PURPOSE: The clinical advantages of end-to-end (ETE) anastomosis have not been clear despite its biomechanical advantage over end-to-side (ETS) anastomosis. We compared the histomorphometric features of intimal remodeling after ETE and ETS anastomosis in a rabbit aortic bypass model. METHODS: Thirty-two bypass operations, 16 with ETS and 16 with ETE anastomoses, were performed using aortic allografts of donor rabbits (15 per group) and polytetrafluoroethylene (PTFE) grafts (1 per group). To minimize bias from the immunologic response to aortic allografts or graft size, a long aortic tissue obtained from one donor was divided into 2 pieces and shared between each ETE and ETS bypass. PTFE graft bypasses, which are commonly used in clinical practice, were performed to provide comparison results for an allograft with a different compliance. Vessels were harvested at 1 day (1 per group), 5 days (1 per group), and 4 weeks (14 per group, including the PTFE bypass group) after surgery. Intimal thickening was evaluated with hematoxylin-eosin, van Gieson, immunohistochemical staining and Western blot analysis of TNF-alpha and proliferative cell nuclear antigen (PCNA) expression. RESULTS: Mean intimal thickness and volume (0.721+/-0.047 mm, 5.734+/-0.387 mm3 vs. 0.883+/-0.048 mm, 9.068+/-0.462 mm3) and intima/media volume ratio (0.70+/-0.05 vs 1.08+/-0.06) were significantly smaller in ETE (P<0.05). Western blotting showed a marked increase in TNF-alpha (203.15+/-5.29 vs. 494.49+/-6.11) and PCNA concentrations (152.66+/-7.37 vs. 175.53+/-4.36) in the ETS group. CONCLUSION: ETE anastomosis results showed significantly decreased inflammatory reaction and volume of intimal hyperplasia, and therefore seemed to be associated with better long-term graft patency.
Aorta ; Bias (Epidemiology) ; Blotting, Western ; Compliance ; Humans ; Hyperplasia ; Imidazoles ; Nitro Compounds ; Polytetrafluoroethylene ; Proliferating Cell Nuclear Antigen ; Rabbits ; Tissue Donors ; Transplantation, Homologous ; Transplants ; Tumor Necrosis Factor-alpha

PURPOSE: We investigated the clinical presentation of febrile pediatric patients with acute pyelonephritis (APN) with a mixed urine culture from an aseptic urine sample, and compared with that of those with a single culture. METHODS: We retrospectively reviewed the medical charts of 95 patients diagnosed as APN with fever between January 2008 and October 2010 at Korea University Medical Center. We classified the patients with APN into two groups with a positive single culture (S group) and a positive mixed culture (M group) from an aseptic urine sample of suprapubic bladder aspiration or urethral catheterization and compared the fever duration, laboratory markers such as serum white blood cell (WBC) counts and C-reactive protein (CRP) values in peripheral blood, and the presence of hydronephrosis, renal scar and vesicoureteral reflux (VUR) between the two groups (If presence of hydronephrosis, scar and VUR=1 and no=0). RESULTS: Total pediatric patients with febrile APN were 95 patients, a positive S group was 89 patients and a positive M group was 6 patients. Fever duration (S vs. M, 4.7+/-3.1 vs. 6+/-5.7 days), serum WBC (S vs. M, 18,630+/-6,483 vs. 20,153+/-7,660/microL) and CRP (S vs. M, 100.6+/-2.46 vs. 81.1+/-0.09 mg/L) values, and the presence of hydronephrosis, renal scar and VUR were not different between the two groups. CONCLUSION: Our data shows that there were no specific differences of clinical manifestation between a positive single urine culture and a positive mixed urine culture in pediatric APN. A mixed urine culture from an aseptic urine sample should be interpreted cautiously.
Academic Medical Centers ; Bacteriuria ; Biomarkers ; C-Reactive Protein ; Cicatrix ; Coinfection ; Fever ; Humans ; Hydronephrosis ; Korea ; Leukocytes ; Pyelonephritis ; Retrospective Studies ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters ; Vesico-Ureteral Reflux

PURPOSE: Most of grafts used as interposition conduits for middle hepatic vein (MHV) in living donor liver transplantation (LDLT) have been allografts and autografts. Recently, polytetrafluoroethylene (PTFE) and bovine pericardium patch have also been used. Thus, we performed large-animal lab tests to assess the feasibility of interposition vessel graft substitutes for MHV. METHODS: The inferior vena cava was replaced in 9 dogs with allograft (3), PTFE (3), and bovine pericardium patch (3). After 28 days, patency rate, outer and inner diameter, intimal thickness, histology, and immunohistochemistry were evaluated according to interposition grafts. RESULTS: The allograft and PTFE groups were all patent at post-operative week 4, but the bovine group was not patent in all dogs. Outer diameter of anastomotic site at 4 weeks was 8.41+/-0.37, 10.83+/-0.51, and 7.41+/-0.86 mm in allograft, PTFE, and bovine group, respectively. Inner diameter of interposition graft at 4 weeks was 7.90+/-0.23, 6.33+/-0.68, and 0 mm in allograft, PTFE, and bovine groups, respectively. Intimal thickness was 48.0+/-8.6, 113.8+/-45.3, and 218.3+/-59.9microm in allograft, PTFE, and bovine groups, respectively. In histologic findings, inflammation was most severe in the bovine group. Intima of anastomotic site in the bovine group was thickest in all groups. Proliferation of smooth muscle cells was most severe in anti-alpha-actin antibody test in bovine group. CONCLUSION: Our data implicate that the use of allografts and PTFE grafts is more feasible than bovine pericardium for MHV reconstruction in LDLT.
Animals ; Dogs ; Glycosaminoglycans ; Hepatic Veins ; Humans ; Immunohistochemistry ; Inflammation ; Liver ; Liver Transplantation ; Living Donors ; Myocytes, Smooth Muscle ; Pericardium ; Polytetrafluoroethylene ; Pyridines ; Thiazoles ; Transplantation, Homologous ; Transplants ; Vena Cava, Inferior

Bio-sulfur can be produced in the process of desulfurization from a landfill and collected by some microorganism such as Thiobacillus sp. as a sulfur element. In order to investigate practical use of bio-sulfur as an agent for controlling plant disease, in vitro antifungal activity of bio-sulfur was tested against Colletotrichum orbiculare known to cause cucumber anthracnose. Efficacy of bio-sulfur for suppressing anthracnose disease was also evaluated in vivo using cucumber leaves. Mycelial growth of C. orbiculare on medium containing bio-sulfur was inhibited. Disease severity of cucumber leaves pre-treated with bio-sulfur was significantly decreased compared to that of untreated ones. To illustrate how bio-sulfur could suppress anthracnose disease, structures of cucumber leaves infected with C. orbiculare were observed under a fluorescent microscope and a scanning electron microscope (SEM). Cucumber leaves pre-treated with bio-sulfur showed a low rate of appressorium formation whereas untreated ones showed abundant appressoria. Shrunk fungal hyphae were mostly observed on bio-sulfur-pretreated leaves by SEM. Similar results were observed on leaves pre-treated with a commercial fungicide Benomyl®. These results suggest that inhibition of appressorium formation of C. orbiculare by bio-sulfur may contribute to its suppression of cucumber anthracnose.

PURPOSE: The effect of intra-portal infusion of glucose-insulin-potassium (GIK) solution on the energy metabolism during cold preservation was investigated using a small-animal liver transplantation model. METHODS: Fifteen white rats were divided into 3 groups: the group A (feeding group) were fed normally before experiment. The group B (fasting group) and group C (GIK group) were fasted from 3 days before experiment, by which acute nutritional deficiency state was induced. In group A and B, the whole liver was procured after intra-portal perfusion of HTK solution and serial liver biopsies were performed during the cold preservation period with 4degrees C HTK solution. In group C, intra-portal GIK solution infusion for 1 hour preceded liver graft harvest. From the liver tissues, the relative intracellular glycogen contents and the ATP concentration were measured. RESULTS: Relative glycogen contents in group A were 100% at 0 h, 64.6% at 2 h, 54.9% at 4 h, and 16.2% at 8 h; 10.3%, 8.3%, 4.9% and 0%, respectively in group B; 109.2%, 96.9%, 54.2% and 9.7%, respectively in group C. There was a temporary supercharge of ATP level in group C only at 0 h. Apoptosis was less expressed in group C comparing with group A and B. CONCLUSION: Rapid intra- portal infusion of GIK solution could make intrahepatic glycogen content fully restored to the normal level. Considering that intracellular glycogen is the main energy source during immediate post-transplant period, its restoration may contribute to improvement of post-transplant graft function.
Adenosine Triphosphate ; Animals ; Apoptosis ; Biopsy ; Cold Temperature ; Energy Metabolism ; Glucose ; Glycogen ; Humans ; Insulin ; Liver ; Liver Transplantation ; Malnutrition ; Mannitol ; Perfusion ; Potassium ; Potassium Chloride ; Procaine ; Rats ; Transplants

BACKGROUND: Although transfusion in neonates needs to be strictly regulated due to the vulnerability of neonates, there is lack of systematic studies and the working process is not well-established. This study was aimed to point out the problems of current status and to improve the efficiency of systems used in blood aliquots for neonatal transfusions. METHODS: Total red blood cell (RBC) aliquots were analyzed between May 2009 and January 2016 in the neonate intensive care unit. We investigated the aliquot number, issued day interval from the first issued aliquot among the post-aliquots, patients' blood type, and discarded RBC units among the requested RBC units. RESULTS: Of the 472 RBC aliquots, 95.4% (450/472) were divided into two units. The distribution of patients' blood type was similar to that of the Korean population, in decreasing order: A blood group (34.3%), B group (28.2%), and O group (27.5%). The second, third, and forth units of post-aliquots were taken after an average of 49.9 (0∼617.9) hours. Among the post-aliquots, the number of units discarded without use was 22.5%. CONCLUSION: According to the evaluation of current status for neonatal transfusions, we should use aliquot RBC properly and reduce unnecessary requests for aliquot RBC. In addition, in order to reduce the number of near misses, we propose a new label to be attached on the aliquotted blood bags and suggest a development of electronic blood issuing system.
Erythrocytes* ; Humans ; Infant, Newborn ; Intensive Care Units

Background: The Omicron variant has become the most prevalent SARS-CoV-2 variant. Omicron is known to induce milder lesions compared to the original Wuhan strain. Fatal infection of the Wuhan strain into the brain has been well documented in COVID-19 mouse models and human COVID-19 cases, but apparent infections into the brain by Omicron have not been reported in human adult cases or animal models. In this study, we investigated whether Omicron could spread to the brain using K18-hACE2 mice susceptible to SARS-CoV-2 infection. Results: K18-hACE2 mice were intranasally infected with 1 × 105 PFU of the original Wuhan strain and the Omicron variant of SARS-CoV-2. A follow-up was conducted 7 days post infection. All Wuhan-infected mice showed > 20% body weight loss, defined as the lethal condition, whereas two out of five Omicron-infected mice (40%) lost > 20% body weight. Histopathological analysis based on H&E staining revealed inflammatory responses in the brains of these two Omicron-infected mice. Immunostaining analysis of viral nucleocapsid protein revealed severe infection of neuron cells in the brains of these two Omicron-infected mice. Lymphoid depletion and apoptosis were observed in the spleen of Omicron-infected mice with brain infection. Conclusion Lethal conditions, such as severe body weight loss and encephalopathy, can occur in Omicron-infected K18-hACE2 mice. Our study reports, for the first time, that Omicron can induce brain infection with lymphoid depletion in the mouse COVID-19 model.