Antioxidant effect of ergothioneine on in vitro maturation of porcine oocytes

Background@#Ergothioneine (EGT) is a natural amino acid derivative in various animal organs and is a bioactive compound recognized as a food and medicine. @*Objectives@#This study examined the effects of EGT supplementation during the in vitro maturation (IVM) period on porcine oocyte maturation and subsequent embryonic development competence after in vitro fertilization (IVF). @*Methods@#Each EGT concentration (0, 10, 50, and 100 µM) was supplemented in the maturation medium during IVM. After IVM, nuclear maturation, intracellular glutathione (GSH), and reactive oxygen species (ROS) levels of oocytes were investigated. In addition, the genes related to cumulus function and antioxidant pathways in oocytes or cumulus cells were investigated. Finally, this study examined whether EGT could affect embryonic development after IVF. @*Results@#After IVM, the EGT supplementation group showed significantly higher intracellular GSH levels and significantly lower intracellular ROS levels than the control group. Moreover, the expression levels of hyaluronan synthase 2 and Connexin 43 were significantly higher in the 10 µM EGT group than in the control group. The expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and NAD(P)H quinone dehydrogenase 1 (NQO1) were significantly higher in the oocytes of the 10 µM EGT group than in the control group. In the assessment of subsequent embryonic development after IVF, the 10 µM EGT treatment group improved the cleavage and blastocyst rate significantly than the control group. @*Conclusions@#Supplementation of EGT improved oocyte maturation and embryonic development by reducing oxidative stress in IVM oocytes.

Real-World Treatment Patterns and Clinical Outcomes in Korean Patients With AML Ineligible for First-Line Intensive Chemotherapy: A Subanalysis of the CURRENT Study, a Non-Interventional, Retrospective Chart Review

Background@#Although most elderly patients with acute myeloid leukemia (AML) are ineligible for intensive chemotherapy (ICT), treatment options remain limited. CURRENT (UMIN000037786), a real-world, non-interventional, retrospective chart review, evaluated clinical outcomes, clinicopathologic characteristics, and treatment patterns in these patients.We present results from a subanalysis of Korean patients in this study. @*Methods@#Patients were aged ≥ 18 years with primary or secondary AML ineligible for ICT who initiated first-line systemic therapy or best supportive care (BSC) between 2015 and 2018 across four centers in Korea. Primary endpoint was overall survival (OS) from diagnosis.Secondary endpoints included progression-free survival (PFS), time to treatment failure, and response rates. Data analyses were primarily descriptive, with time-to-event outcomes estimated using the Kaplan-Meier method, and Cox regression used to determine prognostic factors for survival. @*Results@#Among 194 patients enrolled, 84.0% received systemic therapy and 16.0% received BSC. Median age at diagnosis was 74 and 78 years, and Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 was reported in 73.0% and 48.4% of patients, respectively;poor cytogenetic risk was reported in 30.1% and 16.1% of patients. Median OS was 7.83 vs.4.50 months, and median PFS was 6.73 vs. 4.50 months in the systemic therapy vs. BSC groups. Prognostic factors affecting OS included secondary AML (hazard ratio, 1.67 [95% confidence interval, 1.13–2.45]), ECOG performance status ≥ 2 (2.41 [1.51–3.83]), poor cytogenetic risk (2.10 [1.36–3.24]), and Charlson comorbidity index ≥ 1 (2.26 [1.43–3.58]). @*Conclusion@#Clinical outcomes are poor in Korean patients with AML ineligible for ICT who are prescribed current systemic therapies or BSC. There is a substantial unmet need for novel agents (monotherapy or in combination) to improve clinical outcomes in this patient population.

Efficacy of a Closed-Set Auditory Training Protocol on Speech Recognition of Adult Hearing Aid Users / 대한이비인후과학회지

Background and Objectives@#Auditory training involves active listening to auditory stimuli, and it has garnered attention in recent years because it enhances speech-in-noise recognition and the satisfaction of hearing aids. The purpose of this study was to determine the efficacy of a closed-set auditory training protocol for adult hearing aid users. We also evaluated the retention effect of training at a 1-month follow-up test after the completion of training. @*Subjects and Methods@#Twenty-two hearing-impaired listeners who have used bilateral hearing aids for more than two months participated in this study. Out of 22 participants, 12 participants (training group, TG) received an 8-week auditory training while 10 participants did not receive any training (non-training group, NTG). For training, three types of closed-set training materials (environmental sounds, words, and sentences) were used. The training was conducted eight times over eight weeks (one session per week, about one hour per session). The difficulty level was adjusted by controlling the number of closed-set choices and the signal-to-noise ratios. To determine the efficacy of training, open-set speech recognition abilities and subjective hearing aid satisfaction were evaluated. @*Results@#All the open-set speech recognition performances of the TG were enhanced after the closed-set auditory training, while the performance of the NTG was not significantly changed. The auditory training had a positive impact on the TG individuals’ subjective satisfaction of hearing aids. The improvement from training was maintained over one month after the completion of the auditory training. @*Conclusion@#The closed-set auditory training protocol might lead to enhanced speech understanding as well as more satisfaction with hearing aids for adult hearing aid users.

Multiple Signaling Pathways Contribute to the Thrombin-induced Secretory Phenotype in Vascular Smooth Muscle Cells

We attempted to investigate molecular mechanisms underlying phenotypic change of vascular smooth muscle cells (VSMCs) by determining signaling molecules involved in chemokine production. Treatment of human aortic smooth muscle cells (HAoSMCs) with thrombin resulted not only in elevated transcription of the (C-C motif) ligand 11 (CCL11) gene but also in enhanced secretion of CCL11 protein. Co-treatment of HAoSMCs with GF109230X, an inhibitor of protein kinase C, or GW5074, an inhibitor of Raf-1 kinase, caused inhibition of ERK1/2 phosphorylation and significantly attenuated expression of CCL11 at transcriptional and protein levels induced by thrombin. Both Akt phosphorylation and CCL11 expression induced by thrombin were attenuated in the presence of pertussis toxin (PTX), an inhibitor of Gi protein-coupled receptor, or LY294002, a PI3K inhibitor. In addition, thrombin-induced production of CCL11 was significantly attenuated by pharmacological inhibition of Akt or MEK which phosphorylates ERK1/2. These results indicate that thrombin is likely to promote expression of CCL11 via PKC/Raf-1/ERK1/2 and PTX-sensitive protease-activated receptors/PI3K/Akt pathways in HAoSMCs. We propose that multiple signaling pathways are involved in change of VSMCs to a secretory phenotype.

A Systematic Review on the Effectiveness of Detection of M. tuberculosis and Rifampin Resistance Using Xpert MTB/RIF / 대한임상미생물학회지

BACKGROUND: The purpose of this study was to evaluate the effectiveness of Xpert MTB/RIF (Cepheid, USA) in the detection of Mycobacterium tuberculosis and to determine rifampin resistance. METHODS: The literature review covered the period from 16 August 2011 to 1 October 2011, and eight domestic databases and foreign databases including Ovid-Medline, Embase, and Cochrane Library were used. Key words, such as 'Rifampin, Polymerase Chain Reaction,' 'GeneXpert' and 'Xpert MTB-RIF' were used to search a total of 1,385 documents. The SIGN (Scottish Intercollegiate Guidelines Network) tool was used to evaluate the quality of the 20 selected studies. RESULTS: Test accuracy for the detection of M. tuberculosis was assessed on the basis of 20 studies using the M. tuberculosis culture test as the reference standard. The acid-fast bacteria smearing test had a sensitivity in the range of 0.69-1.00, specificity in the range of 0.72-1.00 and test accuracy in the range of 0.75-1.00. Test accuracy regarding rifampin resistance was assessed on the basis of 17 studies. Using an anti-tuberculosis agent sensitivity test as the reference standard, the sensitivity, specificity and test accuracy of real-time, nested PCR were in the ranges of 0.75-1.00, 0.96-1.00 and 0.95-1.00, respectively. CONCLUSION: Xpert MTB/RIF is a useful test for patients suspected of having rifampin-resistant tuberculosis.

A Nasogastric Tube Inserted into the Gastrocutaneous Fistula

We reported a case in which a nasogastric tube was inserted into the gastrocutaneous fistula, diagnosed by abdominal computed tomography. A 78-year-old man with a history of recurrent cerebral hemorrhage had a percutaneous endoscopic gastrostomy tube due to dysphagia for 2 years. However, soft tissue infection at the gastrostomy site caused the removal of the tube. Immediately, antibiotic agents were infused. For appropriate hydration and medication, a nasogastric tube was inserted. However, there was no significant improvement of the soft tissue infection. Moreover, the amount of bloody exudate increased. Abdominal computed tomography revealed the nasogastric tube placed under the patient's skin via gastrocutaneous fistula. The nasogastric tube was removed, and an antibiotic agents were maintained. After 3 weeks, the signs of infection fully improved, and percutaneous endoscopic gastrostomy was performed again. This case shows necessities of an appropriate interval between removal of the gastrostomy tube and insertion of a nasogastric tube, and suspicion of existence of gastrocutaneous fistula.

A Comparison of the Short-term Results between the PCL Sacrificing Medial Pivot Knee and Nexgen(R) LPS Total Knee Arthroplasty

PURPOSE: We wanted to compare the clinical and radiological results after performing total knee arthroplasty (TKA) with the PCL sacrificing (PS) Medial Pivot Knee (MPK) and the Nexgen(R) LPS. MATERIALS AND METHODS: Seventy knees in 48 patients after TKA with the PS ADVANCE(R) MPK (group I) and 67 knees in 45 patients with the Nexgen(R) LPS (group II) were retrospectively evaluated. All the patients were followed up for more than 2 years. The evaluations included the preoperative and postoperative range of motion (ROM), the Knee Society (KS) scores, the tibiofemoral angle and the postoperative complications. RESULTS: For group I, the ROM increased from a mean flexion contracture of 6.3degrees and further flexion of 116.4degrees to 1.9degrees and 120.5degrees, respectively, and for group II, from 12.6degrees and 117.6degrees to 0.9degrees and 123.0degrees, respectively. For group I, the KS knee and function scores increased from 46 and 37 to 87 and 83, respectively, and for group II, from 50 and 48 to 87 and 83, respectively. For group I, the tibiofemoral angle changed from varus 4.0degrees to valgus 5.5degrees, respectively, and for group II, from varus 4.1degrees to valgus 5.3degrees, respectively. The complications were 2 knees (2.8%) with periprosthetic patellar fractures and 1 knee (1.4%) with a tibial component failure in group I, and 1 knee (1.5%) with early femoral component failure and 1 knee with arthrofibrosis (1.5%) in group II. CONCLUSION: The minimum 2-year follow-up results of PS MPK TKA were comparable to those of Nexgen(R) LPS TKA. However, we think that the MPK system has the advantage of more bony preservation at the femoral intercondylar notch area.

The Relationship between Hand Function and Brain Lesion at Acute Stroke Patients: A Pilot Study

OBJECTIVE: To determine the relationship of hand motor function recovery and Tatu's vascular territory classification of brain lesion in acute stroke. METHOD: Thirty one patients with acute cerebral infarct were included. We divided them into two groups. One had cerebral lesions supplied by the leptomeningeal branches of cerebral artery and the other by the perforating branches of cerebral artery. The leptomeningeal group was subdivided into middle cerebral artery group (LMCA) and posterior cerebral artery group (LPCA). The perforating group was again divided by perforating branch of the middle cerebral artery group (PMCA) and anterior choroidal artery group (PACoA). The diffusion weighted magnetic resonance image was used as a reference image. The hand motor recovery was scored by physical examination at admission and discharge. Score 0 was for no motion, 1 was for synergy movement, and 2 was for isolated hand movement. RESULTS: Eight patients were in LMCA group, while 3 were in LPCA group. Eight were in PMCA group, and twelve patients were in PACoA group. The distribution of the hand motor recovery at admission was score 0 (3,1,5,8, for LMCA, LPCA, PMCA, PACoA), 1 (2,1,1,4) and 2 (3,1,2,0), while at discharge, score 0 (3,0,4,4), 1 (0,0,1,5) and 2 (5,3,3,3). Hand functions significantly improved at discharge compared with those at admission in all groups. Especially in PACoA group, the significant better recovery at discharge was achieved.(p<0.05) Isolated hand movement at discharge was significantly better at the leptomeningeal group than perforating group.(p<0.05). CONCLUSION: Tatu's atlas may be helpful to predict the recovery of hand function for initial assessment of stroke rehabilitation.

Total Knee Arthroplasty with PCL Substituting Medial Pivot Knee: Short-term Follow-up Results

PURPOSE: To evaluate minimum 2-year follow-up clinical and radiological results after total knee arthroplasty (TKA) with a posterior cruciate ligament (PCL) substituting (PS) Medial Pivot Knee. MATERIALS AND METHODS: Seventy knees in 48 patients, who could be followed up more than 2 years after TKA with PS Advance(R) Medial Pivot Knee from October 2004 to February 2006, were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), tibiofemoral angle, Knee Society (KS) knee and function score and postoperative complications. RESULTS: The ROM increased from preoperative mean flexion contracture of 6.3degrees and further flexion of 116.4degrees to a postoperative mean flexion contracture of 1.9degrees and further flexion of 120.5degrees. The tibiofemoral angle changed from preoperative varus 4degrees to postoperative valgus 5.5degrees. The KS knee and function score improved from 46 and 37 before surgery to 87 and 83 after surgery, respectively (p<0.05). The complications were 2 cases of periprosthetic patellar fracture and 1 case of early failure of the tibial component. CONCLUSION: The minimum 2 year follow-up results after TKA with PS Medial Pivot Knee were satisfactory.

Instability after Total Knee Arthroplasty

PURPOSE: To evaluate the patterns and the treatment of instability after primary TKA. MATERIAL & METHOD: We studied 8 patients (9 cases) who had instability after TKA. We analyze the onset of symptom, patterns and main causes of instability, method of treatment, and results. The average follow-up period was 31 months. RESULT: Average onset of symptom after TKA was 10.1 month (8 day -4 years 4 month). The patterns of instability included anterior/posterior instability in 2, valgus/varus instability in 5 and global instability in 2. The treatments were thicker polyethylene exchange in 1, repair or reconstruction of collateral ligament with polyethylene exchange in 5, and revision with constrained or hinged implant in 3 when it was impossible to correct the imbalance of flexion-extension gap. All patients got stable knees and KSS functional and knee scores improved from average 55 and 56 points to 88.8 and 91 points respectively. CONCLUSION: Active repair or reconstruction of the ligament with polyethylene exchange wasone of the good options for treating instability after TKA. In cases of severe instability that could not be corrected by polyethylene exchange and repair or reconstruction of the ligament, revision with constrained or hinged implant was necessary.

Clinical and Functional Result after Internal Fixation of Severely Displaced Floating Shoulder

PURPOSE: To evaluate the follow-up result of 11 cases that were operated with internal fixation of scapular neck and internal fixation of clavicle or acromioclavicular dislocation for severely displaced floating shoulder which was high energy injury and unstable. MATERIALS AND METHODS: We examined the scapular neck fracture with clavicle fracture or acromioclavicular joint dislocation by multidisciplinary research from August 1997 to July 2004. The scapular neck fractures were operated in the case of translational displacement of more than 25 mm and angular displacement of more than 45 degrees with 3.5 mm reconstruction plate fixation and internal fixation for clavicle fracture or acromioclavicular joint perpormed simultaneously. And we evaluated 11 cases that can be followed up for more than 9 months. RESULTS: We achieved bony union in all cases. In ASES functional score, we got average 89.2 (75~95) points. In Rowe functional score, we got average 89.1 (75~100) points. In complication, there was external rotation weakness in 1 case. CONCLUSION: In severely displaced floating shoulder due to high energy injury, we got good clinical and functional result after internal fixation for scapular neck and clavicle or acromioclavicular joint.

A Case of Neonatal Tetanus Cured with Neuromuscular Blocking Agent and Ventilatory Support

A neonate born at 38 gestational weeks was admitted due to generalized tonic-clonic seizure and cyanosis. The neonate was born six days previously at home through normal delivery and the umbilical cord was cut using scissors sterilized in boiling water. The neonate weighed 3,180 g at admission. Physical examination revealed cyanosis, opisthotonus, trismus and reactive muscle spasms. Laboratory exam, brain sonogram and EEG showed no significant abnormal findings. Based on her history and physical examination, the neonate was diagnosed with tetanus and put in an incubator isolated in a quiet, dark room. Treatment with tetanus human immunoglobulin along with antibiotics (penicillin G) were started immediately, and mechanical ventilation, administration of neuromuscular blocking agent and muscle relaxant were also started off. The frequency of seizure episode decreased gradually, and on the 32nd hospital day, mechanical ventilatory support was stopped along with extubation two days later. Thereafter, the neonate was in continuous generalized hypertonic state and showed feeding difficulty, but there was gradual improvement. She was dismissed on the 49th hospital day and is currently under OPD follow-up, doing well with no special problems. Respiratory management is critical to neonatal tetanus. We report here a case of tetanus treated with inhibition of self-respiration, neuromuscular blocker and application of ventilator, and present this method as a useful direction for future treatment of neonatal tetanus.

A Comparison of Efficacy and Safety of Magnesium sulfate and Ritodrine Hydrochloride in the Management of Preterm Labor / 대한산부인과학회잡지

OBJECTIVES: The purpose of this study was to evaluate the efficacy and safety of magnesium sulfate and ritodrine hydrochloride in the management of preterm labor. METHODS: This study was undertaken to assess the clinical efficacy & safety of magnesium sulfate and ritodrine hydrochloride on 120 patients admitted with preterm labor from Jul. 1, 1996 to Dec. 31, 1998. RESULTS: 1. The incidence of preterm labor was showed 6.0~7.7% of total number of delivery. 2. The risk factors of the preterm labor were premature rupture of membrane, severe preeclampsia, previous preterm delivery, twin pregnancy, placenta previa, fetal anomaly, incompetent cervix, placental abruption, and uterine myoma in order, but 28.6% of preterm labor had no apparent risk factors. 3. The days gained in uterus was not statistically different between the magnesium sulfate group and the ritodrine group (p<0.05) but longer in the two groups than the control group. And the delivery time was also not statistically different between the magnesium sulfate group and the ritodrine group (p<0.01) but significantly increased in the two groups than the control group. 4. The rate of complete and incomplete success was similar as 12.5% and 35% (total success rate 47.5%) in the magnesium sulfate group, 7.5% and 45% (total success rate 52.5%) in the ritodrine group but only 2.5% and 27.5% (total success rate 30%) was showed in the control group. 5. The side effects were much more in the ritodrine group than the magnesium sulfate group. The patients requiring second-line therapy were similar in the both groups but the main cause was uncontrolled uterine contraction in the magnesium sulfate group, and intolerable side effects in the ritodrine group. 6. The pulse rate was not statistically different in magnesium sulfate group but markedly increased in ritodrine group (p<0.05). After managements of preterm labor, the serum potassium and ionized calcium level was significantly decreased in the two groups (p<0.05, p<0.01). CONCLUSION: There was not significantly different efficacy and safety of magnesium sulfate and ritodrine hydrochloride in the management of preterm labor.

Treatment of Adult-Onset Otitis Media with Effusion by Morphologic Difference of Nasopharynx and Eustachian Tube Orifice / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, adult-onset otitis media with effusion(OME) tends to increase in its incidence. We compared the treatment of OME by morphologic difference of nasopharynx and eustachian tube orifice in adult-onset OME. MATERIALS AND METHODS: 156 patients were retrospectively studied. 156 patients were divided into 4 groups; group 0: normal finding on eustachian tube orifice and nasopharynx, group I: pathologic lesions on eustachian tube orifice and torus tubarius, group II: pathologic lesions on nasopharynx, group III: pathologic lesions on group I and II. Pathologic lesions are hyperemia, edema, lymphoid follicle hyperplasia. First, we treated patients with antibiotics, if OME was not improved, combined treatment of antibiotics and steroid was administered. If OME was not improved by medical treatment, myringotomy or ventilation tube insertion was done. RESULTS: Antibiotics treatment was effective in group 0, combined treatment of antibiotics and steroid was effective in group I, II. Many cases of surgical treatmnent was done in group III and it was effective. CONCLUSION: Careful examination of nasopharynx and eustachian tube orifice can predict prognosis and choice of treatment.