The objective of this study was to clarify the different inhibitory effects against necrosis according to the injection time of hydrocortisone on adriamycin extravasated wounds. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Thus, many studies on the prevention and alleviation of this tissue injury have been made. However, a comparative study on the inhibitory effect of antidots according to the injection time after extravasation of chemotherapeutic agents has not yet been made. We compared the effect of hydrocortisone succinate on adriamycin-induced tissue necrosis according to its injection time. Sixty mature male Sprague-Dawley rats were divided into 6 groups and each group contained 10 rats. Administration of adriamycin(1.0mg/ml) 0.5ml by subcutaneous injection on the dorsal side of the rats was followed by injection of hydrocortisone succinate(20mg/ml) 0.5ml on the same site according to a time protocol. Group 1(the co-ntrol group): adriamycin injection only; gorup 2(the normal saline group): injection of normal saline 30 minutes after adriamycin injection; group 3: injection of hydrocortisone 30 minutes after adriamycin injection; group 4: injection of hydrocortisone 6 hours after adriamycin injection; group 5: injection of hydrocortisone one day after adriamycin injection; group 6: injection of hydrocortisone 3 days after adriamycin injection. Mean areas of ulcer, measured in mm2, which developed 4 week after adriamycin injection were as follows; group 1 (the control group): 67.3; group 2(the normal saline group):44.8; group 3: 12.9; group 4: 18.9; group 5: 46.7; group 6:72.0. Significant differences among the groups were noted. The groups which received hydrocortisone injection showed smaller ulcers compared to the control group or the normal saline group. As well, earlier injection time correlated with smaller ulcer formation. These findings showed the inhibitory effect of hydrocortisone succinate on tissue damage caused by adriamycin, as well as the increased effectiveness of the inhibitory effect when earlier injections were made. An analysis of this study can be applied in clinical situations for extravasation of adriamycin by administering proper agents such as hydrocortisone succinate. The administration of these agents will also help to minimize tissue necrosis.
Animals ; Doxorubicin ; Humans ; Hydrocortisone* ; Injections, Subcutaneous ; Male ; Necrosis* ; Rats ; Rats, Sprague-Dawley ; Skin ; Succinic Acid ; Ulcer ; Wounds and Injuries

No abstract available.
Clone Cells* ; Cloning, Organism* ; Nucleopolyhedrovirus*

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

The purpose of this study was to investigate the effects of the Co-60 gamma irradiation on the osseointegration. 2.0 mm titanium alloy screw implants were placed in the tibial metaphysis of the rabbits, bilaterally. The mean length of the implants was 6.0 mm. The right tibia was irradiated with a single dose of 15 Gy from 60Co teletherapic machine at 5th postoperative day. The experimental group was irradiated tibia. The control group was non-irradiated tibia. To observe the phase of bone formation, the bone labeling by intramuscular injection of 20mg/Kg of Tetracycline, Calcein, Alizarin red S, was performed. The rabbits were sacrificed on the 1st, 2nd, 4th, 6th, 8th week and the tibia including implants were taken, and then the specimens were examined by the microradiography, light microscopy, and fluorescent microscopy. The obtained results were as follows; 1. There were connective tissue between bone and titanium at 1st week, in both group. Especially, the many empty lacunae without nucleus and obscure cytoplasm in experimental group, were observed. 2. The osteons were observed at 4th week in control group, and at 6th week in experimental group. The bone formation in experimental group was retarded as compared to the control group. 3. In fluorescent microscopy, bone labelling band was observed as linear, arc or concentric shape. Occasionary interrupted labelling band was observed, which is demonstrated bone remodeling. 4. In microradiographic examination, the radiolucent image was found between bone and implant with widening of bone marrow spaces as compared to the control group.
Alloys ; Bone Marrow ; Bone Remodeling ; Connective Tissue ; Cytoplasm ; Haversian System ; Injections, Intramuscular ; Microradiography ; Microscopy ; Osseointegration* ; Osteogenesis ; Rabbits ; Tetracycline ; Tibia ; Titanium

PURPOSE: To investigate the effect of vertical deviation change, head tilt and diplopia relief, we performed a minimal amount of inferior oblique recession regardless of the vertical deviation angle and the degree of inferior oblique overaction (IOOA) in superior oblique palsy patients. METHODS: We retrospectively analyzed 20 cases of unilateral congenital or acquired superior oblique palsy, which were treated with inferior oblique muscle recession from May 2005, to August 2007. We compared vertical deviation change, head tilt and diplopia relief following surgery. Improvement of head tilt was determined by patient satisfaction measurements. The inferior oblique muscle was attached 4 mm posterior and 2 mm temporal to the lateral border of the inferior rectus muscle insertion in all patients. RESULTS: The average angle of vertical deviation prior to surgery was 12.4 prism diopters (PD), and the total average correction in the angle of vertical deviation after surgery was 9.6PD. After surgery, head tilt improved in 13 of 16 eyes(81%), and of the four remaining eyes, vertical diplopia was absent. CONCLUSIONS: Although vertical deviation remained after surgery, if patients have enough vertical fusional amplitude, they should be able to overcome the diplopia and the head tilt. Judging from the indication of inferior oblique recession in diplopia and cosmetic problem in superior oblique palsy, a minimal amount of inferior oblique recession is thought to be an effective treatment of unilateral superioroblique palsy with no significant IOOA.
Cosmetics ; Diplopia ; Eye ; Head ; Humans ; Muscles ; Paralysis ; Patient Satisfaction ; Retrospective Studies

41 cases of complicated cataract in leprosy patients were operated on from May 1989 to March 1990 at National Sorok Island Hospital. In all cases, extracapsular cataract extraction was attempted and sector or peripheral iridectomy was performed. Inferior sphincterotomy was not done in any of the cases. The postoperative results were very satisfactory in most of the operating cases. The results are as follows; 1) Corrected vision above 0.1 was obtained in 29 eyes(70.7%). 2) Corrected vision from F.C. to 0.09 was obtained in 8 eyes(19.5%). 3) Corrected vision below H.M. was obtained in 4 eyes(9.8%). 4) 37 eyes(90.2%) among the total 41 showed an improvement of corrected vision.
Cataract Extraction ; Cataract* ; Humans ; Iridectomy ; Leprosy*

Female ; Follow-Up Studies ; Humans ; Male ; Mandibular Condyle ; Mouth ; Prognosis ; Surgery, Plastic

No abstract available.
Appendicitis* ; Purpura, Schoenlein-Henoch*

In the present study, the authors investigated the management of mechanical valve thrombosis (MVT). From January 1981 through March 2006, 2,908 mechanical valve replacements were performed in 2,298 patients at our institution. Twenty (0.87%) patients presented with MVT, 14 (70.0%) were women, and the mean age of the patients was 42.0+/-14.0 (27-66) yr. Thrombosis involved mitral in 14 (70.0%), aortic in 2 (10.0%), tricuspid/aortic in 1 (5%), and tricuspid in 3 (15%). The interval from first operation to valve thrombosis was 121.8+/-75.4 (0.9-284.7) months. The most frequent clinical presentation was heart failure (13/20, 65%), and predisposing causes of MVT were: poor compliance with warfarin (7), pregnancy (5), drug interaction (2), and unknown (6). All 20 patients underwent valve replacement: mitral (14, 70.0%), tricuspid (3, 15.0%), aortic (2, 10%) and tricuspid/aortic (1, 5%). One early death occurred due to left ventricular failure, but no late mortality occurred during 63.3+/-49.9 (0.5-165.1) months of follow-up. MVT was treated successfully, and pregnancy and inadequate anticoagulation were found to influence the occurrence of this rare complication.
Adult ; Aged ; Anticoagulants/therapeutic use ; Coronary Thrombosis/drug therapy/*mortality/*surgery ; Drug Interactions ; Female ; Follow-Up Studies ; Heart Valve Prosthesis/*adverse effects/*statistics & numerical data ; Heparin/therapeutic use ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Patient Compliance ; Postoperative Complications/drug therapy/*mortality/*surgery ; Pregnancy ; Pregnancy Complications/mortality ; Recurrence ; Reoperation/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Thrombolytic Therapy ; Warfarin/therapeutic use

OBJECTIVE: Our objective was (1) to determine if serum creatine kinase (CK) activity is reduced in rheumatoid arthritis (RA) compared with that of noninflammatory rheumatic diseases, (2) to examine the recently described association of low CK activity and disease variables in our RA population, and (3) to examine the influence of steroid on serum CK activity in patients with RA. METHODS: Cross sectional and longitudinal retrospective analyses of clinical and biochemical data of consecutive patients with RA and noninflammatory arthropathies. In all subjects we evaulated age, sex, weight, and, only for patients with RA, history of use of corticosteroids and Ritchie index. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin, and platelet count were simultaneously determined as variables of disease activity. CK activity was determined by automated biochemical analyzer (Hitachi 747, Japan). RESULTS: Serum CK activity was significantly reduced in RA (mean+SD: 45.7 +24.2 IU/L) compared to controls (81.3+33.9 IU/L) (p < 0.001). Ritchie index, CRP, and platelet count correlated inversely with CK values (correlation coefficient: 0.31, p < 0.01; 0. 45, p < 0.001; 0.42, p < 0.001, respectively). Patients taking steroids had lower CK activity than those without steroid, but not statistically significant.
Adrenal Cortex Hormones ; Arthritis, Rheumatoid* ; Blood Sedimentation ; C-Reactive Protein ; Creatine Kinase* ; Creatine* ; Humans ; Platelet Count ; Retrospective Studies ; Rheumatic Diseases ; Steroids