No abstract available.
DNA* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction*

Objective: To compare the changes in blood urea nitrogen/creatinine (BUN/Cr) ratio, a dehydration status indicator, among patients with mild dysphagia depending on the addition of fluid thickeners. Methods: A total of 81 patients who underwent serial dietary trials of the videofluoroscopic swallowing study (VFSS) and displayed penetration signs with a penetration-aspiration scale of 4 or less during the liquid trials were enrolled and classified into two groups according to the dietary instructions from the VFSS results. Group A comprised patients who were permitted to freely consume water with a regular diet. Group B comprised patients allowed to take a regular diet but with the addition of a fluid thickener while ingesting water. To analyze whether the patients of each group were dehydrated, we calculated the serum BUN/Cr ratio using blood tests, which were performed within 1 week of the VFSS test date and 1 month later. Results: There were 4 cases of suspected pneumonia within 1 month after the VFSS test, with no significant differences between the two groups. The BUN/Cr ratio of the 1-month follow-up blood test when compared to the initial blood test showed a significant decrease in Group A (P=0.022) compared with Group B (P=0.033). Conclusion Patients with mild dysphagia who consumed water freely showed a decrease in the BUN/Cr ratio compared to those who added fluid thickeners to their drinking water.

The nfa1 gene was cloned from a cDNA library of pathogenic Naegleria fowleri by immunoscreening; it consisted of 360 bp and produced a 13.1 kDa recombinant protein (rNfa1) that showed the pseudopodia-specific localization by immunocytochemistry in the previous study. Based on the idea that the pseudopodia-specific Nfa1 protein mentioned above seems to be involved in the pathogenicity of N. fowleri, we observed the effect of an anti-Nfa1 antibody on the proliferation of N. fowleri trophozoites and the cytotoxicity of N. fowleri trophozoites on the target cells. The proliferation of N. fowleri trophozoites was inhibited after being treated with an anti-Nfa1 polyclonal antibody in a dose-dependent manner for 48 hrs. By a light microscope, CHO cells co-cultured with N. fowleri trophozoites (group I) for 48 hrs showed severe morphological destruction. On the contrary, CHO cells co-cultured with N. fowleri trophozoites and anti-Nfa1 polyclonal antibody (1: 100 dilution) (group II) showed less destruction. In the LDH release assay results, group I showed 50.6% cytotoxicity, and group II showed 39.3%. Consequently, addition of an anti-Nfa1 polyclonal antibody produced a decreasing effect of in vitro cytotoxicity of N. fowleri in a dosedependent manner.
Animals ; Antibodies, Protozoan/*immunology ; Antigens, Protozoan/genetics/*immunology ; CHO Cells ; Dose-Response Relationship, Immunologic ; Female ; Hamsters ; Mice ; Mice, Inbred BALB C ; Naegleria fowleri/growth & development/immunology/*pathogenicity ; Protozoan Proteins/genetics/*immunology ; Recombinant Proteins/immunology ; Support, Non-U.S. Gov't

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent joint swelling and progressive destruction of cartilage and bone. Current RA treatments are largely empirical in origin and their precise mechanism of action is uncertain. Increasing evidence shows that chronic inflammatory diseases such as RA are caused by prolonged production of proinflammatory cytokines including tumor necrosis factor (TNF) and interleukin 1 (IL-1). The nuclear factor kappaB (NF-kappaB) plays an essential role in transcriptional activation of TNF and IL-1. NF-kappaB is induced by many stimuli including TNF and IL-1, forming a positive regulatory cycle that may amplify and maintain RA disease process. NF-kappaB and enzymes involved in its activation can be a target for anti-inflammatory treatment. Aspirin and sodium salicylate inhibit activation of NF-KB by blocking IkappaB kinase, a key enzyme in NF-kappaB activation. Glucocorticoids suppress expression of inflammatory genes by binding glucocorticoid receptor with NF-kappaB, and increasing expression of inhibitory protein of NF-kappaB, IkappaBalpha. Sulfasalazine and gold compounds also inhibit NF-kappaB activation. Continuing advances in our understanding of action mechanism of antirheumatic agents will benefit the future development of RA regimens with greater efficacy and less toxicity.
Animal ; Antirheumatic Agents/therapeutic use* ; Arthritis, Rheumatoid/therapy* ; Arthritis, Rheumatoid/metabolism ; Arthritis, Rheumatoid/immunology ; Cytokines/immunology ; Cytokines/genetics ; Gene Expression Regulation ; Human ; Macrophages/immunology ; NF-kappa B/metabolism* ; NF-kappa B/immunology ; NF-kappa B/biosynthesis ; Tumor Necrosis Factor/genetics

BACKGROUND: Myocardial ischemia is known to depress systolic and diastolic functions for a prolonged period of time. Dobutamine and epinephrine are frequently administered to improve myocardial function during cardiac surgery. The vascular response to vasopressors might be altered by ischemia and reperfusion, since alterations in vascular control mechanisms have been demonstrated even after a short period of ischemia. The present study was aimed to investigate the effects of dobutamine and epinephrine on regional and global myocardial functions, coronary blood flow (CBF) and myocardial oxygen consumption (MVO2) in normal and stunned myocardium in an open-chest canine model. METHODS: Forty-eight dogs were acutely instrumented under enflurane anesthesia to measure aortic and left ventricular pressures, and pulmonary (cardiac output) and left anterior descending (LAD) blood flows via a Doppler flowmeter, and a subendocardial segment length in the region supplied by the LAD. In series 1, incremental doses of dobutamine (1, 2, 5, 10microgram/kg/min, n = 9) or epinephrine (0.02, 0.04, 0.1, 0.2microgram/kg/min, n = 10) were infused intravenously (IV) for 10 min before (normal) and after 15 min of LAD occlusion and subsequent 1 hr-reperfusion (stunned). In series 2, incremental doses of dobutamine (50, 125, 250, 375 ng/mL of LAD flow, n = 14) or epinephrine (4, 10, 20, 30 ng/mL of LAD flow, n = 15) were infused directly into the LAD (IC) for 3 5 min before (normal) and after myocardial ischemia (stunned). Segment shortening (%SS), as an index of regional myocardial contractility, and the peak segment lengthening rate (dL/dt max), as an index of regional diastolic function, were evaluated. Simultaneous arterial and coronary venous contents of oxygen and lactate were measured to calculate MVO2 and oxygen (EO2) and lactate extraction (Elac) ratios during IV or IC infusions of epinephrine or dobutamine. Effectiveness of metabolic vasodilation was determined from EO2. RESULTS: IV or IC infusions of dobutamine or epinephrine before ischemia resulted in dose-dependent increases in mechanical functions (%SS and dL/dt max) and MVO2. These changes were accompanied by parallel increases in CBF resulting in unaltered EO2 with an infusion of dobutamine, while CBF increased more than MVO2 with epinephrine, resulting in decreased EO2. After the ischemia and reperfusion, %SS and dL/dt max were depressed and Elac was reduced, but similar mechanical responses (%SS and dL/dt max) to both dobutamine & epinephrine were observed. Also, in the stunned myocardium, CBF increased in parallel with mechanical function and MVO2 with either IC or IV dobutamine, resulting in an unaltered EO2. However, IC but not IV epinephrine did not affect EO2, suggesting abolishment of its direct vasodilating effect in stunned myocardium. In addition, IC epinephrine infusion further decreased Elac, while IC dobutamine did not affect it in stunned myocardium. During IV infusions, dobutamine caused a dose-dependent increase in the heart rate but epinephrine did not affect it, despite the comparable increase in cardiac index and mean aortic pressure. CONCLUSIONS: The results indicate that dobutamine and epinephrine exert similar positive inotropic and lusitropic effects in normal and stunned myocardium in dogs. However, epinephrine causes direct coronary vasodilation in normal myocardium, but it does not directly affect coronary vascular tone in stunned myocardium. In addition, epinephrine infusion dose-dependently depresses Elac in stunned myocardium. In contrast, dobutamine affects neither direct coronary vascular tone nor Elac regardless of ischemia and reperfusion injury.
Anesthesia ; Animals ; Arterial Pressure ; Dobutamine* ; Dogs* ; Enflurane ; Epinephrine* ; Flowmeters ; Heart Rate ; Ischemia ; Lactic Acid ; Myocardial Ischemia ; Myocardial Stunning* ; Myocardium ; Oxygen Consumption ; Oxygen* ; Reperfusion ; Reperfusion Injury ; Thoracic Surgery ; Vasodilation ; Ventricular Pressure

OBJECTIVE: The survey was conducted to improve the health of Korean adolescents and to prepare adequate teaching programs by investigating their sexual behavior. METHODS: The participants of the survey was 80,000 middle and high school students aged 13 to 18. The survey was conducted from September 1st, 2007 to September 22nd, 2007. RESULTS: 78,834 students were surveyed and 74,698 (94.8%) students responded the survey. 35,232 (47.2%) of respondents were male students and 39,466 (52.8%) of respondents were female students. 38,820 (52.0%) of respondents were middle school students, 25,051 (33.5%) of respondents were high school students and 10,827 (14.5%) of respondents were technical high school students. 5.2% of respondents experienced sexual intercourse. The average age of the first sexual intercourse was 14.2 years old. 1.0% of respondents had a sexual intercourse before they enter the middle school. The pregnancy rate was 0.3%. Among respondents who experienced sexual intercourse, the rate of the use of contraceptive methods was 38.2%. The rate of using inappropriate contraceptive methods was 21.6%. The average age of a first wet dream for boys was 13.2 years old. The average age of menarche for girls was 12.4 year old. The rate of respondents who had a sex education was 72.2%. CONCLUSION: The average age of the first wet dream and menarche had been decreased. The average age of the first sex experience among adolescents had been decreased. The rate of adolescents who experienced a sexual intercourse was increased. However, the rate of using reliable contraceptive methods was very low. Therefore, adequate sex educations including effective contraceptive methods needs to be conducted to prevent unwanted pregnancy of adolescents.
Adolescent ; Aged ; Coitus ; Contraception ; Surveys and Questionnaires ; Dreams ; Female ; Humans ; Male ; Menarche ; Pregnancy ; Pregnancy Rate ; Pregnancy, Unwanted ; Sex Education ; Sexual Behavior

Ovarian failure and infertility are typical features in Turner syndrome. Conception without ovum donation is very rare. We experienced one case of pregnancy and Cesarean delivery in a Turner mosaic with previous recurrent miscarriages.
Abortion, Habitual ; Female ; Fertilization ; Infertility ; Mosaicism ; Oocyte Donation ; Pregnancy ; Turner Syndrome

PURPOSE: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. METHODS: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. RESULTS: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (chi2=1.15, p=.283). CONCLUSION: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.
Body Temperature ; Body Weight ; Caregivers/education/psychology ; Counseling ; Female ; Heart Defects, Congenital/mortality/prevention & control/*surgery ; Heart Rate ; Hospitalization ; Hotlines ; Humans ; Infant ; Infant, Newborn ; Male ; Monitoring, Physiologic/*methods ; Oxygen Consumption ; Palliative Care ; *Program Evaluation ; Prospective Studies ; Time Factors

BACKGROUND: Carcinoembryonic antigen (CEA), a serological marker of malignant tumors, demonstrates a modest increase under nonmalignant conditions such as aging and smoking. Also, recent study results suggested that serum CEA levels may be related to insulin resistance or low-grade inflammation. The aim of this study was to investigate the factors associated with serum CEA levels in healthy non-smokers. METHODS: Data was gathered from 21,501 adults aged 20 and over. We excluded 19,081 subjects who had omissions in anthropometric measurements or laboratory tests, or who had previous or current smoking history. RESULTS: The mean CEA level was 1.18 +/- 0.85 ng/dL in males and 0.93 +/- 0.73 ng/dL in females. After adjustment for age, CEA level was positively correlated with fasting glucose, glycosylated hemoglobin (HbA1C), high density lipoprotein (HDL) cholesterol, estimated glomerular filtration rate in males. In females, CEA level was positively correlated with fasting glucose, HbA1C, HDL cholesterol, aspartate aminotransferase, and high-sensitivity C-reactive protein. In both gender groups, HbA1C had a strong influence on CEA levels when all other variables were included in the regression model (P < 0.05). CONCLUSION: Within normal range, serum CEA levels were significantly associated with HbA1C levels but not with homeostasis model assessment of insulin resistance in the non-smoking population. These findings suggest that serum CEA levels are influenced by the glucose level itself instead of insulin resistance.
Adult ; Aging ; Aspartate Aminotransferases ; C-Reactive Protein ; Carcinoembryonic Antigen* ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Fasting ; Female ; Glomerular Filtration Rate ; Glucose ; Hemoglobin A, Glycosylated ; Homeostasis ; Humans ; Inflammation ; Insulin Resistance ; Lipoproteins ; Male ; Reference Values ; Smoke ; Smoking

OBJECTIVE: This research was performed to improve the health of Korean adolescents and to prepare adequate teaching programs by investigating their sexual cognition and behavior and preparing for adequate programs. METHODS: We conducted a survey of eighty thousand middle and high school students whose ages range from 13 to 18, during the period of September 1st, 2006 to October 30th, 2006. RESULTS: 78,593 people are polled and 71,404 people responded. Accordingly, the response rate was 90.0%: 52.1% (37,204) of the respondents were boys and 47.9% (34,200) were girls; 52.4% (37,420) of respondents were middle school students, 32.9% (23,500) of them were high school students, and 14.7% (10,479) of them were technical high school students. The rate of respondents who had experienced sexual relationship was 5.1%. The average age of starting sexual relationship was 14.2 year old. The rate of respondents who had experienced sexual relationship before they go to the middle school was 1.0%. The rate of pregnancy experience was 0.5%. The rate of respondents who were using a contraceptive method was 38.1%. The average boys age of having the first wet dream was 13.1 years old and girls of starting menstruation was 12.5 year old. The rate of using inappropriate contraception was 24.3%. The rate of having a sex education per a year was 62.0%. CONCLUSION: This research shows that the rate of adolescents who are experiencing sexual relationship is increasing. Besides, the age of adolescents starting sexual relationship is decreasing as their age of starting wet dream and menstruation decreases. As a result, it is strongly asserted that adequate sex education programs are indispensable to adolescents.
Adolescent ; Cognition ; Contraception ; Surveys and Questionnaires ; Dreams ; Female ; Humans ; Menstruation ; Pregnancy ; Sex Education ; Sexual Behavior