La crítica y la educación médica: hacia un conocimiento liberador. Parte II / Critique and medical education: towards liberating knowledge. Part II

Resumen La crítica del quehacer médico como espacio educativo implicó caracterizar el entramado de lógicas, ideas y prácticas prevalentes: la disyunción y el reduccionismo; el binomio salud-enfermedad; la historia natural de la enfermedad; la medicalización de la vida social; la tecnologización deshumanizante de la práctica médica, y la medicina supresora reduccionista. La crítica continúa discutiendo la contribución de ese entramado al control social como agente de la dominación de los intereses de lucro sin límites y como expresión del poder de la industria de la salud, justificándose con la argumentación de alternativas tendientes a superar ese entramado: la lógica transdisciplinaria y el concepto de organismo como totalidad jerarquizada e interactuante con su entorno respecto de la disyunción y el reduccionismo; la historia cultural de la enfermedad como alternativa a la historia natural de la enfermedad y al binomio salud-enfermedad; el bien vivir, la búsqueda de la superación espiritual, intelectual, moral y convivencial que confiere sentido profundo a la vida humana, como alternativa a la medicalización y antídoto de la tecnologización deshumanizante y los rasgos degradantes; la medicina estimulante de fuerzas curativas endógenas para afecciones crónicas no trasmisibles, cuyo fundamento de factibilidad y credibilidad radica en la omnipresencia del efecto placebo con respecto a la medicina supresora, basada en fármacos con efectos secundarios indefectibles. Sin una educación basada en la crítica, difícilmente el conocimiento liberador podrá acompañar y orientar a médicos y otros profesionales a organizarse en la búsqueda, desde su ámbito, de un mundo inclusivo, igualitario, justo, solidario y cuidadoso del ecosistema planetario.

Abstract The critique of medicine begins at unveiling and specifying its network of predominant logics, ideas and practices: logics of disjunction and reductionism; the health-disease binomial; the natural history of the disease; the medicalization of social life; the dehumanizing technologization of medical practice and reductionist suppressive medicine. It goes on to argue about its role as agents of domination of limitless profit interests and as an expression of the power of the health industry, justifying itself with the proposal of alternatives tending to overcome that network: transdisciplinarity and the concept of organism as hierarchical totality and interacting with its environment, with respect to disjunction and reductionism; the cultural history of the disease in relation to the health-disease binomial and the dehumanizing technologization; good living, the search for spiritual, intellectual, moral and coexistence growth as meaning of human life, as an alternative to the medicalization and antidote of degrading traits and stimulating medicine of the endogenous healing forces of the organism whose foundation of possibility and credibility is the placebo effect as an alternative to suppressive therapy for non-communicable chronic conditions, based on the pharmacological effect with unfailing side effects. It concludes that without an education based on critique, liberating knowledge would hardly accompany and guide the various social groups in the search for an inclusive, pluralistic, egalitarian, fair, solidary and caring of the planetary ecosystem world.

Protective effect of phytochemicals on the triclosan-induced DNA damag

Aim: Triclosan, an antibacterial and antifungal agent, is widely used in several consumer products, including soaps, toothpaste and surgical cleaning treatments. The present study aimed to examine oxidative DNA damage in rat lymphocytes and its protection by phytochemicals via comet assay. Methodology: DNA damage of rat lymphocytes induced by triclosan was measured by the olive tail moment in the comet assay. Following the addition of N-acetylcysteine, curcumin, berberine and resveratrol, the reduction of DNA damage was observed by using comet assay. Results: The increased olive tail moment induced by triclosan was significantly reduced upon treating N-acetylcysteine and three phytochemicals, such as curcumin, berberine and resveratrol. Notably, the oxidative DNA damage by triclosan was dramatically suppressed by curcumin close to the control value, which means almost complete protection in vitro. Interpretation: These results suggest that in vitro suppressive effect of curcumin, berberine and resveratrol against DNA damage by triclosan might be due to their antioxidative properties, and could be utilized for developing a reducing agent for triclosan toxicity. Key words: These results suggest that in vitro suppressive effect of curcumin, berberine and resveratrol against DNA damage by triclosan might be due to their antioxidative properties, and could be utilized for developing a reducing agent for triclosan toxicity.

Medicina supresora y medicina estimulante: una mirada penetrante de la práctica médica / Suppressive medicine and stimulant medicine: a penetrating view in medical practice

Resumen: La teoría de la medicina supresora (MS) y la medicina estimulante (ME) destaca dos formas radicalmente distintas de entender la enfermedad y de enfrentarla. Para la MS es un objeto extraño o ajeno al organismo que hay que disminuir o destruir (suprimir); para la ME es un trastorno de la armonía interna que requiere fortalecer o avivar el organismo para restablecerla (estimular). En la medicina moderna, el poder de la industria de la salud favorece el predominio de la MS, por su alta rentabilidad, y la marginación de las medicinas alternativas (MA), poco rentables que, al igual que la vacunación o las terapias sustitutivas y regenerativas, son formas de ME. El efecto placebo (EP) inherente a la práctica médica, revelador de fuerzas curativas endógenas susceptibles de estimulación, da sentido a la ME y credibilidad a las MA. La dirección del EP de lo macro (psicosocial) a lo micro (físico-químico) explica su alta especificidad y ausencia de efectos secundarios. El efecto farmacológico de lo micro a lo macro, opuesto a las fuerzas endógenas, conlleva indefectiblemente efectos secundarios que requieren ulteriores supresiones y dosis repetidas indefinidamente. Se analizan equívocos de la ciencia con respecto al EP y al imponer a las MA criterios metódicos propios de la MS, que las desvirtúa, descalifica y excluye como objetos de conocimiento. Se insiste en la necesidad de reconocer la ME y rescatar las MA para la indagación, a fin de explorar sinergias, complementos o reemplazos con relación a la MS en la búsqueda del bien vivir.

Abstract: The theory of suppressive (SuM) and stimulant (StM) medicine highlights two radically different ways of understanding and coping with diseases. For SuM it is a strange or foreign object to the organism that must be diminished or destroyed (suppressed); for StM it is a disorder of internal harmony that requires strengthening or enlivening the body to re-establish it (stimulate). In modern medicine, the power in the health industry favors the predominance of SuM, because of its high profitability, and the marginalization of low-cost alternative medicines (AM) that, like vaccination or substitutive and regenerative therapies, are forms of StM. The placebo effect (PE) inherent to medical practice, revealing of endogenous curative forces susceptible to stimulation, gives meaning to StM and credibility to AM. The direction of the PE from the macro (psychosocial) to the micro (physical-chemical) explains its high specificity and absence of side effects. The pharmacological effect of the micro to the macro, opposed to the endogenous forces, inevitably entails side effects that require further suppression and indefinite repetition of doses. Scientific assertions that misunderstand PE, and impose on the AM methodical criteria of the SuM that detract, disqualify and exclude them as objects of knowledge, are analyzed. The emphasis is on the need to recognize the StM and rescue the AM for inquiry in order to explore synergies, complements or replacements in relation to the SuM, in the quest for to live well.

Gastric cancer: the current status and risk factors / Монголын Анагаах Ухаан

@#Gastric cancer has been and still considered one of the most common causes of cancer-related mortality and it continues to be a major public health issue. The incidence and mortality of gastric cancer in Mongolia is the highest in the world. For this reason, this paper provides the information about current status of gastric cancer in Mongolia in the first section. Morbidity and mortality of gastric cancer increased steadily during the last decade. In the second section we overview the most important factors that can accelerate the risk of gastric cancer. Evidence from case-control, cohort studies and meta-analysis have suggested that the risk of gastric cancer is related to several factors including genetics, Helicobacter pylori, other factors related to the environment and lifestyle. Risk factors could have different effects on the onset and the evolution of gastric cancer.

El orden cultural, la enfermedad y el cuidado de la salud / Cultural order, disease and health care

Resumen: Con la llegada del Homo sapiens, el orden biológico fue reemplazado progresivamente en sus efectos por el orden cultural antropocéntrico (OC), donde las tradiciones preferencias, apreciaciones, así como los deseos de posesión y dominación guiaron las interacciones de los humanos con la naturaleza (depredación o cuidado), al interior de su grupo (rangos, clases) y con otros grupos (comercio, guerras). El OC actual se caracteriza por el lucro sin límite, que trae una concentración de la riqueza y una desigualdad extremas, donde la degradación moral toca fondo y el ecosistema planetario es devastado; todo esto evidencia una civilización colapsada, cuyo trasfondo son sociedades anestesiadas por los medios masivos de control. En el campo de la salud, el control opera por medio de las siguientes ideas y prácticas: la enfermedad como objeto extraño al organismo, la salud como ideal vital imperiosa y la medicina supresora de base tecnológica. Dichas ideas dan forma a la medicalización de la vida, principal "dispositivo" de control y sostén de la industria de la salud. Se argumentan otras ideas y prácticas alternativas: la enfermedad como trastorno de la armonía interna o como forma de ser diferenciada y particular de los humanos; y la medicina estimulante, cuyo objeto son las personas enfermas, teniendo como propósito fortalecerlas y armonizarlas a fin de que se restablezcan, alivien o serenen. Al final, se hacen consideraciones sobre las posibilidades y alcances de la medicina estimulante.

Abstract: With the appearance of Homo sapiens, the biological order was gradually replaced by the anthropocentric cultural order (CO), in which traditions, appreciations, preferences and desires for possession and domination guided their interactions with nature (predation or care), within the group (ranks, classes) and with others groups (commerce, wars). Current CO, characterized by unlimited profit interests, extreme wealth concentration and inequality where moral degradation hits rock bottom and planetary ecosystem is devastated, shows a collapsed civilization with a background of a global media controlled anesthetized societies. Regarding the health field, control works by prevalent ideas and practices: sickness as a strange object to the body, health as an imperative vital ideal and technologically based suppressive medicine shaping life's medicalization, main control "device" and health industry support. Other alternative ideas and practices are discussed: sickness as an inner harmony disturbance or as a differentiated and particular way of human beings, and stimulating medicine, that targets sick people with the purpose of strengthening and harmonizing them so they may recover, alleviate or appease. Considerations about possibilities and significance of stimulating medicine are made at the end.

Systematic Review of Acid-suppressive Drugs Used for the Prophylaxis of Stress Ulcer Bleeding in Postoperative Patients / 中国药师

Objective:To systematically review the efficacy and safety of acid-suppressive therapy including proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) and compare with those of placebo or blank control in the postoperative patients with stress ulcer bleeding (SUB) to provide evidence-based reference for clinical practice.Methods:The Cochrane library,Medline,Embase,CBM,CNKI,VIP,Wan Fang Data,clinicaltrials.gov,ISRCTN Register and WHO ICTRP were searched.Only randomized controlled trials (RCTs) of acid-suppressive therapy compared with placebo or blank control for postoperative stress ulcer bleeding were selected with bleeding rate,mortality,adverse drug reactions,gastric juice pH and length of stay as the indices.After the quality evaluation and data extraction,Meta-analysis was performed by using Stata12.0 statistics software.The results were expressed as relative risk(RR) and its corresponding 95% confidence interval(CI).Funnel plot and Eggers test were used to determine the publication bias;and then Grade approach was applied to assess the confidence in the evidence for each outcome.Results:Totally 15 trials enrolling 971 patients were selected,and acid-suppressive therapy was more effective than placebo or blank control in reducing the risk of stress ulcer bleeding,overt upper gastrointestinal bleeding and clinical important bleeding(RR 0.29,95% CI:0.19-0.45;RR 0.25,95%CI:0.10-0.64;RR 0.36,95%CI:0.17-0.77)(moderate),however,there was no statistical significance in the incidence of occult bleeding,mortality and adverse drug reactions (RR 0.79,95%CI:0.41-1.50;RR 0.49,95%CI:0.17-1.38;RR 0.78,95%CI:0.33-1.85,very low confidence).The subgroup analysis of drug classification,operation types and administration juncture showed that the incidence of SUB using PPI (RR=0.27) was lower than that using H2RA (RR=0.33);that of heart surgery (RR=0.20) was lower than that of general surgery (RR=0.31) and neurosurgery(RR=0.37);that of postoperative administration (RR=0.26) was lower than that of preoperative administration (RR=0.23).Conclusion:Acid-suppressive drugs seem to be more effective than placebo or blank control in reducing the risk of bleeding without significant increase of the risk of mortality or adverse drug reactions.The robustness of the conclusion is limited because of the low quality of the trial methodology,incomplete outcome indicators and lack of safety indices for pneumonia and clostridium diffcile-associated infection.Trials with high-quality and larger sample size are still needed to verify its clinical effects.

Roles of inflammatory cytokines in acute graft-versus-host disease and their mechanisms / 中华微生物学和免疫学杂志

Allogeneic hematopoietic stem cell transplantation ( allo-HSCT) is an effective therapy for the treatment of various malignant and non-malignant hematological diseases. Acute graft-verse-host-dis-ease ( aGVHD) , a major complication following allo-HSCT, is one of the predominant causes of GVHD-re-lated mortality. The development of aGVHD is a typical pathologic process with the release of inflammatory cytokines in great quantities, resulting in the occurrence ofcytokine storm and causing specific pathologi-cal damages by attacking the recipient organ. Therefore, identification of biomarkers specific for aGVHD of-fers promise to the treatment of aGVHD. In this review, we summarizes the functions of several typical in-flammatory cytokines, including IL-1β, IL-6, IL-17A and IL-10, and their mechanisms in the development of aGVHD in order to provide references for the prevention and treatment of aGVHD.

Multidrug resistance associated genes of leukemia separated by suppression subtractive hybridization / 国际检验医学杂志

Objective To isolate and identify differential expression genes associated with multidrug resistance of leukemia . Methods Differential expression genes between leukemia cell line K 562 and resistant cell lines K562/DOX were isolated by using suppression subtractive hybridization (SSH) technique .Total RNA were extracted .cDNA were synthesized and digested by restric-tion enzyme Rsa Ⅰ ,then connected with adopter1 and adopter2R ,and linked with pMD19-T vector .Constructed vectors were trans-ferred into E .coli .Subtracted cDNA library was constructed ,and the positive clones were screened according to base sequences and homologous sequences .The differential expression genes were indentified by comparison analysis of Gene Bank database .Results A total of 220 differential expression genes were sequenced ,including hemoglobin ,ribosomes and mitochondria related genes ,and heat shock factor binding protein 1 (HSPB1) gene and other genes .Conclusion SSH method and molecular cloning technique could be used to construct subtracted cDNA library of differential expression genes between drug resistant and not -resistant leukemia cells , which might be useful for further screening and cloning of differential expression genes of multidrug resistant tumor cells .

Antiplasmodial Activity of Ethanolic Leaf Extracts of Spilanthes uliginosa, Ocimum basilicum (Sweet Basil), Hyptis spicigera and Cymbopogon citratus on Mice Exposed to Plasmodium berghei Nk 65.

In Africa and elsewhere, medicinal plants including Spilanthes uliginosa, Ocimum basilicum, Hyptis spicigera and Cymbopogon citratus are still widely used in the treatment of malaria and other ailments. The aim of the present study was to investigate in vivo antiplasmodial effect of ethanolic leaf extract of these plants in mice. Oral acute toxicity of the extracts was evaluated in mice using modified Lorke’s method and their in vivo anti-plasmodial effect against early infection, curative effect against established infection and prophylactic effect against residual infection were studied using total WBC count in chloroquine-sensitive Plasmodium berghei NK 65-infected mice. The oral median lethal dose of the extract in mice was determined to be greater than 2000 mg kg-1 body weight. The results indicated a significant (P<0.05) daily increase in the level of parasitaemia in the parasitized untreated groups and a significant (P<0.05) dose dependent decrease in the level of parasitaemia in the parasitized groups treated with varying doses of the various medicinal plants and the standard drug. Overall, the dose dependent effects were in the order of: 5mg/kg body weight of chloroquine > 800 mg/kg > 400 mg/kg > 200 mg/kg body weight of the plant extracts with the efficacy of the plants in the order of: H. Spicigera > O. basilicum > C. citratus > S. uliginosa (Sw) with minor variations. The implications of these results is that Spilanthes uliginosa, Ocimum basilicum, Hyptis spicigera and Cymbopogon citratus ethanolic leaf extracts posses potent antimalarial effects and may therefore serve as potential sources of safe, effective and affordable antimalarial drugs.

Thyroid function maintenance following thyroidectomy / 国际外科学杂志

Postoperative hypothyroidism is the most common complication following thyroidectomy,and thyroxine replacement is needed to maintain thyroid function.Levothyroxine (L-T4) is the preferred drug for the treatment of hypothyroidism.L-T4 therapy can be initiated immediately after thyroid operation,and the dosages are influenced by target serum TSH and several other factors.Special consideration should be taken for such patients,including patients with poor compliance,during pregnancy,and elderly patients.Thyroid function should be measured every 4 to 6 weeks,optimal dosages are adjusted according to target serum TSH individually,avoiding under-treatment or over-treatment.T3 in divided doses or L-T4/T3 combination therapy can be served as alternative for those failed to L-T4 therapy alone.

Correlation between acid-suppressive medications and risk of osteoporosis-related fractures:a meta-analysis / 中国组织工程研究

BACKGROUND:Whether a long-term use of acid-suppressive medication for over 3 years can increase the risk of fractures, remains controversial. OBJECTIVE:To systematical y review the effect of acid-suppressive medication on fracture risk. METHODS:Clinical trials about the relationship of acid-suppressive medication use and risk of osteoporosis-related fractures were searched in MEDLINE, Cochrane Library, EMbase, and CNKI database. We also manual y searched some published and unpublished references. Study selection and assessment, data col ection and analyses were undertaken by two reviewers independently. The Cochrane Col aboration’s RevMan 5.0 software was used for data analyses. RESULTS AND CONCLUSION:After a comprehensive search, 11 original clinical trials were included in this meta-analysis, including 3 nested case-control studies, 5 case-control studies, and 3 cohort studies. Patients with fractures were more likely than controls to have previously received supply of proton pump inhibitors [odds ratio (OR)=1.29, 95%confidence interval (CI) (1.18-1.41), P<0.001]. The meta-analysis did not find a significant difference in the patients who received H2 receptor antagonists [OR=1.10, 95%CI (0.99-1.23), P=0.34]. A long-term use of proton pump inhibitors is associated with an increased risk of fracture in elderly persons already at a risk for osteoporosis.

Construction of an SSH cDNA library from symbiotic germinated seeds of Dendrobium officinale and sequence analysis / 中国药学杂志

OBJECTIVE: To investigate differential gene expression profiling of symbiotic germinated seeds of Dendrobium officinale. METHODS: cDNAs from 5-week symbiotic germinated seeds and 5-week aseptic cultivated seeds, taken as the tester and driver respectively, were used to construct a suppressive subtractive hybridization (SSH) cDNA library. RESULTS: By sequencing positive clones and BLASTx analysis against GenBank database, 100 expressed sequence tags (EST) homologous to plant known genes were obtained. Functional annotation revealed that they were grouped into serials of cellular processes including cell and chromosome structure, RNA synthesis, signal transduction, energy metabolism, protein synthesis and degradation, and cell defense, etc. Real-time quantitative RT-PCR analyses showed that the five randomly selected genes were all up-regulated in symbiotic germinated seeds. CONCLUSION: The symbiotic seed germination of D. officinale is involved in multiple pathways, and the results of this study will lay a foundation for further molecular elucidation of seed germination in Orchidaceae.

Ribavirin Does Not Impair the Suppressive Activity of Foxp3+CD4+CD25+ Regulatory T Cells

Ribavirin is an antiviral drug used in combination with pegylated interferon-alpha (IFN-alpha) for the treatment of hepatitis C virus (HCV) infection. Recently, ribavirin was reported to inhibit the suppressive activity of regulatory T (Treg) cells. In the present study, we re-evaluated the effect of ribavirin on Foxp3+CD4+CD25+ Treg cells from normal donors. First, we examined the expression of CTLA-4 and CD39, which are known to play a role in the suppressive function of Treg cells. We found that ribavirin treatment did not modulate the expression of CTLA-4 and CD39 in Treg cells. We also studied the effect of ribavirin on Treg cells in the presence of IFN-alpha; however, the expression of CTLA-4 and CD39 in Treg cells was not changed by ribavirin in the presence of IFN-alpha. Next, we directly evaluated the effect of ribavirin on the suppressive activity of Treg cells in the standard Treg suppression assay, by co-culturing CFSE-labeled non-Treg CD4+ T cells with purified Treg cells. We found that ribavirin did not attenuate the suppressive activity of Treg cells. Taken together, while ribavirin reversed Treg cell-mediated suppression of effector T cells in the previous study, we herein demonstrate that ribavirin does not impair the suppressive activity of Treg cells.

Suppressive Effects of Aqueous Extracts of Neem (Melia Azadirachta L.) on Some Initial Growth Parameters of Cow Pea & Horse Gram.

The suppressive effects of different concentrations of aqueous leaf extracts of Neem (Melia azadirachta L.) on cow pea (Vigna unguiculata L.) and horse gram (Dolichos biflorus L.).The experiment was conducted in sterilized petridishes with a photoperiod of 24 hours on an average temperature. The result showed that aqueous leaf extract of Melia azadirachta caused siginifican inhibitory effect on seed germination, root and shoot elongation and fresh & dry weight of receptor plants. The effect was proportional to the concentrations of the extracts and higher concentration had the stronger inhibitory effect. The study also revealed that inhibitory effect was much pronounced in shoot development than the root of cow pea. Likewise root development greatly inhibited than the shoot in horse gram.

Construction of differential cDNA library on the roots of Dendrobium candidum induced by a symbiotic mycorrhizal fungus / 中国药学杂志

OBJECTIVE: To screen differentially expressed genes on the roots of Dendrobium candidum induced by a symbiotic mycorrhizal fungus, the differential cDNA library was constructed. METHODS: The ds cDNAs were synthesized and enriched by SMARTer PCR cDNA synthesis kit using total RNA of D. candidum roots symbiotic with the fungus as templates. The differential cDNA library was constructed by using suppressive subtraction hybridization (SSH). RESULTS: The differential cDNA library, containing 1975 clones in the storage capacity, was constructed successfully. It was detected that above 90% clones could be amplified effective products. The lengths of the differential cDNA fragments cloned were 150 bp to 1 kb by electrophoresis detection to 20 randomly selected clones. Then, the 20 ESTs similarity analysis based on BLASTx software was carried on and most of the cloned genes were the defensive genes of plant responding to environmental stresses. CONCLUSION: Using this technology system could construct a fine differential cDNA library and be operated easily, especially suitable to the rare species.

Thyrotropin suppressive therapy in differentiated thyroid carcinoma / 中华内分泌代谢杂志

TSH suppression therapy plays an important role in differentiated thyroid carcinoma. It can lower mortality and recurrence rate in high risk patients. Meanwhile, it also has potential side effects on cardiovascular and skeletal systems. Thus, TSH suppressive therapy should be individualized in regard to its possible benefit and potential adverse effects.

Individualized thyrotropin suppression in patients with differentiated thyroid cancers / 中华内分泌代谢杂志

The epidemic characteristics of differentiated thyroid cancer(DTC)are changing, thyrotropin(TSH)suppressive therapy is also improving in recent years. The risks of recurrence and the death of patients, as well as the adverse effects of levothyroxine sodium treatment should be fully considered during thyroid hormone administration for patients of DTC. Hence, the degree of TSH suppression should be individualized in patients with DTC.

Osteoclast-Forming Suppressive Compounds from Anoectochilus formosanus / 日本補完代替医療学会誌

<i>Anoectochilus formosanus</i>, an orchidaceous plant native to Taiwan, is widely used as a folk medicine in Taiwan and other Southeast Asian countries. We attempted to isolate the bioactive principles from <i>A. formosanus</i> and succeeded in purifying the compounds. Two known compounds (<i>N</i>-<i>cis</i>-feruloyl tyramine and <i>N</i>-<i>trans</i>-feruloyl tyramine) were isolated and both significantly inhibited osteoclast formation, which is important in the development of osteoporosis.<br>

DINÁMICA MICROBIANA EN VERMICOMPOSTAS COMERCIALES CON Y SIN INOCULACIÓN DEL HONGO Trichoderma spp / Microbial dynmiccs in commercial vermicomposts with and withot trichoderma sspp. fungus inoculation

En el presente trabajo se presentan los resultados de un ensayo en el cual se evaluó la efectividad de la inoculación del hongo Trichoderma spp, en una vermicomposta comercial, comparándose ésta con la población del hongo presente en un vermicompost sin inocular. El experimento se realizó en el laboratorio de postcosecha de la Universidad de Costa Rica. Se desarrolló en tres fases (cultivo, aislamiento e inoculación de cepas del hongo) y se utilizaron tres vermicompostas comerciales elaboradas a partir de un sustrato de broza de café, procedentes de diferentes composteras. Los resultados muestran que no hubo aumento ni disminución de la población de Trichoderma como producto de la inoculación de cepas del mismo.

In tThis paper, presents the results are presented onof the growthefectiveness of the Trichoderma fungus in a inoculation in a commercial vermicompost, in comparison with the fungus from a vermicompostand without inoculation. In a three-phase laboratory process (cultivation, isolation and inoculation of fungal strains), three different commercial vermicompost, prepared from coffee pulp, have beenwere used, coming from three different commercial vermicomposts. The results of experiments carried out in the Post-Harvest Laboratory of the Universidad de Costa Rica, don’t show any increase or decrease of the Trichoderma population after inoculation. The experiment was carried out in the Post -harvest Laboratory of University of Costa Rica. It was developed following three phases, using three commercial vermicompost prepared with broza of coffee. Results showed no differences in Trichoderma population as product of inoculation of it into the compost.

Effectiveness of Suppressive Therapy with Levothyroxine in Benign Thyroid Nodules / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The effectiveness of suppressive therapy with Levothyroxine in benign thyroid nodule is controversial. The favorable response varies between 9-68%. The aim of this study was to evaluate the effect of Levothyroxine suppressive therapy on benign thyroid nodules in comparison with untreated patients. SUBJECTS AND METHOD: A total 98 patients diagnosed with benign thyroid nodules by high resolution ultrasonography and fine needle aspiration cytology from January 2001 to June 2007 was evaluated retrospectively. The case group included 55 patients who received Levothyroxine suppressive therapy for longer than 6 months with documentation of thyroid stimulating hormone (TSH) suppression level. The control group included 43 patients who were followed up without any treatment. We measured TSH, free T4, and thyroid nodule volume by ultrasound every 6 months. RESULTS: In 13 patients (23.6%) of the case group, nodule volume decreased more than 50% after the Levothyroxine suppressive therapy. In 10 (23.2%) of the control group, nodule volume decreased more than 50 % after the follow-up of 6 months. There was no significant difference between the two groups. The change of nodule volume was not related to the TSH suppression level, the number of nodule or the type of nodule. CONCLUSION: We concluded that Levothyroxine suppressive therapy was not effective in volume reduction of benign thyroid nodules.