A study of neuropsychiatric manifestations in COVID-19 infection in inpatients and its long-term outcomes in Malaysia

INTRODUCTION

This study aimed to determine the prevalence and association between the severity of COVID-19 and short and long-term neuropsychiatric symptoms, as well as the risk factors for the development of these symptoms.

MATERIALS AND METHODS

A prospective observational study was conducted between 1st October 2021 till September 2022 in the state of Johor, Malaysia. 300 patients with confirmed SARS-CoV-2 infection were randomly selected and followed up for six months. Data were analysed by using Chi-square test, Fisher's Exact test, Paired t test and Multiple logistic regression.

RESULTS

The prevalence of short-term neuropsychiatric symptoms was 78%, with anosmia being the most prevalent symptom. Long-term symptoms were found in 22.75% of patients, with headache being the most prevalent (p= 0.001). COVID-19 Stage 2 and 3 infections were associated with a higher risk of short-term neuropsychiatric symptoms, OR for Stage 2 infection was 5.18 (95% CI: 1.48-16.97; p=0.009) and for Stage 3 infection was 4.52 (95% CI: 1.76-11.59; p=0.002). Complete vaccination was a significant predictor of longterm symptoms with adjusted OR 3.65 (95% CI 1.22-10.91; p=0.021).

CONCLUSION

This study demonstrated that neuropsychiatric symptoms were common among COVID-19 patients in Johor, Malaysia and the risk of these symptoms was associated with the severity of the infection. Additionally, complete vaccination does not completely protect against long-term neuropsychiatric deficits. This is crucial for continuous monitoring and addressing neuropsychiatric symptoms in COVID-19 survivors.

New Zealand and Australian MRI technologists' (radiographers) MRI safety knowledge and confidence levels

INTRODUCTION

The MRI technologist (radiographer) is at the frontline of MRI safety decision-making and has the primary responsibility to provide high quality, efficient and safe patient care in the MRI environment. As MRI technology advances and new safety issues emerge, this study aimed to provide a snapshot of the preparedness of MRI technologists in New Zealand (NZ) and Australia to practise confidently and safely.

METHOD

An online questionnaire, administered via Qualtrics and covering a range of MRI safety topics, was distributed in 2018 via the New Zealand MR Users Group, the MRI Australia-NZ Group Facebook, and relevant professional bodies.

RESULTS

A total of 312 MRI technologists attempted the questionnaire, with 246 surveys being fully completed. Of these, 61% (n = 149) were in Australia, 36% (n = 89) in NZ, and 3% (n = 8) from other countries. Findings indicated that current MRI education is preparing MRI technologists in NZ and Australia to practise safely. However, while these technologists are confident in their MRI safety decision-making, accuracy levels within some groups need addressing.

CONCLUSION

To develop a consistent level of safe practice, it is proposed that a minimum level of MRI-specific education is defined and mandated to practise. Continuing professional development focussing on MRI safety must be encouraged and, if audited as part of registration, could also be mandated. Implementation of a supporting regulatory framework similar to NZ is recommended for other countries.

IMPLICATIONS FOR PRACTICE

All MRI technologists are responsible for the safety of their patients and staff. Employers must support and ensure MRI-specific education has been completed. Ongoing engagement in MRI safety events provided by MRI safety experts, professional bodies and/or universities is essential to remain up-to-date.

Methods and reference data for middle ear transfer functions

Human temporal bone specimens are used in experiments measuring the sound transfer of the middle ear, which is the standard method used in the development of active and passive middle ear implants. Statistical analyses of these experiments usually require that the TB samples are representative of the population of non-pathological middle ears. Specifically, this means that the specimens must be mechanically well-characterized. We present an in-depth statistical analysis of 478 data sets of middle ear transfer functions (METFs) from different laboratories. The data sets are preprocessed and various contributions to the variance of the data are evaluated. We then derive a statistical range as a reference against which individual METF measurements may be validated. The range is calculated as the two-sided 95% tolerance interval at audiological frequencies. In addition, the mean and 95% confidence interval of the mean are given as references for assessing the validity of a sample group. Finally, we provide a suggested procedure for measuring METFs using the methods described herein.

Effects of PrObiotics on the Symptoms and Surgical ouTComes after Anterior REsection of Colon Cancer (POSTCARE): A Randomized, Double-Blind, Placebo-Controlled Trial

We investigated microbiota changes following surgical colon cancer resection and evaluate effects of probiotics on microbiota and surgical recovery. This randomized double-blind trial was performed at four medical centers in South Korea. Of 68 patients expected to undergo anterior sigmoid colon cancer resection, 60 were eligible, of whom 29 and 31 received probiotics and placebo, respectively, for four weeks, starting at one week preoperatively. Third- and/or fourth-week information on anterior resection syndrome (ARS), inflammatory markers, and quality of life was obtained. Stool sample analysis was conducted after randomization and bowel preparation and at three and four postoperative weeks. Bacteria were categorized into Set I (with probiotic effects) and II (colon cancer-associated). The probiotic group’s ARS score showed an improving trend (p = 0.063), particularly for flatus control (p = 0.030). Serum zonulin levels significantly decreased with probiotics. Probiotic ingestion resulted in compositional changes in gut microbiota; greater increases and decreases in Set I and II bacteria, respectively, occurred with probiotics. Compositional increase in Set I bacteria was associated with reduced white blood cells, neutrophils, neutrophil-lymphocyte ratio, and zonulin. Bifidobacterium composition was negatively correlated with zonulin levels in the probiotic group. Probiotics improved postoperative flatus control and modified postoperative changes in microbiota and inflammatory markers.

Gastroprotective Effects of Cudrania tricuspidata Leaf Extracts by Suppressing Gastric cAMP and Increasing Gastric Mucins

Cudrania tricuspidata has been used as an East Asian folk remedy to treat various symptoms. Recently, scientific evidence of the efficacy of C. tricuspidata has emerged. The objective of this study was to elucidate protective role of C. tricuspidata in the gastric mucosa using pylorus-ligated Sprague-Dawley rats and primary parietal cells. C. tricuspidata ethanol extracts attenuated gastric mucosal damage, secretion, and juice acidity in pylorus-ligated rats; however, it did not affect expression of gastric acid-related genes [muscarinic acetylcholine receptor M3 receptor (M3R), histamine H2-receptors (H2R), and cholecystokinin-2/gastrin receptors (CCK2R)] or serum gastrin concentrations. Furthermore, extracts greatly reduced levels of gastric cyclic adenosine monophosphate (cAMP) and significantly increased mRNA levels of gastric-type mucins (MUC5AC and MUC6). To identify the mode of action of C. tricuspidata extract in regulating gastric acid secretion, intracellular cAMP and mRNA for H2R, M3R, and CCK2R were measured in primary parietal cells. mRNA levels of H2R, M3R, and CCK2R did not significantly differ following treatment with C. tricuspidata extract, whereas cAMP induced by the H2R-specific agonist was significantly decreased. C. tricuspidata may therefore reduce gastric acid secretion by inhibiting H2R activity rather than regulating mRNA expression. These finding suggest that ethanol extracts of C. tricuspidata inhibit H2R-related gastric acid secretion and increase gastric mucus to help prevent gastric mucosal damage. Therefore, C. tricuspidata extract has potential to be used in foods and medicines to prevent diseases related to gastric mucosal damage, such as gastritis and functional dyspepsia.

Metabolic and Lipidomic Profiling of Vegetable Juices Fermented with Various Probiotics

Fermented vegetable juices have gained attention due to their various beneficial effects on human health. In this study, we employed gas chromatography-mass spectrometry, direct infusion-mass spectrometry, and liquid chromatography-mass spectrometry to identify useful metabolites, lipids, and carotenoids in vegetable juice (VJ) fermented with Lactobacillus plantarum HY7712, Lactobacillus plantarum HY7715, Lactobacillus helveticus HY7801, and Bifidobacterium animalis ssp. lactis HY8002. A total of 41 metabolites, 24 lipids, and 4 carotenoids were detected in the fermented and non-fermented VJ (control). The lycopene, α-carotene, and β-carotene levels were higher in VJ fermented with L. plantarum strains (HY7712 and HY7715) than in the control. Proline content was also elevated in VJ fermented with HY7715. Uracil, succinic acid, and α-carotene concentration was increased in VJ fermented with HY7801, while glycine and lycopene levels were raised in VJ fermented with HY8002. This study confirmed that each probiotic strain has distinctive characteristics and produces unique changes to metabolic profiles of VJ during fermentation. Our results suggest that probiotic-fermented VJ is a promising functional beverage that contains more beneficial metabolites and carotenoids than commercial non-fermented VJ.

Cudrania tricuspidata Extract Protects against Reflux Esophagitis by Blocking H2 Histamine Receptors

Cudrania tricuspidata has been used in East Asia as a folk medicine for symptoms such as inflammation, allergy, and gastritis. Administration of C. tricuspidata extract to pylori-ligated rat stomachs reduces gastric acid secretion and alleviates esophagus damage caused by gastric reflux. Therefore, in this study we aimed to investigate whether C. tricuspidata extracts inhibit reflux esophagitis by blocking H₂ histamine receptor (H₂R). Dimaprit, a H₂R specific agonist, induced intracellular cyclic adenosine monophosphate (cAMP) production in U937 cells. Pretreatment with C. tricuspidata extracts significantly blocked dimaprit-induced cAMP production in a concentration-dependent manner. To extracted C. tricuspidata with different ethanol concentrations to determine the optimum method. We found that the 70% ethanol extract showed the most potent H₂R antagonistic effect against dimaprit-induced cAMP production. However, water extract did not show any H₂R blocking effect. These findings suggest that C. tricuspidata extracted using ethanol specifically inhibits gastric acid secretion and reduces esophageal injury by blocking H₂R in a competitive manner. Therefore, C. tricuspidata extracts may be used in food or medicine to prevent H₂R-related diseases, such as gastric hyperacidity and reflux esophagitis.

Oral Administration of Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 with Cinnamomi Ramulus Extract Reduces Diet-Induced Obesity and Modulates Gut Microbiota

Obesity is a major health issue worldwide, and is associated with many diseases including type 2 diabetes. In this study, we evaluated the anti-obesity effects of combinations of two lactic acid bacteria (LAB), Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032, and Cinnamomi Ramulus (CR) extract, and explored the mechanism through which they modulate gut microbiota using diet-induced obese mice. Male C57BL/6J mice were randomly divided into five groups that received a high-fat diet (HFD), HFD and LAB (HFD+LAB), HFD and CR extract (HFD+CR), HFD with LAB and CR extract (HFD+LAB+CR), or normal diet for 10 weeks. The mice in the HFD+LAB+CR group showed significant reductions in body weight gain, in particular epididymal fat and liver, blood leptin levels, and an increase in the levels of blood adiponectin. In addition, the LAB and CR extract altered the gut microbiota, mainly increasing the alpha diversity. These results demonstrate that a mixture of two LAB (Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032) and CR extracts alleviate HFD-induced obesity, and has potential of being used as a strategy for the treatment of obesity.

Lactobacillus plantarum HY7714 Restores TNF-α Induced Defects on Tight Junctions

In addition to intestinal balance, probiotics are known to have beneficial effects on skin inflammation, metabolic diseases, and emotions. Previously, we have reported the skin anti-aging effects of Lactobacillus plantarum HY7714 (HY7714) in a clinical trial. To prove the protective skin effects of HY7714 through the intestinal tight junction (TJ), we investigated the effects of HY7714 on the intestines through tumor necrosis factor (TNF)-α induced TJ defects in Caco-2 cells. Specifically, 24 h treatment with HY7714 restored the decreased expression of zonula occludens-1, occludin, and claudin-1 compared to the TNF-α-treated groups (P<0.05). It also attenuated the level of pro-inflammatory cytokines interleukin-6, 8, and 1β. Further, increases in the mRNA levels of Elk-1, nuclear factor-κB, and myosin light chain kinase expression induced by TNF-α were recovered by HY7714. These findings imply that HY7714 improves intestinal barrier integrity and is a potential therapeutic agent for dysfunctions derived from TJ defects.

Effects of weight loss using supplementation with Lactobacillus strains on body fat and medium-chain acylcarnitines in overweight individuals

Our previous study showed that supplementation with a combination of Lactobacillus curvatus (L. curvatus) HY7601 and Lactobacillus plantarum (L. plantarum) KY1032 reduced the body weight, body fat percentage, body fat mass and L1 subcutaneous fat area in overweight subjects. We aimed to evaluate whether the changes in adiposity after supplementation with Lactobacillus strains were associated with metabolic intermediates. A randomized, double-blind, placebo-controlled study was conducted on 66 non-diabetic and overweight individuals. Over a 12-week period, the probiotic group consumed 2 g of probiotic powder, whereas the placebo group consumed the same product without the probiotics. To investigate metabolic alterations, we performed plasma metabolomics using ultra-performance liquid chromatography and mass spectrometry (UPLC-LTQ/Orbitrap MS). Probiotic supplementation significantly increased the levels of octenoylcarnitine (C8:1), tetradecenoylcarnitine (C14:1), decanoylcarnitine (C10) and dodecenoylcarnitine (C12:1) compared with the levels from placebo supplementation. In the probiotic group, the changes in the body weight, body fat percentage, body fat mass and L1 subcutaneous fat area were negatively associated with changes in the levels of C8:1, C14:1, C10 and C12:1 acylcarnitines. In overweight individuals, probiotic-induced weight loss and adiposity reduction from the probiotic supplementation were associated with an increase in medium-chain acylcarnitines.

Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 Cell Extracts Inhibit Adipogenesis in 3T3-L1 and HepG2 Cells

Some lactic acid bacteria (LAB) and their cellular components have antiobesity effects. In this study, we evaluated the antiadipogenic effects of a mixture of two LAB-Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032-using 3T3-L1 preadipocytes and HepG2 hepatocarcinoma cells. 3T3-L1 cells treated with a 1:1 ratio of HY7601 and KY1032 during differentiation showed reduced lipid accumulation by Oil Red O staining, as well as decreased leptin secretion and mRNA expression of peroxisome proliferator-activated receptor-γ and CCAAT/enhancer binding protein-α. HY7601 and KY1032 treatment also suppressed mitochondrial biogenesis and inhibited the expression of genes encoding mitochondrial transcription factors, as well as those related to fatty acid synthesis in HepG2 cells. The antiadipogenic effects of LAB were associated with the cell membrane fraction. These results demonstrate that a mixture of two LAB (HY7601 and KY1032) inhibits adipogenesis in preadipocytes and liver cells and is a potential therapeutic strategy for the treatment of obesity.

Metabolomics and Lipidomics Approaches in the Science of Probiotics: A Review

The intestinal microflora plays important roles in the health of the host, such as nutrient processing and the modulation of intestinal immune responses. The constituents of the diet greatly affect the composition of the microbiota and its metabolites. The human intestinal microbiota is made up of around 100 trillion microbial cells encompassing at least 300 species. Consuming probiotics may lead to changes in the intestinal microflora that influence host health. Metabolomics is a powerful tool for revealing metabolic changes in biofluids, tissues, and organs of hosts induced by the consumption of probiotics, and lipidomics in particular is a technical approach that focuses on the analysis of lipids in various cells and biofluids. Metabolomics and lipidomics have been used to investigate intracellular and extracellular metabolites as well as for the nontargeted profiling and fingerprinting of metabolites. Based on metabolomics and lipidomics investigations, we reviewed the effects of consuming probiotics on metabolic profiles in controlled intestinal environments. We also discuss the associations between metabolic changes and human diseases after consuming probiotics in uncontrolled intestinal environments. In addition, we review the metabolic changes that take place within the food matrix during probiotic fermentation.

Tyndallized Lactobacillus plantarum HY7712 Restores Whole-Body γ-Irradiation-Impaired Th Cell Differentiation in Mice

In the present study, we investigated the effect of tyndallized HY7712 (tHY7712) on the expression of Th cell specific transcription factors and cytokines in whole-body γ-irradiated mice. Oral administration of tHY7712 strongly recovered the γ-irradiation-suppressed expression of helper T (Th) cell- and regulatory T cell-related transcription factors and cytokines, such as T-bet, Foxp3, IFN-γ, TNF-α, and IL-10, and suppressed Th2 cell-associated transcription factor and cytokine GATA3 and IL-5, respectively. Furthermore, compared with the control, tHY7712 treatment also restored γ-irradiation-impaired natural killer and cytotoxic T cell activities against YAC-1 tumor cells to 97.8% and 98.6%, respectively.

Apple Pomace Extract Improves Endurance in Exercise Performance by Increasing Strength and Weight of Skeletal Muscle

Ursolic acid is a lipophilic pentacyclic triterpenoid found in many fruits and herbs and is used in several herbal folk medicines for diabetes. In this study, we evaluated the effects of apple pomace extract (APE; ursolic acid content, 183 mg/g) on skeletal muscle atrophy. To examine APE therapeutic potential in muscle atrophy, we investigated APE effects on the expression of biomarkers associated with muscle atrophy and hypertrophy. We found that APE inhibited atrophy, while inducing hypertrophy in C2C12 myotubes by decreasing the expression of atrophy-related genes and increasing the expression of hypertrophy-associated genes. The in vivo experiments using mice fed a diet with or without APE showed that APE intake increased skeletal muscle mass, as well as grip strength and exercise capacity. In addition, APE significantly improved endurance in the mice, as evidenced by increased exhaustive running time and muscle weight, and reduced the expression of the genes involved in the development of muscle atrophy. APE also decreased the concentration of serum lactate and lactate dehydrogenase, inorganic phosphate, and creatinine, the indicators of accumulated fatigue and exercise-induced stress. These results suggest that APE may be useful as an ergogenic functional food or dietary supplement.

Probiotic Mixture KF Attenuates Age-Dependent Memory Deficit and Lipidemia in Fischer 344 Rats

To investigate the memory-enhancing effect of lactic acid bacteria, we selected the probiotic mixture KF, which consisted of Lactobacillus plantarum KY1032 and Lactobacillus curvatus HY7601 (1 × 10(11) CFU/g of each strain), and investigated its antilipidemic and memoryenhancing effects in aged Fischer 344 rats. KF (1 × 10(10) CFU/rat/day), which was administered orally once a day (6 days per week) for 8 weeks, significantly inhibited age-dependent increases of blood triglyceride and reductions of HDL cholesterol (p < 0.05). KF restored agereduced spontaneous alternation in the Y-maze task to 94.4% of that seen in young rats (p < 0.05). KF treatment slightly, but not significantly, shortened the escape latency daily for 4 days. Oral administration of KF restored age-suppressed doublecortin and brain-derived neurotrophic factor expression in aged rats. Orally administered KF suppressed the expression of p16, p53, and cyclooxygenase-2, the phosphorylation of Akt and mTOR, and the activation of NF-κB in the hippocampus of the brain. These findings suggest that KF may ameliorate age-dependent memory deficit and lipidemia by inhibiting NF-κB activation.

In-plane motions of the stapes in human ears

The piston-like (translation normal to the footplate) and rocking-like (rotation along the long and short axes of the footplate) are generally accepted as motion components of the human stapes. It has been of issue whether in-plane motions, i.e., transversal movements of the footplate in the oval window, are comparable to these motion components. In order to quantify the in-plane motions the motion at nine points on the medial footplate was measured in five temporal bones with the cochlea drained using a three-dimensional (3D) laser Doppler vibrometer. It was found that the stapes shows in-plane movements up to 19.1 ± 8.7% of the piston-like motion. By considering possible methodological errors, i.e., the effects of the applied reflective glass beads and of alignment of the 3D laser Doppler system, such value was reduced to be about 7.4 ± 3.1%. Further, the in-plane motions became minimal (≈ 4.2 ± 1.4% of the piston-like motion) in another plane, which was anatomically within the footplate. That plane was shifted to the lateral direction by 118 μm, which was near the middle of the footplate, and rotated by 4.7° with respect to the medial footplate plane.

Immunohistochemical expression of matrix metalloproteinases in the granulomatous rosacea compared with the non-granulomatous rosacea

BACKGROUND

There is a granulomatous variant which is recognized in the rosacea spectrum. However, the pathogenesis of granuloma formation in rosacea has not been clearly demonstrated. Matrix metalloproteinases (MMPs) are required for recruitment of inflammatory cells and for tissue remodelling, making way for the development of well-organized granuloma.

OBJECTIVE

The aim of this study was to investigate the expression of transforming growth factor (TGF)-β, TGF-β type II receptor (TβRII), Tumour necrosis factor (TNF)-α, MMP-1, 2 and 9 in the granulomatous rosacea (GR) compared with the non-granulomatous rosacea (NGR) and test the hypothesis that the changes of these profiles in GR would be related with chronic ultraviolet radiation (UVR)-exposure.

METHODS

Facial skin samples were obtained from 20 patients with GR and NGR (control group). The sections were stained using haematoxylin and eosin, Verhoeff's elastic stain, and antibodies to TGF-β, TβRII, TNF-α, MMP-1, -2 and -9.

RESULTS

The amount of elastotic material was significantly increased in the dermis of GR lesions. Expression of TGF-β was significantly decreased in the epidermis of GR lesions compared with NGR lesions. In addition, the expression of MMP-9 was significantly increased in the dermis of GR lesions compared with NGR lesions, especially at the centre of the granuloma on a semi-quantitative analysis. MMP-2 expression was also increased in GR lesions, although the difference between the two groups was not statistically significant.

CONCLUSIONS

The results of this study suggest that the increased expression of MMPs in the dermis may participate in granuloma formation of GR in association with UVR.

Altered expression of costimulatory molecules in Behçet's disease according to clinical activity

BACKGROUND

The reduced expression of molecules limiting excessive immune responses has been considered a pathogenic mechanism associated with autoimmune diseases.

OBJECTIVES

To understand the implications of costimulatory molecules in Behçet's disease (BD), the expression of CTLA-4 and PD-1 on T-cell subsets and of their ligands CD80, CD86 and PD-L1 on antigen-presenting cells (APCs) was investigated.

METHODS

Peripheral blood mononuclear cells (PBMC) from 11 patients with active BD, eight patients with inactive BD, eight patients with recurrent aphthous ulcers and 10 healthy volunteers as healthy controls (HC) were stimulated with phorbol myristate acetate and ionomycin. The expression of costimulatory molecules was then analysed by flow cytometry. Soluble CTLA-4 (sCTLA-4) concentrations were determined by enzyme-linked immunosorbent assay and the transcript level of PD-L1 was measured by real-time polymerase chain reaction. The PD-L1 expression in skin lesions of patients with BD was evaluated by immunohistochemistry.

RESULTS

Compared with the HC group, reduced expression of CTLA-4 in CD4+ T cells after stimulation was observed in the active BD group, with no difference in the production of sCTLA-4. CD86 expression, in the resting APCs, was reduced in the active BD group compared with the HC group. PD-L1 expression in the APCs was decreased in the active BD group with or without stimulation of cells. Concordantly, the mRNA levels of PD-L1 in PBMC, and PD-L1 expression in the cutaneous lesions, were low in the active BD group.

CONCLUSIONS

The results of this study suggest that altered expression of PD-L1, CTLA-4 and CD86 may be involved in the pathogenesis of BD.

Comparison of the clinical efficacy of NBUVB and NBUVB with benzoyl peroxide/clindamycin in progressive macular hypomelanosis

BACKGROUND

Progressive macular hypomelanosis (PMH) is a skin disorder characterized by multiple hypopigmented patches symmetrically distributed on the trunk. Several treatment modalities have been attempted; however, a standard treatment modality has not been agreed to.

OBJECTIVES

The aim of this study was to compare the effectiveness of antimicrobial therapy combined with narrow band ultraviolet B (NBUVB) with NBUVB monotherapy.

METHODS

A randomized left-right comparison study was conducted in a total of 10 patients. Patients received NBUVB therapy with daily application of antimicrobial gel on one side of the trunk (comb-NBUVB) and without it (mono-NBUVB) for 8 weeks. The clinical efficacy was determined by objective measurements using a colour analyser and subjective assessment by evaluating pictures taken with a digital camera at baseline, at the time of treatment cessation and 6 months after treatment.

RESULTS

Significant repigmentation was observed in all 10 patients during the 8 weeks of treatment. The mean difference in L values between lesional and non-lesional skin was reduced in the comb-NBUVB area (from 4.52 ± 1.65 to 0.94 ± 0.65), and in the mono-NBUVB area, (from 4.34 ± 1.39 to 1.18 ± 0.94). There was no significant difference between treated sites at both of the evaluation points in time. At 6 months after treatment, 7 of 10 patients completed the clinical trial, and some degree of clinical improvement remained in four of seven patients; recurrence occurred in the other patients.

CONCLUSIONS

Although recurrence occurred in some patients, NBUVB treatment appears to be a safe and useful modality for the treatment of PMH.

Microelectrode recording: lead point in STN-DBS surgery

BACKGROUND

Microelectrode recording is an integral part of many surgical procedures for movement disorders. We evaluate the Lead point compared to the NeuroTrek system. We used NeuroTrek in 18 Parkinsonian patients, Lead point-4 in 12 patients, during STN-DBS surgery. We compared MR-Stir image with Microelectrode recording.

METHOD

The MicroGuide system with its integrated screen display provides the user with all the information needed during the surgery on its screen. Microelectrode recordings showed characteristic neuronal discharges on a long trajectory (5-6 mm), intraoperative stimulation induces dramatic improvement of Parkinsonian motor symptoms.

FINDINGS

Microrecording data of the Leadpoint showed high background activity, and firing rate of 14-50 Hz. The discharge pattern is typically chaotic, with frequent irregular bursts and pauses.

DISCUSSION

The microelectrode recording of the neuroTrek and Lead point-4 showed unique results of the typical STN spike. The DBS effect is maximized associated by MER mapping.

Effect of bacteriocin produced by Lactococcus sp. HY 449 on skin-inflammatory bacteria

This study was carried out to evaluate the effect of bacteriocin produced by Lactococcus sp. HY 449 against skin-inflammatory bacteria such as Staphylococcus epidermidis ATCC 12228, Staphylococcus aureus ATCC 65389, Streptococcus pyogenes ATCC 21059, and Propionibacterium acnes ATCC 6919. The spot-on-the-lawn method was used to determine the antimicrobial activity of bacteriocin against indicator strains on the human skin. The bacteriocin produced by Lactococcus sp. HY 449 inhibited the growth of S. epidermidis ATCC 12228, S. aureus ATCC 65389, Strep. pyogenes ATCC 21059, and P. acnes ATCC 6919. The treatment of crude bacteriocin caused a rapid inactivation of P. acnes ATCC 6919. The LC50 of bacteriocin on human fibroblast was ca. 50mg/ml at which the inhibition of cell proliferation was not observed. Neither any irritations nor allergic reactions by the bacteriocin were evident in a human patch test. The bacteriocin produced by Lactococcus sp. HY 449 may be a useful antimicrobial substance to control the growth of P. acnes and to prevent skin inflammation and acne.

Effect of bacteriocin produced by Lactococcus sp. HY 449 on skin-inflammatory bacteria

This study was carried out to evaluate the effect of bacteriocin produced by Lactococcus sp.HY 449 against skin-inflammatory bacteria such as Staphylococcus epidermidis ATCC 12228, Staphylococcus aureus ATCC 65389, Streptococcus pyogenes ATCC 21059, and Propionibacterium acnes ATCC 6919. The spot-on-the-lawn method was used to determine the antimicrobial activity of bacteriocin against indicator strains on the human skin. The bacteriocin produced by Lactococcus sp. HY 449 inhibited the growth of S. epidermidis ATCC 12228, S. aureus ATCC 65389, Strep. pyogenes ATCC 21059, and P. acnes ATCC 6919. The treatment of crude bacteriocin caused a rapid inactivation of P. acnes ATCC 6919. The LC(50) of bacteriocin on human fibroblast was approximately 50mg/ml at which the inhibition of cell proliferation was not observed. Neither any irritations nor allergic reactions by the bacteriocin were evident in a human patch test. The bacteriocin produced by Lactococcus sp. HY 449 may be a useful antimicrobial substance to control the growth of P. acnes and to prevent skin-inflammation and acne.

Molecular basis and characteristics of KATP channel in human corporal smooth muscle cells

Relaxation of the corpus cavernosum smooth muscle is an absolute prerequisite for penile erection. Potassium channels play a role in the physiologic regulation of corporal smooth muscle tone. In spite of the physiological importance of K(ATP) channel in the modulation of corporal smooth muscle tone, there is a shortage of information available about the K(ATP) channel subtype(s) present in the corporal smooth muscle. The purpose of this study was to investigate the subunit type of K(ATP) channel, that is, the combinations of the Kir subunit and the SUR subunit in the human corporal smooth muscle and determine whether the electrophysiological kinetics and pharmacological properties of K(ATP) channels meet the subunit characteristics of the ion channel. We used cultured human corporal smooth muscle cells. To determine the presence of Kir and SURs subunits, RT-PCR was performed using Kir6.1, Kir6.2, SUR1, SUR2A, and SUR2B gene-specific primers. For electrophysiological recordings, the whole-cell, inside-out, and cell-attached configurations of the patch-clamp technique were used. We observed transcripts for Kir6.1, Kir6.2, and SUR2B in mRNA isolated from smooth muscle cells of cultured human corpus carvernosum. We recorded the unitary K(ATP) channel under the condition of intracellular and extracellular 140 mM [K(+)], and the slope conductance of the channel was 42.0+/-2.6 pS which is an intermediate conductance between that of either Kir6.1 or Kir6.2. The pinacidil (10 microM) increased the magnitude of the outward K(+) current (214.6+/-89.2%, n=12, < or = 0.05), which was blocked by the subsequent addition of the specific K(ATP) channel subtype selective blocker, glibenclamide (10 microM). The SIN-1(200 microM) induced increases in whole-cell outward K(+) currents (126.0+/-1.4%, n=4). The increased currents by SIN-1 were inhibited by glibenclamide (10 microM). We are the first to show that K(ATP) channel in human corporal smooth muscle is composed of Kir6.1-Kir6.2 construct expressed with SUR2B by RT-PCR. These findings, taken together with the electrophysiological results, suggest that K(ATP) channel in corporal smooth muscle cells is composed of heteromultimers of Kir6.1 and Kir6.2 with the ratio of 3 : 1 or 4 : 0 and SUR2B.

Capsaicin inhibits the voltage-operated calcium channels intracellularly in the antral circular myocytes of guinea-pig stomach

Studies of the effect of capsaicin (CAP) on the smooth muscle contractions have shown both contraction and relaxation in various preparations. The direct effect of CAP on gastric smooth muscle itself has not yet been reported, though CAP was reported to relax the isolated guinea-pig stomach by releasing nitric oxide from the CAP-sensitive sensory neurons. Here we showed an evidence that CAP evokes a prolonged relaxation of gastric antral circular smooth muscle (CAP-induced relaxation) by blocking the voltage-operated Ca2+ channels (VOCC) from inside of the cell. CAP suppressed dose-dependently the spontaneous contractions of guinea-pig gastric circular muscle strip under the condition without neural influence (IC50 = 5.8 microM). The inhibitory effects of CAP both on the high K+ contracture induced by 50 mM K+ Tyrode solution and on the slow waves recorded using a conventional intracellular microelectrode technique were similar to those of Ca2+ channel antagonists, indicating that Ca2+ influx through the VOCC is decreased by CAP. Ca2+ channel current (I(Ba)) decreased in a concentration-dependent manner on superfusing the physiological salt solution containing various concentrations of CAP. The steady-state activation and inactivation curves of I(Ba) were not affected by the treatment with CAP. The experiment using a synthetic water-soluble analog of CAP, DA-5018 x HCl, suggested that the acting site of CAP is present in the intracellular side. Spontaneous transient outward K+ currents (STOCs) recorded at a holding potential of 0 mV were also inhibited by CAP and verapamil, Ca channel blocker. Taken together, these results indicate that CAP-induced relaxation is associated with the direct inhibitory action on the VOCC from inside of the cell.

The properties of carbachol-activated nonselective cation channels at the single channel level in guinea pig gastric myocytes

We investigated the properties of carbachol (CCh)-activated nonselective cation channels (NSC(CCh)) at the single channel level in the gastric myocytes of guinea pigs using a magnified whole-cell mode or an outside-out mode. The channel activity (NPo) recorded in a magnified whole-cell mode increased with depolarization (from -120 to -20 mV) and had the half activation potential of -81 mV under the symmetrical 140 mM Cs+ condition. The single channel conductance depended upon the extracellular monovalent cations with the order of Cs+ (35 pS) > Na+ (25 pS) > Li+ (21 pS). The channel activities markedly diminished or disappeared when external Cs+ was replaced with Na+ or N-methyl-D-glucamate (NMDG+). With Cs+ and Na+ as external cations, the channel showed a monotonic increase in NPo with the increased mole fraction of Cs+ over Na+, and it had an intermediate conductance value in solution containing 67% Cs+ with 33% Na+. These data suggested that the extracellular monovalent cations regulate the whole-cell current of NSC(CCh) by modulating both the open state probability and the unitary conductance, and there is one binding site for the extracellular cations within the pore.

Protein kinase C suppresses spontaneous, transient, outwards K+ currents through modulation of the Na/Ca exchanger in guinea-pig gastric myocytes

The effect of protein kinase C (PKC) on the Ca2+-activated K+ current (IK,Ca) in guinea-pig gastric myocytes was studied using the whole-cell voltage-clamp technique. At a holding potential of 0 mV, IK,Ca, recorded as spontaneous, transient, outwards currents (STOCs), was markedly inhibited, both in mean amplitude (54 +/- 5%) and frequency (60 +/- 8%) by 1 microM phorbol 12, 13 dibutyrate (PDBu, n = 6). These effects were antagonized by pretreatment with 10 nM bisindolylmaleimide I (n = 5), a selective inhibitor of PKC. The possibility that the inhibition of STOCs was due to direct channel inhibition by PKC was addressed using inside-out or open-cell-attached patch-clamp techniques, the latter established using beta-escin. PDBu did not alter the conductance or open probability of the KCa channel in any mode, suggesting that PKC does not inhibit the KCa channel directly. To study the involvement of the Na/Ca exchanger in the inhibition of STOCs by PDBu, its operation was prevented by replacing Na+ in the internal solution by tris(hydroxymethyl)aminomethane (TRIS) and external Na+ by equimolar K+ and Ca2+-activated inwards K+ currents recorded at a holding potential of 0 mV. Neither the mean amplitude (96 +/- 8%) nor the frequency of these currents was inhibited significantly by 1 microM PDBu (n = 5). Like PDBu, 5 microM 2-(2-[4-(4-nitrobenzyloxy)phenyl]ethyl) isothiourea methanesulphonate (KB-R7943), a selective inhibitor of the reverse mode Na/Ca exchanger, also inhibited the mean amplitude (45 +/- 6%) and frequency (26 +/- 2%) of STOCs at the holding potential of 0 mV (n=6). The results suggest that the suppression of STOCs by PKC is mediated by inhibition of the Na/Ca exchanger.

Background nonselective cationic current and the resting membrane potential in rabbit aorta endothelial cells

The ion channel conductances that regulate the membrane potential was investigated by using a perforated patch-clamp technique in rabbit aorta endothelial cells (RAECs). The whole-cell current/voltage (I-V) relation showed a slight outward rectification under physiological ionic conditions. The resting membrane potential was -23.3 +/- 1.1 mV (mean +/- SEM, n = 19). The slope conductances at the potentials of -80 and 50 mV were 31.0 +/- 4.0 and 62.8 +/- 7.1 pS pF(-1), respectively (n = 15). Changes in the extracellular and intracellular Cl(-) concentrations did not affect the reversal potential on I-V curves. The background nonselective cationic (NSC) current was isolated after the K(+) current was suppressed. The relative permeabilities calculated from the changes in reversal potentials using the constant-field theory were P(K):P(Cs):P(Na):P(Li) = 1:0.87:0.40:0.27 and P(Cs):P(Ca) = 1:0.21. Increases in the external Ca(2+) decreased the background NSC current in a dose-dependent manner. The concentration for half block by Ca(2+) was 1.1 +/- 0.3 mM (n = 7). Through the continuous recording of the membrane potential in a current-clamp mode, it was found that the background NSC conductance is the major determinant of resting membrane potential. Taken together, it could be concluded that the background NSC channels function as the major determinant for the resting membrane potential and can be responsible for the background Ca(2+) entry pathway in freshly isolated RAECs.

A case of very large cyst formation with Gamma Knife radiosurgery for an arteriovenous malformation

A 17-year-old male patient underwent Gamma Knife radiosurgery (GKRS) for a left parietal arteriovenous malformation (AVM), which presented with hemorrhage. The 15.0 cm3 nidus was covered with the 50% isodose. The maximum dose was 50 Gy and the margin dose was 25 Gy. Eleven months later he developed a right hemiparesis and MRI showed a large cyst. Cerebral angiography showed partial obliteration of the AVM nidus. Stereotactic removal of cyst fluid (about 70 cm3) was performed, and an Ommaya reservoir was inserted. Cyst formation after GKRS for cerebral arteriovenous malformation is a is side effect of radiosurgery about which we need to learn more.

Gamma Knife radiosurgery for functioning pituitary microadenoma

Transsphenoidal microsurgery remains the treatment of choice for pituitary microadenomas One hundred and six patients were treated with Gamma Knife radiosurgery (GKRS) for pituitary adenomas, and of these, 23 patients (1 male, 22 female) had microadenomas. Twenty-two of these patients were followed up and endocrinological tests were available for 15 of these 22. Thirteen of these 15 had prolactinomas, while the remaining 2 had acromegaly. The follow-up period was from 3 to 26 months (median 12 months). The mean age was 33.6 years (range 21 to 60 years). The mean maximum tumor dose was 35.7 Gy and the mean margin dose was 22 Gy. Serum prolactin (PRL) was normalized in three patients, decreased in eight and unchanged in two. The growth hormone (GH) secretion in the acromegalic patients has remained unchanged through the follow-up period. Thus, GKRS is a valuable adjuvant to transsphenoidal microsurgery for patients with pituitary microadenomas.

Intracranial aneurysms in Korea

We have 32 university hospitals and 18 general hospitals for neurosurgical training in Korea. Recently I have analyzed intracranial aneurysm cases which had an operation in 28 university hospitals and nine general hospitals. I have reported 2863 aneurysm operation cases. The location of aneurysm consisted of 865 aneurysms (30.2%) in the anterior communicating artery, 724 aneurysms (25.3%) in the internal carotid artery, 687 aneurysms (24.0%) in the middle cerebral artery, 129 aneurysms (4.5%) in the anterior cerebral artery, 152 aneurysms (5.3%) in the posterior circulation, and 306 (10.7%) multiple aneurysms. The overall approximation of the operation rate of aneurysm is approximately 6.6 cases per 100,000 population in 1996 in Korea.

Suppression of the carbachol-activated nonselective cationic current by antibody against alpha subunit of Go protein in guinea-pig gastric myocytes

In this study, we investigated which subtype of GTP-binding protein (G protein) is related to muscarinic activation of nonselective cation (NSC) channels in gastric smooth muscle. Inward cationic current was activated by the application of 50 microM carbachol (ICCh) at a holding potential of -60 mV with the same CsCl-rich solution in both pipette and bath. The same cationic current as ICCh was slowly activated by the dialysis of guanosine 5'-O-(3-thiotriphosphate) (GTP[gamma-S]) through the pipette. Since it is known that pertussis toxin pretreatment can block ICCh, antibodies (Abs) against Galpha,i (anti-Galpha,i) or Galpha,o (anti-Galpha,o) were tested. Activation of ICCh was blocked by the addition of anti-Galpha,o. However, anti-Galpha,i Abs had no significant effect on ICCh. The expression of Galpha,o in guinea-pig gastric smooth muscle was confirmed by Western immunoblot analysis. These results suggest that Go-type protein may mediate signals from the muscarinic receptor to NSC channel in guinea-pig gastric myocytes.

Protein kinase C mediates the desensitization of CCh-activated nonselective cationic current in guinea-pig gastric myocytes

The possibility of the protein kinase C (PKC) pathway being a mechanism underlying the desensitization of carbachol- (CCh-)activated nonselective cationic current (ICCh) was investigated in a study of guinea-pig gastric myocytes. Using the conventional whole-cell patch-clamp technique with symmetrical CsCl-rich solution in pipette and bath, ICCh was induced by bath application of 50 microM CCh. With 0.5 mM EGTA [ethyleneglycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid] in the pipette solution (0.5 mM [EGTA]i), ICCh decayed spontaneously (desensitization of ICCh) to around 20% within 10 min. Desensitization of ICCh was significantly attenuated with 2 mM [EGTA]i. At a concentration of 20 microM OAG (1-oleoyl-2-acetyl-sn-glycerol), a PKC activator, inhibited ICCh at 0.5 mM [EGTA]i but far less at 2 mM [EGTA]i (18% and 81% of control, respectively). The same cationic current induced by intracellular guanosine-5'-O-(3-thiotriphosphate) (GTP[gamma-S]) was not inhibited by OAG with 0.5 mM [EGTA]i. The pretreatment of gastric myocytes with PKC inhibitors, either 1 microM chelerythrine or 1 microM peptide inhibitor, attenuated the desensitization of ICCh. [Ca2+]i was also measured by single cell microfluorometry using fura-2. Under CCh stimulation with 2 mM [EGTA]i, [Ca2+]i did not increase above 100 nM while it increased to around 260 nM with 0.5 mM [EGTA]i. These results suggest that the desensitization of ICCh is partly due to the Ca2+-dependent PKC pathway in guinea-pig gastric myocytes.

Separation of recombinant human growth hormone from Escherichia coli cell pellet extract by capillary zone electrophoresis

Free zone capillary electrophoresis (FZCE) was used to resolve recombinant human growth hormone (rhGH) and its variants from very crude mixtures of Escherichia coli (E. coli) cell paste extract. The methodology employs a phosphate deactivated fused-silica capillary and a 250 mM phosphate (pH 6.8), 1% (v/v) propylene glycol buffer with a high field strength of 600 V/cm. Resolution of rhGH and its variants from very crude mixtures did not change after 80 injections for the PSC capillaries. Bare silica and PVA coated capillaries had a more limited lifetime when injected with the same crude mixtures (10 to 30 injections). This FZC method provides a very powerful tool for assessing rhGH modification during the fermentation and isolation of rhGH that is not possible with other current analytical techniques.