Objective:To explore the variation of tumor cell proteins correlated with cell proliferation and chemo-resis-tance after repeated treatment with chemotherapy drugs.Methods:The human lung cancer cell line(LPET-a-2)was repeat-edly treated with chemotherapy drugs:doxorubicin,etoposide,cisplatin and the combination of the3drugs,and each drug was given at2concentrations.The treatment intervals were recorded.ErbB-2,c-myc,MDR1,MRP,LRP,ref-1and NF-?B were tested by flow cytometry.The cells expressing each protein,the mean and total quantity of each protein after each treat-ment were calculated by different drugs at different concentrations.Results:The levels of every protein decreased along with the time of culture.In high-dose group,every item decreased along with the time of treatment.In low-dose group,there was no rule for the item variation with some decreased and some increased.Conclusion:Low-dose anticancer drugs are easier to induce cell proliferation and chemo-resistance than high-dose one,which suggests that adequate chemotherapy should be given in clinical practice.

OBJECTIVE: To investigate the usefulness and indications of arthrosonography by testing if the new technique could provide additional information on the degrees of rotator cuff tears when compaired to the findings of conventional ultrasonographic examinations. METHOD: Thirty six patients, who were identified to have partial or full-thickness rotator cuff tears by conventional ultrasonography, were included. Intraarticular injection of 15 ml of fluid was performed via posterior approach under ultrasound-guidance, which was followed by arthrosonography. RESULTS: Among 26 patients with partial-thickness tear which was detected by the conventional ultrasonography, eight were identified to have full-thickness tears by the arthrosonography. Although the difference was not significant, the grade 3 partial-thickness tear in the conventional sonography had a higher rate of being identified as full- thickness tear in the arthrosonography than the grade 2 partial-thickness tears. The size of partial-thickness tear was increased after instillation of fluid in the arthrosonography. CONCLUSION: Arthrosonography would be useful in differentiating partial- and full-thickness tears. When a tear of the rotator cuff tendon, especially a grade 3 partial-thickness tear, is detected in the conventional sonographic examination, an obscured full-thickness tear should be suspected and subsequent arthrosonographic procedure could be administered to clarify the extent of the lesion. Moreover, arthrosonography might be helpful in detecting partial-thickness tears by making them appear larger after instillation of fluid.
Humans ; Injections, Intra-Articular ; Rotator Cuff* ; Tendons ; Ultrasonography

Aspergillus tracheobronchitis is one form of invasive pulmonary aspergillosis which is characterized by ulcers and pseudomembrane formation in tracheobronchial tree. In Aspergillus tracheobronchitis, the infection is often limited to the mucosa and it accounts for less than 10 percents of invasive disease. Invasive aspergillosis mainly occurs in immunocompromized patients with prolonged neutropenia, advanced AIDS, organ transplantation, high-dose glucocorticoid therapy or cytotoxic therapy although it can occur in less immunocompromised patients, such as after influenza, COPD, old age, and diabetes. We report a case of Aspergillus tracheobronchitis in a 61 year-old patient with diabetes and Child Pugh class A liver cirrhosis. He presented with cough and purulent sputum for 10 days. He was diagnosed by bronchoscopy and successfully treated with antifungal therapy.
Aspergillosis ; Aspergillus ; Bronchitis ; Bronchoscopy ; Child ; Cough ; Diabetes Mellitus ; Humans ; Immunocompromised Host ; Influenza, Human ; Invasive Pulmonary Aspergillosis ; Liver Cirrhosis ; Mucous Membrane ; Neutropenia ; Organ Transplantation ; Pulmonary Disease, Chronic Obstructive ; Sputum ; Transplants ; Ulcer

The immune correlate of host resistance induced by reinfection of Trichinella spiralis remains unclear. In this study, we investigated immune correlates between the resistance and serum IgG antibody level, CD23⁺ IgM⁺ B cells, and eosinophil responses induced by T. spiralis reinfection. Mice were primarily infected with 10 or 100 T. spiralis larvae (10 TS, 100 TS), respectively, and after 4 weeks, they were challenge infected with 100 T. spiralis larvae (10–100 TS, 100-100 TS). Upon challenge infections, 10–100 TS mice induced significantly higher levels of T. spiralis-specific total IgG antibody responses in sera and antibody secreting cell responses in spleens compared to 100-100 TS mice, resulting in significantly reduced worm burdens in 10–100 TS mice (60% and 70% reductions for adult and larvae, respectively). Higher levels of eosinophils were found in mice primarily infected with 10 TS compared to those of 100 TS at week 8 upon challenge. CD23+ IgM+ B cells were found to be increased significantly in mice primarily infected with 10 TS. These results indicate that primary infection of 10 larvae of T. spiralis, rather than 100 larvae, induces significant resistance against reinfection which closely correlated with T. spiralis-specific IgG, eosinophil, and CD23+ IgM+ B cell responses.
Adult ; Animals ; Antibody Formation ; B-Lymphocytes ; Eosinophils ; Humans ; Immunoglobulin G ; Larva ; Mice* ; Spleen ; Trichinella spiralis* ; Trichinella*

Recent advances in understanding the anatomy of complete atrioventricular septal defect have led to alternative methods of repairing these defects. Here we report two cases of complete atrioventricular septal defect repair by direct closure of the ventricular element of the defect. Follow-up for average of 3 months suggests that, when direct closure can be performed, the results can be comparable with those of the standard technique. Our initial success with this approach is encouraging; however, longer follow-up and more experiences are required to establish whether it will be broadly applicable.
Follow-Up Studies

There have been few reports documenting the outcome of arterial swich operations(ASO) in selected patients with transposition of great arteries(TGA) and with left ventricular outflow tract obstruction(LVOTO). In the case of TGA with LVOTO, if the atrial septal defect(ASD) is large and the ventricular septal defect(VSD) is restricive, this deprives the left ventricle(LV) of approporiate preload and could lead to underdevelopment of the ventircular mass and lead poor LV performance after the arterial switch operation, dspite a high pressure in the LV preoperatively. Because an increase in the systolic ventricular pressure is not necessarily paralleled by an increase in ventricular mass, which is also essential for optimal ventricular performance after the operation. We report here a case of rapid LV training after ASO in TGA with unprepared LV (because of large ASD and restrictive VSD) despite a high pressure in the LV(due to LVOTO) preoperatively.
Heart Septal Defects, Ventricular* ; Humans ; Transposition of Great Vessels* ; Ventricular Pressure

Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6+/-3.4 months), Kawashima operation (n=4, interval=37.5+/-20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16-to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.
Allografts ; Aorta ; Arrhythmias, Cardiac ; Arteries ; Cardiac Output, Low ; Chest Tubes ; Chorea ; Crisscross Heart ; Diagnosis ; Drainage ; Female ; Follow-Up Studies ; Fontan Procedure* ; Heart ; Heart Atria ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Isomerism ; Male ; Mortality ; Myocardial Ischemia ; Pliability ; Polypropylenes ; Polytetrafluoroethylene ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Running ; Sutures ; Transplants ; Transposition of Great Vessels ; Tricuspid Atresia ; Vascular Resistance ; Vena Cava, Inferior ; Ventricular Function

Background: Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain. Methods: A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values. Results: A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007). Conclusion The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.

Background: Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain. Methods: A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values. Results: A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007). Conclusion The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.