No abstract available.
Acoustics* ; Dysarthria*

Fetal thymus may be the organ for NK cell maturation, but the in vivo evidences are few, Here, by analyzing NK cell receptor, we present that NK cells develop in fetal thymus and fetal liver and that NK cell receptor appears earlier than the expression CD16 or CD56. Moreover, the finding that the repertoire of NK cell receptor is different between fetal thymus and fetal liver lymphocytes suggests that the environmental factors may influence the NK cell receptor repertoire during NK cell maturation.
Killer Cells, Natural* ; Liver* ; Lymphocytes* ; Thymocytes* ; Thymus Gland

No abstract available.
Biopsy, Needle* ; Needles*

PURPOSE: The results of anal fistula treatments have improved with the development of the anal fistula operative technique. However, there are still complications, such as recurrence and anal incontinence. To this end, the authors classified anal fistulas by using Sumikoshi's classification and performed an anal-sphincter-preserving procedure. METHODS: We experienced 98 anal fistula cases involving 86 patients who underwent anal fistula operations at The Catholic University of Korea, St. Vincent's Hospital from January 2001 to December 2006. This study was done retrospectively by chart review and telephone questioning. The follow-up period was from 2 to 72 months (mean 29.5, SD: 19.1). RESULTS: The study showed 0 cases of Type I (0.0%), 49 cases of Type II (50.0%), 46 cases of Type III (46.9%), and 3 cases of Type IV (3.1%) fistulas. Among the 98 fistula-in-ano operations were 27 (27.6%) of fistulotomies and 71 (72.4%) sphincter-preserving procedures (2 cases of coring-out+muscle filling+rectal mucosal advancement flap, 31 cases of coring-out+ muscle closure+rectal mucosal advancement flap, 28 cases of coring-out+cutting seton, and 10 cases of loose seton). After the sphincter-preserving operation, there were 4 cases (4/71, 5.6%) of recurrence. There were no major disorders of the anal sphincter. However, minor disorders of the anal sphincter (6/71, 8.5%, soiling) were found. CONCLUSIONS: The anal-sphincter-preserving procedure is very effective in preventing recurrence and anal incontinence, but these results are from a retrospective study with a small number of patients and the follow-up period was short. If further cases are collected and continuous follow-up is done, better results can be expected.
Anal Canal ; Classification ; Fistula ; Follow-Up Studies ; Humans ; Korea ; Rectal Fistula ; Recurrence ; Retrospective Studies* ; Telephone

PURPOSE: Prehospital airway management is crucial to emergency healthcare providers, especially for emergency medical technicians (EMTs). In spite of its clinical importance, adequate airway management cannot be guaranteed only with the use of endotracheal intubation. Many supraglottic airway devices have been introduced as substitutes for endotracheal intubation. We compared 3 such devices - LMA Classic(TM), Cobra PLA(TM) and King LT(TM) - using a manikin and recorded performance skill and preference. METHODS: Thirty EMTs participated in the airway management educational program and were enrolled in this study which was held in the Gyeong-Gi Fire Academy. We surveyed the participants general characteristics and experience by e-mail prior to this laboratory study of their skills. The airway management program consisted of a 10 minute lecture followed by 20 minutes of skill training. We observed the success rate, preference among the 3 devices, and the total procedure time of airway device insertion in different rooms. RESULTS: The LMA Classic(TM), Cobra PLA(TM) and King LT(TM) groups succeeded 90%, 76.7%, and 80%, respectively at the first trial. There was no statistically significant difference among the groups (p=0.372). To achieve adequate airway management, the groups spent 28.6+/-7.2, 24.7+/-4.9, and 26.9+/-7.0 seconds, respectively, again with no significant differences (p=0.108). A preference survey performed after the test showed the highest preference for King LT(TM), 57%. CONCLUSION: Three prehospital supraglottic airway devices showed no differences in success rate or procedure time. Despite this result, King LT(TM) was the most preferred.
Airway Management ; Benzeneacetamides ; Elapidae ; Electronic Mail ; Emergencies ; Emergency Medical Technicians ; Fires ; Health Personnel ; Humans ; Intubation, Intratracheal ; Laryngeal Masks ; Manikins ; Piperidones

Aging is one of the risk factors for the development of cardiovascular diseases. During the progression of cellular senescence, cells enter a state of irreversible growth arrest and display resistance to apoptosis. As a flavonoid, quercetin induces apoptosis in various cells. Accordingly, we investigated the relationship between quercetin-induced apoptosis and the inhibition of cellular senescence, and determined the mechanism of oxidative stress-induced vascular smooth muscle cell (VSMC) senescence. In cultured VSMCs, hydrogen peroxide (H₂O₂) dose-dependently induced senescence, which was associated with increased numbers of senescence-associated β-galactosidase-positive cells, decreased expression of SMP30, and activation of p53-p21 and p16 pathways. Along with senescence, expression of the anti-apoptotic protein Bcl-2 was observed to increase and the levels of proteins related to the apoptosis pathway were observed to decrease. Quercetin induced apoptosis through the activation of AMP-activated protein kinase. This action led to the alleviation of oxidative stress-induced VSMC senescence. Furthermore, the inhibition of AMPK activation with compound C and siRNA inhibited apoptosis and aggravated VSMC senescence by reversing p53-p21 and p16 pathways. These results suggest that senescent VSMCs are resistant to apoptosis and quercetin-induced apoptosis attenuated the oxidative stress-induced senescence through activation of AMPK. Therefore, induction of apoptosis by polyphenols such as quercetin may be worthy of attention for its anti-aging effects.
Aging ; AMP-Activated Protein Kinases ; Apoptosis ; Cardiovascular Diseases ; Cell Aging ; Hydrogen Peroxide ; Muscle, Smooth, Vascular ; Polyphenols ; Quercetin ; Risk Factors ; RNA, Small Interfering

The light and electron microscopic studies were carried out to find the morphological changes of epithelial cells covering Peyer's patch after simple observation of gerbil (Mongolian gerbil) ileum. Animals were classified as the control, 6 hour-ligation and 18 hour-ligation groups. Terminal ileum was ligated with white silk around Peyer's patch without the vascular injury. In control group, epithelia of the gerbil ileum was consisted of villous epithelium and follicle-associated epithelium (FAE) covering Peyer's patch. FAE represented typical dome structure, and was composed of the cuboid absorptive cells mainly and M cells. M cells were distributed at the periphery rather than central portion of dome-like FAE that are distinguishable from absorptive cells, owing to their typically short and thick microvilli on its free surface. In the light mictoscopy on 6 hour-ligation group, cells with vacuoles were appeared in FAE, and some lymphocytes in lymphoid follicle were condensed and then densely stained. There are many lymphocytes in FAE, infiltrated through the interrupted basement membrane. In the electron microscopic findings of 6-hour-ligated group, absorptive cells appeared to have many vesicle and vacuoles in various size, some lipid droplets and membranous structure contained inclusion bodies. Microvilli of M cell appeared to be destroyed at the central portion on its free surface. In the light microscopy of 18 hour-ligation group, FAE destructed partially and lymphoid follicle was hypertrophied and atrophied simultaneously. In the electron microscopic findings of 18 hour-ligation group, absorptive cells appeared to have the irregular and densely stained nucleus, and have many lipid droplets other than structures observed in 6 hour-ligation group. M cell appeared to have various-sized vacuoles, and have the bleb-like and irregular membrane-limited structures that protrude into the lumen and have less the cytoplasmic cell organs. These results suggested that the simple ligation of ileum gives rise to the inflammatory response on FAE of 6 hourligated group and then lead to the various response; degeneration, necrosis and atrophy of cells in FAE, and the hypertrophy and atrophy of lymphocytes in lymphoid follicle. M cell might have no special function and have the degenerative change with the adjacent absorptive cells during simple obstruction.
Animals ; Atrophy ; Basement Membrane ; Cytoplasm ; Electrons ; Epithelial Cells ; Epithelium ; Gerbillinae ; Humans ; Hypertrophy ; Ileum ; Inclusion Bodies ; Ligation ; Light ; Lymphocytes ; Microscopy ; Microvilli ; Necrosis ; Silk ; Vacuoles ; Vascular System Injuries

PURPOSE: To evaluate the clinical and radiological results of patients that underwent total knee replacement arthroplasty (TKRA) using a NexGen(R). implant, and who were followed up for at least 2 years. MATERIALS AND METHODS: Between July 1996 and June 2002, 100 knees in 67 patients, and followed up for at least 2 years following TKRA using a NexGen(R). implant were retrospectively assessed for clinical and radiological results using the assessment standards of the Knee and Functional Score of the American Knee Society. RESULTS: The average preoperative range of motion in patients with osteoarthritis and rheumatoid arthritis were 107.4degrees (50-140degrees) and 105.8degrees (70-120degrees), respectively, which had improved to 127.2degrees (85-140degrees) and 125.6degrees (90-140degrees), respectively, at the final follow up. In addition, the preoperative flexion contracture improved from 11.3degrees (0-30degrees) and 10.6degrees (0-30degrees) to 1.3degrees (0-15degrees) and 3degrees (0-15degrees) postoperatively. The results using the assessment standards of the Knee and Functional Score of the American Knee Society were improved from 62 (35-82) and 40 (0-70) to 95.8 (87-100) and 97 (70-100) in patients with osteoarthritis, whereas the patients with rheumatoid arthritis were improved from 53.8 (32-73) and 36 (0-50) to 95.1 (89-98) and 79 (55-95). As a complication, infection occurred in 2 cases; they were given a reimplantation. CONCLUSION: TKRA using a NexGen(R). implant showed satisfactory improvement in pain relief and function, such as range of motion, as well as a lower occurrence rate of complications.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies* ; Humans ; Knee* ; Osteoarthritis ; Range of Motion, Articular ; Replantation ; Retrospective Studies

Adequate vascular access is essential for hemodialysis and Cimino type arteriovenous fistula is the solution for this purpose. But even after we made that fistula, we faced with early fistula failure in about 5~15% of these internal fistula and about 10% drop of fistula patency during the follow up each year. In order to select adequate salvage procedures after fistula failure, we analyzed the causes of failure and compared the result of salvage procedures performed in 423 re-arteriovenous fistula cases which were done between March 1983 through February 1996 in the Department of Surgery Dongsan Hospital, Keimyung University. In early failure cases, poor arterial flow(51.4%) and missed proximal obstruction of fistulated vein before fistula creation(20.9%) were two most common causes of failure but in late failure, stricture and thrombosis were leading causes(81.4%). In the case of repeated arteriovenous fistula, usage of proximal artery showed less early failure rate(5.6%) than opposite radial or ulnar artery(14.8%). This is especially true in patient with diabetes, collagen disease or obesity. Both repeat arteriovenous fistula and salvage procedure showed more early fistula rate and less mean patency compare with primary fistula. Among the salvage procedures of late onset fistula failure, patch graft and bridge graft showed less failure rate(7.1% and 8.3% each) compared with balloon angioplasty(60.0%) or thrombectomy(25.0%). Thrombosis or occlusion at around the fistula site can be managed by performing new fistula using the arterized vein and artery 1~2 cm proximal to the previous fistula. In summary, salvage procedure in the failed arteriovenous fiatula should be chosen according to their failure causes and onset time.
Arteries ; Arteriovenous Fistula ; Collagen Diseases ; Constriction, Pathologic ; Fistula ; Follow-Up Studies ; Humans ; Obesity ; Renal Dialysis ; Thrombosis ; Transplants ; Veins

PURPOSE: Splenic flexure mobilization in an anterior resection is a subject of controversy, but a tension-free anastomosis is needed in case of a low anterior resection or a coloanal anastomosis. Classical splenic flexure mobilization by means of the lesser sac opening is technically difficult in the laparoscopic era. METHODS: This study retrospectively analyzed the medical records and operation videos of 16 patients who underwent laparoscopic splenic flexure mobilization in Our Lady of Mercy Hospital, The Catholic University of Korea by using a medial approach. The operation procedure is as follows: Under general anesthesia, the patient was placed in the Trendelenburg position, after making pneumoperitoneum, the inferior mesenteric artery (IMA) and the inferior mesenteric vein (IMV) were ligated and divided. A medial-to-lateral mesocolon dissection was done, and the pancreas was dissected from the mesocolon of the transverse colon; then, the greater omentum was dissected. RESULTS: The mean age was 60 years old, and the male- to-female sex ratio was 9:7. The mean operation time was 293 minutes. The mean distal margin was 5.3 cm, and the mean number of harvested lymph nodes was 15. An anterior resection was done in 2 cases, a low anterior resection is 10 cases, and a coloanal anastomosis in 4 cases. The mean time from ligation of the IMA to splenic flexure mobilization was 45 minutes. There was no mortality or morbidity. CONCLUSIONS: Laparoscopic medial splenic flexure mobilization is a technically feasible and safe method.
Anesthesia, General ; Colon, Transverse* ; Head-Down Tilt ; Humans ; Korea ; Laparoscopy ; Ligation ; Lymph Nodes ; Medical Records ; Mesenteric Artery, Inferior ; Mesenteric Veins ; Mesocolon ; Middle Aged ; Mortality ; Omentum ; Pancreas ; Peritoneal Cavity ; Pneumoperitoneum ; Retrospective Studies ; Sex Ratio