Background/Aims: Stress is closely related to the deterioration of digestive disease. Melatonin has potent anti-inflammatory properties. The objective of this study was to determine the effect of water stress (WS) and sleep deprivation (SD) on intestinal microbiota and roles of melatonin in stressful condition. Methods: We used C57BL/6 mice and specially designed water bath for stress and SD for 10 days. We measured melatonin concentrations in serum, feces, and colon tissues by high-performance liquid chromatography. Genomic DNA was extracted from feces and amplified using primers targeting V3 to V4 regions of bacterial 16S ribosomal RNA genes. Results: Compared to the control, melatonin concentration was lower in the WS and SD. Fecal concentration was 0.132 pg/mL in control, 0.062 pg/mL in WS, and 0.068 pg/mL in SD. In colon tissue, it was 0.45 pg/mL in control, 0.007 pg/mL in WS, and 0.03 pg/mL in SD. After melatonin treatment, melatonin concentrations in feces and colon tissue were recovered to the level of control. Metagenomic analysis of microbiota showed abundance in colitogenic microbiota in WS and SD. Melatonin injection attenuated this harmful effect. WS and SD showed decreased Lactobacillales and increased Erysipelotrichales and Enterobacteriales. Melatonin treatment increased Akkermansia muciniphila and Lactobacillus and decreased Bacteroides massiliensis and Erysipelotrichaceae. Conclusions This study showed that stress and SD could affect intestinal dysbiosis and increase colitogenic microbiota, which could contribute to the aggravating digestive disease. Melatonin concentrations in feces and colon tissue decreased under WS and SD. Melatonin treatment brought recovery of melatonin concentration in colon tissue and modulating dysbiosis of intestinal microbiota.

PURPOSE: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS). MATERIALS AND METHODS: Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis. RESULTS: The major curve was corrected from 49.8degrees and 47.2degrees pre-operatively to 24.5degrees and 18.8degrees at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group. CONCLUSION: Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction.
Adolescent ; Adult ; *Bone Screws ; Female ; Humans ; Male ; Retrospective Studies ; Scoliosis/radiography/*surgery ; Thoracic Surgery, Video-Assisted/*methods ; Treatment Outcome

Nitric oxide (NO) regulates proliferation, differentiation and survival of neurons. Although NO is reported to involve in NGF-induced differentiation of PC12 cells, the role of NO has not been characterized in primary neuron cells. Therefore, we investigated the role of NO in neuronal differentiation of primary cortical neuron cells. Primary cortical neuron cells were prepared from rat embryos of embryonic day 18 and treated with NMMA (NOS inhibitor) or PTIO (NO scavenger). Neurite outgrowth of neuron cells was counted and the mRNA levels of p21, p27, c-jun and c-myc were measured by RT-PCR. Neurite outgrowth of primary cortical neuron cells was inhibited a little by NOS inhibitor and completely by NO scavenger. The mRNA levels of p21 and p27, differentiation-induced growth arrest genes were increased during differentiation, but they were decreased by NOS inhibitor or NO scavenger. On the other hand, the level of c-jun mRNA was not changed and the level of c-myc mRNA was increased during differentiation differently from previously reported. The levels of these mRNA were reversed in NOS inhibitor- or NO scavenger-treated cells. The level of nNOS protein was not changed but NOS activity was inhibited largely by NOS inhibitor or NO scavenger. These results suggest that NO is an essential mediator for neuronal differentiation of primary cortical neuron cells.
Animals ; Butyrates ; Cyclic N-Oxides ; Embryonic Structures ; Hand ; Imidazoles ; Neurites ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; PC12 Cells ; Rats ; RNA, Messenger

Identification of prognostic factors and risk-based post-remission therapy was proposed to improve the outcomes of acute myeloid leukemia (AML) and a mutation of FLT3 has been reported to be a risk factor, especially for pediatric patients. Recently, FLT3 expression level was implicated to have prognostic significance in adults, but little is known for childhood AML. To define the prognostic significance, transcript level of FLT3 was analyzed in 52 pediatric AML patients. The median copy number of FLT3 was 4.6x10(3) (40-5.9x10(7) copies)/1.0x10(6) GAPDH copy, and the relapse free survival of patients with high transcript level of FLT3 (>10(6) copy number) (0%) was significantly lower than that of the others (53.2%). High transcript level of FLT3 was associated with a markedly high risk of relapse. The development of new therapeutic scheme such as a frontline allogeneic stem cell transplantation or administration of FLT3 inhibitor is needed to improve outcomes.

BACKGROUND/AIMS: Multidetector computed tomography (MDCT) is considered to be a noninvasive, alternative method for evaluating stent restenosis. However, the diagnostic accuracy of 16-channel MDCT for stent stenosis is reported to have severe limitations because of high-attenuation stent-related artifacts. 64-channel MDCT, which recently became available in clinical practice, has better spatial and temporal resolution than 16-channel MDCT. The diagnostic accuracy of 64-channel MDCT for stent restenosis (in-segment and in-stent) was assessed by comparing it with conventional coronary angiography. METHODS: In-segment and in-stent restenosis (> or =50% in diameter) were evaluated in 96 stent segments in 68 patients [61+/-12 years, 51 (75%) male] using both 64-channel MDCT and conventional coronary angiography. The in-stent analysis was confined to the portion of the artery covered by the stent and the in-segment analysis included the stent and 5 mm proximal or distal to the stent edges. RESULTS: The 64-channel MDCT could evaluate stent restenosis in 93 of 96 (97%) stent segments. Quantitative conventional coronary angiography found in-segment restenosis (> or =50% in diameter) in 16 of 68 (23%) patients and 16 of 96 (17%) segments. For the patients with interpretable stent segments, the sensitivity, specificity, positive predictive value, and negative predictive value of 64-channel MDCT for in-segment restenosis per patient were 63, 96, 83, and 89%, respectively; per segment they were 63, 97, 83, and 93%, respectively; and for in-stent restenosis per stent they were 82, 98, 82, and 98%, respectively. CONCLUSIONS: The diagnostic accuracy of 64-channel MDCT for assessing stent restenosis had high specificity and negative predictive value in the clinical setting. The 64-channel MDCT may be a promising, less-invasive imaging tool for stent restenosis, especially for the purpose of excluding stent restenosis.
Arteries ; Artifacts ; Constriction, Pathologic ; Coronary Angiography ; Coronary Restenosis ; Humans ; Multidetector Computed Tomography ; Sensitivity and Specificity ; Stents

PURPOSE: To find out the relationship between various risk factors and post-operative delirium in elderly patients with hip fractures. MATERIALS AND METHODS: Out of 135 patients older than 65 years old who underwent the surgery for hip fracture in our department, between the periods of March 2003 to March 2005, 14 patients (10.4%) developed post-operative delirium and 121 patients (89.6%) did not. We studied risk factors of post-operative delirium in two groups. RESULTS: In chi-square test between delirium group and non-delirium group, the patients were more likely to develop post-operative delirium if they had previous episodes of delirium, abnormal cognitive function, low walking ability before admission, high dependency on ADL (Activities of Daily Living), other medical accompanying diseases, history of dementia, post-operative hypoxia, post-operative electrolyte imbalance, low post-operative hemoglobin and hematocrit, low post-operative albumin and were older than 75 years old (p<0.05). Sex, type of fracture, anesthesia and the time between admission and operation did not show much difference between the two groups. CONCLUSION: The risk factors of postoperative delirium in elderly patients with hip fracture have a tendency to be multifactorial. Therefore, we conclude that being prepared by thorough understanding of the risk factors and their relationships will help prevent post-operative delirium and result in good postoperative prognosis.
Activities of Daily Living ; Aged ; Anesthesia ; Anoxia ; Delirium ; Dementia ; Dependency (Psychology) ; Hematocrit ; Hemoglobins ; Hip ; Hip Fractures ; Humans ; Prognosis ; Risk Factors ; Walking

A thymic cyst in the middle mediastinum adjacent to the right pericardium is extremely rare. We report a case of a large thymic cyst in the right cardiophrenic angle, compressing the right atrium, which was presented as a cardiomegaly on the chest radiograph and a pericardial cyst on the echocardiography. The definitive diagnosis was confirmed using surgical resection and biopsy.
Biopsy ; Cardiomegaly ; Diagnosis ; Echocardiography ; Heart Atria ; Magnetic Resonance Imaging ; Mediastinal Cyst* ; Mediastinum* ; Pericardium ; Radiography, Thoracic

Sustained-releasing praziquantel (SRP) tablet was designed for single dose treatment regimen of clonorchiasis. A previous pre-clinical study confirmed its sustained-releasing characteristics and a better cure rate than conventional praziquantel (PZQ). In this clinical study, the pharmacokinetics of this SRP tablet were investigated in human volunteers (phase 1; 12 volunteers), and its curative efficacy was examined in clonorchiasis patients (phase 2; 20 volunteers). In the phase 1 clinical study, blood concentrations of both tablets showed wide individual variation. The AUC(last) of SRP was 497.9+/-519.0 ng.hr/ml (mean+/-SD) and PZQ of 628.6+/-695.5 ng.hr/ml, and the AUC(inf) of SRP was 776.0+/-538.5 ng.hr/ml and of PZQ 658.6+/-709.9 ng.hr/ml. C(max) values of SRP and PZQ were 90.7+/-82.2 ng/ml and 214.9+/-251.9 ng/ml, and T(max) values were 3.42+/-1.43 hr and 1.96+/-1.23 hr, respectively. SRP tablets showed similar AUC values, but lower C(max) and longer T(max) values than PZQ. In the phase 2 study, SRP at 30 mg/kg (single dose) achieved a 60% cure rate and a 95.5% egg reduction rate. The cure rate of a single dose SRP was unsatisfactory compared with that of the conventional PZQ dose, but much better than that achieved by a single dose PZQ.
*Praziquantel/adverse effects/pharmacokinetics/therapeutic use ; Parasite Egg Count ; Male ; Humans ; *Delayed-Action Preparations/pharmacokinetics/therapeutic use ; Clonorchis sinensis/*drug effects/isolation & purification ; Clonorchiasis/*drug therapy ; Area Under Curve ; *Anthelmintics/adverse effects/pharmacokinetics/therapeutic use ; Animals ; Adult

PURPOSE: To compare the performance of a total knee arthroplasty with either a PFC Sigma fixed bearing or a rotating platform in the same patient. MATERIALS AND METHODS: 48 cases (24 patients) that received a PFC Sigma fixed bearing and a rotating platform in both knees, one in each knee. The knee score, functional score, activity level, radiologic analyses through fluoroscope , varus/valgus stress, and subjective satisfaction evaluation were performed at the last follow up in the same patient. RESULTS: There were no significant differences in the knee score, functional score, activity level, radiological findings through fluoroscope, and subjective satisfaction. In the varus/valgus stress views, 3 cases of lateral femoral condylar lift-off were observed in the fixed bearing type and 6 cases of lateral femoral condylar lift-off were observed in the rotating platform type. CONCLUSION: In cases of total knee arthroplasty with PFC Sigma fixed bearing and with rotating platform performed in the same patient, there were no significant differences in the clinical, radiological and subjective satisfaction. However, it is considered that the fixed bearing is more stable in terms of medial and lateral femoral condylar lift-off with varus and valgus stress than rotating platform. Therefore long term follow-up would be necessary.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee*

Cysticercosis is a relatively common disease in Korea. Racemose cysticercosis, a peculiar form of the neurocysticercosis usually occurs as meningeal forms and rarely involves the cerebral parenchyme. The authors present a case of cerebral parenchymal racemose cysticercosis in a 55 year-old man with generalized seizure. Brain CT and MRI showed a large multilobulated cyst in the right frontal lobe. At surgery, we removed cyst covered by milkish white, multiple septated membranes completely. Histological dignosis of surgical specimen was racemose cysticercosis without scolex.
Brain ; Cerebrum ; Cysticercosis* ; Frontal Lobe ; Humans ; Korea ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Neurocysticercosis ; Seizures