No abstract available.
Humans ; Prevalence* ; Renal Dialysis*

A 60-year-old man was diagnosed with locally advanced non-small cell lung cancer. He refused treatment with a curative aim and was treated conservatively. Pain had developed on his shoulder and chest wall, which became worse as the cancer progressed. Although his pain initially appeared to be relieved with weak opioids and analgesics, it became more severe Strong opioids (transdermal fentanly patch and oxycodone), antidepressant or epidural block were introduced, However, the background pain became more intense and reached up to 8~9/10 on the visual analog scale (VAS). The dose of the transdermal fentanl patch was gradually increased to 600?g/hr, which resulted in a dramatic improvement in his pain (9/10 of VAS) to 3/10 for most of the time. We described the successful experience with a high dose transdermal fentanyl patch for cancer pain relief, which might be an alternative option for cancer patients suffering from severe pain.
Analgesics ; Analgesics, Opioid ; Carcinoma, Non-Small-Cell Lung ; Fentanyl* ; Humans ; Lung Neoplasms* ; Lung* ; Middle Aged ; Shoulder ; Thoracic Wall ; Visual Analog Scale

PURPOSE: The purpose of this study was to compare the phototoxic effects of blue light exposure on periodontal pathogens in both planktonic and biofilm cultures. METHODS: Strains of Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Porphyromonas gingivalis, in planktonic or biofilm states, were exposed to visible light at wavelengths of 400.520 nm. A quartz-tungsten-halogen lamp at a power density of 500 mW/cm2 was used for the light source. Each sample was exposed to 15, 30, 60, 90, or 120 seconds of each bacterial strain in the planktonic or biofilm state. Confocal scanning laser microscopy (CSLM) was used to observe the distribution of live/dead bacterial cells in biofilms. After light exposure, the bacterial killing rates were calculated from colony forming unit (CFU) counts. RESULTS: CLSM images that were obtained from biofilms showed a mixture of dead and live bacterial cells extending to a depth of 30-45 microm. Obvious differences in the live-to-dead bacterial cell ratio were found in P. gingivalis biofilm according to light exposure time. In the planktonic state, almost all bacteria were killed with 60 seconds of light exposure to F. nucleatum (99.1%) and with 15 seconds to P. gingivalis (100%). In the biofilm state, however, only the CFU of P. gingivalis demonstrated a decreasing tendency with increasing light exposure time, and there was a lower efficacy of phototoxicity to P. gingivalis as biofilm than in the planktonic state. CONCLUSIONS: Blue light exposure using a dental halogen curing unit is effective in reducing periodontal pathogens in the planktonic state. It is recommended that an adjunctive exogenous photosensitizer be used and that pathogens be exposed to visible light for clinical antimicrobial periodontal therapy.
Bacteria ; Biofilms ; Curing Lights, Dental ; Dermatitis, Phototoxic ; Fusobacterium nucleatum ; Homicide ; Light ; Microscopy, Confocal ; Plankton ; Porphyromonas gingivalis ; Sprains and Strains ; Stem Cells

PURPOSE: While single-species biofilms have been studied extensively, we know notably little regarding multispecies biofilms and their interactions. The purpose of this study was to develop and evaluate an in vitro multispecies dental biofilm model that aimed to mimic the environment of chronic periodontitis. METHODS: Streptococcus gordonii KN1, Fusobacterium nucleatum ATCC23726, Aggregatibacter actinomycetemcomitans ATCC33384, and Porphyromonas gingivalis ATCC33277 were used for this experiment. The biofilms were grown on 12-well plates with a round glass slip (12 mm in diameter) with a supply of fresh medium. Four different single-species biofilms and multispecies biofilms with the four bacterial strains listed above were prepared. The biofilms were examined with a confocal laser scanning microscope (CLSM) and scanning electron microscopy (SEM). The minimum inhibitory concentrations (MIC) for four different planktonic single-species and multispecies bacteria were determined. The MICs of doxycycline and chlorhexidine for four different single-species biofilms and a multispecies biofilm were also determined. RESULTS: The CLSM and SEM examination revealed that the growth pattern of the multispecies biofilm was similar to those of single-species biofilms. However, the multispecies biofilm became thicker than the single-species biofilms, and networks between bacteria were formed. The MICs of doxycycline and chlorhexidine were higher in the biofilm state than in the planktonic bacteria. The MIC of doxycycline for the multispecies biofilm was higher than were those for the single-species biofilms of P. gingivalis, F. nucleatum, or A. actinomycetemcomitans. The MIC of chlorhexidine for the multispecies biofilm was higher than were those for the single-species biofilms of P. gingivalis or F. nucleatum. CONCLUSIONS: To mimic the natural dental biofilm, a multispecies biofilm composed of four bacterial species was grown. The 24-hour multispecies biofilm may be useful as a laboratory dental biofilm model system.
Aggregatibacter actinomycetemcomitans ; Bacteria ; Biofilms* ; Chlorhexidine ; Chronic Periodontitis ; Doxycycline ; Fusobacterium nucleatum ; Glass ; Microbial Sensitivity Tests ; Microscopy, Electron, Scanning ; Periodontitis ; Plankton ; Porphyromonas gingivalis ; Streptococcus gordonii

PURPOSE: As a common and dangerous disease, an abdominal aortic aneurysm (AAA) occurs in approximately 2-4% of the general population and recently the incidence of AAA has been gradually increasing in Korea. Since rupture of an AAA is recognized as a lethal event, a more aggressive policy of early diagnosis and of an elective repair of the AAA are that can be performed with a mortality rate of less than 5 percent is the approach of choice for treating an AAA nowadays. METHODS: This retrospective study reports our experience managing forty-two patients with an AAA who had been operated on between January 1993 and December 1999 at Korea University hospitals. RESULTS: Thirty- seven of the patients were male, and five were female. The mean age was 67.1 years. The most common clinical manifestation was abdominal pain in 26 cases (61.9%), followed by abdominal pulsatile mass in 20 cases (47.6%), and back pain in 12 cases (28.5%). The most common associated disease was hypertension in 24 cases (57.1%). An abdominal CT scan was performed in 26 cases (61.9%) and was the most commonly used method for diagnosis. Emergency repair of the AAA was performed in 10 cases; the repair was performed electively in the other cases. Among the 42 aortic grafts implanted for AAA repair, 37 were bifurcated Y grafts and 4 were straight tube grafts. Axillobifemoral bypass surgery was performed in the case of one infected aneurysm. Among the 42 cases, 10 cases (23.8%) experienced ruptures, requiring 4 urgent operation and 6 emergency procedures. Among the 42 cases, 6 patients (14.2%) expired. In the elective cases, one (3.1%) expired. In the urgent cases, one (25.0%) expired, and in the emergency cases, four (66.6%) expired. CONCLUSION: This study showed that an AAA should be considered as a possible cause of unexplained abdominal pain in aged patients. In such patients, various diagnostic tools must be used to eliminate the possibility of an abdominal aortic aneurysm. Early diagnosis and elective surgery are crucial for a better outcome in the management of patients with an abdominal aortic aneurysm.
Abdominal Pain ; Aneurysm, Infected ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Rupture ; Back Pain ; Diagnosis ; Early Diagnosis ; Emergencies ; Female ; Hospitals, University ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Mortality ; Retrospective Studies ; Rupture ; Tomography, X-Ray Computed ; Transplants

During radiotherapy of cancer, neighboring normal cells may receive sub-lethal doses of radiation. To investigate whether such low levels of radiation modulate normal cell responses to death stimuli, primary cultured human fibroblasts were exposed to various doses of gamma-rays. Analysis of cell viability using an exclusion dye propidium iodide revealed that the irradiation up to 10 Gy killed the fibroblasts only to a minimal extent. In contrast, the cells efficiently lost their viability when exposed to 0.5-0.65 mM H2O2. This type of cell death was accompanied by JNK activation, and was reversed by the use of a JNK-specific inhibitor SP600125. Interestingly, H2O2 failed to kill the fibroblasts when these cells were pre-irradiated, 24 h before H2O2 treatment, with 0.25-0.5 Gy of gamma-rays. These cytoprotective doses of gamma-rays did not enhance cellular capacity to degrade H2O2, but elevated cellular levels of p21Cip/WAF1, a p53 target that can suppress H2O2-induced cell death by blocking JNK activation. Consistently, H2O2-induced JNK activation was dramatically suppressed in the pre-irradiated cells. The overall data suggests that ionizing radiation can impart normal fibroblasts with a survival advantage against oxidative stress by blocking the process leading to JNK activation.
Antioxidants/pharmacology ; Cell Death ; Cells, Cultured ; Enzyme Activation/radiation effects ; Fibroblasts/enzymology/radiation effects ; *Gamma Rays ; Heat-Shock Proteins/metabolism ; Humans ; JNK Mitogen-Activated Protein Kinases/*antagonists & inhibitors ; Oxidative Stress/*radiation effects ; Research Support, Non-U.S. Gov't ; Water/pharmacology

BACKGROUNDS: Pituitary hyperplasia can mimic pituitary adenoma. In MRI, enlarged pituitary gland is enhanced homogenously with upward convexity of the superior margin of the gland .The best definition of hyperplasia in the pituitary hyperplasia seems to be a multiplication of one or more cell types. But definition, etiology and clinical courses of this disease are not clear, METHOD: We reviewed clinical symptoms, MRI, and pathologic findindings in 6 patients with pituitary hyperplasia. RESULT: 1. Major clinical symptoms were headache (100%), visual field defect (84%), polyuria/polydipsia (64%), and irregular mensturation (32%). Other symptoms were amenorrhea (16%) and galactorrhea (16%). 2. Three of five cases showed abnormal responses to combined pituitary function test, 3. MRI findings were pituitary hyperplasia (4), macroadenoma (l), and microadenoma (1). 4. In two operated cases, there was no adenoma. One case showed hyperplasia of lactotroph cells, the other was hyperplasia of gonadotroph cells confirmed by the examination of immunocytochemistry. CONCLUSION: Pituitary hyperplasia should be considered in patients with enlarged pituitary gland without focal mass lesion.
Adenoma ; Amenorrhea ; Female ; Galactorrhea ; Gonadotrophs ; Headache ; Humans ; Hyperplasia* ; Immunohistochemistry ; Lactotrophs ; Magnetic Resonance Imaging ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Neoplasms ; Pregnancy ; Visual Fields

BACKGROUND: Proteinase-activated receptor 2 (PAR2) is cleaved, and it is activated by trypsin or mast cell tryptase. PAR2 plays an important role in inflammation. The aim of this study is to examine the potential of PAR2 agonists to modulate TNF-alpha secretion from the human astrocytoma cell line CCF-STTG1. METHODS: PAR2 expression in CCF-STTG1 was examined using reverse transcriptase polymerase chain reaction and immunocytochemistry. The potential of PAR2 agonists to modulate TNF-alpha secretion from CCF-STTG1 was examined by enzyme-linked immunosorbent assays. RESULTS: CCF-STTG1 expresses PAR2. PAR2 agonists such as trypsin, mast cell tryptase, and activating peptide SLIGKV-NH2 (corresponding to the PAR2 tethered ligand) directly signal CCF-STTG1 to induce the secretion of TNF-alpha but not in the case of the soybean trypsin inhibitor (SBTI) or VKGILS-NH2 (control peptide). Furthermore, the secretion of TNF-alpha was significantly reduced in CCF-STTG1 cells pre-treated with either 50 microM PD98059 (mitogen-activated protein/extracellular signal-regulated kinase kinase (MEK) inhibitor) or 1 microM SB203580 (p38 MAPK inhibitor) 30 min before trypsin stimulation. CONCLUSIONS: These results show that trypsin may induce TNF-alpha secretion through the activation of MEK and p38 MAPK via PAR2 in astrocytoma cell line CCF-STTG1.
Astrocytes* ; Astrocytoma ; Cell Line* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunohistochemistry ; Inflammation ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Reverse Transcriptase Polymerase Chain Reaction ; Soybeans ; Trypsin ; Tryptases ; Tumor Necrosis Factor-alpha*

BACKGROUND: The efficacy of two artificial tears, carboxymethylcellulose (CMC) and hyaluronate (HA), was compared in the treatment of patients with dry eye disease. METHODS: We conducted a systematic review and meta-analysis on randomized controlled trials in the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. The efficacy was compared in terms of the mean change from baseline in tear break-up time. The meta-analysis was conducted using both random and fixed effect models. The quality of the selected studies was assessed for risk of bias. RESULTS: Five studies were included involving 251 participants. Random effect model meta-analysis showed no significant difference between CMC and HA in treating dry eye disease (pooled standardized mean difference [SMD]=-0.452; 95% confidence interval [CI], -0.911 to 0.007; P=0.053). In contrast, fixed effect model meta-analysis revealed significant improvements in the CMC group when compared to the HA group (pooled SMD=-0.334; 95% CI, -0.588 to -0.081; P=0.010). CONCLUSION: The efficacy of CMC appeared to be better than that of HA in treating dry eye disease, although meta-analysis results were not statistically significant. Further research is needed to better elucidate the difference in efficacy between CMC and HA in treating dry eye disease.
Bias (Epidemiology) ; Carboxymethylcellulose Sodium* ; Eye Diseases* ; Humans ; Lubricant Eye Drops ; Tears ; Xerophthalmia

Background: Respiratory pathogen infections and air pollution are main causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Air pollution has a direct effect on the airway epithelial barrier and the immune system, which can have an influence on infection. However, studies on the relationship between respiratory infections and air pollutants in severe AECOPD are limited. Thus, the objective of this study was to investigate the correlation between air pollution and respiratory pathogen in severe AECOPD. Methods: This multicenter observational study was conducted by reviewing electronic medical records of patients with AECOPD at 28 hospitals in South Korea. Patients were divided into four groups according to the comprehensive air-quality index (CAI) used in Korea. Identification rates of bacteria and viruses of each group were analyzed. Results: Viral pathogens were identified in 270 (36.7%) of 735 patients. Viral identification rate was different (P = 0.012) according to air pollution. Specifically, the virus detection rate was 55.9% in the group of CAI ‘D’ with the highest air pollution. It was 24.4% in the group of CAI ‘A’ with the lowest air pollution. This pattern was clearly seen for influenza virus A (P = 0.042). When further analysis was performed with particulate matter (PM), the higher/lower the PM level, the higher/lower the virus detection rate. However, no significant difference was found in the analysis related to bacteria. Conclusion Air pollution may make COPD patients more susceptible to respiratory viral infections, especially influenza virus A. Thus, on days with poor air quality, COPD patients need to be more careful about respiratory infections.