No abstract available.
Arthritis* ; Dermatitis* ; Humans ; Neutrophils*

BACKGROUND: Sevoflurane is an inhalational anesthetic that produces rapid induction, emergence and little cardiovascular depression. Elevated sympathetic activity during surgery produces undesirable effects on the cardiovascular system, such as hypertension, tachycardia or arrhythmias. So combined general and epidural anesthesia have been used recently for the operation, especially the abdominal surgery. This study was performed to evaluate the cardiovascular effects of thoracic epidural anesthesia during sevoflurane general anesthesia. METHODS: Forty patients of ASA class 1-2 undergoing elective subtotal gastrectomy were divided into 5 groups. Thoracic epidural bolus injection was administered via an epidural catheter during sevoflurane general anesthesia in a double-blind random manner: Group 1; normal saline (N/S) 10 ml (placebo), Group 2; morphine 0.1 mg/kg mixed with N/S in 10 ml, Group 3; fentanyl 1 mcg/kg mixed with N/S in 10 ml, Group 4; 1% lidocaine 10 ml, and Group 5; 1% lidocaine 10 ml mixed with morphine 0.1 mg/kg and fentanyl 1 mcg/kg. Systolic and diastolic blood pressures, pulse rates, peripheral oxygen saturation levels (SpO2) and end-tidal carbon dioxide partial pressures (ETCO2) were measured every 5 minutes. RESULTS: Systolic and diastolic blood pressures were significantly reduced from 10 minutes after epidural bolus injection in groups 4 and 5, but these decreases in blood pressure were not severe enough to require treatment in either group. Pulse rates were significantly decreased from 10 minutes after injection in groups 3, 4, and 5, but these decreases in pulse rate were not so severe enough to require treatment in 3 groups. SpO2 and ETCO2 were stable, and arrhythmia was not observed. CONCLUSIONS: The thoracic epidural injection of 1% lidocaine mixed with morphine 0.1 mg/kg and fentanyl 1 mcg/kg can be safely used during sevoflurane anesthesia without severe cardiovascular complications during upper abdominal surgery in ASA 1-2 patients.
Anesthesia ; Anesthesia, Epidural ; Anesthesia, General* ; Arrhythmias, Cardiac ; Blood Pressure ; Carbon Dioxide ; Cardiovascular System ; Catheters ; Depression ; Fentanyl* ; Gastrectomy ; Heart Rate ; Humans ; Hypertension ; Injections, Epidural* ; Lidocaine* ; Morphine* ; Oxygen ; Partial Pressure ; Tachycardia

BACKGROUND: We investigated the effects of the common polymorphisms in the peroxisome proliferator- activated receptor gamma2 (PPAR-gamma2 Pro12Ala) and in PPAR-gamma coactivator 1alpha (PGC-1alpha Gly482Ser) genes on the association with the nephropathy of Korean patients with type 2 diabetes mellitus. METHODS: A total of 113 patients with type 2 diabetes and 123 patients with diabetic nephropathy were enrolled in this study. The Pro12Ala polymorphism of the PPAR-gamma2 gene and the Gly482Ser polymorphism in the PGC-1alpha gene were determined with the polymerase chain reaction amplification, BstU-I and Msp I enzyme digestion, and gel electrophoresis. RESULTS: The genotype and allelic frequency of PPAR-gamma2 Pro12Ala gene were not different statistically between the diabetic nephropathy and the control. The genotype of PGC-1alpha Gly482Ser in diabetic nephropathy was also not different from those in control. The allelic frequency and carriage rate of Ser allele in PGC-1alpha Gly482Ser were significantly higher in patients with diabetic nephropathy than those in control (respectively, p<0.05). CONCLUSION: The polymorphisms of the PGC-1alpha Gly482Ser gene are significantly associated with the nephropathy in Korean patients with type 2 diabetes mellitus.

BACKGROUND: We investigated the effects of the common polymorphisms in the peroxisome proliferator- activated receptor gamma2 (PPAR-gamma2 Pro12Ala) and in PPAR-gamma coactivator 1alpha (PGC-1alpha Gly482Ser) genes on the association with the nephropathy of Korean patients with type 2 diabetes mellitus. METHODS: A total of 113 patients with type 2 diabetes and 123 patients with diabetic nephropathy were enrolled in this study. The Pro12Ala polymorphism of the PPAR-gamma2 gene and the Gly482Ser polymorphism in the PGC-1alpha gene were determined with the polymerase chain reaction amplification, BstU-I and Msp I enzyme digestion, and gel electrophoresis. RESULTS: The genotype and allelic frequency of PPAR-gamma2 Pro12Ala gene were not different statistically between the diabetic nephropathy and the control. The genotype of PGC-1alpha Gly482Ser in diabetic nephropathy was also not different from those in control. The allelic frequency and carriage rate of Ser allele in PGC-1alpha Gly482Ser were significantly higher in patients with diabetic nephropathy than those in control (respectively, p<0.05). CONCLUSION: The polymorphisms of the PGC-1alpha Gly482Ser gene are significantly associated with the nephropathy in Korean patients with type 2 diabetes mellitus.

German cockroaches are major household allergens that can trigger allergic airway inflammatory diseases with sensitive T-cell responses. Although the use of immune modulatory biologics, such as antibodies, to mediate allergic responses has recently been examined, only systemic administration is available because of the size limitations on intranasal administration. Here we utilized a cell-permeable peptide, dNP2, to deliver the cytoplasmic domain of cytotoxic T-lymphocyte antigen-4 (ctCTLA-4) through the airway epithelium to modulate Th2 responses in a German cockroach extract (GCE)-induced allergic airway inflammation model. The intranasal delivery efficiency of the dNP2-dTomato protein to the lungs was higher in GCE-induced asthmatic lung parenchymal cells compared to the sham cells. Intranasal administration of the dNP2-ctCTLA-4 protein inhibited airway hyper-responsiveness and reduced airway inflammation and remodeling, including goblet cell metaplasia and collagen deposition around the bronchi. The number of infiltrated cells, including eosinophils, and the levels of IL-4, IL-5, IL-13 and IFN-γ in the lungs were significantly reduced, presumably owing to inhibition of Th2 differentiation. However, intranasal administration of CTLA4-Ig did not inhibit airway inflammation. These results collectively suggest that dNP2-ctCTLA-4 is an efficient intranasally applicable candidate biologic for treating allergic asthma.
Abatacept ; Administration, Intranasal ; Allergens ; Antibodies ; Asthma ; Biological Products ; Blattellidae* ; Bronchi ; Collagen ; Cytoplasm ; Eosinophils ; Epithelium ; Family Characteristics ; Goblet Cells ; Inflammation* ; Interleukin-13 ; Interleukin-4 ; Interleukin-5 ; Lung ; Metaplasia ; Respiratory Hypersensitivity ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic

Cell-penetrating peptides (CPPs) are short amino acids that have been widely used to deliver macromolecules such as proteins, peptides, DNA, or RNA, to control cellular behavior for therapeutic purposes. CPPs have been used to treat immunological diseases through the delivery of immune modulatory molecules in vivo. Their intracellular delivery efficiency is highly synergistic with the cellular characteristics of the dendritic cells (DCs), which actively uptake foreign antigens. DC-based vaccines are primarily generated by pulsing DCs ex vivo with various immunomodulatory antigens. CPP conjugation to antigens would increase DC uptake as well as antigen processing and presentation on both MHC class II and MHC class I molecules, leading to antigen specific CD4+ and CD8+ T cell responses. CPP-antigen based DC vaccination is considered a promising tool for cancer immunotherapy due to the enhanced CTL response. In this review, we discuss the various applications of CPPs in immune modulation and DC vaccination, and highlight the advantages and limitations of the current CPP-based DC vaccination.
Amino Acids ; Antigen Presentation ; Cell-Penetrating Peptides* ; Dendritic Cells ; DNA ; Immune System Diseases ; Immunotherapy ; Peptides ; RNA ; Vaccination* ; Vaccines

OBJECTIVES: We aimed to develop a common health information exchange (HIE) platform that can provide integrated services for implementing the HIE infrastructure in addition to guidelines for participating in an HIE network in South Korea. METHODS: By exploiting the Health Level 7 (HL7) Clinical Document Architecture (CDA) and Integrating the Healthcare Enterprise (IHE) Cross-enterprise Document Sharing-b (XDS.b) profile, we defined the architectural model, exchanging data items and their standardization, messaging standards, and privacy and security guidelines, for a secure, nationwide, interoperable HIE. We then developed a service-oriented common HIE platform to minimize the effort and difficulty of fulfilling the standard requirements for participating in the HIE network. The common platform supports open application program interfaces (APIs) for implementing a document registry, a document repository, a document consumer, and a master patient index. It could also be used for testing environments for the implementation of standard requirements. RESULTS: As the initial phase of implementing a nationwide HIE network in South Korea, we built a regional network for workers' compensation (WC) hospitals and their collaborating clinics to share referral and care record summaries to ensure the continuity of care for industrially injured workers, using the common HIE platform and verifying the feasibility of our technologies. CONCLUSIONS: We expect to expand the HIE network on a national scale with rapid support for implementing HL7 and IHE standards in South Korea.
Computer Security ; Computer Systems ; Continuity of Patient Care ; Delivery of Health Care ; Electronic Health Records ; Health Level Seven ; Humans ; Information Services* ; Korea ; Privacy ; Referral and Consultation ; Workers' Compensation

PURPOSE:Enhanced immunosuppression for preventing acute rejection, But infection is an inevitable complication. This study was performed to evaluate the risk factors of herpes simplex virus (HSV) and varicella zoster virus (VZV) infection which are frequent and serious complication of renal transplant recipients. METHOD:We evaluated the incidence and risk factors for post-transplant HSV and VZV infection in three hundred and twenty three adult renal transplant recipients. RESULTS:The averaged period of infection was 37.8 months and 42% of infection occurred within six month after transplantation. Prevalence of HSV and VZV infection in diabetes patients are higher than that of non-diabetes patients (p=0.01). The other factors such as age, sex, acute rejection and immunosuppressive regimens, antibody induction didnt affect HSV and VZV infections in renal transplant recipients. CONCLUSION:As diabetic condition suggested more susceptibility to HSV and VZV infections, it is necessary to evaluate the possible occurrence of HSV and VZV infections carefully in transplant recipients with diabetes.
Adult ; Chickenpox ; Herpes Simplex ; Herpesvirus 3, Human ; Humans ; Immunosuppression ; Incidence ; Kidney ; Kidney Transplantation ; Methylmethacrylates ; Polystyrenes ; Prevalence ; Rejection (Psychology) ; Risk Factors ; Simplexvirus ; Transplants

The purpose of this study was to obtain instructions for size selection of prefabricated crown and tooth reduction by 3-dimensional analysis of the size and shape of the maxillary primary central and lateral incisors and prefabricated crowns (celluloid strip, resin veneered stainless steel, and zirconia crowns).The maxillary primary central and lateral incisors of 300 Korean children was scanned with three types of prefabricated crown to create standard three-dimensional tooth models and prefabricated crowns. The shapes of the prefabricated crowns and natural teeth were compared according to four parameters (mesio-distal width, height, labio-palatal width, and labial surface curvature coefficient) and calculated the amount of tooth reduction required for each prefabricated crown.The size 2 resin veneered stainless steel crown, size 1 zirconia crown, and size 2 celluloid strip crown were most similar in shape to the primary central incisor. The size 3 rein veneered stainless steel crown, size 2 zirconia crown, and size 3 celluloid strip crown were most similar to the primary lateral incisor.The amount of tooth reduction was similar in both maxillary primary central and lateral incisors. The incisal reduction was greatest for the zirconia crown. At the proximal surface, the zirconia and celluloid strip crowns required a similar amount of tooth reduction, but more than the resin veneered stainless steel crown. The labial surface reduction was greatest for the zirconia crown. The degree of lingual surface reduction was not significant among the three prefabricated crowns.Among the assessment parameters, mesio-distal crown width was the most important for choosing a prefabricated crown closest to the actual size of the natural crown.
Child ; Crowns ; Humans ; Incisor ; Stainless Steel ; Tooth

A pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly presenting as dyspnea or recurrent epistaxis. Ebstein's anomaly (EA), a congenital cardiac malformation, is also a rare condition. There have been no reports concerning the co-existence of PAVM with hereditary hemorrhagic telangiectasia (HHT) and EA. A 40-year-old woman was admitted with a 2-month history of increasing dyspnea and several years of recurrent epistaxis. On transthoracic echocardiography, she was diagnosed with EA and agreed to undergo surgical treatment. A chest CT angiography showed a 12-mm serpiginous vascular structure suspicious for a PAVM and a liver CT suggested HTT. Although it is unclear whether or not a concurrent PAVM and EA have an embryologic or genetic relationship, we report a case of a PAVM with EA. Further genetic and embryonic studies are needed to identify a possible relationship of the two medical conditions.
Adult ; Angiography ; Arteriovenous Malformations ; Dyspnea ; Ebstein Anomaly ; Echocardiography ; Epistaxis ; Female ; Humans ; Liver ; Lung ; Telangiectasia, Hereditary Hemorrhagic ; Thorax