Purpose: Sepsis-related deaths occur during both the early proinflammatory and the late immunosuppressive phases of the condition. The balance of pro- and anti-inflammatory responses is influenced by damaged cells that die via either proinflammatory necroptosis or anti-inflammatory apoptosis. Both forms of cell death may be mediated by reactive oxygen species (ROS) generated during the proinflammatory response. Recent evidence suggests that exercise training boosts antioxidative capacity and could offer protection against sepsis. Given these findings, we aimed to examine the impact of exercise training on neural cell death in the context of sepsis. Methods: We assessed the effectiveness of exercise in reducing ROS production and the inflammatory response using a cecal ligation and puncture (CLP)-induced sepsis model. Forty C57BL/6N male mice were randomly divided into 2 groups: control (CLP-Con; n=20) and experimental (CLP-Ex; n=20). Before the induction of sepsis by CLP, the CLP-Ex mice underwent interval training on a treadmill 3 days per week for 8 weeks. Each day involved 10 cycles of 2 minutes at 8 m/min and 2 minutes at 15 m/min. After the CLP procedure, we monitored the survival of 10 mice from each group over a 30-hour period. Results: The findings indicated that exercise training increased the survival rate among mice with CLP-induced sepsis by enhancing antioxidative capacity and delaying the transition from a hyperdynamic to an immunosuppressive state. Conclusions Exercise training may delay the progression from the hyperdynamic state to the hypodynamic phase of sepsis by increasing antioxidant capacity and reducing apoptotic cell death.

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes PaCO2 to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane.Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein.In a deeply sedated state, the average amount of pH of the entire patients was measured as 7.36 ± 0.06. The average amount of PvCO₂ of the entire patients was measured as 48.8 ± 8.50 mmHg. The average amount of HCO₃₋ of the entire patients was measured as 27.2 ± 3.0 mmol/L.In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.
Anesthesia, General ; Anesthesia, Inhalation ; Anoxia ; Blood Gas Analysis ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Hypercapnia ; Inhalation ; Masks ; Muscle Relaxation ; Nitrous Oxide ; Oxygen ; Respiration ; Respiratory Insufficiency ; Tidal Volume ; Unconsciousness ; Veins ; Ventilation

A 76-year-old, 148-cm woman was scheduled for right upper lobectomy. A 32 Fr left-sided double lumen tube was placed using a conventional technique. Despite several attempts under fiberoptic bronchoscope-guidance, we could not locate the double lumen tube properly. We thus decided to proceed with the bronchial tube in the right mainstem bronchus. During surgery, 8-cm-long laceration was noted on the posterolateral side of the trachea. To check the possibility of laceration of the proximal trachea, the double lumen tube was changed to an LMA for use as a conduit for fiberoptic bronchoscopic evaluation in the lateral position. A plain endotracheal tube with the cuff modified and collapsed was re-intubated after evaluation. And then she was transferred to SICU.
Aged ; Bronchi ; Female ; Humans ; Intubation ; Lacerations ; Trachea

No abstract available.
Humans ; Recurrent Laryngeal Nerve* ; Thyroid Gland* ; Vocal Cord Paralysis*

BACKGROUND: During laparoscopic surgery, high airway pressures are generally followed by a diaphragmatic shift and hyperventilation. We hypothesize that normocapnea can be maintained with the same amount of CO2 output (VCO2) during pneumoperitoneum (PP). METHODS: Six anesthetized rabbits were mechanically ventilated at a respiratory rate of 20/min with FIO2 0.5. At the end of the expiratory limb of the ventilator, the mean partial pressure of CO2 was measured. The internal carotid artery was catheterized. Baseline values for blood pressure, heart rate, arterial blood gas analysis, and ventilatory variables were obtained. CO2 gas was introduced into the peritoneum with an intra-abdominal pressure of 12 mmHg. The measurements at baseline and at PP1 were compared. The respiratory rate was changed from (20/min PP1, to 40/min PP2, 80/min PP3 or 120/min PP4) while calculating VCO2 and comparing ventilatory variables under PP at the same time. RESULTS: The peak inspiratory pressure (PIP) and tidal volume (VT) at PP1 increased, compared with baseline. With the same PaCO2, the VT decreased significantly from (45 +/- 8 ml PP1 to 29 +/- 5 ml PP2, 19 +/- 4 ml PP3 and 15 +/- 2 ml PP4), respectively. The PIP was reduced. However, the dead space to tidal volume ratio (VD/VT) was greater at higher RR during PP. CONCLUSIONS: PP increased the PIP and VT for the removal of overloaded CO2. Less VT at a higher respiratory rate could be used with the same amount of VCO2 during PP. However, the VD/VT was elevated by the induction of PP and by the increase in respiratory rate.
Blood Gas Analysis ; Blood Pressure ; Carbon ; Carotid Artery, Internal ; Catheters ; Extremities ; Heart Rate ; Hyperventilation ; Laparoscopy ; Partial Pressure ; Peritoneum ; Pneumoperitoneum ; Rabbits ; Respiratory Rate ; Tidal Volume ; Ventilators, Mechanical

Zinc is an essential trace element required for bone formation, however not much has been clarified yet for its role in osteoblast. We hypothesized that zinc would increase osteogenetic function in osteoblasts. To test this, we investigated whether zinc treatment enhances bone formation by stimulating osteoblast proliferation, bone marker protein alkaline phosphatase activity and collagen synthesis in osteoblastic MC3T3-E1 cells. MC3T3-E1 cells were cultured and treated with various concentrations of zinc (0, 1, 3, 15, 25 uM) along with a normal osteogenic medium (OSM) as control for 1, 5, 10 days. As measured by MTT assay for mitochondrial metabolic activity, cell proliferation was stimulated even at low zinc treatment (1-3 micrometer) compared to OSM, and it was stimulated in a zinc concentration-dependent manner during 5 and 10 days, with the most pronounced effect at 15 and 25 uM Zn. Cellular (synthesized) alkaline phosphatase (ALP) activity was increased in a zinc concentration-dependent manner, so did medium (secreted) ALP activity. Cellular collagen concentration was increased by zinc as time went by, therefore with the maximum zinc stimulatory effect in 10 days, and medium collagen concentration showed the same pattern even on 1 and 5 day. This zinc stimulatory effect of collagen synthesis was observed in cell matrix collagen staining. The study results imply that zinc can increase osteogenic effect by stimulating cell proliferation, ALP activity and collagen synthesis in osteoblastic cells.
Alkaline Phosphatase ; Cell Proliferation ; Collagen ; Durapatite ; Osteoblasts ; Osteogenesis ; Zinc

Purpose: This study aimed to evaluate the outcomes of isolated common femoral endarterectomy with patch angioplasty (IFEA) in the endovascular era. Materials and Methods: In 2012-2022, 189 limbs underwent femoral endarterectomy with patch angioplasty. Of them, 45 IFEAs were included. We evaluated safety based on early complications; efficacy with primary patency (PP) and reintervention, above-ankle amputation, or stenosis (RAS)-free survival. We also evaluated lesion characteristics and outcomes according to the inclusion criteria (IC) of vascular mimetic implant-common femoral artery (VMI-CFA) stenting trial. Results: Forty-one patients were male, and 30 IFEAs were required for claudication. No cases of early mortality occurred. Ten limbs (22%) developed localonvascular complications (hematoma, 3; lymphocele, 5; wound infection, 2), of which 8 resolved spontaneously. The overall PP and secondary patency rates were 100% at 1 year and 87% and 97% at 3 years, respectively. Twenty-one lesions (47%) did not meet the IC. The PP within the IC was 100% at 1 and 3 years, and the PP outside the IC was 100% at 1 year and 73% at 3 years (P=0.068). The overall RAS-free survival rates were 91% at 1 year and 81% at 3 years. All cases of RAS occurred in lesions outside the IC. The multivariate analysis showed that dialysis was associated with poor RAS-free survival (adjusted odds ratio, 8.56; 95% confidence interval, 1.9-35.5; P=0.005). Conclusion The recent VMI-CFA trial results should be interpreted with caution.IFEA is a low-risk and durable procedure; however, careful follow-up is warranted in patients undergoing dialysis.

165Dy Hydroxide Macroaggregates(165Dy HMA) has a short half life(2.3 hours) and a size range of 3-5µm that give the advantage of reduced leakage and a shorter hospital stay. This report will show the results of a prospective open study on the efficacy and safety of 165Dy HMA in 178 knees of 141 patients with chronic synovitis refractory to conventional antirheumatic therapy. The final global assessment was classified as good, fair or poor. Extra-articular leakage of 165Dy HMA was determined by the scintigraphic evaluation of liver, groin and knee joints. The optimum radiation dose was 250 mCi. The mean follow up periods were 32.4(14-112) weeks. Thirty seven percent of the knees showed good results, 48% fair results and 15% poor results. In the knees with stage I radiographic changes, 82% showed improvement including 32% of the patients with good results. In the knees with stage II radiographic changes, 90% showed improvement including 42% of the patients with good results. The mean period of improvement for the 158 knees that responded to treatment was 41.4(24-106) weeks. Leakage of radioactivity from the injected joint was minimal. Adverse reactions were rare(radiation burn : 4 cases, transient postinjection swelling : 14 cases). In conclusion, 165Dy HMA radiation synovectomy is a safe and useful therapy for chromic synovitis of the rheumatoid knees.
Arthritis, Rheumatoid ; Burns ; Follow-Up Studies ; Groin ; Humans ; Injections, Intra-Articular ; Joints ; Knee Joint ; Knee ; Length of Stay ; Liver ; Prospective Studies ; Radioactivity ; Synovitis

Renal and perirenal abscesses are disease entities caused by infections in or around the kidneys. As imaging modalities have improved in quality and convenience, diagnosing these diseases has become easier. Some cases are refractory to conventional treatment and require surgical correction, although most patients can be cured by antibiotic treatment and percutaneous drainage. We here report the case of a patient with a perirenal abscess that recurred twice after appropriate antibiotic treatment and percutaneous drainage. Although Gram-negative bacilli are the most common pathogenic cause of these diseases, we isolated methicillin-resistant Staphylococcus aureus and Mycobacterium tuberculosis in our patient. Thus, poor responses to appropriate treatment in patients with a perirenal abscess can result not only from antimicrobial resistance or a co-infection but also from the 2 conditions existing concomitantly.
Abscess ; Coinfection ; Drainage ; Escherichia ; Escherichia coli ; Humans ; Kidney ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mycobacterium ; Mycobacterium tuberculosis ; Perinephritis ; Tuberculosis

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor, with a low-grade malignant potential, occurring predominantly in children and young adults. Association between AFH and other malignancies has been rarely reported. A 27-year-old man who presented with a palpable abdominal mass was diagnosed as having testicular cancer with multiple liver and lung metastases. At 16 months after chemotherapy, a follow-up computed tomographic scan revealed a supraclavicular mass measuring 3 cm in size, which was suspected to be a recurrence. The patient underwent surgical excision, and the mass was pathologically diagnosed as a AFH. The patient has had no local recurrence and no distant metastasis for 12 months after resection. To the best of our knowledge, this is the first case report of AFH as a second tumor in a patient with testicular cancer.
Adult ; Child ; Follow-Up Studies ; Histiocytoma ; Histiocytoma, Benign Fibrous ; Humans ; Liver ; Lung ; Neoplasm Metastasis ; Neoplasms, Second Primary ; Recurrence ; Testicular Neoplasms ; Young Adult