PURPOSE: Bronchial asthma is a disorder that is characteized by symptoms of reversible airway obstruction and increased responsiveness of the bronchus and to quantify the degree of br onchial hyperresponsivenes can be very helpful in determing the severity of disease and the prognosis. But the Methacholine provocation test is not always easy to be performed in all patients. Thus we designed this trial to know the relationship between the degree of bronchial hype rresponsiveness by Methacholine and the severity of asthma symptoms, pulmonary function te st and atopic findings. METHODS: Methacholine provocation test was performed on 60 clinically stable asthma patients who visited the pediatric allergy clinic of Taegu Fatima Hospital from July, 1992 to June, 1 993. All patients were free of URI for at least 6 weeks and medications were withhold for 2 weeks for corticosteroid or beta receptor agonist and at least 2 days for theophylline. All subjects ha d FEV1 more than 70% of predicted value, and more than 20% of reversible obstruction. Disease severity score(DSS) was compared by the number of asthmatic attacts, clinical picture, therapeutic medications and the Airway reactivity score(ARS) was measured on the number of nonspecipic irritants provoking the bronchial hyperresponsivess. Methacholine provocation test was performed as follows; Normal saline was inhaled 5 times by tidal breath through De Vilbiss 646 inhaler and FEV1 was measured as baseline. According to Chai standardized method, Mathacholine was diluted to 0.075-25mg/ml concentration and inhaled 5 times and accumulated Methacholine was graded 0.375-225.0 Breath Units(One BU = 1 inhalation of 1 mg/ml). PD20 was determined to the concentration at which the FEV1 faIled to 20% below the baseline. RESULTS: 1) PD20 were distributed variably between 0.375 BU and 225.0 BU 2) Bronchial hyperresponsiveness was high on asthma with allergic rhinitis(p<0.05). 3) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation both DSS(r= -0.473; p<0.01) and ARS(r= -0.32; p<0.05). 4) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation to baseline FEV1/FVC ratio(r= -0.63; p<0.01). 5) Bronchial hyperresponsiveness by Methacholine provocation test had no statistical significant correlation to serum IgE value(r= -0.24; p<0.05). CONCLUSIONS: The severity of bronchial hyperresponsiveness by Methacholine provocation t est had significant correlation with DSS and ARS, and there was a close relation BHR to the baseline FEV1/FVC1 ratio too. Thus exact history about clinical pictures, medications, provocating irritants in asthmatic patients and baseline FEV1/FVC ratio can be very helpful in assessing the bronchial hyperresponsiveness.
Airway Obstruction ; Asthma* ; Bronchi ; Daegu ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inhalation ; Irritants ; Methacholine Chloride* ; Nebulizers and Vaporizers ; Prognosis ; Respiratory Function Tests ; Theophylline

BACKGROUND: The extracellular matrix (ECM) has many functions, such as segregating tissues, providing support, and regulating intercellular communication. Cartilage-derived ECM (CECM) can be prepared via consecutive processes of chemical decellularization and enzyme treatment. The purpose of this study was to improve and treat osteoarthritis (OA) using porcine knee articular CECM. METHODS: We assessed the rheological characteristics and pH of CECM solutions. Furthermore, we determined the effects of CECM on cell proliferation and cytotoxicity in the chondrocytes of New Zealand rabbits. The inhibitory effect of CECM on tumor necrosis factor (TNF)-a-induced cellular apoptosis was assessed using New Zealand rabbit chondrocytes and human synoviocytes. Finally, we examined the in vivo effects of CECM on inflammation control and cartilage degradation in an experimental OA-induced rat model. The rat model of OA was established by injecting monosodium iodoacetate into the intra-articular knee joint. The rats were then injected with CECM solution. Inflammation control and cartilage degradation were assessed by measuring the serum levels of proinflammatory cytokines and C-telopeptide of type II collagen and performing a histomorphological analysis. RESULTS: CECM was found to be biocompatible and non-immunogenic, and could improve cell proliferation without inducing a toxic reaction. CECM significantly reduced cellular apoptosis due to TNF-a, significantly improved the survival of cells in inflammatory environments, and exerted anti-inflammatory effects. CONCLUSION Our findings suggest that CECM is an appropriate injectable material that mediates OA-induced inflammation.

BACKGROUND: Management of primary aldosteronism has undergone dramatic changes in the past 40 years. This retrospective study was carried out to review our surgical experience and postoperative outcome and to identify the clinical charateristics of primary aldosteronism. METHODS: Twenty-five patients who underwent an adrenalectomy for primary aldosteronism from 1983 to 1997 were included in the study. All patients were operated on at the Department of Surgery, School of Medicine, Kyung-Hee University. We reviewed the records of 18 women and 7 men, ranging in age from 22 to 59 years. Data examined included clinical presentation, biochemical results, hormonal evaluation, localization studies, operative results, pathologic details, and postoperative outcome. The diagnosis of primary aldosteronism was based on a demonstration of hypertension, hypokalemia, elevated plasma aldosterone concentration, and suppressed plasma renin activity. Localization studies, including computed tomography (CT) and ultrasonography (US) were performed in all patients. A follow-up study was conducted by either reviewing clinical records, telephone contact, or examination of patients during return visits. RESULTS: Hypertension and hypokalemia were present in all patients. Serum potassium ranged from 1.4 to 3.2 mEq/L (2.3+/-0.5; mean+/-standard deviation {SD}mEq/L), and hypokalemia was considered an important diagnostic clue. We found the accuracy rate for CT results in our patients to be 96.0% (24 patients). An adrenal venous sampling was performed in one patient whose CT results were not confirmatory. A unilateral adrenalectomy was performed through posterior (22 patients), an anterior transabdominal (1 patient), or a lateral transabdominal laparoscopic (2 patients) approach. A laparoscopic adrenalectomy will minimize postoperative pain and hospital stay. The histological findings were 23 aldosterone-producing adenomas and 1 nodular hyperplasia. During a mean follow-up of 31.6 months, 22 (91.7%) of the 24 patients required no further antihypertensive treatment. CONCLUSION: Primary aldosteronism due to an aldosterone-producing adenoma can be diagnosed and localized expeditiously, and surgical treatment can be performed safely.
Adenoma ; Adrenalectomy ; Aldosterone ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hyperaldosteronism* ; Hyperplasia ; Hypertension ; Hypokalemia ; Length of Stay ; Male ; Pain, Postoperative ; Plasma ; Potassium ; Renin ; Retrospective Studies ; Telephone ; Ultrasonography

No abstract available.
Female ; Ovary* ; Teratoma*

Larger animal models, such as porcine, have been validated as appropriate models of the human disc with respect to biomechanics and biochemistry. They are advantageous for research as the models are relatively straightforward to prepare and easily obtainable for research to perform surgical techniques. The intention of this study was to quantitatively analyze gene expression for collagen and proteoglycan components of the extracellular matrix and for collagenase (MMP-1) in porcine discs of varying ages (Newborn; 2-3weeks, Mature; 6-9 month, Older; 2-3 years). In this study, we observed that the cell number and GAG (glycosaminoglycan) formation dramatically decreased with aging. Also, gene expression in the annulus fibrosus (AF) and nucleus pulposus (NP) cells changed with aging. The level of MMP-1 mRNA increased with age and both type I, II collagens decreased with age. The level of aggrecan mRNA was highest in the mature group and decreased significantly with aging. In the mature group, MMP-1 expression was minimal compared to the newborn group. In AF cells, type II collagen was expressed at a high level in the mature group with a higher level of aggrecan, when aged NP showed a decrease in type II collagen. The model of IVD degeneration in the porcine disc shows many changes in gene expression with age that have been previously documented for human and may serve as a model for studying changes in IVD metabolism with age. We concluded that the porcine model is excellent to test hypotheses related to disc degeneration while permitting time-course study in biologically active systems.
Age Factors ; Aggrecans/genetics/metabolism ; Aging/genetics/*metabolism ; Animals ; Animals, Newborn ; Collagen Type I/genetics/metabolism ; Collagen Type II/genetics/metabolism ; Glycosaminoglycans/genetics/metabolism ; Humans ; Intervertebral Disk Degeneration/genetics/*metabolism ; Matrix Metalloproteinase 1/genetics/*metabolism ; *Models, Animal ; Reverse Transcriptase Polymerase Chain Reaction ; Spinal Cord/*metabolism/pathology ; Swine

There are many hemodynamic and physiologic changes during liver transplantation much more than other surgical interventions. The oxygen delivery and oxygen consumption are af- fected by depressed hemodynamic and metabolic status during the operation. At the lower levels of oxygen present in venous blood, a linear relationship exists between saturation and tension. The use of fiberoptic oximetry system in conventional pulmonary artery flotation catheters has made the bedside application of this relationship of practical value in the continuous assessment of mixed venous oxygen saturation. This study was performed to determine changes in SvO2 and other variables of oxygen kinetics during canine OLT and study the correlation between SvO2 and cardiac output, SvO2 and oxygen consumption and oxygen utilization ratio. The continuous rnixed venous oxygen saturation and cardiac output by SO2/CO computer were monitored and the oxygen delivery, oxygen consumption and oxygen utilization ratio were calculated by arterial and venous blood gas analysis and modified Fick's equation during orthotopic liver transplantation in 20 dogs. The results were as follow as ; 1. There was no significant difference in tissue oxygen extraction between preoperative control and anhepatic phase, while cardiac output were decreased during anhepatic phase. 2. By utilizing centrifugal pump(venovenous bypass) oxygen delivery and oxygen utilization ratio were well maintained even though suppressed the change of oxygen delivery and oxygen consumption during anhepatic phase. 3. There was a significant decrease in SvO2 immediately after declamping the suprahepatic vena cava, whereas the oxygen utilization rate and oxygen consumption following reperfusion were significantly increased than just prior to reperfusion of transplanted liver. 4. A Statistically significant correlation was found between SvO2 and cardiac output, oxygen consumption in all surgical stages except reperfusion(CO;r=0.478, p<0.001, VO2,r=-0. 272, p=0.004), but their correlations were relatively poor. However, there was highly significant correlation among SvO2 and oxygen utilization ratio in all surgical stages(O2UR; r=- 0.834, P<0.001). In conclusion, continuous monitoring mixed venous oxygen via a fiberoptic pulmonary catheter could be used as the index for evaluation of hemodynamics and oxygen kinetics during canine OLT, but further research should be performed to determine whether these measurements indicate viability of the grafted liver.
Animals ; Blood Gas Analysis ; Cardiac Output ; Catheters ; Dogs ; Hemodynamics ; Kinetics ; Liver Transplantation* ; Liver* ; Oximetry ; Oxygen Consumption ; Oxygen* ; Pulmonary Artery ; Reperfusion ; Transplants

No abstract available.
Leukemia* ; Sweet Syndrome*

Follicular dendritic cell (FDC) sarcoma is an extremely rare malignant neoplasm arising from FDCs. The exact origin of FDCs remains unclear; both a hematopoietic lineage origin and a stromal cell derivation have been proposed. Proliferation of FDCs can lead to benign reactive lesions or generate neoplastic conditions. The lesions are most commonly found in lymph nodes and usually involve the head and neck area. Castleman's disease is a rare non-neoplasitic lymphoproliferative disorder. Rare cases of hyaline-vascular Castleman's disease have been associated with FDC sarcoma, but a clonal relationship has not been convincingly demonstrated. A pathway toward tumor evolution, beginning with hyperplasia and dysplasia of FDCs, has been proposed. Despite this known association between Castleman's disease and FDC sarcoma, there have only been few reported cases of sarcoma arising as a complication of pre-existing Castleman's disease, especially in abdominal lesions. We describe here a 51-year-old female with an FDC sarcoma arising from unicentric, hyaline-vascular type Castleman's disease in an intra-abdominal mass. Pathologically, the lesion showed a series of changes during the process of transformation from Castleman's disease to FDC sarcoma.
Abdomen/ultrasonography ; Abdominal Neoplasms/*diagnosis/etiology/pathology ; Dendritic Cell Sarcoma, Follicular/*diagnosis/etiology/pathology ; Female ; Giant Lymph Node Hyperplasia/complications/*diagnosis ; Humans ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed

BACKGROUND: The fabrication of microchannels in hydrogel can facilitate the perfusion of nutrients and oxygen, which leads to guidance cues for vasculogenesis. Microchannel patterning in biomimetic hydrogels is a challenging issue for tissue regeneration because of the inherent low formability of hydrogels in a complex configuration. We fabricated microchannels using wire network molding and immobilized the angiogenic factors in the hydrogel and evaluated the vasculogenesis in vitro and in vivo. METHODS: Microchannels were fabricated in a hyaluronic acid-based biomimetic hydrogel by using “wire network molding” technology. Substance P was immobilized in acrylated hyaluronic acid for angiogenic cues using Michael type addition reaction. In vitro and in vivo angiogenic activities of hydrogel with microchannels were evaluated. RESULTS: In vitro cell culture experiment shows that cell viability in two experimental biomimetic hydrogels (with microchannels and microchannels + SP) was higher than that of a biomimetic hydrogel without microchannels (bulk group). Evaluation on differentiation of human mesenchymal stem cells (hMSCs) in biomimetic hydrogels with fabricated microchannels shows that the differentiation of hMSC into endothelial cells was significantly increased compared with that of the bulk group. In vivo angiogenesis analysis shows that thin blood vessels of approximately 25–30 µm in diameter were observed in the microchannel group and microchannel + SP group, whereas not seen in the bulk group. CONCLUSION: The strategy of fabricating microchannels in a biomimetic hydrogel and simultaneously providing a chemical cue for angiogenesis is a promising formula for large-scale tissue regeneration.
Angiogenesis Inducing Agents ; Biomimetics* ; Blood Vessels ; Cell Culture Techniques ; Cell Survival ; Cues ; Endothelial Cells ; Fungi ; Humans ; Hyaluronic Acid ; Hydrogel* ; Hydrogels* ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Oxygen ; Perfusion ; Regeneration ; Substance P

Background/Aims: We developed a new endoscopic submucosal dissection (ESD) simulator and evaluated its efficacy and realism for use training endoscopists. Methods: An ESD simulator was constructed using polyvinyl alcohol hydrogel sheets and compared to a previous ESD simulator. Between March 1, 2020, and December 30, 2021, eight expert endoscopists from three different centers analyzed the procedure-related factors of the simulator. Five trainees performed gastric ESD exercises under the guidance of these experts. Results: Although the two ESD simulators provided overall favorable outcomes in terms of ESD-related factors, the new simulator had several benefits, including better marking of the target lesion’s limits (p<0.001) and overall handling (p<0.001). Trainees tested the usefulness of the new ESD simulator. The complete resection rate improved after 3 ESD training sessions (9 procedures), and the perforation rate decreased after 4 sessions (12 procedures). Conclusions We have developed a new ESD simulator that can help beginners achieve a high level of technical experience before performing real-time ESD procedures in patients.