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Background and Objectives@#Fewer studies are available on geriatric patients’ gustatory dysfunction than on their olfactory dysfunction. Here we aimed to evaluate the relationship between subjective gustatory dysfunction and subjective or objective olfactory dysfunction according to cognitive function in geriatric patients.Subjects and Method We prospectively enrolled patients who underwent both cognitive function test and olfactory function test between August 2018 and May 2019. The correlation between subjective gustatory dysfunction and subjective olfactory dysfunction or conventional olfactory function scores was evaluated for geriatric patients with or withhout cognitive dysfunction. Participants with a threshold-discrimination-identification (TDI) score (<21) on the YSK olfactory function test were diagnosed with olfactory dysfunction. Subjective gustatory function and olfactory function were evaluated using the visual analog scale. The Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet and Mini-Mental State Examination were administered to all participants. Overall, 120 patients (27 male, 93 female; mean age, 73.00±7.50 years) were enrolled. @*Results@#We found that the subjective gustatory function score did not correlate with the threshold, discrimination, identification, or the summation of TDI scores of the olfactory function test but was significantly associated with the subjective olfactory function score (p<0.001). Further, there was no significant correlation between the subjective gustatory function score and cognitive function. @*Conclusion@#The subjective olfactory function score was the only factor significantly correlated with the subjective gustatory function score. Based on these results, we suggest evaluating gustatory function in geriatric patients with olfactory dysfunction.
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Foreign bodies pose a diagnostic challenge to clinicians, and nasal foreign bodies have the potential to lead to significant morbidity. Although foreign bodies in the nasal cavity are a commonly encountered problem in pediatric patients, a foreign body in the nasal cavity not associated with a trauma history is rare in adults. We recently experienced a 35-year-old man who presented with a foreign body in his right nasal cavity and anterior tooth pain. He was not sure what the material was, and we were not able to confirm the material type preoperatively. However, we found that a very large and thick material was impacted and totally obstructed the right anterior nasal cavity. We surgically removed it as a bone block and confirmed postoperatively that the material was glass. This case provided several lessons, and we would like to share our experience.
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Background and Objectives@#To date, no studies have been conducted on the interaction between extracellular heat shock protein 70 (Hsp70) and C-X-C chemokine receptor type 4 (CXCR4) in the upper airway. We aimed to evaluate the relationship between extracellular Hsp70 and CXCR4 and their role in the primary human nasal epithelium. @*Methods@#We cultured primary human nasal epithelial (HNE) cells in an air–liquid interface. Macrogen performed single-cell quantitative polymerase chain reaction and sequencing. We conducted western blot analysis for the CXCR4 and mitogen-activated protein kinase (MAPK) pathways. @*Results@#Extracellular Hsp70 treatment significantly increased the genetic expression and protein levels of CXCR4 in primary HNE cells. Phospho-ERK expression was increased by cotreatment with Hsp70 and CXCL12, but inhibited by pretreatment with AMD3100, a CXCR4 inhibitor. Pretreatment with an anti-Hsp70 antibody reduced phospho-ERK expression upregulation induced by cotreatment with Hsp70 and CXCL12. @*Conclusion@#Extracellular Hsp70 participates in the activation of the CXCR4-dependent downstream signaling pathway in HNE cells. Further studies should evaluate the extracellular Hsp70-CXCL12/CXCR4 axis and the role of its components in the development of inflammatory diseases.
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In recent years, the rise of minimally invasive surgery has driven the development of surgical devices. Indocyanine green (ICG) fluorescence imaging is receiving increased attention in colorectal surgery for improved intraoperative visualization and decision-making. ICG, approved by the U.S. Food and Drug Administration in 1959, rapidly binds to plasma proteins and is primarily intravascular. ICG absorption of near-infrared light (750–800 nm) and emission as fluorescence (830 nm) when bound to tissue proteins enhances deep tissue visualization. Applications include assessing anastomotic perfusion, identifying sentinel lymph nodes, and detecting colorectal cancer metastasis. However, standardized protocols and research on clinical outcomes remain limited. This study explores ICG’s role, advantages, disadvantages, and potential clinical impact in colorectal surgery.
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Sphingosine-1-phosphate (S1P) is an important lipid mediator that regulates a diverse range of intracellular cell signaling pathways that are relevant to tissue engineering and regenerative medicine. However, the precise function of S1P in dental pulp stem cells (DPSCs) and its osteogenic differentiation remains unclear. We here investigated the function of S1P/S1P receptor (S1PR)-mediated cellular signaling in the osteogenic differentiation of DPSCs and clarified the fundamental signaling pathway. Our results showed that S1P-treated DPSCs exhibited a low rate of differentiation toward the osteogenic phenotype in association with a marked reduction in osteogenesis-related gene expression and AKT activation. Of note, both S1PR1/S1PR3 and S1PR2 agonists significantly downregulated the expression of osteogenic genes and suppressed AKT activation, resulting in an attenuated osteogenic capacity of DPSCs. Most importantly, an AKT activator completely abrogated the S1P-mediated downregulation of osteoblastic markers and partially prevented S1P-mediated attenuation effects during osteogenesis. Intriguingly, the pro-inflammatory TNF-α cytokine promoted the infiltration of macrophages toward DPSCs and induced S1P production in both DPSCs and macrophages. Our findings indicate that the elevation of S1P under inflammatory conditions suppresses the osteogenic capacity of the DPSCs responsible for regenerative endodontics.
Subject(s)
Cell Differentiation , Cell Proliferation , Cells, Cultured , Dental Pulp/metabolism , Lysophospholipids , Osteogenesis , Proto-Oncogene Proteins c-akt/metabolism , Signal Transduction , Sphingosine/analogs & derivatives , Stem CellsABSTRACT
Obesity is a complex metabolic disorder that increases the risk for type 2 diabetes, hyperlipidemia, hypertension, and atherosclerosis. In this study, we evaluated the anti-obesity effects of Nelumbo nucifera leaf (NL) extract in 3T3-L1 adipocytes and obese db/db mice. NL extract among various parts (leaf, seed, and root) of N. nucifera most effectively reduced adipogenesis via inhibiting CCAAT enhancer binding protein α (C/EBPα) and peroxisome proliferator activated receptor γ (PPARγ) expression in 3T3-L1 adipocytes. The addition of NL extract enhanced the protein expression of uncoupling protein 2 (UCP2) as compared to untreated 3T3-L1 adipocytes. The oral administration of NL extract (100 mg/kg BW) significantly reduced food efficacy ratio, body weight, and face or total cholesterol level in obese db /db mice. Also, administration of NL extract significantly decreased adipocyte size and C/EBPα or PPARγ expression in the adipose tissues as compared with control (obese db/db mice). Therefore, our results suggest that NL extract among various parts of N. nucifera could be used as a functional food ingredient for the prevention and treatment of metabolic diseases including obesity and diabetes.
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We present a sniffing bead system used to diagnose olfactory dysfunction in coronavirus disease 2019 (COVID-19) patients. A 25-year-old male presented with the loss of olfaction one week after he was diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He had no other symptoms such as fever or myalgia but only showed an absence of respiratory distress. Nasal endoscopy and paranasal sinus CT showed that the patient had no bilateral sinus diseases; cranial nerve MRI showed no abnormal signal intensity or enhancement. A sniffing bead system was applied using 2-phenylethyl alcohol for the objective assessment of olfactory dysfunction to confirm the presence of anosmia. Anosmia was diagnosed early by objective evaluation using a sniffing bead system and early intervention with olfactory training. This case report suggests that a verified, one-off system for objective measurement of olfactory dysfunction in COVID-19 with olfactory training in patients could facilitate the recovery of olfactory function.
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Recent several reports have demonstrated that periodontitis is prevalent and adversely affects the survival in patients with chronic kidney disease (CKD) or end-stage kidney disease. However, its impact on transplant outcomes remains uncertain. Methods: This retrospective cohort study included 136 and 167 patients, respectively, who underwent living donor kidney transplantation (KT) at Seoul National University Hospital from July 2012 to August 2016 and Korea University Hospital from April 2008 to October 2018. We divided patients into three groups according to stages of periodontitis based on a new classification system. Results: Patients with severe periodontitis were older, had a higher prevalence of diabetes, a higher body mass index and C-reactive protein level, a lower cardiac output, and were more likely to be smokers, indicating its association with chronic systemic inflammation. After KT, stage IV periodontitis was independently associated with a lower incidence of acute T cell-mediated rejection, suggesting the possible effect of periodontitis on immune function. However, 1-year and 3-year estimated glomerular filtration rates were not different. Among the KT recipients followed up more than 3 years, new-onset cardiovascular disease occurred in nine patients, and coronary artery disease occurred more frequently in patients with stage IV periodontitis. However, diabetes was the independent predictor of new-onset coronary artery disease in multivariate logistic regression analysis. Conclusion: Our findings showed that periodontitis might be an important player in determining posttransplant outcomes in recipients. Further interventional trials to test whether treating periodontitis could modify transplant outcome are needed.
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Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but life-threatening complication. VITT strongly mimics heparin-induced thrombocytopenia (HIT) and shares clinical features. Heparin is commonly used to prevent coagulation during hemodialysis.Therefore, nephrologists might encounter patients needing dialysis with a history of heparin exposure who developed thrombotic thrombocytopenia after vaccination. A 70-year-old male presented with acute kidney injury and altered mental status due to lithium intoxication. He needed consecutive hemodialysis using heparin. Deep vein thrombosis of left lower extremity and accompanying severe thrombocytopenia of 15,000/µL on 24 days after vaccination and at the same time, nine days after heparin use. Anti-platelet factor 4 antibody test was positive.Anticoagulation with apixaban and intravenous immunoglobulin (IVIG) infusion resolved swelling of his left calf and thrombocytopenia. There were no definitive diagnostic tools capable of differentiating between VITT and HIT in this patient. Although VITT and HIT share treatment with IVIG and non-heparin anticoagulation, distinguishing between VITT and HIT will make it possible to establish a follow-up vaccination plan in a person who has had a thrombocytopenic thrombotic event. Further research is needed to develop the tools to make a clear distinction between the clinical syndromes.
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The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.
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Nasogastric tube placement is a common practice, and complications are rarely reported. We recently encountered and successfully managed a knotted nasogastric tube in a chronically bedridden patient. His nasal and nasopharyngeal mucosa were exceptionally dry, and the tube was not well advanced. The attending physician had difficulty removing the tube, and unsuccessful removal attempts resulted in the patient experiencing epistaxis and respiratory discomfort. Imaging and endoscopic evaluation revealed that the tube was knotted at the choanal level, obstructing the posterior airway. We cut the tube within the middle nasal cavity and removed the knotted part through the mouth; the remaining parts of the tube were removed through the nasal cavity. Herein, we describe our case and other previously reported cases of nasogastric tube knotting to guide healthcare workers who may encounter similar scenarios.
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Since the human papillomavirus (HPV) vaccine guidelines were developed by the Korean Society of Gynecologic Oncology (KSGO) in 2011, 2016, and 2019, several recent studies on the efficacy and safety of HPV vaccines in middle-aged women and men have been reported. Furthermore, there has been an ongoing debate regarding the efficacy of the HPV vaccine in women with prior HPV infection or who have undergone conization for cervical intraepithelial neoplasia (CIN). We searched and reviewed studies on the efficacy and safety of the HPV vaccine in middle-aged women and men and the efficacy of the HPV vaccine in patients infected with HPV and those who underwent conization for CIN. The KSGO updated their guidelines based on the results of the studies included in this review.
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Phellinus strains were collected from different areas in Korea. Of them, the fast mycelial growing strains were artificially cultivated on the oak logs to produce fruiting body. The varieties, Phellinus linteus ASI26099 (Korea Sanghwang) and P. baumii PBJS (Jangsoo Sanghwang) were grown under the same conditions as controls. Their cultivating characteristics including mycelial colonization, pinhead formation, and fruiting body formation rate were investigated on the logs. Basidiocarps of Phellinus strains HN00K9, HN6036, and ASI26099 were concentrically zonate and shallowly sulcate, and dark chestnut showing typical characteristics of Tropicoporus linteus (synonyum: P. linteus, Inonotus linteus, polyporus linteus), which is distinguishably different to PBJS. HN00K9 showed the highest yield of fruiting body among the mushroom strains. The β-glucan content in fruiting bodies of HN00K9 was 20% higher than those of other strains. Bioactive effects of polysaccharide samples from fruiting bodies of Phellinus strains, HN00K9, HN6036, ASI26099, and PBJS were assessed on cell viability and cytokine (IL-6 and TNF-α) inhibition and finally on anticancer to different human cancer cells.
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Background@#Cervical cancer is the fourth common cancer in women worldwide. The Papanicolau test is the primary screening procedure to detect abnormal cervical cells.Colposcopy is the main procedure for discriminating high-grade cervical lesions. The study aimed at clarifying the discrepancy between cervical cytology and colposcopic biopsy histology as well as confounding factors. @*Methods@#Eligible patients visited thirteen tertiary hospitals for colposcopic biopsy following cervical cytology and human papillomavirus (HPV) genotypes between January and December 2018. Baseline characteristics including age, body mass index (BMI), and parity were collected. @*Results@#In our study, 3,798 eligible patients were included. Mean age of patients was 42.7(19–88) years and mean BMI was 22.5 (16.9–34.1) kg/m2 . The referred cervical cytologic findings consisted of 495 normal, 1,390 atypical squamous cells of undetermined significance, 380 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, 792 low-grade squamous intraepithelial lesion, 593 high-grade squamous intraepithelial lesion, 79 atypical glandular cells, 46 squamous cell carcinoma, and 23 adenocarcinoma. HPV-positive findings were found in 3,008 (79.2%) patients and were not detected in 914 (24.1%) cases. The risk of unexpected low-grade lesions from histology was higher in patients > 45 years (odds ratio [OR], 2.137; 95% confidence intervals [CIs], 1.475–3.096). In contrast, the risk of unexpected high-grade lesions from colposcopic biopsy was lower in patients ≥ 45 years (OR, 0.530; 95% CI, 0.367–0.747) and HPV 16/18 infection was higher than other HPV (OR, 1.848; 95% CI, 1.385–2.469). @*Conclusion@#Age and HPV genotypes were responsible for the discrepancies between cytology and histology. Precautions should be taken for women over the age of 45 in triage for colposcopy in order to avoid unnecessary testing.
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Objectives@#. Few studies have reported combined analyses of the microbiome of the adenoids and tonsils in pediatric patients with snoring, and correlations of the adenotonsillar microbiome with clinical characteristics have not been evaluated to date. The aim of this study was to characterize the adenotonsillar microbiome and to determine its correlations with the subjective symptoms of pediatric patients with snoring and with levels of regional mucosal immune molecules. @*Methods@#. Twenty-four children who underwent tonsillectomy with adenoidectomy owing to snoring were enrolled in this cross-sectional study conducted between August 2017 and December 2018. The microbiome of the adenoids and tonsils was characterized, and its alpha- and beta-diversity was determined. Clinical characteristics, including subjective discomfort during sleep (assessed using the obstructive sleep apnea-18 questionnaire), the presence of allergic rhinitis, concentrations of heat shock protein (Hsp)27, Hsp70, and interleukin-8 (IL-8) in lavage fluids, and white blood cell (WBC) counts, were measured. @*Results@#. At the phylum level, the microbiome was not significantly different between the adenoids and tonsils; the alpha and beta indices were likewise not significantly different between these two regions. The alpha-diversity of the entire adenotonsillar microbiome was associated with sex, emotional stress, and IL-8 levels in the tonsil lavage fluids. Beta-diversity was associated with Hsp27 levels in the tonsil lavage fluids and WBC counts. Multiple allergen simultaneous test results were not significant, although total serum immunoglobulin E levels were significantly associated with the beta-diversity of the adenotonsillar microbiome. @*Conclusion@#. The data reported herein suggest, for the first time, that the adenotonsillar microbiome interacts with the regional mucosal immune system. The observed association of the microbiome with subjective discomfort is a novel finding that warrants further investigation.
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Purpose@#The study aimed to evaluate the diagnostic accuracy of polymerase chain reaction ‒based high-risk human papillomavirus (HPV) assays on self-collected vaginal and urine samples for detection of precancerous cervical lesions in referral population. @*Materials and Methods@#Women referred for colposcopy following abnormal cytology, were included this study. A total of 314 matched urine, vaginal, and cervical samples were collected. All samples were tested for HPV DNA using the RealTime HR-S HPV and Anyplex II HPV 28 assays. Primary endpoints were sensitivity for cervical intraepithelial neoplasia (CIN) 2+/CIN3+ and specificity for
ABSTRACT
Background@#Cervical cancer is the fourth common cancer in women worldwide. The Papanicolau test is the primary screening procedure to detect abnormal cervical cells.Colposcopy is the main procedure for discriminating high-grade cervical lesions. The study aimed at clarifying the discrepancy between cervical cytology and colposcopic biopsy histology as well as confounding factors. @*Methods@#Eligible patients visited thirteen tertiary hospitals for colposcopic biopsy following cervical cytology and human papillomavirus (HPV) genotypes between January and December 2018. Baseline characteristics including age, body mass index (BMI), and parity were collected. @*Results@#In our study, 3,798 eligible patients were included. Mean age of patients was 42.7(19–88) years and mean BMI was 22.5 (16.9–34.1) kg/m2 . The referred cervical cytologic findings consisted of 495 normal, 1,390 atypical squamous cells of undetermined significance, 380 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, 792 low-grade squamous intraepithelial lesion, 593 high-grade squamous intraepithelial lesion, 79 atypical glandular cells, 46 squamous cell carcinoma, and 23 adenocarcinoma. HPV-positive findings were found in 3,008 (79.2%) patients and were not detected in 914 (24.1%) cases. The risk of unexpected low-grade lesions from histology was higher in patients > 45 years (odds ratio [OR], 2.137; 95% confidence intervals [CIs], 1.475–3.096). In contrast, the risk of unexpected high-grade lesions from colposcopic biopsy was lower in patients ≥ 45 years (OR, 0.530; 95% CI, 0.367–0.747) and HPV 16/18 infection was higher than other HPV (OR, 1.848; 95% CI, 1.385–2.469). @*Conclusion@#Age and HPV genotypes were responsible for the discrepancies between cytology and histology. Precautions should be taken for women over the age of 45 in triage for colposcopy in order to avoid unnecessary testing.
ABSTRACT
Objectives@#. Few studies have reported combined analyses of the microbiome of the adenoids and tonsils in pediatric patients with snoring, and correlations of the adenotonsillar microbiome with clinical characteristics have not been evaluated to date. The aim of this study was to characterize the adenotonsillar microbiome and to determine its correlations with the subjective symptoms of pediatric patients with snoring and with levels of regional mucosal immune molecules. @*Methods@#. Twenty-four children who underwent tonsillectomy with adenoidectomy owing to snoring were enrolled in this cross-sectional study conducted between August 2017 and December 2018. The microbiome of the adenoids and tonsils was characterized, and its alpha- and beta-diversity was determined. Clinical characteristics, including subjective discomfort during sleep (assessed using the obstructive sleep apnea-18 questionnaire), the presence of allergic rhinitis, concentrations of heat shock protein (Hsp)27, Hsp70, and interleukin-8 (IL-8) in lavage fluids, and white blood cell (WBC) counts, were measured. @*Results@#. At the phylum level, the microbiome was not significantly different between the adenoids and tonsils; the alpha and beta indices were likewise not significantly different between these two regions. The alpha-diversity of the entire adenotonsillar microbiome was associated with sex, emotional stress, and IL-8 levels in the tonsil lavage fluids. Beta-diversity was associated with Hsp27 levels in the tonsil lavage fluids and WBC counts. Multiple allergen simultaneous test results were not significant, although total serum immunoglobulin E levels were significantly associated with the beta-diversity of the adenotonsillar microbiome. @*Conclusion@#. The data reported herein suggest, for the first time, that the adenotonsillar microbiome interacts with the regional mucosal immune system. The observed association of the microbiome with subjective discomfort is a novel finding that warrants further investigation.
ABSTRACT
Purpose@#The study aimed to evaluate the diagnostic accuracy of polymerase chain reaction ‒based high-risk human papillomavirus (HPV) assays on self-collected vaginal and urine samples for detection of precancerous cervical lesions in referral population. @*Materials and Methods@#Women referred for colposcopy following abnormal cytology, were included this study. A total of 314 matched urine, vaginal, and cervical samples were collected. All samples were tested for HPV DNA using the RealTime HR-S HPV and Anyplex II HPV 28 assays. Primary endpoints were sensitivity for cervical intraepithelial neoplasia (CIN) 2+/CIN3+ and specificity for
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The synaptonemal complex (SC) is a meiosis-specific proteinaceous macromolecular structure that assembles between paired homologous chromosomes during meiosis in various eukaryotes. The SC has a highly conserved ultrastructure and plays critical roles in controlling multiple steps in meiotic recombination and crossover formation, ensuring accurate meiotic chromosome segregation. Recent studies in different organisms, facilitated by advances in super-resolution microscopy, have provided insights into the macromolecular structure of the SC, including the internal organization of the meiotic chromosome axis and SC central region, the regulatory pathways that control SC assembly and dynamics, and the biological functions exerted by the SC and its substructures. This review summarizes recent discoveries about how the SC is organized and regulated that help to explain the biological functions associated with this meiosis-specific structure.