Objectives: . Microorganisms are likely present in continuous positive airway pressure (CPAP) devices in daily use. Given the potential risk of infection among CPAP users, we aimed to compare the microbiomes of CPAP devices with those of nasal mucosa samples obtained from patients using these devices. Methods: . We conducted a prospective cohort study at multiple tertiary medical institutions. Samples were collected from the tubes and filters of CPAP devices and the nasal mucosa of device users. Microbiomes and mycobiomes were analyzed using 16S ribosomal RNA and internal transcribed spacer region sequencing. The results were compared according to sampling site and usage duration for each patient. Results: . Overall, 27 paired samples of human nasal mucosa and CPAP components were analyzed. Bacteria were detected in 7 of the 27 tubes (25.9%) and in 22 of the 27 filters (81.5%). Fungi were found in 2 tubes (7.4%) and 16 filters (59.3%). The most prevalent bacterial phyla across all samples were Actinobacteria and Firmicutes. Fungi were not detected in any nasal mucosa samples. However, fungi were identified in the CPAP filters and tubes, with the Basidiomycota and Ascomycota phyla predominating. No significant associations were identified according to sampling site or duration of CPAP use. Conclusion . Some bacteria or fungi are detectable in CPAP samples, even after a short period of CPAP usage. However, the association between respiratory infections and these microbiomes or mycobiomes was not investigated. Further research is required to clarify the risk posed by CPAP devices as a microbial contamination source.

Objectives: . Microorganisms are likely present in continuous positive airway pressure (CPAP) devices in daily use. Given the potential risk of infection among CPAP users, we aimed to compare the microbiomes of CPAP devices with those of nasal mucosa samples obtained from patients using these devices. Methods: . We conducted a prospective cohort study at multiple tertiary medical institutions. Samples were collected from the tubes and filters of CPAP devices and the nasal mucosa of device users. Microbiomes and mycobiomes were analyzed using 16S ribosomal RNA and internal transcribed spacer region sequencing. The results were compared according to sampling site and usage duration for each patient. Results: . Overall, 27 paired samples of human nasal mucosa and CPAP components were analyzed. Bacteria were detected in 7 of the 27 tubes (25.9%) and in 22 of the 27 filters (81.5%). Fungi were found in 2 tubes (7.4%) and 16 filters (59.3%). The most prevalent bacterial phyla across all samples were Actinobacteria and Firmicutes. Fungi were not detected in any nasal mucosa samples. However, fungi were identified in the CPAP filters and tubes, with the Basidiomycota and Ascomycota phyla predominating. No significant associations were identified according to sampling site or duration of CPAP use. Conclusion . Some bacteria or fungi are detectable in CPAP samples, even after a short period of CPAP usage. However, the association between respiratory infections and these microbiomes or mycobiomes was not investigated. Further research is required to clarify the risk posed by CPAP devices as a microbial contamination source.

Objectives: . Microorganisms are likely present in continuous positive airway pressure (CPAP) devices in daily use. Given the potential risk of infection among CPAP users, we aimed to compare the microbiomes of CPAP devices with those of nasal mucosa samples obtained from patients using these devices. Methods: . We conducted a prospective cohort study at multiple tertiary medical institutions. Samples were collected from the tubes and filters of CPAP devices and the nasal mucosa of device users. Microbiomes and mycobiomes were analyzed using 16S ribosomal RNA and internal transcribed spacer region sequencing. The results were compared according to sampling site and usage duration for each patient. Results: . Overall, 27 paired samples of human nasal mucosa and CPAP components were analyzed. Bacteria were detected in 7 of the 27 tubes (25.9%) and in 22 of the 27 filters (81.5%). Fungi were found in 2 tubes (7.4%) and 16 filters (59.3%). The most prevalent bacterial phyla across all samples were Actinobacteria and Firmicutes. Fungi were not detected in any nasal mucosa samples. However, fungi were identified in the CPAP filters and tubes, with the Basidiomycota and Ascomycota phyla predominating. No significant associations were identified according to sampling site or duration of CPAP use. Conclusion . Some bacteria or fungi are detectable in CPAP samples, even after a short period of CPAP usage. However, the association between respiratory infections and these microbiomes or mycobiomes was not investigated. Further research is required to clarify the risk posed by CPAP devices as a microbial contamination source.

Background: Recently, microbiome research has been actively conducted for various skin areas. However, no study has yet compared the microbiome of bacteria and fungi in the ear canal of healthy individuals and patients with chronic otitis externa in Korea. Objective: This study aimed to investigate the difference in the distribution of fungal and bacterial microbial communities in ear canal samples of healthy individuals and patients with chronic otitis externa. Methods: In 24 patients with bilateral chronic otitis externa and 24 healthy controls, cotton swabs were used to obtain samples from the bilateral ear canal. To characterize the fungal and bacterial communities, we sequenced and analyzed the 16S rRNA V4–V5 and ITS1 regions using Quantitative Insights into Microbial Ecology 2, respectively. Results: The alpha diversity analysis for bacteria and fungi confirmed that both richness and evenness decreased in the patient group. The beta diversity analysis for bacteria confirmed that these parameters differed between the control and patient groups. The beta diversity analysis for fungi showed no difference between the groups. Conclusion We observed different skin microbiomes in the patients with chronic otitis externa compared with those in the healthy individuals.

PURPOSE: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. MATERIALS AND METHODS: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopy-assisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. DISCUSSION: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer.Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).
Arm ; Disease-Free Survival ; Endoscopy ; Gastrectomy ; Humans ; Informed Consent ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Postoperative Complications ; Prospective Studies ; Sample Size ; Stomach Neoplasms

OBJECTIVE: To find a new method and usefulness of study on sensory nerve conduction of lateral sural cutaneous nerve (LSCN). METHOD: The 60 extremities of 30 adults without peripheral neuropathy were placed in a prone position. Next, each subject was administered with an antidromic stimulation at a point 3 cm lateral from the center of the popliteal fossa. With the aid of active electrodes, the sensory nerve action potentials (SNAPs) were recorded at points 10 cm inferior and 1 cm lateral to the stimulation site. The method of sensory nerve conduction study suggested by Campagnolo et al. was performed simultaneously, to compare of the frequency of SNAPs and the amplitudes. RESULTS: For the sensory nerve conduction study of the LSCN suggested in this report, SNAPs were obtained in 49 extremities, with a revelation rate of 81.7%. The mean amplitude was 11.91+/-3.68micronV. In the results of the tests suggested by Campagnolo et al., the SNAPs were obtained in 29 extremities, with a revelation rate of 48.3%. The mean amplitude was 8.37+/-5.21micronV. Significance testing of the electrodiagnostic method recommended in this study revealed that many SNAPs were observed for the LSCN, with statistically significant action potential amplitudes. CONCLUSION: This study presents the new method and reference values of sensory nerve conduction for LSCN, which is thought to be useful in electrodiagnostic studies to diagnose entrapment neuropathy.
Action Potentials ; Adult ; Electrodes ; Electromyography ; Extremities ; Humans ; Nerve Compression Syndromes ; Neural Conduction ; Organic Chemicals ; Peripheral Nervous System Diseases ; Peroneal Nerve ; Prone Position ; Reference Values ; Sural Nerve

Kawasaki disease is an acute systemic vasculitis of unknown origin. Coronary aneurysm or ectasia is one of the most serious complications of Kawasaki disease. The major complication of Kawasaki coronary disease is myocardial infarction caused by thrombus formation inside the aneurysm or by organic obstructive lesion following the regression of aneurysm. Percutaneous balloon angioplasty, rotational ablation, directional coronary artherectomy, stent insertion and coronary artery bypass graft can be used to treat coronary artery stenosis or occlusion. We describe a 6-year old boy who had an episode of Kawasaki disease with giant coronary artery aneurysm diagnosed at the age of 3 years. Surveillance echocardiogram showed giant coronary aneurysm with stenosis and large mural thrombus in the proximal portion of left main coronary artery. So we inserted two polytetrafluoroethylene(PTFE) covered graft stent without complication.
Aneurysm ; Angioplasty, Balloon ; Child ; Constriction, Pathologic* ; Coronary Aneurysm* ; Coronary Artery Bypass ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels ; Dilatation, Pathologic ; Humans ; Male ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Infarction ; Stents* ; Systemic Vasculitis ; Thrombosis* ; Transplants*

Panax ginseng roots have long been used as a medicinal herb in oriental countries. We have investigated anti-proliferative effects of lipid soluble Panax ginseng components on human renal cancer cell lines. Petroleum ether extract of Panax ginseng roots (GX-PE) or its partially purified preparation (7:3 GX) was added to cultures of three human renal cell carcinoma (RCC) cell lines, A498, Caki-1, and CURC II. Proliferation of RCC cells was estimated by a [3H]thymidine incorporation assay and cell cycle distribution was analyzed by flow cytometry. GX-PE, 7:3 GX, panaxydol and panaxynol inhibited proliferation of all three RCC cell lines in a dose dependent manner in vitro with an order of potency, 7:3 GX > panaxydol > panaxynol = GX-PE. Additive effect of interleukin 4 was also demonstrated, most prominently in Caki-1 which responded poorly to GX-PE alone. Analysis of cell cycle in CURC II and Caki-1 treated with GX-PE demonstrated increase in G1 phase population and corresponding decrease in S phase population. The present study demonstrated that proliferation of human RCC cell lines were inhibited by lipid soluble components of Panax ginseng roots by blocking cell cycle progression at G1 to S phase transition.
Alkanes ; Alkynes/therapeutic use ; Antineoplastic Agents/therapeutic use ; Antineoplastic Agents, Phytogenic/therapeutic use* ; Carcinoma, Renal Cell/drug therapy* ; Cell Cycle/drug effects ; Fatty Alcohols/therapeutic use ; Ginseng/therapeutic use* ; Ginseng/chemistry ; Human ; Interleukin-4/therapeutic use ; Kidney Neoplasms/drug therapy* ; Plant Extracts/therapeutic use ; Plant Roots/therapeutic use ; Plant Roots/chemistry

Kawasaki disease is an acute illness of early childhood, especially less than 5 years of age, characterized by prolonged fever (>5 days), changes of lips and oral cavity, changes of peripheral extremities, polymorphous skin rash, bilateral conjunctival congestion and acute nonpurulent cervical lymphadenopathy. Usually, the recurrence of Kawasaki disease is not frequent. It is thought that the factors in recurrence of Kawasaki disease was sex, age and IV gammaglobulin. We have experienced the first attack of Kawasaki disease at 18 months-old female who had 5 recurrences during 4 years.
Estrogens, Conjugated (USP) ; Exanthema ; Extremities ; Female ; Fever ; Humans ; Infant ; Lip ; Lymphatic Diseases ; Mouth ; Mucocutaneous Lymph Node Syndrome* ; Recurrence*

Hyperreflexic bladder is a disease manifested in patients with spinal cord lesions above the sacral segment. The treatments for hyperreflexic bladder are medical therapy, interruption of innervation, argumentation cystoplasty, etc. We treated four hyperreflexic bladder patients with 12% a phenol injection into the subarachnoid space for sacral nerve block. Before treatment the average bladder capacity was about 100 ml, and there was one case of autonomic dysreflexia. After the subarachnoid block the average bladder capacity increased above 300 ml and maximal intravesical pressure decreased below 30cmH2O, autonomic dysreflexia disappeared in one patient. The decreased bladder compliance after nerve block was managed by repetitive bladder overdistention. We suggest that subarachnoid block is easier and more effective than sacral nerve block individually, and is a treatment for hyperreflexic bladder refractory to medical therapy.
Autonomic Dysreflexia ; Compliance ; Humans ; Nerve Block ; Phenol ; Spinal Cord ; Subarachnoid Space ; Urinary Bladder*