With the aim of establishing bio-indices for the development of multistep hepatotumorigenesis, rats were fed water containing 0.01% diethylnitrosamine (DEN) ad libitum for 13 weeks. This treatment with DEN only made it possible to induce hepatic tumors in 100%. After the DEN administration, several clinical symptoms were observed including minor behavioral changes, brittleness of hair and a decrease in water and food intake. The concentration of total serum protein and albumin in all treated groups was significantly lower than in non-treated controls (p<0.05). Increase of specific enzyme (AST, ALT and GGT) activity (p<0.05), variable tumor size and hepatomegaly of the liver was observed in all rats treated with DEN for 10 weeks. Both hepatocellular carcinoma and cholangiocarcinoma were found in the same livers at the same time, and were prominently developed after 12 weeks. In case of carcinoma, some of the livers showed more or less advanced states over the 12-15 weeks period. In the present study, hepatocellular carcinoma was developed by treating DEN in only the drinking water, without any other carcinogens or without partial hepatectomy. These results indicate that DEN is a new carcinogen that acts directly on it the liver, moreover, it might be very useful for investigating hepatotumorigenesis.
Alanine Transaminase/blood ; Animals ; Aspartate Aminotransferases/blood ; Biological Markers/blood ; Carcinogens ; *Cell Transformation, Neoplastic ; Diethylnitrosamine/toxicity ; Liver/drug effects/*pathology ; Liver Neoplasms/blood/chemically induced/*pathology ; Liver Neoplasms, Experimental/blood/*pathology ; Male ; Rats ; Rats, Sprague-Dawley ; gamma-Glutamyltransferase/blood

We report one case of implant plate exposure after Ahmed valve implantation, treated with preserved fascia lata transplantation. Exposure of implant occurred in 47-year-old patient with Ahmed glaucoma valve implantation. She was treated with preserved fascia lata graft and amniotic membrane transplantation. No recurrent implant plate exposure has been found since then. Intraocular pressure has been maintained well for 3 months of follow-up. In cases of implant plate exposure, additional preserved fascia lata graft and amniotic membrane transplantation can improve surgical success.
Amnion ; Fascia ; Fascia Lata ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Middle Aged ; Transplants

OBJECTIVES: Anticardiolipin antibody (ACA) and lupus anticoagulant (LA) are acquired antiphospholipid antibodies (APAs), which are regarded as important risk factors far vascular thrombosis and recurrent fetal loss. Although the clinical relevance of APAs in dialysis patients is uncertain, recent studies have suggested that APAs are involved in bioincompatibility and thrombogenic complications in hemadialysis (HD) patients. METHOD: We performed a cross sectional study of ACA and LA in 50 stable HD patients and their 68 vascular accesses (52 native arteriovenous fistulae and 16 synthetic arterovenous grafts), with the analysis of factors associated with the presence of APAs and the retrospective evaluation of vascular access occlusion (VAO). LA was assessed by platelet neutralization method whereas IgG-ACA was measured by a solid phase ELISA. Values higher than 23GPLU/ml (IgG phospholipid units) were considered to be positive for IgG-ACA and positive values for LA was more than 8 seconds in prolongation of the clotting time with human platelet lysate. Vascular access survival was assessed by Kaplan- Meier method, RESULTS: The mean age of the subject (M:F 21:29) was 46 years and the mean duration of hemodialysis was 49 months. The frequency of VAO in entire subjects was 0.45+/-0.98 episodes/patient year. The median value of IgG-ACA was 16.0 GPLU/ml with a distribution from 2.7 to 46.1GPLU/ ml. The median titer of I.A was 4.5 (3.1-45.6) seconds. Fourteen patients (28%) were found to have at least one episode of VAO. In spite of comparable clinical and biochemical data according to the presence of VAO, the titers of IgG-ACA (13.6+/-7.7 vs, 20.3+/-8.7GPLIJ/ml, P<0.05) and LA (4.5+/-2.9 vs. 11.7 +/-12.6sec, P<0.05) were significantly higher in VAO group. Six out of 50 patients(12%) had an increased titer of IgG-ACA and LA was found in 11 patients(22%). No patients were positive for ACA and LA simultaneously. There was no significant difference in sex, etiology of ESRD, diabetic status, the dosage of heparin during HD or the amount of erythropoietin administered according to the presence of APAs. We could not find any significant correlation between the titer of APAs and age, duration of dialysis, blood pressure, platelet count and biochemical parameters. In the patients with positive ACA, the frequency of VAO was 1.05+/-0.12 episodes/patient year, which was significantly higher than patients without ACA (0.33+/-0.17 episodes/ patient year, P<0.05). In the patients with the presence of LA(1.06+/-0.43 vs. 0.12+/-0.06 episodes/ patients year, P<0.01). The median vascular access survival time in IgG-ACA positive patients (32.7 months) was significantly decreased compared to 66.8 months in IgG-ACA negative group. CONCLUSION: Our data suggest that the presence of APAs (ACA and/or LA) affects the event-free vascular access survival in HD patients. Therefore the evaluation of APAs status have to be included in the diagnostic strategies for the patients with recurrent VAO. Further studies are necessary to explore the pharmacologic intervention method to decrease APAs and prevent VAO in HD patients.
Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Arteriovenous Fistula ; Blood Platelets ; Blood Pressure ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; Heparin ; Humans ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor* ; Platelet Count ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis

OBJECTIVES: This study aims to analyze the association between the severity of sleep apnea, sleep and mood related scales, and activity during sleep in obstructive sleep apnea syndrome (OSAS) patients. METHODS: One hundred seventy six drug-free male patients confirmed as OSAS (average age=43+/-11 years) were selected through nocturnal polysomnography (NPSG). OSAS was diagnosed with apnea-hypopnea index (AHI) >5, mean AHI was 39.6+/-26.0. Sleep related scales were Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI) and Morningness-Eveningness Scale (MES). Mood related scales were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI) I, II and Profile of Mood States (POMS). NPSG was performed overnight with both wrist actigraphy (WATG). Parameters produced from WATG were total activity score, mean activity score and fragmentation index. We analyzed the correlation between each scale, AHI scored from NPSG and activity score analyzed from WATG. RESULTS: ESS showed significant positive correlation with PSQI, BDI, BAI and STAI I, II, respectively (p<0.01). SSS showed significant positive correlation with PSQI and BAI (p<0.05, p<0.01). BAI showed significant positive correlation with total activity score, mean activity score and fragmentation index (p<0.05, p<0.01, p<0.05). Total activity score showed significant positive correlation with ESS and BAI, respectively (p<0.05). Fragmentation index showed significant positive correlation with ESS, PSQI and BAI (p<0.05, p<0.01, p<0.05). AHI, indicator of sleep apnea is showed no significant correlation with each sleep and mood related scale. CONCLUSION: The degree of daytime sleepiness tends to be associated with night sleep satisfaction, depression and anxiety, and the activity during sleep rather than the severity of sleep apnea.
Actigraphy ; Anxiety ; Depression ; Humans ; Male ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Weights and Measures ; Wrist

No abstract available.
Free Tissue Flaps*

No abstract available.
Free Tissue Flaps*

PURPOSE: This study was designed to investigate the clinical effects of Newfactan in the treatment of moderate to severe respiratory distress syndrome. METHODS: There were enrolled 20 preterm infants who were diagnosed as grade III or grade IV respiratory distress syndrome at Kosin University Gospel Hospital from July 1997 to May 2000. All of these preterm infants were treated for rescue. To investigate the improvement of respiratory parameters we used FiO2, MAP, a/APO2 ratio, OI. RESULTS: Newfactan was administered to the patients at 7.2+/-7.4 hours (range 1.5- 32) after birth and 7 cases (35%) were administered one dose, 8 (40%) were administered two doses and 5 (25%) were administered three doses. The dose interval from first to second dose was 9.2+/-12.3 hours (range 5-46). The dose interval from second to third dose was 27.6+/-5.4 hours (range 21-35). The need of FiO2 showed decreased tendency especially between 4 to 6 hour after administration (P<0.05). PaCO2 and OI were decreased and a/APO2 ratio was increased after administration (P<0.05). MAP was not changed statistically (P>0.05). There were 41 complications and outcomes including PDA, sepsis, pneumothorax, intraventricular hemorrhage, BPD, ROP, and necrotizing enterocolitis. CONCLUSION: The clinical effects of Newfactan in the treatment of grade III or grade IV respiratory distress syndrome were significant in improving FiO2, PaCO2, a/APO2 ratio and OI.
Enterocolitis, Necrotizing ; Hemorrhage ; Humans ; Infant, Newborn ; Infant, Premature ; Parturition ; Pneumothorax ; Sepsis

PURPOSE: The purpose of this study was to assess the difference between prevalence and risk factors of the metabolic syndrome(MS) by gender in type2 diabetic patients. METHOD: 108 participants(males 69, females 39) were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. MS was defined by a third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel lll)(ATP lll), and abdominal obesity was determined by Asia-Pacific criteria in waist circumference. RESULTS: The prevalence of MS by definition of NCEP-ATPlll and the Asia-Pacific criteria in waist circumference was 39.3% in males and 66.7% in females type2 diabetic patients. The abdominal obesity prevalence was seen in 44.9% of males and in 79.5% of females patients. The prevalence of low HDL-cholesterolemia in serum was 26.2% in male, 52.8% in female type2 diabetic patients. CONCLUSION: These results show that nurses should focus on female diabetic patients for preventing MS.
Cholesterol ; Education ; Endocrinology ; Female ; Humans ; Male ; Obesity, Abdominal ; Outpatients ; Prevalence* ; Risk Factors* ; Tertiary Healthcare ; Waist Circumference

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.
Aged ; Animals ; Cheek ; Female ; Horns* ; Humans ; Keratinocytes

No abstract available.
Apnea* ; Humans