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.

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.

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.

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.