Present study aimed to investigate the immunological activities of cell wall associated protein antigen solubilized with Triton X-100 (TSP) from Mycobacterium tuberculosis H37Rv and conducted on 43 patients with pulmonary tuberculosis (newly diagnosed, medicated within 12 months and chronic refractory patients) and 17 normal healthy controls. These immunological responses were compared with those induced by the PPD or 30 kDa antigen from M, tuberculosis H37Rv culture filtrates, identified as biologically important secreted proteins. Proliferative responses to mycobacterial antigens were compared in peripheral blood mononuclear cells (PBMC) of healthy subjects and pulmonary tuberculosis patients. Signiticant blastogenic responses to the TSP were observed in healthy tuberculin reactors, newly diagnosed and some of antituberculosis drug-medicated patients by H-thymidine incorporation assay. IL-12 p40 and IFN-r mRNA expressions to the TSP were markedly increased, whereas IL-10 and TNF-a mRNA expressions were decreased at a 5 day-stimulation by PBMC in healthy tuberculin reactors, newly diagnosed and medicated patients. However, patients with chronic refractory tuberculosis exhibited more depressed IL-12 p40 and IFN-r mRNA expressions to all of the antigens than another groups. Interestingly, very low IL-10 and TNF-a mRNA expressions cultured with the TSP were also shown. These data suggest that the TSP may be involved in the macrophage activation by induction of Th1 stimulatory signals, such as IL-12, and suppression of Th1 inhibitory cytokine, IL-10.
Tumor Necrosis Factor-alpha

OBJECTIVES: This study was conducted to assess the development of posttraumatic stress disorder (PTSD) after occupational physical injuries and the risk factors in occupational accident patients for PTSD. METHODS: Forty-seven occupational accident patients with physical injuries were administered BDI, STAI I and II, SCL-90-R, IES and questionnaires for risk factors and Clinician-Administered PTSD Scale(CAPS). RESULTS: 1) 12 patients(25%) were diagnosed as PTSD. 2) The BDI, STAI I and II and IES scores are significantly high(<0.05) in PTSD group than non-PTSD group. 3) The subscales of SCL-90-R, with an exception of PAR subscale, showed higher scores(<0.05) in PTSD group. 4) The loss of consciousness(LOC) was only significant risk factor in the occupational accident-related factors(<0.05). CONCLUSION: The results of this study show the development of PTSD among occupational accident patients. The loss of consciousness(LOC) was the only signiticant risk factor for PTSD in occupational accident patients.
Accidents, Occupational* ; Humans ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

The actions and side effcts of the benzodiazepine antagonist flumazenil were evaluated in a clinical study in which midazolam was used as an anesthetir induction agent. Anesthesia was maintained with nitrous oxide-oxygen-fentanyl. Sixty-five adult surgical patients received either 0.3 mg (3 ml) of flumazenil (33 cases) or 3 ml of saline (32 cases) at the conclusion of surgery. Blood pressure, pulse rate, and respiratory rate were checked before premedication, just before, 5 minutes, 30 minutes, and 120 minutes after the administration flumazenil or saline. Also level of consciouseness, orientation in time and space, and cooperativeness along with end tidal carbon dioxide and hemoglobin oxygen saturation were evaluated. Various larboratory parameters were checked before premedication and 24 hours after operation. The results were as follows: 1) The flumazenil group revealed improved level of consciousness, orientation in time and space, and cooperativeness which began just after the administration, and was maintained 30 minutes thereafter. 2) There was no difference in the changes of laboratory parameters between the two groups. 3) The changes of blood pressure, pulse rate, respiratory rate, and SaO2 showed no difference between those two groups. 4) The end tidal concentrations of carbon dioxide after drug administration were significantly lower in the flumazenil group than those of the saline group. 5) Tolerance to flumazenil (0.3 mg) was good without any side effect.
Adult ; Anesthesia* ; Benzodiazepines ; Blood Pressure ; Carbon Dioxide ; Consciousness ; Flumazenil* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication ; Respiratory Rate

To evaluate the relationship between arterial and ent tidal carbon dioxide teneion, we use ETCO2cuffed tracheal tude. Twenty five patients were selected for the study. The anesthesia was induced by pentothal sodium 4-5mg/kg, succinylcholine 1-1.5mg/kg After intubation, anesthesia was maintained by halothane, nitrous oxide and oxygen. The patients were ventilated mechanically with tidal bolume 10 ml/kg and respiration rate 12/min When anesthesia was stabilized, end tidal cardon dioxide tension were measured at proximal and distal site of ETO2cuffed tracheal tube. The arterial blood sample were taken for arterial carbon dioxide tension from radial artery simultaneously. The results were as follows: 1) Both the end tidal carbon dioxide tension at proximal and distal sites of the tube showed close correlationship with arterial carbon dioxide tension 2) There was no statistical significant difference in carbon dioxide tension between proximal and distal site of ETCO2cuffed tracheal tube.
Anesthesia ; Carbon Dioxide ; Halothane ; Humans ; Intubation ; Nitrous Oxide ; Oxygen ; Radial Artery ; Respiratory Rate ; Sodium ; Succinylcholine ; Thiopental

Bovine tuberculosis, which is caused by Mycobacterium bovis, a member of the M. tuberculosis complex, is a zoonosis transmitted through the inhalation of infected droplets or the ingestion of raw milk. Human bovine tuberculosis has been reported rarely in most countries since the introduction of pasteurized milk and M. bovis eradication programs. However, it has been reported in other areas with poorly controlled programs. We encountered a case of localized empyema due to M. bovis infection in a pregnant female immigrant from Vietnam. We report this case with a brief review of the related literature.
Eating ; Emigrants and Immigrants ; Empyema ; Female ; Humans ; Inhalation ; Milk ; Mycobacterium ; Mycobacterium bovis ; Tuberculosis ; Tuberculosis, Bovine ; Vietnam

Bovine tuberculosis, which is caused by Mycobacterium bovis, a member of the M. tuberculosis complex, is a zoonosis transmitted through the inhalation of infected droplets or the ingestion of raw milk. Human bovine tuberculosis has been reported rarely in most countries since the introduction of pasteurized milk and M. bovis eradication programs. However, it has been reported in other areas with poorly controlled programs. We encountered a case of localized empyema due to M. bovis infection in a pregnant female immigrant from Vietnam. We report this case with a brief review of the related literature.
Eating ; Emigrants and Immigrants ; Empyema ; Female ; Humans ; Inhalation ; Milk ; Mycobacterium ; Mycobacterium bovis ; Tuberculosis ; Tuberculosis, Bovine ; Vietnam

The effect of fentanyl on arterial pressure and heart rate during laryngoscopy and intubation was studied in 40 adult normotensive patients. Two groups of 20 patients were observed. Patients received thiopental sodium 5 mg/kg (contal group) or fentanyl 2 ug/kg with thiopental 5 mg/kg (fentanyl group) for induction of anesthesia. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) were measured during the preinduction period, before thiopental (or thiopental+fentanyl), after succinylcholine, immediately after intubation and 5 minutes after intubation. The values were compared with preinduction control values. The results were as follows: The contro#l group showed a significant inerease of SBP, DBP and MAP (p<0.001) but no significant increase was noted in the fentanyl group with tracheal intubation. DBP and MAP returned to normal within 5 minutes and SBP decreased significantly (p<0.05). Significant heart rate elevation following intubation was observed in both groups. It is suggested from the above results that pretreatment with fentanyl 2 g/kg reduce the blood pressure elevation following intubation but dose not prevent the elevation of heart rate.
Adult ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Fentanyl* ; Heart Rate ; Humans ; Intubation* ; Laryngoscopy* ; Succinylcholine ; Thiopental

The Iinvolvement of subaortic structures in the aortic valve endocarditis appears more commonly than previously recognized. These subaortic complications are most commonly located in the mitral-aortic intervalvular fibrosa and may be presented as abscess, or as pseudoaneurysm with or without perforation. Perforated pseudoaneurysm can lead to the development of communication between the left ventricular outflow tract and various cardiac chambers, most commonly the left atrium. These complications are related with poor prognosis. Early and precise recognition of these complications is important for optimal treatment. At present, transesophageal echocardiography (TEE) has been validated as the technique of choice. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa featuring the connection of the fistulous simultaneously to the left atrium and aorta. In our case, accurate interpretation of TEE imaging revealing the subaortic structures was not so easy due to interference of both aortic and mitral prosthetic valves. We expect the further development of (Ed-confirming that here you don't intend, "We expect to further develop") TEE and other imaging modalities to substantially improve the future diagnosis of these undesirable complications.
Abscess ; Aneurysm, False* ; Aorta ; Aortic Valve* ; Diagnosis ; Echocardiography, Transesophageal ; Endocarditis* ; Fistula* ; Heart Atria ; Prognosis

We report a 45-year-old man with type 2 diabetes who presented with recurrent hypoglycemia. Biochemical and imagingstudies did not show any mass-like lesion in the pancreas, so prednisolone and diazoxide were administered for the treatment of hypoglycemia. However, the hypoglycemia persisted during and after the medical treatment. A selective arterial calcium stimulation test was performed and revealed a suspicious lesion at the head of the pancreas. The patient underwent enucleation of the pancreas head lesion. The lesion was confirmed histologically to be focal nesidioblastosis and surgical resection was successfully performed. The patient showed no hypoglycemic symptoms postoperatively.
Calcium ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diazoxide ; Head ; Humans ; Hypoglycemia ; Middle Aged ; Nesidioblastosis ; Pancreas ; Prednisolone

The mandibular canal divides into the mental and incisive canals at the premolar region, forms the anterior loop which crosses anterior to the mental foramen, and turns back to reach the mental foramen. The aim of this study was to elucidate the general anatomical structure of the anterior loop of the mandibular canal using morphometry. Twenty-six hemimandibles from 19 cadavers (16 males, 3 females; mean age at death, 54.4 years) were studied by meticulous dissection with the aid of a surgical microscope. The location of the anterior loop, the diameters of the mandibular, mental, and incisive canals, and their distances from bony landmarks were measured using digital calipers. The anterior loop of the mandibular canal was located 3.05+/-1.15 mm (mean+/-SD) anterior to the anterior margin of the mental foramen and 2.72+/-1.41 mm inferior to the superior margin of the mental foramen, and was 4.34+/-1.46 mm long. The diameters of the mandibular, mental, and incisive canals were 2.8+/-0.49, 2.63+/-0.64, and 2.22+/-0.59 mm, respectively. The distances between the inferior border of the mandible and each of these canals were 7.82+/-1.52, 10.11+/-1.27, and 9.08+/-1.66 mm, respectively. The anterior loop of the mandibular canal was located a mean of 3.1 mm anterior and 2.7 mm inferior to the mental foramen, and continued upward and backward into the mental canal, and forward into the incisive canal. These detailed morphological features of the anterior loop of the mandibular canal represent useful practical anatomical knowledge regarding the interforaminal region.
Bicuspid ; Cadaver ; Female ; Humans ; Male ; Mandible