Aged ; Barium Sulfate ; adverse effects ; Colorectal Neoplasms ; diagnosis ; physiopathology ; Extravasation of Diagnostic and Therapeutic Materials ; complications ; Female ; Humans ; Male ; Peritonitis ; etiology ; physiopathology ; Retrospective Studies

Limonin existed in citrus fruits has been shown to have anti-bacterial, anti-viral, anti-feedant, anti-nociceptive, anti-inflammatory activities and anti-carcinogenic activities. But the clinical use is limited by its low bioavailability. The aim of this study is to observe the absorption and secretion transport mechanisms of limonin in intestine which can pave the way for the further study and clinical use. The transport characteristics and mechanisms of limonin in rat were studied by in situ intestine perfusion and in vitro Caco-2 cells method. The intestinal absorption of limonin was probably via a facilitated diffusion pathway which was poor and without segment-selection. Verapamil and ketoconazole improved the absorption remarkably according to the result of in vitro Caco-2 cells study; however, probenecid had no significant effect on the absorption. The P-gp efflux and CYP3A4 metabolism were involved in the poor intestinal absorption and low bioavailability of limonin. The exploration of the intestinal absorption mechanism is crucial to the design of dosage form and clinical use of limonin.
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Animals ; Biological Availability ; Biological Transport ; drug effects ; Caco-2 Cells ; Cytochrome P-450 CYP3A ; metabolism ; Dose-Response Relationship, Drug ; Humans ; Intestinal Absorption ; drug effects ; Ketoconazole ; pharmacology ; Limonins ; administration & dosage ; pharmacokinetics ; Male ; Perfusion ; Probenecid ; pharmacology ; Rats ; Verapamil ; pharmacology

BACKGROUNDGastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory distress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.

METHODSSixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach. While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of interleukin (IL)-5, -6, -8 in it were measured.

RESULTSCompared with control group, the study group presented a neutrophil pattern of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.

CONCLUSIONThe gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.

Animals ; Asthma ; etiology ; Bronchoalveolar Lavage Fluid ; immunology ; Disease Models, Animal ; Female ; Gastroesophageal Reflux ; complications ; Inflammation ; etiology ; Interleukin-5 ; analysis ; Interleukin-6 ; analysis ; Interleukin-8 ; analysis ; Male ; Rats ; Rats, Sprague-Dawley

PURPOSE: The aim of this study was to compare postoperative pain between single-incision, gasless, endoscopic transaxillary thyroidectomy (SET), and conventional open thyroidectomy. METHODS: From March to December 2015, patients with thyroid disease underwent total thyroidectomy or lobectomy. Patient's clinical and pathological characteristics, postoperative pain score using visual analog scale (VAS) were compared between the 2 groups. The primary endpoint was postoperative pain evaluated by VAS score and postoperative analgesic use. Operation time and length of postoperative hospital stay were secondary outcome measures. RESULTS: Conventional, open cervical surgery was performed on 30 patients (group O) and SET was performed on 27 patients (group E). Pain scores in shoulder area, which is the ipsilateral side of the tumor location at 1 hour and 24 hours after surgery, were higher in group E patients (P < 0.05). Pain scores 7 days after surgery did not differ between the 2 groups according to the locations (P < 0.05). CONCLUSION: In conclusion, endocrine surgeons should be concerned about immediate higher postoperative pain scores in patients who undergo SET.
Humans ; Length of Stay ; Outcome Assessment (Health Care) ; Pain, Postoperative* ; Prospective Studies* ; Shoulder ; Surgeons ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroidectomy* ; Visual Analog Scale

PURPOSE: The measurement of serum thyroglobulin (Tg) of papillary thyroid carcinoma patients, 12 months after total thyroidectomy and radioactive iodine (RAI) ablation following thyroxine hormone withdrawal (T4-off Tg) or recombinant human thyroid-stimulating hormone stimulation (rhTSH-Tg), is standard method for monitoring disease status. The aim of this study was to find predictive factors for detectable T4-off Tg during follow-up. METHODS: A retrospective review was conducted of 329 patients who underwent total thyroidectomy and RAI ablation between October 2008 and August 2012. Subjects were assigned to high (>1 ng/mL, n = 53) and low (≤1 ng/mL, n = 276) groups, based on T4-off Tg measured 12 months postoperatively. Demographic and clinicopathological characteristics at diagnosis and follow-up were compared between the 2 groups. RESULTS: The low and high T4-off Tg groups differed with respect to tumor size, preoperative Tg, ablative Tg, cervical lymph node metastasis, thyroglobulinemia out of proportion to results of diagnostic whole body scan, and American Thyroid Association 3-level stratification and restratification. Multivariate analysis confirmed that ablative Tg > 1.0 ng/mL (odds ratio [OR], 10.801; P = 0.001), more than 5 cervical lymph node metastasis (OR, 6.491; P = 0.003), and thyroglobulinemia out of proportion (OR, 9.221; P = 0.000) were risk factors. CONCLUSION: Ablative Tg >1.0 ng/mL, more than 5 cervical lymph node metastasis, and thyroglobulinemia out of proportion were independent factors for T4-off Tg >1 ng/mL 12 months postoperative. In low-risk patients without these risk factors, the possible omission of Tg measurements could be considered during follow-up.
Diagnosis ; Follow-Up Studies ; Humans ; Iodine* ; Lymph Nodes ; Methods ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors* ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Thyroxine ; Whole Body Imaging

Biomarkers ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cysteine Proteinase Inhibitors ; biosynthesis ; genetics ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Ki-67 Antigen ; analysis ; Liver Neoplasms ; metabolism ; pathology ; Male ; Microtubule-Associated Proteins ; biosynthesis ; genetics ; Neoplasm Proteins ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; RNA, Messenger ; biosynthesis ; genetics

OBJECTIVETo study the role of trisomy 8 in pathogenesis and progression of hematologic disease with trisomy 8.

METHODSThe clinical data on 38 cases with trisomy 8 were investigated retrospectively. Fluorescence in situ hybridization (FISH) using Spectrum Orange labeled chromosome 8 centromere specific probe was carried out to detect trisomy 8 in 10 cases.

RESULTSThirty-two of 38(84.2%) cases with trisomy 8, and fourteen of 17(82.4%) cases with trisomy 8 as the sole chromosome aberration were myeloid disorders such as myelodysplastic syndrome (MDS), acute myelocytic leukemia (AML), chronic myelocytic leukemia (CML). The incidence of trisomy 8 was higher in myeloid disease than in lymphocytic disease (5% vs 1.3%); the incidence of trisomy 8 was higher in acute monocytic leukemia than in other AML (6.1% vs 2.4%), and the incidence of trisomy 8 in chronic myelomonocytic leukemia( CMML) was higher than that in other myelodysplastic syndrome (MDS) (25% vs 13.2%); 17 cases had trisomy 8 as the sole chromosome aberration, 21 cases had other additional chromosome aberrations. The chromosome aberration was confirmed by FISH in 10 cases with trisomy 8 as the sole chromosome aberration. Eleven cases were treated with chemotherapy, among them only 10 cases data were available. Seven cases acquired complete remission but 3 of them were M3, the other 3 cases had no response after two courses of chemotherapy.

CONCLUSIONTrisomy 8 may play an important role in the pathogenesis and progression of the hematological disease, especially myeloid disease. Trisomy 8 might be related with differentiation abnormality of monocyte.

Adolescent ; Adult ; Aged ; Chromosomes, Human, Pair 8 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Trisomy

Objective: To observe the clinical effect of guava leaf (GL) in treating infantile rotaviral enteritis.Methods: Sixty-two patients of rotaviral enteritis were randomly divided into the treated group treated with GL and the control group treated with Gegen Qinlian Decoction. The time for ceasing diarrhea, content of Na+ in blood, content of Na+ and glucose in stool, and the rate of negative conversion of human rotavirus antigen (HRVA) were observed.Results: The 3-day recovery rate in the treated group (87.1%) was significantly higher than that in the control group (58.1%, P<0.05). The time of ceasing diarrhea in the treated group (25.1±9.5 hrs) was significantly shorter than that in the control group (38.7±15.2 hrs, P<0.01). Moreover, content of Na+ and glucose in stool were reduced obviously in the treated group but not in the control group; and negative conversion rate of HRVA in the former group also got better than that in the latter group (87.1% vs 58.1%, P<0.05). Consequently, the effect of GL was superior to that of the control significantly.Conclusion: GL has good curative effect on infantile rotaviral enteritis.

PURPOSE: Single port laparoscopic surgery is an area of active investigation in abdominal surgery. A standard procedure for single port laparoscopic adrenal surgery has not been established. We retrospectively investigated intraoperative and postoperative outcomes following laparoscopic adrenalectomy via mono-port (LAMP). METHODS: Between March 2009 and December 2009, 10 patients underwent LAMP at Kangbuk Samsung Hospital. The same surgeon performed all surgeries. The first 5 cases underwent LAMP using an Alexis Wound Retractor (Applied Medical, Rancho Santa Margarita, CA, USA) with surgical gloves, and others were done with an OCTO Port (Dalim Surgnet, Korea). RESULTS: Of the 10 patients, 5 were male and 5 were female. The mean age was 43.7±9.9 years (range, 34~62), and the mean BMI was 24.1±4.0 kg/m² (Range, 17.1 ~30.0). The mean tumor size was 32.5±16.9 mm (range, 12~60),mean operative time was 127.0±29.5 min (range, 90~180), and mean hospital stay was 4.5 days (range, 3~7). Three patients were diagnosed with non-functioning cortical adenoma, 3 with Cushing's syndrome, 2 patients with pheochromocytoma, and others with primarily hyperaldosteronism and myelolipoma. Major postoperative morbidity, blood transfusions, or conversion to open surgery did not occur. CONCLUSION: The outcome of LAMP demonstrates the safety and feasibility of this procedure. With increasing surgeon experience and refinement in instrument technology, we believe LAMP is likely to become a standard approach to adrenal disease.
Adenoma ; Adrenalectomy* ; Blood Transfusion ; Conversion to Open Surgery ; Cushing Syndrome ; Female ; Gloves, Surgical ; Humans ; Hyperaldosteronism ; Laparoscopy ; Length of Stay ; Male ; Myelolipoma ; Operative Time ; Pheochromocytoma ; Retrospective Studies ; Wounds and Injuries

PURPOSE: Endoscopic thyroid surgery has been widely used because of the cosmetic advantage and the development of laparoscopic instruments. We have performed endoscopic thyroidectomy by breast approach and gasless transaxillary approach on papillary thyroid microcarcinomas. In this study, we describe these two types of endoscopic procedures with the technique of the method and surgical outcomes. METHODS: From Oct. 1999 to Oct. 2009, each procedure was performed in 162 patients divided into two groups. Breast approach group was in 91 patients and gasless transaxillary approach group was in 71 patients. We compared the results of mean ages, sex ratio, extent of operation, mean hospital stay, operating time, pathologic characteristics and postoperative complications between the breast approach group and gasless transaxillary approach group. RESULTS: Ninety-one cases treated using breast approach, and seventy-one cases treated using gasless transaxillary approach. The operation time was 197.4+/-60.7 minutes (95~350) in breast approach group, and 100.1+/-19.8 minutes (65~140) in gasless transaxillary approach group. Post operative complications are; 2 cases of transient hoarseness, 8 cases of hypocalcemia (including 2 cases of permanent hypocalcemia), 2 cases of chest wall discomfort in breast approach group, and 1 case of transient hoarseness, 2 cases of transient hypocalcemia, 1 case of postoperative bleeding in gasless axillary approach group. CONCLUSION: Endoscopic thyroidectomy is a safe and technically feasible alternative to conventional thyroidectomy in patients with benign and highly selected malignant disease. We expect it can increase the extent of surgery.
Breast ; Carcinoma, Papillary ; Cosmetics ; Hemorrhage ; Hoarseness ; Humans ; Hypocalcemia ; Imidazoles ; Length of Stay ; Nitro Compounds ; Postoperative Complications ; Sex Ratio ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy