BACKGROUND/AIMS: This study was conducted to clarify the sustained virological response (SVR) prediction ability of baseline and treatment-related factors in patients with chronic hepatitis C virus (HCV) infection. METHODS: This retrospective study collected data at four tertiary referral hospitals between June 2004 and July 2012. Out of 476 patients, 330 treatment-naïve patients with chronic HCV infection were recruited. Pegylated interferon α-2a/-2b plus ribavirin was administered for either 24 or 48 weeks depending on the HCV genotype. The baseline and treatment-related predictive factors of SVR were evaluated by analyzing data measured before treatment (i.e., baseline) and during treatment. RESULTS: SVR rates for genotypes 1 and 2 were 63% (97/154) and 79.5% (140/176), respectively (p = 0.001). Multivariate analysis for baseline factors revealed that young age (p = 0.009), genotype 2 (p = 0.001), HCV RNA level of < 800,000 IU/mL (p < 0.001), and a baseline platelet count of > 150 × 10³/µL (p < 0.001) were significant SVR predictors, regardless of the genotype. In particular, predictive accuracy for achievement of SVR was 87.3% for a baseline platelet count of > 150 × 10³/µL. In multivariate analysis for treatment-related factors, SVR was associated with achievement of a rapid virological response (RVR; p < 0.001), treatment adherence of ≥ 80/80/80 (p < 0.001). CONCLUSIONS Young age, genotype 2, low HCV RNA level, RVR, and treatment adherence were significantly associated with SVR. In addition, platelet count was an independent predictive factor for SVR. Therefore, platelet count could be used to develop individualized treatment regimens and to optimize treatment outcomes in patients with chronic HCV infection.

BACKGROUND: Spontaneous bacterial peritonitis (SBP) is one of the severe complications of liver cirrhosis. Early detection of high-risk patients is essential for prognostic improvement. The aim of this study is to investigate the predictive factors related to in-hospital mortality in patients with SBP. METHODS: This was a retrospective study of 233 SBP patients (181 males, 52 females) who were admitted to four tertiary referral hospitals between August 2002 and February 2013. The patients' laboratory and radiologic data were obtained from medical records. The Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease sodium model (MELD-Na) scores were calculated using the laboratory data recorded at the time of the SBP episode. RESULTS: The causes of liver cirrhosis were hepatitis B (44.6%), alcohol (43.8%), hepatitis C (6.0%), and cryptogenic cirrhosis (5.6%). The mean MELD-Na and CTP scores were 27.1 and 10.7, respectively. Thirty-one of the patients (13.3%) died from SBP in hospital. Multivariate analysis revealed that maximum creatinine level during treatment was a statistically significant factor for in-hospital mortality (P = 0.005). The prognostic accuracy of the maximum creatinine level during treatment was 78.0% (P < 0.001). The optimal cutoff point for the maximum serum creatinine was 2 mg/dL (P < 0.001). CONCLUSION: The follow-up creatinine level during treatment is an important predictive factor of in-hospital mortality in cirrhotic patients with SBP. Patients with SBP and a serum creatinine level during treatment of ≥ 2.0 mg/dL might have a high risk of in-hospital mortality.
Creatinine* ; Cytidine Triphosphate ; Fibrosis ; Follow-Up Studies* ; Hepatitis B ; Hepatitis C ; Hospital Mortality* ; Humans ; Liver Cirrhosis ; Liver Diseases ; Male ; Medical Records ; Multivariate Analysis ; Peritonitis* ; Retrospective Studies ; Sodium ; Tertiary Care Centers

Stroke is one of the common causes of death and disability. Despite extensive efforts in stroke research, therapeutic options for improving the functional recovery remain limited in clinical practice. Experimental stroke models using genetically modified mice could aid in unraveling the complex pathophysiology triggered by ischemic brain injury. Here, we optimized the procedure for generating mouse stroke model using an intraluminal suture in the middle cerebral artery and verified the blockage of blood flow using indocyanine green coupled with near infra-red radiation. The first week after the ischemic injury was critical for survivability. The survival rate of 11% in mice without any treatment but increased to 60% on administering prophylactic antibiotics. During this period, mice showed severe functional impairment but recovered spontaneously starting from the second week onward. Among the various behavioral tests, the pole tests and neurological severity score tests remained reliable up to 4 weeks after ischemia, whereas the rotarod and corner tests became less sensitive for assessing the severity of ischemic injury with time. Further, loss of body weight was also observed for up 4 weeks after ischemia induction. In conclusion, we have developed an improved approach which allows us to investigate the role of the cell death-related genes in the disease progression using genetically modified mice and to evaluate the modes of action of candidate drugs.
Animals ; Anti-Bacterial Agents ; Body Weight ; Brain Injuries ; Brain Ischemia ; Cause of Death ; Disease Progression ; Indocyanine Green ; Ischemia ; Mice* ; Middle Cerebral Artery ; Stroke* ; Survival Rate ; Sutures ; Therapeutic Human Experimentation

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a method of providing enteral nutrition using endoscopy. The PEG techniques differ according to the insertion method, and include the pull type, push type, and introducer type. The aim of this study was to compare the clinical outcomes associated with the pull-type and introducer-type PEG insertion techniques, which included the adverse events, at our tertiary care center in Korea. METHODS: We retrospectively reviewed 141 cases that had undergone PEG insertion at our center from January 2009 to June 2012. The indications for PEG insertion and the acute and chronic complications caused by each type of PEG insertion were analyzed. RESULTS: The indications for PEG insertion in our cohort included neurologic disease (58.7%), malignancy (21.7%), and other indications (19.6%). Successful PEG insertions were performed on 136 cases (96.5%), and there were no PEG-associated deaths. Bleeding was the most frequent acute complication (12.8%), and wound problems were the most frequent chronic complications (8.8%). There were no statistically significant differences between the pull-type and introducer-type PEG insertion techniques in relation to complication rates in our study population. CONCLUSIONS: PEG insertion is considered a safe procedure. The pull-type and introducer-type PEG insertion techniques produce comparable outcomes, and physicians may choose either of these approaches according to the circumstances.
Cohort Studies ; Endoscopy ; Enteral Nutrition ; Gastrostomy* ; Hemorrhage ; Korea ; Retrospective Studies ; Tertiary Care Centers ; Wounds and Injuries

We correct a typo in the title.

OBJECTIVE: To investigate the effect of simulated stiff knee on the gait parameters. METHOD: Twenty healthy male adults were recruited. The temporospatial, kinematic & kinetic parameters and energy consumption were analyzed under three different conditions which were free gait, fixed knee flexion in neutral position and limited knee flexion to 30 degrees using knee orthosis. RESULTS: When knee flexion was fixed in neutral position, the cadence and walking speed significantly decreased, and the step time, step width, O2 cost significantly increased compared to free gait. When knee flexion was limited or fixed in neutral position, the kinematic and kinetic parameters in pelvis, hip, knee and ankle joints significantly changed compared with free gait. CONCLUSION: Simulated stiff-knee may affect not only knee joint but also pelvis, hip and ankle joints with increased energy consumption. These findings help us to understand the compensatory mechanism and energy conservation of stiff-knee gait.
Adult* ; Ankle Joint ; Gait* ; Hip ; Humans ; Knee ; Knee Joint ; Male ; Orthotic Devices ; Pelvis ; Walking

OBJECTIVE: The aim of this study was to investigate the characteristics of prosthetic gait of unilateral transfemoral amputees on an inclined surface compared with those of normal persons. METHOD: Five male unilateral transfemoral amputees and ten normal persons were recruited. Uphill and downhill walking of inclined surface on slopes of 10 and 20 degrees and level walking were investigated. Kinematic data were obtained with VICON 370 system (Oxford Metrics Ltd., UK). RESULTS: The kinematic data of the transfemoral amputees showed significantly decreased peak hip extension at all situation and peak hip flexion at 20 degrees uphill walking, significant increased knee extension at 20 degrees downhill and all uphill walking, and significant decreased knee flexion at all situation, and significant decreased ankle dorsiflexion at all situation and plantarflexion at all situation except 20 degrees downhill walking compared with those of normal persons. Also they showed significant decreased cadence, speed and increased step time, double support at all situation compared with normal persons. CONCLUSION: Analysis of prosthetic gait of unilateral transfemoral amputees on an inclined surface support the basic data for induction of normal gait pattern.
Amputees* ; Ankle ; Gait* ; Hip ; Humans ; Knee ; Male ; Walking

PURPOSE: Human papillomavirus (HPV) infection has a significant role in cervical carcinogenesis, and HPV oncoprotein E7 plays an important part in the formation and maintenance of cervical cancer. Interleukin-12 (IL-12) has been reported to induce a cellular immune response, and to suppress the tumor growth and the E7 production. Here we describe the use of adenoviral delivery of the HPV 16 E7 subunit (AdE7) along with adenoviral delivery of IL-12 (AdIL-12) in mice with HPV-associated tumors. MATERIALS AND METHODS: Mice were injected with TC-1 cells to establish TC-1 tumor, and then they were immunized with AdIL-12 and/or AdE7 intratumorally. The anti tumor effects induced by AdIL-12 and/or E7 were evaluated by measuring the size of the tumor. E7-specific antibody and INF-gamma production in sera, and the T-helper cell proliferative responses were then measured. Cytotoxic T-lymphocyte (CTL) and T cell subset depletion studies were also performed. RESULTS: Combined AdIL-12 and AdE7 infection at the tumor sites significantly enhanced the antitumor effects more than that of AdIL-12 or AdE7 single infection. This combined infection resulted in regression of the 9 mm sized tumors in 80% of animals as compare to the PBS group. E7-specific antibody and INF-gamma production in the sera, and the T-helper cell proliferative responses were significantly higher with coinfection of AdIL-12 and AdE7 than with AdIL-12 or AdE7 alone. CTL response induced by AdIL-12 and AdE7 in the coinjected group suggested that tumor suppression was mediated by mostly CD8+ and only a little by the CD4+ T cells. CONCLUSION: IL-12 and E7 application using adenovirus vector showed antitumor immunity effects against TC-1 tumor, and this system could be use in clinical applications for HPV-associated cancer.
Adenoviridae ; Animals ; Carcinogenesis ; Coinfection ; Human papillomavirus 16 ; Humans* ; Immunity, Cellular ; Immunization* ; Interleukin-12* ; Mice ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Uterine Cervical Neoplasms

OBJECTIVE: To investigate the kinematic and kinetic characteristics of stair ascent in patients with knee osteoarthritis. METHOD: Twenty patients with knee osteoarthritis and twenty healthy controls were recruited. The kinematic and kinetic data were obtained through a three dimensional motion analyzer. The kinematic and kinetic data during stair ascent were compared between two groups. RESULTS: The total required time of stair ascent was significantly longer in the osteoarthritis group than that of the control group (p<0.05). In comparison with the control group, the angle of maximal pelvis anterior tilting, minimal and maximal hip flexion and minimal knee flexion were significantly increased (p<0.05). However, the angle of knee flexion and ankle dorsiflexion at initial contact were significantly decreased in the osteoarthritis group (p<0.05). The maximal moment and power of knee extension and ankle plantarflexion were significantly decreased in the osteoarthritis group (p<0.05). Sixteen patients (80.0%) in the osteoarthritis group showed flexion arc after initial contact. "W" sign was shown in 16 patients (80.0%). CONCLUSION: We found the unique kinematic and kinetic patterns during stair ascent in patients with knee osteoarthritis, and that knee osteoarthritis influence not only kinematic and kinetic patterns of knee but also those of hip and ankle.
Ankle ; Hip ; Humans ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee* ; Pelvis

OBJECTIVE: To evaluate the changes of kinematic gait patterns at long-term follow up study after selective posterior rhizotomy (SPR) in children with spastic diplegic cerebral palsy. METHOD: Eighteen children with spastic diplegic cerebral palsy participated in this study. Gait patterns on sagittal plane were studied before and at average 3.5 years after SPR. Kinematic and temporospatial data were obtained by the VICON 370 system. RESULTS: The spasticity of hip adductor and ankle plantar flexor were improved significantly after SPR. The maximal angle of pelvic tilt, ankle dorsiflexion angle at initial contact, peak ankle dorsiflexion angle during stance phase, at toe-off and during swing phase, mid-range point of flexion-extension motion on ankle were significantly improved after SPR. The temporospatial data tended to improve after SPR at long-term follow up. CONCLUSION: The SPR reduced spasticity and the gait pat terns were improved in children with spastic diplegic cere bral palsy at long-term follow up.
Animals ; Ankle ; Cerebral Palsy* ; Charadriiformes ; Child* ; Follow-Up Studies* ; Gait* ; Hip ; Humans ; Muscle Spasticity* ; Paralysis ; Rhizotomy*