Sustained-released mixture of vascular endothelial growth factor 165 and fibrin glue strengthens healing of ileal anastomoses in a rabbit model with intraperitoneal infection

PURPOSE: To investigate the effects of a sustained-released mixture of vascular endothelial growth factor 165 (VEGF165) and fibrin glue (FG) local administration on postoperative rabbit ileal anastomoses. METHODS: One hundred twenty-eight male and female New Zealand white rabbits underwent intraperitoneal infection subsequent ileal anastomosis surgery were divided randomly into 4 groups, including 32 animals in each, applied with saline solution, FG, rhVEGF165 and a mixture of rhVEGF165 with FG (VEGF + FG) on the anastomoses, respectively. The incidences of anastomotic leakage were observed. Histopathological examination for inflammatory infiltration, fibroblast proliferation, and capillary vascular proliferation were performed. Then, bursting pressure and hydroxyproline concentrations were assessed in anastomoses sits on postoperative days 3, 5, 7, and 14. RESULTS: Rabbits in VEGF + FG group had the lowest incidence of leakage (P < 0.05). Histological evaluations revealed that granulation tissue was formed on days 5 after anastomosis; fibroblast proliferation and capillary vascular proliferation were significantly increased on days 7 and 14 in VEGF + FG group. Furthermore, there was a statistically significant difference in the mean bursting pressures between VEGF + FG group and other groups on days 7 and 14 (P < 0.05), and rabbits in VEGF + FG group exhibited a higher concentration than VEGF group (P < 0.05) and FG group (P < 0.05) on day 14. CONCLUSION: Administration of VEGF165 mixed with FG to ileal anastomosis accelerates wound healing and enhances the anastomosis by increased angiogenesis.

Current Status and Challenges of Cancer Clinical Trials in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Cancer clinical trials in Korea have rapidly progressed in terms of quantity and quality during the last decade. This study evaluates the current status of cancer clinical trials in Korea and their associated problems. MATERIALS AND METHODS: We analyzed the clinical trials approved by the Korea Food and Drug Administration (KFDA) between 2007 and 2013. A nationwide on-line survey containing 22 questions was also performed with several cooperative study groups and individual researchers in 56 academic hospitals. RESULTS: The number of cancer clinical trials approved by the KFDA increased almost twofold from 2007 to 2013. The number of sponsor-initiated clinical trials (SITs) increased by 50% and investigator-initiated clinical trials (IITs) increased by almost 640%. Three hundred and forty-four clinical trials were approved by the KFDA between 2012 and 2013. At the time of the on-line survey (August 2013), 646 SITs and 519 IITs were ongoing in all hospitals. Six high volume hospitals were each conducting more than 50 clinical trials, including both SITs and IITs. Fifty-six investigators (31%) complained of the difficulties in raising funds to conduct clinical trials. CONCLUSION: The number of cancer clinical trials in Korea rapidly increased from 2007 to 2013, as has the number of multicenter clinical trials and IITs run by cooperative study groups. Limited funding for IIT is a serious problem, and more financial support is needed both from government agencies and public donations from non-profit organizations.

A Study into the Potential for Safe Application of Single-Incision Thoracoscopic Surgery in Various Thoracic Diseases

OBJECTIVE: Single-incision thoracoscopic surgery (SITS) is being applied to various thoracic diseases because it produces a smaller surgical scar, and is associated with less pain and loss of sensation compared to the traditional 3-port video-assisted thoracoscopic surgery (VATS). In our previous study, we showed that SITS can be used as a first-line surgical method to treat primary spontaneous pneumothorax. Therefore in this study, we looked into whether SITS can be safely and conveniently applied to other various thoracic diseases. METHODS: The subjects for this study those patients who underwent SITS at this hospital for thoracic diseases, who were admitted to this hospital between December 2013 and February 2015. RESULTS: In this study, SITS was attempted in 50 patients with various thoracic diseases. In 46 cases, SITS was successfully performed. However, in the remaining 4 cases were converted to 2-port or 3-port VATS (8%, 4/50). The reasons for conversion to VATS was due to difficulty in approaching the lesion (n=3) and severe pleural adhesion (n=1). CONCLUSION: We found that SITS is a relatively easy and safe procedure that can be applied to various thoracic diseases. However, the operation may be difficult to perform depending on the location of the lesions or the extent of pleural adhesions. Therefore we recommend SITS in conditions where the lesion is mainly in the upper lobe, such as spontaneous pneumothorax, and in patients with minimal level of pleural adhesions.

Lifelog Agent for Human Activity Pattern Analysis on Health Avatar Platform / 대한의료정보학회지

OBJECTIVES: To provide accurate personalized medical care, it is necessary to gather individual-related data or contextual information regarding the target person. Nowadays a large number of people possess smartphones, which enables sensors in the smartphones to be used for lifelogging. The objective of the study is to analyze human activity pattern by using lifelog agent cooperating with the Health Avatar platform. METHODS: Using the lifelog measured by accelerometer and gyroscope in a smartphone at a 50 Hz rate, the agent reveals how long the user walks, runs, sits, stands, and lies down, and this information is summarized by hours. The summaries are sent to the Health Avatar platform and finally are written in the Continuity of Care Record (CCR) format. RESULTS: The lifelog agent is successfully operated with the Health Avatar platform. In addition, we implement an application that displays the user's activity patterns in a graph and calculates the metabolic equivalent of task based calorie burned by hour or by day using the lifelog of the CCR form to show that the lifelog can be used as medical records. CONCLUSIONS: The agent shows how lifelogs are analyzed and summarized to help activity recognition. We believe that our agent demonstrates a way of incorporating lifelogs into medical care and a way of exploiting lifelogs in a medical format.

Finite element analysis on the connection types of abutment and fixture / 대한치과보철학회지

PURPOSE: This study was performed to compare the stress distribution pattern of abutment-fixture connection area using 3-dimensional finite element model analysis when 5 different implant systems which have internal connection. MATERIALS AND METHODS: For the analysis, a finite element model of implant was designed to locate at first molar area. Stress distribution was observed when vertical load of 200 N was applied at several points on the occlusal surfaces of the implants, including center, points 1.5 mm, 3.0 mm away from center and oblique load of 200 N was applied 30degrees inclined to the implant axis. The finite element model was analyzed by using of 3G. Author (PlassoTech, California, USA). RESULTS: The DAS tech implant (internal step with no taper) showed more favorable stress distribution than other internally connected implants. AS compare to the situations when the loading was applied within the boundary of implants and an oblique loading was applied, it showed higher equivalent stress and equivalent elastic strain when the loading was applied beyond the boundary of implants. Regardless of loading condition, the abutments showed higher equivalent stress and equivalent elastic strain than the fixtures. CONCLUSION: When the occlusal contact is afforded, the distribution of stress varies depending on the design of connection area and the location of loading. More favorable stress distribution is expected when the contact load was applied within the diameter of fixtures and the DAS tech implant (internal step with no tapering) has more benefits than the other design of internally connected implants.

Evaluation of anxiety level changes during the first three months of orthodontic treatment / 대한치과교정학회지

OBJECTIVE: To determine the changes in dental anxiety, state anxiety, and trait anxiety levels of patients and their parents after 3 months of active orthodontic treatment. METHODS: We evaluated 120 patients and one parent of each patient. State Anxiety (STAI-S), Trait Anxiety (STAI-T), and Corah's Dental Anxiety Scale (DAS) were administered before orthodontic treatment (T1) and after 3 months of treatment (T2). Differences in scores between T1 and T2 were compared using paired-sample t-tests and the relationship between the scores of the DAS and the STAI were analyzed using a bivariate two-tailed Pearson correlation test. RESULTS: Dental anxiety and state anxiety levels decreased among the patients after adjustment to orthodontic treatment (p 0.05). Patient trait anxiety affected patient state anxiety and dental anxiety (p < 0.01). Additionally, a significant correlation was found between patient dental anxiety and parent dental anxiety (p < 0.05). CONCLUSIONS: Dental anxiety and state anxiety levels decrease after patients become familiar with their orthodontist and they became accustomed to orthodontic treatment. However, 3 months is not a sufficient length of time to decrease parental anxiety levels.

Comparison of the Antioxidant Effects of Diallyl Sulfide, Capsaicin, Gingerol and Sulforaphane in H2O2-Stressed HepG2 Cells

Oxygen is necessary to sustain life, yet cellular oxygen metabolism creates destructive elements called free radicals. Free radicals are chemically unbalanced and carrying free electrons that can damage molecules, potentially damaging the cell itself. For this reason, many antioxidant products, including supplements and functional foods, are being developed. In particular, natural products are rich sources of pharmacologically active compounds. The purpose of this study was to investigate the antioxidant effects of target biomaterials in Korean traditional spices such as diallyl sulfide (DAS), capsaicin (CAP), and gingerol (GGR), and to investigate the response of the antioxidant defense system to oxidative stress by hydrogen peroxide (H2O2) compared to sulforaphane (SFN) in HepG2 cells. After the analysis of the cell viability using Cell Counting kit-8 (CCK-8) assay, we determined that the optimum levels were 200 microM DAS, 25 microM CAP, 50 microM GGR, and 12.5 microM SFN. Antioxidant enzymes were measured and protein expression was detected by Western blotting. All treatments showed a significant decrease in antioxidant enzyme activity such as superoxide dismutase, catalse, and glutathione peroxidase in HepG2 cells. Additionally, DAS, CAP, GGR and SFN increased the antioxidant system-related transcription factor Nrf2 which was found to be regulated by the activation of MAPK-JNK in this study. In conclusion, these results indicate the protective effects of DAS CAP, GGR, and SFN against H2O2-induced oxidative stress.

Two Cases of Congenital Vallecular Cyst with Respiratory Distress and Feeding Problems in Young Infant / 대한이비인후과학회지

Congenital vallecular cyst (VC) is a rare cause of stridor and respiratory distress in neonates and infants. Due to the anatomical location of the cyst, an infant with a VC is at risk of life-threatening upper airway obstruction and eventual death. The cyst sits in the vallecular space and can cause significant retroflexion of the epiglottis. It may also present with feeding problems resulting in failure to grow. Endoscopic laryngoscopy is necessary to visualize it and mar-supialization of the cyst is the preferred treatment. We present 2 successfully treated cases of congenital VC in young infants with symptoms of upper respiratory obstruction and feeding problems.

Induction of apoptosis with diallyl disulfide in AGS gastric cancer cell line / 대한외과학회지

PURPOSE: Diallyl disulfide (DADS) is a major organosulfur compound derived from garlic. It has been reported that DADS is able to inhibit the proliferation of several tumor cells. In this study, the effect of DADS was investigated in terms of the proliferation of AGS, gastric adenocarcinoma cell line at various concentrations. METHODS: The viability of cultured cells was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay. To detect the induction of apoptosis, Annexin V-FITC/propodium iodide (PI) staining assay was performed. Analysis of reactive oxygen species (ROS) and the distribution of cells in the cell cycle were measured by a flow cytometer. And using the Western blot analysis, the change of Fas, caspase-3, Bax, Bcl-2 activity was measured. RESULTS: The percentage of live AGS cells was decreased to 23% of that in the control group after 400 microM DADS treatment for 48 hours. The Annexin V positive/PI negative (apoptosis portion) area increased from low concentration of DADS to high concentration. When comparing among the DADS treatment groups, the amount of ROS production increased in a dose dependent manner. The percentage of sub-diploid DNA content increased from 8.71% at 50 microM to 25.74% at 400 microM DADS treatment group. The expressions of Fas, caspase-3, Bax were increased and that of Bcl-2 was decreased in a dose dependent manner. CONCLUSION: DADS decreases the viability of AGS cell lines and induces apoptosis in a dose-dependent manner. But the relationship of the anti-proliferative effect of DADS and related molecular changes were not clearly proportional to the concentration of DADS.

Development of KHapmap Browser using DAS for Korean HapMap Research

The Korean HapMap Project has been carried out for the last 5 years since it started in June, 2003. The project generated data for a sum of 1,764,000 Korean SNPs and formally registered the data to the dbSNP of NCBI (The dbSNP website. 2008). We have developed a series of software programs for association studies as well as for the comparison and analysis of Korean HapMap data with four other populations (CEPH, Yoruba, Han Chinese, and Japanese populations). The KHapmap Browser was developed and integrated to provide haplotype retrieval and comparative study tools of human ethnicities for comprehensive disease association studies (http://www.khapmap.org). On that basis, GBrowse was adopted in the KHapmap Browser for inherent Korean genetic data, and a provision of extended services was pledged with the distributed sequence annotation system (DAS). The dynamic linking service of the KHapmap Browser to other tools in our intranetwork environment provides many enhanced functions over GBrowse without DAS. KHapmap Browser is expected to be an invaluable tool for the study of Korean and international Hapmap data.

Neuroprotection of chloride channel blockers against NMDA-induced apoptosis of cultured rat hippocampal neurons / 南方医科大学学报

Activation of N-methyl-d-aspartic acid (NMDA) receptor plays an important role in neuronal apoptosis induced by cerebral ischemia but the underlying mechanisms are still unclear. The present study examined the neuroprotection of three chloride blockers in an in vitro cell model of cerebral ischemia established by treatment of cultured rat hippocampal neurons with NMDA. Hoechst 33258 staining and MTT assay were used to detect neuronal apoptosis and cell viability, respectively. The neuroprotective effects of chloride channel blockers on the cell viability and neuronal apoptosis were only observed when the blockers were applied before NMDA exposure. In comparison with DIDS, SITS showed more potent protective effect in a dose-dependent manner, whereas NPPB showed no significant neuroprotective effect. The results demonstrate that pretreatment with both SITS and DIDS have protective effect against neuronal apoptosis, which is achieved by blocking both NMDA receptor and chloride channel.

Medical Criteria for Evaluation of Degree of Disability Including Industrial Injury: Orthopedic Surgery

The number of orthopedic patients is increasing according to the increase of traffic and industrial accidents, and there are several approaches to evaluate physical disabilities ensuring after treatment of the injury: The McBride's criteria and the criteria for the evaluation of physical disabilities from industrial injury have been introduced to the medical field. As for the degree of physical disabilities, the McBride's criteria are based on occupations and injured sits, and also amputation, the conditions of joints, and complications of fracture and neural injury. On the other hand, the criteria of physical disability of industrial injuries by the Ministry of Labor in Korea are not satisfactory as compared with the McBride's criteria, and in the future various conditions of joints such as a limited angle of joints should be considered in the criteria of industrial injures.

Pharmacological Suppression of rat distal colon chloride secretion requires two blockers

Rat distal colon epithelium is frequently employed to assess the effect of natural and synthetic chemicals on chloride secretion. Inhibition of chloride secretion is often reported as the loop diuretic-sensitive portion of short-circuit current (Isc). The present work challenges the hypothesis that a loop diuretic alone is able to fully abolish chloride secretion. Isolated mucosa preparations were mounted in an Ussing chamber. The effects on short-circuit current of replacement of normal Ringer by a low (2.5 mmol/L) Cl solution and of blockers of basolateral Na, K, 2 Cl symport (bumetanide), apical Cl channels (diphenylamine-2-carboxylate, DPC), and anion exchange (4-acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid, SITS) alone and combined were assessed. Low Cl reversibly decreased Isc by 76%. In normal Ringer, bumetanide decreased Isc by 65%. SITS also had a significant effect at the serosal side, but not at the apical side, where DPC caused a 40% decrease. Chloride replacement, bumetanide and DPC, but not SITS, increased epithelial resistivity. Combined blockade of Na, K, 2 Cl symport and apical Cl channels, of Na, K, 2 Cl symport and anion antiport, or of anion antiport and apical Cl channels was needed to achieve reduction of short circuit current to the same extent seen with chloride replacement. Present results indicate that Isc of the unstimulated epithelium is mostly due to chloride secretion, and at least two blockers are required to abolish it. This fact should be taken into account in studies of chloride secretion-stimulating agents.

The Characterization of Glucocoritcoid Response Element(GRE) on the Promoter of Thyrotropin-Releasing Hormone(TRH) Gene / 대한내분비학회지

BACKGROUND: We previously demonstrated that the promoter of rat TRH gene has GRE half site (TGTTCT) between -210 bp and -205 bp flanking with similar sequences of TPA response element (TRE), TAGTCA, at a distance of several base pairs from the GRE half site. It promps us to hypothesize that this composite GRE/TRE sequence can provide a site for interaction between glucocorticoid receptor (GR) and c-Jun. Thus, we investigated whether the composite sequence mediates transcriptional regulation induced by dexamethasone (DEX) and 12-O-tetradecanoyl phobol-13-acetate (TPA), and whether it binds GR and c-Jun. METHODS: A luciferase expressing plasmids that contain a part of rat TRH promoter including the composite sequence or their mutants were transfected into HeLa cells by Fugene 6. After the cells were incubated overnight with DEX and TPA, the luciferase activity was measured in a chemiluminometer. A gel retardation assay was performed after binding of the labeled composite sequence or its mutants with GR and c-Jun. RESULTS: DEX increased the transcriptional activity of the plasmid containing the wild type GRE by 2.5 folds, and TPA increased the transcriptional activity by 4 folds. The simultaneous stimulation with DEX and TPA synergistically increased the transcriptional activity by 10 folds. Two mutants whose GRE half sits were altered showed no responses to DEX, and suppressed the TPA-induced or both agents-induced transcriptional activity by 50%. Two mutants whose TRE-like sites were altered suppressed the DEX-induced transcriptional activity by 20%, TPA-induced trarptional activity by 25%, and both agents-induced transcriptional activity by 50%. Gel retardation assay showed that the composite sequence fonned a complex with GR and its mutants bound to GR with remarkably less affinity. c-Jun also bound to the composite sequence to form two cornplexes with less affinity compared to the AP-1 consensus sequence. The mutants of the TRE-like sequence bound to c-Jun with a significantly lower affinity compared to that of the wild type. Simulateous binding of the composite sequence with GR and c-Jun did not form any larger complex. The complex of GR and the composite sequence was much smaller than that formed by c-Jun, suggesting that GR binds to the composite sequence as a monomer. CONCLUSION: These results suggest that the composite sequence of GRE half site and TRE-like site on the promoter of rat TRH gene provides binding sites for GR and c-Jun, which mediate the interaction between two signal transduction pathways. (J Kor Soc Endocrinol 14:265-277, 1999)

Two Cases of Acute Epiglottitis with Sitting up Position, Chin Thrust Forward, Having Dyspnea / 결핵

Acute epiglottitis is a life threatening inflammatory disease of the upper airway mainly in children, however, the recent reports about acute epiglottitis in adults are increasing. The common symptoms are sore throat, dysphagia, dyspnea and salivary drooling. As the laryngeal edema progresses, the patient sits up, leans forward, with the chin thrust forward, having obvious difficulty breathing. Early recognition and proper airway maintenance until the inflammatory edema subsides are essential steps to avoid a possible life threatening upper airway obstruction. We experienced two cases of acute epiglottitis with sitting up position, chin thrust forward, having dyspnea.

Effects of Hydrogen Peroxide on Rabbit Corneal Bioelectric Properties

The rabbit cornea was studied in vitro in modified Ussing chambers to determine the effects of ion transport inhibitors and hydrogen peroxide(H2O2) on ion transport through the cornea by measuring the bioelectric properties. Apical(tear side, T side) addition of furosemide, bumetanide and SITS were ineffective on resting Isc(short circuit current). Apical addition of 1.0mM amiloride(Na+/H+ antiport inhibitor) and NPAA(Cl- channel blocker) markedly reduced the resting Isc, but basolateral(stromal side, S side) addition of amiloride was ineffective. The site of action of these agents was the apical membrane. H2O2, an oxygen free radical, markedly increased the lsc when was added to the T side, but S side addition of the H2O2 was ineffective. To determine the degree of cellular catalase participation in protection against H2O2 induced injury the cornea was pretreated with ATAZ for 30 min prior to H2O2 action. The increase of lsc by H2O2 was markedly potentiated after pretreatment with ATAZ on T side compared to that of S side addition. This result indicates that the corneal endothelial H2O2 may be largely degraded by catalase. When H2O2 was added to the T side, Isc was raised by increased ion transport. All ion transport inhibitors that were used inhibited the H2O2 effect on Isc. Moreover, amiloride and NPAA markedly inhibited induced lsc by H2O2. These results suggest that H2O2 stimulates the corneal epithelial ion transport and that its site of action is apical membrane Na+/H+ antiport system and CI- channel system.

Chronic myelogenous leukemia: alterations in red cell membrane band 3 and increased IgG binding.

Chronic myelogenous leukemia (CML) is a hematologic malignancy arising from an abnormal hemopoietic stem cell. Our earlier studies have identified defects in spectrin tetramer formation and organization of cytoskeletal proteins (Basu et al., Biochim. Biophys. Acta 1988, 121-126); and decreased ankyrin binding to ankyrin-depleted vesicles in CML patients. These may lead to clustering of band 3 and increased binding of autologous IgG. This has now been explored by studying the binding of 125I-protein A to normal and CML erythrocytes. There is increased binding of 125I-protein A in CML erythrocytes compared to normal erythrocytes. Since binding of autologous IgG is responsible for removal of erythrocytes from the circulation, the above findings suggest that CML erythrocytes are likely to be prematurely removed from the circulation, accounting for anemia.

Tannic acid as a marker for membrane sidedness of human red cell vesicles

Membrane sidedness of human eythrocytes was investigated in inside-out vesicles (IOV's), ghosts and intact cells by means of transmission electron microscopy (e.m.) after tannic acid fixation. No gross difference in appeearance of either membrane surface was observed when IOV's were subjected to conventional e.m. preparation. This included in addition to tannic acid, a double fixation with glutaraldehyde and osmium, followed by "en bloc" and thin section staining with uranyl acetate and lead citrate. By contrast, if IOV's were treated with a high EDTA concentration (2-5 mM) before tannic fixation, granular, electron-dense deposits were found on one of the surfaces. The presence of such a meterial was unaffected by neuraminidase treatment prior to the EDTA step. On the hand, red cells show no electron-dense deposits when exposed to EDTA (5 mM) unless they presented a light cytoplasm and an altered membrane appearance. Such a material was only observed on the inner membrane surface. Furthermore, a similar distribution of such deposits following EDTA treatment was also found in white ghosts before being induced to vesiculate. These results indicate that tannic acid can be employed as a marker for the cytoplasmic surface of the human erythrocyte membrane when used in combination with EDTA

The Comparative Study of Diazepam, Lorazepam and Meperidine as Premedicants / 대한마취과학회지

Among the elective Surgeries performed at Hanyang University Hospital from March to July 1986, 150 cases were studied. Each 50 cases were given diazepam, lorazepam and mep-eridine as prefnedicants. In the diazepam and lorageparm group, each 25 cases were given by intramuscvlary and intravenously. 40 minutes after injection, scoring the degree of sedation was performed. Scoring the degree of sedation was adopted by "Simple Scoring System" (Nisbet and Norria, 1963). The results were as follows : 1) Comparison of diazepam, lorazepam and meperidine intramusclar administration, sign-ificantly lower souring wan defined in meperidine. (p0.05 by ridit analrsis in both groups) 3) Environmental factors (sex, grade of education, religion and sits of operation) were not influenced on scoring significantly. (p>0.05 by Chi-square test)

CT findings in rhinocerebral mucormycosis & aspergillosis

Invasive aspergilosis or mucormycosis of the paranasal sinuses involving the cranial cavity is termed'rhinocerebral' mycosis, which is often difficult to differentiate from malignancy. Prognosis of rhinocerabralmycosis: is diastrous and usually fatal. The authors herein report 6 cases of rhinocerebral mycosis: two of themwe mucormycosis and four were aspiergillosis histopathologically. Main CT featurs are nodular mucosal thickeningin the multiple sits of the paranasal sinuses that extend to orbital apex or cavernosu sinus through focaldestruction of bony wall. In spite of their invasiveness beyond bony boundary, destruction is not so remarkableand it is always accompained by bony sclerosis. Awareness of these diseases and CT patterns discussed in thisreport should be helpful in leading to early biopsy and treamtent.