Impact of the Ratio of Visceral to Subcutaneous Adipose Tissue in Donor Nephrectomy Patients

OBJECTIVE

It was reported that a metabolic syndrome affected the remaining renal function after living donor nephrectomy. However, the measurement of waist circumference is unclear because it cannot distinguish between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). We investigate the clinical correlation between body adipose tissue and renal function recovery after living donor nephrectomy.

METHODS

From July 2013 to February 2015, 75 living kidney donors were enrolled. The VAT and SAT were measured by preoperative computed tomography (CT) scan. Body mass index (BMI), VAT, SAT, and VAT-to-SAT ratio were analyzed according to a postoperative renal function recovery. Receiver operating characteristic (ROC) was performed to predict estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m² at postoperative 6 months for BMI, VAT, SAT, and VAT-to-SAT ratio.

RESULTS

The lowest value of eGFR (57.52 ± 11.20 mL/min/1.73 m²) was measured at postoperative day 7. There was no statistically significant difference in eGFR between 1 month and 3 months. BMI, VAT, SAT, and VAT-to-SAT ratio showed a statistically significant correlation with each other (Pearson correlation, P < .05). Also, the recovery time of eGFR was correlated with VAT-to-SAT ratio; it was significant at postoperative 1, 3, and 6 months. VAT-to-SAT ratio (0.654, 95% confidence interval 0.525-0.783, P = .024) had higher predictive value in ROC.

CONCLUSION

We developed a new variable to predict the value of lower eGFR (less than 60 mL/min/1.73 m²) at a postoperative 6 months in living kidney donor. According to a CT scan, VAT-to-SAT ratio can predict renal function recovery.

Plasma Neutrophil Gelatinase-associated Lipoprotein in Living Kidney Donors

BACKGROUND

Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for acute kidney injury. This study was conducted to determine the clinical implications of perioperative plasma NGAL levels for renal function after living donor nephrectomy.

METHODS

Between July 2013 and May 2014, 112 donors underwent live donor nephrectomy at our institution. Donor plasma NGAL levels were measured perioperatively for 6 months. The relationship between perioperative plasma NGAL and recovery of renal function was analyzed. Renal function was estimated with the Modification of Diet in Renal Disease formula.

RESULTS

Mean preoperative NGAL was 62.1 ± 29.5 ng/mL. Plasma NGAL was most elevated 1 week postoperatively (218 ± 95.5 ng/mL), and stabilized after 1 month (122.9 ± 45.3 ng/mL). Preoperative plasma NGAL was not correlated with donor age or preoperative estimated glomerular filtration rates (eGFR), but was negatively correlated with 6-month eGFR (r = -0.458, P < .001). During the observation period, plasma NGAL at 1 week was most correlated with 6-month eGFR (r = -0.554, P < .001). An ROC curve analysis showed that age, preoperative eGFR, and 1-week postoperative plasma NGAL were highly predictive of developing of chronic kidney disease (CKD), defined as eGFR <60 mL/min/1.73 m(2), 6 months postoperatively (AUC = 0.91, P < .001). One-week postoperative plasma NGAL was also independently associated with CKD risk at 6 months (odds ratio: 1.13 for each 10 ng/mL increase, P = .013).

CONCLUSION

Plasma NGAL becomes elevated after kidney donation and can provide information about acute kidney injury during the compensatory hyperfiltration period. Donors with increased perioperative plasma NGAL require close observation because their possibility of developing CKD after donation may be greater.

A study of the dietary intakes by the pre-pregnancy body mass index in pregnant women

The authors analyzed the difference in weight gain and nutrition, according to the BMI before pregnancy. They divided 91 subjects into BMI group I (normal weight) and BMI group 2 (overweight) before pregnancy. In general, the BMI before pregnancy did not influence weight gain but, in the BMI group 2, the intakes of all of cholesterol, total fatty acids, vitamin B 12, iron, and copper were significantly higher. Neither group exhibited sufficient intake of vitamin B 1, vitamin B2, niacin, vitamin B6, folic acid, calcium, magnesium, iron, or zinc. Pre-pregnancy weight management and nutrition during pregnancy is very important.

Efficacy of computed tomography for the diagnosis of postpartum hemorrhage

The authors evaluated the diagnosis of the cause of post-partum haemorrhage (PPH) by computed tomography (CT). They retrospectively transferred 15 patients with PPH from local clinics between January 2010 and December 2011. CT revealed diverse causes. Only two cases had no additional finding on CT. They found deep tearing extending to the lower uterine segment and uterine artery in two cases, whereas five cases were an arteriovenous malformation, and one case was a uterine pseudoaneurysm.

Effects of age-based movement on the estimation of growth assuming random-at-age or random-at-length data

Simulation methods were used to generate paired data from a simulated population that included the age-based process of movement and the length-based process of gear selection. The age-based process caused bias in the estimates of growth parameters assuming random at length, even when relatively few age classes were affected. Methods that assumed random at age were biased by the subsequent inclusion of the length-based process of gear selection. Additional knowledge of the age structure of the sampled area is needed to ensure an unbiased estimate of the growth parameters when using the length-conditional approach in the presence of age-based movement. Estimates of the variability in the length-at-age relationship were better estimated with the length-conditional than the traditional method even when the assumptions of random at length were violated. Inclusion of paired observations of length and associated age inside the population dynamics model may be the most appropriate way of estimating growth.

Study on the heat flux reconstruction with the infrared thermography for the divertor target plates in the KSTAR tokamak

An infrared (IR) thermography is the preferred diagnostic that can quantify heat flux by measuring the surface temperature distributions of the divertor plates. The IR thermography is successfully instrumented on Korea Superconducting Tokamak Advanced Research (KSTAR). In this study, finite volume method is considered to solve the heat conduction equations. 1D-, 2D-, and 3D models are developed and compared with various calculation algorithms, such as Duhamel's theorem and THEODOR. These comparisons show good agreement. In order to acquire more efficient and reliable calculation results, we consider two numerical analysis schemes, influence of temperature on thermal properties and image stabilization. Recently, this reconstruction code is successfully applied to the KSTAR IR thermography.

Disparities in Emergency Department Pain Treatment for Toothache

Racial disparities in how pain is treated in the emergency department (ED) for toothache have not been reported. Due to increasing reliance on EDs for dental care, the authors investigated whether race/ethnicity and insurance type are associated with treatment for toothache pain. The authors conducted a nationally representative cross-sectional study of ED toothache visits by adults (19 to 64 y old), using the 2008-2010 National Hospital Ambulatory Medical Care Survey. Multinomial regression models accounted for the complex survey design. Outcomes were pain medicines received: none, nonopioid only, or opioids. After adjusting for sociodemographic factors, black patients had 1.99 greater odds (P < 0.005) than white patients of receiving only a nonopioid pain medicine for toothache. Visits made by patients on Medicare, Medicaid, uninsured, or "other" insurance status had greater odds than the privately insured of receiving only a nonopioid pain medicine rather than an opioid (odds ratios, respectively: 4.8, P < 0.001; 2.1, P ≤ 0.001; 2.3, P < 0.01; and 4.1, P < 0.001). Blacks are less likely than whites to receive opioids in the ED for a toothache, even with similar levels of pain. Nonprivately insured patients have lower odds than the privately insured to receive opioids for toothache pain. A better understanding of the etiology of these disparities could lead to directed interventions. Knowledge Transfer Statement: This study presents findings novel to the body of pain and oral health care literature. Because there is an increasing reliance on the emergency department to address dental pain, disparities in how toothache pain is treated will be of great interest to a growing number of Americans, clinicians, and policy makers.

Impact of phytic acid on nutrient bioaccessibility and antioxidant properties of dehusked rice

Whole grains consumption promotes health benefits, but demonstrates controversial impacts from phytic acid in meeting requirements of good health. Therefore, this study was aimed to determine the nutrient bioaccessibility and antioxidant properties of rice cultivars named "Adan" or "Bario" and deduce the nutritional impact of phytic acid. Majority of the dehusked rice in the collection showed an acceptable level of in-vitro starch digestibility and in-vitro protein digestibility, but were poor in antioxidant properties and bioaccessibility of minerals (Ca, Fe and Zn). The drawbacks identified in the rice cultivars were due to relatively high phytic acid content (2420.6 ± 94.6 mg/100 g) and low phenolic content (152.39 ± 18.84 μg GAE/g). The relationship between phytic acid content and mineral bioaccessibility was strongest in calcium (r = 0.60), followed by iron (r = 0.40) and zinc (r = 0.27). Phytic acid content did not significantly correlate with in-vitro starch digestibility and in-vitro protein digestibility but showed a weak relationship with antioxidant properties. These suggest that phytic acid could significantly impair the mineral bioaccessibility of dehusked rice, and also act as an important antioxidant in non-pigmented rice. Bario rice cultivars offered dehusked rice with wide range of in-vitro digestibility of starch and protein, and also pigmented rice as a good source of antioxidants. However, there is a need to reduce phytic acid content in dehusked rice for improved mineral bioaccessibility among Bario rice cultivars.

Efficacy of fetal thigh volumetry in predicting birth weight using the virtual organ computer-aided analysis (VOCAL) technique

OBJECTIVES

The present study was conducted to compare the accuracy of formulas used to calculate fetal thigh volume (FTV) using the virtual organ computer-aided analysis (VOCAL) technique with two-dimensional (2D) in formulas predicting birth weight.

MATERIALS AND METHODS

This was a prospective, cross-sectional study of 84 pregnant women with 72 hours of delivery evaluated at a university hospital between May, 2008 and April, 2010. After 2D ultrasounds (US) measurement, 3DUS was also used to determine FTV with estimates computed using the VOCAL program.

RESULTS

The correlation between fetal weight predicted by the 3D equation of FTV and the actual birth weight was significant. While FTV and the Hadlock II equation exhibited a low sensitivity for detection of low-birth-weight infants, FTV was a more sensitive method of detecting high-birth-weight infants than the Hadlock II equation.

CONCLUSIONS

It is clear that using 3DUS-VOCAL to measure FTV provides more accurate estimation of fetal birth weight.

Rotation characteristics during the resonant magnetic perturbation induced edge localized mode suppression on the KSTAR

Measuring rotation profiles with a reliable spatial resolution is one of the critical diagnostics in understanding the plasma behavior especially for the edge transport. In the KSTAR experiments, it has been consistently observed from the charge exchange spectroscopy measurements that the magnetic perturbations not only suppresses edge localized modes (ELMs) but also reduces toroidal rotations. In this paper, toroidal velocities of the carbon impurity and their profile evolutions during ELMy and ELM-suppressed phases are presented. The rotation profiles are shown to collapse immediately after an ELM burst and continue to build up until the next burst that accompanies another collapse. Toroidal rotations following the resonant magnetic perturbations applications are observed to be reduced along with the ELMs suppressed.

Optics design of the divertor infrared television of KSTAR

The divertor Infrared television (IR TV) system for monitoring the temperature of a divertor and localized hot spots will be installed on the upper port of the N-port in the Korea Superconducting Tokamak Advanced Research (KSTAR). The cassette of KSTAR makes a periscope inevitable for the divertor IR TV. In this article, 4 design concepts for the periscope were examined, and the design based on Keplerian was shown to have better stabilities in alignment and the vibration. The final optics design based on an f-theta lens, Keplerian, and telecentric lens was derived.

Test of prototype ITER vacuum ultraviolet spectrometer and its application to impurity study in KSTAR plasmas

To optimize the design of ITER vacuum ultraviolet (VUV) spectrometer, a prototype VUV spectrometer was developed. The sensitivity calibration curve of the spectrometer was calculated from the mirror reflectivity, the grating efficiency, and the detector efficiency. The calibration curve was consistent with the calibration points derived in the experiment using the calibrated hollow cathode lamp. For the application of the prototype ITER VUV spectrometer, the prototype spectrometer was installed at KSTAR, and various impurity emission lines could be measured. By analyzing about 100 shots, strong positive correlation between the O VI and the C IV emission intensities could be found.

Evaluation of dietary multiple enzyme preparation (natuzyme) in laying hens

The current experiment was designed to evaluate the efficacy of adding the multi-enzyme mixture (Natuzyme) into layers' diets with different levels of energy and available phosphorus in relation to laying performance, egg qualities, blood cholesterol level, microflora and intestinal viscosity. Two hundred and fifty 43-wk-old Hy-Line commercial layers were divided into five groups with five replicates per group (10 birds per replicate) and fed one of five experimental diets. A corn and soybean meal-based control diet was formulated and used as a control diet. Two experimental control diets were formulated to reduce energy and crude protein contents (rE) or energy, crude protein and phosphorus contents (rEP). In addition, Natuzyme was added into either rE (rE-Natu500) or rEP (rEP-Natu500) diet to reach a concentration of 500 mg per kg of diet. The experiment lasted 8 weeks. There were no significant differences in feed intake, egg production, egg weight, egg qualities such as eggshell color or Haugh unit, total cholesterol, relative organ weights and cecal microflora profiles between any dietary treatments. Natu500 supplementation into the rE diet, but not rEP diet significantly increased egg mass and eggshell qualities such as strength and thickness, but it decreased cecal ammonia concentration and intestinal viscosity in laying hens. In conclusion, the present study shows that adding multiple enzyme preparation could improve performance of laying hens fed energy and protein restricted diets.

Isolation and characterization of CCoAOMT in interspecific hybrid of Acacia auriculiformis x Acacia mangium--a key gene in lignin biosynthesis

This study was directed at the understanding of the function of CCoAOMT isolated from Acacia auriculiformis x Acacia mangium. Full length cDNA of the Acacia hybrid CCoAOMT (AhCCoAOMT) was 1024-bp long, containing 750-bp coding regions, with one major open reading frame of 249 amino acids. On the other hand, full length genomic sequence of the CCoAOMT (AhgflCCoAOMT) was 2548 bp long, containing three introns and four exons with a 5' untranslated region (5'UTR) of 391 bp in length. The 5'UTR of the characterized CCoAOMT gene contains various regulatory elements. Southern analysis revealed that the Acacia hybrid has more than three copies of the CCoAOMT gene. Real-time PCR showed that this gene was expressed in root, inner bark, leaf, flower and seed pod of the Acacia hybrid. Downregulation of the homologous CCoAOMT gene in tobacco by antisense (AS) and intron-containing hairpin (IHP) constructs containing partial AhCCoAOMT led to reduction in lignin content. Expression of the CCoAOMT in AS line (pART-HAS78-03) and IHP line (pART-HIHP78-06) was reduced respectively by 37 and 75% compared to the control, resulting in a decrease in the estimated lignin content by 24 and 56%, respectively. AhCCoAOMT was found to have altered not only S and G units but also total lignin content, which is of economic value to the pulp industry. Subsequent polymorphism analysis of this gene across eight different genetic backgrounds each of A. mangium and A. auriculiformis revealed 47 single nucleotide polymorphisms (SNPs) in A. auriculiformis CCoAOMT and 30 SNPs in A. mangium CCoAOMT.

Advanced biomatrix designs for regenerative therapy of periodontal tissues

Periodontitis is an inflammatory disease that causes loss of the tooth-supporting apparatus, including periodontal ligament, cementum, and alveolar bone. A broad range of treatment options is currently available to restore the structure and function of the periodontal tissues. A regenerative approach, among others, is now considered the most promising paradigm for this purpose, harnessing the unique properties of stem cells. How to make full use of the body's innate regenerative capacity is thus a key issue. While stem cells and bioactive factors are essential components in the regenerative processes, matrices play pivotal roles in recapitulating stem cell functions and potentiating therapeutic actions of bioactive molecules. Moreover, the positions of appropriate bioactive matrices relative to the injury site may stimulate the innate regenerative stem cell populations, removing the need to deliver cells that have been manipulated outside of the body. In this topical review, we update views on advanced designs of biomatrices-including mimicking of the native extracellular matrix, providing mechanical stimulation, activating cell-driven matrices, and delivering bioactive factors in a controllable manner-which are ultimately useful for the regenerative therapy of periodontal tissues.

Relevance of hepatoduodenal ligament lymph nodes in resectional surgery for gastric cancer

BACKGROUND

Hepatoduodenal lymph node (HDLN) positivity is considered distant metastasis in gastric cancer according to the seventh American Joint Committee on Cancer (AJCC) classification. In contrast, the International Union Against Cancer seventh edition and the Japanese Gastric Cancer Association both consider HDLN as a regional lymph node that can be included in the context of a curative resection. The purpose of this study was to determine whether there was justification for considering HDLN involvement as a distant metastasis for which resectional surgery could not have survival benefit.

METHODS

This study enrolled consecutive patients with gastric cancer having D2 or greater resections, with removal and pathological assessment of the HDLN, between 1989 and 2009. The pathological stage of all patients was determined based on the seventh AJCC criteria, with HDLN included as a regional lymph node.

RESULTS

A total of 1872 patients had their HDLN removed, of whom 68 had a metastatic lymph node in the hepatoduodenal ligament. The 5-year survival rate of these 68 patients was 30 per cent, compared with 47·7 per cent for those with stage III (P < 0·001) and 9·8 per cent for those with stage IV (P = 0·007) HDLN-negative tumours. The 5-year survival rate of 41 patients with HDLN metastasis and no evidence of distant metastasis at any other site was significantly higher than that among 120 patients with stage IV disease without HDLN metastasis (P < 0·001), whereas 5-year survival did not differ between the 41 patients with stage I-III disease with HDLN metastasis and 568 patients with stage III tumours without HDLN metastasis (P = 0·184). HDLN metastasis was not a significant factor for survival in multivariable analysis.

CONCLUSION

It is inappropriate to include the HDLN in the distant metastatic lymph node group in gastric cancer. The seventh AJCC criteria for node grouping should be revised.

Vestibular effects of lidocaine intratympanic injection in rats

When lidocaine is locally delivered into the inner ear, it rapidly paralyzes the peripheral vestibular afferent neurons and induces unilateral vestibular loss. The goals of this study were to explore the possibility of developing intratympanic injection (IT) of lidocaine as a modality for treating acute vertigo. To evaluate the minimum concentration required, latent time, action duration, and possibility of lidocaine IT readministration to the vestibular system, we compared the development of horizontal nystagmus after IT of 2, 4, 6, 8, and 10% lidocaine solutions in rats. To identify the induction of vestibular compensation, c-Fos-like protein expression was observed in the vestibular nucleus. Results of our investigation showed that lidocaine IT concentrations greater than 4% induced vestibular hyporeflexia in the injected ear. In order to induce hyporeflexia 4 and 6% lidocaine solutions could also be repeatedly injected. Regardless of concentration, effects of the lidocaine IT dissipated gradually over time. Our findings could be used to develop novel methods for symptom control in vestibular disorder patients.

The routine value of anogenital distance as an anthropometric measurement in newborns

OBJECTIVE

Anogenital distance (AGD) is a sexually dimorphic trait; AGD is an external marker of sexual differentiation at birth in animals.

STUDY DESIGN

The present study used a prospective, cross-sectional design. Data were collected from newborn infants that were delivered at hospital in Bucheon between March and September 2009. The mothers of the infants provided sociodemographic information and obstetric history. The relationships between AGD and other anthropometric measures (i.e., weight, height, and head circumference) were analyzed. Moreover adjusted AGD values were compared with obstetric characteristics, including number of deliveries, abortion history, preterm history, and duration of gestation.

RESULTS

Significant correlations were noted for all anthropometric measures in male and female newborns (p < 0.0001). The adjusted AGD values in males and females were also significantly associated with the duration of gestation (p = 0.0008 and p = 0.0148, respectively). Moreover, the adjusted AGD in female newborns, but not in males, was significantly associated with maternal abortion history (p = 0.0242).

CONCLUSION

The AGD is a valuable anthropometric marker in term infants.

Differences in omega-3 and fatty acid profiles between patients with endometriosis and those with a functional ovarian cyst

Endometriosis is a chronic inflammatory gynaecological disease. Problems associated with endometriosis include dysmenorrhoea, dyspareunia and infertility. We evaluated the omega-3 and fatty acid profiles in erythrocytes and tissues in patients with endometriosis (n = 10) or a functional ovarian cyst (n = 12), using a food frequency questionnaire that included questions about 117 food items typical of Korean meals. Erythrocyte levels of 20:5n3 and 22:6n3, the omega-3 index, and n-3 PUFA were significantly higher, and the n-6:n-3 ratio was significantly lower in the endometriosis group than in the functional ovarian cyst group. The functional ovarian cyst group consumed significantly more fruit than the group with endometriosis.

Effects of electron-cyclotron-resonance-heating-induced internal kink mode on the toroidal rotation in the KSTAR Tokamak

It is observed that the magnitude of the toroidal rotation speed is reduced by the central electron cyclotron resonance heating (ECRH) regardless of the direction of the toroidal rotation. The magnetohydrodynamics activities generally appear with the rotation change due to ECRH. It is shown that the internal kink mode is induced by the central ECRH and breaks the toroidal symmetry. When the magnetohydrodynamics activities are present, the toroidal plasma viscosity is not negligible. The observed effects of ECRH on the toroidal plasma rotation are explained by the neoclassical toroidal viscosity in this Letter. It is found that the neoclassical toroidal viscosity torque caused by the internal kink mode damps the toroidal rotation.

Biochemical analysis of Hyphantria cunea NPV attachment to Spodoptera frugiperda 21 cells

Binding characteristics of Hyphantria cunea nuclear polyhedrosis virus (HcNPV) to Spodoptera frugiperda 21 (Sf21) cells was determined. The cells displayed an affinity of 0.9 x 10(10) M(-1) with about 8900 binding sites per cell. The biochemical nature of HcNPV-binding sites on the cell surface was also partially elucidated. There were 45 to 49% reductions in HcNPV binding following the pretreatment of cells with three proteases, suggesting the involvement of a cellular protein component in virus binding. Tunicamycin, which inhibits N-linked glycosylation and the expression of some membrane proteins on the cell surface, reduced virus binding suggesting a role for glycoprotein(s) in binding. Treatment of cells with wheat germ agglutinin or neuraminidase did not measurably reduce virus binding, indicating that oligosaccharides containing N-acetylglucosamine or sialic acid are not directly involved in HcNPV attachment. The negative effect of methylamine on HcNPV binding seems to be due to the fact that HcNPV entry via an endocytic pathway is blocked by the increased pH of the endosome. Data on energy inhibitors (sodium azide and dinitrophenol) indicates that HcNPV attachment to Sf21 cells may be closely linked to viral entry via receptor-mediated endocytosis. These findings suggest that the binding site moiety has a glycoprotein component, but that direct involvement of oligosacccharides containing N-acetylglucosamine or sialic acid residues in binding is unlikely, and that HcNPV attachment to Sf21 cells might be via receptor-mediated endocytosis.

Metastatic sarcomatoid carcinoma to liver and bone marrow in renal transplant recipient: due to exacerbation of quiescent renal cancer? A case report

Sarcomatoid carcinoma is a rare tumor with rapid growth and a poor prognosis. A 60-year-old man underwent kidney transplantation. Three months after transplantation, multiple tumors were found in the liver and bone, and the patient died several days later. Pathological examination of liver and bone marrow biopsies revealed metastatic sarcomatoid carcinoma. Pretransplantation, the patient's workup was positive only for mild thrombocytopenia and a complicated cyst with peripheral rim calcification (Bosniak IIF) in the right kidney. Retrospectively, we found the abdominal computed tomography film, which had been examined at another hospital 6 years previously. The calcified complicated cyst was a 3-cm enhancing solid mass in the right kidney, suggesting renal cell cancer. It is possible that the cancer developed from the calcified complicated cyst. In this case, immunosuppressants may have altered malignant cell proliferation, invasion, and the form of metastasis.