Objective: The optimum chest compression point during cardiopulmonary resuscitation (CPR) associated with a good neurological outcome is unestablished. We aimed to suggest the association between the point and a simple index measured on anteroposterior chest radiography (chest_AP). Methods: This retrospective, cross-sectional study included all adults with available chest_AP who arrived at a university hospital from January 2014 to June 2019 for non-traumatic out-of-hospital cardiac arrest (OHCA). Distances from the vertical midsternum to the farthest right and left cardiac borders were defined as RB and LB, respectively. Their sum provided cardiac diameter (CD). Assuming the universality of cardiac anatomy, the cardiac structure immediately beneath the midsternum was compressed most forcefully during CPR. The influencing outcome of CPR was determined using the RB:CD ratio. We investigated the association of RB:CD ratio with a good neurological outcome at discharge using multiple logistic regression analysis, adjusting for the core Utstein elements and comorbidities. Results: Among 429 patients (63.2±14.5 years; 121 [28.2%] female), return of spontaneous circulation, survival-to-discharge and good neurological outcome at discharge were achieved in 259 (60.4%), 121 (28.2%) and 84 (19.6%) cases, respectively. The RB:CD ratio (0.279±0.072) was divided into semi-tertiles to enhance clinical usage: <0.25 (n=149, reference), 0.25-0.30 (n=119) and >0.30 (n=161). The second group was associated with good neurological outcome (odds ratio, 6.00 [95% confidence interval, 1.58-22.8], P=0.010). Conclusion An RB:CD ratio of 0.25-0.30 measured on chest_AP is associated with good neurological outcomes in OHCA victims receiving CPR.

Tuberculosis (TB) is the second leading infectious cause of mortality worldwide with about two million deaths per year. The only licensed TB vaccine, Mycobacterium bovis bacillus Calmette-Guerin (BCG) shows limited protection efficacy suggesting an improved vaccination strategy is required. Recently, several TB vaccine candidates have entered clinical trials. These vaccine candidates are live mycobacterial vaccines designed to replace BCG or subunit vaccines designed to boost immunity induced by BCG. Vaccines with different strategy such as therapeutic vaccines, which can also be used in combination with drug therapy, are in the early stages of development to resolve latent TB or reactivation from the latent state. In this review, we discuss about development of BCG and BCG-based vaccines and further studies necessary for novel TB vaccine development to sterilize tuberculosis.
Bacillus* ; Drug Therapy ; Mortality ; Mycobacterium bovis* ; Mycobacterium tuberculosis ; Tuberculosis* ; Vaccination ; Vaccines* ; Vaccines, Subunit

Swine hepatitis E virus (HEV) is widespread throughout pigs in both developing and industrialized countries. This virus is an important zoonotic agent and a public concern worldwide. Infected pigs are asymptomatic, so diagnosing swine HEV relies on detection of the virus or antibodies against the virus. However, several obstacles need to be overcome for effective and practical serological diagnosis. In this study, we developed an enzyme-linked immunosorbent assay (ELISA) that used a purified recombinant capsid protein of swine HEV. The potential clinical use of this assay was evaluated by comparing it with a commercial kit (Genelabs Technologies, Diagnostics, Singapore). Results of the ELISA were highly correlated with those of the commercial kit with a sensitivity of 97% and specificity of 95%. ROC (receiving operator characteristic) analysis of the ELISA data produced a value of 0.987 (95% CI, 0.977~0.998, p < 0.01). The cut-off value for the ELISA was also determined using negative pig sera. In summary, the HEV-specific ELISA developed in the present study appears to be both practical and economical.
Animals ; Antibodies, Anti-Idiotypic/*analysis/blood/genetics ; Capsid Proteins/*genetics/metabolism ; Enzyme-Linked Immunosorbent Assay/*methods/veterinary ; Hepatitis E/diagnosis/immunology/*veterinary/virology ; Hepatitis E virus/genetics/*isolation & purification/metabolism ; Immunoglobulin G/blood/genetics ; ROC Curve ; Recombinant Proteins/genetics/metabolism ; Swine ; Swine Diseases/*diagnosis/immunology/virology

No abstract available.
Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Interferons ; Polyneuropathies ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

A solitary fibrous tumor (SFT) is now commonly accepted to derive from mesenchymal cells differentiating toward fibroblast or myofibroblast. Although the extrapleural manifestations of SFT have been documented in almost all sites, an SFT arising in the genitourinary tract is extremely rare, with less than 10 cases having been reported. The histopathological criteria between a benign and a malignant SFT are obscure, and their biological behaviors remain controversial. The choice of treatment of an SFT remains to be clarifies. Herein, a case of a bladder SFT, well encased within the submucosa and bladder muscle, is reported. The SFT of bladder was completely excised, and there was no evidence of recurrence after 15 months of follow-up.
Fibroblasts ; Follow-Up Studies ; Mesoderm ; Myofibroblasts ; Recurrence ; Solitary Fibrous Tumors* ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: To investigate the characteristic features of B cells in murine cervical lymph node. Animal experiment. SUBJECTS AND METHOD: We obtained cervical lymph node of mice. Isolated B cells were cultured in media after the addition of several stimuli. The expression of various surface molecules to characterize lymphoid B cells were analysed by flow cytometry. Immunoglobulin secreted into the culture supernatants was evaluated by enzyme-linked immunosorbent assay. B220+ cells cultured for 5 days with media alone, or LPS. Entering into S phase in response to stimuli was measured by proliferative assay. RESULTS: Identifying phenotypic characteristics for B cells of lymph node include CD5low, CD23high, CD43low, B220high, Ig (sIg)Mlow, sIgDhigh, CD80 (B7.1)low, CD86 (B7.2)low, and Syndecam-1low. Spontaneous Immunoglobulin production did not occur in lymphoid B cells. When stimulation, IgM secretion was increased more than that of IgA and IgG. Lipopolysaccharide is a most powerful stimulus which secreted immunoglobulin. In thymidine incorporation, B cells were entered actively S phase after 48hours stimulation. CD40 plus anti-CD8 stimulated B cells to produce substantial thymidine incorporation that was much greater than those of other stimuli. CONCLUSION: The B cells in cervical lymph node are conventional B cells (B2). Lymph node B cells secreted mainly IgM at stimuli and cell proliferation was activated at 48 hours of stimulation.
Animal Experimentation ; Animals ; B-Lymphocytes* ; Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lymph Nodes* ; Mice ; S Phase ; Thymidine

Background: Psoriasis is a chronic T17 cell-driven immune-mediated inflammatory disease. However, patients with psoriasis may have elevated total serum immunoglobulin E (IgE) levels, which is a hallmark of Th2 inflammation.In previous case reports, psoriasis patients with elevated total serum IgE levels did not respond well to treatment or had exacerbated eczema lesions. Objective: We sought to investigate the clinical characteristics of psoriasis patients with elevated total serum IgE levels. Methods: This is a retrospective chart review of 130 patients with psoriasis who were tested for total serum IgE levels from November 1, 2009, to October 31, 2019. We compared the demographics, clinical characteristics, disease severity, and treatment regimen for each elevated IgE group (＞214 U/mL) and normal IgE group (≤214 U/mL). Results: Among 130 patients with psoriasis, 41 (31.5%) had elevated total serum IgE levels. Elevated total serum IgE levels were positively associated with the severity of disease; psoriasis lesions including those on the scalp, hands, feet, and flexures, which are difficult to treat, were observed to be significantly higher in patients with elevated total serum IgE levels. There was no correlation between age, sex, disease duration, or presence of pruritus and total serum IgE levels. Conclusion This study identified the clinical characteristics of psoriasis patients with elevated total serum IgE levels in Korea.

PURPOSE: The pulsatility index (PI), measured by transcranial Doppler (TCD), is a surrogate marker for distal vascular resistance in cerebral arteries, and elevated plasma total homocysteine (tHcyt) is regarded as a cause of ischemic stroke, including lacunar infarction. We investigated the relationship between the PI of cerebral arteries and plasma tHcyt in patients with lacunar infarction. MATERIALS AND METHODS: Plasma tHcyt level and TCD examination were performed in 94 patients with lacunar infarction. Mean flow velocity (MFV) and PI were assessed at the ipsilateral middle cerebral artery (MCA) and contralateral MCA, relative to the infarction, and the basilar artery (BA). Multivariate regression analysis was conducted between log-transformed tHcyt levels (logHcyt) and the PI of individual arteries. RESULTS: There was a significant correlation between logHcyt and the PI in all tested arteries (ipsilateral MCA: r=0.21, p=0.03; contralateral MCA: r=0.21, p=0.04; BA: r=0.35, p=0.01). In multivariate regression analysis, this significance remained unchanged after adjusting for vascular risk factors, creatinine, hematocrit and platelet count (ipsilateral MCA: beta=0.26, p=0.01; contralateral MCA: beta=0.21, p=0.04; BA: beta=0.39, p=0.001). There was no significant association between logHcyt and MFV of individual arteries. CONCLUSION: A significant association between plasma tHcyt and the PI of cerebral arteries indicates that homocysteine plays a role in the increase of distal arterial resistance in lacunar infarction.
Aged ; Basilar Artery/ultrasonography ; Cerebral Arteries/physiopathology/*ultrasonography ; Female ; Hematocrit ; Homocysteine/*blood ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery/ultrasonography ; Regression Analysis ; Risk Factors ; Stroke, Lacunar/*blood/physiopathology/ultrasonography ; Ultrasonography, Doppler, Transcranial ; Vascular Resistance

BACKGROUND: An alpha2-adrenergic receptor (alpha2-AR, ADRA2) mediates induction of hypotension and inhibition of lipolysis and insulin secretion. We evaluated whether single nucleotide polymorphisms (SNPs) of alpha2A (ADRA2A), alpha2B (ADRA2B), and alpha2C (ADRA2C) adrenergic receptors are associated with cerebral white matter lesion (cWML). METHODS: Total 336 study subjects who had no stroke were enrolled in this study. The Indices of cWML include total WML (TWML), periventricular WML (PVWML), and subcortical WML (SCWML) on brain fluid-attenuated inversion recovery (FLAIR) image. Common genetic variants of ADRA2A (1780G>A), ADRA2B (Ins/Del301-303), and ADRA2C (Ins/Del322-325) were examined. RESULTS: Among 336 study subjects, cWML was found in 66 patients (20%). In multivariate analysis, there were no significant effects of all tested ADRA2 polymorphisms on TWML. Significant association of ADRA2A 1780 AA genotype was found in PVWML (OR: 3.368, 95% CIs: 1.280-8.865, adjusted p-value after false discovery rate (FDR) correction=0.014) but not SCWML. CONCLUSION: Although SNPs of three ADRA2 subtypes failed to reach a significance in overall risk for cWML, the ADRA2A 1780G>A polymorphism may be associated with development of PVWML.
Brain ; Genotype ; Humans ; Hypotension ; Insulin ; Lipolysis ; Multivariate Analysis ; Polymorphism, Single Nucleotide ; Receptors, Adrenergic ; Stroke

Germanium biotite, a natural mineral, has been used as a feed supplement to reinforce innate immune ability. The aim of the present study was to evaluate the effects of germanium biotite on the adsorptive and inhibition of growth abilities against Escherichia (E.) coli and Salmonella spp. in vitro. Two strains of enterotoxigenic E. coli and four strains of two Salmonella serotypes (Salmonella Derby and Salmonella Typhimurium), major bacterial diarrheal pathogens, were used for this experiment. The absorptive ability of germanium biotite against most Salmonella used in present experiment was observed weakly. The germanium biotite, however, showed significant effect of bacterial growth inhibition in most experiment bacteria. These results suggest that the use of the germanium biotite as feed supplement could alleviate diarrhea following inhibition of bacteria growth. It is also presumed that antibiotics usage for farm animals, considered as causes of antibiotic residue in meat and emerging antibiotic resistance, could be reduced through the use of germanium biotite as a feed supplement, in place of antibiotics used for the prevention of diarrhea.
Aluminum Silicates ; Animals, Domestic ; Anti-Bacterial Agents ; Bacteria ; Diarrhea ; Drug Resistance, Microbial ; Enterotoxigenic Escherichia coli ; Escherichia ; Ferrous Compounds ; Germanium ; Hypogonadism ; Meat ; Mitochondrial Diseases ; Ophthalmoplegia ; Salmonella