No abstract available.
Cesarean Section* ; Endometritis* ; Female ; Pregnancy

No abstract available.
Esophageal Achalasia

Inducible nitric oxide(NO) is understood as a tumoricidal molecule. In animal study, urinary NO excretion after intravesical BCG instillation is recently known. In this study, the authors investigated the pattern of urinary nitrite (stable oxidizide form of nitric oxide) excretion according to the dosage of instilled BCG or number of BCG instillation. According to the dosage of instilled BCG(Pasteur strain :8.l5 x 1000000CFU/mg), 32 Sprauge-Dawley female rats were di-vided into 4 Groups(Group I: control, Group II: BCG1/l0X, Group III: BCGlX. Group IV :BCG10X). Also, each Group was subdivided into a one-time instillation subgroup(one time instillation at the first day) and a six-time instillation subgroup( weekly instillation for six weeks). The urinary nitrite in 24 hours' urine was measured quantitatively in each group by Titertek Multiscan MCC/340 ELISA Reader on an every other day basis after BCG instillation until decreased to control level. Intravesical BCG instillation of the rats led to significant urinary nitrite excretion in Group II (BCG 1/10X:one-time ;30+/-12, six-time ;52+/-6), Group III(BCG 1X,57+/-8, 62+/-2uM/L), Group IV (BCG 10X;65+/-2, 80+/-5uM/L) compared to Group I (control;22+/-4, 21+/-3uM/L) respectively( p<0.05). There was no statistical difference in the increment of urinary nitrite excretion between Group II, Group III and Group IV. The urinary nitrite excretion increased significantly in Group II and Group IV of six-time instillation subgroup compared to one-time instillation subgroup(p <0.05). BCG instillation resulted in significant excretion of urinary nitrite at the first day, which reached peak urinary level at the period of the 3rd to 9th day and the 11th day after instillation in one-time and six-time instillation subgroup respectively. The excretion also remained increased for 33 days and 44 days in two subgroups respectively. The preservation of the urine at -40'C for 4-weeks had no influence on the urinary nitrite concentration. The study demonstrates the pattern of urinary excretion according to the dosage of instilled BCG or number of instillations in addition to disclosing good effects of BCG on the excretion of urinary nitrite in rats. The following can be deduced from this study. Intravesical BCG instillation using only one tenth of the usual dose of which the BCG is used for treatment of superficial bladder tumor, and six-times resulted in effective excretion of urinary nitrite in rats.
Animals ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Mycobacterium bovis* ; Nitric Oxide* ; Rats* ; Urinary Bladder Neoplasms

The authors report a case of superficial femoral arterial trauma caused by external fixator in 53 year-old male patient who had supracondylar fracture of femur due to automobile accident. After removal of external fixator, autogenous bypass graft was perfomed with reversed great saphenous vein. The occlusion of the graft occurred 3 months later, we thought that interposition graft in the chronic inflammatory and fibrotic tissue should be avoided.
Automobiles ; External Fixators ; Femoral Artery ; Femur ; Humans ; Male ; Middle Aged ; Rupture ; Saphenous Vein ; Transplants

Herpes zoster is a disease that causes a skin rash with blisters and extreme pain along mainly the unilateral dermatome. It often occurs in the thoracic nerve area, but can also occur in the cranial, cervical, and lumbar nerve areas. It is not clear that the interventions such as nerve block or subcutaneous local anesthetics result in a lower incidence of postherpetic neuralgia than the natural course of herpes zoster. However, the severity of acute pain is known as a risk factor for postherpetic neuralgia. There have been many studies on the epidural block or paravertebral block for acute pain control of herpes zoster, but superficial cervical plexus block has not been widely applied. We performed a superficial cervical plexus block to alleviate the acute pain of herpes zoster in the neck and obtained the expected result, so we present it with a literature review.

Herpes zoster is a disease that causes a skin rash with blisters and extreme pain along mainly the unilateral dermatome. It often occurs in the thoracic nerve area, but can also occur in the cranial, cervical, and lumbar nerve areas. It is not clear that the interventions such as nerve block or subcutaneous local anesthetics result in a lower incidence of postherpetic neuralgia than the natural course of herpes zoster. However, the severity of acute pain is known as a risk factor for postherpetic neuralgia. There have been many studies on the epidural block or paravertebral block for acute pain control of herpes zoster, but superficial cervical plexus block has not been widely applied. We performed a superficial cervical plexus block to alleviate the acute pain of herpes zoster in the neck and obtained the expected result, so we present it with a literature review.

PURPOSE: The purpose of this study was to assess the clinician satisfaction of a newly introduced around-the-clock radiology coverage system for the emergency department. MATERIALS AND METHODS: Seventeen emergency physicians (8 board certified physicians, 9 residents) were invited to fill out a survey pertaining to the newly introduced radiology coverage system for the emergency department. The questionnaire included 10 questions covering three major topics. The first topic related to the around-the-clock radiology coverage by two full-time radiology residents. The second topic focused on the preliminary interpretations of radiology residents. The last topic included the interpretation assistance system by board-certified radiologists. The answers to each question were assessed using a scoring system of 1 to 5. RESULTS: The mean satisfaction score of the around-the-clock radiology coverage system by the two full-time radiology residents was 4.6 (range 3-5). The mean score for the preliminary interpretation system by the radiology residents was 4.8 (range 4-5). The score for the reliability of the preliminary versus the final interpretations was 4.1 (range 4-5). Lastly, the mean score for the interpretation assistance system by board-certified radiologists was 4.9 (range 4-5). CONCLUSION: The results of this study indicate a high satisfaction rating among clinicians' of the new around-the-clock radiology coverage system for the emergency department.
Emergencies ; Emergency Service, Hospital ; Surveys and Questionnaires

No abstract available.
Carcinoma, Hepatocellular*

STUDY DESIGN: A Retrospective study OBJECTIVES: To analyze the causes of revision arthrodesis for the degenerative changes at the adjacent segment after lumbosacral fusion for degenerative lumbar diseases. SUMMARY OF LITERATURE REVIEW: Revision arthrodesis is quite common. However, there is some controversy regarding the causes and risk factors. MATERIALS AND METHODS: Twenty cases who had undergone revision arthrodesis after lumbosacral fusion were examined. Preexisting degenerative changes to the adjacent segment, location of the adjacent segment and extent of fusion, as well as changes in lumbar lordosis were observed in primary arthrodesis, and the relationship between the changes in the adjacent segment degeneration were analyzed in terms of the area of residence, activity level and living pattern of the patients. RESULTS: Preexisting degenerative changes in the adjacent segment were observed in 14 cases and degenerative changes developed at the proximal junction in 19. Multiple segment fusion were performed in 13 cases during primary arthrodesis, 9 cases developed degenerative changes at the proximal junction. Fifteen cases with abnormal postoperative lumbar lordosis demonstrated adjacent segment degeneration. Sixteen cases living in the countryside and 15 cases with a history of severe physical labor after the primary operation showed degenerative changes in the adjacent segment before secondary arthrodesis. CONCLUSION: The causes of revision arthrodesis for the degenerative changes at the adjacent segment are believed to be preexisting degenerative changes in the adjacent segment at the proximal junction, loss of lordosis after primary fusion, and severe physical labor from living in the countryside
Animals ; Arthrodesis ; Humans ; Lordosis ; Retrospective Studies

OBJECTIVE: The occurrence of acute cerebral infection following deep brain stimulation (DBS) is currently being reported with elevation of C-reactive protein (CRP) level. The aim of the present study was to establish normal range of the magnitude and time-course of CRP increases following routine DBS procedures in the absence of clinical and laboratory signs of infection. METHODS: A retrospective evaluation of serial changes of plasma CRP levels in 46 patients undergoing bilateral, two-staged DBS was performed. Because DBS was performed as a two-staged procedure involving; implantation of lead and internal pulse generator (IPG), CRP was measured preoperatively and postoperatively every 2 days until normalization of CRP (post-lead implantation day 2 and 4, post-IPG implantation day 2, 4, and 6). RESULTS: Compared with preoperative CRP levels (0.12+/-0.17 mg/dL, n=46), mean CRP levels were significantly elevated after lead insertion day 2 and 4 (1.68+/-1.83 mg/dL, n=46 and 0.76+/-0.38 mg/dL, n=16, respectively, p<0.001). The mean CRP levels at post-lead implantation day 2 were further elevated at post-IPG implantation day 2 (3.41+/-2.56 mg/dL, n=46, respectively, p<0.01). This elevation in post-IPG day 2 rapidly declined in day 4 (1.24+/-1.29 mg/dL, n=46, p<0.05) and normalized to preoperative value at day 6 (0.42+/-0.33 mg/dL, n=46, p>0.05). Mean CRP levels after IPG implantation were significantly higher in patients whose IPGs were implanted at post-lead day 3 than those at post-lead day 5-6 (3.99+/-2.80 mg/dL, n=30, and 2.31+/-1.56 mg/dL, n=16, respectively, p<0.05). However, there was no difference in post-IPG day 2 and 4 between them (p>0.05). CONCLUSION: The mean postoperative CRP levels were highest on post-IPG insertion day 2 and decreased rapidly, returning to the normal range on post-IPG implantation day 6. The duration of post-lead implantation period influenced the magnitude of CRP elevation at post-IPG insertion day 2. Information about the normal response of CRP following DBS could help to avoid unnecessary diagnostic and therapeutic efforts.
C-Reactive Protein* ; Deep Brain Stimulation* ; Humans ; Inflammation ; Plasma ; Reference Values ; Retrospective Studies