BACKGROUND: Intravenous injection of rocuronium produces intense discomfort at the site of injection in conscious patient. The purpose of this study was 2 folds; First, to determine the incidence of pain associated IV injection of rocuronium in adult patients. Second, to determine whether pretreatment with IV ondansetron affects the incidence of pain associated with the injection of rocuronium. METHODS: Eighty adult patients were randomly assigned to four groups. Before general anesthesia was induced with thiopental sodium (5 mg/ml), manual occlusion (70 mmHg) with tourniquet of venous inflow was performed. Randomly associated 20 patients received 4 ml of normal saline as a placebo control (Group 1). Other 60 patients allocated randomly to one of three groups: ondansetron 4 mg (Group 2), 6 mg (Group 3), 8 mg (Group 4) respectively. The patients' pain response to rocuronium injection was graded with using Memis' 4-point scale and withdrawal response was graded with using Kim's 4-point scale. RESULTS: Nineteen patients (95%) in the group 1, 18 patients (90%) in the group 2, 19 patients (95%) in the group 3, and 14 patients (85%) in the group 4 reported pain. Moderate to sever pain was 17 patients (85%), in the group 1, 11 patients (55%) in the group 2, 9 patients (45%) in the group 3, and 1 patient (5%) in the group 4. CONCLUSIONS: Ondansetron 4 mg, 6 mg, and 8 mg IV given before administration of rocuronium did not reduce incidence of pain on injection of rocuronium but significantly reduced severity of pain on injection of rocuronium and the 8 mg was more effective.
Adult* ; Anesthesia, General ; Humans ; Incidence ; Injections, Intravenous ; Ondansetron* ; Thiopental ; Tourniquets

Alveolar Ridge Augmentation ; Dental Implants ; Esthetics ; Humans ; Osseointegration ; Osteogenesis, Distraction ; Osteotomy ; Prostheses and Implants ; Tissue Expansion ; Titanium

Tumor necrosis factor-Related Apoptosis-Inducing Ligand (TRAIL) has been reported to specifically kill malignant cells but to be relatively nontoxic to normal cells. One of disadvantages to previous in vivo protocols was the need for large quantities of TRAIL recombinant protein to suppress tumor growth. To evaluate the antitumor activity and therapeutic value of the TRAIL gene, we constructed adenoviral vectors expressing the human TRAIL gene (Ad.hTRAIL) and transferred them into malignant glioma cells in vitro and tumors in vivo, as an alternative to recombinant soluble TRAIL protein. The results show that TRAIL-sensitive glioma cells infected Ad.hTRAIL undergo apoptosis through the production and expression of TRAIL protein. The in vitro transfer elicited apoptosis, as demonstrated by the quantification of viable or apoptotic cells and by the analysis of cleavage of poly (ADP-ribose) polymerase. Furthermore, in vivo administration of Ad.hTRAIL at the site of tumor implantation suppressed the outgrowth of human glioma xenografts in SCID mice. These results further define Ad.hTRAIL as an anti-tumor therapeutic and demonstrate its potential use as an alternative approach to treatment for malignant glioma.
Adenoviridae/*genetics ; Animals ; Apoptosis ; Apoptosis Regulatory Proteins/*genetics ; Cell Line, Tumor ; Gene Expression ; Gene Therapy/*methods ; Glioma/pathology/*therapy ; Humans ; Membrane Glycoproteins/*genetics ; Mice ; Mice, SCID ; Neoplasm Transplantation ; Research Support, Non-U.S. Gov't ; Transplantation, Heterologous ; Tumor Necrosis Factor-alpha/*genetics

The resistance to recombinant human erythropoietin (r-HuEPO) in patients with chronic renal failure can develop in conditions such as iron deficiency, chronic bleeding, or chronic inflammatory disease. Recently, there have been several case reports of pure red cell aplasia due to antibody production to r-HuEPO in chronic hemodialysis patients. A 59-year old female undergoing chronic hemodialysis responded well to r-HuEPO for 6 years. But, a rapidly progressive anemia was then noted which was unresponsive to maximal doses of r-HuEPO and the patient became transfusion-dependent. Bone marrow examination showed absence of red cell precursors. A detailed search for the cause of this pure red cell aplasia was unrevealing. We conclude that although very rare, pure red cell aplasia should be considered in evaluating chronic hemodialysis patients with erythropoietin-resistant anemia.
Anemia* ; Antibody Formation ; Bone Marrow Examination ; Erythropoietin ; Female ; Hemorrhage ; Humans ; Iron ; Kidney Failure, Chronic ; Middle Aged ; Red-Cell Aplasia, Pure* ; Renal Dialysis*

PURPOSE: Hippocampal sclerosis is known to strongly correlate with medical intractability of temporal lobe epilepsy. However, the informations about this have been biased due to improper selection of the sampling obtained from severe cases of tertiary epilepsy center and surgical epilepsy field. We tried to investigate the influence of hippocampal sclerosis on the pharmacoresistance in temporal lobe epilepsy by group comparison study. METHODS: The fifty patients with complex partial seizures of temporal lobe origin, and temporal spike on EEG and/or hippocampal sclerosis on brain MRI were selected. Follow-up period of them were more than 2 years. The patients who had a seizure or seizures during the last 1-year period and had already been in adequate doses of two or more antiepileptic drugs were considered to be poorly controlled epileptics. RESULTS: Five of 17 patients without hippocampal sclerosis (29. 4%) and 24 of 33 patients with hippocampal sclerosis (72.7%) were poorly controlled by medication and the difference was significant (p=0.003, chi-square). Other factors, including sex, age of onset, febrile convulsion, secondary generalization, familial history of epilepsy, duration of disease, and delay of initial therapy had no significant effects on medical response (p>0.05). The only independent predictor of intractable epilepsy after multiple logistic regression analysis was also hippocampal sclerosis (p=0.005). CONCLUSION: Medical response in temporal lobe epilepsy was significantly associated with hippocampal sclerosis. Hippocampal sclerosis on brain MRI itself may be a crucial factor determining pharmacoresistance of temporal lobe epilepsy.
Age of Onset ; Anticonvulsants ; Bias (Epidemiology) ; Brain ; Drug Resistance ; Electroencephalography ; Epilepsy ; Epilepsy, Complex Partial ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Generalization (Psychology) ; Hippocampus ; Humans ; Logistic Models ; Magnetic Resonance Imaging* ; Sclerosis* ; Seizures ; Seizures, Febrile ; Temporal Lobe*

Hemodialysis (HD) patients continually exposed to heparin are at risk of developing heparin-induced thrombocytopenia (HIT). However, HIT is very rare in chronic HD patients with end-stage renal disease (ESRD). The authors report the case of a chronic HD patient with ESRD who developed HIT complicated by recurrent thrombocytopenia and significant bleeding episodes. A 67-year-old man with diabetic ESRD on chronic HD suddenly developed recurrent acute bleeding episodes and severe thrombocytopenia (platelet count <1.0x10(3)/uL) 2 months prior to presentation. These bleeding episodes and the thrombocytopenia always occurred 1 week after initiating HD with heparin, and improved within 1 week of discontinuing heparin. HIT was confirmed by ELISA for anti-heparin/platelet factor 4 antibody. HD was conducted successfully and thrombocytopenia did not occur after switching argatroban for heparin. This case report suggests that clinicians must consider HIT in the differential diagnosis of thrombocytopenia during maintenance HD.
Aged ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Hemorrhage ; Heparin ; Humans ; Kidney Failure, Chronic ; Pipecolic Acids ; Renal Dialysis ; Thrombocytopenia

The aim of this project was to use 3D scanning data collected at incident scenes and various evidence to 1) develop surveying methods based on 3D data consisting of overall and detailed scene evidence, captured by long-range and micros-canner, which can be shared by personnel working in different fields such as forensic medicine, video analysis, physical analysis, traffic engineering, and fire investigation; 2) create digital storage for human skeletons and set the foundation for virtual anthropology; and 3) improve the credibility of 3D evidence by virtual remodeling and simulation of incident scenes and evidence to provide a basis for advanced and high-tech scientific investigation. Two complete skeletons of male and female were scanned using 3D micro-scanner. Each bone was successfully reproduced and assembled in virtual space. In addition, recreating evidence scheduled for invasive examination by creating RP (rapid prototype) was possible. These outcomes could play an important role in setting up the new field of virtual anthropology. Case-specific surveying methods were developed through analysis of 3D scanning data collected by long-range surface scanners at the scenes of vehicular accidents, falls, shootings, and violent crimes. A technique and recording method was also developed for detecting forged seals by micro-scanning the pressure exerted on the seal. Appraisal methods developed in this project could be utilized to secure 3D data of human skeletal remains and incident scenes, create a standard for application, and increase objectivity, reproducibility, and accuracy of scanning methods. We plan to develop case-specific 3D data analysis techniques to improve the credibility of analysis at the NFS and to establish a 3D data collection and analysis team.
Crime ; Data Collection ; Female ; Fires ; Forensic Medicine ; Forensic Sciences ; Humans ; Male ; Skeleton ; Statistics as Topic