No abstract available.
Ultrasonography, Prenatal*

BACKGROUND: In our previous report, we observed the increaseed epidermal glucose concentrations and decreased hexokinase actiuities of diabetic patients which were ciimpared to those of normal individuals. And we considered that, there were some derrangement of lipid metabolism and glycolysis of diabetic epidermis. OBJECTIVES: This study wns planed to prove the above possible changes of lipid metabolism and glycolysis of diabetic epidermis. METHODS: The epidermal enzymatic activties of glucose-6-phophate dehydrogenase(G6PDH), phosphofructokinase(PFK), 1-glycerophosphate dehydrogenase(GOPDH) and b-hydroxybutyryl CoA dehydrogenase(HBDH) were assayed in the skin samples obtained friom diabetic patients and normal individuals by the fluorometric: method. RESULTS: Teh epidermal PFK activities of diabetic patients were decreased(3.49+1.35(mmole/hr/kg dry weight)) compared to that of normal individuals(5.00+0.56(mmcle/hr/kg dry weight))(p<0.05). The epidermal HBDH activities of diabetic patients were decreised(0.28+0.10(mole/hr/kg dry weight)) compared to that of normal individuals(0.49+0.20(mole/hr/kg dry weight)(p<0.01). The mean epidermal G6PDH activity of diabetic patients was decreasec. compased to that of normal individuals, but there was no statisical significance. The mean epidermal 3OPDH activittes of diabetic patients and normal individual; showed no significant difference. CONCLUSION: We consider that the decreased epidermal HBDH actiities of diabetic patients can decrease keton body formatiori, and the abnormal glycolysis can exist in the diabetic epidermis because the decreased enzymatic activities of diabetic epidermal PFK may decrease the velocity of glycolysis.
Diabetes Mellitus ; Epidermis ; Glucose ; Glycolysis ; Hexokinase ; Humans ; Lipid Metabolism ; Skin

OBJECTIVE: To define the anatomy of the lateral antebrachial cutaneous nerve (LABCN) and the cephalic vein (CV) in the anterior forearm region of living humans using ultrasonography for preventing LABCN injury during cephalic venipuncture. METHODS: Thirty forearms of 15 healthy volunteers were evaluated using ultrasonography to identify the point where the LABCN begins to contact with the CV, and the point where the LABCN separates from the CV. The LABCN pathway in the forearm in relation to a nerve conduction study was also evaluated. RESULTS: The LABCNs came in contact with the CV at a mean of 0.6±1.6 cm distal to the elbow crease, and separated from the CV at a mean of 7.0±3.4 cm distal to the elbow crease. The mean distance between the conventionally used recording points (point R) for the LABCN conduction study and the actual sonographic measured LABCN was 2.4±2.4 mm. LABCN usually presented laterally at the point R (83.3%). CONCLUSION: The LABCN had close proximity to the CV in the proximal first quarter of the forearm. Cephalic venipuncture in this area should be avoided, and performed with caution if needed.
Elbow ; Forearm ; Healthy Volunteers ; Humans ; Neural Conduction ; Phlebotomy ; Ultrasonography ; Veins*

We reviewed 48 skin bicpsies obtained from 48 patients with epidermal nevus during a 10 year period from January 1981 to December 1990. The results are summarized as follows : 1) Of our 48 patients, 23 were male and 25 were female, and male to female ratio was 1 to 1.1. 2) The average of the patients was 19.8 years at the time of diagnois. 3) Lesions were present at birth in 45.7 percent of patients, and most of the remainder de veloped in childhood. The mean age of onset was 7.7 years. 4) The clinical varieties of the nevi in 48 patients were classified according to caicegories of nevus verrucosus, including systematized epidermal nevus, nevu, unius lateris, ichthyosis hystrix, epidermal nevus syndrome and inflammatory linear veirucous epidermal nevus. The most common type was nevus verrucosus(88.6%). 5) A large variety of histopathologic changes can be seen in epidermal nevi. The most common histopathologic .ype was nonspecific(31.3%), follows by common(12.5%), epidermolytic hyperkertosis(12.5%), and acanthosis nigricans(10.4%). 6) The most commonly affected area was head and neck(48.5%) followed by trunk(28.6%), upper limb(11.4%) and lower limb(2.9%).
Age of Onset ; Female ; Head ; Humans ; Ichthyosis ; Male ; Nevus* ; Parturition ; Porcupines ; Skin

A massive pulmonary embolism occurring during surgery is a fatal complication. Therefore, early detection and subsequent treatment of pulmonary emboli are important clinical challenges. In this report, an acute pulmonary embolism associated with cardiac arrest occurred during the surgical reduction of a femur fracture. It was diagnosed by echocardiography and treated with urokinase successfully. Therefore, we recommend the use of urokinase for the treatment of a intraoperative massive pulmonary embolism.
Echocardiography ; Femur* ; Heart Arrest ; Pulmonary Embolism* ; Urokinase-Type Plasminogen Activator*

Treatment challenges persist in advanced lung cancer despite the development of therapies beyond the traditional platinum-based chemotherapy. The early 2000s marked a shift to tyrosine kinase inhibitors targeting epidermal growth factor receptor, ushering in personalized genetic-based treatment. A further significant advance was the development of immune checkpoint inhibitors (ICIs), especially for non–small cell lung cancer. These target programmed death-ligand 1 (PD-L1) and cytotoxic T lymphocyte antigen 4, which enhanced the immune response against tumor cells. However, not all patients respond, and immune-related toxicities arise. This review emphasizes identifying biomarkers for ICI response prediction. While PD-L1 is a widely used, validated biomarker, its predictive accuracy is imperfect. Investigating tumor-infiltrating lymphocytes, tertiary lymphoid structure, and emerging biomarkers such as high endothelial venule, Human leukocyte antigen class I, T-cell immunoreceptors with Ig and ITIM domains, and lymphocyte activation gene-3 counts is promising. Understanding and exploring additional predictive biomarkers for ICI response are crucial for enhancing patient stratification and overall care in lung cancer treatment.

Massive intraoperative pulmonary embolism (PE) is a fatal complication. However, the diagnosis of PE is difficult because clinical symptoms and signs are nonspecific, and specialized diagnostic facilities are not readily available in the operating room. We report a case of cardiac arrest due to a massive PE diagnosed by transthoracic and transesophageal Echocardiography during a nephrectomy in patient with renal cancer. This case demonstrates the great value of echocardiography in the diagnosis of an intraoperative massive pulmonary embolism.
Diagnosis ; Echocardiography ; Echocardiography, Transesophageal* ; Heart Arrest ; Humans ; Kidney Neoplasms* ; Nephrectomy* ; Operating Rooms ; Pulmonary Embolism*

The technique of computer-assisted continuous infusion (CACI) has revolutionised the administration of drugs by intravenous infusion. A stable blood concentration is achieved rapidly with CACI, allowing the anesthesiologist to monitor therapeutic effect and titrate drug concentrations accordingly. Propofol and opioids can be administered by CACI for the induction and maintenance of anesthesia in adult patients. Also, the ability to maintain a constant blood concentration of drugs is also extremely important for studying the pharmacodynamic interactions of drugs, and research in the area has increased with advent of CACI. We experienced a case of total intravenous anesthesia which was totally conducted by CACI, using a Master TCI for propofol and Stelpump program for fentanyl infusion.
Adult ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Intravenous* ; Fentanyl ; Humans ; Infusions, Intravenous ; Propofol

Insulin-like growth factor binding proteins (IGFBPs) are major regulators of insulin-like growth factor bioavailability and activity in metabolic signaling. Seven IGFBP family isoforms have been identified. Recent studies have shown that IGFBPs play a pivotal role in metabolic signaling and disease, including the pathogenesis of obesity, diabetes, and cancer. Although many studies have documented the various roles played by IGFBPs, transcriptional regulation of IGFBPs is not well understood. In this review, we focus on the regulatory mechanisms of IGFBP gene expression, and we summarize the findings of transcription factor activity in the IGFBP promoter region.
Biological Availability ; Gene Expression ; Humans ; Insulin-Like Growth Factor Binding Protein 2* ; Insulin-Like Growth Factor Binding Proteins ; Liver ; Metabolic Diseases ; Obesity ; Promoter Regions, Genetic ; Protein Isoforms ; Transcription Factors

OBJECTIVE: The purposes of this study were 1) to evaluate the effectiveness of follow-up urologic evaluation of neurogenic bladder in patients with spinal cord injury, 2) to define risk factors causing upper urinary tract complications, and 3) to evaluate changes of the vesicoureteral reflux grade on follow-up study. METHOD: Urodynamic studys, ultrasonographys, and voiding cystourethrographys of 90 patients with spinal cord injury who admitted to the bladder clinic of National Rehabilitation Hostpital were evaluated. Of the 90 patients, twenty four patients (27%) had upper urinary tract complication (vesicoureteral reflux or hydronephrosis). The risk factors of upper urinary tract complication were compared. The patients who had vesicoureteral reflux were devided into two main groups: conservative medical treatment group (oxybutynin, atropine intravesical instillation and intermittent catheterization) and primary surgical treatment group, and then the changes of the vesicoureteral reflux grade on follow-up study were evlauated. RESULTS: 1) The incidence of upper urinary tract complication was 27% for all patients. After bladder clinic evaluation, the patients who were recommended the change of the voiding mothods were 24%, and 58% of the patients were need management to decrease maximal detrusor pressure. 2) Maximal bladder capacity by clinical voiding chart recording (< or =250 ml), bladder wall deformity (> or =trabeculation grade 2), leak point pressure (> or =40 cmH20), and maximal detrusor pressure (> or =90 cmH2O) were significantly different between patients with upper urinary tract complication and patients without that. 3) In the eight vesicoureteral reflux patients, five of six patients were cured or improved with conservative treatment and two patients were cured with surgical treatment. CONCLUSION: The periodic follow-up evaluation of neurogenic bladder of spinal cord injuredpatients was important to prevent upper urinary tract deterioration. The factors related upper urinary tract complication were clinical bladder capacity, leak point pressure, bladder wall deformity (trabeculation) and maximal detrusor pressure.
Administration, Intravesical ; Atropine ; Congenital Abnormalities ; Follow-Up Studies* ; Humans ; Incidence ; Rehabilitation ; Risk Factors ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Tract ; Urodynamics ; Vesico-Ureteral Reflux