This nationwide, prospective cohort study evaluated pulmonary function and radiological sequelae according to infection severity in 73 survivors from the 2015 Middle East respiratory syndrome (MERS) outbreak in Korea. Patients with severe pneumonia in MERS-coronavirus infection had more impaired pulmonary function than those with no or mild pneumonia at the 1-year follow-up, which was compatible with the radiological sequelae. Severe pneumonia significantly impairs pulmonary function and makes long radiological sequelae in MERS.
Cohort Studies ; Coronavirus ; Coronavirus Infections* ; Follow-Up Studies ; Humans ; Korea ; Middle East* ; Pneumonia* ; Prospective Studies ; Survivors

The gastrointestinal motility is regulated by extrinsic and intrinsic neural regulation. Intrinsic neural pathways are controlled by sensory input, inter-neuronal relay and motor output. Enteric motor neurons release many transmitters which affect post-junctional responses. Post-junctional responses can be excitatory and inhibitory depending on neurotransmitters. Excitatory neurotransmitters induce depolarization and contraction. In contrast, inhibitory neurotransmitters hyperpolarize and relaxe the gastrointestinal smooth muscle. Smooth muscle syncytium is composed of smooth muscle cells, interstitial cells of Cajal and platelet-derived growth factor receptor alpha-positive (PDGFRalpha+) cells (SIP syncytium). Specific expression of receptors and ion channels in these cells can be affected by neurotransmitters. In recent years, molecular reporter expression techniques are able to study the properties of ion channels and receptors in isolated specialized cells. In this review, we will discuss the mechanisms of ion channels to interpret the post-junctional responses in the gastrointestinal smooth muscles.
Gastrointestinal Motility ; Giant Cells ; Interstitial Cells of Cajal ; Ion Channels ; Motor Neurons ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neural Pathways ; Neurotransmitter Agents ; Receptors, Platelet-Derived Growth Factor

Functional dyspepsia (FD) is defined as the presence of symptoms thought to originate in the gastroduodenal area, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Based on the available evidence and consensus opinion, thirteen consensus statements for the treatment of FD were developed using the modified Delphi approach. Proton pump inhibitor, prokinetics, and histamine 2 receptor antagonists are effective for the treatment of FD. Mucosal protecting agents, fundus relaxant, and drugs for visceral hypersensitivity can improve symptoms in FD. Antacids and antidepressants may help improving symptoms in FD. Comparing endoscopy with 'test and treat' of Helicobacter pylori, endoscopy may be more effective initial strategy for managing patients with FD in Korea given high incidence of gastric cancer and low cost of endoscopy. Helicobacter pylori eradication can be one of the therapeutic options for patients with FD. Psychotherapy is effective for those who have severe symptoms and refractoriness. Further studies are strongly needed to develop better treatment strategies for Korean patients with FD.
Antacids/therapeutic use ; Anti-Ulcer Agents/therapeutic use ; Antidepressive Agents/therapeutic use ; Dyspepsia/diet therapy/*therapy ; Gastroscopy ; Helicobacter Infections/drug therapy ; Helicobacter pylori ; Histamine H2 Antagonists/therapeutic use ; Humans ; Proton Pump Inhibitors/therapeutic use ; Psychotherapy ; Serotonin 5-HT3 Receptor Antagonists/therapeutic use ; Vasoconstrictor Agents/therapeutic use

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the value of microbubble destruction using low-frequency ultrasound for enhancing gene delivery to skeletal muscles of laboratory animals. MATERIALS AND METHODS: Lac-Z gene was injected into 21 mouse anterior tibialis muscles. Seven muscles received the gene only, and seven each received either 20-kHz ultrasound exposure or ultrasound-PESDA (perfluorocarbon-exposed sonicated albumin) destruction, respectively, following the injection; the extent of Lac-Z expression was then compared. Luciferase gene was injected into the muscles (N=80). The muscles were divided into two groups according to the mixture; in the first group saline was used as the mixture solute, with PESDA used in the second group. The groups were subdivided into two groups, one receiv 10 seconds of ultrasound at the injection site after injection, and the other that received no further intervention. Luciferase activities were measured and compared. RESULTS: The proportions of Lac-Z stained cells were 0, 5.7+/-1.2 and 7.7+/-1.7%, respectively, showing a significant stepwise increase microbubble destruction (p<0.05). Luciferase activities were as follows: Luciferase only (Group 1, N=17), 5727+/-2178 RLU/mg; luciferase plus PESDA (Group 2, N=17), 1170+/-470.7 RLU/mg; luciferase plus ultrasound (Group 3, N=17), 16480+/-5239 RLU/mg; and luciferase plus PESDA destruction (Group 4, N=17), 49910+/-16500 RLU/mg. The activity in group 4 was significantly higher than in group 1 (p<0.01), showing an 8.7-fold increase in gene delivery due to microbubble destruction. CONCLUSION: Microbubble destruction using low-frequency ultrasound is an efficient method for increasing the efficacy of direct gene delivery to skeletal muscles.
Animals ; Animals, Laboratory ; Genetic Therapy ; Luciferases ; Mice* ; Microbubbles* ; Muscle, Skeletal* ; Muscles ; Ultrasonography*

BACKGROUND AND OBJECTIVES: The Maze operation is known to be an effective measure for restoring sinus rhythm in patients with atrial fibrillation (AF). The purpose of this study was to identify the relationship of pre- and post-operative left atrial volume (LAV) and diameter (LAD) with successful restoration of sinus rhythm in the Maze operation. SUBJECTS AND METHODS: The subjects for this study were 28 patients who underwent open-heart surgery in conjunction with the Maze-III operation for chronic AF from October, 2002, to April, 2003. Electrocardiographic and transthoracic echocardiographic studies were done pre-operatively and three months post-operatively. LAV and LAD were assessed and corrected for body surface area (LAV index=LAV/BSA, LAD index=LAD/BSA). RESULTS: Sinus rhythm was restored and maintained in 22 of the 28 patients (78.6%). Between the group with successful restoration of sinus rhythm (Group A;n=22) and the group with unsuccessful restoration (Group B;n=6), there was no difference in age, gender, and NYHA functional class. The duration of AF in group A was significantly shorter than that of B (3.6+/-2.7 years versus 15.8+/-7.5 years, p=0.003). Group A and B did not show any difference in pre-operative left ventricular ejection fraction. However, pre-operative LAV index in group A was significantly smaller than that of group B (80.7+/-22.4 mL/m2 versus 118.1+/-42.5 mL/m2, p=0.048). In group A, the LAV index (80.7+/-22.4 mL/m2 versus 52.8+/-14.7 mL/m2, p<0.001) and LAD index (35.4+/-5.3 mm/m2 versus 31.7+/-4.7 mm/m2, p=0.001) decreased significantly three months after the operation. In group B, however, no significant changes are found in the LAV index (118.1+/-42.5 mL/m2 versus 89.2+/-38.9 mL/m2, p=0.116) and LAD index (39.1+/-7.9 mm/m2 versus 36.2+/-9.2 mm/m2, p=0.144). CONCLUSION: Pre-operative LAV index measured by echocardiography and the duration of AF were significant predictors of successful sinus rhythm restoration after the Maze operation. Significant reduction of the LAV index after the Maze operation was found in patients whose rhythm was successfully restored and maintained.
Atrial Fibrillation ; Body Surface Area ; Echocardiography ; Electrocardiography ; Humans ; Stroke Volume

BACKGROUND/AIMS: The aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. METHODS: 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. RESULTS: The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. CONCLUSIONS: Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.
Abdominal Pain ; Cisapride* ; Diarrhea ; Dizziness ; Dyspepsia* ; Eructation ; Humans ; Korea* ; Retrospective Studies

The glucose uptake rate by plerocercoid of Diphyllobothrium sp. was a mean value of 5.35+/-0.80 micro-mole/hr/g of wet wt, and total CO(2) production rates by the plerocercoid larva averaged 7.54+/-0.73 micro-mole/hr/g of wet wt. The relative specific activity into respiratory CO(2) showed a mean value of 7.30 +/-0.90 per cent. The rate of CO(2) production derived from medium C(14)-glucose was a mean of 0.58+/-0.13 micro-mole/hr/g of wet wt. Therefore, the average value of 1.92+/-0.38 per cent of glucose utilized by the larvae from the medium C(14)-glucose was oxidized to respiratory CO(2). The tissue concentration of glycogen in plerocercoid larva was a mean of 46.28 +/-2.23 mg/g or 4.63+/-0.22 per cent/g of wet wt., and the turnover rate of glycogen pool was a mean of 0.049 +/- 0.012 %/hr or 0.010 +/- 0.003 mg/hr/g of wet wt. The average value of 2.76+/-1.00 per cent of glucose utilized by the larvae from the medium C(14)-glucose was incorporated to the glycogen. These data accounts for that only 5 per cent of the utilized glucose by the plerocercoid larvae participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen.
parasitology-helminth-cestoda ; Diphyllobothrium sp. ; sparganum ; plerocercoid ; biochemistry ; autoradiography ; glucose ; metabolism ; CO(2)

The adult trematodes, Fasciola hepatica, Eurytrema pancreaticum and Paramphistomum cervi, employed in this experiment were obtained from the cattle slaughtered at the local abbatoir. The worms selected and washed several times in normal sterilized saline solution. Each about ten of intact F. hepatica, fourty of E. pancreaticum, and twenty of P. cervi were incubated in 50 cc volume of special incubation flasks with incubation medium consisting of 10 cc. of Krebs-Ringer phosphate buffer(pH 7.4) The incubation medium was added C(14)-1-acetate and non-radioactive carrier Na-acetate so as to contain acetate concentration of 50 mg per cent . The worms were allowed to incubate for 5 hours in the Dubnoff metabolic shaking incubator at 38 C. After incubation period, respiratory CO(2) samples from central well of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). The lactate and pyruvate appearance rates were determined by analyzing the lactate and pyruvate concentration in a medium after incubation. The glycogen samples isolated from worms were analyzed for the tissue concentration and their radioactivities in order to determine the turnover rate of glycogen pool. Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-acetate utilized by F. hepatica, E. pancreaticum and P. cervi were compared and discussed in this report. According to these data of the experiment, it is suggested that the fatty acid such as acetate may play a part of their oxidative process into the respiratory CO2 and the synthetic process into glycogen in the above species of trematodes.
parasitology ; helminth ; trematoda ; Fasciola hepatica ; Eurytrema pancreaticum ; Paramphistomum cervi ; acetate ; metabolism ; biochemistry ; CO(2) ; glycogen ; Krebs-Ringer phosphate buffer

The adult worms of cestodes, Moniezia expansa and Diphyllobothrium mansoni employed in this experiment. The worms were divided into three portions, i.e. immature , mature and gravid proglottids, and each proglottids were incubated in a certain incubation period, and the glucose uptake rate, total CO2 production rate, tissue concentration and their radioactivities were employed as previous reports(Rim et al., 1965). The glucose uptake rate by M. expansa was a mean value of 6.46+/-1.23 micromole per hour per gram of wet wt. and the rate by D. mansoni was a mean value of 18.8+/-0.8 micro-mole per hour per gram of wet wt. The higher rates were observed in the mature proglottid of M. expansa and in the immature proglottid of D. mansoni . The total CO(2) production rates by the worms averaged 14.0+/-2.37 micro-mole per hour per gram in M. expansa and 17.51+/-1.54 micro-mole per hour per gram of wet wt. The relative specific activities of respiratory CO(2)(R.S.A CO(2)) averaged 22.2+/-5.15 percent in M. expansa and 54.2+/-2.2 per cent in D. mansoni. In the both worms, the higher values were obtained in the mature proglottids. Therefore, the average value of 8.84+/-2.66 per cent of glucose utilized by M. expansa and 8.23+/-0.50 percent of glucose utilized by D. mansoni from the medium glucose was oxidized into respiratory CO(2). The tissue concentrations of glycogen were a mean of 2.21+/-0.46 percent per gram of wet wt. in M. expansa and 7.56+/-1.24 percent per gram of wet wt. in D. mansoni. The higher concentration of glycogen was observed in the gravid proglottids of M. expansa, however the gravid proglottids of D. mansoni showed lower concentration of glycogen than the other proglottids. The turnover rate of glycogen pool yielded with a mean of 0.04+/-0.01 miligram per hour per gram of wet wt. of M. expansa, whereas a mean of 1.66+/- 0.46 miligram per hour per gram wet wt. of D. mansoni. Therefore, a mean value of 2.58+/-0.93 per cent(R.G.D gly) of glucose utilized by M. expansa and 53.6+/-1.4 percent by D. mansoni was incorproated into the glycogen . These data account for that at least 11.42 per cent of the utilized glucose by M. expansa and 61.83 per cent of the utilized glucose by D. mansoni participated in furnishing the oxidation into respiratory CO2 and the synthetic process into glycogen.
parasitology ; helminth ; Moniezia expansa ; Diphyllobothrium mansoni ; metabolism ; glucose ; glycogen ; CO(2) ; biochemistry

The fowl nematode Ascaridia galli employed in this experiment was obtained from the intestine of domestic fowls at the local market. The worms selected and washed several times in normal sterilized saline solution. Each about thirty of intact worms were incubated in 50 cc volume of special incubation flasks with incubation mixture consisting of 10 cc of Krebs-Ringer phosphate buffer (pH 7.4) to which were added universally labeled C14-glucose and non-radioactive carrier glucose so as to contain concentration of 200 mg per cent. The worms were allowed to incubation for 3 hours in Dubnoff metabolic shaking incubator at 38 C. After incubation period, respiratory CO(2) samples from central well of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). Glycogen samples isolated from worms were analysed for uptake rate was determined by analyzing the difference of the glucose concentration in a medium before and after incubation period . Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-glucose utilized by Ascaridia galli was summarized as the following . The glucose uptake rate by A. galli was a mean value of 1.73+/-0.32 micro-mole per hour per gram of wet wt. and total CO(2) production rate by the worms averaged 8.44+/-1.11 micro-mole per hour per gram of wet wt. The relative specific activity of respiratory CO(2) (R.S.A CO(2)) averaged 2.68+/-0.38 per cent . Thus , a man of 2.68 per cent of total CO(2) production rate was originated from the glucose in the medium, therefore the rate of CO(2) production derived from medium glucose was a mean of 0.23+/-0.03 micro-mole per hour per gram of wet wt. Thus, the average value of 2.58+/-0.55 percent (R.G.D CO(2))of glucose utilized by the worms from the medium glucose was oxidized to respiratory CO2. The tissue concentration of glycogen in A. galli was a mean of 22.59+/-1.18 miligram per gram of wet wt or 2.26+/-0.123 percent per gram, and the turnover rate of glycogen pool yielded with a mean of 0.17+/-0.04 percent per hour or 0.037+/-0.006 miligram per hour per gram of wet wt. Therefore, a mean value of 16.37+/-4.04 per cent (R.G.D gly) of glucose was incorporated to the glycogen. These data account for that at least 18.95 per cent of the utilized glucose by the worms participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen. According to the above data of the experiment, it is suggested in the metabolic process of glucose by Ascaridia galli that the synthetic process into the glycogen is more active than the oxidative process into the respiratory CO(2).
parasitology ; helmith ; nematoda ; Ascaridia galli ; metabolism ; biochemistry ; glucose ; CO(2) ; radioactivity ; glycogen ; Krebs Rigner phosphate buffer