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Background@#The aim of this study was to investigate the clinical characteristics of nontuberculous mycobacterial tenosynovitis and to report the process of diagnosis and the outcomes of surgical debridement and drug administration in South Korea. @*Methods@#Between 2010 and 2019, 23 patients (10 men and 13 women) with nontuberculous tenosynovitis of the hand were treated at two centers. Their average age was 64 years, and the average duration of symptoms was 8 months (range, 1–36 months).Eight patients had a history of trauma or surgery. The average number of corticosteroid injections before diagnosis was 2.6 for 7 patients. All 23 patients were treated with a combination of extensive tenosynovectomy and antibiotics. @*Results@#Of the 23 patients, 20 were available for the final follow-up (1, lost to follow-up; 1, transferred to another hospital; and 1, died from a comorbidity). The most common species was Mycobacterium intracellulare (70%), followed by Mycobacterium abscessus (10%). The frequency of involvement of the extensor/flexor tendon was similar to that of the wrist/finger. The mean number of surgical debridement operations was 2.2. The average duration of antibiotic administration was 9.8 months. At the last follow-up, 3 patients were symptom-free with full range of motion at the involved site, 1 patient complained of localized swelling or pain with full range of motion, 1 patient was found to have a recurrence of infection in a finger, and 15 complained of restricted joint motion. @*Conclusions@#The most common species noted in patients with nontuberculous mycobacterial tenosynovitis was M. intracellulare. Patients with only 1 finger involved showed good range of motion at the final follow-up. Most patients experienced delayed wound healing and adverse effects from drug therapy during treatment and limited joint motion at the final follow-up.
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Assays of clinical diagnosis and species identification using molecular markers are performed according to a quantitative method in consideration of sensitivity, cost, speed, convenience, and specificity. However, typical polymerase chain reaction (PCR) assay is difficult to quantify and have various limitations. In addition, to perform quantitative analysis with the quantitative real-time PCR (qRT-PCR) equipment, a standard curve or normalization using reference genes is essential. Within the last a decade, previous studies have reported that the digital PCR (dPCR) assay, a third-generation PCR, can be applied in various fields by overcoming the shortcomings of typical PCR and qRT-PCR assays. We selected Stilla Naica System (Stilla Technologies), Droplet Digital PCR Technology (Bio-Rad), and Lab on an Array Digital Real-Time PCR analyzer system (OPTOLANE) for comparative analysis among the various droplet digital PCR platforms currently in use commercially. Our previous study discovered a molecular marker that can distinguish Hanwoo species (Korean native cattle) using Hanwoo-specific genomic structural variation. Here, we report the pros and cons of the operation of each dPCR platform from various perspectives using this species identification marker. In conclusion, we hope that this study will help researchers to select suitable dPCR platforms according to their purpose and resources.
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Importance of accurate molecular diagnosis and quantification of particular disease-related pathogenic microorganisms is highlighted as an introductory step to prevent and care for diseases. In this study, we designed a primer/probe set for quantitative real-time polymerase chain reaction (qRT-PCR) targeting rgpA gene, known as the specific virulence factor of periodontitis-related pathogenic bacteria ‘Porphyromonas gingivalis’, and evaluated its diagnostic efficiency by detecting and quantifying relative bacterial load of P. gingivalis within saliva samples collected from clinical subjects. As a result of qRT-PCR, we confirmed that relative bacterial load of P. gingivalis was detected and quantified within all samples of positive control and periodontitis groups. On the contrary, negative results were confirmed in both negative control and healthy groups. Additionally, as a result of comparison with next-generation sequencing (NGS)–based 16S metagenome profiling data, we confirmed relative bacterial load of P. gingivalis, which was not identified on bacterial classification table created through 16S microbiome analysis, in qRT-PCR results. It showed that an approach to quantifying specific microorganisms by applying qRT-PCR method could solve microbial misclassification issues at species level of an NGS-based 16S microbiome study. In this respect, we suggest that P. gingivalis–specific primer/probe set introduced in present study has efficient applicability in various oral healthcare industries, including periodontitis-related microbial molecular diagnosis field.
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In ischemic heart disease (IHD), the myocardium does not receive enough blood and oxygen. Although the IHD-related mortality rate is decreasing, the risk remains and is a major predictor of cardiac complications following noncardiac surgery. Given the increase in the older population, the number of patients with spinal diseases requiring surgery is increasing. Among these patients, those with underlying IHD or a high risk of cardiac complications before and after surgery are also increasing. Given that cardiac complications following spinal surgery are associated with delayed patient recovery and even death, spinal surgeons should be knowledgeable about overall patient management, including medication therapy in those at high risk of developing perioperative cardiac complications for successful patient care. Before surgery, the underlying medical conditions of patients should be evaluated. Patients with a history of myocardial infarction should be checked for a history of surgical treatments, and the anticoagulant dose should be controlled depending on the surgery type. In addition, the functional status of patients must be examined before surgery. Functional status can be assessed according to the metabolic equivalent of task (MET). More preoperative cardiac examinations are needed for patients who are unable to perform four METs in daily because of the high risk of postoperative cardiac complications. Patients with a history of IHD require appropriate preoperative management and further postoperative evaluation. When considering surgery, spinal surgeons should be knowledgeable about patient care before and after surgery.
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Eurotiales is a relatively large order of Ascomycetes, well-known for their ability to produce secondary metabolites with potential beneficial applications. To understand their diversity and distribution, different environmental sources including soil, freshwater, insect, and indoor air were investigated. Eight strains of Eurotiales were isolated and identified based on their morphological characters and a multi-gene phylogenetic analysis of the ITS, BenA, CaM, and RPB2 regions. We identified eight taxa that were previously not reported from Korea: Aspergillus baeticus, A. griseoaurantiacus, A. spinulosporus, Penicillium anthracinoglaciei, P. labradorum, P.nalgiovense, Talaromyces atroroseus, and T. georgiensis. Detailed descriptions, illustrations, and phylogenetic tree for the eight new records species are presented, and information regarding the records is also discussed.
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Objective@#This study aimed to predict the injury risk to attendants by simulating and analyzing the joint moment that occurs during wheelchair transportation for five different ramp ratios and five different velocities. Method: Three-dimensional musculoskeletal models and rigid structure of a standard wheelchair were developed using the AnyBody Modeling System. The ramp ratio was set to 1：6 (the steepest), 1：8, 1：10, 1：12, and 1：14 (the gentlest). The wheelchair speeds were set to 0.4, 0.5, 0.6, 0.7, and 0.8 m/s. Both the uphill and downhill movement conditions were investigated. @*Results@#Most of the joint moments that occur in the wrist joint, elbow and shoulder while driving uphill increased or decreased proportionally to the slope and speed of the ramp. However, the external moment of the wrist occurring downhill was largely influenced by the slope, and the joint moment of the shoulder showed a dynamic pattern of change in the middle of the ramp in spite of constant driving speed. @*Conclusion@#The influence that occurs during deceleration while wheelchair driving on a ramp is primarily on the proximal shoulder joint, and the influence of the release control in the middle of driving primarily causes loads on the distal wrist and forearm. A high risk of damage exists because the moment change value of the load on the shoulder joint is relatively large and increases with inclination. The increase in wrist abduction moment for deceleration while driving downhill also suggests the possibility of damage.
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Lysophosphatidic acid (LPA) is a bioactive lipid messenger involved in the pathogenesis of chronic inflammation and various diseases. Recent studies have shown an association between periodontitis and neuroinflammatory diseases such as Alzheimer’s disease, stroke, and multiple sclerosis. However, the mechanistic relationship between periodontitis and neuroinflammatory diseases remains unclear. The current study found that lysophosphatidic acid receptors 1 (LPAR1) and 6 (LPAR6) exhibited increased expression in primary microglia and astrocytes. The primary astrocytes were then treated using medium conditioned to mimic periodontitis through addition of Porphyromonas gingivalis lipopolysaccharides, and an increased nitric oxide (NO) production was observed. Application of conditioned medium from human periodontal ligament stem cells with or without LPAR1 knockdown showed a decrease in the production of NO and expression of inducible nitric oxide synthase and interleukin 1 beta. These findings may contribute to our understanding of the mechanistic link between periodontitis and neuroinflammatory diseases.
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Bone marrow edema syndrome of the foot and ankle in adolescents is extremely rare. The correct diagnosis and appropriate treatment are often delayed because of the nonspecific clinical signs. This paper reports two cases of bone marrow edema syndrome of the foot and ankle in adolescents with a review of the relevant literature.
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Posterior lumbar fusion is a safe and effective surgical method for diseases, such as lumbar stenosis, spondylolisthesis, lumbar instability, spinal deformity, and tumor. Pedicle screw (PS) fixation was first introduced by Bouche and has been adopted as the gold standard for posterior lumbar fusion. Santoni and colleagues introduced a new methodological screw insertion technique that uses a cortical bone trajectory (CBT), described as that from a medial to lateral path in the transverse axial plane and caudal to the cephalad path in the sagittal plane through the pedicle for maximum contact of the screw with the cortical bone. Owing to the lower invasiveness, superior cortical bone contact, and reduced neurovascular injury incidence, the CBT technique has been widely used in posterior lumbar fusion; however, these advantages have not been proven in clinical/radiological and biomechanical studies. We designed the present study to review the existing evidence and evaluate the merit of CBT screw fixation. Six electronic databases were searched for relevant articles published in August 2020 using the search terms “cortical bone trajectory,” “CBT spine,” “CBT fixation,” “cortical pedicle screws,” and “cortical screws.” Studies were analyzed and divided into the following groups: “biomechanics investigation,” “surgical technique,” and “clinical/radiological studies.” Most studies compared CBT and PS fixation, and the CBT screw fixation method showed better or similar outcomes.
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Objective@#Several factors contribute to the progression of complicated appendicitis (CA) in patients diagnosed with acute appendicitis. The goal of this study was to investigate whether the pelvic location of an appendix may be a new prehospital risk factor associated with CA. @*Methods@#The study retrospectively reviewed 375 patients who underwent surgery for appendicitis from January 2013 to December 2013. Patients were divided into two groups: patients diagnosed with uncomplicated appendicitis (UA) and patients with CA. Demographics, clinical and laboratory findings, duration of symptoms, and the location of the appendix were evaluated. Univariate and multivariate statistical analyses identified risk factors leading to CA. @*Results@#Of the 375 patients, 46 (12.3%) had CA. The univariate analysis confirmed that the patients diagnosed with CA had a higher body temperature (BT), longer duration of symptoms (DOS), and complained of left lower quadrant abdominal (LLQ) pain more frequently. Furthermore, compared to the UA group, the appendix was more frequently located in the pelvic region in the CA group. Multivariate analysis confirmed that BT >37.5°C (odds ratio [OR], 3.29; 95% confidence interval [CI], 1.64-6.61; P<0.01), LLQ pain (OR, 2.78; 95% CI, 1.16-6.69; P=0.02), DOS ≥48 hours (OR, 3.87; 95% CI, 1.94-7.71; P<0.01), and the pelvic location of appendix (OR, 3.18; 95% CI, 1.49-6.75; P<0.01) were risk factors for CA. @*Conclusion@#The pelvic location of an appendix may be a new prehospital risk factor associated with CA.
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Objective@#Several factors contribute to the progression of complicated appendicitis (CA) in patients diagnosed with acute appendicitis. The goal of this study was to investigate whether the pelvic location of an appendix may be a new prehospital risk factor associated with CA. @*Methods@#The study retrospectively reviewed 375 patients who underwent surgery for appendicitis from January 2013 to December 2013. Patients were divided into two groups: patients diagnosed with uncomplicated appendicitis (UA) and patients with CA. Demographics, clinical and laboratory findings, duration of symptoms, and the location of the appendix were evaluated. Univariate and multivariate statistical analyses identified risk factors leading to CA. @*Results@#Of the 375 patients, 46 (12.3%) had CA. The univariate analysis confirmed that the patients diagnosed with CA had a higher body temperature (BT), longer duration of symptoms (DOS), and complained of left lower quadrant abdominal (LLQ) pain more frequently. Furthermore, compared to the UA group, the appendix was more frequently located in the pelvic region in the CA group. Multivariate analysis confirmed that BT >37.5°C (odds ratio [OR], 3.29; 95% confidence interval [CI], 1.64-6.61; P<0.01), LLQ pain (OR, 2.78; 95% CI, 1.16-6.69; P=0.02), DOS ≥48 hours (OR, 3.87; 95% CI, 1.94-7.71; P<0.01), and the pelvic location of appendix (OR, 3.18; 95% CI, 1.49-6.75; P<0.01) were risk factors for CA. @*Conclusion@#The pelvic location of an appendix may be a new prehospital risk factor associated with CA.
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no abstract available.
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Digital PCR (dPCR) is the third-generation PCR that enables real-time absolute quantification without reference materials. Recently, global diagnosis companies have developed new dPCR equipment. In line with the development, the Lab On An Array (LOAA) dPCR analyzer (Optolane) was launched last year. The LOAA dPCR is a semiconductor chip-based separation PCR type equipment. The LOAA dPCR includes Micro Electro Mechanical System that can be injected by partitioning the target gene into 56 to 20,000 wells. The amount of target gene per wells is digitized to 0 or 1 as the number of well gradually increases to 20,000 wells because its principle follows Poisson distribution, which allows the LOAA dPCR to perform precise absolute quantification. LOAA determined region of interest first prior to dPCR operation. To exclude invalid wells for the quantification, the LOAA dPCR has applied various filtering methods using brightness, slope, baseline, and noise filters. As the coronavirus disease 2019 has now spread around the world, needs for diagnostic equipment of point of care testing (POCT) are increasing. The LOAA dPCR is expected to be suitable for POCT diagnosis due to its compact size and high accuracy. Here, we describe the quantitative principle of the LOAA dPCR and suggest that it can be applied to various fields.
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Purpose@#This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19. @*Methods@#This study adopted the double diamond process of service design comprising the discovery, defining, and development stages. @*Results@#We developed an untact visit service based on an application that considered the child’s status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder. @*Conclusion@#Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child’s information in real-time, and provide one-stop service without increasing healthcare providers’ work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.
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Objectives@#The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. @*Methods@#Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. @*Results@#After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. @*Conclusions@#Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.
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Transposable elements (TEs) constitute approximately half of Bovine genome. They can be a powerful species-specific marker without regression mutations by the structure variation (SV) at the time of genomic evolution. In a previous study, we identified the Hanwoo-specific SV that was generated by a TE–association deletion event using traditional PCR method and Sanger sequencing validation. It could be used as a molecular marker to distinguish different cattle breeds (i.e., Hanwoo vs. Holstein). However, PCR is defective with various final copy quantifications from every sample. Thus, we applied to the droplet digital PCR (ddPCR) platform for accurate quantitative detection of the Hanwoo-specific SV. Although samples have low allele frequency variation within Hanwoo population, ddPCR could perform high sensitive detection with absolute quantification. We aimed to use ddPCR for more accurate quantification than PCR. We suggest that the ddPCR platform is applicable for the quantitative evaluation of molecular markers.
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Transposable elements (TEs) constitute approximately half of Bovine genome. They can be a powerful species-specific marker without regression mutations by the structure variation (SV) at the time of genomic evolution. In a previous study, we identified the Hanwoo-specific SV that was generated by a TE–association deletion event using traditional PCR method and Sanger sequencing validation. It could be used as a molecular marker to distinguish different cattle breeds (i.e., Hanwoo vs. Holstein). However, PCR is defective with various final copy quantifications from every sample. Thus, we applied to the droplet digital PCR (ddPCR) platform for accurate quantitative detection of the Hanwoo-specific SV. Although samples have low allele frequency variation within Hanwoo population, ddPCR could perform high sensitive detection with absolute quantification. We aimed to use ddPCR for more accurate quantification than PCR. We suggest that the ddPCR platform is applicable for the quantitative evaluation of molecular markers.
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Identifying the patterns of gene expression in breast cancers is essential to understanding their pathophysiology and developing anticancer drugs. Breast cancer is a heterogeneous disease with different subtypes determined by distinct biological features. Luminal breast cancer is characterized by a relatively high expression of estrogen receptor (ER) and progesterone receptor (PR) genes, which are expressed in breast luminal cells. In ~25% of invasive breast cancers, human epidermal growth factor receptor 2 (HER2) is overexpressed; these cancers are categorized as the HER2 type. Triple-negative breast cancer (TNBC), in which the cancer cells do not express ER/PR or HER2, shows highly aggressive clinical outcomes. TNBC can be further classified into specific subtypes according to genomic mutations and cancer immunogenicity. Herein, we discuss the brief history of TNBC classification and its implications for promising treatments.
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Identifying the patterns of gene expression in breast cancers is essential to understanding their pathophysiology and developing anticancer drugs. Breast cancer is a heterogeneous disease with different subtypes determined by distinct biological features. Luminal breast cancer is characterized by a relatively high expression of estrogen receptor (ER) and progesterone receptor (PR) genes, which are expressed in breast luminal cells. In ~25% of invasive breast cancers, human epidermal growth factor receptor 2 (HER2) is overexpressed; these cancers are categorized as the HER2 type. Triple-negative breast cancer (TNBC), in which the cancer cells do not express ER/PR or HER2, shows highly aggressive clinical outcomes. TNBC can be further classified into specific subtypes according to genomic mutations and cancer immunogenicity. Herein, we discuss the brief history of TNBC classification and its implications for promising treatments.
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Background@#Palmoplantar pustulosis is a specific form of localized pustular psoriasis occurring on the palm and sole. Multiple therapeutic options, including topical and systemic agents as well as phototherapies, are available for palmoplantar pustulosis; however, treatment outcomes are not satisfactory in most cases. Recently, a gain-switched 311-nm Ti:Sapphire Laser was developed and showed good treatment response in vitiligo and atopic dermatitis. @*Objective@#To investigate the efficacy and safety of the 311-nm Ti:Sapphire Laser in the treatment of palmoplantar pustulosis. @*Methods@#A total of 24 patients with palmoplantar pustulosis were treated with a 311-nm Ti:Sapphire Laser twice a week for up to 32 sessions and had a 3-month follow-up visit. The treatment dose started at 300 mJ/cm 2 and was increased by 50 mJ/cm 2 at each subsequent session. The Palmoplantar Pustular Psoriasis Area and Severity Index score, 5-grade patient satisfaction score, and adverse events were evaluated. @*Results@#The mean Palmoplantar Pustular Psoriasis Area and Severity Index score decreased from 8.31±3.31 at baseline to 4.75±2.70 at 16 sessions, 3.26±2.18 at 32 sessions, and 4.05±2.19 at follow-up visit. In the subgroup analysis, non-smokers and emollients user groups showed better responses in Palmoplantar Pustular Psoriasis Area and Severity Index (p=0.033 and p=0.027, respectively). Adverse effects, including burning sensation and transient erythema, were limited and well-tolerated. @*Conclusion@#The 311-nm Ti:Sapphire Laser can be considered as a treatment option for palmoplantar pustulosis.Moreover, habitual risk factor modifications, such as smoking cessation and steady use of emollients, can impact treatment outcomes in patients with palmoplantar pustulosis.