BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac* ; Arterial Pressure ; Heart ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Respiration, Artificial* ; Respiratory Insufficiency* ; Risk Factors* ; Ventilation ; Ventilators, Mechanical

PURPOSE: Pathologic tumor volume is closely related with pathologic stage, pathologic Gleason grade, surgical margin status, and disease progression after radical prostatectomy. Therefore, an accurate assessment of prostate cancer volume is essential in prediction of pathologic stage. We evaluated that the calculated prostate cancer volume (cVca), a new clinical parameter, can predict for pathologic stage T3 in patients with clinical stage T1, 2 prostate cancer. MATERIALS AND METHODS: The cVca was determined in 26 men treated with radical prostatectomy in clinically localized prostate cancer (clinical stage T1, T2) based on pretreatment PSA, biopsy Gleason score, and prostate ultrasound volume. Logistic regression analysis evaluating the value of the PSA, biopsy Gleason score, cVca was performed. RESULTS: The mean of cVca was 4.07cm3 and the mean of cVca in localized and extensive prostate cancer was 1.77cm3 and 6.74cm3, respectively. The difference between the mean of cVca in localized and extensive prostate cancer was statistically significant (p<0.05). PSA and cVca were significant predictors of pathologic stage T3 disease in patients with clinical stage T1, T2 disease on univariate analysis, but cVca was only significant predictor on multivariate analysis. CONCLUSIONS: The cVca was more reliable parameter than PSA and Gleason score in predicting of pathologic stage T3 disease in patients with clinical stage T1 and T2 prostate cancer. Therefore, this new parameter can be used to select patients who are likely to have pathologic organ-confined disease.
Biopsy ; Disease Progression ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Neoplasm Grading ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Tumor Burden ; Ultrasonography

We report a cases of solid and papillary neoplasm of the pancreas, which is a rare pancreatic tumor. we described clinical characteristics, sonographic, computed tomographic and pathologic finding. The tumors had a smooth, enhanced capsule and variable architecture. The tumor was distributed tail of pancreas without local invasion. the origin of the tumor is probably from a multipotential stem cell of the pancreas. Neoplasm usually behave like a very low grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancrease. This unusual tumor should be considered in the differential diagnosis of a young female with pancreatic mass.
Diagnosis, Differential ; Female ; Humans ; Pancreas* ; Pancrelipase ; Stem Cells ; Ultrasonography

Twenty seven patients with known rectal cancer were evaluated with CT and CT findings were correlated with surgical and pathologic results on the aspect of perirectal fat infiltration and lymph node involvement. The accuracy in assessment of perirectal fat infiltration was 77.8% (21 of 27); sensitivity, 73.3% (11 of 13); specificity, 83.3% (10 of 12). In the detection of lymph node involvement, lymph nodes were divided into five groups according to the arterial teritories. Overall accuracy in the evaluation of lymph node involvement was 86.7%. Accuracy of peritumoral lymph node involvement was 51.9% (14 of 27); sensitivity, 42.9%(9 of 21); specificity 83.3% (5 of 6). Accuracy of internal iliac lymph node involvement was 88.9% (24 of 27); sensitivity, 85.7% (6 of 7); specificity, 90.0% (18 of 20). Of the common and external iliac lymph node, accuracy was 100% (27 of 27); sensitivity, 100% (2 of 2); specificity, 100% (25 of 25). Of the aortic bifurcation and mid sacral lymph node, accuracy was 92.6% (25 of 27); sensitivity, 50% (2 of 4); specificity, 100% (23 of 23). In regard to the inferior mesenteric lymph node, no lymphadenopathy was found on CT and pathologic results. In conclusion, CT has limited value in evaluating rectal cancer but with the satisfactory outcome in assessment of perirectal fat infiltration and lymph node, involvement except peritumoral node preoperative CT is useful in the evaluation of rectal cancer.
Humans ; Lymph Nodes* ; Lymphatic Diseases ; Rectal Neoplasms* ; Sensitivity and Specificity

Even though the value of computed tomography (CT) used to detect the colon carcinoma with minimal invasion is limited, its usefulnes sin the evaluation of the extent of disease such as hepatic metastasis or distant lymph node invasion has been emphasized. To examine the role of CT in the evaluation of colon carcinoma, CT scans obtained during the past 2 years in 56 patients with surgically proven colon carcinoma were reviewed and the findings correlated with pathologic results. The sensitivity and accuracy of CT for pericolic fat infiltration were 86, 58 and 80% respectively. Those of regional node were 60, 83 and 75% and distant node 67, 100 and 95%. Liver metastases showed sensitivity, specificity and accuracy of 83, 98, 96% and peritoneal metastases 67, 94 and 89% respectively. CT detected local invasion with fair degree of accuracy but the true value of CT lie in the detection of distant invasions such as liver and distant lymph node metastases thereby leading to preclusion of unnecessary procedures and implementation of appropriate precedures.
Colon* ; Humans ; Liver* ; Lymph Nodes* ; Neoplasm Metastasis* ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Unnecessary Procedures

BACKGROUND: Oral allergy syndrome(OAS) is composed of it,ching sense and edema in oral cavity, lips, throat, pharynx, and larynx following eating some fresh fruits or vegetables. It has been known that most of patients with OAS are allergic to pollens. Common epitopes were found among pollens, fruits and vegetables. Although OAS is a common farm of food allergy in adults, this is the first epidemiologic study of OAS in Korea. MATERIAL AND METHOD: One hundred and fifty one patients who showed positive skin reaction to pollens were telephone-interviewed. Investigation of the prevalence and clinical manifestations of OAS was possible in 81 patients. RESULT: The prevalence of OAS among these patients was 34.6% (28/81). OAS was found in 24(48%) out of 50 patients sensitized to tree pollens, whereas 4(13%) of 31 grass or weed pollen-sensitized paients had OAS. Most common causative food was apple and all of 17 apple- OAS patients were sensitized to tree pollens. Peach was the second common food and 14 of 15 peach-OAS patients were sensitized to tree pollens. Besides oral symptoms, rhinitis, asthma, diarrhea, nausea, vomiting or generalized urticaria were accompanied in half of the OAS patients (14/28). Some patients showed OAS to some unique Korean foods such as dropwort, taro and Aster. CONCLUSION: OAS was very common in pollen-sensitized patients. Larger epidemiologic studies are needed to find unique Korean foods and their antigensm causing OAS.
Adult ; Asthma ; Colocasia ; Diarrhea ; Eating ; Edema ; Epidemiologic Studies ; Epitopes ; Filipendula ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity* ; Korea ; Larynx ; Lip ; Mouth ; Nausea ; Pharynx ; Poaceae ; Pollen* ; Prevalence ; Prunus persica ; Rhinitis ; Skin ; Urticaria ; Vegetables ; Vomiting

OBJECTIVES: This study aimed to investigate the 3-year mean periods aftermath of child sexual abuse and to compare the sexual violence victims regard to the treatment. METHODS: 682 sexual violence victims were recruited by Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center for children age 13, from 2004 to 2008. Data from 49 victims among 116 consented a follow-up, were analyzed. The victims were assessed by psychological test. Data was analyzed by SPSS ver. 15.0 (SPSS Inc.). RESULTS: The average time elapsed from the last presumed sexual abuse was 39.7 months [standard deviation (SD) 26.02]. Overall, Children's Depression Inventory (CDI) was significantly decreased from 15.8 (SD 9.33) to 10.4 (SD 9.98), and several subscales (depression, anxiety, anger, posttraumatic stress, and dissociation) of Trauma Symptom Checklist for Children (TSCC) were also significantly decreased. CDI and TSCC scores showed no statistical difference between treatment-given and not-given groups, but Revised Children's Manifest Anxiety Scale (RCMAS) was decreased in treatment-given group, whereas it was increased in treatment-not-given group. The difference of RCMAS scores between the two groups was statistically significant [F(1,28)=4.54, p < 0.05]. CONCLUSION: Sexually abused children showed overall symptom decreases over time, but anxiety was not decreased in treatment not-given group.
Anger ; Anxiety ; Checklist ; Child ; Child Abuse, Sexual* ; Child* ; Depression ; Follow-Up Studies ; Helianthus ; Humans ; Korea* ; Manifest Anxiety Scale ; Psychological Tests ; Seoul ; Sex Offenses*

Objective: Hypercholesterolaemia transforms macrophages into lipid-laden foam cells in circulation, which can activate the immune response. Compromised autophagy and inflammatory cytokines are involved in the pathogenesis and progression of metabolic diseases.The aim of this study was to identify the role of autophagy as a modulator of the inflammatory response and cytotoxicity in macrophages under hypercholesterolaemic conditions. Methods: High cholesterol-induced cytokine secretion and alteration of autophagyassociated molecules were confirmed by cytokine array and western blot analysis, respectively. To confirm whether autophagic regulation affects high cholesterol-induced cytokine release and cytotoxicity, protein levels of autophagic molecules, cell viability, and cytotoxicity were measured in cultured macrophages treated autophagy enhancers. Results: Cholesterol treatment increased cytokine secretion, cellular toxicity, and lactate dehydrogenase release in lipopolysaccharide (LPS)-primed macrophages. Concomitantly, altered levels of autophagy-related molecules were detected in LPS-primed macrophages under hypercholesterolaemic conditions. Treatment with autophagy enhancers reversed the secretion of cytokines, abnormally expressed autophagy-associated molecules, and cytotoxicity of LPS-primed macrophages. Conclusion Autophagy enhancers inhibit inflammatory cytokine secretion and reduce cytotoxicity under metabolic disturbances, such as hypercholesterolaemia. Modulation of autophagy may be a novel approach to control the inflammatory response observed in metabolic diseases.

BACKGROUND: The recognition of bronchial asthma as an inflammatory disease led to a search for soluble markers that would be useful in assessing airway inflammation. Interleukin-6 (IL-6) is a representative proinflammatory cytokine that has been shown to be connected with various inflammatory diseases. IL-6 acts via specific receptors that consist of the IL-6 binding glycoprotein gp80 and the signal transducer gp130. In the search for markers of airway inflammation, we investigated the role of soluble interleukin-6 receptor (sIL-6R) and IL-6 in acute asthma. METHODS: Serum levels of sIL-6R and IL-6 were measured in 78 acute asthmatics, in 15 patients with asymptomatic asthma and in 10 healthy control subjects by a specific ELISA using a murine antihuman IL-6R, IL-6 mAb (Quantikine sIL-6R, IL-6). RESULTS: Serum levels of IL-6 in acute asthmatics significantly exeeded those of control subjects. Those of sIL-6R in acute asthmatics were also significantly increased compared to those of control subjects. The serum concentration of IL-6 obtained in acute asthmatics was elevated as compared with the asymptomatic asthmatics. However, Association between eosinophilic count / IgE and IL-6 / sIL-6R in acute asthma could not found. CONCLUSION: Our results suggest that IL-6 may be involved in the pathogenesis of acute asthma and serum levels of IL-6 and sIL-6R may reflect the severity of airway inflammation.
Asthma* ; Cytokine Receptor gp130 ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Glycoproteins ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-6*

Neural stem cells (NSCs) have been suggested as a groundbreaking solution for stroke patients because they have the potential for self-renewal and differentiation into neurons. The differentiation of NSCs into neurons is integral for increasing the therapeutic efficiency of NSCs during inflammation. Apoptosis signal-regulating kinase 1 (ASK1) is preferentially activated by oxidative stress and inflammation, which is the fundamental pathology of brain damage in stroke. ASK1 may be involved in the early inflammation response after stroke and may be related to the differentiation of NSCs because of the relationship between ASK1 and the p38 mitogen-activated protein kinase pathway. Therefore, we investigated whether ASK1 is linked to the differentiation of NSCs under the context of inflammation. On the basis of the results of a microarray analysis, we performed the following experiments: western blot analysis to confirm ASK1, DCX, MAP2, phospho-p38 expression; fluorescence-activated cell sorting assay to estimate cell death; and immunocytochemistry to visualize and confirm the differentiation of cells in brain tissue. Neurosphere size and cell survival were highly maintained in ASK1-suppressed, lipopolysaccharide (LPS)-treated brains compared with only LPS-treated brains. The number of positive cells for MAP2, a neuronal marker, was lower in the ASK1-suppressed group than in the control group. According to our microarray data, phospho-p38 expression was inversely linked to ASK1 suppression, and our immunohistochemistry data showed that slight upregulation of ASK1 by LPS promoted the differentiation of endogenous, neuronal stem cells into neurons, but highly increased ASK1 levels after cerebral ischemic damage led to high levels of cell death. We conclude that ASK1 is regulated in response to the early inflammation phase and regulates the differentiation of NSCs after inflammatory-inducing events, such as ischemic stroke.
Animals ; Cell Death ; Infarction, Middle Cerebral Artery/*metabolism ; Lipopolysaccharides/pharmacology ; MAP Kinase Kinase Kinase 5/genetics/*metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Microtubule-Associated Proteins/genetics/metabolism ; Neural Stem Cells/cytology/drug effects/*metabolism ; *Neurogenesis ; Neuropeptides/genetics/metabolism ; p38 Mitogen-Activated Protein Kinases/genetics/metabolism