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Relationship of Glucose Control and Wound Infection in Diabetics after Lumbar Spine Surgery

  • Kim, Byung-Ook;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.44-47
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    • 2005
  • Objective: The purpose of this study is to investigate the elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing lumbar spine surgery. Methods: Of 2896 patients who underwent lumbar spine operations by one surgeon between 1993 and 2002, 329(11.4%) were diabetics. The rate of deep wound infections in diabetic patients was 6.4%, versus 3.2% for nondiabetics. 152 patients had their operation before implementation of the protocol and 177 after implementation. Charts of the diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. Results: Twenty-one diabetic patients suffered deep wound infection. Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients($230{\pm}6.9$ versus $175{\pm}3.8mg/dL$; p<0.003) and had a long operation time($216{\pm}57.9$ versus $167.5{\pm}42.2$ minute; p<0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 postoperative days, long operation time, and use of the instrumentation(p<0.02) were all related predictiors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200mg/dL was began in september 1997. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infection, from 8.3%(11/132) to 5.1%(10/195) (p<0.02). Conclusion: The incidence of deep wound infection in diabetic patients is reduced after implementation of a protocol to maintain mean blood glucose level less than 200mg/dL in the immediate postoperative period.

Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.99-102
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    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

Nutrient Intake and Utilization by Range Managed Sheep in Critical Physiological Stages Maintained on Grazing with Concentrate Supplementation in a Hot Semi-Arid Environment

  • Karim, S.A.;Santra, A.;Sharma, V.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.9
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    • pp.1228-1234
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    • 2000
  • The reported study was conducted on range managed Malpura ewes that were non-breeding empty, were at an advanced stage of pregnancy, and were in early lactation, under a protocol of free grazing with concentrate supplementation at 1.00, 1.25 and 1.50% of their body weight to assess their plane of nutrition and nutrient intake. The biomass yield of pasture plots was 1689, 1820 and 2912 kg/ha in pregnancy, lactation and empty phases, respectively. In addition to natural shrubs and forbs, Cenchrus ciliaris (36.4%) and dead litter (31.6%) were the major component of pasture vegetation during pregnancy. The dead litter disappeared during the lactation and empty phase with a concomitant increase in distribution of Cenchrus ciliaris to 73.0 and 87.2% respectively. The daily dry matter consumption from supplemental concentrate and free grazing was 70.1, 57.3 and 63.5 g/kg $W^{0.75}/d$ with concentrate to roughage ratio of 40:60, 47:53 and 33:67 in pregnancy, lactation and empty phases respectively. Digestibility of DM and OM were similar in the three phases while CP digestibility was higher (p<0.0l) during lactation than other two phases. Digestibility of NDF, ADF and cellulose were higher (p<0.0l) in empty than pregnancy and lactation, while hemicellulose digestibility was similar in lactation and empty and lower in pregnancy phase. The ewes in ~hases of pregnancy, lactation and empty consumed 7.1, 7.7 and 6.1 g DCP and 197.2, 214.6 and 232.5 kcal DE/kg $W^{0.75}/d$ respectively. It is concluded that ewes maintained on semi-arid Cenchrus dominated pasture with concentrate supplementation during pregnancy, lactation and empty phases consumed 45.2, 45.1 and 35.2 g DCP/Mcal ME respectively.

Clinical Features and Prognosis of Patients with Benign Thyroid Disease Accompanied by an Incidental Papillary Carcinoma

  • Wang, Shi-Fu;Zhao, Wen-He;Wang, Wei-Bin;Teng, Xiao-Dong;Teng, Li-Song;Ma, Zhi-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.707-711
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    • 2013
  • Purpose: To investigate the clinical features and prognosis of papillary thyroid carcinoma (PTC) with a background of benign disease. Method: A total of 709 patients with papillary thyroid carcinoma undergoing surgical resection were analyzed retrospectively. In 147 patients who underwent surgery for benign thyroid disease, incidental PTC (IPC group) were identified by intraoperative or postoperative pathological examination of surgical specimens but were not detected by preoperative imaging studies. In the other group, according to the pathological examination with or without co-existing benign thyroid disease, 253 cases were clarified as concomitant PTC and 309 cases were clarified as dominant PTC. Results: Incidental PTC was more common in women, about 85.7%, the mean age was $47.6{\pm}11.3$ years old. Average tumor diameter was $4.4{\pm}2.2$ mm, multiple lesions accounted for 12.9% (19/147), and the cervical lymph node metastasis rate was 6.1% (9/147). After radical resection 8 cases recurred, the median time of recurrence was about 12 months (0.5 to 162), there was no tumor-related death. The tumor-free survival rates were 97.3%, 95.9%, 91.5%, and 79.3% in 1, 5, 10 and 14 year respectively. Conclusion: Incidental PTC with a background of benign lesions is common, and the generally good prognosis can be attributed to tumor early detection and early treatment. On the intraoperative finding of incidental PTC, lobectomy (unilateral) or total thyroidectomy (bilateral) should be the first choice, but with a postoperative pathologic finding of incidental PTC, further treatment, such as completion thyroidectomy or immediate lymph dissection is not necessary. Central lymph node dissection is also not needed unless lymphadenectasis is present.

Analysis of the Apoptotic Mechanisms of Snake Venom Toxin on Inflammation-induced HaCaT Cell-line

  • Chun, Youl Woong;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • v.34 no.1
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    • pp.23-30
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    • 2017
  • Objectives : In this study, the roles of Interleukin (IL)-4 and Signal transducer and activator of transcription 6 (STAT6), which have been reported to play a role in the pathogenesis of inflammation and cancer, were evaluated in snake venom toxin (SVT)-induced apoptosis. Methods : Inflammation was induced in human HaCaT kerationocytes, by lipopolysaccharide (LPS; $1{\mu}g/mL$) or tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), followed by treatment with SVT (0, 1, or $2{\mu}g/mL$). Cell viability was assessed by MTT assays after 24 h, and the expression of levels of IL-4, STAT6, and the apoptosis-related proteins p53, Bax, and Bcl-2 were evaluated by western blotting. Electro mobility shift assays (EMSAs) were performed to evaluate the DNA binding capacity of STAT6. Results : MTT assays showed that inflammation-induced growth of HaCaT cells following LPS or TNF-${\alpha}$ stimulation was inhibited by SVT. Western blot analysis showed that p53 and Bax, which promote apoptosis, were increased, whereas that of Bcl-2, an anti-apoptotic protein, was decreased in a concentration-dependent manner in LPS- or TNF-${\alpha}$-induced HaCaT cells following treatment with SVT. Moreover, following treatment of HaCaT cells with LPS, IL-4 concentrations were increased, and treatment with SVT further increased IL-4 expression in a concentration-dependent manner. Western blotting and EMSAs showed that the phosphorylated form of STAT6 was increased in HaCaT cells in the context of LPS- or TNF-${\alpha}$-induced inflammation in a concentration-dependent manner, concomitant with an increase in the DNA binding activity of STAT6. Conclusion : SVT can effectively promote apoptosis in HaCaT cells in the presence of inflammation through a pathway involving IL-4 and STAT6.

A CLINICAL STUDY OF THE BLOOD LOSS AND TRANSFUSION ON ORTHOGNATHIC SURGER (악교정 수술시 출혈량과 수혈에 관한 임상적 연구)

  • Bae, Jun-Soo;Lyoo, Jong-Ho;You, Jun-Young;Kim, Yong-Kwan;Shin, Dong-Yong;Lee, Chang-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.300-304
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    • 1998
  • Moderns have desire likely to be further good-looking concomitant with a qualitative advancement of the life. With one of this phenomenon, an orthognathic surgery performing at the dept. of oral and maxillofacial surgery have been becoming a more extensively. It's possible to occur many complications during the operations and especially, an excessive bleeding of those may be fatal and so a transfusion is performing for the prevention &management of that. But, because of the rate of increase of an blood-born infection like AIDS via transfusion, nowadays an autologous blood transfusion is interesting to us. We made a comparative study of an amount of blood loss &transfusion using hemoglobin value after classifying the orthognathic surgeries from Feb. '97 to Mar. '98 in single-jaw and doublejaw surgery. And we intended to set a standard against of a routine preoperative cross-matching deciding the amount of predictive homologous blood transfusion according to operative method. Simultaneously, we studied the realization &effectiveness of autologous blood transfusion with some cases, so would like to present. Results: 1. Single-jaw operation can be performed without blood transfusion or with homologous blood transfusion through only blood typing & screening. 2. We commonly transfuse two units of blood with double-jaw operation and an autologous blood transfusion has much more advantage than an homologous blood transfusion. 3. We can reduce charge associated with blood transfusion through precisely preoperative evaluation of patients and proper type of blood transfusion.

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A Study of the normativeness on the Influence of the Memphis on the Comtemporary Fashion Design - Focused on the End of the 20th Century - (멤피스(Memphis)디자인이 현대 패션에 미친 조형적 특징에 관한 연구 -20세기말을 중심으로-)

  • 임영자;한윤숙
    • Journal of the Korean Society of Costume
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    • v.51 no.1
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    • pp.5-20
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    • 2001
  • The purpose of this study suggest the fashion of communication for 21th century fashion. Especially, Memphis fashion have the possibility of communicating through objects. The results of this study are as follows : First, Memphis idea is to make design into a sophisticated, conscious instrument of communication. As the Memphis fashion points out : design is an extraordinary tool for communicating because its intrinsic characteristic is the fact that it is used and distributed anyway, even without communicating anything. The Memphis fashion is trying to connect design and industry to the broader culture within which fashion moves. Second, Using different materials provides not only new structural Possibilities. but - above all - new semantic and metaphoric possibilities, order modes of communication, another language, and even a change of direction, broadening of perspective, appropriation and digestion of new values and the concomitant rejection of traditional structures that renewal always Involves. The memphis fashion works on the fabric of contemporaneity (lurex yarn, latex, chrome metal and steel) and contemporaneity means computers, electronics, a new awareness of the body. mass exercise and tourism. Third, color in Memphis has never been an ideological vehicle. As with decoration it is born tilth the design, forming an integral part of the structure. It alters the objects molecules. It works as a mass, as an intrinsic feature of a certain form and volume. The Memphis fashion was realized the introduction of ultramodern science into such experimental and creative implementation as optical motive, brilliancy of colour of electronic medium in audition to metallic fabric and high technical synthetic fiber. A color tilth pop culture connotations that weaver between technological allusions and Mcdonald's.

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Correlative Production of Mn-Peroxidase and Glucose Oxidase Depending on the Culture Condition of Schizopora paradoxa (좀구멍버섯균의 배양조건에 따른 Mn-Peroxidase와 Glucose Oxidase의 생성조절)

  • Lee, Sang-Yoon;Shin, Hyeon-Dong;Kim, Kyu-Joong
    • The Korean Journal of Mycology
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    • v.22 no.4
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    • pp.325-331
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    • 1994
  • White-rot fungus, Schizopora paradoxa did not produce Mn-peroxidase and glucose oxidase without manganese. But, in high concentration of manganese (40 ppm), the activities of both enzymes were higher than those in basal concentration of manganese (11.15 ppm). Unlike the activities of the enzymes, mycelial mass was the same level as the control culture (11.15 ppm manganese) through out the culture period, depending on the concentration of manganese. The same experiments were carried out for the effect of copper and veratryl alcohol added to the culture. The results were not consistent dependent on the concentration of copper and veratryl alcohol, respectively. The involvement of cAMP in the correlative production of MNP and GOX was investigated. In this study, addition of atropine to the culture resulted in a concomitant inhibition of production of MNP and GOX, depending on the concentration of inhibitor added.

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Specific Biodegradation of Polychlorinated Biphenyls (PCBs) Facilitated by Plant Terpenoids

  • Jung, Kyung-Ja;Eungbin kim;So, Jae-Seong;Koh, Sung-Cheol
    • Biotechnology and Bioprocess Engineering:BBE
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    • v.6 no.1
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    • pp.61-66
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    • 2001
  • The aim of this study was to examine how plant terpenoids, as natural growth substrates or inducers, would affect the biodegradation of PCB congeners. Various PCB degraders that could grow on biphenyl and several terpenoids were tested for their PCB degradation capabilities. Degradation activities of the PCB congeners, 4,4-dichlorobiphenyl (4,4-DCBp) and 2,2-dichlorobiphenyl (2,2-DCBp), were initially monitored through a resting cell assay technique that could detect their degradation products. The PCB degraders, Pseudomonas ((S)-(-) limonene, p-cymene and $\alpha$-terpinene) whereas Arthrobacter sp. B1B could not grow on the terpenoids as a sole carbon source. The B1B strain grown on biphenyl exhibited good degradation activity for 4,4-DCBp and 2,2-DCBp, while the activity of strains P166 and T104 was about 25% that of the B1B strain, respectively. Concomitant GC analysis, however, demonstrated that strain T104, grown on (S)-(-) limonene, p-cymene and $\alpha$-terpinene, could degrade 4,4-DCBp up to 30%, equivalent to 50% of the biphenyl induction level. Moreover, strain T104 grown on (S)-(-) limonene, could also degrade 2,2-DCBp up to 30%. This indicates that terpenoids, widely distributed in nature, could be utilized as both growth and/or inducer substrate(s) for PCB biodegradation in the environment.

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Biochemical Changes Induced due to Staphylococcal Infection in Spongy Alphonso Mango(Mangifera indica L.) Fruits

  • Janave, Machhindra Tukaram
    • Journal of Crop Science and Biotechnology
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    • v.10 no.3
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    • pp.167-174
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    • 2007
  • Spongy Alphonso mangoes were found to be infected with Staphylococcus bacteria. A Gram positive Staphylococcus strain was isolated from spongy pulp and identified from CABI Bioscience, UK, by partial 16S rDNA sequence analysis and by morphological and biochemical characterization through IMTECH, Chandigarh, India. Although identification by both of these methods indicated the organism belonged to same genus, different species names were given. Changes in total phenolics, reducing, and non-reducing sugars, respiration rate, total carotenoids, peroxidase(POX), and catalase activities were monitored during ripening of these fruits. The climacteric rise in spongy fruits was marked by an increase in respiration rate and a decrease in sugar content. Total phenolics content increased in spongy fruits as compared to ripe non-spongy fruits. Development of corky white tissue in spongy fruits was associated with about a 2.5-fold reduction in total carotenoids and a concomitant increase in lipoxygenase-mediated, $\beta$-carotene co-oxidation. A marked decrease in soluble protein content and about a 1.5-fold increase in POX activity was observed. Maximum POX activity was confined to 50-70%$(NH_4)_2SO_4$ fraction. The intense dark bands visible after POX specific substrate staining of the Native gel indicated a high expression of isoenzymes of POX in spongy fruits. Similarly, changes in levels of catalase activity were also observed in spongy fruits. The results suggest that infection of Alphonso mangoes with Staphylococcus bacteria affects the normal ripening processes of the fruit interfering with the carbohydrate and carotenoid metabolism. Also, the studies indicate the expression of POX and catalase enzymes as a plant defense response to microbial invasion.

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