• Title/Summary/Keyword: non-vascular

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A Case of Empyema and Mediastinitis by Non-typhi Salmonella (비장티푸스성 살모넬라 감염으로 발생한 농흉과 종격동염 1예)

  • Yang, Suh Yoon;Kwak, Hee Won;Song, Ju Han;Jeon, Eun Ju;Choi, Jae Cheol;Shin, Jong Wook;Kim, Jae Yeol;Park, In Won;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.537-540
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    • 2008
  • There are few reports of the pleuropulmonary involvement of a non-typhi Salmonella infection in immunocompromised patients with AIDS, malignancy, collagen vascular diseases, extended use of corticosteroids, sickle cell disease, or diabetes. We report a case of a non-immunocompromised patient who presented with concomitant empyema and mediastinitis due to Salmonella without a comorbid disease. A 26-year-old male patient, with a history of pneumonia 5 years earlier and having lived abroad for several years, presented chronic cough and febrile sensation. Pneumonia, empyema and mediastinitis were noted in a chest CT scan and Salmonella enteritidis and ${\beta}-hemolytic$ streptococcus were identified from a culture of the pleural fluid. Initially, he was treated with cefepime, metronidazole and clarithromycin. He was cured clinically and radiographically after an 8 week treatment with antibiotics. In conclusion, this report suggests that S. enteritidis can cause empyema and mediastinitis, albeit rarely.

Comparative Effectiveness of Risk-adapted Surveillance vs Retroperitoneal Lymph Node Dissection in Clinical Stage I Nonseminomatous Germ Cell Testicular Cancer: A Retrospective Follow-up Study of 81 Patients

  • Fan, Gang;Zhang, Lin;Yi, Lu;Jiang, Zhi-Qiang;Ke, Yang;Wang, Xiao-Shan;Xiong, Ying-Ying;Han, Wei-Qin;Zhou, Xiao;Liu, Chun;Yu, Xie
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3267-3272
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    • 2015
  • Purpose: To retrospective assess the potential predictors for relapse and create an effective clinical mode for surveillance after orchidectomy in clinical stage I non-seminomatous germ cell testicular tumors (CSI-NSGCTs). Materials and Methods: We analyzed data for CSI-NSGCTs patients with non-lymphatic vascular invasion, %ECa < 50% (percentage of embryonal carcinoma < 50%), and negative or declining tumor markers to their half-life following orchidectomy (defined as low-risk patients); these patients were recruited from four Chinese centers between January 1999 and October 2013. Patients were divided into active surveillance group and retroperitoneal lymph node dissection (RPLND) group according to different therapeutic methods after radical orchidectomy was performed. The disease-free survival rates (DFSR) and overall survival rates (OSR) of the two groups were compared by Kaplan-Meier analysis. Results: A total of 121 patients with CSI-NSGCT were collected from four centers, and 81 low-risk patients, including 54 with active surveillance and 27 with RPLND, were enrolled at last. The median follow-up duration was 66.2 (range 6-164) months in the RPLND group and 65.9 (range 8-179) months in the surveillance group. OSR was 100% in active surveillance and RPLND groups, and DFSR was 89.8% and 87.0%, respectively. No significant difference was observed between these two groups ($X_2=0.108$, P=0.743). No significant difference was observed between the patients with a low percentage of embryonal carcinoma (<50%) and those without embryonal carcinoma (87.0% and 91.9%, $X_2=0.154$, P=0.645). No treatment-related complications were observed in the active surveillance group whereas minor and major complications were observed in 13.0% and 26.1% of the RPLND group, respectively. Conclusions: Active surveillance resulted in similar DFSR and OSR compared with RPLND in our trial. Patients with low-risk CSI-NSGCTs could benefit from risk-adapted surveillance after these patients were subjected to radical orchidectomy.

Clinical Analysis of Intractable Diabetic Foot Ulcers: Accessing Risk Factors (난치성 당뇨 족부 궤양에 대한 임상적 고찰: 치료에 영향을 미치는 인자 분석)

  • Park, Se-Jin;Lee, Seung-Hee;Park, Hun-Yong;Kim, Jang-Hwan;Shin, Hun-Kyu;Kim, Eu-Gene;Choi, Jae-Yeol
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.232-239
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    • 2011
  • Purpose: Diabetic foot ulcer is one of the most important diabetic complications because it increases the risk of amputations. Moreover, it lowers the quality of patients' life and increases the social medical expenses. Authors analyzed risk factors of intractable diabetic foot ulcer using retrospective study. Materials and Methods: From January 2007 to December 2010, 40 patients who could not achieve complete healing despite more than 12 weeks of proper management among who had been diagnosed and treated as diabetic foot ulcer at our hospital were included and evaluated retrospectively. We compared the risk factors between two groups who were finally treated by amputation and non-amputation. Results: The sample was composed of 31 male patients (77.5%) and 9 female patients (22.5%). Comorbidity including hypertension and hyperlipidemia were 77.5% and 80% each. By Wagner classification, 30 patients (80%) had ulcerative lesion over the grade 3. From bacteriology results, 29 patients (72.5%) had polybacteria infection. 35 patients (87.5%) had neuropathy and 26 patients (65%) had vascular stenosis at least one level. The mean initial ankle-brachial index and toe-brachial index were 0.982 and 0.439. In comparison between amputation group and non-amputation group, ulcer severity, number of stenotic vessel and initial ankle-brachial index/toe-brachial index had statistical significance. Conclusion: The most commonly risk factor of intractable diabetic foot ulcer was peripheral neuropathy reaching 87.5% of cases. In comparison with non-amputation group, ulcer severity according to Wagner classification, number of stenotic vessel and initial ankle-brachial index/toe-brachial index were demonstrated as a risk factor of amputation in intractable diabetic foot ulcer.

The Relationship among Blood-stasis, CAVI and Cardiovascular Risk in Stroke Patients (뇌졸중환자의 어혈병태모형과 CAVI, 심혈관질환 위험도간의 상호관계에 관한 임상적 연구)

  • Kim, Seok-Min;Sun, Jong-Joo;Choi, Chang-Min;Jung, Jae-Han;Hwang, Jae-Woong;Min, In-Kyu;Kim, Chang-Hyun;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.421-433
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    • 2007
  • Objectives : This study was performed to evaluate the relationships among blood-stasis. cardio-ankle vascular index(CAVI) and cardiovascular risk. Methods : We obtained general characteristics. blood-stasis score and CAVI from 150 stroke patients. Blood-stasis score was evaluated by blood-stasis criteria. Cardiovascular risk (the following. Stuart's risk score) was evaluated by Stuart's risk scoring scale. We divided subjects into a blood-stasis group and a non blood-stasis group by blood-stasis scores. high CAVI and normal CAVI groupsby CAVI. We compared the general characteristics. CAVI (excluded from comparison between high CAVI group and normal CAVI group), Stuart's risk score and blood-stasis score (excluded from comparison between blood-stasis group and non blood-stasis group) between each pair of groups. Pearson correlation analysis was applied to examine the relationship between blood stasis score and CAVI, blood stasis score and Stuart's risk score. CAVI and Stuart's risk score. Results : The blood-stasis group had significantly higher CAVI and Stuart's risk scores than the non blood stasis group. The high CAVI group had significantly higher blood-stasis score and Stuart's risk score than the normalCAVI group. In correlation analysis. there were significant positive relationship between blood stasis score and Stuart's risk score, CAVI and Stuart's risk score. and blood stasis score and CAVI. Conclusions : This study suggeststhat there is a significant relationship among blood stasis,CAVI and cardiovascular risk.

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Engraftment of Intraperitoneally Injected Bone Marrow Cells to Newborn Mice Injected with an Angiogenesis Inhibitor (혈관생성 억제제를 주사한 마우스 모델에서의 골수 세포의 복강 내 주입 후 생착)

  • Cho, Su-Jin;Ju, Sun-Young;Woo, So-Youn;Kang, Hyoung-Jin;Ahn, Hyo-Seop;Ryu, Kyung-Ha;Park, Eun-Ae
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.22-31
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    • 2008
  • Purpose : Bronchopulmonary dysplasia (BPD) is characterized by arrested vascular and alveolar growth in the premature lung. Considering the consequences of arrested lung growth, the idea of administering bone marrow cells to enhance the inborn repair mechanism is promising as this may reduce the morbidity and mortality of BPD. We followed enhanced green fluorescent protein (EGFP)-labeled bone marrow cells (BMC) injected intraperitoneally into non-EGFP mice in order to determine their fate after transplantation. Methods : An angiogenesis inhibitor, SU1498, was injected subcutaneously on day 3 in non-EGFP C57BL/6 newborn mice to create a model of arrested alveolar development. On the following day, $1{\times}10^6$ BMCs isolated from major histocompatibility complex (MHC)- matched syngenic EGFP mice were injected intraperitoneally to non-EGFP BPD mice. Morphometric analysis, immunostaining, and confocal microscopy were performed to determine the fate of EGFP-positive stem cells in the injured lung. Results : SU1498 injection reduced alveolar surface area and mean alveolar volume in newborn mice. BMC injection resulted in recovery of lung structure comparable to controls. EGFP-positive BMCs were identified in the lungs of the recipient mice after intraperitoneal injection. The injected EGFP cells were co-stained with endothelial and epithelial cells of the developing lung as determined by confocal microscopy. Conclusion : Our results illustrated that EGFP-positive BMCs engrafted and trans-differentiated into epithelial and endothelial cells after intraperitoneal injection in a mouse model of arrested alveolar development.

Biological Control of Crown Gall

  • Kerr, Allen;Biggs, John;Ophel, Kathy
    • Proceedings of the Korean Society of Plant Pathology Conference
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    • 1994.06a
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    • pp.11-26
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    • 1994
  • Crown gall of stonefruit and nut trees is one of the very few plant diseases subject to efficient biological control. The disease is caused by the soil-inhabiting bacteria Agrobacterium tumefaciens and Agrobacterium rhizogenes and the original control organism was a non-pathogenic isolate of A. rhizogenes strain K84. Control is achieved by dipping planting material in a cell suspension of strain K84 which specifically inhibits pathogenic strains containing a nopaline Ti plasmid. Because the agrocin 84-encoding plasmid (pAgK84) is conjugative, it can be transmitted from the control strain to pathogenic strains which, as a result, become immune to agrocin 84 and cannot be controlled. To prevent this happening, the transfer genes on pAgK84 were located and then largely eliminated by recombinant DNA technology. The resulting construct, strain K1026, is transfer deficient but controls crown gall just as effectively as does strain K84. Field data from Spain confirm that pAgK84 can transfer to pathogenic recipients from strain K84 but not from strain K1026. The latter has been registered in Australia as a pesticide and is the first genetically engineered organism in the world to be released fro commercial use. It is recommended as a replacement for strain K84 to prevent a breakdown in the effectiveness of biological control of crown gall. Several reports indicate that both strains K84 and K1026 sometimes control crown gall pathogens that are resistant to agrocin 84. A possible reason for this is that both strains produce a second antibiotic called 434 which inhibits growth of nearly all isolates of A. rhizogenes, both pathogens and non-pathogens. Crown gall of grapevine is caused by another species, Agrobacterium vitis. It is resistant to agrocin 84 and cannot be controlled by strains K84 or K1026. It is different from other crown gall pathogens in several characteristics, including the fact that, although a rhizosphere coloniser, its also lives systemically in the vascular tissue of grapevine. Pathogen free propagating material can be obtained from tissue culture or, less surely, by heat therapy of dormant cuttings. A number of laboratories are searching for a biocontrol strain that will prevent, or at least delay, reinfection. A non-pathogenic A. vitis strain F/25 from South Africa looks very promising in this regard.

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Antiangiogenic activity of non-aqueous fraction from Sparassis crispa extract in human umbilical vein endothelial cells (혈관내피세포에서 꽃송이버섯(Sparassis crispa) 소수성 추출물의 항혈관신생 활성)

  • Han, Jang Mi;Gong, So Youn;Sohng, Jae Kyung;Kang, Yue Jai;Jung, Hye Jin
    • Korean Journal of Food Science and Technology
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    • v.51 no.2
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    • pp.141-146
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    • 2019
  • Sparassis crispa is an edible mushroom that is distributed in Korea, Japan, Europe, and North America. It exerts various biological activities such as immunopotentiation, anti-diabetic, anti-cancer, and anti-inflammatory effects. Recently, we separated the health functional non-aqueous fraction from the chloroform extract of S. crispa (SCF4). In this study, we evaluated the antiangiogenic activity of SCF4 in human umbilical vein endothelial cells (HUVECs). SCF4 effectively inhibited vascular endothelial growth factor (VEGF)-induced cell growth at concentrations ($5-25{\mu}g/mL$) showing no cytotoxic effects. SCF4 inhibited VEGF-induced invasiveness and tube formation ability, which are in vitro angiogenic features of HUVECs, in a dose-dependent manner. In addition, SCF4 markedly suppressed in vivo angiogenesis of chorioallantoic membrane from growing chick embryos without cytotoxicity. Furthermore, SCF4 downregulated the phosphorylation of VEGFR2, AKT, and ERK1/2, which are major angiogenic signal mediators. These results suggest that SCF4 inhibited angiogenesis by suppressing the VEGFR2 signaling pathways without cytotoxicity.

Prediction of Prognosis in Glioblastoma Using Radiomics Features of Dynamic Contrast-Enhanced MRI

  • Elena Pak;Kyu Sung Choi;Seung Hong Choi;Chul-Kee Park;Tae Min Kim;Sung-Hye Park;Joo Ho Lee;Soon-Tae Lee;Inpyeong Hwang;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Ji-Hoon Kim;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • v.22 no.9
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    • pp.1514-1524
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    • 2021
  • Objective: To develop a radiomics risk score based on dynamic contrast-enhanced (DCE) MRI for prognosis prediction in patients with glioblastoma. Materials and Methods: One hundred and fifty patients (92 male [61.3%]; mean age ± standard deviation, 60.5 ± 13.5 years) with glioblastoma who underwent preoperative MRI were enrolled in the study. Six hundred and forty-two radiomic features were extracted from volume transfer constant (Ktrans), fractional volume of vascular plasma space (Vp), and fractional volume of extravascular extracellular space (Ve) maps of DCE MRI, wherein the regions of interest were based on both T1-weighted contrast-enhancing areas and non-enhancing T2 hyperintense areas. Using feature selection algorithms, salient radiomic features were selected from the 642 features. Next, a radiomics risk score was developed using a weighted combination of the selected features in the discovery set (n = 105); the risk score was validated in the validation set (n = 45) by investigating the difference in prognosis between the "radiomics risk score" groups. Finally, multivariable Cox regression analysis for progression-free survival was performed using the radiomics risk score and clinical variables as covariates. Results: 16 radiomic features obtained from non-enhancing T2 hyperintense areas were selected among the 642 features identified. The radiomics risk score was used to stratify high- and low-risk groups in both the discovery and validation sets (both p < 0.001 by the log-rank test). The radiomics risk score and presence of isocitrate dehydrogenase (IDH) mutation showed independent associations with progression-free survival in opposite directions (hazard ratio, 3.56; p = 0.004 and hazard ratio, 0.34; p = 0.022, respectively). Conclusion: We developed and validated the "radiomics risk score" from the features of DCE MRI based on non-enhancing T2 hyperintense areas for risk stratification of patients with glioblastoma. It was associated with progression-free survival independently of IDH mutation status.

Treatment Response Evaluation by Computed Tomography Pulmonary Vasculature Analysis in Patients With Chronic Thromboembolic Pulmonary Hypertension

  • Yu-Sen Huang;Zheng-Wei Chen;Wen-Jeng Lee;Cho-Kai Wu;Ping-Hung Kuo;Hsao-Hsun Hsu;Shu-Yu Tang;Cheng-Hsuan Tsai;Mao-Yuan Su;Chi-Lun Ko;Juey-Jen Hwang;Yen-Hung Lin;Yeun-Chung Chang
    • Korean Journal of Radiology
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    • v.24 no.4
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    • pp.349-361
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    • 2023
  • Objective: To quantitatively assess the pulmonary vasculature using non-contrast computed tomography (CT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) pre- and post-treatment and correlate CT-based parameters with right heart catheterization (RHC) hemodynamic and clinical parameters. Materials and Methods: A total of 30 patients with CTEPH (mean age, 57.9 years; 53% female) who received multimodal treatment, including riociguat for ≥ 16 weeks with or without balloon pulmonary angioplasty and underwent both non-contrast CT for pulmonary vasculature analysis and RHC pre- and post-treatment were included. The radiographic analysis included subpleural perfusion parameters, including blood volume in small vessels with a cross-sectional area ≤ 5 mm2 (BV5) and total blood vessel volume (TBV) in the lungs. The RHC parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI). Clinical parameters included the World Health Organization (WHO) functional class and 6-minute walking distance (6MWD). Results: The number, area, and density of the subpleural small vessels increased after treatment by 35.7% (P < 0.001), 13.3% (P = 0.028), and 39.3% (P < 0.001), respectively. The blood volume shifted from larger to smaller vessels, as indicated by an 11.3% increase in the BV5/TBV ratio (P = 0.042). The BV5/TBV ratio was negatively correlated with PVR (r = -0.26; P = 0.035) and positively correlated with CI (r = 0.33; P = 0.009). The percent change across treatment in the BV5/TBV ratio correlated with the percent change in mPAP (r = -0.56; P = 0.001), PVR (r = -0.64; P < 0.001), and CI (r = 0.28; P = 0.049). Furthermore, the BV5/TBV ratio was inversely associated with the WHO functional classes I-IV (P = 0.004) and positively associated with 6MWD (P = 0.013). Conclusion: Non-contrast CT measures could quantitatively assess changes in the pulmonary vasculature in response to treatment and were correlated with hemodynamic and clinical parameters.

The Clinical Characteristics of Diffuse Alveolar Hemorrhage : A Retrospective Study of 21cases (미만성 폐포 출혈의 임상 양상과 예후)

  • Ham, Hyoung-Suk;Roh, Gil-Hwan;Kang, Eun-Hae;Kang, Soo-Jung;An, Chang-Hyeok;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.614-623
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    • 2000
  • Background : Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. Method : A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveolar lavage or lung biopsy. Results : Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD ($3.27{\pm}3.15$ mg/dl vs. $1.19{\pm}0.94$ mg/dl, p=0.030). The corresponding drop in hemoglobin level was $2.69{\pm}1.26$ g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by $1.38{\pm}4.22$ days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). Conclusion : The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.

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