Increased formation and activation of osteoclast lead to unwanted bone resorption. Several natural products which have inhibitory effects on osteoclast differentiation and function are under investigation to prevent and treat the osteoporotic bone disease. Liriopis tuber has been used in Oriental medicine for the suppression of cough, expectoration, thirst, and has been used for sthenia, diuresis, blood glucose regulation, treatment of xerostomia, and constipation. Also, recently it has been reported that Liriopsis tuber has anti-inflammatory, anti-thrombic, anti-adhesive activities. The purpose of this study was to evaluate the effects of Liriopis tuber on osteoclast differentiation and was to evaluate of its mechanism. Water extract of Liriopis tuber significantly inhibited receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast differentiation in bone marrow macrophages (BMMs) in a dose dependent manner. However, water extract of Liriopis tuber did not affect cytotoxicity when compared with control. The mRNA expression of c-Fos, NFATc1, tartrate resistant-acid phosphatase (TRAP), and cathepsin K induced by RANKL was inhibited by water extract of Liriopis tuber treatment. Also, water extract of Liriopis tuber inhibited the protein expression of c-Fos and NFATc1 expression in BMMs treated with RANKL. Among the signal pathways, water extract of Liriopis tuber suppressed the phosphorylation of p38 induced by RANKL. In summary, Liriopis tuber exerted inhibitory effects on osteoclast diffentiation via suppression of c-Fos and NFATc1 which are essential gene to osteoclastogenesis. Taken together, these results suggest that Liriopis tuber may be a useful candidate in the treatment of osteoporosis without special toxicity.
Biological Agents ; Blood Glucose ; Bone Diseases ; Bone Marrow ; Bone Resorption ; Cathepsin K ; Constipation ; Cough ; Diuresis ; Genes, Essential ; Macrophages ; Medicine, East Asian Traditional ; Osteoclasts ; Osteoporosis ; Phosphorylation ; RANK Ligand ; RNA, Messenger ; Signal Transduction ; Tartrates ; Thirst ; Water ; Xerostomia

Background: Preauricular sinus (PAS) is a common congenital anomaly, and complete excision is recommended to prevent recurrence. However, PAS has a high recurrence rate as a result of incomplete removal due to the high variability of the sinus ramifications, making its treatment challenging. In this study, we standardized the surgical procedure to reduce the complications and recurrence rate and compared the postoperative results between the non-standardized and the standardized groups. Methods: This retrospective study included 97 patients (120 ears) who had undergone PAS excision by a single surgeon between October 2014 and September 2022 and underwent at least 6 months of follow-up. After October 2018, all patients were treated using the standardized method, which comprised the use of magnifying glasses, exploration with a lacrimal probe, the use of methylene blue staining, and excision of a piece of surrounding normal tissue and related cartilage in continuity with the specimen. There were 38 patients (45 ears) in the non-standardized group and 59 patients (75 ears) in the standardized group. Results: Recurrence was observed in six of 120 ears, indicating an overall recurrence rate of 5.0%. Recurrence occurred in five ears (11.1%) in the non-standardized group and one ear (1.3%) in the standardized group. The standardized group had a significantly lower recurrence rate (p= 0.027) than the non-standardized group. Conclusion We defined a standardized sinectomy protocol and used it for the surgical treatment of PAS. With this standardized method, we were able to reduce the rates of complications and recurrence without the use of a long incision.

BACKGROUND: There is a well recognized interlaboratory variation in the results using the polymerase chain reaction(PCR) to detect the IS6110 sequence. The clinical utility of a commercially developed PCR test(Amplicor) in bronchial washings for detecting pulmonary tuberculosis in smear negative patients was evaluated. The sensitivity and specificity of Amplicor was compared with that of an in-house PCR test used for detecting the IS6110 sequence of Mycobacterium tuberculosis(M.tbc) in the bronchial washing fluid. METHODS: 66 patients whose sputum smear for M.tbc were negative or who could not produce any sputum were recruited from January 1999 to July 1999. They all had a bronchoscopy performed to determine if there were signs of hemoptysis, patients who could not cough up sputum, lung lesion that exclude pulmonary tuberculosis. Pulmonary tuberculosis was diagnosed on the basis of a positive culture or a response to anti-tuberculosis therapy. RESULTS: 19 patients with tuberculosis were identified and samples from 16 patients were later confirmed by culture. Bronchial washing for Amplicor PCR revealed a sensitivity, specificity, positive and negative predictive values of 94.7%, 97.9%, 94.7%, 97.9%, respectively. Using IS6110 based PCR, the sensitivity, specificity, positive and negative predictive values were of 73.7%, 87.2%, 70%, 89.1% respectively. CONCLUSION: Bronchial washing for Amplicor PCR proved to be more useful than IS6110 based PCR in rapidly diagnosing smear negative pulmonary pulmoary tuberculosis in patients where tuberculosis was likely to be differential and rapid diagnosis was essential for optimal treatment.
Bronchoscopy ; Cough ; Diagnosis* ; Hemoptysis ; Humans ; Lung ; Mycobacterium ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

BACKGROUND: Recent studies have produced conflicting results on the influence of hemodilution on the coagulation system. Furthermore, only a few clinical studies have been conducted regarding actual blood loss and associated hemodilution. The purpose of this study was to investigate changes in thromboelastograph (TEG) findings after moderate bleeding-induced hemodilution in patients undergoing radical hysterectomy. METHODS: 23 patients scheduled for radical hysterectomy were included. No patient had a preoperative coagulation abnormality or was receiving anticoagulant or antiplatelet medication. TEG findings 15 min after induction of anesthesia and after an estimated blood loss equaling 15% of the estimated blood volume were compared. Only crystalloid solution was administered until the second blood sampling for TEG analysis in order to produce a hemodilution state. RESULTS: After hemodilution R time, K time and coagulation time (r + k) showed significant reductions, and alpha angle and TEG index showed significant increases (P < 0.01), and increased coagulability. MA increased after hemodilution, but this was not statistically significant. A60 and CL60 also increased, showing decreased fibrinolysis (P < 0.05). CONCLUSIONS: Moderate bleeding-induced hemodilution increased coagulability according to TEG compared to pre-hemodilution findings. We recommend that the decision to replace coagulation factors and/or platelets should not be based on empirically derived, arbitrary standards.
Anesthesia ; Blood Coagulation Factors ; Blood Volume ; Fibrinolysis ; Hemodilution* ; Humans ; Hysterectomy*

BACKGROUND: Laparoscopic surgery may affect the coagulation system in several ways. The purpose of this study was to compare the hemostatic changes between open and laparoscopic colorectal surgery by using thromboelastography. METHODS: Forty patients who were undergoing open (n = 15) or laparoscopic (n = 25) colorectal cancer surgery were included in this prospective study. Blood samples were drawn from a forearm vein by fresh venipunctures for determining the thromboelastography (TEG) parameters at after induction of anesthesia T0, 2 hours after the beginning of surgery T1, and immediately before discharge from the recovery room T2. RESULTS: The PT-INR and aPTT did not show significant differences between laparoscopic and open colorectal surgery. There were no significant differences of the TEG parameters (R, K, MA, alpha angle, CI, LY30 and CL30) between the two groups. CONCLUSIONS: The overall coagulation and fibrinolysis detected by TEG were not different between laparoscopic and open colorectal surgery
Anesthesia ; Colorectal Neoplasms ; Colorectal Surgery ; Fibrinolysis ; Forearm ; Humans ; Laparoscopy ; Phlebotomy ; Prospective Studies ; Recovery Room ; Thrombelastography ; Veins

Objective: To determine the factors influencing the life satisfaction of people with physical disabilities during the COVID-19 pandemic, considering demographics, disability-related characteristics, health behaviors, and psychosocial characteristics. Methods: We used cross-sectional data from 301 respondents of the 2021/2022 survey of the Korean Health Cohort Study for People with Physical Disabilities. Descriptive statistics were used to analyze the research subjects’ characteristics, and chi-square tests and multiple logistic regression were used to identify the determinants of life satisfaction. Results: Among socio demographic variables, occupation had a strong association with life satisfaction. Significant health behavior variables included daily regular meals, weight control effort, and chronic pain. All psychosocial characteristics (perceived stress, depression, suicidal ideation, cognitive function assessment, subjective health status, family satisfaction, income satisfaction) were strongly associated with life satisfaction. Results of the analysis of factors affecting life satisfaction showed that unemployment, lack of regular exercise, elevated stress, suicidal thoughts, and dissatisfaction with family contributed to increased life dissatisfaction. Conclusion Economic support through job creation that considers the specific characteristics of people with disabilities, and social access through community integration services that encourage participation in social activities, should be prioritized.

Objective: To determine the factors influencing the life satisfaction of people with physical disabilities during the COVID-19 pandemic, considering demographics, disability-related characteristics, health behaviors, and psychosocial characteristics. Methods: We used cross-sectional data from 301 respondents of the 2021/2022 survey of the Korean Health Cohort Study for People with Physical Disabilities. Descriptive statistics were used to analyze the research subjects’ characteristics, and chi-square tests and multiple logistic regression were used to identify the determinants of life satisfaction. Results: Among socio demographic variables, occupation had a strong association with life satisfaction. Significant health behavior variables included daily regular meals, weight control effort, and chronic pain. All psychosocial characteristics (perceived stress, depression, suicidal ideation, cognitive function assessment, subjective health status, family satisfaction, income satisfaction) were strongly associated with life satisfaction. Results of the analysis of factors affecting life satisfaction showed that unemployment, lack of regular exercise, elevated stress, suicidal thoughts, and dissatisfaction with family contributed to increased life dissatisfaction. Conclusion Economic support through job creation that considers the specific characteristics of people with disabilities, and social access through community integration services that encourage participation in social activities, should be prioritized.

Objective: To determine the factors influencing the life satisfaction of people with physical disabilities during the COVID-19 pandemic, considering demographics, disability-related characteristics, health behaviors, and psychosocial characteristics. Methods: We used cross-sectional data from 301 respondents of the 2021/2022 survey of the Korean Health Cohort Study for People with Physical Disabilities. Descriptive statistics were used to analyze the research subjects’ characteristics, and chi-square tests and multiple logistic regression were used to identify the determinants of life satisfaction. Results: Among socio demographic variables, occupation had a strong association with life satisfaction. Significant health behavior variables included daily regular meals, weight control effort, and chronic pain. All psychosocial characteristics (perceived stress, depression, suicidal ideation, cognitive function assessment, subjective health status, family satisfaction, income satisfaction) were strongly associated with life satisfaction. Results of the analysis of factors affecting life satisfaction showed that unemployment, lack of regular exercise, elevated stress, suicidal thoughts, and dissatisfaction with family contributed to increased life dissatisfaction. Conclusion Economic support through job creation that considers the specific characteristics of people with disabilities, and social access through community integration services that encourage participation in social activities, should be prioritized.

BACKGROUND: We conducted this study to determine the optimal dose of esmolol in combination with nicardipine to block undesirable cardiovascular responses effectively during endotracheal intubation in patients undergoing ambulatory surgery. METHODS: One-hundred and twenty patients were randomly allocated into one of the following 4 groups: the E0 group (no esmolol, control), the E0.25 group (esmolol 0.25 mg/kg), the E0.5 group (esmolol 0.5 mg/kg) and the E1.0 group (esmolol 1.0 mg/kg). Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9mg/kg. All the patients received 20 microgram/kg of nicardipine, and esmolol was subsequently administered according to the group. Endotracheal intubation was performed 150 seconds after inhalation of 6 vol% of desflurane. The systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure and the heart rate (HR) were measured before and immediately after intubation, and at 1, 3, 5, and 10 minutes after intubation. The rate changes were calculated using the baseline values as the standard (change rate [%] = measured value/baseline value x 100). RESULTS: There were no significant differences in SBP, DBP and MBP after intubation between the control and the experimental groups. The rate changes of HR in the experimental groups were significantly lower than those in the control group throughout the study period (P < 0.05). However, there was no difference in therate changes of HR among the experimental groups. CONCLUSIONS: The combination of nicardipine 20 microgram/kg and esmolol 0.25 mg/kg can most effectively and safely attenuate thecardiovascular responses during anesthetic induction in ambulatory patients.
Ambulatory Surgical Procedures ; Androstanols ; Anesthesia ; Blood Pressure ; Heart Rate ; Humans ; Inhalation ; Intubation ; Intubation, Intratracheal ; Isoflurane ; Nicardipine ; Propanolamines ; Propofol ; Tachycardia

General treatment of short bowel syndrome is long-term total parenteral nutrition (TPN). But long-term TPN therapy produces thrombus, infection and obstruction of central veins and results in the life-threatening complications. Recently we experienced first case of small bowel transplantation in a 57-year old female with only 30 cm jejunum and distal part of colon to the splenic flexure who was suffering short bowel syndrome due to previous wide resection of small bowel. We report successful anesthetic management of small bowel transplantation in the patient with short bowel syndrome who has been suffered from life threatening complications due to long-term TPN therapy.
Colon ; Colon, Transverse ; Female ; Humans ; Jejunum ; Middle Aged ; Parenteral Nutrition, Total ; Short Bowel Syndrome* ; Thrombosis ; Veins