BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury

Background: Telemetry is a wireless implanted device that measures biological signals in conscious animals and usually requires surgery for its removal when the study is finished. After removing the device, the animals are either used for other studies or euthanatized.Case presentation: Herein, we report the case of a living cynomolgus monkey (Macaca fascicularis) that was used for the entire experimental period, instead of euthanasia, after surgical removal of an implanted telemetry system.Radiography was used to determine the status of the implanted telemetry, following which, a repair surgery was performed for removing the system; clinical signs were used to preserve the life of the cynomolgus monkey. Postoperative clinical signs, food consumption, hematology, and serum biochemistry were examined during the 12-month observational period. No abnormal readings or conditions were observed in the subject after implant removal. Conclusions This study may be a useful case report for living cynomolgus monkeys in telemetry implantations used throughout the study period. We suggest minimizing the suffering and improving the welfare of these animals.

The claustrum, a brain nucleus located between the cortex and the striatum, has recently been highlighted in drug-related reward processing. Methyl CpG-binding protein-2 (MeCP2) is a transcriptional regulator that represses or activates the expression of the target gene and has been known to have an important role in the regulation of drug addiction in the dopaminergic reward system. The claustrum is an important region for regulating reward processing where most neurons receive dopamine input; additionally, in this region, MeCP2 is also abundantly expressed. Therefore, here, we hypothesized that MeCP2 would be involved in drug addiction control in the Claustrum as well and investigated how claustral MeCP2 regulates drug addiction. To better understand the function of human claustral MeCP2, we established a non-human primate model of methamphetamine (METH) - induced conditioned place preference (CPP). After a habituation of two days and conditioning of ten days, the CPP test was conducted for three days. Interestingly, we confirmed that virus-mediated overexpression of MECP2 in the claustrum showed a significant reduction of METH-induced CPP in the three consecutive days during the testing period. Moreover, they showed a decrease in visit scores (frequency for visit) for the METH-paired room compared to the control group although the scores were statistically marginal. Taken together, we suggest that the claustrum is an important brain region associated with drug addiction, in which MeCP2 may function as a mediator in regulating the response to addictive drugs.

PURPOSE: To find out the effect of transplanted umbilical cord blood derived human mesenchymal stem cells (hUCB- MSCs) in the rat model of bilateral cavernosal nerve injury (BCNX) MATERIALS AND METHODS: Male Sprague Dawley rats were divided into three groups: Group I (7 rats, Control, Sham operation) had only bilateral cavernosal nerve crushing injury. PKH-26 fluorescent cell linker was labeled to hUCB- MSCs Group II (7 rats) had transplantation of hUCB- MSCs (3x10(5)cells/50microliter PBS) into MPG after BCNX. Group III (7 rats) had transplantation of hUCB- MSCs (3x10(5)cells/50microliter PBS) into the CC after BCNX. We detected the PKH-26 labeled MSCs in Group II, and III at four weeks after transplantation. Peak intracavernosal pressure (ICP) and ICP/mean arterial pressure (MAP) were recorded after pelvic nerve stimulation at 12 weeks after transplantation. RESULTS: PKH-26 labeled hUCB-MSCs were detected in MPG and CC of group II and III at four weeks after transplantation. The peak ICP was significantly higher in the Group II (69.6+/-5.9mmHg) and Group III (59.7+/-7.6mmHg) compared to Group I40.6+/-10.5mmHg) at 12 weeks after transplantation. The rates of ICP/MAP were significantly higher in Group II (32.2+/-6.4%) and Group III (57.8+/-4.9%) compared to Group I (49.5+/-2.9%) at 12 weeks after transplantation. CONCLUSIONS: The intracavernosal and major pelvic ganglion transplantation of hUCB- MSCs improve erectile function in a rat model of neurogenic impotence.
Animals ; Arterial Pressure ; Fetal Blood ; Ganglion Cysts ; Humans ; Male ; Mesenchymal Stromal Cells ; Nerve Crush ; Organic Chemicals ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Transplants ; Umbilical Cord

PURPOSE: To find out the effect of transplanted umbilical cord blood derived human mesenchymal stem cells (hUCB- MSCs) in the rat model of bilateral cavernosal nerve injury (BCNX) MATERIALS AND METHODS: Male Sprague Dawley rats were divided into three groups: Group I (7 rats, Control, Sham operation) had only bilateral cavernosal nerve crushing injury. PKH-26 fluorescent cell linker was labeled to hUCB- MSCs Group II (7 rats) had transplantation of hUCB- MSCs (3x10(5)cells/50microliter PBS) into MPG after BCNX. Group III (7 rats) had transplantation of hUCB- MSCs (3x10(5)cells/50microliter PBS) into the CC after BCNX. We detected the PKH-26 labeled MSCs in Group II, and III at four weeks after transplantation. Peak intracavernosal pressure (ICP) and ICP/mean arterial pressure (MAP) were recorded after pelvic nerve stimulation at 12 weeks after transplantation. RESULTS: PKH-26 labeled hUCB-MSCs were detected in MPG and CC of group II and III at four weeks after transplantation. The peak ICP was significantly higher in the Group II (69.6+/-5.9mmHg) and Group III (59.7+/-7.6mmHg) compared to Group I40.6+/-10.5mmHg) at 12 weeks after transplantation. The rates of ICP/MAP were significantly higher in Group II (32.2+/-6.4%) and Group III (57.8+/-4.9%) compared to Group I (49.5+/-2.9%) at 12 weeks after transplantation. CONCLUSIONS: The intracavernosal and major pelvic ganglion transplantation of hUCB- MSCs improve erectile function in a rat model of neurogenic impotence.
Animals ; Arterial Pressure ; Fetal Blood ; Ganglion Cysts ; Humans ; Male ; Mesenchymal Stromal Cells ; Nerve Crush ; Organic Chemicals ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Transplants ; Umbilical Cord

PURPOSE: We purpose to determine the correlation of HER-2/neu and paxillin expression in ductal carcinoma in situ (DCIS), invasive ductal carcinoma with ductal carcinoma in situ (IDC with DCIS) and mucinous carcinoma. METHODS: To evaluate the expression of HER-2/neu and paxillin, the immunohistochemical staining was performed for 13 cases of DCIS, 13 cases of IDC with DCIS and 6 cases of mucinous carcinoma. RESULTS: The DCIS and IDC were associated with infiltration of the inflammatory cells, especially in the comedo type and solid type of tumor. In cases with infiltration of the inflammatory cells, HER-2/neu and paxillin were strongly expressed. When comparing the expression level of HER-2/neu from adjacent normal tissue between DCIS and IDC with DCIS, expression of HER-2/neu was similar to that of normal tissue adjacent to DCIS. However, in the adjoining normal ductal epithelial cells, paxillin was highly expressed in cells of all of the tumor types, and especially for IDC with DCIS. HER-2/neu and paxillin were not expressed in mucinous carcinoma cells in all cases. CONCLUSION: HER-2/neu in the DCIS and IDC with infiltration of inflammatory cells shows higher expression than non-inflammatory DCIS and IDC. If normal duct epithelial cells show a high level of HER-2/neu expression, the epithelial cells have a high probability of transformation into anaplastic cells. However, paxillin appears to have no value as a prognostic factor. The difference of expression of HER-2/neu between IDC with DCIS and DCIS suggests a different origin of tumor cells. The growth pattern of mucinous carcinoma cell is different from the that of DCIS or IDC cell, which grow slowly.
Adenocarcinoma, Mucinous ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Epithelial Cells ; Mucins ; Paxillin

Although adriamycin is a potent chemotherapeutic agent, it elicits serious adverse effects, including cardiac toxicity. Evidence suggests that congestive heart failure induced by adriamycin is mediated by oxidative stress. We investigated whether regulators of adenosine A1 receptor and KATP channel, which have been demonstrated to mediate protective effects of ischemic -preconditioning in myocardium, are able to modulate adriamicin -induced impairment of cardiomyocyte. To study the effect of antioxidant, adenosine A1 receptor agonist & antagonist and KATP channel agonist & antagonist, ICR mice were pretreated with Cu,Zn -SOD, dimethyl thiourea, RPIA (R (-)N6 -(2 -Phenylisopropropyl)- adenosine, adenosine A1 receptor agonist), 8 -CPDPX (8 -Cyclopentyl -1, 3 -dipropylxanthine, adenosine A1 receptor antagonist), Pinacidil (KATP channel opener) and glibenclamide (KATP channel closer), followed by i.p injection with adriamycin. Mice were sacrificed day 1 or day 4 after adriamycin injection and cardiac toxicity was accessed by measurement of creatine phosphokinase (CK) levels in serum, immunohistochemistry using anti -Bcl -2 antibody and TUNEL histochemical assay. As expected, pretreatment of mice with Cu, Zn -SOD and DMTU reduced the frequency of TUNEL positive cells, indicating antioxidants protected cardiocytes from adriamycin -induced apoptosis. Interestingly, pretreatment with RPIA and pinacidil induced a significant decrease in adriamycin -induced cytotoxicity, whereas 8 -CPDPX and glibenclamide generated the opposite results. In Bcl -2 immunohistochemistry, an increased expression of Bcl -2 was found in all ADR treated groups, especially in glibenclamide pretreated group, and 8 -CPDPX pretreated groups, but Bcl -2 failed to protect myocytes from apoptosis. All ADR treated groups exhibited elevated levels of serum CK, compared with nomal controls, especially mice sacrificed at day 4 than those at day 1, and showed similar patterns of TUNNEL assay, reflecting heart tissue damages. This observation implicated cytoprotective roles of RPIA and pinacidil against adriamycin -induced cardiac toxicity. In conclusion, these results demonstrated that adriamycin -induced cardiotoxicity was associated with the generation of reactive oxygen species and that regulators including SOD, DMTU, RPIA and pinacidil elicited protective effects on this toxicity. In particular, pinacidil, the KATP channel opener, was more effective than RPIA, the adenosine A, receptor agonist, to attenate the adriamycin -induced cardiac toxicity.
Adenosine* ; Animals ; Antioxidants ; Apoptosis ; Creatine Kinase ; Doxorubicin* ; Glyburide ; Heart ; Heart Failure ; Immunohistochemistry ; In Situ Nick-End Labeling ; Mice ; Mice, Inbred ICR ; Muscle Cells ; Myocardium ; Myocytes, Cardiac ; Oxidative Stress ; Pinacidil ; Reactive Oxygen Species ; Receptor, Adenosine A1* ; Thiourea

Hemangiomas result from proliferation of immature capillary vessels. This disorder in the genitourinary tract is a rare lesion. We experienced one case of a 31 years old man suffered from cavernous hemangioma of the penis shaft with painful erection. He was treated successfully with surgical excision. Herein, we report our experience and a critical review of the literature.
Capillaries ; Caves ; Hemangioma ; Hemangioma, Cavernous ; Male ; Penis