In August 2000, the American Heart Association and the European Resuscitation Council published the conclusions of the International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care which contains both the new recommendations and an in-depth review. The most important changes in the recommendations according to the authors are discontinuation of the pulse-check for lay people, 500 ml instead of 800~1,200 ml tidal volume during bag-valve-mask ventilation (FiO2 >0.4) of a patient with an unprotected airway, unifying correct endotracheal intubation size as 8.0 mm, vasopressin (40 units) and epinephrine (1 mg) as comparable drugs to treat patients with ventricular fibrillation, early prehospital survey and intravenous lysis for patients who have suffered coronary artery syndrome and stroke.
American Heart Association ; Cardiopulmonary Resuscitation* ; Coronary Vessels ; Emergencies ; Epinephrine ; Heart Arrest ; Humans ; Intubation, Intratracheal ; Resuscitation ; Stroke ; Tidal Volume ; Vasopressins ; Ventilation ; Ventricular Fibrillation

BACKGROUND: Reactive oxygen species (ROS) contribute to development of neuropathic pain. A neuropathic pain syndrome was produced in rats following prolonged hindpaw ischemia/reperfusion injury, creating an animal model of complex regional pain syndrome-Type I (CRPS-I). This study was designed to evaluate the validity of this model for ROS and pain research. Herein we show superoxide produces N-methyl-D-aspartate (NMDA) mediated mechanical allodynia. METHODS: Male adult SD rats were used for neuropathic pain model. Plasma superoxide production rates of before ischemia (BI) and 5 min after reperfusion (JR) were measured via cytochrome C reduction in the presence of xanthine (without xanthine oxidase, kinetics, 550 nm). Mechanical allodynia was measured in both hindpaws. Activation of NMDA receptor subunit 1 (P-NR1) of lumbar spinal cord (L4-L6) in accordance with the change of allodynia was analyzed by the Western blot. RESULTS: Allopurinol-inhibitable, xanthine oxidase-mediated plasma superoxide production was increased at AR. Mechanical allodynia was present in both hindpaws as early as 1 hr after reperfusion, and lasted at least 1 week. The expression of P-NR1 was the highest at 3 days after reperfusion when the withdrawal threshold was the lowest point. SOD significantly blocked P-NR1 activation. CONCLUSIONS: This study suggests that ischemia/reperfusion injury induced neuropathic pain model is a good candidate for the research fields of ROS and pain mechanism. The generation of ROS, especially superoxide is partly responsible for NMDA-mediated mechanical allodynia.
Adult ; Animals ; Blotting, Western ; Central Nervous System Sensitization ; Cytochromes c ; Hindlimb ; Humans ; Hyperalgesia ; Ischemia ; Kinetics ; Male ; Models, Animal ; N-Methylaspartate ; Neuralgia ; Plasma ; Rats ; Reactive Oxygen Species ; Reperfusion ; Spinal Cord ; Superoxides ; Xanthine ; Xanthine Oxidase

We experienced 5 cases of acute rubella encephalitis, a serious complication of rubella. The patients presented with convulsions and a deteriorated mental state, both of which occurred with a vanishing maculopapular rash and a low grade fever. The cerebrospinal fluid analysis showed pleocytosis and increased protein and normal glucose levels. We diagnosed the rubella encephalitis by detection of IgM in the serum. Rubella encephalitis is known to be a serious complication of rubella, and with poor prognosis. The mortality rate may reached as high 20%. Our cases recovered without any sequelae.
Cerebrospinal Fluid ; Encephalitis* ; Exanthema ; Fever ; Glucose ; Humans ; Immunoglobulin M ; Leukocytosis ; Mortality ; Prognosis ; Rubella* ; Seizures

Cervical spondylolysis is an extremely rare abnomality of unknown etilogy, first described by Hadley. It is defined s a corticated cleft between the superior and inferior articular facets of the articular pillar, the cervical equivalent of the pars interarticularis in the lumbar spine. A 50-yar-old woman was presented with occipital headache, and pain in the upper neck region. Neurological examination revealed the patients inability to walk because of quadriparesis with mild hypesthesia in both hands and feet. The DTR was hyperactive and pathological reflexes, including Babinski's and Hoffman's, were positive bilaterally. CT showed the bilateral pars interarticularis defects and spinal canal stenosis. MRI revealed signal alteration on the upper spinal cord which was compromised due to the hypertrophied ligamentum flavum. Decompressive laminectomy of C2 was performed and the patient's neurological deficits had recovered to some extent and resulting to her ability to walk without assistance.
Axis, Cervical Vertebra* ; Constriction, Pathologic ; Female ; Foot ; Hand ; Headache ; Humans ; Hypesthesia ; Laminectomy ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Neck ; Neurologic Examination ; Quadriplegia* ; Reflex ; Spinal Canal ; Spinal Cord ; Spine ; Spondylolysis*

OBJECTIVE: The purpose of this study was to examine the symmetry and parallelism of the skeletal and soft-tissue poria by three-dimensional (3D) computed tomographic (CT) imaging. METHODS: The locations of the bilateral skeletal and soft-tissue poria in 29 patients with facial asymmetry (asymmetric group) and 29 patients without facial asymmetry (symmetric group) were measured in 3D reconstructed models of CT images by using a 3D coordinate system. The mean intergroup differences in the anteroposterior and vertical angular deviations of the poria and their anteroposterior and vertical parallelism were statistically analyzed. RESULTS: The symmetric and asymmetric groups showed significant anteroposterior angular differences in both the skeletal and the soft-tissue poria (p = 0.007 and 0.037, respectively; Mann-Whitney U-test). No significant differences in the anteroposterior and vertical parallelism of the poria were noted (p < or = 0.05; Wilcoxon signed-rank test). CONCLUSIONS: In general, the skeletal poria are parallel to the soft-tissue poria. However, patients with facial asymmetry tend to have asymmetric poria.
Facial Asymmetry* ; Humans ; Poria*

No abstract available.
Hand* ; Hyperpigmentation* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Intraarterial embolization for a congenital vascular malformation can provide transient symtomatic relief but recurrence of the lesion occurs in most cases. The authors present a 29-year-old female patient with extensive pelvic vascular malformation who was underwent preoperative embolzation twice and a final operative intervention.
Adult ; Female ; Humans ; Recurrence ; Vascular Malformations

PURPOSE: E-cadherin (ECD) plays a pivotal role in integrating the normal tissue architecture and the suppression of cancer invasion, including stomach cancer. The epidemiology of stomach cancers is noticeably different according to the site of the index tumor, even though the stomach cancers all have similar gross shapes. In this study, the relation between the expression of ECD, along with the clinicopathologic parameters and recurrence or survival, were investigated for patients with gastric adenocarcinoma according to the tumor location. METHODS: We examined formalin-fixed, paraffin-embedded archival tissues from 50 surgically resectable gastric adenocarcinomas, which were grouped by the index tumor site as follows: distal (antrum) versus proximal (mid and upper body). To elucidate the correlation between the ECD expression and the site of the stomach cancer with the other clinicopathologic factors, we examined the ECD tissue status via performing immunohistochemistry. To compare the rates of recurrence and survival among subgroups, the patients were followed up for an average of 42 months. RESULTS: Among the 50 tumors examined, 28 (56%) tumors showed various degrees of a ECD expression. The gender, age, size, depth of invasion, lymph node metastasis, stage, lymphatic invasion and vascular invasion were not related with the ECD expression. The Lauren classification was cor-related with the ECD expression in the mid and upper body stomach cancer, but not in the antral stomach cancer (P=0.042). The expression of ECD was not related with the survival rate (P=0.223). There was no significant difference in the recurrence rate between the subgroups with and without an abnormal expression of ECD (P=0.588). CONCLUSION: For the mid and upper body stomach cancer, the expression of E-cadherin correlated with the diffuse type of cancer, according to the Lauren classification, but not with the survival rate.
Adenocarcinoma ; Cadherins* ; Classification* ; Epidemiology ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms* ; Stomach* ; Survival Rate

Phytophotodermatitis is a condition caused by sequential exposure to photosensitizing substances present in plants followed by ultraviolet light. Several plants (e.g., limes, celery, fig, and wild parsnip) contain furocoumarin compounds (psoralens). It is important for dermatologists to be aware of phytophotodermatitis because it may be misdiagnosed as cellulitis, tinea, or allergic contact dermatitis. We present five patients with a sharply defined erythematous swollen patch with bullae on both feet. They described soaking their feet in a fig leaves decoction to treat their underlying dermatologic diseases. Within 24 hours, all patients had a burning sensation in their feet, and erythema and edema had developed on the feet dorsa with exception of the portion of the skin covered by the sandals. Histopathologic examinations revealed sub-epithelial blisters with intensive epidermal necrosis. Phytophotodermatitis was ultimately diagnosed and, after several days, the patients' skin lesions began to recover upon treatment with systemic and topical corticosteroids. Unfortunately, since there are no studies providing sufficient evidence on the benefits of fig leaves, they should be used with caution.
Adrenal Cortex Hormones ; Apium graveolens ; Blister ; Burns ; Cellulitis ; Citrus aurantiifolia ; Dermatitis, Allergic Contact ; Edema ; Erythema ; Ficus ; Foot ; Humans ; Necrosis ; Photosensitivity Disorders ; Sensation ; Skin ; Tinea ; Ultraviolet Rays

Phytophotodermatitis is a condition caused by sequential exposure to photosensitizing substances present in plants followed by ultraviolet light. Several plants (e.g., limes, celery, fig, and wild parsnip) contain furocoumarin compounds (psoralens). It is important for dermatologists to be aware of phytophotodermatitis because it may be misdiagnosed as cellulitis, tinea, or allergic contact dermatitis. We present five patients with a sharply defined erythematous swollen patch with bullae on both feet. They described soaking their feet in a fig leaves decoction to treat their underlying dermatologic diseases. Within 24 hours, all patients had a burning sensation in their feet, and erythema and edema had developed on the feet dorsa with exception of the portion of the skin covered by the sandals. Histopathologic examinations revealed sub-epithelial blisters with intensive epidermal necrosis. Phytophotodermatitis was ultimately diagnosed and, after several days, the patients' skin lesions began to recover upon treatment with systemic and topical corticosteroids. Unfortunately, since there are no studies providing sufficient evidence on the benefits of fig leaves, they should be used with caution.
Adrenal Cortex Hormones ; Apium graveolens ; Blister ; Burns ; Cellulitis ; Citrus aurantiifolia ; Dermatitis, Allergic Contact ; Edema ; Erythema ; Ficus ; Foot ; Humans ; Necrosis ; Photosensitivity Disorders ; Sensation ; Skin ; Tinea ; Ultraviolet Rays