BACKGROUND: Despite the many advantages of recombinant subunit vaccines, they have critical weaknesses that include a low efficacy for promoting cellular and humoral immune responses against antigens because of their poor immunogenicity, and a rapidly cleared properties as a result of proteolytic enzymes in the body. To circumvent these problems, we developed mannan-decorated inulin acetate microparticles (M-IA MPs) that functioned as carriers and adjuvants for immunization with the recombinant foot-and-mouth disease multi-epitope subunit vaccine (M5BT). METHODS: The M5BT-loaded M-IA MPs were obtained by a double-emulsion solvent-evaporation method. Their properties including morphology, size and release ability were determined by field emission scanning electron microscope, dynamic light-scattering spectrophotometer and spectrophotometer. To assess the immunization efficacy of the MPs, mice were immunized with MPs and their sera were analyzed by ELISA. RESULTS: The M-IA MPs obtained by a double-emulsion solvent-evaporation method were spherical and approximately 2–3 µm, and M5BT was encapsulated in the M-IA MPs. The M5BT-loaded M-IA MPs showed higher antigen-specific IgG, IgG1, IgG2a and anti-FMDV antibodies than the M5BT-loaded IA MPs and the Freund’s adjuvant as a control. CONCLUSION The M-IA MPs showed a powerful and multifunctional polymeric system that combined two toll-like receptor agonists compared to the conventional adjuvant.

BACKGROUND: Despite the many advantages of recombinant subunit vaccines, they have critical weaknesses that include a low efficacy for promoting cellular and humoral immune responses against antigens because of their poor immunogenicity, and a rapidly cleared properties as a result of proteolytic enzymes in the body. To circumvent these problems, we developed mannan-decorated inulin acetate microparticles (M-IA MPs) that functioned as carriers and adjuvants for immunization with the recombinant foot-and-mouth disease multi-epitope subunit vaccine (M5BT). METHODS: The M5BT-loaded M-IA MPs were obtained by a double-emulsion solvent-evaporation method. Their properties including morphology, size and release ability were determined by field emission scanning electron microscope, dynamic light-scattering spectrophotometer and spectrophotometer. To assess the immunization efficacy of the MPs, mice were immunized with MPs and their sera were analyzed by ELISA. RESULTS: The M-IA MPs obtained by a double-emulsion solvent-evaporation method were spherical and approximately 2–3 µm, and M5BT was encapsulated in the M-IA MPs. The M5BT-loaded M-IA MPs showed higher antigen-specific IgG, IgG1, IgG2a and anti-FMDV antibodies than the M5BT-loaded IA MPs and the Freund’s adjuvant as a control. CONCLUSION The M-IA MPs showed a powerful and multifunctional polymeric system that combined two toll-like receptor agonists compared to the conventional adjuvant.

BACKGROUND/AIMS: Neutrophil gelatinase-associated lipocalin (NGAL) is a well-known biomarker of acute kidney injury. We evaluated the value of plasma NGAL (pNGAL) as an independent predictor of prognosis in immunoglobulin A nephropathy (IgAN). METHODS: In total, 91 patients with biopsy-proven IgAN at a single center were evaluated. pNGAL was measured using a commercial enzyme-linked immunosorbent assay kit (R&D Systems). Adverse renal outcome was defined as chronic kidney disease (CKD) stage 3 or above at the last follow-up. Pearson correlation coefficient and Cox regression were used for analyses. RESULTS: The mean age of all patients (male:female, 48:43) was 35 years (range, 18 to 77). pNGAL ranged between 21.68 and 446.40 ng/mL (median, 123.97) and showed a correlation with age (r = 0.332, p = 0.001), creatinine (r = 0.336, p = 0.001), estimated glomerular filtration rate (r = -0.397, p < 0.001), uric acid (r = 0.289, p = 0.006), and the protein-to-creatinine ratio (r = 0.288, p = 0.006). During a mean follow-up period of 37.6 months, 11 patients (12.1%) had CKD stage 3 or above. In a multivariate Cox regression model, hypertension (hazard ratio [HR], 8.779; 95% confidence interval [CI], 1.526 to 50.496; p = 0.015), proteinuria > 1 g/day (HR, 5.184; 95% CI, 1.124 to 23.921; p = 0.035), and pNGAL (HR, 1.012; 95% CI, 1.003 to 1.022; p = 0.013) were independent predictors associated with adverse renal outcome. CONCLUSIONS: pNGAL showed strong correlations with other clinical prognostic factors and was also an independent predictor of adverse renal outcome. We suggest pNGAL as a potential predictor for prognosis in IgAN, while further studies are needed to confirm the clinical value.
Acute-Phase Proteins ; Adolescent ; Adult ; Aged ; Biomarkers/blood ; Biopsy ; Chi-Square Distribution ; Creatinine/blood ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/*blood/complications/pathology/physiopathology ; Humans ; Kidney/*metabolism/pathology/physiopathology ; Linear Models ; Lipocalins/*blood ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Proto-Oncogene Proteins/*blood ; Renal Insufficiency, Chronic/blood/etiology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Time Factors ; Young Adult

BACKGROUND/AIMS: Encapsulating peritoneal sclerosis (EPS) is an often-fatal complication of long-term peritoneal dialysis (PD). We here report the clinical features of EPS in Korean PD patients from a single university center. METHODS: The data were collected retrospectively from 606 PD patients at Kyungpook National University Hospital, between August 2001 and August 2011. The diagnosis of EPS was based on clinical signs and symptoms, and confirmed by radiological findings. RESULTS: Eight patients (1.3%, four males) were diagnosed with EPS. The mean age of the patients was 48.5 years (range, 33 to 65). The mean duration of PD was 111.8 months (range, 23 to 186). All patients except for one had three or more episodes of peritonitis. Seven patients were diagnosed with EPS after stopping PD, and only one stayed on PD after initial diagnosis and treatment. Total parenteral nutrition and corticosteroids, in addition to tamoxifen therapy, were used to treat most of the patients, and one patient underwent surgery (adhesiolysis). The overall mortality rate was 50%. CONCLUSIONS: EPS is a serious, life-threatening complication in patients on long-term PD. To reduce the incidence and mortality rate of EPS, careful monitoring and early diagnosis is needed.
Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Female ; *Hospitals, University ; Humans ; Male ; Middle Aged ; Parenteral Nutrition, Total ; Peritoneal Dialysis/*adverse effects/mortality ; *Peritoneal Fibrosis/diagnosis/etiology/mortality/therapy ; *Peritonitis/diagnosis/etiology/mortality/therapy ; Republic of Korea ; Retrospective Studies ; Tamoxifen/therapeutic use ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

STUDY DESIGN: A retrospective study. OBJECTIVES: We attempted to establish an efficient diagnosis and treatment modality by analyzing clinical manifestations and operative results of upper lumbar disc herniations. SUMMARY OF LITERATURE REVIEW: Upper lumbar disc herniations represented a lower incidence but have become easier to diagnose by predictable clinical aspects and an MRI scan. The operative results have been satisfactory. MATERIALS AND METHODS: We evaluated 41 cases, which were operated with posterior laminectomy and discectomy from September, 1996 to November, 2009. We analyzed pre-operative history, clinical and MRI findings, and then assessed operative results by Kim's criteria and functional change in the follow up. RESULTS: The prevalence of upper lumbar disc herniations in all disc herniations was 8.8%. Pre-operative manifestations were lower back pain (85.4%), radiating pain (80.5%), sensory deficit (53.7%), motor deficit (53.7%), and depressed knee jerk (65.9%). The positive rate of the femoral stretching test (78.0%) was higher than the straight leg raising test (39.0%). The VAS score changed from preoperative 9.0+/-0.8 into postoperative 1.4+/-1.3 points. The operative results were excellent or good in 82.9%. The rate of resuming previous work, including slight modification was 90.2%. CONCLUSIONS: Predictable clinical aspects of the upper lumbar disc herniations are anterior thigh pain with lower back pain, variable motor deficit, sensory deficit, depressed knee jerk and the positive femoral nerve stretching test. Through careful examination and radiological evaluations such as MRI, operative treatment can obtain a symptomatic improvement and satisfactory results.
Diskectomy ; Femoral Nerve ; Incidence ; Knee ; Laminectomy ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Thigh

BACKGROUND: Natural killer cells expanded from human peripheral blood (PB) have been used in cancer immunotherapy research. Although most research teams have access to human PB, it is necessary to find a source of blood that can be easily obtained. We have tested the possibility of using blood retained in a disposable platelet apheresis set as an alternative source, with special interest in expansion of NK cells for use in cancer immunotherapy research. METHODS: For expansion of NK cells, peripheral blood mononuclear cells (PBMCs) were isolated from an MCS+ platelet apheresis kit (Haemonetics, Braintree, USA) and PB from the same donor (n=7) and co-cultured with 100-Gy gamma ray-irradiated K562 cells expressing the 4-1BB ligand and membrane-bound IL-15 for three weeks in RPMI1640 medium in the presence of IL-2 and IL-15. Cytotoxicity was measured using WST-1 at 1:1, 2:1, and 4:1 effector-to-target (E:T) ratios for a period of four hours. RESULTS: Mean rate of expansion of NK cells was 1,097-fold and their purity was 94.4% from blood retained in a disposable platelet apheresis set; mean rate of expansion of NK cells was 953-fold and their purity was 92.0% from PB after a period of three weeks. No differences in cytotoxicity against K562, 697, Raji, and RPMI8226 were observed between NK cells expanded from two blood sources. CONCLUSION: Blood retained in a disposable platelet apheresis set is a useful and convenient source for expansion of NK cells for use in cancer immunotherapy research.
4-1BB Ligand ; Blood Component Removal ; Blood Platelets ; Humans ; Immunotherapy ; Interleukin-15 ; Interleukin-2 ; K562 Cells ; Killer Cells, Natural ; Tissue Donors

PURPOSE: Macrophage migration inhibitory factor (MIF) may serve as a general marker for systemic inflammation in septic and nonseptic acute critical illness. Additionally, our previous experiment has demonstrated that immunosuppressant Prostaglandin E2 (PGE2) lowered MIF levels and inhibited T-cells proliferation when compared to control levels. The addition of hypertonic saline (HTS) increased MIF production as compared with PGE2-stimulated T-cells in concordance with restore PGE2-suppressed T-cells proliferation. Generally, HTS has been well known for its anti-inflammatory effect so far. Therefore, the experiments were conducted to evaluate MIF after stimulating lipopolysaccharide (LPS) either in the presence or absence of HTS in monocyte, in response to early phase injury. METHODS: Human acute monocytic leukemic cell line (THP-1) cells were cultured in RPMI media, to a final concentration of 1 x 10(6) cells/mL. The effect of HTS on LPS-induced MIF was evaluated in monocyte with 1 microg/mL LPS. HTS at 10, 20 or 40 mmol/L above isotonicity was added. MIF concentrations of the supernatant were determined by enzyme-linked immunosorbent assay, and cell lysates were used for Western blots analysis to determine the MIF expression. RESULTS: MIF concentrations in the cell supernatant increased in LPS-induced cells compared to control cells. Also, levels of MIF protein expression were higher in LPS stimulating cells. However, the addition of HTS to LPS stimulated cell restored MIF concentrations and MIF expression. CONCLUSION: The role of HTS in maintaining physiological balance in human beings, at least in part, should be mediated through the MIF pathway.
Anti-Inflammatory Agents ; Blotting, Western ; Cell Line ; Critical Illness ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunosuppression ; Inflammation ; Lipopolysaccharides ; Macrophage Migration-Inhibitory Factors ; Macrophages ; Monocytes ; Saline Solution, Hypertonic ; T-Lymphocytes

Cheek ; Dentofacial Deformities ; Female ; Humans ; Male ; Orbit ; Smiling

OBJECTIVE: To investigate the effects of different pilot-drilling methods on the biomechanical stability of self-tapping mini-implant systems at the time of placement in and removal from artificial bone blocks. METHODS: Two types of artificial bone blocks (2-mm and 4-mm, 102-pounds per cubic foot [102-PCF] polyurethane foam layered over 100-mm, 40-PCF polyurethane foam) were custom-fabricated. Eight mini-implants were placed using the conventional motor-driven pilot-drilling method and another 8 mini-implants were placed using a novel manual pilot-drilling method (using a manual drill) within each of the 2-mm and 4-mm layered blocks. The maximum torque values at insertion and removal of the mini-implants were measured, and the total energy was calculated. The data were statistically analyzed using linear regression analysis. RESULTS: The maximum insertion torque was similar regardless of block thickness or pilot-drilling method. Regardless of the pilot-drilling method, the maximum removal torque for the 4-mm block was statistically higher than that for the 2-mm block. For a given block, the total energy at both insertion and removal of the mini-implant for the manual pilot-drilling method were statistically higher than those for the motor-driven pilot-drilling method. Further, the total energies at removal for the 2-mm block was higher than that for the 4-mm block, but the energies at insertion were not influenced by the type of bone blocks. CONCLUSIONS: During the insertion and removal of mini-implants in artificial bone blocks, the effect of the manual pilot-drilling method on energy usage was similar to that of the conventional, motor-driven pilot-drilling method.
Foot ; Linear Models ; Polyurethanes ; Torque

Limy bile is a rare condition characterized by excessive precipitation of calcium carbonate in the gallbladder; limy bile in the common bile duct is also very rare. Limy bile was first described by Churchman in 1911. The etiology of limy bile is unclear, but complete cystic duct obstruction by gallstones is believed to be a prerequisite for the development of limy bile. Recently, we experienced a case with obstructive jaundice in which the initial simple radiograph showed limy bile in the cystic and common bile ducts, but not the gallbladder. Here, we report the case and review the literature.
Bile ; Calcium Carbonate ; Common Bile Duct ; Cystic Duct ; Gallbladder ; Gallstones ; Jaundice, Obstructive