Changes in the glymphatic system before and after dialysis initiation in patients with end-stage kidney disease.

INTRODUCTION: The aims of this study were to evaluate 1) glymphatic system function in patients with end-stage kidney disease (ESKD) before initiating dialysis compared to healthy controls, and 2) changes in the glymphatic system function after kidney replacement therapy including dialysis in patients with ESKD using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method. MATERIALS AND METHODS: This study was prospectively conducted at a single hospital. We enrolled 14 neurologically asymptomatic patients who first initiated hemodialysis or peritoneal dialysis for ESKD and 17 healthy controls. Patients had magnetic resonance imaging scans before initiating dialysis and again 3 months after initiating dialysis and the DTI-ALPS index was calculated. We compared the DTI-ALPS index before and after the initiation of dialysis and compared the DTI-ALPS index between the patients with ESKD and healthy control. RESULTS: There were differences in the DTI-ALPS index between ESKD patients before initiating dialysis and healthy controls (1.342 vs. 1.633, p = 0.003). DTI-ALPS index between ESKD patients before initiating dialysis and those after dialysis were not different (1.342 vs. 1.262, p = 0.386). There was a positive correlation between DTI-ALPS index and phosphate (r = 0.610, p = 0.020) in patients with ESKD. CONCLUSION: We confirmed the presence of glymphatic dysfunction in patients with ESKD. However, there was no difference in the glymphatic system before and after dialysis initiation. This finding may be related to uremic toxins that are not removed by dialysis in patients with ESKD. This study can be used for the development of pathophysiology of patients with ESKD.

Insect fauna including unrecorded species in Ulleungdo, South Korea.

Background: Ulleungdo harbours a unique ecosystem owing to its isolation from the mainland alongside its maritime climate. The island, formed via volcanic activity, is the largest island in the East Sea of Korea and retains a primeval forest. The ecosystems are being destroyed owing to increasing human activity on the island. Therefore, through the investigation of the insect fauna of Ulleungdo, we tried to provide information that can be the basis for understanding the island ecology of Ulleungdo. This survey was conducted four times between April and October in 2020 at Seonginbong. New information: The findings of the survey regarding insect fauna at Seonginbong, Ulleungdo included 10 orders, 105 families, 216 genera and 212 species, of which 12 families, two subfamilies, 13 genera and 74 species were previously unrecorded. The data have been registered in the Global Biodiversity Information Facility (GBIF; www.GBIF.org).

Photochemical advanced oxidative process treatment effect on the pesticide residues reduction and quality changes in dried red peppers.

Pesticide residues in crops are widely monitored, and the residue reduction techniques at the post-harvest stage are important to maintain food safety. In dried crops, pesticide residues can be concentrated after dehydration, which increases concerns regarding residue risk. Therefore, the residue reduction effects of ultraviolet (UV), ozone, and photochemical advanced oxidative process (pAOP) were investigated for dried peppers at the post-harvest stage. UV254 treatment reduced 59.7% of the residue concentration on average, while UV360 showed a reduction of only 13.3% under 9.6 W m-2 of UV exposure for 24 h. Gaseous ozone treatments reduced the residue concentrations up to 57.9% on average. In contrast, the pAOP treatment reduced the concentration up to 97% and was superior to UV or ozone treatment alone. Increased drying temperature under pAOP condition resulted in higher reduction ratios at 40-80 °C. The pAOP conditions with 12 and 24 µmol/mol of ozone and UV254 irradiation for 24-48 h reduced the residue concentrations to 39-67%. Particularly, difenoconazole, fludioxonil, imidacloprid, and thiamethoxam residue concentrations were drastically reduced by over 50% under 12 µmol/mol ozone of the pAOP condition, while carbendazim, fluquinconazole, and pyrimethanil were relatively stable and their concentrations reduced below 50% under 24 µmol/mol ozone of the pAOP treatment. Various drying-related quality parameters of drying peppers such as water-soluble color, capsanthin, capsaicinoids, acid value, peroxide value, and thiobarbituric acid value were slightly altered, but not significantly, under 12 µmol/mol ozone of the pAOP condition, while the peroxide value was significantly altered under the higher ozone conditions. Therefore, pAOP treatment combined with gaseous ozone can be used for reducing residual pesticides in peppers without greatly reducing quality.

Long-term Survival Analysis of Kidney Transplant Recipients Receiving Mizoribine as a Maintenance Immunosuppressant: A Single-Center Study.

BACKGROUND: Mizoribine (MZR) has been developed as an immunosuppressant and is widely used in Asia. However, most studies on MZR have been performed in Japan, and there remains a lack of reports on long-term use in other countries. The purpose of this study is to evaluate the efficacy and safety of MZR's use in Korean kidney transplant recipients by observing their clinical courses and analyzing their long-term patent and graft survival rates. METHODS: We studied 129 subjects who had received MZR as a maintenance immunosuppressant since January 2000. Our analysis was based on the patients' medical records from January 2000 to December 2017. RESULTS: The overall survival rates of the kidney transplant recipients were 100% at 1 year, 99.1% at 5 years, 96.8% at 10 years, and 92.5% at 15 years. The graft survival rates were 100% at 1 year, 98.3% at 5 years, 93.2% at 10 years, and 82.2% at 15 years. There were differences in the recipient survival and graft survival rates according to the kidney donor and the use of renal replace therapy before transplant. There were no differences in the survival rates according to the MZR dose, the type of underlying disease, or other clinical factors. CONCLUSIONS: The use of low doses of MZR as a maintenance immunosuppressant could be an effective means of ensuring relatively good long-term patient and graft survival rates in cases of kidney transplant.

Comparative Study of Clinical and Radiographic Outcomes of High Tibial Osteotomy in Patients with Kissing Lesions and Non-Kissing Lesions.

PURPOSE: High Outerbridge grade lesions of the articular cartilage have been associated with poor outcomes of high tibial osteotomy (HTO). However, there has been no report on the efficacy of HTO in the presence of kissing lesions. The purpose of this study was to compare clinical and radiographic outcomes of HTO between kissing lesion and non-kissing lesion groups. MATERIALS AND METHODS: Of the patients with medial compartment osteoarthritis and varus deformity treated with HTO between 2007 and 2012, 21 cases with kissing lesions and 22 cases without kissing lesions were selected. Clinical outcomes were assessed using the Lysholm knee scoring scale score, visual analogue scale score, Hospital for Special Surgery score, Western Ontario and McMaster Universities score, and Tegner activity score. Radiographic outcomes were assessed using the femoral-tibial angle, mechanical axis deviation, medial proximal tibial angle, posterior tibial slope angle, and joint space width. RESULTS: Clinical outcomes were improved in both groups from the postoperative assessment to the final follow-up, which showed no statistically significant difference between groups at the final follow-up. No statistically significant differences were observed with regard to radiographic assessment. CONCLUSIONS: Since both groups showed favorable short-term clinical and radiographic outcomes, HTO might be an alternative treatment option for degenerative osteoarthritis with kissing lesions in relatively young patients.

Characteristics and outcomes of ALK+ non-small cell lung cancer patients in Korea.

AIM: This study aimed to describe characteristics, treatment patterns and survival among Korean patients diagnosed with locally advanced or metastatic anaplastic lymphoma kinase (ALK)+ non-small cell lung cancer (NSCLC). METHODS: A retrospective patient chart review was conducted in major cancer centers in Korea in 2014-2015. Participating physicians reviewed patient charts and reported characteristics, treatment patterns, clinician-defined progression-free survival (PFS) and overall survival (OS) of ALK+ locally advanced or metastatic NSCLC patients. PFS and OS were estimated using Kaplan-Meier analysis. RESULTS: Physicians reported on 55 ALK+ NSCLC patients. Median age at locally advanced or metastatic NSCLC diagnosis was 60 years. Most patients (82%) received initial chemotherapy; 13% received an ALK inhibitor in the first line; 62% received an ALK inhibitor by the end of follow-up. Of the 30 patients who received crizotinib, 83% discontinued and 13% died during crizotinib therapy. Median PFS on crizotinib was 6.7 months. Of those who discontinued, 32% switched to chemotherapy, 16% switched to a different ALK inhibitor and 52% received no further therapy. After discontinuing crizotinib, median OS was 6.0 months overall, and 3.4 months among patients who did not receive a second-generation ALK inhibitor. CONCLUSION: In this study of locally advanced or metastatic ALK+ NSCLC patients in Korea, roughly one-third did not receive an ALK inhibitor. Among patients who discontinued crizotinib, over half received no further antineoplastic therapy and OS was poor, particularly among patients without second-generation ALK inhibitor use. These findings suggest a need for greater access to effective treatments following crizotinib discontinuation for ALK+ NSCLC patients in Korea.

Gene profiling of bone around orthodontic mini-implants by RNA-sequencing analysis.

This study aimed to evaluate the genes that were expressed in the healing bones around SLA-treated titanium orthodontic mini-implants in a beagle at early (1-week) and late (4-week) stages with RNA-sequencing (RNA-Seq). Samples from sites of surgical defects were used as controls. Total RNA was extracted from the tissue around the implants, and an RNA-Seq analysis was performed with Illumina TruSeq. In the 1-week group, genes in the gene ontology (GO) categories of cell growth and the extracellular matrix (ECM) were upregulated, while genes in the categories of the oxidation-reduction process, intermediate filaments, and structural molecule activity were downregulated. In the 4-week group, the genes upregulated included ECM binding, stem cell fate specification, and intramembranous ossification, while genes in the oxidation-reduction process category were downregulated. GO analysis revealed an upregulation of genes that were related to significant mechanisms, including those with roles in cell proliferation, the ECM, growth factors, and osteogenic-related pathways, which are associated with bone formation. From these results, implant-induced bone formation progressed considerably during the times examined in this study. The upregulation or downregulation of selected genes was confirmed with real-time reverse transcription polymerase chain reaction. The RNA-Seq strategy was useful for defining the biological responses to orthodontic mini-implants and identifying the specific genetic networks for targeted evaluations of successful peri-implant bone remodeling.

Dynamics of alloplastic bone grafts on an early stage of corticotomy-facilitated orthodontic tooth movement in beagle dogs.

Alveolar augmented corticotomy is effective in accelerating orthodontic tooth movement, but the effect only lasts for a relatively short time. Therefore, the purpose of this study was to investigate the underlying biology of the immediate periodontal response to orthodontic tooth movement after a corticotomy with alloplastic bone grafts. The results demonstrated that measurable tooth movement began as early as 3 days after the intervention in beagle dogs. Based on the results and histological findings, augmented corticotomy-facilitated orthodontic tooth movement might enhance the condition of the periodontal tissue and the stability of the outcomes of orthodontic treatment.

Periodontal responses to augmented corticotomy with collagen membrane application during orthodontic buccal tipping in dogs.

This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60° and 28.12 ± 11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.

Tooth movement out of the bony wall using augmented corticotomy with nonautogenous graft materials for bone regeneration.

This prospective randomized split-mouth study was performed to compare the effects of augmented corticotomy with those of different nonautogenous bone graft materials combined with orthodontic tooth movement in dogs. Decortication was performed on the buccal bone surface of 6 male beagle dogs that were randomly assigned to receive grafts of deproteinized bovine bone mineral, irradiated cortical bone, or synthetic bone. Immediate orthodontic force was applied to the second and third premolars for buccal tipping for 6 weeks. The pocket depth and width of keratinized tissue (WKT) were measured. Histologic and histomorphometric analyses were performed. The probing depth, WKT, and ratio of the area of new bone to that of total bone on the buccal side were not significantly different between groups. All groups had considerable new bone formation on the pressure side. New bone formation on the buccal side and buccal plate formation in the coronal direction along the root surfaces were induced by the bone-derived and PDL-derived mesenchymal matrix, respectively. The angular change between groups was significantly different (P < 0.001). Augmented corticotomy using nonautogenous graft materials facilitated tooth movement without fenestrations and accelerated new bone formation on the pressure side.

A case of aortic dissection with fistula from aorta to right ventricle.

Aorto-right ventricular fistula is a very rare complication of aortic dissection. We report a case of acute aortic dissection extending into the right ventricle as documented by echocardiography. The patient survived after successful surgical repair.

Accelerated decompensation of mandibular incisors in surgical skeletal class III patients by using augmented corticotomy: a preliminary study.

INTRODUCTION: Our objectives were to evaluate the amount of decompensation of the mandibular incisors and the change of periodontal support around them after corticotomy with bone augmentation before orthognathic surgery. METHODS: Before orthognathic surgery for 15 skeletal Class III patients, orthodontic treatment was combined with corticotomy and bone augmentation labially to the anterior mandibular roots. Lateral cephalograms were taken before orthodontic treatment and before surgery (completion of preoperative orthodontic treatment). The amounts of mandibular incisor proclination, alveolar bone thickness, and periodontal support (gingival margin levels and augmentation pattern) were evaluated. RESULTS: Significant proclination of the mandibular incisors was shown after decompensation (P <0.001; incisor mandibular plane angle, 10.45°; incisor symphyseal plane angle, 10.74°). The incisor edge moved labially by 3.47 mm. The alveolar bone thickness increased by 1.56 mm at the root apex and 1.98 mm at the level of B-point (P <0.001). There was no gingival recession irrespective of the degree of proclination of the mandibular incisiors. Two types of bone augmentation pattern were evident. One was characterized by alveolar bone proclination proportional to the labial tipping of the mandibular incisors. Buccal alveolar bone at the cervical area was well maintained (60%, 9 subjects). The other showed greater increases in alveolar thickness at B-point than at the cervical area (40%, 6 subjects). CONCLUSIONS: The augmented corticotomy provided effective decompensation of the mandibular incisors in skeletal Class III patients while maintaining labial bone thickness and with no periodontal side effects. This technique reduces or eliminates the risk of moving the roots through the labial plate during decompensation with the associated risk of gingival recession.

A giant unruptured right coronary sinus of valsalva aneurysm.

There have been few case reports on giant sinus of Valsalva aneurysm (SVA). We report a case of a giant unruptured right coronary SVA that was confused with a pericardial cyst by transthoracic echocardiography.

Papillary fibroelastoma mimicking vegetation of the mitral valve.

Although cardiac papillary fibroelastoma is rare, it is the most common primary tumor of cardiac valves. The clinical presentation of these tumors varies from asymptomatic to embolic complications. We report an asymptomatic case of papillary fibroelastoma of mitral valve which was diagnosed by transthoracic echocardiography. The tumor was successfully resected by surgery.

Subclinical Myocardial Dysfunction in Metabolic Syndrome Patients without Hypertension.

BACKGROUND: The aim of this study was to evaluate myocardial function in patients with non-hypertensive metabolic syndrome. METHODS: We selected metabolic syndrome patients (n = 42) without evidence of hypertension and compared them to age-matched control individuals (n = 20). All patients were evaluated by two-dimensional and tissue Doppler echocardiography including tissue Doppler derived strain and strain rate measurements. RESULTS: There were no significant differences between the two groups in mitral E and A inflow velocities or the E/A ratio. However, systolic and early diastolic myocardial velocities, and strain rate were significantly lower in patients with metabolic syndrome than in the control group (all p < 0.05). Multiple stepwise regression analyses revealed that age, waist circumference, and systolic blood pressure were independently associated with peak systolic myocardial velocity. CONCLUSION: These results indicate that metabolic syndrome patients without hypertension may have decrease of myocardial systolic and early diastolic velocities on tissue Doppler imaging, even if they appear to have normal systolic and diastolic function on conventional echocardiography.

A comparison of different gingival depigmentation techniques: ablation by erbium:yttrium-aluminum-garnet laser and abrasion by rotary instruments.

PURPOSE: The aim of this study is to compare two different gingival depigmentation techniques using an erbium:yttrium-aluminum-garnet (Er:YAG) laser and rotary instruments. METHODS: Two patients with melanin pigmentation of gingiva were treated with different gingival depigmentation techniques. Ablation of the gingiva by Er:YAG laser was performed on the right side, and abrasion with a rotary round bur on the opposite side. RESULTS: The patients were satisfied with the esthetically significant improvement with each method. However, some pigment still remained on the marginal gingival and papilla. The visual analog scale did not yield much difference between the two methods, with slightly more pain on the Er:YAG laser treated site. CONCLUSIONS: The results of these cases suggest that ablation of the gingiva by an Er:YAG laser and abrasion with a rotary round bur is good enough to achieve esthetic satisfaction and fair wound healing without infection or severe pain. Prudent care about the gingival condition, such as the gingival thickness and degree of pigmentation along with appropriate assessment is needed in ablation by the Er:YAG laser procedure.

I-shaped incisions for papilla reconstruction in second stage implant surgery.

PURPOSE: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. METHODS: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. RESULTS: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. CONCLUSIONS: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.

Continuous H2 and CH4 production from high-solid food waste in the two-stage thermophilic fermentation process with the recirculation of digester sludge.

A thermophilic two-stage fermentation process using 10% total solids (TS) food waste was tested at varying organic loading rates (OLRs). The system was configured to produce H(2) and CH(4) in conjugation with the chemical oxygen demand (COD), nitrogen removal, and adjustment of the pH by returning sludge as an alkali buffer from the sludge storage tank for denitrification. The pH in the H(2) fermentation reactor was maintained in the range of 5.4-5.7 using sludge recirculation (Q(r)/Q(i) ratio 1). The average H(2) (11.1l-H(2) l(-1)-fed d(-1)) and CH(4) (47.4l-CH(4) l(-1)-fed d(-1)) production rates were achieved at OLRs of 39 (H(2) fermentation reactor) and 4.16 gCOD l(-1)d(-1) (CH(4) fermentation reactor), respectively. These results suggest that long-term stability of the continuous two-stage process can be successfully achieved by recirculation of high-alkalinity sludge of 6.7-7.5 g l(-1) as CaCO(3), without any added external chemical buffer.

Fermentative hydrogen production from tofu-processing waste and anaerobic digester sludge using microbial consortium.

The combination of tofu-processing waste and anaerobic digester sludge was studied for its fermentative H(2) production capacity in batch and continuous modes using a thermophilic mixed culture. Heat-treatment (110 degrees C, 30 min) in the presence of 0.5% HCl increased the soluble carbohydrate content of the tofu waste from 2.2 to 10.4 g/l. Anaerobic digester sludge was added to the tofu waste for supplementary nutrients with the optimal mixing ratio of 20% (v/v) under batch conditions. In continuous experiments, the effects of HRT(hydraulic retention time) and pH were investigated for the ranges of 2-6h and 5.0-6.0, respectively. The maximal H(2) production rate (12.0 l H(2)/l/day) and yield (2.3 mol H(2)/mol glucose equivalent) were obtained at HRT 4h and pH 5.5 while maintaining the head space gas at 50-60% (v/v) of H(2) without CH(4). This study indicates that the combination of tofu-processing waste and digester sludge can be considered to be one of the most promising forms of organic waste for continuous H(2) production.

Continuous H2 production by anaerobic mixed microflora in membrane bioreactor.

The characteristics of H(2) production by anaerobic mixed microflora in a submerged membrane bioreactor (MBR) were investigated. For comparative purposes, a continuous stirred tank reactor (CSTR) was operated in parallel under the same conditions. The experimental results showed that 35-day stable and continuous H(2) fermentation was successfully achieved, the MBR revealing an H(2) content of 51% and the CSTR, 58%. No methane gas was detected during the experiments for the long solids retention time (SRT) of 90 days. The MBR's H(2) production rate was 2.43-2.56 l H(2) l(-1)d(-1), which was about 2.6 times higher than that (0.95-0.97 l H(2) l(-1)d(-1)) of the CSTR, reflecting the MBR's higher H(2) productivity.