BACKGROUND: We compared the clinical outcomes of cardiac valve surgery in adult Jehovah's Witness patients refusing blood transfusion to those in non-Jehovah's Witness patients without any transfusion limitations. METHODS: From 2005 to 2014, 25 Jehovah's Witnesses (JW group) underwent cardiac valve surgery using a blood conservation strategy. Twenty-five matched control patients (non-JW group) were selected according to sex, age, operation date, and surgeon. Both groups were managed according to general guidelines of anticoagulation for valve surgery. RESULTS: The operative mortality rate was 4.0% in the JW group and 0% in the non-JW group (p = 1.000). There was no difference in postoperative major complications between the groups (p = 1.000). The overall survival rate at 5 and 10 years was 85.6% ± 7.9% and 85.6% ± 7.9% in the JW group, respectively, and 100.0% ± 0.0% and 66.7% ± 27.2% in the non-JW group (p = 0.313). The valve-related morbidity-free survival rates (p = 0.625) and late morbidity-free survival rates (p = 0.885) were not significantly different between the groups. CONCLUSIONS: Using a perioperative strategy for blood conservation, cardiac valve surgery without transfusion had comparable clinical outcomes in adult patients. This blood conservation strategy could be broadly applied to major surgeries with careful perioperative care.
Adult ; Blood Transfusion ; Bloodless Medical and Surgical Procedures* ; Heart Valves* ; Humans ; Jehovah's Witnesses* ; Mortality ; Perioperative Care ; Survival Rate

No abstract available.
Humans

No abstract available.
Keloid* ; Recurrence*

No abstract available.
Neck*

No Abstract Available.
Receptors, Cytoplasmic and Nuclear*

This study identified an effective control method for periodontitis by investigating the association between blood levels of vitamin D and periodontitis in Korean elderly based on raw data from the fifth Korea National Health & Nutrition Examination Survey of 2010 (KNHANES). In this study, 1,021 adults over 65 years of age were evaluated based on data from the KNHANES. Periodontal disease was assessed using community periodontal index (CPI), with CPI codes ≥3 defined as periodontitis. Blood levels of vitamin D were measured from blood samples and divided into four groups (first quartile: ≤13.23 ng/ml, second quartile: 13.24∼16.95 ng/ml, third quartile: 16.96∼21.58 ng/ml), and fourth quartile >21.59 ng/ml). Using multiple logistic regression analyses, the variables were adjusted for general characteristics, oral health-related characteristics, health-related characteristics, and bone mineral density. The statistical analysis was performed using the SAS (ver. 9.2). The results of this study are as follows: the prevalence of periodontitis was 42.6% in Korean elderly. After adjusting for general, oral health-related, and health-related, the risk of periodontitis in the first quartile group was 1.74 times (95% confidence interval [CI], 1.02∼2.98) higher than that of the fourth quartile group (p=0.041). After adjusting for general, oral health-related, and health-related characteristics as well as bone mineral density, the risk of periodontitis in the first quartile group was 1.73 times (95% CI, 1.02∼2.96) higher than that of the four quartile group (p=0.042). There was a significant relationship between blood vitamin D level and periodontitis in Korean elderly. For the prevention of periodontitis, factors related to vitamin D should be considered along with other risk factors.
Adult ; Aged* ; Bone Density ; Humans ; Korea ; Logistic Models ; Methods ; Periodontal Diseases ; Periodontal Index ; Periodontitis* ; Prevalence ; Risk Factors ; Vitamin D* ; Vitamins*

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

BACKGROUND: Tuberculous pleurisy treatment improve symptoms such as fever, chest pain, cough, and prevents the progression to active pulmonary tuberculosis and the development of residual pleural thickening that decrease diaphragm and rib cage movement. This study investigated how the degree of residual pleural thidkening affects the pulmonary function. METHODS: Fifty seven patients who were initially diagnosed as having tuberculous pleurisy, were treated with anti-tuberculous medication for 6 months and had residual pleural thickening between May 1998 and January 2000 at the Eulji university hospital were reviewed. A chest X-ray and pulmonary function test(PFT, Sensormedics 2200) were perfored. The predicted value (%) of the forced vital capacity(FVC), forced inspiratory vital capacity(FIVC) and total lung capacity(TLC) were measured. The residual pleural thickening was defined the average of the summation in the lateral chest at the level of the imaginary line intersecting from the cardiophrenic angle to the diaphragmatic dome and the lowest part of the costophrenic angle between them. The results were sorted into three grades according to pleural thickness; <2mm(grade I), 2~10mm(grade II), 10mm(grade III). RESULTS: 1. FVC(% pred) and FIVC(% pred) were statistically different between grade I and III, and II and III. However, there was no difference between the TLC(% pred) between each of the groups. 2. The pleural thickness that cause restrictive dysfunction(FVC<80%) and a statisticall difference, is 3 mm. CONCLUSION: The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3 mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.
Chest Pain ; Cough ; Diaphragm ; Fever ; Humans ; Lung ; Respiratory Function Tests ; Ribs ; Thorax ; Tuberculosis, Pleural* ; Tuberculosis, Pulmonary

PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.
Comorbidity ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Lung Diseases ; Mortality* ; Operative Time ; Retrospective Studies