In order to confirm whether the migrating larvae of parasites could carry pathogenic organisms into liver and cause hepatitis, a series of experiments has been carried out. Clonorchis sinensis: Recovery rate of larvae in the abdominal cavity of rabbits: One to seven days after the administration adolescariae were recovered from the abdominal cavity in less than l percent of the total number of metacercariae given. Generally, 1-6 larvae were found from each animal which was given 900-1,000 metacercariae, though many larvae were already found in the common bile ducts or remained still in intestine. Fate of Clonorchis sinensis in abdominal cavity: The young or mature worms which were introduced directly into the abdominal cavity were examined l5, 32, 40 and 42 days after the inoculation. Several larvae were found on the surface of liver in four animals. All the worms on the surface of the liver were dead and the biopsied liver tissues on the area where the worms were attached showed no pathological changes. Two of them were between bile duct and liver tissue but pus cell infiltration surrounding them was observed. In every case, pus cell infiltration was found in the peripheral portion of the liver and pus nodules on the surface of intestine and mesentery. The nodule in the intestinal wall contained the eggs of Clonorchis sinensis. Two worms in the abdominal cavity were still alive. From the above results it is suggested that the larvae of Clonorchis sinensis were capable of penetrating the intestinal wall and reaching the organs in the abdominal cavity and surviving for l5-42 days, but they were unable to penetrate the organs. No bacterial flora appeared from the lesion by culture method. Fate of Clonorchis sinensis which was inoculated into the peripheral region of liver: Small abscess was observed at the same area. Microscopically, the area became edematous and the vessels in the peripheral region were dilated. The parasites became necrotic and amorphous. Pathologically the lesions appeared as eosinophilic masses and neutrophile leukocytes were infiltrated surrounding the masses. In some cases, the dead worms were found apart from the original place of inoculation but no leukocyte infiltration was found. There was linear infiltration between the original site and the portion where the dead worm was found. The distance from the capsule varied from 0 to 4 mm. Sometimes, the eggs of Clonorchis sinensis were also found. In all cases, there were no living worms in liver tissues and hepatic ducts. In all case,. the bacteriological examination was negative. Do clonorchis sinensis transfer the microorganism? Five adult worms of clonorchis sinensis were incubated in the saline solution containing Staphylococcus aureus. The intestinal contents of these worms were cultured in the Nutient-agar plate and examined by Methylene Blue and Gram's stain. The area of liver tissue where the Clonorchis sinensis were inoculated showed no inflammatory changes after the 3 days of inoculation but no living Staphylococcus aureus was found in the culture media with which the pieces of liver tissues were smeared. Hookworm: Cutaneous infection: Four to eight days after the cutaneous infection of Ancylostoma caninum, the mice were sacrificed. Grossly, there was no abnormal finding in liver. The pieces of liver tissues were smeared on the Nutrient-agar plate, and cocci were found in four out of six examined. The microorganism were confirmed as the same species of Diplococcus pneumoniae which were grown in the hookworm culture media. Oral infection: 1,000 filariform larvae of Ancylostoma caninum were given orally. 24 hours later, the mice were sacrificed and the pieces of liver tissue were smeared on the Nutrient-agar plate. After 50 hours at 36 C, the bacterial colonies were examined bacteriologically. Staphylococcus albus was found from two out of four samples. Grossly there was no abnormality on the surface of liver, but microscopically there were spots like microabscesses which were infiltrated by leukocytes. The larvae were also found from other portions of liver tissues and they were surrounded by yellow colored material. In another experiment, a combination of Ancylostoma duodenale and Staphylococcus aureus was fed to mice. The mice sacrificed five days after the oral administration of Ancylostoma duodenale cultivated in the media containing Staphylococcus aureus. The liver pieces were examined routinely. The larvae cultivated in normal tap water which contained no Staphylococcus aureus was used as control. In the experimental mouse, the cocci appeared in the liver. Pathologically, microabscesses infiltrated with neutrophile leukocytes were found, but there was no manifestation of inflammatory change due to Staphylococcus aureus. There was only mechanical trauma due to the larvae penetration. Haemorrhage appeared only where the larvae were found.
parasitology-helminth-trematoda-nematoda ; Clonorchis sinensis ; Ancylostoma caninum ; pathogenicity ; Staphyllococcus aureus ; Staphyllococcus albus ; Diplococcus pneumoniae ; rabbit-liver

No abstract available.
Intestinal Fistula*

No abstract available.
Busan* ; Epidemiology* ; Gyeongsangnam-do* ; Sepsis* ; Vibrio vulnificus* ; Vibrio*

The prevalence of burnout amongst primary care physicians (PCPs) in Singapore is likely to be high. The resilient PCP is less likely to suffer from burnout and might recover faster from this condition. Mindfulness and self-compassionate practices are evidence-based skill sets that can enhance PCP resilience in the face of high work-stress. This article briefly explores the evidence base for mindfulness and self-compassionate practices, and details some simple examples of these practices that the reader can attempt.

The prevalence of burnout amongst primary care physicians (PCPs) in Singapore is likely to be high. Burnout has a negative impact on sleep quality, and poor sleep quality in turn feeds into burnout resulting in a vicious perpetuating cycle. Evidenced-based behavioural strategies can be useful to help improve sleep quality, which in turn contributes to the amelioration of burnout. This article details some of the evidence-based behavioural strategies that PCPs can use to improve their own sleep quality if used consistently.

No abstract available.
Anesthesia* ; Animals ; Guinea Pigs* ; Guinea*

The management of chronic skin defect over the pretibial region, sacral pressure sore and other bony protuberant area is extremely difficult due to the presence of necrotic and infected bone, avascular and infected scar tissue, dead space and anatomical sparse of available adjacent structure. The present methods of management include versatile varieties and have left much to be revised, but they often despaired of both surgeon and patient, especially due to persistent chronic osteomyelitis and recurrent ulcer. From January, 1975 to April, 1979, we have had treated 20 such cases with application of muscle flap transposition and following has been observed. 1. The cause of lesion were 11 cases of the traffic accident, 4 cases of the industrial accident, 2 cases of the falling from a height, 2 cases of the pressure sore and 1 case of the chronic osteomyelitis. And 15 cases of them were physically active young adult between 2nd decade to 4th decade. 2. The muscles used for pretibial lesion were medial head of gastrocnemius m., soieus m., flexor digitorum longus m. and peroneus brevis m. Used abductor hallucis m. for medial malleolar defect, gluteus maximus m. for sacral pressure sores and sartorius m. for exposed knee joint. 3. There existed hematoma formation in 2 cases, partial necrosis of transposed muscle in 3 cases and persistent infected sinuses in 3 cases. Other cases except the last 3 cases, which needed another surgical procedure and antibiotic therapy, were controlled without difficulty and all of them did not develope any recurrence of ulcer during the follow up duration. 4. There did not appear to be any significant long term functional residua due to loss of original function of the transposed muscle except somewhat unacceptable cosmetic result. 5. It was 2 months average for the healing cases which did not need a bone graft and 5 months average for the cases needed a bone graft.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Cicatrix ; Follow-Up Studies ; Head ; Hematoma ; Humans ; Knee Joint ; Muscles ; Necrosis ; Osteomyelitis ; Pressure Ulcer ; Recurrence ; Sacrococcygeal Region ; Skin ; Transplants ; Ulcer ; Young Adult

BACKGROUND: Acute normovolemic hemodilution (ANH) and deliberate hypotension (DH) are methods used for reducing homologous transfusions in cases of massive intraoperative bleeding. Using the technique of combining ANH and DH, we can save more homologous blood than a single use of ANH or DH, but the risk of tissue hypoxia may increase. METHODS: Fourteen male dogs were used for this study and divided into two groups. After performing ANH by 25 ml/kg, mean arterial pressures were reduced to 60 mmHg by sodium nitroprusside (S group) or esmolol (E group). The critical oxygen delivery and the hemoglobin concentration at the critical oxygen delivery were determined by measurements of hemodynamic change, systemic oxygen delivery and systemic oxygen consumption during subsequent hemodilution. RESULTS: After performing ANH by 25 ml/kg, the cardiac output was significantly increased, and systemic vascular resistance and hemoglobin concentration were significantly decreased compared with control values. The critical oxygen deliveries were 179.6 ml/min in the S group and 169.1 ml/min in the E group. There was a difference in mean systemic oxygen consumption between the S group (123.4 +/- 16.7 ml/min) and E group (112.9 +/- 15.4 ml/min) above the critical oxygen delivery point (mean +/- SD). The hemoglobin concentrations at the critical oxygen delivery were 2.6 +/- 0.7 g/dl in S group and 4.0 +/- 1.3 g/dl in E group (mean +/- SD). CONCLSIONS: The critical oxygen delivery during hemodilution under DH by sodium nitroprusside was 179.6 ml/min and by esmolol was 169.1 ml/min. However, esmolol was higher in hemoglobin concentrations at the critical oxygen delivery than sodium nitroprusside. These results suggest thathemodilution under DH by esmolol rather than sodium nitroprusside requires more careful monitoring of systemic oxygen delivery for prevention of tissue hypoxia.
Animals ; Anoxia ; Arterial Pressure ; Cardiac Output ; Dogs* ; Hemodilution* ; Hemodynamics ; Hemorrhage ; Humans ; Hypotension* ; Male ; Nitroprusside* ; Oxygen Consumption ; Oxygen* ; Sodium* ; Vascular Resistance

No abstract available.
Aneurysm, False* ; Aorta*

Chronic Disease ; Comorbidity ; Humans ; Mental Disorders ; epidemiology