The diagnosis of Barrett's esophagus generally is based on the endoscopic examination. The findings include columnar epithelium lining the distal esophagus and the presence of specialized intestinal metaplasia in biopsy specimens from that columnar epithelium. However, the diagnostic yield of dysplasia with standard endoscopy is suboptimal. To improve detection of Barrett's esophagus and surveillance for dysplasia and cancer, many new endoscopic techniques including chromoendoscopy, magnification endoscopy, narrow band imaging, autofluorescence endoscopy, optical coherence tomography, and confocal laser endomicroscopy are used. We will review standard endoscopic findings and advanced imaging modalities for Barrett's esophagus.
Barrett Esophagus ; Biopsy ; Endoscopy ; Epithelium ; Esophagus ; Metaplasia ; Narrow Band Imaging ; Tomography, Optical Coherence

This research proposes a safety strategy for coronavirus disease 2019 (COVID-19) walkthrough booths to optimize pandemic preparedness. These booths, designed for respiratory sample collection during the COVID-19 pandemic, effectively reduce infection risk and personal protective equipment-related fatigue among healthcare workers. However, inadequate disinfection and glove management could escalate infection transmission. Using computational fluid dynamics simulations, we analyzed droplet dispersion on booth surfaces and gloves under various wind conditions. Our findings suggest that when setting up COVID-19 walk-through booths, their location should be strategically chosen to minimize the effects of wind. All surfaces of booth gloves must be thoroughly disinfected with a certified disinfectant after nasopharyngeal swab collection. It is also recommended to wear disposable gloves over booth gloves when changing between patient examinations. In wind-affected areas, individuals nearby should not solely rely on the 2-meter distancing rule due to potential droplet spread from walk-through booths. We strongly recommend consistent and proper mask use for effective droplet blocking. Adherence to these guidelines can significantly enhance the safety and efficiency of walk-through booths, particularly in potential future pandemics.

Tissue engineering has the potential to provide cartilaginous constructs capable of restoring the normal function of native articular cartilage following joint injury or degradation. One approach to functional tissue engineering of cartilage involves the in vitro cultivation of tissue constructs by using: (i) chondrogenic cells that can be selected, expanded, and transfected to overexpress the genes of interest, (ii) scaffolds that provide a defined three-dimensional structure for tissue development and biodegrade at a controlled rate. Understanding the functional potential of the cells and the signaling mechanisms underlying their differentiation should lead to innovative protocols for clinical orthopaedic interventions. A large number of growth factors and hormones have been implicated in the regulation of chondrocyte biology, relatively little is known about the intracellular signaling pathways involved. We have tried to define the roles of specific TGF-betadependent signaling pathways involved in the regulation of chondrogenesis from human mesenchymal stem cells. Chondrogenesis induced by TGF-beta in alginate bead system was confirmed by examining cartilage specific type II collagen expression and aggrecan, whereas type I collagen expression was not affected by TGF-beta. Type II collagen mRNA expression was expressed strongly during chondrogenesis and MEK inhibition (U0126) resulted in complete down-regulation of type II collagen. In contrast, aggrecan expression was detected in same level by treatment of U0126. These results strongly suggest that the ERK signaling cascade is involved in TGF-beta induced-chondrogenesis signaling pathways and a role of its pathway is necessary over a longer period to promote type II collagen expression. However, their end product properties in vivo have not been well known. In this study, an articular cartilage from chondrogenic MSCs with PLGA scaffolds (75:25 and 65:35) were made and analyzed its biochemical, histological and mechanical properties in vitro and in vivo. And also, we evaluated the cartilage formation in vivo through the injection of cell-thermosensitive gel complex, a newly developed injectable material. At 12 weeks after PLGA scaffolds containing chondrogenic MSCs transplantation, the separated rabbit distal femur showed a good gross articular cartilage appearance in the transplanted site. In indentation test, compare to the native articular cartilage, the engineered cartilage from two types of (75:25 and 65:35) achieved up to 30-60% in mechanical stiffness. And also, a new model for cartilage formation in bladder, at 14 weeks after injection, we could find out mass formation in the submucosal area grossly. H&E staining, alcian blue staining and other special staining confirmed the chondrogenic differentiation in the mass. These cell therapy technologies can provide the possibility of clinical applications for vesicoureteral reflux and reflux esophagitis, and urinary incontinence as well as articular cartilage regeneration.
Animals ; Cell Differentiation ; Chondrocytes/*cytology ; Humans ; Mesenchymal Stem Cells/*cytology ; Research Support, Non-U.S. Gov't ; *Tissue Engineering

No abstract available.
Factor VII Deficiency* ; Factor VII*

Latent transforming growth factor (TGF)-beta-binding protein (LTBP) is required for the assembly, secretion, matrix association, and activation of latent TGF-beta complex. To elucidate the cell specific expression of the genes of LTBP-1 and their splice variants and the factors that regulate the gene expression, we cultured primary human glomerular endothelial cells (HGEC) under different conditions. Basal expression of LTBP-1 mRNA was suppressed in HGEC compared to WI-38 human embryonic lung fibroblasts. High glucose, H2O2, and TGF-beta1 upregulated and vascular endothelial growth factor (VEGF) further downregulated LTBP-1 mRNA in HGEC. RT-PCR with a primer set for LTBP-1S produced many clones but no clone was gained with a primer set for LTBP-1L. Of 12 clones selected randomly, Sca I mapping and DNA sequencing revealed that only one was LTBP-1S and all the others were LTBP-1S delta 53. TGF-beta1, but not high glucose, H2O2 or VEGF, tended to increase LTBP-1S delta 53 mRNA. In conclusion, HGEC express LTBP-1 mRNA which is suppressed at basal state but upregulated by high glucose, H2O2, and TGF-beta1 and downregulated by VEGF. Major splice variant of LTBP-1 in HGEC was LTBP-1S delta 53. Modification of LTBP-1S delta 53 gene in HGEC may abrogate fibrotic action of TGF-beta1 but this requires confirmation.
*Alternative Splicing ; Amino Acid Sequence ; Cell Line ; Cells, Cultured ; Cloning, Molecular ; Comparative Study ; Endothelial Cells/drug effects/*metabolism ; *Gene Expression Regulation ; Glucose/pharmacology ; Humans ; Hydrogen Peroxide/pharmacology ; Intracellular Signaling Peptides and Proteins/*genetics ; Kidney Glomerulus/cytology ; Protein Isoforms/genetics ; RNA, Messenger/genetics/metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; *Transcription, Genetic ; Transfection ; Transforming Growth Factor beta/pharmacology ; Vascular Endothelial Growth Factor A/pharmacology

BACKGROUND: Epidermal growth factor receptor (EGFR) is overexpressed in the tissue of various malignancies including carcinoma of the breast, lung, esophagus, cervix, and ovary. In patients with cervical neoplasia, there may be a relationship between the expressions of EGFR in cervical neoplastic tissue and serum. METHODS: The expression of EGFR was determined in cervical tissues from 23 cervical intraepithelial neoplasia (CIN) patients and 16 invasive cervical carcinoma patients using immunohistochemical staining and the level of serum EGFR ECD (extracellular domain) was measured in serum from 17 CIN patients and 14 cervical carcinoma patients using ELISA (enzyme-linked immunosorbent assay). RESULTS: The expression of EGFR in cervical tissue was significantly increased as normal cervical tissue progressed to CIN then to invasive cervical carcinoma (p=0.009). And the mean level of serum EGFR according to the histologic diagnosis of normal cervix, CIN, invasive cervical carcinoma was 23.18+/-1.92 fmol/ml, 23.49+/-8.95 fmol/ml, and 30.46+/-19.72 fmol/ml, respectively. The mean level of serum EGFR was higher in invasive cervical carcinoma than that of normal cervix or CIN. But there was no significant statistical difference (p=0.471). Also the mean level of serum EGFR according to the intensity of immunohistochemical staining in negative (-), weakly positive (+), positive (++), and strongly positive (+++) staining was 19.36+/- 3.12 fmol/ml, 20.99+/-3.59 fmol/ml, 29.08+/-16.86 fmol/ml, and 24.34+/-10.35 fmol/ml, respectively. The mean level of serum EGFR in positive (++) and strongly positive (+++) staining was higher than in negative (-) staining, but there was no significant statistical difference (p=0.450). CONCLUSIONS: The authors believe that the expression of EGFR in cervical neoplastic tissue could be used as a marker for reflecting the malignant transformation of cervical epithelial cells. Although the mean level of serum EGFR in invasive cervical carcinoma was higher than in normal cervix and CIN, and the mean level of serum EGFR in positive (++) and strongly positive (+++) immunohistochemical staining was higher than in negative (-) staining, there was no significant statistical difference, possibly due to the limited number of cases in this preliminary study. So, the authors believe that the level of serum EGFR may have a similar role as a tumor marker like the EGFR expression in cervical neoplastic tissue. This study should be continued further with more cases and the relationship between the level of serum EGFR and prognostic parameters of uterine cervical carcinoma need to be analyzed.
Breast ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Esophagus ; Female ; Humans ; Lung ; Ovary ; Receptor, Epidermal Growth Factor

Over the last few decades, laparoscopy has evolved from a useful diagnostic tool to a complex surgical method. With its increasing popularity, the complications associated with laparoscopy are also increasing in number and variety. Subcutaneous emphysema, a complication related to the pneumoperitoneum, may result in hypercarbia, pneumomediastinum, and pneumothorax. It can result in even respiratory failure in serious cases. However, it may be easily detected with the signs of increased maximum positive end-tidal CO2 (PETCO2) and crepitus. Fortunately, most of them are recovered by proper conservative management. We report two cases of subcutaneous emphysema and pneumomediastinum identified during laparoscopic tubal anastomosis.
Laparoscopy ; Mediastinal Emphysema* ; Pneumoperitoneum ; Pneumothorax ; Respiratory Insufficiency ; Subcutaneous Emphysema*

OBJECTIVE: A constituent of green tea, (-)-epigallocatechin-3-gallate (EGCG), has been known to possess anti-diabetes, anti-hypertension and anti-cancer properties. In this study, we investigated the anticancer effects of EGCG on human ovarian cancer cell lines. The growth inhibitory mechanism(s) and regulation of cell cycle-related proteins by EGCG were also evaluated. METHODS: To carry out cell counting assay to observe the anti-proliferative effects, we treated 25, 50, and 100 uM EGCG to both ovarian cancer cell lines SKOV-3 and OVCAR-3, respectively. Also, we treated EGCG to PA-1 cells with 6.25, 12.5 and 25 uM, respectively. Six days later, we examined the characteristics of apoptosis and changes in cell cycle regulation by cell counting assay, Annexin V-FITC staining and DNA fragmentation assay, and FACS analysis. In addition, protein and gene expression patterns in SKOV-3 cell were investigated by using cell cycle cDNA chip, RT-PCR, and Western blot analyses. RESULTS: Inhibition of cell growth by cell counts showed in SKOV-3 cells with 48.8%, 82.5%, 99.2% after six days of the treatment with 25, 50, 100 uM of EGCG, respectively. OVCAR-3 cells showed 53.9%, 84.8%, and 97.7% growth inhibition patterns. And PA-1 cells showed 17.1%, 48.4%, and 74.1%, as compared to control. When SKOV-3 cells were tested for EGCG-induced apoptosis, apoptotic cells were observed with 8.6, 11.4, and 23.3-fold at 25, 50, 100 uM EGCG, respectively. And PA-1 cells showed 1.7, 2.4, and 4.2-fold, as compared to control. In contrast, OVCAR-3 did not show EGCG-induced apoptosis. When SKOV-3 cells were tested for their gene expression using cell cycle cDNA chip after treatment with 24.5 uM of EGCG, up-regulations of p21, Bax and cyclin G were shown, while down-regulations of CDK6, E2F-4, and cyclin A were shown. In Western blot assay, up-regulations of Bax and p21 proteins were shown, while down- regulations of cyclin D1, Bcl-XL, Rb, CDK2, E2F-1, E2F-4, PCNA proteins were shown. CONCLUSION: These data support that EGCG can inhibit ovarian cancer cell growth through induction of apoptosis and cell cycle arrest as well as regulation of gene and protein expressions. Thus, EGCG likely provides an additional option for a new and potential drug approach for ovarian cancer.
Apoptosis ; Blotting, Western ; Cell Count ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line* ; Cyclin A ; Cyclin D1 ; Cyclin G ; DNA Fragmentation ; DNA, Complementary ; Gene Expression ; Humans ; Ovarian Neoplasms* ; Proliferating Cell Nuclear Antigen ; Social Control, Formal ; Tea*

Allergic bronchopulmonary aspergillosis(ABPA) is a syndrome seen in patients with asthma and cystic fibrosis. It is characterized by chronic cololinization of the airways with a ubiquitous fungus, Aspergillus fumigatus. Clinically, it is a syndrome characterized by recurrent episodes of wheezing, mucus production, pulmonary infiltrates, and elevated levels of serum IgE. ABPA patients are also accompanied with bronchiectasis in 89% and observed in 10% of cystic fibrosis that show the features of end-stage lung pattern. There are few reports of ABPA associated with bullae. We will report here a case of ABPA developing in an old cicartrical and bullous lesion of a lung.
Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus fumigatus ; Asthma ; Blister ; Bronchiectasis ; Cystic Fibrosis ; Fungi ; Humans ; Immunoglobulin E ; Lung* ; Mucus ; Respiratory Sounds

BACKGROUND: Several studies have found an association between decreased respiratory function and renal impairment in those with chronic kidney disease. The relationship has not been investigated for healthy smokers. The aim of this study was to examine the association between respiratory function and renal function according to smoking status in Korean male population. METHODS: From the 5th Korean National Health and Nutrition Examination Survey (KNHANES), we enrolled 1246 male participants who were 40 years or older. As a cross-sectional study, the association between respiratory function and renal function were analysed depending on the' smoking status. Pearson correlation analysis was used to find the association between respiratory function and renal impairment. Covariance Analysis allowed to compare renal function (albuminuria, eGFR) with respiratory function (FEV1, FVC) according to smoking status. RESULTS: Regardless of smoking status, there was a negative correlation between respiratory function (FEV1 and FVC) and urinary albumin to creatinine ratio (LogUACR), and positive correlation between respiratory function (FEV1 and FVC) and estimated glomerular filtration rate (eGFR). Smokers have lower FEV1 and FVC in case they have albuminuria, after adjusting for covariant (P=0.012, P=0.010, respectively). CONCLUSIONS: Respiratory function was significantly lower in male smokers with albuminuria. Primary care physicians need to recognize that albuminuria may accompany with decreased respiratory function and to detect renal function impairment earlier in male smokers.
Albuminuria* ; Creatinine ; Cross-Sectional Studies ; Glomerular Filtration Rate ; Humans ; Korea* ; Male* ; Nutrition Surveys* ; Physicians, Primary Care ; Renal Insufficiency, Chronic ; Smoke* ; Smoking*