No abstract available.
Lipomatosis*

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Cause of Death ; Critical Illness ; Gram-Negative Bacteria* ; Hemoperfusion* ; Humans ; Middle Aged ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa ; Sepsis ; Shock, Septic*

No abstract available.
Stomach Neoplasms*

Thirty nine strains and 109 strains of Shigella sonnei were isolated from the outbreaks of Youngchun and Kyungju, respectively, while 15 strains were isolated from sporadic cases of eight regions in Kyungbuk province from September to November in 1998. We investigated the relationship among the S. sonnei strains by using biochemical characteristics, biotyping, antibiotic resistance pattern, and plasmid profile. Among the isolates, seven strains of S. sonnei isolated in Youngchun showed gelatin hydrolyase positive but the others showed gelatin hydrolyase negative. One hundred and fifty two strains were a type, while eleven among thirty nine strains isolated in Youngchun were g type. Antibiotics resistance patterns of S. sonnei strains isolated in Youngchun and Kyungju were significantly different. Thirty nine strains of S. sonnei isolated in Youngchun were resistant to SM, TE, and TMP/SMX, while eighty six of S. sonnei among one hundred and nine strains isolated in Kyungju were resistant to AM, CB, K, SM, TE, and TMP/SMX. Antibiotics resistance patterns of residual twenty three isolates were similar to those of eighty six strains. The Plasmid profiles of strains of S. sonnei isolated from the Kyungju were different from those of S. sonnei strains isolated in Youngchun. The Plasmid profiles of S. sonnei strains isolated from Youngchun were identical to those of a S. sonnei strains randomly selected from the outbreak in Daegu in 1998. The Plasmid profiles of S. sonnei strains isolated from Kyungju were identical to those of two strains of S. sonnei randomly selected from the outbreaks of Kanglung and Wonju in 1998. From the above results, it is considered that the strains of S. sonnei isolated from Kyungju and Youngchun region are not identical clone.
Anti-Bacterial Agents ; Clone Cells ; Daegu ; Disease Outbreaks ; Drug Resistance, Microbial* ; Gangwon-do ; Gelatin ; Gyeongsangbuk-do* ; Plasmids* ; Shigella sonnei* ; Shigella*

Background: Impaired diastolic heart function has been observed in persons with non-alcoholic fatty liver disease (NAFLD) and/or with type 2 diabetes mellitus (T2DM). However, it is unclear whether NAFLD fibrotic progression, i.e., non-alcoholic steatohepatitis, poses an independent risk for diastolic dysfunction in T2DM. We investigated the association between liver fibrosis and left ventricular (LV) diastolic dysfunction in T2DM. Methods: We analyzed 606 patients with T2DM, aged ≥50 years, who had undergone liver ultrasonography and pulsed-wave Doppler echocardiography. Insulin sensitivity was measured by short insulin tolerance test. Presence of NAFLD and/or advanced liver fibrosis was determined by abdominal ultrasonography and NAFLD fibrosis score (NFS). LV diastolic dysfunction was defined according to transmitral peak early to late ventricular filling (E/A) ratio and deceleration time, using echocardiography. Results: LV diastolic dysfunction was significantly more prevalent in the NAFLD versus non-NAFLD group (59.7% vs. 49.0%, P=0.011). When NAFLD was stratified by NFS, subjects with advanced liver fibrosis exhibited a higher prevalence of diastolic dysfunction (49.0%, 50.7%, 61.8%; none, simple steatosis, advanced fibrosis, respectively; P for trend=0.003). In multivariable logistic regression, liver fibrosis was independently associated with diastolic dysfunction (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.34; P=0.022) after adjusting for insulin resistance and cardiometabolic risk factors. This association remained significant in patients without insulin resistance (OR, 4.32; 95% CI, 1.73 to 11.51; P=0.002). Conclusions Liver fibrosis was associated with LV diastolic dysfunction in patients with T2DM and may be an independent risk factor for diastolic dysfunction, especially in patients without systemic insulin resistance.

PURPOSE: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. MATERIALS AND METHODS:4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. RESULTS:The mean talocalcaneal height was 6.94 cm (range, 5.9~7.6 cm) preoperatively and 7.34 cm (range, 6.0~8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6~8 degrees) preoperatively and 13.1 degrees (range, 5.7~21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14~36) and 4 (range, 3~6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54~68) and 3 (range, 2~4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). CONCLUSION: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.
Animals ; Ankle ; Calcaneus ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Orthopedics

OBJECTIVE: We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution. METHODS: Data from patients diagnosed with UIA from March 2000 to May 2008 at our hospital were subjected to a retrospective analysis. The cumulative and annual aneurysm rupture rates were calculated. Additionally, risk factors associated with aneurysmal rupture were identified. RESULTS: A total of 1339 aneurysms in 1006 patients met the inclusion criteria. During the follow-up period, 685 aneurysms were treated before rupture via either an open surgical or endovascular procedure. Six hundred fifty-four UIAs were identified and not repaired during the follow-up period. The mean UIA size was 4.5+/-3.2 mm, and 86.5% of the total UIAs had a largest dimension <7 mm. Among these UIAs, 18 ruptured at a median of 1.6 years (range : 27 days to 9.8 years) after day 0. The annual rupture risk during a 9-year follow-up was 1.00%. A multivariate Cox proportional hazards analysis revealed that the aneurysm size and a history of subarachnoid hemorrhage (SAH) were statistically significant risk factors for rupture. For an aneurysms smaller than 7 mm in the absence of a history of SAH, the annual rupture risk was 0.79%. CONCLUSION: In our study, the annual rupture risk for UIAs smaller than 7 mm in the absence of a history of SAH was higher than that of Western populations but similar to that of the Japanese population.
Aneurysm ; Asian Continental Ancestry Group ; Cohort Studies ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Natural History* ; Retrospective Studies* ; Risk Factors ; Rupture ; Subarachnoid Hemorrhage

INTRODUCTION AND METHODS: Apoptosis is a natural suicidal mechanism of eukaryotic cells to maintain the homeostasis of hosts. It comprises important pathogenesis of autoimmune diseases, cancers, and some infectious diseases. To access the role of apoptosis in the pathogenesis of infectious diseases, we studied the difference in apoptotic patterns of polymorphonuclear leukocytes and of monocytes to various stimuli, such as lipopolysaccharide (LPS), tumor necrosis factor (TNF)-alpa, interleukin (IL)-6, granulocyte, macrophage-colony stimulating factor (GM-CSF), or Escherichia coli (E. coli). The cell survival and expression of Fas and Fas ligand (FasL), bcl-2, and IL-1beta converting enzyme (ICE) were evaluated by flow cytometry, northern blotting or western blotting analysis. RESULTS: The survival of polymorphonuclear leukocytes and monocytes was prolonged after stimulation with LPS and cytokines. Stimulation of Fas with Fas monoclonal antibody induced apoptosis in both polymorphonuclear leukocytes and monocytes. Expressions of Fas and FasL were more dominant in polymorphonuclear leukocytes than in monocytes. bcl-2 was expressed onlyin monocytes and was associated with the de-lay of apoptosis. ICE is a common pathway to apoptosis and thus pretreatment with ICE inhibitor could partially inhibit the apoptosis in both cells. Interestingly, E. coli prolonged the life-span of polymorphonuclear leukocytes but accelerated apoptosis in monocytes in spite of the over-expression of bcl-2. CONCLUSION: Polymorphonuclear leukocytes and monocytes might have different apoptotic mechanisms to maintain their homeostasis. Polymorphonuclear leukocytes have only one mechanism to apoptosis, namely via Fas- FasL, whereas, monocytes have both Fas-FasL and bcl-2 mechanisms. These differences may be associated with their primary functions and natural life-span. Direct stimulation by live E. coli accelerated apoptosis in monocytes in spite of the over-expression of inhibitor of apoptosis, i.e. bcl-2. It could be due to activation of other apoptotic mechanisms by E. coli, which may detour the anti-apoptotic action of bcl-2 or direct inhibition of bcl-2 function.
Apoptosis* ; Autoimmune Diseases ; Blood Cells* ; Blotting, Northern ; Blotting, Western ; Cell Survival ; Communicable Diseases ; Cytokines* ; Escherichia coli* ; Escherichia* ; Eukaryotic Cells ; Fas Ligand Protein ; Flow Cytometry ; Granulocytes ; Homeostasis ; Ice ; Interleukins ; Monocytes ; Neutrophils ; Tumor Necrosis Factor-alpha

PURPOSE: The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS: A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS: Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION: The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.
Bicuspid ; Dental Implants ; Dental Porcelain ; Dentition ; Dentures ; Follow-Up Studies ; Humans ; Life Tables ; Percussion ; Prosthodontics ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Splints ; Survival Rate ; Tooth ; Tooth Loss

PURPOSE: The present study is aimed to evaluate the combined effect of recombinant human bone morphogenetic protein 2 (rhBMP-2) and recombinant human vascular endothelial growth factor (rhVEGF) coated onto anodized implants on osseointeration. MATERIALS AND METHODS: Six New Zealand white rabbit were used in this study. Each animal received 4 implants that were either coated with rhBMP-2 and rhVEGF (Study group) or anodized implant (Control group) in both tibia. This was performed using a randomized split-mouth design. A total 24 implants were used. The implant stability quotient (ISQ) value using resonance frequency analyser and removal torque (RTQ) measurement were investigated at 2 and 8 weeks. The t-test was used for statistical analysis (alpha=.05). RESULTS: Control and study group showed good osseointegration at 8 weeks. The ISQ and RTQ values of study group were significant compared with the control group at 8 weeks (P<.05). However, No statistical significance was observed at 2 weeks (P>.05). CONCLUSION: It was concluded that rhBMP-2 with rhVEGF coated onto anodized implants can induce better osseointegration at late healing period.
Animals ; Bone Morphogenetic Protein 2 ; Humans ; New Zealand ; Osseointegration ; Pilot Projects ; Tibia ; Torque ; Vascular Endothelial Growth Factor A