Dynamic Fixation versus Static Screw Fixation for Syndesmosis Injuries in Pronation External Rotation Ankle Fractures: A Retrospective Case Control Study

Introduction

The current standard treatment for ankle syndesmosis injury is static screw fixation. Dynamic fixation was developed to restore the dynamic function of the syndesmosis. The purpose of this study was to determine that which of static screw fixation and dynamic fixation is better for treatment of ankle syndesmosis injury in pronation-external rotation fractures.

Materials and methods

Thirty patients were treated with dynamic fixation (DF group) and 28 patients with static screw fixation (SF group). The primary outcome was Olerud-Molander Ankle Outcome Score. The secondary outcome were Visual Analogue Scale score and American Orthopedic Foot and Ankle Society score, radiographic outcomes, complications and cost effectiveness. To evaluate the radiographic outcome, the tibiofibular clear space, tibiofibular overlap, and medial clear space were compared using the pre-operative and last follow-up plain radiographs. To evaluate the cost effectiveness, the total hospital cost was compared between the two groups.

Results

There was no significant difference in primary outcome. Moreover, there were no significant difference in secondary outcome including Visual Analogue Scale score and American Orthopedic Foot and Ankle Society score and radiographic outcome. Two cases of reduction loss and four cases of screw breakage were observed in the SF group. No complication in the DF group was observed. Dynamic fixation was more cost effective than static screw fixation with respect to the total hospital cost.

Conclusion

Although dynamic fixation provided similar clinical and radiologic outcome, dynamic fixation is more cost effective with fewer complications than static screw fixation in ankle syndesmosis injury of pronation-external rotation fractures.

Life satisfaction of multicultural married couples: Actor-Partner Interdependence Model analysis

We aimed to identify the actor and partner effects of health status, relationship satisfaction, and depression on the life satisfaction of married immigrant women and their husbands in South Korea. We used a cross-sectional design that included 2865 multicultural married couples with data from the 2015 national survey of multicultural families in Korea. We analyzed the data using path analyses within the Actor-Partner Interdependence Model (APIM) framework. Health status, depression, and relationship satisfaction had actor effects in both wives and husbands, while depression had no partner effects on either. Health status had partner effects only for wives, and relationship satisfaction had partner effects for both husbands and wives. Given that factors influencing life satisfaction differed in couples and since those with depression and poor health were more susceptible to lower life satisfaction, it is essential to introduce efforts to prevent depression and improve relationships considering differences of partner effects.

The association between occupational stress level and health-related productivity loss among Korean employees

OBJECTIVES

Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers' health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers.

METHODS

In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions.

RESULTS

Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress.

CONCLUSIONS

Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.

Nanomaterials for microplastic remediation from aquatic environment: Why nano matters?

The contamination of microplastics in aquatic environment is regarded as a serious threat to ecosystem especially to aquatic environment. Microplastic pollution associated problems including their bioaccumulation and ecological risks have become a major concern of the public and scientific community. The removal of microplastics from their discharge points is an effective way to mitigate the adverse effects of microplastic pollution, hence has been the central of the research in this realm. Presently, most of the commonly used water or wastewater treatment technologies are capable of removing microplastic to certain extent, although they are not intentionally installed for this reason. Nevertheless, recognizing the adverse effects posed by microplastic pollution, more efforts are still desired to enhance the current microplastic removal technologies. With their structural multifunctionalities and flexibility, nanomaterials have been increasingly used for water and wastewater treatment to improve the treatment efficiency. Particularly, the unique features of nanomaterials have been harnessed in synthesizing high performance adsorbent and photocatalyst for microplastic removal from aqueous environment. This review looks into the potentials of nanomaterials in offering constructive solutions to resolve the bottlenecks and enhance the efficiencies of the existing materials used for microplastic removal. The current efforts and research direction of which studies can dedicate to improve microplastic removal from water environment with the augmentation of nanomaterial-enabled strategies are discussed. The progresses made to date have witnessed the benefits of harnessing the structural and dimensional advantages of nanomaterials to enhance the efficiency of existing microplastic treatment processes to achieve a more sustainable microplastic cleanup.

Effect of Ni content in PdNi/C anode catalysts on power and methanol co-generation in alkaline direct methane fuel cell type

PdNi electrocatalysts supported on carbon were used as anode materials for methane oxidation in alkaline direct methane fuel cells (ADMEFCs). The electrocatalysts were successfully synthesized by the NaBH₄ reduction method. X-ray diffraction measurements showed the formation of non-alloyed Pd in the face- centered cubic (FCC) structure for all materials and formation of NiO and Ni(OH)₂ species. TEM images showed that the metal particles are well dispersed on the support with small agglomeration regions. Information about the surface structure of the catalyst were obtained by Raman spectra, mainly confirming the presence of Ni(OH)₂. The species observed by DEMS, that is, methanol (m/z = 32), CO₂ (m/z = 44) and potassium formate (m/z = 84) were confirmed by FTIR, which also showed the presence of a high amount of carbonate in the methane oxidation products of the ADMEFC with Pd₅₀Ni₅₀/C as the anode catalyst. Tests in ADMEFCs showed that the dependence of the maximum power density on nickel content in the catalysts goes through a maximum value of 13.5 μW cm^-2 at 50 at% Ni. Moreover, the amount of produced methanol decreases with increasing Ni content in the PdNi/C catalysts. Both these results can be explained by the enhanced methanol oxidation in the presence of nickel.

Effects of acute lipopolysaccharide-induced toxemia model on some neglected blood parameters

The presence of lipopolysaccharide (LPS) in blood induces an inflammatory response which leads to multiple organ dysfunction and numerous metabolic disorders. Uncontrolled, improper or late intervention may lead to tissue hypoxia, anaerobic glycolysis and a disturbance in the acid -base balance. The effects of LPS-induced toxemia on biological and immunological markers were well studied. However, parameters such as base excess, ions, and acid-base balance were not fully investigated. Therefore, the objective of this study was to examine these blood parameters collectively in LPS-induced inflammatory toxemia in rat's model. After induction of toxemia by injecting LPS at a rate of 5 mg/kg body weight intravenously, blood was collected from the tail vein of twenty rats and immediately analyzed. After 24 hours, the animals were sacrificed and the blood was collected from the caudal vena cava. The results revealed that the levels of pH, bicar- bonate, partial pressure of oxygen, oxygen saturation, Alveolar oxygen, hemoglobin, hematocrit, magnesium (Mg2+), and calcium (Ca2+) were significantly decreased. On the other side, the levels of Base excess blood, Base excess extracellular fluid, partial pressure of carbon dioxide, lactate, Ca2+/Mg2+, potassium, and chloride were significantly increased compared to those found pre toxemia induction. However, sodium level showed no significant change. In conclusion, Acute LPS-toxemia model disturbs acid-base balance, blood gases, and ions. These parameters can be used to monitor human and animal toxemic inflammatory response induced by bacterial LPS conditions to assist in the management of the diagnosed cases.

MRI analysis of extra-capsular ganglia at the gastrocnemius origin and their association with osteoarthritis

AIM

To evaluate the prevalence, clinical relevance, and magnetic resonance imaging (MRI) features of extra-capsular ganglia at the gastrocnemius origin and to assess their association with internal derangement and osteoarthritis of the knee.

MATERIALS AND METHODS

One hundred consecutive knee MRI examinations, obtained within a 6-month period from patients with no history of recent knee trauma, recent injections, inflammatory arthritis, infection, or tumours, were evaluated retrospectively for the presence of ganglia at the gastrocnemius origin. The lesions were divided into two groups: an intra-capsular and an extra-capsular group. Cyst morphology (size, shape, and internal septa), internal derangement of the knee (cartilage lesion, cruciate ligament injury, meniscal tear, and corner injury on MRI, and osteoarthritis of the knee on radiographs) were evaluated. The chi-square, Fisher's exact, and t-tests were used to compare the two groups, in addition to multivariate stepwise logistic regression analysis.

RESULTS

Thirty-nine ganglia with an extra-capsular location were identified on 100 knee MRI (39 %). Rounded shape and internal septa were more common in the extra-capsular than in the intra-capsular group (p<0.001). Frequencies of high-grade cartilage, meniscal tear, and high-grade osteoarthritis significantly differed between the groups (p≤0.038). In multivariate analysis, the only significant association was between high-grade osteoarthritis and the extra-capsular group.

CONCLUSION

Extra-capsular ganglia at the gastrocnemius origin were not uncommon on knee MRI and had features typical of ganglia found at other sites. High-grade osteoarthritis was significantly associated with extra-capsular ganglia.

MRI Features of Aquaporin-4 Antibody-Positive Longitudinally Extensive Transverse Myelitis: Insights into the Diagnosis of Neuromyelitis Optica Spectrum Disorders

BACKGROUND AND PURPOSE

Longitudinally extensive transverse myelitis is a well-documented spinal manifestation of neuromyelitis optica spectrum disorders, however, other forms of nontumorous myelopathy can also manifest as longitudinally extensive transverse myelitis. Our aim was to evaluate the MR imaging features of aquaporin-4 antibody-positive longitudinally extensive transverse myelitis, which is strongly associated with neuromyelitis optica spectrum disorders.

MATERIALS AND METHODS

We evaluated cervicomedullary junction involvement, cord expansion ratios, bright spotty lesions, the number of involved segments, skipped lesions, enhancement patterns, and axial distribution patterns using spinal MR imaging of 41 patients with longitudinally extensive transverse myelitis who underwent aquaporin-4 antibody testing. Univariate logistic regression analysis was performed to identify factors associated with aquaporin-4 antibody seropositivity, which were then used to develop a scoring system for diagnosing aquaporin-4 antibody-positive longitudinally extensive transverse myelitis. Interrater reliability for cord expansion ratio measurement and bright spotty lesions was determined using intraclass correlation coefficients and κ values, respectively.

RESULTS

Fifteen patients with longitudinally extensive transverse myelitis were aquaporin-4 antibody-positive. Sex (female), cervicomedullary junction involvement, a cord expansion ratio of >1.4, and bright spotty lesions were significantly associated with aquaporin-4 antibody seropositivity. The sensitivity and specificity of the scoring system were 73.3% and 96.2%, respectively. The interclass correlation value for the cord expansion ratio was 0.78, and the κ value for bright spotty lesions was 0.61.

CONCLUSIONS

Our scoring system, based on cervicomedullary junction involvement, higher cord expansion ratio, bright spotty lesions, and female sex, can facilitate the timely diagnosis of neuromyelitis optica spectrum disorders.

Evaluation of treatment pattern and symptom control in patients with gastroesophageal reflux disease: multihospital questionnaire survey on the current situation in Korea

Proton pump inhibitors (PPIs) are the most effective treatment for gastroesophageal reflux disease (GERD); however, a considerable number of patients fail to respond to PPI therapy and complain of nocturnal heartburn and sleep disturbance. The aims of this study are to evaluate the treatment pattern of GERD-related medications and their efficacy in relieving nocturnal heartburn. A total of 334 patients with GERD receiving PPI therapy within 6 months were enrolled in a multihospital questionnaire survey from January, 2014 to March, 2015. GERD symptoms and patients' satisfaction were assessed by patient questionnaires, and treatment patterns of GERD-related medications were assessed by investigators. Among the 334 patients, 95.8% used PPI once daily and 58.6% used a half-dose of PPI. The PPI treatment pattern was changed in 26.6% of all patients, of those, 54% of the patients doubled the PPI dose, and 29.2% of the patients switched to another PPI. Approximately 60.3% of all patients were prescribed more than three GERD-related medications. The overall satisfaction rate was 61.8%, and 32.2% of patients experienced nocturnal heartburn and sleep disturbance. In the extended-release PPI group, there were fewer nocturnal symptoms compared with the conventional PPI group (10% vs. 33.7%, respectively, P = 0.027). The use of more than three medications was inversely associated with patients' satisfaction (OR = 0.355, 95% CI; 0.197-0.642, P = 0.001). Most patients were prescribed adjunctive medications other than PPIs; however, patients' satisfaction was inversely associated with multiple drugs. Patients' satisfaction was superior in extended-release PPIs than conventional PPIs for the relief of nocturnal heartburn in Korean patients.

Assessment of neurotoxicity of pharmacological compounds during early neural development of human embryonic stem cells

Human embryonic stem cells (hESCs), with the potential for differentiation, have been used to evaluate the embryotoxicity of various compounds. The effects of pharmacological compounds (cytosine arabinoside, 5-fluorouracil, hydroxyurea, indomethacin, and dexamethasone) on neurogenesis of hESCs over 28 days were examined based on cytotoxicity (half-maximal inhibitory concentration of viability, IC₅₀) and expression of neural markers. Cytosine arabinoside, 5-fluorouracil, and hydroxyurea showed strong cytotoxicity (IC₅₀ < 10 μM), whereas indomethacin and dexamethasone had weaker cytotoxic effects. Dose-dependent expression profiles of neural markers in the compound-treated groups are presented in triangular charts to allow comparison with the standard expression levels in the control group. Differences in compound-specific reductions in expression patterns of GAD1, OLIG2, FABP, and NES were similar to the differences in cytotoxic strength. Cytosine arabinoside diminished nestin and β3-tubulin in neural differentiated hESCs. The results of this study extend the understanding of how differentiated hESCs may be useful for assessment of cell viability or neurogenesis impairment by chemicals that could have effects during the embryonic stage, particularly during neurogenesis.

Prophylactic Antiplatelet Medication in Endovascular Treatment of Intracranial Aneurysms: Low-Dose Prasugrel versus Clopidogrel

BACKGROUND AND PURPOSE

Prophylactic antiplatelet medication is beneficial in decreasing thromboembolic complications during endovascular treatment of unruptured intracranial aneurysms. The efficacy may be limited by variability of individual response to antiplatelet medication, especially clopidogrel. We compared the efficacy of 2 antiplatelet medications, low-dose prasugrel and clopidogrel, in patients undergoing endovascular treatment of unruptured aneurysms.

MATERIALS AND METHODS

From November 2014 to July 2015, 194 patients with a total of 222 unruptured aneurysms underwent endovascular treatment at a single institution. Laboratory and clinical data from the prospectively maintained registry were used in this study. Antiplatelet medication was given the day before endovascular treatment (prasugrel 20 mg or 30 mg or clopidogrel 300 mg). Response to the antiplatelet medication was measured by the VerifyNow system. Periprocedural adverse event rates between the 2 groups were compared.

RESULTS

There were no significant differences in the baseline characteristics of patients and aneurysms between the 2 groups. The P2Y12 reaction unit values were lower (clopidogrel group versus prasugrel group, 242.7 ± 69.8 vs 125.7 ± 79.4; P < .0001) and percentage inhibition values were higher (22.1% ± 19.7% vs 60.2 ± 24.7%; P < .0001) in the prasugrel group. There were no thromboembolic events, but there was 1 procedural bleed in each group, without any clinical consequences.

CONCLUSIONS

The prasugrel group showed more effective and consistent platelet inhibition. We may omit the antiplatelet response assay with the low-dose prasugrel premedication before the endovascular treatment of patients with unruptured aneurysms. Further study is required to determine whether there is benefit of this strategy regarding clinical outcome.

In-situ Hybridization for the Detection of Sacbrood Virus in Infected Larvae of the Honey Bee (Apis cerana)

The aim of this study was to develop and use in-situ hybridization (ISH) for the detection and localization of the sacbrood virus (SBV) in Korean honey bee (Apis cerana) larvae that were infected naturally with SBV. A 258 base pair cDNA probe for SBV was generated by polymerase chain reaction. Cells positive for viral genome typically showed a dark brown reaction in the cytoplasm. SBV was detected consistently in trophocytes and urocytes. The ISH was successfully applied to routinely fixed and processed tissues and thus should prove helpful in the diagnosis and characterization of viral distribution in infected larvae.

Optimization of Swine Breeding Programs Using Genomic Selection with ZPLAN

The objective of this study was to evaluate the present conventional selection program of a swine nucleus farm and compare it with a new selection strategy employing genomic enhanced breeding value (GEBV) as the selection criteria. The ZPLAN+ software was employed to calculate and compare the genetic gain, total cost, return and profit of each selection strategy. The first strategy reflected the current conventional breeding program, which was a progeny test system (CS). The second strategy was a selection scheme based strictly on genomic information (GS1). The third scenario was the same as GS1, but the selection by GEBV was further supplemented by the performance test (GS2). The last scenario was a mixture of genomic information and progeny tests (GS3). The results showed that the accuracy of the selection index of young boars of GS1 was 26% higher than that of CS. On the other hand, both GS2 and GS3 gave 31% higher accuracy than CS for young boars. The annual monetary genetic gain of GS1, GS2 and GS3 was 10%, 12%, and 11% higher, respectively, than that of CS. As expected, the discounted costs of genomic selection strategies were higher than those of CS. The costs of GS1, GS2 and GS3 were 35%, 73%, and 89% higher than those of CS, respectively, assuming a genotyping cost of $120. As a result, the discounted profit per animal of GS1 and GS2 was 8% and 2% higher, respectively, than that of CS while GS3 was 6% lower. Comparison among genomic breeding scenarios revealed that GS1 was more profitable than GS2 and GS3. The genomic selection schemes, especially GS1 and GS2, were clearly superior to the conventional scheme in terms of monetary genetic gain and profit.

Poor physical fitness is independently associated with mild cognitive impairment in elderly Koreans

The purpose of this study was to investigate the association between physical fitness and mild cognitive impairment (MCI) in elderly Koreans. This was a cross-sectional study that involved 134 men and 299 women aged 65 to 88 years. Six senior fitness tests were used as independent variables: 30 s chair stand for lower body strength, arm curl for upper body strength, chair-sit-and-reach for lower body flexibility, back scratch for upper body flexibility, 8-ft up-and-go for agility/dynamic balance, and 2-min walk for aerobic endurance. Global cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). Potential covariates such as age, education levels, blood lipids, and insulin resistance (IR) markers were also assessed. Compared to individuals without MMSE-based MCI, individuals with MMSE-based MCI had poor physical fitness based on the senior fitness test (SFT). There were significant positive trends observed for education level (p=0.001) and MMSE score (p<0.001) across incremental levels of physical fitness in this study population. Individuals with moderate (OR=0.341, p=0.006) and high (OR=0.271, p=0.007) physical fitness based on a composite score of the SFT measures were less likely to have MMSE-based MCI than individuals with low physical fitness (referent, OR=1). The strength of the association between moderate (OR=0.377, p=0.038) or high (OR=0.282, p=0.050) physical fitness and MMSE-based MCI was somewhat attenuated but remained statistically significant even after adjustment for the measured compounding factors. We found that poor physical fitness was independently associated with MMSE-based MCI in elderly Koreans.

Calpain activation by ROS mediates human ether-a-go-go-related gene protein degradation by intermittent hypoxia

Human ether-a-go-go-related gene (hERG) channels conduct delayed rectifier K(+) current. However, little information is available on physiological situations affecting hERG channel protein and function. In the present study we examined the effects of intermittent hypoxia (IH), which is a hallmark manifestation of sleep apnea, on hERG channel protein and function. Experiments were performed on SH-SY5Y neuroblastoma cells, which express hERG protein. Cells were exposed to IH consisting of alternating cycles of 30 s of hypoxia (1.5% O2) and 5 min of 20% O2. IH decreased hERG protein expression in a stimulus-dependent manner. A similar reduction in hERG protein was also seen in adrenal medullary chromaffin cells from IH-exposed neonatal rats. The decreased hERG protein was associated with attenuated hERG K(+) current. IH-evoked hERG protein degradation was not due to reduced transcription or increased proteosome/lysomal degradation. Rather it was mediated by calcium-activated calpain proteases. Both COOH- and NH2-terminal sequences of the hERG protein were the targets of calpain-dependent degradation. IH increased reactive oxygen species (ROS) levels, intracellular Ca(2+) concentration ([Ca(2+)]i), calpain enzyme activity, and hERG protein degradation, and all these effects were prevented by manganese-(111)-tetrakis-(1-methyl-4-pyridyl)-porphyrin pentachloride, a membrane-permeable ROS scavenger. These results demonstrate that activation of calpains by ROS-dependent elevation of [Ca(2+)]i mediates hERG protein degradation by IH.

Narrative therapy with an emotional approach for people with depression: Improved symptom and cognitive-emotional outcomes

ACCESSIBLE SUMMARY

Narrative therapy is a useful approach in the treatment of depression that allows that person to 're-author' his/her life stories by focusing on positive interpretations, and such focus on positive emotions is a crucial component of treatment for depression. This paper evaluates narrative therapy with an emotional approach (NTEA) as a therapeutic modality that could be used by nurses for persons with depression. A nurse-administered NTEA intervention for people with depression appears effective in increasing cognitive-emotional outcomes, such as hope, positive emotions and decreasing symptoms of depression. Thus, NTEA can be a useful nursing intervention strategy for people with depression.

ABSTRACT

Narrative therapy, which allows a person to 're-author' his/her life stories by focusing on positive interpretations, and emotion-focused therapy, which enables the person to realize his/her emotions, are useful approaches in the treatment of depression. Narrative therapy with an emotional approach (NTEA) aims to create new positive life narratives that focus on alternative stories instead of negative stories. The purpose of this study was to evaluate the effects of the NTEA programme on people with depression utilizing a quasi-experimental design. A total of 50 patients (experimental 24, control 26) participated in the study. The experimental group completed eight sessions of the NTEA programme. The effects of the programme were measured using a self-awareness scale, the Nowotny Hope Scale, the Positive Affect and Negative Affect Scale, and the Center for Epidemiological Studies-Depression Scale. The two groups were homogeneous. There were significant differences in hope, positive and negative emotions, and depression between the experimental and control group. The results established that NTEA can be a useful nursing intervention strategy for people with depression by focusing on positive experiences and by helping depressed patients develop a positive identity through authoring affirmative life stories.

Estimation of Genetic Parameters for Pork Belly Components in Yorkshire Pigs

This study was conducted to estimate the genetic parameters for pork belly traits and muscles in Yorkshire pigs. Each pork belly was cut into nine parts perpendicular to the thoracic vertebrae (6th to 14th). Traits of belly muscles including the deep pectoral, latissimus dorsi, cutaneous trunci, rectus abdominis, external and internal abdominal oblique from 382 purebred pigs were recorded and analyzed using SAS Package (9.1) and Derivative-free restricted maximum likelihood methods. Heritability estimates for belly traits ranged from 0.27 to 0.49, while they were 0.12 to 0.66 for belly muscles. Moderate to high heritability estimates were noted in belly weight (0.33), belly length (0.28), and belly width (0.49). In belly muscles, the latissimus dorsi and deep pectoral, which are located only in the 6th to 9th vertebrae sections, were found to have heritability estimates ranging from 0.21 to 0.29 and 0.23 to 0.35, respectively. Strong heritability estimates were observed in the 7th to 13th sections of cutaneous trunci muscle ranging from 0.42 to 0.66. Genetic correlations of latissimus dorsi m. with belly length were positive (0.50), while cutaneous trunci m. with belly weight also revealed a positive relationship that ranged from 0.35 to 0.47. The estimated genetic parameters indicate that belly weight can be improved by genetic selection. Differences in the levels of heritability occurred among various parameters of Yorkshire pork belly, which should be considered when performing selection to improve pork belly quality. Moreover, these results can provide valuable information that can be used as the basis for further investigations to improve pork belly.

Estimation of Genetic Associations between Production and Meat Quality Traits in Duroc Pigs

Data collected from 690 purebred Duroc pigs from 2009 to 2012 were used to estimate the heritability, and genetic and phenotypic correlations between production and meat quality traits. Variance components were obtained through the restricted maximum likelihood procedure using Wombat and SAS version 9.0. Animals were raised under the same management in five different breeding farms. The average daily gain, loin muscle area (LMA), backfat thickness (BF), and lean percent (LP) were measured as production traits. Meat quality traits included pH, cooking loss, lightness (L*), redness (a*), yellowness (b*), marbling score (MS), moisture content (MC), water holding capacity (WHC), and shear force. The results showed that the heritability estimates for meat quality traits varied largely from 0.19 to 0.79. Production traits were moderate to highly heritable from 0.41 to 0.73. Genotypically, the BF was positively correlated (p<0.05) with MC (0.786), WHC (0.904), and pH (0.328) but negatively correlated with shear force (−0.533). The results of genetic correlations indicated that selection for less BF could decrease pH, moisture content, and WHC and increase the shear force of meat. Additionally, a significant positive correlation was recorded between average daily gain and WHC, which indicates pork from faster-growing animals has higher WHC. Furthermore, selection for larger LMA and LP could increase MS and lightness color of meat. The meat quality and production traits could be improved simultaneously if desired. Hence, to avoid further deterioration of pork characteristics, appropriate selection of traits should be considered.

Aerobic training increases the expression of adiponectin receptor genes in the peripheral blood mononuclear cells of young men

Little is known about the effect of exercise training on the expression of adiponectin receptor genes in peripheral blood mononuclear cells (PBMCs). In this study, we investigated the effects of aerobic training on the expression of AdipoR1 and AidpoR2 mRNAs in PBMCs, whole body insulin sensitivity, and circulating adiponectins in men. Thirty young men were randomly assigned to either a control (n=15) or an exercise (n=15) group. Subjects assigned to the exercise group underwent a 12-week jogging and/or running programme on a motor-driven treadmill at an intensity of 60%-75% of the age-based maximum heart rate with duration of 40 minutes per session and a frequency of 5 days per week. Two-way mixed ANOVA with repeated measures was used to test any significant time-by-group interaction effects for the measured variables at p=0.05. We found significant time-by-group interaction effects for waist circumference (p=0.001), VO2max (p<0.001), fasting insulin (p=0.016), homeostasis model assessment for insulin resistance (HOMA-IR) (p=0.010), area under the curve (AUC) for insulin response during the 75-g oral glucose tolerance test (p=0.002), high-molecular weight (HMW) adiponectin (p=0.016), and the PBMC mRNA levels of AdipoR1 (p<0.001) and AdipoR2 (p=0.001). The exercise group had significantly increased mRNA levels of AdipoR1 and AdipoR2 in PBMCs, along with increased whole body insulin sensitivity and HMW adiponectin, decreased waist circumference, and increased VO2max compared with the control group. In summary, the current findings suggest that exercise training modulates the expression of AdipoR1 and AdipoR2 mRNAs in PBMCs, implying that manipulation of the expression of these genes could be a potential surrogate for lifestyle intervention-mediated improvements of whole body insulin sensitivity and glucose homeostasis.

Genome-wide Association Study for Warner-Bratzler Shear Force and Sensory Traits in Hanwoo (Korean Cattle)

Significant SNPs associated with Warner-Bratzler (WB) shear force and sensory traits were confirmed for Hanwoo beef (Korean cattle). A Bonferroni-corrected genome-wide significant association (p<1.3×10⁻⁶) was detected with only one single nucleotide polymorphism (SNP) on chromosome 5 for WB shear force. A slightly higher number of SNPs was significantly (p<0.001) associated with WB shear force than with other sensory traits. Further, 50, 25, 29, and 34 SNPs were significantly associated with WB shear force, tenderness, juiciness, and flavor likeness, respectively. The SNPs between p = 0.001 and p = 0.0001 thresholds explained 3% to 9% of the phenotypic variance, while the most significant SNPs accounted for 7% to 12% of the phenotypic variance. In conclusion, because WB shear force and sensory evaluation were moderately affected by a few loci and minimally affected by other loci, further studies are required by using a large sample size and high marker density.

Proteome Analysis of Bovine Longissimus dorsi Muscle Associated with the Marbling Score

The breeding value of marbling score in skeletal muscle is an important factor for evaluating beef quality. In the present study, we investigated proteins associated with the breeding value of the marbling score for bovine sirloin to select potential biomarkers to improve meat quality through comparative proteomic analysis. Proteins isolated from muscle were separated by two-dimensional gel electrophoresis. After analyzing images of the stained gel, seven protein spots for the high marbling score group were identified corresponding to changes in expression that were at least two-fold compared to the low marbling score group. Four spots with increased intensities in the high marbling score group were identified as phosphoglycerate kinase 1, triosephophate isomerase, acidic ribosomal phosphoprotein PO, and capping protein (actin filament) Z-line alpha 2. Spots with decreased intensities in the high marbling score group compared to the low score group were identified as 14-3-3 epsilon, carbonic anhydrase II, and myosin light chain 1. Expression of myosin light chain 1 and carbonic anhydrase 2 was confirmed by Western blotting. Taken together, these data could help improve the economic performance of cattle and provide useful information about the underlying the function of bovine skeletal muscle.

Comparison and correlation analysis of different Swine breeds meat quality

This study was performed to determine the influence of pig breed and gender on the ultimate pH and physicochemical properties of pork. The correlations between pH and pork quality traits directly related to carcass grade, and consumer’s preference were also evaluated. The pH and meat grading scores for cold carcasses of 215 purebred pigs (Duroc, Landrace, and Yorkshire) from four different farms were obtained. Meat quality parameters of the pork loin were analyzed. Duroc and female animals were more affected compared to other breeds and male pigs. Duroc animals had the highest ultimate pH, carcass back fat thickness, marbling scores, yellowness, and fat content (p<0.05). Landrace pigs had the highest color lightness and cooking loss values (p<0.05). Among all trait parameters, marbling scores showed the highest significant differences when evaluating the impact of breed and gender on meat quality characteristics (p<0.001). Ultimate pH was positively correlated with carcass weight (0.20), back fat thickness (0.19), marbling score (0.17), and color score (0.16) while negatively correlated with cooking loss (−0.24) and shear force (−0.20). Therefore, pork samples with lower ultimate pH had lower cooking loss, higher lightness, and higher shear force values irrespective of breed.

Effects of xenoestrogens on streptozotocin-induced diabetic mice

In diabetic mellitus, apoptotic or necrotic deaths of pancreatic β-cells lead to insulin deficiency because plasma insulin is synthesized and released from pancreatic β-cells and involved with blood glucose homeostasis. Since estrogen receptors have been related with glucose metabolis, estrogen-like chemicals (xenoestrogens) including bisphenol A (BPA) and octylphenol (OP) alter the endocrine system, and cause adverse health consequences such as obesity and diabetes. In the current study, levels of plasma glucose were evaluated after administration of BPA and OP using biochemical analysis, and were investigated in insulin and insulin synthesis-related genes in the pancreas and liver of streptozotocin (STZ)-induced insulin-deficient mice. Although the STZ-induced insulin-deficient groups showed an increase in blood glucose compared with control groups, the induced blood glucose level dropped to that of baseline after administration of xenoestrogens. When insulin level and mRNA expression of insulin transcriptional regulators (Pdx1, Mafa, and Neurod1) in pancreatic β-cells were decreased in STZ-induced insulin-deficient groups, they were significantly restored by administration of xenoestrogens. The latter observation is also related to NF-κB activation for anti-apoptosis effects in pancreatic β-cells. In addition, we observed a complementary convergence in regulation of gluconeogenesis for determination of blood glucose levels. Therefore, the current study may be particularly important for assessment of xenoestrogens under condition of diabetic mellitus or metabolic disorder.

Abstract P1-01-19: Role of axillary clearance with tumor positive sentinel node in mastectomy group: Is the results of ACOSOG Z0011 trial adaptable to mastectomy patient?

Background: Recent data from ACOSOG Z0011 trial or AMAROS trial suggest that axillary lymph node dissection(ALND) may be unnecessary for patients with positive sentinel lymph node biopsy(SLNB) receiving breast conserving surgery(BCS) with irradiation. However, consensus statements and guidelines until recently recommended that patients with mastectomy and tumor positive sentinel node undergo completion ALND. In this preliminary study, we compared these patients who did not undergo ALND with the patients who received BCS with SLNB only and irradiation and we analyzed the locoregional recurrence rate to show no differences of outcomes between two groups.

Method: We identified 6,163 women with invasive breast cancer who underwent surgical resection at the National Cancer Center (Goyang,Gyeonggi-do,Korea) between January 2000 to December 2011. Clinico-pathological data obtained from prospective collecting medical database of our institution were analyzed retrospectively. The mastectomy with positive SLNB group was 47 patients and BCS with positive SLNB and irradiation group was 172 patients. The primary end point was loco-regional recurrence rate.

Result : Clinical and tumor characteristics were similar between two groups except T stage and receptor status. The mean tumor size was 5.5cm with mastectomy group and 3.5cm with BCS group. The median number of nodes removed was three. There was not a single case of locoregional recurrence in both groups. At a median follow-up of 53.5 months (last follow-up, May 2013), 5-year overall survival was 85.7% with mastectomy and 97.3% with BCS group.

Conclusion : In our study, there was no case of locoregional recurrence as above. This results lend weight to the argument that SLNB without ALND may be reasonable management for selected patients with appropriate surgery and adjuvant systemic therapy. This study can be regarded as a preliminary study with a sufficient value despite of the prognosis showed some statistical differences between two groups. It resides in the difference of initial stage of patients of two groups. We will present additional data compared with the mastectomy with axillary clearance group at the meeting.

Acknowledgement This work was supported by grant from the National Cancer Center Korea (1210331-2).

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-01-19.

Plasma-assisted combustion technology for NOx reduction in industrial burners

Stronger regulations on nitrogen oxide (NOx) production have recently promoted the creation of a diverse array of technologies for NOx reduction, particularly within the combustion process, where reduction is least expensive. In this paper, we discuss a new combustion technology that can reduce NOx emissions within industrial burners to single-digit parts per million levels without employing exhaust gas recirculation or other NOx reduction mechanisms. This new technology uses a simple modification of commercial burners, such that they are able to perform plasma-assisted staged combustion without altering the outer configuration of the commercial reference burner. We embedded the first-stage combustor within the head of the commercial reference burner, where it operated as a reformer that could host a partial oxidation process, producing hydrogen-rich reformate or synthesis gas product. The resulting hydrogen-rich flow then ignited and stabilized the combustion flame apart from the burner rim. Ultimately, the enhanced mixing and removal of hot spots with a widened flame area acted as the main mechanisms of NOx reduction. Because this plasma burner acted as a low NOx burner and was able to reduce NOx by more than half compared to the commercial reference burner, this methodology offers important cost-effective possibilities for NOx reduction in industrial applications.

The effect of lipopolysaccharide on enhanced inflammatory process with age: Modulation of NF-κB

Oxidative stress is thought to be a causative factor for age-related damage in a wide variety of cellular constituents that can lead to dysfunction and various pathological conditions, including the inflammatory process. At the molecular level, the redox-sensitive transcription factor, NF-κB plays a key role in the regulation of the inflammatory process, along with cytokines, cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS). We studied the mechanism underlying the modulation of the inflammatory reaction with age by investigating NF-κB activation and the expression of COX-2, iNOS, and cytokines genes in hepatic tissues isolated from young and old rats. We expanded our investigation of these factors in rats injected with the inflammatory activator, lipopolysaccharide (LPS). Data showed that NF-κB activity was up-regulated with age and was further enhanced by LPS injection, indicating an increased susceptibility and sensitivity to the inflammatory stimulus with age. To explore further the molecular events leading to NF-κB activation, we investigated the inhibitory component of NF-κB complex, IκB. Cytosolic IκBα, but not IκBβ, was significantly decreased in both old and LPS-treated rats, signifying the enhanced migration of cytosolic NF-κB complex into the nucleus following dissociation from the inhibitor. The appearance of the polypeptide, p65, as determined in the nucleus, corresponded with the change in IκBα, providing further supporting evidence for the molecular process involved in NF-κB activation. Our additional investigation of two proinflammatory-related enzymes, COX-2 and iNOS, and three cytokines, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α, clearly showed aged-related increases, in corroboration with the NF-κB activation. Our results demonstrated that LPS injection caused the enhanced gene expression of inducible proinflammatory proteins, COX-2 and iNOS through NF-κB activation.

Comparison of MR imaging findings between extraligamentous and subligamentous disk herniations in the lumbar spine

BACKGROUND AND PURPOSE

The method of treating an HIVD in the lumbar spine may depend on the integrity of the PLL. The purpose of this study was to analyze and compare the MR imaging findings of extraligamentous and subligamentous HIVDs in the lumbar spine.

MATERIAL AND METHODS

One hundred seventeen patients (M/F = 71:46; mean age, 47 years; age range, 15-79 years) underwent lumbar spine MR imaging and disk surgery (extraligamentous/subligamentous = 66:51) from May 2003 to November 2006. Two radiologists in consensus retrospectively reviewed all MR images, focusing on 10 criteria.

RESULTS

The following 5 criteria are suggestive of extraligamentous HIVD in the lumbar spine: 1) spinal canal compromised for more than half its dimension, 2) internal signal difference in the HIVD, 3) an ill-defined margin of the HIVD, 4) disruption of the continuous low-signal-intensity line covering the HIVD, and 5) the presence of an internal dark line in the HIVD (P < .05). When we combined these 5 MR imaging criteria, the sensitivity, specificity, accuracy, and odds ratio were 77.3%, 74.5%, 76.1%, and 9.93 (P < .0001).

CONCLUSIONS

Our proposed 5 MR imaging criteria will be helpful in differentiating extraligamentous and subligamentous HIVDs in the lumbar spine.

Effects of Lactation Stage and Individual Performance on Milk cis-9, trans-11 Conjugated Linoleic Acids Content in Dairy Cows

The goal of this study was to evaluate the effects of lactation stage and individual performance on milk cis-9, trans-11 conjugated linoleic acid (CLA) content in dairy cows. In experiment 1, the milk cis-9, trans-11 CLA content from dairy cows in early (0.33±0.014%), middle (0.37±0.010%), and late stages (0.44±0.020%) showed significant differences (p<0.05); and the individual contents of the major fatty acids, especially cis-9, trans-11 CLA in cows of the same lactation were also variable. In the second experiment design as a validation test, our results once again showed that the individual contents of cis-9, trans-11 CLA were various, and a difference of about 2-fold (0.55% vs 0.95%) was observed, although the animals were offered same diet. These data demonstrated that lactation stage and individual performance have considerable effects on milk cis-9, trans-11 CLA contents.

The efficacy of i-SCAN for detecting reflux esophagitis: a prospective randomized controlled trial

New imaging technologies have been applied in endoscopy to improve the detection and differentiation of subtle mucosal changes using a digital contrast method. Among them, i-SCAN technology is the most recently developed image-enhancing technology. We investigated whether i-SCAN could improve the detection rate of reflux esophagitis. Interobserver agreement between endoscopists was compared with conventional white light (WL) endoscopic examination. We performed a prospective randomized controlled trial. A consecutive series of 514 subjects that underwent an esophagogastroduodenoscopy for health inspection were enrolled and randomized into the i-SCAN group (n = 246) and WL group (n = 268). An esophagogastroduodenoscopy with video recording was used for detecting reflux esophagitis, and reflux esophagitis were categorized by the modified Los Angeles (LA) classification. The total number of reflux esophagitis identified by WL and i-SCAN was 58 (21.7%) and 74 (30.1%), respectively. The diagnostic yield of reflux esophagitis was significantly higher (P = 0.034) in the i-SCAN group (30.1%) as compared to the WL group (21.6%). Using the modified LA classification, the detection rate of minimal changes was significantly higher (P = 0.017) in the i-SCAN group (11.8%) as compared to the WL group (5.6%), but the detection rates of LA-A and LA-B were not significantly different between the two groups (P = 0.897 and P = 0.311, respectively). After comparison of the interobserver agreement using randomly selected video clips, the i-SCAN group showed better agreement than the WL group (Kappa value, 0.793 vs. 0.473). Compared to WL endoscopy, applying i-SCAN in daily practice can improve the diagnostic yield of reflux esophagitis by detecting more minimal changes in the squamo-columnar junction of the esophagus and can improve the interobserver agreement of the modified Los Angeles classification.

Tissue-specific expression of occludin, zona occludens-1, and junction adhesion molecule A in the duodenum, ileum, colon, kidney, liver, lung, brain, and skeletal muscle of C57BL mice

Tight junctions are the most apically positioned intercellular junction and play many roles such as securing adjacent cells, forming barriers from extracellular materials, and facilitating paracellular transport. Occludin and junction adhesion molecule A (JAM-A) are classified as transmembrane proteins that are directly involved in paracellular transport. Zona occludens-1 (ZO-1) is a protein that contains a PDZ domain which forms a binding site for other tight junction proteins. In this study, we assessed the differential expression of these tight junction components in various mouse organs including the intestine (duodenum, ileum, and colon), kidney, liver, lung, brain, and skeletal muscle. Realtime PCR and Western blot assays were performed to measure the gene and protein expression of occludin, JAM-A, and ZO-1. Similar levels of occludin gene expression were detected in all tissues except for skeletal muscle in which occludin expression was not found. The JAM-A and ZO-1 genes were highly expressed in all the tested tissues. Localization of occludin, JAM-A, and ZO-1 was determined by immunohistochemistry. These proteins were detected in the intercellular apical junctions in each tissue except for occludin (which was not observed in skeletal muscle). These immunostaining data were consistent with the gene expression profiles we obtained. Our results suggest that occludin, JAM-A, and ZO-1 genes are normally expressed in the intestine, kidney, liver, lung, and brain indicating that these factors may be essential for maintaining appropriate physiological concentration of ions, solutes and water.

Conjugated linoleic acid synthesis-related protein proteasome subunit α 5 (PSMA5) is increased by vaccenic acid treatment in goat mammary tissue

This study was conducted to identify proteins associated with the endogenous synthesis of conjugated linoleic acid (CLA) from trans-vaccenic acid (TVA; trans-11 C18:1, a precursor for CLA endogenous synthesis) in mammary tissues. Six lactating goats were divided into 2 groups. One group was given an intravenous bolus injection of TVA (150mg) twice daily over 4 d; the other group received saline injections. Treatment with TVA increased the concentration of cis-9,trans-11 CLA and TVA in goat milk. Additionally, TVA treatment increased the expression of stearoyl-CoA desaturase (SCD) in mammary tissue. Using 2-dimensional gel electrophoresis and electrospray ionization quadrupole time-of-flight mass spectrometry, 3 proteins affected by infusions of TVA were identified. Proteasome (prosome, macropain) subunit α type 5 (PSMA5) was upregulated, whereas peroxiredoxin-1 and translationally controlled tumor protein 1 were downregulated in TVA-treated animals compared with the vehicle-injected controls. Only the effect of TVA on PSMA5 could be confirmed by Western blot analysis. To further explore the regulation of PSMA5 in mammary epithelial cells when TVA is converted into CLA, we used a differentiated bovine mammary epithelial cell line treated with TVA for 6h. Changes in cis-9,trans-11 CLA concentrations and mRNA expression patterns of both SCD and PSMA5 were monitored. The concentration of cis-9,trans-11 CLA increased after TVA treatment. The mRNA expression level of PSMA5 was significantly elevated to 6h, but SCD mRNA expression only increased in 2h after TVA treatment. These results indicate that PSMA5 is highly expressed in goat mammary tissue and bovine mammary epithelial cells when TVA is converted into CLA. Our data suggest that PSMA5 protein is associated with CLA biosynthesis in mammary tissue.

Resumption or persistence of menstruation after cytotoxic chemotherapy is a prognostic factor for poor disease-free survival in premenopausal patients with early breast cancer

BACKGROUND

We investigated the relationship between resumption or persistence of menstruation after cytotoxic chemotherapy (RM) and disease-free survival (DFS) in premenopausal patients with early breast cancer.

METHODS

Medical records from 872 patients who received cytotoxic chemotherapy for stage I to III breast cancer were retrospectively reviewed.

RESULTS

The median patient age was 41 years (range, 21-54) and the median follow-up duration was 6.2 years (range, 0.7-10.4). Six hundred ninety-two patients (79.4%) were hormone receptor (HR) positive and the majority of these received tamoxifen therapy after completing chemotherapy. The chemotherapy-induced amenorrhea (CIA) rate was 76.7% (n = 669), and 51.8% (n = 452) experienced RM during the follow-up period. One hundred twenty-one (13.9%) patients had persistent menstruation without CIA. DFS was significantly affected by younger age at diagnosis (≤35 years) (P = 0.013), tumor size > 2 cm (P < 0.001), node positivity (P < 0.001), HR negativity (P < 0.001), HER2 positivity (P = 0.010), and RM (P < 0.001). HR negativity [hazard ratio 1.7, 95% confidence interval (CI) 1.2-2.4, P = 0.006], tumor size > 2 cm (hazard ratio 2.1, 95% CI 1.4-3.0, P < 0.001), node positivity (hazard ratio 3.0, 95% CI 2.0-4.7, P < 0.001), and RM (hazard ratio 1.8, 95% CI 1.2-2.7, P = 0.004) remained significant factors for DFS on multivariate analysis.

CONCLUSIONS

A considerable proportion of premenopausal patients treated with chemotherapy experienced RM after CIA. RM was a poor prognostic factor for DFS in premenopausal patients with early breast cancer.

Effect of a self-help program for mothers of hemophilic children in Korea

Mothers of hemophilic children are under stressful situations because of the characteristics of disease and inheritance. The purpose of this study was to evaluate the effect of the self-help group program for the mothers of hemophilic children. Fifty one mothers of hemophilic children were participated. The experiment group (n = 24) participated in the self-help group program for 5 weeks, while the control group (n = 27) received a self-help booklet only. Knowledge, self-efficacy, depression, parenting stress, and quality of life were evaluated using questionnaires. Data were analyzed using χ(2) -test, t-test, and analysis of covariance (ancova). The experiment and control groups were homogeneous in general characteristics and depending variables except knowledge (P < 0.05; P > 0.05, respectively). Knowledge, self-efficacy, and quality of life in the experiment group were increased after the program (P < 0.001). Especially, the knowledge in the experiment group was lower than the control group in pretest, but higher in the posttest (P < 0.001). Depression and parenting stress were reduced in the experiment group compared to the control group (P < 0.001). It is suggestive that the self-help group program can be a useful opportunity for mothers of hemophilic children to improve knowledge and self-efficay of child care and quality of life of themselves; to decrease depression and parenting stress. Extended application of the program to fathers or all family members may be needed to investigate in the future.

Diagnostic yield of fluoroscopy-guided biopsy for infectious spondylitis

BACKGROUND AND PURPOSE

CT is currently the method of choice for guiding biopsy of lesions of the spine. However, in our hospital, fluoroscopy-guided percutaneous biopsy has been preferred for several years because of equipment availability and easy craniocaudal angulation. The aim of this study was to evaluate the efficacy of fluoroscopy-guided percutaneous biopsy in a clinical setting for diagnosing infectious spondylitis.

MATERIALS AND METHODS

A retrospective study was performed to evaluate 170 fluoroscopy-guided percutaneous biopsies in 140 patients (male/female = 70:70; mean age, 65.1 years; range, 16-89 years) in a clinical setting who were suspected of having infectious spondylitis between July 2003 and March 2010. Diagnosis was based on pathologic confirmation by tissue or culture from biopsy. The percentage of adequate specimens for diagnosis, histopathologic diagnosis for infectious spondylitis, and positive cultures for causative organisms were evaluated by retrospective review of medical records.

RESULTS

Adequate specimens for diagnosis were obtained in 165 of 170 cases (97.1%). The diagnosis of infectious spondylitis resulted in 134 of 170 cases confirmed through histopathology or clinical outcome (78.8%). In 51 of 134 cases (38.1%), the causative organism was confirmed by specimens from percutaneous bone biopsy. There were no biopsy-related major complications. The most common organism isolated was Mycobacterium tuberculosis (24 cases), followed by Staphylococcus aureus, Streptococcus agalactiae, and Streptococcus viridans.

CONCLUSIONS

Fluoroscopy-guided percutaneous biopsy is as accurate and effective as CT-guided biopsy for diagnosing infectious spondylitis.

Frequency of adverse reactions to first- and second-line anti-tuberculosis chemotherapy in a Korean cohort

OBJECTIVE

To determine the frequency of and risk factors for major adverse drug reactions (MADRs) associated with anti-tuberculosis treatment at a tuberculosis (TB) referral hospital in the Republic of Korea.

METHODS

Data from an ongoing natural history cohort study were analyzed for permanent regimen changes due to adverse drug reactions and confirmed by chart review.

RESULTS

Among 655 subjects, there were 132 MADRs in 112 (17%) subjects. The most common MADRs were gastrointestinal (n = 53), musculoskeletal (n = 22), psychiatric (n = 10), visual (n = 9) and peripheral neuropathic (n = 8). MADRs were more frequent in subjects being treated with second-line regimens (16%) compared to first-line regimens (2.5%). Drugs frequently associated with MADRs were amikacin (3/10, 30%), linezolid (8/29, 28%), para-aminosalicylic acid (47/192, 24%), pyrazinamide (31/528, 5.8%), macrolides (2/44, 4.5%) and cycloserine (12/272, 4.4%). Fluoroquinolones accounted for a single MADR (1/377, 0.003%), despite widespread usage. In multivariate analysis, infection with multi- or extensively drug-resistant disease and previous history of anti-tuberculosis treatment were risk factors for MADR, with adjusted hazard ratios of respectively 2.2 (P = 0.02) and 1.6 (P = 0.04).

CONCLUSION

MADRs are common during anti-tuberculosis chemotherapy in this population, occurring in more than one in six subjects. New and less toxic agents to treat drug-resistant TB are urgently needed.

Patterns of pncA mutations in drug-resistant Mycobacterium tuberculosis isolated from patients in South Korea

BACKGROUND

Pyrazinamide (PZA), one of the most effective anti-tuberculosis drugs, becomes toxic to Mycobacterium tuberculosis when converted to pyrazinoic acid by pyrazinamidase (PZase). PZA resistance is caused mainly by the loss of enzyme activity by mutation.

OBJECTIVE

To investigate the patterns of pncA mutations in PZA-resistant mycobacteria isolated from South Korean patients.

METHODS

Mycobacterial isolates with clinically proven drug resistance were cultured to determine susceptibility to anti-tuberculosis agents. pncA mutations were recognised by sequencing and compared with the relevant wild-type DNA sequence.

RESULTS

Among 108 isolates, 102 were successfully cultured and underwent drug susceptibility testing; all were multidrug-resistant (MDR). pncA mutations were found in 86 cultured isolates (85.1%): 55 (84.6%) in MDR and 31 (86.1%) in extensively drug-resistant isolates. Substitution of a single nucleotide was most common. The most frequent mutations were a deletion that caused a frameshift at nucleotide (nt) 71, a substitution at nt 403 and a substitution at nt 11. Combined, these accounted for ≈ 40% of all mutations. However, 15 samples (14.9%) with defective PZase activity showed no mutation.

CONCLUSION

pncA mutation in M. tuberculosis is a major mechanism of PZA resistance in MDR isolates from patients in South Korea. The patterns of mutation might be more scattered and diverse. DNA-based diagnosis of PZA resistance has potential for the rapid detection of drug resistance.

Comparison of 2-year angiographic outcomes of stent- and nonstent-assisted coil embolization in unruptured aneurysms with an unfavorable configuration for coiling

BACKGROUND AND PURPOSE

Stents are known to have hemodynamic and biologic effects in addition to their mechanical scaffold effect. To determine whether stents affect long-term outcomes after coiling of unruptured aneurysms, we compared angiographic outcomes at 2 years postembolization for stent- and nonstent-assisted coiled unruptured aneurysms.

MATERIALS AND METHODS

Stent-assisted coiling was used in unruptured aneurysms unfavorable for simple coiling (neck size >4 mm and dome-to-neck ratio <1.5) in our practice. Therefore, 126 coiled unruptured aneurysms in total (40 [31.7%] stent group and 86 [68.3%] nonstent group) with these conditions were selected for this study. The nonstent group aneurysms were treated with multiple microcatheter technique (53 cases) or balloon-assisted technique (33 cases). Self-expandable stents were used for coiling in stent group aneurysms. No significant difference in aneurysmal characteristics (aneurysm type [sidewall/bifurcation], diameter, neck size, and dome-to-neck ratio) or angiographic outcome at embolization (packing attenuation, obliteration grade, and contrast filling) were observed between the 2 study groups.

RESULTS

At 2-year follow-up visits, rates of progressive occlusion (stent group, 17/40 [42.5%] versus nonstent group, 34/86 [39.5%]) and recanalization (7/40 [17.5%] versus 18/86 [21.0%]) did not show a statistically significant difference between the 2 groups (P = .895).

CONCLUSIONS

The present study did not show that additional hemodynamic and biologic effects of stents designed for neck remodeling were enough to enhance progressive occlusion and prevent the recanalization of unruptured aneurysms. Our finding suggests that stent placement provides no better long-term angiographic outcomes for unruptured aneurysms with an unfavorable configuration for coiling.

The effect of the respiratory cycle on liver stiffness values as measured by transient elastography

The findings of several studies suggest that liver stiffness values can be affected by the degree of intrahepatic congestion respiration influence intrahepatic blood volume and may affect liver stiffness. We evaluated the influence of respiration on liver stiffness. Transient elastography (TE) was performed at the end of inspiration and at the end of expiration in patients with chronic liver disease. The median values obtained during the inspiration set and during the expiration set were defined as inspiratory and expiratory liver stiffness, respectively. A total of 123 patients with chronic liver disease were enrolled (mean age 49years; 64.2% men). Liver cirrhosis coexisted in 29 patients (23.6%). Expiratory liver stiffness was significantly higher than inspiratory liver stiffness (8.7 vs 7.9kPa, P=0.001), while the expiratory interquartile range/median ratio (IQR ratio) did not differ from the inspiratory IQR ratio. Expiratory liver stiffness was significantly higher than inspiratory liver stiffness in 49 (39.8%) patients (HE group), expiratory liver stiffness was significantly lower than inspiratory stiffness in 15 (12.2%) patients, and there was no difference in 59 (48.0%) patients. Liver cirrhosis was more frequent in those who had a lower liver stiffness reading in expiration, and only the absence of liver cirrhosis was significantly associated with a higher reading in expiration in multivariate analysis. In conclusion, liver stiffness was significantly elevated during expiration especially in patients without liver cirrhosis. The effect of respiration should be kept in mind during TE readings.

Growth of carbon nanotube field emitters on single strand carbon fiber: a linear electron source

The multi-stage effect has been revisited through growing carbon nanotube field emitters on single strand carbon fiber with a thickness of 11 µm. A prepared linear electron source exhibits a turn-on field as low as 0.4 V µm(-1) and an extremely high field enhancement factor of 19,300, when compared with those results from reference nanotube emitters grown on flat silicone wafer; 3.0 V µm(-1) and 2500, respectively. In addition, we introduce a novel method to grow nanotubes uniformly around the circumference of carbon fibers by using direct resistive heating on the continuously feeding carbon threads. These results open up not only a new path for synthesizing nanocomposites, but also offer an excellent linear electron source for special applications such as backlight units for liquid crystal displays and multi-array x-ray sources.

Two-year follow-up of contrast stasis within the sac in unruptured aneurysm coil embolization: progressive thrombosis or enlargement?

BACKGROUND AND PURPOSE

The fate of contrast stasis within an aneurysmal sac after coiling has not been established. We followed and evaluated the potential risks of recanalization of unruptured aneurysms embolized with BPCs for 2 years.

MATERIALS AND METHODS

A total of 301 unruptured aneurysms in 252 patients were treated with BPCs. Contrast stasis was observed on initial postembolization angiograms in 104 (34.6%) of these aneurysms. For follow-up, skull images by an angiographic unit (at 3, 9, 15, and 21 months), CE-MRA including TOF source images (at 6, 12, and 18 months), and DSA (at 24 months) were used.

RESULTS

In 89 (85.6%) of the 104 aneurysms with contrast stasis, the stasis disappeared on 6-month MRAs and occlusions remained unchanged without recanalization for 2 years. In the remaining 15 (14.4%), recanalization occurred during follow-up. The presence of contrast stasis was not found to be associated with the obliteration rate (P = .641) or packing attenuation (aneurysms without contrast stasis 30.7% ± 11.18 versus aneurysms with contrast stasis 33.0% ± 12.11, P = .113). Contrast stasis was not found to be a risk factor for recanalization (15/104 [14.4%] versus 29/197 [14.7%], P = 1.000).

CONCLUSIONS

Contrast stasis is a benign angiographic finding that can disappear within 6 months on follow-up MRA. In addition, contrast stasis was not found to be associated with a low obliteration rate or packing attenuation or to be a risk factor for recanalization. The present study shows that aneurysms with contrast stasis on initial postembolization angiograms are no more likely to recanalize than aneurysms without contrast stasis.

Therapeutic trial of fluoroscopic interlaminar epidural steroid injection for axial low back pain: effectiveness and outcome predictors

BACKGROUND AND PURPOSE

An ESI for managing LBP is one of the most commonly performed interventions. The purpose of this observational study was to assess the effect of a therapeutic trial of a fluoroscopic interlaminar ESI for axial LBP and to analyze the outcome predictors.

MATERIALS AND METHODS

All patients who received an interlaminar ESI for axial LBP at our facility in 2007 and 2008 were included. Initial short-term follow-up was done at <1 month after ESI. ESI was considered effective if patients had a reduction of >50% in their pain scores. In July 2009, telephone interviews were conducted by using formatted questions including the NASS patient-satisfaction index. The symptom-free interval was computed by the Kaplan-Meier method. Outcome predictors such as age, sex, duration of LBP, and MR imaging findings were statistically analyzed by the Mann-Whitney U and the Fisher exact tests.

RESULTS

Eighty-one patients (male/female = 16:65; mean age, 49.9 years; range, 17-77 years) were included in the study. The interlaminar ESI was effective in 63 of the 81 patients (77.8%) at initial short-term follow-up. For the 63 patients in whom ESI was effective, the median symptom-free interval was 154 days (95% CI, 96-212 days). Among 68 patients for whom telephone interviews were possible, 44 patients (64.7%) replied positively to the NASS patient satisfaction index (NASS patient-satisfaction index, 1 or 2). There were no significant outcome predictors.

CONCLUSIONS

The therapeutic trial of a fluoroscopic interlaminar ESI was effective for axial LBP without significant outcome predictors.

Survival and predictors of outcomes in non-HIV-infected patients with extensively drug-resistant tuberculosis

SETTING

A tuberculosis (TB) referral hospital in South Korea.

OBJECTIVE

To evaluate predictors of treatment outcomes and survival among non-human immunodeficiency virus (HIV) infected patients with extensively drug-resistant TB (XDR-TB).

DESIGN

Patients who were diagnosed with XDR-TB at the National Masan Tuberculosis Hospital from January 2001 to December 2005 were included in this study. We conducted a retrospective review of their medical records and mortality data.

RESULTS

A total of 176 non-HIV-infected patients with XDR-TB were included. TB-related mortality was 48% (84/176), and the median survival time from the diagnosis date of XDR-TB was 51 months (range 0-127, 95%CI 32.53-69.47). Cure and treatment completion were classified as favourable outcome and treatment failure, death during treatment and default as poor outcome. Previous TB treatment with second-line drugs (aOR 2.76, 95%CI 1.02-7.44) and cavitary disease (aOR 3.01, 95%CI 1.12-8.08) were independent risk factors for poor outcome. Use of linezolid (aOR 0.10, 95%CI 0.01-0.69) and surgical resection (aOR 0.18, 95%CI 0.04-0.78) were associated with favourable outcome.

CONCLUSION

There was high mortality in non-HIV-infected patients with XDR-TB at a TB referral hospital in South Korea. Adjunctive surgical treatment and linezolid improved the outcome for selected patients with XDR-TB.

Building a backlight unit with lateral gate structure based on carbon nanotube field emitters

This paper describes the fabrication of a backlight unit for liquid crystal display based on printed carbon nanotube field emitters with lateral gate and additional mesh structures. The device architecture has been optimized through field emission characterization and supporting numerical simulation. The emission current depends strongly on the cathode-gate gap, mesh position, and mesh bias. Direct observation of luminous images on a phosphor screen reveals that the electron beams undergo a noticeable shrinkage along the lateral direction with increasing anode bias, which is in good agreement with the simulation results. We suggest and demonstrate a modified structure equipped with double emitter edges leading to approximately 20% improved phosphor efficiency (34.4 lm W(-1)) and luminance (9600 cd m(-2)), compared to those from a single edge structure.

Effects of molinate on survival and development of Bombina orientalis (Boulenger) embryos

Molinate, a thiocarbamate chemical is a slightly to moderately toxic herbicide in EPA (Environmental Protection Agency) toxicity class III, and is a registered as a General Use Pesticide (GUP). Bombina orientalis is one of the most common amphibians in the world and comprise a large proportion of their total number in Korea. B. orientalis spawns in the rice fields at spring when the massive application of agricultural chemicals occurs. In the present study, we examined the effects of molinate on embryonic survival and developmental abnormality in B. orientalis embryos. The difference in survival rate between vehicle control and molinate treated embryos was not observed until the blastula stage. The first statistically significant decrease in embryonic survival was observed at mouth open stage following exposure to 100 microM molinate (46.8% vs. 81.1% in control). When the embryos develop to tadpole stage survival was significantly decreased at 50 microM molinate (35.9% vs. 68.9% in control), suggesting that the lowest observed effective dose (LOED) for systemic toxicity in B. orientalis embryos is 50 microM. In survived embryos molinate exposure produced several types of severe developmental abnormalities in order of frequency with bent trunk, neurula with yolk plug, bent tail, tail dysplasia, ventral blister, eye dysplasia, thick-set body and cephalic dysplasia. This suggests that molinate targets multiple events in embryonic and larval development in this frog species. Together this suggested that molinate was detrimental for survival and development following zygotic transcription after midblastula transition in B. orientalis embryos.

Spinal epidural hemangiomas: various types of MR imaging features with histopathologic correlation

BACKGROUND AND PURPOSE

Because of the high vascularization of hemangiomas, preoperative misinterpretation may result in unexpected intraoperative hemorrhage and incomplete resection, which results in the persistence of clinical symptoms or recurrence. Our purpose was to analyze various MR imaging features of a spinal epidural hemangioma with histopathologic correlation.

MATERIALS AND METHODS

After searching through the pathology data bases in 3 hospitals, we included 14 patients (9 male and 5 female; mean age, 38 years; age range, 2-62 years) with spinal epidural hemangiomas confirmed by surgical resection after MR imaging. Three radiologists reviewed the MR imaging in consensus and categorized the features into subtypes on the basis of histopathologic findings.

RESULTS

We categorized the MR imaging features as follows: type A for a cystlike mass with T1 hyperintensity (2 cases, arteriovenous type with an organized hematoma), type B for a cystlike mass with T1 isointensity (3 cases, venous type), type C for a solid hypervascular mass (7 cases, cavernous type), and type D for an epidural hematoma (2 cases, cavernous type with hematoma). Types A and B had frequent single segmental involvement (4/5), whereas types C and D had multisegmental involvement in all. Regardless of MR types, lobular contour (8/14) and a rim of low T2 signal intensity (8/14) of the mass were common. T1 hyperintensity of the mass was occasionally seen (5/14).

CONCLUSIONS

Spinal epidural hemangiomas can have various MR imaging features according to their different histopathologic backgrounds. In addition to common features such as solid hypervascularity, lobular contour, and a rim of low T2 signal intensity, T1 hyperintensity or multisegmental involvement may also be a clue in the differential diagnosis of a spinal epidural hemangioma.

Successful endovascular occlusion of a ruptured distal anterior inferior cerebellar artery aneurysm of the caudal trunk: case report

SUMMARY

We report a rare case of a ruptured distal anterior inferior cerebellar artery (possibly dissecting) aneurysm of the caudal trunk, successfully treated by endovascular occlusion. A 41-yearold man presented with sudden severe headache and drowsiness. On the day of ictus, conventional angiography was performed to make the above diagnosis, followed by endovascular occlusion of the sac and the parent artery. The patient recovered completely without any neurologic deficit after treatment. Endovascular occlusion could be a safe and effective treatment option in a case of a ruptured distal AICA aneurysm of the caudal trunk.

Comparison of the temporary diagnostic relief of transforaminal epidural steroid injection approaches: conventional versus posterolateral technique

BACKGROUND AND PURPOSE

Conventional transforaminal epidural steroid injection (TFESI) has several problems. The purpose of this study was to compare the temporary diagnostic relief and advantages of TFESI performed using the conventional and posterolateral approaches.

METHODS

From August to December 2004, 187 patients received TFESI for lumbar radicular pain. A total of 108 patients (65 women, 43 men; mean age, 56 years) fulfilled the inclusion criteria. In essence, the needle target point was the "safe triangle," but if there was a possibility that the needle could penetrate the nerve root or that the injectate could contact spinal nerve, posterolateral TFESI was used as an alternative. Image analyses of needle positions and chart reviews were performed. Logistic regression analysis and t test were used for statistical analysis.

RESULTS

Of the 108 patients, 75 (69.4%) showed an improvement at 2 weeks after TFESI. In 46 patients (42.6%), the needle was located in the posterolateral epidural space, and 33 (71.7%) of those experienced pain relief. Of the 62 patients in whom the needle was located in the anterior epidural position, 42 (68%) experienced pain relief. There was a significant reduction in pain sense for the posterolateral approach (P < .05). However, no statistical difference was found between the 2 approaches and temporary diagnostic relief, and no correlation was found between the other variables tested and temporary diagnostic relief (P > .05).

CONCLUSION

Our findings suggest that the posterolateral approach is an alternative method for TFESI in cases where needle tip positioning in the anterior epidural space is difficult.

Frequency and distribution of patellar luxation in dogs. 134 cases (2000 to 2005)

This study investigated the frequency and distribution of patellar luxation in the dogs presented to the Chonbuk National University Animal Medical Centre during January 2000 to September 2005. Patellar luxations were classified as medial or lateral, and unilateral or bilateral, were graded I to IV, and were subdivided according to age, sex and size of the dogs. The incidence of medial patellar luxation (MPL) was greater than the incidence of lateral patellar luxation (LPL) in both small and large dogs. Small-breed dogs were admitted almost exclusively with MPL. LPL was found uncommon; however it was observed more often in larger-breed dogs. Surgical correction was performed primarily in the dogs (165 stifles in 111 dogs) with grade II, III and IV patellar luxations following different surgical techniques. The combination of the surgical techniques was found to be more effective for the management of the disease. The prognosis was found to be favourable, because when the grade was low, the dog was younger, without cruciate ligament rupture, and as the surgical correction was performed with combination of more techniques.