BACKGROUND: Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. the development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. METHOD: A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation(Etheophyl®) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. the patients were subsequently switched to the once-daily preparation(Uniphyl®) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. RESULTS: the mean serum levels of theophylline were 8.18±1.66µg/ml in the Etheophyl®-treated period and 8.00±1.75µg/ml in the Uniphyl®-treated period. In addition, the FEV1 showed 71.40±7.48 percent in the Etheophyl®-treated and 69.18±9.00 percent in the Uniphyl®-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. CONCLUSION: The results indicated little clinical differences between the two medication. The two drugs are equally effective in controlling asthma over the four weeks of treatment.
Adult ; Asthma* ; Cross-Over Studies ; Female ; Humans ; Male ; Theophylline

BACKGROUND: Colistin (polymyxin E) is active against multidrug-resistant Gram-negative bacteria (MDR-GNB). However, the effectiveness of inhaled colistin is unclear. This study was designed to assess the effectiveness and safety of aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) caused by MDR-GNB. METHODS: In this retrospective longitudinal study, we evaluated the medical records of 63 patients who received aerosolized colistin treatment for VAP caused by MDR-GNB in the medical intensive care unit (MICU) from February 2012 to March 2014. RESULTS: A total of 25 patients with VAP caused by MDR-GNB were included in this study. The negative conversion rate was 84.6% after treatment, and acute kidney injury (AKI) occurred in 11 patients (44%, AKI group). The average length of MICU stay and colistin treatment- related factors, such as daily and total cumulative doses and administration period, were not significantly different between groups. In-hospital mortality tended to be higher in the AKI group (p = 0.07). Multivariate analysis showed that a body mass index less than 18 was an independent risk factor of mortality (odds ratio [OR] = 21.95, 95% confidence interval [CI] 1.59-302.23; p = 0.02). Notably, AKI occurrence was closely related to the administration of more than two nephrotoxic drugs combined with aerosolized colistin (OR = 15.03, 95% CI 1.40-161.76; p = 0.025) and septic shock (OR = 8.10, 95% CI 1.40-161.76; p = 0.04). CONCLUSIONS: The use of adjunctive aerosolized colistin treatment appears to be a relatively safe and effective option for the treatment of VAP caused by MDR-GNB. However, more research on the concomitant use of nephrotoxic drugs with aerosolized colistin will be necessary, as this can be an important risk factor of development of AKI.
Acute Kidney Injury ; Body Mass Index ; Colistin* ; Drug Resistance, Microbial ; Gram-Negative Bacteria ; Hospital Mortality ; Humans ; Intensive Care Units ; Longitudinal Studies ; Medical Records ; Mortality ; Multivariate Analysis ; Pneumonia* ; Pneumonia, Ventilator-Associated ; Retrospective Studies ; Risk Factors ; Shock, Septic ; Treatment Outcome*

No abstract available.
Epinephrine*

No abstract available.
Epinephrine*

OBJECTIVE: The purpose of this study was to evaluate the survival rate of vitrified blastocyst according to the freezing vessels, equilibration time in cryoprotectant and artificial dehydration method. METHODS: Human blastocysts were vitrified after loading onto the plastic straw, open-pulled straw (OPS), electron microscopy grid (EM grid) for 1.5 min or 3 min. They also were directly plunged into LN2 within 30sec. For artificial shrinkage of blastocysts, 36 gauge fine needle was pushed at the cellular junction of the trophectoderm into the blstocoele cavity until it shrank without damage of inner cell mass. RESULTS: The survival rate of vitrified blastocysts on plastic straw, OPS, EM grid as freezing vessels were 26.7, 13.0 and 60.5%, respectively. The survival rate of EM grid was significantly higher than that of plastic straw and OPS (p<0.05). For 1.5 min equilibrium, the survival rates of early blastocyst (EB), middle blastocyst (MB) and late blastocyst (LB) were 64.4, 81.0, and 20.0% respectively. For 3 min equilibrium, the survival rates of EB, MB, and LB were 69.9, 50.0 and 57.5% respectively. The survival rates of EB and MB were significantly higher than that of LB in 1.5 min equilibrium group (p<0.05), however, the significance was not observed in 3 min equilibrium groups. In cytoplasmic shrinkage before vitrification, the survival rates of EB, MB and LB were 92.9, 100 and 75.9% respectively. The survival rate of MB was significantly higher than that of LB (p<0.05). The survival rates of vitrified blastocysts by artificial dehydration and slow-frozen blastocysts were not significantly different as 88.9 and 66.7%, respectively. CONCLUSION: This study showed that the vitrification of human blastocysts using EM grid and artificial dehydration is an effective method. Therefore, these methods would be an useful techniques for blastocyst cryopreservation.
Blastocyst* ; Cryopreservation ; Cytoplasm ; Dehydration ; Freezing ; Humans* ; Microscopy, Electron ; Needles ; Plastics ; Survival Rate ; Vitrification*

Vaginal intraepithelial neoplasia III, is a relatively rare disease. Consequently standard treatments for this disease were not established until recently. Although several convenient methods, such as laser ablation, 5-fluorouracil topical injection, and radiation therapy, have been applied for treating these lesions, surgical treatments, including vaginectomy, have not yet been attempted, as they would likely be accompanied by technical difficulties and various complications. Herein, we report a case of refractory vaginal intraepithelial neoplasia III in the vaginal vault that was successfully treated with a total vaginectomy.
Fluorouracil ; Laser Therapy ; Rare Diseases

OBJECTIVE: This study was conducted to investigate the effect of vitrification on the implantation the pregnancy of human blastocysts. METHOD: The transfer of the frozen-thawed blastocysts by the slow freezing or vitrification was performed between January 1998 and July 1999. The zygotes derives from IVF were cocultured with cumulus cells in YS medium containing 20% hFF for 5days. Two or three of the best balstocysts produced on day 5 were transferred into the uterus, and then supernumerary blastocysts were randomly divided into two groups. One was frozen by slow freezing and the other was frozen by vitrification method. The slow freezing procedure was performed in two steps (5% glycerol and 9% glycerol + 0.2 M sucrose for 10 min, respectively) using programmed freezer (-2degrees C/min to -7degrees C, 0.3degrees C and plunged into LN2). The blastocysts frozen by slow freezing were thawed at 36degrees C then removed glycerol in 7 steps. The vitrification procedure was performed in three steps (10% glycerol for 5 min, 10% glycerol + 20% ethylene glycol for 5 min, 25% glycerol + 25% ethylene glycol and directly LN2 within 1 min). The blastocysts frozen by vitrification were thawed at 20degrees C water then removed cryoprotectant in 3 steps. In each group, thawed blastocysts were cocultured with cumulus cells in YS medium containing 20% hFF for 18h and transferred into the uterus. The implantation rate was evaluated per transferred blastocysts and the pregnancy rate was evaluated per transfers. RESULTS: The survival rate of vitrified group (74.5%) was higher than slow freezing group (68.0%), but not significant. When 98 thawed blastocysts of vitrification were transferred in 40 cycles, 19 pregnancies (clinical pregnancy rate; 47.5%) were established. One miscarriage occurred in the eighth week of pregnancy (ongoing pregnancy rate; 45.0%). 7 pregnancies were ongoing, 11 pregnancies went to term, and 16 healthy infants were born. The Implantation rate was 31.6%. These results were higher than those obtained by the slow freezing (clinical pregnancy rate; 40.3%, ongoing pregnancy rate; 32.5% and implantation rate; 25.3%), but not significant. CONCLUSION: Vitrification is a simple, quick and economical method when compared to slow freezing. It will be chosen as a good method of human embryo freezing in IVF-ET programs.
Abortion, Spontaneous ; Blastocyst* ; Cumulus Cells ; Embryonic Structures ; Ethylene Glycol ; Female ; Freezing ; Glycerol ; Humans ; Infant ; Pregnancy Rate ; Pregnancy* ; Sucrose ; Survival Rate ; Uterus ; Vitrification* ; Water ; Zygote

Mycoplasma pneumoniae and Chlamydia pneumoniae have been suggested to take part in the acute exacerbation of bronchial asthma and chronic obstructive pulmonary disease (COPD). Several studies have questioned whether they may play pathogenic roles in connection with bronchial asthma and COPD. This study was designed to evaluate the seroprevalences of M. pneumoniae and C. pneumoniae in stable asthma and COPD patients, and to compare with control patients. The medical records of one hundred forty patients who underwent M. pneumoniae and C. pneumoniae serology were retrospectively reviewed. Seroprevalences of M. pneumoniae and C. pneumoniae in the asthma group (11.1% and 8.3%, respectively) were higher than in the control group (4.4% and 2.2%, respectively) without statistical significance. The seroprevalence of M. pneumoniae in the COPD group (16.9%) was significantly higher than in the control group, and the seroprevalence of C. pneumoniae in the COPD group (3.4%) was higher than in the control group without statistical significance. This study raises important questions about the relation of M. pneumoniae and C. pneumoniae infection with stable asthma or COPD.
Adult ; Aged ; Asthma/*microbiology ; Chlamydophila Infections/*epidemiology ; Chlamydophila pneumoniae/immunology ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Mycoplasma/*epidemiology ; Pulmonary Disease, Chronic Obstructive/*microbiology ; Seroepidemiologic Studies

Gastric motility is controlled by gastric myoelectrical activity, which propagates from the proximal body to the distal antrum at a frequency of 3 cycles per minute(cpm). Peritoneal infusion of dialysate may influence on gastric motility in continuous ambulatory peritoneal dialysis(CAPD) patients. To investigate the concentration of dialysate affects the gastric myoelectrical activity in CAPD patients, we performed electrogastrographic studies(EGG) in 13 non-diabetic CAPD patients. EGG was measured noninvasively using abdominal surface electrodes at the fasting state at empty and 2 hours after 1.5% and 4.25% 2,000mL dialysate, respectively. The dominant power (DP) and the percentage of normal slow-wave frequency(NSWF) had significantly decreased after 4.25 % infusion than the baseline. Tachygastria had significantly increased after 4.25% infusion. Changes in the gastric myoelectrical activity after 1.5% was less prominent than that of 4.25%. In conclusion, peritoneal dialysis may influence on gastric myoelectrical activity and higher osmolar solution may more aggrevate gastric myoelectrical activity than lower one.
Electrodes ; Fasting ; Humans ; Infusions, Parenteral ; Ovum ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory*

Heteratopic or ectopic pancreas is found in 0.5% to 13% autopsy series and also found one in approximately every 500 operations in abdominal surgery. The mast common sites are stomach (esp, greater curvature of the antrum), duodenum and proximal jejunum. Many ar most of these lesions do not cause clinical symptoms and the symptoms with heterotopie pancreas are nonspecific. When it produces complication(hemorrhage, pancreatitis, pyloric or CBD obstruction, pseudocyst, cancer etc.), the symytoms depend on the site of lesion, the size of mass, and the primary pathologic processes occurring within the heterotopic pancreatic tissue. Gaetrofiberoscopy revealed a small round, submucosal projection with a central niche or umblication, but this characteristic umbilication is not always present. The lesions are frequently confused with polyp, leiomyoma, intramural neoplasm, gastric ulcer and early gastric cancer, The tumors are predominantly intramural masses; 75 percent are submuicosal and the others are either intrsmuscular or subserosal. We have recently experienced a case of heterotopic pancreas on the antrum of greater curvature of stomach in 54-year-old man, who visited our hospital for melena. Gastrofiberoscopy revealed a 2 x 2 cm sized submucosal mass without bleeding focus and local excision was performed. Histologic finding showed a pancreatic acini within the gastric poper muscle layer.
Autopsy ; Duodenum ; Hemorrhage ; Humans ; Jejunum ; Leiomyoma ; Melena ; Middle Aged ; Pancreas* ; Pancreatitis ; Pathologic Processes ; Polyps ; Stomach ; Stomach Neoplasms ; Ulcer