BACKGROUND: To reduce surgical stress, fentanyl is frequently used for neurosurgical procedure where focal and/or global ischemia may occur. However, the effect of fentanyl on the cytokine level during ischemia/reperfusion is still uncertain. The goal of this study was to evaluate the effect of fentanyl infusion on the proinflammatory cytokine, TNF-alpha and IL-1beta, levels during global cerebral ischemia/reperfusion (I/R) in rats using the intracerebral microdialysis technique. METHODS: Forty male S-D rats weighing 280 320 g were randomly assigned to four groups. Group 1: no fentanyl infusion and only I/R, Group 2: 1.5 ng/ml of fentanyl infusion during I/R, Group 3: 3.0 ng/ml of fentanyl infusion during I/R (n = 10 in each group). Rats were anesthetized with a intraperitoneal injection of pentobarbital (50 mg/kg), intubated and ventilated with room air using an animal ventilator. Two femoral arteries and one femoral vein were cannulated with PE-50 tubing for hemorrhagic hypotension, drug infusion and hydration. Both carotid arteries were dissected and a sling was placed for brain ischemia. The head was fixed on a stereotaxic device and a small burrhole was made for probe insertion. A CMA-12 probe was inserted into the left hippocampal CA-1 region according to the guidelines. Artificial CSF was run from the inserted microdialysis probe and infused with or without fentanyl at 3 microliter/min using a microinjection syringe pump during I/R. Ischemia was induced by clamping the carotid arteries while hemorrhagic hypotension for 17 min via the femoral artery and reperfusion were accomplished by the unclamping of the sling and reinfusing the blood via the femoral artery. Nasopharyngeal and rectal temperatures were maintained within the normal range during the whole procedure. After 2 hours of stabilization, the microdialysate was collected every 17 min just before (control) and during I/R and stored at 80oC until analysis using HPLC. RESULTS: During global I/R, TNF-alpha and IL-1 beta significantly increased at reperfusion (R5) compared to the control value (P < 0.05). However, in both cases of fentanyl infusion, TNF-alpha and IL-1 beta did not increase compared to the control value. CONCLUSIONS: Fentanyl inhibited the increase of proinflammatory cytokine TNF-alpha and IL-1 beta levels during global cerebral ischemia/reperfusion in rats.
Animals ; Brain Ischemia ; Carotid Arteries ; Chromatography, High Pressure Liquid ; Constriction ; Femoral Artery ; Femoral Vein ; Fentanyl* ; Head ; Humans ; Hypotension ; Injections, Intraperitoneal ; Interleukin-1beta ; Ischemia ; Male ; Microdialysis ; Microinjections ; Neurosurgical Procedures ; Pentobarbital ; Rats* ; Reference Values ; Reperfusion ; Syringes ; Tumor Necrosis Factor-alpha* ; Ventilators, Mechanical

PURPOSE: Patency of the arteriovenous fistula remains the most important support for patients with end stage renal disease. Prosthetic materials have been used only when autogenous arteriovenous fistula procedure is not feasible, because of the relatively low patency in prosthetic arteriovenous fistula. We designed this study to determine the appropriateness of primary prosthetic arteriovenous fistula. METHOD: Twenty-one consecutive patients who underwent prosthetic arteriovenous fistula formation on the arm in Chosun university hospital from Mar. 1998 to Feb. 2001 were retrospectively analysed. RESULT: The median patency in radio-antecubital fistula, brachio-antecubital fistula, and brachio-axillary fistula was 9.6, 11.4, and 16.6 months, respectively. The primary assisted patency rates in radio-antecubital fistula and brachio-antecubital fistula were 44.9% and 70.0% at the first year, respectively (P=0.03). The secondary patency rates in radio-antecubital fistula and brachio-antecubital fistula were 71.4% and 80.0% at the first year and 28.6% and 48.0% at the second year, respectively (0.02). CONCLUSION: The patency rates according to the site of prosthetic arteriovenous fistula were statistically significant in the radio-antecubital fistula and brachio-antecubital fistula groups. Nevertheless, the patency rates of the brachio-axillary fistula group were statistically insignificant. Primary brachio-antecubital fistula with PTFE creation showed favorable patency rates and many other benefits. Therefore, we suggest primary brachio-antecubital fistula with PTFE as the appropriate arteriovenous access in patients with poor vessel condition.
Arm ; Arteriovenous Fistula* ; Fistula ; Humans ; Kidney Failure, Chronic ; Polytetrafluoroethylene ; Retrospective Studies

To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation(KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: 16.76~17.92) per 100,000 and the cumulative rates for the ages 0~64 and 0~74 were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in 1983~1987. The truncated rate for ages 35~64 was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged 55~59 years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.
Asian Continental Ancestry Group ; Cervix Uteri* ; China ; Diagnosis ; Epidemiology ; Female ; Gynecology ; Humans ; Incidence* ; Insurance ; International Classification of Diseases ; Japan ; Korea ; Medical Records ; Specialization

Background: Vitamin D concentrations are associated with sepsis, pneumonia, and mortality in critically ill patients. However, the role of vitamin D in critically injured patients with trauma remains unknown. This study investigated the effects of vitamin D concentrations on outcomes in critically injured patients with trauma. Methods: A prospective observational study was conducted by randomly selecting 100 patients among those who visited our trauma center. The serum vitamin D concentration was measured upon arrival at the hospital, and the length of stay in a trauma intensive care unit after admission, duration of mechanical ventilation, number of days spent in the hospital, development of complications, and death were investigated. The association between the surveyed variables and vitamin D concentrations was investigated using regression analysis. Results: Of the 100 patients, 69 were men and 31 were women with an average age of 51.7 years. The average intensive care unit stay length was 18.4 days, and 6 patients (5.9%) died. Univariate regression analysis showed that the factors affecting patient mortality were age (p = 0.02), volume of blood transfused within 24 hours of arrival (p = 0.009), systolic blood pressure measured upon hospital arrival (p = 0.01), and serum lactate concentration measured upon hospital arrival (p = 0.03). Multivariate regression analysis showed that the factors affecting patient mortality were age (p = 0.01), volume of blood transfusion (p = 0.04), and systolic blood pressure measured upon hospital arrival (p = 0.01). Conclusions There were no statistically significant effects of serum vitamin D concentrations in critically ill patients with trauma on death during hospitalization.

OBJECTIVE: To evaluate the difference of implantation rate (IR) and clinical pregnancy rate (CPR) between two protocols of endometrial preperation in women undergoing frozen-thawed embryo transfer (FET) cycles. METHODS: This study was performed during the different time periods: A retrospective study from January 2000 to June 2001 (phase I) and a prospective study from July 2001 to March 2002 (phase II). All the patients received estradiol valerate (6 mg p.o. daily) starting from day 1 or 2 of the menstrual cycle without pituitary down regulation. Progesterone was administered around day 14 after sonographic confirmation of endometrial thickness > or = 7 mm and no growing follicle. In Group A (n=88, 99 cycles) of phase I, progesterone was administered i.m. at a dose of 50 mg daily from one day prior to thawing of pronuclear (PN) stage frozen embryo or three days prior to thawing of 6-8 cell stage frozen embryo and then each stage embryos were trasnsferred 2 days or 1 day later after thawing. In Group B (n=246, 299 cycles) of phase I, patients recieved progesterone 100 mg i.m. from one day earlier than group A; two days prior to PN embryo thawing, four days prior to of 6-8 cell embryo thawing. During the phase II, to exclude any differences in embryo transfer procedures, in Group 1 (n=23, 28 cycles) of phase II embryo was transfered by one who have used the progesterone protocol since the phase I. In Group 2 (n=122, 139 cycles) of phase II embryo was transfered by one who use the progesterone protocol from the phase II. RESULTS: When compared across the phase and group, there were no significant differences in the characteristics. During the phase I, there were significant increase in IR (14.4% vs 5.9%, p=0.001) and CPR (28.3% vs 14.5%, p=0.000) in group A. During the phases II, IR (11.8% vs 10.6%) and CPR (27.6% vs 27.3%) show no differences between two groups. CONCLUSIONS: In FET cycles, IR and CPR are increased significantly by the change of dosage and timing of progesterone administraton. And the timing is considered to be more important factor because the dosage of progesterone did not affect implantation window in previous studies. Therefore, we suggest that progesterone administration in FET cycle should begin from one day prior to PN stage embryo thawing and three days prior to 6-8 cell stage embryo thawing.
Cardiopulmonary Resuscitation ; Down-Regulation ; Embryo Transfer* ; Embryonic Structures* ; Estradiol ; Female ; Humans ; Menstrual Cycle ; Pregnancy Rate* ; Pregnancy* ; Progesterone* ; Prospective Studies ; Retrospective Studies ; Ultrasonography

Mitochondria-targeted vitamin E (MVE) is designed to accumulate within mitochondria and is applied to decrease mitochondrial oxidative damage. However, the protective effects of MVE in skin cells have not been identified. We investigated the protective effect of MVE against UVB in dermal fibroblasts and immortalized human keratinocyte cell line (HaCaT). In addition, we studied the wound-healing effect of MVE in animal models. We found that MVE increased the proliferation and survival of fibroblasts at low concentration (i.e., nM ranges). In addition, MVE increased collagen production and downregulated matrix metalloproteinase1. MVE also increased the proliferation and survival of HaCaT cells. UVB increased reactive oxygen species (ROS) production in fibroblasts and HaCaT cells, while MVE decreased ROS production at low concentration. In an animal experiment, MVE accelerated wound healing from laser-induced skin damage. These results collectively suggest that low dose MVE protects skin from UVB irradiation. Therefore, MVE can be developed as a cosmetic raw material.
Animal Experimentation ; Cell Line ; Collagen ; Fibroblasts ; Humans ; Keratinocytes ; Mitochondria ; Models, Animal ; Reactive Oxygen Species ; Skin* ; Vitamin E* ; Vitamins* ; Wound Healing

PURPOSE: To investigate the usefulness of sonography for the evaluation of osteoarthritic articular cartilage. MATERIALS AND METHODS:Ten asymptomatic volunteers and 20 patients with osteoarthritis of the knee under-went sonographic evaluation. For this, the knee was maintained of full flexion in order to expose the deep portion of femoral condylar cartilage. Both transverse and longitudinal scans were obtained in standardized planes. Sonographic images of the articular cartilages were analyzed in terms of surface sharpness, echogenicity and thickness, along with associated bone changes. RESULTS: Normal cartilages showed a clearly-defined surface, omogeneously low echogenicity and regular thickness. Among 20 patients, the findings for medial and lateral condyles, respectively, were as follows: poorly defined cartilage surface, 16(80%) and ten(50%); increased echogenicity of cartilage, 17(85%) and 16(80%); cartilage thinning, 16(80%) and 14(70%) (two medial condyles demonstrated obvious cartilage thickening); the presence of thick subchondral hyperechoic bands, five (25%) and four (20%); the presence of osteophytes, 13 (65%) and 12(60%). CONCLUSION: Sonography is a convenient and accurate modality for the evaluation of femoral articular cartilage. In particular, it can be useful for detecting early degenerative cartilaginous change and for studying such change during clinical follow-up.
Cartilage ; Cartilage, Articular* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Osteophyte ; Ultrasonography* ; Volunteers

Fibrosarcoma of the ovary is an exceedingly rare primary ovarian stromal tumor, which has a poor prognosis. Fibrosarcoma may arise de novo or as a result of malignant change in a benign fibromatous or fibrothecomatous tumor of the ovary. There are only about 30 cases in the literature reported within past three decades, showing the extreme rarity of these tumors. We report a case of primary ovarian fibrosarcoma with a review of the available literature.
Female ; Fibrosarcoma* ; Ovary ; Prognosis

A liposarcoma is the most common soft tissue sarcoma in adults with an incidence of betwen 9.8 and 16% of all soft tissue sarcomas. Among the various histological types, a dedifferentiated liposarcoma has rarely been reported. We experienced a case of a giant 7 kg dedifferentiated liposarcoma arising in the mesentery of a 57-year old male patient. Abdominal computed tomography showed a huge lipoid mass occupying the whole abdomen. A surgical excision was carried out. Histologically, the tumor was composed of a well-differentiated liposarcomatous area and a leiomyosarcoma-like dedifferentiated area. The authors reviewed the prognostic factors and treatments for a liposarcoma.
Abdomen ; Adult ; Humans ; Incidence ; Liposarcoma* ; Male ; Mesentery* ; Sarcoma

A liposarcoma is the most common soft tissue sarcoma in adults with an incidence of betwen 9.8 and 16% of all soft tissue sarcomas. Among the various histological types, a dedifferentiated liposarcoma has rarely been reported. We experienced a case of a giant 7 kg dedifferentiated liposarcoma arising in the mesentery of a 57-year old male patient. Abdominal computed tomography showed a huge lipoid mass occupying the whole abdomen. A surgical excision was carried out. Histologically, the tumor was composed of a well-differentiated liposarcomatous area and a leiomyosarcoma-like dedifferentiated area. The authors reviewed the prognostic factors and treatments for a liposarcoma.
Abdomen ; Adult ; Humans ; Incidence ; Liposarcoma* ; Male ; Mesentery* ; Sarcoma