BACKGROUND: This study was designed to evaluate the antihypertensive efficacy and safety of benidipine hydrochloride, a Ca(++)-channel blocker, in patients with mild to moderate essential hypertension. METHODS: Benidipine was administered in 2-8mg once daily for 10 weeks in 16 hypertensive patients with diastolic blood pressure over 95mmHg and adverse effects were checked every two weeks after benidipine administration. Chest X-ray, ECG, funduscopy, and laboratory examination were performed before and after benidipine administration. RESULTS: The antihypertensive effect of benidipine was evaluated in 15 patients and the safety in 16 patients. The blood pressure significantly reduced from 170+/-12mmHg/102+/-5mmHg to 137+/-15mmHg/86+/-8mmHg at 10-week administration of benidipine and the overall effective rate was 100%. Heart rate was not affected by benidipine. The slight increase of total protein, BUN, potassium, and glucose was observed at 10 weeks of benidipine administration. Four cases of headache and 1 case of frequent urination were observed and the medication was discontinued in one patient due to headache. CONCLUSION: Benidipine proved effective and safe in the treatment of essential hypertension.
Blood Pressure ; Electrocardiography ; Glucose ; Headache ; Heart Rate ; Humans ; Hypertension ; Potassium ; Thorax ; Urination

Mesenchymal stem cell (MSC)-based therapy using gene delivery systems has been suggested for degenerative diseases. Although MSC-based clinical applications are effective and safe, the mode of action remains unclear. Researchers have commonly applied viral-based gene modification because this system has efficient vehicles. While viral transfection carries many risks, such as oncogenes and chromosomal integration, nonviral gene delivery techniques are less expensive, easier to handle, and safe, although they are less efficient. The electroporation method, which uses Nucleofection technology, provides critical opportunities for hard-to-transfect primary cell lines, including MSCs. Therefore, to improve the therapeutic efficacy using genetically modified MSCs, researchers must determine the optimal conditions for the introduction of the Nucleofection technique in MSCs. Here, we suggest optimal methods for gene modification in PD-MSCs using an electroporation gene delivery system for clinical application.

Background: Acute bronchiolitis is a common cause of hospitalization during infancy that carries significant morbidity and mortality rates.Purpose: This study compared the efficacy of different treatment modalities for infants with bronchiolitis in terms of hospital stay and clinical severity scores. Methods: The PubMed database was searched for relevant studies. Eligibility criteria included double-blind randomized controlled trial design, assessment of the effect of treatment on bronchiolitis in infants under 2 years of age, and publication in English from inception through July 31, 2020. The primary efficacy outcome was the length of hospital stay, while the secondary outcome was the clinical severity score. The standardized treatment effect and standard error of the effect size were calculated. Results: We identified 45 randomized controlled trials of 24 pairwise comparisons. These 45 trials included 5,061 participants and investigated 13 types of interventions (12 active, 1 placebo). Inhalation therapy with epinephrine (standard mean difference [SMD], -0.41; 95% confidence interval [CI], -0.8 to -0.03) and hypertonic saline (SMD, -0.29; 95% CI, -0.55 to -0.03) reduced the length of hospital stay compared with normal saline. Hypertonic saline was the most effective at improving the clinical severity score (SMD, -0.52; 95% CI, -0.95 to -0.10). Conclusion Inhalation therapy with epinephrine and hypertonic saline reduced the length of hospital stay and the clinical severity of bronchiolitis among infants under 2 years of age.

Background: Acute bronchiolitis is a common cause of hospitalization during infancy that carries significant morbidity and mortality rates.Purpose: This study compared the efficacy of different treatment modalities for infants with bronchiolitis in terms of hospital stay and clinical severity scores. Methods: The PubMed database was searched for relevant studies. Eligibility criteria included double-blind randomized controlled trial design, assessment of the effect of treatment on bronchiolitis in infants under 2 years of age, and publication in English from inception through July 31, 2020. The primary efficacy outcome was the length of hospital stay, while the secondary outcome was the clinical severity score. The standardized treatment effect and standard error of the effect size were calculated. Results: We identified 45 randomized controlled trials of 24 pairwise comparisons. These 45 trials included 5,061 participants and investigated 13 types of interventions (12 active, 1 placebo). Inhalation therapy with epinephrine (standard mean difference [SMD], -0.41; 95% confidence interval [CI], -0.8 to -0.03) and hypertonic saline (SMD, -0.29; 95% CI, -0.55 to -0.03) reduced the length of hospital stay compared with normal saline. Hypertonic saline was the most effective at improving the clinical severity score (SMD, -0.52; 95% CI, -0.95 to -0.10). Conclusion Inhalation therapy with epinephrine and hypertonic saline reduced the length of hospital stay and the clinical severity of bronchiolitis among infants under 2 years of age.

Background: Acute bronchiolitis is a common cause of hospitalization during infancy that carries significant morbidity and mortality rates.Purpose: This study compared the efficacy of different treatment modalities for infants with bronchiolitis in terms of hospital stay and clinical severity scores. Methods: The PubMed database was searched for relevant studies. Eligibility criteria included double-blind randomized controlled trial design, assessment of the effect of treatment on bronchiolitis in infants under 2 years of age, and publication in English from inception through July 31, 2020. The primary efficacy outcome was the length of hospital stay, while the secondary outcome was the clinical severity score. The standardized treatment effect and standard error of the effect size were calculated. Results: We identified 45 randomized controlled trials of 24 pairwise comparisons. These 45 trials included 5,061 participants and investigated 13 types of interventions (12 active, 1 placebo). Inhalation therapy with epinephrine (standard mean difference [SMD], -0.41; 95% confidence interval [CI], -0.8 to -0.03) and hypertonic saline (SMD, -0.29; 95% CI, -0.55 to -0.03) reduced the length of hospital stay compared with normal saline. Hypertonic saline was the most effective at improving the clinical severity score (SMD, -0.52; 95% CI, -0.95 to -0.10). Conclusion Inhalation therapy with epinephrine and hypertonic saline reduced the length of hospital stay and the clinical severity of bronchiolitis among infants under 2 years of age.

Background: Acute bronchiolitis is a common cause of hospitalization during infancy that carries significant morbidity and mortality rates.Purpose: This study compared the efficacy of different treatment modalities for infants with bronchiolitis in terms of hospital stay and clinical severity scores. Methods: The PubMed database was searched for relevant studies. Eligibility criteria included double-blind randomized controlled trial design, assessment of the effect of treatment on bronchiolitis in infants under 2 years of age, and publication in English from inception through July 31, 2020. The primary efficacy outcome was the length of hospital stay, while the secondary outcome was the clinical severity score. The standardized treatment effect and standard error of the effect size were calculated. Results: We identified 45 randomized controlled trials of 24 pairwise comparisons. These 45 trials included 5,061 participants and investigated 13 types of interventions (12 active, 1 placebo). Inhalation therapy with epinephrine (standard mean difference [SMD], -0.41; 95% confidence interval [CI], -0.8 to -0.03) and hypertonic saline (SMD, -0.29; 95% CI, -0.55 to -0.03) reduced the length of hospital stay compared with normal saline. Hypertonic saline was the most effective at improving the clinical severity score (SMD, -0.52; 95% CI, -0.95 to -0.10). Conclusion Inhalation therapy with epinephrine and hypertonic saline reduced the length of hospital stay and the clinical severity of bronchiolitis among infants under 2 years of age.

PURPOSE: To determine the correlation between areas of decreased parenchymal attenuation seen in cases of bronchiectasis, and the severity and extent of the condition, as revealed by HRCT and the plmonary function test (PFT). MATERIALS AND METHODS: The findings of forty-five patients with bronchiectasis who had undergone PFT and HRCT were retrospectively analysed. CT scores were calculated according to the severity and extent of the condition, and areas of low attenuation, and the correlation coefficients between these were determined. Bronchiectasis was classified as either cylindrical or cystic, and using Student's t test, the statistical significance of the results of the PFT were determined. RESULT: The severity and extent of bronchiectasis correlated with the extent of areas of low attenuation (r > .45, p < .05), with especially significant correlation between the extent of these areas and the extent of the condition (r =.84, p=.0001). Correlation was greater in cases involving the cylinlrical variety than the cystic. The extent of low attenuation areas correlated with FEV1, FVC, MMEF, and DLCO (r > .44, p < .01). The functional parameters of the PFT which help differentiate between cylindrical and cystic bronchiectasis are FEV1, FVC, MMEF, DLCO (p < .01), RV, and TLC (p < .05). CONCLUSION: In patients with bronchiectasis, the extent of the condition correlated closely with the extent of low attenuation, and the latter, especially in cases of cylindrical bronchiectasis, showed significant correlation with the extent of abnormalities revealed by the pulmonary function test.
Bronchiectasis* ; Humans ; Respiratory Function Tests* ; Retrospective Studies

While carbapenems are the drug of choice to treat extended-spectrum-β-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient’s clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.
Aged ; Anti-Bacterial Agents ; Bacteremia ; Carbapenems ; Ciprofloxacin* ; Electrophoresis, Gel, Pulsed-Field ; Emergency Service, Hospital ; Escherichia coli* ; Escherichia* ; Female ; Fever ; Flank Pain ; Humans ; In Vitro Techniques ; Point Mutation ; Pyelonephritis* ; Serogroup ; Treatment Failure

While carbapenems are the drug of choice to treat extended-spectrum-β-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient’s clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.
Aged ; Anti-Bacterial Agents ; Bacteremia ; Carbapenems ; Ciprofloxacin* ; Electrophoresis, Gel, Pulsed-Field ; Emergency Service, Hospital ; Escherichia coli* ; Escherichia* ; Female ; Fever ; Flank Pain ; Humans ; In Vitro Techniques ; Point Mutation ; Pyelonephritis* ; Serogroup ; Treatment Failure