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Objectives@#. This study aimed to investigate the relationship between tinnitus and joint pain from representative samples of Koreans. @*Methods@#. The demographics and the responses to a questionnaire about tinnitus and joint pain severity and mental health status of adults aged ≥50 years in the 2010–2012 Korean National Health and Nutrition Examination Survey were analyzed. @*Results@#. Among 9,032 individuals, 26.7% reported experiencing tinnitus within the past year. Participants with tinnitus were more frequently older, hearing loss, and had lower education levels, income, and body weight. Participants with regular exercise and sleep had a lower tinnitus prevalence. The incidences of stress, depressed mood, and suicidal ideation were significantly higher in the tinnitus group and participants with joint pain. The rates of participants with tinnitus according to the number of joint pain sites (zero, one, two, and three) was 22.1%, 31.4%, 33.3%, and 44.2%, and those of participants with severely annoying tinnitus according to the number of joint pain sites (zero, one, two, and three) were 3.3%, 6.8%, 7.9%, and 10.7%, respectively. @*Conclusion@#. Tinnitus prevalence and severity were significantly related to joint pain, and both conditions were related to psychiatric distress. Thus, the authors suggest that psychiatric distress as a common risk factor for tinnitus and joint pain should be considered when deciding treatment strategies and in guiding public health policy.
ABSTRACT
Masson’s tumor, also known as intravascular papillary endothelial hyperplasia (IPEH), is a rare, benign vascular tumor characterized by the proliferation of endothelial cells with papillary formations. Differential diagnosis between IPEH and angiosarcoma is important because both have microscopic similarity. Herein, we report a rare case of IPEH on the right lateral neck of a 50-year-old female presenting with a neck mass, which was completely removed without complication.
ABSTRACT
Lipoblastoma is a rare benign tumor with 80–90% occurring in children less than 3 years of age and 40% occurring in children less than 1 year of age. The most common site of incidence is limb, and then trunk. Neck is the rare site of incidence. The main symptom that the patient complains about is a rapidly growing neck mass without pain. When the size of mass increases, it can cause dyspnea, Horner's syndrome. Lipoblastoma is usually diagnosed as a lipoma in the fine needle aspiration. Since it is not differentiated from lipoma, liposarcoma, and hibernating adenoma in CT and MRI, the definitive diagnosis is histologic diagnosis through surgical resection. The treatment is complete surgical resection. And recurrence rate is 9–25% due to incomplete resection. Authors report this case with a review of literatures since we experienced a case of lipoblastoma diagnosed histopathologically after surgical treatment of neck mass.
Subject(s)
Child , Humans , Adenoma , Biopsy, Fine-Needle , Diagnosis , Dyspnea , Extremities , Horner Syndrome , Incidence , Lipoblastoma , Lipoma , Liposarcoma , Magnetic Resonance Imaging , Neck , Pediatrics , RecurrenceABSTRACT
BACKGROUND AND OBJECTIVES@#Head and neck cancer surgery has a high risk of infection, because surgical fields are exposed to the oral cavity and the pharynx during surgery. The purpose of this study is to evaluate the usefulness of prophylactic metronidazole by identifying factors contributing to postoperative fistulas in clean-contaminated head and neck cancer surgery.SUBJECTS AND METHOD: A total of 234 patients underwent mucosa-opening surgery between January 2002 and October 2015. Of those, 167 patients received conventional prophylactic antibiotics and 67 patients received metronidazole in addition to the conventional prophylactic antibiotics. Various clinical factors were evaluated to find association with postoperative fistula.@*RESULTS@#The multivariate analysis showed that the tumor site, advanced T stage, and the preoperative treatment were significantly associated with fistula formation, and the prophylactic use of metronidazole significantly reduced the number of postoperative fistulas.@*CONCLUSION@#In cases where the incidence of postoperative fistulas are more likely to increase, such as in the advanced T stage, in oral/pharyngeal cancer, and preoperative non-surgical treatment, prophylactic metronidazole may be useful for preventing postoperative fistulas.
ABSTRACT
BACKGROUND AND OBJECTIVES: Previous studies have suggested the usefulness and importance of postoperative voice therapy, for which there are indirect and direct methods. The aim of this study was to evaluate the efficacy of treatment according to different voice therapy methods. SUBJECTS AND METHOD: Patients with vocal polyp were divided into three groups. Group 1 received direct voice therapy after phonomicrosurgery and Group 2 indirect voice therapy after phonomicrosurgery. Group 3 did not receive any voice therapy. RESULTS: Perceptual, acoustic, aerodynamic voice outcome parameters differed significantly between pre and post-operative treatments. In almost all of the voice analysis, Group 1, who underwent direct voice therapy, improved more significantly compared with Group 2 and 3. CONCLUSION: Postoperative voice therapy following phonomicrosurgery may be an effective adjuvant treatment in patients with vocal polyps. In particular, direct voice therapy can be effective for improving postoperative voice outcome.
Subject(s)
Humans , Acoustics , Methods , Polyps , VoiceABSTRACT
BACKGROUND/AIMS: To develop a novel treatment method for hepatitis B virus (HBV) infection, we aimed to make a human monoclonal antibody inhibiting reverse transcriptase (RT) activity of P protein which was important in HBV replication by using phage display technique. Therefore, we analysed the usability of human monoclonal antibody as a protein based gene therapy. METHODS: Reverse transcriptase/polymerase (RT/POL) functional motif of P protein of HBV was cloned in pMAL-c vector and expressed as maltose binding fusion protein form. The RT/POL recombinant protein (pMRT/POL) was purified by amylose resin column. Using human single chain Fv phage antibody library with 1.1x10(10) size, human antibody against pMRT/POL was selected with BIAcore panning. Selected antibody fragments were analyzed for the activity of RT inhibition. Finally, they were analyzed for the affinity with BIAcore and the complementarity determining regions with nucleotide sequencing. RESULTS: pMRT/POL recombinant protein expressed in E. coli showed RT activity, 1microgram of recombinant protein had an activity equivalent to 5 unit of MMLV RT. By BIAcore panning, we could select 3 clones; POL-A5, POL-B8 and POL-B12. Each clone's RT inhibiting activity were 52-82%, affinity against antigen were 8.15x10(-8) M to 1.75x10(-6) M. CONCLUSIONS: Human monoclonal antibodies produced in this study showed low affinity, but efficiently inhibited the activity of RT in vitro. If POL-A5, POL-B8, and POL-B12 can be converted to intracellular antibody form, it can be used for protein-based gene therapy by inhibiting the replication through the neutralization of polymerase protein of HBV.
Subject(s)
Humans , Antibodies, Monoclonal/biosynthesis , Complementarity Determining Regions/chemistry , Gene Products, pol/antagonists & inhibitors , Genetic Vectors , Hepatitis B virus/enzymology , Peptide Library , RNA-Directed DNA Polymerase/genetics , Recombinant Fusion Proteins/biosynthesis , Reverse Transcriptase Inhibitors/chemistryABSTRACT
PURPOSE: Transforming growth factor (TGF)-beta is recognized as being associated with cataractogenesis. We quantitated the mRNA expression of TGF-beta isoforms in cataractous crystalline lens to determine the effect of the isoforms on cataractogenesis. METHODS: With lens epithelial cells from thirty eyes in thirty patients, the mRNA expressions of TGF-beta1, beta2 and beta3 were quantitated by real-time SYBR Green polymerase chain reaction and the results were compared according to cataract type and presence of diabetes mellitus. RESULTS: Each isoform mRNA of TGF-beta was expressed: TGF-beta3 in all 30 eyes, TGF-beta1 in 29 eyes (96.7%), with the exception being one diabetic senile cataract, and TGF-beta2 in 9 eyes. The amount of TGF-beta1 mRNA expression was significantly lower in the diabetic cataracts than in the non-diabetic cataracts (P=0.056). CONCLUSIONS: TGF-beta was associated with cataractogenesis. It is significant that the expression of TGF-beta2 mRNA was decreased in all cataracts. The decrease of TGF-beta1 mRNA expression was more meaningful in the diabetic cataracts than in the non-diabetic cataracts.
Subject(s)
Humans , Cataract , Diabetes Mellitus , Epithelial Cells , Lens, Crystalline , Polymerase Chain Reaction , Protein Isoforms , RNA, Messenger , Transforming Growth Factor beta , Transforming Growth Factor beta1 , Transforming Growth Factor beta2 , Transforming Growth Factor beta3 , Transforming Growth FactorsABSTRACT
BACKGROUND: To develop a novel treatment strategy for hepatitis B virus infection, a major cause of liver chirosis and cancer, we aimed to make human monoclonal antibodies inhibiting RNase H activity of P protein playing in important role in HBV replication. In this regard, phage display technology was employed and demonstrated as an efficient cloning method for human monoclonal antibody. So this study analysed the usability of human monoclonal antibody as protein based gene therapy. METHODS: RNase H of HBV was expressed as fusion protein with maltose binding protein and purified with amylose resin column. Single chain Fv (scFv) phage antibody library was constructed by PCR cloning using total RNAs of PBMC from 50 healthy volunteers. Binders to RNase H were selected with BIAcore 2000 from the constructed library, and purified as soluble antibody fragment. The affinity and sequences of selected antibody fragments were analyzed with BIAcore and ABI automatic sequencer, respectively. And finally RNase H activity inhibiting assay was carried out. RESULTS: Recombinant RNase H expressed in E. coli exhibited an proper enzyme activity. Naive library of 4.46 X 10(9) cfu was screened by BIAcore 2000. Two clones, RN41 and RN56, showed affinity of 4.5 X 10(-7) M and 1.9 X 10(-7) M, respectively. But RNase H inhibiting activity of RN41 was higher than that of RN56. CONCLUSION: We cloned human monoclonal antibodies inhibiting RNase H activity of P protein of HBV. These antibodies can be expected to be a good candidate for protein-based antiviral therapy by preventing a replication of HBV if they can be expressed intracellularly in HBV-infected hepatocytes.
Subject(s)
Humans , Amylose , Antibodies , Antibodies, Monoclonal , Bacteriophages , Cell Surface Display Techniques , Clone Cells , Cloning, Organism , Genetic Therapy , Healthy Volunteers , Hepatitis B virus , Hepatitis B , Hepatitis , Hepatocytes , Immunoglobulin Fragments , Liver , Maltose-Binding Proteins , Polymerase Chain Reaction , Ribonuclease H , Ribonucleases , RNA , Single-Chain AntibodiesABSTRACT
BACKGROUND: Hepatitis C virus(HCV), a family of Flaviviridae, has a host cell-derived envelope containing a positive-stranded RNA genome, and has been known as the maj or etiological agent for chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. There remains a need to dissect a molecular mechanism of pathogenesis for the development of therapeutic and effective preventive measure for HCV. Identification of cellular receptor is of central importance not only to understand the viral pathogenesis, but also to exploit strategies for prevention of HCV. This study was aimed at identifying peptide mimotopes inhibiting the binding of E2 protein of HCV to MOLT-4 cell . METHODS: In this study, phage peptide library displaying a random peptides consisting of 7 or 12 random peptides was employed in order to pan against E2 protein. Free HCV particles were separated from the immune complex forms by immunoprecipitation using anti-human IgG antibody, and used for HCV-capture ELISA. To identify the peptides inhibiting E2-binding to MOLT-4 cells, E2 protein was subj ect to bind to MOLT-4 cells under the competition with phage peptides. RESULTS: Several phage peptides were selected for their specific binding to E2 protein, which showed the conserved sequence of SHFWRAP from 3 different peptide sequences. They were also able to recognize the HCV particles in the sera of HCV patient s captured by monoclonal antibody against E2 protein. Two of them, showing peptide sequence of HLGPWMSHWFQR and WAPPLERSSLFY respectively, were revealed to inhibit the binding of E2 protein to MOLT-4 cell efficiently in dose dependent mode. However, few membrane-associated receptor candidates were seen using Fasta3 programe for homology search with these peptides. CONCLUSION: Phage peptides containing HLGPWMSHWFQR and WAPPLERSSLFY respectively, showed the inhibition of E2-binding to MOLT-4 cells. However, they did not reveal any homologues to cellular receptors from GenBank database. In further study, cellular receptor could be identified through the screening of cDNA library from MOLT-4 or hepatocytes using antibodies against these peptide mimotopes.
Subject(s)
Humans , Antibodies , Antigen-Antibody Complex , Bacteriophages , Carcinoma, Hepatocellular , Conserved Sequence , Databases, Nucleic Acid , Enzyme-Linked Immunosorbent Assay , Flaviviridae , Gene Library , Genome , Hepacivirus , Hepatitis C , Hepatitis , Hepatitis, Chronic , Hepatocytes , Immunoglobulin G , Immunoprecipitation , Liver Cirrhosis , Mass Screening , Peptide Library , Peptides , RNAABSTRACT
No Abstract Available.
Subject(s)
Humans , Hepacivirus , Hepatitis C , Hepatitis , Polymerase Chain ReactionABSTRACT
No Abstract Available.
Subject(s)
Humans , Hepacivirus , Hepatitis C , Hepatitis , Polymerase Chain ReactionABSTRACT
We expressed anti-HBsAg human antibody fragment (B7 Fd) using pRSET-A vector and BL21(DE3)pLysS strain of E. coli. B7 Fd is composed only of variable domain (VH) and CH1 constant domain of IgG heavy chain molecule. This Fd molecule was solubilized using guanidine salt and then expressed in the form of inclusion body and successfully refolded into functional antibody molecule by rapid dilution in refolding buffer. B7 Fd reacted with d epitope of hepatitis B virus surface antigen (HBsAg). Its affinity was determined by competition enzyme-linked immunosorbent assay (competition ELISA). The K value of B7 Fd was 3.3 * 10.
Subject(s)
Humans , Antigens, Surface , Enzyme-Linked Immunosorbent Assay , Guanidine , Hepatitis B virus , Immunoglobulin G , Inclusion BodiesABSTRACT
In our previous report an anti-HBsAg human monoclonal antibody was generated using antibody phage display library technique. Using pComb3 filamentous phagemid vector, Fab molecule was expressed in fusion form to a phage coat protein in the periplasm of E. coli. A clone of HBsAg binder was selected after panning and designated as B7. In order to select the clones with higher affinity and to examine which chain contributes most to the affinity of B7, the light and heavy chain of B7 was sequentially deleted and replaced with new library. HBsAg-binders were selected and tested by EIA (enzyme immunoassay). It was revealed that the affinity of B7 depends only on the heavy chain of Fd. B7 Fd was constructed without light chain and specificity and affinity was further confirmed by western blot analysis. This human monoclonal Fd antibody was found to react with d antigenic determinant of HBsAg as the original clone did. The nucleotide sequence analysis revealed that VH of B7 could be classified into Kabat's subgroup II and human IgG heavy chain family IV. The CH1 of B7 was IgG1.
Subject(s)
Humans , Bacteriophages , Base Sequence , Blotting, Western , Clone Cells , Hepatitis B Surface Antigens , Immunoglobulin G , Periplasm , Sensitivity and SpecificityABSTRACT
In this study, we are to produce the single chain variable fragment (scFv) antibodies against surface protein of hepatitis B virus (HBV) using antibody phage display technique. Balb/c mice were immunized with preS1 and cDNAs of heavy and light chains of splenic B cells from immunized mice were prepared using RT-PCR. Two cDNAs were linked with (64S) linker DNA under recombination PCR to produce single chain Fv DNA. After digestion of scFv DNA with Sp 1 and Not 1, the digested DNA was ligated into pCANTAB 5E and electroporated into E. coli XL1-Blue to prepare scFv-library. The size of library was 1 * 10' pfu/ml. Phage antibodies (phabs) against preS1 were rescued with M13K07 helper phages, and preS1-binders were selected through 3 times of panning using 96 well microtitre plates. Phage antibody clones were assayed directly for the ability to bind preS1 by ELISA. And then 7 phage antibody clones had high ELISA signals against preS1. Phabs from preS1-specific pMsc-17 had the strongest ELISA signal to preS1. Phabs from pMsc-17 were used for Western blot to preS1 and the results revealed that it was specific to preS1. To prepare the soluble scFv antibody, phabs from pMsc-17 were transfected into non-suppressor E. coli HB2151, and grown under 1 mM IPTG. Soluble scFv antibody was mainly accumulated in the periplasmic space, but small amount of antibody was secreted into culture media.
Subject(s)
Animals , Mice , Antibodies , B-Lymphocytes , Bacteriophages , Blotting, Western , Cell Surface Display Techniques , Clone Cells , Culture Media , Digestion , DNA , DNA, Complementary , Enzyme-Linked Immunosorbent Assay , Hepatitis B virus , Hepatitis B , Hepatitis , Isopropyl Thiogalactoside , Periplasm , Polymerase Chain Reaction , Recombination, Genetic , Single-Chain AntibodiesABSTRACT
Human monoclonal antibodies have considerable potential in the prophylaxis and treatment of viral disease. By cloning human Ig gene segments from the B cells of volunteer into pComb3 phagemid vector, antibody library was created of filamentous phage particles displaying Fab fragments on their surface after being rescued with M13KO7 helper phages. The size of library was 7x10' pfu. Phage antibodies (phabs) were panned against biotinylated preS1 using streptavidine coated Dynabead. The soluble Fab antibodies were prepared from phagemid colonies and assayed directly for the ability to bind preS1 by ELISA. And then 3DW and SGW specific to preS1 which have both heavy and light chain to form Fab fragment, were selected. The soluble Fab antibody from 3DW was expressed highly at the concentration of 0.1 - 1.0 mM of IPTG, and 5 hours postinduction. The soluble antibodies from 3DW and SGW showed their relative affinities of 2x10' M ', and Sx10 M ', respectively, and the specificities to preS1 on ELISA. Our results suggest that antibody phage display library is very useful method to generate the human monoclonal antibody and that the human Fab monoclonal antibodies specific to preS1 selected in this study open the way to treat hepatitis B as a component of passive irnmunotherapeutics.
Subject(s)
Humans , Antibodies , Antibodies, Monoclonal , B-Lymphocytes , Bacteriophages , Clone Cells , Cloning, Organism , Enzyme-Linked Immunosorbent Assay , Genes, Immunoglobulin , Hepatitis B virus , Hepatitis B , Hepatitis , Immunoglobulin Fab Fragments , Isopropyl Thiogalactoside , Streptavidin , Virus Diseases , VolunteersABSTRACT
STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Subject(s)
Humans , Braces , Decompression , Incidence , Lumbosacral Region , Pseudarthrosis , Retrospective Studies , Spinal Fusion , SpineABSTRACT
In a conservative treatment of lumbar disc herniation, authors customarily had included the flexion exercise untill 1991. Thereafter, the extension exercise started to be included for the selected patients and this study was designed to assess the clinical outcome of the extension exercise compared to the flexion exercise in the conservative treatments of lumbar disc herniations. 55 consecutive patients (31 males and 24 females having ages ranging from 19-68 years with a mean of 37.2) were included in this prospective study. Criteria for inclusion in this group were: 1. Contained herniations of a single lumbar disc, documented by CT or MRI; 2. no other concurrent spine pathology; 3. conservative treatments with an uniform program including the extension exercise; 4. follow-up for a minimum of one year. For comparison with this prospective group, another 62 consecutive patients (36 males and 26 females having ages ranging from 17-63 years with a mean of 35.7) were selected who were treated during 1991 with flexion exercise before this study was designed and who were matched with the designed criteria except for the direction of exercise. Apart from the therapeutic exercise, the conservative treatments also included medication, physiotheraphy, epidural injection, and back school in the both groups uniformly. The clinical outcome of the extension exercise group indicated that 28 (50.9%) patients excellent, 23 (41.8%) patients good, three (5.5%) patients fair, and one (1.8%) patient failed outcomes. In the flexion exercise group, there were 23 (37.1%) excellent, 27 (43.5%) good, seven (11.3%) fair, and five (8.1%) failed outcomes. From these results, it would seem to follow that the extension exercise group had superior clinical outcome compared to the flexion exercise, i.e. higher excellent and good outcomes (92.7% vs. 80.6%) and lower poor and failed outcomes (7.3% vs. 19.4%), respectively, Moreover, the excellent outcome in terms of full recovery without any pain and disability was more common in the extension exercise group (50.9% vs. 37.1%). A better clinical outcome was obtained in the extension exercise group of patients who were younger than 40 years and who had a history of three months or less compared with those who were older and had longer history of disease. The sizes of disc protrusion did not affect the clinical outcome. In conclusion, we would recommend that the extension exercise, instead of the flexion exercise, should be included in the conservative treatment of a contained herniation of lumbar disc for a better clinical outcome.