No abstract available.
Animals ; Hemorrhagic Fever with Renal Syndrome* ; Rats* ; Singapore*

Lumbar fusion using the pedicle screw system is a popular operative procedure, with favorable clinical results and high fusion rates. However, the risk of adjacent segment disease after lumbar fusion is problematic. We report a complicated case of severe retrolisthesis at L3-4 level following dynamic interspinous process stabilization at L2-3 level and a fusion at L4-5 level. The radiological and clinical findings of this complication are discussed, and a review of the literature is presented.
Lumbar Vertebrae ; Pedicle Screws ; Spinal Diseases ; Spinal Fusion ; Surgical Procedures, Operative

Azoreductases are involved in the bioremediation by bacteria of azo dyes found in waste water. In the gut flora, they activate azo pro-drugs, which are used for treatment of inflammatory bowel disease, releasing the active component 5-aminosalycilic acid. The bacterium P. aeruginosa has three azoreductase genes, paAzoR1, paAzoR2 and paAzoR3, which as recombinant enzymes have been shown to have different substrate specificities. The mechanism of azoreduction relies upon tautomerisation of the substrate to the hydrazone form. We report here the characterization of the P. aeruginosa azoreductase enzymes, including determining their thermostability, cofactor preference and kinetic constants against a range of their favoured substrates. The expression levels of these enzymes during growth of P. aeruginosa are altered by the presence of azo substrates. It is shown that enzymes that were originally described as azoreductases, are likely to act as NADH quinone oxidoreductases. The low sequence identities observed among NAD(P)H quinone oxidoreductase and azoreductase enzymes suggests convergent evolution.
Benzoquinones ; metabolism ; Catalytic Domain ; Enzyme Stability ; Evolution, Molecular ; Flavins ; chemistry ; Hot Temperature ; Kinetics ; Mesalamine ; chemistry ; NAD ; metabolism ; NADH, NADPH Oxidoreductases ; chemistry ; NADP ; metabolism ; Osmolar Concentration ; Oxidation-Reduction ; Phenylhydrazines ; chemistry ; Phylogeny ; Protein Binding ; Pseudomonas aeruginosa ; enzymology ; Spectrophotometry, Ultraviolet

PURPOSE: In order to determine the value of first-pass MR imaging in the diagnosis of myocardial ischemia, first-pass perfusion abnormality of coronary artery stenosis was observed in MRI after gadopentate dimeglumine (Gd-DTPA) enhancement. MATERIALS AND METHODS: The left anterior descending (LAD) coronary arteries of six dogs were subjected to approximately 70% stenosis confirmed by coronary angiography. Half an hour after adenosine and 99mTc-sestamibi infusion, Gd-DTPA (0.2 mmol/kg) and methylene blue were administered and termination was induced with potassium chloride. SE T1-weighted and single-photon emission computed tomography (SPECT) images were subsequently obtained and the findings of perfusion defect compared with specimen stain. Three dimensionally reconstructed MR images were used to measure signal intensity (SI) of normal myocardium and perfusion defect from their sectional and total volume. RESULTS: Five of six dogs with LAD artey stenosis ranging from 66% to 73% displayed perfusion defect on MRI, SPECT, and specimen stain, but the remaining dog with stenosis of 58% showed no such defect. MRI showed the perfusion defect as distinct low SI, enabling the measurement of percentage perfusion defect (24.4+/-5.4%), which increased inferiorly. SI of normal myocardium and perfusion defect decreased inferiorly; their difference indicated stenosis-induced perfusion loss according to section location. Volumetric SI of normal myocardium and perfusion defect were 3.42+/-0.52 and 2.16+/-0.45, respectively (p < 0.05). CONCLUSION: Gd-DTPA enhanced MRI displayed first-pass perfusion abnormality of coronary artery stenosis as perfusion defect with distinct low SI ; this enabled the measurement of its volume and SI changes according to section location, and thus indicated the value of first-pass MR imaging in the diagnosis of myocardial ischemia.
Adenosine ; Animals ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Diagnosis ; Dogs ; Gadolinium DTPA* ; Magnetic Resonance Imaging* ; Methylene Blue ; Myocardial Ischemia ; Myocardium ; Perfusion* ; Potassium Chloride ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Anomia* ; Cognition Disorders* ; Hypoglycemia

Hypereosinophilic syndrome is a rare disorder involving the eosin concentration being elevated to more than 1500/µL in the peripheral blood for 6 months, and it causes various complications in the heart, skin, and nervous and respiratory systems. The simultaneous occurrence of neurological complications of hypereosinophilic syndrome is rare. Here we report a patient with hypereosinophilic syndrome who suffered from acute cerebral infarction and peripheral neuropathy during the same period.
Cerebral Infarction* ; Eosine Yellowish-(YS) ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Peripheral Nervous System Diseases* ; Respiratory System ; Skin

BACKGROUND AND OBJECTIVES: To identify the relation between the preservation status of the parathyroid glands and the risk of hypoparathyroidism after total thyroidectomy and central lymph node dissection in papillary thyroid carcinoma. SUBJECTS AND METHOD: A retrospective review was carried out for the medical records of 63 patients with papillary thyroid carcinoma (PTC), who satisfied our inclusion criteria and received treatment at the Department of Otolaryngology-Head and Neck Surgery, Hospital from May 2010 to December 2011. Patients with PTC who underwent total thyroidectomy with central lymph node dissection (CLND) were included and grouped according to the number of preserved parathyroid glands as follows: Group 1 (with four intact glands), Group 2 (three intact glands), Group 3 (less than two intact glands). The total and ionized serum calcium and intact parathyroid hormone levels of each group were monitored after the surgery. Patients with postoperative symptomatic hypocalcemia were considered to have postoperative hypoparathyroidism and received calcium/vitamin D therapy. The hypoparathyroidism was considered to be permanent when calcium/vitamin D therapy was still required six months after surgery. RESULTS: Out of 63 cases of total thyroidectomy with CLND, 31 (49.2%) showed postoperative hypoparathyroidism as demonstrated by laboratory findings. Permanent hypoparathyroidism, however, was not observed in these cases. The development of hypoparathyroidism was not significantly related with the number of preserved parathyroid glands. CONCLUSION: To prevent postoperative hypoparathyroidism following total thyroidectomy and CLND, at least two parathyroid glands should be preserved in situ with an intact blood supply in order to prevent permanent hypoparathyroidism after the surgery.
Calcium ; Carcinoma ; Factor IX ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Lymph Node Excision ; Lymph Nodes ; Medical Records ; Neck ; Parathyroid Glands ; Parathyroid Hormone ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Purpose: This study aimed to update the previously published nursing practice guideline for oral care. Methods: The guideline were updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 1.0. Results: Updated nursing practice guideline for oral care was consisted of 10 domains and 79 recommendations. The number of recommendations in each domain were: 5 general issues, 2 oral care indications, 9 oral assessment, 16 general oral care, 12 oral care for critically ill patients, 16 oral care for cancer patients, 12 oral care for cancer patients with oral complications, 5 oral care education, 1 oral care referral, and 1 documentation and report. In terms of grades for recommendations, 11.4% was grade A, 17.0% was grade B, and 68.2% was grade C. Twelve new recommendations were developed and 7 previous recommendations were deleted. Conclusion Updated nursing practice guideline for oral care is expected to serve as an evidence-based practice guideline for oral care in South Korea. It is recommended that this guideline be spread to clinical nursing settings nationwide to improve the effectiveness of oral care practice.

Objective: We aimed to investigate whether 2-[ 18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[ 18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[ 18F]FDG PET/CT for endoscopy-detected ampullary tumors 5–87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13–36.18;P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80–13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41–19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00–14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16–21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874–0.956] vs. 0.815 [0.732–0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816–0.967) in candidates for endoscopic papillectomy. Conclusion Adding 2-[ 18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

Vascular cell functionality is critical to blood vessel homeostasis. Constitutive NF-κB activation in vascular cells results in chronic vascular inflammation, leading to various cardiovascular diseases. However, how NF-κB regulates human blood vessel homeostasis remains largely elusive. Here, using CRISPR/Cas9-mediated gene editing, we generated RelA knockout human embryonic stem cells (hESCs) and differentiated them into various vascular cell derivatives to study how NF-κB modulates human vascular cells under basal and inflammatory conditions. Multi-dimensional phenotypic assessments and transcriptomic analyses revealed that RelA deficiency affected vascular cells via modulating inflammation, survival, vasculogenesis, cell differentiation and extracellular matrix organization in a cell type-specific manner under basal condition, and that RelA protected vascular cells against apoptosis and modulated vascular inflammatory response upon tumor necrosis factor α (TNFα) stimulation. Lastly, further evaluation of gene expression patterns in IκBα knockout vascular cells demonstrated that IκBα acted largely independent of RelA signaling. Taken together, our data reveal a protective role of NF-κB/RelA in modulating human blood vessel homeostasis and map the human vascular transcriptomic landscapes for the discovery of novel therapeutic targets.
Blood Vessels ; cytology ; metabolism ; CRISPR-Cas Systems ; Embryonic Stem Cells ; cytology ; Gene Knockout Techniques ; Homeostasis ; Humans ; NF-kappa B ; deficiency ; metabolism ; Transcription Factor RelA ; deficiency ; metabolism