No abstract available.
Humans ; Muramidase*

No abstract available.
Humans ; Muramidase*

No abstract available.
Humans ; Muramidase*

BACKGROUND: Colloid solutions are used to treat hypovolemia and expanding plasma, but they may inhibit platelet function and reduce the level of coagulation factors during surgery. This study was conducted to compare the effects of hydroxyethyl starch (HES) on adenosine diphosphate (ADP)- and collagen-induced platelet aggregation in patients undergoing total intravenous anesthesia. METHODS: Patients undergoing endoscopic sinus surgery under total intravenous anesthesia with propofol and remifentanil were divided into a group that underwent fluid management with only crystalloid solution (n = 15) and a group that was managed with crystalloid solution that included 6% HES (130/0.4) (n = 15). ADP- and collagen-induced platelet aggregation were measured 5 minutes before induction, after the first intraoperative hour, and one hour postoperatively. RESULTS: Significantly diminished ADP- and collagen-induced aggregation values were observed intraoperatively when compared with the preoperative value in the patients that were managed with colloid solution that included HES. In addition, significantly diminished collagen-induced aggregation values were observed intraoperatively when compared with the preoperative value in the group that was managed with the solution that only contained the crystalloid. However, ADP- and collagen-induced platelet aggregation were recovered postoperatively in both groups. CONCLUSIONS: The results of this study indicated that fluid therapy with colloid solution that contained 6% HES (130/0.4) may diminish ADP-induced platelet aggregation intraoperatively in patients subjected to total intravenous anesthesia.
Adenosine Diphosphate ; Anesthesia, Intravenous ; Blood Coagulation Factors ; Blood Platelets ; Colloids ; Fluid Therapy ; Hetastarch ; Humans ; Hypovolemia ; Isotonic Solutions ; Piperidines ; Plasma ; Platelet Aggregation ; Propofol

PURPOSE: To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). MATERIALS AND METHODS: From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. RESULTS: The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. CONCLUSION: Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities.
Disease Progression ; Disease-Free Survival ; Esophageal Neoplasms* ; Esophagus ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy ; Retrospective Studies

PURPOSE: To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). MATERIALS AND METHODS: From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. RESULTS: The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. CONCLUSION: Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities.
Disease Progression ; Disease-Free Survival ; Esophageal Neoplasms* ; Esophagus ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy ; Retrospective Studies

BACKGROUND/AIMS: Delayed bleeding after gastric endoscopic submucosal dissection (ESD) commonly occurs within 3 days, but it may also occur after 1 week following ESD, especially in antiplatelet agent users. We evaluated the risk of delayed bleeding in post-ESD ulcers using the Forrest classification. METHODS: Registry data on the Forrest classification of post-ESD ulcers (n=371) at 1 week or 2 weeks after ESD were retrospectively evaluated. The Forrest classification was categorized into two groups: increased risk (Forrest Ia to IIc) or low risk (Forrest III). The odds ratios (ORs) were calculated using logistic regression analysis. RESULTS: Among 371 post-ESD ulcers, one ulcer (0.3%) was classified as Forrest Ib, two (0.5%) as Forrest IIa, 17 (4.6%) as Forrest IIb, 172 (46.4%) as Forrest IIc, and 179 (48.2%) as Forrest III. The proportion of increased-risk ulcers was 72.2% (140/194) at 1 week after ESD, which decreased to 29.4% (52/177) at 2 weeks after ESD (p<0.001). In the multivariate analysis, a post-ESD ulcer at 1 week after ESD (OR, 7.54), younger age (OR, 2.17), and upper/middle ulcer location (OR, 2.05) were associated with increased-risk ulcers. CONCLUSIONS: One week after ESD, ulcers still have an increased risk of bleeding when assessed using the Forrest classification. This risk should be considered when resuming antiplatelet therapy.
Classification* ; Hemorrhage* ; Logistic Models ; Multivariate Analysis ; Odds Ratio ; Platelet Aggregation Inhibitors* ; Retrospective Studies ; Stomach Neoplasms ; Ulcer

OBJECTIVE: Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. METHODS: Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. RESULTS: The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. CONCLUSION: We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.
Ankle ; Cerebral Palsy ; Contracture ; Follow-Up Studies ; Hip* ; Humans ; Muscle Contraction ; Muscle Spasticity* ; Muscles ; Obturator Nerve ; Pain, Intractable ; Paralysis ; Tenotomy

This experiment was carried out to investigate the effects of depressor and stimulator of central nervous system on the reticuloendothelial phagocytic function in vivo. The phagocytic activity was assessed by means of carbon clearance method after intra-muscular adimnistration of phenobarbital(1mg/0.2 ml of normal saline/100 gm of body weight) and intravenous administ-ration of theophylline(1 mg/0.2 ml of normal saline/100 gm of body weight) into rats. The obtained results were as follows; 1. In the groups administrered with phenobarbital, the alteration in the phagocytic activity wi-thin three hours after administration was decreased compared with the normal and control gro-up, but thereafter, it was increased progressively to the normal level by 12 hours after administr-ation. 2. In the groups administered with theophylline, the alteration in the phagocytic activity within one hour after adminstration was increased compared with normal and control group, but after that decreased gradually to the normal level by 12 hours after injection. 3. From these results, it is concluded that stimulation of central nervous system may increa-se the phagocytic activity and depression of central nervous system may decrease the phagocy-tic activity of reticuloendothelial system.
Animals ; Carbon ; Central Nervous System ; Depression ; Mononuclear Phagocyte System* ; Phenobarbital* ; Rats* ; Theophylline*

This study examined the chemical composition of A. blasiliensis and the chemical structural properties of an immuno-stimulating polysaccharide. The amino acids, free sugars, and organic acids by HPLC and fatty acids by GC were analyzed. The immuno-stimulating substance from A. blasiliensis was extracted with hot water and purified by ethanol precipitation. It underwent ion exchange chromatography on DEAE-cellulose and gel filtration on Toyopearl HW 65F. Through GP-HPLC, the substance was found to be homogeneous. Its chemical structure was determined by 13C-NMR. Fatty acids, organic acids, and sugar alcohol composition consisted exclusively of linoleic acid, fumaric acid and mannitol, respectively. The amino acids were mainly glutamic acid, glycine, and arginine. By 13C-NMR analysis, the immuno-stimulating substance was identified as beta-(1-->3) (1-->6)-glucan, composed of a backbone with (1-->3)-linked D-glucopyranosyl residues branching a (1-->6)-linked D-glucopyranosyl residue. The beta-glucan from A. blasiliensis showed pronounced immuno-stimulating activity on the antibody-production ability of B-lymphocytes by the hemolytic suspension assay. In these results, A. blasiliensis was estimated to have potent pharmacological properties and potential nutritional values.
Agaricus ; Amino Acids ; Arginine ; B-Lymphocytes ; Carbohydrates ; Chromatography, Gel ; Chromatography, High Pressure Liquid ; Chromatography, Ion Exchange ; DEAE-Cellulose ; Ethanol ; Fatty Acids ; Fumarates ; Glutamic Acid ; Glycine ; Linoleic Acid ; Mannitol ; Nutritive Value ; Water