The focus of this study was o aialyze the morphologic expression of p53, Pan-ras, c-erbB-2, and PCNA in preneoplastic and neoplastic liver lesions induced with NNM of rats. The development of hepatocellular tumors was investigated by histology and electron microscope in 65 Splague-Dawley rats administered with NNM in drinking water at low dose(5 mg/100 ml) and high dose(20 mg/100 ml). Three types of hepatocytic degeneration glycogenotic, eosinophilic and basophilic changes were followed by the appearance of hepatocellullar carcinoma. Hepatocellular carcinoma was increased in number and size according to NNM dosage and to duration of exposure. The histological classifications of hepatocelular carcinoma wer trabecular type, which was which was the most common, large eosinophilic, small cell, adenocarcinomatous and clear cell type. The expression of p53, Pan-ras, c-erbB-2 PCNA was examined by immunohistochemical stains. Eosinophilic degeneration revealed mild positivity at 18-26 weeks for expression of all oncogenic proteins studied and PCNA, whereas precancerous lesions showed variable expression from negative to moderate positivity on PCNA. Hepatocellular carcinoma lesions showed strong positivity for all stains and increased intensity during experimental period. These may indicate that chemical carcinogen produce hepatic eosinophilic degeneration and preCancerOus lesions by genetic mutation, resulting in hepatocellular carcinoma.
Rats ; Animals ; Carcinoma, Hepatocellular ; Carcinogens

No abstract available.
Humans

PURPOSE: To investigate audiometery and characteristics related to tinnitus in tinnitus patients. and to understand the relationship between the discomfort of tinnitus and the quality of life. Methods: The subjects were 110 patients with tinnitus. The data were collected using tinnitus handicap questionnaire. quality of life, and pure tone audiometry, which measured hearing level in dB and frequency in Hz matching of tinnitus. RESULTS: Majority of tinnitus patients (75.5%~81.8%) had normal auditory sensation. but 82.7% of patients indicated that they have heard tinnitus frequently. or always, and the major sounds of tinnitus were wing, wung, wang, The matching sounds of tinnitus had various range in hearing level(dB) and frequency(Hz). Tinnitus patients reported moderate levels of the discomfort of tinnitus and the quality of life, and there were negative correlation between the discomfort of tinnitus and the quality of life(r=-.314, p .00l). CONCLUSION: These findings suggest that special attention is needed for tinnitus patients because the physical. psychological. and social impacts of tinnitus could be decrease their quality of life, Specialized nursing intervention considering specific conditions related to tinnitus is required to solve various health problems of tinnitus patients.
Audiometry ; Hearing ; Humans ; Nursing ; Quality of Life* ; Surveys and Questionnaires ; Sensation ; Social Change ; Tinnitus*

BACKGROUND: Electroconvulsive therapy (ECT) that works by electrically inducing grand mal seizure is an effective therapy for patients with major psychosis and affective disorders. But ECT may produce intense stimulation of the central nervous system resulting in hypertension and tachycardia. Such an acute hyperdynamic state may be undesirable because of possible cardiovascular complications. We compared the ability of different bolus doses of esmolol to blunt the hemodynamic effects of ECT. METHODS: Twenty ASA physical status 1~2 patients were enrolled in a crossover design study to determine the effects of two standard esmolol bolus doses (0.5 mg/kg and 1.0 mg/kg) on the hemodynamic response and seizure duration during ECT. In each patients receiving esmolol or placebo, arterial pressure, heart rate, seizure duration and peripheral oxygen saturation (SpO2) were recorded. RESULTS: The seizure duration with placebo was 43 +/- 9 sec, esmolol 0.5 mg/kg bolus dose was 39 +/- 14 sec and esmolol 1.0 mg/kg bolus dose was 39 +/- 12 sec, but it was not significant. Compared with esmolol 0.5 mg/kg bolus dose, esmolol 1.0 mg/kg bolus dose decreased blood pressure and heart rate during ECT more effectively. CONCLUSIONS: Esmolol 1.0 mg/kg bolus dose was considered to be the better dose in blunting the hyperdynamic response during ECT without shortening of seizure duration.
Arterial Pressure ; Blood Pressure* ; Central Nervous System ; Cross-Over Studies ; Electroconvulsive Therapy* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Mood Disorders ; Oxygen ; Psychotic Disorders ; Seizures ; Tachycardia

No abstract available.
Child* ; Glomerulonephritis* ; Humans

BACKGROUND: Unlike other diseases, the management of sepsis has not been fully integrated in our daily practice. The aim of this study was to determine whether repeated training could improve compliance with a 6-h resuscitation bundle in patients with severe sepsis and septic shock. METHODS: Repeated education regarding a sepsis bundle was provided to the intensive care unit and emergency department residents, nurses, and faculties in a single university hospital. The educational program was led by a multidisciplinary team. A total of 175 adult patients with severe sepsis or septic shock were identified (88 before and 87 after the educational program). Hemodynamic resuscitation bundle and timely antibiotics administration were measured for all cases and mortality at 28 days after sepsis diagnosis was evaluated. RESULTS: The compliance rate for the sepsis resuscitation bundle before the educational program was poor (0%), and repeated training improved it to 80% (p < 0.001). The 28-day mortality was significantly lower in the intervention group (16% vs. 32%, p = 0.040). Within the intervention group, patients for whom the resuscitation bundle was successfully completed had a significantly lower 28-day mortality than other patients (11% vs. 41%, p = 0.004). CONCLUSIONS: Repeated education led by a multidisciplinary team and interdisciplinary communication improved the compliance rate of the 6-h resuscitation bundle in severe sepsis and septic shock patients. Compliance with the sepsis resuscitation bundle was associated with improved 28-day mortality in the study population.
Adult ; Anti-Bacterial Agents ; Compliance ; Critical Pathways ; Diagnosis ; Education ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Intensive Care Units ; Interdisciplinary Communication ; Mortality ; Resuscitation* ; Sepsis* ; Shock, Septic

Congenital pseudarthrosis of the tibia is a condition most often combined with cafe-au-lait spots and neurofibromatosis. It is notoriously difficult to attain a sound bony union. Compression plating and screw fixation with massive bone graft resulted in successful union in our case.
Cafe-au-Lait Spots ; Neurofibromatoses ; Pseudarthrosis ; Tibia ; Transplants

Neonatal and obstetrical problems related to the low birth weight infants were evaluated by a retrospective review of the medical records of the 186 low birth weight infants born at Yeungnam University Hospital during 3 years and 8 months from May 1, 1983 to February 28, 1987. The results were as follows: 1. The incidence of the low birth weight infants was 4.98% among 3,803 live births. 2. Male to female ratio was 1.02:1. 3. The incidence of the low birth weight infants was lowest in mothers of 25 to 29 years, increased in mothers of 19 years of less and 30 to 39 years significantly. 4. There was no difference in the incidence of low birth weight infants between primiparous and multiparous mothers. 5. Common obstetrical complications associated with low weight infants were multiple pregnancy, toxemia and premature rupture of membrane in order of frequency. 6. Common neonatal problems in low birth weight infants were jaundice, idiopathic respiratory, distress syndrome, asphyxia and metabolic derangement such as hypocalcemia and hypoglycemia in order of frequency.
Asphyxia ; Clinical Study* ; Female ; Humans ; Hypocalcemia ; Hypoglycemia ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Jaundice ; Live Birth ; Male ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Pregnancy, Multiple ; Retrospective Studies ; Rupture ; Toxemia

Malignant hyperthermia is defined as a potentially fatal hypermetabolic syndrome characterized by hyperpyrexia, skeletal muscle rigidity, tachycardia, respiratory and metabolic acidosis, cyanosis etc. Any inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catastrophic reaction. This case is presented of a 37 year old female patient in whom total gastrectomy was planed to perform under oxygen-nitrous oxide-isoflurane anesthesia with induction by thiopental sodium and succinylcholine. When administer of succinylcholine to induction, the jaw was very tight and the mouth was impossible to open. We retried with vecuronium and the jaw was slightly resistant to opening, but intubation was successfully performed. After induction, hyperpyrexia, tachycardia, increased end-tidal carbon dioxide developed. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated successfully with early detection and intensive care. According to decrease of temperature and normalization of arterial blood gas, the procedure continued with nontriggering agent, fentanyl. The etiologic factors, clinical features, treatment and preventive measures of malignant hyperthermia are discussed.
Acidosis ; Adult ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Carbon Dioxide ; Cyanosis ; Emergency Treatment ; Female ; Fentanyl ; Fever ; Gastrectomy ; Humans ; Inhalation ; Critical Care ; Intubation ; Isoflurane ; Jaw ; Malignant Hyperthermia* ; Mouth ; Muscle, Skeletal ; Succinylcholine ; Tachycardia ; Thiopental ; Vecuronium Bromide

No abstract available.
Carboxyhemoglobin* ; Humans ; Hyperbilirubinemia* ; Infant, Newborn*