<p>Dorsal and ventral thoracic 12 vertebra body height is associated with incident lumbar vertebral fracture in postmenopausal osteoporotic women</p>

Purpose

We measured dorsal and ventral thoracic 12 vertebral (T12V) body heights as a way to predict lumbar vertebral fracture (LVF) in postmenopausal women. MRI of dorsal and ventral T12V body heights has not yet been used to investigate their association with LVF. We hypothesized that the dorsal and ventral T12V body height are important morphologic parameters in the prediction of LVF.

Patients and methods

In total, 80 osteoporotic patients with LVF (LVF group) and 80 osteoporotic patients without LVF (control group) were examined by MRI at the lumbothoracic level. Sagittal T2-weighted MRI images in the T12 level were obtained from all subjects. We analyzed both the dorsal and ventral T12V body height. The difference in dorsal and ventral body heights of the control and LVF patients was calculated at the T12V level.

Results

The average dorsal T12V body height was 21.25±1.64 mm in the control group and 20.11±1.49 mm in the LVF group. The average ventral T12V body heights were 19.51±1.54 mm and 17.62±1.95 mm, respectively. The LVF group had significantly lower dorsal and ventral T12V body heights (both P<0.001). ROC curve analysis showed the best cut-off value for dorsal T12V body height value of 20.74 mm, with 62.5% sensitivity and 60.0% specificity. The best cut-off point of ventral T12V body height was 18.76 mm, with 68.8% sensitivity and 67.5% specificity.

Conclusion

This study confirmed the association between dorsal and ventral T12V body height and occurrence of LVF in postmenopausal women with osteoporosis. Dorsal and ventral T12V body height were both significantly associated with LVF, with ventral T12V body height being a more sensitive measurement parameter. Thus, to predict risk of LVF in patients, the treating physician should carefully inspect the ventral T12V body height.

Optimal cut-off points of lumbar pedicle thickness as a morphological parameter to predict lumbar spinal stenosis syndrome: a retrospective study

Purpose

Lumbar spinal stenosis syndrome (LSSS) is induced by factors such as ligamentum flavum hypertrophy, facet joint hypertrophy and disc degeneration. However, the role of lumbar pedicle (LP) in LSSS has yet to be evaluated. We devised a new morphological parameter called the lumbar pedicle thickness (LPT) to evaluate the connection between LSSS and the LP. We hypothesized that the LPT is a major morphological parameter in the diagnosis of LSSS.

Patients and methods

The LPT data were collected from 136 patients diagnosed with LSSS. A total of 99 control subjects underwent lumbar spine magnetic resonance imaging (MRI) as part of a detailed medical assessment. Axial T2-weighted magnetic resonance (MR) images were acquired from all the participants. Using our picture archiving and communication system, we analyzed the thickness of the LP at the level of L5 vertebra on MRI.

Results

The average LPT was 9.46±1.81 mm in the control group and 13.26±1.98 mm in the LSSS group. LSSS patients showed a significantly greater LPT (P<0.001) than the control group. The receiver operating characteristic (ROC) curve analysis showed an optimal cutoff point of 11.33 mm for the LPT, with 83.8% sensitivity, 83.8% specificity and area under the curve of 0.92 (95% confidence interval [CI], 0.89-0.96).

Conclusion

A higher LPT was associated with a higher possibility of LSSS, suggesting its importance in the evaluation of patients with LSSS.

Facet joint hypertrophy is a misnomer: A retrospective study

One of the major causes of lumbar spinal canal stenosis (LSCS) has been considered facet joint hypertrophy (FJH). However, a previous study asserted that "FJH" is a misnomer because common facet joints are no smaller than degenerative facet joints; however, this hypothesis has not been effectively demonstrated. Therefore, in order to verify that FJH is a misnomer in patients with LSCS, we devised new morphological parameters that we called facet joint thickness (FJT) and facet joint cross-sectional area (FJA).We collected FJT and FJA data from 114 patients with LSCS. A total of 86 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of routine medical examinations, and axial T2-weighted MRI images were obtained from all participants. We measured FJT by drawing a line along the facet area and then measuring the narrowest point at L4-L5. We measured FJA as the whole cross-sectional area of the facet joint at the stenotic L4-L5 level.The average FJT was 1.60 ± 0.36 mm in the control group and 1.11 ± 0.32 mm in the LSCS group. The average FJA was 14.46 ± 5.17 mm in the control group and 9.31 ± 3.47 mm in the LSCS group. Patients with LSCS had significantly lower FJTs (P < .001) and FJAs (P < .001).FJH, a misnomer, should be renamed facet joint area narrowing. Using this terminology would eliminate confusion in descriptions of the facet joint.

Thalamic Pain Misdiagnosed as Cervical Disc Herniation

Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease.

Silane grafted chitosan for the efficient remediation of aquatic environment contaminated with arsenic(V)

HYPOTHESIS

Chitosan, naturally abundant biomaterial showed an insignificant affinity toward arsenate. The incorporation of organosilane could improve the physical and chemical properties of chitosan for the efficient removal of arsenate from aquatic environment.

EXPERIMENT

The hybrid materials were obtained by grafting the natural biopolymer chitosan with 3-mercaptopropyl trimethoxysilane (CHMS) and trimethoxy-octylsilane (CHTS). The hybrid materials along with bare chitosan were characterized with SEM-EDX, FT-IR and BET specific surface area analyses and the solid materials were further employed in the efficient remediation of aqueous solutions contaminated with As(V) under batch and column reactor operations.

FINDINGS

The hybrid materials showed an extremely high percentage of As(V) removal compared to bare chitosan within a wide range of pH. As(V) was aggregated rapidly onto the solid surfaces and relatively high percent removal of As(V) was achieved in a wide range of As(V) initial concentrations. Moreover, As(V) was bound with, relatively, weaker forces and forming an 'outer sphere complexes' at the surface of solids. The presence of co-existing ions could not significantly affect the removal of As(V) from aqueous solutions. Furthermore, breakthrough data confirmed that these two hybrid materials possessed significantly high loading capacity of As(V) even under dynamic conditions.

Reference intervals for whole blood viscosity using the analytical performance-evaluated scanning capillary tube viscometer

OBJECTIVES

This study was performed to establish the reference intervals for whole blood viscosity (WBV) using the analytical performance-evaluated scanning capillary tube viscometer (SCTV).

DESIGN AND METHODS

The analytical performance of the SCTV was evaluated using three different levels of QC materials and sixty human EDTA-blood samples. To establish the reference intervals for WBV, 297 healthy individuals (123 men and 174 women) were selected from 1083 subjects.

RESULTS

Within-day precisions with QC materials and human whole blood and between-day precisions with QC materials were below 5.0%, 6.6% and 8.0% in CVs at all shear rates, respectively. Comparison tests between the SCTV and the Brookfield viscometer showed a significant correlation (R(2)=0.972, p<0.001). The reference intervals for WBV in healthy men were 3.66-5.41cP at 300s(-1) and 23.15-36.45cP at 1s(-1) while those in women were 3.27-4.32cP at 300s(-1) and 18.20-27.36cP at 1s(-1), respectively.

CONCLUSIONS

Using the analytical performance-evaluated SCTV, the reference intervals for WBV were established in healthy adults, which could be beneficial to the clinical utility of WBV in the aspect of appropriate modalities for the improvement of blood viscosity.

A case of neuromyelitis optica misdiagnosed as cervicogenic headache

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system associated with longitudinally extensive myelitis and optic neuritis. It is characterized by relapses that lead to blindness and paralysis sequelaes. But, this is rare disease; therefore high clinical suspicion for a correct diagnosis and proper examinations are not easy. However, early diagnosis is essential to prevent sequelae. We report the case of NMO with headache. A 30-year male patient who suffered headache visited our pain clinic because of aggravated pain despite treatment. The cause of the pain was revealed as NMO by more detailed previous history and examination.

Gender and age differences in the impact of overweight on obesity-related quality of life among Korean adults

SUMMARY

OBJECTIVE

To investigate gender and age difference in impact of overweight on health-related quality of life (HRQOL) among Korean adults.

METHODS

Cross-sectional obesity-related quality of life (QOL) scores were measured by a Korean obesity-related QOL scale (KOQOL) from 448 Korean adults aged 20-80 years. A body mass index (BMI) was categorized with normal-weight as BMI < 23 kg/m(2), overweight as BMI ≥ 23 kg/m(2) based on the alternative cutoff points for Asians. Each gender was respectively stratified by median age, 45 years for men and 50 years for women, to examine the obesity-related QOL by age groups.

RESULTS

Women had a poorer obesity-related QOL compared to men (p < 0.001). In the younger age group, overweight women had a poorer obesity-related QOL compared with normal-weight women (p < 0.001), however normal-weight and overweight men showed no difference in obesity-related QOL. In the older age group, overweight men showed better QOL on the domains of work-related and psychosocial health than those for normal-weight men, but overweight women still suffered from work-related and routine life QOL.

CONCLUSIONS

This study showed the impact of overweight on obesity-related QOL was different for gender and age group. We should consider the results to manage weight in overweight persons.

Recurrent unilateral lung ventilation disorder in a patient that experienced rocuronium-induced anaphylactic bronchospasm during laparoscopic rectal surgery -A case report-

Rocuronium is the anesthetic agent most likely to cause anaphylaxis. Immediately after intravenous rocuronium administration, the authors experienced ventilatory impairment due to unilateral bronchospasm (left lung), which was relieved by emergency treatment. However, 80 minutes after beginning laparoscopic surgery for rectal cancer, the left lung suddenly re-collapsed under pneumoperitoneum in the Trendelenburg position. A postoperative intradermal test revealed that rocuronium, vecuronium, atracurium, succinylcholine, or thiopental could induce anaphylaxis in this patient, but it was not established whether the second incident during surgery was due to endobronchial intubation or anaphylactic bronchospasm. This case cautions that under pneumoperitoneum in the Trendelenburg position, patients suspected of being prone to anaphylactic bronchospasm should also be considered at risk of endobronchial intubation.

Patient repositioning and the amelioration of airway obstruction by an anterior mediastinal tumor during general anesthesia -A case report-

An 18-year-old male with huge anterior mediastinum mass was scheduled for thoracotomic incisional biopsy under general anesthesia after failed fluoroscopy-guided percutaneous needle biopsy. Under propofol and succinylcholine anesthesia, intubation was successfully achieved using a Univent tube. However, when we changed the patient's position from supine to right lateral decubitus, oxygen saturation declined. He was then positioned supine, but hypoxemia did not improve. Because the tumor expanded toward the left thoracic field, we considered that the left lateral decubitus position might help relieve the mass effect on the main bronchus. His position was changed accordingly and soon after, hypoxemia improved and surgery was undertaken under cardiopulmonary bypass (CPB). The biopsy was successfully performed under CPB without complication.

Metabolic syndrome and quality of life (QOL) using generalised and obesity-specific QOL scales

OBJECTIVES

We investigated the association between metabolic syndrome (MS) and health-related quality of life (HRQOL) assessed using generalised and obesity-specific QOL instruments.

METHODS

We recruited 456 outpatients [age: 19-81 years, body mass index (BMI): 16.3-36.7 kg/m2] in the primary care division from 12 general hospitals in Korea. HRQOL was measured using EuroQol comprising the health states descriptive system (EQ-5D) and visual analogue scale (EQ-VAS) as a general instrument. The Korean Obesity-related QOL scale (KOQOL) composed of six domains was used as a disease-specific QOL instrument. MS was defined on the basis of International Diabetes Federation (IDF) criteria with Korean-specific waist circumference cutoffs (men: 90 cm, women: 85 cm).

RESULTS

Subjects with MS displayed significantly higher impairment of EQ-5D and KOQOL. Binary logistic regression analysis of MS patients with controls for age, gender, smoking, alcohol, exercise, education, income, marital status and medication history disclosed odds ratio (OR) values of 2.13 (1.33-3.41) for impaired total KOQOL, 2.07 (1.31-3.27) for impaired physical health, 1.63 (1.03-2.60) for impaired work-related health, 2.42 (1.45-4.04) for impaired routine life, 2.08 (1.27-3.40) for impaired sexual life and 2.56 (1.59-4.11) for diet distress. Among the EQ-5D dimensions, only pain/discomfort displayed a significantly increased OR of 1.60 (1.01-2.56) in MS group.

CONCLUSIONS

Subjects with MS displayed a significantly impaired HRQOL compared with those without MS. MS and HRQOL were more strongly associated in obesity-specific QOL than in generalised QOL.

Applicability of reused industrial dry sanding powder for adsorption of arsenic

This study examined the potential reuse of powdered wastes (PW) generated during the sanding and sawing process in a local chemical company in Korea with the viewpoint of the recycling these wastes and minimizing the level of contamination. As the aluminium hydroxide inside the PW could be thermally converted to various types of aluminium oxides depending on the calcination temperature, the adsorptive properties could be changed and it may affect on adsorption ability. Calcination of the PW was performed for 3 h at 550 degrees C, 750 degrees C, and 950 degrees C. From the results, amorphous aluminium oxide was thermally generated by calcinating the PW at 550 degrees C and with further increase of temperature to 950 degrees C, the crystallinity of amorphous aluminium oxide was gradually increased. The physicochemical analysis of calcined powdered wastes (CPW) at various temperatures showed that more developed porosity was noted in the CPW as the calcinations temperature increased, whereas surface area was significantly decreased from 175.5 m2 g(-1) to 46.5 m2 g(-1). The removal efficiency of arsenate on the CPW decreased as the calcinations temperature increased from 550 degrees C to 950 degrees C. The CPW550 exhibited the highest adsorption capacities toward arsenate over pH range of 2-8 and showed a complete removal of the arsenate (10.0 mg L(-1)) within the first 10 min. Adsorption kinetic studies showed that the rate of arsenic adsorption on the CPW decreased with the increase of the calcination temperature. When the maximum adsorption capacity of arsenic onto the CPW was calculated by Langmuir equation, the CPW550 has the highest value as 43.9 mg g(-1).

Alleviation of osteoarthritis by calycosin-7-O-beta-D-glucopyranoside (CG) isolated from Astragali radix (AR) in rabbit osteoarthritis (OA) model

OBJECTIVE

This work was undertaken to assess the protective effect of an isoflavonoid, calycosin-7-O-beta-D-glucopyranoside (CG), isolated from Astragali radix (AR) on the pathogenesis of osteoarthritis (OA)-like lesion in a rabbit model.

METHODS

Nine rabbits underwent an anterior cruciate ligament and menisectomy transection (ACLMT) of the rear knee joints to induce OA-like lesion. They were randomly divided into three groups (n=6/group): a negative control group treated with 200 microl of 0.5% (v/v) dimethyl sulfoxide (DMSO), a positive control group treated with 200 microl of 100 microM piroxicam, and a test group treated with 100 microg/500 microl of CG, where the test agents were administered by injection once a week for 4 weeks starting from the third week. Rabbits were then sacrificed to observe the progression of OA-like lesion. The synovial fluid was analyzed for the amounts of total proteins, glycosaminoglycans (GAG) and prostaglandin E(2) (PGE(2)). In addition, histopathologic analyses were performed on the OA-like articular cartilage with or without therapeutic treatments.

RESULTS

The total synovial fluid volume (P<0.05) was most strikingly reduced by the treatment with CG. Moreover, the CG treatment also significantly alleviated the OA-induced accumulation of prostaglandin (PG) (P<0.001) and total proteins (P<0.001) in the synovial fluid. The histopathologic analyses revealed that the CG treatment reduced the severity of the OA-like structural damages in the cartilage. However, the level of PGE(2), a pathologic inflammatory molecule, was not diminished by CG or piroxicam.

CONCLUSION

These results indicate that the isoflavonoid CG isolated from AR significantly alleviated the pathologic changes in the OA-like rabbit knee joints. This suggests that CG from AR could be a promising treatment for the therapy of OA.

Immunostimulatory effects of the anionic alkali mineral complex Barodon on equine lymphocytes

Previous studies have shown that the anionic alkali mineral complex BARODON has an immunoenhancing effect on pigs as an adjuvant and as a nonspecific immunostimulant. Likewise, the equine immune system has been defined with various monoclonal antibodies specific to equine leukocyte differentiation antigens to determine the possibility of enhancing equine resistance to respiratory diseases and promoting other immunostimulatory effects with the application of BARODON. Compared with the control group, after 3 weeks of treatment, BARODON-treated groups showed higher proportions of cells (P < 0.05) expressing major histocompatibility complex class II and CD2, CD4(+), CD4(+) CD25(+), CD8(+), and CD8(+) CD25(+) T lymphocytes, dendritic cells, and surface immunoglobulin M(+) B lymphocytes in peripheral blood, as well as enhanced cell proliferative responses with phytohemagglutinin and increased phagocytic activity against Streptococcus equi and Staphylococcus aureus strains with high antibiotic resistance, the bacteria frequently identified as etiologic agents of equine respiratory diseases at the Seoul Race Park in Seoul, Korea. This study shows that BARODON may act as an immunostimulator and can be an effective alternative to antimicrobial feed additives for nonspecific improvements in equine immune responses, particularly against respiratory diseases.

Relative atrophy of the flocculus and ocular motor dysfunction in SCA2 and SCA6

Two hereditary ataxia syndromes show distinct profiles of region-specific atrophy and ocular motor deficits. Selective pontine atrophy is associated with slowed saccades in ataxin-2 mutations, and selective floccular atrophy is associated with impaired pursuit and gaze-holding abnormalities in Ca(V)2.1 mutations. Although the flocculus seems to be spared relative to the pons in ataxin-2 mutations, and pursuit and gaze-holding appear to be relatively normal, these can be difficult to assess at the bedside, as corrective saccades are also slow and hard to discern. Here, we show the presence of significant floccular atrophy compared with controls in both ataxin-2 and Ca(V)2.1 mutations, which raises the possibility that abnormalities of smooth pursuit or gaze-holding are present in both conditions.

Pontine and cerebellar atrophy correlate with clinical disability in SCA2

Spinocerebellar ataxia type 2 (SCA2) has protean manifestations, and a clinical marker of progression is needed. Although MRI is a promising tool, it is unclear whether the degree of atrophy shown on MRI is correlated with clinical dysfunction. Here the authors used high-resolution volumetric MRI analysis to show that cerebellar and pontine volumes specifically and closely correlate with functional staging scores.

A case of 49,XXXXX in which the extra X chromosomes were maternal in origin

This report describes an 11 month old female baby with features of pentasomy X. A molecular and cytogenetic evaluation revealed that her karyotype was 49,XXXXX and her extra X chromosomes were of maternal origin. She has muscular hypotonia, mental retardation, a cleft palate, mild hydrocephalus as a result of dilatation of both lateral ventricles, hyperextensible elbow joints, proximal radioulnar synostosis, clinodactyly of the fifth finger, valgus of the feet, and small hands and feet. In addition, she has a persistent pupillary membrane and congenital chorioretinal atrophy. The pathogenesis of pentasomy X is not clear at present, but it is thought to be caused by successive maternal non-dysjunctions.

Nitrogen removal characteristics analyzed with gas and microbial community in thermophilic aerobic digestion for piggery waste treatment

In order to characterize the nitrogen conversion characteristics in a thermophilic aerobic digestion (TAD) system, a laboratory study has been conducted with the analysis of effluent gas and microbial community in the sludge samples. The lab TAD system was operated with HRT of 3 days and 60 degrees C. Based on the nitrogen mass balance, it has been found that about 2/3 of the daily load of nitrogen was converted to the gaseous form of nitrogen whereas cellular transformation and unmetabolized nitrogen accounted for about 1/3. Among the gaseous nitrogen transformation, significant amount of influent nitrogen had been converted to N2 gas (29% of influent N) and N2O (9% of influent N). Ammonia conversion was only 28% of influent N. The detection of N2O gas is a clear indication of the biological nitrogen reduction process in the thermophilic aerobic digester. No conclusive evidence for the existence of aerobic deammonification has been found. The microbial community analysis showed that thermophilic bacteria such as Bacillus thermocloacae, Bacillus sp. and Clostridial groups dominated in this TAD reactor. The diverse microbial community in TAD sludge may play an important role in removing both strong organics and nitrogen from piggery waste.

Gas analysis reveals novel aerobic deammonification in thermophilic aerobic digestion

A laboratory-scale thermophilic aerobic digester was operated with piggery wastewater. The operating temperature varied from 50-70 degrees C. It has been found that excessive nitrogen removal occurred in the laboratory-scale thermophilic system at various HRTs. Nitrite and nitrate were not observed in the effluent. Gas measurement reveals the presence of significant amount of N2O along with NH3 gas. The rational production of N2O gas in accordance with temperature and HRT suggests that biologically mediated deammonification processes significantly contribute to the N removal. Although further microbiological investigation is required to clarify the exact nitrogen removal mechanism, the large production of N2O gas seems to be a result of the existence of a rapid growing heterotrophic deammonification process in the thermophilic system.

Recombinant enterokinase light chain with affinity tag: expression from Saccharomyces cerevisiae and its utilities in fusion protein technology

Enterokinase and recombinant enterokinase light chain (rEK(L)) have been used widely to cleave fusion proteins with the target sequence of (Asp)(4)-Lys. In this work, we show that their utility as a site-specific cleavage agent is compromised by sporadic cleavage at other sites, albeit at low levels. Further degradation of the fusion protein in cleavage reaction is due to an intrinsic broad specificity of the enzyme rather than to the presence of contaminating proteases. To offer facilitated purification from fermentation broth and efficient removal of rEK(L) after cleavage reaction, thus minimizing unwanted cleavage of target protein, histidine affinity tag was introduced into rEK(L). Utilizing the secretion enhancer peptide derived from the human interleukin 1 beta, the recombinant EK(L) was expressed in Saccharomyces cerevisiae and efficiently secreted into culture medium. The C-terminal His-tagged EK(L) was purified in a single-step procedure on nickel affinity chromatography. It retained full enzymatic activity similar to that of EK(L), whereas the N-terminal His-tagged EK(L) was neither efficiently purified nor had any enzymatic activity. After cleavage reaction of fusion protein, the C-terminal His-tagged EK(L) was efficiently removed from the reaction mixture by a single passage through nickel-NTA spin column. The simple affinity tag renders rEK(L) extremely useful for purification, post-cleavage removal, recovery, and recycling and will broaden the utility and the versatility of the enterokinase for the production of recombinant proteins.

Occlusive myocardial infarction: investigation of bis-gadolinium mesoporphyrins-enhanced T1-weighted MR imaging in a cat model

PURPOSE

To test whether bis-gadolinium mesoporphyrins-enhanced magnetic resonance (MR) imaging can accurately depict irreversibly damaged myocardium in occlusive myocardial infarction.

MATERIALS AND METHODS

Ten cats were subjected to 90 minutes of occlusion of the left anterior descending coronary artery. Bis-gadolinium mesoporphyrins-enhanced T1-weighted MR imaging was performed in the cats for 6 hours. Histopathologic examinations with 2'3'5-triphenyl tetrazolium chloride (TTC) staining and electron microscopy were performed on the resected specimens. The time course and pattern of signal intensity enhancement were evaluated. The size of the infarcted myocardium was estimated on the MR images by measuring the size of the signal intensity-enhanced area.

RESULTS

In eight of 10 cats, it was impossible to distinguish infarcted myocardium from normal myocardium at visual inspection of T1-weighted MR images. The contrast ratio between infarcted and normal myocardium did not increase significantly over time. In one of the two remaining cats, a doughnut pattern of signal intensity enhancement was noted. The other cat showed intensely homogeneous enhancement of infarcted myocardium at MR imaging. The size of the area of signal intensity enhancement at MR imaging in these two cats was accurately mapped to that of the infarction on the TTC-stained specimens.

CONCLUSION

Occlusive myocardial infarction cannot be accurately detected at bis-gadolinium mesoporphyrins-enhanced MR imaging.

Immunostimulatory effects of anionic alkali mineral complex solution Barodon in porcine lymphocytes

The anionic alkali mineral complex solution, Barodon (Barodon-S.F. Corp., Korea), was evaluated for its effectiveness as a nonspecific immunostimulator in pigs. The effects of Barodon were determined by analysis of feed efficiency, growth rate, and phenotype of leukocyte subpopulations using monoclonal antibodies specific to porcine leukocyte differentiation antigens and flow cytometry (FC). The study was focused to investigate the change in proportion of the CD4+CD8+ double positive T lymphocyte subpopulation (dpp) which exists uniquely in pigs. In addition, the mitogen-stimulated lymphoproliferative response, tissue distribution in lymphoid organs and the adjuvant effect of Barodon on hog cholera vaccine efficiency were determined. The study has revealed the average daily gain rates and feed conversion rates were significantly (p<0.05) improved in either group of pigs fed with 0.05% Barodon-spray feed (Tx-1) or pigs fed with 3% Barodon-fermented feed (Tx-2) in comparison with group of pigs fed with feed containing no Barodon (control). The proportion of cells expressing CD4+ antigen in Barodon-treated group increased from 3 weeks posttreatment and was significantly higher (p<0.05) than that of control at 8 weeks posttreatment. Particularly, the significantly higher proportion was maintained from 8 weeks through 13 weeks posttreatment in Tx-1 group (p<0.05). The proportion of cells expressing CD8+ antigen was significantly higher at 3 weeks posttreatment in Tx-2 (p<0.01). Proportion of MHC class II-expressing cells was significantly higher in Tx-1 and Tx-2 group at 11 weeks and 8 weeks posttreatment (p<0.05), respectively. In addition, the proportion of Non T/Non B (N) cells was also significantly higher in Tx-2 at 3 weeks posttreatment (p<0.01) and maintained to 13 weeks posttreatment (p<0.1). Between Barodon-treated groups, the proportion of MHC class II-expressing cells was observed to be larger in Tx-2 than Tx-1 from 3 weeks to 8 weeks posttreatment (p<0.05). However, there were no significant difference in the proportions of CD2+ cells, B cells, monocytes and granulocytes between Barodon-treated and control group during the experiment. Dual-color FC analysis, study has revealed an increased proportion of dpp present in lymphocytes obtained from peripheral blood (PB) and mesenteric lymph node (MLN) of Barodon-treated group at 8 and 11 weeks posttreatment. The proportion of dpp in PB was 27.5% and 32.1% in Tx-1 and Tx-2, respectively, but only 2.2% in control group at 8 weeks posttreatment. In MLN, the proportion was 45.1% and 52.1% in Tx-1 and Tx-2, respectively, otherwise 16.5% in control group at 8 weeks posttreatment. The mitogen-stimulated activity was significantly higher in Tx-1 than in the control group at 11 weeks posttreatment when cells were stimulated with Con A and PHA, respectively (p<0.01). Also, Con A-, PHA and PWM-stimulated activity was significantly higher in Tx-2 than in the control group at the same time (p<0.05). The tissue distribution of CD4+, CD8+ and CD4+CD8+ dpp in MLN and spleen was significantly larger in Tx-1 and Tx-2 than in the control group (p<0.01). Also, a larger proportion of dpp was observed in Tx-2 than Tx-1 in spleen between Barodon-treated groups (p<0.01). In conclusion, the study has demonstrated that Barodon had an immunostimulatory effect on pigs through proliferation and activation of porcine immune cells, specially CD4+CD8+ dpp lymphocytes.

Oxidative stress and neurodegeneration in prion diseases

Transmissible spongiform encephalopathies (TSEs), also termed prion diseases, are a group of fatal neurodegenerative diseases that affect humans and a number of other animal species. The etiology of these diseases is thought to be associated with the conversion of a normal protein, PrPC, into an infectious, pathogenic form, PrPSc. The PrPSc form shows greater protease resistance than PrPC and accumulates in affected individuals, often in the form of extracellular plaques. The pathogenesis and the molecular basis of neuronal cell death in these diseases are not well understood. Oxidative stress has been proposed to play an important role in the pathogenesis of several neurodegenerative disorders. In the present study, evidence of oxidative stress in scrapie, the archetype disease of the TSEs, is discussed. In addition, the mechanisms whereby oxidative stress could lead to neuronal degeneration are described.

Determination of human angiotensin converting enzyme (ACE) gene polymorphisms in erectile dysfunction: frequency differences of ACE gene polymorphisms according to the method of analysis

The D polymorphism of angiotensin converting enzyme (ACE) gene has been found to be associated with various diseases, and ACE may also be involved in the pathogenesis of erectile dysfunction. On the other hand, interpretation of the data on the association of DD genotype with various diseases is controversial, due to methodological and technical variations in detection of the polymorphisms. We investigated a possible association between the DD genotype and erectile dysfunction in a Korean population, and compared the frequency of ACEgenotypes using our multiplexed PCR method with those based on the conventional PCR method in a sample of erectile dysfunctional and control subjects. There was significant difference in the distribution of ACE genotypes between the erectile dysfunctional (conventional PCR) and the control subjects (multiplexed PCR) (chi2=7.395, p<0.05), but there was no significant difference in the distribution of the genotypes between both groups (chi2=0.815, p>0.05) when our multiplexed PCR method was used. Therefore our results suggest that especially the conventional PCR method for ACE gene polymorphism may require careful control and may need repeated testing to verify the insertion deletion (ID) heterozygotes, and that a multiplexed PCR method can markedly increase the detection rate of the I allele in ID heterozygotes. No association was found between I/D polymorphism and erectile dysfunctional subjects in the Korean population studied.

Differential expression of Bax and Bcl-2 in the brains of hamsters infected with 263K scrapie agent

To study the mechanism(s) of neuronal cell death during scrapie infection, we investigated the expression of Bax and Bcl-2 in brains of hamsters infected with 263K scrapie agent. The expression of Bcl-2 mRNA was significantly decreased in the brains of 263K scrapie-infected hamsters compared with controls, whereas the expression levels of Bax mRNA were significantly increased in scrapie-infected brain. The levels of Bax and Bcl-2 proteins in brains of scrapie and control animals reflected the difference in mRNA levels. Immunoreactivity for Bax and Bcl-2 were found predominantly within neurons. In scrapie-infected brains, the number of neuronal cells positive for Bcl-2 was significantly lower in the hippocampal CA3 region and was decreased in the cerebral cortex, whereas the number of neuronal cells positive for Bax was significantly increased in both regions. The possibility that differential regulation of Bax and Bcl-2 expression may play an important role in neuronal cell death induced by scrapie infection is discussed.

Irreversibly damaged myocardium at MR imaging with a necrotic tissue-specific contrast agent in a cat model

PURPOSE

To investigate the capability of a necrosis-avid magnetic resonance (MR) contrast agent, bis-gadolinium mesoporphyrins, for assessment of irreversibly damaged myocardium and to evaluate the time course of signal enhancement in the reperfused myocardium.

MATERIALS AND METHODS

Nine cats were subjected to 90 minutes of occlusion of the left anterior descending coronary artery followed by 90 minutes of reperfusion. Contrast material-enhanced T1-weighted spin-echo images were obtained for 12 hours in five cats and 6 hours in four cats. Pathologic examinations of the resected specimens were performed with 2'3'5-triphenyl tetrazolium chloride (TTC) histochemical staining and electron microscopy. The size of enhanced area on MR images was compared with that of irreversibly damaged myocardium with TTC staining. The time course of signal enhancement was evaluated.

RESULTS

The size of enhanced area on MR images was well correlated with that of irreversibly damaged myocardium with TTC staining. Maximum enhancement occurred 1-3 hours after administration of the contrast material, with mean enhancement of 171% that of normal myocardium. Electron microscopic examinations showed severe myocardial damage in the irreversibly damaged myocardium but only mild edematous changes in the reversibly damaged myocardium.

CONCLUSION

MR images enhanced with bis-gadolinium mesoporphyrins provide accurate sizing of irreversibly damaged myocardium with a strong and persistent signal enhancement in the reperfused myocardium.

Application of breath-hold T2-weighted, first-pass perfusion and gadolinium-enhanced T1-weighted MR imaging for assessment of myocardial viability in a pig model

The purpose of this study was to correlate the abnormal signal area on various magnetic resonance (MR) images to the infarct area on pathologic examination and to assess the myocardial viability on the basis of MR images. T2-weighted, first-pass perfusion, and delayed gadolinium-enhanced T1-weighted images were used as "one-stop examinations" in a pig model of reperfused myocardial infarction. The results of each MR image were compared with those of 2,3, 5-triphenyltetrazolium chloride (TTC) staining. The abnormal signal areas on T2-weighted and Gd-enhanced T1-weighted images were larger than the infarct areas on TTC staining (34.7% and 32.3% vs. 28.3%; P< 0.05), whereas the nonperfused areas on perfusion images were correlated (25.6% vs, 28.3%; P = 0.139). Electron microscopic examination showed severely distorted ultrastructures in the infarct areas and mildly damaged ultrastructures in the peri-infarct areas. Perfusion images probably reflected the infarct areas, whereas T2-weighted and Gd-enhanced T1-weighted images seemed to include peri-infarct as well as infarct areas.

MRI of myocardial infarction

With the advances in magnetic resonance imaging (MRI) technology that have occurred in recent years, it is possible to examine the myocardial status with high spatial and temporal resolutions in the evaluation of ischemic heart disease. The purpose of this article is to review the current status and the role of MRI for the evaluation of myocardial infarction. We discuss the pathophysiology of myocardial infarction, MRI techniques for the evaluation of myocardial status, and the pathophysiological significance of MR signal changes observed in various MRI techniques. We conclude that, with further development of MR techniques and contrast agents, MRI will play an increasing role in the diagnosis of ischemic heart disease. J. Magn. Reson. Imaging 1999;10:686-693.

Novel secretion system of recombinant Saccharomyces cerevisiae using an N-terminus residue of human IL-1 beta as secretion enhancer

An N-terminus sequence of human interleukin 1beta (hIL-1beta) was used as a fusion expression partner for the production of two recombinant therapeutic proteins, human granulocyte-colony stimulating factor (hG-CSF) and human growth hormone (hGH), using Saccharomyces cerevisiae as a host. The expression cassette comprised the leader sequence of killer toxin of Kluyveromyces lactis, the N-terminus 24 amino acids (Ser5-Ala28) of mature hIL-1beta, the KEX2 dibasic endopeptidase cleavage site, and the target protein (hG-CSF or hGH). The gene expression was controlled by the inducible UAS(gal)/MF-alpha1 promoter. With the expression vector above, both recombinant proteins were well secreted into culture medium with high secretion efficiencies, and especially, the recombinant hGH was accumulated up to around 1.3 g/L in the culture broth. This is due presumably to the significant role of fused hIL-1beta as secretion enhancer in the yeast secretory pathway. In our recent report, various immunoblotting analyses have shown that the presence of a core N-glycosylation resident in the hIL-1beta fragment is likely to be of crucial importance in the high-level secretion of hG-CSF from the recombinant S. cerevisiae. When the N-glycosylation was completely blocked with the addition of tunicamycin to the culture, the secretion of hG-CSF and hGH was decreased to a negligible level although the other host-derived proteins were well secreted to the culture broth regardless of the presence of tunicamycin. The N-terminal sequencing of the purified hG-CSF verified that the hIL-1beta fusion peptide was correctly removed by in vivo KEX2 protease upon the exit of fusion protein from Golgi complex. From the results presented in this article, it is strongly suggested that the N-terminus fusion of the hIL-1beta peptide could be utilized as a potent secretion enhancer in the expression systems designed for the secretory production of other heterologous proteins from S. cerevisiae.

Mitochondrial dysfunction induced by oxidative stress in the brains of hamsters infected with the 263 K scrapie agent

Scrapie, one of the prion diseases, is a transmissible neurodegenerative disease of sheep and other animals. Clinical symptoms of prion diseases are characterized by a long latent period, followed by progressive ataxia, tremor, and death. To study the induction of neurodegeneration during scrapie infection, we have analyzed the activities of various antioxidant enzymes and mitochondrial enzymes in cerebral cortex, brain stem, and cerebellum of scrapie-infected hamsters. The activity of mitochondrial Mn-superoxide dismutase (SOD) was decreased, while the activities of cytosolic Cu/Zn-SOD and catalase were not altered in infected brains. The activities of glutathione peroxidase and glutathione reductase were increased in scrapie-infected hamsters. The decreased activity of Mn-SOD might result in increasing oxidative stress in the mitochondria of infected brain; this concept is supported by our findings of a high level of lipid peroxidation, and low levels of ATPase and cytochrome c oxidase activity in the infected cerebral mitochondria. In addition, structural abnormalities of mitochondria have been observed in the neurons of hippocampus and cerebral cortex of infected brain. These results suggest that mitochondrial dysfunction caused by oxidative stress gives rise to neurodegeneration in prion disease.

Nevus spilus (speckled lentiginous nevus) associated with a nodular neurotized nevus

We report a case of nevus spilus with neurotized nevus studied by immunohistochemical methods using S-100, leu-6, glial fibrillary acid protein (GFAP), and myelin basic protein (MBP). Histologic findings of the speckled lesion showed irregular rete ridge elongation, increased epidermal melanocytes and melanin in the epidermis, and scattered nevus cell nests in the upper dermis, but showed neurotized nevus in the deep dermis, which has many features of neurofibroma. Diffuse expression of S-100 protein and MBP, focal staining with GFAP, and lack of staining with leu-7 were observed, Leu-7, positive only in neurofibromas and not in neurotized nevus, appears to be the more pertinent method for distinguishing neurotized nevus from neurofibroma.

Lymphoepithelial cyst associated with epithelial inclusion cyst

Lymphoepithelial cyst of the oral cavity is an uncommon cystic lesion lined with stratified squamous epithelium surrounded by lymphoid tissue. We report a case of lymphoepithelial cyst associated with two large epithelial inclusion cysts.

Pleomorphic fibroma on the scalp

We present the eleventh case of benign pleomorphic fibroma arising on the scalp in a young Korean woman. Histopathologically these lesions were characterized by a polypoid or dome-shaped cutaneous fibrous mass with sparse cellularity but striking nuclear atypia and rare mitotic figures. They all showed benign clinical behavior, despite these histopathological findings.

Congenital giant pigmented nevus associated with angiolipoma

We report a 20-year-old-Korean woman with a congenital giant pigmented nevus and angiolipoma. She was admitted our department with a large, dark, pigmented lesion on the right flank and abdomen and a slowly growing mass on the right flank area since birth. On biopsy, the specimen taken from the giant pigmented patch showed typical findings of compound nevus. The right flank mass was surgically removed. The specimen was composed of mature fat cells with an increased vascular component. These findings are compatible with angiolipoma.

Distribution of Lipiodol in hepatocellular carcinoma

Intrahepatic distribution of Lipiodol and I-131 Lipiodol infused via the hepatic arteries was evaluated in six patients with HCC who had undergone hepatic lobectomy or segmentectomy. CT scan and gamma camera radiograph confirmed that the oily contrast material or I-131 radioactivity accumulated selectively in the tumor over a long period. One to two thirds of the tumor mass appeared necrotic, although the extent tended to be larger in the case of radioactive Lipiodol infusion. The tumor cells contained numerous lipid globules within the cytoplasm. Also, oil red 0 stain demonstrated that the individual tumor cells had non-globular lipid on their surface. In conclusion, Lipiodol leaks out of the vascular spaces to attach to the cancer cell membrane as a non-globular lipid as well as to enter the cancer cells as a globular lipid. This phenomenon specific to cancer cells suggests a biochemical membrane change which may have occurred during carcinogenesis, causing alteration of membrane transport and cell death.

Acute nonlymphocytic leukemia in 171 children

The initial features, response to therapy, complications, cause of death, and prognostic factors of 171 consecutive children with ANLL are described and compated to historical data for adults with ANLL and for children with ALL. Major differences between children and adults with ANLL include a higher frequency of CNS leukemia and a lower frequency of early deaths in the children. The most important differences between children with ANLL and ALL are the absence of a peak age of incidence in ANLL and the far better response to therapy in ALL. Among features present at 100,000/mm3 or above, and no palpable hepatomegaly had significantly longer survivals, while patients with platelet counts below 10,000/mm3 had significantly shorter survivals. The frequency and duration of remission were significantly better with three protocols used since 1968 than previously. However, even with these protocols, the results were far from satisfactory, with a complete remission frequency of 66%, a median duration of hematological remission of 6 months, and a median duration of survival of 10 months. The striking contrast of these results in childhood ANLL with current results in childhood ALL underscores the need for novel, imaginative therapeutic approaches for ANLL.