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BACKGROUND: In patients with cervical immobilization, jaw thrust can cause cervical spine movement. Concurrent use of a laryngoscope may facilitate lightwand intubation, allowing midline placement and free movement of the lightwand in the oral cavity without jaw thrust. We compared the effects of laryngoscope-assisted lightwand intubation (LALI) versus conventional lightwand intubation (CLI) on cervical spine motion during intubation in patients with simulated cervical immobilization. METHODS: In this randomized crossover study, the cervical spine angle was measured before and during intubation at the occiput-C1, C1-C2, and C2-C5 segments in 20 patients with simulated cervical immobilization who underwent intubation using both the LALI and CLI techniques. Cervical spine motion was defined as the change from baseline in angle measured at each cervical segment during intubation. RESULTS: Cervical spine motion at the occiput-C1 segment was 5.6° (4.3) and 9.3° (4.5) when we used the LALI and CLI techniques, respectively (mean difference [98.33% CI]; -3.8° [-7.2 to -0.3]; P = .007). At other cervical segments, it was not significantly different between the 2 techniques (-0.1° [-2.6 to 2.5]; P = .911 in the C1-C2 segment and -0.2° [-2.8 to 2.5]; P = .795 in the C2-C5 segment). CONCLUSIONS: The LALI technique produces less upper cervical spine motion during intubation than the CLI technique in patients with simulated cervical immobilization.
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Vértebras Cervicales/patología , Intubación Intratraqueal/métodos , Laringoscopios , Laringoscopía , Luz , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca , Movimiento , Adulto JovenRESUMEN
BACKGROUND: In this study we investigated whether cerebral ventricle indices based on brain computed tomography (CT) scans are reliable for predicting intracranial pressure (ICP) in hydrocephalic patients. METHODS: Electronic medical records of 221 patients undergoing ventriculoperitoneal shunt due to hydrocephalus were retrospectively reviewed. Cerebral ventricle indices including Evans' index, third ventricle index, cella media index, and ventricular score were calculated from transverse diameters measured at various levels on preoperative brain CT scans. ICP was considered as CSF opening pressure. Patients were categorized into three groups: communicating hydrocephalus, non-communicating hydrocephalus, and normal pressure hydrocephalus (NPH). The non-communicating hydrocephalus group was further divided according to the obstruction site; aqueduct, fourth ventricle outlet, third ventricle, and the foramen of Monro. The primary endpoint was the extent of the correlation between cerebral ventricle indices and ICP in each hydrocephalus group. RESULTS: No cerebral ventricle index correlated with ICP in patients with communicating hydrocephalus (n = 113) and NPH (n = 62). In the non-communicating hydrocephalus group (n = 46), only the third ventricle index revealed moderate negative correlation with ICP (r = -0.395, p < 0.01). In subgroup analyses, the third ventricle index showed a strong negative relationship with ICP only in patients with the third ventricle obstruction (r = -0.779, p < 0.05). CONCLUSIONS: In this study we showed that although an inverse correlation existed between ICP and the third ventricle index only in patients with non-communicating hydrocephalus due to obstruction of the third ventricle, cerebral ventricle indices based on brain CT scan were non-reliable predictors of ICP in hydrocephalic patients.
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Ventrículos Cerebrales/patología , Hidrocefalia/diagnóstico por imagen , Presión Intracraneal/fisiología , Derivación Ventriculoperitoneal , Adulto , Anciano , Ventriculografía Cerebral , Femenino , Humanos , Hidrocefalia/clasificación , Hidrocefalia/fisiopatología , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
PURPOSE: The aim in this study was to investigate the diet and nutritional knowledge of elite Korean wrestlers and verify the differences in their exercise performance , muscle damage indicators, and antioxidant enzyme levels according to wrestler level. METHODS: A 7-day dietary and nutrition knowledge survey was administered to 30 adult male elite wrestlers (national team: n=11; professional team: n=19). The Wingate test was conducted for 60 seconds to analyze muscle damage indicators and antioxidant levels. Blood and blood lactate concentration analyses were performed four times; the statistical significance level of all data was p<0.05. RESULTS: Significant differences were found in general nutrition knowledge questionnaire (GNKQ) scores (p=0.043), diet (p=0.001), anaerobic performance (p=0.001), muscle damage indicators (p=0.026), antioxidant levels, and blood lactic acid concentrations (30 min after exercise, p=0.007; 90 min after exercise, p=0.038) between the national and the professional groups. CONCLUSION: To the findings confirm the relationship between the differences in diet, nutrition, and motor function for wrestlers of different expertise levels. In a follow-up, a comprehensive study on nutrition knowledge, athlete training , and weight loss is needed that considers a wider scope of subjects and analyzes additional variables.
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Inflammatory Bowel Disease (IBD) is a chronic and relapsing inflammatory condition characterized by severe symptoms such as diarrhea, fatigue, and weight loss. Growing evidence underscores the direct involvement of the nuclear factor-erythroid 2-related factor 2 (NRF2) in the development and progression of IBD, along with its associated complications, including colorectal cancer. The NRF2 pathway plays a crucial role in cellular responses to oxidative stress, and dysregulation of this pathway has been implicated in IBD. Flavones, a significant subclass of flavonoids, have shown pharmacological impacts in various diseases including IBD, through the NRF2 signaling pathway. In this study, we conducted a screening of compounds with a flavone structure and identified NJK15003 as a promising NRF2 activator. NJK15003 demonstrated potent NRF2 activation, as evidenced by the upregulation of downstream proteins, promoter activation, and NRF2 nuclear translocation in IBD cellular models. Treatment with NJK15003 effectively restored the protein levels of tight junctions in cells treated with dextran sodium sulfate (DSS) and in DSS-treated mice, suggesting its potential to protect cells from barrier integrity disruption in IBD. In DSS-treated mice, the administration of NJK15003 resulted in the prevention of body weight loss, a reduction in colon length shortening, and a decrease in the disease activity index. Furthermore, NJK15003 treatment substantially alleviated inflammatory responses and apoptotic cell death in the colon of DSS-treated mice. Taken together, this study proposes the potential utility of NRF2-activating flavone compounds, exemplified by NJK15003, for the treatment of IBD.
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Colitis , Flavonas , Enfermedades Inflamatorias del Intestino , Sulfatos , Ratones , Animales , Factor 2 Relacionado con NF-E2/metabolismo , Dextranos/metabolismo , Colitis/inducido químicamente , Colitis/tratamiento farmacológico , Colitis/metabolismo , Flavonas/farmacología , Flavonas/uso terapéutico , Enfermedades Inflamatorias del Intestino/inducido químicamente , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/metabolismo , Sulfato de Dextran/toxicidad , Ratones Endogámicos C57BL , Modelos Animales de Enfermedad , Colon/metabolismoRESUMEN
BACKGROUND: Emerging evidence has revealed a close relationship between obesity and osteoporosis. It was reported recently that conditional knockout of the Spry1 gene in mice adipocytes causes an increase in body fat and a decrease in bone mass, and that these phenotypes are rescued by Spry1 overexpression in adipose tissue. In this study, we investigated whether genetic variation in the human SPRY1 gene is associated with obesity-related phenotypes and/or osteoporosis in humans. METHODS: We performed a candidate gene association analysis between the four single nucleotide polymorphisms (SNPs) and 14 imputed SNPs in the SPRY1 gene and obesity-related traits and osteoporosis in a Korean women cohort (3013 subjects). RESULTS: All four SPRY1 gene SNPs were significantly associated with either obesity-related traits or osteoporosis. The TGCC haplotype in the SRPY1 gene showed simultaneous association with an increased risk for obesity-related traits, percentage body fat (p=0.0087) and percentage abdominal fat (p=0.047), and osteoporosis (odds ratio=1.50; p=0.025) in the recessive genetic model. CONCLUSIONS: Our results support a previous finding in conditional Spry1 gene knockout mice and suggest that the SPRY1 gene is an important genetic factor for determining the risk of both obesity and osteoporosis in humans.
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Proteínas de la Membrana/genética , Obesidad/genética , Osteoporosis/genética , Fosfoproteínas/genética , Polimorfismo Genético , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Osteoporosis/complicaciones , Osteoporosis/fisiopatología , República de CoreaRESUMEN
The structured adsorption filter material is one of the ways to enhance the practical applicability of powdered adsorbents, which have limitations in the real water treatment process due to difficulty in the separation process. In this study, three-dimensional (3D) printing technology was applied to prepare filter materials for water treatment processes. A 3D-printed graphene-oxide (GO)-based adsorbent is prepared on a polylactic acid (PLA) scaffold. The surface of the PLA scaffold was modified by subjecting it to strong alkaline or organic solvent treatment to enhance GO doping for realizing effective adsorption of cationic dye solutions. When subjected to 95% acetone treatment, the structural properties of PLA changed, and particularly, two main hydrophilic functional groups (carboxylic acids and hydroxyls) were newly formed on the PLA through cleavage of the ester bond of the aliphatic polyester. Owing to these changes, the roughness of the PLA surface increased, and its tensile strength decreased. Meanwhile, its surface was doped mainly with GO, resulting in approximately 75% methylene blue (MB) adsorption on the 3D-printed GO-based PLA filter. Based on the established optimal pretreatment conditions, a kinetic MB sorption study and an isotherm study were conducted to evaluate the 3D-printed GO-based PLA filter. The pseudo-second-order model yielded the best fit, and the MB adsorption was better fitted to the Langmuir isotherm. These results suggested that chemical adsorption was the main driver of the reaction, and monolayer sorption occurred on the adsorbent surface. The results of this study highlight the importance of PLA surface modification in enhancing GO doping and achieving effective MB adsorption in aqueous solutions. Ultimately, this study highlights the potential of using 3D printing technology to fabricate the components required for implementing water treatment processes.
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Panax ginseng is one of the most important herbal medicinal plants consumed as health functional food and can be fermented to achieve better efficacy. Lacticaseibacillus, one of the representative genera among lactic acid bacteria (LAB), has also been used as a probiotic material for health functional foods due to its beneficial effects on the human body. To achieve a synergistic effect by using these excellent dietary supplement ingredients together, a novel LAB strain was isolated from the root of 6-year-old ginseng. Through similarity analysis of 16S rRNAs and whole-genome sequences, the strain was confirmed as belonging to the genus Lacticaseibacillus and was named L. casei KGC1201. KGC1201 not only met all safety standards as food, but also showed excellent probiotic properties such as acid resistance, bile salt resistance, and intestinal adhesion. In particular, KGC1201 exhibited superior acid resistance through morphological observation identifying that the cell surface damage of KGC1201 was less than that of the L. casei type strain KCTC3109. Gene expression studies were conducted to elucidate the molecular mechanisms of KGC1201's acid resistance, and the expression of the glycosyltransferase gene was found to be significantly elevated under acidic conditions. Exopolysaccharides (EPSs) biosynthesized by glycosyltransferase were also increased in KGC1201 compared to KCTC3109, which may contribute to better protection of KGC1201 cells from strong acidity. Therefore, KGC1201, with its increased acid resistance through molecular mechanisms and excellent probiotic properties, can be used in health functional foods to provide greater benefit to overall human health and well-being.
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Lacticaseibacillus casei , Lactobacillales , Panax , Probióticos , Humanos , Niño , Lacticaseibacillus casei/genética , Lacticaseibacillus , Ácidos y Sales BiliaresRESUMEN
We investigated the potential probiotic properties of Limosilactobacillus fermentum KGC1601 isolated from Panax ginseng. Ginseng cultivated in an experimental field of the Korea Ginseng Research Institute was fermented, followed by single colony selection from MRS agar. We performed 16s-rRNA sequencing and whole-genome analysis to identify L. fermentum and evaluate the biosafety parameters of this strain, respectively. We confirmed this strain was susceptible to six antibiotics, as proposed by the European Food Safety Authority, did not produce biogenic amines, and did not exhibit any hemolytic activity. Acid resistance and bile salt tolerance, which are essential properties of a probiotic agent, were investigated. Notably, distinguishing properties of this strain were that it exhibited excellent bile salt tolerance and anti-inflammatory effects. The excellent bile salt tolerance was confirmed by scanning electron microscopy. Through qRT-PCR and ELISA studies, it was revealed that L. fermentum KGC1601 pre-treatment up-regulates anti-inflammatory cytokines and down-regulates pro-inflammatory cytokines in RAW 264.7 cells. Consequently, we suggested that L. fermentum KGC1601 can be safely used as a potential anti-inflammatory functional probiotic agent.
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The onset, severity, and ultimate outcome of malaria infection are influenced by parasite-expressed virulence factors as well as by individual host responses to these determinants. In both humans and mice, liver injury follows parasite entry, persisting to the erythrocytic stage in the case of infection with the fatal strain of Plasmodium falciparum. Hepatic nuclear factor (HNF)-1α is a master regulator of not only the liver damage and adaptive responses but also diverse metabolic functions. In this study, we analyzed the expression of host HNF-1α in relation to malaria infection and evaluated its interaction with the 5'-untranslated region of subtilisin-like protease 2 (subtilase, Sub2). Recombinant human HNF-1α expressed by a lentiviral vector (LV HNF-1α) was introduced into mice. Interestingly, differences in the activity of the 5'-untranslated region of the Pf-Sub2 promoter were detected in 293T cells, and LV HNF-1α was observed to influence promoter activity, suggesting that host HNF-1α interacts with the Sub2 gene.
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Regiones no Traducidas 5'/genética , Regulación de la Expresión Génica/genética , Factor Nuclear 1-alfa del Hepatocito/metabolismo , Malaria Falciparum/parasitología , Plasmodium falciparum/genética , Subtilisinas/genética , Animales , Línea Celular , ADN Protozoario/genética , Vectores Genéticos , Factor Nuclear 1-alfa del Hepatocito/administración & dosificación , Factor Nuclear 1-alfa del Hepatocito/genética , Interacciones Huésped-Parásitos , Humanos , Inyecciones Intravenosas , Lentivirus/genética , Malaria Falciparum/metabolismo , Malaria Falciparum/patología , Ratones , Plasmodium falciparum/efectos de los fármacos , Regiones Promotoras Genéticas/genética , ARN Mensajero/genética , ARN Protozoario/genética , Proteínas Recombinantes , Transducción de Señal , Subtilisinas/metabolismoRESUMEN
A comprehensive monitoring program was conducted during 2005-2007 to investigate seasonal variations of hydrologic stability and water quality in the Yeongsan Reservoir (YSR), located at the downstream end of the Yeongsan River, Korea. A principal component analysis (PCA) was performed to identify factors dominating the seasonal water quality variation from a large suite of measured data--11 physico-chemical parameters from 48 sampling sites. The results showed that three principal components explained approximately 62% of spatio-seasonal water quality variation, which are related to stratifications, pollutant loadings and resultant eutrophication, and the advective mixing process during the episodic rainfall-runoff events. A comparison was then made between YSR and an upstream freshwater reservoir (Damyang Reservoir, DYR) in the same river basin during an autumn season. It was found that the saline stratification and pollutant input from the upstream contributed to greater concentrations of nutrients and organic matter in YSR compared to DYR. In YSR, saline stratification in combination with thermal stratification was a dominant cause of the longer period (for two consecutive seasons) of hypoxic conditions at the reservoir bottom. The results presented here will help better understand the season- and geography-dependent characteristics of reservoir water quality in Asian Monsoon climate regions such as Korea.
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Agua Dulce/química , Contaminantes del Agua/análisis , Abastecimiento de Agua/análisis , Monitoreo del Ambiente/métodos , Eutrofización , Análisis de Componente Principal , República de Corea , Estaciones del AñoRESUMEN
Water quality response in a reservoir has often been assessed using relatively restricted datasets that cannot provide sufficient information, thereby giving rise to a dramatic over- or underestimate of actual figures. In this paper we discuss how the levels of metallic elements between the sediment and overlying water in an estuarine reservoir can be influenced by aquatic parameters in response to spatial and seasonal conditions. To better elucidate the interfacial exchange between sediment and water, statistical analyses are employed to intensive data sets collected from the Yeongsan Reservoir (YSR), Korea, which has undergone widespread deterioration in water quality due to the continuous growth of anthropogenic sources. During three seasonal sampling campaigns, we found that oxygen deficiency at the bottom water layer promotes Fe and Ni accumulation in sediment, likely due to the formation of sulfide and oxide complexes under anoxic and suboxic environments, respectively. In addition, salinity levels as high as 11 per thousand in the bottom water layer during autumn substantially increase the release of Mn, restricting the use of YSR as a primary source of agricultural irrigation water. Although most dissolved metals are at acceptable levels for sustaining aquatic life, it is recommended that for long-term planning the elevated Fe and Mn levels in sediment should be controlled with oxygen deficiency during dry weather to ensure a sustainable water supply or, at a minimum, better coordinated operation of YSR.
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Agua Dulce/química , Sedimentos Geológicos/química , Contaminantes Químicos del Agua/química , Abastecimiento de Agua/normas , Anaerobiosis , Monitoreo del Ambiente/métodos , Sedimentos Geológicos/análisis , Hierro/química , Corea (Geográfico) , Manganeso/química , Oxígeno/química , Estaciones del Año , Solubilidad , Contaminantes Químicos del Agua/análisisRESUMEN
Comprehensive water quality monitoring was conducted to assess the water quality conditions and to determine the impact of urban infrastructure on ambient water quality in Angkor, Cambodia. During this study, surface water, groundwater, and sediment samples were collected for two distinctive seasons in 2006-2007 at 58 monitoring sites along and near the Siem Reap River, in Tole Sap Lake (TSL), and West Baray, the primary water resources in this region. To assess the seasonal and spatial variability of 27 water quality parameters, multivariate analysis of variance, hierarchical cluster analysis, and the Kruskal-Wallis test were conducted using the obtained data. Differences and relationships between the surface water and groundwater were also investigated using t-test and correlation analysis, respectively. The results of these tests showed that the bacterial indicators need special attention as the urban infrastructure of the downtown area caused increased levels of these bacterial indicators in both surface water and groundwater. However, for most parameters, though surface water showed strong seasonal variations, groundwater presented relatively stable conditions between seasons (p > 0.05) with site-specific geochemical conditions. Sediment quality illustrated that pollution levels of 10 trace metals were the highest in TSL because of its unique characteristic (river with backward flow), but did not reflect any potential enrichment from urban development. Overall, the results reveal that while the urban infrastructure in this region has not significantly affected most of the water quality parameters, bacteria and coliphages are still a main concern due to their contributions in widespread waterborne diseases. Thus, careful mitigation plans for reducing each pollutant source are needed in the Angkor area.
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Monitoreo del Ambiente/estadística & datos numéricos , Agua Dulce/química , Agua Dulce/microbiología , Análisis de Varianza , Cambodia , Carbono/análisis , Clorofila/análisis , Clorofila A , Conductividad Eléctrica , Monitoreo del Ambiente/métodos , Sedimentos Geológicos/análisis , Concentración de Iones de Hidrógeno , Nitrógeno/análisis , Oxígeno/análisis , Fósforo/análisis , Estadísticas no Paramétricas , Temperatura , Abastecimiento de AguaRESUMEN
The aim of this study was to examine the therapeutic potential of sulfasalazine and prednisolone in a mouse collagen antibody-induced arthritis (CAIA) model. Twenty-five male BALB/c mice were randomly divided into five groups: group 1 (G1): control, group 2 (G2): probe control, group 3 (G3): CAIA, group 4 (G4): CAIA+sulfasalazine (10 mg/kg, oral), and group 5 (G5): CAIA+prednisolone (100 mg/kg, oral). Fluorescence bioimaging was performed in vivo 24 and 48 h after treatment with a fluorescence probe (OsteoSense® 680 EX), and all mice were sacrificed. The hind knee joints were fixed in 10% neutral phosphate-buffered formalin, and micro-computed tomography (micro-CT) and histopathological analyses were performed. The paw thickness increased in a time-dependent manner in G3 mice, but trended toward a decrease in both G4 and G5 mice. Fluorescence intensity increased in G3 mice at 24 and 48 h after fluorescence probe treatment, but the fluorescence intensity in G4 and G5 mice was lower than that in G3. Micro-CT analyses showed that the joint surfaces of G3 mice had a rough and irregular articular appearance, but the occurrence of these irregularities was lower in G4 and G5. Hematoxylin and eosin and Safranin O-fast green staining confirmed that destruction of the cartilage and bony structures, synovial hyperplasia, and inflammatory cell infiltration all occurred in G3, and that the occurrence of these phenomena was lower in G4 and G5 than in G3. Taken together, these results suggest that sulfasalazine and prednisolone can reduce acute rheumatoid arthritis in mice.
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Nanotechnology has advanced at an extremely rapid pace over the past several years in numerous fields of research. However, the uptake of nanoparticles (NPs) into the body after administration through various routes may pose a risk to human health. In this study, we investigated the potential ocular toxicity of 20-nm, negatively- charged zinc oxide (ZnO) NPs in rats using micro-computed tomography (micro-CT) and histopathological assessment. Animals were divided into four groups as control group, ZnO NPs treatment group (500 mg/kg/day), control recovery group, and ZnO NPs treatment and recovery group. Ocular samples were prepared from animals treated for 90 days (10 males and 10 females, respectively) and from recovery animals (5 males and 5 females, respectively) sacrificed at 14 days after final treatment and were compared to age-matched control animals. Micro-CT analyses represented the deposition and distribution of foreign materials in the eyes of rats treated with ZnO NPs, whereas control animals showed no such findings. X-ray fluorescence spectrometry and energy dispersive spectrometry showed the intraocular foreign materials as zinc in treated rats, whereas control animals showed no zinc signal. Histopathological examination revealed the retinopathy in the eyes of rats treated with ZnO NPs. Neuronal nuclei expression was decreased in neurons of the ganglion cell layer of animals treated with ZnO NPs compared to the control group. Taken together, treatment with 20-nm, negatively-charged ZnO NPs increased retinopathy, associated with local distribution of them in ocular lesions.
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In reviewing the literature, we found few cases of Salmonella osteomyelitis of the femoral diaphysis in a healthy patient. Most are typically associated with sickle cell anemia or immunosuppressed patients. We report on the successful treatment of Salmonella osteomyelitis in the mid-diaphyseal region of the femur caused by Salmonella species in a healthy individual.
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Fémur/diagnóstico por imagen , Osteomielitis/diagnóstico por imagen , Infecciones por Salmonella/diagnóstico por imagen , Diáfisis/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Salmonella/aislamiento & purificaciónRESUMEN
To clarify the role of stem cells in hepatocarcinogenesis, the expression of epithelial cell adhesion molecule (EpCAM) and proliferating cell nuclear antigen (PCNA) was investigated in mouse hepatic tumors and embryonic cell lineages. Ten ICR mice were treated with diethylnitrosamine (DEN) at 14 days of age and sacrificed at 36 weeks subsequent to DEN treatment to obtain the hepatic tumors. Mouse embryonic stem cells, hepatic progenitor cells and hepatocyte-like cells, representing 0, 22 and 40 days of differentiation, respectively, were treated in vitro with DEN at four doses (0, 1, 5 and 15 mM; G1, G2, G3 and G4, respectively) for 24 h and RNA was isolated. A total of 71 hepatic tumors were obtained from the DEN-treated mice. EpCAM expression was increased mainly in hepatic tumor cells, although it was also detected in the surrounding visually normal cells. Double staining showed that EpCAM and PCNA were co-expressed in numerous tumor cells. In vitro, EpCAM expression was significantly different for G4 at day 0 (P<0.01) and for G2, G3 and G4 at day 40 (P<0.01) compared with the control (G1) at the corresponding time-point. PCNA expression was significantly different for G3 and G4 at day 0 (P<0.01), for G2, G3 and G4 at day 22 (P<0.01) and for G2 at day 40 (P<0.01) compared with G1 at the corresponding time-point. In summary, the expression of EpCAM and PCNA was increased in DEN-induced tumors and the expression of EpCAM and PCNA was altered by DEN treatment in cultured cells. This suggests that EpCAM expression may be modulated in the progeny of adult liver stem cells during their differentiation toward hepatocytes and may be increased during DEN-induced hepatocarcinogenesis.
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Chronic intestinal pseudo-obstruction is a rare clinical syndrome which is characterized by intestinal obstruction without occluding lesions in the intestinal lumen and pregnancy is one of the important aggravating factors. Here, we report a case of a woman with intractable intestinal pseudo-obstruction that was precipitated by pregnancy. She could not make any stool passage for more than 4 weeks until a fetal gestational age of 17 weeks was reached. However, the patient could be maintained by repetitive colonoscopic decompressions and finally total colectomy could be performed successfully at a fetal gestational age of 21 weeks.
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PURPOSE: To investigate the efficacy of early infliximab use and to follow the progress of pediatric cases of Crohn's disease for 3 years. METHODS: We reviewed the medical records of 28 pediatric patients who had been treated with infliximab for Crohn's disease. Eighteen patients (the 'top-down' group) received infliximab and azathioprine for induction and maintenance therapy for the first year, and then were treated with azathioprine for 2 additional years. Ten patients who were refractory to conventional therapy were categorized in the 'step-up' group. All patients were followed for at least 36 months. Treatment efficacy was assessed by the relapse rate using the pediatric Crohn's disease activity index (PCDAI) score in each group at 12, 24, and 36 months. Blood samples were available from 10 patients, and were used to assess antibody to infliximab (ATI). RESULTS: The relapse rate in 'top-down' group was lower than that in 'step-up' group at 1, 2, and 3 years. But, just the relapse rate at the 2 years was significantly different. At 3 years, the relapse rate according to different characteristic variables (sex, age at diagnosis, involvement, PCDAI at diagnosis) was not significantly different. Only one patient treated with infliximab had an adverse event, consisting of dyspnea and tachycardia. ATI was not detected in the blood samples from 10 patients. CONCLUSION: Early induction with infliximab at diagnosis ('top-down' therapy) is effective for reducing the relapse rate compared to conventional therapies in pediatric Crohn's disease possibly for up to 3 years.
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Stormwater runoff poses a great challenge to the scientific assessment of the effects of diffuse pollution sources on receiving waters. In this study, a self-organizing map (SOM), a research tool for analyzing specific patterns in a large array of data, was applied to the monitoring data obtained from a stormwater monitoring survey to acquire new insights into stream water quality profiles under different rainfall conditions. The components of the input data vectors used by the SOM included concentrations of 10 metal elements, river discharge, and rainfall amount which were collected at the inlet and endpoint of an urban segment of the Yeongsan River, Korea. From the study, it was found that the SOM displayed significant variability in trace metal concentrations for different monitoring sites and rainfall events, with a greater impact of stormwater runoff on stream water quality at the upstream site than at the downstream site, except under low rainfall conditions (≤ 4 mm). In addition, the SOM clearly determined the water quality characteristics for "non-storm" and "storm" data, where the parameters nickel and arsenic and the parameters chromium, cadmium, and lead played an important role in reflecting the spatial and temporal water quality, respectively. When the SOM was used to examine the efficacy of stormwater quality monitoring programs, between 34 and 64% of the sample size in the current data set was shown to be sufficient for estimating the stormwater pollutant loads. The observed errors were small, generally being below 10, 6, and 20% for load estimation, map resolution, and clustering accuracy, respectively. Thus, the method recommended may be used to minimize monitoring costs if both the efficiency and accuracy are further determined by examining a large existing data set.
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Monitoreo del Ambiente/métodos , Metales/análisis , Redes Neurales de la Computación , Ríos/química , Contaminantes del Agua/análisis , Algoritmos , Lluvia , República de Corea , Movimientos del Agua , Abastecimiento de AguaRESUMEN
A comprehensive water quality monitoring program was conducted in the Yeongsan (YS) River, Korea from 2005 to present to investigate wet and dry weather pollutant discharge in an attempt to establish point and non-point pollution management strategies. As part of this monitoring program, 11 heavy metal species were measured during dry and wet weather conditions in the YS River, where Gwangju City (GJ), a subcatchment of the YS River, was further monitored to clarify the responsibility of different metal species discharged into the mainstream. Monthly grab water samples showed that greater amounts of metals along the YS River were discharged during the wet summer months due largely to storm runoff. In addition, further monitoring results revealed that GJ, a highly urbanized area, was a significant contributor of the heavy metals being discharged into the YS River during both wet and dry weather. The most abundant metal species discharged from GJ were manganese, aluminum and iron with different contributions of wet and dry weather flows to the total discharge load. Wet weather flow was a significant contributor to the annual dissolved metal loads, accounting for 44-93% of the annual load depending on the metal species, with the exception of chromium and cadmium (9% and 27%, respectively). Mostly, metal loads during wet weather were shown to be proportional to the rainfall depth and antecedent dry period. A substantial fraction of metals were also associated with solids, suggesting that sedimentation might be an appropriate management practice for reducing the metal load generated in GJ. Overall, although dissolved metal concentrations in YS River were at an acceptable level for aquatic community protection, continual metal discharge throughout the year was considered to be a potential problem in the long-term due to gradual water quality degradation as well as continuous metal accumulation in the system.