Computed Tomography-Derived Skeletal Muscle Radiodensity Is an Early, Sensitive Marker of Age-Related Musculoskeletal Changes in Healthy Adults

Background@#A decrease in computed tomography (CT)-derived skeletal muscle radiodensity (SMD) reflects age-related ectopic fat infiltration of muscle, compromising muscle function and metabolism. We investigated the age-related trajectory of SMD and its association with vertebral trabecular bone density in healthy adults. @*Methods@#In a cohort of healthy adult kidney donors aged 19 to 69 years (n=583), skeletal muscle index (SMI, skeletal muscle area/height2), SMD, and visceral-to-subcutaneous fat (V/S) ratio were analyzed at the level of L3 from preoperative CT scans. Low bone mass was defined as an L1 trabecular Hounsfield unit (HU) <160 HU. @*Results@#L3SMD showed constant decline from the second decade (annual change –0.38% and –0.43% in men and women), whereas the decline of L3SMI became evident only after the fourth decade of life (–0.37% and –0.18% in men and women). One HU decline in L3SMD was associated with elevated odds of low bone mass (adjusted odds ratio, 1.07; 95% confidence interval, 1.02 to 1.13; P=0.003), independent of L3SMI, age, sex, and V/S ratio, with better discriminatory ability compared to L3SMI (area under the receiver-operating characteristics curve 0.68 vs. 0.53, P<0.001). L3SMD improved the identification of low bone mass when added to age, sex, V/S ratio, and L3SMI (category-free net reclassification improvement 0.349, P<0.001; integrated discrimination improvement 0.015, P=0.0165). @*Conclusion@#L3SMD can be an early marker for age-related musculoskeletal changes showing linear decline throughout life from the second decade in healthy adults, with potential diagnostic value for individuals with low bone mass.

Influence of Besifovir Dipivoxil Maleate Combined with L-Carnitine on Hepatic Steatosis in Patients with Chronic Hepatitis B

Background@#Besifovir dipivoxil maleate (BSV) with L-carnitine is the first-line antiviral agent for chronic hepatitis B (CHB) infection. We investigated whether BSV combined with L-carnitine improves hepatic steatosis (HS). @*Methods@#Treatment-naïve patients with CHB who were initiated on antiviral therapy (AVT) were enrolled. The magnitude of HS was assessed using hepatic steatosis index (HSI), and HS improvement was defined as a ≥ 10% reduction in the HSI score from the baseline. @*Results@#The mean age of the study patients was 56 years with a male predominance (n = 178,64.7%). The mean body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count were 23.5 kg/m2, 49.6 IU/L, 49.0 IU/L, and 191.3 × 109/L, respectively. The mean HSI and fibrosis (FIB)-4 index were 32.6 and 0.5, respectively. After 6 months of AVT, platelet count (mean, 191.3→167.0 × 109/L), fasting glucose (mean, 113.1→105.9 mg/dL), AST (mean, 49.6→28.0 IU/L), ALT (mean, 49.0→33.9 IU/L), and total cholesterol (mean, 170.0→162.1 mg/dL) levels significantly decreased (all P 0.05). In the univariate analysis, age, BMI, diabetes, cirrhosis, fasting glucose level, and ALT were significantly associated with HS improvement (all P < 0.05). @*Conclusion@#BSV with L-carnitine did not show any improvement of HS in patients with CHB. Further prospective randomized controlled studies are needed to validate the potential beneficial effects of BSV with L-carnitine in CHB infection.

Risk assessment of hepatocellular carcinoma development for indeterminate hepatic nodules in patients with chronic hepatitis B

BACKGROUND/AIMS: A risk prediction model for the development of hepatocellular carcinoma (HCC) from indeterminate nodules detected on computed tomography (CT) (Rad(CT) score) in patients with chronic hepatitis B (CHB)-related cirrhosis was proposed. We validated this model for indeterminate nodules on magnetic resonance imaging (MRI).METHODS: Between 2013 and 2016, Liver Imaging Reporting and Data System (LI-RADS) 2/3 nodules on MRI were detected in 99 patients with CHB. The Rad(CT) score was calculated.RESULTS: The median age of the 72 male and 27 female subjects was 58 years. HCC history and liver cirrhosis were found in 47 (47.5%) and 44 (44.4%) patients, respectively. The median Rad(CT) score was 112. The patients with HCC (n=41, 41.4%) showed significantly higher Rad(CT) scores than those without (median, 119 vs. 107; P=0.013); the Chinese university-HCC and risk estimation for HCC in CHB (REACH-B) scores were similar (both P>0.05). Arterial enhancement, T2 hyperintensity, and diffusion restriction on MRI were not significantly different in the univariate analysis (all P>0.05); only the Rad(CT) score significantly predicted HCC (hazard ratio [HR]=1.018; P=0.007). Multivariate analysis showed HCC history was the only independent HCC predictor (HR=2.374; P=0.012). When the subjects were stratified into three risk groups based on the Rad(CT) score (<60, 60–105, and >105), the cumulative HCC incidence was not significantly different among them (all P>0.05, log-rank test).CONCLUSIONS: HCC history, but not Rad(CT) score, predicted CHB-related HCC development from LI-RADS 2/3 nodules. New risk models optimized for MRI-defined indeterminate nodules are required.

Effect of the Ethanol Extract of Propolis on Formation of Streptococcus mutans Biofilm

Streptococcus mutans (S. mutans) is one of the most important bacteria in the formation of dental plaque and dental caries. S. mutans adheres to an acquired pellicle formed on the tooth surface, and aggregates with many oral bacteria. It initiates plaque formation by synthesizing glucan from sucrose, which is catalyzed by glucosyltransferases. Propolis is a resinous mixture produced by honeybees, by mixing saliva and beeswax with secretions gathered from wood sap and flower pollen. Bees prevent pathogenic invasions by coating the propolis to the outer and inner surface of the honeycomb. Propolis has traditionally been used for the treatment of allergic rhinitis, asthma and dermatitis. We investigated the inhibitory effects of propolis ethanol extract on biofilm formation and gene expression of S. mutans. The biofilm formation of S. mutans was determined by scanning electron microscopy (SEM) and safranin staining. We observed that the extract of propolis had an inhibitory effect on the formation of S. mutans biofilms at concentrations higher than 0.2 mg/ml. Real-time PCR analysis showed that the gene expression of biofilm formation, such as gbpB, spaP, brpA, relA and vicR of S. mutans, was significantly decreased in a dose dependent manner. The ethanol extract of propolis showed concentration dependent growth inhibition of S. mutans, and significant inhibition of acid production at concentrations of 0.025, 0.05, 0.1 and 0.2 mg/ml, compared to the control group. These results suggest that the ethanol extract of propolis inhibits gene expression related to biofilm formation in S. mutans

Clinical Assessment and Management of Papillary Thyroid Carcinoma with Coexistent Hashimoto's Thyroiditis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The frequency of co-occurence of Hashimoto's thyroiditis and papillary thyroid carcinoma has been variously reported to range from 0.3% to 38%, and the association of these two diseases is still controversial. The aim of our study is to determine the relationship between these two entities, and in this paper, we compare the clinical characteristics of patients with and without histopathological evidence of Hashimoto's thyroiditis. SUBJECTS AND METHOD: Among 366 patients treated for thyroid nodules (including benign nodules and thyroid cancers) during the period of July 2004-June 2005, 278 patients (male versus female=1 : 7.9) with papillary thyroid carcinoma were included in this study. RESULTS: Hashimoto's thyroiditis co-occurred with papillary thyroid carcinoma in 68 of 278 patients (24.5%), compared with 0 of 21 patients (0%) with other thyroid malignancies. The age at presentation (median, 43.9 years), tumor size (median, 1.31 cm), methods of diagnostic evaluation, and the extent of surgery had not influenced by the presence of Hashimoto's thyroiditis. However, TNM stage, AMES stage, MACIS score were slightly lower and the proportion of female patients (1 : 67) was higher in patients with Hashimoto's thyroiditis. CONCLUSION: These results suggest that patients who have papillary thyroid carcinoma may have more favorable prognosis in the co-ocurring Hashimoto's thyroiditis. Further studies are required to confirm the long-term prognostic association between these two diseases.

Primary Cutaneous Actinomycosis of the Nasolabial Fold / 대한이비인후과학회지

Actinomycosis is a chronic and suppurative infection caused by an endogenous Gram-positive bacterium. The usual sites of infection are the head and neck, thorax, and abdomen. Primary cutaneous actinomycosis is very rare and usually associated with external trauma and local ischemia. We report on the case of a primary cutaneous actinomycosis of the nasolabial fold in a 70-year-old woman. The patient had a well-defined subcutaneous nodule on the nasolabial fold without any other lesion. The patient was treated successfully with surgical resection and combined antibiotic therapy. There has been no recurrence during the 3 months period of follow-up.

Two Cases of Synovial Sarcoma Arising in the Anterior Neck / 대한이비인후과학회지

Synovial sarcomas is a mesenchymal tumor that usually occurs in the extremities. Fewer than 100 cases of synovial sarcoma have been reported in the head and neck lesion. We experienced 2 cases of synovial sarcoma of neck, and so reported with a review of literature.