Background: In order to elucidate one of the pathogenic mechanisms of ARDS associated with pulmonary surfactant and oxidant injury, acute lung injury was induced by N-nitroso- N-methylurethane (NNNMU). In this model, the role of phospholipase A2 (PLA2), surfactant, gamma glutamyl transferase (GGT) and morphology were investigated to delineate one of the pathogenic mechanisms of ARDS by inhibition of PLA2 with high dose of dexamethasone. Method: Acute lung injury was induced in Sprague-Dawley rats by NNNMU which is known to induce acute lung injury in experimental animals. To know the function of the alveolar type II cells, GGT activity in the lung and bronchoalveolar lavage was measured. Surfactant phospholipid was measured also. PLA2 activity was measured to know the role of PLA2 in ARDS. Morphological study was performed to know the effect of PLA2 inhibition on the ultrastructure of the lung by high dose of dexamethasone. Results: Six days after NNNMU treatment (4 mg/kg), conspicuous pulmonary edema was induced and the secretion of pulmonary surfactant was decreased significantly. In the acutely injured rats' lung massive infiltration of leukocytes was observed. At the same time rats given NNNMU had increased PLA2 and GGT activity tremendously. Morphological study revealed bizarre shaped alveolar type II cells and hypertrophied lamellar bodies in the cytoplasm of the alveolar type II cells. But after dexamethasone treatment (20 mg/kg, for six days) in NNNMU-treated rats, these changes were diminished i.e. there were decrease of pulmonary edema and increase of surfactant secretion from alveolar type II cells. Rats given dexamethasone and NNNMU had decreased PLA2 and GGT activity in comparison to NNNMU induced ARDS rats. Conclusion: Inhibition of PLA2 by high dose of dexamethasone decreased pathological findings caused by infiltration of leukocytes and respiratory burst. Based on these experimental results, it is suggested that an activation of PLA2 is the one of the major factors to evoke the acute lung injury in NNNMU-induced ARDS rats.
Acute Lung Injury ; Animals ; Bronchoalveolar Lavage ; Cytoplasm ; Dexamethasone* ; Leukocytes ; Lung* ; Phospholipases A2 ; Pulmonary Edema ; Pulmonary Surfactants ; Rats* ; Rats, Sprague-Dawley ; Respiratory Burst ; Transferases

BACKGROUND AND OBJECTIVES: The spinal accessory nerve dysfunction is a serious sequela following selective neck dissections despite preservation of the spinal accessory nerve. The incidence of this complication is known to be 20%-30% and the primary cause of nerve dysfunction is known as significant traction during resection of level IIb lymph node group. To try to answer whether level IIb could be preserved, we evaluated the incidence of metastasis to level IIb lymph node from various types of the head and neck cancer. MATERIALS AND METHODS: Sixty patients who underwent surgery for their head and neck cancer as an initial treatment from February 1999 to July 2000 were prospectively evaluated. Histopathological evaluations for 106 neck dissection specimens were performed in 60 patients with the head and neck cancer. RESULTS: A total of 7 patients (11.7%) had metastasis to level IIb lymph node. All but one case had ipsilateral level IIb metastasis. All seven cases had multiple lymph node metastases to other levels, including level I, IIa, III, IV, or V. Occult metastasis to level IIb was noted in one case of 25 clinically proven N0 head and neck cancer patients (4%). Primary sites and pathologies with level IIb metastasis were varied, including such sites as upper eyelid, parotid gland, or thyroid gland. CONCLUSIONS: This preliminary report reveals low incidence of level IIb metastasis in some of clinically proven N0 head and neck cancer. Contralateral level IIb lymph node could be preserved in clinically proven N0 heasd and neck cases. Multiple lymph node metastases increase the probability of metastasis to level IIb. Level IIb resection is necessary in clinically proven N+ cases with multiple nodes or multiple levels of metastases. Also, Level IIb metastasis may tend to increase in some of the primary sites, which drain into the jugular chain via level IIb lymph node.
Accessory Nerve ; Eyelids ; Head and Neck Neoplasms* ; Head* ; Humans ; Incidence ; Lymph Nodes* ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Parotid Gland ; Pathology ; Prospective Studies ; Thyroid Gland ; Traction

BACKGROUND: Arm span measurements provide a practical substitute for standing height to predict normal spirometric values in subjects unable to stand or those with a skeletal deformity such as kyphoscoliosis. The relationship between arm span and height has previously been reported as either a fixed ratio unaffected by age or as a regression equation in which the ratio varies as a function of age. The fixed ratio or regression equation is known to be specific for sex and race. METHODS: We studied the relationship between standing height, arm span, and age in 381 Korean adult female subjects (ages 20 to 69 yrs) sampled in a general population. RESULTS: The mean ratio for arm span to height is 1.004. Multiple linear analysis found arm span and age to be predictive of standing height (p=0.0001, r2=0.76). We performed the analysis of the difference between the predicted height using either fixed ratio or regression equation and actual height. At the extremes of arm span and age, the ratio method either underestimated (at smaller arm span or younger age) or overestimated (at larger arm span or older age) as compared with actual height (p=0.0001). CONCLUSION: This results indicate that the estimated height using the fixed ratio method provides a less acceptable method of estimating height for the prediction of lung volumes in the Korean adult women when compared with the regression equations, especially at the extremes of stature or age.
Adult* ; Arm* ; Congenital Abnormalities ; Continental Population Groups ; Female ; Humans ; Lung ; Spirometry

PURPOSE: This study sought to determine the 1-year clinical effectiveness and safety of a biodegradable, polymer-containing Biolimus A9™-eluting stent (BES) in Korean patients with acute coronary syndrome (ACS). MATERIALS AND METHODS: A total of 1000 ACS patients with 1251 lesions who underwent implantation of BESs at 22 centers in Korea were enrolled between May 2011 and July 2013. We assessed major adverse cardiac events (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinical-driven target vessel revascularization at 12 months. RESULTS: Patient mean age was 62.6±11.4 years. 72.8% of the patients were male, 28.5% had diabetes, 32.8% had multi-vessel disease (MVD), and 47.9% presented with acute MI (AMI). The mean global registry of acute coronary events risk score of all patients was 103.0±27.6. The number of stents per patient was 1.3±0.6. The incidences of MACE and definite stent thrombosis at 12 months were 3.9% and 0.2%, respectively. On multivariate Cox-regression analysis, age ≥65 years was identified as an independent predictors of 1-year MACE (hazard ratio=2.474; 95% confidence interval=1.202−5.091). Subgroup analyses revealed no significant differences in the incidence of MACE between patients with and without diabetes (4.3% vs. 3.7%, p=0.667), between those who presented with and without AMI (4.4% vs. 3.4%, p=0.403), and between those with and without MVD (4.6% vs. 3.5%, p=0.387). CONCLUSION: Our study demonstrated excellent 1-year clinical outcomes of BES implantation in patients at low-risk for ACS.
Acute Coronary Syndrome/drug therapy ; Aged ; Drug-Eluting Stents/adverse effects ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Republic of Korea ; Sirolimus/adverse effects ; Sirolimus/analogs & derivatives ; Sirolimus/therapeutic use ; Time Factors ; Treatment Outcome