Objective: To evaluate predictors of difficult intubation in patients with obstructive sleep apnoea (OSA). Methodology: Prospective series of 405 OSA patients (350 males/55 females) who had upper airway surgery. Procedures included functional endoscopic sinus surgery, septoplasty, turbinate reduction, palate/tonsil surgery, and/or tongue base surgery. Intubation difficulty (ID) was assessed using Mallampati grade, Laryngoscopic grade (Cormack and Lehane), and clinical parameters including BMI, neck circumference, thyromental distance, jaw adequacy, neck movements and glidescope grading. Results: Mean age was 41.6 years old; mean BMI 26.6; mean neck circumference 44.5cm; mean Apnea Hypopnea Index (AHI) was 25.0; and mean LSAT 82%. The various laryngeal grades (based on Cormack and Lehane), grade 1 - 53 patients (12.9%), grade 2A - 127 patients (31.0%), grade 2B - 125 patients (30.5%), grade 3 - 93 patients (22.7%) and grade 4 - seven patients (1.7%); hence, 24.4% had difficulties in intubation. Parameters that adversely affected intubation were, age of the patient, opening of mouth, retrognathia, overbite, overjet, limited neck extension, thyromental distance, Mallampati grade, and macroglossia (p<0.001). Body mass index (BMI) (p=0.087), neck circumference (p=0.645), neck aches (p=0.728), jaw aches (p=0.417), tonsil size (p=0.048), and AHI (p=0.047) had poor correlation with intubation. BMI-adjusted for Asians and Caucasians, showed that Asians were more likely to have difficulties in intubation (adjusted OR = 4.6 (95%Confidence Interval: 1.05 to 20.06) (p=0.043), compared to the Caucasian group.

Sphingosine-1-phosphate (S1P) plays an important role in trafficking leukocytes and developing immune disorders including autoimmunity. In the synovium of rheumatoid arthritis (RA) patients, increased expression of S1P was reported, and the interaction between S1P and S1P receptor 1 (S1P1) has been suggested to regulate the expression of inflammatory genes and the proliferation of synovial cells. In this study, we investigated the level of S1P1 mRNA expression in the blood leukocytes of RA patients. In contrast to the previous reports, the expression level of this gene was not correlated to their clinical scores, disease durations and ages. However, S1P1 was transcribed at a significantly lower level in the circulating leukocytes of RA patients when compared to age-, and sex-matched healthy controls. Since these data may suggest the participation of S1P1, further studies are needed to determine the role of this receptor in the pathogenesis of RA.
Arthritis, Rheumatoid* ; Autoimmunity ; Humans ; Immune System Diseases ; Leukocytes* ; Receptors, Lysosphingolipid* ; RNA, Messenger ; Synovial Membrane

Asian-lineage H5 highly pathogenic avian influenza (HPAI) viruses have caused continuous outbreaks in poultry and wild birds. Development of rapid and accurate diagnostic methods is needed for preventing further spread of the virus and reducing the time required for eradication of the virus. We developed a low-density microarray for the rapid detection and identification of avian influenza virus subtypes H5, H7, and H9 and their pathotypes in a previous study. In the present study, we evaluated previously developed diagnostic microarray using avian influenza viruses isolated in Mongolia, including H5 HPAI viruses. All H5 HPAI viruses isolated in Mongolia were shown as H5-specific and highly pathogenic pattern in the microarray. H2, H3 and H12 viruses isolated in Mongolia used in this study did not show any H5, H7 and H9 patterns. These results indicated that this diagnostic microarray has enormous potential for the rapid subtyping and pathotyping of influenza viruses, including viruses isolated in Mongolia.
Animals ; Birds ; Disease Outbreaks ; Influenza in Birds* ; Mongolia* ; Orthomyxoviridae ; Poultry

Antiviral activity against Influenza virus of 14 Lactobacillus species isolated from food was monitored. Lactobacillus species were isolated from traditional Korean fermented food. Each live Lactobacillus was administered into the nasal cavity of SPF 6-week-old BALB/c mice. After the Lactobacillus treatment, Influenza virus (A/NWS/33/H1N1) was inoculated to each mouse. Clinical signs and mortality was monitored for 21 days. Each Lactobacillus strain showed various level of antiviral activity against Influenza virus. As a result of this study, this mouse experiment model, including intranasal treatment of live Lactobacillus species, could be effective model in evaluating immunomodulatory response of probiotics against respiratory viruses.
Administration, Intranasal* ; Animals ; Influenza, Human ; Lactobacillus ; Mice* ; Models, Animal ; Mortality ; Nasal Cavity ; Orthomyxoviridae* ; Probiotics

Spontaneous pneumothorax is a common clinical problem in emergency care. However, the overall incidences of primary spontaneous pneumothorax has been reported from as low as 1.4% to 7.6%. The clinical findings of simultaneous bilateral spontaneous pneumothorax can be variable. Clinical presentation is variable, ranging from mild dyspnea to tension pneumothorax. Bilateral tension pneumothorax can defined as cases where no tracheal deviation is detected in chest X-ray, and symptoms may be equal bilaterally. Herein, we present a case with simultaneous bilateral tension pneumothorax, severely deteriorated (i.e. with loss of consciousness, cyanosis, and hemodynamically unstable), that was successfully treated with immediate large-size needle decompression.
Cyanosis ; Decompression ; Dyspnea ; Emergency Medical Services ; Incidence ; Needles ; Pneumothorax ; Thorax ; Unconsciousness

Hepatitis A virus (HAV) infection is common in developing countries, including Korea. It can be accompanied by extrahepatic complications such as renal failure, arthritis, and vasculitis. Pleural effusion is a very rare complication of HAV infection, which has been reported usually in children, and has benign clinical courses. Here we report a case of pleural effusion with ascites which occurred in an adult hepatitis A patient. A 26-year-old-woman presented generalized myalgia and fever and was diagnosed as acute hepatitis A. Despite of the improvement of laboratory findings, fever and cough persisted. Pleural effusion newly appeared on the serial chest radiologic images. After the fever settled down, the pleural effusion resolved spontaneously at 13th day of admission.
Acute Disease ; Adult ; Female ; Hepatitis A/complications/*diagnosis ; Humans ; Pleural Effusion/complications/*diagnosis/radiography ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The aim of this study was to evaluate targeting the epidermal growth factor receptors (EGFRs) of colon cancer cells with fluorescent magnetic nanoparticles (FMNP) conjugated to anti-EGFR antibodies. METHODS: The expression of EGFRs was evaluated in the HT-29 colon cancer cell lines and the control H-520 lung cancer cells by performing Western blot analysis. We synthesized silica-overcoated iron oxide nanoparticles that contained rhodamine B isothiocyanate (RITC) within a silica shell of a controllable thickness. This FMNP was conjugated to anti-EGFR mouse monoclonal antibody. The cells were treated with this probe conjugate for 4 hours and then the targeting was assessed via confocal microscopy. The fluorescence properties were evaluated for their binding to the expressed EGFRs with using a FACScan flow cytometer. RESULTS: EGFR was expressed in the HT-29 cells, as assessed by Western blot analysis. Red fluorescence was only detected in the membrane regions of the HT-29 cells on the confocal microscope imaging. On the FACS analysis, there was a significant shift of fluorescence intensity for the HT-29 cells. CONCLUSIONS: Our data show the feasibility of targeting colon cancer cells with FMNP conjugated with anti-EGFR antibodies in vitro.
Animals ; Antibodies ; Blotting, Western ; Cell Line ; Colon ; Colonic Neoplasms ; Ferric Compounds ; Fluorescence ; HT29 Cells ; Humans ; Iron ; Lung Neoplasms ; Magnetics ; Magnets ; Membranes ; Mice ; Microscopy, Confocal ; Nanoparticles ; Receptor, Epidermal Growth Factor ; Rhodamines ; Silicon Dioxide

OBJECTIVE: The purpose of this study was to analyze the inclination, pertinence and influential factor in emergent cesarean section according to the assortment and analysis of the indication of emergent cesarean section. METHODS: The retrospective study was performed with the review of 360 emergent cesarean section cases from January 2003 to December 2003. RESULTS: The indication of cesarean section was followed by the order of progress failure (47.5%), previous cesarean section (19.2%), and fetal distress (15.8%). The improper operation of emergent cesarean section was done in fetal distress (28.1%), progress failure (8.6%), and induction failure (16.7%). The absence of acceleration with prolonged bradycardia was the most common (50.0%) type of fetal distress. The emergent cesarean section were done more commonly on Tuesday and Friday during weekdays and it was the peak time in a whole day of cesarean section from 11 o'clock to 12 o'clock and 16 o'clock to 17 o'clock. CONCLUSION: It was proved that twenty six (7.2%) cases of emergent cesarean section were done improperly. Now, work through the non-medical factors are considered more important to reduce improper section rate.
Acceleration ; Bradycardia ; Cesarean Section* ; Female ; Fetal Distress ; Pregnancy ; Retrospective Studies

OBJECTIVES: The purpose of this study is to evaluate and compare the maternal and neonatal complications of the overt diabetes with that of gestational diabetes. METHOD : The medical records of 65 pregnant patients complicated by diabetes mellitus at Eulji medical center from January, 2001 to December, 2002 were reviewed retrospectively. Thirteen patients of them were diagnosed as a overt diabetes and the others were diagnosed as a gestational diabetes. RESULTS: Maternal complications were that preeclampsia in 15.4% and preterm labor in 15.4% in overt diabetes patients and preeclampsia in 9.6%, fourth degree laceration in 1.9%, preterm labor in 3.8%, placenta abruption in 1.9%, cardiomyopathy in 1.9% and polyhydroamnios in 1.9% in gestational diabetes patients. Neonatal complications were that hypoglycemia in 38.5% and respiratory distress syndrome in 15.4% in overt diabetes patients and hypoglycemia in 25%, hyperbilirubinemia in 9.6% and shoulder dystocia in 1.9% in gestational diabetes patients. There were no statistic differences in maternal and neonatal complications in two groups when management had done. And in gestational diabetes group, maternal and neonatal complications were significantly higher in no management group than management group regardless of management types. CONCLUSION: If early detection and management were done in overt and gestational diabetes, there were no difference in maternal and neonatal complications. Regardless of types of diabetes, early detection and management were important.
Cardiomyopathies ; Diabetes Mellitus ; Diabetes, Gestational* ; Dystocia ; Female ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Lacerations ; Medical Records ; Obstetric Labor, Premature ; Placenta ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Shoulder

Epithelioid trophoblastic tumor (ETT) is an unusual variant of gestational trophoblastic tumor that is closely related to choriocarcinoma and placental site trophoblastic tumor (PSTT) but shows different morphologic, immunohistochemical features. ETT grows in a nodular pattern compared with the infiltrative pattern of PSTT. Histologically the tumor is characterized by uniform population of mononucleate intermediate trophoblastic cells that resemble the trophoblastic cells in the chorionic laeve, so we called them "chorionic-type intermediate trophoblast". Immunohistochemically ETT was positive for cytokeratin, epithelial membrane antigen(EMA) and staining for human placental lactogen (hPL) and human chorionic gonadotrophin (hCG) was generally patchy, focal or negative whereas PSTT contained more hPL-positive cells than hCG-positive cells. ETT can behave in a malignant fashion such as distant metastasis. We experienced a case of ETT by clinical result, pathologic finding, so we report a case with brief literature review.
Choriocarcinoma ; Chorion ; Female ; Humans ; Keratins ; Membranes ; Neoplasm Metastasis ; Placental Lactogen ; Pregnancy ; Trophoblastic Neoplasms* ; Trophoblastic Tumor, Placental Site ; Trophoblasts*