Simultaneous vacuum ultra violet-amalgam lamp radiation and near-infrared radiation heating for a synergistic bactericidal effect against Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium in black peppercorn.

This study evaluated the effect of simultaneous irradiation with vacuum ultraviolet (VUV)-amalgam lamp and near-infrared radiation (NIR) to inactivate foodborne pathogens in black peppercorn (Piper nigrum) while monitoring its piperine content and color. NIR treatment for 20 min caused an increase in black peppercorn temperature to 70 °C, and its bactericidal effect showed only 3.14 and 1.88 log reductions of Escherichia coli O157:H7 and Salmonella Typhimurium respectively. Single treatment with a VUV-amalgam lamp for 20 min achieved 2.26 and 1.55 log reductions of E. coli O157:H7 and S. Typhimurium, respectively. However, simultaneous treatment for 15 min produces a greater than 5-log reduction of both foodborne pathogens without changes of black peppercorn quality. The underlying bactericidal mechanism of the VUV-amalgam lamp is 254 nm irradiation with ozone generated by 185 nm irradiation. The ozone concentration was maintained with VUV-amalgam lamp single treatment but decreased during simultaneous treatment. In contrast, due to the drying effect of NIR irradiation, water vapor reacts with 185 nm irradiation or ozone to produce a variety of reactive oxygen species (ROS) such as hydrogen peroxide and hydroxyl radical during simultaneous treatment. The hydrogen peroxide concentration measured by Gastec increased during simultaneous treatment. We also investigated various generated types of ROS that can contribute to a synergistic bactericidal effect. We compared the bactericidal effect of sequential and simultaneous treatments with NIR and VUV-amalgam lamps to black peppercorn. Although sequential treatment showed additional inactivation efficacy, reductions of pathogens were significantly lower than with simultaneous treatment. These findings suggest that simultaneous VUV-amalgam lamp and NIR irradiation treatment via generation of ROS can increase bacterial inactivation efficacy of foodborne pathogens in black peppercorns without quality changes.

Effects of storage temperature on microbiota shifts in raw milk biofilm developed on stainless steel.

This study aimed to investigate the microbiota in raw milk and the influence of storage temperature on the microbiota shift after biofilm formation. Raw milk stored at 4 °C and biofilms developed in raw milk incubated at 4 °C or 25 °C for 7 days were subjected to microbiota analysis as well as quantitative analyses of aerobic or anaerobic bacteria. The levels of aerobic bacteria increased during biofilm formation, while no significant changes were observed within anaerobic bacteria. In addition, there was a difference between aerobic and anaerobic bacterial counts in raw milk and biofilm stored for 7 days. The pattern of microbial composition differed by temperature. In addition, the genus Pseudomonas (53-71%) occupied a high proportion in raw milk, and the raw milk biofilm developed at 4 °C, while the genus Lactobacillus (75-83%) was predominant in biofilms developed at 25 °C. Intriguingly, bacterial richness was higher in raw milk on day 0 and biofilm developed at 4 °C than raw milk after 7 days of storage at 4 °C. These findings suggest that temperature critically affects the bacterial composition of both raw milk and its associated biofilm.

Comparison of the Radiologic, Morphometric, and Clinical Outcomes between Kinematically and Mechanically Aligned Total Knee Arthroplasty: A Propensity Matching Study.

The purpose of this study was to compare radiologic, morphometric, and clinical outcomes between kinematically aligned (KA) and mechanically aligned (MA) total knee arthroplasty (TKA) in Korean patients. Overall, 168 patients who underwent primary TKA were retrospectively reviewed, and propensity matching (age, sex, and body mass index) was performed as 1:3 ration (KA TKAs [n = 42]: MA TKAs [n = 126]). Joint-line orientation angle (JLOA), coronal and axial alignments of implants, hip-knee-ankle (HKA) angle, and patellar tilt angle were assessed using full-length standing radiograph, axial computed tomography (CT) scan, and plain radiographs. Morphometric assessment was performed by analyzing the intraoperative measurement of the femoral cut surface and femoral components fitting in five zones. Clinical outcomes more than 2 years of follow-up were evaluated with the Knee Society (KS) knee and functional scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and the Short-Form Health Survey (SF-36). In radiologic results, JLOA was more parallel to the floor in KA TKAs (KA: medial tilt 0.9 ± 1.5 degrees; MA: lateral tilt 1.7 ± 1.5 degrees, p < 0.05), and patellar tilt angle was closer to preoperative status after KA TKA (KA: 2.0 ± 1.6 degrees; MA;0.3 ± 1.2 degrees, p < 0.05). HKA angle and rotational mismatch were similar between two groups. In morphometric analysis, entire overhang of anterior femoral cutting surface was reduced in KA TKA compared with MA TKA (KA: 11.7 ± 6.2 mm; MA: 14.4 ± 5.9 mm, p < 0.05). However, both of MA and KA TKAs showed underhang in mediolateral dimension without difference. There were no significant differences in clinical scores between two groups. KA TKA showed more parallel JLOA to floor, closer patellar tilt to preoperative status, and better anterior flange fitting that can reproduce more natural knee kinematics compared with MA TKA. Although clinical outcomes assessed by conventional evaluating tools were similar between two groups, further evaluation focusing on the patellofemoral symptoms or unawareness of TKA is necessary to clarify the clinical benefit of KA TKA.

Effect of Isolated Medial Patellofemoral Ligament Reconstruction in Patellofemoral Instability Regardless of Predisposing Factors.

The purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to -0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18-74) preoperatively to 94.71 (range: 86-100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10-81) preoperatively to 94.14 (range: 86-100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT-TG distance, or valgus alignment. This is a Level 4, case series study.

Tumour-infiltrating bystander CD8+ T cells activated by IL-15 contribute to tumour control in non-small cell lung cancer.

BACKGROUND: Tumour-unrelated, virus-specific bystander CD8+ T cells were recently shown to be abundant among tumour-infiltrating lymphocytes (TILs). However, their roles in tumour immunity have not been elucidated yet. METHODS: We studied the characteristics of bystander CD8+ TILs from non-small cell lung cancer (NSCLC) tissues (N=66) and their activation by interleukin (IL)-15 to repurpose them for tumour immunotherapy. RESULTS: We show that bystander CD8+ TILs specific to various viruses are present in human NSCLC tissues. We stimulated CD8+ TILs ex vivo using IL-15 without cognate antigens and found that IL-15 treatment upregulated NKG2D expression on CD8+ TILs, resulting in NKG2D-dependent production of interferon (IFN)-γ (p=0.0006). Finally, we tested whether IL-15 treatment can control tumour growth in a murine NSCLC model with or without a history of murine cytomegalovirus (MCMV) infection. IL-15 treatment reduced the number of tumour nodules in the lung only in mice with MCMV infection (p=0.0037). We confirmed that MCMV-specific bystander CD8+ TILs produced interferon (IFN)-γ after IL-15 treatment, and that IL-15 treatment in MCMV-infected mice upregulated tumour necrosis factor-α and IFN-γ responsive genes in tumour microenvironment. CONCLUSION: Thus, the study demonstrates that bystander CD8+ TILs can be repurposed by IL-15 for tumour immunotherapy.

Comparison of the Predicting Performance for Fate of Medial Meniscus Posterior Root Tear Based on Treatment Strategies: A Comparison between Logistic Regression, Gradient Boosting, and CNN Algorithms.

This study aimed to validate the accuracy and prediction performance of machine learning (ML), deep learning (DL), and logistic regression methods in the treatment of medial meniscus posterior root tears (MMPRT). From July 2003 to May 2018, 640 patients diagnosed with MMPRT were included. First, the affecting factors for the surgery were evaluated using statistical analysis. Second, AI technology was introduced using X-ray and MRI. Finally, the accuracy and prediction performance were compared between ML&DL and logistic regression methods. Affecting factors of the logistic regression method corresponded well with the feature importance of the six top-ranked factors in the ML&DL method. There was no significant difference when comparing the accuracy, F1-score, and error rate between ML&DL and logistic regression methods (accuracy = 0.89 and 0.91, F1 score = 0.89 and 0.90, error rate = 0.11 and 0.09; p = 0.114, 0.422, and 0.119, respectively). The area under the curve (AUC) values showed excellent test quality for both ML&DL and logistic regression methods (AUC = 0.97 and 0.94, respectively) in the evaluation of prediction performance (p = 0.289). The affecting factors of the logistic regression method and the influence of the ML&DL method were not significantly different. The accuracy and performance of the ML&DL method in predicting the fate of MMPRT were comparable to those of the logistic regression method. Therefore, this ML&DL algorithm could potentially predict the outcome of the MMRPT in various fields and situations. Furthermore, our method could be efficiently implemented in current clinical practice.

Comparative Analysis of Serial Union Patterns After Opening-Wedge High Tibial Osteotomy with and without Bone-Void Fillers.

BACKGROUND: Opening-wedge high tibial osteotomy produces opening gaps; however, there is little consensus on bone graft necessity and the material that would produce a superior union. The purposes of the present study were (1) to compare the serial union patterns associated with various bone-void fillers, (2) to determine whether bone-void filler is necessary to achieve bone union of the opening gap, and (3) to determine whether bone union is different according to the correction degree during opening-wedge high tibial osteotomy. METHODS: In this retrospective study, 97 knees were randomly assigned to treatment with hydroxyapatite chip bone (Group A), allogenic chip bone (Group B), or no bone graft (Group C) and were analyzed after a minimum 1-year follow-up. To compare the bone union pattern, the area of callus filling located at the most medial side on an anteroposterior radiograph of the knee was recorded, and a modified van Hemert scoring system was used in the mediolaterally divided 5 zones. The correlations between the correction degree and bone union scores were evaluated. RESULTS: There were no significant differences in the extent of mediolateral bone-healing at 6 weeks or 3 months postoperatively (p = 0.172 and p = 0.228). However, Group C showed more prominent progression of the gap filling to the medial side compared with Groups A and B at 6 months postoperatively (p = 0.002). Group C showed slow progression of bone union up to 6 weeks but surpassed the other groups at 6 months. The union pattern was not different between Groups A and B, and the correction degree was not correlated with bone union beyond 3 months postoperatively. CONCLUSIONS: Despite the different gap-healing patterns, opening-wedge high tibial osteotomy without bone graft achieved bone union comparable with allogenic and synthetic graft materials. Group C (no bone graft) showed slower progression of bone union but surpassed the other groups at around 6 months. Based on the union pattern, there was no difference depending on the correction degree and the use of bone-void fillers. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Retro-Tubercle Biplanar Opening Wedge High Tibial Osteotomy Is Favorable for the Patellofemoral Joint But Not for the Osteotomized Tubercle Itself Compared With Supra-Tubercle Osteotomy.

PURPOSE: To identify whether retro-tubercle opening-wedge high tibial osteotomy (RT-OWHTO) produces more favorable radiographic outcomes on patellofemoral joint alignment and clinical outcomes than supra-tubercle opening-wedge high tibial osteotomy (ST-OWHTO). METHODS: From January 2017 to July 2018, patients who underwent biplanar OWHTO were allocated to 1 of 2 groups (ST-OWHTO and RT-OWHTO). Plain radiographs and computed tomography were used to analyze patellofemoral alignment and other radiologic parameters representing osteotomy configurations. Clinical outcomes were assessed using American Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index. RESULTS: In total, 50 knees that underwent ST-OWHTO and 44 knees that underwent RT-OWHTO were enrolled. Patellar height was significantly decreased only after ST-OWHTO (Caton-Deschamps ratio: P = .007; Blackburne-Peel ratio: P = .012). Patellar tilt angle was decreased in both groups (P = .009 and .004, respectively). Postoperative posterior tibial slope (PTS) (P = .013), PTS (Δ) (P < .001), retro-tuberosity gap distance (P = .001), and retro-tuberosity tip distance (P = .001) were significantly larger in RT-OWHTO. Retro-tuberosity tip distance was significantly correlated with retro-tuberosity gap distance (P = .002), thickness of second plane osteotomy fragment (P = .027), and anterior osteotomy ratio (P = .031) in ST-OWHTO. In RT-OWHTO, it was significantly correlated with PTS (△) (P < .001), retro-tuberosity gap distance (P < .001), and sagittal angle of bi-planar osteotomy (P = .005). There were 2 cases of tibial tuberosity fracture, 9 cases of delayed union on second plane osteotomy and 5 cases of tuberosity protrusion in RT-OWHTO. CONCLUSIONS: Although the RT-OWHTO technique maintains patellofemoral joint alignment, no difference in clinical outcome was detected. The RT-OWHTO has increased risk of tuberosity fracture, delayed union, and prominent tibial tuberosity. The surgeon should consider these negative aspects of the technique and consider adjusting additional stabilization. LEVEL OF EVIDENCE: Level III, retrospective cohort study.

Analysis of Affecting Factors of the Fate of Medial Meniscus Posterior Root Tear Based on Treatment Strategies.

Meniscal tear is a common reason for patients to undergo knee operation, and the medial meniscus posterior root tear (MMPRT) is one of the most frequent kinds of meniscal tears. The purpose of this study was to analyze participants' factors (anthropometric and medical) to the fate of the MMPRT based on the treatment strategy. The hypothesis of this study was that treatment modalities from conservative treatment to final arthroplasty would be affected by participants' affecting factors. From July 2003 to May 2018, 640 participants were included. Groups were categorized according to the treatment strategies such as conservative treatment, arthroscopic surgery, high tibial osteotomy (HTO) and arthroplasty surgery. Participants' affecting factors were analyzed by one-way analysis of variance according to the four different treatment strategies and a correlation between affecting factors was also analyzed. Participants with K-L (Kellgren-Lawrence) Grade 4 and high BMI > 28.17 were appropriate candidates for arthroplasty, with K-L Grade 4 being a greater determining factor than high BMI. Participants with alignment factors such as low initial weight bearing line (WBL) (26.5%) and high delta WBL ratio (5.9%) were appropriate candidates for HTO, with the delta WBL ratio being a greater determining factor than initial WBL. Longer MRI-event times (1.44 year) and a lesser extent of meniscal extrusion (2.98 mm) were significantly associated with conservative treatment. Understanding the correlation of each affecting factor to the treatment strategy will help clinicians decide on the appropriate treatment for patients with MMPRT.

Difference of preoperative varus-valgus stress radiograph is effective for the correction accuracy in the preoperative planning during open-wedge high tibial osteotomy.

PURPOSE: This study aimed to evaluate (1) the efficacy of varus-valgus stress radiographs to adjust the preoperative soft-tissue imbalance and (2) ascertain whether varus-valgus stress radiographs are effective for the correction accuracy in the preoperative planning of the opening wedge high tibial osteotomy (OWHTO). METHODS: From February 2017 to December 2018, a total of 121 consecutive knees that underwent bi-planar OWHTO were enrolled in this retrospective analysis. Preoperative planning was performed using a weight-bearing line (WBL). Target WBL was determined according to the status of the medial compartments such as cartilage, meniscus, and preoperative arthritic grade. Preoperative varus-valgus stress radiographs were used to assess the preoperative mediolateral ligament imbalance. The final target correction length of the opening gap was determined by subtracting the difference between the varus-valgus stress radiographs (VVD). All patients were divided into two groups according to the preoperatively planned correction degree: (group A), smaller than average; (group B), larger than average. Patients were also divided into two other groups (VVD adjusted and neglected groups). RESULTS: Groups A and B were 56 and 54 knees, respectively. The preoperatively planned correction lengths of the opening gap were 9.33 ± 1.5 and 14.16 ± 3.96 mm, respectively (p < 0.01). Mean values of the VVD were 0.85 ± 0.72, and 1.27 ± 1.78 mm, respectively (p < 0.01). Correction errors were 2.17 ± 2.06 and 3.52 ± 2.16%, respectively (p < 0.01). Planned and final correction degrees were also significantly larger (p < 0.01, and p < 0.01, respectively), because the preoperative WBL ratio was significantly smaller in the VVD adjusted group (p < 0.01). CONCLUSION: The VVD values could reproduce the preoperative soft-tissue imbalance and it was more prominent as the correction degree increased. The strategy of subtracting the VVD as assumed soft-tissue imbalance in the preoperative planning worked well for the correction accuracy during OWHTO. LEVEL OF EVIDENCE: Level IV, retrospective study.

How does geometric change after open-wedge high tibial osteotomy affect anterior cruciate ligament status?

BACKGROUND: Open-wedge high tibial osteotomy (OWHTO) produces three- dimensional (3D) geometric changes. Among them, increased posterior tibial slope (PTS), and altered coronal inclination that induces unintended tibial translation may affect anterior cruciate ligament (ACL) status. The purpose of current study was to evaluate the geometric changes following OWHTO, such as increasing PTS and decreasing tibial subluxation, which may affect the status of ACL. METHODS: From April 2014 to December 2015, a total of 72 knees in 64 patients that underwent OWHTO, second-look arthroscopy, and magnetic resonance imaging (MRI) assessment, were enrolled. Preoperative and postoperative coronal and sagittal translation, joint line orientation angle, the distance between medial femoral notch marginal line and medial tibial spine, and PTS were evaluated. ACL status was arthroscopically graded from grade 1 (best) to 4 (worst). The MRI signal of the graft in three portions (proximal, middle, and distal) was graded from grade 1 (best) to 4 (worst). RESULTS: High grade (3: partial, and 4: complete rupture) was noted in 28 cases (38.9%) at the second-look arthroscopy compared with 10 cases (13.9%) at index arthroscopy. The MRI signal grade significantly increased at follow up MRI compared with preoperative MRI (P<0.01). An increased signal was commonly noted in the middle and distal portions of the graft. CONCLUSIONS: Geometric changes after OWHTO were related to ACL deterioration. The ACL was commonly affected at the middle and distal portions and rarely at the proximal portion. There is a possibility of impingement because of the geometric changes. LEVEL OF EVIDENCE: Level IV.

Simulated microgravity with floating environment promotes migration of non-small cell lung cancers.

A migration of cancer is one of the most important factors affecting cancer therapy. Particularly, a cancer migration study in a microgravity environment has gained attention as a tool for developing cancer therapy. In this study, we evaluated the proliferation and migration of two types (adenocarcinoma A549, squamous cell carcinoma H1703) of non-small cell lung cancers (NSCLC) in a floating environment with microgravity. When we measured proliferation of two NSCLCs in the microgravity (MG) and ground-gravity (CONT), although initial cell adhesion in MG was low, a normalized proliferation rate of A549 in MG was higher than that in CONT. Wound healing results of A549 and H1703 showed rapid recovery in MG; particularly, the migration rate of A549 was faster than that of H1703 both the normal and low proliferating conditions. Gene expression results showed that the microgravity accelerated the migration of NSCLC. Both A549 and H1703 in MG highly expressed the migration-related genes MMP-2, MMP-9, TIMP-1, and TIMP-2 compared to CONT at 24 h. Furthermore, analysis of MMP-2 protein synthesis revealed weaker metastatic performance of H1703 than that of A549. Therefore, the simulated microgravity based cancer culture environment will be a potential for migration and metastasis studies of lung cancers.

The attenuating effects of pyridoxamine on adipocyte hypertrophy and inflammation differ by adipocyte location.

It is known that receptor for advanced glycation end products (RAGE) and its ligands accumulate in the fat tissues of obese individuals, and RAGE ligands induce M1 macrophage polarization, which in turn induces inflammation. We evaluated the effect of pyridoxamine on RAGE ligand accumulation and M1 polarization in the visceral, subcutaneous, and perivascular fat tissues of Sprague-Dawley rats fed a high fat diet (HFD). Pyridoxamine reduced HFD-induced weight gain, attenuated adipocyte size increases, RAGE ligand accumulations, RAGE-RAGE ligands binding, decreased macrophage M1 polarization and increased M2 polarization in visceral fat tissues, but not in subcutaneous tissues. Pyridoxamine induced glyoxalase 1 (Glo-1) expression in visceral fat in the HFD group, whereas pyridoxamine induced Glo-1 expression in perivascular fat tissues was no higher than that observed in the normal fat diet (NFD) controls. In vitro, pyridoxamine suppressed the release of RAGE ligands from AGE treated macrophages, but non-significantly attenuated RAGE ligands release in AGE treated adipocytes. Pyridoxamine was found to suppress weight increases and M1 polarization, and to increase Glo-1 expression through the RAGE pathway in perivascular and visceral fat tissues of HFD-induced obese rats. These findings suggest pyridoxamine is a candidate for the treatment of obesity or complications related to obesity-induced inflammation.

Development of a flexible 3D printed scaffold with a cell-adhesive surface for artificial trachea.

Trachea stents are widely used to treat stenosis arising from various trachea injuries. However, they are associated with inflammation, re-stenosis, and tracheal obstruction. Seeking to overcome these problems, the development of an artificial trachea using tissue engineering has been explored. However, the artificial trachea did not mimic the natural rigidity and flexibility of the trachea and provide the micro-environment necessary for re-epithelialization. In this study, we developed a thermoplastic polyurethane (TPU) trachea scaffold that possesses a restoration characteristic, using flexible 3D printed patterns, and an improved cell attachment performance, utilizing electrospun fibers. With the aim of enhancing flexibility, we compared two geometric tubes, one with a straight pattern (SP) and the other with a wave pattern (WP). Simulation results showed that the WP scaffold was more flexible than the SP scaffold. A tensile expansion and torsion experiment demonstrated lower tensile strength and elastic modulus, and higher elongation ratio and rotation angle of the WP scaffold. Addition of the electrospun layers increased the tensile strength and elastic modulus and decreased the elongation ratio and rotation angle of both the SP and WP scaffolds. The same trend was observed regardless of electrospinning. However, polycaprolactone (PCL)-based scaffolds displayed lower elongation ratio and rotation angle in simulations and experiments. Although the cell attachment capacity of TPU-based electrospun WP scaffolds was less than 10% that of PCL-based scaffolds, the former showed good initial cell attachment performance and their cell numbers increased by more than three times within a week. The improved biomechanical performance and cell affinity of the TPU trachea scaffold could be exploited in patient-customized grafts for trachea reconstruction.

Susceptibility of Escherichia coli O157:H7 grown at low temperatures to the krypton-chlorine excilamp.

This study was conducted to investigate the resistance of Escherichia coli O157:H7 to 222-nm krypton-chlorine(KrCl) excilamp and 254-nm low-pressure Hg lamp (LP lamp) treatment according to growth temperature. As growth temperature decreased, lag time of E. coli O157:H7 significantly increased while the growth rate significantly decreased. Regardless of growth temperature, the KrCl excilamp showed higher disinfection capacity compared to the LP lamp at stationary growth phase. KrCl excilamp treatment showed significantly higher reduction as growth temperature decreased. Conversely, reduction levels according to growth temperature were not significantly different when the pathogen was subjected to LP lamp treatment. Inactivation mechanisms were evaluated by the thiobarbituric acid reactive substances (TBARS) assay and SYBR green assay, and we confirmed that lipid oxdiation capacity following KrCl excilamp treatment increased as growth temperature decreased, which was significantly higher than that of LP lamp treated samples regardless of growth temperature. DNA damage level was significantly higher for LP Hg lamp treated samples compared to those subjected to the KrCl excilamp, but no significant difference pursuant to growth temperature was observed. At the transcriptional level, gene expression related to several metabolic pathways was significantly higher for the pathogen grown at 15 °C compared that of 37 °C, enabling it to adapt and survive at low temperature, and membrane lipid composition became altered to ensure membrane fluidity. Consequently, resistance of E. coli O157:H7 to the KrCl excilamp decreased as growth temperature decreased because the ratio of unsaturated fatty acid composition increased at low growth temperature resulting in higher lipid oxidation levels. These results indicate that KrCl excilamp treatment should be determined carefully considering the growth temperature of E. coli O157:H7.

The Association between Red Blood Cell Distribution Width and Sarcopenia in U.S. Adults.

One pathophysiological sign of sarcopenia is chronic inflammation. Given that levels of red blood cell distribution width (RDW) are increased in chronic inflammation, we evaluated the association between increased RDW and sarcopenia among adults in the general U. S. population and analyzed data from 11,761 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Sarcopenia was defined as an appendicular skeletal muscle mass (ASM) divided by weight (%) that was less than one standard deviation (SD) below the mean of young adults. The odds ratios (ORs) and confidence intervals (CIs) for sarcopenia were calculated across RDW quartiles after adjusting for confounding factors. Elevated RDW levels were significantly associated with sarcopenia after adjusting for age, sex, race, education, household income, smoking, physical activity, hypertension, diabetes, cardiovascular disease, C-reactive protein, and hemoglobin (OR of highest quartile: 1.72 (95% CI: 1.43, 2.06)). Further, in a model stratified by obesity, an elevated RDW was associated with sarcopenia in the overweight and obese group, but not in the normal weight group. Our study shows that elevated RDW is associated with sarcopenia, and this association is particularly strong in people who are overweight and obese.

Isolated Unilateral Absence of Pulmonary Artery Associated with Contralateral Lung Cancer.

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that may present with various symptoms, depending on the nature and severity of other cardiovascular anomalies. Furthermore, contralateral lung surgery in patients with UAPA is extremely rare, and clinical experience is limited. This report describes a case of surgical treatment of contralateral primary lung cancer in a patient with isolated UAPA. A 56-year-old man was diagnosed with primary lung cancer accompanied by isolated UAPA on the contralateral side. He underwent meticulous cardiorespiratory function tests preoperatively. We performed a right lower lobectomy. Although in the immediate postoperative period, the patient suffered from a mild decline in his respiratory function, he recovered uneventfully. The present case shows that preoperative awareness of UAPA and meticulous perioperative management enable contralateral lung surgery to be performed safely.

Esophageal Endoscopic Vacuum Therapy with Enteral Feeding Using a Sengstaken-Blakemore Tube.

Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Conservative treatment methods require long-term fasting with total parenteral nutrition or enteral feeding through invasive procedures, such as percutaneous endoscopic gastrostomy or a feeding jejunostomy. We report 2 cases of esophageal leakage after primary repair treated by endoscopic vacuum therapy with continuous enteral feeding using a Sengstaken-Blakemore tube.

Asymptomatic Secondary Aortoduodenal Fistula Incidentally Diagnosed During a Health Check-up: A Case Report.

Secondary aortoenteric fistulas (AEFs) are an uncommon but fatal complication of abdominal aortic reconstructive surgery. Aortoduodenal fistulas (ADFs) are the most frequent secondary AEFs (80%). The incidence of secondary AEFs is increasing because of the increasing number of individuals undergoing aortic aneurysm repairs with prosthetics. In most cases of secondary AEFs, surgical repair is performed with the patient in a poor condition, owing to late diagnosis. Thus, an early diagnosis is crucial. We report a case of an asymptomatic secondary ADF that was incidentally diagnosed using esophagogastroduodenoscopy (EGD) and computed tomography during a health check-up and was successfully repaired, with the patient in a stable condition even after the development of life-threatening symptoms. Based on our case, we suggest that noticing unexplained leukocytosis in regular hematological examination and performing surveillance EGD in an asymptomatic individual who has undergone abdominal aortic reconstructive surgery may aid in the early diagnosis of secondary AEFs before fatal complications manifest.