No abstract available.
Hemangioma*

BACKGROUND: Endovascular stent graft placement is a useful treatment option in lesions of the thoracic aorta. The aim of this study was to assess the possibility of sedation with dexmedetomidine compared with general anesthesia in patients undergoing thoracic endovascular aortic repair (TEVAR) in a multi-center clinical trial. METHODS: Data from 38 patients with thoracic aorta lesions treated by TEVAR between April 2010 and November 2013 were retrospectively collected at two hospitals. General anesthesia or sedation with dexmedetomidine was determined according to the hospital. Demographics, anesthetic recordings, and complications were reviewed. RESULTS: Stent graft placement was technically successful in all patients. There were no events during the anesthetic period. A total of 38 patients underwent TEVAR; 29 patients received general anesthesia, and 9 received sedation. Dexmedetomidine sedation (loading dose: 0.5-1.0 microg/kg for 10 min, maintenance: 0.2-0.8 microg/kg/h) was successfully performed without anesthesia-related complications or mortality. During the procedure, mean arterial pressure, heart rate, and saturation of peripheral oxygen were not statistically different between general anesthesia and dexmedetomidine sedation. CONCLUSIONS: In our study, TEVAR under sedation with dexmedetomidine was shown to be a feasible procedure that was well tolerated without specific complications.
Anesthesia, General* ; Aorta, Thoracic ; Arterial Pressure ; Blood Vessel Prosthesis ; Demography ; Dexmedetomidine* ; Heart Rate ; Humans ; Mortality ; Oxygen ; Retrospective Studies*

BACKGROUND: The purpose of this study is to find out the effect of ApoE genotype on the relationship between nutritional risk and cognition of the elderly in a community. METHODS: A total of 996 subjects (343 men and 653 women) aged 60~91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history, K-SGDS (Korean version of Short Form Geriatric Depression Scale), K-MMSE (Korean version-Mini Mental State Examina- tion), and NSI (Nutritional Screening Initiative) checklist. We also examined blood pressure, fasting serum glucose, lipid profile, body mass index, and ApoE genotyping. RESULTS: 649 subjects (65.2%) were on good nutritional state (NSI score < or = 2) and 347 subjects (34.8%) were on moderate or high nutritional risk (NSI score > or = 3). On multiple logistic regression analysis, moderate or high nutritional risk was associated with an increa- sed risk for cognitive impairment (K-MMSE score < or = 17) after adjustment with age, sex, K-GDS and educational level in the absence of ApoE epsilon4 allele (OR 1.78, 95% CI 1.15-2.77). CONCLUSION: These results suggest that nutritional risk may be associated with cognitive function in the elderly only in the absence of ApoE epsilon4 allele.
Aged* ; Alleles ; Apolipoproteins E* ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Checklist ; Cognition* ; Dementia ; Depression ; Fasting ; Genotype* ; Humans ; Logistic Models ; Male ; Mass Screening ; Surveys and Questionnaires

This study was to determine the effects of allogenicumbilical cord blood (UCB)-derived mesenchymal stemcells (MSCs) and recombinant methionyl humangranulocyte colony-stimulating factor (rmhGCSF) on acanine spinal cord injury model after balloon compressionat the first lumbar vertebra. Twenty-five adult mongreldogs were assigned to five groups according to treatmentafter a spinal cord injury: no treatment (CN); salinetreatment (CP); rmhGCSF treatment (G); UCB-MSCstreatment (UCB-MSC); co-treatment (UCBG). The UCB-MSCs isolated from cord blood of canine fetuses wereprepared as 10(6) cells/150microl saline. The UCB-MSCs weredirectly injected into the injured site of the spinal cord andrmhGCSF was administered subcutaneously 1 week afterthe induction of spinal cord injury. The Olby score,magnetic resonance imaging, somatosensory evokedpotentials and histopathological examinations were used toevaluate the functional recovery after transplantation. TheOlby scores of all groups were zero at the 0-week evaluation.At 2 week after the transplantation, the Olby scores in thegroups with the UCB-MSC and UCBG were significantlyhigher than in the CN and CP groups. However, there wereno significant differences between the UCB-MSC andUCBG groups, and between the CN and CP groups. Thesecomparisons remained stable at 4 and 8 week aftertransplantation. There was significant improvement in thenerve conduction velocity based on the somatosensory evokedpotentials. In addition, a distinct structural consistency ofthe nerve cell bodies was noted in the lesion of the spinalcord of the UCB-MSC and UCBG groups. These resultssuggest that transplantation of the UCB-MSCs resulted inrecovery of nerve function in dogs with a spinal cord injuryand may be considered as a therapeutic modality for spinalcord injury.
Animals ; Behavior, Animal/physiology ; Cord Blood Stem Cell Transplantation/methods/*veterinary ; Dog Diseases/pathology/*therapy ; Dogs ; Evoked Potentials, Somatosensory/physiology ; Histocytochemistry/veterinary ; Magnetic Resonance Imaging/veterinary ; Random Allocation ; Spinal Cord Injuries/pathology/therapy/*veterinary ; Videotape Recording

This study was performed to evaluate the osteogenic effect of allogenic canine umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) mixed with beta-tricalcium phosphate (beta-TCP) in orthotopic implantation. Seven hundred milligrams of beta-TCP mixed with 1 x 10(6) UCB-MSCs diluted with 0.5 ml of saline (group CM) and mixed with the same volume of saline as control (group C) were implanted into a 1.5 cm diaphyseal defect and wrapped with PLGC membrane in the radius of Beagle dogs. Radiographs of the antebrachium were made after surgery. The implants were harvested 12 weeks after implantation and specimens were stained with H&E, toluidine blue and Villanueva-Goldner stains for histological examination and histomorphometric analysis of new bone formation. Additionally, UCB-MSCs were applied to a dog with non-union fracture. Radiographically, continuity between implant and host bone was evident at only one of six interfaces in group C by 12 weeks, but in three of six interfaces in group CM. Radiolucency was found only near the bone end in group C at 12 weeks after implantation, but in the entire graft in group CM. Histologically, bone formation was observed around beta-TCP in longitudinal sections of implant in both groups. Histomorphometric analysis revealed significantly increased new bone formation in group CM at 12 weeks after implantation (p < 0.05). When applied to the non-union fracture, fracture healing was identified by 6 weeks after injection of UCB-MSCs. The present study indicates that a mixture of UCB-MSCs and beta-TCP is a promising osteogenic material for repairing bone defects.
Animals ; Biocompatible Materials/metabolism/therapeutic use ; Bone Substitutes/*therapeutic use ; Calcium Phosphates/*therapeutic use ; Dogs ; Fetal Blood/*cytology ; Fracture Fixation/methods/veterinary ; Mesenchymal Stem Cells/*physiology ; Osteogenesis/*physiology ; Tissue Engineering/methods ; Wound Healing/physiology

A model that provides reproducible, submaximal yet sufficient spinal cord injury is needed to allow experiments leading to development of therapeutic techniques and prediction of clinical outcome to be conducted. This study describes an experimental model for spinal cord injury that uses three different volumes of balloon inflation and durations of compression to create a controlled gradation outcome in adult dogs. Twenty-seven mongrel dogs were used for this study. A 3-french embolectomy catheter was inserted into the epidural space through a left hemilaminectomy hole at the L4 vertebral arch. Balloons were then inflated with 50, 100, or 150 microliter of a contrast agent at the L1 level for 6, 12, or 24 h and spinal canal occlusion (SCO) measured using computed tomography. Olby score was used to evaluate the extent of spinal cord injury and a histopathologic examination was conducted 1 week after surgery. The SCO of the 50, 100, and 150 microliter inflations was 22-46%, 51-70%, and 75-89%, respectively (p < 0.05). Olby scores were diminished significantly by a combination of the level of SCO and duration of inflation in all groups. Olby scores in the groups of 150 microliter-12 h, 150 microliter-24 h, and 100 microliter-24 h were 0.5, 0, and 1.7, respectively. Based on these results, a SCO > 50% for 24 h, and > 75% for 12 h induces paraplegia up to a week after spinal cord injury.
Animals ; Balloon Dilatation/*methods ; *Disease Models, Animal ; *Dogs ; Epidural Space/injuries ; Spinal Cord Compression/*etiology/pathology ; Tomography, X-Ray Computed

Congenital laryngeal atresia is a rare cause of airway obstruction that is almost always lethal within a few minutes after birth. Therefore congenital laryngeal atresia should be diagnosed in the prenatal period. If not, it should be considered in newborn infant with life-threatening symptoms at birth such as cyanosis and dyspnea that need emergent procedures like a tracheotomy. We report a case of congenital laryngeal atresia with single umbilical artery diagnosed in a one-day-old neonate who required a tracheotomy and ventilator care after intubation failure.
Airway Obstruction ; Cyanosis ; Dyspnea ; Humans ; Infant, Newborn ; Intubation ; Parturition ; Single Umbilical Artery* ; Tracheotomy* ; Ventilators, Mechanical

PURPOSE: Determination of adenosine deaminase (ADA) in pleural fluid has been suggested as another tool to establish early diagnosis of tuberculous pleural effusion. However, there are few studies concerning its usefulness in children. The objective of this study was to evaluate the utility of the determination of ADA level in pleural fluid for the differential diagnosis between tuberculous pleural effusion (TPE) and Mycoplasma pneumonia with pleural effusion (MP) in children. METHODS: We retrospectively reviewed the clinical records of 13 TPE patients and 21 MP patients with pleural effusion. Also, we analyzed ADA levels, and clinical, biochemical, microbiologic and cytologic findings in the pleural fluid. RESULTS: The pleural fluid of all the subjects revealed exudative rather than transudate characteristics. The mean ADA level in the TPE group was significantly higher than that in the MP group (106.27+/-43.71 IU/L vs. 65.28+/-26.27 IU/L, P=0.003). The area under the curve in receiver operating characteristic analysis was 0.810. With a cut-off level for ADA of 60 U/L, the sensitivity, specificity, positive predictive value, and negative predictive value were 92.3%, 61.9%, 60.0%, and 92.9%, respectively. As many as 38.9% of patients with MP were false-positive with this ADA cut-off setting. CONCLUSION: Although the measurement of ADA activity in pleural fluid can help TPE diagnosis, we should consider that some cases of MP with pleural effusion showed high ADA activities. Accordingly, the utility of the ADA level in pleural fluid for the differentiation of TPE from MP declines and additional relevant studies are required.
Adenosine ; Adenosine Deaminase ; Child ; Diagnosis, Differential ; Early Diagnosis ; Exudates and Transudates ; Humans ; Mycoplasma ; Pleural Effusion ; Pneumonia, Mycoplasma ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

OBJECTIVES: The purpose of this study was as follows: 1) to compare the current status of management for dementia between city and country health center. 2) to check the amount and detailed items of budgets for dementia in dementia counseling center, referral courses for registration of dementia patient, number of dementia patient referred to welfare institutions for the elderly. 3) to understand the troubles in management for dementia in health center and to provide baseline data about future community dementia management system. METHOD: The questionnaire was administered to 248 public health centers. The 162 collected questionnaires were used in analysis and the whole response rate was 65.3%. Questionnaire composed by general contents about dementia management in health center and dementia counseling center. Statistical analysis was conducted to compare the difference about each item in city and country health center. RESULTS: City and country health center showed differences in number of registered dementia patient, budgets for dementia, referral courses for registration of dementia patient, number of dementia patient referred to institution, troubles in management for dementia in health center. CONCLUSION: Current dementia management system does not meet the various needs of community for management of dementia. Thus, complementary strategies are needed to solve this problem.
Aged ; Budgets ; Counseling ; Dementia* ; Humans ; Public Health ; Surveys and Questionnaires ; Referral and Consultation

The 150 microl and 50 micol was reversed in the labeled line of the insert box in above article, on page 92, Fig. 4. The correct figure is printed below. We apologize for any confusion resulting from this error.