BACKGROUND: This randomized, controlled study was designed to compare the effects of recruitment maneuvers (RMs) with a 15 cmH₂O positive end-expiratory pressure (PEEP) on the systemic oxygenation and lung compliance of patients with healthy lungs following robot-assisted laparoscopic prostatectomy (RALP). METHODS: Sixty patients undergoing a RALP with an intraoperative 15 cmH₂O PEEP were randomly allocated to an RM or a Control group. The patients in the RM group received a single RM through the application of a continuous positive airway pressure of 40 cmH₂O for 40 s 15 min after being placed in the Trendelenburg position. The arterial oxygen tension (PaO₂, primary endpoint) and the pulmonary dynamic and static compliances (secondary endpoints) were measured 10 min after the anesthetic induction (T1), 10 min after establishment of the pneumoperitoneum (T2), 10 min after establishment of the Trendelenburg position (T3), 10 min after the RM (T4), 60 min after the RM (T5), and 10 min after deflation of the pneumoperitoneum in the supine position (T6). RESULTS: The intergroup comparisons of the PaO₂ showed significantly higher values in the RM group than in the Control group at T4 and T5 (193 ± 35 mmHg vs. 219 ± 33 mmHg, P = 0.015, 188 ± 41 mmHg vs. 214 ± 42 mmHg, P = 0.005, respectively). However, the PaO₂ at T6 was similar in the two groups (211 ± 39 mmHg vs. 224 ± 41 mmHg, P = 0.442). Moreover, there were no statistical differences between the groups in the dynamic and static compliances of the lungs at any time point. CONCLUSIONS: The arterial oxygenation of the patients with a healthy lung function who had undergone a RALP with intraoperative 15 cmH₂O PEEP was improved by a single RM. However, this benefit did not last long, and it did not lead to an amelioration of the lung mechanics.
Continuous Positive Airway Pressure ; Head-Down Tilt ; Humans ; Lung ; Lung Compliance ; Mechanics ; Oxygen* ; Pneumoperitoneum ; Positive-Pressure Respiration* ; Prostatectomy* ; Supine Position

Angiotensin II (Ang II) induces the pathological process of vascular structures, including renal glomeruli by hemodynamic and nonhemodynamic direct effects. In kidneys, Ang II plays an important role in the development of proteinuria by the modification of podocyte molecules. We have previously found that Ang II suppressed podocyte AMP-activated protein kinase (AMPK) via Ang II type 1 receptor and MAPK signaling pathway. In the present study, we investigated the roles of AMPK on the changes of p130Cas of podocyte by Ang II. We cultured mouse podocytes and treated them with various concentrations of Ang II and AMPK-modulating agents and analyzed the changes of p130Cas by confocal imaging and western blotting. In immunofluorescence study, Ang II decreased the intensity of p130Cas and changed its localization from peripheral cytoplasm into peri-nuclear areas in a concentrated pattern in podocytes. Ang II also reduced the amount of p130Cas in time and dose-sensitive manners. AMPK activators, metformin and AICAR, restored the suppressed and mal-localized p130Cas significantly, whereas, compound C, an AMPK inhibitor, further aggravated the changes of p130Cas. Losartan, an Ang II type 1 receptor antagonist, recovered the abnormal changes of p130Cas suppressed by Ang II. These results suggest that Ang II induces the relocalization and suppression of podocyte p130Cas by the suppression of AMPK via Ang II type 1 receptor, which would contribute to Ang II-induced podocyte injury.
AMP-Activated Protein Kinases/antagonists & inhibitors/chemistry/*metabolism ; Aminoimidazole Carboxamide/analogs & derivatives/pharmacology ; Angiotensin II/*pharmacology ; Angiotensin II Type 1 Receptor Blockers/pharmacology ; Animals ; Blotting, Western ; Cell Line ; Cell Nucleus/metabolism ; Crk-Associated Substrate Protein/*metabolism ; Cytoplasm/metabolism ; Focal Adhesion Kinase 1/metabolism ; Losartan/pharmacology ; Metformin/pharmacology ; Mice ; Microscopy, Confocal ; Podocytes/cytology/drug effects/metabolism ; Protein Kinase Inhibitors/*pharmacology ; Ribonucleotides/pharmacology ; Signal Transduction/*drug effects

OBJECTIVES: This study was conducted to investigate the effect of low sodium diet education program on dietary habits, diet quality, and measures of obesity in overweight or obese middle-aged women. METHODS: Subjects were 81 individuals aged 45 years or over, who completed an 8-week nutrition education. The subjects were divided into a normal group (N = 30) and an overweight-obese group (N = 51) according to the BMI. The effects were evaluated by anthropometric measurement, biochemical analysis, questionnaire, and diet records before and after the program. RESULTS: Overweight-obese group showed significant decreases in weight (p < 0.0001), BMI (p < 0.0001), percent of body fat (p = 0.0087), waist circumference (p < 0.0001), systolic (p = 0.0003) and diastolic blood pressure (p = 0.0261). Nutrients intakes were not different between the two groups and only sodium intake was decreased after education. Total score of general dietary habits, dietary behavior related to sodium intake, dietary diversity score (DDS), diet variety score (DVS), and diet quality index-international (DQI-I) were improved in both groups compared to the baseline. Overweight-obese group showed significant improvement in 'having fruits everyday', 'having fish everyday', 'trying to eat many kinds of food', 'eating less broth when eating soup, stew, and noodles', 'eating less kimchi and salt-fermented vegetable', and 'propensity to think that dishes should be pretty seasoned'. In addition, moderation of empty calories food (p = 0.0064) and macronutrient ratio (p = 0.0004) were improved in the overweigh-obese group, but in the normal group, the results did not reach statistical significance. CONCLUSIONS: These results suggested that low sodium diet education program may contribute to obesity management by improving diet quality and dietary habits in middle-aged women.
Adipose Tissue ; Blood Pressure ; Diet Records ; Diet* ; Diet, Sodium-Restricted* ; Eating ; Education* ; Female ; Food Habits* ; Fruit ; Humans ; Obesity* ; Overweight* ; Surveys and Questionnaires ; Sodium ; Waist Circumference

Multiple tooth loss can cause disharmonious occlusial plane, loss of vertical dimension and deflection of mandibular movement. Therefore, restoring proper vertical dimension and occlusion in the centric relation is an important treatment goal. Implant-assisted removable partial denture is a recently used clinical technique, because it increases patient satisfaction by improving retention, support, and stability of conventional denture. The objective of this article is to present a case report describing the fabrication of treatment denture and implant assisted removable partial denture using previously placed implants for a patient with partial loss of posterior support and anterior stop.

Solid pseudopapillary tumor (SPT) is a low grade malignant tumor in the pancreas, and extrapancreatic SPT is extremely rare. We report a case of a 61-year-old woman who complained abdominal pain with diffuse tenderness. She was diagnosed with extrapancreatic SPT with extensive peritoneal dissemination and hepatic metastases. Although a few cases have reported imaging findings of extrapancreatic SPT, there have been no reports of extrapancreatic SPT with aggressive tumor behavior and dismal prognosis. Although imaging features closely resembled those of classical pancreatic SPTs, malignant transformation of extrapancreatic SPT should be considered when focal discontinuity of the tumor capsule with ill-defined margin and invasion of adjacent structures were identified.
Abdominal Pain ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Prognosis ; Ultrasonography

OBJECTIVES: Hearing loss is the most common sensory disorder in humans and genetic causes are estimated to cause more than 50% of all incidents of congenital hearing loss. To develop an efficient method for a genetic diagnosis of hearing loss, we have developed and validated a genetic hearing loss DNA chip that allows the simultaneous analysis of 7 different mutations in the GJB2, SLC26A4, and the mtDNA 12S rRNA genes in Koreans. METHODS: A genotyping microarray, based on the allele-specific primer extension (ASPE) method, was used and preliminary validation was examined from the five patients and five controls that were already known their genotypes by DNA sequencing analysis. RESULTS: The cutoff Genotyping index (GI) of genotyping for each mutation was set up and validated to discriminate among the genotypes. The result of the DNA chip assay was identical to those of previous results. CONCLUSION: We successfully designed the genetic hearing loss DNA chip for the first time in Korea and it would be useful for a clinical genetic diagnosis of hearing loss. Further consideration will be needed in order to examine the accuracy of this DNA chip with much larger patient sample numbers.
DNA ; DNA, Mitochondrial ; Genes, rRNA ; Genotype ; Hearing ; Hearing Loss ; Humans ; Korea ; Mass Screening ; Oligonucleotide Array Sequence Analysis ; RNA, Ribosomal ; Sensation Disorders ; Sequence Analysis, DNA

No abstract available.
Abscess*

Excessive sodium intake leading to hypertension, stroke, and stomach cancer is mainly caused by excess use of salt in cooking. This study was performed to estimate the salt content in school meals and to compare differences in perceptions related to sodium intake between students and staffs working for school meal service. We collected 382 dishes for food from 24 schools (9 elementary, 7 middle, 8 high schools) in Gyeonggi-do and salt content was calculated from salinity and weight of individual food. The average salt content from elementary, middle, and high school meals were 2.44 g, 3.96 g, and 5.87 g, respectively. The amount of salt provided from the school lunch alone was over 80% of the recommended daily salt intake by WHO. Noodles, stews, sauces, and soups were major sources of salt intake at dish group level, while the most salty dishes were sauces, kimchies, and stir-fried foods. Dietary knowledge and attitude related to sodium intake and consumption frequency of the salty dishes were surveyed with questionnaire in 798 students and 256 staffs working for school meal service. Compared with the staffs, the students perceived school meals salty and the proportions of students who thought school meals were salty increased with going up from elementary to high schools (P < 0.001). Among the students, middle and high school students showed significant propensity for the preference to one-dish meal, processed foods, eating much broth and dipping sauce or seasoning compared with the elementary students, although they had higher nutrition knowledge scores. These results proposed that monitoring salt content of school meals and consideration on the contents and education methods in school are needed to lower sodium intake.
Cooking ; Eating ; Humans ; Hypertension ; Lunch ; Meals ; Surveys and Questionnaires ; Salinity ; Seasons ; Sodium ; Stomach Neoplasms ; Stroke

PURPOSE: The purpose of this study was to identify the effects of a multi agent obesity control program in obese school children. This program was composed of strategies to modify diet and exercise habits and to change cognitive behavior variables(stress, coping, and self-efficacy). METHOD: The subjects were 40 obese school children who participated in our project voluntarily via homepage, TV, newspaper, public paper and school official documents. The program was implemented daily for 4 sessions per day for ten days from August 16 to 26, 2004. The daily program consisted of exercise therapy, dance therapy, cognitive behavior therapy and aroma therapy. The data was analyzed by paired t-test using the SPSSWIN program. RESULT: There was a significant decrease in children's waist-hip ratio (p=.04) and in children's stress (p=.00) after the program. There was a significant increase in children's self-confidence after the program(p=.02) and a significant decrease in children's diet habit after the program(p=.02). CONCLUSION: This study provides evidence that a multiagent obese control program is effective in changing waist-hip ratio, stress, self-confidence, and diet habits in obese school children.
Child ; Child Behavior ; Diet, Reducing ; Female ; Food Habits ; Humans ; Male ; Multivariate Analysis ; Obesity/psychology/*therapy ; *Program Evaluation ; Schools ; Self Efficacy ; Waist-Hip Ratio ; Weight Loss

OBJECTIVES: Nasal septal perforation is an anatomic defect of the cartilaginous and bone tissues of the nasal septum. Many approaches and techniques to repair nasal septal perforations have been reported on. The purpose of this paper is to report on our surgical technique and the results of the treatment for nasal septal perforations. METHODS: From May 2001 to March 2008, 14 patients (12 males and 2 females; mean age: 41.3 yr) were enrolled. The mean perforation size was 15 mm, and all the perforations were located at the cartilaginous portion. Our surgical technique is based on an endoscope-assisted endonasal approach, with dissection of unilateral advanced mucosal flaps with using a temporalis fascia graft. The follow-up periods ranged from 3 to 23 months (mean follow-up period: 8 months). RESULTS: Using our surgical technique on 14 patients, 12 cases (85.7%) of septal perforation were closed without complication. The remaining two patients (14.3%) had incomplete closures (about 2-3 mm) without any significant symptoms related to the remaining perforation. CONCLUSION: Our technique is a viable procedure with a high success rate for achieving closure of nasal septal perforations. It has the advantages of shortening the operative time, no external incision and avoiding any other perforation during the operation. Therefore, we consider it to be a good alternative for repairing nasal septal perforations.
Bone and Bones ; Fascia ; Follow-Up Studies ; Humans ; Male ; Nasal Septal Perforation ; Nasal Septum ; Operative Time ; Transplants