Gamma Knife Radiosurgery for ARUBA-Eligible Patients with Unruptured Brain Arteriovenous Malformations

BACKGROUND: A randomized trial of unruptured brain arteriovenous malformations (ARUBA) reported superior outcomes in conservative management compared to interventional treatment. There were numerous limitations to the study. This study aimed to investigate the efficacy of gamma knife radiosurgery (GKS) for patients with brain arteriovenous malformations (AVMs) by comparing its outcomes to those of the ARUBA study. METHODS: We retrospectively reviewed ARUBA-eligible patients treated with GKS from June 2002 to September 2017 and compared against those in the ARUBA study. AVM obliteration and hemorrhage rates, and clinical outcomes following GKS were also evaluated. RESULTS: The ARUBA-eligible cohort comprised 264 patients. The Spetzler-Martin grade was Grade I to II in 52.7% and III to IV in 47.3% of the patients. The mean AVM nidus volume, marginal dose, and follow-up period were 4.8 cm³, 20.8 Gy, and 55.5 months, respectively. AVM obliteration was achieved in 62.1%. The annual hemorrhage rate after GKS was 3.4%. A stroke or death occurred in 14.0%. The overall stroke or death rate of the ARUBA-eligible cohort was significantly lower than that of the interventional arm of the ARUBA study (P < 0.001) and did not significantly differ from that of the medical arm in the ARUBA study (P = 0.601). CONCLUSION: GKS was shown to achieve a favorable outcome with low procedure-related morbidity in majority of the ARUBA-eligible patients. The outcome after GKS in our patients was not inferior to that of medical care alone in the ARUBA study. It is suggested that GKS is rather superior to medical care considering the short follow-up duration of the ARUBA study.

Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample. MATERIALS AND METHODS: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively. RESULTS: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period. CONCLUSION: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.

First Report of Web Blight of Rosemary (Rosmarinus officinalis) Caused by Rhizoctonia solani AG-1-IB in Korea

Herein, we report the first occurrence of web blight of rosemary caused by Rhizoctonia solani AG-1-IB in Gangneung, Gangwon Province, Korea, in August 2014. The leaf tissues of infected rosemary plants were blighted and white mycelial growth was seen on the stems. The fungus was isolated from diseased leaf tissue and cultured on potato dextrose agar for identification. The young hyphae had acute angular branching near the distal septum of the multinucleate cells and mature hyphal branches formed at an approximately 90degrees angle. This is morphologically identical to R. solani AG-1-IB, as per previous reports. rDNA-ITS sequences of the fungus were homologous to those of R. solani AG-1-IB isolates in the GenBank database with a similarity percentage of 99%, thereby confirming the identity of the causative agent of the disease. Pathogenicity of the fungus in rosemary plants was also confirmed by Koch's postulates.

The First Report of Postharvest Stem Rot of Kohlrabi Caused by Sclerotinia sclerotiorum in Korea

In March 2014, a kohlrabi stem rot sample was collected from the cold storage room of Daegwallyong Horticultural Cooperative, Korea. White and fuzzy mycelial growth was observed on the stem, symptomatic of stem rot disease. The pathogen was isolated from the infected stem and cultured on potato dextrose agar for further fungal morphological observation and to confirm its pathogenicity, according to Koch's postulates. Morphological data, pathogenicity test results, and rDNA sequences of internal transcribed spacer regions (ITS 1 and 4) showed that the postharvest stem rot of kohlrabi was caused by Sclerotinia sclerotiorum. This is the first report of postharvest stem rot of kohlrabi in Korea.

Biocontrol of Fusarium Crown and Root Rot and Promotion of Growth of Tomato by Paenibacillus Strains Isolated from Soil

In this study, bacterial strains were isolated from soils from 30 locations of Samcheok, Gangwon province. Of the isolated strains, seven showed potential plant growth promoting and antagonistic activities. Based on cultural and morphological characterization, and 16S rRNA gene sequencing, these strains were identified as Paenibacillus species. All seven strains produced ammonia, cellulase, hydrocyanic acid, indole-3-acetic acid, protease, phosphatase, and siderophores. They also inhibited the mycelial growth of Fusarium oxysporum f. sp. radicis-lycopersici in vitro. The seven Paenibacillus strains enhanced a range of growth parameters in tomato plants under greenhouse conditions, in comparison with non-inoculated control plants. Notably, treatment of tomato plants with one identified strain, P. polymyxa SC09-21, resulted in 80.0% suppression of fusarium crown and root rot under greenhouse conditions. The plant growth promoting and antifungal activity of P. polymyxa SC09-21 identified in this study highlight its potential suitability as a bioinoculant.

First Report of Potato Stem-End Rot Caused by Fusarium oxysporum in Korea

In this study, we identified the causative agent of stem-end rot in potatoes that were grown in Gangwon alpine areas of Korea in 2013. The disease symptoms included appearance of slightly sunken circular lesion with corky rot on the potato surface at the stem-end portion. The fungal species isolated from the infected potatoes were grown on potato dextrose agar and produced white aerial mycelia with dark violet pigments. The conidiophores were branched and monophialidic. The microconidia had ellipsoidal to cylindrical shapes and ranged from 2.6~11.4 x 1.9~3.5 microm in size. The macroconidia ranged from 12.7~24.7 x 2.7~3.6 microm in size and had slightly curved or fusiform shape with 2 to 5 septate. Chlamydospores ranged from 6.1~8.1 x 5.7~8.3 microm in size and were present singly or in pairs. The causal agent of potato stem-end rot was identified as Fusarium oxysporum by morphological characterization and by sequencing the internal transcribed spacer (ITS1 and ITS4) regions of rRNA. Artificial inoculation of the pathogen resulted in development of disease symptoms and the re-isolated pathogen showed characteristics of F. oxysporum. To the best of our knowledge, this is the first study to report that potato stem-end rot is caused by F. oxysporum in Korea.

A Clinical Study on Acromioclavicular Separation / 대한정형외과학회잡지

The Acromioclavicular joint is classified as a diarthrodial joint. Its stability is maintained by articular capsule, acromioclavicular ligament, articular disc, coraco clavicularligament(trapezoid and conoid ligament) and attached muscles. 17 cases of acromioclavicular dislocation which had been seen at Seoul Red Cross Hospital during the period of January 1975 through December 1977 were studied. The following observations were made. 1. This injury is more prevalent in male (82%) with the peak incidence in the 3rd and 4 th decades (53%). 2. Conservative treatment was given in 11 cases by adhersive strapping around the elbow and lateral one third of the clavicle reinforced by Velpeau dressing for 3 weeks, then followed by active exercise. 3. Operative treatment consist of modified Phemister technique in 3 cases, Mumford technique in 2 cases, and Dewar and Barington's technique in 1 case. 4. Results were evaluated in 4 groups as excellent, good, fair, and poor according to Gerald weitzman's classification(1975). 5. Overall results of more than good (satisfactory) was obtained in 72.7% of the 11 cases with conservative treatment and in 50% of the 6 cases with operative treatment.

A case of Equinus Deformity due to Mesenchymoma of Calf Muscle: A case Report / 대한정형외과학회잡지

Joint deformity secondary to neoplastic involvement of the soft tissue has been well described and is easy to diagnose. Mesenchymema is a rare neoplasm which can arise at anyplace of the body and called as angiomyolipoma, lipomyohemangioma, fibromyxolipoma and etc. according to the composition of the various tissues. We experienoed a case of equinus deformity due to mesenchymoma of calf muscle. The patient was treated by excision and tendo calcaneus lengthening with satisfactory result.