PURPOSE: The purpose of the study were to examine the nutritional status of severe brain injury adult patients in critical period, and to compare the nutritional states before and after tube feeding. METHODS: Data from 19 patients admitted to the SICU in a university hospital due to severe brain injury were analyzed. Nutritional states were measured by anthropometric and blood biochemical indicators. RESULTS: MAC and MAMC were significantly decreased only at 7 days after admission compared with those on the day of admission. TSF was significantly decreased from 7 days to 14 days after admission. Fat rate was significantly decreased from 3 days to 14 days after admission. Hb was significantly decreased only at 3 days after admission. Albumin was significantly decreased from 3 days to 14 days after admission. However, lymphocyte was significantly increased at 14 days after admission. TSF and Albumin became significantly worse even after initiating tube feeding. CONCLUSIONS: Nutritional status of severe brain injury patients in SICU became worse after admission whichever indicators were adopted to evaluate nutritional status, anthropometric or blood biochemical indicators, and became worse even after initiating tube feeding.
Adult ; Brain ; Brain Injuries ; Critical Period (Psychology) ; Enteral Nutrition ; Humans ; Lymphocytes ; Nutrition Assessment ; Nutritional Status ; Tosyl Compounds

BACKGROUND: Vibrio(V.) vulnificus is a halophilic, gram-negative bacillus that causes a fatal sepsis in patients with underlying chronic disease such as liver cirrhosis and alcoholic abuse. Because V. vulnificus infection has a fulminant course and high mortality rate, early recognition and rapid diagnosis with prompt therapy are necessary to improve survival rate. OBJECTIVE: The purpose of this study was to develop a new selective medium for rapid identification of V. vulnificus through color change of medium according to pH from patients suspected of having V. vulnificus sepsis. METHODS: Rapid isolation and identification of V. vulnificus can be possible by modifying the component of PNC(5% peptone, 1% NaCl, and 0.08% cellobiose [pH 8.0]) broth medium. From this PNC broth, a basal broth(5% peptone+1% NaCl+cellobiose) was prepared and used to evaluate additional medium supplements(cellobiose concentration [0.08, 0.2, 0.1%], pH [6.8, 7.5, 8.0] and pH indicator dye [bromthymol blue, thymol blue, phenol red, bromcresol purple, crystal violet, cresol red, and neutral red]). To examine the rapid identification and selectivity of this basal medium according to various conditions, V. vulnificus was tested by using saline and normal human blood containing these bacteria(1, 000 bacteria/ml), respectively at 37degrees C. A positive reaction(V. vulnificus growth) appeared as color change. The selectivity and identification capacity of this new broth was tested by using other 6 Vibrio species and 14 strains of other bacteria. RESULTS: Color change appeared only in the medium including bromthymol blue and thymol blue as a pH indicator dye. It was called the basal medium containing blue dyes as PNCB(peptone, NaCl, cellobiose and blue dye) medium. It took an average time of 4.8hr for becoming aware of yellow color change in PNCB broth after cultivating with saline mixed with V. vulnificus and 6hr in PNCB broth after cultivating with blood mixed with V. vulnificus. One Vibrio species and another 3 bacteria produced color change. So we confirmed that the final composition and pH of PNCB broth medium was 5% peptone, 1% NaCl, 0.2% cellobiose, 0.0004% bromthymol blue and 0.0004% thymol blue [pH 7.5] CONCLUSIONS: PNCB broth could be used as a selective and differential medium for rapid isolation and identification of V. vulnificus in patients with V. vulnificus sepsis.
Alcoholics ; Bacillus ; Bacteria ; Bromcresol Purple ; Bromthymol Blue ; Cellobiose ; Chronic Disease ; Coloring Agents ; Diagnosis ; Gentian Violet ; Humans ; Hydrogen-Ion Concentration ; Liver Cirrhosis ; Mortality ; Peptones ; Phenolsulfonphthalein ; Sepsis* ; Survival Rate ; Thymol ; Vibrio vulnificus* ; Vibrio*

During advanced prostate cancer, androgen deprivation therapy (ADT) using gonadotropin-releasing hormone and antiandrogen is an effective treatment modality. Recently, it has been reported that ADT may result in diabetes mellitus (DM), metabolic syndrome, and cardiovascular disease. Here, we report the first case in the literature of new-onset DM and hyperosmolar nonketotic coma (HNKC) associated with ADT. A 69-year-old man visited our hospital because of altered mentality. The patient had been taking leuprolide and bicalutamide for metastatic prostate cancer for the past 4 months. In laboratory tests, new-onset DM with HNKC was diagnosed. The patient was immediately treated with intravenous hydration and insulin therapy, and recovered without sequela. Because ADT can cause DM, or rarely HNKC, it is necessary to monitor fasting blood glucose and lipid profiles carefully while ADT is performed.
Aged ; Anilides ; Blood Glucose ; Cardiovascular Diseases ; Coma ; Diabetes Mellitus ; Fasting ; Gonadotropin-Releasing Hormone ; Humans ; Insulin ; Leuprolide ; Nitriles ; Organothiophosphorus Compounds ; Prostate ; Prostatic Neoplasms ; Tosyl Compounds

PURPOSE: Depression is common in patients with chronic renal failure on maintenance hemodialysis, though success rate of treatment is low. This study aimed to investigate the features and severity of the depressive symptoms and nutritional indices, and significant changes after antidepressant treatment. METHODS: The authors assessed 45 patients. Diagnosis of depression was made using DSM-IV-TR and the depressive symptoms were evaluated using Hamilton Rating Scale for Depression via semi- structured interview. Subjective global assessment, anthropometric measurements and nutritional indices such as Kt/V, nPCR were examined. Depressive patients were treated for 8 weeks with SSRI (citalopram), and all the variables were examined again after the treatment. RESULTS: 19 (42.2%) patients were diagnosed as depression. Nutritional status was not different between patients with depression and those without depression. Compared to non-depressed patients, depressed patients showed significantly higher depressed mood, guilty feeling, suicide idea, psychic and somatic anxiety, lower work and activities, psychomotor retardation, sleep disturbances, general somatic symptoms and hypochondriasis. After antidepressant treatment, depressed mood, guilty feeling, suicide idea, psychic anxiety, initial insomnia, middle insomnia, early awakening, work and activities and general somatic symptoms were improved significantly. TSF (p<0.05), handgrip strength (p<0.01) and hematocrit (p<0.05) were significantly increased. CONCLUSION: Antidepressant treatment is helpful not only for the improvement of depressive symptoms such as sleep and somatic symptoms but for the improvement of quality of life. Proper treatment should be more actively attempted for the hemodialytic patients with depression.
Anxiety ; Depression ; Hematocrit ; Humans ; Hypochondriasis ; Kidney Failure, Chronic ; Nutrition Assessment ; Nutritional Status ; Quality of Life ; Renal Dialysis ; Sleep Initiation and Maintenance Disorders ; Suicide ; Tosyl Compounds

OBJECTIVETo compare the antimicrobial efficacy of four endodontic irrigants using an in vitro model infected by Enterococcus faecalis (Ef).

METHODSThe root canals of fifty extracted teeth were infected by Ef in vitro. The test groups were irrigated with 3% H(2)O(2), 2.5% sodium hypochlorite (SH), 2% chloramine-T (CR), and 2% chlorhexidine (CHX), respectively, and the control group was irrigated with 0.9% NaCl. The concentration of Ef in canals of each group was calculated before and after irrigation. The residual bacteria within the dentinal tubules and vitalities of the residual bacteria were also examined.

RESULTSAll chemical irrigants were significantly more effective than 0.9% NaCl (P < 0.05); 2.5% SH and 2% CHX were statistically more effective than 3% H(2)O(2) (P < 0.05). Residual bacteria could be found in the dentinal tubules and propagated 72 h after.

CONCLUSIONS2% CR and 2% CHX had almost the equivalent antimicrobial effect as 2.5% SH, but 3% H(2)O(2) was less effective.

Chloramines ; pharmacology ; Chlorhexidine ; pharmacology ; Dental Pulp Cavity ; microbiology ; Enterococcus faecalis ; drug effects ; Humans ; Hydrogen Peroxide ; pharmacology ; In Vitro Techniques ; Root Canal Irrigants ; pharmacology ; Sodium Hypochlorite ; pharmacology ; Tosyl Compounds ; pharmacology

OBJECTIVETo establish a labeling method for a specific lung cancer-targeting small molecule peptide cNGQGEQc with ¹³¹I and observe the radioactivity distribution of the labeled peptide in rabbits using single-photon emission computed tomography (SPECT).

METHODSChloramine-T method was used for ¹³¹I labeling of the tyrosine amino group on cNGQGEQc, and the labeling efficiency and radiochemical purity of ¹³¹I-cNGQGEQc were determined with paper chromatography. The stability of ¹³¹I-cNGQGEQc in saline and human serum was assessed after incubation in water bath at 37 degrees celsius; for 24 h. The octanol-water partition coefficient lg P (the radioactivity counting ratio of ¹³¹I-cNGQGEQc dissolved in 100 µl octanol or in 100 µl saline) was calculated. SPECT was performed in 3 male New Zealand white rabbits after intravenous injection of ¹³¹I-cNGQGEQc to observe the dynamic distribution of the peptide with the time-radioactivity curve (T-A curve) of the region of interest (ROI).

RESULTSWith a labeling efficiency of 90%, ¹³¹I-cNGQGEQc showed a radiochemical purity of was 95% after purification with HPLC. The radiochemical purity of ¹³¹I-cNGQGEQc was (93.12 ± 1.18)% and (88.34 ± 5.43)% after intubation in saline and human serum for 24 h, respectively. The octanol-water partition coefficient lg P of ¹³¹I-cNGQGEQc was -1.75, suggesting its hydrosolubility. In rabbits with intravenous injection of ¹³¹I-cNGQGEQc, SPECT visualized the kidneys at 1 min after the injection; the imaging of the heart and liver became attenuated at 5 min when the bladder was visualized with an increasing radioactivity. The radioactivity of the soft tissues began to fade at 30 min. No gallbladder visualization was detected, and the radioactivity of the abdomen remained low. No obvious radioactivity concentration was observed in the thyroid and stomach. The T-A curves of the ROI of all the tissues and organs descended over time.

CONCLUSIONRadiolabeling of cNGQGEQc with ¹³¹I is simple and highly efficient. ¹³¹I-cNGQGEQc has good stability in vitro and good distribution characteristics for in vivo imaging, and is cleared mainly by renal excretion due to its hydrosolubility. These results provide experimental basis for further studies of diagnosis and therapy of lung cancer with targeting polypeptide.

Animals ; Antineoplastic Agents ; pharmacokinetics ; Chloramines ; Humans ; Iodine Radioisotopes ; chemistry ; Lung Neoplasms ; Male ; Peptides ; pharmacokinetics ; Rabbits ; Radiopharmaceuticals ; pharmacokinetics ; Tissue Distribution ; Tomography, Emission-Computed, Single-Photon ; Tosyl Compounds

PURPOSE: The purpose of this study was to investigate the role of mast cells and their product, histamine and leukotriene in ischemia-reperfusion injury. METHODS: Forty Sprague-Dawley rats were divided into four groups. (Group I: Control group without ischemia, Group II: Normal saline with ischemia, Group III: Cimetidine with ischemia, Group IV: Zafirlukast with ischemia) Skin flap was elevated and ischemic insult was given by clamping the artery for 12 hours. Before reperfusion, the rats were treated with saline, cimetidine and zafirlukast. Flap survival was evaluated at 7 days. Neutrophil counts, mast cell counts were evaluated 24 hours after reperfusion. RESULTS: Flap survival rate in the control group was 92.33%, whereas normal saline group had 37.34% survivals. Cimetidine and zafirlukast treated group showed significantly higher survival rates than normal saline group. The neutrophil and mast cell counts in cimetidine and zafirlukast treated group were significantly decreased than normal saline group. Cimetidine treated group showed higher survival rate and lower cell counts than zafirlukast treated group. CONCLUSION: The administration of cimetidine and zafirlukast can decrease neutrophils and mast cells caused by ischemia-reperfusion and increase flap survivals. It is suggests that antihistamine and leukotriene receptor antagonist have protective effect against ischemia-reperfusion injury to skin flap in rat.
Animals ; Arteries ; Cell Count ; Cimetidine ; Constriction ; Histamine ; Ischemia ; Mast Cells ; Neutrophils ; Rats ; Rats, Sprague-Dawley ; Receptors, Leukotriene ; Reperfusion ; Reperfusion Injury ; Skin ; Survival Rate ; Tosyl Compounds

Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.
Anilides ; Anti-Infective Agents ; Bronchoalveolar Lavage Fluid ; Collagen ; Cough ; Environmental Exposure ; Eosinophilia ; Fever ; Fibrosis ; Flutamide ; Glass ; Humans ; Imidazolidines ; Lung ; Lung Diseases, Interstitial ; Male ; Neoplasm Metastasis ; Nitriles ; Prednisolone ; Prostatic Neoplasms ; Tosyl Compounds ; Vascular Diseases

OBJECTIVESTo assess the hemodynamic, oxygen-dynamic and ventilative effects of Zafirlukast in chronic obstructive pulmonary disease (COPD) induced chronic cor pulmonale at acute exacerbation stage and the mechanisms of Zafirlukast efficacy.

METHODSEleven cases of chronic cor pulmonale at acute exacerbation were examined using Swan-Ganz catheter and peripheral intra-artery catheter. The hemodynamic, oxygen-dynamic parameters and respiratory rate, plasma endothelium-1 (ET-1) level, and urea leukotriene E(4) (LTE(4)) level were measured before and at the 1st, 3rd, 5th, 7th, 9th, 12th hour after taking 40 mg Zafirlukast orally. Arterial and mixed venous blood gas analyses were done correspondingly.

RESULTSThe average pulmonary arterial pressure (mPAP) and pulmonary vascular resistance index (PVRI) were lowered at the 3rd hour after taking Zafirlukast by 23% and 36.5%, respectively. They returned to the baseline around 12th hour. Respiratory rate decreased significantly within the 3rd-7th hour after taking Zafirlukast. LTE(4) and ET-1 levels lowered at the 3rd hour and showed a positive correlation with change of mPAP.

CONCLUSIONSZafirlukast can reduce mPAP, pulmonary vascular resistance (PVR) and does not affect the ambulatory blood pressure monitoring (ABPM) and oxygenation in cases of chronic cor pulmonale at acute exacerbation stage. Zafirlukast may play a role as an alternative to decrease PAP in COPD patients.

Aged ; Female ; Hemodynamics ; drug effects ; Humans ; Hypertension, Pulmonary ; drug therapy ; Leukotriene Antagonists ; therapeutic use ; Leukotriene E4 ; urine ; Male ; Oxygen ; metabolism ; Pulmonary Disease, Chronic Obstructive ; complications ; Respiration ; drug effects ; Tosyl Compounds ; therapeutic use

OBJECTIVE: To investigate the timing of reaching maximum improvement of the lower urinary tract symptoms (LUTS) in patients with advanced prostate cancer treated with maximal androgen blockade(MAB), and to provide guidelines for the treatment program. METHODS: We collected the data of 45 advanced prostate cancer patients complicated with lower urinary tract symptoms who were treated by MAB. The international prostate symptom score (IPSS) and maximum urinary flow rate (Qmax) were selected as indicators reflecting the degree of lower urinary tract symptoms and were observed before the MAB, 3, 6, and 9 months after the patients received MAB. We also observed the changes of prostate volume and analyzed the role of MAB in improving LUTS in patients with prostate cancer. RESULTS: The IPSS and Qmax had significant difference between the 3rd month after the patients received MAB and before the MAB (P<0.05). No significant difference was found between the 3rd month and the 6th month after the patients received MAB (P>0.05). The prostate volume had significant difference in the 3rd month and the 6th month (P<0.05), but no significant difference in the 6th month and the 9th month (P>0.05). CONCLUSION MAB for patients with advanced prostate cancer can improve their lower urinary tract symptoms, whose main effect is presented in the 3rd months after the androgen deprivation therapy.
Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Anilides ; therapeutic use ; Flutamide ; therapeutic use ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Prostatic Neoplasms ; complications ; drug therapy ; Tosyl Compounds ; therapeutic use ; Urination Disorders ; drug therapy ; etiology