Tools to Detect Influenza Virus

In 2009, pandemic influenza A (H1N1) virus (H1N1 09) started to spread quickly in many countries. It causes respiratory infection with signs and symptoms of common infectious agents. Thus, clinicians sometimes may miss the H1N1 patient. Clinical laboratory tests are important for the diagnosis of the H1N1 infection. There are several tests available, however, the rapid test and direct fluorescence antigen test are unable to rule out the influenza virus infection and viral culture test is time consuming. Therefore, nucleic acid amplification techniques based on reverse transcription polymerase chain reaction assays are regarded as a specific diagnosis to confirm the influenza virus infection. Although the nucleic acid-based techniques are highly sensitive and specific, the high mutation rate of the influenza RNA-dependent RNA polymerase could limit the utility of the techniques. In addition, their use depends on the availability, cost and throughput of the diagnostic techniques. To overcome these drawbacks, evaluation and development of the techniques should be continued. This review provides an overview of various techniques for specific diagnosis of influenza infection.

Involvement of MITF-A, an alternative isoform of mi transcription factor, on the expression of tryptase gene in human mast cells

Mast cells play a central role in the initiation and development of allergic diseases through release of various mediators. Tryptase has been known to be a key mediator in mast cell-mediated inflammatory reactions. In the present study, we investigated whether the transcription of tryptase gene in human mast cells was induced by microphthalmia (mi)-associated transcription factor (MITF). We observed that the human CD34+ progenitor-derived cultured mast cells and human mast cell line HMC-1 expressed strongly the transcripts of tryptase-beta1 and MITF-A, which is a MITF alterative splicing isoform. The transcriptional activity of tryptase gene was specifically higher in HMC-1 cells compared to the tryptase-negative cells. Using mutant constructs of tryptase promoter, we observed that two E-box (CANNTG) motifs including between -817 to -715 and -421 to -202 are able to involve in the transactivation of tryptase gene by MITF-A. In addition, the binding of these motifs-containing oligonucleotides to MITF proteins was detectable by EMGA using the nuclear extracts of HMC-1 cells and anti-MITF mAb. The overexpression of MITF-A elevated tryptase production by HMC-1 cells, while the introduction of specific siRNA against MITF attenuated the expression and enzymatic activity of tryptase. These data suggest that MITF might play a role in regulating the transcription of tryptase gene in human mast cells.

Spinal Cord Compression as Initial Presentation of Follicular Thyroid Carcinoma

Follicular thyroid carcinoma with metastasis rarely manifests as spinal cord compression without any previous symptoms of its malignancy. This report describes a 64-year-old man with follicular thyroid carcinoma who presented initially with left arm motor weakness. Magnetic resonance images demonstrated severe cervical cord compression by a mass with destruction of C4 vertebra. Corpectomy of C4 and anterior interbody fusion was carried out. Histopathological study revealed a metastatic follicular carcinoma of the thyroid. We present our case, especially focused of its possible pathophysiology, with review of pertinent literatures.

An Experience of Management of Homeless Neurosurgical Patients

OBJECTIVE: Homeless patients probably have epidemiologic features that are different from those of general population. However, there have been no published articles about clinical characteristics of neurosurgical homeless patients. The authors tried to assess the clinical characteristics and treatment outcome of homeless neurosurgical patients. METHODS: We retrospectively reviewed the medical records and radiological films of 76 homeless patients and 72 non-homeless patients following head trauma who were admitted to our neurosurgical department between June 2001 and June 2005. We compared two groups of the patients with the demographics, the clinical and laboratory characteristics. Also, 30-day mortality was determined according to Glasgow Coma Scale (GCS) score. RESULTS: Age of homeless patients was younger than that of non-homeless patients. Homeless patients had previous craniotomy evidences in skull x-rays more frequently (10.5% vs. 1.4%). Acute subdural hematoma was the most common type of head injury in the two groups. Moderate and severe head injury, based on GCS score on admission was more frequent in homeless patients (64% vs. 39%). Fifty percent of homeless patients underwent operation for traumatic head injury. However, 30-day mortality according to GCS score was not significantly higher in homeless patients. CONCLUSION: Most homeless neurological patients were relatively young men. Also, moderate or severe brain injuries were observed more frequently. However, mortality rate of homeless patients in neurosurgical field is not significantly higher in the present study.

An Experience of Management of Homeless Neurosurgical Patients

OBJECTIVE: Homeless patients probably have epidemiologic features that are different from those of general population. However, there have been no published articles about clinical characteristics of neurosurgical homeless patients. The authors tried to assess the clinical characteristics and treatment outcome of homeless neurosurgical patients. METHODS: We retrospectively reviewed the medical records and radiological films of 76 homeless patients and 72 non-homeless patients following head trauma who were admitted to our neurosurgical department between June 2001 and June 2005. We compared two groups of the patients with the demographics, the clinical and laboratory characteristics. Also, 30-day mortality was determined according to Glasgow Coma Scale (GCS) score. RESULTS: Age of homeless patients was younger than that of non-homeless patients. Homeless patients had previous craniotomy evidences in skull x-rays more frequently (10.5% vs. 1.4%). Acute subdural hematoma was the most common type of head injury in the two groups. Moderate and severe head injury, based on GCS score on admission was more frequent in homeless patients (64% vs. 39%). Fifty percent of homeless patients underwent operation for traumatic head injury. However, 30-day mortality according to GCS score was not significantly higher in homeless patients. CONCLUSION: Most homeless neurological patients were relatively young men. Also, moderate or severe brain injuries were observed more frequently. However, mortality rate of homeless patients in neurosurgical field is not significantly higher in the present study.

Vitamin E Reduces Symptoms in a CFA-induced Model of Monoarthritis / 대한마취과학회지

BACKGROUND: Adjuvant arthritic animals show immunologic and inflammatory features which are also observed in patients with rheumatoid arthritis. This study investigated whether high dose vitamin E (alpha-tocopherol) has any additional anti-inflammatory or analgesic effects, or both, in Complete Freund's adjuvant (CFA) induced arthritic rat model. METHODS: Male Sprague-Dawley rats (300-350 g, n = 3) underwent testing up to 26 days after induction of the model. Vitamin E (100 mg/kg) or vehicle was given daily intraperitoneally (IP) for 10 or 20 days following induction. Thus, groups were as follows: group 1, untreated, n = 3; group 2, CFA + vehicle, n = 10; group 3, CFA + vitamin E for 10 days, n = 10; group 4, CFA + vitamin E for 20 days, n = 10. Parameters compared between groups included ankle circumference, range of articulation of the arthritic joint, extravasation of plasma proteins in the tissues around the arthritic joint and sensory withdrawal threshold to von Frey filament mechanical stimulation. RESULTS: Compared to CFA rats administered drug vehicle, those given vitamin E for 20 days exhibited a reduction in all symptoms of monoarthritis, including less ipsilateral ankle swelling, reduced loss of the range of joint articulation, low plasma extravasation and reversal of the decrease in sensory withdrawal threshold. But, vitamin E for 10 days has only analgesic effect until 10 days. CONCLUSIONS: This study showed relatively long duration of high-dose vitamin E treatment have anti-inflammatory and early onset analgesic effects. The findings raise the possibility of high dose vitamin E, or potentially other antioxidants, as adjuvant therapy for alleviation of symptoms of rheumatoid arthritis.

Protease-activated Receptor 2 is Associated with Activation of Human Macrophage Cell Line THP-1

BACKGROUND: Protease-activated receptor 2 (PAR2) belongs to a family of G protein- coupled receptors activated by proteolytic cleavage. Trypsin-like serine proteases interact with PAR2 expressed by a variety of tissues and immune cells. The aim of our study was to investigate whether PAR2 stimulation can lead to the activation of human macrophages. METHODS: PAR2-mediated proliferation of human macrophage cell line THP-1 was measured with MTT assay. We also examined the extracellular regulated kinase (ERK) phosphorylation and cytokine production induced by trypsin and PAR2-agonist using western blot and enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: Treatment of trypsin or PAR2-activating peptide increased cell proliferation in a dose-dependent manner, and induced the activation of ERK1/2 in THP-1 cells. In addition, trypsin-induced cell proliferation was inhibited by pretreatment of an ERK inhibitor (PD98059) or trypsin inhibitor (SBTI). Moreover, PAR2 activation by trypsin increased the secretion of TNF-alpha in THP-1 cells. CONCLUSION: There results suggest that PAR2 activation by trypsin-like serine proteases can induce cell proliferation through the activation of ERK in human macrophage and that PAR2 may play a crucial role in the cell proliferation and cytokine secretion induced by trypsin-like serine proteases.

Study of Spinal Sensory Block Height with 0.5% Heavy Bupivacaine in Elderly Patients / 대한마취과학회지

BACKGORUND: The relationship among age, height and sensory block height in elderly patients who underwent spinal anesthesia using 0.5% heavy bupivacaine were studied. METHODS: Ninety-seven elderly patients, 65 years of age or older, who were scheduled for spinal anesthesia were divided into four groups. 8 mg of 0.5% heavy bupivacaine was injected in patients who were shorter than 160 cm, and 9 mg was injected in patients who were taller than 160 cm. Then they were further divided into a 65 74 year old group and an older than 75 year old group, and the area of sensory block was compared by the age and height. RESULTS: Sensory block height was not significantly different between the 65 74 year old group and the older than 75 year old group. Height did not correlate with sensory block height in all groups, and the distribution shapes showed variable patterns. CONCLUSiONS: The effect of age and height on the spinal sensory block height in elderly patients is small.

Experience of Percutaneous Nephrolithotomy in Patients with Older Age / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) preformed in patients aged 65 years or older. MATERIALS AND METHODS: We retrospectively evaluated the data of 26 PCNL, performed on 25 patients aged 65 years or older (mean 68.7), and compared the data with those of another 127 PCNL procedures on 123 patients, aged under 65 years, performed at our clinic. RESULTS: The presence of staghorn calculi (6 of 26 renal units [23.1%] versus 41 of 127 renal units [30.7%], p=0.44) and the average stone size (29mm versus 26mm, p=0.19) were similar for the 2 groups. The success rates (stone-free patients and patients with residual stones <4mm) were similar, being 80.8% for the elderly group and 84.2% for the younger patients (p=0.66). The transfusion rates for the 2 groups were similar, 15.4% in the elderly group versus 11.8% in the younger group (p=0.61). No serious complications or deaths were observed. CONCLUSIONS: PCNL is a safe, effective and less invasive therapy for the treatment of elderly patients with complex stone diseases.

Renal Cell Carcinoma with Absence of Inferior Vena Cava / 대한비뇨기과학회지

The congenital absence of an inferior vena cava is an uncommon abnormality. With the advent of modern imaging techniques, such cases are being found with increasing frequency. Here we report a case of a renal cell carcinoma with the absence of an inferior vena cava in a 44 year-old male. He was referred for a further evaluation of a right renal mass, which was observed by ultrasonography, and for persistent epigastric discomfort. Computed tomography showed a huge mass in the right kidney and multicystic lesions in the left. In addition, the inferior vena cava had disappeared at the infrahepatic portion. He was treated with a right radical nephrectomy.

An inclination for medical students' career choice and A cognitive degree on family medicine

No abstract available.