No abstract available.
Frontal Sinus*

Background: The prognostic consequences of transient hemodynamic deterioration due to cardiac displacement, which is most severe during left circumflex artery (LCX) grafting in off-pump coronary artery bypass surgery (OPCAB) are unknown. This study aimed to investigate the association between mixed venous oxygen saturation (SvO2) < 60% during LCX grafting and the occurrence of composite of morbidity endpoints. Methods: Data of patients who underwent elective OPCAB between January 2010 and December 2019 were reviewed. Logistic regression analysis was performed to detect risk factors for the composite of morbidity endpoints, defined as 30-day or in-hospital mortality, postoperative myocardial infarction, prolonged mechanical ventilation > 24 h, cerebrovascular accident, and acute kidney injury. Results: Among 1,071 patients, the composite of morbidity endpoints occurred in 303 (28%) patients. SvO2 < 60% during LCX grafting was significantly associated with the composite of morbidity (OR: 2.72, 95% CI [1.60, 4.61], P < 0.001) along with advanced age, chronic kidney disease, ratio of early mitral inflow velocity to mitral annular early diastolic velocity, and EuroSCORE II. Other major hemodynamic variables including the cardiac index were not associated with the outcome. Additional regression analysis revealed pre-operative anemia as a predictor of SvO2 < 60% during LCX grafting (OR: 2.09, 95% CI [1.33, 3.29], P = 0.001). Conclusions A decrease in SvO2 < 60%, albeit confined to the period of cardiac displacement, was associated with a 2.7-fold increased risk of detrimental outcomes after OPCAB, implying the prognostic importance of this transient deterioration in oxygen supply-demand balance.

Human monoclonal antibodies have considerable potential in the prophylaxis and treatment of viral disease. By cloning human Ig gene segments from the B cells of volunteer into pComb3 phagemid vector, antibody library was created of filamentous phage particles displaying Fab fragments on their surface after being rescued with M13KO7 helper phages. The size of library was 7x10' pfu. Phage antibodies (phabs) were panned against biotinylated preS1 using streptavidine coated Dynabead. The soluble Fab antibodies were prepared from phagemid colonies and assayed directly for the ability to bind preS1 by ELISA. And then 3DW and SGW specific to preS1 which have both heavy and light chain to form Fab fragment, were selected. The soluble Fab antibody from 3DW was expressed highly at the concentration of 0.1 - 1.0 mM of IPTG, and 5 hours postinduction. The soluble antibodies from 3DW and SGW showed their relative affinities of 2x10' M ', and Sx10 M ', respectively, and the specificities to preS1 on ELISA. Our results suggest that antibody phage display library is very useful method to generate the human monoclonal antibody and that the human Fab monoclonal antibodies specific to preS1 selected in this study open the way to treat hepatitis B as a component of passive irnmunotherapeutics.
Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes ; Bacteriophages* ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; Genes, Immunoglobulin ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans* ; Immunoglobulin Fab Fragments ; Isopropyl Thiogalactoside ; Streptavidin ; Virus Diseases ; Volunteers

In this study, we are to produce the single chain variable fragment (scFv) antibodies against surface protein of hepatitis B virus (HBV) using antibody phage display technique. Balb/c mice were immunized with preS1 and cDNAs of heavy and light chains of splenic B cells from immunized mice were prepared using RT-PCR. Two cDNAs were linked with (64S) linker DNA under recombination PCR to produce single chain Fv DNA. After digestion of scFv DNA with Sp 1 and Not 1, the digested DNA was ligated into pCANTAB 5E and electroporated into E. coli XL1-Blue to prepare scFv-library. The size of library was 1 * 10' pfu/ml. Phage antibodies (phabs) against preS1 were rescued with M13K07 helper phages, and preS1-binders were selected through 3 times of panning using 96 well microtitre plates. Phage antibody clones were assayed directly for the ability to bind preS1 by ELISA. And then 7 phage antibody clones had high ELISA signals against preS1. Phabs from preS1-specific pMsc-17 had the strongest ELISA signal to preS1. Phabs from pMsc-17 were used for Western blot to preS1 and the results revealed that it was specific to preS1. To prepare the soluble scFv antibody, phabs from pMsc-17 were transfected into non-suppressor E. coli HB2151, and grown under 1 mM IPTG. Soluble scFv antibody was mainly accumulated in the periplasmic space, but small amount of antibody was secreted into culture media.
Animals ; Antibodies ; B-Lymphocytes ; Bacteriophages* ; Blotting, Western ; Cell Surface Display Techniques ; Clone Cells ; Culture Media ; Digestion ; DNA ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Isopropyl Thiogalactoside ; Mice* ; Periplasm ; Polymerase Chain Reaction ; Recombination, Genetic ; Single-Chain Antibodies*

No abstract available.
Stevens-Johnson Syndrome*

We report a case of Waardenburgs syndrome in 18-year-old male patient who has total deafness of the right ear, heterochromia irides, hypopigmented patches on the face and trunk, and disseminated lentigines on the entire body surface since birth. His 51-year-old mother also has total deafness, heterochromia irides, white foreloek, and disseminated lentigines on the entire body surface. The patient with this disorder may complain of pigmentary abnormalities, and we believe dermatologists should pay more attention to systemic signs of the congenital pigmentary disorders.
Adolescent ; Deafness ; Ear ; Humans ; Lentigo ; Male ; Middle Aged ; Mothers* ; Parturition ; Waardenburg Syndrome*

Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. The absolute number of reported cases of double primary malignant tumors has increased in recent years diagnostic procedures. Primary adenocarcinoma of duodenum is a rare disease and represents less than 0.5% of all gastrointestinal malignancies. Therefore, synchronous multiple primary cancers of the stomach and duodenum are very rare. Recently, we experienced a case of triple primary malignant tumors of different site originating from the stomach, duodenum and cervix in 71- year-old woman. She had had radiation therapy and chemotherapy for squamous cell carcinoma of the uterine cervix 8 years previously. We performed subtotal gastrectomy and pancreaticoduodenectomy with radical lymph node dissection. She remained healthy without any evidence of recurrence 12 months after the operation.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Pancreaticoduodenectomy ; Rare Diseases ; Recurrence ; Stomach ; Stomach Neoplasms* ; Uterine Cervical Neoplasms*

No abstract available.
Kasabach-Merritt Syndrome*

Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

OBJECTIVE: Our purpose was to compare the pregnancy outcomes of nulliparous women aged 40 years and older with those of nulliparous women under 35 years of age. METHODS: From January 1989 to December 1998 total 57,563 deliveries were seen in Gachon Gil Medical Center. Among them we experienced 59 cases of nulliparas at 40 years and older. These women were compared with 188 young nulliparas under 35 years of age as the control group. The statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence rate of elderly nulliparas aged 40 years and older was increased from 0.04% in 1989 to 0.30% in 1998. The age distribution was from 40 years to 45 years. The gravidity of eldery nulliparas was 2.2 in comparison with 1.6 in control group. The incidence of uterine myoma, gestational DM, IUGR and oligohydramnios was significantly high rate in elderly nulliparas. There was significantly high rate of cesarean section in elderly nulliparas(88.1%) in comparison with control group(40.4%). The reasons of cesarean section were her demand(39.0%), CPD(15.3%) and breech presentation(13.6%) in decreasing order. The preterm delivery rate was 10.2% in elderly nulliparas in comparison with 4.3% in the control group. Placenta accreta and uterine atony were significantly high in elderly nulliparas and mean estimated blood loss was also high. There was no difference in 5-minute Apgar score between both group, but there were more cases of neonatal intensive care unit admission in neonates of elderly nulliparas(6.8% vs 0%). CONCLUSION: The incidence of elderly nulliparas is continuously increasing. The elderly nulliparas and their babies are at greater risk than young women. Therefore all elderly nulliparas aged 40 years and older can be regarded as high risk patients and they must be managed with careful attention.
Age Distribution ; Aged ; Apgar Score ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gravidity ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Leiomyoma ; Oligohydramnios ; Placenta Accreta ; Pregnancy ; Pregnancy Outcome ; Uterine Inertia