group IV, and diastolic blood pressure was elevated in group II with significance. 2. The stroke volume and cardiac output were increased significantly in group III. 3. The peripheral resistance was reduced particularly in group III, and the volume elasticit coefficient was decreased in group IV. 4. The QS1 interval was prolonged significantly in group II and IV, but QS1 interval corrected by multiple regression equation proposed by our laboratory (illustrated in the text) did not show significant difference compared with that of normal subjects. 5. The left ventricular ejection time(LVET) and total electromechanical systole(QS 2) appeared to be shortened in group II and IV, but the corrected LVET and QS 2 were not different significantly from those of the normal subjects
Adult ; Anemia ; Ascites ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Fibrosis ; Hemodynamics* ; Humans ; Liver Cirrhosis* ; Liver* ; Stroke Volume ; Systole ; Vascular Resistance

The investigation of systolic time intervals and hemodynamics was performed in 42 patients with liver cirrhosis by noninvascive methods. The patients were divided into four groups according to the presence or absence of anemia and/or ascites: i.e. group I; cirrhosis without anemia and ascites, group II; cirrhosis with ascites only, group III; cirrhosis with anemia only, and group IV; cirrhosis with ascites and anemia. In the resting state of the patients, the systolic time intervals and hemodynamic data were measured by the high speed simultaneous recordings of electrocardiogram, phonocardiogram, carotid and femoral arterial pulse tracings, and compared with those obtained from 155 normal adult subjects. 1. The pulse were increased considerably in group IV, and diastolic blood pressure was elevated in group II with significance. 2. The stroke volume and cardiac output were increased significantly in group III. 3. The peripheral resistance was reduced particularly in group III, and the volume elasticit coefficient was decreased in group IV. 4. The QS1 interval was prolonged significantly in group II and IV, but QS1 interval corrected by multiple regression equation proposed by our laboratory (illustrated in the text) did not show significant difference compared with that of normal subjects. 5. The left ventricular ejection time(LVET) and total electromechanical systole(QS 2) appeared to be shortened in group II and IV, but the corrected LVET and QS 2 were not different significantly from those of the normal subjects
Adult ; Anemia ; Ascites ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Fibrosis ; Hemodynamics* ; Humans ; Liver Cirrhosis* ; Liver* ; Stroke Volume ; Systole ; Vascular Resistance

Laparoscopic surgery is rapidly evolving with technological advances, but there are several drawbacks. An articulating device, with freedom of a perfect 360°, is attractive as a solution to overcome the restriction of instrument movement caused by straight tools. Its usefulness or efficacy should be supported by relevant scientific evidence. However, it is sometimes difficult to prove it because the factors influencing the surgical outcomes are complex and closely related to each other.

PURPOSE: The Mesima-Ex is a kind of biologic response modifier, which is extracted from a mushroom called Phellinus linteus. Mesima-Ex consists of various chemical compounds which include protein bound polysaccharide, mucoprotein, triterpenoid, and quinones. Mesima-Ex exerts its antitumor effects by augmenting host immune response without any toxic side effects. In vitro study, Mesima-Ex seems to potentiates antibody dependent cell mediated cytotoxicity (ADCC) and cell mediated cytotoxicity (CMI) against tumor cells. We initiated this study to verify antitumor effects of Mesima-Ex as an antineoplastic agent. MATERIALS AND METHOD: Gastric cancer patients who underwent curative resection with normal hepatic and renal function were eligible. They were divided into two groups by random number table. One group (N=30: Mesima-Ex group) received postoperative adjuvant chemotherapy with 5-FU (500 mg/m2 weekly), adriamycin (40 mg/m2 every 3 weeks) and Mesima-Ex (6 cap daily per Os). Another group (N=37: control group) received 5-FU and adriamycin only without Mesima-Ex. NK (natural killer cell) activity, ADCC (antibody dependent cell mediated cytotoxicity), CD4 , and CD8 cells were measured and an analysis of disease free survival rate of the two study groups was performed. RESULTS: Sixty seven patients were enrolled in this study. Their median age was 55 years old. NK activity (basal activity: 25%) was enhanced significantly at the 2nd, and 4th months in the Mesima-Ex group (28.9%, 43.4%, p<0.05). ADCC was also enhanced from 37% to 42.1% at the 2nd month in the Mesima-Ex group (p<0.05). The control group did not show any significant change in NK activity or ADCC. The CD4 cell ratio was increased from 37% to 42.1% at the 2nd months in the Mesima-Ex group but not in the control group (p<0.05). There was no significant change in CD8 subsets (p>0.05). There were no toxic side effects more than grade III from Mesima-Ex administration. The two year disease free survival rate was higher in the Mesima-Ex group than that of the control group (77% vs 58%, p<0.05). CONCLUSION: Mesima-Ex can be used safely as an immunomodulator with standard chemotherapeutic agents for purpose of adjuvant chemotherapy. Mesima-Ex was effective in augmenting host immune response in vitro. The Mesima-Ex group showed a higher two year disease free survival rate than that of the control group.
Agaricales ; Antibody-Dependent Cell Cytotoxicity ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Doxorubicin ; Fluorouracil ; Humans ; Middle Aged ; Quinones ; Stomach Neoplasms*

The bone graft materials are grossly divided into autogenous bone, allogenic bone, xenogenic bone, and alloplastic material. Among the various allogenic graft materials, hydroxyapatite(Ca10(PO4)6(OH)2, HA), the main inorganic phase of human hard tissue, is widely used as a repair material for bones. When HA applied to bony defect, however, it may be encapsulated with fibrous tissue and floated in the implanted area by the lack of consolidation. Fluoridated hydroxyapatite(Ca10(PO4)6(OH)2, FHA), where F- partially replaces the OH- in the hydroxyapatite, is considered as an alternative material for bone repair due to its solubility and biocompatibility. This study was designed to find out the bone healing capacity of FHA newly produced as a nanoscale fiber in the laboratory. We implanted HA and FHA in the rabbit cranium defect and histologically analysed the specimen. The results were as follows. 1. In the 4 weeks, fibrous connective tissue and little bone formation around materials of the experimental group I implanted HA were observed. In the experimental group II implanted FHA, newly formed bone around materials were observed. 2. In the 8 weeks, the amount of newly formed and matured bone of the experimental group II was more than the experimental group I and control group. From the results obtained, we suggest that FHA, newly synthesized, is relatively favorable bone substitute with bioconpatibility and has better bone healing capacity than pure HA.
Bone Substitutes ; Connective Tissue ; Durapatite* ; Humans ; Osteogenesis ; Skull* ; Solubility ; Transplants

BACKGROUND: Monophasic Action Potential(MAP) recording using contact electrode is very sensitive method to detect the ischemic changes of myocardium. The purpose of this study were to investigate changes of MAP during percutaneous transluminal coronary angioplasty(PTCA) and to evaluate through MAP whether or not a brief episode of ischemia influenced on subsequent ischemic episode during PTCA. Method: MAPs using endocardial contact electrode were recorded dbefore, during the fitst and second inflation and 3 min after PTCA in 7 patients undergoing PTCA. RESULTS: 1) MAP amplitude significantly decreased to 79.1+/-11.0% during the first inflation(p<0.05) and to 86.3+/-9.0% during the second inflation(p<0.05) and recovered to 92.7+/-3.7% at 3 min after PTCA. 2) MAP duration to 90% repolarization(MAPD 90) significantly decreased to 91.4+/-5.1% during the first inflation(p<0.05) and to 95.3+/-3.5% dudring second inflation(p<0.05) and recovered to 97.3+/-2.8% at 3 min after PTCA. 3) Double prodducts showed no significant difference between the first and second inflation. 4) The changes of MAP amplitude and MAP duration during the second inflation was significantly lower than that recorded during the first inflation. CONCLUSION: MAP recording using endocardial contact electode may be safe and very sensitive method to detect the ischemic changes of human endocardium and the lessened MAP changes during the second inflation supports the concept of preconditioning ischemia.
Action Potentials* ; Electrodes ; Endocardium ; Humans ; Inflation, Economic ; Ischemia ; Myocardium

OBJECTIVE: The aim of this study was to identify the factors associated with the wearing of Personal Protective Equipment (PPE) in small scale industries. METHODS: In a cross-sectional study, the data were obtained from self-administered questionnaires, a special health examination and the industrial hygiene records. The study included 230 workers in small-scale industries (the print industry and automobile repair shops), which were provided with a subsidiary occupational health program funded by government in 1998. The authors used the Precede-Proceed model. RESULTS: Among the subjects who were recommended to wear a PPE, 32.7% (35/107) wore the gas/vapor respirators, 43.9 % (101/230) wore the particulate respirators, and 44.3 % (102/230) wore hearing aids. Among them, 64.3 % (148/230) wore one of the above PPE. The wearing of PPE wearing was associated with knowledge (OR=2.34), the value of prevention (OR=3.46), social support (OR=2.78), the type of task (OR=2.18-4.47), and income level (OR=7.64). CONCLUSIONS: In small scale industries, the proportion workers wearing PPE was low. To increase this proportion, the reinforcing, enabling, and environmental factors as well as the predisposing factors need to be modified.
Automobiles ; Causality ; Cross-Sectional Studies ; Financial Management ; Hearing Aids ; Humans ; Occupational Health ; Questionnaires ; Ventilators, Mechanical

OBJECTIVES: To compare the effect of three different cryoprotectants on basic stem cell characteristics for the possibility of using well defined, dimethyl sulfoxide (DMSO) and serum free freezing solutions to cryopreserve human Wharton's jelly-derived mesenchymal stem cells (WJMSCs) following controlled rate freezing protocol. METHODS: The mesenchymal stem cells isolated from human Wharton's jelly were cryopreserved using 10% DMSO, 10% polyvinylpyrrolidone (PVP) and a cocktail solution comprising of 0.05 M glucose, 0.05 M sucrose and 1.5 M ethylene glycol following controlled rate freezing protocol. We investigated the post-thaw cell viability, morphology, proliferation capacity, basic stem cell characteristics, in vitro differentiation potential and apoptosis-related gene expression profile before and after cryopreservation. RESULTS: The cryoprotectant 10% DMSO has shown higher post-thaw cell viability of 81.2+/-0.58% whereas 10% PVP and cocktail solution have shown 62.87+/-0.35% and 72.2+/-0.23%, respectively at 0 h immediately thawing. The cell viability was further reduced in all the cryopreserved groups at 24 h later post-thaw culture. Further, the complete elimination of FBS in cryoprotectants has resulted in drastic reduction in cell viability. Cryopreservation did not alter the basic stem cell characteristics, plasticity and multipotency except proliferation rate. The expression of pro-apoptotic BAX and p53 genes were higher whilst p21 was lower in all the cryopreserved groups when compare to the control group of WJMSCs. CONCLUSION: Although 10% DMSO has shown higher post-thaw cell viability compare to 10% PVP and cocktail solution, the present study indicates the feasibility of developing a well-defined DMSO free cryosolution which can improve storage and future broad range applications of WJMSCs in regenerative medicine without losing their basic stem cell characteristics.
Apoptosis ; Cell Survival ; Cryopreservation* ; Dimethyl Sulfoxide ; Ethylene Glycol ; Freezing* ; Genes, p53 ; Glucose ; Humans* ; Mesenchymal Stromal Cells* ; Plastics ; Povidone ; Regenerative Medicine ; Stem Cells ; Sucrose ; Transcriptome ; Wharton Jelly

Background: The aim of this study was to determine an intravenous dose of ketorolac providing augmentation of analgesia and lowering adverse events for patients using postoperative intravenous patient-controlled analgesia (IV-PCA) with morphine Methods: One hundred and ninety eight patients who underwent an elective gynecologic operation were allocated to one of seven groups (ketorolac 180 mg K6, ketorolac 150 mg + morphine 10 mg K5M1, ketorolac 120 mg + morphine 20 mg K4M2, ketorolac 90 mg + morphine 30 mg K3M3, ketorolac 60 mg + morphine 40 mg K2M4, ketorolac 30 mg + morphine 50 mg K1M5, morphine 60 mg M6). After a loading dose of 3 ml, the PCA was started at a setting of 1 ml per demand, with a 8 minute lockout interval and 5-h limit. Results: The total PCA volume was lower in the K3M3, K2M4 and M6 groups. Visual analogue scale pain scores were higher in the K6 and M6 groups. More additional analgesics were required in the K6, K5M1, K1M5 and M6 groups. More antiemetics were required in the M6 group, although the incidence of nausea/vomiting and pruritus was similar among the groups. The sedation scores were lower in the K6 group and higher in the M6 group, 6 h postoperatively; and higher in the M6 and K1M5 groups, 24 h postoperatively. Conclusions: The combination of morphine 30 mg and ketorolac 90 mg, or morphine 40 mg and ketorolac 60 mg in IV-PCA with a total volume of 60 ml, is more effective in analgesia and has less adverse events.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Antiemetics ; Female ; Gynecologic Surgical Procedures* ; Humans ; Incidence ; Ketorolac* ; Morphine* ; Passive Cutaneous Anaphylaxis ; Pruritus

Herpes simplex virus type I (HSV-I) causes an acute necrotizing encephalitis that selectively affects tempioral and frontal lobes. The sequelae and mortality of herpes simplex encephalitis(HSE) may be reduced by available antiviral therapy and therefore early diagnosis of HSE is essential. We have assessed the potential of brain perfusion scintigraphy using Tc-99m-HMPAO single photon emission computed tomoglaphy(SPECT) in HSE. Nine Tc-99m-HMPAO SPECTs were performed in eight patients with clinically suspected herpes simplex encephalitis. The examinations were made between 18 days and 10 months after onset of encephalitic symptoms The SPECT images in seven patients revealed decreased accumulation ol radioactivity in the affected temporal, frontal or parietal lobes. In a 30 yr-old female patient, two SPECT images were obtained on 18th day after the onset of symptoms and 3 months later. Her initial SPECT showed increased accumulation of radioactivity in the affected temporal and inferior frontal lobes. 3 month later follow-up SPECT image revealed the decreased radioactivity in the affected temporal, inferior frontal, and inferior parietal lobes. We found that the SPECT done at early stage of HSE may show increased cerebral perfusion due to inflammatory or other pathologic mechanism and the later stage SPECT may show decreased cerebral perfusion due to decreased cerebral metabolism caused by neuronal death We suggest that Tc-99m-HMPAO SPECT may support the clinical diagnosis of HSE.
Brain ; Diagnosis ; Early Diagnosis ; Encephalitis, Herpes Simplex ; Female ; Follow-Up Studies ; Frontal Lobe ; Herpes Simplex ; Humans ; Leukoencephalitis, Acute Hemorrhagic ; Metabolism ; Mortality ; Neurons ; Parietal Lobe ; Perfusion ; Perfusion Imaging ; Radioactivity ; Simplexvirus ; Tomography, Emission-Computed, Single-Photon*