BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is commonly planned to prevent and treat complications, unnecessary admission to the S-ICU increases medical costs and length of hospital stay. This study aimed evaluated outcome and the predictive factors for mortality in patients admitted to the S-ICU after abdominal surgery. METHODS: The 168 patients admitted to the S-ICU immediately after abdominal surgery were reviewed retrospectively from January to December 2011. RESULTS: The mortality rate of patients admitted to the S-ICU after abdominal surgery was 8.9% (15 of 168). Two preoperative factors (body mass index [BMI] < 18.5 kg/m2 [p < 0.001] and serum albumin < 3.0 g/dL [p = 0.018]), two operative factors (the need for transfusion [p = 0.008] or vasopressors [p = 0.013] during surgery), and three postoperative variables (mechanical ventilation immediately following surgery [p < 0.001], sequential organ failure assessment [p = 0.001] and SAPS II [p = 0.001] score) were associated with mortality in univariate analysis. After adjusting for age, gender, and SAPS II by a Cox regression, which revealed that BMI < 18.5 kg/m2 (p < 0.001, hazard ratio [HR] 9.690, 95% confidence interval [CI] 2.990-25.258) and the use of mechanical ventilation on admission to S-ICU (p < 0.001, HR 34.671, 95% CI 6.440-186.649) were independent prognostic factors. CONCLUSIONS: In patients in S-ICU after abdominal surgery, low BMI and postsurgical mechanical ventilation should be considered important predictors of mortality.
Abdomen* ; Body Mass Index ; Humans ; Critical Care ; Intensive Care Units ; Length of Stay ; Mortality ; Postoperative Complications ; Prognosis* ; Respiration, Artificial ; Retrospective Studies ; Serum Albumin ; Ventilation

This study was performed to investigate the changes of nerve after the injection of alcohol and glycerol at the infraorbital nerve in rats. Using the eighteen Sprague-Dawley rats, weighing 200-250g, 99% alcohol, pure glycerol, and sterile saline was injected to the epineurium of the infraorbital nerve. Glycerol injected rats were devided into 0.01ml, 0.03ml and 0.05ml groups. The alcohol and control group were injected 0.03ml at the left infraorbital nerve. The following results were obtained by histopathological examination after 1 week, 1 month, and 3 months. A few inflammatory cell infiltration and no signs of nerve degeneration were noted in control group. Total nerve degeneration was noted in the alcohol group and no regeneration was noted in 1month, and partial regeneration was noted at 3month. The nerve degeneration was noted at the periphery of nerve bundle in 0.01ml glycerol injection group. Total degeneration was noted in the 0.03ml and 0.05ml glycerol injection group and the degree was propotional to dose. These results suggest that injection of alcohol and glycerol are effective to nerve blockage by nerve degeneration, and nerve degeneration by glycerol injection is propotional to dose and nerve regeneration by glycerol injection is inversely propotional to dose.
Animals ; Glycerol* ; Nerve Degeneration ; Nerve Regeneration ; Peripheral Nerves ; Rats* ; Rats, Sprague-Dawley ; Regeneration

The purpose of the present study was to investigate the effect of Bioactive glass on bone regeneration in the experimental mandibular bone defects. Five rabbits, weighing about 2.0kg, were used. Three artificial bone defects, 5x5x5mm in size, were made at the inferior border of the mandible. In the experimental group 1, the bone defect was grafted with Biogran and covered with Bio-Gide resorbable membrane. In the experimental group 2, Biogran was grafted only. In the control group, the bone defect was filled with blood clot and was spontaneously healed. The animals were sacrificed at 1, 2, 4, and 8 weeks after the graft. Microscopic examination was performed. Results obtained were as follows: In the control group, the osteoid tissue was observed at week 1 and the bone trabeculi were connected each other and matured at week 2. The lamellar bone formation appeared at week 4, and the amount of bone tissue was increased at week 8. In the experimental group 1, the fibrous tissue was filled between the granules of Bioactive glass and the cartilage formation was found adjacent to the normal bone at week 1. The bone tissue was formed between the granules at week 2, while the amount of bone tissue increased and the lamellar bone formation was observed at week 4. The lamellar bone was increased at week 8. Histologic findings were Similar between the experimental groups 1 and 2, although the amount of Bioactive glass granules lost was increased in the latter. These results suggest that new bone formation is found around the Bioactive glass granules grafted into the bone defects, and the membrane plays a role in keeping the granules and preventing the fibrous tissue invasion.
Animals ; Bone and Bones ; Bone Regeneration* ; Cartilage ; Glass* ; Mandible ; Membranes* ; Osteogenesis ; Rabbits ; Transplants

Cicatrix ; Cleft Lip ; Humans ; Hypertrophy ; Incidence ; Jeollanam-do ; Lip ; Nose ; Surgery, Oral

Abscess ; Branchial Region ; Branchioma ; Clavicle ; Diagnostic Errors ; Drainage ; Epithelium ; Female ; Fistula ; Humans ; Inflammation ; Lymphoid Tissue ; Male ; Neck ; Pregnancy ; Recurrence

BACKGROUND: The cell-mediated immune reaction to tuberculosis infection involves a complex network of cytokines. The extent of inflammation, tissue damage and severity of the disease suggested to be determined by the balance between extent and duration of the proinflammatory cytokine response versus those of the suppressive cytokines. The systemic cytokine response in pathogenesis of tuberculosis can be assessed by measuring serum cytokine levels. METHOD: Serum interleukin-1 beta(IL-1 ), IL-2, IL-4, IL-6, IL-10, IL-12(p40), tumor necrosis factor-alpha(TNF-alpha), interferon-gamma(IFN-gamma) and transforming growth factor-beta(TGF-beta) levels were measured in 83 patients with pulmonary tuberculosis, 10 patients with endobronchial tuberculosis before treatment and 20 healthy subjects by using a sandwich ELISA. In patients with pulmonary tuberculosis, they were divided into mild, moderate and far advanced group according to the severity by ATS guidelines. To compare with those of pretreatment levels, we measured serum IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-12(p40), TNF-alpha, IFN-gamma and TGF-beta levels in 45 of 83 patients with pulmonary tuberculosis after 2 and 6 months of treatment. RESULTS: 1) In sera of patients with active pulmonary tuberculosis(n=83), IL-1beta, IL-6(p<0.05), TNF-alpha, and IFN-gamma were elevated and TGF-beta was decreased comparing to control. IL-2, IL-12(p40), IL-4 and IL-10 were similar between the patients with tuberculosis and control. 2) In endobronchial tuberculosis, IL-6 and TNF-alpha were elevated and TGF-beta was decreased comparing to control. IL-12(p40) seemed to be elevated comparing to pulmonary tuberculosis. 3) Far advanced tuberculosis showed markedly elevated IL-6 and IFN-gamma level(p<0.05). 4) The significant correlations were noted between IL-1, IL-6 and TNF-alpha and between IL-12, IL-2 and IL-4(p<0.01). 5) After 2 and 6 months of standard treatment, the level of IL-6 and IFN-gamma was significantly decreased(p<0.05). CONCLUSION: These results showed that an altered balance between cytokines is likely to be involved in the extent of inflammation, tissue damage and severity of the disease tuberculosis. But, it should be considered diversities of cytokine response according to type of tuberculosis and immunity in clinical application and interpreting future studies.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-1 ; Interleukin-10 ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Korea* ; Necrosis ; Transforming Growth Factor beta ; Tuberculosis* ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha

Cancers are mainly sustained by a small pool of neoplastic cells, known as cancer stem cells or tumor-initiating cells. These cells possess the ability to self-renew and proliferate, and are thus able to form the tumor. In the present study cells that correspond to cancer stem cells in mammary and liver cancers in animals were identified by the expression of CD133, CD44, CK7, and OCT4 using immunochemistry. As a result, we found with CD133+ and CD44+ cancer stem cell-like phenotypes in mouse and canine hepatocellular carcinoma and canine mammary gland tumors. However, CK7+ and OCT4+ cells were not identified in animal mammary and liver cancer. CD133+ and CD44+ cells are wellknown stem cell lines and play key roles in development and metastasis in human cancer. These findings suggest that cancer stem cells are involved in animal tumorigenesis and may provide insight into mechanisms in cancer development as well as cancer diagnostics.
Animals ; Carcinoma, Hepatocellular ; Cell Transformation, Neoplastic ; Humans ; Immunochemistry ; Liver Neoplasms ; Mammary Glands, Human ; Mice ; Neoplasm Metastasis ; Neoplastic Stem Cells ; Phenotype ; Stem Cells

BACKGROUND: The presence of infiltrated mediastinal lymph nodes is a crucial factor for the prognosis of lung cancer. The aim of our study is to investigate the pattern of metastatic non-small cell lung cancer that spreads to the mediastinal lymph nodes, in relation to the primary tumor site, in patients who underwent major lung resection with complete mediastinal lymph node dissection. MATERIAL AND METHOD: We retrospectively studies 293 consecutive patients [mean age 63.0+/-8.3 years (range 37~88) and 220 males (75.1%)] who underwent major lung resection due to non-small cell lung cancer from January 1998 to December 2005. The primary tumor and lymph node status was classified according to the international TNM staging system reported by Mountain. The histologic type of the tumors was determined according to the WHO classification. Fisher's exact test was used; otherwise the chi-square test of independence was employed. A p-value <0.05 was considered significant. RESULT: Lobectomy was carried out in 180 patients, bilobectomy in 50, sleeve lobectomy in 10 and pnemonectomy in 53. The pathologic report revealed 124 adenocarcinomas, 138 squamous-cell tumors, 14 adenosquamous tumors, 1 carcinoid tumor, 8 large cell carcinomas, 1 carcinosarcoma, 2 mucoepidermoid carcinomas and 5 undifferentiated tumors. The TNM stage was IA in 51 patients, IB in 98, IIB in 41, IIIA in 71, IIIB in 61 and IV in 6. 25.9 % of the 79 patients had N2 tumor. Most common infiltrated mediastinal lymph node was level No.4 in the right upper lobe, level No. 4 and 5 in the left upper lobe and level No. 7 in the other lobes, but no statistically significant difference was observed. Thirty-six patients (12.3%) presented with skip metastasis to the mediastinum. CONCLUSION: Mediastinal lymph node dissection is necessary for accurately determining the pTNM stage. It seems that there is no definite way that non-small cell lung cancer spreads to the lymphatics, in relation to the location of the primary cancer. Further, skip metastasis to the mediastinal lymph nodes was present in 12.3% of our patients.
Adenocarcinoma ; Carcinoid Tumor ; Carcinoma, Large Cell ; Carcinoma, Mucoepidermoid ; Carcinoma, Non-Small-Cell Lung ; Carcinosarcoma ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Mediastinum ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies

BACKGROUND: Chemotaxis is one of the cardinal functions of leukocytes, which enables them to be recruited efficiently to the right place at the right time. Analyzing chemotactic activities is important not only for the study on leukocyte migration but also for many other applications including development of new drugs interfering with the chemotactic process. However, there are many technical limitations in the conventional in vitro chemotaxis assays. Here we applied a new optical assay to investigate chemotactic activities induced in differentiated HL-60 cells. METHODS: HL-60 cells were stimulated with 0.8% dimethylformamide (DMF) for 4 days. The cells were analyzed for morphology, flow cytometry as well as chemotactic activities by a time-lapse videomicroscopic assay using a chemotactic microchamber bearing a fibronectin-coated cover slip and an etched silicon chip. RESULTS: Videomicroscopic observation of the real cellular motions in a stable concentration gradient of chemokines demonstrated that HL-60 cells showed chemotaxis to inflammatory chemokines (CCL3, CCL5 and CXCL8) and also a homeostatic chemokine (CXCL12) after DFM-induced differentiation to granulocytic cells. The cells moved randomly at a speed of 6.99+/-1.24 micrometer/min (n=100) in the absence of chemokine. Chemokine stimulation induced directional migration of differentiated HL-60 cells, while they still wandered very much and significantly increased the moving speeds. CONCLUSION: The locomotive patterns of DMF-stimulated HL-60 cells can be analyzed in detail throughout the course of chemotaxis by the use of a time-lapse videomicroscopic assay. DMF-stimulated HL-60 cells may provide a convenient in vitro model for chemotactic studies of neutrophils.
Chemokines ; Chemotaxis ; Dimethylformamide ; Flow Cytometry ; HL-60 Cells* ; Humans ; Leukocytes ; Microscopy, Video ; Neutrophils ; Silicon

Although failure of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) is generally believed to be associated with cross-resistance to other EGFR TKI, the benefit of administering erlotinib as a second EGFR TKI after resistance of gefitinib as the first TKI has been well known. However, good response to gefitinib after an initial response to erlotinib has been rare. We report that a 45-year-old woman (never smoked), with lung adenocarcinoma and EGFR mutation, showed an initial response to erlotinib, and then responded to gefitinib again.
Adenocarcinoma ; Female ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride