BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

No abstract available.
Dermatitis* ; Tacrolimus ; Tetracycline*

BACKGROUND/AIMS: This study aimed to determine the regulatory role of N-acetyl-l-cysteine (NAC), an antioxidant, in interleukin 17 (IL-17)-induced osteoclast differentiation in rheumatoid arthritis (RA). METHODS: After RA synovial fibroblasts were stimulated by IL-17, the expression and production of receptor activator of nuclear factor κ-B ligand (RANKL) was determined by real-time polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA). Osteoclastogenesis was also determined after co-cultures of IL-17-stimulated RA synovial fibroblasts, Th17 cells and various concentrations of NAC with monocytes. After human peripheral CD4⁺ T cells were cultured with NAC under Th17 condition, IL-17, interferon γ, IL-4, Foxp3, RANKL, and IL-2 expression and production was determined by flow cytometry or ELISA. RESULTS: When RA synovial fibroblasts were stimulated by IL-17, IL-17 stimulated the production of RANKL, and NAC reduced the IL-17-induced RANKL production in a dose-dependent manner. NAC decreased IL-17-activated phosphorylation of mammalian target of rapamycin, c-Jun N-terminal kinase, and inhibitor of κB. When human peripheral blood CD14⁺ monocytes were cultured with macrophage colony-stimulating factor and IL-17 or RANKL, osteoclasts were differentiated, and NAC reduced the osteoclastogenesis. After human peripheral CD4⁺ T cells were co-cultured with IL-17-pretreated RA synovial fibroblasts or Th17 cells, NAC reduced their osteoclastogenesis. Under Th17 polarizing condition, NAC decreased Th17 cell differentiation and IL-17 and RANKL production. CONCLUSIONS: NAC inhibits the IL-17-induced RANKL production in RA synovial fibroblasts and IL-17-induced osteoclast differentiation. NAC also reduced Th17 polarization. NAC could be a supplementary therapeutic option for inflammatory and bony destructive processes in RA.
Acetylcysteine* ; Arthritis, Rheumatoid* ; Coculture Techniques ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Flow Cytometry ; Humans ; Interferons ; Interleukin-17 ; Interleukin-2 ; Interleukin-4 ; JNK Mitogen-Activated Protein Kinases ; Macrophage Colony-Stimulating Factor ; Monocytes ; Osteoclasts ; Osteogenesis ; Phosphorylation ; RANK Ligand ; Real-Time Polymerase Chain Reaction ; Sirolimus ; T-Lymphocytes ; Th17 Cells

In the article cited above, there was an error in the title.

The epithelial-mesenchymal transition (EMT) is important for embryonic development and the formation of various tissues or organs. However, EMT dysfunction in normal cells leads to diseases, such as cancer or fibrosis. During the EMT, epithelial cells are converted into more invasive and active mesenchymal cells. E-box-binding proteins, including Snail, ZEB and helix-loop-helix family members, serve as EMT-activating transcription factors. These transcription factors repress the expression of epithelial markers, for example, E-cadherin, rearrange the cytoskeleton and promote the expression of mesenchymal markers, such as vimentin, fibronectin and other EMT-activating transcription factors. Signaling pathways that induce EMT, including transforming growth factor-beta, Wnt/glycogen synthase kinase-3beta, Notch and receptor tyrosine kinase signaling pathways, interact with each other for the regulation of this process. Although the mechanism(s) underlying EMT in cancer or embryonic development have been identified, the mechanism(s) in embryonic stem cells (ESCs) remain unclear. In this review, we describe the underlying mechanisms of important EMT factors, indicating a precise role for EMT in ESCs, and characterize the relationship between EMT and ESCs.
Animals ; Cadherins/metabolism ; Embryonic Stem Cells/*cytology/metabolism ; *Epithelial-Mesenchymal Transition ; Humans ; Signal Transduction ; Transcription Factors/metabolism

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We will discuss clinical outcomes of adult traumatic atlantoaxial rotatory subluxation (Fielding type I) and verify the correlation between the clinical outcomes and radiological reduction rate. SUMMARY OF LITERATURE REVIEW: Atlantoaxial rotatory subluxation which usually occur in children by non-traumatic sources or minor trauma has been discussed persistently. However, studies of atlantoaxial rotatory subluxation which occur in adults over 20 years old, especially by traumatic injury is rare. MATERIALS AND METHODS: From October 2004 to April 2011, thirty patients diagnosed of traumatic atlantoaxial rotatory subluxation with 6 months follow-up period were enrolled in the study. After diagnosis, we started treating Halter traction with 5 lbs. We discontinued traction when the patient recovered over 90% of ROM and applied Philadelphia collar to the patient. We measured visual analogue scale (VAS) for cervical pain and ROM. We measured atlanto-dens interval (ADI) and lateral mass-dens interval (LDI) difference using three-dimensional computed tomography (3D-CT) to validate radiological reduction rate. RESULTS: At the end of follow-up, none of the patients complained over pain and all recovered to full ROM. ADI was in normal range during the whole treatment period. LDI difference gradually decreased during treatment period, however, only 8 cases (26.7%) came back to normal range. CONCLUSIONS: In traumatic atlantoaxial rotatory subluxation (Fielding type I), satisfactory clinical outcomes such as pain relief or ROM improvement using traction and the radiological reduction rate was also improved but it failed to achieve a complete reduction of LDI difference in radiography.
Adult ; Child ; Follow-Up Studies ; Humans ; Neck Pain ; Philadelphia ; Porphyrins ; Reference Values ; Retrospective Studies ; Traction

BACKGROUND: The objective of this study was to examine the correlation between arterial blood gas (ABG) and peripheral venous blood gas (VBG) samples for all commonly used parameters in patients admitted to a medical intensive care unit (ICU). METHODS: A single-center, prospective trial was carried out in a medical ICU in order to determine the level of correlation of ABG and peripheral VBG measurements. A maximum of five paired ABG-VBG samples were obtained per patient to prevent a single patient from dominating the data set. RESULTS: Regression equations were derived to predict arterial values from venous values as follows: arterial pH=-1.108+1.145xvenous pH+0.008xPCO2-0.012xvenous HCO3+0.002xvenous total CO2 (R2=0.655), arterial PCO2=88.6-10.888xvenous pH+0.150xPCO2+0.812xvenous HCO3+0.124xvenous total CO2 (R2=0.609), arterial HCO3=-89.266+12.677xvenous pH+0.042xPCO2+0.675xvenous HCO3+0.185xvenous total CO2 (R2=0.782). The mean ABG minus peripheral VBG differences for pH, PCO2, and bicarbonates were not clinically important for between-person heterogeneity. CONCLUSION: Peripheral venous pH, PCO2, bicarbonates, and total CO2 may be used as alternatives to their arterial equivalents in many clinical contexts encountered in the ICU.
Bicarbonates ; Blood Gas Analysis ; Humans ; Hydrogen-Ion Concentration ; Critical Care ; Intensive Care Units ; Prospective Studies

BACKGROUND: The objective of this study was to examine the correlation between arterial blood gas (ABG) and peripheral venous blood gas (VBG) samples for all commonly used parameters in patients admitted to a medical intensive care unit (ICU). METHODS: A single-center, prospective trial was carried out in a medical ICU in order to determine the level of correlation of ABG and peripheral VBG measurements. A maximum of five paired ABG-VBG samples were obtained per patient to prevent a single patient from dominating the data set. RESULTS: Regression equations were derived to predict arterial values from venous values as follows: arterial pH=-1.108+1.145xvenous pH+0.008xPCO2-0.012xvenous HCO3+0.002xvenous total CO2 (R2=0.655), arterial PCO2=88.6-10.888xvenous pH+0.150xPCO2+0.812xvenous HCO3+0.124xvenous total CO2 (R2=0.609), arterial HCO3=-89.266+12.677xvenous pH+0.042xPCO2+0.675xvenous HCO3+0.185xvenous total CO2 (R2=0.782). The mean ABG minus peripheral VBG differences for pH, PCO2, and bicarbonates were not clinically important for between-person heterogeneity. CONCLUSION: Peripheral venous pH, PCO2, bicarbonates, and total CO2 may be used as alternatives to their arterial equivalents in many clinical contexts encountered in the ICU.
Bicarbonates ; Blood Gas Analysis ; Humans ; Hydrogen-Ion Concentration ; Critical Care ; Intensive Care Units ; Prospective Studies

We present a 55-year-old female patient who underwent burr-hole drainage due to chronic subdural hematoma, with obstructive prosthetic aortic valve dysfunction. Anesthetic management of a patient with severe obstructive prosthetic aortic valve dysfunction can be challenging. Similar considerations should be given to patients with aortic stenosis with an additional emphasis on thrombotic complication due to discontinuation of anticoagulation, which may further jeopardize the valve dysfunction. This case emphasizes the importance of a comprehensive understanding of the etiology and hemodynamic consequences of obstructive prosthetic valve dysfunction and the adequacy of anticoagulation for patients undergoing noncardiac surgery even after a successful valve replacement.
Aortic Valve Stenosis ; Aortic Valve* ; Drainage ; Echocardiography ; Female ; Heart Valve Prosthesis ; Hematoma, Subdural, Chronic ; Hemodynamics ; Humans ; Middle Aged ; Thrombosis

BACKGROUND: The cuff of the laryngeal mask airway (LMA) is preferred to be partially inflated before insertion in pediatric cases. However, it is not known how much inflation is appropriate. In addition, intra-cuff pressure is not routinely monitored in many institutions despite the fact that a neglected high cuff pressure could cause several complications. This study was conducted to determine whether the cuff inflated with its resting volume before insertion could have a clinically tolerable intra-cuff pressure after insertion. METHODS: One hundred fifty unpremedicated children aged 0 to 9 yrs were enrolled. The pilot balloon valve was connected to a piston-free syringe to keep the valve open to the atmosphere and allowing the pressure within the cuff of to LMA to equalize to atmospheric pressure. Anesthesia was induced with 6 vol% of sevoflurane in oxygen. After insertion and final positioning of the LMA, the intra-cuff pressure was measured using a cuff pressure manometer. RESULTS: The mean intra-cuff pressure was 50 +/- 12.9 cmH2O; intra-cuff pressures were 39.1 +/- 9.3, 51.6 +/- 11.2, and 64.6 +/- 12.5 cmH2O for LMAs of sizes 1.5, 2, and 2.5, respectively. Intra-cuff pressure of more than 60 cmH2O was measured in 26 patients, and the median value was 70 cmH2O. There was weak statistical correlation among age, height, and weight with intra-cuff pressure. CONCLUSIONS: The cuff inflated by the resting volume before insertion may be a simple method for guaranteeing tolerable cuff pressure after insertion.
Aged ; Anesthesia ; Atmosphere ; Atmospheric Pressure ; Child ; Humans ; Inflation, Economic ; Laryngeal Masks ; Methyl Ethers ; Oxygen ; Syringes