ABSTRACT
Purpose@#Sepsis-related deaths occur during both the early proinflammatory and the late immunosuppressive phases of the condition. The balance of pro- and anti-inflammatory responses is influenced by damaged cells that die via either proinflammatory necroptosis or anti-inflammatory apoptosis. Both forms of cell death may be mediated by reactive oxygen species (ROS) generated during the proinflammatory response. Recent evidence suggests that exercise training boosts antioxidative capacity and could offer protection against sepsis. Given these findings, we aimed to examine the impact of exercise training on neural cell death in the context of sepsis. @*Methods@#We assessed the effectiveness of exercise in reducing ROS production and the inflammatory response using a cecal ligation and puncture (CLP)-induced sepsis model. Forty C57BL/6N male mice were randomly divided into 2 groups: control (CLP-Con; n=20) and experimental (CLP-Ex; n=20). Before the induction of sepsis by CLP, the CLP-Ex mice underwent interval training on a treadmill 3 days per week for 8 weeks. Each day involved 10 cycles of 2 minutes at 8 m/min and 2 minutes at 15 m/min. After the CLP procedure, we monitored the survival of 10 mice from each group over a 30-hour period. @*Results@#The findings indicated that exercise training increased the survival rate among mice with CLP-induced sepsis by enhancing antioxidative capacity and delaying the transition from a hyperdynamic to an immunosuppressive state. @*Conclusions@#Exercise training may delay the progression from the hyperdynamic state to the hypodynamic phase of sepsis by increasing antioxidant capacity and reducing apoptotic cell death.
ABSTRACT
PURPOSE: The rapid recognition of cardiac arrest is an important factor for survival in cardiac arrest patients, and gasping is a primary barrier to the recognition of a cardiac arrest. This study examined differences in capability of recognizing a cardiac arrest and gasping among lay people, hospital nurses, and medical dispatchers. METHODS: From January to July 2016, 193 participants (65 lay people 62 hospital nurses, and 66 medical dispatchers) watched video clips of a collapsed virtual patient with unresponsiveness, gasping or seizure and answered a questionnaire asking whether the patient was in cardiac arrest or not. The results of the questionnaire were analyzed and compared among the groups. RESULTS: The total score of the questionnaire on the determination of cardiac arrest among lay people, nurses, and medical dispatchers were significant (3.09±1.43 vs. 4.15±1.22 vs. 4.45±1.29 points, p < 0.01). In the questions regarding cardiac arrest with gasping, the correct answer rate was highest in the dispatchers, followed in order by nurses and lay people (82.5% vs. 54.8% vs. 29.7%, p < 0.001). CONCLUSION: In this study, lay people had the lowest recognition capability of a cardiac arrest and gasping among the groups. In addition, gasping is a meaningful barrier to cardiac arrest recognition for both lay people and healthcare providers.
Subject(s)
Humans , Cardiopulmonary Resuscitation , Health Personnel , Heart Arrest , Respiration , SeizuresABSTRACT
Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor, with a low-grade malignant potential, occurring predominantly in children and young adults. Association between AFH and other malignancies has been rarely reported. A 27-year-old man who presented with a palpable abdominal mass was diagnosed as having testicular cancer with multiple liver and lung metastases. At 16 months after chemotherapy, a follow-up computed tomographic scan revealed a supraclavicular mass measuring 3 cm in size, which was suspected to be a recurrence. The patient underwent surgical excision, and the mass was pathologically diagnosed as a AFH. The patient has had no local recurrence and no distant metastasis for 12 months after resection. To the best of our knowledge, this is the first case report of AFH as a second tumor in a patient with testicular cancer.
Subject(s)
Adult , Child , Humans , Young Adult , Follow-Up Studies , Histiocytoma , Histiocytoma, Benign Fibrous , Liver , Lung , Neoplasm Metastasis , Neoplasms, Second Primary , Recurrence , Testicular NeoplasmsABSTRACT
Myxoma of the aortic valve is an exceedingly uncommon condition. In this article, we report the case of a 72-year-old man with myxoma arising from the aortic valve. We extirpated the mass and repaired the aortic valve with the patient under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination confirmed that the mass was a myxoma.
Subject(s)
Aged , Humans , Aortic Valve , Cardiopulmonary Bypass , MyxomaABSTRACT
Renal and perirenal abscesses are disease entities caused by infections in or around the kidneys. As imaging modalities have improved in quality and convenience, diagnosing these diseases has become easier. Some cases are refractory to conventional treatment and require surgical correction, although most patients can be cured by antibiotic treatment and percutaneous drainage. We here report the case of a patient with a perirenal abscess that recurred twice after appropriate antibiotic treatment and percutaneous drainage. Although Gram-negative bacilli are the most common pathogenic cause of these diseases, we isolated methicillin-resistant Staphylococcus aureus and Mycobacterium tuberculosis in our patient. Thus, poor responses to appropriate treatment in patients with a perirenal abscess can result not only from antimicrobial resistance or a co-infection but also from the 2 conditions existing concomitantly.
Subject(s)
Humans , Abscess , Coinfection , Drainage , Escherichia , Escherichia coli , Kidney , Methicillin Resistance , Methicillin-Resistant Staphylococcus aureus , Mycobacterium , Mycobacterium tuberculosis , Perinephritis , TuberculosisABSTRACT
PURPOSE: Coronary artery disease is the main cause of morbidity and mortality in dialysis patients. Some observational studies proposed that coronary artery bypass graft (CABG) might provide higher survival benefit than percutaneous coronary intervention (PCI) in dialysis patients. There were not many studies of the comparison between the methods of coronary artery reperfusion therapy. Therefore, we compared the long term survival between PCI and CABG groups in dialysis patients. METHODS: We selected 104 patients with end stage renal disease (ESRD) who had PCI (N=75) or CABG (N=29) in Ilsan-Paik Hospital from December 1999 to February 2010. We collected data from medical records and performed a retrospective analysis in ESRD patients hospitalized for the first coronary revascularization procedure. RESULTS: There was no difference in the basic characteristics between the two groups. However, the frequency of more than 3-vessel lesions or less than 30% ejection fraction was higher in the group of CABG than that of PCI. One and three-year survival rates were higher in the PCI group than those in the CABG group. However, there was no difference in the 5 year survival rate between the groups. In subgroup analysis for severe patients with 3-vessel coronary diseases or less than 30% of ejection fraction, there were no statistical differences in the 1, 3 and 5 year survival rates between the groups. In subgroup analysis for the patients maintaining dialysis more than three months, 1, 3, and 5 year survival rates were not statistically different. CONCLUSION: In ESRD and dialysis patients, there was no difference in the long-term survival between PCI and CABG.
Subject(s)
Humans , Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Coronary Artery Disease , Coronary Disease , Coronary Vessels , Dialysis , Kidney Failure, Chronic , Medical Records , Percutaneous Coronary Intervention , Reperfusion , Retrospective Studies , Survival Rate , TransplantsABSTRACT
Zinc is an essential trace element required for bone formation, however not much has been clarified yet for its role in osteoblast. We hypothesized that zinc would increase osteogenetic function in osteoblasts. To test this, we investigated whether zinc treatment enhances bone formation by stimulating osteoblast proliferation, bone marker protein alkaline phosphatase activity and collagen synthesis in osteoblastic MC3T3-E1 cells. MC3T3-E1 cells were cultured and treated with various concentrations of zinc (0, 1, 3, 15, 25 uM) along with a normal osteogenic medium (OSM) as control for 1, 5, 10 days. As measured by MTT assay for mitochondrial metabolic activity, cell proliferation was stimulated even at low zinc treatment (1-3 micrometer) compared to OSM, and it was stimulated in a zinc concentration-dependent manner during 5 and 10 days, with the most pronounced effect at 15 and 25 uM Zn. Cellular (synthesized) alkaline phosphatase (ALP) activity was increased in a zinc concentration-dependent manner, so did medium (secreted) ALP activity. Cellular collagen concentration was increased by zinc as time went by, therefore with the maximum zinc stimulatory effect in 10 days, and medium collagen concentration showed the same pattern even on 1 and 5 day. This zinc stimulatory effect of collagen synthesis was observed in cell matrix collagen staining. The study results imply that zinc can increase osteogenic effect by stimulating cell proliferation, ALP activity and collagen synthesis in osteoblastic cells.
Subject(s)
Alkaline Phosphatase , Cell Proliferation , Collagen , Durapatite , Osteoblasts , Osteogenesis , ZincABSTRACT
165Dy Hydroxide Macroaggregates(165Dy HMA) has a short half life(2.3 hours) and a size range of 3-5µm that give the advantage of reduced leakage and a shorter hospital stay. This report will show the results of a prospective open study on the efficacy and safety of 165Dy HMA in 178 knees of 141 patients with chronic synovitis refractory to conventional antirheumatic therapy. The final global assessment was classified as good, fair or poor. Extra-articular leakage of 165Dy HMA was determined by the scintigraphic evaluation of liver, groin and knee joints. The optimum radiation dose was 250 mCi. The mean follow up periods were 32.4(14-112) weeks. Thirty seven percent of the knees showed good results, 48% fair results and 15% poor results. In the knees with stage I radiographic changes, 82% showed improvement including 32% of the patients with good results. In the knees with stage II radiographic changes, 90% showed improvement including 42% of the patients with good results. The mean period of improvement for the 158 knees that responded to treatment was 41.4(24-106) weeks. Leakage of radioactivity from the injected joint was minimal. Adverse reactions were rare(radiation burn : 4 cases, transient postinjection swelling : 14 cases). In conclusion, 165Dy HMA radiation synovectomy is a safe and useful therapy for chromic synovitis of the rheumatoid knees.