The histochemical changes of the resting, pregnant, lactating and involuting mammaryglands of ninety mice (virgins and first pregnancy) aged 2--3 months have been studied.The changes of nucleoproteins, alkaline phosphatase, glycogen and lipid were studied bymethods of methyl green-pyronin, Gomori's Ca-Co method, periodic acid-Schiff's reagentand Sudan black stain respectively. The morphological changes were demonstrated byH-E stain. RNA was observed in the cytoplasm and neucleoli of the glandular epithelium. Thecontent of RNA increased gradually from midpregnancy and reached maximum duringlactation. During involution it decreased rapidly, and recovered to the normal level atthe 6th day after weaning. In the glandular epithelium the alkaline phosphatase was more evident in the restingstage. During pregnancy it weakened gradually. It was minimal during lactation andincreased markedly after weaning. The content of alkaline phosphatase was more in theactive-secreting cells than that of the resting cells. Myoepithelial cells always gavestrong reaction. In the glandular epithelium glycogen was only present in a few lactating mammaryglands, and absent in all the others. During late pregnant and lactating stage, the glan-dular epithelium was weakly positive by PAS stain. Lipid was observed in the cytoplasm of the glandular epithelium. The content ofit increased gradually from midpregnancy and reached the maximum during lactation, butdecreased during involution. After weaning, lipid granules were present only in thelumen of the duct. We did not find any significant changes of the mentioned substances during theestrous cycle. The relationships and the functional significances of the mentioned substances werediscussed.

Twenty-four adult rabbits(body weight 1500—2000 gm),under light urethane ana- thesia(1 gm/kg),were subjected to craniotomy.The symmetrical areas of the parietal cortex were exposed and each side was covered by a filter paper which had been soaked with any one of the following drugs:(1)2% Strychnine(Sulphate),(2) 1‰ Stry- chnine,(3)20% KCI,(4)2% KCl.The normal saline was used for the controls. Thirty minutes later,all animals were killed by decapitation.The cortical areas were rapidly removed within one minute and stained with the following method:(1)Gomori's method for acid phosphatase(ACP),(2)Unna's method for ribonucleic acid(RNA), and(3)Toluidine blue stain for Nissl bodies.The cevical cord(C3-4)was also re- moved in some animals and stained for RNA.In five animals,the EEG records were obtained from the cortical surface with the silver-silver chloride nonpolarized electrodes. The EEG results confirmed the established experiments that when 20% KCl was placed locally,the amplitudes of the EEG waves became markedly decreased,while 2% Stry- chnine was applied,the typical 'Strychnine Spikes'appeared consistently. The local application of 20% KCl did not produce any significant effect on the RNA contents of the horizontal cells(Cajal's cells)in the lst layer.But the pyramidal cells of the 2nd,3rd layers exhibited a typical central chromatolysis,i.e.,RNA decreased or disappeared,nucleus became eccentric,Nissl bodies underwent dissolution.The granu- lar cells of the fourth layer also showed central chomatolysis,but less marked.The ganglion cells and polymorphic cells in 5th,6th layers did not differ apparently from that of the normal saline controls.2% KCl produced the similar effect although the de- generative changes were not so severe as compared with that of the 20% KCl. Local application of 2% Strychnine did not alter the RNA levels of the Cajal cells. The RNA content of pyramidal cells in 2nd—3rd layers decreased to a considerable de- gree,but the typical chromotalytical changes were absent.The RNA of the large pyramidal cells in the 5th layer appeared as clusters of large granules.The RNA levels of 4th,6th layer showed no considerable changes as compared with that of the normal saline controls,1‰ Strychnine had no significant effect on the RNA content of the cere- bral cortex. The RNA of the anterior horn cells of the cevical cord was the same as the control animals no matter what drugs had been applied. 20% KCl enhanced the ACP reaction of the whole cortex,especially the 2nd—3rd layers.2% KCl produced the same effect but to a lesser degree.1% Strychnine also increased the ACP activities of the 2nd—4th layers.But 1‰ Strychnine had no signifi- cant effect. Based on the mentioned results,the significance of RNA and ACP for the functions and the functional relations of nerve cells between cortical neurons were discussed.

Acne scarring affects 30% of patients with moderate to severe acne vulgaris. It is particularly common in acne conglobata and acne fulminans. To reduce the incidence of scarring, acne is best treated early. There are various treatments available for acne scars, such as chemical peel, dermabrasion, laser (resurfacing), dermal fillers, punch grafting and subcision therapy. Fractional photothermolysis is a novel technology designed to create a network of microscopic intradermal zones of thermal injury in the dermis and overlying epidermis with islands of spared, normal tissue, using focused beams of infrared laser energy (1550nm). Fractional photothermolysis (Fraxel laser treatment; Reliant Technologies; Palo Alto; California) is currently approved by the US Food and Drug Administration for the treatment of periorbital rhytids and dyspigmentation. The Fraxel laser is a 30watt, diode pumped, 1,550nm erbium fiber laser that targets water as its chromophore. It is a safe and gradual laser procedure that stimulates the body to replace aged and photo-damaged skin, even on delicate skin areas, such as the neck, chest and hands. Utilizing the concept of fractional treatment, 70-100um wide and 250-800um deep, microthermal zones of tissue coagulation are produced. Tissue is not vaporized and the stratum corneum remains intact. The epidermal coagulated tissue is expelled and replaced by keratinocyte migration.When there is a significant damage to the basement membrane zone, the dermal contents are also expelled as microscopic epidermal and dermal necrotic debris. Zone of collagen denaturation in the dermis cause upregulation of the inflammatory cascade, which leads to collagen remodeling and new collagen formation. The mid-infrared wavelength of the Fraxel laser allows deeper penetration into the tissue without the injury observed with traditional ablative laser (such as lengthy downtime, severe pain and prolonged edema). The reported complications are post-inflammatory hyperpigmentation (up to 20%), hypopigmentation, infection and scarring.

Background: Dacryocystorhinostomy (DCR) is a surgical treatment for site of obstruction in the nasolacrimal duct system [1]. This surgery is performed in cases of congenital nasolacrimal obstruction, partial and complete occlusion of the nasolacrimal duct in adults, chronic tearing disorders, ineffective probing treatment and placement of a silicone tube in the nasolacrimal system [2,3]. the present findings indicate that preservation of lacrimal sac flaps with end-to-end anastomosis to the nasal mucosa using histoacryl has a positive impact on surgical outcome in patients undergoing endonasal endoscopic dacryocystorhinostomy [4]. Histoacryl glue is one of the most commonly surgical materials used recently. The basis of our study is the lack of research on the use of this glue in the practice of oculoplastic and reconstructive surgery. Purpose: The purpose of this study to comparing outcomes of surgical methods of histoacryl glue and silicone tube during endoscopic endonasal dacryocystorhinostomy. Methods: Retrospective, case series study. The study included 83 patients who underwent endonasal endoscopic dacryocystorhinostomy between January 2017 to June 2020. Whole case was divided into two groups. In group 1, an anastomosis was made during surgery by using histoacryl glue to the posterior wall of the lacrimal sac and the wall formed by the nasal mucosa [5]. In group 2, a silicone tube was placed in the nasolacrimal duct during endonasal dacryocystorhinostomy and the results were evaluated in the 1st, 3rd, 6th, and 12th months after surgery. Statistical calculations were performed using SPSS software. Results: The age of the whole cases was between 17 and 82 years. There were no significant difference among the age groups. In terms of gender, n=48 (78.7%) were female and n=13 (21.3%) were male, indicating that dacryocystitis was predominant in women. Study reports no significant difference in intraoperative and postoperative complication. The surgical success rate was significantly higher in histoacryl group 94.9%, than silicone tube group 79.5%. Recurrent cases n=2 (5.1%) in group 1 and n=9 (20.4%) in group 2 respectively. Conclusion Histoacryl glue is highly effective, commodity, inexpensive and easy to apply during endonasal endoscopic dacryocystorhinostomy surgery.

Objective Experiments were designed to investigate the effect of Euro-Collins (EC) solution and University of Wisconsin (UW) solution on function of pulmonary arterial endothelium.Methods Third order canine pulmonary artery segments were preserved in cold (4℃) UW (group 1, n=8) or EC (group 2, n=9) solutions for 16 hours. The preserved (group 1 and 2) and control (group 3, n=7) pulmonary arterial segments with and without endothelium were studied in vitro in organ chambers to measure isometric tension.Results The endothelium-dependent relaxation to acetylcholine and adenosine diphosphate of group 1 and 3 were significantly better than those of group 2.Conclusions We concluded that endothelium-dependent relaxation of canine pulmonary arterial endothelium to receptor-dependent acetylcholine and adenosine diphosphate were impaired after preservation with Euro-Collins solution. However, endothelium-dependent relaxation of pulmonary segments were well maintained after preservation with University of Wisconsin solution.

Hypoglycemia is a common finding in both daily clinical practice and acute care settings. The causes of severe hypoglycemia (SH) are multi-factorial and the major etiologies are iatrogenic, infectious diseases with sepsis and tumor or autoimmune diseases. With the advent of aggressive lowering of HbA1c values to achieve optimal glycemic control, patients are at increased risk of hypoglycemic episodes. Iatrogenic hypoglycemia can cause recurrent morbidity, sometime irreversible neurologic complications and even death, and further preclude maintenance of euglycemia over a lifetime of diabetes. Recent studies have shown that hypoglycemia is associated with adverse outcomes in many acute illnesses. In addition, hypoglycemia is associated with increased mortality among elderly and non-diabetic hospitalized patients. Clinicians should have high clinical suspicion of subtle symptoms of hypoglycemia and provide prompt treatment. Clinicians should know that hypoglycemia is associated with considerable adverse outcomes in many acute critical illnesses. In order to reduce hypoglycemia-associated morbidity and mortality, timely health education programs and close monitoring should be applied to those diabetic patients presenting to the Emergency Department with SH. ED disposition strategies should be further validated and justified to achieve balance between the benefits of euglycemia and the risks of SH. We discuss relevant issues regarding hypoglycemia in emergency and critical care settings.
Diabetes Mellitus/drug therapy ; Humans ; Hypoglycemia/blood/*chemically induced/*complications/epidemiology ; Hypoglycemic Agents/adverse effects/therapeutic use ; Insulin/adverse effects/therapeutic use

BACKGROUND/OBJECTIVES: Heavy alcohol consumption causes the development of alcoholic liver disease (ALD), a neglected but important public health problem. Many studies have pointed out that probiotics could improve gut health, which is also considered to be a cause of ALD. Therefore, this study screened the probiotics, Lactobacillus casei GKC1 (GKC1), L. fermentum GKF3 (GKF3), Bifidobacterium lactis GKK2 (GKK2), L. rhamnosus GKLC1 (GKLC1), L. paracasei GKS6 (GKS6), and L. plantarum GKM3 (GKM3), for their potential benefits in alleviating ALD for applications to disease prevention. SUBJECTS/METHODS: C57BL/6N mice were divided into 8 groups (n = 6 in each): normal control, positive control (alcohol-diet fed), and treatments of feeding probiotics GKC1, GKF3, GKK2, GKLC1, GKS6, and GKM3 under an oral dose 0.82 g/kg B.W. per day by oral gavage. The experiment was conducted for 8 weeks, and the concentrations of alanine aminotransferase (ALT), aspartate aminotransferase, triglyceride (TG), and total cholesterol (TC) in mice were measured. The glutathione (GSH), catalase (CAT), and histology were analyzed after sacrifice. RESULTS: The results showed a decrease in the serum ALT, liver TG, and liver TC levels in the GKS6, GKM3, and GKLC1 groups compared to the positive control. In addition, the decreasing GSH and CAT levels were inhibited in the GKS6 and GKM3 groups. The histopathological results showed that all probiotics could reduce the accumulation of liver fat. Furthermore, there was a significant difference in GKLC1 with lower stomach damage compared to the alcohol-fed mice without any addition of probiotics. CONCLUSIONS GKLC1, GKS6, and GKM3 can be used as supplements for alleviating the development of ALD.

Introduction: Dacryocystorhinostomy (DCR) is a surgical treatment for site of obstruction in the nasolacrimal duct system. This surgery is performed in cases of congenital nasolacrimal obstruction, partial and complete occlusion of the nasolacrimal duct in adults, chronic tearing disorders, ineffective probing treatment and placement of a silicone tube in the nasolacrimal system. the present findings indicate that preservation of lacrimal sac flaps with end-to-end anastomosis to the nasal mucosa using histoacryl has a positive impact on surgical outcome in patients undergoing endonasal endoscopic dacryocystorhinostomy. Histoacryl glue is one of the most commonly surgical materials used recently. The basis of our study is the lack of research on the use of this glue in the practice of oculoplastic and reconstructive surgery. Purpose: To report the use of fibrin glue as an adjunctive procedure in endoscopic dacryocystorhinostomy (En-DCR) surgery and compare it to silicone tubing Material and Method: Patients with primary nasolacrimal duct obstruction were retrospectively reviewed for endo-DCR between January 2017 and December 2019. Group I patients applied fibrin glue and Group II used silicone tube insertion. The fibrin glue group received end-to-end anastomosis of the nasal mucosa and lacrimal sac using fibrin glue at the end of surgery. The demographics, recurrence, causes of failure, formation of scars, final ostium size and the success rate were compared. This study was approved by the Institutional Review Board of the Chang Gung Memorial Hospital Clinical Research Ethnics Committee and followed the Declaration of Helsinki. All statistical analysis was performed with SPSS version 24.0 software (SPSS Inc., Chicago, IL, USA), and a P value < .05 was considered statistically significant. Continuous variables were presented as mean ± standard deviation, while categorical data was represented as numbers and percentages. Independent t-tests were used to compare the differences in parametric variables. The Mann-Whitney U test was performed to compare the follow-up period. Pearson’s chi-squared and Fisher’s exact tests were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factors associated with recurrence. Result: The age of the whole cases was between 17 and 82 years. There was no significant difference among the age groups. In terms of gender, n=48 (78.7%) were female and n=13 (21.3%) were male, indicating that dacryocystitis was predominant in women. Study reports no significant difference in intraoperative and postoperative complication. The surgical success rate was significantly higher in histoacryl group 94.9%, than silicone tube group 79.5%. Recurrent cases n=2 (5.1%) in group 1 and n=9 (20.4%) in group 2 respectively. Conclusion Fibrin glue improves the surgical outcome in patients undergoing Endo-DCR compared to commonly used silicone stenting by securing flaps apposition and maintaining the ostium opening.

PURPOSE: Severe hypoglycemia can result in neural damage, impaired cognitive function, coma, seizures, or death. The decision to admit diabetic patients after initial treatment in the emergency department remains unclear. Our purpose is to identify risk factors for developing recurrent hypoglycemia in diabetic patients admitted for severe hypoglycemia. MATERIALS AND METHODS: We reviewed the records of 233 subjects (92 males, 141 females; mean age, 74.1 +/- 9.8 years) with type 2 diabetes treated at a tertiary care teaching hospital and hospitalized for severe hypoglycemia. RESULTS: Seventy-four (31.8%) patients were categorized with recurrent hypoglycemia and 159 (68.2%) with non-recurrent. Multivariate logistic regression analysis revealed that patients with loss of a recent meal, coronary artery disease, infection, and poor renal function (lower estimated glomerular filtration rate) were at risk for recurrent hypoglycemia. The use of calcium-channel blockers appeared to be a protective factor for the development of recurrent hypoglycemia. CONCLUSION: There may be a subset of patients with severe hypoglycemia and certain risk factors for recurrent hypoglycemia that should be admitted.
Aged ; Aged, 80 and over ; Calcium Channel Blockers/adverse effects/therapeutic use ; Coronary Artery Disease/complications ; Diabetes Mellitus, Type 2/complications ; Female ; Glomerular Filtration Rate ; Hospitalization ; Humans ; Hypoglycemia/*etiology/*prevention & control ; Kidney Diseases/complications ; Logistic Models ; Male ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Risk Factors

PURPOSE: Aortic dissection (AoD) is one of the most common catastrophes involving the aorta. Nevertheless, early diagnosis remains to be a challenge in the Emergency Department (ED), particularly in young individuals. In this study, we attempted to identify the characteristics of acute AoD among young individuals, particular in patients with Marfan syndrome. MATERIALS AND METHODS: This was an retrospective chart-review study conducted in a tertiary referring hospital. The hospital database was queried for the combination of AoD and patients under age of 40 years. The medical charts were reviewed to obtain demographic data, clinical data and laboratory characteristics by using a standardized data collection sheet. A comparison between Marfan syndrome and non-Marfan syndrome patients was performed. RESULTS: During the 10-years period, 18 of 344 patients with acute AoD were younger than 40 years-old. Patients with Marfan syndrome developed acute AoD at a younger age than patients without Marfan syndrome. The mean diastolic blood pressure was significantly lower in patients with Marfan syndrome upon presenting to the ED than those without. Patients with Marfan syndrome had trends toward higher risk of development of type A AoD, increased recurrence rate and higher mortality rate than those without. However, statistical significance was not present. CONCLUSION: ED physicians should have high alert to acute AoD in young patients presenting with severe unexplained chest and back pain, particularly in those patients with a history of heart diseases, hypertension, and Marfan syndrome or featuring Marfanoid habitus. Acute coronary syndrome, unexplained abdominal symptoms, and sudden cardiac arrest could be the initial manifestation of AoD in young patients. A low threshold to perform enhanced computed tomography may facilitate early diagnosis and timely treatment in this patient population.
Adult ; Aneurysm, Dissecting/*complications/epidemiology/*pathology ; Aortic Aneurysm/complications/epidemiology/*pathology ; Asian Continental Ancestry Group ; Female ; Heart Defects, Congenital/complications/physiopathology ; Humans ; Hypertension/complications/physiopathology ; Male ; Marfan Syndrome/*complications/*physiopathology ; Middle Aged ; Retrospective Studies ; Young Adult