Mechanism of Action of Antimicrobial Peptides Against Bacterial Membrane

Resistance to antibiotics is becoming a very serious problem, with so-called superbugs exhibiting resistance to nearly all conventional antibiotic drugs. Consequently, these organisms often cause severe illness and even death. Alternatives to conventional antibiotics are antimicrobial peptides (AMPs). These widely expressed short peptides, which have been isolated from insects, plants, marine organisms and mammals, including humans, show strong antimicrobial activity against both Gram-negative and Gram-positive bacteria. Most AMPs act by disrupting the bacterial membrane through "Barrel-stave", "Toroidal pore", "carpet" mechanism. In addition, AMPs may prevent septic shock through strongly binding lipopolysaccharides and lipoteichoic acid located on the bacterial membrane. The action mechanisms of AMP to minimize the likelihood developing resistance to the peptides would be particular advantage. For these reasons, we anticipate that AMPs will replace conventional antibiotic drugs in a variety of contexts.

New Bone Formation Following Transplantation of Stem Cells and Nanoscale Hydroxyapatite Scaffold Materials into Rabbit Long Bone Defects / 대한정형외과학회잡지

PURPOSE: We observed new bone formation following the transplantation of allogenic periosteum-derived stem cells and different sizes of hydroxyapatite (HA) scaffold materials into rabbit long-bone defects. MATERIALS AND METHODS: Thirty-two white rabbits were grouped according to the material transplanted into their tibial bone defects: group 1 (microscale HA only); group 2 (nanoscale HA only); group 3 (microscale HA plus stem cells); and group 4 (nanoscale HA plus stem cells). Viscosity was controlled by the relative amounts of HA and agar. After surgery, radiologic, microscopic, and biochemical observations were performed weekly for 8 weeks. RESULTS: Nanoscale HA (groups 2 and 4) provided better bone formation than microscale HA (groups 1 and 3). The rabbits that had been transplanted with nanoscale HA plus stem cells (group 4) had more homogeneous bone formation during the natural repair process than the other groups. CONCLUSION: Further study is required using nanoscale HA plus organic substance and stem cells, which are more similar to human bone structure, for better bone formation.

A Case of Streptococcal Toxic Shock Like Syndrome with Pleural Effusion

Streptococcal toxic shock like syndrome is a rapidly progressive and a fatal disease like staphylococcal toxic shock syndrome. In spite of the wide expansion and development of potent antibiotics, streptococcal infection still threatens human being. Recently we experienced a patient with toxic shock like syndrome who was suffered from fever and neck pain with rapid progression to hypotension and multiorgan failure. Streptococcus pyogenes was proven in his throat culture which was done on admission. Pleural effusion and suspicious carditis with aortic and mitral valve regurgitation were examined on the third hospital day. He was treated successfully with antibiotics but we wanted to emphasize potentially fatal streptococcal toxic shock like syndrome in pediatric patients.

Correlation between the Change of Mean Arterial Pressure and the Change of Percutaneous Oxygen Saturation in Patients with Tetralogy of Fallot / 대한마취과학회지

BACKGROUND: Hypoxia often occurs during anesthesia of patients with tetralogy of Fallot (TOF). The factors that determine pulmonary circulation and oxygenation in patient with TOF are the degree of obstruction of right ventricular outflow tract (RVOT), right ventricular filling pressure, systemic vascular resistance, loss of negative pleural cavity pressure by thoracotomy, change of pulmonary vascular resistance due to positive pressure ventilation and degree of arteriopulmonary collateral connection. Hence pulse oximetry is a noninvasive technique for measuring arterial O2 saturation continuously, this study examined the correlation between the change of percutaneous arterial oxygen saturation (delta SpO2) and the change of mean arterial pressure (delta MAP) using pulse oximetry in these patients. METHODS: Twenty pediatric patients undergoing modified Blalock-Taussig shunt or total corrective operation were prospectively investigated. Immediately after induction, baseline values of MAP and SpO2 were determined and if there were some changes in SpO2 from baseline during operation, MAP on that value of SpO2 were collected. If SpO2 reduced, patients were treated with infusion of fresh frozen plasma or pentastach (2-10 ml/kg), injection of phenylephrine (10 microgram/kg) or esmolol (0.5 mg/kg). RESULTS: Intravascular volume loading only was executed in 4 patients, intravascular volume loading and phenylephrine administration was executed in 11 patients, and intravascular volume loading, phenylephrine and beta-blocker administration was executed in 5 patients. There were no significant correlation between delta MAP and delta SpO2 from linear correlation and regression analysis (r=0.23, p<0.05). CONCLUSIONS: Because delta SpO2 were not closely related with delta MAP and above mentioned factors could act closely among each others, meticulous anesthetic management is necessary during palliative or total corrective operation in patients with TOF.

Low Flow Anesthesia with Continuous Infusion of Liquid Enflurane into Breathing Circuit / 대한마취과학회지

BACKGROUND: Lowe and Ernst's square root of time model employs direct injection of liquid agent into breathing circuit for low flow anesthesia. Intermittent injections of the agent by Lowe's method change rapidly arterial partial pressure of the agent and fail to maintain hemodynamic stability to surgical stimuli. We designed to investigate the possibility and safety of low flow anesthesia with continuous infusion of liquid enflurane into breathing circuit. METHODS: Twenty patients, ASA physical status I or II, undergoing gastrectomy under inhalational general anesthesia were randomly divided into two groups. Anesthesia was maintained with a fresh gas flow of O2 500 ml/min and continuous infusion of liquid enflurane. An identical semiclosed Dr ger circle anesthesia system was used to all patients. Liquid enflurane calculated by the Lowe's method (group I) or simplified by patient's weight (group II) was continuously infused directly into inspiratory limb of breathing circuit using syringe pump. Inspiratory and expiratory concentrations of enflurane, enflurane consumptions, hemodynamic parameters, carboxyheomoglobin were checked intraoperatively. Hepatic and renal functions were evaluted postoperatively. RESULTS: Liquid enfurane was initially infused at a rate in ml/hr of 16.1 0.8 weight in kg in group I and 1.0 weight in kg in group II. After 5 minutes the infusion rate was reduced to 20% of this value and then well adjusted to maintain blood pressure within 20% of the reference preoperative value. Enflurane consumptions and recovery time were similar between the two groups. There were no clinical significant changes in arterial blood gas, carboxyheomoglobin, and hepatic and renal functions. CONCLUSIONS: These data show that low flow anesthesia with continuous infusion of liquid enflurane into breathing circuit is safe and effective, and that the infusion method simplified by patient's weight may easily be applied to clinical practice for low flow anesthesia.

Comparison of Enflurane Consumptions and Costs in Low Flow and High Flow Anesthesia / 대한마취과학회지

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.

Comparison of Enflurane Consumptions and Costs in Low Flow and High Flow Anesthesia / 대한마취과학회지

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.

Clinical Application of Serum CEA, SCC, Cyfra2l-1, and TPA in Lung Cancer / 결핵

BACKGROUND: Tumor markers have been used in diagnosis, predicting the extent of disease, monitering recurrence after therapy and prediction of prognosis. But the utility of markers in lung cancer has been limited by low sensitivity and specificity. TPA-M is recently developed marker using combined monoclonal antibody of Cytokeratin 8, 18, and 19. This study was conducted to evaluate the efficacy of new tumor marker, TPA-M by comparing the estabilished markers 8CC, CEA, Cyfra2 I - I in hmg cancer. METHODS: An immunoradiometric assay of serum CEA, SCC, Cyfra2l-I, and TPA-M was performed in 49 pathologically confirmed lung cancer patients who visited Keimyung University Hospital from April 1996 to August 1996, and 29 benign lung diseases. Commercially available kits, Ab bead CM (Eiken) to CEA, SCC RIA BEAD (DAINABOT) to SCC, CA21-1 (TEE) to Cyfra21-1, arid TPA-M (DAIICHI) to TPA-M were used for this study. RESULTS: The mean serum values of lung cancer group and control group were 10.05 +/- 38.39 micro/L, l.59+/-0.94 micro/L in CEA, 3.04+/-5.79 micro/L, 1.58+/-2.85 micro/L in SCC, 8.27+/-11.96 micro/L, 1.77+/-2.72 micro/L in Cyfra21-1, and 132.02+/-209.35 U/L, 45.86+/-75.86 U/t in TPA-M respectively. Serum values of Cyfra21-1 and TPA-M in lung cancer group were higher than control group (p0.05). CONCLUSION: Serum TPA-M and Cyfra21-1 shows higher sensitivity and specificity than CEA and SCC in overall lung cancer and nonsmall cell lung cancer those were confirmed pathologically. SCC has higher specificity in nonsmall cell lung cancer. And the level of serum SCC are significantly related with TNM staging.

Release of linear scar contracture using multiple Y-V plasty

No abstract available.

Microsurgical replantation of amputated penis in a child: a case report

No abstract available.

A Study of Internal Spermatic Vein Cortisol in Patients with Varicocele / 대한비뇨기과학회지

Although it is generally accepted that varicocele is a major cause of male infertility, the mechanism by which varicocele exerts its deleterious effect on spermatogenesis still remains obscure. So, to elucidate the cause of infertility that is the result of varicocele, cortisol levels in the internal spermatic vein blood samples were compared with those of the peripheral vein blood samples from 20 patients with varicocele. In 14 of the 20 patients, cortisol levels were found to be lower in the internal spermatic vein blood than in the peripheral vein blood. In the other 6 patients, cortisol levels were higher in the internal spermatic vein blood. However, no significant differences were observed between the concentrations in the internal spermatic vein (13.12+/-12.12 microgram/dl) and those in the peripheral vein (13.89+/-9.94 microgram/dl) of all cases. Therefore it seems unlikely that testicular dysfunction in patients with varicocele is caused by reflux of adrenal venous blood with toxic metabolites into the internal spermatic vein.

A Study of Internal Spermatic Vein Cortisol in Patients with Varicocele / 대한비뇨기과학회지

Although it is generally accepted that varicocele is a major cause of male infertility, the mechanism by which varicocele exerts its deleterious effect on spermatogenesis still remains obscure. So, to elucidate the cause of infertility that is the result of varicocele, cortisol levels in the internal spermatic vein blood samples were compared with those of the peripheral vein blood samples from 20 patients with varicocele. In 14 of the 20 patients, cortisol levels were found to be lower in the internal spermatic vein blood than in the peripheral vein blood. In the other 6 patients, cortisol levels were higher in the internal spermatic vein blood. However, no significant differences were observed between the concentrations in the internal spermatic vein (13.12+/-12.12 microgram/dl) and those in the peripheral vein (13.89+/-9.94 microgram/dl) of all cases. Therefore it seems unlikely that testicular dysfunction in patients with varicocele is caused by reflux of adrenal venous blood with toxic metabolites into the internal spermatic vein.

A Case of Primary Prostatic Urethral Tumor in Male / 대한비뇨기과학회지

Primary malignancies of the urethra are uncommon and prognosis is poor except in patients with disease that is limited to the anterior urethra. Urethral tumors in the male patient comprise less then one percent of all urologic malignancies. We experienced a case of malignant urethral tumor(transitional cell carcinoma). Herein we report this case with brief review of the literatures.

A Case of Primary Prostatic Urethral Tumor in Male / 대한비뇨기과학회지

Primary malignancies of the urethra are uncommon and prognosis is poor except in patients with disease that is limited to the anterior urethra. Urethral tumors in the male patient comprise less then one percent of all urologic malignancies. We experienced a case of malignant urethral tumor(transitional cell carcinoma). Herein we report this case with brief review of the literatures.

A Case of Epidermoid Cyst of Testis / 대한비뇨기과학회지

Benign tumors of the testis are rare, accounting for one percent of all testicular tumors including epidermoid cyst of the testis. Herein we report one case of epidermoid cyst of the testis and discuss the pathological criteria for diagnosis and clinical management of the lesion.

Foreign Body in the Airway: A review of 71 patients

Seventy one children aged 3 months and 8 months with a foreign body in the airway were analysed. Most of the patients were less than 3 years of age, and male to female ratio 2.6:1. Most foreign bodies were food materials (58.2%), metallic bodies (20.9%) and plastic materials(13.4%). Of all the foreign bodies, 61 cases were lodged in the main bronchi and 3 cases were lodged in the larynx or trachea. Common symptoms and signs were cough, dyspnea, mild pyrexia, recurrent respiratory tract infection, decreased air entry, cyanosis and rales. The most common roentgenographic finding was obstructive emphysema (61.2%). A positive history of foreign body aspiration was obtained in 77.5% of the patients and it was found that carelessness of some sort is responsible in almost all the cases. Of the foreign bodies removed, 84.6% were done bronchoscopy. Direct laryngoscopy was performed in 4.6% of patients. Complications were involved in 19.7% of the cases with bronchoscopy. Three patients died of septic shock, asphyxia and hypoxic brain damage respectively.

Foreign Body in the Airway: A review of 71 patients

Seventy one children aged 3 months and 8 months with a foreign body in the airway were analysed. Most of the patients were less than 3 years of age, and male to female ratio 2.6:1. Most foreign bodies were food materials (58.2%), metallic bodies (20.9%) and plastic materials(13.4%). Of all the foreign bodies, 61 cases were lodged in the main bronchi and 3 cases were lodged in the larynx or trachea. Common symptoms and signs were cough, dyspnea, mild pyrexia, recurrent respiratory tract infection, decreased air entry, cyanosis and rales. The most common roentgenographic finding was obstructive emphysema (61.2%). A positive history of foreign body aspiration was obtained in 77.5% of the patients and it was found that carelessness of some sort is responsible in almost all the cases. Of the foreign bodies removed, 84.6% were done bronchoscopy. Direct laryngoscopy was performed in 4.6% of patients. Complications were involved in 19.7% of the cases with bronchoscopy. Three patients died of septic shock, asphyxia and hypoxic brain damage respectively.