In postanesthetic period, infants and children have a risk of hypoxemia due to decreased functional residual capacity(FRC) and increased alveolar-arterial O2 tension gradient(A-a DO2). We measured arterial oxygen saturation(SaO2) with a pulse oximeter in 60 ASA class 1 infants and children. Group 1 was breathing with supplemental oxygen(4L/min) by mask and Group 2 was breathing with room air in recovery room after general anesthesia. SaO2 was measured on arrival in the recovery room, 2,4,6, 8,10,15, and 20 minute after arrival The results were as follows: 1) Postanesthetic SaO2 measured on arrival in the recovery room had decreased significantly(p<0.05) to preanesthetic SaO2 2) SaO2 measured in room air had decreased significantly compared with SaO measured in supplemental oxygen. As a result of the study, it is thought to be safe that supplemental oxygen is administered to patient on transfer and in recovery room.
Anesthesia* ; Anesthesia, General ; Anoxia ; Child ; Humans ; Infant ; Masks ; Oxygen* ; Recovery Room ; Respiration

BACKGROUND/AIMS: Patient compliance and resistance to antibiotics are main factors determining the success of Helicobacter pylori eradication. This study provides basic data to verify the efficacy of currently implemented eradication therapy and reports changes in H. pylori resistance to all antibiotics used at Asan Medical Center, Seoul, Korea from 2004 to 2010. METHODS: We investigated the resistance rates to amoxicillin, clarithromycin, metronidazole, ciprofloxacin, and levofloxacin in 88, 100, and 47 strains isolated from adult patients without H. pylori eradication history in 2004, 2007, and 2010. RESULTS: The resistance rate to amoxicillin increased from 5.0% in 2007 to 10.6% in 2010. The resistance rate to clarithromycin increased from 10.2% in 2004 and 11.0% in 2007 to 14.8% in 2010. However, no difference was observed in the resistance rate to metronidazole, and strains resistant to tetracycline were not detected at all in this study. The resistance rates to quinolone lingered at 15-17% for 3 years. The non-resistant strains to antibiotics accounted for 56% of the total in 2004 and 62% in 2007. In contrast, a decreasing tendency was found for those strains in 2010 (43%). No significant differences were shown in the multi-drug resistance rate or the co-resistance rates of amoxicillin and clarithromycin over the 3 years. CONCLUSIONS: We showed increased resistance rates to clarithromycin and amoxicillin over the last 7 years, aligning with the results of previous studies performed domestically. Efforts are needed to inhibit the increase in resistant bacteria to maintain the effectiveness of eradication therapy.
Adult ; Amoxicillin ; Anti-Bacterial Agents ; Bacteria ; Chungcheongnam-do ; Ciprofloxacin ; Clarithromycin ; Drug Resistance, Microbial* ; Drug Resistance, Multiple ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Levofloxacin ; Metronidazole ; Patient Compliance ; Seoul* ; Tetracycline

No abstract available.
Leukemia* ; Sweet Syndrome*

BACKGROUND AND OBJECTIVES: Hypopharyngeal cancer is notorious for its poor prognosis and severe surgical morbidity with functional deficits. This study was conducted to compare the efficacy between the neoadjuvant chemotherapy followed by radiotherapy and surgery with postoperative radiotherapy in the treatment of hypophayngeal cancer. MATERIAL AND METHOD: Medical records of 64 patients, treated for hypopharyneal cancer at Pusan National University Hospital from March 1986 through May 2000, were retrospectively reviewed. Thirty-three patients were grouped into the chemotherapy and radiotherapy (CRTx) group, who received neoadjuvant chemotherapy and radiotherapy. Thirty-one patients were grouped into the operation and radiotherapy (ORTx) group, who received laryngectomy with or without reconstruction and postoperative radiotherapy. RESULTS: There was no significant difference of three years survival rate between CRTx group and ORTx group (p>0.05). Laryngeal preservation rate was 45% in CRTx group but 3% in ORTx group (p<0.05). CONCLUSION: Although this had not been a randomized study of chemotherapy followed by radiotherapy versus surgery plus postoperative radiotherapy, the survival rate of CRTx group appears to be as identical as ORTx group and more effective in the preservation of the larynx.
Busan ; Drug Therapy* ; Humans ; Hypopharyngeal Neoplasms* ; Laryngectomy ; Larynx ; Medical Records ; Neoadjuvant Therapy ; Organ Preservation ; Prognosis ; Radiotherapy* ; Retrospective Studies ; Survival Rate

Background/Aims: We developed a new endoscopic submucosal dissection (ESD) simulator and evaluated its efficacy and realism for use training endoscopists. Methods: An ESD simulator was constructed using polyvinyl alcohol hydrogel sheets and compared to a previous ESD simulator. Between March 1, 2020, and December 30, 2021, eight expert endoscopists from three different centers analyzed the procedure-related factors of the simulator. Five trainees performed gastric ESD exercises under the guidance of these experts. Results: Although the two ESD simulators provided overall favorable outcomes in terms of ESD-related factors, the new simulator had several benefits, including better marking of the target lesion’s limits (p<0.001) and overall handling (p<0.001). Trainees tested the usefulness of the new ESD simulator. The complete resection rate improved after 3 ESD training sessions (9 procedures), and the perforation rate decreased after 4 sessions (12 procedures). Conclusions We have developed a new ESD simulator that can help beginners achieve a high level of technical experience before performing real-time ESD procedures in patients.

OBJECTIVE: To compare single-dose prophylactic antibiotics after cord clamping with multi-dose postoperative antibiotics in operative complications after elective cesarean section. METHODS: Forty-five women undergoing elective cesarean section had 1g cefazolin administration after umbilical cord clamping. Forty-five women was control group who had antibiotics administration postoperatively 4 times 1 g cefazolin and 5 days more per oral. Postoperative complication including febrile morbidity, wound infection, endometritis, urinary tract infection, pneumonia were recorded, as were the duration of hospital stay and the need for therapeutic antibiotics. RESULTS: Postoperative complication incuding febrile morbidity, wound infection, endometritis, urinary tract infection, pneumonia had no difference between two groups significantly. Also, their hospital stay had no difference significantly. CONCLUSION: Single-dose prophylactic antibiotics administration after cord clamping in elective cesarean section is considered to have no difference in comparison with multi-dose post-operative administration. Single-dose prophylactic antibiotics administration after cord clamping will reduce side effect of drugs and resistance. Also it will provide better cost effectiveness.
Anti-Bacterial Agents* ; Cefazolin ; Cesarean Section* ; Constriction* ; Cost-Benefit Analysis ; Endometritis ; Female ; Humans ; Length of Stay ; Pneumonia ; Postoperative Complications ; Pregnancy ; Umbilical Cord ; Urinary Tract Infections ; Wound Infection

Primary neuroendocrine carcinoma of the gallbladder is extremely rare because normal gallbladder mucosa does not contain neuroendocrine cells. Neuroendocrine cells can be detected at sites of intestinal metaplasia induced by chronic inflammation, which may be the initial step in the development of neuroendocrine tumor of the gallbladder. Anomalous union of the pancreaticobiliary duct (AUPBD) is an uncommon congenital anomaly that is frequently associated with choledocholithiasis, cholangitis, pancreatitis, and cancer of the gallbladder or bile duct. In AUPBD, cancers of the gallbladder and bile duct can be induced by chronic inflammation. We report herein a case of large-cell neuroendocrine tumor of the gallbladder associated with AUPBD.
Bile Ducts ; Carcinoma, Neuroendocrine ; Cholangitis ; Choledocholithiasis ; Gallbladder ; Gallbladder Neoplasms ; Inflammation ; Metaplasia ; Mucous Membrane ; Neuroendocrine Cells ; Neuroendocrine Tumors ; Pancreatitis

BACKGROUND/AIMS: MicroRNAs (miRNAs) regulate gene expression. We assess miRNA regulation by Helicobacter pylori infection and elucidate their role in H. pylori-infected gastric epithelial cells. METHODS: The relationship between miRNA expression and DNA methylation was examined. Cells were treated with the nuclear factor-kappaB (NF-κB) inhibitor Bay 11-7082 to determine the relationship between miRNA expression and NF-κB signal transduction. RESULTS: In the negative control cells infected with H. pylori 26695, the expression of six miRNAs was increased, whereas the expression of five miRNAs was decreased. The expression of upregulated miRNAs was increased when the host cells were treated with H. pylori and an NF-κB inhibitor. miR-127-5p, -155, and -181 were associated with increased interleukin 6 (IL-6) secretion in H. pylori infected cells treated with anti-miRNA. The expression of miR-155, -127-5p, -195, -216, -206, and -488 increased by approximately 3-fold following treatment with the methylation inhibitor Aza. CONCLUSIONS: We found novel miR-NAs in H. pylori-infected negative control cells using miRNA microarrays. Upregulated miRNA expression was inversely related to the transcription of NF-κB. miR-195 and miR-488 appear to play a pivotal role in controlling IL-6 activity in H. pylori infection. miRNA expression in H. pylori infection was affected by methylation.
Bays ; Cytokines ; DNA Methylation ; Epithelial Cells ; Gene Expression ; Helicobacter pylori* ; Helicobacter* ; Interleukin-6 ; Methylation ; MicroRNAs* ; NF-kappa B ; Signal Transduction

Agmatine, a widely distributed molecule in mammalian tissues, shows neuroprotective effects in brain ischemia. We describe the neuroprotective effects of agmatine in the mouse MCAO model and the quantitative change of agmatine in ischemic injury. Brain ischemic injured mice were injected with agmatine (100 mg/kg of mouse, IP). Agmatine significantly reduced the infarct area after MCAO. Despite the similar patterns of agmatine change observed in control or agmatine injected animals, the agmatine levels of the penumbra were significantly higher than those of the striatum and the cerebral cortex during the early period (<1 hour after 2 hours of MCA occlusion). This suggests that the early period, during which agmatine levels increase in the brain, is the crucial period in terms of neuroprotective effect during ischemia.
Agmatine* ; Animals ; Brain Ischemia ; Brain* ; Cerebral Cortex ; Chromatography, High Pressure Liquid* ; Ischemia ; Mice ; Neuroprotective Agents ; Reperfusion

BACKGROUND/AIMS: The Barrett's esophagus is confirmed by performing a biopsy when the gastroesophageal junction (GEJ) and Z-line do not coincide. In Japan, the GEJ is at the distal end of the palisading vessel while Western countries define it as the proximal tip of the gastric fold. However, there is little data on the prevalence of an endoscopic Barrett's esophagus and the inter-observer variation. METHODS: Four experienced endoscopists reviewed the endoscopic still images of 111 consecutive patients. The level of inter-observer agreement was expressed as a kappa value. RESULTS: The average percentage of patients with an endoscopically confirmed esophagus was 34.2%. The level of inter-observer agreement was substantial (kappa=0.698). CONCLUSIONS: The prevalence of an endoscopic confirmed Barrett's esophagus was high, and the inter-observer variation was substantial when the GEJ was defined as the distal end of the palisading vessel. Considering the low incidence of esophageal adenocarcinoma and the risk of hemorrhage from a biopsy, a more specific marker is needed in this high-risk group.
Adenocarcinoma ; Barrett Esophagus* ; Biopsy ; Esophagogastric Junction ; Esophagus ; Hemorrhage ; Humans ; Incidence ; Japan ; Observer Variation* ; Prevalence*