No abstract available.
Hypertension ; Leigh Disease*

STUDY OBJECTIVE: determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a religious mass gathered ceremony. DESIGN: Standard charts and a four-tiered triage system(minor, moderate, urgent, and emergent) were developed before the event. The triage system was applied to each chart retrospectively by a single emergency physician. SETTING: Medical staff(10 physicians,13 nurses,1 pharmacist, and 54 first-aid attendants) were based in 8 advanced life support (ALS) clinics. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue. Three ambulances were stationed at the venues. RESULT: 22 trauma patients were developed and 183 medical complaints were encountered. Only 7 urgent medical problems were encountered.
Ambulances ; Emergencies* ; Humans ; Pharmacists ; Retrospective Studies ; Triage

No abstract available.
*Environmental Pollution ; History of Medicine, 20th Cent. ; Human ; Lead/*history ; Lead Poisoning/*history ; Paint/*history ; United States

No abstract available.
Humans ; Hypothyroidism* ; Siblings*

No abstract available.
Pregnancy*

No abstract available.
Genioplasty*

No abstract available.
Aged ; Biopsy ; Humans ; Liver Cirrhosis/diagnosis/*etiology/therapy ; Male ; Pericarditis, Constrictive/*complications/diagnosis/therapy ; Tomography, X-Ray Computed

BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome. RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs. 10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production. CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.
Anti-Bacterial Agents ; beta-Lactamases* ; Drug Resistance, Multiple* ; Female ; Hospital Mortality ; Humans ; Intensive Care Units* ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Sepsis* ; Urinary Tract ; Urinary Tract Infections

BACKGROUND/AIMS: The effect of preoperative Transcatheter Arterial Chemoembolization (TACE) in the management of Hepatocellular carcinoma (HCC) has remained controversial and lack of prospective study. To investigate the impact of preoperative TACE, we have performed a prospective study in HCC patients with tumor size below 5 cm. METHODS: From November 1998 through March 2002, 126 patients with HCC who had been referred for surgical resection were prospectively allocated to Group I (preoperative TACE, n=42) and Group II (simple hepatic angiography only, n=38). Patients who were underwent noncurative hepatic resection (n=4) were excluded and the groups with large tumor mass (above 5 cm) with or without TACE (n=64) were excluded from this analysis due to insufficient number. The impact of preoperative TACE on incidence of complication as well as long term overall and disease free survival rate were analyzed. RESULTS: Preoperative demographics and intraoperative data were compatible between two groups. There were no difference in complication rates between two groups. The 3 year survival rate of Group I and Group II were 88.10% and 58.32% respectively. The 3 year disease-free survival rate of Group I and Group II were 40.14% and 34.89% respectively. The 3 year overall rate was significantly high in Group I (p=0.0348), disease-free survival rate did not show difference between two groups (p=0.6132). CONCLUSION: Preoperative TACE can be done safely and showed improved overall survival rate in this prospective study, however fruther prospective study with longer period of follow up will be necessary to prove the effect of preoperative TACE.
Angiography ; Carcinoma, Hepatocellular* ; Demography ; Disease-Free Survival ; Follow-Up Studies ; Hepatectomy ; Humans ; Incidence ; Prospective Studies ; Survival Rate

PURPOSE: Osteolysis has become a major cause of aseptic loosening in total hip arthroplasty. Macrophages phagocytose wear debris from implants and release the pro-inflammatory mediators such as IL-1beta, IL-6, TNF-alpha and nitric oxide. We evaluated the effects of metal patricles on the release of bone-associated cytokines and nitric oxide from J774 mouse macrophage cell line. MATERIALS AND METHODS: Titanium-Aluminum-Vanadium (Ti6Al4V) and Cobalt-Chrome-Aluminium (CoCr) particles were loaded and nitric oxide production was measured indirectly by the nitrite assay. The effect on cell proliferation, and apoptosis were also investigated with non-isotopic proliferation assay, and ELISA to DNA and histone. The levels of two proinflammatory cytokines, IL-6 and TNF-alpha, were measured with ELISA. The modulatory effect of anti-inflammatory cytokine on the nitrite, IL-6 and TNF-alpha production was additionally investigated. RESULTS: Nitrite levels increased after administration of Ti6Al4V and CoCr particle. IL-10 and IL-4 inhibited the production of nitrite with TiAl4V particle, but not in significant amount with CoCr particles. Cellular proliferative activity decreased and apoptosis increased after administration of Ti6Al4V and CoCr particle. Levels of IL-6 and TNF-a increased with both particles. IL-10 and IL-4 inhibited the production of IL-6 and TNF-alpha in varying degrees. CONCLUSION: Our data confirmed the increased production of pro-inflammatory cytokines and nitric oxide with metal particles and the inhibitory effect of IL-10 and IL-4 on the production of these substances, and suggest differences in the specific action between different metal particles.
Animals ; Apoptosis ; Arthroplasty, Replacement, Hip ; Cell Line ; Cell Proliferation ; Cytokines* ; DNA ; Enzyme-Linked Immunosorbent Assay ; Histones ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Macrophages ; Mice ; Nitric Oxide ; Osteolysis* ; Tumor Necrosis Factor-alpha