Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when $1^{st}$ follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.
Recent studies have shown that opiods can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. This study sougt to compare the effects of morphine with those of bupivacaine administered intraarticularly upon pain after arthroscopic knee surgery. In a ramdomized manner, 60 healthy patients received either morphine(3 mg in 20 ml NaCl ; n=20), bupivacaine(20 ml, 0.25% ; n=20) intraarticularly at the completion of surgery, and others were not administered(n=20) under general anesthesia after 1, 2, 4, 6, 12 and 24h of postoperative day, pain was assessed by a visual analogue pain scales, time to first analgesic use were recorded. Pain scores were significantly greater in the morphine group than two groups at 1h. From 4th until the end of the study period, pain scores were significantly greater in the bupivacaine group than in the other two group. Anagesic requirements were significantly greater in the morphine group than two groups at 1h but were significantly greater in the bupivacaine group than in the other groups throughout the remainder of the study period. The results suggest that intraarticular morphine produces an analgesic effect of delayed onset but of remarkably long duration.
This presents the preliminary results from work in progress of a paired study of the acquisition of voiceless stops by Spanish speakers learning English, and American English speakers learning Spanish. For this study the hypothesis was that the American speakers would have no difficulty suppressing the aspiration in Spanish unaspirated stops; the Spanish speakers would have difficulty acquiring the aspiration necessary for English voiceless stops, according to Eckman's Markedness Differential Hypothesis. The null hypothesis was proved. All subjects were given the same set of disyllabic real words of English and Spanish in carrier phrases. The tokens analyzed in this report are limited to word-initial voiceless stops, followed by a low back vowel in stressed syllables. Tokens were randomized and then arranged in a list with the words appearing three separate times. Aspiration was measured from the burst to the onset of voicing(VOT). Both the first language (Ll) tokens and second language (L2) tokens were compared for each speaker and between the two groups of language speakers. Results indicate that the Spanish speakers, as a group, were able to reach the accepted target language VOT of English, but English speakers were not able to reach the accepted range for Spanish, in spite of statistically significant changes of p<.OOl by speakers in both groups of learners. A closer analysis of the speech samples revealed wide variability within the speech of native speakers of English. Not only is variability in English due to the wide range of VOT (120 msecs. for English labials, for example) but individual speakers showed different patterns. These results are revealing for the demands requied in experimental designs and the number of speakers and tokens requied for an adequate description of different languages. In addition, a simple report of means will not distinguish the speakers and the respective language learning situation; measurements must also include the RANGE of acceptability of VOT for phonetic segments. This has immediate consequences for the learning and teaching of foreign languages involving aspirated stops. In addition, the labelling of spoken language in speech technology is shown to be inadequate without a fuller mathematical description.
Objectives : This study was designed to examine the effects of hyperbaric oxygen therapy on cerebral infarction. Methods : Fifty-five patients with acute or subacute cerebral infarction were classified into two groups, the study group and control group. The study group was treated by hyperbaric oxygen therapy(HBOT) for 2 weeks(5 times/week) and the control group wasn't treated by HBOT. We compared the score of National Institutes of Health Scale(NIHSS scale) between two groups. We subdivided the study group by TOAST classification and onset stage, and compared the results. All of this data was analyzed by statistical method. Results : The study group patients who were treated by hyperbaric oxygen therapy saw more improvement than the control group patients in NIHSS score, and there was significant consideration. Among the study group patients, we saw more improvement during the first week period than in the course of the second week, and there was significant consideration. Conclusion : These results suggest that hyperbaric oxygen therapy(HBOT) could be a useful medical treatment to treat cerebral infarction. Further studies are needed on more cases to make sure that hyperbaric oxygen therapy (HBOT) is surely effective for cerebral infarction.
Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.
Journal of The Korean Dental Society of Anesthesiology
/
v.2
no.1
s.2
/
pp.1-6
/
2002
The usage of nitrous oxide is increased for the anxious patient to dental treatment. There are two methods to induce the sedation during dental treatment. One is sedation with drugs the other no need of drugs. We discussed here about sedation with drugs. The methods of drug administration are oral, intramuscular, intravenous, inhalation. The method of oral administration of drugs are convenient to patient and doctor but poor controllability. Intramuscular method is a parenteral technique that maintains several advantages over the enteral technique. However its pales in comparison to other parenteral technique. Intravenous method represents most effective method of ensuring predictable and adequate sedation in all patients. But it has inability to reverse the action of drugs after they have been injected except some drugs (e.g., narcotics and benzodiazepine). A variety of gaseous agents may be administered by inhalation to produce sedation. In dental practice, the inhalation administration of gas means use of nitrous oxide. There are many advantages of nitrous oxide administration. First, very short latent period and rapid onset of drug action which lead to possible titration of drug concentration. With nitrous oxide, clinical effects may become noticeable as quickly as 15 to 30 seconds after inhalation. Recovery from inhalation sedation is also quite rapid. In out patient dental practice rapid recovery is very important because it permit to discharge the patient without escort and the patient return to their ordinary life without limit. To success the conscious sedation with nitrous oxide, the administrator should be keep the mind that always titration of nitrous oxide concentration during induction and treatment. Careful observation need during treatment to prevent oversedation because the adequate nitrous oxide concentration to patients changed by environmental stress. Always begins with 100% oxygen and ends with 100% oxygen to prevent diffusion hypoxia which rare in clinical practice.
The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows ; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was $12.09{\pm}11.44$ hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.
Background: The expression of MMP genes has been demonstrated to be associated with tumor invasion, metastasis and survival rate for a variety of cancers. The functional promoter polymorphism MMP-2 C-735T is associated with decreased expression of the MMP-2 gene. The aim of present study was to detect any association between MMP-2 C-735T and susceptibility to breast cancer. Materials and Methods: The MMP-2 C-735T polymorphism was studied in 233 women (98 with breast cancer and 135 healthy controls). All studied women were from Kermanshah and Ilam provinces of Western Iran. The MMP-2 C-735T polymorphism was detected using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: The frequencies of MMP-2 CC, CT and TT genotypes in healthy individuals were 59.3, 38.5 and 2.2%, respectively. However, in breast cancer patients, only CC (71.4%) and CT (28.6%) genotypes were observed (p=0.077). In patients the frequency of the MMP-2 C allele was significantly higher (85.7%) compared to that in controls (78.5 %, p=0.048). The presence of C allele of MMP-2 increased the risk of breast cancer by 1.64-fold [OR=1.64 (95%CI 1.01-2.7, p=0.049)]. The frequency of MMP-2 C allele was also higher in patients ${\leq}40$ years (88.9%) than those aged ${\geq}41$ years (67.5%, p=0.07). In addition, the frequency of MMP-2 C allele tended to be higher in patients with a family history of cancer in first-degree relatives (76.6%) compared to that without a family history of cancer (67.3%, p=0.31). Conclusions: Our findings indicate that the C allele of MMP-2 C-735T polymorphism is associated with increased risk of breast cancer. Also, the MMP-2 C allele might increase the risk of young onset breast cancer in our population.
This study investigated the dynamics associated with prolonged ensiling and aerobic deterioration of whole crop corn (WCC) silages and total mixed ration (TMR) silages containing WCC (C-TMR silages) to clarify the differences that account for the enhanced aerobic stability of TMR silages. Laboratory-scale barrel silos were randomly opened after 7, 14, 28, and 56 d of ensiling and were subjected to analyses of fermentation quality, microbial and temperature dynamics during aerobic exposure. WCC and C-TMR silages were both well preserved and microorganisms were inhibited with prolonged ensiling, including lactic acid bacteria. Yeast were inhibited to below the detection limit of 500 cfu/g fresh matter within 28 d of ensiling. Aerobic stability of both silages was enhanced with prolonged ensiling, whereas C-TMR silages were more aerobically stable than WCC silages for the same ensiling period. Besides the high moisture content, the weak aerobic stability of WCC silage is likely attributable to the higher lactic acid content and yeast count, which result from the high water-soluble carbohydrates content in WCC. After silo opening, yeast were the first to propagate and the increase in yeast levels is greater than that of other microorganisms in silages before deterioration. Besides, increased levels of aerobic bacteria were also detected before heating of WCC silages. The temperature dynamics also indicated that yeast are closely associated with the onset of the aerobic deterioration of C-TMR silage, whereas for WCC silages, besides yeast, aerobic bacteria also function in the aerobic deterioration. Therefore, the inclusion of WCC might contribute to the survival of yeast during ensiling but not influence the role of yeast in deterioration of C-TMR silages.
Background: Expression of matrix metalloproteinases (MMPs) is up-regulated in human cancers. The aim of present study was to investigate the role of MMP-9 C-1562T polymorphism and its interaction with MMP-2 C-735T polymorphism in susceptibility to breast cancer in a population from Western Iran with Kurdish ethnic background. Materials and Methods: The study sample of 205 individuals consisted of 101 breast cancer patients and 104 healthy subjects. MMP-9 C-1562T and MMP-2 C-735T variants were identified using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: Among 67.4% of studied patients the breast cancer developed in the third and forth decades of the life. The frequency of MMP-9 T allele was 17.3% in patients and 10.1% in controls. The presence of T allele significantly increased the risk of breast cancer by 1.87-fold [OR=1.87 (95% CI 1.05-3.33, p=0.035)]. The frequency of MMP-9 CT+TT genotype tended to be higher in those patients with a family history of cancer in first degree-relatives (36.8%) than those without a family history (28.3%, p=0.37). We observed an interaction between the MMP-9 -1562 T allele with MMP-2 -735 C allele that significantly increased the risk of breast cancer [OR=1.42 (95% CI 1.02-1.98, p=0.036)]. Conclusions: The present study demonstrated that MMP-9 C-1562T polymorphism alone and in combination with MMP-2 C-735T polymorphism increased the risk of breast cancer that might be a useful biomarker in identifying women at risk of developing breast cancer. Also, this study revealed that in most women from Western Iran breast cancer presents in third and fourth decades of life.
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