Wearable device for continuous sweat lactate monitoring in sports: a narrative review

In sports science, the use of wearable technology has facilitated the development of new approaches for tracking and assessing athletes' performance. This narrative review rigorously explores the evolution and contemporary state of wearable devices specifically engineered for continuously monitoring lactate levels in sweat, an essential biomarker for appraising endurance performance. Lactate threshold tests have traditionally been integral in tailoring training intensity for athletes, but these tests have relied on invasive blood tests that are impractical outside a laboratory setting. The transition to noninvasive, real-time monitoring through wearable technology introduces an innovative approach, facilitating continuous assessment without the constraints inherent in traditional methodologies. We selected 34 products from a pool of 246 articles found through a meticulous search of articles published up to January 2024 in renowned databases: PubMed, Web of Science, and ScienceDirect. We used keywords such as "sweat lactate monitoring," "continuous lactate monitoring," and "wearable devices." The findings underscore the capabilities of noninvasive sweat lactate monitoring technologies to conduct long-term assessments over a broad range of 0-100 mM, providing a safer alternative with minimal infection risks. By enabling real-time evaluations of the lactate threshold (LT) and maximal lactate steady state (MLSS), these technologies offer athletes various device options tailored to their specific sports and preferences. This review explores the mechanisms of currently available lactate monitoring technologies, focusing on electrochemical sensors that have undergone extensive research and show promise for commercialization. These sensors employ amperometric reactions to quantify lactate levels and detect changes resulting from enzymatic activities. In contrast, colorimetric sensors offer a more straightforward and user-friendly approach by displaying lactate concentrations through color alterations. Despite significant advancements, the relationship between sweat lactate and blood lactate levels remains intricate owing to various factors such as environmental conditions and the lag between exercise initiation and sweating. Furthermore, there is a marked gap in research on sweat lactate compared to blood lactate across various sports disciplines. This review highlights the need for further research to address these shortcomings and substantiate the performance of lactate sweat monitoring technologies in a broader spectrum of sports environments. The tremendous potential of these technologies to supplant invasive blood lactate tests and pioneer new avenues for athlete management and performance optimization in real-world settings heralds a promising future for integrating sports science and wearable technology.

Soccer's AI transformation: deep learning's analysis of soccer's pandemic research evolution

Introduction

This paper aims to identify and compare changes in trends and research interests in soccer articles from before and during the COVID-19 pandemic.

Methods

We compared research interests and trends in soccer-related journal articles published before COVID-19 (2018-2020) and during the COVID-19 pandemic (2021-2022) using Bidirectional Encoder Representations from Transformers (BERT) topic modeling.

Results

In both periods, we categorized the social sciences into psychology, sociology, business, and technology, with some interdisciplinary research topics identified, and we identified changes during the COVID-19 pandemic period, including a new approach to home advantage. Furthermore, Sports science and sports medicine had a vast array of subject areas and topics, but some similar themes emerged in both periods and found changes before and during COVID-19. These changes can be broadly categorized into (a) Social Sciences and Technology; (b) Performance training approaches; (c) injury part of body. With training topics being more prominent than match performance during the pandemic; and changes within injuries, with the lower limbs becoming more prominent than the head during the pandemic.

Conclusion

Now that the pandemic has ended, soccer environments and routines have returned to pre-pandemic levels, but the environment that have changed during the pandemic provide an opportunity for researchers and practitioners in the field of soccer to detect post-pandemic changes and identify trends and future directions for research.

Effect of a Cognitive Function and Social Skills-Based Digital Exercise Therapy Using IoT on Motor Coordination in Children with Intellectual and Developmental Disability

This study aimed to determine the effects of a virtual reality exercise program based on cognitive function and social skills on motor coordination in children with intellectual and developmental disabilities (IDD). Thirty-five children with IDD were randomly assigned to either the cognitive function and social skills-based virtual reality exercise system (CS-VR) group or the conventional virtual reality exercise system (C-VR) group. Before and after the intervention, each participant was tested for motor coordination (extended horizontal jump, hop, stationary dribble, overarm throw) and exercise performance (standing long jump, YMCA step test). Compared with the C-VR group, the CS-VR group showed significant improvements in motor coordination in terms of extended horizontal jump, hop, and overarm throw (p < 0.01, p < 0.05, and p < 0.01, respectively). In addition, compared with the C-VR group, the CS-VR group showed a significant increase in standing long jump (p < 0.01), although no significant between-group variation was found in stationary dribble and recovery heart rate (RHR) as part of the YMCA step test (p > 0.05, and p > 0.05, respectively). These results suggest that for the development of motor skills in children with IDD, it is essential to develop an exercise program that reflects the levels of cognitive functions and social skills of these children.

Transcranial Direct Current Stimulation of Motor Cortex Enhances Spike Performances of Professional Female Volleyball Players

The purpose of this study was to investigate effects of brain excitability by transcranial direct current stimulation (tDCS) on spike performances of professional female volleyball players. Thirteen professional female volleyball players were recruited for participation. We performed a randomized single-blind, SHAM-stimulus controlled, and counter-balanced crossover design with two interventions in this study. An anodal tDCS current was applied over the primary motor cortex (M1) for 20 min at 2 mA. In the SHAM intervention, the current was first applied for 30 s, after which it was terminated. Exercise performance assessment which comprised spike performance (spike ball speed, spiking consistency), two vertical jumps (jump and reach: JaR, countermovement jump: CMJ), bench-press and back-squat one-repetition maximum (1RM) were tested pre- and post-intervention. Results indicated that spike ball speed and spiking consistency following tDCS were significantly higher than those after SHAM intervention (both p < 0.05). However, JaR and CMJ did not show any significant differences between tDCS and SHAM intervention groups (both p > 0.05). There was no significant difference in bench-press and back-squat 1RM between two groups either (both p > 0.05). These findings suggest that tDCS could be effective in enhancing motor coordination performances of professional female volleyball athletes.

Evidence of slow and variable choice-stepping reaction time in cancer survivors with chemotherapy-induced peripheral neuropathy

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is reported to affect up to 70 % of cancer survivors. Despite evidence that CIPN-related impairments often translate into balance and mobility deficits, the effects on stepping and quality of gait, well-documented risk factors for falls, are unclear.

AIMS

(i) Establish choice-stepping reaction time (CSRT) performance in survivors with CIPN compared to young and older healthy controls and people with Parkinson's disease; (ii) document walking stability; (iii) investigate relationships between stepping and gait data to objective and patient-reported outcomes.

METHODS

41 cancer survivors with CIPN (mean (SD) age: 60.8 (9.7) years) who were ≥3months post chemotherapy, performed tests of simple and inhibitory CSRT. Walking stability measures were derived from 3-D accelerometry data during the 6-minute walk test. CIPN was assessed using neurological grading and patient-reported outcome measures (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in CIPN Questionnaire scale EORTC CIPN20).

RESULTS

In both stepping tests, CIPN participants performed at the level of adults aged 10 years older and people with mild to moderate Parkinson's disease. Mean (SD) total stepping response times in both CSRT (1160 (190) milliseconds) and inhibitory CSRT (1191 (164) milliseconds) tests were not associated with objective neurological grading but were correlated with increased difficulty feeling the ground. Participants with lower-limb vibration sensation deficit had slower and more variable CSRT times. There were no associations between walking stability and objective measures of CIPN, and limited correlations with the EORTC-CIPN20.

CONCLUSIONS

Cancer survivors with CIPN showed deficits in voluntary stepping responses and seemed to compensate for their sensory and motor deficits by walking slower to maintain stability. Objective and patient-reported outcomes of CIPN were correlated with slower and more variable stepping response times. Future studies should aim to identify the causes of the apparent premature decline in cognitive-motor function and develop remediating interventions.

Changes in high-sensitivity C-reactive protein levels and metabolic indices according to grip strength in Korean postmenopausal women

OBJECTIVE

This study aimed to investigate the changes in high-sensitivity C-reactive protein (hs-CRP) level and metabolic indices such as blood pressure, serum lipid level and serum glucose level according to grip strength in postmenopausal women.

METHOD

Data from participants (postmenopausal women) in the Seventh Korea National Health and Nutrition Examination Survey 2018 were analyzed. Absolute handgrip strength was the sum of the maximal grip strength of both hands, and relative handgrip was calculated as absolute handgrip divided by the body mass index. We performed linear regression analysis after adjusting for confounders to assess the influence of grip strength on hs-CRP level and metabolic indices.

RESULTS

Linear regression analysis showed that after adjusting for confounders, with an increased absolute grip strength, systolic blood pressure and hs-CRP levels were decreased; however, the changes were not significant for the remaining indices. Relative grip strength was associated with hs-CRP levels and metabolic indices. With a high relative grip strength, hs-CRP, blood pressure, fasting blood glucose, hemoglobin A1c and triglyceride levels were decreased, while the high-density lipoprotein cholesterol level was increased.

CONCLUSION

Our study evaluated the overall health status using grip strength in postmenopausal women. The grip strength adjusted by body size was suitable in evaluating the overall health status, including inflammatory and metabolic indices. Additionally, increased grip strength was associated with a better health status in postmenopausal women.

Bioluminescence Imaging of Matrix Metalloproteinases-2 and -9 Activities in Ethanol-injured Cornea of Mice

BACKGROUND/AIM

This study aimed to investigate the usefulness of in vivo bioluminescence imaging (BLI) to examine the role of matrix metalloproteinases (MMP)-2 and MMP-9 activation in the development and healing of ethanol-induced damage in the cornea of mice.

MATERIALS AND METHODS

Mouse corneal injury was induced by topical treatment with 20% ethanol. BLI was obtained from the ocular region of mice intravenously injected with an active-MMP-2/9 probe. In vivo results were validated in primary corneal epithelial cells.

RESULTS

BLI indicated that treatment of the eye with 20% ethanol elevated MMP-2/9 activity, which was inhibited by the application of eye drops (hyaluronic acid and serum). Treatment of corneal epithelial cells with 20% ethanol-increased the activities of MMP-2 and MMP-9, which were also inhibited by eye drops.

CONCLUSION

BLI can be applied in vivo in mice with corneal injury to examine the activity of MMPs and clarify the efficacy of eye drops.

Vocal Feature Extraction-Based Artificial Intelligent Model for Parkinson's Disease Detection

As a neurodegenerative disorder, Parkinson’s disease (PD) affects the nerve cells of the human brain. Early detection and treatment can help to relieve the symptoms of PD. Recent PD studies have extracted the features from vocal disorders as a harbinger for PD detection, as patients face vocal changes and impairments at the early stages of PD. In this study, two hybrid models based on a Support Vector Machine (SVM) integrating with a Principal Component Analysis (PCA) and a Sparse Autoencoder (SAE) are proposed to detect PD patients based on their vocal features. The first model extracted and reduced the principal components of vocal features based on the explained variance of each feature using PCA. For the first time, the second model used a novel Deep Neural Network (DNN) of an SAE, consisting of multiple hidden layers with L1 regularization to compress the vocal features into lower-dimensional latent space. In both models, reduced features were fed into the SVM as inputs, which performed classification by learning hyperplanes, along with projecting the data into a higher dimension. An F1-score, a Mathews Correlation Coefficient (MCC), and a Precision-Recall curve were used, along with accuracy to evaluate the proposed models due to highly imbalanced data. With its highest accuracy of 0.935, F1-score of 0.951, and MCC value of 0.788, the probing results show that the proposed model of the SAE-SVM surpassed not only the former model of the PCA-SVM and other standard models including Multilayer Perceptron (MLP), Extreme Gradient Boosting (XGBoost), K-Nearest Neighbor (KNN), and Random Forest (RF), but also surpassed two recent studies using the same dataset. Oversampling and balancing the dataset with SMOTE boosted the performance of the models.

Changes in long term peripheral nerve biophysical properties in childhood cancer survivors following neurotoxic chemotherapy

OBJECTIVE

In the context of increasing numbers of childhood cancer survivors (CCS), this study aimed to enhance understanding of the biophysical basis for long term chemotherapy induced peripheral neuropathy from different chemotherapy agents in CCS.

METHODS

Detailed cross-sectional neurophysiological examination, using median nerve axonal excitability studies, alongside clinical assessments, in 103 long term CCS (10.5 ± 0.6 years post-treatment).

RESULTS

Cisplatin treated CCS (n = 16) demonstrated multiple sensory axonal excitability changes including increased threshold (P < 0.05), alterations in depolarising and hyperpolarising threshold electrotonus (P < 0.05) and reduction in resting and minimum IV slope (P < 0.01). Vincristine treated CCS (n = 73) were comparable to controls, except for prolonged distal motor latency (P = 0.001). No differences were seen in the non-neurotoxic chemotherapy group (n = 14). Abnormalities were more evident in the cisplatin subgroup with greater clinical neuropathy manifestations.

CONCLUSION

Persistent long term changes in axonal biophysical properties vary with different chemotherapy agents, most evident after cisplatin exposure. Longitudinal studies of nerve function during chemotherapy treatment are required to further evaluate these differences and their mechanistic basis.

SIGNIFICANCE

This study provides a unique biophysical perspective for persistent cisplatin related neurotoxicity in children, previously under recognised.

Deficiency in proliferative, angiogenic, and LH receptors in the follicle wall: implications of season toward the anovulatory condition

This study aimed to gain insight on the effect of different seasons of the year on the expression pattern of growth factor and hormone receptors involved in follicle development. A novel follicle wall biopsy technique was used to collect in vivo follicle wall layers (ie, granulosa, theca interna, and theca externa) and follicular fluid samples from growing dominant follicles, simultaneously and repeatedly, using the same mares during the spring anovulatory (SAN), spring ovulatory (SOV), summer (SU), and fall ovulatory (FOV) seasons. The immunofluorescent expression patterns of epidermal growth factor receptor (EGFR), Ki-67, vascular endothelial growth factor receptor (VEGFR), and LH receptor (LHR) were evaluated in each follicle wall layer, in addition to intrafollicular estradiol and nitric oxide (NO). Proliferative proteins (EGFR and Ki-67) were highly (P < 0.05-P < 0.001) expressed during the SOV season compared with the SAN and FOV seasons. Lower (P < 0.05-P < 0.001) expression of both proteins was observed during SU compared with the SOV season. The expression of VEGFR was greater (P < 0.05-P < 0.01) in the theca interna of dominant follicles during the SOV season compared with the SAN and SU seasons. Similarly, in the overall quantification, the VEGFR expression was greater (P < 0.001) during the SOV season compared with the SU and FOV seasons. A higher (P < 0.05) LHR expression was detected in the theca interna during the SOV season than the SAN season. Furthermore, a higher (P < 0.05-P < 0.001) expression of LHR was observed in the granulosa, theca interna, and in the overall quantification during the SOV season compared with the SU and FOV seasons. Intrafollicular NO concentration did not differ (P > 0.05) among different seasons of the year. The intrafollicular estradiol concentration was higher (P < 0.05) during the SU compared with the SAN season and higher (P < 0.05) during the FOV season compared with the SAN and SOV seasons. In conclusion, the synergistic effect of lower expression of proliferative protein, angiogenic, and LH receptors in at least some of the layers of the follicle wall seems to trigger dominant follicles toward the anovulation process during the spring and fall transitional seasons.

Comparison of the diagnostic performance of the 2017 and 2018 versions of LI-RADS for hepatocellular carcinoma on gadoxetic acid enhanced MRI

AIM

To compare the diagnostic performance of the 2017 (v2017) and 2018 versions (v2018) of the Liver Imaging-Reporting and Data System (LI-RADS) for hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI) and to evaluate the effect in v2018.

MATERIALS AND METHODS

Treatment-naive patients at high-risk for HCC who underwent Gd-EOB-MRI were included. The LI-RADS categories were assigned according to v2017 and v2018. The diagnostic performances were compared between v2017 and v2018 according to the size and combination of imaging features.

RESULTS

A total of 117 patients with 137 observations were identified, including 89 HCCs; 76.2% (64/84) of observations with threshold growth were re-classified as subthreshold growth when using v2018 instead of v2017. The final categories changed in nine (14%) cases. For the combination of LR-5/LR-5V, there were no significant differences in sensitivity and specificity between the two versions (sensitivity, 64% versus 58.4%; specificity, 87.5% versus 85.4%; all p>0.05). For the combination of LR-4 and LR-5/5V, the diagnostic performance of v2018 was inferior to that of v2017 when considering only major features (accuracy, 86.1% versus 80.3%, respectively; p=0.013), particularly in observations measuring 10-20 mm, but was comparable after adding the ancillary features (accuracy, 86.9% versus 86.1%, respectively; p=1.00).

CONCLUSION

In LI-RADS v2018, although a considerable number of observations re-classified subthreshold growth, changes in the assigned categories were insignificant; overall diagnostic performance was comparable to that of v2017, but v2018 might emphasise the value of ancillary features in combination with major features for determining the probability of HCC.

A monoclonal antibody derived by inoculation of human umbilical vein endothelial cells is a potential inhibitor of acetylcholine receptor-linked vasorelaxation

In a previous study, we produced antibodies from rats immunized with human umbilical vein endothelial cells (HUVECs) and determined the vascular function of the monoclonal antibodies. However, unanswered question remains still about their role in vascular function. The current study explored vasoreactivity, in particular, focusing on the vascular contractility of a functional antibody against proteins expressed on the plasma membrane of HUVECs developed in a previous study. Among the antibodies developed, A-7 significantly attenuated endothelium-dependent vasorelaxation in response to acetylcholine (ACh) but not to sodium nitroprusside or histamine. In addition, the A-7 antibody did not affect norepinephrine-stimulated contraction in both endothelium-intact and -denuded aorta. Immunocytochemical and immunoblotting analyses showed that A-7 attenuated ACh-increased expression of ACh receptor on the plasma membrane of HUVECs. These findings suggest that the monoclonal A-7 antibody may act as an inhibitor of endothelium-dependent vasorelaxation, probably in part via downregulation of ACh receptor expression.

Conduction block in immune-mediated neuropathy: paranodopathy versus axonopathy

BACKGROUND AND PURPOSE

Conduction block is a pathognomonic feature of immune-mediated neuropathies. The aim of this study was to advance understanding of pathophysiology and conduction block in chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN).

METHODS

A multimodal approach was used, incorporating clinical phenotyping, neurophysiology, immunohistochemistry and structural assessments.

RESULTS

Of 49 CIDP and 14 MMN patients, 25% and 79% had median nerve forearm block, respectively. Clinical scores were similar in CIDP patients with and without block. CIDP patients with median nerve block demonstrated markedly elevated thresholds and greater threshold changes in threshold electrotonus, whilst those without did not differ from healthy controls in electrotonus parameters. In contrast, MMN patients exhibited marked increases in superexcitability. Nerve size was similar in both CIDP groups at the site of axonal excitability. However, CIDP patients with block demonstrated more frequent paranodal serum binding to teased rat nerve fibres. In keeping with these findings, mathematical modelling of nerve excitability recordings in CIDP patients with block support the role of paranodal dysfunction and enhanced leakage of current between the node and internode. In contrast, changes in MMN probably resulted from a reduction in ion channel density along axons.

CONCLUSIONS

The underlying pathologies in CIDP and MMN are distinct. Conduction block in CIDP is associated with paranodal dysfunction which may be antibody-mediated in a subset of patients. In contrast, MMN is characterized by channel dysfunction downstream from the site of block.

Transcranial Direct Current Stimulation of motor cortex enhances running performance

Transcranial direct current stimulation (tDCS) is a technique used to modulate neuronal excitability through non-invasive brain stimulation that can enhance exercise performance. We hypothesize that tDCS would improve submaximal running time to exhaustion (TTE) and delay the increase in the rating of perceived exertion (RPE) over time. We also hypothesize that tDCS would not lead to difference in cardiorespiratory responses. We employed a randomized, single-blinded, and counterbalanced design in which 10 trained men participated. After receiving either 20 min of 1.98 mA anodal tDCS applied over the primary motor cortex (M1) or sham-operated control on separate days, participants completed a constant-load test involving running at a speed equivalent to 80% of their own maximum oxygen consumption (VO2max). During this constant-load test, RPE, heart rate (HR), VO2, pulmonary ventilation (VE), respiratory exchange ratio (RER), and ventilatory threshold (VT) were continuously monitored. TTE was recorded at the end of the test. TTEs were significantly longer in the tDCS than in the sham conditions (21.18 ± 7.13 min; 18.44 ± 6.32 min; p = 0.011). For TTE, no significant differences were found in RPE between conditions at isotime. In addition, no significant differences in HR, VO2, VE, RER, and VT were found during TTE between the two stimulation conditions at any time point. These results indicate that the application of tDCS does not induce a change of the exercise performance-related index; however, it can affect the increase of the exercise duration due to the stimuli in the M1 area.

Is the Clinical Outcome Good or Bad in Patients Hospitalized Within 1 Year After Kidney Transplantation?

BACKGROUND

Although the hospitalization rate at early period of kidney transplantation (KT) is still high, the association between the hospitalization within 1 year after KT and graft survival is unclear. We investigated the incidence and causes of hospitalization and clinical outcome of the patients hospitalized within 1 year after KT.

METHODS

We retrospectively analyzed 174 KT recipients (KTRs) hospitalized within 1 year after KT between 2013 and 2015.

RESULTS

Among them, 84 (48%) KTRs were admitted within 1 year after KT, and the number of hospitalizations was 116. The mean time from KT to first hospitalization was 4.2 months. Seventy-eight percent of the patients were hospitalized for medical causes and 22% for surgical causes. The most common cause was cytomegalovirus infection (CMV) (23.3%), followed by acute rejection (11.2%) and urinary tract infection (10.3%). Recipients and donors in the hospitalized group were significantly older than the nonhospitalized group. The proportions of deceased donor KT, acute rejection, more than 50% panel-reactive antibody, and positive donor-specific antibody were significantly higher in the hospitalized group than in the nonhospitalized group. Graft and patient survivals were lower in the hospitalized group than in the nonhospitalized group. Deceased donor KT and acute rejection were independent risk factors for hospitalization.

CONCLUSION

The incidence of KTRs hospitalized within 1 year after KT was high. Most causes of hospitalization were CMV infection, acute rejection, and urinary tract infection. Therefore, the immunosuppression status of these patients should be closely monitored to reduce the hospitalization rate.

Construction and evaluation of type III secretion system mutants of the catfish pathogen Edwardsiella piscicida

Catfish is the largest aquaculture industry in the United States. Edwardsiellosis is considered one of the most significant problems affecting this industry. Edwardsiella piscicida is a newly described species within the genus Edwardsiella, and it was previously classified as Edwardsiella tarda. It causes gastrointestinal septicaemia, primarily in summer months, in farmed channel catfish in the south-eastern United States. In the current study, we adapted gene deletion methods used for Edwardsiella to E. piscicida strain C07-087, which was isolated from a disease outbreak in a catfish production pond. Four genes encoding structural proteins in the type III secretion system (T3SS) apparatus of E. piscicida were deleted by homologous recombination and allelic exchange to produce in-frame deletion mutants (EpΔssaV, EpΔesaM, EpΔyscR and EpΔescT). The mutants were phenotypically characterized, and virulence and vaccine efficacy were evaluated. Three of the mutants, EpΔssaV, EpΔyscR and EpΔesaM, were significantly attenuated compared to the parent strain (p < .05), but EpΔescT strain was not. Vaccination of catfish with the four mutant strains (EpΔssaV, EpΔesaM, EpΔyscR and EpΔescT) provided significant protection when subsequently challenged with wild-type strain. In conclusion, we report methods for gene deletion in E. piscicida and development of vaccine candidates derived from a virulent catfish isolate.

Kidney Transplantation in Korean Patients With End-Stage Renal Disease Aged 65 and Older: A Single-Center Experience

BACKGROUND

The mean age of patients starting dialysis in Korea has increased to older than 60 years and the proportion of patients aged 65 and older exceeded 40% in 2014. Although the number of elderly dialysis patients is increasing rapidly, percentages of elderly patients undergoing kidney transplantation (KT) are very low.

METHODS

We retrospectively reviewed the medical records of patients who underwent KT at Keimyung University Dongsan Medical Center between 1982 and 2016. Elderly patients (≥65 years old) were compared with the control group of patients in their early sixties (60-64 years old).

RESULTS

Among a total of 1209 KT patients, those in their early sixties totaled 34 (2.8%) and the elderly totaled only 18 (1.5%). Patient and allograft survival rate showed no significant differences between the elderly and those in their early sixties. Death with a functioning graft accounted for 50% in both groups. However, occurrences of bacterial infection and tuberculosis were higher in the elderly (P = .011 and .047, respectively). In a multivariate analysis, longer duration of renal replacement therapy before KT and the occurrence of malignancy were independent risk factors for patient death (hazard ratio [HR], 1.027; P = .014; HR, 31.934; P = .016, respectively). Also, albuminuria at 6 months after KT was an independent risk factor for allograft loss (HR, 51.155; P = .016).

CONCLUSION

The overall survival rate of the elderly was not significantly lower than those in their early sixties. Even in the elderly, KT should not be delayed. In addition, careful surveillance for malignancy and measures to decrease the risk of infection are necessary.

Long-term Clinical Outcomes of Kidney Re-transplantation

BACKGROUND

Kidney re-transplantation is commonly considered to have a higher immunological risk than first kidney transplantation. Because of the organ shortage and increasing waiting lists, long-term outcomes of kidney re-transplantation are being studied. However, reports of re-transplantation outcomes are not common. We have reported our 30 years of experience with second kidney transplantations.

METHODS

Of 1210 kidney transplantations between November 1982 and August 2016 performed in our hospital, 105 were second kidney transplantations (2nd KT). Living donor KT was 44; deceased donor KT was 61.

RESULTS

Patient survival rates at 1, 5, and 10 years were 100%, 97.2%, and 90.7%, and graft survival rates were 97.0%, 94.6%, and 71.5%, respectively. The leading cause of graft failure in the 2nd KT was chronic rejection (60%). In addition, induction immunosuppressant, maintenance immunosuppressant, delayed graft function, and graft survival time at the 1st KT had a significant impact on graft survival time at the 2nd KT.

CONCLUSIONS

Reasonable results in both patient survival and graft survival rates were found in the 2nd KT. Careful monitoring of immunologic risk is needed.

Clinical and genetic predictors of paclitaxel neurotoxicity based on patient- versus clinician-reported incidence and severity of neurotoxicity in the ICON7 trial

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of paclitaxel, with no reliable method to identify at-risk patients. We investigated the incidence and risk factors including genetic polymorphisms associated with the development of CIPN based on clinician and patient reporting of neuropathic symptoms.

PATIENTS AND METHODS

Risk factors for the development of CIPN were examined in 454 patients treated with paclitaxel/carboplatin from the International Collaboration on Ovarian Neoplasms 7 (ICON7) trial. Neuropathy was graded by clinicians by standard adverse event reporting and by patients utilising OV28 questionnaire. Genetic risk factors were examined by selecting six single nucleotide polymorphisms in genes associated with microtubule function. Risk factors were assessed via dose-to-event cox regression models.

RESULTS

Grade >2 neuropathy was reported by clinicians in 28% of patients, while 67% of patients reported 'quite a bit' or 'very much' tingling or numbness. Agreement between clinicians and patients was poor (κ = 0.236, 95% confidence interval, 0.177-0.296, P < 0.001). Older age, bevacizumab treatment and bowel resection were associated with clinician reported CIPN, while older age and volume of residual disease were associated with patient-reported neuropathy. There were no significant associations between clinician-reported neuropathy or patient-reported neuropathy and TUBB2, CEP72 or individual MAPT or GSK3B SNPs, however MAPT additive polymorphisms were associated with patient-reported neuropathy and GSK3B additive polymorphisms were associated with clinician reported CIPN.

CONCLUSIONS

There was significant discordance between patient- and clinician-reported neurotoxicity. The lack of consensus regarding optimal outcome measures and whose opinion with regard to CIPN takes precedence is a limitation in the investigation of risk factors for CIPN. Care must be taken to select and include patient-reported outcome measures in CIPN assessment to enable accurate identification of genetic and other risk factors for neuropathy.

Morphometric analysis of the maxillary root apex positions according to crowding severity

OBJECTIVES

To determine differences in arch forms derived from the root apices locations between individuals with <2 mm maxillary crowding and controls.

SETTING AND SAMPLE POPULATION

The Department of Orthodontics, Pusan National University. Cone-beam computed tomography (CBCT) images of 102 patients in the control group and 95 patients in the crowding group.

MATERIALS AND METHODS

X, Y and Z coordinates of the tip of the crowns and the apex of the root of the maxillary teeth (except second molars) were determined on the CBCT images. The acquired three-dimensional (3D) coordinates were converted into two-dimensional (2D) coordinates via projection on the palatal plane, and the Procrustes analysis was employed to process the converted 2D coordinates. The mean shape of the arch form derived from the location of the tip of the crowns and the apex of the root was compared between groups using the statistical shape analysis.

RESULTS

There was a statistically significant difference (P = .046) between the groups for the mean shape of the root apex arch form, but the difference was small and clinically irrelevant as it is minor compared to the degree of crowding.

CONCLUSIONS

Maxillary arch from at the level of the maxillary apices only shows minor differences between crowded and non-crowded dentitions.

Effects of stock density on the laying performance, blood parameter, corticosterone, litter quality, gas emission and bone mineral density of laying hens in floor pens

The effects of stocking density on the performance, egg quality, leukocyte concentration, blood biochemistry, corticosterone levels, bone mineral density, and noxious gas emission of laying hens were investigated. Eight hundred 34-week-old Hy-Line Brown laying hens (Gallus gallus domesticus) were randomly assigned to one of 4 treatments, each of which was replicated 4 times. Four stocking densities, including 5, 6, 7, and 10 birds/m2, were compared. A commercial-type basal diet was formulated to meet or exceed nutrient recommendations for laying hens from the National Research Council. The diet was fed to the hens ad libitum for 8 wk. Results indicated that hen-day egg production, egg mass, and feed intake were less for (P < 0.01) 10 birds/m2 stock density than other stock densities. Production rate of floor and broken eggs and eggshell strength were greater (P < 0.01) for 10 birds/m2 stock density than other stock densities. There were no significant differences in the level of leukocytes among densities. However, heterophils and the H/L ratio were greater (P < 0.01) for 10 birds/m2 than in stock density of 6 or 7 birds/m2 Serum corticosterone was greater (P < 0.01) 10 birds/m2 than stock density than other stock densities. Litter moisture and gas emission (CO2 and NH3) were greater (P < 0.01) for 10 birds/m2 than stock density than 6 and 7 birds/m2 stock density. Bone mineral content was not influenced by increasing stock density. However, bone mineral density was less (P < 0.05) for 10 m2 stock density than other stock densities. These results indicate that increasing the density beyond 5 birds/m2 elicits some negative effects on laying performance of Hy-Line brown laying hens.

Efficacy and safety of ursodeoxycholic acid composite on fatigued patients with elevated liver function and/or fatty liver: a multi-centre, randomised, double-blinded, placebo-controlled trial

AIM

The aim of this study was to assess the effects of ursodeoxycholic acid composite (URSA-S) on fatigue in patients with elevated liver function tests and/or fatty liver disease.

METHODS

In this multi-centre randomised double-blinded placebo-controlled trial, 168 adults who were diagnosed with fatigue based on our criteria and had elevated liver function tests (but not > 5 times the normal level) and/or fatty liver on ultrasonography, were randomised to either the placebo or URSA-S administration group. The rate of improvement of checklist individual strength (CIS) using a cut-off of 76 points at the end of the study (8 weeks), the change in fatigue scale [CIS score and visual analogue scale (VAS)] were evaluated. The adverse effects of URSA-S were also recorded.

RESULTS

The rate of CIS improvement at the end-point was 79.76% and 45.68% in the therapy and placebo groups, respectively (p < 0.05). The fatigue recovery rate of the CIS score and VAS were higher in the therapy (-25.44 ± 18.57, -27.84 ± 2.70) than in the placebo group (-16.59 ± 17.29, -19.46 ± 2.81) (p < 0.05). The difference in fatigue recovery rate between the therapy and placebo groups was significant after 8 weeks. When analysed separately in patients with abnormal liver function tests and fatty liver disease, the fatigue recovery rate of the CIS score and VAS at 8 weeks was higher in the therapy than in the placebo group (p < 0.05). The frequency of adverse events in the therapy group was not significantly higher than that in the placebo group.

CONCLUSION

URSA-S is effective for alleviating fatigue in patients with liver dysfunction and/or fatty liver. The adverse effects of URSA-S are not significant. This study is registered at https://clinicaltrials.gov/ct2/show/NCT02415777.

Suppressing activity of staurosporine from Streptomyces sp. MJM4426 against rice bacterial blight disease

AIM

To identify the active compounds from the Streptomyces sp. MJM4426 that can protect rice from bacterial blight disease (BB), and to evaluate the potential of this Streptomyces strains and the compound for biocontrol of rice bacterial blight disease.

METHODS AND RESULTS

The ethyl acetate extract of Streptomyces sp. MJM4426 can significantly protect rice leaf explants from the infection of Xanthomonas oryzae pv. oryzaeKACC 10331 (Xoo), the pathogen which cause BB. To identify the active compounds, the ethyl acetate extract of Streptomyces sp. MJM4426 was fractionated through a Sephadex LH-20 column chromatography, and further purified by preparative HPLC guided by the inhibitory activity against BB in rice leaf explants. UPLC-Q-TOF/MS analysis showed the active compound displayed its m/z values at [M+H](+) 467·2086 and [M+FA-H](-) 511·1963, and the molecular formula was estimated as C28 H26 N4 O3 which is identical to commercial standard staurosporine. In this study, the isolated staurosporine dramatically suppressed bacterial blight in rice leaf explants with the lowest concentration at 12·5 μmol l(-1) , however, it exhibited low inhibitory activity against Xoo with the MIC value at 256 μg ml(-1) . In addition, greenhouse study showed both crude extract and purified staurosporine can suppress the bacterial blight at the concentration of 5000 and 200 μg ml(-1) respectively.

CONCLUSION

Streptomyces sp. MJM4426 can protect rice leaf explants from the infection of Xoo by producing staurosporine, but not by direct inhibitory activity against Xoo.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report that staurosporine can protect rice leaf against bacterial blight disease and showed the potential of Streptomyces sp. MJM4426 as an alternative to chemical bactericide for bacterial blight disease in rice.

Hierarchical MoSe₂ yolk-shell microspheres with superior Na-ion storage properties

Yolk-shell-structured MoSe₂ microspheres were prepared via a simple selenization process of MoO₃ microspheres. The yolk-shell-structured MoSe₂ and MoO₃ microspheres delivered initial discharge capacities of 527 and 465 mA h g(-1) in the voltage range of 0.001-3 V vs. Na/Na(+) at a current density of 0.2 A g(-1), respectively, and their discharge capacities after 50 cycles were 433 and 141 mA h g(-1), respectively. The yolk-shell-structured MoSe₂ microspheres also exhibited outstanding high rate capabilities. The hierarchical yolk-shell structure comprised of wrinkled nanosheets facilitated fast Na-ion and electron kinetics, and buffered the large volume changes encountered during cycling.

Unique features of non-obstructive emphysema and pure airway obstruction

SETTING

Emphysema without airway obstruction or airway obstruction without emphysema are often detected clinically, although they are commonly co-existent. We therefore tested the hypothesis that non-obstructive emphysema and pure airway obstruction have unique features.

METHODS

A case-control observation study was undertaken retrospectively in a patient cohort at a single centre. Among 2662 subjects who underwent chest computed tomography and pulmonary function tests, we enrolled 90 patients with non-obstructive emphysema, 119 with pure airway obstruction, 81 with obstructive emphysema and 2031 subjects as normal controls. The features of the four groups were analysed and compared.

RESULTS

Higher serum homocysteine (13.4 ± 7.4 vs. 11.6 ± 4.6 mol/l), higher rate of osteoporosis (15.8% vs. 4.5%), higher leukocyte count, higher male ratio, lower serum albumin and lower body mass index were observed in subjects with non-obstructive emphysema than in controls (P < 0.05). In multiple logistic regression analysis of groups without airway obstruction, osteoporosis, hyperhomocysteinaemia, hypoalbuminaemia and higher leukocyte count were independent factors associated with non-obstructive emphysema (P < 0.05).

CONCLUSION

Hyperhomocysteinaemia, hypoalbuminaemia, osteoporosis and higher leukocyte count were independent predictors of non-obstructive emphysema.

Superior electrochemical properties of MoS2 powders with a MoS2@void@MoS2 configuration

Yolk-shell MoS2 powders with a distinct configuration of MoS2@void@MoS2 were prepared for the first time by applying spray pyrolysis. The yolk-shell MoO3 powders prepared by spray pyrolysis were converted into MoS2 powders by a simple sulfidation process at 400 °C without altering the morphology. Dense structured MoS2 powders were also prepared by a similar process. The respective initial discharge capacities of the yolk-shell and dense structured MoS2 powders at a current density of 1000 mA g(-1) were 651 and 490 mA h g(-1), and the corresponding capacity retentions after 100 cycles measured from the second cycle were 100 and 72%.

Historical comparison of prophylactic ganciclovir for gastrointestinal cytomegalovirus infection in kidney transplant recipients

BACKGROUND

Cytomegalovirus (CMV) can cause morbidity in kidney transplant recipients. The gastrointestinal (GI) tract is a major target for CMV disease. The aim of this study was to evaluate the benefit of ganciclovir prophylaxis on GI CMV infection in intermediate-risk CMV seropositive transplant recipients.

METHODS

Since January 2009, intravenous ganciclovir (5 mg/kg, twice daily) was administered for 14 days after kidney transplantation in 41 patients. The historical control group consisted of 45 patients who received kidney transplantations between January 2007 and December 2008. To evaluate the effects of prophylaxis on GI CMV infection, we performed routine endoscopic examinations with mucosal biopsies at the time of transplantation as well as 1, 3, and 6 months thereafter.

RESULTS

The average age of the 86 studied patients was 43.7 ± 10.6 years (range = 14-63) and the male-to-female ratio 1:1.3. Forty-three (50%) patients underwent deceased donor transplantations and 84 (97.7%) patients were CMV seropositive at that time. The incidence of GI CMV infection was significantly lower among the prophylaxis than the historical control group (24.4% vs 48.9%, P = .026). Patient age, numbers of deceased donors, and tacrolimus trough levels at 1 and 3 months posttransplant were significantly lower in the prophylaxis than the historical control group. Logistic regression analysis revealed ganciclovir prophylaxis to be the only significant risk factor for GI CMV infection.

CONCLUSION

Prophylactic treatment with ganciclovir decreased the incidence GI CMV infection among seropositive kidney transplant recipients.

Adenoma malignum of the uterine cervix: ultrasonographic findings in 11 patients

OBJECTIVE

To evaluate the ultrasonographic features of adenoma malignum, a minimal deviation adenocarcinoma of the uterine cervix.

METHODS

Eighteen consecutive patients with pathologically confirmed adenoma malignum were enrolled in this study at two institutions. Preoperative ultrasound examination was performed and the results were available in 11 patients. We analyzed retrospectively the gray-scale ultrasound findings for the following morphologic characteristics: cervical enlargement, as well as size, location and ultrasonographic characteristics of lesions. In five patients we also evaluated Doppler features with regard to intralesional vascularity.

RESULTS

The cervix was enlarged in 73% (8/11) of cases. The mean greatest tumor diameter was 4.2 (range, 2.5-6.8) cm. In five (45%) cases, the cervix was completely infiltrated by the tumor. At gray-scale ultrasound examination, three (27%) tumors were multilocular lesions, four (36%) were multilocular lesions with solid components and four (36%) were solid lesions. In the multilocular lesions with or without a solid component, locules tended to be 1 cm or less in average diameter (86%, 6/7 cases) and there tended to be 11-20 in number (57%, 4/7 cases). In most (57%, 4/7) cases the locular fluid was homogeneously hypoechoic. Most (75%, 3/4) solid lesions manifested heterogeneous echogenicity. The five (100%) tumors examined with Doppler manifested moderate or abundant color content on color or power Doppler.

CONCLUSIONS

Adenoma malignum can appear sonographically as solid, multilocular and multilocular solid cervical lesions. Awareness of its clinical and ultrasonographic features might improve diagnosis before surgery.

Detection of antigenic proteins expressed by lymphocystis virus as vaccine candidates in olive flounder, Paralichthys olivaceus (Temminck & Schlegel)

Although the major capsid proteins (MCPs) of lymphocystis disease virus (LCDV) have been characterized, little is known about the host-derived immune response to MCPs and other LCDV antigenic proteins. To identify antigenic proteins of LCDV that could be used as vaccine candidates in olive flounder, Paralichthys olivaceus, we analysed the viral proteins responsible for its virulence by applying immuno-proteomics. LCDV proteins were separated by one-dimensional gel electrophoresis, transferred to polyvinylidene difluoride membrane, and probed with homogeneous P. olivaceus antisera elicited by LCDV natural infection and vaccination with formalin-killed LCDV. Four immune-reactive proteins were obtained at 68-, 51-, 41- and 21 kDa using antisera collected from natural infection while two proteins at 51- and 21 kDa exhibited response to antisera from vaccinated fish, indicating that the latter two proteins have vaccine potential. Using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and nanoelectrospray MS/MS, the 51 and 21 kDa proteins were identified as MCP and an unknown protein, respectively.

SLC11A1 gene polymorphisms in Korean patients with Behçet's disease

OBJECTIVE

To investigate the potential susceptibility to the solute carrier family 11 member 1 (SLC11A1) gene polymorphisms of Korean patients with Behçet's disease (BD).

METHODS

Ninety-nine patients with BD and 98 controls were recruited. Analyses of three polymorphisms of the SLC11A1 gene [the 5'-promoter (GT)n, D543N and A318V] were performed, either by denaturing high-performance liquid chromatography for D543N and A318V or by using automatic DNA sequencing for the (GT)n. The genotypes and alleles between patients with BD and the controls were compared using the chi2 test and Yate's correction test.

RESULTS

No significant differences were found in the distribution of genotypes and alleles of the (GT)n polymorphism between BD patients and the controls. However, subjects with the allele 3 or the genotype allele 3/allele 3 of this polymorphism had a significantly lower risk of developing BD than those without this allele or genotype [allele: p = 0.029, pc = 0.039, odds ratio (OR) = 0.60, 95% confidence interval (CI) 0.37-0.95; genotype: p = 0.036, pc = 0.048, OR = 0.54, 95% CI 0.31-0.96]. In addition, the distributions of genotypes and alleles of D543N were similar between BD patients and controls (p>0.05). In the case of A318V, all of the BD patients and controls had a wild-type genotype.

CONCLUSION

The allele 3 and the genotype allele 3/allele 3 of the 5'-promoter (GT)n in the SLC11A1 gene may have a protective effect for the development of BD in the Korean population. Further studies in other populations are required to confirm our results.

Decreased expression of p12 is associated with more advanced tumor invasion in human gastric cancer tissues

BACKGROUND/AIMS

p12(DOC-1) is a well-known growth suppressor; however, its role in gastric carcinogenesis is still unclear. We investigated the expression of p12(DOC-1) in gastric cancer tissues and its possible correlation with p53 expression, and determined its clinical significance.

METHODS

Immunohistochemical staining using the tissue array method was performed on 180 human gastric carcinomas. The clinicopathological features and prognostic significance were analyzed.

RESULTS

Of the 180 tissue samples, p53 expression was positive in 85 (47.2%) and p12(DOC-1) expression was negative in 140 (77.8%). The negative expression of p12(DOC-1) was significantly associated with a more advanced depth of tumor invasion and stage (p < 0.05). No apparent correlation was found between p12(DOC-1) and p53 expressions. The 5-year survival rate of the p12(DOC-1)-positive cases (53.7%) was higher than that of the p12(DOC-1)-negative cases (39.3%); however, neither p12(DOC-1) nor p53 expression status had any statistically significant prognostic value. Multivariate analysis revealed that lymph node metastasis, distant metastasis, lymphatic invasion and perineural invasion were independent prognostic factors.

CONCLUSIONS

This is the first report that suggests that p12(DOC-1) may be involved in the development and progression of gastric cancer. Further studies are required to clarify its exact role in the mechanism of gastric carcinogenesis.

Mechanisms underlying chemotherapy-induced neurotoxicity and the potential for neuroprotective strategies

Chemotherapy-induced neurotoxicity is a significant complication in the successful treatment of many cancers. Neurotoxicity may develop as a consequence of treatment with platinum analogues (cisplatin, oxaliplatin, carboplatin), taxanes (paclitaxel, docetaxel), vinca alkaloids (vincristine) and more recently, thalidomide and bortezomib. Typically, the clinical presentation reflects an axonal peripheral neuropathy with glove-and-stocking distribution sensory loss, combined with features suggestive of nerve hyperexcitability including paresthesia, dysesthesia, and pain. These symptoms may be disabling, adversely affecting activities of daily living and thereby quality of life. The incidence of chemotherapy-induced neurotoxicity appears critically related to cumulative dose and infusion duration, while individual risk factors may also influence the development and severity of neurotoxicity. Differences in structural properties between chemotherapies further contribute to variations in clinical presentation. The mechanisms underlying chemotherapy-induced neurotoxicity are diverse and include damage to neuronal cell bodies in the dorsal root ganglion and axonal toxicity via transport deficits or energy failure. More recently, axonal membrane ion channel dysfunction has been identified, including studies in patients treated with oxaliplatin which have revealed alterations in axonal Na(+) channels, suggesting that prophylactic pharmacological therapies aimed at modulating ion channel activity may prove useful in reducing neurotoxicity. As such, improved understanding of the pathophysiology of chemotherapy-induced neurotoxicity will inevitably assist in the development of future neuroprotective strategies and in the design of novel chemotherapies with improved toxicity profiles.

Cytokine array after cyclosporine treatment in rats

OBJECTIVES

Long-term treatment with cyclosporine (CsA) results in chronic nephrotoxicity, which is known to be mediated by several cytokines including transforming growth factor-betal. Cytokines are known to play an important role in innate immunity, apoptosis, angiogenesis, cell growth, and differentiation. They are known to be involved in most disease processes, including cancer, cardiac disease, and nephrotoxicity. To evaluate changes of cytokines in a rat model of CsA-induced chronic nephrotoxicity, we performed a cytokine array.

METHODS

Experiments were performed on two groups of rats; normal control group and CsA-treated group. Cytokine array in rat serum was performed using Cytokine Antibody Array I kit from RayBiotech.

RESULTS

Serum creatinine, urine creatinine, and creatinine clearance increased in the CsA-treated group. Among the several cytokines, the expressions of the lipopolysaccharide-induced CXC chemokine (LIX), monocyte chemoattractant protein 1 (MCP-1), nerve growth factor (beta-NGF), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the CsA-treated group were increased above that of cytokines in the control group. The density of the LIX in controls was 0.62, and in the CsA-treated group was 1.24. The density of the MCP-1 in controls was 0.68, and in CsA-treated, 1.43. The density of the beta-NGF in controls was 0.62, and that in CsA-treated, 1.24. The density of the TIMP-1 in controls 1.13, and in CsA-treated, 1.40.

CONCLUSIONS

Our data suggested that among several cytokines elevated levels of the LIX, MCP-1, beta-NGF, and TIMP-1 are the contributing factors to CsA-induced nephropathy.

Effects of cyclosporine on the production of the reactive oxygen species in the glial cells

OBJECTIVES

After organ transplantation, some patients suffer mild neurological symptoms such as tremor to severe complications including seizures and encephalopathy. Among the immunosuppressants, cyclosporine (CsA) can induce neurological side effects. However, the mechanisms of encephalopathy by CsA are not fully understood. We measured the production of reactive oxygen species (ROS) in the glioma cells after CsA treatment.

METHODS

CsA (2.5 mmol/L) added to glioma cells was incubated for 60 minutes at 37 degrees C. ROS production was evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2',7'-dichlorofluorescin using VICTOR3 multilabel counter.

RESULTS

CsA resulted in ROS production by glioma cells. The ROS production increased with the time of exposure to CsA.

CONCLUSIONS

These findings indicated that CsA may contribute to neurological side effects via ROS production.

The production of reactive oxygen species in tacrolimus-treated glial cells

OBJECTIVE

After organ transplantation, some patients suffer from mild neurological symptoms, such as tremor, to severe complications, including seizures and encephalopathy. These neurological side effects can be caused by immunosuppressants such as tacrolimus. However, the mechanism of encephalopathy by tacrolimus is not fully understood.

METHODS

We measured the production of reactive oxygen species (ROS) in glioma cells after tacrolimus treatment. Tacrolimus added to glioma cells was incubated for 60 minutes at 37 degrees C. The production of ROS was evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2',7'-dichlorofluorescin using VICTOR3TM multilabel counter.

RESULTS

Tacrolimus resulted in the production of the ROS in glioma cells. The production of the ROS was increased in time-dependent fashion.

CONCLUSIONS

These findings indicated that the tacrolimus may contribute the neurological side effects by ROS production.

Case of adult mumps infection after renal transplantation

Viruses are the most common cause of opportunistic infections, important complications of transplantation. Mumps infection in renal transplant recipients is uncommon. This report focused on a 23-year-old woman who received immunosuppressive therapy based on tacrolimus, prednisolone, and mycophenolate mofetil for renal transplantation. Sixteen months after transplantation, she was admitted with pain and swelling in both infra-auricular areas. Laboratory findings demonstrated positive mumps IgM and IgG antibodies and an increased serum amylase level. Computed tomography revealed both parotid glands to be diffusely enlarged. After the diagnosis of mumps parotitis, the patient's immunosuppression was reduced and the clinical course was satisfactory.

Feasibility study on driver's stress detection from differential skin temperature measurement

Prolonged monotonous driving may lower a driver's awareness level as well as increasing their stress level due to the compulsion to maintain safe driving, which may result in an increased risk of a traffic accident. There is therefore an opportunity for technological assessment of driver physiological status to be applied in-car, hopefully reducing the incidence of potentially dangerous situations. As part of our long-term aim to develop such a system, we describe here the investigation of differential skin temperature measurement as a possible marker of a driver's stress level. In this study, healthy male (n=18) & female (n=7) subjects were investigated under environment-controlled conditions, whilst being subjected to simulated monotonous travel at constant speed on a test-course. We acquired physiological variables, including facial skin temperature which consists of truncal and peripheral skin temperatures (Ts) using thermography, beat-by-beat blood pressure (BP), cardiac output (CO), total peripheral resistance (TPR), and normalized pulse volume (NPV) used as an indicator of local peripheral vascular tone. We then investigated the driver's reactivity in terms of skin temperatures with this background of cardiovascular haemodynamics. We found that the simulated monotonous driving produced a gradual drop in peripheral Ts following the driving stress, which, through interpretation of the TPR and NPV recordings, could be explained by peripheral sympathetic activation. On the other hand, the truncal Ts was not influenced by the stress. These findings lead us to suggest that truncal-peripheral differential Ts could be used as a possible index indicative of the driver's stress.