Background: Maintenance of stable blood pressure (BP) during cerebrovascular bypass surgery is crucial to prevent cerebral ischemia. We compared the effect of remimazolam anesthesia with that of propofol-induced and desflurane-maintained anesthesia on intraoperative hemodynamic stability and the need for vasoactive agents in patients undergoing cerebrovascular bypass surgery. Methods: Sixty-five patients were randomized into remimazolam (n = 31, remimazolam-based intravenous anesthesia) and control groups (n = 34, propofol-induced and desflurane-maintained anesthesia). The primary outcome was the occurrence of intraoperative hypotension. The secondary outcomes included hypotension duration, lowest mean BP (MBP), generalized average real variability (ARV) of MBP, and consumption of phenylephrine, norepinephrine, or remifentanil. Results: Occurrence rate and duration of hypotension were significantly lower in the remimazolam group (38.7% vs. 73.5%, P = 0.005; 0 [0, 10] vs. 7.5 [1.25, 25] min, P = 0.008). Remimazolam also showed better outcomes for lowest MBP (78 [73, 84] vs. 69.5 [66.25, 75.8] mmHg, P < 0.001) and generalized ARV of MBP (1.42 ± 0.49 vs. 1.66 ± 0.52 mmHg/min, P = 0.036). The remimazolam group required less phenylephrine (20 [0, 65] vs. 100 [60, 130] μg, P < 0.001), less norepinephrine (162 [0, 365.5] vs. 1335 [998.5, 1637.5] μg, P < 0.001), and more remifentanil (1750 [1454.5, 2184.5] vs. 531 [431, 746.5] μg, P < 0.001) than the control group. Conclusions Remimazolam anesthesia may provide better hemodynamic stability during cerebrovascular bypass surgery than propofol-induced and desflurane-maintained anesthesia.

Background: Maintenance of stable blood pressure (BP) during cerebrovascular bypass surgery is crucial to prevent cerebral ischemia. We compared the effect of remimazolam anesthesia with that of propofol-induced and desflurane-maintained anesthesia on intraoperative hemodynamic stability and the need for vasoactive agents in patients undergoing cerebrovascular bypass surgery. Methods: Sixty-five patients were randomized into remimazolam (n = 31, remimazolam-based intravenous anesthesia) and control groups (n = 34, propofol-induced and desflurane-maintained anesthesia). The primary outcome was the occurrence of intraoperative hypotension. The secondary outcomes included hypotension duration, lowest mean BP (MBP), generalized average real variability (ARV) of MBP, and consumption of phenylephrine, norepinephrine, or remifentanil. Results: Occurrence rate and duration of hypotension were significantly lower in the remimazolam group (38.7% vs. 73.5%, P = 0.005; 0 [0, 10] vs. 7.5 [1.25, 25] min, P = 0.008). Remimazolam also showed better outcomes for lowest MBP (78 [73, 84] vs. 69.5 [66.25, 75.8] mmHg, P < 0.001) and generalized ARV of MBP (1.42 ± 0.49 vs. 1.66 ± 0.52 mmHg/min, P = 0.036). The remimazolam group required less phenylephrine (20 [0, 65] vs. 100 [60, 130] μg, P < 0.001), less norepinephrine (162 [0, 365.5] vs. 1335 [998.5, 1637.5] μg, P < 0.001), and more remifentanil (1750 [1454.5, 2184.5] vs. 531 [431, 746.5] μg, P < 0.001) than the control group. Conclusions Remimazolam anesthesia may provide better hemodynamic stability during cerebrovascular bypass surgery than propofol-induced and desflurane-maintained anesthesia.

Background: Maintenance of stable blood pressure (BP) during cerebrovascular bypass surgery is crucial to prevent cerebral ischemia. We compared the effect of remimazolam anesthesia with that of propofol-induced and desflurane-maintained anesthesia on intraoperative hemodynamic stability and the need for vasoactive agents in patients undergoing cerebrovascular bypass surgery. Methods: Sixty-five patients were randomized into remimazolam (n = 31, remimazolam-based intravenous anesthesia) and control groups (n = 34, propofol-induced and desflurane-maintained anesthesia). The primary outcome was the occurrence of intraoperative hypotension. The secondary outcomes included hypotension duration, lowest mean BP (MBP), generalized average real variability (ARV) of MBP, and consumption of phenylephrine, norepinephrine, or remifentanil. Results: Occurrence rate and duration of hypotension were significantly lower in the remimazolam group (38.7% vs. 73.5%, P = 0.005; 0 [0, 10] vs. 7.5 [1.25, 25] min, P = 0.008). Remimazolam also showed better outcomes for lowest MBP (78 [73, 84] vs. 69.5 [66.25, 75.8] mmHg, P < 0.001) and generalized ARV of MBP (1.42 ± 0.49 vs. 1.66 ± 0.52 mmHg/min, P = 0.036). The remimazolam group required less phenylephrine (20 [0, 65] vs. 100 [60, 130] μg, P < 0.001), less norepinephrine (162 [0, 365.5] vs. 1335 [998.5, 1637.5] μg, P < 0.001), and more remifentanil (1750 [1454.5, 2184.5] vs. 531 [431, 746.5] μg, P < 0.001) than the control group. Conclusions Remimazolam anesthesia may provide better hemodynamic stability during cerebrovascular bypass surgery than propofol-induced and desflurane-maintained anesthesia.

Background: Maintenance of stable blood pressure (BP) during cerebrovascular bypass surgery is crucial to prevent cerebral ischemia. We compared the effect of remimazolam anesthesia with that of propofol-induced and desflurane-maintained anesthesia on intraoperative hemodynamic stability and the need for vasoactive agents in patients undergoing cerebrovascular bypass surgery. Methods: Sixty-five patients were randomized into remimazolam (n = 31, remimazolam-based intravenous anesthesia) and control groups (n = 34, propofol-induced and desflurane-maintained anesthesia). The primary outcome was the occurrence of intraoperative hypotension. The secondary outcomes included hypotension duration, lowest mean BP (MBP), generalized average real variability (ARV) of MBP, and consumption of phenylephrine, norepinephrine, or remifentanil. Results: Occurrence rate and duration of hypotension were significantly lower in the remimazolam group (38.7% vs. 73.5%, P = 0.005; 0 [0, 10] vs. 7.5 [1.25, 25] min, P = 0.008). Remimazolam also showed better outcomes for lowest MBP (78 [73, 84] vs. 69.5 [66.25, 75.8] mmHg, P < 0.001) and generalized ARV of MBP (1.42 ± 0.49 vs. 1.66 ± 0.52 mmHg/min, P = 0.036). The remimazolam group required less phenylephrine (20 [0, 65] vs. 100 [60, 130] μg, P < 0.001), less norepinephrine (162 [0, 365.5] vs. 1335 [998.5, 1637.5] μg, P < 0.001), and more remifentanil (1750 [1454.5, 2184.5] vs. 531 [431, 746.5] μg, P < 0.001) than the control group. Conclusions Remimazolam anesthesia may provide better hemodynamic stability during cerebrovascular bypass surgery than propofol-induced and desflurane-maintained anesthesia.

Bovine viral diarrhea virus (BVDV) is an RNA virus belonging to Pestivirus in the family Flaviviridae. BVDV has economic significance for the livestock industry because of its association with acute disease, fetal loss, and birth of persistently infected (PI) animals. This study aimed to investigate the BVDV infection rates in Korean native cattle farms in Jeju for further planning of a BVDV control program in the Jeju Province. BVDV antibodies and antigens were tested in 15,842 sera collected from 302 Korean native cattle herds between January 2014 and June 2017 using enzyme-linked immunosorbent assay (ELISA). Viral antigen was detected by reverse transcription-polymerase chain reaction from 60 sera that were antigen ELISA-positive. BVDV antibodies were found in 90.7% (274/302) herds and 61.1% (9,678/15,842) cows. BVDV antigens were found in 13.2% (40/302) herds and 0.4% (61/15,842) cows. The oldest animal group (> 8 years) exhibited the highest sero-positive rates (91%), while the youngest animal group (< 1 years) had the highest antigen positivity rates (0.52%). Of the 60 antigen-positive sera, BVDV types 1 and 2 were found in 36 and 12 sera, respectively. Additionally, six animals were considered to be PI as BVDV was continually detected in annual examination.

This study was performed to evaluate the effects of microstructural change of zirconia surface on tensile bond strength with resin cement. The zirconia partially sintered block was cut into a size of 18 × 18 × 7 mm, and then the Zirface slurry (DMAX, Daegu, Korea) containing 15% and 30% zirconia was applied and followed by sintering at 1530 ℃ for 2 hours. Resin cement (PermaCem 2.0, DMG, Hamburg, Germany) was applied on zirconia specimen and polymerized to prepare an 18 × 18 × 14 mm block. In addition, for comparison of bond strength, specimens were prepared for the group that was polished and the group that was blasted at 3 atm using 110 µm alumina. Thereafter, all blocks were cut into a cross-sectional area of 1.0 × 1.0 mm to prepare 12 specimens. The specimens were immersed in distilled water at 37 ℃. for 10 days for aging treatment. A holder for tensile testing was attached to each of the specimens, and then a tensile force was applied at a crosshead speed of 0.5 mm/min to measure the fracture load. The fracture surfaces of each test piece was observed with a high-resolution field emission scanning electron microscope. Through the above tests, the following results were obtained. 1. On the blasted surface, zirconia grains were locally removed but on the Zirface treated surface, a porous microstructure was created on the zirconia surface. 2. Arithmetical mean deviation from the mean line ra was the highest in the blasted group and the lowest in the polished group, and as a result of Tukey analysis, there were statistically significant differences between all test groups (P<0.05). 3. The maximum tensile bond strength was 18.8±5.4 MPa in the Zirface 30% group, and as a result of Tukey analysis, there was a statistically significant difference from the other test groups (P<0.05). 4. As a result of observing the fracture surface after the tensile test with a high-resolution field emission scanning electron microscope, in the Zirface 30% group, cohesive fracture and interfacial fracture in the resin was observed, but the other test groups showed the interfacial fracture pattern. In conclusion, within the limits of this study, treating the zirconia surface with Zirface 30% to form a porous microstructure can contribute to the improvement of the bond strength between zirconia and resin cement.

Background: Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR). Methods: In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment. Results: In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. –10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017). Conclusion Simultaneous PR improved pulmonary function, particularly in measures of FEV1, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR’s effects during thoracic radiotherapy.

This study was performed to evaluate the effects of microstructural change of zirconia surface on tensile bond strength with resin cement. The zirconia partially sintered block was cut into a size of 18 × 18 × 7 mm, and then the Zirface slurry (DMAX, Daegu, Korea) containing 15% and 30% zirconia was applied and followed by sintering at 1530 ℃ for 2 hours. Resin cement (PermaCem 2.0, DMG, Hamburg, Germany) was applied on zirconia specimen and polymerized to prepare an 18 × 18 × 14 mm block. In addition, for comparison of bond strength, specimens were prepared for the group that was polished and the group that was blasted at 3 atm using 110 µm alumina. Thereafter, all blocks were cut into a cross-sectional area of 1.0 × 1.0 mm to prepare 12 specimens. The specimens were immersed in distilled water at 37 ℃. for 10 days for aging treatment. A holder for tensile testing was attached to each of the specimens, and then a tensile force was applied at a crosshead speed of 0.5 mm/min to measure the fracture load. The fracture surfaces of each test piece was observed with a high-resolution field emission scanning electron microscope. Through the above tests, the following results were obtained. 1. On the blasted surface, zirconia grains were locally removed but on the Zirface treated surface, a porous microstructure was created on the zirconia surface. 2. Arithmetical mean deviation from the mean line ra was the highest in the blasted group and the lowest in the polished group, and as a result of Tukey analysis, there were statistically significant differences between all test groups (P<0.05). 3. The maximum tensile bond strength was 18.8±5.4 MPa in the Zirface 30% group, and as a result of Tukey analysis, there was a statistically significant difference from the other test groups (P<0.05). 4. As a result of observing the fracture surface after the tensile test with a high-resolution field emission scanning electron microscope, in the Zirface 30% group, cohesive fracture and interfacial fracture in the resin was observed, but the other test groups showed the interfacial fracture pattern. In conclusion, within the limits of this study, treating the zirconia surface with Zirface 30% to form a porous microstructure can contribute to the improvement of the bond strength between zirconia and resin cement.

BACKGROUND AND OBJECTIVES: Mucin is an important component of mucus that performs the first line of defense against inhaled pathogens and particles, lubrication of organs, and protection of airway. It is hyper-secreted in inflammatory airway diseases and is associated with morbidity and mortality of the affected patients. Resolvin, an autacoid of a specific lipid structure, exhibits anti-inflammatory property against inflammatory airway diseases although its effects on mucin secretion by human airway epithelial cells have not yet been demonstrated. In this regard, we investigated the effects of Resolvin on lipopolysaccharide (LPS)-induced mucin expression in human airway epithelial cells. MATERIALS AND METHOD: In mucin-producing human NCI-H292 epithelial cells, the effects and brief signaling pathways of Resolvin D1 (RvD1) and Resolvin E1 (RvE1) on the LPS-induced MUC4, MUC5AC, and MUC5B expression were investigated using reverse transcription-polymerase chain reaction, enzyme-linked immunosorbent assay and Western blot analysis. RESULTS: RvD1 attenuated LPS-induced MUC4, MUC5AC, and MUC5B mRNA expression and protein production in human NCI-H292 cells while RvE1 did not. RvD1 significantly blocked LPS-induced activated phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) mitogen-activated protein kinase (MAPK) and p38 MAPK and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) while RvE1 did not. CONCLUSION: These results suggest that RvD1 attenuates LPS-induced MUC4, MUC5AC, and MUC5B expressions via ERK1/2 MAPK, p38 MAPK, and NF-κB signaling pathways in airway epithelial cells. Therefore, RvD1 may modulate the control of mucus-hypersecretion in inflammatory airway diseases.
B-Lymphocytes ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Humans* ; Lubrication ; Methods ; Mortality ; Mucins* ; Mucus ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; RNA, Messenger

BACKGROUND: Salmonella is an important pathogen that causes gastroenteritis and sepsis in humans. Recently, changes in serotype prevalence and an increase in antimicrobial resistance have been reported. This study investigated the distribution of Salmonella serotypes and determined the antimicrobial susceptibility of various strains. METHODS: We collected 113 Salmonella isolates other than Salmonella serotype Typhi from 18 university hospitals in 2015. The serotypes were identified by Salmonella antisera O and H according to the Kauffman White scheme. Antimicrobial susceptibility tests for 12 antibiotics were performed using the disk diffusion method or E-test. RESULTS: We identified 22 serotypes. Serotype group B (44.2%) was the most common, followed by groups C (34.5%) and D (21.2%). Salmonella I 4,[5],12:i:- (23.0%), S. Enteritidis (16.8%), and S. Typhimurium (12.4%) were the most common species. Resistance rates for ampicillin, chloramphenicol, ceftriaxone, and trimethoprim/sulfamethoxazole were 46.9%, 18.5%, 8.8%, and 5.3%, respectively. The intermediate resistance rate to ciprofloxacin was 29.2%. Six isolates were extended-spectrum β-lactamase (ESBL) producers, including 5 bla(CTX-M-15) and 1 bla(CTX-M-55). CONCLUSION: There have been changes in the serotype prevalence and antimicrobial resistance of Salmonella in Korea, with a high prevalence of CTX-M 15-positive strains. Continuous monitoring of Salmonella serotypes and antimicrobial resistance is warranted.
Ampicillin ; Anti-Bacterial Agents ; Ceftriaxone ; Chloramphenicol ; Ciprofloxacin ; Diffusion ; Gastroenteritis ; Hospitals, University ; Humans ; Immune Sera ; Korea ; Methods ; Prevalence ; Salmonella ; Sepsis ; Serogroup ; Serotyping