No abstract available.

BACKGROUND: There are few studies about risk factors for poor outcomes from multi-level lumbar posterolateral fusion limited to three or four level lumbar posterolateral fusions. The purpose of this study was to analyze the outcomes of multi-level lumbar posterolateral fusion and to search for possible risk factors for poor surgical outcomes. METHODS: We retrospectively analyzed 37 consecutive patients who underwent multi-level lumbar or lumbosacral posterolateral fusion with posterior instrumentation. The outcomes were deemed either 'good' or 'bad' based on clinical and radiological results. Many demographic and radiological factors were analyzed to examine potential risk factors for poor outcomes. Student t-test, Fisher exact test, and the chi-square test were used based on the nature of the variables. Multiple logistic regression analysis was used to exclude confounding factors. RESULTS: Twenty cases showed a good outcome (group A, 54.1%) and 17 cases showed a bad outcome (group B, 45.9%). The overall fusion rate was 70.3%. The revision procedures (group A: 1/20, 5.0%; group B: 4/17, 23.5%), proximal fusion to L2 (group A: 5/20, 25.0%; group B: 10/17, 58.8%), and severity of stenosis (group A: 12/19, 63.3%; group B: 3/11, 27.3%) were adopted as possible related factors to the outcome in univariate analysis. Multiple logistic regression analysis revealed that only the proximal fusion level (superior instrumented vertebra, SIV) was a significant risk factor. The cases in which SIV was L2 showed inferior outcomes than those in which SIV was L3. The odds ratio was 6.562 (95% confidence interval, 1.259 to 34.203). CONCLUSIONS: The overall outcome of multi-level lumbar or lumbosacral posterolateral fusion was not as high as we had hoped it would be. Whether the SIV was L2 or L3 was the only significant risk factor identified for poor outcomes in multi-level lumbar or lumbosacral posterolateral fusion in the current study. Thus, the authors recommend that proximal fusion levels be carefully determined when multi-level lumbar fusions are considered.
Aged ; Female ; Humans ; Lumbar Vertebrae/surgery ; Lumbosacral Region ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Scoliosis/complications/surgery ; Spinal Fusion/methods ; Spinal Stenosis/complications/diagnosis/*surgery ; Spondylolisthesis/complications/surgery ; Treatment Outcome

No abstract available.
Lupus Vulgaris* ; Tuberculosis, Miliary*

Human papillomavirus (HPV) is associated with cervical cell changes, genital warts, recurrent respiratory papillomatosis, laryngeal papillomatosis, head and neck cancer, and cervical cancer. Two commercial HPV vaccines have successfully been made available in the clinical field. This review covers the progress of cervical disease by understanding the nature of HPV infection, as well as the relationship between the host factors and HPV vaccine effectiveness. Among these host factors, microbiota has been revealed to influence the development and function of both the innate and adaptive immune systems. Therefore, the composition of the microbiome may ultimately affect vaccine efficacy. Understating the relationship between host factors and HPV infection/vaccine efficacy may prove to be useful in earlier diagnosis, as well as disease prophylaxis.
Condylomata Acuminata ; Diagnosis ; Head and Neck Neoplasms ; Humans* ; Immune System ; Microbiota ; Papilloma ; Papillomavirus Infections* ; Papillomavirus Vaccines ; Probiotics ; Uterine Cervical Neoplasms

Obesity is connected with numerous diseases, such as type 2 diabetes, atherosclerosis, cancer, and nervous system dysfunctions. Obesity is affected by genetic, environmental, and cultural factors. However, numerous studies indicate that several pathogens might cause obesity. This review discusses recent data and the characteristics of pathogens that are implicated in obesity. In particular, human adenovirus 36 (Ad36) is the most clearly implicated virus in human obesity. It was recently shown that obese groups from the USA, Korea, and Italy have a higher prevalence of serum antibodies against Ad36. The mechanisms of Ad36-induced obesity remain unclear. However, glucose uptake and inflammation are possible mechanisms of Ad36-induced obesity. Overall, this new understanding of causes of obesity has developed into the concept of 'infectobesity' and the possibility of developing a 'vaccine' or 'therapeutic agents' for obesity.
Adenoviruses, Human ; Antibodies ; Atherosclerosis ; Glucose ; Humans ; Inflammation ; Italy ; Korea ; Nervous System ; Obesity ; Prevalence ; Viruses

No abstract available.
Pemphigoid, Bullous*

Obesity has been considered a risk factor for infectious diseases including the influenza virus. Most epidemiological investigations indicated that obesity is connected to the severity of influenza, although there are some exceptions. Many studies using obese humans and animal models showed that immune response was impaired in the obese group, increasing susceptibility and severity of influenza virus. However, the exact mechanism by which obesity inhibits anti-viral immune response remains unknown. This review discusses current studies about the properties of immune cells in obesity. In obesity, the balance of adipokines is disrupted and the level of proinflammatory cytokine is increased compared with non-obese control. Moreover, macrophages induced systemic inflammation by secreting cytokines such as TNF-alpha and IL-6, antigen presenting capacity of dendritic cells was diminished which affect T cell responses, and influenza-specific antibody production seems reduced and decreased even faster after vaccination in obese mouse. The number of circulating T cells and proliferation of mitogen-stimulated T cells dropped and T cell memory was significantly low in influenza infected obese mouse. Therefore, obesity may be one of factors for disease progression in influenza virus infection and vaccine efficacy.
Adipokines ; Animals ; Antibody Formation ; Communicable Diseases ; Cytokines ; Dendritic Cells ; Disease Progression ; Humans ; Inflammation ; Influenza Vaccines ; Influenza, Human* ; Interleukin-6 ; Leptin ; Macrophages ; Memory ; Mice ; Mice, Obese ; Models, Animal ; Obesity* ; Orthomyxoviridae ; Pathology* ; Risk Factors ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Vaccination

To investigate the NS4 region of JEV, NS4 cDNA of K94P05 (JEV strain isolated from Korea in 1994) was amplified by RT-PCR and analyzed by sequencing PCR product. Genomic size of NS4 was 1212bp and nucleotide sequence was compared with that of other JEV strains. Nucleotide homology between JaOAr582 and K94P05 was 91.1% and that between Beijing and K94P05 was 89.8%, respectively. But the nucleotide sequence of I region of JaOAr582 and K94P05 showed 97.0% homology and that of Beijing and K94P05 did 95.8% homology. NS4 protein was expressed as a form of fusion protein by a prokaryotic expression system. The induced fusion product showed a lower molecular weight than predicted size and remained insoluble. The NS4 protein might be cleavages by E. coli protease. Concluding above results, high hydrophobicity of the NS4 protein supported the fact that this protein played a role as a membrane component and the poor nucleotide sequence conservativity among JEV strains suggested that this region might be important to adapt each viral growth environment.
Asian Continental Ancestry Group* ; Base Sequence ; DNA, Complementary ; Encephalitis Virus, Japanese* ; Encephalitis, Japanese* ; Humans ; Hydrophobic and Hydrophilic Interactions ; Korea* ; Membranes ; Molecular Weight ; Polymerase Chain Reaction

An important concern in treatment for gonorrhea is the high frequency of coexisting chlarnydial and gonococcal infections. But there is difficulty in the diagnosing chlamydial infection. And so, CDC recommends epidemiological treatment, of both gonorrhea and non-gonococcal urethritis in the gonorrheal treatment in order to prevent post-gonococcal urethritis(PGU), A total of 140 male patients with uncomplicated gonococcal urethritis at the VD clinic, Choong-ku Publir. Health Center, in Seoul during December, 1987 February, 1988 were subjected to this study. The patients treated with kanamycin(KM), 2g and aqueous penicillin G(ACPG) 8 million units imaccompanied by probenecid(BEN) 1g by mouth. This combination regimen showed good effect in the treatment of gonococcal urethritis (failure rate 4.2% ). After gonorrheal treatment, the patients were divided randomly into group A and group B. In the group A, adminstrated with doxycycline monohydrate, 100mg, by mouth two times daily for 7 days, 44 and 29 patients were followed at 7th and 14th day after gonorrheal treatment. In the group B, administrated with placebo, 1 tablet, by mouth two times daily for 7 days, 49 and 39 patients were followed at 7th and 14th day after gonorrheal treatment. The PGU incidences were 27.3%(12/44), 20.7%(6,'29) in the group A and 55. 1%(27,'49), 53.8(21/39) in the group B at 7th and 14th day after gonorrheal treatment. Conclusively, eoncornitant administration of doxycycline monohydrate, 100mg, by mouth two times daily for 7 days with gonorrheal treatment lowered PGU significantly.
Centers for Disease Control and Prevention (U.S.) ; Doxycycline ; Gonorrhea ; Humans ; Incidence ; Male* ; Mouth ; Penicillins ; Seoul ; Urethritis*

Obesity is associated with a state of chronic low-grade inflammation. This abnormal inflammation state may cause metabolic dysfunction. Many studies have supported the claim that immune cells such as adipose tissue macrophage and invariant natural killer T-cells (iNKT) are related to the development of metabolic diseases like diabetes. It has recently been reported that while human adenovirus 36 (Ad36) infection is associated with human obesity, it also helps to improve the serum level of lipid factors (glycemic control). However, the detailed cellular mechanism remains unclear. This study (The Journal of Clinical Investigation, 2012;122:3343-54) showed that iNKT cell-deficient mice on a low-fat diet used as a control for high-fat diet boasted insulin resistance phenotype without adipose tissue inflammation. The results of this study offer insight into the possibility of a novel role for iNKT related to the improvement of metabolic diseases, especially insulin resistance, and hint that Ad36-induced inflammation may be associated with iNKT in adipose tissue, while also playing a role in the improvement of glycemic control.
Adenoviruses, Human ; Adipose Tissue ; Animals ; Diet, Fat-Restricted ; Diet, High-Fat ; Humans ; Inflammation ; Insulin Resistance ; Macrophages ; Metabolic Diseases ; Mice ; Natural Killer T-Cells ; Obesity ; Phenotype