No abstract available.
Funnel Chest*

Background: Inter1eukin-6(IL-6) is known to be produced by osteoblastic cells and to have impartant role in regulation of bone remodelling, Most previous studies indicated that IL-6 bas a major role in stimulating osteoclastic resorption by increasing recruitment and proliferation of preosteoclasts. But its autocrine effect on osteoblastic cells has not been well established yet. Therefore, we studied the effects of IL-6 on messenger RNA (mRNA) expression of proteins that are characteristic of osteoblastic cells in human bone marrow stromal (osteoprogenitor) cells (hRMSC). Methods: The expression of mRNAs for alkaline phosphatase, al(1)-collagen, osteopontin and decorin were studied by northern blot analysis after 3 7 days' treatrnent with IL-6 in the concenttation range of 101,000 U/ml. Results: The mRNA levels for any of the osteoblastic proteins studied did not change significantly by IL-6 treatment up to the concentration of 1,000 U/ml. Conclusion: These results suggest that IL-6 does not have a significant role in differentiatian or activities of human bone rnarrow stromal.
Alkaline Phosphatase ; Blotting, Northern ; Bone Marrow ; Decorin ; Humans ; Interleukin-6 ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteoclasts ; Osteopontin ; RNA, Messenger

In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.
Autoantibodies ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia* ; Dermatomyositis* ; Dyspnea ; Fibrosis ; Humans ; Immunoglobulins* ; Immunosuppressive Agents ; Inflammation ; Lung Diseases, Interstitial ; Middle Aged ; Pneumonia ; Prognosis ; Respiratory Insufficiency ; Steroids

PURPOSE: Billroth I and II reconstructions are commonly performed after a distal subtotal gastrectomy. However, both may cause duodenogastric and duodenogastroesophageal reflux, which are conditions reported to have carcinogenic potential. This study investigated which reconstructive procedure would be most effective in prevent bile reflux into the gastric remnant after a distal gastrectomy. METHODS: A group of 43 patients who underwent a curative distal gastrectomy for gastric cancer were assigned to three groups prospectively according to the reconstructive procedure undertaken: 14, Billroth I (B-I); 14, Billroth II with Braun anastomosis (B-II with Braun); and 15 Billroth II (B-II). The bile reflux period (percent time) for the gastric remnant was measured using a Bilitec 2000 under standardized conditions. The endoscopic findings for reflux gastritis were classified into four grades. RESULTS: The mean standard error time of bile reflux in B-I, B-II with Braun and the B-II groups was 30.9+/-3.9%, 32.8+/-5.1% , and 60.9+/-7.0%, respectively. The B-II group showed significantly higher levels of the % time of bile reflux than the B-I or B-II with Braun groups (P<0.001). Regarding the endoscopic classification for reflux gastritis, the remnant stomach after B-II showed significantly more severe and extensive gastritis than that after the B-I and B-II with Braun procedures (P=0.003). There was also a positive correlation between the degree of % time of bile reflux and the extent of gastritis in the gastric remnant (P<0.001). CONCLUSION: After a distal subtotal gastrectomy, a B-II reconstruction is associated with a high reflux of duodenal content, whereas a Braun enteroenterostomy after a B-II reconstruction minimized the reflux at the levels of a B-I reconstruction.
Bile Reflux ; Classification ; Duodenogastric Reflux* ; Gastrectomy* ; Gastric Stump ; Gastritis ; Gastroenterostomy ; Humans ; Prospective Studies ; Stomach Neoplasms

Patients, aged ≥ 50 years, with gastric neoplasm are reported to be at increased risk for colorectal neoplasia (CRN), while data regarding the risk of CRN in young patients, aged < 50 years with gastric neoplasm are limited. We aimed to investigate the risk of CRN according to the presence of gastric neoplasm in patients, aged < 50 years, and conducted a cross-sectional study on 131,888 asymptomatic examinees who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health screening program between 2010 and 2014. The prevalence of overall CRN (8.6% vs. 13.2%, P = 0.251) and advanced colorectal neoplasia (ACRN) (0.0% vs. 1.3%, P = 0.345) did not significantly differ according to the presence of gastric neoplasm in subjects, aged < 50 years. However, among subjects aged ≥ 50 years, patients with gastric neoplasm had a significantly higher proportion of overall CRN (48.2% vs. 31.7%, P < 0.001) and ACRN (12.5% vs. 4.5%, P < 0.001) compared with those without gastric neoplasm. Particularly, gastric neoplasm was an independent risk factor for ACRN after controlling for confounding factors among subjects, aged ≥ 50 years. In conclusion, gastric neoplasm was a risk factor for CRN in patients, aged ≥ 50 years, but not in patients, aged < 50 years. Young patients, aged < 50 years with gastric neoplasm do not need to undergo colonoscopy, whereas patients, aged ≥ 50 years with gastric neoplasm, should be considered a higher priority for colonoscopy.
Adenoma* ; Colonoscopy ; Colorectal Neoplasms ; Cross-Sectional Studies ; Endoscopy, Digestive System ; Humans ; Mass Screening* ; Prevalence ; Risk Factors ; Stomach Neoplasms

BACKGROUND/AIMS: To prevent the transmission of pathogens by endoscopes, following established reprocessing guidelines is critical. An ideal reprocessing step is simple, fast, and inexpensive. Here, we evaluated and compared the efficacy and safety of two disinfectants, a tertiary amine compound (TAC) and ortho-phthalaldehyde (OPA). METHODS: A total of 100 colonoscopes were randomly reprocessed using two same automated endoscope reprocessors, according to disinfectant. The exposure time was 10 minutes for 0.55% OPA (Cidex® OPA, Johnson & Johnson) and 5 minutes for 4% TAC (Sencron2®, Bab Gencel Pharma & Chemical Ind. Co.). Three culture samples were obtained from each colonoscope after reprocessing. RESULTS: A total of nine samples were positive among the 300 culture samples. The positive culture rate was not statistically different between the two groups (4% for OPA and 2% for TAC, P=0.501). There were no incidents related to safety during the study period. CONCLUSIONS: TAC was non-inferior in terms of reprocessing efficacy to OPA and was safe to use. Therefore, TAC seems to be a good alternative disinfectant with a relatively short exposure time and is also less expensive than OPA.
Colonoscopes* ; Disinfectants* ; Endoscopes* ; o-Phthalaldehyde*

PURPOSE: Several studies have reported relationships among physical activity, healthy metabolic status, and increased natural killer (NK) cell activity. However, large-scale data thereon are lacking. Thus, the present study aimed to assess NK cell activity according to physical activity and metabolic status. MATERIALS AND METHODS: A cross-sectional study was performed on 12014 asymptomatic examinees. Using a patented stimulatory cytokine, NK cell activity was quantitated by the amount of interferon-γ secreted into the plasma by NK cells. Physical activity levels were assessed using the validated Korean version of the International Physical Activity Questionnaire Short Form. RESULTS: The physically inactive group showed lower NK cell activity than the minimally active group (median, 1461 vs. 1592 pg/mL, p < 0.001) and health-enhancing physically active group (median, 1461 vs. 1712 pg/mL, p=0.001). Compared to women with a body mass index (BMI) of 18.5–27.5 kg/m2, those with a BMI < 18.5 kg/m2 had significantly lower NK cell activity (1356 vs. 1024 g/mL, p < 0.001), and those with a BMI ≥27.5 kg/m2 tended to have lower NK cell activity (1356 vs. 1119 g/mL, p=0.070). Subjects with high hemoglobin A1c levels and low high-density lipoprotein cholesterol levels, as well as men with high blood pressure and women with high triglyceride levels, exhibited lower NK cell activity. Moreover, physical inactivity and metabolic abnormalities were independently associated with low NK cell activity, even after adjusting for confounders. CONCLUSION: Physical inactivity and metabolic abnormalities are associated with reduced NK cell activity. Immune systems may become altered depending on physical activity and metabolic status.
Body Mass Index ; Cholesterol ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; Immune System ; Killer Cells, Natural* ; Lipoproteins ; Male ; Motor Activity ; Plasma ; Triglycerides

Some studies have reported a decrease in the natural killer (NK) cell activity in smokers. However, large-scale data on the relationshipbetween NK cell activity and smoking are unavailable. A cross-sectional study was performed on 12,249 asymptomatic examineeswho underwent an NK cell activity test, between January 2016 and May 2017. The test quantitated the amount of interferon-γsecreted into the plasma by NK cells, using a patented stimulatory cytokine. The mean age of the study population was 39.1 years,and the proportions of “never”, “former”, and “current” smokers were 65.5%, 20.9%, and 13.6%, respectively. Current smokers (1,422pg/mL) had a lower median level of NK cell activity than never smokers (1,504 pg/mL, P = 0.039) and former smokers (1,791 pg/mL, P < 0.001). Among current smokers, NK cell activity decreased with increase in the number of cigarettes smoked among currentsmokers (median, 1,537, 1,429, and 1,175 pg/mL at <10, 10-19, and ≥ 20 pack-years, respectively; P < 0.001). Additionally, itdecreased linearly with increasing quartiles of cotinine levels (median, 1,707, 1,636, 1,348, and 1,292 pg/mL at cotinine levels < 292,292-879, 880-1,509, and ≥ 1,510 ng/mL, respectively; r = –0.122, P < 0.001). NK cell activity was lower in current smokers. It alsodecreased with an increase in the number of cigarettes smoked, and it was negatively correlated with cotinine levels among currentsmokers. Our findings indicate a clear relationship between smoking and decreased NK cell activity.

BACKGROUND: The main cause of atherosclerotic peripheral vascular disease is known to be atherosclerotic processing. In patients with atherosclerotic peripheral vascular disease, other atherosclerotic diseases are frequently combined, especially coronary artery disease. There were some suggestions that the risk factors of the atherosclerotic peripheral vascular disease be different from the those of the coronary artery disease. The aim of this study was to evaluate the independent risk factors for the atheroslerotic peripheral vascular disease(PVD) without influence of coronary artery disease(CAD). METHODS: The study population was male patients with atherosclerotic peripheral vascular disease(n=66) documented by peripheral angiogram form February 1991 to Octobor 1993, and during their abmission all patients with suspected atherosclerotic peripheral vascular diaease underwent both peripheral angiogram and coronary angiogram. Careful history taking and physical examination and lipid battery sampling after at least 14 hours of fasting were also performed. RESULTS: 60% of patients with peripheral vascular disease also had coronary artery disease. There was no significant difference in total cholesterol, HDL cholesterol, LDL cholestrerol, triglyceride between patients with peripheral vascular disease and age-matched control. The prevalence of hypertension was higher in patients with peripheral vascular disease but with no statistical significance. Smoking(p<0.0001) and diabetes(p<0.05) were strongly associated with peripheral vascular disease. When patients without coronary artery disease were compared to control from the viewpoint of risk factors again, the results were the same, that is, smoking and diabetes were also associated with periperal vascular diseaes. CONCLUSION: The prevalence of associated coronary artery disease was relatively high in patients with atherosclerotic peripheral vascular disease. And smoking and diabetes seem to be important risk factors of atherosclerotic peripheral vascular disease.
Cholesterol, HDL ; Cholesterol, LDL ; Coronary Artery Disease ; Coronary Vessels ; Diabetes Mellitus ; Fasting ; Humans ; Hypertension ; Male ; Peripheral Vascular Diseases ; Physical Examination ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Triglycerides

STUDY DESIGN: This is a retrospective study for radiographically and clinically assessing nonunion after lumbar spine fusion. OBJECTIVES: We wanted to analyze the risk factors for nonunion that requires surgical treatment after lumbar spine fusion SUMMARY OF THE LITERATURE REVIEW: A diagnosis of the nonunion after lumbar spine fusion was made by using only the only radiologic images. The incidence of nonunion has been underreported because there are many asymptomatic patients. MATERIALS AND METHODS: The plain X-ray films were evaluated for 1317 patients who could be followed up more than 1 year after lumbar fusion. Nonunion was diagnosed at 1 year after fusion by instability seen on the flexion-extension radiograph and the clinical findings like as sustained pain and local tenderness at the surgical site. The risk factors we reviewed included age, the number of levels fused, associated diseases, smoking, alcohol drinking, the initial diagnosis, a previous history of spinal operation, infection, a clear zone and malposition of pedicle screws and metal failure. The relations between nonunion and the factors mentioned above were analyzed. RESULTS: Thirty-nine patients were diagnosed as having nonunion underwent reoperation and all had surgically confirmed nonunion. Smoking, infection and a previous history of spine operation had a significant influence on nonunion (p < 0.05). Clear zones persisting more than 1 year and metal failure also had a significant influence on nonunion (p < 0.05). Age, the number of fused levels, the initial diagnosis and alcohol drinking were not shown to influence the rate of nonunion (p < 0.05). CONCLUSION: A through clinical and radiologic evaluation is essential to diagnose nonunion, and this should not be done according to the radiologic images only. Risk factors such as a previous history of spine operation, infection, smoking, the development of a clear zone and metal failure all showed a statistically significant influence on nonunion. Additionally, preoperative and postoperative evaluation of these parameters is needed to achieve bone union.
Alcohol Drinking ; Humans ; Incidence ; Reoperation ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Spine ; X-Ray Film