No abstract available.

No Abstract Available.
Keratomileusis, Laser In Situ*

BACKGROUND: Tumor necrosis factor-alpha(TNF-alpha) has been thought to play a major role in neurological injury during global brain ischemia and subsequent reperfusion following resuscitation in cardiac arrest. So, we hypothesized that the elevation in TNF-alpha was dependent upon the duration of the global brain ischemia, and related to delayed neuronal damage. METHODS: Fourteen rats were divided two groups ; 1 minute-cardiac arrest group(n=7) and 3 minute-cardiac arrest group(n=7). we induced cardiac arrest by chest compression and damping of tracheal tube for 1 minute and 3 minutes respectively. And then, resuscitation was initiated. To measure the plasma activity of TNF-alpha, blood samples were drawn before and at the end of cardiac arrest, and 30, 60, 90, and 120 minutes after initiation reperfusion. At 72 hours after resuscitation, the ND(neurologic deficit) score was determined and the histopathologic outcome of hippocampal CA1 neuron was observed by the percent dead hippocampal CA1 neurons. RESULTS: 1. TNF-alpha level during the early reperfusion period(<2h) was significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(p=0.0001). 2. There was a no significant difference of neurologic deficit score between 1 min- and 3 min-cardiac arrest. 3. Percent dead hippocampal neurons were significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(9.1+/-1.2% vs 1.2+/-0.9%, p<0.05). CONCLUSION: The results suggest that longer duration of global brain ischemia causes a more profound increase in plasma TNF-alpha level during the early reperfusion period(<2h) and more delayed neuronal damage than lessor duration of global brain ischemia, and that increase in TNF-alpha level during the early reperfusion period(<2h) is related to delayed neuronal damage.
Animals ; Brain Ischemia ; Brain* ; Heart Arrest* ; Heart Arrest, Induced ; Necrosis ; Neurologic Manifestations ; Neurons ; Plasma ; Rats* ; Reperfusion ; Reperfusion Injury* ; Resuscitation ; Thorax ; Tumor Necrosis Factor-alpha*

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus intracervical dinoprostone (prostaglandin E2 gel) for cervical ripening and labor induction. METHODS: 60 patients with indication for labor induction and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone. 50 microgram tablets of misoprostol were placed in the posterior vaginal fornix every 4 hours for a maximum of 3 doses or dinoprostone 0.5mg was placed into the endocervix every 6 hours for a maximum of 2doses. No more medication was given after either spontaneous rupture of membranes or beginning of active labor. RESULTS: Among 60 patients enrolled, 30 received misoprostol and 30 received dinoprostone. The average interval from start of induction to active labor was shorter in misoprostol group (6.5+/-3.2 hours) than in the dinoprostone group (10.7+/-7.3 hours) (p<0.05). Oxytocin augmentation of labor occurred more often in the dinoprostone group (36.7%) than in the misoprostol group (10.0%) (p<0.05). There was a higher prevalence of fetal distress (23.3% versus 3.3%) and tachysystole (16.6% versus 6.6%) in the misorprostol group than in the dinoprostone group(p<0.05). CONCLUSIONS: Vaginally administered misoprostol is an effective agent for cervical ripening and induction of labor. Furthermore, the cost of misoprostol ( 360/200microgram) is much less than that of dinoprostone ( 42,000/0.5mg). Cost benefits from administration of misoprostol are evident, especially in clinics under system of diagnosis-related group (DRG) : however when given at this dosage, it is associated with a higher prevalence of fetal distress and tachysystole than dinoprostone. Further studies to compare the safety of misoprostole to that of dinoprostone and to delineate an optimal dosing regimen for misoprostol are needed.
Cervical Ripening* ; Cost-Benefit Analysis ; Diagnosis-Related Groups ; Dinoprostone* ; Female ; Fetal Distress ; Humans ; Membranes ; Misoprostol* ; Oxytocin ; Pregnancy ; Prevalence ; Prospective Studies* ; Rupture, Spontaneous ; Tablets

In recent years there has been an increase in the number of outpatient surgical procedures performed using local anesthesia with intravenous sedation. However, many patients are reluctant to undergo surgery because of their concerns about pain and pain-awareness during the operation. We performed a study to evaluate the effectiveness and safety of midazolam during outpatient surgical procedures. Between March 1997 and December 1998, 50 patients were anesthetized with bolus intravenous injection of 0.1mg/kg of midazolam, followed by local anesthesia. The blood pressure, pulse and oximeter values were monitored. There was no significant change of arterial oxygen saturation. Midazolam induced antegrade amnesia in most cases. All patients except three (94%) said they would willingly choose this anesthetic technique again. Major complications were not noted. We concluded that midazolam is a good sedative agent in providing favorable antegrade amnesia, as well as reduced anxiety and fear of pain during surgical procedures. This suggests that midazolam may be used routinely in outpatient surgical procedures. Monitoring of oxygen saturation, however is essential in preventing severe hypoxia during procedures.
Amnesia ; Anesthesia, Local* ; Anoxia ; Anxiety ; Blood Pressure ; Humans ; Injections, Intravenous ; Methods ; Midazolam* ; Outpatients ; Oxygen

BACKGROUND: Chronic exposure to ultraviolet radiation(UVE) nduces photoaging characterized by dry, deeply wrinkled, inelastic, leathery, and irregulaity pigmented skin. UVR also induces solar keratosis and carcinoma, and is a contributing factor in melanoma. Sunscreens are used to prevent solar damage to skin and, if used on a daily lass should significantly reduce the incidence of the chronie photodamaging events. OBJECTIVE: We tried to evaulate the photoaging effects of UVR in the skin and the photoprotective effect of sunscreens. METHOD: We examined the gross and microscopic changes skin of albino hairless Skh : HR-1 mice exposed chronically to ultraviolet B(UVB) and suncreen-treated mice. RESULTS: The skin of the UVB-irradiated mouse shows chear, cteristic signs of photoaging, such as deep wrinkles across the back, and thickened and a hery skin. Histologically, the photoaged skin shows increased epidermal thickness, numeross fibroblasts and inflammatory cell infiltration in the upper dermis, and many enlarged keratering cysts in the lower dermis. By the 20th week, seven of the total of 9 mice(78%) in UVB irradiated mice developed at least one tumor. Histologically, the tumor is a papilloma, but the he are many dyskeratotic cells and loss of polarity in epidermis. Octyl methoxycinnamate or TiO ZnO Talc-treated mic show a significantly decreased wrinkling score, mimmal epidermal hyperplasia, slightly increased dermal cellularity, and lack of proliferation of cysts. The octyl dimethyl PABA-treatd mice shows significantly increased wrinkling score and marked inflammatory infiltration dermis. By the 20th week, only one mouse had developed a tumor in the octyl methoxy irmamate-treated group and no evidence of tumor was seen in the TiO ZnO Talc-treated group. In the octyl dimethyl PABA-treated group, five of 7 mice(71%) developed at least one tumor. CONCLUSION: The skin which is chronically exposed to UVB is subject to photoaging and photocarcinogenesis and regular use of an adequate sunscreen would prevent these photodamaging effects of UVB.
Animals ; Dermis ; Epidermis ; Fibroblasts ; Hyperplasia ; Incidence ; Keratosis ; Melanoma ; Mice ; Mice, Hairless ; Papilloma ; Skin* ; Sunscreening Agents*

No abstract available.
Humans ; Lung Neoplasms* ; Lung* ; Survival Analysis*

No abstract available.
Calcium* ; Lithium* ; Parathyroid Hormone*

A tender, non-healing ulcer of 3 months' duration developed on the tongue tip of a 51-year-old male with active pulmonary tuberculosis. Acid-fast bacilli were grown in the tissue and sputum cultures. The patient was anergic to PPD skin test before the treatment and IL-2 productivity was significantly decreased. Sections from the tongue tip showed ulceration, infiltration of neutrophils and tuberculoid granulornas accompanying caseation necroses in the dermis. The ulcer healed after administration of anti-tuberculosis medication for 2 months.
Dermis ; Efficiency ; Humans ; Interleukin-2 ; Male ; Middle Aged ; Necrosis ; Neutrophils ; Skin Tests ; Sputum ; Tongue* ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

This study was carried out to investigate the ultrastructural findings of rats after administration of 0.5% lead acetate with drinking water. The Sprague-Dawley rats were divided into control and experimental groups. The control group was composed of 12 rats and was orally administered with 0.5% sodium acetate. The experimental group was composed of 36 rats and orally administered with 0.5% lead acetate. Two rats in the control group and four rats in the experimental group were sacrificed on day 2, and week 1, 2, 4, 6 and 8 after administration. The kidney was extirpated and examined by electron microscopy. The results obtained were as follows: The blood lead concentration in the experimental group began to increase from the second day after administration and it increased gradually until the 6th week and it decreased at the 8 week. The urinary excretion of delta-ALA also increased from the secondary and gradually increased up to the 8th week. On electron microscopic examination, the proximal tubular cells showed fat droplets, dilatation of the endoplasmic reticulum, mitochondrial swelling, increased numbers of secondary lysosomes and myelin figure-like residual bodies and intranuclear inclusion bodies. All these findings peaked at the eighth week after administration. Ultrastructural findings after Timm sulphide silver reaction revealed the lead granules in the proximal tubular lumen and between the microvilli of the proximal tubular cells without membrane-bounded. It can be concluded that most of the changes of micro-organelles are compatible with degenerative changes of lead exposure and passive diffusion of lead granules are involved in the proximal tubular cells.
Rats ; Animals