The epidemiology of total knee replacement in South Korea: national registry data

OBJECTIVE

Knee osteoarthritis (OA) is prevalent among the elderly in Asian countries; however, the utilization of total knee replacement (TKR) is unknown. Using data from a national registry, we sought to estimate the incidence of TKR by age and sex, and the trend for TKR utilization from 2002 to 2005 in South Korea.

METHODS

Reimbursement records from all hospitals in South Korea were extracted from the Health Insurance Review Agency (HIRA) database. Records with both the procedure code corresponding to a TKR and the diagnosis code of knee OA were selected. We estimated the age- and sex-specific rates of TKR. To compare the rate of TKR between men and women, we calculated age-standardized risk ratios. A TKR registry from a single centre containing more clinical information was analysed, and the differences in the clinical features between men and women were compared.

RESULTS

From 2002 to 2005, 47 961 TKRs were performed in subjects over the age of 40 yrs due to OA. The rate of TKR has increased over the 4 yrs and was much higher in women than in men. Compared with men, the age-standardized rate ratios for TKR in women ranged from 7.4 to 8.0. The single-centre registry data revealed that there was no difference in age, disease duration and the Kellgren-Lawrence grade at the time of surgery between men and women.

CONCLUSION

Using a national database, we found that the rate of TKR increased steadily from 2002 to 2005 in South Korea. The TKR rate in women was much higher than that in men. Risk factors that account for such disparity in TKR utilization need to be further investigated.

Discordant MRI/FDG-PET imaging for the diagnosis of borderline ovarian tumors

The objective of this study was to assess the role of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) for the characterization of ovarian masses that were diagnosed as ovarian malignancies by magnetic resonance imaging (MRI). We performed a retrospective review of eight patients with pathologically confirmed borderline ovarian tumors (BOT) who underwent MRI and FDG-PET before surgical staging from August 2005 to March 2007. We assessed the PET imaging of the BOT, measured the FDG uptake and quantified the findings as a standardized uptake value (SUV). The FDG-PET scans, of all eight patients, showed uptake of FDG with a mean SUV of less than 2.0 in the solid portion of the masses evaluated. We conclude that the MRI-PET differences may help differentiate borderline from malignant ovarian tumors.

Preparation and properties of electrophoretic microcapsules for electronic paper

This paper shows two types of microcapsules used for electrophoretic display. One is prepared by in-situ polymerization which is based on urea, melamine and formaldehyde and another by complex coacervation, which is composed of gelatin and gum Arabic. Microcapsules attract interests of many research groups for longer lifetime of electrophoretic display by reducing agglomerization or lateral movements of nanoparticles. The gelatin microcapsules were more attractive in providing more uniform microcapsule coverage on electrodes due to their flexibility as compared to the melamine-urea microcapsules. The properties of microcapsules were characterized by FTIR, OM, SEM and TGA. Migration of nanoparticles in the two types of microcapsules was also observed when an electric field was applied.

Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea

OBJECTIVES

The high incidence of invasive liver abscess caused by Klebsiella pneumoniae in Taiwan, contrasted with the rareness of this disease in Western countries, has aroused special interest. There have been few detailed reports from other Asian countries. To investigate a current epidemiology of K. pneumoniae liver abscess in Korea and to determine K serotype distribution in K. pneumoniae strains causing liver abscess, we performed a nationwide prospective study.

METHODS

Community-acquired, culture-proven liver abscess cases were enrolled between 2004 and 2005. Etiologies and clinical features were analyzed. K. pneumoniae isolates were serotyped according to K antigen. Meta-analysis was done to determine the time trend of the etiologies of liver abscess in Korea.

RESULTS

Out of 371 cases collected prospectively, 290 (78.2%) were caused by K. pneumoniae. Most K. pneumoniae liver abscesses were monomicrobial. Diabetes mellitus was the most common underlying disease (39.9%). Distant metastatic infections were frequently observed (8.7%). magA PCR revealed that 95 (59.4%) out of 160 K. pneumoniae isolates belonged to the K1 serotype.

CONCLUSIONS

Our study indicates that K. pneumoniae has emerged as a major etiologic agent of liver abscess in Korea, and these emerging infections seem to be attributable to invasive K. pneumoniae strains with capsular K1 serotype.

Effect of tacrolimus on the production of oxygen free radicals in hepatic mitochondria

OBJECTIVES

Cyclosporine (CsA) causes side effects that occur mainly in the kidney but also in the liver. Several reports have strongly suggested that the production of oxygen free radicals (OFRs) is a common mechanism of CsA toxicity. However, tacrolimus is believed to suppress the production of OFRs.

METHODS

We obtained the mitochondrial fraction with 96% purity from rat liver using a sucrose density gradient solution. Zero to 100 micromol/L tacrolimus was incubated with the mitochondrial fraction for 6 hours at 37 degrees C. OFRs were evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2,7-dichlorefluorescein using a VICTOR3 multilabel counter.

RESULTS

The fluorescence units for OFR production were increased as the time of exposure to tacrolimus passed from 1 to 6 hours. The fluorescence units in 0.1 micromol/L tacrolimus were 6.0 x 10(5) at 1 hour, 7.8 x 10(5) at 2 hours, 9.0 x 10(5) at 3 hours, 10.0 x 10(5) at 4 hours, 11.1 x 10(5) at 5 hours, and 11.4 x 10(5) at 6 hours. However, the fluorescence units were similar although the tacrolimus concentration increases from 0.1 to 100 micromol/L.

CONCLUSIONS

The results in this experiment suggested that tacrolimus induced the production of OFRs depending on the exposure time.

Apoptosis by cyclosporine in mesangial cells

INTRODUCTION

The immunosuppressive agent cyclosporine (CsA) is widely used to treat allograft rejection and various autoimmune disorders. A major limiting factor in the use of CsA is chronic nephrotoxicity. The pathogenesis of CsA-induced nephrotoxicity is not fully understood. Several recent studies have suggested that CsA treatment directly induces apoptosis in several cell types. The present study was undertaken to investigate the effects of CsA on apoptosis of cultured rat mesangial cells (RMCs).

METHODS

RMCs were treated with CsA at concentrations of 0.1 to 40 mumol/L. Cell viability was determined by MTT assay. Apoptotic protein expression was determined by Western blot analysis.

RESULTS

Cell viability was decreased with increasing concentrations of CsA in dose-dependent manner. CsA produced dose-dependent induction of p53, caspase-6, and Bax protein expression. CsA treatment caused proteolytic cleavage of caspase-3 and induced the degradation of 116-kDa PARP into 89-kDa fragment. RMCs with CsA reduced Bcl-2 and cIAP expression.

CONCLUSIONS

In this study, CsA induced apoptosis by up-regulating proapoptotic factors, caspase-3 and -6, p53, Bax, cleaving PARP, and down-regulating antiapoptotic factor, Bcl-2, and cIAP. These results suggested that the increased cell apoptosis exerted by CsA may be one of the mechanisms promoting CsA-induced nephrotoxicity.

Total antioxidant status and oxygen free radicals during hepatic regeneration

OBJECTIVES

The damage induced by oxygen free radicals (OFRs) is caused by an imbalance of the production of versus the antioxidant defenses against OFRs.

METHODS

To understand hepatic damage induced by oxygen free radicals after hepatectomy in rats, total antioxidant status and total production of oxygen free radicals were serially measured in regeneration liver. At 1, 2, 3, 7, and 10 days after hepatectomy of Sprague-Dawley rats, blood was obtained into a capillary tube from a tail vein. Total antioxidant status and total production of oxygen free radicals were measured using the Randox kit, a colorimetric method, and the Free Radical Analytical System. We also measured the amount of malonyldialdehyde, which provides an indirect index of oxidative injury.

RESULTS

The level of malonyldialdehyde after hepatectomy was higher compared with that before hepatectomy. The level of total oxygen free radicals after hepatectomy was higher compared with that before hepatectomy. Total antioxidant status after hepatectomy was lower compared with that before hepatectomy.

CONCLUSIONS

The results suggested that the damage by OFRs to the regenerating liver was caused by increased production of OFRs and decreased antioxidant defense against OFRs.

Effects of cyclosporine and tacrolimus on the oxidative stress in cultured mesangial cells

OBJECTIVES

Cyclosporine (CsA) and tacrolimus (Tac) are two primary immunosuppressive agents used for the prevention of graft rejection. However, their use is associated with significant side effects, most notably nephrotoxicity. The mechanisms of this toxicity are not fully understood, but they seem to be associated with increases in the production of oxygen free radicals (OFRs). This present work examined the effect of CsA and Tac on the production of OFRs in cultured rat renal mesangial cells (RMCs).

METHODS

Varying concentrations of CsA and Tac (0 to 40 micromol/L) were added to RMCs and incubated for 60 minutes at 37 degrees C. The production of OFRs was evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2', 7'-dichlorofluorescin.

RESULTS

At 60 minutes, the relative fluorescence units (RFU) for OFRs production in RMCs exposure to CsA were increased by 2.5%, 11.5%, 22.5%, 57.2%, and 174% at 2.5, 5, 10, 20, and 40 micromol/L, respectively. Tac increased the RFU by 15.9%, 13.6%, 14.8%, 13.2%, 21.4%, 13.2%, and 28.1% at 0.1, 1, 2.5, 5, 10, 20, and 40 micromol/L, respectively. In RMCs, the RFU produced by CsA was higher than that by Tac.

CONCLUSIONS

The results of this experiment suggest that CsA and Tac induced renal injury by OFRs.

Comment on "An enhanced polarization mechanism for the metal cations modified amorphous TiO2 based electrorheological materials" by Qing Wu, Bin Yuan Zhao, Chen Fang and Ke Ao Hu

Comments on a recent article on an enhanced polarization mechanism for the metal cations modified amorphous TiO2 based electrorheological materials are presented, based upon an examination of the yield stress, which is a function of electric-field strength, of the materials. Using the deduced critical electric-field strengths, we find that the universal yield stress equation proposed collapses the data given by Qing Wu, Bin Yuan Zhao, Chen Fang, Ke Ao Hu, Eur. Phys. J. E 17, 63 (2005), onto a single curve.

Multinucleation of koilocytes is actually multilobation

In order to clarify the complete cytomorphology of cytopathic changes as a consequence of human papillomavirus (HPV) infection, we performed three-dimensional (3D) reconstruction from confocal fluorescent images. After confirming 22 HPV types using a DNA chip, we performed 3D confocal image restoration in human uterine cervical swab samples and corresponding tumor tissues. On restoration of 3D confocal images, the multinucleated feature of koilocytes was revealed to be multilobation of a single nucleus, as opposed to true multinucleation.

Cyclosporine-Induced Apoptosis in Osteosarcoma Cells

INTRODUCTION

Posttransplant bone disease is one of the complications of cyclosporine (CsA), which is widely used as an immunosuppressive agent in the field of kidney transplantation. Cyclosporine treatment causes osteopenia as a result of altered bone turnover, but the pathogenic mechanisms of this process remain unclear. This study examined the ability of CsA to induce apoptosis in a rat osteoblast cell line.

RESULTS

We induced apoptosis in rat osteoblastic ROS 17/2.8 cells by exposure to CsA. MTT assay showed that CsA exhibited significant cytotoxic effects on ROS 17/2.8 cells in a dose-dependent manner. Western blot analysis showed enhanced processing of caspase-8, Bax, and p53 after CsA treatment. Expression of cleaved poly (ADP-ribose) polymerase (PARP) was elevated by CsA treatment. Pro-caspase-3 and Bcl-2 proteins were decreased by CsA.

CONCLUSIONS

These results suggested that CsA induced apoptosis of osteoblasts.

The effects of apigenin-7-O-beta-D-glucuronopyranoside on reflux oesophagitis and gastritis in rats

1. This study evaluated the inhibitory action of apigenin-7-O-beta-D-glucuronopyranoside (AGC), apigenin, and omeprazole on reflux oesophagitis and gastritis in rats. AGC was isolated from Clerodendron trichotomum leaves. 2. Oesophagitis and gastritis were induced by surgical procedure and the administration of indomethacin, respectively. The intraduodenal (i.d.) administration of AGC decreased the volume of gastric juice and increased the gastric pH compared with apigenin and omeprazole. The acid output was more inhibited by AGC in a dose-dependent manner than by apigenin and omeprazole. Compared with apigenin and omeprazole, AGC significantly decreased the size of gastric lesions, which were induced by exposure of the gastric mucosa to indomethacin. 3. Malondialdehyde (MDA) content, which is the end product of lipid peroxidation, was increased significantly after the induction of reflux oesophagitis. The MDA content was decreased by AGC (i.d. 3 mg kg(-1)), but not by either apigenin or omeprazole. This suggests that AGC has an antioxidative effect. In the oesophagitis group, the mucosal levels of glutathione (GSH) were significantly lower than that in the normal group. However, the GSH levels were preserved after administering the AGC, suggesting that AGC possesses scavenging activity. 4. In summary, AGC is more potent than apigenin and omeprazole at inhibiting reflux oesophagitis and gastritis and may therefore be a promising drug for their treatment.

Dielectrophoretic alignment of gallium nitride nanowires (GaN NWs) for use in device applications

We report on a simple and effective ac and dc dielectrophoresis (DEP) method that can be used to align and manipulate semiconductor gallium nitride (GaN) nanowires (NWs) with variations in the type of electrical fields as well as variations of frequency. We observed that the ability of the alignment and the formation of the assembling nanowires (single or a bundle configuration) strongly depend on the magnitude of both the ac and dc electric fields. The yield results indicate that the GaN NWs, using ac DEP, are better aligned with a higher yield rate of approximately 80% over the entire array in the chip than by using dc DEP. In addition, we first demonstrated the simple hybrid p-n junction structures assembled by n-type GaN nanowires together with a p-type silicon substrate (n-GaN NW/p-Si substrate) using dielectrophoresis. From the transport measurements, the p-n junction structures show well-defined current rectifying behaviour with a low reverse leakage current of approximately 3 x 10(-4) A at -25 V. We believe that our unique p-n junction structures can be useful for electronic and optoelectronic nanodevices such as rectifiers and UV nano-LEDs.

Possible role of Fas/Fas ligand-mediated apoptosis in the pathogenesis of fixed drug eruption

BACKGROUND

Although epidermal and dermal T cells play roles in the pathogenesis of fixed drug eruption (FDE), not much is known about keratinocyte death and its precise mechanism in FDE.

OBJECTIVES

Our aim is to elucidate the mechanism that underlies keratinocyte death in FDE, that is, the role of apoptosis and its signalling pathway.

METHODS

We first examined the involvement of apoptosis in the active FDE lesions by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labelling (TUNEL) assay and immunohistochemical analysis of caspase-3. We then examined the expressions of Fas and Fas ligand (FasL) to deduce the possible upstream signalling pathway of apoptosis, if apoptosis were involved. We finally characterized the infiltrated T-cell subpopulations in the active FDE lesions.

RESULTS

In the active FDE lesions, TUNEL positivity was strongly observed in the basal keratinocytes, and also weakly observed in the upper dermal infiltrates as well as in a few keratinocytes in the granular layer. The distribution of TUNEL-positive cells was similar to that of the strong staining of active capase-3. Fas was found mainly in the keratinocytes and some infiltrated dermal cells, whereas FasL was identified predominantly in the intraepidermal and dermal infiltrated cells and in some basal keratinocytes. Overlapping expression of Fas and FasL was accompanied by apoptosis in the FDE lesions. Many of the infiltrated mononuclear cells were CD8+. Perforin was rarely observed in the FDE lesions.

CONCLUSIONS

These findings suggest that apoptosis of the keratinocyte is highly likely to be involved in the pathogenesis of FDE, and this cytotoxicity might be predominantly mediated by the FasL of the infiltrating CD8+ T cells, possibly also playing an inflammatory role.

Changes of serum cytokine profiles in Korean vivax malarial patients after chemotherapy

Changes of serum cytokines including interferon gamma inducible protein-10 (IP-10) chemokine were analyzed in a total of eight vivax malarial patients before and after chemotherapy by immunostaining for human cytokine antibodies attached to membranes. IP-10 was strongly reactive in the period before chloroquine/primaquine combined chemotherapy and disappeared after chemotherapy in all patients. Therefore, IP-10 chemokine may be of importance in the pathogenesis of vivax malaria and a good marker of a complete cure.

Comparison of two commercial interferon- assays for diagnosing Mycobacterium tuberculosis infection

The clinical usefulness of ex vivo interferon-gamma assays may largely depend on the assay format and epidemiological status of tuberculosis (TB) in the region studied. From July 2004 to June 2005 a prospective comparison study was undertaken at a tertiary referral hospital in South Korea. The results of tuberculin skin tests (TST) and the commercially available QuantiFERON-TB Gold (QFT-G) and T SPOT-TB (SPOT) assays were compared in an intermediate TB-burden country. Of the 224 participants studied, results from all three tests (TST, QFT-G, and SPOT) were available in 218; 87 with active TB and 131 at a low risk for TB. Using 10 mm as a cut-off for TST, SPOT sensitivity (96.6%) was significantly higher than that seen for TST (66.7%) and QFT-G (70.1%). QFT-G showed superior specificity over TST (91.6 versus 78.6%). Although the specificity of QFT-G was higher than that of SPOT (91.6 versus 84.7%), the difference was not statistically significant. Whilst some differences were found in the performance of the two commercialised interferon-gamma assays, they seemed to be superior in their detection of Mycobacterium tuberculosis infection compared with tuberculin skin tests. The most appropriate choice of interferon-gamma assay to use may depend on the clinical setting.

Comment on “Preparation and electrorheological property of rare earth modified amorphous BaxSr1−xTiO3 gel electrorheological fluid”

The comments on the recent results on electrorheological (ER) property of rare earth modified amorphous barium strontium titanate gel based ER fluid are given via analysis of its dynamic yield stress data as a function of applied electric field strengths. Using our previously reported universal yield stress equation, we obtained the critical electric field strength and collapsed their data onto a single curve.

Multinucleation of koilocytes is in fact multilobation and is related to aberration of the G2 checkpoint

AIMS

To clarify the fine structure of koilocytes and correlate this with genetic aberration of the G2 checkpoint.

METHODS

Three dimensional reconstruction from confocal fluorescent images, together with functional assays for key molecules of the G2 checkpoint-cdc2 and cyclin B1-was performed in human uterine cervical samples. After confirming 22 human papillomavirus (HPV) types using a DNA chip from 30 cervical swabs, previously confirmed as 15 cervical low grade and 15 high grade intraepithelial lesions, the activity of molecules involved in the G2 checkpoint was evaluated using western blotting for cyclin B1, cdc2, and phospho-cdc2 (Y15 and T161), a nuclear extraction fractional assay, and a reverse transcription polymerase chain reaction assay. In addition, three dimensional confocal image restoration was performed on confirmed cervical intraepithelial neoplasia tissue samples.

RESULTS

T161 phospho-cdc2 and cyclin B1 expression was higher in HPV infected cervical lesions than in normal samples. Immunofluorescence, revealed that cyclin B1 was present predominantly in the nuclei of HPV infected cells, confirming the results of the nuclear fractional assay. On restoration of three dimensional confocal images, the multinucleation of koilocytes was revealed to be multilobation of a single nucleus, rather than true multinucleation. This multilobation appeared to be associated with chromosomal instability and aberration of the G2 checkpoint.

CONCLUSIONS

The multiple nuclei of koilocytes are in fact multilobation of a single nucleus, and this phenomenon is associated with upregulation of gene products related to the G2 checkpoint.

Phosphorylation of Potato Starch and Its Electrorheological Suspension

Highly substituted potato starch phosphate (HPSP) particles were synthesized via an esterification process of potato starch with a mixture of several different concentrations of disodium hydrogen phosphate and sodium hydrogen phosphate. These particles were characterized via thermogravimetric analysis, scanning electron microscope, and inductively coupled plasma mass spectrometer. The electrorheological (ER) fluid was prepared by dispersing these HPSP particles in nonconducting silicone oil, and their ER properties were investigated. The HPSP particle-based ER fluid exhibited typical ER responses with a nonzero yield stress under an applied electric field. We examined the yield stresses for the potato starch-based anhydrous ER system by varying the degree of phosphate substitution and found that the higher polarization induced by the external electric field strength resulted in the higher values of yield stresses and shear stresses.

Plant uptake and downward migration of 85Sr and 137Cs after their deposition on to flooded rice fields: lysimeter experiments with and without the addition of KCl and lime

In order to study the plant uptake and downward migration of radiostrontium and radiocesium deposited on to a flooded rice field, 85Sr and 137Cs were applied to the standing water over an acidic sandy soil in planted lysimeters. The plant uptake was quantified with the areal transfer factor (TFa, m2 kg(-1)-dry plant). Following the spiking 14 days after transplanting, the TFa values for the hulled seeds were 3.9 x 10(-4) for 85Sr and 1.4 x 10(-4) for 137Cs, whereas those for the straws were 1.3 x 10(-2) and 3.2 x 10(-4), respectively. The 137Cs TFa from the spiking at the anthesis/milky-ripe stage was several times higher than that from the earlier spiking, whereas the difference was much less in the 85Sr TFa. Such an increase in the 137Cs TFa was attributed mainly to an enhanced plant-base uptake. The addition of KCl and lime after the spiking significantly reduced the TFa values of both radionuclides. The reducing effect was greater for the later spiking. An appreciable fraction of the applied activity leached out of the lysimeter for 85Sr, whereas a negligible fraction leached for 137Cs. The leaching was remarkably increased by the KCl and lime addition for both. A conspicuous localization of 137Cs with respect to the soil surface was observed. In a batch experiment, the 137Cs concentration in the standing water decreased more rapidly than that of 85Sr, both of which were fitted to the power functions of the elapsed time. To add KCl and lime slowed such decreases to lessen the distribution coefficients (Kd) of both 85Sr and 137Cs.

Orientation-dependent C60 electronic structures revealed by photoemission spectroscopy

We observe, with angle-resolved photoemission, a dramatic change in the electronic structure of two C60 monolayers, deposited, respectively, on Ag (111) and (100) substrates, and similarly doped with potassium to half filling of the C60 lowest unoccupied molecular orbital. The Fermi surface symmetry, the bandwidth, and the curvature of the dispersion at Gamma point are different. Orientations of the C60 molecules on the two substrates are known to be the main structural difference between the two monolayers, and we present new band-structure calculations for some of these orientations. We conclude that orientations play a key role in the electronic structure of fullerides.