No abstract available.
Hemorrhage*

PURPOSE: Respiratory syncytial virus is the primary cause of pneumonia and bronchiloitis in young children and infants. RSV infection is also known to be very important to asthma patient, because previous RSV infection increases the frequency of the asthma development and RSV infection may cause airway hyperresponsiveness. Natural RSV infection does not provide complete immunity and reinfection occurs throughout life. Several strategies have recently been used in RSV vaccine development, including the generation of formalin inactivated RSV(FI-RSV), peptides, recombinant vaccine viruses (rVV), and DNA based vaccines. Previous studies in mice primed with RSV G protein enhanced lung pathology resulted from a Th2 host immune response against the viral G protein. We studied for the evaluation of protective immunity, effect on airway hyperesponsiveness, and influence on lung pathology after pND G immunization. METHODS: BALB/c mice were injected with pND G(50g in 1 g/l PBS), pND G-HA (50 g), pND(50 g) FI-RSV(10 6PFU) i.d.at 0, 2, 4 weeks. Four weeks later, mice were challenged with RSV(10 6PFU). Mice were sacrificed on postchallenge day 4 and their lungs were removed for RT-PCR and viral titration. The other mice were sacrificed on postchallenge day 6 for bronchoalveolar lavage, serum and histologic examination. Airway responsiveness was assessed by using a single chamber whole body plethysmography on post challenge day 5. RESULTS: 1) Vaccination with pND-G reduced the Mch(methacholine) induced airway hyperresponsiveness after RSV infection(P<0.05). 2) Viral titers are decreased in pND-G group and FI-RSV group(P<0.05) and complete protection from RSV infection was 9/12(75%) in pND-G group. 3) Serum anti-G IgG antibody is more increased in pND-G group than RSV group(P<0.05). 4) IFN-/IL-5 ratio is increased in pND-G group(0.59) and decreased in FI-RSV group(P<0.036). 5) Inflammatory response in BAL after RSV infection was decreased by pND-G vaccination(P>0.05). CONCLUSION: In this study, immunization with pND encoding G protein induced decrease in airway hyperresponsiveness, and protection against RSV infection of the lower respiratory tract infection and also induced virus neutralizing antibody and decrease in lymphocytic inflammation. pND G immunization elicited balanced pulmonary Th1/Th2 cytokine response without atypical pulmonary inflammatory responses.
Animals ; Antibodies, Neutralizing ; Asthma ; Bronchoalveolar Lavage ; Child ; DNA* ; Formaldehyde ; GTP-Binding Proteins ; Humans ; Immunization* ; Immunoglobulin G ; Infant ; Inflammation ; Lung ; Mice ; Pathology ; Peptides ; Plethysmography, Whole Body ; Pneumonia ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections ; Vaccination ; Vaccines

Ankylosing spondylitis (AS) is a chronic inflammatory disorder, commonly characterized by inflammation of axial skeleton and development of enthesopathies. Tumor necrosis factor inhibitors (TNFi) shows good therapeutic responses in AS patients without good response to non-steroidal anti-inflammatory drugs. Although TNFi are relatively safe for AS patients, serious opportunistic infections, including tuberculosis and fungal infection, could develop. Here, according to our knowledge, we report a first Korean case of pulmonary cryptococcosis in a patient with AS treated with etanercept. A 64 year-old man with AS visited due to a newly appeared pulmonary nodule on a routine chest radiography. He had been administered etanercept for 5 months. Histologic findings of the lung nodule showed characteristic features of cryptococcosis. Etanercept was discontinued and oral fluconazole was administrated, as there was no evidence of central nervous system involvement. After 7 months of treatment, chest CT showed an improvement of the pulmonary lesion.
Central Nervous System ; Cryptococcosis* ; Fluconazole ; Humans ; Inflammation ; Lung ; Opportunistic Infections ; Radiography ; Rheumatic Diseases ; Skeleton ; Spondylitis, Ankylosing* ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis ; Tumor Necrosis Factor-alpha ; Etanercept

Breast cancer is the most common type of female cancer. Tamoxifen, a selective estrogen receptor modulator, is widely used to decrease breast cancer recurrence and mortality among patients. However, it also increases the risk of endometrial cancer. This study aimed to assess knowledge and decisional conflict regarding tamoxifen use. Between June and October 2014, breast cancer patients using tamoxifen were consecutively screened and requested to complete a survey including the EQ-5D, Satisfaction with Decision Scale (SWD), Decisional Conflict Scale (DCS), and a self-developed, 15-item questionnaire measuring tamoxifen-related knowledge. The study sample comprised 299 patients. The mean total knowledge score was 63.4 of a possible 100.0 (range, 13.3-93.3). While 73.9% of the participants knew that tamoxifen reduces the risk of breast cancer recurrence, only 57.9% knew that the drug increases endometrial cancer risk. A higher education level (> or =college) was associated with a higher, total knowledge score (beta = 4.291; P = 0.017). A higher knowledge score was associated with a decreased DCS score (beta = -0.366; P < 0.001). A higher SWD score was also associated with decreased decisional conflict (beta = -0.178; P < 0.001). In conclusion, the breast cancer patients with higher levels of tamoxifen-related knowledge showed lower levels of decisional conflict regarding tamoxifen use. Clinicians should provide the exact information about tamoxifen treatment to patients, based on knowledge assessment results, so as to aid patients' decision-making with minimal conflict.
Adult ; Aged ; Antineoplastic Agents, Hormonal/adverse effects/therapeutic use ; Breast Neoplasms/*drug therapy/epidemiology ; Consent Forms/*statistics & numerical data ; Decision Making ; Endometrial Neoplasms/*chemically induced/epidemiology/prevention & control ; Female ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Middle Aged ; Patient Education as Topic/*statistics & numerical data ; Patient Participation/statistics & numerical data ; Prevalence ; Republic of Korea ; Risk Assessment ; Tamoxifen/*adverse effects/*therapeutic use

No abstract available.
Stroke*

PURPOSE: We are inclined to analyze the relationship between the intrapulmonary right-to-left shunt and the PaO2/PaCO2 after endotracheal single-dose surfactant instillation to premature neonates with respiratory distress syndrome within 6 hours after birth. METHODS: From Jan. 1993 to Jun. 1995, we have conducted a clinical trial of surfactant replacement therapy to the premature neonates with respiratory distress syndrome at the neonatal intensive care unit of InHa University Hospital. The surfactant group (n=17) was given Surfactant-TA and mechanical ventilator care, but the control group (n=22) was treated with only mechanical ventilator. We analyzed umbilical arterial blood gases and estimated respiratoy indexes before and after treatment. RESULTS: 1) The QSP/QT decreased initially in the surfactant group, but significantly increased 24 hours after treatment in the control group (40.6+/-4.7%, P<0.05). 2) The PaO2 significantly decreased 2 hours and 24 hours after treatment in the control group (60.8+/-10.1mmHg, 63.5+/-7.6mmHg, P<0.05 respectively). There were significant correlations between the QSP/QT and the PaO2 in both groups, and specifically in the conrol group 24 hours after treatment (r=-0.94, P<0.001). 3) The PaCO2 significantly increased 1 hour after treatment, but significantly decreased specifically in the control group 24 hours after treatment (32.5+/-1.8mmHg, P<0.01). However, there were no signifacnt correlations between the QSP/QT and the PaCO2 in both groups. CONCLUSIONS: Specifically in the control group 24 hours after treatment, with hypocapnia, significant increase in pulmonary blood flow to capillary shunt and low VA/Q units (VA/Q<0.1) at high FIO2 (>0.5) resulted in a decrease in PaO2 and also a significant relationship was found between the QSP/QT and the PaO2. However, there was no significant relationship between the QSP/QT and the PaCO2.
Capillaries ; Gases ; Humans ; Hypocapnia ; Infant, Newborn* ; Intensive Care, Neonatal ; Parturition ; Pulmonary Surfactants* ; Ventilators, Mechanical

OBJECTIVE: To suggest early surgical treatment of fronto-orbital fibrous dysplasia, the authors present the surgical experiences of fronto-orbital fibrous dysplasia in 8 cases. METHODS: A total of 8 surgically treated patients with fronto-orbital fibrous dysplasia is included in this study. There were 4 males and 4 females with age range between 6 and 50(average 23.5 years). All presented with painless bulging mass in fronto-orbital region, and seven had varying degrees of proptosis with variable degrees of visual symptoms. Six cases were treated with radical resection and immediate orbital and cranial reconstruction using polymethylmethacrylate(PMMA) and miniplates. Two cases were treated with minimal resection and contouring using autogenous bone graft. RESULTS: No complications were seen except transient ptosis and wound infection in one case, respectively. There were no signs of recurrence during follow-up period(up to 4 years). Cosmetic results were acceptable in 7 seven patients but reoperation was required in remaining one patient 4 years after first operation. The patients who had visual symptoms showed improvement postoperatively. CONCLUSION: These results emphasize the importance of the early treatment with surgical approach in patients with fronto-orbital fibrous dysplasia who have visual sympotoms and cosmetinc problems. However, further study with larger population is warranted to validate early surgical correction in patients with varying degrees of symptomatologies.
Exophthalmos ; Female ; Follow-Up Studies ; Frontal Bone ; Humans ; Male ; Orbit ; Recurrence ; Reoperation ; Transplants ; Vision Disorders ; Wound Infection

No abstract available.
Adenoma* ; Rectum*

The purpose of current study was to investigate associations of serum 25-hydroxyvitamin D (OHVD) levels with markers for metabolic syndrome in elderly Koreans. We conducted a panel study on 301 individuals over 60 yr old in Seoul, Korea, and repeatedly measured serum OHVD, glucose, insulin, and lipid levels. Mixed effect model and generalized estimating equations were used to investigate relationships between serum OHVD levels with marker levels for metabolic syndrome and each of its categories. Of all subjects, 76.6% were vitamin D deficient (< 50 nM) and 16.9% were insufficient (< 75 nM). Inverse association was demonstrated between serum OHVD levels and insulin (P = 0.004), triglyceride (P = 0.023) and blood pressure (systolic blood pressure: P = 0.002; diastolic blood pressure: P < 0.001). Vitamin D deficiency was found to increase risk of 'hypertriglyceridemia' category of metabolic syndrome (odds ratio: 1.73, 95% confidence interval: 1.13-2.66). In conclusion, we found from our repeated measure analysis that decreasing serum OHVD levels are associated with increasing insulin resistance, increasing serum triglyceride levels and increasing blood pressure in elderly Koreans, and confirmed on the risk of 'hypertriglyceridemia' in vitamin D deficient subjects.
Aged ; Aged, 80 and over ; Biological Markers/blood ; Blood Pressure ; Female ; Humans ; Hypertriglyceridemia/diagnosis/etiology ; Insulin/blood ; Insulin Resistance ; Male ; Metabolic Syndrome X/*diagnosis/etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Triglycerides/blood ; Vitamin D/*analogs & derivatives/blood ; Vitamin D Deficiency/complications

BACKGROUND: As GHBP is believed to be derived from proteolytic cleavage of the extracellular domain of the GH receptor and may be regarded as an intrinsic part of the GH-IGF-1 axis, an effect of body composition on circulating GHBP levels may be expected. We investigated GHBP variations in obesity with varying glucose tolerance and its relationship to body fat distribution, sex hormones, insulin secretion, and the GH-IGF-1 axis. METHODS: Bioelectrical impedence for measurement of total body fat and computed tomography for visceral fat and subcutaneous fat at umbilicus level were performed in 69 obese Koreans and 21 lean Koreans. Insulin secretion in response to an oral glucose tolerance test (OGTT) and a GH stimulation test by L-dopa, growth hormone-binding protein (GHBP), insulin-like growth factor (IGF)-1 and sex hormones (estrone, estradiol, total and free testosterone) were measured. RESULTS: Obese type 2 DM group had the highest GHBP levels and the most visceral fat amount. GHBP levels were most strongly correlated with the ratio of visceral fat area to body weight (VWR) above other parameters (r=0.725, p<0.001). Insulin- and free fatty acid-area under the curve (AUC) during OGTT and IGF-1 level were also positively correlated with GHBP levels (r=0.474, p<0.005; r=0.572, p<0.005; r=0.453, p<0.005). GH-AUC to L-dopa stimulation test was negatively correlated with GHBP levels (r=0.432, p<0.005). The GHBP level was slightly higher in females than in male in the same glucose tolerance category. In males, total and free testosterone levels were negatively correlated with GHBP levels (r=-0.516, p<0.001;r=-0.653, p<0.001). Stepwise multiple linear regression analysis showed that VWR, FFA-and insulin-AUC significantly contributed to the variability of GHBP (r=0.58). CONCLUSION: We demonstrated that 1) visceral fat amount was mainly determined GHBP levels in obese subjects with varying glucose tolerance; 2) hyperglycemia per se did not influence GHBP level, whereas insulin and FFA could play a role in regulation of GHBP level. 3) The constant concentration of IGF-1 despite GH hyposecretion suggests that increased GHBP level retlect GHBP hypersensitivity in order to compensate for decreased GH secretion in obesity; 5) the lower level of GHBP in males might be explained at least in part by a suppressive effect of androgen.
Adipose Tissue* ; Axis, Cervical Vertebra* ; Body Composition ; Body Fat Distribution* ; Body Weight ; Carrier Proteins* ; Estradiol ; Female ; Glucose Tolerance Test ; Glucose* ; Gonadal Steroid Hormones ; Growth Hormone* ; Humans ; Hyperglycemia ; Hypersensitivity ; Insulin* ; Insulin-Like Growth Factor I ; Intra-Abdominal Fat ; Levodopa ; Linear Models ; Male ; Obesity* ; Subcutaneous Fat ; Testosterone ; Umbilicus