Abstract Chronic inflammation plays a key role in the development and progression of several chronic diseases. Inhibiting the inflammatory cascade, thereby minimising the damage caused by the inflammatory mediators, can be one of the strategies in chronic disease management. In addition, inflammation is closely related to apoptosis, and inflammation can cause apoptosis. Lemon peel has been reported to have antioxidant and anti-inflammatory biological activities. This study aimed to investigate the antioxidant activity of fermented lemon peel (FLP) by Lactobacillus plantarum PNU and the effect of its extract (FLPE) on LPS-induced inflammatory response in RAW 264.7 cells. The results show that FLP has better antioxidant activity than unfermented lemon peel (UFLP). Compared with UFLP extract, FLPE more effectively inhibited the release of NO and pro-inflammatory cytokines (IL-1β, IL-6, TNF-α and IFN-γ) and down-regulated pro-inflammatory genes (IL-1β, IL-6, NF-κB p65, COX-2, IFN-γ, iNOS, IL-5), and pro-apoptotic genes (caspase-3, caspase-9, p53, p21 and Bax), meanwhile, promoted the release of anti-inflammatory cytokine (IL-10) and up-regulated anti-inflammatory genes(IL-10 and IL-4), and anti-apoptotic gene (Bcl2) in LPS-induced RAW 264.7 cells. Therefore, this study elucidates the anti-inflammatory activity mechanism of fermented lemon peel by studying the balance of inflammatory response and the inhibition of apoptosis. It provides an important reference for the future research and treatment of chronic inflammation and related diseases, as well as the development of fermented foods with anti-inflammatory effects.

Abstract Background Mechanoreceptor activation modulates GABA neuron firing and dopamine (DA) release in the mesolimbic DA system, an area implicated in reward and substance abuse. The lateral habenula (LHb), the lateral hypothalamus (LH), and the mesolimbic DA system are not only reciprocally connected, but also involved in drug reward. We explored the effects of mechanical stimulation (MS) on cocaine addiction-like behaviors and the role of the LH-LHb circuit in the MS effects. MS was performed over ulnar nerve and the effects were evaluated by using drug seeking behaviors, optogenetics, chemogenetics, electrophysiology and immunohistochemistry. Results Mechanical stimulation attenuated locomotor activity in a nerve-dependent manner and 50-kHz ultrasonic vocalizations (USVs) and DA release in nucleus accumbens (NAc) following cocaine injection. The MS effects were ablated by electrolytic lesion or optogenetic inhibition of LHb. Optogenetic activation of LHb suppressed cocaine-enhanced 50 kHz USVs and locomotion. MS reversed cocaine suppression of neuronal activity of LHb. MS also inhibited cocaine-primed reinstatement of drug-seeking behavior, which was blocked by chemogenetic inhibition of an LH-LHb circuit. Conclusion These findings suggest that peripheral mechanical stimulation activates LH-LHb pathways to attenuate cocaine-induced psychomotor responses and seeking behaviors.

Abstract Kombucha is a fermented beverage containing organic acids by yeast and acetic acid bacteria. In this study, microbial community analysis of kombucha produced in Korea was performed, and changes in components during kombucha fermentation were analyzed using commercial kombucha pellicle and culture broth as starter. The major phylum-level strains of commercial kom-1 and kom-2 showed differences in proteobacteria of 35.60% and 78.1%, and Firmicutes of 64.06% and 15.57%, respectively. During fermentation with pellicle (Kom-P) and broth (Kom-F), the level of reducing sugar during fermentation tended to decrease rapidly. The production of acetic acid and D-saccharic acid-1,4-lactone (DSL) in Kom-P and -F tended to increase with increasing fermentation time. In Kom-P, lactic acid and glucuronic acid production increased until 7 days of fermentation and then decreased, whereas in Kom-F, it continued to increase with fermentation time. ABTS radical scavenging activity tended to decrease with increasing fermentation time. However, DPPH radical scavenging activity increased within 7 days of fermentation and then decreased slightly (Kom-P) or remained constant (Kom-F). It has been found that the use of culture broth rather than the use of pellicle as a starter is advantageous to increase the active compound content and DPPH radical scavenging ability.

Abstract Phycocyanin, a natural pigment extracted from spirulina (Spirulina platensis), is used in foods, but its use is limited due to its relatively heat labile nature. Thus, here, we aimed to investigate the effect of cysteine addition on increasing the thermal stability of phycocyanin extracted from spirulina using Collupulin. Our results showed that 0.5% cysteine was the most effective in extracting phycocyanin. Furthermore, 95 °C heat treatment increased the stability of phycocyanin extracted with Collupulin and cysteine. The thermal kinetic model of the phycocyanin extracted with Collupulin and cysteine was confirmed to follow the second order. The activation energy of phycocyanin extracted with Collupulin and cysteine, calculated using the reaction constant (k) obtained from the secondary thermal kinetic model, was 65.3 kJ. Collectively, the addition of 0.5% cysteine increased the thermal stability of phycocyanin extracted with Collupulin, and this phycocyanin could be used in foods that undergo a heating process.

Abstract Hops (Humulus lupulus L. [Cannabaceae]), used to increase storage and palatability of food, exert various pharmacological effects, including sleep-promoting and antioxidant effects. Here, we evaluated the effects of Saaz, Saphir, Simcoe, and their mixtures on pentobarbital-induced sleep in mice and reactive oxygen species (ROS) production in H2O2-treated HT22 cells. Compared to administration of Saaz, Simcoe, and Saphir alone, the administration of Saaz/Saphir (75:25) and Simcoe/Saphir (50:50) mixtures resulted in slightly longer sleep durations in pentobarbital-administered mice. The Saaz/Saphir (75:25) group showed a longer sleep duration in the caffeine-induced insomnia model and slightly lower IC50 values for radicals than the Simcoe/Saphir (50:50) group. Xanthohumol present in hop mixtures suppressed ROS production and increased the expression of superoxide dismutase-1, catalase, and glutathione peroxidase-1 in H2O2-treated HT22 cells. Collectively, Simcoe/Saphir (50:50) and Saaz/Saphir (75:25) mixtures were more effective in removing ROS in brain cells and promoting sleep than hops alone.

ABSTRACT Persea americana Mill., Lauraceae, commonly known as the avocado, is native to tropical and subtropical regions, including Brazil. From the leaves of P. americana, one previously undescribed flavonol glycoside (1) together with ten known flavonoids (2-11), four megastigmane glycosides (12-15) and two lignans (16-17) were isolated. Their structures were determined by extensive spectroscopic methods including 1D- and 2D-nuclear magnetic resonance and mass spectrometry data. This is the first investigation that reports megastigmane glycoside and lignan classes within the genus Persea. All the isolated compounds have been assessed through the cell survival of larval zebrafish following neomycin-induced damage and the cell viability of a House Ear Institute-Organ of Corti 1 mouse auditory cell line. Among the tested compounds, juglanin (2) and (+)-lyoniresinol (16) showed significant cell regeneration in neomycin-damaged hair cell without cellular toxicity.

ABSTRACT The present study investigated the impacts of additional feeding (AF; containing 16% excess feed than control diet in the last two weeks of gestation) during late gestation period and different backfat thickness (BFT) including low (<20 mm) and high (≥20 mm) backfat on reproductive performance, litter size, blood metabolites, hormonal profiles, colostrum, and milk composition of sows from day 90 of gestation to farrowing, and from farrowing to weaning during summer (average 28.3 °C). Fifty-four crossbred sows (Yorkshire × Landrace) were allotted to one of four treatments according to a 2×2 factorial arrangement. There was no AF×BFT interaction for any of the measured variables. The body weight change of sows was decreased for <20 mm in BFT and AF treatments during late gestation and farrowing to weaning periods. The BFT change of sows was higher in AF during late gestation and higher in ≥20 mm BFT during late gestation and farrowing to weaning periods. There were no effects of AF and BFT on the average daily feed intake and weaning-to-oestrus interval; however, sows in AF groups had a greater litter uniformity at birth and initial litter weight. Hormone profiles, colostrum, and milk composition of sows were not different among the treatments. Additional feeding during the last two weeks of gestation increases initial litter size in summer; however, final litter weight is not affected.

Resumo Justificativa e objetivos: O tamponamento cardíaco é uma condição médica potencialmente fatal, cuja ocorrência como uma complicação da lobectomia pulmonar é muito rara. Apresentamos o primeiro caso de tamponamento cardíaco desencadeado na sala de recuperação pós-anestésica (SRPA) após uma lobectomia pulmonar. Relato de caso: Paciente do sexo masculino, 54 anos, com carcinoma de células escamosas pulmonares, submetido à lobectomia pulmonar aparentemente sem complicações. Sua hemodinâmica não apresentou alteração durante toda a cirurgia e também inicialmente na sala de recuperação pós-anestésica. Porém, após cinco minutos na SRPA, o paciente apresentou hipotensão e dispneia de forma repentina e respondeu mal ao inotrópico e à reanimação hídrica. Uma ecocardiografia transesofágica feita por um anestesiologista que suspeitou de etiologia cardíaca revelou um derrame pericárdico que comprimia o coração. Após tentativa malsucedida de pericardiocentese, foi feita uma janela pericárdica de emergência. O paciente apresentou melhoria dramática com a descompressão do coração. Conclusão: Como o tamponamento cardíaco geralmente não é suspeito como causa de instabilidade hemodinâmica após lobectomia pulmonar, como ocorreu neste caso, um diagnóstico errado da condição do paciente poderia ter levado a um manejo inadequado, que resultaria em morte. Como os anestesiologistas estão frequentemente envolvidos na reanimação inicial de pacientes debilitados em salas de recuperação pós-anestésica, seu conhecimento de várias complicações pós-operatórias e competência na ecocardiografia para avaliar problemas cardíacos podem contribuir para a sobrevivência do paciente.

Abstract Background and objectives: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. Case report: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit. However, after 5 min in the Post-Anesthesia Care Unit, he suddenly became hypotensive and dyspneic. He responded poorly to inotropics and fluid resuscitation. Transesophageal echocardiography conducted by an anesthesiologist who suspected a cardiac etiology revealed a pericardial effusion compressing the heart. After a failed attempt of pericardiocentesis, an emergency pericardial window operation was performed. The patient improved dramatically once the heart was decompressed. Conclusion: Since cardiac tamponade is generally not suspected as a cause of hemodynamic instability after a lung lobectomy, as it was in this case, a misdiagnosis of the patient's condition may have led to improper management resulting in death. As anesthesiologists are often involved in the initial resuscitation of morbid patients in Post-Anesthesia Care Units, their acquaintance with various postoperative complications and competence in echocardiography for assessing cardiac problems may contribute to patient survival.

The incidence of detection of accessory hepatic vein (AHV) using MRI or CT has been reported. However, previous studies had a small sample size or only reported on the incidence of hepatic vein variants. To the best of our knowledge, there has been no previous report evaluating the factors predictive of the presence of an AHV. To evaluate the incidence and morphology of the accessory hepatic vein (AHV) using multidetector row computed tomography (MDCT) and to investigate the factors which may be helpful in predicting the presence of an AHV. We enrolled 360 patients who underwent abdominal MDCT. We investigated whether the AHV was present and evaluated the frequency of AHVs greater than 5 mm in diameter. We classified the morphology of the AHV entering the inferior vena cava (IVC). We also examined the factors that predicted the presence of an AHV by comparing the diameter of the middle hepatic vein (MHV) and the right hepatic vein (RHV). We identified an AHV in 164 of the 360 patients (45.6 %). Among the 164 AHVs, 56.7 % were larger than 5 mm in diameter. The most common morphologies of the inferior RHV were a single main trunk (58.5 %), followed by two main trunks with a V-shape (19.5 %) and two trunks entering the IVC separately (17.0 %). The possibility that an AHV will be present was significantly higher when the diameter of the RHV was smaller than that of the MHV. MDCT can provide important information regarding AHV incidence and morphology. The possibility of an AHV being present was significantly higher when the diameter of the RHV was smaller than that of the MHV.

Se ha informado de la incidencia de la detección de la vena hepática accesoria (VHA) mediante RM o TC. Sin embargo, estudios previos tenían un tamaño muestral pequeño o solo informaban sobre la incidencia de variantes de las venas hepáticas. Hasta donde sabemos, no ha habido ningún informe previo que evalúe los factores predictivos de la presencia de una VHA. El objetivo del estudio fue evaluar la incidencia y morfología de la vena hepática accesoria (VHA) mediante tomografía computarizada multidetector (TCMD) e investigar los factores que pueden ser útiles para predecir la presencia de un VHA. Se evaluaron 360 pacientes que se sometieron a TCMD abdominal. Se investigó si la VHA estaba presente y se evaluó la frecuencia de VHA mayores de 5 mm de diámetro. Se clasificó la morfología del VHA que drenaba en la vena cava inferior (VCI). Además, se examinaron los factores que predijeron la presencia de una VHA mediante la comparación del diámetro de la vena hepática media (VHM) y la vena hepática derecha (VHD). Se identificó un VHA en 164 de los 360 pacientes (45,6%). Entre las 164 VHA, el 56,7% tenía más de 5 mm de diámetro. Las morfologías más frecuentes del VHD inferior fueron un tronco principal único (58,5%), seguido por dos troncos principales con forma de V (19,5%) y dos troncos que drenaban en la VCI por separado (17,0%). La posibilidad de que una VHA esté presente fue significativamente mayor cuando el diámetro de la VHD era menor que la de la VHM. La MDCT puede proporcionar información importante sobre la incidencia de la VHA y su morfología. La posibilidad de que un VHA estuviera presente era significativamente mayor cuando el diámetro del VHD era menor que la VHM.

ABSTRACT Objectives To investigate the renal function outcomes and contralateral kidney volume change measured by using a 3-dimensional reconstructive method after open partial nephrectomy (PN) or open radical nephrectomy (RN) according to the endophytic degree of tumors. Materials and Methods We included 214 PN and 220 RN patients. According to the endophytic degree of the tumors, we divided patients into 3 groups. Patients were assessed for renal function and kidney volume change both preoperatively and postoperatively at 6 months. Kidney volume was calculated by using personal computer-based software. Subgroup analyses was performed for tumor >4cm. Results Larger and complex tumors were more frequent in the RN group than PN group. Among patients with exophytic and mild endophytic tumors, the mean postoperative renal function was well preserved in PN group and the mean contralateral kidney volume significantly increased in the RN compared to the PN group (PN, 145.55 to 149.98mL; 3.0% versus RN, 143.93 to 169.64mL;17.9% p=0.006). However, in fully endophytic tumors, compensatory hypertrophy of the contralateral kidney was similar between PN and RN (PN, 138.16 to 159.64mL; 15.5 % versus RN, 138.65 to 168.04mL; 21.2% p=0.416) and renal functional outcomes were similar between both groups. These results were also confirmed in tumors >4cm in size. Conclusions In fully endophytic tumors, especially large tumors, the postoperative renal function and contralateral kidney volume were similar; therefore, we should consider RN preferentially as surgical option for these tumors.

Objectives: The objective of this study was to update the long-term outcome in the treatment of locally advanced upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) regarding the role of adjuvant chemotherapy. Materials and methods: Clinical data from 138 patients who underwent RNU for locally advanced UTUC (pT3/4 or pN+) were analyzed. Results: The adjuvant chemotherapy group comprised 66 patients, and other 72 patients did not receive adjuvant chemotherapy. Cisplatin-based chemotherapy was the most common regimen, depending on the patient's eligibility and renal function. The median follow-up period was 48.7 months (interquartile range: 29.2-96.9 months). The 3-and 5-year disease-specific survival (DSS) rates were 76.0% and 69.9% for the non-adjuvant chemotherapy group versus 74.6% and 54.5% for the adjuvant chemotherapy group (p=0.301, log-rank test). Overall survival (OS) rates for the same time period were 70.1% and 62.9% for the non-adjuvant chemotherapy group versus 73.8% and 53.2% for the adjuvant chemotherapy group (p=0.931, log-rank test). On multivariate analysis, adjuvant chemotherapy could not predict DSS and OS after surgery. When patients who received cisplatin-based adjuvant chemotherapy (n=59) were compared to those who did not receive adjuvant chemotherapy, similar results were found. Conclusions: There does not appear to be a significant DSS or OS benefit associated with adjuvant chemotherapy. Prospective randomized clinical trials are necessary to verify the effect of adjuvant chemotherapy on locally advanced UTUC.

Antecedentes: los extractos de la planta Forsythia suspensa contienen pinoresinol. Dicha planta se ha propuesto como una alternativa a los antibióticos debido a su contenido de antioxidantes, antiinflamatorios y sus efectos moduladores de la microflora. Objetivo: evaluar los efectos dietarios de F. suspensa sobre la utilización del alimento, fermentación ruminal, parámetros sanguíneos y respuesta inmune en cabras nativas coreanas (Capra hircus). Métodos: un total de nueve cabras nativas coreanas fueron asignadas a 1 de 3 tratamientos: (1) una dieta basal sin F. suspensa, (2) una dieta basal con 0,25%, o (3) 0,50% de F. suspensa dietaría en un diseño change-over por tres periodos consecutivos con nueve réplicas por tratamiento. Cada periodo se prolongó por 18 días, incluyendo 15 días de adaptación al alimento y a las condiciones ambientales, y tres días de colección total de heces y orina. Tambien se colectó fluido ruminal y muestras sanguineas. Se midió la digestibilidad de nutrientes, nitrógeno retenido, contenido ruminal y metabolitos sanguíneos —incluyendo inmunoglobulinas—. Resultados: la suplementación con F. suspensa no tuvo efecto sobre la digestibilidad de los nutrientes, la tasa de retención de N, pH ruminal, ni sobre los contenidos de acetato, propionato, isobutirato, butirato, isovalerato o valerato (p>0,05). Sin embargo, la suplementación con F. suspensa disminuyo la concentración total de ácidos grasos volátiles (VFA) en comparacion con la dieta control, sin tener en cuenta las concentraciones de F. suspensa (p<0,05). Las cabras alimentadas con la dieta de 0,25% de F. suspensa tuvieron mayor concentración de fosfatasa alcalina (ALP) que cuando fueron alimentadas con la dieta control o con la de 0,50% de F. suspensa (p<0,05). Aunque la alimentación con diferentes concentraciones de F. suspensa no influyo en los niveles de IgA y IgM en plasma (p>0,05), las cabras que recibieron 0,25 y 0,50% de F. suspensa tuvieron mayor concentración de IgG en plasma que aquellas alimentadas con la dieta control (p<0,05). Conclusiones: la suplementación de 0,25% de F. suspensa disminuyo significativamente la concentración total de VFA e incrementó la IgG en el plasma de las cabras nativas coreanas, en comparación con aquellas que consumieron la dieta control.

Background: plant extracts of Forsythia suspensa, which contain pinoresinol, have been proposed as an alternative to antibiotics due to their antioxidant, anti-inflammatory, and microflora modulating effects. Objective: to evaluate the effects of dietary F. suspensa on feed utilization, rumen fermentation, blood parameters and immune response of Korean native goats (Capra hircus). Methods: a total of nine Korean native goats were assigned to one of three dietary treatments: 1) a basal diet without F. suspensa, 2) a basal diet added with 0.25% F. suspensa, or 3) a basal diet added with 0.50% F. suspensa. A change-over design was used in three consecutive periods to give 9 replicates per treatment. Each period lasted 18 days, including 15 days of adaptation to feed and environmental conditions and three days of total collection of feces and urine. Rumen fluid and blood samples were also collected. Nutrient digestibility, nitrogen retention, ruminal content, and blood metabolites—including immunoglobulins—were measured. Results: F. suspensa supplementation had no effect on nutrient digestibility, whole body nitrogen retention rate, ruminal pH, acetate, propionate, isobutyrate, butyrate, isovalerate, or valerate content (p>0.05). However, F. suspensa supplementation decreased total volatile fatty acids (VFA) concentration compared with the control diet, regardless of F. suspensa concentrations (p<0.05). Goats fed a diet containing 0.25% F. suspensa had greater alkaline phosphatase (ALP) concentration than those fed a control or a diet with 0.50% F. suspensa (p<0.05). Feeding different concentrations of dietary F. suspensa did not influence plasma IgA and IgM levels (p>0.05), although goats receiving both 0.25% and 0.50% F. suspensa diets had greater plasma IgG than those fed the control diet (p<0.05). Conclusion: supplementation of 0.25% F. suspensa significantly decreased total VFA concentrations and increased plasma IgG in Korean native goats, compared with those fed the control diet.

Antecedentes: a Forsythiae suspensa é uma planta e seu extrato contém pinoresinol. Tem sido proposta como uma alternativa aos antibióticos existentes, devido ao seu teor de antioxidantes, anti-inflamatórias e efeitos moduladores da microflora, com base em estudos feitos in vivo e in vitro. Objetivo: avaliar os efeitos na dieta da inclusão de F. suspensa no aproveitamento alimentar, fermentação ruminal, parâmetros sanguíneos e resposta imune em caprinos coreanos nativos (Capra hircus). Métodos: um total de nove cabras coreanas nativas foram assignadas a um de três tratamentos na dieta: (1) uma dieta basal sem F. suspensa, (2) uma dieta basal com 0,25% de F. suspensa, ou (3) com 0,50% de F. suspensa na dieta. Se fez um desenho change-over por três períodos consecutivos com nove repetições por tratamento. Cada período de pesquisa consistiu de 18 dias, incluindo 15 dias de adaptação às condições alimentares e ambientais, e três dias de coleta total de fezes e urina. Também foram coletadas amostras de líquido ruminal e sangue. Mediou-se a digestibilidade dos nutrientes, o nitrogênio (N) retido, o conteúdo ruminal, e os parâmetros sanguíneos —incluindo imunoglobulinas—. Resultados: a suplementação com F. suspensa não teve nenhum efeito sobre a digestibilidade dos nutrientes, a taxa de retenção de N, o pH do rúmen, nem sobre os conteúdos de: acetato, propionato, isobutirato, butirato, isovalerato e valerato (p>0,05). No entanto, a suplementação de F. suspensa diminuiu a concentração total de ácidos gordurosos voláteis (AGV) em comparação com a dieta controle, independentemente das concentrações de F. suspensa (p<0,05). As cabras alimentadas com 0,25% F. suspensa na dieta tiveram maiores quantidades da enzima fosfatasse alcalina (ALP) do que quando elas foram alimentadas com a dieta controle ou com 0,50% de F. suspensa (p<0,05). Ainda que a alimentação com diferentes níveis de F. suspensa não influenciou os níveis de IgA e IgM no plasma (p>0,05), as cabras que receberam na dieta 0,25 e 0,50% de F. suspensa tiveram uma maior concentração de IgG no plasma comparadas as cabras alimentadas com a dieta controle (p<0,05). Conclusões: a suplementação com 0,25% e 50% diminuiu significativamente a concentração de AGV e incrementou a concentração em plasma de IgG em cabras nativas coreanas comparadas com aquelas que consumiram a dieta controle.

The stereoscopic morphology of the iliofemoral, pubofemoral, and ischiofemoral ligaments in hip joint is hard to understand, either in anatomy books or from cadaver dissection. To aid in understanding, three-dimensional models were built from the sectioned images of cadaver hip, which demonstrate fine components better than CTs and MRIs. In the female data of Visible Korean project, the ligaments and neighboring structures were recognized and outlined in detail. Successively, the outlines were stacked and reconstructed to manufacture their surface models by using the sophisticated computer method. The surface models were overlapped with the original sectioned images, which enhanced comprehension of the hip joint anatomy. With the surface models, hip joint was hyperextended to suggest the function of the ligaments. The graphic data of the surface reconstructed hip ligaments are expected to be the source of interactive simulators for anatomy and surgery of the hip joint.

La morfología estereoscópica de los ligamentos iliofemoral, pubofemoral e isquiofemoral de la articulación de la cadera es difícil de entender, ya sea a partir de lo hallado en los libros de anatomía como en la disección de cadáveres. Para ayudar en su comprensión, se construyeron modelos tridimensionales a partir de imágenes de secciones cadavéricas de la cadera, que demuestran de mejor manera los componentes finos, en comparación a las imágenes de tomografía axial computada y resonancia magnética nuclear. En los datos obtenidos del "Visible Korean Project", correspondientes a mujeres, los ligamentos de la articulación y sus estructuras vecinas fueron reconocidos y descritos en detalle. Sucesivamente, se identificaron los contornos y se reconstruyeron para la fabricación de modelos de superficie, mediante el uso de un sofisticado método informático. Los modelos de superficie se asociaron con las imágenes de sección originales, que aumentaron la comprensión de la anatomía de la articulación de la cadera. En los modelos de superficie se provocó la hipertensión de la articulación de la cadera para permitir evidenciar la función de los ligamentos. Se espera que los datos gráficos obtenidos de los modelos de superficie de los ligamentos de la cadera sirvan como fuente para el desarrollo de simuladores interactivos que permitan el estudio de la anatomía y la cirugía de la articulación de la cadera.

BACKGROUND: Since healthcare-associated pneumonia (HCAP) is heterogeneous, clinical characteristics and outcomes are different from region to region. There can also be differences between HCAP patients hospitalized in secondary or tertiary hospitals. This study aimed to evaluate the clinical characteristics of HCAP patients admitted into secondary community hospitals. METHODS: This was a retrospective study conducted in patients with HCAP or community-acquired pneumonia (CAP) hospitalized in two secondary hospitals between March 2009 and January 2011. RESULTS: Of a total of 303 patients, 96 (31.7%) had HCAP. 42 patients (43.7%) resided in a nursing home or long-term care facility, 36 (37.5%) were hospitalized in an acute care hospital for > 2 days within 90 days, ten received outpatient intravenous therapy, and eight attended a hospital clinic or dialysis center. HCAP patients were older. The rates of patients with CURB65 scores of 3 or more (22.9% vs. 9.1%; p = 0.001) and PSI class IV or more (82.2% vs. 34.7%; p < 0.001) were higher in the HCAP group. Drug-resistant pathogens were more frequently detected in the HCAP group (23.9% vs. 0.4%; p < 0.001). However, Streptococcus pneumoniae was the most common pathogen in both groups. The rates of antibiotic change, use of inappropriate antibiotics, and failure of initial antibiotic therapy in the HCAP group were significantly higher. Although the overall survival rate of the HCAP group was significantly lower (82.3% vs. 96.8%; p < 0.001), multivariate analyses failed to show that HCAP itself was a prognostic factor for mortality (p = 0.826). Only PSI class IV or more was associated with increased mortality (p = 0.005). CONCLUSIONS: HCAP should be distinguished from CAP because of the different clinical features. However, the current definition of HCAP does not appear to be a prognostic for death. In addition, the use of broad-spectrum antibiotics for HCAP should be reassessed because S. pneumoniae was most frequently identified even in HCAP patients.

Sparganosis in humans is an incidental infection and is known to be associated with eating insufficiently cooked meat of frogs and snakes or drinking unboiled stream water. Although it can involve various internal organs, pulmonary and pleural involvement due to sparganum is rare. Because we recently experienced two cases involving lung parenchyma and pleura that were misdiagnosed as bacterial pneumonia and lung cancer, we herein intend to present them in detail.