Humans ; Liver Diseases ; Practice Guidelines as Topic ; Prognosis

Objective An effective reproducible protocol for complete plant regeneration via somatic embryogenesis has beendeveloped for Herpetospermum pedunculosum,an endangered Tibetan medicinal herb.Methods The cotyledonexplants used in this study were excised from seedlings germinated in vitro.Callus was induced from cotyledonexplants on Murashige and Skoog's medium,supplemented with 2,4-dichlorophenoxyacetic acid(2,4-D,0.1-1.0mg/L)alone or in combination with 6-benzylaminopurine(BA,0.5,1.0,and 2.0 mg/L).Results The calli showeddifferentiation of globular embryos after three weeks of incubation on MS medium supplemented with variouscombinations of BA and NAA.Sixty-two percent of the embryogenic calli produced somatic embryos in MS basalmedium supplemented with BA(1.0 mg/L)+NAA(2.0 mg/L).The addition of KN(0.5 mg/L)to MS mediumcontaining both BA and NAA(2.0 mg/L each)significantly increased the frequency of somatic embryogenesis.Themaximum percentage of embryogenic calli formation was 83%,and globular embryos formed and germinatedsuccessfully in this medium.Then,transferring the regenerated plants from this medium to hormone-free MSmedium will further enhanced the development of the plants,and the healthy plantlets are formed successfullywithin four weeks.The plantlets were transferred to soil to acclimatize under greenhouse conditions and 75%survived.Conclusion Somatic embryogenesis protocol as reported here can play a key role in the propagation andconservation of this endangered species.

Objective To explore the clinical features, surgical techniques and treatment efficacy of blood blis?ter-like aneurysms (BBA) of the internal carotid artery (ICA). Method We retrospectively reviewed 45 BBAs of the ICA treated surgically at our department between Jan. 2006 and Jan. 2016. The data was analyzed. Results Direct clipping of BBA was performed in 38 patients, clipping over wrapping in 3 patients and trapping of ICA in 4 patients. Intraoperative rupture occurred in 12 patients (27%). Postoperative cerebral infarction developed in 10 cases (22%). Seven patients died (16%). During the follow-up time of 47 months (range, 6~126 months), Good results were achieved in 34 patients (76%) with a modified Rankin Scale (mRS) 0~2 and 4 patients were in mRS 3~5. Follow-up angiography revealed a re?currence of BBA in one patient, which was retreated with endovascular coiling. No rebleeding was found in all fol?lowed-up patients. Conclusions BBAs of the ICA are difficult to treat surgically with high risk and complications. Thoughtful pre-operative evaluation of BBA and application of various surgical strategies during operation can signifi?cantly reduce the surgical risk and achieve good outcomes.

PURPOSE: The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. METHOD: For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. RESULT: The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. CONCLUSION: The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.
Constipation ; Dysuria ; Hospice Care ; Hospices* ; Humans ; Medical Records ; Nursing* ; Pain Management ; Pruritus ; Resuscitation ; Sensation ; Seoul

Objective To investigate the glucose metabolic pattern of brain functional loop in patients with refractory obsessive compulsive disorder (OCD) using 18 F-FDG PET.Methods Eight patients with refractory OCD and 8 age- and gender-matched healthy volunteers underwent 18F-FDG PET brain imaging.SPM software was used for image post-processing and quantitative analysis.Correlation analysis between 18F-FDG uptake and Yale-Brown obsessive compulsive scale(Y-BOCS) score was performed.Results Compared with the controls,the glucose metabolism of bilateral frontal cortices ( including the rectal gyrus,orbital gyrus and cingulate gyrus),left thalamus,right temporal lobe and bilateral cerebellum in refractory OCD patients increased significantly ( Zmax =3.45 - 5.80,all P ＜ 0.001 ).Bilateral motor cortices and bilateral parietal lobes (BA7),however,showed decreased glucose metabolism (Zmax =3.44 - 4.46,all P ＜0.001 ).Y-BOCS score was positively correlated with the glucose metabolism of the bilateral anterior cingulate cortex (Zmax =3.77,3.48 and 2.97,all P ＜ 0.01 ).Conclusions There is a characteristic metabolic pattern of increased glucose utilization in the fronto-striato-thalamic loop and decreased glucose utilization in bilateral motor cortices and parietal lobes in patients with OCD.The glucose metabolism in the anterior cingulate cortex might serve as a quantitative parameter for the assessment of the severity of OCD.

No abstract available.
Clostridium difficile* ; Clostridium* ; Critical Illness* ; Humans ; Proton Pump Inhibitors* ; Proton Pumps* ; Protons*

BACKGROUND: Procalcitonin (PCT) is a new marker of severe systemic bacterial infection. PCT consists of fragments katacalcin and calcitonin, which are precursors of calcitonin in thyroid. The source and role of PCT in pathogenesis of sepsis remains clarified. This study was focused on which subsets of peripheral blood mononuclear cells (PBMC) can induce PCT when they are stimulated with endotoxin or phorbol myristate acetate (PMA), and how the PCT production is controlled. MATERIALS AND METHODS: PBMC were isolated and incubated overnight in each media containing 1 ug/mL lipopolysaccharide (LPS), or 5 ng/mL PMA. Intracellular PCT was detected using fluorescein isothiocyanate (FITC) labeled anti-katacalcin antibody (Ab). Monocytes and lymphocytes were identified by phycoerythrin-conjugated CD14 Ab and CyChrome-conjugated CD3 Ab, respectively. Ten micrograms of soluble TNF receptor (sTNFR) were pretreated in PBMC 1 hr prior to adding the stimuli. Then, PBMC were analyzed using a flow cytometer. RESULTS: LPS increased intracellular PCT from 10.0 % to 27.2% in CD14-positive monocytes from healthy donors, but PMA induced more PCT production from 10.0% to 40.8%. (one representative, n=8). For CD3-p ositive lymphocytes, LPS did not stimulate PCT, but PMA increased PCT production by 2.35 fold (P<0.05, n=8). In the PBMC from the same donor, sTNFR highly decreased LPS-stimulated PCT (control 10.0%, LPS 27.2%, sTNFR 12.3%), but it did not significantly affect PMA-stimulated PCT. For sepsis patients, PMA stimulated more PCT than LPS did and PCT was more expressed compared with healthy donors. CONCLUSION: The PCT was produced in both monocytes and lymphocytes. PMA stimulated more PCT production than LPS did. The LPS-induced PCT production is partly mediated through TNF-alpha production.
Bacterial Infections ; Calcitonin ; Fluorescein ; Humans* ; Lymphocytes ; Monocytes ; Receptors, Tumor Necrosis Factor ; Sepsis ; Tetradecanoylphorbol Acetate ; Thyroid Gland ; Tissue Donors ; Tumor Necrosis Factor-alpha

BACKGROUND: Procalcitonin (PCT) is a new marker of severe systemic bacterial infection. PCT consists of fragments katacalcin and calcitonin, which are precursors of calcitonin in thyroid. The source and role of PCT in pathogenesis of sepsis remains clarified. This study was focused on which subsets of peripheral blood mononuclear cells (PBMC) can induce PCT when they are stimulated with endotoxin or phorbol myristate acetate (PMA), and how the PCT production is controlled. MATERIALS AND METHODS: PBMC were isolated and incubated overnight in each media containing 1 ug/mL lipopolysaccharide (LPS), or 5 ng/mL PMA. Intracellular PCT was detected using fluorescein isothiocyanate (FITC) labeled anti-katacalcin antibody (Ab). Monocytes and lymphocytes were identified by phycoerythrin-conjugated CD14 Ab and CyChrome-conjugated CD3 Ab, respectively. Ten micrograms of soluble TNF receptor (sTNFR) were pretreated in PBMC 1 hr prior to adding the stimuli. Then, PBMC were analyzed using a flow cytometer. RESULTS: LPS increased intracellular PCT from 10.0 % to 27.2% in CD14-positive monocytes from healthy donors, but PMA induced more PCT production from 10.0% to 40.8%. (one representative, n=8). For CD3-p ositive lymphocytes, LPS did not stimulate PCT, but PMA increased PCT production by 2.35 fold (P<0.05, n=8). In the PBMC from the same donor, sTNFR highly decreased LPS-stimulated PCT (control 10.0%, LPS 27.2%, sTNFR 12.3%), but it did not significantly affect PMA-stimulated PCT. For sepsis patients, PMA stimulated more PCT than LPS did and PCT was more expressed compared with healthy donors. CONCLUSION: The PCT was produced in both monocytes and lymphocytes. PMA stimulated more PCT production than LPS did. The LPS-induced PCT production is partly mediated through TNF-alpha production.
Bacterial Infections ; Calcitonin ; Fluorescein ; Humans* ; Lymphocytes ; Monocytes ; Receptors, Tumor Necrosis Factor ; Sepsis ; Tetradecanoylphorbol Acetate ; Thyroid Gland ; Tissue Donors ; Tumor Necrosis Factor-alpha

Objective: To explore the clinical characteristics, therapeutic methods and effects of blood blister-like aneurysms (BBA) of the supraclinoid segment of the internal carotid artery (ICA). Methods: A total of 40 patients with BBAs of the ICA treated at Department of Neurosurgery of West China Hospital between January 2010 and January 2016 were retrospectively reviewed. There were 14 males and 26 females with the mean age of 44.7 years (ranging from 25 to 64 years). There were 38 patients presented with subarachnoid hemorrhage (SAH), and 2 patients were found incidentally with unruptured aneurysms in regular examination. Surgical treatment was performed in 22 patients, including direct clipping, clipping over wrapping and trapping. Endovascular treatment with single or multiple stents and coiling was performed in 18 patients. Clinical outcomes were assessed with modified Rankin Scale. The patients were followed up with CT angiography. Results: Direct clipping of BBA was performed in 18 patients, clipping over wrapping in 3 patients and trapping of ICA in 1 patient. Intraoperative rupture occurred in 5 patients. Postoperative cerebral infarction developed in 6 cases, 4 patients died. Single stent-assisted coiling was performed in 8 cases, and multiple stents with coiling in 10 patients. Procedure-related hemorrhage occurred in 2 patients, postoperative massive cerebral infarction developed in 1 patient with stent-assisted coiling. The follow-up time was 26.8 months (ranging from 6 to 72 months), among the patients with surgery, good results (modified Rankin Scale 0-2) were achieved in 16 patients; one patient was score 3, and the other was 4. In endovascular group, 15 patients had good results and one with mRS 4. Follow-up angiography revealed recurrence of BBA in 2 patients treated with stent and coiling, which was retreated with coiling. No recurrence was found in surgical group. Conclusions BBA of the supraclinoid ICA is a specific and complicated intracranial aneurysm with high risk and complications no matter the treatment is surgical or endovascular, take proper operation methods could achieve satisfactory results.

Plummer-Vinson syndrome is a complex syndrome characterized by upper esophageal webs, dysphagia, and iron deficiency anemia. This syndrome develops principally in middle-aged women, and only rarely in patients over age 80. We present a case of Plummer-Vinson syndrome occurring in an 82-year-old woman who visited the hospital because of progressive dysphagia. Esophagogram and endoscopic examination showed an upper esophageal web, and laboratory examination revealed iron deficiency anemia. Dysphagia improved after endoscopic balloon dilatation, and iron deficiency anemia improved after iron supplementation. Even Plummer-Vinson syndrome can be improved by sufficient amounts of oral ferrous sulfate and endoscopic balloon dilatation, it is important to identify the cause of iron deficiency anemia and to check for the presence of malignant disease. The common causes of anemia differ between middle-aged and elderly women, and the clinician needs to look for malignancy-induced chronic gastrointestinal tract blood loss and chronic inflammatory diseases. We report a rare case of Plummer- Vinson syndrome in a woman over 80 years of age.
Aged ; Aged, 80 and over ; Anemia ; Anemia, Iron-Deficiency ; Deglutition Disorders ; Dilatation ; Female ; Ferrous Compounds ; Gastrointestinal Tract ; Humans ; Iron ; Plummer-Vinson Syndrome