BACKGROUND/AIMS: Recent reports have suggested that precolonoscopy bowel preparation is easier to tolerate if a small volume solution is used. The aim of this study was to compare oral sodium phosphate with polyethylene glycol solution in terms of the quality of colon cleansing, ease of preparation, and gastrointestinal intolerance. METHODS: Sixty one patients were prospectively randomized to receive either a standard 4-liter polyethylene glycol solution or a 90 ml oral sodium phosphate preparation. Before and after bowel preparation all patients were weighted, and serum electrolytes were measured. Patients were asked to record the effects of the preparation and to give it a "discomfort rating" on a scale from 1 to 5. Surgeons were blinded to the preparation used and rated the quality of bowel cleansing on a scale of 1 to 5. RESULTS: The smaller volume of oral sodium phosphate was not associated with any clinically significant problem,caused no increase in the incidence of side effects, was preferred by patients, and was effective in colonic cleansing. The incidence of sleep disturbance, abdominal pain, nausea, vomiting, anal discomfort, chest pain, chilling and dizziness associated with oral sodium phosphate was similar to that with polyethylene glycol lavage. Abdominal distension was more common with polyethylene glycol lavage and statistical difference was seen(P<0.01). There were no clinically significant changes in any biochemical parameters and vital signs caused by precolonoscopic preparation except asymptomatic hyperphosphatemia in the sodium phosphate group that was not statistically different. The decreased body weight was seen with Colonlyte(R) that was statistically different(P<0.01). CONCLUSION: The overall quality of bowel preparation with oral sodium phosphate was similar to that with polyethylene glycol lavage. Patients tolerated preparation with oral sodium phosphate to be somewhat easier than polyethylene glycol lavage. Therefore, we conclude that the use of oral sodium phosphate as a precolonoscopy bowel preparation is clinically useful.
Abdominal Pain ; Body Weight ; Chest Pain ; Colon ; Dizziness ; Electrolytes ; Humans ; Hyperphosphatemia ; Incidence ; Nausea ; Polyethylene Glycols ; Prospective Studies ; Sodium ; Therapeutic Irrigation ; Vital Signs ; Vomiting

No abstract available.
Coronary Artery Disease* ; Coronary Vessels*

BACKGROUND: The oxidative modification of lipids and the endothelial expression of adhesion molecules are key events in the pathogenesis of atherosclerosis. The appropriate antioxidants that protected and slowed the progression of the disease were reported. We measured the antioxidant enzyme activities and the levels of soluble cellular adhesion molecules in order to evaluate whether antioxidant vitamin supplementation affected the oxidative changes and the expression of cellular adhesion molecules. METHODS: Seventy-seven patients participated in a randomized, double blind, placebo-controlled trial. The test group (38 patients) was given antioxidant vitamin doses including a daily dose of vitamin C 500 mg, beta-carotene 15 mg, vitamin E 400 IUs, and selenium 50 microgram, The control group (44 patients) received placeboes for three months. We measured the vitamin serum levels, intercellular adhesion molecules-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin and activities of erythrocyte enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPX) before and at 3 months after supplementation. RESULTS: After supplementation, the serum vitamin levels increased significantly (P<0.05) and the activity of the erythrocyte SOD significantly increased by 0.85 unit/mg hemoglobin (P<0.05) in the test group. Soluble ICAM-1, VCAM-1 and E-selectin levels did not change significantly in the test group after supplementation. CONCLUSIONS: These results suggest that the antioxidant vitamin supplementation may affect erythrocyte SOD activity, but not soluble cellular adhesion molecule levels.
Antioxidants ; Ascorbic Acid ; Atherosclerosis ; beta Carotene ; Catalase ; E-Selectin ; Erythrocytes ; Glutathione Peroxidase ; Humans ; Intercellular Adhesion Molecule-1 ; Selenium ; Superoxide Dismutase ; Vascular Cell Adhesion Molecule-1 ; Vitamin E ; Vitamins*

OBJECTIVES: Prehypertension is associated with a higher risk of developing hypertension compared with normotension. Yet, factors predicting the development of hypertension among prehypertensive people are ill-understood. This prospective cohort study was performed to examine if serum gamma-glutamyltrasferase (GGT) within a normal range can predict the future risk of hypertension among prehypertensive adults. METHODS: Study subjects were 293 prehypertensive persons >30-years-of-age who participated in a community-based health survey in 2003 and who were followed up in 2008. Sex-specific quartiles of baseline serum GGT were used to examine association with 5-year hypertension incidence. RESULTS: Baseline serum GGT within normal range predicted the risk of developing hypertension for 5 years only in prehypertensive women. Adjusted relative risks were 1.0, 3.7, 3.6, and 6.0 according to quartiles of baseline serum GGT (P for trend <0.01). This pattern was similarly observed in non-drinkers. However, serum GGT was not associated with incident hypertension in men. Different from serum GGT, baseline serum alanine aminotransferase, another well-known liver enzyme, did not predict the risk of incident hypertension in both genders. CONCLUSIONS: Even though baseline serum GGT within normal range strongly predicted the future risk of hypertension, it was observed only in women, Although underlying mechanisms of this association are currently unclear, serum GGT can be used to select a high risk group of hypertension in prehypertensive women.

PURPOSE: To determine the sonographic findings of degenerative change in femoral articular cartilage of the knee by comparative study of specimen sonography and pathology. MATERIALS AND METHODS: We obtained 40 specimens of cartilage of the femur (20 medial and 20 lateral condylar) from 20 patients with osteoarthritis of the knee who had undergone total knee replacement. The specimens were placed in a saline-filled container and sonography was performed using a 10MHz linear transducer. Sonographic abnormalities were evaluated at the cartilage surface, within the cartilage, and at the bone-cartilage interface, and were compared with the corresponding pathologic findings. In addition, cartilage thickness was measured at a representative portion of each femoral cartilage specimen and was compared with the thickness determined by sonography. RESULTS: 'Dot 'lesions, irregularity or loss of the hyperechoic line, were demonstrated by sonography at the saline-cartilage interface of 14 cartilages. Pathologic examination showed that these findings corresponded to cleft, detachment, erosion, and degeneration. Irregularities in the hyperechoic line at the bone-cartilage interface were revealed by sonography in eight cartilages and were related to irregularity or loss of tidemark, downward displacement of the cartilage, and subchondral callus formation. Dot lesions, corresponding to cleft and degeneration, were noted within one cartilage. Cartilage thickness measured on specimen and by sonography showed no significant difference (p=0.446). CONCLUSION: Specimen sonography suggested that articular cartilage underwent degenerative histopathological change. Cartilage thickness measured by sonography exactly reflected real thickness.
Arthroplasty, Replacement, Knee ; Bony Callus ; Cartilage ; Cartilage, Articular* ; Femur ; Humans ; Knee* ; Osteoarthritis ; Pathology* ; Transducers ; Ultrasonography

Seminal vesicle cyst (SVC) with ipsilateral renal agenesis is a rare congenital anomaly. When the patient is symptomatic, surgical treatment may be necessary. The open surgical approach, traditionally considered the definite form of treatment, has been associated with a high rate of morbidity. The laparoscopic approach for the management of SVCs has recently been described. A 18-year-old man presented with a 2-year history of dysuria and perineal pain. The diagnostic evaluation revealed a 45x35x48 mm sized left seminal vesicle cyst. In addition, he had a solitary, right, functioning kidney, with left renal agenesis. Transperitoneal laparoscopic excision of the cyst was performed successfully. The patient was discharged from the hospital on the fourth postoperative day and did not present with any complaints or complications.
Adolescent ; Congenital Abnormalities ; Dysuria ; Humans ; Kidney ; Kidney Diseases ; Seminal Vesicles

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate whether antioxidant supplementation with tocopherol, vitamin C, beta-carotene, and selenium reduces lipid peroxide levels and increases antioxidative enzyme activities in patients with coronary heart disease. SUBJECTS AND METHODS: Eighty nine patients participated in a randomized, double-blind, placebo-controlled trial. The antioxidant group (45 patients) was given daily doses of tocopherol (400 IU), vitamin C (500 mg), beta-carotene (15 mg), and selenium (50 microgram) and the placebo group (44) received placebo. Thirty eight of the antioxidant group (84.4%) and thirty nine (88.6%) of the placebo group completed the 3-month supplementation. RESULTS: Serum levels of alpha-tocopherol, vitamin C and beta-carotene were significantly increased in the antioxidant group as compared to the placebo group (p<0.05), however, retinol was not. Thiobarbituric acid-reactive substances (TBARS) decreased significantly (0.6 nmol MDA/mL) in the antioxidant group as compared with the level (0.09 nmol MDA/mL) seen in the placebo group (p<0.05). Antioxidants did not affect the oxidized-LDL level. The activities of erythrocyte superoxide dismutase (SOD) significantly increased by 0.85 unit/mg hemoglobin in the antioxidant group versus 0.27 unit/mg hemoglobin in the placebo group (p<0.01), and the activities of erythrocyte catalase significantly decreased by 0.04 unit/mg hemoglobin versus 3.37 unit/mg hemoglobin (p<0.01). However, the activities of erythrocyte glutathione peroxidase (GPX) increased insignificantly by 0.09 unit/mg hemoglobin vs 0.1 unit/mg hemoglobin. CONCLUSION: These results suggest that antioxidant supplementation with tocopherol, vitamin C, beta-carotene and selenium in patients with coronary heart disease may provide a prophylactic effect against oxidative stress.
alpha-Tocopherol ; Antioxidants ; Ascorbic Acid ; beta Carotene ; Catalase ; Coronary Disease* ; Erythrocytes ; Glutathione Peroxidase ; Humans ; Lipid Peroxidation* ; Oxidative Stress ; Selenium ; Superoxide Dismutase ; Tocopherols ; Vitamin A

Prevent vaginal bleeding before and after conservative management of cervical pregnancy is the important part of the treatment. We can choose two methode for the conservative management of cervical pregnancy. One is curettage and bleeding control, and the other is using fetocidal agent. Most frequently used fetocidal agent is methotrexate. But additional treatment would be needed after single dose of MTX, and for multiple dosage of MTX, one should be hospitalized about 7 to 10 days. We have used H2O2 intracervical irrigation through enema syringe for conservative management of cervical pregnancy, which is very useful and has no risk of consequent bleeding. So we report it with brief review of literatures.
Curettage ; Enema ; Hemorrhage ; Methotrexate ; Pregnancy* ; Syringes ; Uterine Hemorrhage

The scarring process of burns can be accompanied by pain and/or paresthetic sensation which may persist after completion of scar formation. Once the wound is healed, it is possible that paresthetic and/or painful sensations persist as a result of abnormalities in the newly regenerated nerve endings or because of deficient reinnervation of the scarred tissue, that may give rise to abnormal inputs. Existence of glutamate receptors in peripheral nerves innervating normal and inflamed skin has been well addressed. Therefore we tried ketamine in postburn neuropathic pain expecting the antagonistic effect as a NMDA antagonist. We experienced two postburn pain patients who were successfully managed without any significant sign of side effects by an intralesional injection of ketamine and bupivacaine.
Bupivacaine ; Burns ; Cicatrix ; Humans ; Injections, Intralesional* ; Ketamine* ; N-Methylaspartate ; Nerve Endings ; Neuralgia* ; Peripheral Nerves ; Receptors, Glutamate ; Sensation ; Skin ; Wounds and Injuries

Disseminated coccidioidomycosis is a systemic fungal infection that is occurring more commonly and causes high mortality in patients with compromised host defense or debilitated. It is endemic in certain areas of North, Central, and South America. Increasingly, cases are being recognized outside the endemic area, due to travelers who have visited an endemic area. We experienced a case of disseminated coccidioidomycosis, as a reactivation of infection acquired earlier in a patient, who was a former resident of an endemic area.
Amphotericin B/therapeutic use ; Case Report ; Coccidioidomycosis/diagnosis/drug therapy/*pathology ; Female ; Human ; Middle Age