Effects of Presenteeism on Burnout among Rehabilitation Medical Workers in Korea: Multiple Mediating Effects of Organization and Supervisor Supports.

PURPOSES: This study aimed to examine the discriminatory impacts of two major impairment factors-job presenteeism and attention presenteeism (JP and AP)-in presenteeism on burnout and to verify the multiple mediating effects of organizational and supervisory support in their causal relationship to provide theoretical and practical implications for alleviating burnout among rehabilitation medical workers (RMWs). METHODS: Participants were convenience sampled from 23 hospitals and rehabilitation medical institutions in Korea, and 494 datasets were analyzed using the R packages R-studio, Jamovi, and JASP. RESULTS: The significant effects of JP and AP on burnout were investigated; AP (0.609) had a much higher effect than JP (0.170) on burnout among RMWs. Moreover, the multiple mediating effects of organizational support and supervisory support were verified in the JP-AP relationship and burnout among RMWs. Additionally, the absolute effect on burnout was more from AP than JP, and organizational support had a far more significant effect than supervisory support in the process of affecting burnout. CONCLUSIONS: The present study contributes to the literature on burnout by examining the relationships between presenteeism and burnout and by extending the current understanding of burnout and presenteeism to RMWs. And it is practically important to understand that the effect of AP was greater than that of JP between the two key sub-factors of presenteeism affecting burnout among RMWs, and Korean RMWs are more affected by support from the organization system than by personal support from their boss. Related theoretical and practical implications are further elaborated.

The Effect of Kinesio Taping Combined with Virtual-Reality-Based Upper Extremity Training on Upper Extremity Function and Self-Esteem in Stroke Patients.

(1) Background: The purpose of this study is to investigate the effect of virtual-reality-based hand motion training (VRT) in parallel with the Kinesio Taping (KT) technique on upper extremity function in stroke patients and to present a more effective therapeutic basis for virtual reality training intervention. (2) Methods: First, 43 stroke patients were randomly assigned to two groups: 21 experimental subjects and 22 controls. The experimental group performed Kinesio Taping (KT) on the dorsal part of the hand along with virtual-reality-based hand motion training, and the control group performed only virtual-reality-based hand motion training. The intervention was conducted for a total of 30 sessions over 6 weeks. To evaluate changes in upper extremity function, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), the Wolf Motor Function Test (WMFT), and the Motor Activity Log (MAL) (including amount of use (AOU) and quality of movement (QOM)) were evaluated. In addition, the Self-Efficacy Scale (SEF) was evaluated to examine the change in the self-esteem of the study subjects. (3) Results: The experimental group who participated in the virtual reality training in parallel with the KT technique showed statistically significant improvement (** p < 0.01) in the FMA-UE, WMFT, and MAL evaluations that investigate changes in upper extremity function. SEF evaluation also showed a statistically significant improvement (** p < 0.01). A statistically significant difference between the two groups was observed in the evaluation of FMA-UE, WMFT, MAL-QOM, and SEF (†p < 0.05), showing that that combined intervention was more effective at improving upper extremity function than the existing VRT intervention. There was no statistical difference between the two groups in the MAL-AOU item, which is an evaluation of upper extremity function (p > 0.05). There was a statistically significant difference between the two groups in the amount of change in upper limb function (††p < 0.01). (4) Conclusions: It was confirmed that virtual-reality-based hand motion training performed in parallel with the KT technique had a positive effect on the recovery of upper extremity function of stroke patients. The fact that the KT technique provided stability to the wrist by assisting the wrist extensor muscles appears to have improved the upper extremity function more effectively than VRT alone.

Effect of 3-Dimensional Robotic Therapy Combined with Electromyography-Triggered Neuromuscular Electrical Stimulation on Upper Limb Function and Cerebral Cortex Activation in Stroke Patients: A Randomized Controlled Trial.

(1) Background: This study investigated the effect of 3-dimensional robotic therapy (RT) combined with electromyography-triggered neuromuscular electrical stimulation (RT-ENMES) on stroke patients' upper-limb function and cerebral cortex activation. (2) Methods: Sixty-one stroke patients were assigned randomly to one of three groups. The stroke patients were in the subacute stage between 2 and 6 months after onset. The three groups received 20 min of RT and 20 min of electromyography-triggered neuromuscular electrical stimulation (ENMES) in the RT-ENMES group (n = 21), 40 min of RT in the RT group (n = 20), and 40 min of ENMES in the ENMES group (n = 20). The treatments were for 40 min, 5 days per week, and for 8 weeks. Upper-extremity function was evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE), Wolf motor function test, and action research arm test (ARAT); cerebral cortex activation and motor-evoked potential (MEP) amplitude were evaluated before and after the study. (3) Results: The analysis showed significant changes in all evaluation items for all three groups in the before-and-after comparisons. Significant changes were observed in the FMA-UE, ARAT, and MEP; in the posttest, the RT-ENMES group showed more significant changes in the FMA-UE, ARAT, and MEP than the other two groups. (4) Conclusions: The study analysis suggests that RT-ENMES effectively improves upper-limb function and cerebral cortex activation in patients with stroke.

DYRK3 phosphorylates SNAPIN to regulate axonal retrograde transport and neurotransmitter release.

Among the five members of the dual-specificity tyrosine-phosphorylation-regulated kinase (DYRK) family, the cellular functions of DYRK3 have not been fully elucidated. Some studies have indicated limited physiological roles and substrates of DYRK3, including promotion of glioblastoma, requirement in influenza virus replication, and coupling of stress granule condensation with mammalian target of rapamycin complex 1 signaling. Here, we demonstrate that serum deprivation causes a decrease in intracellular DYRK3 levels via the proteolytic autophagy pathway, as well as the suppression of DYRK3 gene expression. To further demonstrate how DYRK3 affects cell viability, especially in neurons, we used a yeast two-hybrid assay and identified multiple DYRK3-binding proteins, including SNAPIN, a SNARE-associated protein implicated in synaptic transmission. We also found that DYRK3 directly phosphorylates SNAPIN at the threonine (Thr) 14 residue, increasing the interaction of SNAPIN with other proteins such as dynein and synaptotagmin-1. In central nervous system neurons, SNAPIN is associated with and mediate the retrograde axonal transport of diverse cellular products from the distal axon terminal to the soma and the synaptic release of neurotransmitters, respectively. Moreover, phosphorylation of SNAPIN at Thr-14 was found to positively modulate mitochondrial retrograde transport in mouse cortical neurons and the recycling pool size of synaptic vesicles, contributing to neuronal viability. In conclusion, the present study demonstrates that DYRK3 phosphorylates SNAPIN, positively regulating the dynein-mediated retrograde transport of mitochondria and SNARE complex-mediated exocytosis of synaptic vesicles within the neurons. This finding further suggests that DYRK3 affects cell viability and provides a novel neuroprotective mechanism.

The Effect of Action Observation Combined with Motor Imagery Training on Upper Extremity Function and Corticospinal Excitability in Stroke Patients: A Randomized Controlled Trial.

This study aimed to investigate the effect of motor imagery (MI) intervention with action observation (AO) on upper extremity function and corticospinal activation in stroke patients. MI and AO are two forms of motion simulation that activate the motor system without physical activity. There are many studies that show the effect of AO and MI alone, but there are few studies in parallel. This study was conducted on 45 patients who were divided into an experimental group (n = 22) and a control group (n = 23) using a computer randomization program. The experimental group conducted AO with MI, and the control group only AO. All participants received interventions for twenty-five minutes per session, five times a week, for eight weeks. For the pre- and post-evaluation of all participants, motor evoked potential (MEP) amplitude was measured to compare corticospinal activation, and Fugl-Meyer Assessment Upper Extremity (FMA UE), Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL) were evaluated for changes in upper extremity function. In comparing the amount of change before and after the intervention, a significant change was observed in the experimental group's MEP amplitude. In the comparison between groups after the intervention and the amount of change before and after the intervention, the experimental group showed significant changes in FMA UE and MAL Amount of Use (MAL AOU) items. As a result of this study, AO with MI is effective in enhancing upper extremity function and increasing cortical spinal cord activation in patients with severe stroke with limited movement.

A Dual Electrode Biosensor for Glucose and Lactate Measurement in Normal and Prolonged Obese Mice Using Single Drop of Whole Blood.

Understanding the levels of glucose (G) and lactate (L) in blood can help us regulate various chronic health conditions such as obesity. In this paper, we introduced an enzyme-based electrochemical biosensor adopting glucose oxidase and lactate oxidase on two working screen-printed carbon electrodes (SPCEs) to sequentially determine glucose and lactate concentrations in a single drop (~30 µL) of whole blood. We developed a diet-induced obesity (DIO) mouse model for 28 weeks and monitored the changes in blood glucose and lactate levels. A linear calibration curve for glucose and lactate concentrations in ranges from 0.5 to 35 mM and 0.5 to 25 mM was obtained with R-values of 0.99 and 0.97, respectively. A drastic increase in blood glucose and a small but significant increase in blood lactate were seen only in prolonged obese cases. The ratio of lactate concentration to glucose concentration (L/G) was calculated as the mouse's gained weight. The results demonstrated that an L/G value of 0.59 could be used as a criterion to differentiate between normal and obesity conditions. With L/G and weight gain, we constructed a diagnostic plot that could categorize normal and obese health conditions into four different zones. The proposed dual electrode biosensor for glucose and lactate in mouse whole blood showed good stability, selectivity, sensitivity, and efficiency. Thus, we believe that this dual electrode biosensor and the diagnostic plot could be used as a sensitive analytical tool for diagnosing glucose and lactate biomarkers in clinics and for monitoring obesity.

Production of Minor Ginsenosides C-K and C-Y from Naturally Occurring Major Ginsenosides Using Crude ß-Glucosidase Preparation from Submerged Culture of Fomitella fraxinea.

Minor ginsenosides, such as compounds (C)-K and C-Y, possess relatively better bioactivity than those of naturally occurring major ginsenosides. Therefore, this study focused on the biotransformation of major ginsenosides into minor ginsenosides using crude ß-glucosidase preparation isolated from submerged liquid culture of Fomitella fraxinea (FFEP). FFEP was prepared by ammonium sulfate (30-80%) precipitation from submerged culture of F. fraxinea. FFEP was used to prepare minor ginsenosides from protopanaxadiol (PPD)-type ginsenoside (PPDG-F) or total ginsenoside fraction (TG-F). In addition, biotransformation of major ginsenosides into minor ginsenosides as affected by reaction time and pH were investigated by TLC and HPLC analyses, and the metabolites were also identified by UPLC/negative-ESI-Q-TOF-MS analysis. FFEP biotransformed ginsenosides Rb1 and Rc into C-K via the following pathways: Rd → F2 → C-K for Rb1 and both Rd → F2→ C-K and C-Mc1 → C-Mc → C-K for Rc, respectively, while C-Y is formed from Rb2 via C-O. FFEP can be applied to produce minor ginsenosides C-K and C-Y from PPDG-F or TG-F. To the best of our knowledge, this study is the first to report the production of C-K and C-Y from major ginsenosides by basidiomycete F. fraxinea.

Restriction endonuclease T.Smu451I with new cleavage specificity-neoschizomer of T.AsuI.

A specific type II restriction endonuclease T.Smu451I has been purified to electrophoretic homogeneity from the frozen cells of soil bacterium Sphingobacterium multivorum 451 (formerly Flavobacterium multivorum 451), using ultrasonic grinding, nucleic acid removal by streptomycin sulfate, protein precipitation by ammonium sulfate and phosphocellulose P-11, DEAE-Cellulose DE-52, Hepharin-Sepharose CL-6B chromatography, and elucidated several characteristics of T.Smu451I. The molecular weight of the enzyme determined by gel filtration and SDS-polyacrylamide gel electrophoresis was calculated to be 45,000 ± 2000 D (dimer) and 23,000 ± 1000 D (monomer), respectively. The isoelectric point (pI) of T.Smu451I is 5.4. T.Smu451I recognizes pentanucleotide palindromic sequences 5'-GGNC↓C-3' and cleaves between C and C in position shown by arrow to produce 3'-cohesive terminus of trinucleotide. Therefore, T.Smu451I is a neoschizomer of T.AsuI.

Sandwich ELISA-Based Electrochemical Biosensor for Leptin in Control and Diet-Induced Obesity Mouse Model.

Leptin is a peptide hormone produced primarily in adipose tissues. Leptin is considered a biomarker associated with obesity and obesity-mediated diseases. Biosensor detection of leptin in the blood may play a critical role as an indicator of dynamic pathological changes. In this paper, we introduce an electrochemical biosensor that adopts o-Phenylenediamine (oPD) on screen-printed gold electrodes (SPGEs) for detecting the leptin from a mouse model of diet-induced obesity (DIO). A linear calibration curve for the leptin concentration was obtained in the ranges from 0.1 to 20 ng/mL with a lower detection limit of 0.033 ng/mL. The leptin concentration was quantified with HRP (horseradish peroxidase)-catalyzed oxidation of oPD by two voltammetry methods: cyclic voltammetry (CV) and square-wave voltammetry (SWV). The proposed sandwich enzyme-linked immunosorbent assay (ELISA)-based electrochemical biosensor for the leptin in mouse blood serum showed high stability, sensitivity, selectivity, and effectivity compared to the commercial Leptin ELISA measurement. Thus, we believe that this leptin biosensor can be a sensitive analytical tool to detect low-levels of biomarkers in clinics and point-of-care testing (POCT).

Computational Insights Into the Electronic Structure and Magnetic Properties of Rhombohedral Type Half-Metal GdMnO3 With Multiple Dirac-Like Band Crossings.

In spintronics, half-metallic materials (HMMs) with Dirac-like cones exhibit interesting physical properties such as massless Dirac fermions and full spin polarization. We combined first-principles calculations with the quasi-harmonic Debye model, and we proposed that the rhombohedral GdMnO3 is an HMM with multiple linear band crossings. The physical properties of GdMnO3 were studied thoroughly. Moreover, the changes of multiple linear band crossings and 100% spin polarization under spin-orbit coupling as well as the electron and hole doping were also investigated. It is noted that such spin-polarized HMMs with linear band crossings are still very rare in two-dimensional and three-dimensional materials.

Highly Flexible Graphene Derivative Hybrid Film: An Outstanding Nonflammable Thermally Conductive yet Electrically Insulating Material for Efficient Thermal Management.

In modern society, advanced technology has facilitated the emergence of multifunctional appliances, particularly, portable electronic devices, which have been growing rapidly. Therefore, flexible thermally conductive materials with the combination of properties like outstanding thermal conductivity, excellent electrical insulation, mechanical flexibility, and strong flame retardancy, which could be used to efficiently dissipate heat generated from electronic components, are the demand of the day. In this study, graphite fluoride, a derivative of graphene, was exfoliated into graphene fluoride sheets (GFS) via the ball-milling process. Then, a suspension of graphene oxide (GO) and GFSs was vacuum-filtrated to obtain a mixed mass, and subsequently, the mixed mass was subjected to reduction under the action hydrogen iodide at low temperature to transform the GO to reduced graphene oxide (rGO). Finally, a highly flexible and thermally conductive 30-µm thick GFS@rGO hybrid film was prepared, which showed an exceptional in-plane thermal conductivity (212 W·m-1·K-1) and an excellent electrical insulating property (a volume resistivity of 1.1 × 1011 Ω·cm). The extraordinary in-plane thermal conductivity of the GFS@rGO hybrid films was attributed to the high intrinsic thermal conductivity of the filler components and the highly ordered filler alignment. Additionally, the GFS@rGO films showed a tolerance to bending cycles and high-temperature flame. The tensile strength and Young's modulus of the GFS@rGO films increased with increasing the rGO content and reached a tensile strength of 69.3 MPa and a Young's modulus of 10.2 GPa at 20 wt % rGO. An experiment of exposing the films to high-temperature flame demonstrated that the GFS@rGO films could efficiently prevent fire spreading. The microcombustion calorimetry results indicated that the GFS@rGO had significantly lower heat release rate (HRR) compared to the GO film. The peak HRR of GFS@rGO10 was only 21 W·g-1 at 323 °C, while that of GO was 198 W·g-1 at 159 °C.

High Thermal Conductivity Enhancement of Polymer Composites with Vertically Aligned Silicon Carbide Sheet Scaffolds.

Owing to the growth of demand for highly integrated electronic devices, high heat dissipation of thermal management materials is essential. Epoxy composites have been prepared with vertically aligned (VA) three-dimensional (3D)-structured SiC sheet scaffolds. The required VA-SiC sheet scaffolds were prepared by a novel approach starting with a graphene oxide (GO) scaffold. The VA-GO scaffolds were reduced to VA-graphene scaffolds in an argon environment, and the latter were subsequently transformed into VA-SiC sheet scaffolds by a template-assisted chemical vapor deposition method. Epoxy resin was filled in the empty spaces of the 3D scaffold of SiC sheets to prepare the composite mass. The material so prepared shows anisotropic thermal property with ultrahigh through-plane conductivity of 14.32 W·m-1·K-1 at a SiC sheet content of 3.71 vol %. A thermal percolation is observed at 1.78 vol % SiC filler. The SiC sheet scaffold of covalently interconnected SiC nanoparticles plays a vital role in the formation of the thermal conductive network to significantly enhance the thermal conductivity of epoxy composites. The application of the VA-SiC/epoxy composite as an efficient thermal dissipating material has also been presented. The VA-SiC/epoxy composites have a strong potential for preparing heat-dissipating components in integrated microelectronics.

Bci528I, a new isoschizomer of EcoRI isolated from Bacillus circulans 528.

Bacillus circulans 528 produces a restriction endonuclease, Bci528I which is an isoschizomer of EcoRI. We purified the enzyme, using Sephadex G-150, Phospho-cellulose, DEAE-cellulose, Hepharin-Sepharose CL-6B chromatography. The specific activity of Bci528I was 29,400 U/mg·protein. Bci528I recognizes 5'-GAATTC-3' in dsDNA and cleaves between G and A of the recognition sequence, producing a symmetric four base 5'overhang.

Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data.

PURPOSE: Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data. MATERIALS AND METHODS: A total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/ obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage. RESULTS: The median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn't receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132). CONCLUSION: Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.

Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data. MATERIALS AND METHODS: A total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage. RESULTS: The median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn’t receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132). CONCLUSION: Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.

Anticancer Effects of the Marine Sponge Lipastrotethya sp. Extract on Wild-Type and p53 Knockout HCT116 Cells.

Interest in marine bioresources is increasing in the drug development sector. In particular, marine sponges produce a wide range of unique metabolites that enable them to survive in challenging environments, which makes them attractive sources of candidate pharmaceuticals. In previous study, we investigated over 40 marine specimens collected in Micronesia and provided by the Korean Institute of Ocean Science and Technology, for their antiproliferative effects on various cancer cell lines, and Lipastrotethya sp. extract (LSSE) was found to have a marked antiproliferative effect. In the present study, we investigated the mechanism responsible for its anticancer effect on wild-type p53 (WT) or p53 knockout (KO) HCT116 cells. LSSE inhibited cell viability and induced apoptotic cell death more so in HCT116 p53 KO cells than the WT. HCT116 WT cells treated with LSSE underwent apoptosis associated with the induction of p53 and its target genes. On the other hand, in HCT116 p53 KO cells, LSSE reduced mTOR and Bcl-2 and increased Beclin-1 and LC3-II protein levels, suggesting autophagy induction. These results indicate that the mechanisms responsible for the anticancer effect of LSSE depend on p53 status.

Vertically aligned ZnCdS nanowire arrays/P3HT heterojunctions for solar cell applications.

Nowadays, solid-state inorganic-organic hybrid solar cells based on one-dimensional (1D) inorganic semiconducting nanostructures and organic polymers are believed to offer convincing solutions for the realm of next generation solar cells. In this regard, 1D ZnCdS nanowire (NW) arrays were fabricated on transparent conducting substrates through a catalyst free co-evaporation method and their wurtzite structural characteristics, 1D morphological layout and valence state/composition were studied in detail using X-ray diffraction, high-resolution electron microscopy and X-ray photoelectron spectroscopy, respectively. The existence of deep level traps and optical band gap of ZnCdS NWs were additionally studied using room-temperature cathodoluminescence and UV-vis absorbance measurements. The inorganic-organic hybrid cells were then fabricated using these NWs via spin coating poly(3,4-ethylenedioxythiophene) and poly(styrene sulfonate) based polymers. The morphological dissemination of the polymer deposits on NWs were also studied individually by electron microscopy. The solar cell (J-V) characteristics of the fabricated architectures were investigated at room-temperature and as a function of temperature and different intensities of incident light irradiation. The trap energy of the devices was noted to decrease from 68.1 to 40.7eV, suggesting the active role of trap sites that could have originated from the surface defects and other structural disorders across the hybrid heterostructures.

Enzymatic formation of compound-K from ginsenoside Rb1 by enzyme preparation from cultured mycelia of Armillaria mellea.

BACKGROUND: Minor saponins or human intestinal bacterial metabolites, such as ginsenosides Rg3, F2, Rh2, and compound K, are more pharmacologically active than major saponins, such as ginsenosides Rb1, Rb2, and Rc. In this work, enzymatic hydrolysis of ginsenoside Rb1 was studied using enzyme preparations from cultured mycelia of mushrooms. METHODS: Mycelia of Armillaria mellea, Ganoderma lucidum, Phellinus linteus, Elfvingia applanata, and Pleurotus ostreatus were cultivated in liquid media at 25°C for 2 wk. Enzyme preparations from cultured mycelia of five mushrooms were obtained by mycelia separation from cultured broth, enzyme extraction, ammonium sulfate (30-80%) precipitation, dialysis, and freeze drying, respectively. The enzyme preparations were used for enzymatic hydrolysis of ginsenoside Rb1. RESULTS: Among the mushrooms used in this study, the enzyme preparation from cultured mycelia of A. mellea (AMMEP) was found to convert ginsenoside Rb1 into compound K with a high yield, while those from G. lucidum, P. linteus, E. applanata, and P. ostreatus produced remarkable amounts of ginsenoside Rd from ginsenoside Rb1. The enzymatic hydrolysis pathway of ginsenoside Rb1 by AMMEP was Rb1 → Rd → F2 → compound K. The optimum reaction conditions for compound K formation from ginsenoside Rb1 were as follows: reaction time 72-96 h, pH 4.0-4.5, and temperature 45-55°C. CONCLUSION: AMMEP can be used to produce the human intestinal bacterial metabolite, compound K, from ginsenoside Rb1 with a high yield and without food safety issues.

Modified Surgical Intervention for Extensive Mitral Valve Endocarditis and Posterior Mitral Annular Calcification.

The concomitant presence of posterior mitral annular calcification and infectious mitral valve lesions poses a technical challenge with considerable perioperative risk when using previously proposed techniques for mitral valve surgery. Herein, we report a case of the use of a modified surgical technique to successfully treat a patient with mitral infective endocarditis complicated by a subendocardial abscess and extensive posterior mitral annular calcification.

Modified Surgical Intervention for Extensive Mitral Valve Endocarditis and Posterior Mitral Annular Calcification

The concomitant presence of posterior mitral annular calcification and infectious mitral valve lesions poses a technical challenge with considerable perioperative risk when using previously proposed techniques for mitral valve surgery. Herein, we report a case of the use of a modified surgical technique to successfully treat a patient with mitral infective endocarditis complicated by a subendocardial abscess and extensive posterior mitral annular calcification.