RESUMO
Objective@#: Exploring protein requirements for critically ill patients has become prominent. On the other hand, considering the significant impact of coma therapy and targeted temperature management (TTM) on the brain as well as systemic metabolisms, protein requirements may plausibly be changed by treatment application. However, there is currently no research on protein requirements following the application of these treatments. Therefore, the aim of this study is to elucidate changes in patients’ protein requirements during the application of TTM and coma therapy. @*Methods@#: This study is a retrospective analysis of prospectively collected data from March 2019 to May 2022. Among the patients admitted to the intensive care unit, those receiving coma therapy and TTM were included. The patient’s treatment period was divided into two phases (phase 1, application and maintenance of coma therapy and TTM; phase 2, tapering and cessation of treatment). In assessing protein requirements, the urine urea nitrogen (UUN) method was employed to estimate the nitrogen balance, offering insight into protein utilization within the body. The patient’s protein requirement for each phase was defined as the amount of protein required to achieve a nitrogen balance within ±5, based on the 24-hour collection of UUN. Changes in protein requirements between phases were analyzed. @*Results@#: Out of 195 patients, 107 patients with a total of 214 UUN values were included. The mean protein requirement for the entire treatment period was 1.84±0.62 g/kg/day, which is higher than the generally recommended protein supply of 1.2 g/kg/day. As the treatment was tapered, there was a statistically significant increase in the protein requirement from 1.49±0.42 to 2.18±0.60 in phase 2 (p<0.001). @*Conclusion@#: Our study revealed a total average protein requirement of 1.84±0.62 g during the treatment period, which falls within the upper range of the preexisting guidelines. Nevertheless, a notable deviation emerged when analyzing the treatment application period separately. Hence, it is recommended to incorporate considerations for the type and timing of treatment, extending beyond the current guideline, which solely accounts for the severity by disease.
RESUMO
A chiral derivatization strategy with phenylglycine methyl ester (PGME) was employed to develop a straightforward method to determine the absolute configurations of N,N-dimethyl amino acids. The PGME derivatives were analyzed using liquid chromatography-mass spectrometry to identify the absolute configurations of various N,N-dimethyl amino acids based on their elution time and order. The established method was applied to assign the absolute configuration of the N,N-dimethyl phenylalanine in sanjoinine A (4), a cyclopeptide alkaloid isolated from Zizyphi Spinosi Semen widely used as herbal medicine for insomnia. Sanjoinine A displayed production of nitric oxide (NO) in LPS-activated RAW 264.7 cells.
RESUMO
The anti-melanogenic activity of 259 actinomycete strains was tested, and based on the results for the inhibition of mushroom tyrosinase activity and the reduction in melanin content, Micromonospora sp. JCS1 and JCS7 were selected as the strains with the highest anti-melanogenic potential. The activity-guided fractionation of extracts from JCS1 and JCS7 led to the isolation of the dipeptides cyclo(L-Phenyl alanine (Phe)-L-Proline (Pro)) (1) and cyclo(L-Tryptophan (Trp)-L-Proline (Pro)) (2). These two compounds were tested for their inhibition of mushroom tyrosinase by monitoring L-DOPA levels and melanin production. Cyclo(L-Phe-L-Pro) (1) and cyclo(L-Trp-L-Pro) (2) were thus confirmed to have the potential for use in functional whitening cosmetics containing actinomycete-derived secondary metabolites.
RESUMO
OBJECTIVE: To assess the efficacy and safety of ultrasound-guided intragestational injection of methotrexate (MTX) and systemic intramuscular MTX in the management of cesarean scar pregnancies. METHODS: This was a retrospective case-control study that included women diagnosed with cesarean scar pregnancy at CHA Bundang Medical Center unit between 2009 and 2015. The 26 cases were managed with local injection of MTX under ultrasound guidance and 15 cases were treated with systemic intramuscular of MTX. After the procedure, serial follow-up sonographic examination and serum beta-human chorionic gonadotropin (β-hCG) measurement were performed. RESULTS: The mean initial β-hCG level was 20,610.73 mIU/mL and ranged from 263.00–71,316.50 mIU/mL. Mean gestational age was 6.3 weeks and ranged from 4.8 to 8.5 weeks. The majority of ectopic cases were treated successfully and follow-up β-hCG level declined abruptly following the first dose of MTX. The rate of success of local MTX treatment was significantly higher than that of systemic MTX treatment. It was 93.75% vs. 73.33%, respectively (P < 0.05). CONCLUSION: Ultrasound-guided intragestational injection of MTX is an effective method for the management of cesarean scar pregnancies and is associated with minimal side effects and high treatment success.
Assuntos
Feminino , Humanos , Gravidez , Estudos de Casos e Controles , Gonadotropina Coriônica , Cicatriz , Seguimentos , Idade Gestacional , Métodos , Metotrexato , Estudos Retrospectivos , UltrassonografiaRESUMO
OBJECTIVE: To identify the associations between polymorphisms of the 3′-untranslated region (UTR) of methylenetetrahydrofolate reductase (MTHFR) gene, which codes for an important regulatory enzyme primarily involved in folate metabolism, and idiopathic recurrent pregnancy loss (RPL) in Korean women. METHODS: The study population comprised 369 RPL patients and 228 controls. MTHFR 2572C>A, 4869C>G, 5488C>T, and 6685T>C 3′-UTR polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis or by TaqMan allelic discrimination assays. Natural killer cell proportions were determined by flow cytometry. RESULTS: The MTHFR 2572-5488-6685 (A-C-T) haplotype had an adjusted odds ratio of 0.420 (95% confidence interval, 0.178–0.994; p=0.048) for RPL. Analysis of variance revealed that MTHFR 4869C>G was associated with altered CD56⁺ natural killer cell percentages (CC, 17.91%±8.04%; CG, 12.67%±4.64%; p=0.024) and folate levels (CC, 12.01±7.18 mg/mL; CG, 22.15±26.25 mg/mL; p=0.006). CONCLUSION: Variants in the 3′-UTR of MTHFR are potential biomarkers for RPL. However, these results should be validated in additional studies of ethnically diverse groups of patients.
Assuntos
Feminino , Humanos , Gravidez , Biomarcadores , Discriminação Psicológica , Citometria de Fluxo , Ácido Fólico , Haplótipos , Células Matadoras Naturais , Metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2) , Razão de ChancesRESUMO
BACKGROUND: Adiponectin is a plasma protein secreted by adipose tissues and low serum adiponectin concentration has been reported to be associated with insulin resistance and metabolic syndrome (MS). We evaluated the performance of an ELISA-based assay for measuring serum adiponectin levels and established reference intervals of adiponectin for Korean population. METHODS: Laboratory performance, including precision and linearity, of the AdipoMark Human Adiponectin ELISA kit (Mesdia Co., Korea) was assessed. Reference intervals of adiponectin concentration were determined after evaluation of 1200 subjects with no history of MS. Adiponectin was also measured in 100 patients with MS. RESULTS: The mean concentrations of serum samples tested for precision evaluation were 6.66, 12.61, and 23.42 microg/mL: the ELISA showed total imprecision of 13.6%, 9.3%, and 10.5% CV for the respective concentrations. The assay demonstrated linear responses in the range of 1.8-29.9 microg/mL serum adiponectin levels. The 95% reference intervals for Korean population were 3.6-19.2 microg/mL for men and 4.5-34.2 microg/mL for women. ROC-area under the curve values of adiponectin for the diagnosis of MS were 0.85 for men and 0.83 for women. Low adiponectin level was independently associated with MS in the multivariate analysis. CONCLUSIONS: The adiponectin quantitation assay evaluated in this study showed acceptable laboratory and clinical performances in an ELISA platform. To meet the ever-increasing demand for a reliable assay for measuring adiponectin levels in the study of various metabolic diseases, this assay could be further improved by the automation of the platform.
Assuntos
Feminino , Humanos , Masculino , Adiponectina , Automação , Ensaio de Imunoadsorção Enzimática , Resistência à Insulina , Doenças Metabólicas , PlasmaRESUMO
BACKGROUND: Specimens for the external quality assessment (EQA) need to be highly stable during the EQA process. Therefore, we evaluated the stability of pooled sera (PS) for tumor markers including alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA 125), and carbohydrate antigen 19-9 (CA 19-9). METHODS: PS with 2 different levels (high and low) of each of the 4 tumor markers were collected and stored at -20degrees C, 4degrees C, and room temperature (RT). The concentration of each tumor marker was then measured after storage under these different conditions at baseline and on days 1, 3, 7, 14, 30, 90, and 181. Internal quality control (QC) results during the evaluation period were also analyzed. RESULTS: Irrespective of storage conditions, coefficients of variation (CVs) of AFP and CA 125 levels in the PS during the evaluation period ranged from 3.3% to 7.5% in EQA assays and were similar to the CVs of QC assays. However, the levels of CEA detected in PS stored at -20degrees C, and 4degrees C, showed higher variability, with CVs ranging from 4.0% to 10.4%, and samples stored at RT showed especially high CVs, i.e., >8.3%. Samples for CA 19-9 testing stored at RT also showed lower stability than the QC samples as well as samples stored at -20degrees C, after 3 days. CONCLUSIONS: CEA and CA 19-9 levels in PS showed higher variability than AFP and CA 125, especially when stored at RT. These results indicate that all EQA specimens for tumor marker assays need to be tested as soon as possible and not stored at RT for longer than 3 days during the EQA process.
Assuntos
alfa-Fetoproteínas , Antígeno Carcinoembrionário , Controle de Qualidade , Biomarcadores TumoraisRESUMO
BACKGROUND: We comparatively evaluated the performance of the conventional COBAS Amplicor HCV test v2.0 (CAM; Roche Molecular Systems, USA) and the newly developed COBAS AmpliPrep/COBAS TaqMan HCV test v2.0 (CAP/CTM; Roche Molecular Systems) for qualitative detection of hepatitis C virus (HCV) RNA in clinical samples. METHODS: Six hundred serum samples (100 HCV-positive, 500 HCV-negative, as determined by CAM) were selected and analysed using the new qualitative HCV RNA test, CAP/CTM qualitative test. Results were compared by confirmatory CAP/CTM quantitative test, which is a quantitative HCV RNA real-time polymerase chain reaction by Roche Molecular Systems, and anti-HCV test (Roche Diagnostics GmbH, Germany). Twenty-two additional serum samples, which gave a gray zone result by CAM, were selected for comparison. RESULTS: The two qualitative HCV RNA assays yielded concordant results for 586 of 600 tested samples (concordance rate, 97.7%; kappa coefficient, 0.92; 95% confidence interval [CI], 0.87 to 0.96; P<0.001). Upon re-testing by CAM, we found that the concordance rate increased to 98.2% (kappa coefficient, 0.93; 95% CI, 0.89 to 0.97; P<0.001). The additional 22 samples showing gray zone results for CAM were retested and were also tested by CAP/CTM. The results for 13 of these samples changed to negative and were now concordant with the CAP/CTM and confirmatory CAP/CTM quantitative results. For the remaining samples, the results were variable. For all the 22 samples, the results of the new CAP/CTM were in agreement with those obtained by confirmatory CAP/CTM quantitative test. CONCLUSIONS: The results of the two assays were in good agreement, with 97.7% concordance rate. However, CAP/CTM is more sensitive than CAM and showed no gray zone results. Therefore, it can be a more efficient and useful test for the qualitative detection of HCV RNA in clinical samples.
Assuntos
Hepacivirus , Hepatite C , Hepatite , Reação em Cadeia da Polimerase em Tempo Real , RNARESUMO
Assuntos
Obstrução das Vias Respiratórias , Antibacterianos , Drenagem , Diagnóstico Precoce , Fasciite Necrosante , Gangrena , Cabeça , Hemorragia , Mediastino , Pescoço , Pele , Lesões do Sistema VascularRESUMO
Assuntos
Humanos , Masculino , Anestesia Local , Biópsia , Seguimentos , Trato Gastrointestinal , Gengiva , Imuno-Histoquímica , Leiomiossarcoma , Linfonodos , Boca , Músculo Liso , Metástase Neoplásica , Prognóstico , Recidiva , Taxa de Sobrevida , Úlcera , ÚteroRESUMO
Assuntos
Feminino , Humanos , Masculino , Adenolinfoma , Incidência , Mandíbula , Glândula Parótida , Glândulas Salivares , Glândulas Salivares Menores , Glândula SubmandibularRESUMO
Mesenchymal chondrosarcoma is very aggressive and represents approximately 1% of all chondrosarcomas. While it affects a very wide age range, the peak frequency is in the second decade of life. It may occur in the head and rib region with a predilection for the maxillofacial skeleton. The small cell undifferentiated component may assume a hemangiopericytoma-like vascular pattern and should be distinguished from hemangiopericytoma. Treatment is en bloc resection, the intended tissue margins of excision should be designed to extend well beyond the actual tumor margin, as mesenchymal chondrosarcomas. Aggressive behavior of mesenchymal chondrosarcoma of the jaw, with a tendency for delayed recurrence and metastasis even many years after treatment. The most frequent site of metastasis was the lung. Here we present 52 years old , female case of mesenchymal chondrosarcoma occurs on Rt. mandible.
Assuntos
Feminino , Humanos , Condrossarcoma , Condrossarcoma Mesenquimal , Cabeça , Hemangiopericitoma , Arcada Osseodentária , Pulmão , Mandíbula , Metástase Neoplásica , Recidiva , Costelas , EsqueletoRESUMO
The purpose of this study is to investigate the effects of alendronate and pamidronate on proliferation and the alkaline phosphatase activity of human bone marrow derived mesenchymal stem cells and to relate the results with bisphosphonate related osteonecrosis of the jaw(BRONJ). With the consent of patients with no systemic disease and undergoing iliac bone graft, cancellous bone was collected to obtain human bone marrow derived mesenchymal stem cells through cell culture. 96 well plate were prepared with a concentration of 10(4)cell/ well. Alendronate and pamidronate were added to each well with the concentration of 10(-6)M, 10(-8)M and 10(-10)M, respectively. Then proliferation capacity of each well was evaluated with the cell counting kit. 24 well plates were prepared with a concentration of 10(5)cell/ml/well and with the bone supplement, alendronate and pamidronate were added with the concentration of 10(-6)M, 10(-8)M and 10(-10)M, respectively on each plate. The plates were cultured for either 24 or 72 hours. Then the cells were sonicated to measure the alkaline phosphatase activity and protein assay was done to standardize the data for analysis. As the concentration of alendronate or pamidronate added to the culture increased, the proliferation capacity of the cells decreased. However, no statistical significance was found between the group with 10(-10)M of bisphophonate and the control group. Pamidronate was not capable of increasing the alkaline phosphatase activity in all trials. However, alkaline phosphatase activity increased with 24 hours of 10(-8)M of alendronate treatment and with 48 hours of 10(-10)M of alendronate treatment. Cell toxicity increased as the bisphosphonate concentration increased. This seems to be associated with the long half life of bisphosphonate, resulting in high concentration of bisphosphonate in the jaw and thus displaying delayed healing after surgical procedures. Alendronate has shown to increase the alkaline phophatase activity of human bone marrow derived mesenchymal stem cells. However, this data is insufficient to conclude that alendronate facilitates the differentiation of human bone marrow derived mesenchymal stem cells. Further studies on DNA level and animal studies are required to support these results.
Assuntos
Animais , Humanos , Alendronato , Fosfatase Alcalina , Medula Óssea , Contagem de Células , Técnicas de Cultura de Células , Proliferação de Células , Difosfonatos , DNA , Meia-Vida , Arcada Osseodentária , Células-Tronco Mesenquimais , Osteonecrose , Ácidos Polimetacrílicos , TransplantesRESUMO
Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissues and involve, essentially, the same pathological process. They are usually classified, depending on their extent and radiographic appearances, into three main groups. Periapical cemental dysplasia predominantly involves the periapical region of the anterior mandible. Florid cemento-osseous dysplasia presents with multifocal lesions in the tooth bearing or edentulous areas of the maxilla and mandible, often occurring bilaterally with symmetric involvement. Focal cemento-osseous dysplasia exhibits a single site of involvement in any tooth bearing or edentulous area of the mandible or maxilla, with the posterior mandible representing the most common site. We report the clinical, radiographic and histological findings of 3 types of cemento-osseous dysplasia with a review of literatures.
Assuntos
Displasia Fibrosa Óssea , Mandíbula , Maxila , Osteomielite , Ligamento Periodontal , Dente , UrsidaeRESUMO
Out of all oral malignant tumor, malignant lymphoma occurs in only 3.5%. Especially, most of the primary malignant lymphomas, which occur in the head & neck region are high-grade diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue (MALT) marginal zone B-cell lymphoma is very rare. In the head & neck region, malignant lymphoma is reported to occur in the thyroid, salivary gland, trachea, larynx, orbital lobe and the Waldeyer's ring. Among the Waldeyer's ring, palatal tonsil is reported to be the most common region, but, only 1 case report was published in Korea. Until now, there were no case reports of MALT lymphoma that occurred in the tongue. The purpose of this case report is to report and discuss on a case of MALT lymphoma of the tongue.
Assuntos
Cabeça , Coreia (Geográfico) , Laringe , Tecido Linfoide , Linfoma , Linfoma de Células B , Linfoma de Zona Marginal Tipo Células B , Pescoço , Órbita , Tonsila Palatina , Glândulas Salivares , Glândula Tireoide , Língua , TraqueiaRESUMO
Assuntos
Feminino , Humanos , Dente Pré-Molar , Cemento Dentário , Mandíbula , Dente Molar , Tumores Odontogênicos , Recidiva , Dente , Raiz DentáriaRESUMO
Assuntos
Humanos , Matriz Óssea , Linhagem Celular , Cemento Dentário , Esmalte Dentário , Durapatita , Fibroblastos , Imunoensaio , Células-Tronco Mesenquimais , Osteoblastos , Osteocalcina , Osteopontina , Ligamento Periodontal , Periodonto , Proteínas , RegeneraçãoRESUMO
Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) and non-symptoms is presented.
Assuntos
Cartilagem , Condromatose Sinovial , Arcada Osseodentária , Articulações , Membrana Sinovial , Articulação TemporomandibularRESUMO
Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) and non-symptoms is presented.