Arterial restenosis frequently develops after open or endovascular surgery due to intimal hyperplasia. Since tissue transglutaminase (TG2) is known to involve in fibrosis, wound healing, and extracellular matrix remodeling, we examined the role of TG2 in the process of intimal hyperplasia using TG2-null mice. The neointimal formation was compared between TG2-null and wild-type (C57BL/6) mice by two different injury models; carotid ligation and carotid loop injury. In ligation model, there was no difference in intimal thickness between two groups. In loop injury model, intimal hyperplasia developed in both groups and the intimal/medial area ratio was significantly reduced in TG2-null mice (P = 0.007). TG2 was intensely stained in neointimal cells in 2 weeks. In situ activity of TG2 in the injured arteries steadily increased until 4 weeks compared to uninjured arteries. Taken together, intimal hyperplasia was significantly reduced in TG2-null mice, indicating that TG2 has an important role in the development of intimal hyperplasia. This suggests that TG2 may be a novel target to prevent the arterial restenosis after vascular surgery.
Animals ; Carotid Arteries/pathology/*surgery ; Disease Models, Animal ; GTP-Binding Proteins/deficiency/genetics/*metabolism ; Hyperplasia ; Mice ; Mice, Inbred C57BL ; Transglutaminases/deficiency/genetics/*metabolism ; Tunica Intima/*pathology

Tophi is one of the clinical manifestations of gout. On the other hand, it does not draw the patient's attention when it is asymptomatic, which leads to delayed management. The current case is a typical example of delayed diagnosis and management. The authors' preferred management of tophi was medical not surgical, even though the hitherto therapeutic issue has been conservative versus surgical. The authors chose conservative treatment in the osteolytic lesion resulting from huge tophi in the patella, and the report the results of 6 years follow-up.
Delayed Diagnosis ; Febuxostat ; Follow-Up Studies ; Gout ; Hand ; Osteolysis ; Patella

The purposes of this study were to assess the accuracy of measurements in pre-enlarged canals with small instruments and to compare the accuracies, in enlarged canal, with small size instruments and instruments that match the actual canal diameter using Root ZX, Bingo1020, SmarPex, and e-Magic Finder. Ten extracted teeth were embedded in an alginate model made for testing apex locators. A size 10 file was placed into the root canal until the tip of the file reached the plane of the major diameter of the foramen under a dental operating microscope at the 25 x magnification. The measurement was done with digital caliper and defined as actual length. Electronic length measurement with a size 10 file in pre-enlarged canal was done by reading the index indicating Apex of each device to gain a definite value. After completion of canal enlargement to a size 45 file, each difference between actual length and electric measurement value with a size 10 and 40 files in enlarged canal was recorded as L10 and L40. The one-way ANOVA and Scheffe's multiple range tests were computed for analyze the differences among the four apex locators in the same group. The Student's t-test between L10 and L40 of each locator was done. The accuracies of electronic measurements were significantly different among the 4 devices. The file size made no difference on the accuracy of electronic measurement in enlarged canal with same device. The e-Magic Finder was the most accurate device among the 4 apex locators used in this study.
Dental Pulp Cavity ; Tooth

PURPOSE: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. METHODS: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. RESULTS: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). CONCLUSION: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.
Analgesics, Opioid ; Humans ; Inpatients ; Korea ; Pain Measurement ; Sleep Stages ; Terminally Ill

Omental cyst is a rare disease and its accurate time and cause of outbreak has not been reported. This disease is known as can be afflicted with postnatally and in case of being afflicted with pre-natally the abdominal cavity and thoracic organ of fetus are oppressed due to fetal abdominal distention leading to fetal death caused by organ dysgenesis. No medical report has yet been published on congenital omental cyst of fetus. This study was conducted on a case of congenital omental cyst of fetus we have experienced in a mother with 16weeks of gestational period and the result is hereby reported along with literally documents.
Abdominal Cavity ; Fetal Death ; Fetus ; Humans ; Mothers ; Rare Diseases

Recent studies have demonstrated that tumor necrosis factor-alpa(TNF-alpa) decreased production of type I and III procollagens and increased production of collagenase in cultured human dermal fibroblasts. The purpose of this study was to examine the effect of TNF-alpa on the level of expression of type I procollagen, collagenase mRNA in hypertrophic scar and keloid fibroblasts in culture. The cultured fibroblasts from normal skin, hypertrophic scar and keloid were exposed to 0, 1, 10, and 100 ng/ml of TNF-alpa for 24 hours. Then, type I procollagen mRNA and collagenase mRNA were measured by quantitative RT-PCR and quantified by computerized densitometry(TINA). In normal skin fibroblasts, TNF-alpa significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa and maximal enhancement for collagenase mRNA was noted at 100ng/ml of TNF-alpa. In hypertrophic scar fibroblasts, TNF-alpa significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa which was the same as normal skin fibroblasts but there were no significant differences among TNF-alpa treated groups for collagenase mRNA. In keloid fibroblasts, TNF-alpa also significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa which was the same as normal skin and hypertrophic scar fibroblasts but there were no significant differences among TNF-alpa treated groups for collagenase mRNA. These results strongly suggested that TNF-alpa might have a role in preventing progression of fibroproliferative disease, such as hypertrophic scar or keloid, and that the most effective concentration of TNF-alpa was found in 100 ng/ml.
Cicatrix, Hypertrophic* ; Collagen Type I* ; Collagenases* ; Fibroblasts* ; Gene Expression* ; Humans ; Keloid* ; Necrosis* ; Procollagen ; RNA, Messenger ; Skin

BACKGROUND: Serum cystatin C has been suggested to be a better marker for GFR than creatinine because believed to be produced at a constant rate by most nucleated cells, and eliminated exclusively by glomerular filtration We compared serum cystatin C with creatinine-based estimates, especially in patients with old age or extreme protein composition to investigate the utility of cystatin C and to identify factors that influence on cystatin C other than renal function. METHODS: A total of 446 patients, admitted to department of nephrology of Korea University Anam Hospital From September 2003 to March 2004, had their glomerular filtration rate (GFR) estimated by DTPA scintigraphy, clearance of creatinine, and calculated from Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) formula. A body composition, the serum creatinine and cystatin C levels were also measured. RESULTS: Serum cystatin C showed similar correlation with DTPA GFR to serum creatinine. The formula, GFR (mL/min/1.73m2) = 61.84 x cystatin C(-0.8135), was derived with better precision than either Cockcroft-Gault or MDRD. The diagnostic accuracy of cystatin C was not better than creatinine in older patients as well as those with overweight, or an extreme protein composition. The addition of age, body surface area, and gender increased the R2 for both serum creatinine and cystatin C. CONCLUSION: Serum cystatin C is a good marker for GFR, but not superior to serum creatinine even in patients with old age, overweight, or an extreme protein composition, and affected by age, body surface area, and gender independent on renal function.
Body Composition ; Body Surface Area ; Creatinine ; Cystatin C* ; Diet ; Filtration ; Glomerular Filtration Rate* ; Humans ; Korea ; Nephrology ; Overweight ; Pentetic Acid ; Radionuclide Imaging

The bronchogenic cyst is an uncommon benign congenital anomaly of the primitive ventral foregut. They usually occur in the mediastinum and intrapulmonary regions. Localization in the cervical area is unusual and the majority of cases reported have been found in the pediatric population. Radiologically, it can not be differentiated from other cystic lesions. Therefore, it is pa-thologically confirmed only when there are bronchial tissues such as pseudostratified ciliated columnar epithelium, smooth muscle, mucous gland or cartilage. Since this cyst has potential for complication, a complete excision is mandatory. We recently experienced a case of retropharyngeal bronchogenic cyst presenting as a lump sensation in 32-year-old male. In this article, we reviewed the etiology, the diagnosis, and the treatment of this case with a review of the literatures.
Bronchial Neoplasms ; Bronchogenic Cyst ; Cartilage ; Epithelium ; Humans ; Male ; Mediastinum ; Muscle, Smooth ; Oropharyngeal Neoplasms ; Sensation

Purpose: The present study aimed to develop guidelines regarding initial choice of antibiotics for diabetic foot ulcers (DFU) by investigating bacterial isolates. Materials and Methods: This study included 223 DFU patients that visited a single tertiary hospital and underwent bacterial culture between January 2016 and February 2020. The study was conducted in two parts: 1) to compare bacterial isolates and wound healing according to comorbidities such as chronic kidney disease (CKD) and peripheral artery disease (PAD), and 2) to compare bacterial isolates according to wound depth using the Wagner classification. Results: Of the 223 patients, 43 had CKD (group A), 56 had PAD (group B), 30 had CKD and PAD (group C), and 94 had none of these comorbidities (group D). The isolation rate for multidrug-resistant gram-negative bacteria (MRGNB) and gram-negative to grampositive bacteria ratio were highest in group C (p=0.018, p=0.038), and the proportion that achieved wound healing was lowest in group C (p<0.001). In the second part of the study, subjects were classified into 5 grades by wound depth using the Wagner classification; 13 grade I, 62 grade II, 60 grade III, 70 grade IV, and 17 grade V. No significant difference was observed between these grades in terms of isolation rates or gram-negative to gram-positive bacteria ratios. Conclusion This study suggests antibiotics that cover gram-negative bacteria including MRGNB produces better results in the presence of CKD and PAD and that initial antibiotic choice should be based on the presence of CKD and PAD rather than wound depth.

Purpose: The present study aimed to develop guidelines regarding initial choice of antibiotics for diabetic foot ulcers (DFU) by investigating bacterial isolates. Materials and Methods: This study included 223 DFU patients that visited a single tertiary hospital and underwent bacterial culture between January 2016 and February 2020. The study was conducted in two parts: 1) to compare bacterial isolates and wound healing according to comorbidities such as chronic kidney disease (CKD) and peripheral artery disease (PAD), and 2) to compare bacterial isolates according to wound depth using the Wagner classification. Results: Of the 223 patients, 43 had CKD (group A), 56 had PAD (group B), 30 had CKD and PAD (group C), and 94 had none of these comorbidities (group D). The isolation rate for multidrug-resistant gram-negative bacteria (MRGNB) and gram-negative to grampositive bacteria ratio were highest in group C (p=0.018, p=0.038), and the proportion that achieved wound healing was lowest in group C (p<0.001). In the second part of the study, subjects were classified into 5 grades by wound depth using the Wagner classification; 13 grade I, 62 grade II, 60 grade III, 70 grade IV, and 17 grade V. No significant difference was observed between these grades in terms of isolation rates or gram-negative to gram-positive bacteria ratios. Conclusion This study suggests antibiotics that cover gram-negative bacteria including MRGNB produces better results in the presence of CKD and PAD and that initial antibiotic choice should be based on the presence of CKD and PAD rather than wound depth.