A Bivalent Inactivated Vaccine Prevents Enterovirus 71 and Coxsackievirus A16 Infections in the Mongolian Gerbil

Hand-foot-and-mouth disease (HFMD) is a viral infectious disease that occurs in children under 5 years of age. Its main causes are coxsackievirus (CV) and enterovirus (EV). Since there are no efficient therapeutics for HFMD, vaccines are effective in preventing the disease. To develop broad coverage against CV and EV, the development of a bivalent vaccine form is needed. The Mongolian gerbil is an efficient and suitable animal model of EV71 C4a and CVA16 infection used to investigate vaccine efficacy following direct immunization. In this study, Mongolian gerbils were immunized with a bivalent inactivated EV71 C4a and inactivated CVA16 vaccine to test their effectiveness against viral infection. Bivalent vaccine immunization resulted in increased Ag-specific IgG antibody production; specifically, EV71 C4a-specific IgG was increased with medium and high doses and CVA16-specific IgG was increased with all doses of immunization. When gene expression of T cell-biased cytokines was analysed, Th1, Th2, and Th17 responses were found to be highly activated in the high-dose immunization group. Moreover, bivalent vaccine immunization mitigated paralytic signs and increased the survival rate following lethal viral challenges. When the viral RNA content was determined from various organs, all three doses of bivalent vaccine immunization were found to significantly decrease viral amplification. Upon histologic examination, EV71 C4a and CVA16 induced tissue damage to the heart and muscle. However, bivalent vaccine immunization alleviated this in a dose-dependent manner. These results suggest that the bivalent inactivated EV71 C4a/CVA16 vaccine could be a safe and effective candidate HFMD vaccine.

A comparative study of the phenotype with kainic acid-induced seizure in DBA/2 mice from three different sources / 한국실험동물학회지

The kainic acid-induced seizure mouse model is widely used in epilepsy research. In this study, we applied kainic acid to the subcutaneous injections of three different sources of DBA/2 mice to compare and evaluate the seizure response. The three mouse sources consisted of DBA/2Kor1 (Korea FDA source), DBA/2A (USA source), and DBA/2 (Japan source), and were purchased from different vendors. To compare the responses of DBA/2 mice to kainic acid injections, we examined the survival rate, seizure phenotype scoring, and behavioral changes. We also evaluated brain lesions using histopathological analysis. Following the administration of kainic acid, almost half of the cohort survived, and the seizure phenotype displayed a moderate level of sensitivity (2 ~ 4 out of 6). In the histopathologic analysis, there was no change in morphological features, and levels of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule 1 (Iba-1) increased in the kainic acid-treated groups. However, there was no difference in the neuronal nuclei (NeuN) expression level. All the data showed that the responses in the kainic acid-treated group were similar across the three strains. In conclusion, our results suggest that the three sources of DBA/2 mice (DBA/2Kor1, DBA/2A, and DBA/2B) have similar pathological responses to kainic acid-induced seizures.

A comparative study of the phenotype with kainic acid-induced seizure in DBA/2 mice from three different sources / 한국실험동물학회지

The kainic acid-induced seizure mouse model is widely used in epilepsy research. In this study, we applied kainic acid to the subcutaneous injections of three different sources of DBA/2 mice to compare and evaluate the seizure response. The three mouse sources consisted of DBA/2Kor1 (Korea FDA source), DBA/2A (USA source), and DBA/2 (Japan source), and were purchased from different vendors. To compare the responses of DBA/2 mice to kainic acid injections, we examined the survival rate, seizure phenotype scoring, and behavioral changes. We also evaluated brain lesions using histopathological analysis. Following the administration of kainic acid, almost half of the cohort survived, and the seizure phenotype displayed a moderate level of sensitivity (2 ~ 4 out of 6). In the histopathologic analysis, there was no change in morphological features, and levels of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule 1 (Iba-1) increased in the kainic acid-treated groups. However, there was no difference in the neuronal nuclei (NeuN) expression level. All the data showed that the responses in the kainic acid-treated group were similar across the three strains. In conclusion, our results suggest that the three sources of DBA/2 mice (DBA/2Kor1, DBA/2A, and DBA/2B) have similar pathological responses to kainic acid-induced seizures.

The Effect of Care-Robots on Improving Anxiety/Depression and Drug Compliance among the Elderly in the Community / 생물치료정신의학

Objectives@#：Community managements for elderly are changing due to increased social and economic burdens.The purpose of this study was to find out if there is an effect on depression, anxiety, quality of life, and life management by using a care robot, which is a future technology. @*Methods@#：For 100 elderly patients who visited the hospital with cognitive impairment or type 2 diabetes, we install a care robot between August 20 and November 14, 2019. The self-report questionnaire was used to measure changes in depression, sleep quality, quality of life, and life management among patients. In this study, 77 patients completed the survey were compared before and after the use of a care robot. @*Results@#：It was confirmed that the elderly patients using the care robot improved in terms of depression, sleep quality, anxiety, and life management. When the mean values of the scores before and after the care robot intervention were compared, there was a significant decrease (p≤0.001) in depression scale. In the sleep quality category, there was a significant positive effect (p≤0.001). In quality of life category, anxiety/depression showed a significant decrease (p≤0.001). In the life management category, there was a significant improvement (p=0.004) in the cognitive impairment group, and especially in the drug compliance, patients with the cognitive impairment group had a positive effect (p=0.01). @*Conclusion@#：For elderly patients, the use of care robots as a non- pharmacological intervention can help improve depression, anxiety and sleep quality. In particular, in the cognitive impairment group, it is effective in improving life management.

Impact of Longitudinal Changes in Metabolic Syndrome Status over 2 Years on 10-Year Incident Diabetes Mellitus

BACKGROUND: Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM. METHODS: We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models. RESULTS: During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group (P for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later. CONCLUSION: We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.

Comparison study of the response with botulinum toxin muscle injection in the ICR mice from three different sources / 한국실험동물학회지

Botulinum-toxin A (BoNT/A) is a widely used not only for cosmetics but also for various experimental purposes including muscle-related research. In this study, we applied BoNT/A to mouse muscle of three different sources to compare and evaluate the biological and pathological response. The three different mouse sources consist of Korl: ICR (Korea FDA source), A:ICR (USA source) and B:ICR (Japan source) which were purchased from each different vendors. To compare the responses of ICR mice with BoNT/A muscle injection, we examined the body weight, hematological and serum biochemistry analysis. Also, we evaluated the muscle change by histopathological analysis and gene expression patterns of muscle-related target by qPCR. The body weight gain was decreased in the BoNT/ A-treated group compared with the control group. In clinical pathologic analysis and gene expression patterns, the data showed that the responses in the BoNT/A-treated group were similar compared with the control group. Decreased muscle fiber was observed in BoNT/A-treated group compared with control group, while Korl:ICR showed a little low response with the other mouse sources. In conclusion, our results suggest that three different sources ICR mice (Korl:ICR, A:ICR and B:ICR) have a similar biological and pathological responses in BoNT/A muscle injection.

The Correlation between Clinical Symptoms, Serum Uric Acid Level and EEG in Patient with Bipolar I Disorder / 신경정신의학

OBJECTIVES: High uric acid level is related to increased locomotor activities and refractory mood swings. The purpose of this study is to examine the correlation between clinical symptoms of mania, serum uric acid level, and quantitative electroencephalography (QEEG) findings. METHODS: Twenty-four patients with bipolar disorder and 24 healthy control subjects agreed to participate in the study. When they were hospitalized, the degree of clinical symptoms, uric acid level in blood, and brain QEEG were measured. RESULTS: The bipolar disorder group showed higher scores on the Young Mania Rating Scale (YMRS ; z=6.02, p<0.05). Patients in their manic episodes showed higher plasma uric acid levels (4.9+/-1.3 mg/dL) than healthy control subjects (4.2+/-0.9 mg/dL ; z=2.14, p<0.05). Uric acid levels showed correlation with severity of manic symptoms as assessed using the YMRS in all participants (rho=0.28, p<0.05). The bipolar disorder group showed decreased relative delta and alpha activity in the fronto-temporo-occipital region compared to the control group (p<0.05). Relative beta in Fp1 (frontopolar), Cz (central mid-line), and Pz (parietal mid-line) and relative gamma in Fp1 were increased in the bipolar disorder group, relative to the control group (p<0.05). The relative beta (rho=0.47, p<0.05) and gamma (rho=0.41, p<0.05) in Fp1 electrodes showed positive correlation with the YMRS scores. CONCLUSION: Adenosinergic transmission dysfunction may lead to occurrence of manic symptoms, considering that a key role of central nervous system adenosinergic receptors is to inhibit the release of various neurotransmitters and limit neuronal excitability. In addition, QEEG appeared to indicate excitatory neuro-modulation in manic patients.

Liver Inflammatory Pseudotumor Mimicking Cholangiocarcinoma / 대한췌담도학회지

Inflammatory pseudotumor of the liver is a benign disease which is histologically characterized by plasma cell infiltration and reactive fibrotic inflammation. Differentiating this disease from malignant tumor is not easy. The authors report a case of inflammatory pseudotumor mimicked as intrahepatic cholangiocarcinoma. A 74-year-old man visited the emergency department complaining of jaundice and myalgia which have lasted for 1 to 2 weeks. After computed tomography (CT) scan and magnetic resonance imaging of the liver, he was initially diagnosed with intrahepatic cholangiocarcinoma, but was ultimately found to be inflammatory pseudotumor after pathologic examination of the liver tissue. His symptoms improved after a course of antibiotic therapy and conservative treatment, and the lesion disappeared on follow-up CT scan.

The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Occupational Stress among Health Care Workers: A Pilot Study

OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) was approved by the Food and Drug Administration to alleviate symptoms of treatment-resistant depression. This study aimed to evaluate the effectiveness of rTMS treatment on alleviating occupational stress by evaluating clinical symptoms and quantitative electroencephalography (QEEG). METHODS: Twenty-four health care workers were randomized to receive 12 sessions of active or sham rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC). Each session consisted of 32 trains of 10 Hz repetitive TMS delivered in 5-second trains at 110% of the estimated prefrontal cortex threshold. Before and after the intervention, the Korean version of the occupational stress inventory (K-OSI), Beck's depression inventory (BDI), and Beck's anxiety inventory (BAI) were administered and EEG was performed using a 21-channel digital EEG system. RESULTS: After TMS, the average scores for the affective responses to stressors on the personal strain questionnaire (PSQ) subscale of K-OSI and BDI decreased significantly for the active-TMS group compared to the sham-TMS group. Also, the active-TMS group showed a significantly greater decrease in relative alpha in the F3 electrode and a significantly greater increase in the F4 electrode. CONCLUSION: High-frequency rTMS on the left DLPFC had stress-relieving and mood-elevating effects in health care workers, likely by stimulating the left frontal lobe.

Shigella flexneri Inhibits Intestinal Inflammation by Modulation of Host Sphingosine-1-Phosphate in Mice

Infection with invasive Shigella species results in intestinal inflammation in humans but no symptoms in adult mice. To investigate why adult mice are resistant to invasive shigellae, 6~8-week-old mice were infected orally with S. flexneri 5a. Shigellae successfully colonized the small and large intestines. Mild cell death was seen but no inflammation. The infected bacteria were cleared 24 hours later. Microarray analysis of infected intestinal tissue showed that several genes that are involved with the sphingosine-1-phosphate (S1P) signaling pathway, a lipid mediator which mediates immune responses, were altered significantly. Shigella infection of a human intestinal cell line modulated host S1P-related genes to reduce S1P levels. In addition, co-administration of S1P with shigellae could induce inflammatory responses in the gut. Here we propose that Shigella species have evasion mechanisms that dampen host inflammatory responses by lowering host S1P levels in the gut of adult mice.

Current Status for Report of Blood Donor Reactions in South Korea

BACKGROUND: There is no comprehensive report on the donor reaction rate among blood donors in South Korea. We attempted to analyze the patterns and rates of immediate blood donor reactions and the current status of the reporting system in our country. METHODS: Immediate donor reaction rate was defined as the number of donor reaction cases in 10,000 donations during or immediately after donation. We retrospectively analyzed the 4,835,499 donations collected in 2 yr (2008 and 2009) at the Korean Red Cross Blood Center. The data presented are the average data of the 2 yr. RESULTS: The overall donor reaction rate was 8.7. The rate for subcutaneous bleeding, vasovagal reaction, and nerve injury was 4.1, 4.0, and 0.1, respectively. For citrate reaction, which occurred among apheresis donations, the donor reaction rate was 0.4. The overall reaction rates among male and female donors were 6.0 and 16.2, respectively. The rates were highest in teenagers (12.0) and lowest in those in their forties (4.3). The most frequent reaction in male donors was subcutaneous bleeding (3.3); that in female donors was vasovagal reaction (8.9). CONCLUSIONS: The donor reaction rate of the study was lower than that of other countries or that of domestic prospective studies by a local blood center. These data suggested that the reporting system for blood donor reactions in Korean donors is not active, and that national standards and the continuing education of blood-collection personnel regarding donor reactions should be established to ensure reliable data collection.

A Case of Misidentification of Dermabacter hominis as Listeria grayi / 대한임상미생물학회지

Listeria grayi is a catalase-positive, non-spore forming, and glucose-fermenting Gram-positive rod. L. grayi is widely distributed in environments such as soil, water and fresh food. Human infection by L. grayi is very rare, and there have been no cases reported in Korea, and only two cases worldwide. Dermabacter hominis is a relatively new species belonging to the coryneform bacteria and is a component of the normal human skin flora. D. hominis is a non-motile, glucose-fermenting, Gram-positive rod that has similar biochemical characteristics to L. grayi. The authors of the present study report a case initially misidentified as L. grayi via a traditional morphological and biochemical identification method but that was subsequently confirmed as D. hominis using sequence analysis of 16S rRNA.

A Case of Primary Laryngeal Aspergillosis Confused with Vocal Cyst / 대한이비인후과학회지

With a surge in the population of immunocompromised patients, the incidence of laryngeal fungal infection has also been increased. Infection by aspergillus, which is a kind of mold, or a filamentous fungus, occurs rarely in larynx. Furthermore, most aspergillosis of the upper airway is an extension of the pulmonary or systemic aspergillosis in the immunocompromised host. So, the primary laryngeal aspergillosis that occurrs as an isolated laryngeal infection of aspergillus without other aerodigestive tract extension is very rarely encountered. We present a case of primary laryngeal aspergillosis misconceived as a vocal cord cyst in a 24-year-old female who had no past history of immune deficiency, voice abuse or steroid use.

Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Steno-occlusive Disease of the Supraaortic Arteries: Comparison with Computed Tomography Angiography and Digital Subtraction Angiography

PURPOSE: To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. MATERIALS AND METHODS: Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: 0.66x0.66x1.1 or 1.2 mm3), and CTA on 64-slice CT scanners (voxel dimension: 0.42x0.42x0.63 mm3). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. RESULTS: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n=19) and intracranial (n=15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity, specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1% on CTA, with DSA as the standard of reference. CONCLUSION: Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.

A Case of Oculocardiac Reflex During Endoscopic Sinus Surgery / 대한이비인후과학회지

Endoscopic sinus surgery has been used popularly for treatment of chronic paranasal sinusitis. Sometimes endoscopic sinus surgery is complicated by narrow visual field and anatomical variations. Oculocardiac reflex is developed by surgical or nonsurgical procedures to the eyeball. It occurs because of decreasing of heart rate and other arrhythmia including atrioventricular block, ventricular premature beat and cardiac arrest. Oculocardiac reflex during endoscopic sinus surgery is unusual and it is potentially a life threatening complication. The authors report the first case of oculocardiac reflex experienced during endoscopic sinus surgery in Korea with a review of the literature.

CM1 Ligation Induces Apoptosis via Fas-FasL Interaction in Ramos Cells, but via Down-regulation of Bcl-2 and Subsequent Decrease of Mitochondrial Membrane Potential in Raji Cells

BACKGROUND: CM1 (Centrocyte/-blast Marker I) defined by a mAb developed against concanavalin-A activated PBMC, is expressed specifically on a subpopulation of centroblasts and centrocytes of human germinal center (GC) B cells. Burkitt lymphoma (BL) is a tumor consisting of tumor cells with the characteristics of GC B cell. Previously we reported that CM1 ligation with anti-CM1 mAb induced apoptosis in Ramos (IgM(high)) and Raji (IgM(low)) cells. METHODS & RESULTS: In the present study, we observed that CM1 ligation with anti-CM1 mAb induced Fas ligand and Fas expression in Ramos cells, but not in Raji cells. Furthermore, anti-Fas blocking antibody, ZB4, blocked CM1-mediated apoptosis effectively in Ramos cells, but not in Raji cells. Increased mitochondrial membrane permeabilization, which was measured by DiOC6, was observed only in Raji cells. In contrast to no significant change of Bax known as pro-apoptotic protein, anti-apoptotic protein Bcl-2 was significantly decreased in Raji cells. In addition, we observed that CM1 ligation increased release of mitochondrial cytochrome c and upregulated caspase-9 activity in Raji cells. CONCLUSION: These results suggest that apoptosis induced by CM1-ligation is mediated by Fas-Fas ligand interaction in Ramos cells, whereas apoptosis is mediated by down-regulation of Bcl-2 and subsequent decrease of mitochondrial membrane potential in Raji cells.

Development of Tumor Screening ELISA kit by Using Novel Tumor Antigen, CM1

BACKGROUND: CM1 (centrocyte/-blast marker 1) is originally defined as a germinal center B cell marker. It is known that CM1 plays a critical role on B cell development in germinal center. In addition, we have found that CM1 is expressed on lymphoma cell lines, such as Raji, Ramos and IM-9. This means that CM1 might be served as a tumor marker as well. In the present study, we examined the expression of CM1 on the surface of the other tumors and the possibility of the development of tumor screening ELISA kit by using CM1. METHODS: First, we have examined the expression of CM1 on stomach cancer and hepatoma, which are predominantly (discovered) occurred in Korean, by flow cytometry analysis. After purifying of CM1 antigen from Raji and Ramos, the optimal ELISA condition was determined. And then we compared the level of CM1 between normal individuals and cancer patients by ELISA. To decrease the non-specific binding of anti-CM1 mAb with serum components except CM1 and to enhance the diagnostic accuracy, albumin depletion spin column was used. RESULTS: CM1 was highly expressed on stomach cancer and hepatoma cell lines. In addition, we have also confirmed the increased CM1 expression on cancer patients. The difference of CM1 expression between normal individuals and cancer patients were more clearly observed, after deletion of serum albumin by using albumin depletion spin column. CONCLUSION: Based on the results from this study, CM1 might be a useful molecule for the early diagnosis of cancer. In addition, further studies for the increase of ELISA sensitivity and appropriate albumin depletion methods should be needed.

The Selective Cyclooxygenase-2 Inhibitor Rofecoxib Reduces Chronic Cerebral Hypoperfusion-induced Apoptosis in the Rat Hippocampus

BACKGROUND: Chronic cerebral hypoperfusion induced by permanent occlusion of bilateral common carotid arteries (2VO) in rats caused cognitive deficits and neuronal damage. Cyclooxygenase-2 (COX-2) inhibitor was reported to attenuate both post-ischemic prostaglandin accumulation and neuronal damage. We studied the expression of mRNA of COX-2 in the hippocampus during hypoperfusion and the effectiveness of selective cyclooxygenase-2 inhibitor, rofecoxib, in preventing the neuronal damage of this model. METHODS: Bilateral common carotid arteries of the rat were ligated with silk sutures. The expression of mRNA for COX-1 and COX-2 were detected by the RT-PCR. The first group of animals (n=6) was treated with rofecoxib (10 mg/kg, i.p.) 7 days after operation and the following 7 days. The second group of animals (n=6) was treated with diclofenac sodium (9mg/kg, i.p.) and the third group of animals (n=5) was treated with vehicle (DMSO). TdT-mediated dUTP nick end labeling (TUNEL) technique was performed to estimate delayed cell death. RESULTS: Bilateral carotid artery occlusion (2VO) was shown to induce apoptotic morphology and DNA strand break in hippocampal neurons from 7 days with a peak at 14, 28 days. mRNA of COX-2 appeared in the frontal cortex (14, 28 days) and hippocampus (14, 28, 63 days). Treatment with rofecoxib significantly (p<0.05) attenuated the number of TUNEL-labeled cells in the hippocampus, whereas the cells of the diclofenac treated group were not protected. CONCLUSIONS: We concluded that COX-2 might contribute to cell death of pyramidal cells of the hippocampus of hypoperfusion and selective COX-2 inhibitor, rofecoxib, could prevent the neuronal damage.

A Case of Chorea in the Recovery Phase of Pneumococcal Meningitis

Movement disorders (chorea, athetosis, ballism) are a rare complication that develops during the course of bacterial meningitis although associations with tuberculous meningitis are established to some extent. Movement disorders are generally believed to reflect injury to the basal ganglia, thalamus, cerebellum and cerebral cortex. Ischemic infarctions of these areas have been proposed as the cause of dyskinesias in bacterial meningitis. We experienced a case of chorea which developed in the recovery phase of pnemococcal meningitis in a 37-month-old boy. The choreic movement was initially misinterpreted as a seizure, and anticonvulsants were administered. The movement continued during the alert state in spite of anticonvulsant therapy but subsided during sleep. EEG showed severely depressed background activitiy with no epileptiform discharge. When the movement was recognized as a choreic movement, anticonvulsants were withheld and haloperidol was administered orally. The abnormal movement gradually disappeared in 3 months. But like the two other previously reported cases of postmenigitic movement disorders, this patient shows severe impairment in cognitive and motor function in the 10 months of follow up. He can only recognize some close persons and can not control the trunk and extremities well. The movement disorder which develops in the recovery phase and lasts for a long period may be associated with poor neurologic prognosis.

Metabolic Abnormalities in Patients with Mitochondrial Myopathy Evaluated by In Vivo 31P Magnetic Resonance Spectroscopy

PURPOSE: To investigate the phosphorus metabolic abnormalities in skeletal muscle of patients with mitochondrial myopathy using in vivo 31P magnetic resonance spectroscopy(MRS). MATERIAL AND METHODS: Patients with mitochondrial myopathy(N=10) and normal control subjects (N=10) participated. All in vivo 31P MRS examinations were performed on 1.5T whole-body MRI/MRS system by using an image selected in vivo spectroscopy (ISIS) pulse sequence that provided a 4 X 4 X 4 cm3 volume of interest (VOI) in the right thigh muscle tissue. Peak areas for each phophorus methabolite were measured using a Marquart algorithm. RESULTS: The specific features in patients with mitochondrial myopathy were a significant increase of Pi/PCr ratio (p=0.003) and a significant decrease of ATP/PCr ratio (p=0.004) as compared with normal controls. In particular, the beta-ATP/PCr ratio between controls and patients with mitochondrial myopathy was predominantly altered. CONCLUSIONS: In vivo 31P MRS may be a useful modality in the clinical evaluation of patients with mitochondrial myopathy based on ATP/PCr and Pi/PCr ratios in skeletal muscle tissue and provides a valuable information in further understanding disorders of muscle metabolism.