A Protocol to Acquire the Degenerative Tenocyte from Humans.

Tendinopathy, a painful condition that develops in response to tendon degeneration, is on the rise in the developed world due to increasing physical activity and longer life expectancy. Despite its increasing prevalence, the underlying pathogenesis still remains unclear, and treatment is generally symptomatic. Recently, numerous therapeutic options, including growth factors, stem cells, and gene therapy, were investigated in hopes of enhancing the healing potency of the degenerative tendon. However, the majority of these research studies were conducted only on animal models or healthy human tenocytes. Despite some studies using pathological tenocytes, to the best of our knowledge there is currently no protocol describing how to obtain human degenerative tenocytes. The aim of this study is to describe a standard protocol for acquiring human degenerative tenocytes. Initially, the tendon tissue was harvested from a patient with lateral epicondylitis during surgery. Then biopsy samples were taken from the extensor carpi radialis brevis tendon corresponding to structural changes observed at the time of surgery. All of the harvested tendons appeared to be dull, gray, friable, and edematous, which made them visually distinct from the healthy ones. Tenocytes were cultured and used for experiments. Meanwhile, half of the harvested tissues were analyzed histologically, and it was shown that they shared the same key features of tendinopathy (angiofibroblastic dysplasia or hyperplasia). A secondary analysis by immunocytochemistry confirmed that the cultured cells were tenocytes with the majority of the cells having positive stains for mohawk and tenomodulin proteins. The qualities of the degenerative nature of tenocytes were then determined by comparing the cells with the healthy control using a proliferation assay or qRT-PCR. The degenerative tenocyte displayed a higher proliferation rate and similar gene expression patterns of tendinopathy that matched previous reports. Overall, this new protocol might provide a useful tool for future studies of tendinopathy.

Long-term Surgical Outcomes of Initial Postoperative Overcorrection in Adults with Intermittent Exotropia.

PURPOSE: To evaluate the relationship between initial postoperative overcorrection and long-term surgical success in exotropia patients. METHODS: The medical records of 46 patients who underwent surgery for intermittent exotropia after the age of 18 were enrolled. Enrolled patients also had at least 2 years of postoperative follow-up. Based on the initial postoperative deviation at distance measured by prism and the alternating cover test at 1 week, patients were assigned to one of the following groups: group A included patients who demonstrated any esodeviation, while group B included patients who showed orthophoria to exodeviation of 10 prism diopters. The records were analyzed to determine the preoperative deviation with stereoacuity and postoperative deviations with stereoacuity at the follow-up examinations at the following intervals: 1 week; 1, 3, and 6 months; and 1 and 2 years. A comparison between groups for demographic data and preoperative and postoperative angles of deviation was performed using analysis of variance. RESULTS: Of the 46 patients with intermittent exotropia included in this study, 18 (39%) belonged to group A, while 28 (73%) belonged to group B. The postoperative angle of deviation for distant fixation until 2 years of follow-up showed statistically significant differences in each group (p < 0.003 in all comparisons). The amount of exodrift until 2 years in group A (from ?9.7 ± 6.1 to 1.6 ± 3.7) was greater than that in group B (from 2.0 ± 2.7 to 6.8 ± 5.6). The long-term surgical success rate within 2 years of surgery was significantly better in group A than in group B (p = 0.027). The number of patients with intermittent diplopia and the duration of diplopia were greater in group A (n = 8) than in group B (n = 2). CONCLUSIONS: Long-term surgical success was achieved in 89% of patients who were initially overcorrected. Overcorrection of an average of 10 prism diopters at the first postoperative week was found to be associated with a more favorable long-term surgical outcome.

Investigation of the Changes in Refractive Surgery Trends in Korea.

PURPOSE: To evaluate changes in clinical practice in the field of refractive surgery in Korea over the past 10 years. METHODS: A survey consisting of 59 multiple-choice questions regarding the preferred types of refractive surgery, excimer laser machine, and presbyopia surgery was mailed to 742 members of the Korean Society of Cataract and Refractive Surgery in January 2016, and 50 members responded to the survey. These data were compared with the 2005 or 2007 survey results. RESULTS: The majority of respondents were in their 40s (54%), and the average number of refractive surgeries performed in one month was 53. The most commonly used excimer laser machine was the VISX S4 in both 2005 (32%) and 2015 (25%); however, a greater variety of machines (EX500 [18%], Allegretto wave Eye-Q [13%], AMARIS 750 [10%]) were used in 2015. The preferred corneal refractive surgery in 2015 was surface ablation (40%), representing a significant increase in its popularity compared to 2005 (15%) (p < 0.001). The popularity of laser in situ keratomileusis (LASIK) surgery decreased to 20% in 2015 compared to 48% in 2005 (p < 0.001). Eighty percent of LASIK procedures in 2015 were performed using femtosecond laser. In 2015, surface ablation and phakic intraocular lens implantation were preferred for the treatment of myopia less than -8 diopters and more than -8 diopters, respectively. The proportion of respondents performing presbyopia surgery in 2015 (76%) was significantly increased from 2007 (30%) (p < 0.001). CONCLUSIONS: Over the past decade, the most commonly performed corneal refractive surgery has changed from LASIK to surface ablation, and there has been a significant increase in the popularity of presbyopia surgery.

Sex differences in the effect of aging on dry eye disease.

PURPOSE: Aging is a major risk factor in dry eye disease (DED), and understanding sexual differences is very important in biomedical research. However, there is little information about sex differences in the effect of aging on DED. We investigated sex differences in the effect of aging and other risk factors for DED. METHODS: This study included data of 16,824 adults from the Korea National Health and Nutrition Examination Survey (2010-2012), which is a population-based cross-sectional survey. DED was defined as the presence of frequent ocular dryness or a previous diagnosis by an ophthalmologist. Basic sociodemographic factors and previously known risk factors for DED were included in the analyses. Linear regression modeling and multivariate logistic regression modeling were used to compare the sex differences in the effect of risk factors for DED; we additionally performed tests for interactions between sex and other risk factors for DED in logistic regression models. RESULTS: In our linear regression models, the prevalence of DED symptoms in men increased with age (R=0.311, P=0.012); however, there was no association between aging and DED in women (P>0.05). Multivariate logistic regression analyses showed that aging in men was not associated with DED (DED symptoms/diagnosis: odds ratio [OR] =1.01/1.04, each P>0.05), while aging in women was protectively associated with DED (DED symptoms/diagnosis: OR =0.94/0.91, P=0.011/0.003). Previous ocular surgery was significantly associated with DED in both men and women (men/women: OR =2.45/1.77 [DED symptoms] and 3.17/2.05 [DED diagnosis], each P<0.001). Tests for interactions of sex revealed significantly different aging × sex and previous ocular surgery × sex interactions (P for interaction of sex: DED symptoms/diagnosis - 0.044/0.011 [age] and 0.012/0.006 [previous ocular surgery]). CONCLUSION: There were distinct sex differences in the effect of aging on DED in the Korean population. DED following ocular surgery also showed sexually different patterns. Age matching and sex matching are strongly recommended in further studies about DED, especially DED following ocular surgery.

Serological and molecular prevalence of canine vector-borne diseases (CVBDs) in Korea.

BACKGROUND: Previous surveys in dogs from Korea indicated that dogs are exposed to a variety of vector- borne pathogens, but perception for a nation-wide canine vector-borne disease (CVBD) occurrence has been missing. We report here results of both serological and molecular prevalence studies for major CVBDs of dogs from all over the South Korean Peninsula except for Jeju Island. RESULTS: Serological survey of 532 outdoor dogs revealed the highest prevalence for Dirofilaria immitis (25.2%), followed by Anaplasma phagocytophilum (15.6%), Ehrlichia canis (4.7%) whereas Borrelia burgdorferi showed the lowest prevalence (1.1%). The number of serologically positive dogs for any of the four pathogens was 216 (40.6%). Concurrent real-time PCR assay of 440 dogs in the study indicated that DNA of "Candidatus M. haematoparvum", Mycoplasma haemocanis, Babesia gibsoni, A. phagocytophilum, and Hepatozoon canis was identified in 190 (43.2%), 168 (38.2%), 23 (5.2%), 10 (2.3%) and 1 (0.2%) dogs, respectively. DNA of Bartonella spp., Ehrlichia spp., Leishmania spp., Rickettsia spp. and Neorickettsia risticii was not identified. Analysis of questionnaires collected from owners of 440 dogs showed that the number of dogs with heartworm preventive medication was 348 (79.1%) among which dogs still positive to D. immitis infection were 60 (17.2%), probably due to the mean months of heartworm preventive medication being only 6.5. The high prevalence rates of both "Ca. M. haematoparvum" and Mycoplasma haemocanis in dogs from Korea indicate that these organisms may be transmitted by vectors other than Rhipicephalus sanguineus because this tick species has rarely been found in Korea. This is the first nationwide survey for canine haemotropic mycoplasma infections in Korea. CONCLUSIONS: This study showed that the risk of exposure to major vector-borne diseases in dogs is quite high throughout all areas of South Korean Peninsula. Since achieving full elimination of many pathogens causing CVBDs from infected animals is often impossible even when they are clinically cured, dogs once exposed to CVBDs can remain as lifetime reservoirs of disease for both other animals and humans in the close vicinity, and should therefore be treated with preventative medications to minimise the risk of pathogen transmission by the competent vectors.

Size distribution and settling velocities of suspended particles in a tidal embayment.

Field studies were carried out to investigate seasonal and bay-wide variations in the particle size distributions (PSDs) and settling velocities of suspended particles in Newport Bay, the second largest tidal embayment in southern California. Maximum Entropy Classification (MEC) of the data identified three PSD groups: (1) suspended particles with a single mode around 10-20 µm (Group 1), (2) suspended particles with a single mode similar to Group 1, but shifted to smaller particle sizes (Group 2), and (3) suspended particles with a coarse mode at around 100 µm (Group 3). The three PSD groups have distinct seasonal and spatial patterns, and different size-settling velocity relationships, consistent with the hypothesis that Newport Bay longitudinally fractionates allochthonous particles from its tributaries by both size and settling velocity, and generates large and fast settling autochthonous particles, probably in the form of biological debris. Particle concentrations in Groups 1 and 2 are significantly correlated with fecal indicator bacteria, suggesting possible linkages between fecal pollution and particle transfer in this tidal embayment.

Evaluation of chemical, molecular, and traditional markers of fecal contamination in an effluent dominated urban stream.

In this paper we present a quantitative sanitary survey of the Middle Santa Ana River, in southern California, utilizing a variety of source tracking tools, including traditional culture-dependent fecal markers (Enterococcus and Escherichia coli by IDEXX), speciation of enterococci isolates, culture-independent fecal markers (human-specific HF183 Bacteroides and Enterococcus by quantitative polymerase chain reaction, qPCR), and chemical markers of sewage and wastewater (nutrients, enantiomeric fraction (EF) of propranolol and ethylenediaminetetraacetic acid). To facilitate comparison of these different methods, data are interpreted in a loading (i.e., mass per time) framework that enables a quantitative apportionment of fecal markers and nutrients to specific source waters in the Middle Santa Ana River. Multiple lines of evidence support the hypothesis that Enterococcus in the Middle Santa Ana River originates primarily from in situ growth in streambed sediments, not from significant and persistent sources of untreated human waste. The EF of propranolol of tertiary treated wastewater effluent is in the range (0.42 to 0.71) previously reported for raw sewage, making EF of propranolol an unsuitable marker for fecal pollution, at least at this site. The human fecal marker HF183 Bacteroides was detected at a few sites, although not in a source of disinfected and tertiary treated wastewater effluent. Based on the results presented here and prior experience at other sites in southern California, HF183 Bacteroides would appear to be a candidate marker of fecal contamination for inland waters, although more qPCR measurements in disinfected wastewater effluent are needed to account for variations due to treatment plant performance and other factors. More generally, our results support the notion that regrowth of fecal indicator bacteria (FIB) in river sediments may lead to a decoupling between FIB and pathogen concentrations in the water column and thus limit the utility of FIB as an indicator of recreational waterborne illness in inland waters.

Use of salinity mixing models to estimate the contribution of creek water fecal indicator bacteria to an estuarine environment: Newport Bay, California.

The contribution of freshwater discharge to fecal indicator bacteria (FIB) impairment of an estuarine environment can be approximated from simple, two end-member mixing models using salinity as a tracer. We conducted a yearlong time series investigation of Newport Bay, a regionally important estuarine embayment in southern California, assessing the concentrations of FIB, specifically Escherichia coli and enterococci bacteria, and salinity. In total, eight within-bay stations and one offshore control site were sampled nearly once per week and the three tributaries draining into Newport Bay were sampled approximately daily. Using salinity as a conservative tracer for water mass mixing and determining the end-member values of FIB in both the creek sites and the offshore site, we created a linear, two end-member mixing model of FIB within Newport Bay. Deviations from the mixing model suggest either an additional source of FIB to the bay (e.g. bird feces, storm drain discharge) or regrowth and/or die-off of FIB within the bay. Our results indicate that salinity mixing models can be useful in predicting changes in FIB concentrations in the estuarine environments and can help narrow the search for sources of FIB to the bay and enhance our understanding of the fate of FIB within the bay.

Size distribution, sources, and seasonality of suspended particles in southern California marine bathing waters.

In this paper we define seasonal and along-shore variations in suspended particle size distributions (PSDs) at two marine bathing beaches in southern California, using a low-angle light scattering instrument (LISST). Empirical Orthogonal Function (EOF) analysis of the LISST data set (n = 55 651) identified three particle size modes that collectively account for > 90% of the variance in the de-meaned PSD data at six sites along the shoreline at Huntington Beach and Newport Beach: a dinoflagellate mode, a large particle mode, and a small particle mode. These three modes exhibit distinct seasonal patterns, and along-shore distributions, reflecting both the sources of particles and environmental factors that trigger their occurrence. Comparison of volume-based PSDs generated from the LISST and from image analysis of optical micrographs indicates that the LISST performs well when measuring the size distribution of particles associated with dinoflagellate blooms. However, LISST measurements on stormwater-impacted samples consistently yield a rising tail at small particle sizes that may be an artifact arising from the non-spherical nature of inorganic particles in terrestrial runoff. The results presented here demonstrate that PSDs measured by light scattering instruments such as the LISST represent a new data resource for assessing water quality, and managing human health risk, at marine bathing beaches.

Flow fingerprinting fecal pollution and suspended solids in stormwater runoff from an urban coastal watershed.

Field studies were conducted to characterize the concentration vs streamflow relationships (or "flow fingerprints") of fecal pollution and suspended solids in stormwater runoff from the Santa Ana River watershed, the largest watershed in southern California. The concentrations of fecal indicator bacteria and F+ coliphages (viruses infecting E. coli) exhibit little-to-no dependence on streamflow rates, whereas the concentrations of total suspended solids (TSS) exhibit a very strong (power-law) dependence on streamflow rates. The different flow fingerprints observed for fecal pollutants, on one hand, and TSS, on the other hand, reflect different sources and transport pathways for these stormwater constituents. The flow-independent nature of fecal indicator bacteria and F+ coliphages is consistent with the idea that these contaminants are ubiquitously present on the surface of the urban landscape and rapidly partition into the surface water as the landscape is wetted by rainfall. The flow-dependent nature of TSS, on the other hand, is usually ascribed to the shear-induced erosion of channel bed sediments and/or the expansion of drainage area contributing to runoff. The apparent ubiquity of fecal indicator bacteria and F+ coliphages, together with the very high storm-loading rates of fecal indicator bacteria and the low detection frequency of human adenovirus and human enterovirus, suggest that fecal pollution in stormwater runoff from the Santa Ana River watershed is primarily of nonhuman waste origin.

Coastal water quality impact of stormwater runoff from an urban watershed in southern California.

Field studies were conducted to assess the coastal water quality impact of stormwater runoff from the Santa Ana River, which drains a large urban watershed located in southern California. Stormwater runoff from the river leads to very poor surf zone water quality, with fecal indicator bacteria concentrations exceeding California ocean bathing water standards by up to 500%. However, cross-shore currents (e.g., rip cells) dilute contaminated surf zone water with cleaner water from offshore, such that surf zone contamination is generally confined to < 5 km around the river outlet. Offshore of the surf zone, stormwater runoff ejected from the mouth of the river spreads out over a very large area, in some cases exceeding 100 km2 on the basis of satellite observations. Fecal indicator bacteria concentrations in these large stormwater plumes generally do not exceed California ocean bathing water standards, even in cases where offshore samples test positive for human pathogenic viruses (human adenoviruses and enteroviruses) and fecal indicator viruses (F+ coliphage). Multiple lines of evidence indicate that bacteria and viruses in the offshore stormwater plumes are either associated with relatively small particles (< 53 microm) or not particle-associated. Collectively, these results demonstrate that stormwater runoff from the Santa Ana River negatively impacts coastal water quality, both in the surf zone and offshore. However, the extent of this impact, and its human health significance, is influenced by numerous factors, including prevailing ocean currents, within-plume processing of particles and pathogens, and the timing, magnitude, and nature of runoff discharged from river outlets over the course of a storm.

Santonin-Kainic Acid Complex As A Mass Chemotherapeutic Of Ascaris Lumbricoides Control In Korea.

Santonin-kainic acid complex was evaluated as a chemotherapeutic of the mass treatment of the Ascaris lumbricoides infection in Korea. The results could be summarized as follows: 1) The negative conversion rate was 82.9% in average in 4 treated groups. Some variations of negative conversion rate among the treated groups were noticed. 2) The egg reduciton rate was 97.7% in average and the results were rather uniform among the three evaluated groups. 3) By the analysis of egg reduction, it seems that the lightly infected cases whose E.P.G. were under 5,000 were resistant to treatment with the less reduced egg output. 4) After the treatment with this complex, the number of egg discharged cases were reduced to 1.84% and the average number of discharge eggs per incompletely treated or untreated cases were reduced to 12.5% compared with the level of before-treatment egg output. 5) The successive observations of the pattern of worm expulsion after drug intake was made. The worms were mostly expelled in the stool within 3 days, and 58.9% of total expelled worms were collected within 24-hour stool. 6) The minimum length of the immature worms expelled was 7.6cm. Among the 659 Ascaris collected in the first-day stool from 91 rural people, 8.5% were in the range of 7.6-12.2 cm-long, immature worms. The sex ratio, male: female= 0.69: 1.

The Prevalence Of Intestinal Helminthes In Inhabitants Of Cheju Do.

The authors examined 3,169 fecal specimens from inhabitants of seven localities such as City, Eups and Myons in Cheju Do on July 1970 with cellophane thick smear technique. The results were analysed and summarized as follows: 1) The overall egg positive rate of helminths was 82.2% and it was attributed to high rates of soil-transmitted helminths as in case of other parts in Korea. 2) The infection rates of each species were; A. lumbricoides 44.3%, T. trichiurus 65.6%, hookworm 1.5%, T. orientalis 0.8%, C. sinensis 0.2%, P. westermani 0.4%, M. yokogawai 0.9%, Taenia sp. 12.7% and H. nana 1.4%. 3) The infection rates of soil-transmitted helminths were relatively lower than those of mainland Korea especially in case of hookworm and T. orientalis. The proportion of unfertilized ova passers among the Ascaris infected case was 22.1%. 4) The ova of heterophyids, most probably Metagonimus yokogawai were detected in lower percentage but discovered throughout the localities surveyed and in all age groups. It is certainly presumed that Metagonimus infection is autochthonous. 5) The most interesting results were obtained in Taenia sp. infection and the higher rates were shown in rural area than in urbanized areas. The positive rates were within 5% in childhood and adolescence but abruptly increased up to 36.4 % in adults.