BACKGROUND AND OBJECTIVES: Hyperacute rejection (HAR) is a major obstacle to successful xenotransplantation of vascularized organs. This study was conducted to observe the effect of hemolysis of perfused human whole blood on pig heart function, and determine the major risk factors for preservation of xenoperfused cardiac function using ex-vivo pig to human xenogeneic cardiac perfusion model. MATERIALS AND METHODS: Harvested pig hearts were perfused with normal human whole blood (group 1), two different types of pre-treated human whole blood (group 2: immunoglobulins were depleted by plasmapheresis, group 3: pre-treated with plasmapheresis, GAS914, cobra venom factor (CVF) and steroid), and normal porcine whole blood as control (group 4) for 3 hours. RESULTS: Duration of heart beat was significantly prolonged in group 2 and group 3. Histological examination showed widespread HAR features but was gradually delayed in groups 2 and 3 compared to group 1. The absolute levels of serum creatine kinase-MB and Troponin I increased gradually, and was lower in group 3. Serum hemoglobin levels were rapidly increased in groups 3 and 4, compared to group 1. Extracellular potassium level increased sharply from the beginning of blood perfusion in groups 1, 2 and 3, compared to group 4. CONCLUSION: Pretreatment of human whole blood, including immunoglobulin depletion, CVF and steroid reduced and delayed the destruction of pig myocardium by HAR. However, the increased extracellular potassium levels in groups 1, 2 and 3 reflected that these treatments could not prohibit myocardial injury by HAR.
Cobra Venoms ; Creatine ; Diphtheria Toxoid ; Extracorporeal Circulation ; Haemophilus Vaccines ; Heart ; Hemoglobins ; Hemolysis ; Humans ; Hyperkalemia ; Immunoglobulins ; Myocardium ; Perfusion ; Plasmapheresis ; Potassium ; Rejection (Psychology) ; Risk Factors ; Transplantation, Heterologous ; Trisaccharides ; Troponin I

Radiographic sagittal plane analysis of VATS (video-assisted thoracoscopic surgery) anterior instrumentation for adolescent idiopathic scoliosis. This is retrospective study. To report, in details about effects of VATS anterior instrumentation on the sagittal plane. Evaluations of the surgical outcome of scoliosis have primarily studied in coronal plane correction, functional, and cosmetic aspects. Sagittal balance, as well as coronal balance, is important in functional spine. Recently, scoliosis surgery applying VATS has been increasingly performed. Its outcome has been reported several times; however, according to our search of the literature, the only one study partially mentioned. The study population was a total of 42 cases of idiopathic scoliosis patients (8 male, 34 female). Their mean age was 15.6 years (13 to 18 years). The 18 cases were Lenke IA type, 16 cases were Lenke IB type, and 8 cases were Lenke IC type. The preoperative Cobb's angle was 54.5 +/- 13.9 degrees. All patients were followed up for a minimum of 2 years and implanted, on average, at the 5.9 level (5 to 8 levels). The most proximal implant was the 4th thoracic spine, and the most distal implant was the 1st lumbar spine. Whole spine standing PA and lateral radiographs were taken before surgery, 2 months after surgery, and at the last follow up (range 24-48 months, mean 35 months). The C7 plumbline proximal junctional measurement (PJM), distal junctional measurement (DJM), thoracic kyphosis, and lumbar lordosis angles were measured and compared. In all cases, follow-ups were possible and survived till the last follow up. The Cobb's angle in coronal plane at the last follow up was 19.7 +/- 9.3 degrees and was corrected to 63.8% on average. The preoperative C7 sagittal plumbline before surgery was -13.9 +/- 29.1mm, the final follow up was -9.9 +/- 23.8mm, and the average positive displacement was 4mm. Thoracic kyphosis was increased from preoperative 18.2 +/- 7.7 degrees to 22.4 +/- 7.2 degrees on average at the last follow up, and the increase was, on average, 4.2 degrees. The PJM angel was increased from 6.2 +/- 4.3 degrees preoperative to 8.8 +/- 3.7 degrees at the last follow up, and the increment was, on the average, 2.6 degrees. The DJM angle before surgery was 6.8 +/- 5.1 degrees and 6.7 +/- 4 degrees at the last follow up, and did not change noticeably. Preoperative lumbar lordosis was 42 +/- 10.7 degrees and 43.5 +/- 11.1 degrees after surgery. Similarly, it did not change greatly. The scoliosis surgery applying VATS displaced the C7 sagittal plumb line by 4mm to the anteriorly, increased thoracic kyphosis by 4.2 degrees, and increased PJM by 2.6 degrees. DJM and lumbar lordosis, before and after operation, were not significantly different. Although the surgical technique of VATS thoracic instrumentation is difficult to make the normal thoracic kyphosis, an acceptable sagittal balance can be obtained in Lenke type I adolescent idiopathic scoliosis using VATS.

PURPOSE: Certain pitching mechanics is thought to lead pitchers in danger of surgical risk and decrease performance. The objective of this study is to analyze the effect of shoulder hyperabduction position during early cocking phase in association with surgical risk and performance in professional baseball players.METHODS: From 2009 to 2013, total of 93 candidates reached minimum inning qualification. After exclusion criteria (overlapped players, foreign players, age over 31 years, proceed to other league and retirement), 19 players were analyzed with slow-motion pitching video for hyperabduction of the shoulder and hyperpronation of forearm in cocking-phase. Also players were analyzed with innings pitched, earned run average (ERA), walks and hits divided by innings pitched (WHIP) and surgical history with database offered by official Korean Baseball Organization website.RESULTS: Out of total 19 players, nine players had hyperabduction arm movement and 10 players did not. Group with hyperabduction had average age of 24.3 years old, average inning/ERA/WHIP for 5 years were 55 innings/yr, 6.52 ERA/yr and 1.33 WHIP/yr, respectively, and seven players (77%) had surgeries eventually. Group without hyperabduction arm movement had average age of 25.4 years old; average inning, ERA/WHIP for 5 years were 127 1/3 innings/yr, 4.84 ERA/yr, and 1.32 WHIP/yr, respectively and five players (50%) went for surgeries. Player performance (ERA, p=0.66; WHIP, p=0.14) was not statistically influenced by the certain arm position at cocking phase but average inning pitched was statistically affected (p<0.01).CONCLUSION: Hyperabduction of shoulder in early cocking phase of throwing motion does not lead to decrease in performance (ERA, WHIP) but will result in tremendous decline of average IP. Also, risk of surgery is not associated to hyperabduction motion of the shoulder.
Arm ; Baseball ; Forearm ; Mechanics ; Shoulder

Sertoli cells (SC) are known to contain immunoprotective properties, which allow them to survive as allografts without the use of immunosuppressive drugs. Experiments were designed to determine which factors are related to prolonged survival of allogeneic SC. Balb/c derived Sertoli (TM4) and colon cancer (CT-26) cell lines were implanted beneath the kidney capsule of non-immunosuppressed C57BL/6 mice and compared their survival as allografts. Compared to TM4 graft, which survived more than 7 days after transplantation, CT-26 showed massive infiltration of polymorphonuclear cells, necrosis and enlargement of draining lymph nodes. Cultured cell lines showed no differences in their expression patterns of FasL, TGF beta1, clusterin and two complement regulatory proteins (CRP, i.e., membrane cofactor protein, MCP; decay accelerating factor, DAF), but protectin (CD59), another member of CRP was expressed only on TM4. These results suggest that CD59 and unknown factors may contribute to the prolonged survival of SC in non-immunoprivileged sites.
Transplantation, Homologous/immunology ; Transforming Growth Factor beta1/*immunology ; Sertoli Cells/*immunology/*transplantation ; Mice, Inbred C57BL ; Mice ; Male ; Graft Survival/*immunology ; Female ; Fas Ligand Protein/*immunology ; Complement System Proteins/*immunology ; Clusterin/*immunology ; Cells, Cultured ; Cell Survival ; Animals

According to recent studies, the immunogenetic factors are thought to be account for a part of the etiopathogenesis of autoimmune thyroid disease. In Korea, there was one report on the relationship between HLA DR5, DR8, B13 and autoimmune thyroid disease. There were also several reports on a familial hereditary transmission of autoimmune thyroid disease in other countries but not in Korea. We describe the occurrence of autoimmune thyroid disease that affected three members of a family through three generations. This is the first report on familial hereditary transmission of autoimmune thyroid disease in Korea. We report on an 80-year-old woman who presented with Hashimoto's thyroiditis, her 53-year-old daughter who had Graves' disease, and her 29-year-old grand-daughter who had Graves' disease. In order to identify the immunogenetic influence in these cases, HLA haplotypes & thyroid autoantibody were studied. HLA DRB3*02 was obseved in each of the patents. HLA DQB1*0301, DR11, DQB1*05031 and DR14 were observed in the two cases. However, HLA B13, DR5 and DR8 were not observed. The patients are currently undergoing follow-up using PTU, methimazole and synthyroid medication.
Adult ; Aged, 80 and over ; Family Characteristics ; Female ; Follow-Up Studies ; Graves Disease ; Haplotypes ; HLA-B13 Antigen ; Humans ; Immunogenetics ; Korea ; Methimazole ; Middle Aged ; Nuclear Family ; Thyroid Diseases* ; Thyroid Gland* ; Thyroiditis

No abstract available.
Leukemia, Myeloid, Acute*

The understanding of main mechanisms that determine the ability of immune privilege related to Sertoli cells (SCs) will provide clues for promoting a local tolerogenic environment. In this study, we evaluated the property of humoral and cellular immune response modulation provided by porcine SCs. Porcine SCs were resistant to human antibody and complement-mediated formation of the membrane attack complex (38.41+/-2.77% vs. 55.02+/-5.44%, p=0.027) and cell lysis (42.95+/-1.75% vs. 87.99 +/-2.25%, p<0.001) compared to immortalized aortic endothelial cells, suggesting that porcine SCs are able to escape cellular lysis associated with complement activation by producing one or more immunoprotective factors that may be capable of inhibiting membrane attack complex formation. On the other hand, porcine SCs and their culture supernatant suppressed the up-regulation of CD40 expression (p<0.05) on DCs in the presence of LPS stimulation. These novel findings, as we know, suggest that immune modulatory effects of porcine SCs in the presence of other antigen can be obtained from the first step of antigen presentation. These might open optimistic perspectives for the use of porcine SCs in tolerance induction eliminating the need for chronic immunosuppressive drugs.
Animals ; Antibodies, Heterophile/immunology ; Antibody Formation/*immunology ; Antigens, CD40/immunology ; Aorta/cytology ; Cell Line, Transformed ; Cell Survival/immunology ; Complement Membrane Attack Complex/immunology ; Complement System Proteins/immunology ; Dendritic Cells/cytology/immunology ; Endothelial Cells/cytology/immunology ; Epitopes/immunology ; Humans ; Immune Tolerance/*immunology ; Immunity, Cellular/*immunology ; Male ; Mice ; Mice, Inbred C57BL ; Sertoli Cells/cytology/*immunology ; Swine ; *Tissue Engineering ; Transplantation, Heterologous

STUDY DESIGN: Literature review. OBJECTIVE: The aim of this article is to introduce the EOS imaging device, with a focus on spinal and pelvic alignment. SUMMARY OF LITERATURE REVIEW: The EOS imaging device can obtain images of spinal and pelvic alignment with almost no distortion, using a low radiation dose. MATERIALS AND METHODS: We searched for studies related to the use of EOS imaging device for spinal and pelvic alignment. RESULTS: The EOS is not only capable of simultaneously obtaining paired anteroposterior and lateral X-ray images with a low radiation dose, but also can reconstruct the image as if it was acquired in the patient's reference plane, limiting the distortion to the patient's thickness instead of the whole distance between the source and detector. The EOS device also has the advantage of accurately measuring the sagittal alignment of the spine and pelvis and the torsional deformity of the lower limbs, as the subject can be imaged while standing upright in a weight-bearing posture. CONCLUSIONS: EOS is a new diagnostic technique that can detect spinal and pelvic alignment and deformities of the lower limbs under weight-bearing conditions with a low radiation dose.
Congenital Abnormalities ; Lower Extremity ; Pelvis ; Posture ; Spine ; Weight-Bearing

OBJECTIVE: The aim of this article is to introduce the EOS imaging device, with a focus on spinal and pelvic alignment.SUMMARY OF LITERATURE REVIEW: The EOS imaging device can obtain images of spinal and pelvic alignment with almost no distortion, using a low radiation dose. MATERIALS AND METHODS: We searched for studies related to the use of EOS imaging device for spinal and pelvic alignment. RESULTS: The EOS is not only capable of simultaneously obtaining paired anteroposterior and lateral X-ray images with a low radiation dose, but also can reconstruct the image as if it was acquired in the patient's reference plane, limiting the distortion to the patient's thickness instead of the whole distance between the source and detector. The EOS device also has the advantage of accurately measuring the sagittal alignment of the spine and pelvis and the torsional deformity of the lower limbs, as the subject can be imaged while standing upright in a weight-bearing posture. CONCLUSIONS EOS is a new diagnostic technique that can detect spinal and pelvic alignment and deformities of the lower limbs under weight-bearing conditions with a low radiation dose.

Background: Limited information is available about the proportion of patients with degenerative lumbar spinal disease (DLSD) who have gastrointestinal (GI) and cardiovascular (CV) risk factors. Many DLSD patients are prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) that are known to carry risks to the GI and CV systems by increasing GI bleeding and thromboembolic events.This study aimed to measure the prevalence of GI and CV risk in patients with DLSD and to ascertain whether the prescription of NSAIDs is in line with current guidelines. Methods: This study included 153 patients with symptomatic DLSD who were planning to undergo lumbar spinal surgery. The GI profile was checked using the GI Standardized Calculator of Risk for Event system and CV risk was evaluated using the presence of metabolic syndrome. The conformity of the prescription of NSAIDs was investigated according to the recommendations in current guidelines. Results: More than half of the patients (59.5%) had high or very high GI risk, and 66% of the patients were diagnosed with metabolic syndrome, which corresponds with CV risk. The rate of simultaneous GI and CV risk was 40.5% (n = 62 / 153; gastrointestinal Standardized Calculator of Risk for Event, > high and metabolic syndrome, yes). The actual prescription of NSAIDs was not in accordance with current guidelines. Conclusions Two out of 3 patients had GI or CV risk factors, and approximately 40% of patients had both. Detailed assessment of GI and CV risk in patients with DLSD by using effective evaluation tools is mandatory for optimal medical treatment.