Thawing fresh frozen plasma(FFP) by waterbath(WB) requires about 30 minutes, which is too slow in emergency situations and carries the risk of bacterial contamination of FFP. To solve these problems, a new thawing method using a microwave oven(MWO) has been developed. Twenty units of equally divided plasma from 10 units of plasma were frozen, stored at -55 degrees C, and thawed in parallel using microwave oven or waterbath. Coagulation factors, plasma proteins and thawing time were measured. Except for antithrombin III(MWO: 85.2+/-6.94%, WB : 90.8+/-9.14%, p<0.05), no significant differences were observed in the 18 other coagulation parameters and the plasma proteins studied. Mean thawing time by MWO was 5.9 minutes per 1 unit, 10.4 minutes per 2 units and 12.5 minutes per 3 units; by WB, it was 19.0, 20.0 and 22.0 minutes, respectively. In conclusion, FFP can be thawed faster using a microwave oven than using 37 degrees C waterbath and the thawed plasma proteins were generally equivalent to those of FFP thawed by waterbath.
Blood Coagulation Factors ; Blood Proteins ; Emergencies ; Microwaves* ; Plasma*

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndromes(TS). In this case, 14 years old boys developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.
Adolescent ; Anxiety, Separation ; Haloperidol* ; Humans ; Imipramine ; Tics ; Tourette Syndrome*

Ameloblastic fibrosarcoma is an extremely rare variety of odontogenic tumor. It has not previously been reported in Korea. The tumor is composed of benign odontogenic epithelium with a mesenchymal part which exhibits the histologic features of fibrosarcoma. We have reported a case of amloblastic fibrosarcoma of the mandible in a 26-year-old man with swelling of right mandible for 2 weeks. The tumor showed yellowish ill-demarcated ulcerating mass involving right premolar and molar area. Light microscopy revealed irregularly arranged strands and islands of odontogenic epithelium surrounded by abundant mesenchymal tissue with the feature of fibrosarcoma. The fibrosarcoma cells were strong positive on immunostain for vimentin and ameloblastic cells were weakly positive for cytokeratin. S-100 and CEA were negative in both epithelial and sarcoma cells. The sarcoma cells were corresponding to fibroblasts on the electron microscopy with abundancy of RER and mitochondria and covering of basal lamina. Two types of virus like particles were distributed in the cytoplasm and nuclei of sarcoma cells. We treated the patient with surgery and chemotherapy. The recovery was uneventful and the prognosis is under observation.
Male ; Humans

This study was performed to investigate the effect of endotoxin to the CCl4-induced liver injury. Twelve Sprague-Dawley rats were intraperitoneally injected 1.6 g/kg CCl4 as control group. Another 24 rats were orally administrated 300 mg/kg of neomycin at 16 and 3 hours prior to CCl4 injection as experimental group. Twelve among them were intraperitoneally infected 1.0 mg/kg of endotoxin(E-Coli, 0111:B4, No L-2630, lipopolysaccharide, Sigma, USA) and CCl4 simultaneously for offsetting neomycin effect. The rats were sacrificed at 1, 4, 10, and 24 hours after CCl4 injection. The liver tissues from all experimental groups were observed by light and electron microscopy. The results obtained were summarized as follows: In the CCl4 only group, the hepatocytes revealed sweling of ER and mitochondria with many lipid droplet in the cytoplasm. Focal cellular necrosis was seen at the later phase. The Kupffer cells were activated and showed many cytoplasmic processes, secondary lysosomes, and vaculoles. The endothelial cells were edematous. Several neutrophils, platelets, and microthrombi were scattered in the sinusoid. In the neomycin-CCl4-endotoxin administrated group, both hepatocytic destruction and intrasinusoidal microthrombi formation were more pronounced. In the neomycin pretreated group, the hepatocytes revealed mild cellular destruction without necrosis. There is no intrasinusoidal microthrombi. According to these results, it would be concluded that the small dosage of gastrointestinal tract-derived endotoxin affects to the liver injury caused by CCl4. The synergistic effects of CCl4 and gastrointestinal tract-derived endotoxin which can not be detoxified by damaged Kupffer cells, may be more important in the pathogenesis of CCl4-induced liver injury.
Rats ; Animals

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

Central pontine myelinolysis (CPM) is a demyelinating disorder that almost exclusively affects the central portion of basis pontis and occurs in patients with malnutrition, chronic debilitating disorders and electrolyte abnormalities. CPM after liver transplantation is considered that had the relationship to rapid correction of hyponatremia and shift in osmolality. Our first case of 4 liver transplantations altered consciousness at the 5th day after transplantation and did not recover fully until 14 months. At first, atrial fibrillation and atelectasis due to left main broncheal obstruction were thought the causes of impaired consciousness as postoperative hypoxic event. At that time, CT scan showed diffuse brain atropy that suggested previous hepatic encephalopathy and/or hypoxic ischemic encephalopathy. After that, MRI revealed CPM and diffuse cortical atropy. We concluded that CPM associated with rapid correction of hyponatremia perioperatively alter patient's consciousness with hypoxic brain injury.
Atrial Fibrillation ; Brain ; Brain Injuries ; Consciousness ; Demyelinating Diseases ; Hepatic Encephalopathy ; Humans ; Hyponatremia ; Hypoxia-Ischemia, Brain ; Liver Transplantation* ; Liver* ; Magnetic Resonance Imaging ; Malnutrition ; Myelinolysis, Central Pontine* ; Osmolar Concentration ; Pulmonary Atelectasis ; Tomography, X-Ray Computed

No abstract available.
Erythema*

BACKGROUND: Despite progress in surgical techniques and adjuvant treatments, the prognosis for advanced gastric cancer has not improved. Knowledge of the kinds of tumor markers that might indicate the postoperative prognosis for gastric cancer is important in detecting microscopic residual cancers but still needs to be developed. METHODS: The serum levels of carcinoembryonic antigen (sCEA) and carbohydrate antigen 19-9 (sCA19-9), as well as the CEA, the CA19-9, and the tissue-type plasminogen activator levels in peritoneal washings (pCEA, pCA19-9, pTPA) were measured in 57 patients with gastric cancer who had undergone laparotomies from Oct. 1996 to Mar. 1997. The relationships between the positivity of tumor markers and several clinicopathological factors were evaluated by using a univariate analysis. Also, the significance of tumor markers in predicting the survival and the recurrence of disease was analyzed. RESULTS: The positivity of pCEA and pCA19-9 increased according to the stage (p<0.01) and the presence of serosal invasion (P<0.01). When pCEA or pCA19-9 is positive, the rate of curative surgery in those patients was lower than it was in the patients with negative tumor markers (p<0.01 and p<0.05, respectively). The positivities of pCEA, sCA19-9, pCA19-9 were higher in recurring cases than in nonrecurring cases after curative surgery (p<0.01, p<0.01, and p<0.05, respectively). The positivities of the tumor markers pCEA and pCA19-9 in the 4 cases with peritoneal seeding at the laparotomy were significantly different from those in the 53 cases with no peritoneal seeding (p<0.01) and (p<0.01), respectively pCEA. The risk of peritoneal recurrence after curative surgery was higher in pCEA positive cases than in negative cases (p=0.016) and in serosal positive and pCEA positive cases than in the other cases (p=0.016). CONCLUSION: pCEA and pCA19-9 are useful prognostic factors and an adjuvant treatment to prevent peritoneal recurrence should be considered, especially, in patients presenting positive pCEA with positive serosal invasion.
Biomarkers, Tumor* ; Carcinoembryonic Antigen ; Humans ; Laparotomy ; Neoplasm, Residual ; Prognosis ; Recurrence ; Stomach Neoplasms* ; Tissue Plasminogen Activator

The purpose of this study was to examine the designs of the menu books as an important tool of marketing and then present its improvement strategies. For this, the investigator comparatively examined the current status of menu book designs of the restaurants in Incheon area with 295 managers and then analyzed menu book designs by its designers. Menu book designers were printing houses (42.0%), specialized business (31.9%) and managers/employees (26.1%). 51.5% of menu books were impossible to substitute partially. Even there were seasonal menus or event menus, 27.5% of them were impossible to replace menu books partially; therefore, it was impossible to take a prompt action for seasonal or event menus. The easiness of understanding the terminology in menu books was average 2.74 +/- 0.45(3-point scale). The harmony of menu book design with restaurants was average 2.46 +/- 0.51 (3-point scale). Comparing to the menu books designed in specialized business, the menu books designed in printing houses or by managers/employees were uniform in type sizes (p < 0.001), had no menu photos (p < 0.001) and explanations (p < 0.001), and did not classify menus by groups (p < 0.001) in general. In addition, profit-making menus were not properly emphasized (p < 0.001), thus making the design of menu books a little improper. Therefore, it is necessary to educate managers in the restaurants to understand the importance of menu books and thus improve it. In addition, by maintaining close communication with designers of menu books, managers in the restaurants must ensure for their menu books to be designed appropriately, thus making their menu books play the role of an important marketing tool.
Commerce ; Dietary Sucrose ; Humans ; Marketing ; Research Personnel ; Restaurants ; Seasons