BACKGROUND/AIMS: This study was tried to determine the role of β-catenin in invasion in pancreatic cancer. METHODS: We analyzed cancer invasiveness according to β-catenin expression in pancreatic cancer cell line. We also investigated the change in cancer invasiveness when β-catenin expression was changed. To enhance β-catenin activity, we treated low β-catenin cancer cell line, PANC1, with Wnt-3a conditioned media and transected β-catenin. We also treated high β-catenin expressing cell line, BxPC3, with XAV939, β-catenin inhibitor and siRNA for β-catenin to inhibit β-catenin expression. RESULTS: The high β-catenin expressing cancer cell line, BxPC3 showed higher invasiveness, and low β-catenin expressing cell lines, PANC1and MIA-PaCa-2, were less invasive. By adding the Wnt-3a conditioned media or performing transfection with β-catenin in PANC1, cell invasiveness was increased (p < 0.05 and p < 0.01, respectively). On inhibition of β-catenin by XAV939 and siRNA in BxPC3 cell line, invasiveness was significantly decreased (p < 0.01). It was not correlated with the expression of cluster of differentiation 44 (CD44) or CD44 variant 6 (CD44v6), the invasion related protein. On analysis of association with metastasis in human tissue, Wnt-3a expression was statistically correlated with the development of metastasis (p = 0.029). CONCLUSIONS Based on our data, β-catenin may be involved in cancer invasion in pancreatic cancer, and it is not associated with CD44, the invasion related protein.

OBJECTIVES: An atypical Shigella flexneri strain with a plural agglutination pattern [i.e., reacting not only with serum samples containing type antigen II but also with serum samples containing group antigens (3)4 and 7(8)] was selected for genome sequencing, with the aim of obtaining additional comparative information about such strains. METHODS: The genomic DNA of atypical S. flexneri strain NCCP 15744 was sequenced using an Ion Torrent PGM sequencing machine (Life Technologies, USA). The raw sequence data were preprocessed and reference-assembled in the CLC Assembly Cell software (version 4.0.6; CLC bio, USA). RESULTS: Ion Torrent sequencing produced 1,450,025 single reads with an average length of 144 bp, totaling ~209 Mbp. The NCCP 15744 genome is composed of one chromosome and four plasmids and contains a gtrX gene. Among the published genome sequences of S. flexneri strains, including 2457T, Sf301, and 2002017, strain NCCP 15744 showed high similarity with strain 2002017. The differences between NCCP 15744 and 2002017 are as follows: i) NCCP 15744 carries four plasmids whereas 2002017 carries five; ii) 19 genes (including CI, CII, and cro) were lost in the SHI-O genomic island of NCCP 15744 and six genes were gained as compared with strain 2002017. CONCLUSION: Strain NCCP 15744 is genetically similar to 2002017, but these two strains have different multilocus sequence types and serotypes. The exact reason is unclear, but the 19 lost genes may be responsible for the atypical seroconversion of strain NCCP 15744.
Agglutination ; DNA ; Genome* ; Genomic Islands ; Genomics ; Korea* ; Plasmids ; Sequence Analysis ; Seroconversion ; Serogroup ; Shigella flexneri* ; Shigella*

OBJECTIVES: To investigate the prevalence and toxin production characteristics of non-emetic and emetic Bacillus cereus strains isolated via the laboratory surveillance system in Korea. METHODS: A total of 667 B. cereus strains were collected by the Korea National Research Institute of Health laboratory surveillance system from 2012 to 2014. The collected strains were analyzed by geographical region, season, patient age, and patient sex. Additionally, the prevalence rates of enterotoxin and emetic toxin genes were evaluated. RESULTS: The isolation rate of B. cereus strains increased during the summer, but the isolation rate was evenly distributed among patient age groups. Emetic toxin was produced by 20.2% of the isolated strains. The prevalence rates of five enterotoxin genes (entFM, nheA, cytK2, hblC, and bceT) were 85.0, 78.6, 44.5, 36.6, and 29.7%, respectively, among non-emetic strains and 77.8, 59.3, 17.8, 11.9 and 12.6%, respectively, among emetic strains. Thus, the prevalence rates of all five enterotoxin genes were lower in emetic B. cereus. CONCLUSION: The prevalence of enterotoxin genes differed between non-emetic and emetic B. cereus strains. Among emetic B. cereus strains, the prevalence rates of two enterotoxin genes (cytK2 and hblC) were lower than those among the non-emetic strains. In both the emetic and non-emetic strains isolated in Korea, nheA and entFM were the most prevalent enterotoxin genes.
Academies and Institutes ; Bacillus cereus* ; Bacillus* ; Enterotoxins ; Epidemiology ; Humans ; Korea* ; Prevalence ; Seasons

BACKGROUND: We investigated the effects of the combined administration of nefopam, a N-methyl-D-aspartate receptor antagonist and low dose remifentanil, on early postoperative pain and analgesic requirement. METHODS: Fifty patients scheduled to undergo mastoidectomy and tympanoplasty were randomized to be given either nefopam 40 mg mixed with normal saline 100 ml (Group N) or an equal amount of normal saline (Group C) before anesthesia induction. Anesthesia was maintained with 5-6 vol% desflurane and remifentanil 0.05-0.15 microg/kg/min during the surgery. Postoperative pain was controlled by titration of ketorolac in the postanesthesia care unit (PACU) and ward. We evaluated the intraoperative remifentanil dose, recovery profiles, ketorolac demand in the PACU and ward, numeric rating scale (NRS) for pain at time intervals of every 10 min for 1 h in the PACU, 6, 12, 18 and 24 h in a ward, as well as the time to first analgesic requirement in the PACU and ward. RESULTS: Ketorolac demand and NRS in the PACU were significantly lower in Group N than Group C (P = 0.002, P = 0.005, respectively). The time to first analgesic requirement in the PACU in Group N were significantly longer than Group C (P = 0.046). There were no significant differences in intraoperative remifentanil dose, ketorolac demand, NRS, and the time to first analgesic requirement in the ward between the groups. CONCLUSIONS: Nefopam administration combined with low dose remifentanil infusion reduces pain and analgesic consumption during the immediate postoperative period in patients undergoing middle ear surgery under desflurane anesthesia.
Anesthesia* ; Ear, Middle* ; Humans ; Ketorolac ; N-Methylaspartate ; Nefopam* ; Pain, Postoperative ; Postoperative Period ; Tympanoplasty

BACKGROUND: Sevoflurane anesthesia commonly causes emergence agitation (EA) in children. One previous study has reported that the use of nitrous oxide (N2O) during the washout of sevoflurane may reduce EA by decreasing the residual sevoflurane concentration, while many animal studies suggest that N2O poses a potential risk to children. The present study was designed to compare EA in children assigned to receive sevoflurane with N2O (group N) or sevoflurane alone (group S). METHODS: We enrolled 80 children aged 3-10 years. Anesthesia was induced with 5 mg/kg thiopental sodium, 0.6 mg/kg rocuronium and 0.5 mg/kg ketorolac, and was maintained with 50% N2O and sevoflurane in group N or with sevoflurane alone in group S. The sevoflurane concentration was adjusted with a bispectral index (BIS) of 40-60. After completion of the surgery, N2O and sevoflurane were simultaneously discontinued and replaced with oxygen (O2) at 6 L/min. End-tidal sevoflurane concentration (Et Sevo) (%), BIS at the end of surgery, Et Sevo at recovery of self-respiration and emergence profiles were recorded. EA occurrence, pain score and rescue fentanyl consumption were assessed in the postanesthesia care unit. RESULTS: Et Sevo was significantly lower in group N (1.9%) than in group S (2.3%) at the end of surgery. However, there were no differences in Et Sevo at recovery of self-respiration, emergence times, the incidence of EA, pain score or dose of rescue fentanyl between the groups. CONCLUSIONS: In children undergoing adenotonsillectomy with preemptive ketorolac, anesthetic maintenance using sevoflurane alone does not affect the incidence of EA or emergence profiles compared to anesthetic maintenance using sevoflurane with N2O.
Anesthesia ; Animals ; Child* ; Dihydroergotamine* ; Fentanyl ; Humans ; Incidence ; Ketorolac* ; Nitrous Oxide ; Oxygen ; Thiopental

To perform the major operation for high risk patients with both serious systemic diseases and major organ complications, the monitored anesthesia care could be available as a reasonable alternative for both general and regional anesthesia when it is impossible to administer; however, the choice of analgesics and sedatives is still an important and difficult task. We present a high risk patient who suffers from neurologic complications including decreased consciousness caused by brain metastasis of lung cancer, cerebral infarction, quadriplegia and seizure as well as decreased respiratory function and bleeding tendency. When performing the operation on hip joints, we administered both dexmedetomidine as a major sedative, and remifentanil as an adjunct analgesic; as a result, we could successfully perform the monitored anesthesia care without any complications including cardiovascular instability, respiratory depression, and seizure.
Analgesics ; Anesthesia ; Anesthesia, Conduction ; Brain ; Cerebral Infarction ; Consciousness ; Dexmedetomidine ; Hemorrhage ; Hip ; Hip Joint ; Humans ; Hypnotics and Sedatives ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Piperidines ; Quadriplegia ; Respiratory Insufficiency ; Seizures

Although the development of arrhythmias including atrial fibrillation (AF) is common under general anesthesia during surgery, the first episode of AF to occur during this period is rather uncommon. Moreover, most instances of AF are associated with old age, cardiopulmonary diseases as well as metabolic, endocrine, or genetic abnormalities. The occurrence of paroxysmal AF in the perioperative period in an adolescent without any underlying diseases or organic abnormalities has never been reported. Herein, we report a case of a 16-year-old adolescent whose paroxysmal AF was suspected before the anesthesia induction for strabismus surgery and diagnosed after anesthetic induction. Nevertheless, he was managed successfully with esmolol infusions during and after the surgery and thus recovered spontaneously.
Adolescent* ; Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Humans ; Perioperative Period* ; Propanolamines ; Strabismus

BACKGROUND: Through change in the climate and living environment, bacterial pathogens that cause diarrhea also change. This study sought to determine the characteristics of pathogens according to species, isolated region, and patient age/sex using National Surveillance Data for diarrhea, and to provide basic data for the prevention of diarrheal disease. METHODS: From January to December 2012, stool specimens were collected from 21,180 diarrheal patients in Korea to identify the pathogenic bacteria involved. Pathogenic bacteria were analyzed according to isolated region and patient age/sex. Identification and analysis of the pathogens were conducted based on the Guidelines of the National Institute of Health Diagnostic Laboratory: Disease-specific protocol (2005). RESULTS: Among the 21,180 stool specimens, pathogenic bacteria known to cause diarrhea were isolated from 2,444 stool specimens (11.5%). The isolation rate was highest in the summer (from June to September) for most pathogenic bacteria, except Escherichia coli, Staphylococcus aureus, and Clostridium perfringens. The isolation rate of pathogenic bacteria based on patient age was highest in children under the age of 10. CONCLUSION: Hygiene education should be addressed in diarrheal disease-susceptible groups, such as children under 10, people in their 50s, and those greater than 70 years old, and ongoing monitoring for pathogens is needed. In addition, an efficient information system and surveillance program should be continued for infection prevention.

No abstract available.
Catheterization ; Catheters ; Humans ; Kyphosis ; Pneumothorax

Acupuncture has been widely used in alternative medicine for pain relief but may have many complications due to lack of appropriate cares. Pharmacopuncture is a sort of acupuncture that injects a herbal ingredient through a thin tube for the purpose of combining the effects of the herb and acupuncture and it has many pitfalls. The agents used in pharmacopuncture are not refined for a desired effect and not produced by sterile standard processes under strict medical surveillance. We report a case of a 44-yr-old male patient who had multiple abscesses in the psoas region with fever, right low back and hip pain that began after the pharmacopuncture treatment. This case shows that although pharmacopuncture has been practiced widely, it is important that the appropriate aseptic technique should be used to prevent severe infections and other complications.
Abscess ; Acupuncture ; Complementary Therapies ; Fever ; Hip ; Humans ; Male ; Psoas Abscess