There has been no study of Toll-like receptor (TLR) expression in lung-derived sensory neurons and their relevance to respiratory symptoms such as cough. In this study, we used the bleomycin-induced pulmonary fibrosis (PF) model to investigate the increase of TLR expression in pulmonary neurons and the association of TLRs with transient receptor potential (TRP) channels in pulmonary neurons. Male Spraque–Dawley rats were given a single dose of bleomycin (2.5 mg/kg, intratracheally) in PF model groups and saline in control group. 1,19-dioctadecyl-3,3,3 9, 39-tetramethylindocarbocyanine perchlorate (DiI) labeling was used to identify pulmonary sensory neurons from the nodose/jugular ganglion (NJG) and the dorsal root ganglion (DRG). Expression of TLRs and TRP channels was analyzed using single cell RT PCR in isolated sensory neurons. TLR2 expression were detected in 29.5% (18/61 neurons) and 26.9% (21/78) of DiI labeled pulmonary NJG neurons and DRG neurons in PF model, respectively. TLR5 were also detected in 55.7% (34/61) and 42.3% (33/78) of pulmonary NJG neurons and DRG neurons of PF model, respectively. Expression of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential vanilloid 1 (TRPV1) and transient receptor potential melastatin 8 (TRPM8) were observed in 19.5%, 38% and 14.6% of TRPM8 positive neurons. And TLR5 was expressed in 63.4% of TRPV1 positive cells. TLR2 and TLR5 expression were enhanced especially in vagal neurons in PF model group. It also showed co-expression of TLR5 and TRP channels in pulmonary sensory neurons. . It might involve in controlling and manifesting clinical symptoms such as cough.
The immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with sepsis. One hundred and three patients admitted to the medical intensive care unit with sepsis were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer. Forty four patients (42.7%) were diagnosed with severe sepsis/septic shock. Overt disseminated intravascular coagulation (DIC) occurred in 40 (38.8%). DNI was significantly higher in patients with severe sepsis/septic shock and overt DIC than in patients without (p 6.5% was a better indicator of severe sepsis/septic shock than C-reactive protein, lactate, white blood cell count, and absolute neutrophil count (sensitivity, 81.3%; specificity, 91.0%; positive predictive value, 88.6%; and negative predictive value, 84.7%). In 36 (82%) of the 44 patients with severe sepsis/septic shock, DNI values were already elevated up to 12 hours before the onset of organ/circulatory failure. DNI may be used as a marker of disease severity in critically ill patients with sepsis. High levels of DNI may help to identify patients with an impending risk of developing severe sepsis/septic shock.
Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an important cause of not only healthcare-associated pneumonia (HCAP) but also community-acquired pneumonia (CAP).We determined the impact of MRSA on differences in clinical characteristics, courses, and outcomes between CAP and HCAP.Materials and Methods: We conducted a retrospective observational study on 78 adult patients admitted with MRSA pneumonia at a university-affiliated tertiary hospital between January 2008 and December 2011.We compared baseline characteristics, chest radiographs, treatment outcomes, and drug resistance patterns between the CAP and HCAP groups.Results: Of the 78 patients with MRSA pneumonia, 57 (73.1%) were HCAP and 21 (26.9%) were CAP.MRSA infection history in the previous year (29.8% vs. 14.3%, p=0.244) tended to be more common in HCAP than in CAP.Despite similar Pneumonia Severity Index scores (151 in CAP vs. 142 in HCAP), intubation rates (38.1% vs. 17.5%;p=0.072) and intensive care unit admission (42.9% vs. 22.8%; p=0.095) tended to be higher in the CAP group, while 28-day mortality was higher in the HCAP group (14.3% vs. 26.3%;p=0.368), although without statistical significance.All patients showed sensitivity to vancomycin and linezolid; meanwhile, HCAP patients showed greater resistance to gentamicin than CAP patients (58.3% vs. 16.6%;p=0.037).The median total hospital charges were 6899 American dollars for CAP and 5715 American dollars for HCAP (p=0.161).Conclusion: MRSA pneumonia showed significantly differences in baseline characteristics, chest radiographs, treatment outcomes, and medical expenses between HCAP and CAP groups.
Introduction: 모든 정복성 관절원판변위가 비정복성 관절원판변위로 진행되는 것은 아니지만 심각한 포착이나 걸림을 동반하는 정복성 관절원판변위는 비정복성 관절원판변위로 진행하게 된다. 이번 연구에서는 Locking-free Appliance(LA)를 이용한 개구운동치료의 효과를 살펴보고자 한다. Patients and Method: 후향적으로, 2010년 1월부터 2011년 12월까지 전북대학교병원 치과진료처 구강내과에서 LA를 이용한 개구운동치료를 받은 37명의 환자를 대상으로 분석을 시행하였다. 환자는 LA를 착용한 상태에서 하루 30번의 개구운동을 할 것을 교육받았다. Results: 치료를 받은 환자들 중 비정복성 관절원판변위로 악화된 환자는 없었다. 37명 중 16명의 환자들은 과두걸림 없이 개구가 가능해졌다. Mann-whitney test와 fisher's test, Chi-square test를 이용하여 분석 시, 과두걸림이 해소된 환자와 그렇지 않은 환자간의 나이, 성별, 통증유무, 과두걸림 호소 기간, 통증의 정도(VAS score)에는 통계학적으로 유의한 차이가 없었다. Conclusion: 이번 연구에서, LA를 이용한 개구운동치료 후 일부 환자는 과두걸림 없이 개구가 가능해졌고, 일부 환자는 과두걸림이 해소되지 않았으나, 비정복성 관절원판변위로 악화된 경우는 없었다. 이 치료는 기존의 전통적인 치료방법에 비해 환자의 교합장치 착용 시간이 짧고, 비용이 저렴하며, 환자의 불편함을 최소화 할 수 있다는 장점이 있다. 따라서, LA를 이용한 개구운동치료는 과두걸림을 해소하거나, 비정복성 관절원판변위로의 악화를 예방하는데 새로운 치료방법이 될 것으로 기대된다. Objective: All patients who have the disc displacement with reduction (DDwR) are always not progressive but some of them with significant catching or locking progress to disc displacement without reduction (DDw/oR). In this study, we suggest opening exercise therapy using Locking-free Appliance (LA) to be helpful to prevent progressive derangement. Methods: Retrospectively, a total 37 patients who received exercise treatment using LA was analyzed from January 2010 to December 2011. Patients had been instructed in proper exercise technique to practise for opening and closing of mouth wearing the appliance 30 times a day in locking-free position. Results: None of the patients took a turn for worse to DDw/oR (37 patients). The 16 patients (43.2%, locking-free group) of them could open their mouth without intermittent condylar locking. Measurement of data was analyzed using and Mann-Whitney test. There was no statistically significant difference for age, gender, presence of palpational pain, locking period, VAS quantitative pain score between locking-free group and locking group. Conclusions: In this study, some patients could open their mouth without intermittent locking and did not take a turn for worse to DDw/oR after opening exercise therapy with LA. Furthermore, LA had advantages which were short wearing time, low costs and minimizing patients' uncomfortable compared to conventional treatment method. This therapy can be more appropriate new treatment to prevent progress to DDw/oR.
Abstract. The objective of this study was to explore the utilization of deep learning networks in individual tree crown (ITC) delineation, a very important step in individual tree analysis. Even though many traditional machine learning methods have been developed for ITC delineation, the accuracy remains low, especially for dense forests where branches, crowns, and clusters of trees usually have similar characteristics and boundaries of tree crowns are not distinct. Advance in deep learning provides a good opportunity to improve ITC delineation. In this study, U-net, Residual U-net, and attention U-net were implemented for the first time in ITC delineation. In order to ensure that the boundaries of tree crowns were classified correctly, a weight map was generated to give more weights to boundary pixels between two close crowns in the loss function. These three networks were trained and tested using optical imagery obtained over a study site within the Great Lakes-St. Lawrence forest region, Ontario Canada. Based on two test sites dominated by open mixed forest and closed deciduous forests, respectively, the overall accuracies were 0.94 and 0.90, respectively for U-net, 0.89 and 0.62 for Residual U-net, and 0.96 and 0.83 for attention U-net.
Background and aims: We compared the prevalence of adenomatous and cancerous colon polyps in patients who underwent endoscopic removal of gastric neoplasms and in healthy controls.
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