No abstract available.
Bile Ducts* ; Bile*

We experienced a case of a primary aortoduodenal fistula, which was successfully diagnosed and repaired. This diagnosis must be considered in cases of gastrointestinal bleeding with an abdominal aortic aneurysm. If the correct diagnosis can be made promptly, surgical repair of the fistula is possible.
Aortic Aneurysm, Abdominal ; Diagnosis ; Fistula* ; Hemorrhage

No abstract available.
Insemination* ; Spermatozoa*

This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows: 1) Total number of respondents was 405; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized in surgery, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's major discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.
Surveys and Questionnaires ; Dentists* ; Fathers ; Hospitals, General ; Humans ; Internal Medicine ; Parents ; Surveys and Questionnaires ; Siblings ; Specialization ; Workplace

Total knee arthroplasty has been associated with marked blood loss despite the use of a tourniquet and minimal postoperative suction drainage. The purpose of this study was to determine the effect and complication of topically applied fibrin glue(Tisseel) on blood loss. Fibrin glue was used to coat the operative site with a fibrin clot to determine the effect on postoperative blood loss. We reviewed 71 cemented total knee arthroplasties from June, 1996 to April, 1998. 71 cases of the total knee arthroplasty was composed of 31 case without fibrin glue(Group I), 12 cases with 5cc fibim glue(Group II) and 28 cases with 10cc fibrin glue(Group III). Hemoglobin and hematocrit were assayed before surgery and 1 day after surgery, and we compared the amount of the total blood loss, autotransfusion in each groups. The average amount of total blood loss is 1362cc(775-2150) in group I,1164cc(505-1670) in Group II, 772 cc(380-1410) in Group III. The average amount of autotransfusion is 72.7%(990cc) of total blood loss in group I, 91.4%(1064cc) in group II, 90%(650cc) in Group III, and Group II & III can autotransfuse above 90% of total blood loss. No significant difference was noted in preoperative and postoperative hemoglobin and hematocrit between each groups. Administration of fibrin glue gives a significant reduction of blood loss, enables autotransfusion about 90% of total blood loss, and provide the advantages of safety from transmission of viral diseases and from immunologic reaction. In conclusion, fibrin glue is a safe and effective hemostatic agent for bleeding control after cemented total knee arthroplasty.
Arthroplasty* ; Blood Transfusion, Autologous ; Fibrin Tissue Adhesive* ; Fibrin* ; Hematocrit ; Hemorrhage* ; Knee* ; Postoperative Hemorrhage ; Suction ; Tourniquets ; Virus Diseases

No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

OBJECTIVE: To evaluate whether the rate of early mouse embryonal development could be enhanced by cumulus cell coculture in vitro. METHODS: Ham's F-10 culture media supplemented with 0.4% bovine serum albumin were used. Two-cell F1 mouse embryos were cultured in media with or without cumulus cells of female ICR mouse embryo for 96 hours, and the rates of embryonal development were observed and compared. RESULTS: The percentage of hatched blastocyst in the coculture group was significantly higher than that in the control group by 87.3% vs 64.8% respectively (p< 0.05). CONCLUSION: This study provides confirmative information that cumulus cell coculture will be useful in enhancing early mouse embryonal development.
Animals ; Blastocyst ; Coculture Techniques* ; Culture Media ; Cumulus Cells* ; Embryonic Structures ; Female ; Humans ; Mice* ; Mice, Inbred ICR ; Serum Albumin, Bovine

STUDY DESIGN: Thirteen patients with cervical interlocked facets dislocation in whom closed reduction by skull traction was failed were evaluated about the patterns of ruptured disc fragment. Objects : To evaluate the causes of failure at closed reduction, and the relation between ruptured discs and interlocked facets, and the treatment results through an anterior approach. SUMMARY OF LITERATURE REVIEW: In traumatic dislocation of the cervical facet joints, spinal cord or nerve roots injury associated with the ruptured disc fragment has been reported. However, there is few report evaluating the patterns of ruptured disc fragment as a cause of reduction failure. MATERIALS AND METHODS: Between 1988 and 1997, thirteen patients were treated by anterior fusion with plate after complete removal of the intervertebral disc through anterior approach and reduction of interlocked facets by O1iveira method. They have been followed for an average of 36 months(range : 12-96 months). The interlocking was bilateral in seven cases and unilateral in six cases. We assessed the types of ruptured disc fragment by preoperative MRI and CT and the clinical and radiological results. RESULTS: Ruptured disc fragment was found in all thirteen patients with interlocked facets dislocation. The patterns of ruptured discs were within the uncovertebral joints in 5 cases, posterioly under the posterior longitudinal ligament in 3 cases, anteriorly under intact anterior longitudinal ligament in 3 cases and combined under the anterior and posterior longitudinal ligament in 2 cases. The displacement of ruptured disc fragment were seemed to be the cause of failure in closed reduction. CONCLUSIONS: Intervertebral disc injury should be evaluated carefully with MRI and CT in the lower cervical interlocked facet dislocations before trial of reduction or decision makings of treatment.
Dislocations* ; Humans ; Intervertebral Disc ; Joints ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Skull ; Spinal Cord ; Spine* ; Traction ; Zygapophyseal Joint

OBJECTIVE: To estimate the predictive value of initial serum B-hCG and progesterone measurement for pregnancy outcome in IVF-ET. METHODS: Serum B-hCG at 11-12th day after embryo transfer and progesterone at 7th day after oocyte aspiration were measured in 48 successful pregnant IVF-ET cases from July 1993 to June 1997. RESULTS: Of 48 cases, 26 cases (54.2%) successfully carried to sustaining gestation and 22 cases (45.8%) failed to sustain gestation. The estimated initial serum B-hCG levels in the normal sustaining pregnancy group (132.28+ 22.42 mlU/ml) were statistical significantly higher than 29.43+8.08 mIU/ml in the failed sustaining pregnancy group (p<0.001), while the estimated initial serum progesterone levels showed no significant differences (p=0.159). In order to determine the predictive values using the Receiver Operator Curve (ROC), an appropriate cutoff value of 38 mIU/ml for initial serum B-hCG was obtained. In IVF-ET pregnancies, the estimated serum B-hCG levels in cases of chemical abortion in failed sustaining pregnancy were significantly lower compared to the normal sustaining pregnancy group (p<0.001). CONCLUSION: The initial serum B-hCG levels at 11 days after embryo transfer could be used to predict the pregnancy outcome in an IVF program. An initial progesterone level acquired on the 7th day after oocyte retrieval is not a useful indicator to predict pregnancy outcome.
Chorionic Gonadotropin* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Humans* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Progesterone*

The cytochrome P450 (CYP) 3A subfamily is estimated to participate in the biotransformation of 50% of the currently prescribed drugs. Four members of the CYP3A subfamily have been identified in humans: CYP3A4, CYP3A5, CYP3A7, and CYP3A43. Initial data suggested that CYP3A5 accounts for only a small proportion of the total hepatic CYP3A in about 20% of samples, but it was later revealed that CYP3A5 represents more than 50% of the total CYP3A amount in some individuals. Several genetic variants have been described for the CYP3A5 gene, of which the CYP3A5*3 allele (gA6986G), the most common form and leading to the loss of CYP3A5 activity, has been extensively investigated in the aspect of pharmacokinetics and disease risk. This review summarized the molecular characteristics of the CYP3A5 gene, and discusses the association of the CYP3A5*3 polymorphism with disease risks such as cancer and hypertension, along with its role in the pharmacokinetics of CYP3A substrates.
Alleles ; Biotransformation ; Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; Humans ; Hypertension ; Pharmacogenetics ; Pharmacokinetics