ABSTRACT
Background@#Since the onset of the coronavirus disease 2019 pandemic, virtual simulation has emerged as an alternative to traditional teaching methods as it can be employed within the recently established contact-minimizing guidelines. This prospective education study aimed to develop a virtual reality simulator for a lumbar transforaminal epidural block (LTFEB) and demonstrate its efficacy. @*Methods@#We developed a virtual reality simulator using patient image data processing, virtual X-ray generation, spatial registration, and virtual reality technology. For a realistic virtual environment, a procedure room, surgical table, C-arm, and monitor were created. Using the virtual C-arm, the X-ray images of the patient’s anatomy, the needle, and indicator were obtained in real-time. After the simulation, the trainees could receive feedback by adjusting the visibility of structures such as skin and bones. The training of LTFEB using the simulator was evaluated using 20 inexperienced trainees. The trainees’ procedural time, rating score, number of C-arm taken, and overall satisfaction were recorded as primary outcomes. @*Results@#The group using the simulator showed a higher global rating score (P = 0.014), reduced procedural time (P = 0.025), reduced number of C-arm uses (P = 0.001), and higher overall satisfaction score (P = 0.007). @*Conclusions@#We created an accessible and effective virtual reality simulator that can be used to teach inexperienced trainees LTFEB without radiation exposure. The results of this study indicate that the proposed simulator will prove to be a useful aid for teaching LTFEB.
ABSTRACT
Background@#Refractory angina pectoris (RAP) is a chronic, severe chest pain associated with coronary artery disease that cannot be resolved using optimal medical or surgical approaches. Spinal cord stimulation (SCS) is a suitable treatment option. Conventional waveforms of SCS have shown a potent effect on the tempering of RAP. However, SCS is associated with undesired paresthesia. The new burst SCS waveforms have been reported to have fewer adverse effects.Case: We reviewed a case in which RAP was successfully treated with burst SCS in a middle-aged male, with a tonic waveform employed for breakthrough pain as needed. @*Conclusions@#Appropriate use of tonic and burst stimulations according to the symptoms is expected to maximize the effect of relieving chest pain induced by RAP.
ABSTRACT
Bifidobacteria is one of the prototypes of probiotics bacteria, normally inhabitating the intestinal tract of humans. To search for a potent immunoregulatory Bifidobacteria strain, we screened the Bifidobacteria strains isolated from the feces of healthy Korean children. The mRNA or protein expression of an anti-inflammatory cytokine, IL-10, from mouse macrophages stimulated with live Bifidobacteria was examined. Of tested strains, Bifidobacteria A28 induced the highest IL-10 gene expression of murine macrophages. To probe immunoregulatory activity of the selected strain on the mice, we evaluated the proportional changes of CD4+CD25+ surface marker in the murine splenocytes. Flow cytometric analysis showed that the overall percentages of CD4+CD25+ cells in A28-treated splenocytes were higher than those of untreated splenocytes. In parallel, IL-10 release from A28-treated mouse peritoneal macrophages and splenocytes was significantly higher than that of untreated control cells. Collectively, the Bifidobacteria A28 strain isolated from the feces of healthy Korean children augments the mRNA or protein expression of IL-10 release from mouse peritoneal macrophages as well as the proportion of CD4+CD25+ cells of naive splenocytes. These provide in vitro scientific clues that Bifidobacteria A28 might be usable for anti-inflammatory disease such as inflammatory bowel disease (IBD).
Subject(s)
Animals , Child , Humans , Mice , Bacteria , Feces , Gene Expression , Inflammatory Bowel Diseases , Interleukin-10 , Macrophages , Macrophages, Peritoneal , Probiotics , RNA, Messenger , Sprains and StrainsABSTRACT
All of the methicillin-resistant Staphylococcus aureus (MRSA) strains exhibit resistance to oxacillin by producing PBP2a encoded by mecA, whereas methicllin-susceptible Staphylococcus aureus (MSSA) strains do not. To investigate phenotypic differences other than oxacillin resistance level in responses to oxacillin between MSSA and MRSA, we compared alterations of viability and ultrastructure of MSSA by oxacillin treatment with those of MRSA. When MSSA and MRSA strains were exposed to oxacillin of their respective MICs, and then were assayed for viability and observed by transmission electron microscope, increase in thickness of cell wall was more prominent in MRSA strains than in MSSA strains, while decrease in number of surviving cells was more evident and change in morphology of growing cross wall was greater in MSSA strains than in MRSA strains. It is assumed that these different responses to oxacillin between MSSA and MRSA strains may be due to activation of some PBP2a unbound to oxacillin. In conclusion, MSSA and MRSA showed different functional and morphological responses to oxacillin, although they were treated with oxacillin of concentrations that respectively inhibit their proliferation.
Subject(s)
Adenosine , Cell Wall , Electrons , Methicillin-Resistant Staphylococcus aureus , Oxacillin , Staphylococcus aureusABSTRACT
Candida albicans is an important human pathogen that causes systemic infections, predominantly among population with weakened immune system. Cell wall structures of C. albicans are important to adhere to host tissue and evade to host immune system. Among cell wall structure, the outermost fibrillar layer of C. albicans is of interest since it may play important roles in antigenicity, phagocytosis, and adherence. The expression of virulent factors could be affected by the growth conditions. The dynamic nature of the cell surface alters the physical properties of the fungal interface with host cells and thereby influences adhesion to the host and recognition by components of the host immune system. In this study, we investigated the effects of culture conditions on cell surface fibril expression of C. albicans by a transmitting electron microscopy and SDS-PAGE. The protein fibril of C. albicans was expressed in the presence of whole serum, however, the fibril expression was decreased in 25% serum and serum containing 1% glucose. Also, germ tube can be induced by serum, RMPI medium, N-acetyl glucosamine, and 39 degrees C culture condition, hence, the fibrillar structure of C. albicans was detected only in serum-induced germ tube. The expression of fibril layer and the major fibril proteins of 66, 47, 30 kDa were reduced as increasing cell concentration of intial inoculum from 2x10(7) cells/ml to 8x10(7) cells/ml. The fibrillar layer of C. albicans was expressed in serum early within 10 min, and the thickness of fibril layer was increased according to the increase of culture time. When the fibrillar proteins were analysed by SDS-PAGE, major protein of 30 kDa was maintained continuously during over night culture although expression of the other proteins were various. These results suggest that expression of serum induced protein fibril is influenced by culture conditions and is not related to hyphal transition of C. albicans.
Subject(s)
Humans , Candida , Candida albicans , Cell Wall , Electrophoresis, Polyacrylamide Gel , Glucosamine , Glucose , Immune System , Microscopy, Electron , Phagocytosis , ProteinsABSTRACT
Percutaneous liver biopsy is valuable for making the diagnosis and follow-up of many liver diseases. Complications after ultrasonography-guided liver biopsy are rare, but a few serious complications have been reported. We report here on a 43-year-old man with acute cholangitis and gallbladder hematoma secondary to hemobilia; these occurred 4 days after performing ultrasonography guided percutaneous liver biopsy for the evaluation of multiple liver nodules.
Subject(s)
Adult , Humans , Biopsy , Cholangitis , Diagnosis , Follow-Up Studies , Gallbladder , Hematoma , Hemobilia , Liver Diseases , Liver , UltrasonographyABSTRACT
Rhabdomyolysis is a potentially life-threatening syndrome resulting form the breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation. Rhabdomyolysis may complicate many disease states. In some cases, patients with malaria may be complicated with rhabdomyolysis. Also hydroxychloroquine may induce myopathy and rhabdomyolysis. But there is no case report of rhabdomyolysis after use of hydroxychloroquine in a Korean patient with Plasmodium vivax malaria. Recently we experienced a patient who developed rhabdomyolysis 20 days after starting therapy with hydroxychloroquine for the treatment of P. vivax malaria. We report the case with the review of the literature.
Subject(s)
Humans , Hydroxychloroquine , Malaria , Malaria, Vivax , Muscle Fibers, Skeletal , Muscular Diseases , Plasmodium vivax , RhabdomyolysisABSTRACT
Rhabdomyolysis is a potentially life-threatening syndrome resulting form the breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation. Rhabdomyolysis may complicate many disease states. In some cases, patients with malaria may be complicated with rhabdomyolysis. Also hydroxychloroquine may induce myopathy and rhabdomyolysis. But there is no case report of rhabdomyolysis after use of hydroxychloroquine in a Korean patient with Plasmodium vivax malaria. Recently we experienced a patient who developed rhabdomyolysis 20 days after starting therapy with hydroxychloroquine for the treatment of P. vivax malaria. We report the case with the review of the literature.
Subject(s)
Humans , Hydroxychloroquine , Malaria , Malaria, Vivax , Muscle Fibers, Skeletal , Muscular Diseases , Plasmodium vivax , RhabdomyolysisABSTRACT
BACKGROUND: Disialoganglioside GD2 is a tumor-associated antigen that is overexpressed on tumor cells of neuroectodermal origin, such as melanoma, small cell lung carcinoma and neuroblastoma. Immunity against GD2 has anti-tumor activities, but GD2 is poorly immunogenic. Anti-idiotypic antibodies that mimic GD2 may induce more effective immune responses than GD2 antigen itself, because they are protein antigens and are known to be able to break immune tolerance. In our previous study, we produced anti-idiotypic antibodies mimicking GD2 (3A4 and 3H9), which induced humoral immunity. However, cellular immunity is essential to eradicate tumor cells in vivo as well as humoral immunity. In the present study, we investigated whether these anti-idiotypic antibodies 3A4 and 3H9 could induce cellular immunes responses. METHODS: BALB/C mice were immunized with anti-idiotypic antibody 3A4 or 3H9, or normal mouse IgG as a negative control. Lymphoproliferative responses, cytokine production responses, and delayed-type hypersensitivity reactions were measured in mice immunized with the anti-idiotypic antibodies. RESULTS: Both the anti-idiotypic antibody 3A4 and 3H9 induced GD2-specific lymphoproliferative responses and IFN-gamma production of lymph node lymphocytes in BALB/C mice. Only anti-idiotypic antibody 3H9 induced significant GD2-specific delayed-type hypersensitivity in the mice. CONCLUSION: These results show that anti-idiotypic antibodies 3A4 and 3H9 have the potentiality of inducing GD2-specific cellular immune responses that cannot be induced by the native antigen GD2 itself.
Subject(s)
Animals , Mice , Antibodies, Anti-Idiotypic , Hypersensitivity , Immune Tolerance , Immunity, Cellular , Immunity, Humoral , Immunoglobulin G , Lymph Nodes , Lymphocytes , Melanoma , Neural Plate , Neuroblastoma , Small Cell Lung CarcinomaABSTRACT
BACKGROUND: Disialoganglioside GD2 is a tumor-associated antigen that is overexpressed on tumor cells of neuroectodermal origin, such as melanoma and neuroblastoma. Anti-idiotypic antibodies that mimic GD2 may induce more effective immune responses than GD2 antigen itself, because they are protein antigens and are known to be able to break immune tolerance. In this study, to explore the potential of anti-idiotypic antibodies as tumor vaccines, the ability of anti-idiotypic antibodies (Ab2) to induce anti-anti-idiotypic antibodies (Ab3) that bind to the original antigen GD2 was investigated. METHODS: Six monoclonal anti-idiotypic antibodies (1A8, 1G5, 2B6, 3A4, 3D6, 3H9) to monoclonal antibody M2058, which is a monoclonal antibody to GD2, were produced in mice. Three (1A8, 3A4, 3H9) of them were selected based on their ability to inhibit the binding of Ab1 to D142.34 (murine melanoma cell expressing GD2). These 3 different Ab2 were injected into rabbits, and rabbit Ab3 induced by each of them were characterized. RESULTS: Ab3-containing sera from two rabbits immunized with 1A8, 3A4, or 3H9 bound significantly (P<0.05) to D142.34 but not to B78.96 (GD2-negative cell), and bound significantly (P<0.05) to isolated GD2 but not to GD1a. Ab3-containing sera from two rabbits immunized with 3A4 or 3H9 inhibited significantly (P<0.05) the binding of Ab1 M2058 to D142.34, and inhibited significantly (P<0.05) the binding of Ab1 M2058 to the Ab2. CONCLUSION: These results suggest that anti-idiotypic antibodies 3A4 and 3H9 have a potential to be used as vaccines against tumors expressing GD2 by inducing GD2-specific antibodies (Ab3).
Subject(s)
Animals , Mice , Rabbits , Antibodies , Antibodies, Anti-Idiotypic , Cancer Vaccines , Immune Tolerance , Immunization , Melanoma , Neural Plate , Neuroblastoma , VaccinesABSTRACT
No abstract available.
Subject(s)
Candida albicans , Candida , Hydrophobic and Hydrophilic InteractionsABSTRACT
Candida albicans is one of the most frequently isolated fungal pathogens in human. Recently, the prevalence of candida infection has markedly increased, partially due to the increase of immunocompromised hosts. Proposed virulence factors of the pathogenic Candida are the ability to form hyphae to adhere to epithelial cell surfaces, and to secrete acid proteinases and phospholipases. We measured the relative cell surface hydrophobicity (CSH) and the ability of proteinase production (PROT), phospholipase production (PLase), adherence to host epithelium (ADH), and hyphal transition (Germ). The relative risk of virulence factors was analyzed by lethality test in murine model of hematogeneously disseminated candidal infection. According to Cox's proportional hazard analysis, the statistically significant virulence factors were PROT, ADH, and CSH. PROT was the highest risk factor of them. To evaluate the applicability for the diagnosis and treatment of Candidiasis, we examined the protective effect of the active and passive immunizations with the materials purified from virulence factors and antibodies to them in Candia-infected mice model. The mean survival times of active and passive immunized groups were slightly longer than those of non-immunized groups.
Subject(s)
Animals , Humans , Mice , Antibodies , Candida , Candida albicans , Candidiasis , Diagnosis , Epithelial Cells , Epithelium , Hydrophobic and Hydrophilic Interactions , Hyphae , Immunization, Passive , Immunocompromised Host , Peptide Hydrolases , Phospholipases , Prevalence , Risk Factors , Survival Rate , Virulence Factors , VirulenceABSTRACT
PURPOSE: The p16(INK4A) gene encodes a specific inhibitor of cell cycle progression. In recent years, genetic deletion and altered expression of p16(INK4A) gene were frequently showed in many human cancers. So, the p16(INK4A) gene is considered as tumor suppressor gene. However, there has been a few data for the p16(INK4A) in gastric cancer, colon cancer, and hepatoma.So.we investigated the genetic deldtion and altered expression of p16(INK4A) in gastric cancer, colon cancer and hepatoma cell lines. MATERIALS AND METHODS: The homozygous deletion of p16(INK4A) was examined by using PCR and the protein expression of p16(INK4A) by using Western blotting in cancer cell lines established from Korean patients: stomach cancer, colon cancer and hepatoma cell lines. RESULTS: Homozygous deletion of p16(INK4A) was detected only 1 stomach cancer cell line out of 13 cell lines examined. The p16(INK4A) was detected in 3 of 13 cancer cell line. These results showed the low frequency of p16(INK4A) homozygous deletion and high frequency of p16(INK4A) expression alteration in stomach cancer, colon cancer and hepatoma cell lines. CONCLUSION: In this study, it may be suggested that the altered pl6(INK4A) expression as well as p16(INK4A) gene deletion play important role in oncogenesis. Further studies to determine the mechanism of p16(INK4A) gene inactivation are expected.