Prostate imaging-reporting and data system version 2 has improved biopsy tumor grade accuracy: a single, tertiary institutional experience.

PURPOSE: To investigate change in prostate biopsy accuracy regarding tumor grade before and after the release of Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) in a single tertiary institution. METHODS: We retrospectively evaluated 1191 patients with biopsy-proven prostate cancer (PCa) who had undergone prostate magnetic resonance imaging (MRI) and surgery before (2013 cohort, n = 394) and 5 years after PI-RADSv2 release (2020 cohort, n = 797). The highest tumor grade of each biopsy and surgical specimen was recorded, respectively. We compared concordant, underestimated, and overestimated biopsy rates regarding tumor grade to surgery between two cohorts, respectively. For patients who underwent both prostate MRI and biopsy at our institution, we investigated proportion of pre-biopsy MRI, age, and prostate-specific antigen of patients, and performed logistic regression to analyze which parameters are associated with concordant biopsy. RESULTS: Concordant and underestimated biopsy rates were significantly different between two cohorts: Concordance and underestimation rates were 47.2% and 46.3% in 2013 and 54.5% and 36.4% in 2020 (p = .019; p = .003), respectively. Overestimated biopsy rates were similar (p = .993). Proportion of pre-biopsy MRI was significantly higher in 2020 than in 2013 (80.9% versus 4.9%; p < .001), and was independently associated with concordant biopsy results in multivariate analysis (odds ratio = 1.486; 95% confidence interval, 1.057-2.089; p = .022). CONCLUSIONS: There was a significant change in proportion of pre-biopsy MRI before and after the release of PI-RADSv2 in patients who underwent surgery for PCa. This change appears to have improved biopsy accuracy regarding tumor grade by reducing underestimation.

Gut microbiota of Tenebrio molitor and their response to environmental change.

A bacterial community analysis of the gut of Tenebrio molitor larvae was performed using pyrosequencing of the 16S rRNA gene. A predominance of genus Spiroplasma species in phylum Tenericutes was observed in the gut samples, but there was variation found in the community composition between T. molitor individuals. The gut bacteria community structure was not significantly affected by the presence of antibiotics or by the exposure of T. molitor larvae to a highly diverse soil bacteria community. A negative relationship was identified between bacterial diversity and ampicillin concentration; however, no negative relationship was identified with the addition of kanamycin. Ampicillin treatment resulted in a reduction in the bacterial community size, estimated using the 16S rRNA gene copy number. A detailed phylogenetic analysis indicated that the Spiroplasma-associated sequences originating from the T. molitor larvae were distinct from previously identified Spiroplasma type species, implying the presence of novel Spiroplasma species. Some Spiroplasma species are known to be insect pathogens; however, the T. molitor larvae did not experience any harmful effects arising from the presence of Spiroplasma species, indicating that Spiroplasma in the gut of T. molitor larvae do not act as a pathogen to the host. A comparison with the bacterial communities found in other insects (Apis and Solenopsis) showed that the Spiroplasma species found in this study were specific to T. molitor.

Application of Protein-Rich Oriental Diet in a community-based obesity control program.

PURPOSE: To evaluate the efficacy, safety and availability of a 12-week, community-based obesity control program called the Protein-Rich Oriental Diet (PRO Diet) and to compare it to a conventional diet. MATERIALS AND METHODS: A total of 515 overweight people (55 men and 460 women; mean age 41.9 ± 9.8 years; body mass index (BMI) 28.1 ± 3.6 kg/m²) participated in the program at two public health centers. PRO Diet was offered as the main diet recommendation for 12 weeks. As a control group, we selected a population who had followed a conventional diet program conducted at a public health center in 2006. RESULTS: 177 subjects (34.3%) completed the 12-week PRO Diet program. In a per protocol (PP) analysis, the mean changes in anthropometry were (conventional program vs. PRO Diet; weight, -2.3 kg vs. -4.7 kg, p < 0.001; BMI, -1.1 kg/m² vs. -1.9 kg/m², p < 0.001; waist circumference, -3.3 cm vs. -6.8 cm, p < 0.001; fat mass, -2.0 kg vs. -4.2 kg, p < 0.001; fat % mass, -1.8% vs. -3.9%, p < 0.001). The triglyceride reduction was significantly greater (-30.16 mg/dL, p < 0.001) in the PRO Diet group after intervention compared to the conventional group. CONCLUSION: The PRO Diet was an effective tool for weight loss in a community-based weight control program and well-tolerated.

Difference of body compositional changes according to the presence of weight cycling in a community-based weight control program.

Many obese people who try to control body weight experience weight cycling (WC). The present study evaluated the importance of WC in a community-based obesity intervention program. We analyzed the data of 109 Korean participants (86% women) among 177 subjects who had completed a 12-week intervention program at two public health centers in Korea from April to December, 2007. Completion of a self-administrated questionnaire at baseline was used to obtain anthropometric measurements, and laboratory testing was done before and after the program. Differences in body composition change and obesity-related life style between the two groups were compared with respect to WC and non-weight cycling (NWC). After 12 weeks, both groups showed reductions in weight, waist circumference, and body mass index. The group differences were not significant. However, significant differences were evident for the WC group compared to the NWC group in fat percent mass (WC vs. NWC, -3.49+/-2.31% vs. -4.65+/-2.59%, P=0.01), fat free mass (WC vs. NWC, -0.95+/-1.37 kg vs. -0.38+/-1.05 kg, P=0.01), and total cholesterol (WC vs. NWC, -3.32+/-14.63 vs. -16.54+/-32.39, P=0.005). In conducting a community-based weight control program that predominantly targets women, changes of body composition and total cholesterol may be less effective in weight cyclers than in non-weight cyclers.

Cost-effectiveness of a community-based obesity control programme.

We evaluated two 12-week long community-based obesity control programmes in Korea. One was a visiting-type programme (V-type) (n = 515) administered by a public health centre and the other was a remote-type programme (R-type) (n = 410) utilizing an Internet website and mobile phones with a short message service. The total cost for the intention-to-treat subjects was US$116,993 in the V-type programme and $24,555 in the R-type programme. In the per-protocol subjects, 66% of V-type participants (n = 117) achieved the target bodyweight reduction (5%) and 13% of R-type participants (n = 15). In the per-protocol subjects, the cost per person was $227 (V-type) and $60 (R-type). The cost per person achieving the target weight reduction was $975 (V-type) and $1637 (R-type). The average amount that participants were willing to pay was $71 (V-type) and $21 (R-type). The cost-effectiveness of the visiting-type community-based, short-duration obesity control programme was higher than the remote-type programme.

Xyloglucan for generating tensile stress to bend tree stem.

In response to environmental variation, angiosperm trees bend their stems by forming tension wood, which consists of a cellulose-rich G (gelatinous)-layer in the walls of fiber cells and generates abnormal tensile stress in the secondary xylem. We produced transgenic poplar plants overexpressing several endoglycanases to reduce each specific polysaccharide in the cell wall, as the secondary xylem consists of primary and secondary wall layers. When placed horizontally, the basal regions of stems of transgenic poplars overexpressing xyloglucanase alone could not bend upward due to low strain in the tension side of the xylem. In the wild-type plants, xyloglucan was found in the inner surface of G-layers during multiple layering. In situ xyloglucan endotransglucosylase (XET) activity showed that the incorporation of whole xyloglucan, potentially for wall tightening, began at the inner surface layers S1 and S2 and was retained throughout G-layer development, while the incorporation of xyloglucan heptasaccharide (XXXG) for wall loosening occurred in the primary wall of the expanding zone. We propose that the xyloglucan network is reinforced by XET to form a further connection between wall-bound and secreted xyloglucans in order to withstand the tensile stress created within the cellulose G-layer microfibrils.

Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean men.

It remains unclear as to whether insulin resistance alone or in the presence of wellknown risk factors, such as diabetes or obesity, is associated with gallstones in men. The aim of this study was to determine whether insulin resistance is associated independently with gallstone disease in non-diabetic men, regardless of obesity. Study subjects were 19,503 Korean men, aged 30-69 yr, with fasting blood glucose level <126 mg/dL and without a documented history of diabetes. Gallbladder status was assessed via abdominal ultrasonography after overnight fast. Body mass index and waist circumference were measured. Insulin resistance was estimated by the Homeostasis Model Assessment of insulin resistance (HOMA-IR). The prevalence of obesity, abdominal obesity, and metabolic syndrome in the subjects with gallstones were higher than in those without. The prevalence of elevated HOMA (>75 percentile) in subjects with gallstones was significantly higher than in those without, and this association remained even after the obesity stratification was applied. In multiple logistic regression analyses, only age and HOMA proved to be independent predictors of gallstones. Insulin resistance was positively associated with gallstones in non-diabetic Korean men, and this occurred regardless of obesity. Gallstones appear to be a marker for insulin resistance, even in non-diabetic, nonobese men.

Overexpression of poplar cellulase accelerates growth and disturbs the closing movements of leaves in sengon.

In this study, poplar (Populus alba) cellulase (PaPopCel1) was overexpressed in a tropical Leguminosae tree, sengon (Paraserianthes falcataria), by the Agrobacterium tumefaciens method. PaPopCel1 overexpression increased the length and width of stems with larger leaves, which showed a moderately higher density of green color than leaves of the wild type. The pairs of leaves on the transgenic plants closed more slowly during sunset than those on the wild-type plants. When main veins from each genotype were excised and placed on a paper towel, however, the leaves of the transgenic plants closed more rapidly than those of the wild-type plant. Based on carbohydrate analyses of cell walls, the leaves of the transgenic plants contained less wall-bound xyloglucan than those of the wild-type plants. In situ xyloglucan endotransglucosylase activity showed that the incorporation of whole xyloglucan, potentially for wall tightening, occurred in the parenchyma cells (motor cells) of the petiolule pulvinus attached to the main vein, although the transgenic plant incorporated less whole xyloglucan than the wild-type plant. These observations support the hypothesis that the paracrystalline sites of cellulose microfibrils are attacked by poplar cellulase, which loosens xyloglucan intercalation, resulting in an irreversible wall modification. This process could be the reason why the overexpression of poplar cellulase both promotes plant growth and disturbs the biological clock of the plant by altering the closing movements of the leaves of the plant.

Hemodialysis using a valveless pulsatile blood pump.

Research on pulsatile blood pumps for extracorporeal life support has been widely performed because of the proven advantageous effects of blood pulsation. However, studies on the use of pulsatile blood pumps for hemodialysis are limited, although available evidence demonstrates that pulsatile blood flow has a positive influence on dialysis outcome. Therefore, the authors designed a new pulsatile pump, which is characterized by minimal-occlusion of blood-containing tubing, no requirement for valves, and no blood flow regurgitation. In-vitro hemolysis tests were conducted using fresh bovine blood, and the normalized index of hemolysis was adopted to compare blood traumas induced by the devised pulsatile pump and a conventional roller pump. In addition, experimental hemodialyses with a canine renal failure model were performed using the devised pump. Normalized index of hemolysis levels obtained was much smaller for the devised pulse pump (45 +/- 21 mg/100 L) than for the roller pump (103 +/- 10 mg/100 L), and no technical problems were encountered during dialysis sessions. Blood and dialysate flow rates were maintained at predetermined values and molecular removal was satisfactory. Postdialysis urea and creatinine reduction ratios were 61.8% +/- 10.6% and 57.4% +/- 9.0%, respectively. Pulsatile flow has usually been generated using pulsatile devices containing valves, but the valves cause concern in terms of the clinical applications of these devices. However, the described pulsatile pump does not require valves, and yet no blood flow regurgitation was observed.

Convection-enhanced high-flux hemodialysis.

Internal filtration contributes to convective clearance in high-flux hemodialysis but its contribution is limited by low pressure gradients. Therefore, a modification using a conventional dialyzer was conceived to enhance internal filtration and backfiltration (BF) rates. The modified dialyzer includes two longitudinal independent regions for blood flow, which were created by redesigning dialyzer caps. Blood pressures remained higher than dialysate pressures in one region and lower in the other region, allowing continuous internal filtration and BF in these respective regions. Modified and conventional dialyzers were compared in terms of pressure gradients and solute clearances. Thus, our experiments involved two groups: the modified dialyzer group and the conventional dialyzer group. A renal failure model was established using a dog weighing 25-30 kg by renal artery and vein ligation. With the exception of the dialyzers, experimental conditions were identical in the two groups. The pressure gradients between blood and dialysate were much higher for the modified dialyzer than for the conventional dialyzer. No significant differences were observed with respect to small solute clearances between the two groups, but mid-range solute clearances were significantly higher in the modified group. More optimization is required before the devised unit can be used clinically. However, the devised unit offers a straightforward means of regulating internal filtration and BF rates.

Transformation of poplar (Populus alba) plastids and expression of foreign proteins in tree chloroplasts.

Plastid transformation offers several unique advantages compared with nuclear genome transformation, such as high level of transgene expression within plastids, expressing multiple transgenes as operons, lack of position effect due to site-specific transgene integration, and reducing risks of gene flow via pollen due to maternal inheritance of the plastid genome. Plastid transformation has been applied to several herbal species, but as yet there are no applications to tree species. We report here the first successful plastid transformation in a tree species, Populus alba. A vector for plastid transformation of poplar (Populus alba) was constructed, which carried the spectinomycin resistance gene and the green fluorescence protein gene as marker genes. In the regenerated shoots, the site-specific integration of foreign genes and the establishment of a high homoplastomic state were confirmed. Immunoblot analysis and histological observations corroborated the accumulation of green fluorescence protein in chloroplasts. The establishment of a plastid transformation system in poplar provides a novel tool for tree biotechnology.

The sequential changes in the fasting plasma glucose levels within normoglycemic range predict type 2 diabetes in healthy, young men.

AIMS: We assessed whether the increased sequential changes in the fasting plasma glucose level (FPG) that is still within the normoglycemic range could be a predictor for future diabetes. METHODS: A prospective cohort study was conducted with 5296 male employees, aged 31-44 years. A sequential change in the FPG level was defined as the first follow-up FPG level minus the baseline FPG level. The incident diabetes was assessed at annual examinations during the next 4.1 years. Cox proportional hazard analyses were performed. RESULTS: During the 21,575.5 person-years follow-up among the 5,296 subjects, a total of 156 incident cases of type 2 diabetes occurred (116 cases among the 4,975 normoglycemic subjects and 40 cases among the 321 subjects with impaired fasting glucose). An increase in the FPG level from the baseline to the first follow-up, although still within the normoglycemic range (FPG<100 mg/dl), significantly predicted future diabetes: the multivariate hazard ratios associated with the sequential changes in the FPG of <-3, -3 to 3, 4-6, 7-9, and >9 mg/dl were 0.75, 1.00 (reference), 2.28, 3.28, and 6.10, respectively (p for trend <0.001). CONCLUSIONS: The increase of the sequential changes in the FPG level that were within the normal glucose range was associated with a higher risk for developing diabetes. Thus, conducting assessment for the serial changes in the FPG level may help to identify the young, healthy, normoglycemic individuals at risk for type 2 diabetes.

Cellulose metabolism in plants.

Many bacterial genomes contain a cellulose synthase operon together with a cellulase gene, indicating that cellulase is required for cellulose biosynthesis. In higher plants, there is evidence that cell growth is enhanced by the overexpression of cellulase and prevented by its suppression. Cellulase overexpression could modify cell walls not only by trimming off the paracrystalline sites of cellulose microfibrils, but also by releasing xyloglucan tethers between the microfibrils. Mutants for membrane-anchored cellulase (Korrigan) also show a typical phenotype of prevention of cellulose biosynthesis in tissues. All plant cellulases belong to family 9, which endohydrolyzes cellulose, but are not strong enough to cause the bulk degradation of cellulose microfibrils in a plant body. It is hypothesized that cellulase participates primarily in repairing or arranging cellulose microfibrils during cellulose biosynthesis in plants. A scheme for the roles of plant cellulose and cellulases is proposed.

Enhancement of growth and cellulose accumulation by overexpression of xyloglucanase in poplar.

Because the loosening of xyloglucan in the cell wall promotes plant growth (Takeda et al. (2002) Proc. Natl. Acad. Sci. USA 99, 9055-9060; Park et al. (2003) Plant J. 33, 1099-1106), we expressed Aspergillus xyloglucanase constitutively in Populus alba. The expression increased the length of stem even in the presence of sucrose. Increased stem growth was accompanied by a decrease in Young's elastic modulus in the growth zone but an increased elasticity in mature tissue. The increased internode length corresponded to an increase in cellulose content as well as specific gravity, showing that the removal of xyloglucan might cause an increase in cellulose density in the secondary xylem.

Prevalence of metabolic syndrome and waist circumference estimation in some korean adults.

OBJECTIVE: The purpose of this study was to estimate the prevalence of metabolic syndrome, as defined by the ATP III report, in some Korean adults and use the Asian-Pacific proposed waist circumference to investigate waist circumference in some Korean adults using ROC curves. METHODS: Study subjects were seventy-five thousands and ninety one persons (47, 979 men and 27, 111 women) who were selected among the patients who visited hospital for health evaluation from January 2000 to December 2001. All subjects were measured by height, weight, waist and hip circumferences, blood pressure and blood chemistry (lipid profile). RESULTS: The mean age was 41.6+/-8.5 years in men, 41.1+/-10.4 years in women (p< 0.05). Body mass index was in the normal range in 35.3% of men, and 55.9% of women. In both men and women, blood pressure, blood sugar, total cholesterol and triglyceride were positively correlated with BMI. waist circumference, and Broca's index (p< 0.01). However HDL. choloesterol was correlated negatively (p< 0.01). Using ROC curve, the calculated waist circumferences were 84 cm in men (sensitivity 61.4% and specificity 64.1%) and 74 cm in women (sensitivity 65.0% and specificity 73.2%). The age adjusted prevalences of the metabolic syndrome as defined by NCEP ATP III were different for men (6.4%) and women (14.6%). The prevalence increased from 1.2% among participants aged 20 through 29years to 15.0% among participants aged over 60years in men (p< 0.05) and from 1.6% to 27.4% respectively, in women. The age adjusted prevalences, as defined by using the waist circumference that was recommended by WHO's regional office for the western Pacific, were 10.6% in men and 18.5% in women. The age adjusted prevalences, as defined by using the waist circumference that was calculated by the ROC curves, were 17.1% in men and 22.4% in women. And All prevalences were increased following increased BMI and Broca's index. CONCLUSIONS: The prevalence of metabolic syndrome in some Korean adults was lower than that in western adults. Nevertheless because waist circumference was differed among race and region, application of the same criteria was not proper. Morcover, a higher awareness was required in women, because the prevalence of metabolic syndrome was rapidly increased with increment of age.

The role of PopCel1 and PopCel2 in poplar leaf growth and cellulose biosynthesis.

Poplar calli transcribed two cellulase (endo-1,4-beta-glucanase) genes, PopCel1 and PopCel2, whose mRNAs were differentially located in the growing leaves of poplar during cell wall synthesis. Histochemical and RT-PCR analyses of promoter-GUS fusion gene activities in transgenic poplar demonstrated that PopCel1 promoter-derived GUS activity was localized in the petiole and leaf veins, whereas PopCel2 was confined to mesophyll cells and disappeared from the tip during the development of leaves. Autoradiography of the leaf showed that the radioactivity of [14C]sucrose incorporated into cellulose corresponded to the combination of the sucrose-induced tissue-specific patterns of PopCel1 and PopCel2. Interestingly, 2,6-dichlorobenzonitrile (DCB) not only inhibited the incorporation of the radioactivity into cellulose, but also repressed the induction of both cellulase genes. Suppression of cellulases by expression of PopCel1 antisense cDNA or co-suppression of PopCel1 mRNA by overexpression of PopCel1 sense cDNA reduced leaf growth. Therefore, we came to the conclusion that PopCel1 and PopCel2 probably function to promote leaf growth in poplar by the endohydrolysis of 1,4-beta-glucan.

Enhancement of growth by expression of poplar cellulase in Arabidopsis thaliana.

To study the role of cellulose and cellulase in plant growth, we expressed poplar cellulase (PaPopCel1) constitutively in Arabidopsis thaliana. Expression increased the size of the rosettes due to increased cell size. The change in growth was accompanied by changes in biomechanical properties due to cell wall structure indicative of decrease in xyloglucan cross-linked with cellulose microfibrils by chemical analysis and nuclear magnetic resonance (NMR) spectra. The result supports the concept that the paracrystalline sites of cellulose microfibrils are attacked by poplar cellulase to loosen xyloglucan intercalation and this irreversible wall modification promotes the enlargement of plant cells.

The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994.

BACKGROUND: The metabolic syndrome is an important cluster of coronary heart disease risk factors with common insulin resistance. The extent to which the metabolic syndrome is associated with demographic and potentially modifiable lifestyle factors in the US population is unknown. METHODS: Metabolic syndrome-associated factors and prevalence, as defined by Adult Treatment Panel III criteria, were evaluated in a representative US sample of 3305 black, 3477 Mexican American, and 5581 white men and nonpregnant or lactating women aged 20 years and older who participated in the cross-sectional Third National Health and Nutrition Examination Survey. RESULTS: The metabolic syndrome was present in 22.8% and 22.6% of US men and women, respectively (P =.86). The age-specific prevalence was highest in Mexican Americans and lowest in blacks of both sexes. Ethnic differences persisted even after adjusting for age, body mass index, and socioeconomic status. The metabolic syndrome was present in 4.6%, 22.4%, and 59.6% of normal-weight, overweight, and obese men, respectively, and a similar distribution was observed in women. Older age, postmenopausal status, Mexican American ethnicity, higher body mass index, current smoking, low household income, high carbohydrate intake, no alcohol consumption, and physical inactivity were associated with increased odds of the metabolic syndrome. CONCLUSIONS: The metabolic syndrome is present in more than 20% of the US adult population; varies substantially by ethnicity even after adjusting for body mass index, age, socioeconomic status, and other predictor variables; and is associated with several potentially modifiable lifestyle factors. Identification and clinical management of this high-risk group is an important aspect of coronary heart disease prevention.

Determinants of non-compliance with lipid-lowering therapy in hyperlipidemic patients.

PURPOSE: In order to assess the determinants of non-compliance with a lipid-lowering therapy, a prospective study of the hyperlipidemic Korean subjects was carried out. METHODS: A total of 1019 patients was observed by 46 family physicians for the period of 1 year from January 1999 to January 2000. To ascertain the compliance associated with a lipid lowering drug (Simvastatin), we regularly followed up the hyperlipidemic patients at intervals of 4, 12 and 24 weeks. The criterion for evaluating compliance is to measure clinic attendance. Using a structured questionnaire, patients and physicians were asked about risk factors for the compliance. RESULTS: During the first 24 weeks of treatment, the lipid-lowering medication was continued by 52.3% and discontinued by 19.7%. The remaining 28% dropped out. Patient-related factors for non-compliance were young age, current smoker, lack of low fat diet and exercise, new user, no concomitant medication, and occurrence of adverse reactions. Physician-related factors for non-compliance were low patients' satisfaction with the physician, small number of hyperlipidemic patients per month and working in a relatively small hospital. CONCLUSIONS: Compliance with the lipid-lowering therapy was relatively low and several factors for non-compliance were detected.