PURPOSE: Concomitant splenectomy in cirrhotic patients is known to ameliorate the tendency to bleed and it decreases the portal venous pressure (PVP). However, the direct measurement of the change in the PVP after concomitant splenectomy has not yet been reported. We tried to measure the change of the PVP before and after splenectomy. METHODS: From March 2000 to May 2006, 18 patients underwent anatomical liver resection with concomitant splenectomy. All the patients had liver cirrhosis, thrombocytopenia and/or esophageal varix. Through the 5 French feeding tube, which was inserted into the right gastroepiploic vein after laparotomy, we directly measured the PVP before and after splenectomy, and also under portal triad clamping (PTC). RESULTS: After splenectomy, the PVP decreased significantly from 261.11+/-45.87 mmH2O to 221.11+/-38.48 mmH2O (p<0.05). Under PTC, the PVP decreased significantly from 605.00+/-116.48 mmH2O to 513.89+/-70.56 mmH2O (p<0.05). CONCLUSION: Concomitant splenectomy in patients with liver cirrhosis resulted in a significant reduction of the PVP.
Constriction ; Esophageal and Gastric Varices ; Factor IX ; Humans ; Laparotomy ; Liver ; Liver Cirrhosis ; Portal Pressure ; Splenectomy ; Thrombocytopenia ; Veins

The number of wild animal species is gradually decreasing due to poaching, hunting and habitat loss. While several endangered animal species have been successfully preserved at the zoo, assisted reproductive technology (ART) must be applied to restore wild animals. In the case of critically endangered animals, somatic cell cloning is considered the most appropriate method of ART. Somatic cell cloning can be beneficial for the reproduction of endangered species with limited female populations. However, gene and cell banks, and understanding of reproductive physiology and optimization of ART for wild animals are urgently required for further activation of artificial reproduction of endangered species, which enlarges its application and maintains biodiversity. Care should also be taken to consider ethical and legal issues associated with somatic cell cloning for conservation of endangered animals.
Animals ; Animals, Wild ; Biodiversity ; Clone Cells ; Cloning, Organism ; Ecosystem ; Endangered Species* ; Female ; Humans ; Physiology ; Reproduction ; Reproductive Techniques, Assisted

OBJECTIVES: Although the mechanisms underlying the initiation and maintenance of inflammation in unilateral maxillary fungal balls (FBs) are poorly understood, the relationship between intranasal anatomy and maxillary FB is thought to play an important role. The aim of this study was to investigate the relationship between anatomic variations and FB. METHODS: We enrolled 140 patients who were composed of 56 patients with FB, 56 patients with unilateral chronic rhinosinusitis (CRS), and 28 patients with no sinus disease. Computed tomography scans were retrospectively analyzed to identify and compare the associated nasal anatomic abnormalities. To measure the volume of the nasal cavity and middle meatus, computed tomography scans were reconstructed into three-dimensional images. RESULTS: The relatively larger volume of the middle meatus was associated with the localization of the FB in contrast with the CRS. However, the nasal-cavity volume, nasal valve area, and nasal septal deviation were not significantly associated with localization of FB. The mean volumetric and areal measurements such as nasal cavity, middle meatus, and nasal valve in FB-ipsilateral sides were not significantly different from those in contralateral sides as well as other groups. CONCLUSION: The middle meatus bears the major part of the inspiratory nasal airflow, and its volume may influence the occurrence of FB.
Humans ; Inflammation ; Nasal Cavity ; Nasal Septum ; Paranasal Sinuses ; Retrospective Studies ; Ursidae

Purpose: Deodeok (Codonopsis lanceolata) is generally used in conventional medicines and is considered to have remedial properties to cure several diseases. However, application of the C. lanceolata bud as a novel food ingredient has not been fully explored. Hydrogen peroxide (H2O2) is associated with the production of oxidative damage that results in mutagenesis, carcinogenesis, and cell death. This study examines the neuroprotective effect of C. lanceolata bud extracts (CLBE) on H2O2 -stimulated apoptosis in SH-SY5Y cells. Methods: C. lanceolata bud of length 10 to 15 cm was collected and extracted using 70% ethanol. Cytotoxicity was evaluated by the EZ-cytox reagent, measurement of lactic dehydrogenase (LDH) release and reactive oxygen species (ROS). The morphological changes of the nuclei were determined using the Hoechst 33258 dye. Enzyme activities were analyzed using the caspase activity assay kit. Related protein expressions were quantified by the Western blot immunoassay in H2O2 -stimulated SH-SY5Y cells. Results: Cell viability, LDH release and ROS generation, demonstrated neuroprotective effects of CLBE in H2O2-stimulated SH-SY5Y cells. The occurrence of apoptosis in H2O2-stimulated cells was confirmed by caspase activity, which was increased in H2O2-stimulated SH-SY5Y cells compared to the unexposed group. Pretreatment of CLBE was observed to inhibit the H2O2–stimulated apoptosis. In addition, exposure to CLBE resulted in increased expression of the Bcl-2 (B cell lymphoma 2) protein and decreased expression of the Bax (Bcl2 associated X) protein. Conclusion This study shows that exposure to CLBE alleviates the H2O2-stimulated neuronal damage in SH-SY5Y cells. Our results indicate the potential application of CLBE in neurodegenerative disease therapy or prevention.

Objective: The use of a high flow nasal cannula (HFNC) might cover the gap between conventional oxygen therapy andmechanical ventilation in the management of acute respiratory failure patients and could be a significant factor in determiningpatient outcomes. Early predictors of HFNC failure may help a clinician decide whether to shift the patient to amechanical ventilator. We aimed at identifying the predictors associated with HFNC failure and the application of amechanical ventilator using arterial blood gas analysis (ABGA). Methods: We retrospectively analyzed patients who were admitted to the emergency room at a single center with respiratorydistress and a PaO2/FiO2 ratio (ratio of arterial partial pressure of oxygen to fraction of inspired oxygen) of less than300. Comparing keeping and weaning HFNC groups with the escalation group, we sought to identify a few discriminatingfactors. Initial ABGA was done when the patients entered the emergency room and this was followed up within 2 hoursafter HFNC therapy. Results: Two hundred and eighteen patients were enrolled and of these HFNC therapy succeeded in 153 and failed in65. At baseline Glasgow Coma Scale, follow-up (F/U) pH, ΔpH, and F/U respiratory rate-oxygenation index were lowerand pro-brain natriuretic peptide, initial lactate, F/U lactate, ΔPCO2, heart rate, acidosis, consciousness, oxygenation,respiratory rate score, Acute Physiology And Chronic Health Evaluation score, Simplified Acute Physiology Score, andSequential Organ Failure Assessment score were significantly higher in the HFNC failure group. The results of the multivariateanalysis indicated that initial lactate (odds ratio [OR], 1.215; 95% confidence interval [CI], 1.081-1.366; P=0.001)and ΔpH (OR, 0.000; 95% CI, 0.000-0.018; P<0.001) were independently associated with the prediction of application ofthe mechanical ventilator. Conclusion Patients who had higher initial lactate levels and insufficiently corrected pH after HFNC therapy may needto be monitored carefully and escalation of oxygen therapy may need to be considered.

Objective: The use of a high flow nasal cannula (HFNC) might cover the gap between conventional oxygen therapy andmechanical ventilation in the management of acute respiratory failure patients and could be a significant factor in determiningpatient outcomes. Early predictors of HFNC failure may help a clinician decide whether to shift the patient to amechanical ventilator. We aimed at identifying the predictors associated with HFNC failure and the application of amechanical ventilator using arterial blood gas analysis (ABGA). Methods: We retrospectively analyzed patients who were admitted to the emergency room at a single center with respiratorydistress and a PaO2/FiO2 ratio (ratio of arterial partial pressure of oxygen to fraction of inspired oxygen) of less than300. Comparing keeping and weaning HFNC groups with the escalation group, we sought to identify a few discriminatingfactors. Initial ABGA was done when the patients entered the emergency room and this was followed up within 2 hoursafter HFNC therapy. Results: Two hundred and eighteen patients were enrolled and of these HFNC therapy succeeded in 153 and failed in65. At baseline Glasgow Coma Scale, follow-up (F/U) pH, ΔpH, and F/U respiratory rate-oxygenation index were lowerand pro-brain natriuretic peptide, initial lactate, F/U lactate, ΔPCO2, heart rate, acidosis, consciousness, oxygenation,respiratory rate score, Acute Physiology And Chronic Health Evaluation score, Simplified Acute Physiology Score, andSequential Organ Failure Assessment score were significantly higher in the HFNC failure group. The results of the multivariateanalysis indicated that initial lactate (odds ratio [OR], 1.215; 95% confidence interval [CI], 1.081-1.366; P=0.001)and ΔpH (OR, 0.000; 95% CI, 0.000-0.018; P<0.001) were independently associated with the prediction of application ofthe mechanical ventilator. Conclusion Patients who had higher initial lactate levels and insufficiently corrected pH after HFNC therapy may needto be monitored carefully and escalation of oxygen therapy may need to be considered.

PURPOSE: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. METHODS: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. RESULTS: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). CONCLUSION: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.
Ambulatory Care Facilities ; Breast Feeding ; Caregivers ; Constipation* ; Defecation ; Diet ; Female ; Fissure in Ano ; Gastrointestinal Hemorrhage ; Humans ; Infant ; Male ; Medical Records ; Milk ; Milk, Human ; Pediatrics ; Surveys and Questionnaires ; Skin ; Telephone ; Weaning

BACKGROUND AND OBJECTIVES: Superantigens such as Staphylococcus aureus exotoxin (SE) have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyposis (NP). The aim of this study was to determine the immunologic response of peripheral blood mononuclear cells (PBMCs) to staphylococcal exotoxin B (SEB) in patients with NP. METHODS: The interleukin (IL)-4, IL-5, and interferon-gamma(IFN-gamma) responses of PBMCs to nonspecific mitogens such as phylohemagglutin (PHA) and SEB were examined in 24 NP patients and 16 control subjects. The presence or absence of atopy and asthma was determined to evaluate the correlation of these conditions with the levels of cytokines. RESULTS: PBMCs from the NP patients were more likely to produce IL-4 and IL-5 in response to SEB than those from controls. There was no difference in the mitogen-induced cytokine responses between NP patients and controls. SEB-induced IL-5 and IL-4 levels were higher in patients with NP with asthma than in patients with NP without asthma. CONCLUSION: Patients with NP show an exaggerated Th2 cytokine response of PBMCs to SEB.
Asthma ; Exotoxins ; Humans ; Interleukin-4 ; Interleukin-5 ; Interleukins ; Mitogens ; Staphylococcus ; Staphylococcus aureus ; Superantigens

OBJECTIVES: This study aimed to investigate the anatomy of the intraorbital structures regarding to endoscopic sinus surgery and external frontal sinus surgery analyzing computer tomography (CT) scans. METHODS: The CT scans of 100 patients were retrospectively evaluated. The anatomic relationships between the intraorbital structures and paranasal structures were measured using multiplanar reconstruction of the CT scan. RESULTS: The mean distances from the medial orbital floor (MOF) to the intraorbital structures were measured at the depth of the anterior ethmoid (AE), basal lamella (BL), and midportion of posterior ethmoid (PE) in the coronal planes respectively. The mean distances from the MOF to the medial rectus muscle and inferior rectus muscle at the depth of AE were approximately 8 mm and those distances in the BL and PE decreased rapidly. The mean distances from the MOF to the infraorbital nerve at the depth of the AE and BL were approximately more than 10 mm. The mean distances from the vertical axis, which passed through the MOF, to the superior oblique muscle and optic nerve at the depth of the PE were approximately 5 mm medially and 1 mm laterally. In addition, the mean distance from the midline to the trochlea of the superior oblique muscle was approximately 15 mm. CONCLUSIONS: Those measurements provide spatial information on the placements of the extraocular muscles within the orbit. The measurements will contribute to the avoidance of orbital complications during sinus surgery.
Endoscopy ; Floors and Floorcoverings ; Frontal Sinus ; Humans ; Muscles ; Optic Nerve ; Orbit ; Retrospective Studies ; Axis, Cervical Vertebra

PURPOSE: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children. METHODS: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed. RESULTS: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together. CONCLUSION: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.
Anti-Bacterial Agents ; Appendicitis* ; Child* ; Diagnosis ; Follow-Up Studies* ; Humans ; Sensitivity and Specificity ; Ultrasonography