Differentiation of osteosarcoma from osteomyelitis using microarchitectural analysis on panoramic radiographs.

Diagnosing osteosarcoma (OS) is very challenging and OS is often misdiagnosed as osteomyelitis (OM) due to the nonspecificity of its symptoms upon initial presentation. This study investigated the possibility of detecting OS-induced trabecular bone changes on panoramic radiographs and differentiating OS from OM by analyzing fractal dimensions (FDs) and degrees of anisotropy (DAs). Panoramic radiographs of patients with histopathologically proven OS and OM of the jaw were obtained. A total of 23 patients with OS and 40 patients with OM were enrolled. To investigate whether there was a microarchitectural difference between OS lesions and normal trabecular areas in each patient, two regions of interest (ROIs) were located on the CT images. Three microarchitectural parameters (box-counting FD, fast Fourier transform-based FD, and DA) were calculated. For both OS and OM, significant differences were found for all three microarchitectural parameters. Compared to normal trabecular bone, trabecular bone affected by OS and OM became isotropic and more complex. When comparing OS and OM, a statistically significant difference was found only in DA. Trabecular bones affected by OS became more isotropic than those affected by OM. Microarchitectural analysis, especially DA, could be useful for detecting OS-induced trabecular alterations and differentiating OS from OM.

Short-term change of handgrip strength after trigger point injection in women with muscular pain in the upper extremities.

OBJECTIVE: To determine overall handgrip strength (HGS), we assessed the short-term change of HGS after trigger point injection (TPI) in women with muscular pain in the upper extremities by comparison with established pain scales. METHODS: The study enrolled 50 female patients (FMS with MPS group: 29 patients with combined fibromyalgia [FMS] and myofascial pain syndrome [MPS]; MPS group: 21 patients with MPS) who presented with muscular pain in the upper extremities at Konyang University Hospital. In addition, a total of 9 healthy women (control group) were prospectively enrolled in the study. We surveyed the three groups using the following established pain scales: the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), and the Short Form McGill Pain Questionnaire (MPQ). HGS was measured in both hands of study participants using a handgrip dynamometer. We performed TPI (0.5% lidocaine, total 10 mL, injected at the pain site of upper extremities). After 20 minutes, we remeasured the patient's HGS and MPQ score. RESULTS: ANOVA analysis was conducted among groups. Based on Tukey multiple comparison test, the majority of FIQ and SF-36 subscales, total FIQ and SF-36 scores, MPQ and HGS were significantly different between FMS with MPS and the other groups. There was no statistically significant difference between MPS and control groups. Higher HGS was positively associated with enhanced physical function, negatively associated with total FIQ and MPQ scores, and positively associated with the total SF-36 score calculated using Spearman correlation. Post-TPI MPQ decreased and HGS increased. In patient groups, a negative correlation was found between MPQ and HGS. CONCLUSION: The HGS test might potentially be a complementary tool in assessing the short-term treatment effects of women with muscular pain in the upper extremities.

Therapeutic effect of korean red ginseng extract on infertility caused by polycystic ovaries.

Polycystic ovarian syndrome (PCOS) is a very common endocrine disorder in women of reproductive age. Nerve growth factor (NGF) may be involved in the pathogenesis of PCOS. In this study, we investigated the effect of Korean red ginseng extract (KRGE) on the ovarian morphology and NGF expression in an estradiol valerate (EV)-induced rat model. Polycystic ovaries were induced by a single intramuscular injection of estadiol valerate (4 mg, dissolved in sesame oil) in adult cycling rats. KRGE was administered orally (200 mg/kg body weight/day) for 60 consecutive days, beginning 60 days after the induction. Ovarian morphology was almost normalized and NGF was normalized in the EV+KRGE group. KRGE lowered the high numbers of antral follicles and increased the number of corpora lutea in the polycystic ovaries. The results are consistent with a beneficial effect of KRGE in the treatment of PCOS.

Antimicrobial resistance patterns and characterization of integrons of Shigella sonnei isolates in Seoul, 1999-2008.

A total of 66 Shigella sonnei isolates from 1999 to 2008 in Seoul was analyzed for their antimicrobial resistance, carriage of integron, and the patterns of Pulsed-field gel electrophoresis (PFGE). A high level of antimicrobial resistance to streptomycin (100%), trimethoprim/sulfamethoxazole (95%), tetracycline (94%), nalidixic acid (65%), and ampicillin (41%) was observed among S. sonnei isolates. Fourteen profiles of antimicrobial resistance were identified with the most common resistance profile being nalidixic acid, streptomycin, tetracycline, and trimethoprim/sulfamethoxazole (35%). PCR and DNA sequencing analysis revealed the presence of class 2 integron in all isolates, and class 1 and 2 integrons in 7 isolates. The class 2 integron carried two types of gene cassettes. One cassette array was dfrI, sat2, and aadA1 (91%), and the other was dfr1 and sat1 (8%). dfrA12 and aadA2 gene cassette was found in one isolate containing class 1 integron. PFGE was carried out to examine the genetic relatedness among isolates. All isolates except for one showed similar PFGE patterns (similarity of 80.1%). These results suggest that the S. sonnei isolated during 1999-2008 in Seoul have similar lineages that have not undergone evolutionary changes with time.

Genotypic and phenotypic diversity of Salmonella enteritidis isolated from chickens and humans in Korea.

Salmonella Enteritidis is the most common cause of salmonellosis in humans in South Korea. It has been recognized that the principal source of human infection with S. Enteritidis is chickens and their products such as meat and eggs. A total of 173 S. Enteritidis isolates from humans (65 isolates) and chickens or their products (108 isolates) were analyzed by antibiotic susceptibility assay, phage typing, and pulsed-field gel electrophoresis (PFGE). Drug resistance was found to streptomycin (32.3%), ampicillin (30.6%), nalidixic acid (30.1%), ticarcillin (30.1%), and tetracycline (28.3%). More than 70% of the isolates were found to be resistant to one or more antibiotics tested. The most frequent patterns of resistant isolates were resistance to nalidixic acid only (28.3%) and resistance to two antibiotics (four combinations; 20.2%). The most predominant phage type (PT) was PT1 (27.2%) followed by PT21 (20.8%) and PT4 (8.7%) in chicken and human isolates. Nineteen different PFGE patterns were found among the 173 isolates, and A1 was the most common PFGE pattern, followed by A6 (17.3%). Most S. Enteritis isolates (except two isolates with patterns B and C) showed similar PFGE patterns that differed by only a few bands. These results show that 2 or 3 subtypes of S. Enteritidis are shared to a large extent by humans and chickens. This implies the possibility of the spread of chicken S. Enteritidis to humans.

Characteristics of non-typhoidal Salmonella isolates from human and broiler-chickens in southwestern Seoul, Korea.

Non-typhoidal Salmonella (NTS) is an important commensal microorganism. The purpose of this study was to determine the epidemiological relation between NTS isolates from livestock and NTS isolates from human by analyzing antimicrobial susceptibilities and performing molecular typing. We determined the serotypes of 36 human clinical isolates and 64 livestock isolates, performed antimicrobial susceptibility testing against 8 antibiotics, and determined the molecular types of isolated NTS spp. by pulsed field gel electrophoresis (PFGE). In human isolates, S. enteritidis was the most common serotype (17 isolates; 47.2%) and S. typhimurium the second most (8 isolates; 22.2%). In livestock isolates, S. typhimurium was the most common serotype (15 isolates; 23.44%), and S. enteritidis was the second most (14 isolates; 21.88%). Ampicillin and tetracycline resistance were 50% (32/64 isolates) each among broiler-chicken NTS isolates. No human or livestock NTS isolates showed resistance to ciprofloxacin, TMP-SMX, or ceftriaxone. However, 19.4% (7/36) and 46.8% (30/64) of the human and livestock NTS isolates were resistant to nalidixic acid (MIC > or = 16 mg/mL), respectively. The presence of the three identical PFGE molecular types from human and broiler-chicken NTS isolates suggests the possibility of transmission from livestock to humans.