No abstract available.
Clone Cells* ; Cloning, Organism* ; DNA* ; Flagellin* ; Helicobacter pylori* ; Helicobacter* ; Sequence Analysis, DNA*

Clinical problem occuring in the early post operative period after cardiopulmonary bypass may ne related to the altered function of capillary bed which was affected by activation of complement system. This is so called post perfusion syndrome. We selected 20 patients with confirmed congenital heart disease by cariac catheterization. We studied the changes in the C3 , immunolglobulins, total protein, and WBC count while performing open heart surgery. The results were as followed. 1. C3 level was lowest during cardiopulmonary bypass and returned to the normal level after 8 days. 2. Each immunoglobulin level decreased just after cardiopulmonary bypass, especially the IgG level, and immunoglobulins slowly returned to the normal range after 8 days. 3. Serum total protein level and electrophoretic fractions were comperatively reduced as much as immunoglobulin levels. 4. WBC count was lower just before cardiopulmonary bypass than baseline.
Capillaries ; Cardiopulmonary Bypass* ; Catheterization ; Catheters ; Complement System Proteins* ; Heart Defects, Congenital ; Humans ; Immunoglobulin G ; Immunoglobulins ; Oxygenators ; Perfusion ; Reference Values ; Thoracic Surgery

We report a rare case of a 47-year-old male with posttraumatic phlegmasia cerulea dolens caused by a ruptured right external iliac vein and treated with an endovascular venous stent graft. The patient was the victim of motor vehicle accident, and suffered direct injuries to the head and abdomen. The patient had a cyanotic and swollen right lower leg. Abdominal and lower extremity computed tomography angiography revealed a large retroperitoneal hematoma caused by a ruptured right external iliac vein, and grade I liver injury. The right external iliac vein rupture was successfully treated with a venous stent graft, followed by inferior vena cava filtering, because a venous thrombus was identified below the stent graft. He initially was hemodynamically unstable but recovered following treatment. The patient was comatose when presenting at the emergency department. He was discharged, fully recovered, on hospital day 18.
Abdomen ; Angiography ; Blood Vessel Prosthesis ; Coma ; Emergency Service, Hospital ; Head ; Hematoma ; Humans ; Iliac Vein* ; Leg ; Liver ; Lower Extremity ; Male ; Middle Aged ; Motor Vehicles ; Rupture* ; Thrombosis ; Vena Cava, Inferior

BACKGROUND/AIMS: Resection of the esophagus for malignant disease or a benign stenosis, has a choice not only of palliative surgery, but also of replacement of the esophagus with a transposed stomach, jejunum, or colon. The first-line method is replacement with a tubulized stomach. The purpose of this study was to investigate the association of esophageal motor dysfunction and gastric emptying time with symptoms after esophagectomy. METHODS: We performed the esophageal manometry and gastric emptying time after esophagectomy for esophageal cancer in 12 patients and for benign esophageal disease in 2 patients. RESULTS: In manometric studies, a zone of high pressure in the esophago-gastric anastomosis distal to the upper esophageal sphincter was associated with symptoms after esophagectomy. The gastric emptying rate was slowed in 7 out of 14 patients, but not associated with symptoms after esophagectomy. CONCLUSIONS: Our data suggest that a high-pressure zone distal to the upper esophageal sphincter was associated with symptoms after esophagectomy in manometric study. The gastric emptying rate was not associated with postoperative symptoms.
Colon ; Constriction, Pathologic ; Esophageal Diseases ; Esophageal Neoplasms ; Esophageal Sphincter, Upper ; Esophagectomy* ; Esophagus ; Gastric Emptying* ; Humans ; Jejunum ; Manometry* ; Palliative Care ; Stomach

OBJECTIVE: Microbial aggregation around dental implants can lead to loss/loosening of the implants. This study was aimed at surface treating titanium microimplants with silver nanoparticles (AgNPs) to achieve antibacterial properties. METHODS: AgNP-modified titanium microimplants (Ti-nAg) were prepared using two methods. The first method involved coating the microimplants with regular AgNPs (Ti-AgNP) and the second involved coating them with a AgNP-coated biopolymer (Ti-BP-AgNP). The topologies, microstructures, and chemical compositions of the surfaces of the Ti-nAg were characterized by scanning electron microscopy (SEM) equipped with energy-dispersive spectrometer (EDS) and X-ray photoelectron spectroscopy (XPS). Disk diffusion tests using Streptococcus mutans, Streptococcus sanguinis, and Aggregatibacter actinomycetemcomitans were performed to test the antibacterial activity of the Ti-nAg microimplants. RESULTS: SEM revealed that only a meager amount of AgNPs was sparsely deposited on the Ti-AgNP surface with the first method, while a layer of AgNP-coated biopolymer extended along the Ti-BP-AgNP surface in the second method. The diameters of the coated nanoparticles were in the range of 10 to 30 nm. EDS revealed 1.05 atomic % of Ag on the surface of the Ti-AgNP and an astounding 21.2 atomic % on the surface of the Ti-BP-AgNP. XPS confirmed the metallic state of silver on the Ti-BP-AgNP surface. After 24 hours of incubation, clear zones of inhibition were seen around the Ti-BP-AgNP microimplants in all three test bacterial culture plates, whereas no antibacterial effect was observed with the Ti-AgNP microimplants. CONCLUSIONS: Titanium microimplants modified with Ti-BP-AgNP exhibit excellent antibacterial properties, making them a promising implantable biomaterial.
Aggregatibacter actinomycetemcomitans ; Biopolymers ; Dental Implants ; Diffusion ; Methods ; Microscopy, Electron, Scanning ; Nanoparticles* ; Photoelectron Spectroscopy ; Silver* ; Streptococcus ; Streptococcus mutans ; Titanium

Sixteen dogs were used to study the effect of bone morphogenic protein(BMP-4), betaig-h3 and chitosan during the early bony consolidation stage in the distracted zones of mandibles. The lateral surface of the mandibular body was exposed in the subperiosteal plane and vertical osteotomy was carried out on the mandibular body. An external distraction device was applied to the mandibular body about 1 cm apart from the osteotomy line. Mandibular distraction was started 5 days after the mandibular osteotomy at a rate of 2 mm per day for a total of 10 mm distraction for 5 days. The experimental group was divided into 4 groups: control group, BMP-4 group, betaig-h3 group and chitosan group depending on the injected material into the distracted area. Four dogs were allocated to each group. On the day of completion of distraction, 0.5 ml of BMP-4, 0.5 ml of betaig-h3, 0.5 ml of 5% chitosan solution was injected respectively into the distracted area of each group with the same amount of tripolyphosphate in dual syringe for solidification of the injected solution. In the control group, 1 ml of tripolyphosphate was injected into the distracted area. After injection of the study materials, the distraction device was left in place for 4 or 7 weeks to allow bony consolidation. Radiographs were taken weekly. Two dogs in each group, a total of eight dogs, were sacrified in 4 weeks, and another eight dogs in 7 weeks after completion of distraction. Bone specimens of the distracted mandibles were taken for histologic examination. The mineral density of the distracted bone was measured during the radiological procedures and analysed by the computer. In the radiographs of the distracted areas of the mandibles, the control group has shown a mostly radiolucent zone but the other groups have shown the radiodense zones with various width of central radiolucent zones. The central radiolucent zone became narrower in time and vertical thickness of the radiodense zone was about twice thicker in 7 weeks than that of 4 weeks after finishing bone distraction. BMP-4 group showed the thickest radiodense zone and the chitosan group shows the thinnest radiodense zone. The mineral density of bone was highest in the BMP-4 group and lowest in the control group. In the histological findings of the distracted areas of mandibles, the control group showed whole fibrous tissue but the other groups showed new woven bones with central narrow fibrous interzone. The degree of new bone formation was most remarkable in the BMP-4 group and was least remarkable in the chitosan group. In conclusion, there was an active formation of a new bone in the distracted area of the mandible by injection of BMP-4, betaig-h3 and chitosan. The new bone formation was most remarkable in the BMP-4 group followed by betaig-h3, chitosan and control group. These findings suggest that BMP-4 is clinically worth using for early bony consolidation in the distraction osteogenesis.
Animals ; Chitosan* ; Dogs ; Humans* ; Mandible* ; Mandibular Osteotomy ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy ; Syringes

PURPOSE: To identify a useful screening test leading to diagnosis of hypertension in the emergency department (ED). METHODS: This was a retrospective medical record review of adult patients (18> or =years of age) admitted to the ED at a tertiary care educational hospital, between January 1, 2010 and February 28, 2010. Only those patients with a triage systolic blood pressure greater than or equal to 140 mmHg, or a diastolic blood pressure greater than or equal to 90 mmHg, were enrolled. Data including baseline characteristics, basic metabolic panel (BMP), urinalysis, electrocardiogram (ECG), chest radiograph, and whether or not they were diagnosed with hypertension, were obtained. Multivariate analysis was performed to determine an appropriate screening test for diagnosis of hypertension. RESULTS: Of the 447 enrolled patients, 81(18.1%) were diagnosed with hypertension. Age above 35 years (Odds ratio [OR]=8.263; 95% Confidence interval (CI), 1.034-66.062; p=0.046), diagnosis of diabetes mellitus (DM) (OR=3.99; 95% CI, 1.582-10.064; p=0.003), left ventricular hypertrophy (LVH) (OR=4.348; 95% CI, 1.968-9.607; p<0.001), and suspected stage II hypertension (OR=2.699; 95% CI, 1.151-6.329; p=0.022) were independently associated with a positive hypertension diagnosis. The area under the Receiver operating characteristic (ROC) curve for a positive diagnosis of hypertension was 0.687(95% CI, 0.642-0.730). CONCLUSION: Age above 35 years, existence of DM or LVH, and suspected stage II hypertension may be useful data points for screening and diagnosis of hypertension in the ED.
Adult ; Blood Pressure ; Diabetes Mellitus ; Electrocardiography ; Emergencies ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Mass Screening ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; ROC Curve ; Tertiary Healthcare ; Thorax ; Triage ; Urinalysis

PURPOSE: To identify a useful screening test leading to diagnosis of hypertension in the emergency department (ED). METHODS: This was a retrospective medical record review of adult patients (18> or =years of age) admitted to the ED at a tertiary care educational hospital, between January 1, 2010 and February 28, 2010. Only those patients with a triage systolic blood pressure greater than or equal to 140 mmHg, or a diastolic blood pressure greater than or equal to 90 mmHg, were enrolled. Data including baseline characteristics, basic metabolic panel (BMP), urinalysis, electrocardiogram (ECG), chest radiograph, and whether or not they were diagnosed with hypertension, were obtained. Multivariate analysis was performed to determine an appropriate screening test for diagnosis of hypertension. RESULTS: Of the 447 enrolled patients, 81(18.1%) were diagnosed with hypertension. Age above 35 years (Odds ratio [OR]=8.263; 95% Confidence interval (CI), 1.034-66.062; p=0.046), diagnosis of diabetes mellitus (DM) (OR=3.99; 95% CI, 1.582-10.064; p=0.003), left ventricular hypertrophy (LVH) (OR=4.348; 95% CI, 1.968-9.607; p<0.001), and suspected stage II hypertension (OR=2.699; 95% CI, 1.151-6.329; p=0.022) were independently associated with a positive hypertension diagnosis. The area under the Receiver operating characteristic (ROC) curve for a positive diagnosis of hypertension was 0.687(95% CI, 0.642-0.730). CONCLUSION: Age above 35 years, existence of DM or LVH, and suspected stage II hypertension may be useful data points for screening and diagnosis of hypertension in the ED.
Adult ; Blood Pressure ; Diabetes Mellitus ; Electrocardiography ; Emergencies ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Mass Screening ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; ROC Curve ; Tertiary Healthcare ; Thorax ; Triage ; Urinalysis

PURPOSE: There is increasing interest in intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) in critically ill patients. This study investigated the effects and outcomes of elevated IAP in a trauma intensive care unit (ICU) population. METHODS: Eleven consecutive critically ill patients admitted to the trauma ICU at Pusan National University Hospital Regional Trauma Center were included in this study. IAP was measured every 8–12 hours (intermittently) for 72 hours. IAP was registered as mean and maximal values per day throughout the study period. IAH was defined as IAP ≥12 mmHg. Abdominal compartment syndrome was defined as IAP ≥20 mmHg plus ≥1 new organ failure. The main outcome measure was in-hospital mortality. RESULTS: According to maximal and mean IAP values, 10 (90.9%) of the patients developed IAH during the study period. The Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with IAP ≥20 mmHg than in those with IAP <20 mmHg (16 vs. 5, p=0.049). The hospital mortality rate was 27.3%. Patients with a maximum IAP ≥20 mmHg exhibited significantly higher hospital mortality rates (p=0.006). Non-survivors had higher maximum and mean IAP values. CONCLUSIONS Our results suggest that an elevated IAP may be associated with a poor prognosis in critically ill trauma patients.

BACKGROUND: One of the limitation during the irradiation of malignant tumor is hazard to normal tissue although it is important and effective tool for treating malignant tumor. We studied the role of interleukin-1 alpha (IL-1alpha) and interleukin-6 (IL-6) in the radiation-induced lung injury especially on fibrosis. METHODS: We irradiated right-side lungs of thirty Sprague-Dawley rats with single fraction of 20 Gy and then sacrificed the animals until 20th week at intervals of two weeks. Both irradiated and unirradiated lung tissues were stained hematoxilin and eosin, Masson trichrome, reticulin and immunohistochemical staining for IL-1alpha and IL-6. The degree of the staining for IL-1alpha and IL-6 were examined semiquantitatively. RESULTS: Two weeks after irradiation interstitial edema and capillary congestion appeared, followed by increase of the monocytes infiltration and proteinaceous material during 4th and 8th week. After eight weeks of irradiation, collagen and reticulin fibers were detected along alveolar wall. 12th to 20th week, fibrosis in interstitium, decreased number of alveoli and thickening of bronchial wall were observed. The degree of immunohistochemical staining for IL-1alpha and IL-6 was increased rapidly during the first three week and then decreased slowly, but remain incresed until 20th week. CONCLUSION: Our Study demonstrate the early and persistent elevation of cytokines IL-1alpha and IL-6 by immunohistochemical stain in rat lung following pulmonary irradiation. We think cytokines are produced immediately after irradiation, make collagen genes turn on and perisist until the expression of late effects become apparent pathologically and clinically.
Animals ; Capillaries ; Collagen ; Cytokines ; Edema ; Eosine Yellowish-(YS) ; Estrogens, Conjugated (USP) ; Fibrosis ; Interleukin-1* ; Interleukin-1alpha ; Interleukin-6* ; Lung Injury ; Lung* ; Monocytes ; Rats* ; Rats, Sprague-Dawley ; Reticulin