OBJECTIVE: From the perspective of clinical application to analyze the effectiveness and reliability of CPC/PMMA bone cement in percutaneous kyphoplasty (PKP) for the treatment of elderly patients with osteoporotic thoracolumbar fractures. METHODS: A retrospective analysis was performed on 62 patients with osteoporotic compression fracture of single-vertebral thoracic or lumbar segment who underwent PKP surgery and had a bone density less than or equal to -3.0 SD from February 2016 to December 2016. Among them, 23 patients were in CPC/PMMA group, with an average age of (77.6±2.2) years old, 39 patients in PMMA group, with an average age of (77.1±1.1) years old. The indexes between two groups were compared, including the visual analogue scale (VAS), height ratio of anterior vertebra (AVHR), local Cobb angle, cement leakage, new adjacent vertebral fracture(NAVF). RESULTS: There were no significant difference in gender, age, follow-up time and preoperative VAS, AVHR, local Cobb angle between two groups (>0.05), at the 1 day after operation, VAS, AVHR, local Cobb angle in all patients got obvious improvement (<0.05), which was no significant difference at 1 day after operation and final follow-up (>0.05). At the same time, there was no statistically significant difference in the incidence of new adjacent vertebral fracture and cement leakage (>0.05). The pain in both groups continued to improve at follow up after operation (<0.05), the local Cobb angle increased (<0.05) and AVHR decreased slightly (<0.05). However, the images of conventional methods (X-ray or CT) could not find signs about CPC degeneration and new bone ingrowth. CONCLUSION CPC/PMMA composite bone cement is safe and reliablein PKP for treatment of elderly patients with osteoporotic thoracolumbar fractures, which can effectively relieve pain and maintain vertebral body stability. It has the same curative effect as PMMA bone cement. It was worthy to research more in future, although no direct evidences support the CPC/PMMA composite bone cement can reduce the incidence of adjacent vertebral fracture, CPC degeneration or new bone ingrowth.
Aged ; Bone Cements ; Dinucleoside Phosphates ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Polymethyl Methacrylate ; Reproducibility of Results ; Retrospective Studies ; Spinal Fractures ; Treatment Outcome ; Vertebroplasty

OBJECTIVETo clone, express, and purify cyclic diadenosine monophosphate (c-di-AMP) metabolism-related genes from Porphyromonas gingivalis (P. gingivalis) ATCC33277.

METHODSPolymerase chain reaction (PCR) from the genome of P. gingivalis ATCC33277 amplified, the coding regions of pgn0523, pgn1187, and pgn2003 genes. The amplified DNA fragments were ligated with a prokaryotic expression vector pET28a to construct the recombinant expression plasmids pET-pgn0523, pET-pgn1187, and pET-pgn2003. These recombinant plasmids were transformed into Escherichia coli (E. coli) BL21 (DE3) competent cells. The expression of recombinant proteins was induced by isopropyl-β-D-thiogalactoside and detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Proteins were purified using a Ni²⁺ matrix column, and their concentrations were determined by a BCA Protein Quantitative Kit.

RESULTSThe c-di-AMP metabolism-related genes from P. gingivalis ATCC33277 were amplified successfully with the correct molecular size. The recombinant expression vectors were constructed by ligating enzyme-digested PCR products and pET28a vector, and verified by PCR and sequencing. After induction and purification, recombinant proteins were expressed successfully and obtained with the correct molecular size (19.5 x 10³, 39.9 x 10³, 66.0 x 10³). The final protein concentrations were 0.708, 0.523, and 0.861 mg · mL⁻¹ after dialysis.

CONCLUSIONThe c-di-AMP metabolism-related genes from P. gingivalis ATCC33277 are cloned successfully, and their coding products are expressed correctly in E. coli. High-purity proteins are finally obtained. The cloning and purification of these important proteins will help us to further investigate the physiological function and regulatory mechanism of c-di-AMP signaling system in P. gingivalis.

Bacterial Proteins ; biosynthesis ; genetics ; isolation & purification ; Cloning, Molecular ; Dinucleoside Phosphates ; Escherichia coli ; genetics ; Genetic Vectors ; Plasmids ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; genetics ; Recombinant Proteins

OBJECTIVETo test the different contrctile responses of extracellular nucleotides, such as ATP, UTP and nucleotide uridine adenosine tetraphosphate (Up4A) in gastric longitudinal muscle (LM) and circular muscle (CM). Examined the effect of P2X and P2Y receptor antagonists (in this study, we used IP5I and suramin) and cyclooxygenase inhibitor (indomethacin) on Up4A induced contractile responses in LM and CM.

METHODSThe rats were sacrificed and the stomachs were opened to gain LM and CM. Using organ bath system to assess contrctile responses of smooth muscle.

RESULTSUp4A could induce contractile responses in both CM and LM, which were similar with ATP and UTP. IP5 did not attenuate Up4A could induce contractions in both LM and CM, but suramin and indomethacin significantly inhibited Up4A contraction in CM, but not in LM.

CONCLUSIONOur results suggest that extracellular nucleosides and their inhibitors induce different responses between LM and CM.

Adenosine Triphosphate ; pharmacology ; Animals ; Dinucleoside Phosphates ; pharmacology ; Indomethacin ; Muscle Contraction ; Muscle, Smooth ; physiology ; Nucleotides ; pharmacology ; Rats ; Suramin ; Uridine Triphosphate ; pharmacology

Drug-eluting stent (DES) implatation was the major method of coronary revascularization and marked reduction in target-lesion revascularization. Stent thrombosis (ST) is a severe complication that is associated with a high incidence of acute myocardial infarction and death. To prevent ST, dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is recommended for at least 12 months. The premature discontinuation of DAPT is the single most significant predictor of perioperative ST. The risk of surgical bleeding is increased approximately 20% by aspirin or clopidogrel alone, and 50% by DAPT. But the increased risk of perioperative bleeding is not necessarily associated with increased mortality or surgical outcome. Usually, the risk of a cardiovascular event when stopping antiplatelet agents preoperatively is higher than the risk of surgical bleeding when continuing these drugs, except during high risk surgery in a closed space. We remember that DES are never low risk situation for ST and aspirin must never be stopped in all patients with DES.
Aspirin ; Dinucleoside Phosphates ; Drug-Eluting Stents ; Hemorrhage ; Humans ; Incidence ; Myocardial Infarction ; Platelet Aggregation Inhibitors ; Stents ; Thrombosis ; Ticlopidine

PURPOSE: We report on neurologic outcomes and experience with specialized post-cardiac arrest (PCA) care of transferred patients at a regional emergency center in Seoul over a one-year period, and we evaluate factors related to neurologic outcomes by analyzing the characteristics of the patients, transport processes, and therapeutic interventions. METHODS: We conducted a retrospective review of patients who were transferred to our facility after successful resuscitation at another hospital. The variables evaluated included clinical variables, whether there was the presence of any critical event on arrival, the transport time, the transport distance, the PCA care delay, and whether or not specialized PCA care was administered. RESULTS: A total of 31 cardiac arrest patients were included in this study. Of these, 27 patients (87.1%) were treated with therapeutic hypothermia. Thirteen patients (41.9%) were ultimately included in the good outcome group (discharge CPC 1, 2), and 18 were included in the poor outcome group (discharge CPC 3-5). During transport, occurrence of re-arrest was uncommon (n=1, 3.2%). Conversely, other critical events were common (11 patients, 35.5%). Transport time, distance, and PCA care delay were not statistically relevant to occurrence of critical events during inter-facility transport. A critical event was more likely to occur in patients who were on vasopressors (p=0.045), and it was an independent risk factor of poor outcome (odds ratio 12.28 [95% confidence interval, 1.44-104.83]). CONCLUSION: The transfer of resuscitated patients is reasonable for specialized PCA care. Because critical events were common during transport and showed correlation with poor neurologic outcomes, a critical care transport team must be used with these patients.
Critical Care ; Dinucleoside Phosphates ; Emergencies ; Heart Arrest ; Humans ; Hypothermia ; Passive Cutaneous Anaphylaxis ; Republic of Korea ; Resuscitation ; Retrospective Studies ; Risk Factors

PURPOSE: The purpose of this study is to evaluate relevance of postanoxic seizure with prognosis in cases of out-of hospital cardiac arrest (OHCA) patients treated with TH and to research the prognostic role of portable electroencephalography (EEG). METHODS: A total of 180 OHCA patients arrived during July of 2008 and June of 2011, and 144 patients who had been treated with therapeutic hypothermia were included in this study. Portable EEG was taken 24 hours after induction of TH and classified by the attending neurologist. As an outcome variable, overall mortality and neurological outcome after six months from discharge were evaluated (Good neurological outcome; Cerebral performance category (CPC) scale 1, 2, Poor neurological outcome; CPC scale 3~5). RESULTS: Among 144 patients, 93 patients (63.9%) were male, and mean age was 51. Eighty two patients (56.9%) survived and almost 30% (43/144) of patients had a good neurological outcome. Sixty five patients (45.1%) had seizures, and, among this group, 19 patients (29.2%) were discharged with a good neurological outcome. No statistical difference was observed between the seizure group and the non-seizure group. Initial rhythm, APACHI II score, and time from basic life support to return of spontaneous circulation (OR, 2.169; 95% CI, 1.158~4.063, OR 1.107; 95% CI 1.064~1.152, OR 1.014; 95% CI 1.006~1.022, respectively) showed statistical importance, however, the seizure group (OR, 0.67, 95% CI, 0.356~1.032, p=0.065) had no statistical relevance with mortality. Grading of EEG by the neurologist showed a positive association with neurological outcomes (p<0.001). Factors associated with good neurological outcome were VF/VT initial rhythm (p=0.005), cardiac cause of arrest (p=0.001), high initial body temperature (p<0.001), low APACHI II score (p=0.010), and shorter time interval between arrest from basic life support (p=0.005). CONCLUSION: In our study, the seizure group showed no relevance with mortality and prognosis. In hope of achieving a better outcome, careful treatment should be provided in cases of OHCA patients with seizure. Conduct of larger, prospective studies is needed.
Body Temperature ; Dinucleoside Phosphates ; Electroencephalography ; Heart Arrest ; Humans ; Hypothermia ; Male ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Seizures

PURPOSE: This study was conducted to evaluate Korean version of the beliefs about Papanicolau (Pap) test and cervical cancer [CPC-28] in unmarried university students. METHODS: The Korean version of CPC-28 (K-CPC-28) was developed through forward-backward translation techniques. A reliability, confirmatory factor analysis and correlations coefficients were evaluated. Data were collected from 303 unmarried female students attending university using a questionnaire that included28 items of CPC, 5 items of susceptibility of cervicalcancer and 8 items of HPV knowledge. RESULTS: K-CPC-28 had reliable internal consistency with Cronbach's alpha=.74 of six subscales ranged from .66 to .80. Factor loadings of the 28 items of subscales ranged from .31 to .86. Six factors in this study explained 55% of the total variance. In convergent validity of the K-CPC-28, the subscales of K-CPC-28 were significantly correlated with susceptibility scale of cervical cancer and HPV knowledge scale. CONCLUSION: K-CPC-28has satisfactory construct validity and reliability. It seems to be an acceptable tool to assess the attitudes toward cervical cancer prevention and Pap smear in unmarried women. This tool would be also applicable to screen the risk group in cervical cancer prevention and to identify its association with actual Pap test or cervical cancer prevention behaviors.
Dinucleoside Phosphates ; Female ; Health Promotion ; Humans ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results ; Single Person ; Uterine Cervical Neoplasms ; Vaginal Smears

PURPOSE: Therapeutic hypothermia (TH) improves the probability of survival and neurologic recovery after resuscitation from out-of-hospital cardiac arrest (OHCA). However, the best time to initiate TH after the return of spontaneous circulation (ROSC) remains unknown. METHODS: The aim of this study was to evaluate the correlation between TH initiation time after ROSC and the resulting neurological outcome. Methods: A retrospective analysis was performed on 122 OHCA patients enrolled between January 2008 and December 2011. Therapeutic hypothermia (32~34degrees C) was induced immediately after ROSC. The primary measure of outcome was neurological function at hospital discharge, as determined by a cerebral performance category (CPC) scale. RESULTS: Out of the 122 patients, 34 patients (27.9%) had a good neurological outcome at hospital discharge. The initiation time following ROSC was shorter, although not statistically significant, in patients with good neurological outcomes compared to those with poor outcomes. Based on subgroup analysis, only the shockable rhythm group showed a significant difference, in the time after ROSC to TH initiation, between good and poor neurological outcome groups. Receiver operator characteristic analysis suggested that an initiation time of 250 min after ROSC was most predictive of CPC 1-2 outcomes compared to other time points. Furthermore, the 250 min initiation time after ROSC correlated with neurological outcome in patients with OHCA undergoing TH treatment. CONCLUSION: Compared to late initiation, early initiation (within 250 min) with TH had neurologic benefits for patients with OHCA.
Dinucleoside Phosphates ; Humans ; Hypothermia ; Hypothermia, Induced ; Out-of-Hospital Cardiac Arrest ; Resuscitation ; Retrospective Studies

PURPOSE: Anoxic neurologic deficits are an important cause of morbidity and mortality in post-cardiac arrest patients. Cardiopulmonary resuscitation (CPR), a series of life-saving actions, improve the chance of survival following cardiac arrest; however, there are few reports on neuropsychiatric function in patients successfully resuscitated after cardiac arrest. We conducted this study to evaluate the long-term neurologic, psychiatric, and social deficits in post-cardiac arrest patients. METHODS: We reviewed medical records from eight university hospitals from January 2009 to December 2009. Patients, older than 14 years old, successfully resuscitated after cardiac arrest and with a cerebral performance category scale (CPC) 1 or 2 were enrolled. Among 56 included patients, the mean age was 57 years old and 37 patients were male. Forty-two cases were presumed to have cardiac etiology and 14 were considered to have a non-cardiac etiology. The initially recorded rhythms, in 50% of patients, were ventricular fibrillation and pulse-less ventricular tachycardia. The mean length of a hospital stay was 30 days. RESULTS: At hospital discharge, 51 patients (91.1%) with successful resuscitation showed CPC 1 and 5 patients (8.9%) showed CPC 2. Twenty-four (42.9%) patients suffered from a variety of neuro-psychosocial deficits, such as memory disturbances, attention deficits, post-traumatic stress disorder, and difficulty initiating exercise. CONCLUSION: Despite successful resuscitation, a considerable number of patients complained of various neuro-psychiatric deficits. The most common neuro-psychosocial deficits were disturbances in short-term memory.
Cardiopulmonary Resuscitation ; Dinucleoside Phosphates ; Heart Arrest ; Hospitals, University ; Humans ; Length of Stay ; Male ; Medical Records ; Memory ; Memory, Short-Term ; Neurologic Manifestations ; Prognosis ; Resuscitation ; Stress Disorders, Post-Traumatic ; Tachycardia, Ventricular ; Ventricular Fibrillation

BACKGROUND: The aim of this study was to examine the efficacies of somatosensory evoked potential (SEP) and diffusion-weighted magnetic resonance imaging (DWI) in predicting the clinical prognosis of comatose patients following cardiac arrest. METHODS: Forty-one patients resuscitated from out-of hospital cardiac arrest (OHCA) were retrospectively studied. After return of spontaneous circulation (ROSC), SEP was conducted between one and three days after resuscitation, and DWI was conducted within five days of resuscitation. SEP was classified into three grades: normal, delayed conduction or unilateral loss of the N20 peak, and bilateral loss of the N20 peak. Bilateral loss of the N20 peak was considered a predictor of poor prognosis. For DWI, diffuse signal intensity (SI) abnormality in the cerebral cortex or abnormality in other brain areas in addition to the bilateral cerebral cortex was taken as a predictor of poor prognosis. For patient clinical prognosis, the Glasgow-Pittsburgh Cerebral Performance Category (CPC) was used to evaluate neurological results at the time of discharge. Resulting CPC scores of 1 and 2 were considered as a favorable prognosis, and scores of 3, 4, and 5 were considered as a poor prognosis. Sensitivity, specificity, positive predictive value, and negative predictive value for the prediction of poor prognosis were analyzed for each test individually and for the combination of the two tests. RESULTS: Among the 41 subject patients, 31 underwent SEP, 30 underwent DWI, and 20 underwent both tests. The prognosis predictor of SEP (bilateral loss of the N20 peak) predicted poor prognosis with 56.5% sensitivity, 100% specificity, 100% positive predictive value, and 44.4% negative predictive value. The prognosis predictor of DWI (diffuse SI abnormality in the cerebral cortex or abnormality in other brain areas in addition to the bilateral cerebral cortex) predicted poor prognosis with 85% sensitivity, 100% specificity, 100% predictive value, and 76.9% predictive value. For patients who underwent both tests, the sensitivity and negative predictive value for the prediction of poor prognosis increased to 92.3% and 87.5%, respectively, and the specificity and positive predictive value were maintained at 100%. CONCLUSIONS: The accuracy of poor prognosis prediction for patients in prolonged comas after resuscitation is enhanced by combining the results of SEP and DWI along with the individual results of each test.
Brain ; Cerebral Cortex ; Coma* ; Dinucleoside Phosphates ; Evoked Potentials, Somatosensory* ; Heart Arrest* ; Humans ; Magnetic Resonance Imaging* ; Prognosis* ; Resuscitation ; Retrospective Studies ; Sensitivity and Specificity