BACKGROUND: Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation. METHODS: This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed. RESULTS: The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant. CONCLUSIONS: Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Body Mass Index* ; Hospitalization ; Humans ; Intensive Care Units ; Lung Transplantation* ; Medical Records ; Oxygen ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Tidal Volume ; Ventilator Weaning* ; Weaning

Ochrobactrum anthropi, a rarely encountered organism in humans, is usually associated with infections in immunocompromised hosts and patients with indwelling catheters. We report a case of bacteremia associated with O. anthropi in a 80-year-old male with intrahepatic duct carcinoma. After insertion of biliary stent with endoscopic retrograde cholangiopancreatography, fever and neutrophilic leukocytosis developed in the patient. Blood cultures were performed three times, and O. anthropi was isolated from an aerobic bottle. Although the patient did not receive effective antibiotic treatment, fever and neutrophilic leukocytosis were improved.
Aged, 80 and over ; Bacteremia* ; Catheters, Indwelling ; Cholangiopancreatography, Endoscopic Retrograde ; Fever ; Humans ; Immunocompromised Host ; Leukocytosis ; Male ; Neutrophils ; Ochrobactrum anthropi* ; Ochrobactrum* ; Stents

A prerequisite for the development of a cancer cell selective targeting adenovirus is the generation of adenoviral vectors that lack native receptor binding ability and additionally contain domains redirecting the vector to cancer cell specific receptors. Towards this goal, we have generated an E1B 55kDa-deleted oncolytic and coxoackie and adenovirus receptor (CAR)-binding ablated adenovirus, YKL-K420A. This newly engineered adenovirus resulted in a dramatic reduction of transduction efficiency compared to the control adenovirus, YKL-1, in all of the cell lines tested. The malaria circumsporozoite (CS) protein interacts with glycosaminoglycans (GAG) present on the liver cell surface, and plays a prominent role in sporozoite attachment and invasion into hepatocytes. To redirect the CAR binding ablated adenovirus YKL-K420A to hepatocytes, CS protein epitope (EWSPCSVTCGNGIQVRIK) was incorporated onto the C-terminus of the YKL-K420A fiber protein, generating an YKL-K420A-hepa. The In vitro efficacy and specificity of YKL-K420A-hepa was then evaluated by comparing the cytopathic effect in hepatoma and other cancer cells from different origins. In hepatoma cells, YKL-K420A-hepa exerted upto 20-fold higher cytolytic ability compared to the control adenovirus, YKL-1, in hepatoma cell lines. Treatment with YKL-K420A-hepa also significantly suppressed tumor growth in a hepatoma xenograft tumor model when compared to YKL-1. Taken together, these studies demonstrate that the strategy to alter adenovirus tropism may greatly improve adenoviral utilities in gene therapy applications.
Adenoviridae* ; Carcinoma, Hepatocellular ; Cell Line ; Genetic Therapy ; Glycosaminoglycans ; Hepatocytes ; Heterografts ; Liver ; Malaria ; Sensitivity and Specificity ; Sporozoites ; Tropism

No abstract available.
Humans ; Lymphocytes*

BACKGROUND: The MicroScan MICroSTREP plus panel for susceptibility testing of various streptococci, including Streptococcus pneumoniae, has recently been introduced in Korea. The current study evaluated the usefulness of MicroScan MICroSTREP plus panel for antimicrobial susceptibility test of S. pneumoniae. METHODS: A total of 75 clinical isolates of S. pneumoniae were tested for antimicrobial susceptibility to penicillin, cefotaxime, ceftriaxone, meropenem, vancomycin, clindamycin, erythromycin, and levofloxacin with the MicroScan MICroSTREP plus panel and clinical and laboratory standard institute (CLSI) reference broth microdilution method. For 46 of 75 isolates, additional susceptibility tests to penicillin and cefotaxime were performed with Etest. RESULTS: The overall essential agreement of MICs (within one dilution of MICs) defined by the MicroScan MICroSTREP plus panel and reference method was 93.0%. Overall there were 11.7% minor, 0.7% major, and 0.7% very major interpretative category errors observed. The results of antibiotic susceptibility testing by Etest were similar to those obtained by the MicroScan MICroSTREP plus panel. CONCLUSION: The MicroScan MICroSTREP plus panel, a commercial broth microdilution method, has a comparable accuracy to CLSI broth microdilution method for the resistance testing of S. pneumonia. This panel can be used for determining susceptibilities of S. pneumoniae to a wide variety of antimicrobial agents in clinical microbiology laboratories.
Anti-Infective Agents ; Cefotaxime ; Ceftriaxone ; Clindamycin ; Erythromycin ; Korea ; Ofloxacin ; Penicillins ; Pneumonia ; Streptococcus ; Streptococcus pneumoniae ; Thienamycins ; Vancomycin

BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.
Dermatitis, Atopic* ; Erythema ; Forearm ; Humans ; Incidence ; Lactic Acid* ; Patch Tests* ; Permeability ; Skin* ; Sodium* ; Surface-Active Agents

A 46-year-old man had noticed an asymptomatic, small, yellowish, papular eruption on the scalp about one year ago. Since then, the lesions had slowly increased in size and number. There was no family history of similar lesions. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp.
Biopsy ; Humans ; Middle Aged ; Scalp* ; Steatocystoma Multiplex*

Trisomy 19 is frequently encountered in cases of chronic myeloid leukemia (CML) as a secondary abnormality: however, trisomy 19 rarely occurs as a sole chromosomal abnormality and, to date, it has only been reported in 48 hematopoietic malignancies, 1 case of adenocarcinoma and 1 case of astrocytic tumor. Here, we report two additional cases of trisomy 19 as a sole karyotypic aberration in myeloid malignancies. One of these cases involved a 6-month-old male who was diagnosed with acute myeloid leukemia minimally differentiated. His karyotype was 47,XY,+19[20]. He expired 5 days after diagnosis. Another case occurred in an 80-yr-old female who had refractory anemia with excess blasts. Her karyotype was 47,XX,+19[16]/46,XX[4]. Four months later, her peripheral blood smears suggested that the disease had progressed, but she refused further evaluation. Based on a review of the existing literature and the results of this report, trisomy 19 not only as a secondary abnormality but also as a sole karyotypic aberration is strongly associated with myeloid disorder; however, it is not preferentially found in specific FAB subgroups of myelodysplasic syndrome or acute myeloid leukemia.
Acute Disease ; Aged, 80 and over ; Anemia, Refractory/*diagnosis/*genetics ; *Chromosomes, Human, Pair 19 ; Female ; Humans ; Infant ; Karyotyping ; Leukemia, Myeloid/*diagnosis/*genetics ; Male ; *Trisomy

PURPOSE: This study has been planned to generate a replication-competent adenovirus which replicates in a cancer cell-specific manner, thus minimizing the side effects and toxicity of cancer gene therapy. MATERIALS AND METHODS: we have generated an E1B 19 kD attenuated recombinant adenoviruses, Ad-TERT-delta19 and Ad-mTERT-delta19, which encode E1A gene driven by the wild type hTERT and modified m-hTERT promoter containing additional c-myc and Sp1 binding sites in the backbone of Ad-deltaE1B19. The in vitro efficacy and specificity of the hTERT and m-hTERT promoter have been evaluated by the comparison of viral replication and cytopathic effect in cancer cells and normal cell lines. To assess anti-tumor effect and safety of hTERT or m-hTERT promoter driven replication competent adenoviruses, tumor regression after subcutaneous injection in subcutaneous C33A xenografts and lacZ expression after systemic injection in organs were examined. RESULTS: The activation of hTERT or m-hTERT promoter was significantly up-regulated only in hTERT-positive cells, but not in hTERT-negative cells. Moreover, the activity of m-hTERT promoter was substantially increased in hTERT-positive cancer cells, but not in hTERT-negative cells. While Ad-TERT-delta19 replicated in and induced cytopathic effect in cancer and in some normal cell lines, Ad-mTERT-delta19 enhanced viral replication and cytopathic effect in cancer cells only. Furthermore, the growth of established human cervical carcinoma in nude mice was significantly suppressed by intratumoral injection of Ad-mTERT-delta19. CONCLUSIONS: The use of m-hTERT promoter is not only useful in the regulation of therapeutic gene expression but also that replication-competent oncolytic adenovirus under the control of m-hTERT promoter may be a new promising tool for the treatment of human malignancies.
Adenoviridae* ; Animals ; Binding Sites ; Cell Line ; Gene Expression ; Genes, Neoplasm ; Heterografts ; Humans* ; Injections, Subcutaneous ; Mice ; Mice, Nude ; Sensitivity and Specificity ; Telomerase*

Lp(a) is an independent risk factor of atherosclerotic cardiovascular diseases. Marked increase in plasma lipoprotein(a)[Lp(a)] was reported in conti- nuous ambulatory peritoneal dialysis(CAPD) patients. Serum albumin, parameters of nutritional status and parameters of dialysis have been reported to be related with Lp(a) concentration. Eighty nine patients(age 52 +/- 13, M: F 61: 28) undergoing CAPD were included in this study. We measured Lp(a) concentration, apolipoprotein(a) [apo(a)] phenotype, serum albumin, parathyroid hormone (PTH), Creactive protein(CRP), fibrinogen, 24 hour peritosol protein ancl albumin, 24 hour urine protein and albumin, total albumin clearance, residual renal function(RRF), and parameters of nutritional status such as prealbumin, triceps skin fold(TSF), mid-arm muscle area(MAMA), and normalized protein cata- bolic rate(nPCR). Peritoneal equilibration test(PET) and weekly Kt/V,. were also measured to evaluate relationship of Lp(a) and the adequacy of dialysis. The median serum Lp(a) was 48.9mg/dl(29.1-73.5 mg/dl) (quartiles). Higher Lp(a) level was observed in the low molecular weight apo(a) subgroup. There was no significant difference in serum Lp(a) levels between male and female, diabetic and non-diabetic patients, smokers and non-smokers. Serum albumin was negatively correlated(r=-0.28, p<0.01), while total albumin clearance was positively correlated with Lp (a)(r=0.20, p<0.05). 4)gLp(a) was not correlated with age, duration of dialysis, prealbumin, fibrinogen, RRF, weekly Kt/V, PET, PTH, CRP, TSF, MAMA, nPCR, 24hour peritosol protein and albumin and 24hour urine protein and albumin. Multivariate analysis using apo(a) phenotype, serurn albumin, total albumin clearance as independent variables revealed that serum albumin and apo(a) phenotype were significantly related with logLp(a)(p<0.05). Apo(a) phenotype and serum albumin were the factors that were independently associated with se- rum Lp(a) concentration in CAPD patients.
Apoprotein(a) ; Cardiovascular Diseases ; Dialysis ; Female ; Fibrinogen ; Humans ; Lipoprotein(a)* ; Male ; Molecular Weight ; Multivariate Analysis* ; Nutritional Status ; Parathyroid Hormone ; Peritoneal Dialysis, Continuous Ambulatory* ; Phenotype ; Plasma ; Prealbumin ; Risk Factors ; Serum Albumin ; Skin