BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

BACKGROUND: The Amplified Mycobacterium tuberculosis Direct Test (AMTDT) has been developed for the direct detection of M. tuberculosis complex in respiratory specimens. Traditional methods for diagnosis of extrapulmonary tuberculosis such as the acid-fast bacilli (AFB) stain have their well-known limitations. We investigated the usefulness of the AMTDT for a wide range of non-respiratory specimens to establish early diagnosis of extrapulmonary tuberculosis. METHODS: 346 specimens (219 urine, 117 pleural fluid, 6 ascitic fluid, 2 lymph node, 1 gastric aspirate, and 1 pus specimens) from 340 patients referred from November 1997 to September 1998 were tested by the AMTDT. The AMTDT results were evaluated by comparing with clinical diagnosis and smear results. RESULTS: The overall sensitivity, specificity, and positive and negative predictive values of the AMTDT were 82.9%, 93.8%, 64.2%, and 97.6%, respectively. There were no difference in sensitivity and specificity between pleural fluid and urine specimens. In 31 specimens from tuberculosis patients concurrently tested with AMTDT and stain, 15 were only AMTDT positive and 4 were only stain positive. Among the results considered to be false positive, 47.2% of cases were shown as being less than 150,000 relative light units (RLU). In 30 specimens from tuberculosis patients during or after treatment, all six of the patients with reactivation or aggravation were AMTDT positive, and one case was considered to be false positive. CONCLUSIONS: Our study demonstrates the efficacy of the AMTDT in diagnosing extrapulmonary tuberculosis. Prudent interpretation of the AMTDT's results is recommended in case of that being less than 150,000 RLU.
Ascitic Fluid ; Diagnosis ; Early Diagnosis ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Suppuration ; Tuberculosis

BACKGROUND: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia. METHODS: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer. RESULTS: The cumulative incidence rate increased with age, consuming > or =3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming > or =3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037). CONCLUSIONS: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.
Edible Grain ; Endoscopy ; Follow-Up Studies ; Gastritis, Atrophic ; Humans ; Incidence ; Life Style ; Metaplasia ; Multivariate Analysis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Stomach Neoplasms

BACKGROUND: The risk of squamous cell carcinoma (SCC) is significantly increased in chronic cutaneous ulcers. Moreover, if the proliferating epithelium of the ulcer margin shows pseudoepitheliomatous hyperplasia, it can be very difficult to discriminate between the two diseases. Enzymes such as matrix metalloproteinases (MMPs) are thought to be implicated at all stages of tumorigenesis. OBJECTIVE: We investigated the expression patterns of epithelial MMP-7 and MMP-13 in chronic ulcers and SCCs by an immunohistochemical technique and the usefulness in differentiating these two entities. METHODS: Formalin-fixed and paraffin-embedded tissues obtained from 16 chronic ulcers and 12 SCC patients were studied using an immunohistochemical staining method for MMP-7 and MMP-13. RESULTS: MMP-7 and MMP-13 were expressed by the malignant tumor cells of 4 (33.3%) and 9 SCC samples (75%), respectively, while they were absent from the proliferating epithelium of chronic ulcers. CONCLUSION: Our results suggest that epithelial expression of both MMP-7 and MMP-13 have a specificity in differentiating the benign epithelial proliferation of chronic ulcer from malignant tumor cells, but MMP-13 seems to be a more sensitive and useful marker due to the lower sensitivity of MMP-7 in SCCs.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Epithelium ; Humans ; Hyperplasia ; Matrix Metalloproteinases ; Sensitivity and Specificity ; Ulcer*

No abstract available.
Child* ; Gastroenteritis* ; Humans* ; Infant*

PURPOSE: To evaluate the usefulness of CT for the diagnosis and treatment planning of mechanical intestinal obstruction. MATERIALS AND METHODS: We retrospectively reviewed 38 patients who were clinically suspected of mechanical intestinal obstruction and had undergone abdominal CT. The CT scans were evaluated for the absence or presence, severity, cause and site of intestinal obstruction. CT findings were compared with the results of laparotomy, barium study and clinical course. The absence or presence and severity of intestinal obstruction were classified into no obstruction, partial obstruction, complete obstruction. Diagnosis was estabilished by means of laparotomy in 20 cases, barium study in 9 cases and clinical course in 9 cases. RESULTS: Of 38 cases, 7(18.4%) showed no obstruction, 22(57.9%) showed partial obstruction, and 9(23.7%) showed complete obstruction. The presence or absence and severity on CT scans were corretly predicted in 36 of 38 cases (sensitivity 95%, specificity 97%, accuracy 96%) (in case of no obstruction:sensitivity 100%, specificity 94%, accuracy 95%;in case of partial obstruction:sensitivity 91%, specificity 100%, accuracy 95%;in case of complete obstruction:sensitivity 100%, specificity 100%, accuracy 100%). All 9 cases with complete obstruction underwent prompt and immediate laparotomy. 13 cases, excluding those with mass around the site of transition and adhesion with strangulation, with partial obstruction improved with conservative treatment without laparotomy. The causes of obstruction were adhesion in 13, hernia in 6, primary cancer in 5, metastatic cancer in 3, abscess in 2, intestinal tbc in 1, and Crohn's disease in 1. The cause of obstruction on CT scans were correctly predicted in 27 of 31 cases (87.1%). The sites of obstruction on CT scans were correctly predicted in 22 of 26 cases (84.6%). CONCLUSION: CT is valuable in the evaluation of absence or presence, severity, cause and site of intestinal obstruction, and is considered to be helpful in treatment planning for the patients with intestinal obstruction.
Abscess ; Barium ; Crohn Disease ; Diagnosis ; Hernia ; Humans ; Intestinal Obstruction* ; Laparotomy ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

No abstract available.
Cactaceae* ; Dermatitis* ; Humans ; Leprosy*

No abstract available.
Chondrocytes* ; Ear* ; Intercellular Signaling Peptides and Proteins*

No abstract available.
Edema* ; Hydrops Fetalis*

No abstract available.
Edema* ; Hydrops Fetalis*