RESUMO
With the activity of intestinal stem cells and continuous turnover, the gut epithelium is one of the most dynamic tissues in animals. Due to its simple yet conserved tissue structure and enteric cell composition as well as advanced genetic and histologic techniques, Drosophila serves as a valuable model system for investigating the regulation of intestinal stem cells. The Drosophila gut epithelium is in constant contact with indigenous microbiota and encounters externally introduced “non-self” substances, including foodborne pathogens. Therefore, in addition to its role in digestion and nutrient absorption, another essential function of the gut epithelium is to control the expansion of microbes while maintaining its structural integrity, necessitating a tissue turnover process involving intestinal stem cell activity.As a result, the microbiome and pathogens serve as important factors in regulating intestinal tissue turnover. In this manuscript, I discuss crucial discoveries revealing the interaction between gut microbes and the host’s innate immune system, closely associated with the regulation of intestinal stem cell proliferation and differentiation, ultimately contributing to epithelial homeostasis.
RESUMO
Monitored anesthesia care (MAC) has been used as a specific anesthesia service for diagnostic or therapeutic procedures performed under local anesthesia along with sedation and analgesia. Procedures such as trans arterial chemoembolization (TACE) or uterine artery embolization (UAE) performed in interventional radiology are typically accompanied by post-embolization syndrome (PES). While in TACE for hepatocellular carcinoma treatment, the severity of PES tends to be milder due to the liver’s dual blood supply, the degree is notably more severe in the case of UAE. Furthermore, the symptoms of PES after UAE procedure tend to follow a typical pattern. Most UAE patients do not develop pain until after the procedure has concluded. It is during the recovery period that patients frequently need significant doses of narcotics and analgesics to alleviate the pain. This report elucidates the application of MAC using dexmedetomidine in UAE, aimed to maintain adequate sedation during procedure and reduce severe pain after procedure.
RESUMO
Spontaneous intracranial hypotension (SIH) is a condition caused by spontaneous cerebrospinal fluid (CSF) leakage, resulting in orthostatic headache as the main symptom, but other symptoms such as memory loss, nausea, and tinnitus may also be present. Various imaging techniques are used to diagnose SIH, with magnetic resonance imaging myelography being an important tool for detecting the leakage site of CSF. Conservative treatments including hydration, bed rest, and intravenous caffeine have been tried with limited success. Epidural blood patch (EBP) is the most commonly performed treatment for SIH after the failure of conservative management. There are different opinions about the EBP procedure (e.g., blind EBP vs. targeted EBP). This report describes the treatment of SIH with targeted EBP according to imaging diagnosis after the failure of initial blind lumbar EBP.
RESUMO
Background@#This study aimed to evaluate the association between sleep duration and handgrip strength (HGS) with the consideration for sex and age groups. @*Methods@#Among 10,783 individuals of the Korea National Health and Nutrition Examination Survey 2016-2017, the associations of weekend and weekdays sleep duration with HGS were analyzed using logistic regression analysis after adjusting for income, education, smoking·alcohol use, weight status, presence of metabolic syndrome and chronic illness according to sex and age (19-40, 41-60, ≥61). @*Results@#With respect to the weekdays sleep duration, the odds ratios for low HGS in men and women aged ≥61 years with >8 hours sleep duration were 1.8 and 1.7, while the odds ratio (OR) was 1.4 in women aged ≥61 years with 8 hours sleep were 2.7 and 4.9, while the OR in men ≥61 years with >8 hours sleep was 2.1. In women, the OR was 1.5 for those 19-40 years with >8 hours sleep duration; 1.4, 1.4, and 2.0 for those ≥61 years with 8 hours sleep. @*Conclusions@#Higher risk for low HGS was associated with >8 hours sleep duration in weekdays and weekend in older men and women, 8 hours weekend sleep duration in younger men and women.
RESUMO
Background@#Previous studies have shown that body composition is associated with chronic kidney disease (CKD), and perimenopause is associated with increased fat mass and decreased lean body mass. Muscle wasting is common among patients with CKD. Sarcopenic obesity (SO) refers to excess adiposity with decreased muscle mass. However, little is known about the relationship between SO and renal function decline. Here, we identified the relationship between SO and decreased estimated glomerular filtration rate (eGFR) in postmenopausal women. @*Methods@#We conducted a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Survey (2008–2011). We analyzed 4,560 postmenopausal women who underwent dual energy X-ray absorptiometry. Sarcopenia was defined based on weight-adjusted appendicular skeletal muscle mass. Obesity was defined based on body mass index. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were classified into four groups: normal, obese, sarcopenic, and sarcopenic obese. Logistic regression analysis was performed to examine the association between SO and decreased eGFR. The results were adjusted for variable confounders. @*Results@#In the unadjusted model, the odds ratio (OR) of decreased eGFR for SO was 1.67 (95% confidence interval [CI], 1.23–2.26). The obese and sarcopenic groups had ORs of 0.67 (95% CI, 0.44–1.03) and 0.70 (95% CI, 0.44–1.10), respectively. After controlling for confounding variables, there was also a significant association between SO and decreased eGFR (adjusted OR, 1.48; 95% Cl, 1.05–2.07). @*Conclusion@#SO was independently associated with decreased eGFR in postmenopausal Korean women.
RESUMO
Objective@#This study was undertaken to establish a radiologic report monitoring system (RRMS) for missed and incidental findings (MIFs) in computed tomography (CT) and magnetic resonance imaging (MRI) reports, to help determine the clinical significance of MIFs in the emergency department (ED). @*Methods@#Patients presenting to our ED in 2017 were subjected to RRMS. Preliminary reports and final reports were subsequently compared based on the clinical significance of the MIFs. If required, the patient was contacted and instructed to revisit the ED. @*Results@#Totally, 12,132 CT and MRI exams were performed during the study period, and 321 cases (2.6%) encompassed MIFs. We attempted to contact 228 cases (1.9%) who had clinically significant MIF findings; 9 patients were instructed to return to the ED, whereas 105 cases were instructed to report to the outpatient department. Hospitalization was required for 12 patients: 2 cases required surgical intervention, 2 cases had an additional procedure, and 8 cases required medical hospitalization. @*Conclusion@#This study applied RRMS for a timely assessment of MIFs, determine rearrangements required, and present an active response to the MIFs determined in the ED. To improve patient care and safety, we hereby propose monitoring MIFs using the RRMS or similar methods.
RESUMO
PURPOSE: This study compared the effects of Static stretching and Mulligan's Two-leg rotation about the Hamstring flexibility, Hip range of motion, and pain.METHODS: The subjects were allocated randomly into two groups: Static stretching group (n=13) and Mulligan's two leg rotation group (n=14). The study was designed with stretching protocols for four minutes and thirty seconds per day five times a week for three weeks in total. Measurements, including the Sit and reach test, Active/Passive Straight leg raise, and Visual analogue scale, were conducted before and after the intervention. The data were analyzed using a paired t-test and independent t-test.RESULTS: The flexibility of the two leg rotation group was higher than the static stretching group after the intervention. The post-sit and reach test value of the two leg rotation group was significantly higher than the pre-sit and reach test value of the static stretching group. In addition, the variance of the sit and reach test of the two leg rotation group was significantly higher than that of the static stretching group.CONCLUSION: These results showed that two leg rotation techniques have a positive effect on the changes in the sit and reach test and active straight leg raise test. Two leg rotation techniques can be recommended as a self-stretching and easier way to stabilize the lumbopelvic rhythm, reduce the stiffness of the muscle and relieve pain. This is effective in preventing muscle damage, enabling muscle relaxation and reducing the risk of injury to the spine during daily lives and in sports activities.
Assuntos
Humanos , Adulto Jovem , Quadril , Perna (Membro) , Relaxamento Muscular , Exercícios de Alongamento Muscular , Maleabilidade , Amplitude de Movimento Articular , Coluna Vertebral , EsportesRESUMO
BACKGROUND@#This study used the data of Korea Youth Risk Behavior Web-based Survey (KYRBS) to confirm the relationship between electronic cigarette use for smoking cessation among Korean adolescents and demographic, health behavior, and school-life factors.@*METHODS@#Data were taken from the 13th KYRBS in 2017. In this study on 62,276 adolescents, characteristics of 1,244 electronic cigarette users were compared with those of non-electronic cigarette users. The 1,244 adolescent electronic cigarette users were evaluated for characteristics related to smoking cessation. Among the related characteristics, demographic factors comprised sex, grade, economic status, weekly allowance, and residence type. Health status-related factors comprised physical activity, lifetime drinking experience, smoking amount, subjective health perception, and stress perception. School characteristics included school type, academic performance, and smoking cessation education. Chi-square test and logistic regression analysis were performed using complex sample analysis.@*RESULTS@#The proportion of current electronic cigarette users was 2.2% (boys, 3.3%; girls, 0.9%). Of the 41.5% of cigarette users willing to quit smoking, 11% used electronic cigarettes for this purpose. Among the electronic cigarette users, characteristics related to smoking cessation were grade, weekly allowance, and residence type, but logistic regression analysis revealed that increases in grade (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.21–3.35) and living with family (OR, 4.17; 95% CI, 1.89–9.18) were associated with smoking cessation.@*CONCLUSIONS@#According to the 13th KYRBS in 2017, adolescents were likely to use electronic cigarette for smoking cessation when they are older and live with their families.
RESUMO
BACKGROUND: This study used the data of Korea Youth Risk Behavior Web-based Survey (KYRBS) to confirm the relationship between electronic cigarette use for smoking cessation among Korean adolescents and demographic, health behavior, and school-life factors. METHODS: Data were taken from the 13th KYRBS in 2017. In this study on 62,276 adolescents, characteristics of 1,244 electronic cigarette users were compared with those of non-electronic cigarette users. The 1,244 adolescent electronic cigarette users were evaluated for characteristics related to smoking cessation. Among the related characteristics, demographic factors comprised sex, grade, economic status, weekly allowance, and residence type. Health status-related factors comprised physical activity, lifetime drinking experience, smoking amount, subjective health perception, and stress perception. School characteristics included school type, academic performance, and smoking cessation education. Chi-square test and logistic regression analysis were performed using complex sample analysis. RESULTS: The proportion of current electronic cigarette users was 2.2% (boys, 3.3%; girls, 0.9%). Of the 41.5% of cigarette users willing to quit smoking, 11% used electronic cigarettes for this purpose. Among the electronic cigarette users, characteristics related to smoking cessation were grade, weekly allowance, and residence type, but logistic regression analysis revealed that increases in grade (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.21–3.35) and living with family (OR, 4.17; 95% CI, 1.89–9.18) were associated with smoking cessation. CONCLUSIONS: According to the 13th KYRBS in 2017, adolescents were likely to use electronic cigarette for smoking cessation when they are older and live with their families.
Assuntos
Adolescente , Feminino , Humanos , Demografia , Autoavaliação Diagnóstica , Ingestão de Líquidos , Educação , Sistemas Eletrônicos de Liberação de Nicotina , Comportamentos Relacionados com a Saúde , Coreia (Geográfico) , Modelos Logísticos , Atividade Motora , Assunção de Riscos , Fumaça , Abandono do Hábito de Fumar , Fumar , Produtos do TabacoRESUMO
BACKGROUND/AIMS: Magnetic resonance enterography (MRE) has emerged as an important tool in the diagnosis and follow-up of Crohn's disease (CD). The aim of this study was to evaluate whether MRE findings could predict the prognosis of CD. METHODS: In this retrospective study, a total of 173 patients with clinical remission of CD (n=61) or active CD (n=112) were identified. The outcomes of clinical relapse, admission, surgery, and need for other medications according to the MRE findings were evaluated. RESULTS: The presence of active inflammation on MRE was observed in 93 (83%) patients with clinically active CD and in 44 (72.1%) patients with clinical remission of CD, without a statistically significant difference (P=0.091). In multivariate analysis, active inflammation on MRE increased the risk for clinical relapse (hazard ratio [HR], 6.985; 95% confidence interval [CI], 1.024–47.649) in patients with clinical remission of CD. In patients with clinically active CD, active inflammation on MRE increased the risk for CD-related hospitalization (HR, 2.970; 95% CI, 1.006–8.772). CONCLUSIONS: The presence of active inflammation on MRE was significantly associated with poor prognosis both in patients with clinical remission of CD and in those with active CD.
Assuntos
Humanos , Doença de Crohn , Diagnóstico , Seguimentos , Hospitalização , Inflamação , Análise Multivariada , Prognóstico , Recidiva , Estudos RetrospectivosRESUMO
Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.
Assuntos
Adulto , Feminino , Humanos , Masculino , Gravidez , Índice de Apgar , Audiometria , Líquido Cefalorraquidiano , Cesárea , Infecções por Citomegalovirus , Citomegalovirus , Retardo do Crescimento Fetal , Ganciclovir , Perda Auditiva Neurossensorial , Imunoglobulina M , Articulações , Coreia (Geográfico) , Microcefalia , Micrognatismo , Parto , Reação em Cadeia da Polimerase , Retinite , GêmeosRESUMO
Restless legs syndrome (RLS) is chronic neurological disorder, in which the primary symptoms is unpleasant and disturbing sensation accompanied by urge to move in multiple body parts especially in legs. RLS may present in distinct phenotypes often described as “primary” vs. “secondary.” Secondary RLS can arise from etiologies such as iron deficiency, pregnancy, peripheral neuropathy, and end-stage renal disease. We report a rare case of RLS associated with neurogenic tumor of the sciatic nerve. A 72-year-old man complained of recurrent and worsening RLS symptoms in his right lower extremity, despite medical treatment. Interestingly, we found a neurogenic tumor at the right greater sciatic notch region on magnetic resonance imaging of the hip.
Assuntos
Idoso , Humanos , Gravidez , Quadril , Corpo Humano , Ferro , Falência Renal Crônica , Perna (Membro) , Extremidade Inferior , Imageamento por Ressonância Magnética , Doenças do Sistema Nervoso , Doenças do Sistema Nervoso Periférico , Fenótipo , Síndrome das Pernas Inquietas , Nervo Isquiático , SensaçãoRESUMO
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a potential cause of hyponatremia of the central nervous system (CNS). Although SIADH has been reported to be associated with many other central nervous disorders, its association with neuromyelitis optica (NMO) or NMO spectrum disorders are rare. NMO is a demyelinating disorder characterized by optic neuritis and transverse myelitis. Aquaporin-4 (AQP4), which is the target antigen for a NMO autoantibody, is the predominant CNS water channel. However, some NMO patients show seronegative AQP4 antibody results. The spectrum of NMO has been changed, and new findings about the disease have been reported. Here, we report a case of seronegative NMO spectrum disorder associated with SIADH.
Assuntos
Humanos , Sistema Nervoso Central , Doenças Desmielinizantes , Hiponatremia , Síndrome de Secreção Inadequada de HAD , Mielite Transversa , Neuromielite Óptica , Neurite Óptica , ÁguaRESUMO
STUDY DESIGN: A retrospective review of prospectively collected data. PURPOSE: To introduce the sternum-disk distance (SDD) method for approaching the exact surgical level without C-arm guidance during anterior cervical discectomy and fusion (ACDF) surgery and to evaluate its accuracy and reliability. OVERVIEW OF LITERATURE: Although spine surgeons have tried to optimize methods for identifying the skin level for accessing the operative disk level without C-arm guidance during ACDF, success has rarely been reported. METHODS: In total, 103 patients who underwent single-level ACDF surgery with the SDD method were enrolled. The primary outcome measure was the accuracy of the SDD method. The secondary outcome measures were the mean SDD value at each cervical level from the cranial margin of the sternum in the neutral and extension positions of the cervical spine and the inter- and intra-observer reliability of the SDD outcome determined using repeated measurements by three orthopedic spine surgeons. RESULTS: The SDD accuracy (primary outcome measure) was indicated in 99% of the patients (102/103). The mean SDD values in the neutral-position magnetic resonance imaging (MRI) were 108.8 mm at C3–C4, 85.3 mm at C4–C5, 64.4 mm at C5–C6, 44.3 mm at C6–C7, and 24.1 mm at C7–T1; and those in the extension-position MRI were 112.9 mm at C3–C4, 88.7 mm at C4–C5, 67.3 mm at C5–C6, 46.5 mm at C6–C7, and 24.3 mm at C7–T1. The Cohen kappa coefficient value for intra-observer reliability was 0.88 (excellent reliability), and the Fleiss kappa coefficient value for inter-observer reliability as reported by three surgeons was 0.89 (excellent reliability). CONCLUSIONS: Based on the results of the present study, we recommend performing ACDF surgery using the SDD method to determine the skin level for approaching the surgical cervical segment without fluoroscopic guidance.
Assuntos
Feminino , Humanos , Vértebras Cervicais , Discotomia , Fluoroscopia , Imageamento por Ressonância Magnética , Métodos , Ortopedia , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Estudos Retrospectivos , Pele , Fusão Vertebral , Coluna Vertebral , Esterno , CirurgiõesRESUMO
No abstract available.
Assuntos
Doenças do Nervo Hipoglosso , Nervo Hipoglosso , Paralisia , PrognósticoRESUMO
Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness. Characteristics of tsutsugamushi disease are fever, rash and eschar. However, severe complications might rarely occur, such as acute fulminant myocarditis caused by scrub typhus. Thus, there are few reports of recovery from seriously complicated cases. We report on an adult male with scrub typhus complicated with acute fulminant myocarditis with no previous comorbid illness who recovered successfully with proper treatment including antibiotics, ventilator support, percutaneous cardiopulmonary support, and continuous renal replacement therapy.
Assuntos
Adulto , Humanos , Masculino , Antibacterianos , Exantema , Circulação Extracorpórea , Febre , Miocardite , Orientia tsutsugamushi , Terapia de Substituição Renal , Tifo por Ácaros , Ventiladores MecânicosRESUMO
Surgical resection is mainstay treatment of hepatocellular carcinoma (HCC). However, its prognosis is poor, because of the high incidence of HCC recurrence (cumulative 5-year HCC recurrence rate of 70-80%). The most common site of HCC recurrence is the remnant liver, and extrahepatic recurrence occurs in 6.7-13.5% of patients. Because the tumor characteristics in extrahepatic recurrence are usually multiple and aggressive, the optimal treatment modality has not yet been determined. We report a case of complete remission and long term survival over 60 months in patient with extrahepatic metastasis after curative resection of HCC by aggressive treatment, which include lung resection for lung metastasis, radiotherapy for mediastinal lymph node metastasis, and systemic chemotherapy.
Assuntos
Humanos , Carcinoma Hepatocelular , Tratamento Farmacológico , Incidência , Fígado , Pulmão , Linfonodos , Metastasectomia , Metástase Neoplásica , Prognóstico , Radioterapia , RecidivaRESUMO
STUDY DESIGN: Retrospective interventional study. PURPOSE: To introduce a free-hand pedicle screw (PS) insertion technique without fluoroscopic guidance in the C7 vertebra and evaluate the procedure's feasibility and radiologic outcomes. OVERVIEW OF LITERATURE: Although PS insertion at C7 has been recognized as a critical procedure in posterior cervical fusion surgery, conventional techniques for C7 PS have several limitations. METHODS: Thirty two patients (64 screws) who underwent PS insertion in C7 with the novel technique were included in this study. Postoperative clinical and radiological outcomes were evaluated. Special attention was paid to the presence of any problems in the screw position including cortical breaches of the PS and encroachment of the PS into the spinal canal or the vertebral foramen. This novel technique for PS insertion in C7 without fluoroscopy guidance had three key elements. First, the ideal PS entry point was chosen near the C6-7 facet joint using preoperative images. Second, the convergent angle distance was measured at axial computed tomography (CT) imaging, which defined the distance between the tip of C7 spinous process and the extended line passing through the pedicle axis from the ideal entry point. Third, the cranial-caudal angle distance was measured in sagittal CT images, which defined the distance between the tip of the C7 spinous process and the extended line passing through the pedicle axis. RESULTS: Cortical breach on postoperative CT images was observed in three screws. All violated only the lateral wall of the affected pedicle. The breached screws occurred in the initial five cases. Postoperative neurologic deterioration was not observed in any patient, regardless of cortical breaching. CONCLUSIONS: The novel technique successfully allows for C7 PS to be placed and is associated with a low rate of cortical breach.
Assuntos
Humanos , Vértebra Cervical Áxis , Estudos de Viabilidade , Fluoroscopia , Estudos Retrospectivos , Canal Medular , Coluna Vertebral , Articulação ZigapofisáriaRESUMO
BACKGROUND: Immunoglobulin E (IgE) has traditionally been associated with anaphylaxis and atopic disease. Previous studies reported that serum IgE levels are elevated in nephrotic syndrome and suggested IgE levels as a prognostic indicator in glomerular diseases. The aim of this study was to explore the association between serum IgE levels and renal outcome in patients with immunoglobulin A nephropathy (IgAN). METHODS: We included 117 patients with biopsy-proven IgAN. Renal progression was defined if a patient meets one of these criteria: (1) a negative value of delta estimated glomerular filtration rate (mL/min/1.73 m²/mo) or (2) a rise in serum creatinine to an absolute level of ≥ 1.3 mg/dL (male) or 1.2 mg/dL (female). We defined delta changes in serum creatinine, estimated glomerular filtration rate, and proteinuria as a difference of values during the follow-up period. RESULTS: A total of 117 patients with IgAN were included. The serum IgE level was significantly high in the renal progressive group compared with the nonprogressive group. Sex and history of gross hematuria were significantly different between the high-IgE group and the low-IgE group. Regression analysis showed that a male sex, initial proteinuria, and change of proteinuria were significantly associated with serum IgE levels. CONCLUSION: The serum IgE level is potentially associated with disease progression and pathogenesis of IgAN.
Assuntos
Humanos , Masculino , Anafilaxia , Creatinina , Progressão da Doença , Seguimentos , Taxa de Filtração Glomerular , Glomerulonefrite , Glomerulonefrite por IGA , Hematúria , Imunoglobulina A , Imunoglobulina E , Imunoglobulinas , Síndrome Nefrótica , ProteinúriaRESUMO
BACKGROUND Synthesis of selenium nanoparticles from selenite by Shewanella sp. HN-41 demonstrated that particle size depended on the reaction time and biomass of cells. The slow reaction and low biomass tended to form small particles. In this study, Shewanella sp. HN-41 was introduced into the anode of a nonexternal circuit bioelectrochemical system (nec_BES) to convert chemical energy from lactate to low electron current to the cathode, where selenite was reduced. RESULTS Our experiment with two systems, one bioelectrochemical system with a cathode flushed with nitrogen and the other with a no-nitrogen-flushing cathode, showed that the former could not produce Se nanoparticles after 21 d, but the latter formed them with an average size of 37.7 nm. The SEM and TEM images demonstrated that the particle size of 10 nm occupied over 10% and most of the particles were in the range of 3060 nm. The XRD result and SAED image demonstrated no clear peaks of crystal and proved that the Se nanoparticles are amorphous. CONCLUSIONS : The clean Se nanoparticles were synthesized and completely separated from bacterial cells in the bioelectrochemical system. This study opened a new approach for the biological synthesis of metal nanoparticles. Finally, the Se products in the range of 3060 nm can be tested for antimicrobial activities in medical applications