Clinical outcomes of two-stage revision arthroplasty using a spiked tibial cement spacer in infected total knee arthroplasty.

PURPOSE: A tibial cement spacer (TCS) with spikes offers better initial stability than a conventional TCS and reduces spacer-related problems in two-stage revision total knee arthroplasty (R-TKA) for infection. We compared the clinical outcomes of two-stage revision arthroplasty for infected TKA using spiked TCS with that of conventional TCS. METHODS: This retrospective cohort study included 29 patients who underwent two-stage revision arthroplasty using an articulating cement spacer and who could be followed up for at least one year. Group S comprised 14 patients using spiked TCS, whereas Group C comprised 15 patients using conventional TCS. Demographic data, the interval from first to second stage revision, motion arc, numerical rating scale (NRS), Knee Society (KS) score, serum levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and frequency of repeating the first-stage and infection recurrence after R-TKA between the groups were analyzed. RESULTS: No significant differences were observed in the female ratio and mean age between both groups. The mean interval between the first and second stage revision was significantly shorter in Group S than in Group C. The mean motion arc was significantly larger in Group S than in Group C. The mean NRS was significantly lower in Group S than in Group C. The mean KS score in Group S was significantly higher than that in Group C. Serum ESR and CRP levels did not differ between the groups. The frequency of repeating the first stage was lower in Group S than in Group C. However, the recurrence rate after R-TKA was higher in Group S than in Group C. CONCLUSION: Compared with conventional TCS, spiked TCS shortened the period until R-TKA and improved pain and function levels. However, no significant difference existed in the rate of infection recurrence after R-TKA.

Intestinal nematodes from small mammals captured near the demilitarized zone, Gyeonggi province, Republic of Korea.

A total of 1,708 small mammals (1,617 rodents and 91 soricomorphs), including Apodemus agrarius (n = 1,400), Microtus fortis (167), Crocidura lasiura (91), Mus musculus (32), Myodes (= Eothenomys) regulus (9), Micromys minutus (6), and Tscherskia (= Cricetulus) triton (3), were live-trapped at US/Republic of Korea (ROK) military training sites near the demilitarized zone (DMZ) of Paju, Pocheon, and Yeoncheon, Gyeonggi Province from December 2004 to December 2009. Small mammals were examined for their intestinal nematodes by necropsy. A total of 1,617 rodents (100%) and 91 (100%) soricomorphs were infected with at least 1 nematode species, including Nippostrongylus brasiliensis, Heligmosomoides polygyrus, Syphacia obvelata, Heterakis spumosa, Protospirura muris, Capillaria spp., Trichuris muris, Rictularia affinis, and an unidentified species. N. brasiliensis was the most common species infecting small mammals (1,060; 62.1%) followed by H. polygyrus (617; 36.1%), S. obvelata (370; 21.7%), H. spumosa (314; 18.4%), P. muris (123; 7.2%), and Capillaria spp. (59; 3.5%). Low infection rates (0.1-0.8%) were observed for T. muris, R. affinis, and an unidentified species. The number of recovered worms was highest for N. brasiliensis (21,623 worms; mean 20.4 worms/infected specimen) followed by S. obvelata (9,235; 25.0 worms), H. polygyrus (4,122; 6.7 worms), and H. spumosa (1,160; 3.7 worms). A. agrarius demonstrated the highest prevalence for N. brasiliensis (70.9%), followed by M. minutus (50.0%), T. triton (33.3%), M. fortis (28.1%), M. musculus (15.6%), C. lasiura (13.2%), and M. regulus (0%). This is the first report of nematode infections in small mammals captured near the DMZ in ROK.

Mucosal immune responses of mice experimentally infected with Pygidiopsis summa (Trematoda: Heterophyidae).

Mucosal immune responses against Pygidiopsis summa (Trematoda: Heterophyidae) infection were studied in ICR mice. Experimental groups consisted of group 1 (uninfected controls), group 2 (infection with 200 metacercariae), and group 3 (immunosuppression with Depo-Medrol and infection with 200 metacercariae). Worms were recovered in the small intestine at days 1, 3, 5, and 7 post-infection (PI). Intestinal intraepithelial lymphocytes (IEL), mast cells, and goblet cells were counted in intestinal tissue sections stained with Giemsa, astra-blue, and periodic acid-Schiff, respectively. Mucosal IgA levels were measured by ELISA. Expulsion of P. summa from the mouse intestine began to occur from days 3-5 PI which sustained until day 7 PI. The worm expulsion was positively correlated with proliferation of IEL, mast cells, goblet cells, and increase of IgA, although in the case of mast cells significant increase was seen only at day 7 PI. Immunosuppression suppressed all these immune effectors and inhibited worm reduction in the intestine until day 7 PI. The results suggested that various immune effectors which include IEL, goblet cells, mast cells, and IgA play roles in regulating the intestinal mucosal immunity of ICR mice against P. summa infection.

Increased intestinal epithelial cell turnover and intestinal motility in Gymnophalloides seoi-infected C57BL/6 mice.

The changing patterns of goblet cell hyperplasia, intestinal epithelial cell turnover, and intestinal motility were studied in ICR and C57BL/6 mice infected with Gymnophalloides seoi (Digenea: Gymnophallidae). Whereas ICR mice retained G. seoi worms until day 7 post-infection (PI), C57BL/6 mice showed a rapid worm expulsion within day 3 PI. Immunosuppression with Depo-Medrol significantly delayed the worm expulsion in C57BL/6 mice. Goblet cell counts were increased in both strains of mice, peaking at day 1 PI in C57BL/6 mice and slowly increasing until day 7 PI in ICR mice. In C57BL/6 mice infected with G. seoi, newly proliferating intestinal epithelial cells were remarkably increased in the crypt, and the increase was the highest at day 1 PI. However, in ICR mice, newly proliferating intestinal epithelial cells increased slowly from day 1 to day 7 PI. Intestinal motility was increased in G. seoi-infected mice, and its chronological pattern was highly correlated with the worm load in both strains of mice. Meanwhile, immunosuppression of C57BL/6 mice abrogated the goblet cell proliferation, reduced the epithelial cell proliferation, and suppressed the intestinal motility. Goblet cell hyperplasia, increased intestinal epithelial cell turnover, and increased intestinal motility should be important mucosal defense mechanisms in G. seoi-infected C57BL/6 mice.

Evaluation of stiffness changes in a high-rise building by measurements of lateral displacements using GPS technology.

The outrigger truss system is one of the most frequently used lateral load resisting structural systems. However, little research has been reported on the effect of installation of outrigger trusses on improvement of lateral stiffness of a high-rise building through full-scale measurements. In this paper, stiffness changes of a high-rise building due to installation of outrigger trusses have been evaluated by measuring lateral displacements using a global positioning system (GPS). To confirm the error range of the GPS measurement system used in the full-scale measurement tests, the GPS displacement monitoring system is investigated through a free vibration test of the experimental model. Then, for the evaluation of lateral stiffness of a high-rise building under construction, the GPS displacement monitoring system is applied to measurements of lateral displacements of a 66-story high-rise building before and after installation of outrigger truss. The stiffness improvement of the building before and after the installation is confirmed through the changes of the natural frequencies and the ratios of the base shear forces to the roof displacements.

Shank 2 expression coincides with neuronal differentiation in the developing retina.

The retinal activity for vision requires a precise synaptic connectivity. Shank proteins at postsynaptic sites of excitatory synapses play roles in signal transmission into the postsynaptic neuron. However, the correlation of Shank 2 expression with neuronal differentiation in the developing retina remains to be elucidated regardless of previous evidences of Shank 2 expression in retina. Herein, we demonstrated that with progression of development, Shank 2 is initially detected in the inner plexiform layer at P2, and then intensively detected in inner plexiform layer, outer plexiform layer, and ganglion cell layer at P14, which was closely colocalized to the neurofilament expression. Shank 2 was, however, not colocalized with glial fibrillary acidic protein. Shank 2 expression was increased in the differentiated retinoblastoma cells, which was mediated by ERK 1/2 activation. Moreover, Shank 2 expression was colocalized with neurofilament at the dendritic region of cells. In conclusion, our data suggests that Shank 2 is expressed in the neurons of the developing retina and could play a critical role in the neuronal differentiation of the developing retina.

Intestinal helminth infections in feral cats and a raccoon dog on Aphaedo Island, Shinan-gun, with a special note on Gymnophalloides seoi infection in cats.

Four feral cats and a raccoon dog purchased from a local collector on Aphaedo Island, Shinan-gun, where human Gymnophalloides seoi infections are known to be prevalent, were examined for their intestinal helminth parasites. From 2 of 4 cats, a total of 310 adult G. seoi specimens were recovered. Other helminths detected in cats included Heterophyes nocens (1,527 specimens), Pygidiopsis summa (131), Stictodora fuscata (4), Acanthotrema felis (2), Spirometra erinacei (15), toxocarids (4), and a hookworm (1). A raccoon dog was found to be infected with a species of echinostome (55), hookworms (7), toxocarids (3), P. summa (3), and S. erinacei (1). No G. seoi was found in the raccoon dog. The results indicate that feral cats and raccoon dogs on Aphaedo are natural definitive hosts for intestinal trematodes and cestodes, including G. seoi, H. nocens, and S. erinacei. It has been first confirmed that cats, a mammalian species other than humans, play the role of a natural definitive host for G. seoi on Aphaedo Island.

Echinostome infections in the striped-field mouse, Apodemus agrarius, and the Ussuri white-toothed shrew, Crocidura lasiura, caught near the demilitarized zone, Gyeonggi-do (Province), Republic of Korea.

A total of 1,498 small mammals (rodents and insectivores), including Apodemus agrarius (n = 1,366), Crocidura lasiura (54), Mus musculus (32), Micronytus fortis (28), Eothenomys regulus (9), Micronys minutes (6), and Cricetulus triton (3), were live-trapped in Gyeonggi-do (Province) (Paju-si, Pocheon-gun, and Yeoncheon-gun) near the demilitarized zone (DMZ) from December 2004 to September 2005. A. agrarius was found to be infected with 3 species of echinostomes (Echinostoma hortense, Echinostoma cinetorchis, and Euparyphium murinum), while C. lasiura was infected with 1 species (Echinochasmus japonicas) of echinostome. Other mammals were free from echinostome infections. Total 16 E. hortense were detected in 7 (0.5%) mice, 9 E. cinetorchis from 5 (0.4%), and 3 E. murinum from 2 (0.1%) out of 1.366 A. agrarius examined. E. japonicus was found only in 1 (1.9%; total 3 specimens) C. lasiura. These results demonstrate that A. agrarius and C. lasiura, inhabiting near the DMZ of Gyeonggi-do serve as the natural definitive hosts for several species of echinostomes, although their infection rates are low. This is the first record of natural infections of A. agrarius with E. cinetorchis and C. lasiura with E. japonicus in the Republic of Korea.

Label-free calcium imaging in ischemic retinal tissue by TOF-SIMS.

The distribution and movement of elemental ions in biologic tissues is critical for many cellular processes. In contrast to chemical techniques for imaging the intracellular distribution of ions, however, techniques for imaging the distribution of ions across tissues are not well developed. We used time-of-flight secondary ion mass spectrometry (TOF-SIMS) to obtain nonlabeled high-resolution analytic images of ion distribution in ischemic retinal tissues. Marked changes in Ca(2+) distribution, compared with other fundamental ions, such as Na(+), K(+), and Mg(2+), were detected during the progression of ischemia. Furthermore, the Ca(2+) redistribution pattern correlated closely with TUNEL-positive (positive for terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate nick end-labeling) cell death in ischemic retinas. After treatment with a calcium chelator, Ca(2+) ion redistribution was delayed, resulting in a decrease in TUNEL-positive cells. These results indicate that ischemia-induced Ca(2+) redistribution within retinal tissues is associated with the order of apoptotic cell death, which possibly explains the different susceptibility of various types of retinal cells to ischemia. Thus, the TOF-SIMS technique provides a tool for the study of intercellular communication by Ca(2+) ion movement.

Structural, optical, and electrical properties of semiconducting ZnO nanosheets.

ZnO nanosheets were fabricated by an oxygen-assisted carbothermal reduction process and their properties were evaluated. In particular, the FET characteristics and photoluminescence properties of ZnO nanosheets were evaluated. The conduction type of ZnO nanosheets was determined as an n-type and the mobility was 20-40 cm2/ V-s, which is fairly high compared to ZnO nanowires. This might be attributed to the wide conduction area of ZnO nanosheet compared to nanowire structures and their better crystallinity.

[Biological characteristics of the Korean isolate KI-1 of Toxoplasma gondii].

OBJECTIVE: To study the biological characteristics of newly isolated Toxoplasma gondii Korean isolate-1 (KI-1). METHODS: The morphology and infectivity of KI-1 were observed by transmission electron microscopy and animal inoculation. Both RH and KI-1 antigens were detected by an anti-T. gondii monoclonal antibody (mAb), Tg563, and an anti-Neospora caninum mAb, 12B4. The genotype was determined by PCR-RFLP analysis of SAG2 locus. The sequence heterogeneity of the SAG1, ROP1 gene coding regions of the RH and KI-1 was detected by an automated sequencer. RESULTS: The morphology and infectivity of KI-1 were similar to those of RH strain. Both RH and KI-1 antigens reacted with Tg563, not with 12B4. In comparison to RH strain, the KI-1 showed a difference of seven positions of nucleotide substitutions and six positions of amino acid substitutions in both SAG1 and ROP1 gene coding regions. CONCLUSION: KI-1 is an isolate of T. gondii with strong virulence. Compared with RH strain, certain genetic differences exist.

Dexamethasone Delivery by an Implant-Mediated Drug Delivery System in the Canine Mandible.

BACKGROUND: A newly introduced implant-mediated drug delivery system (IMDDS) showed promising results in a rabbit tibia model. The aim of the present study is to evaluate whether dexamethasone administered by the IMDDS has sustained effects in the canine mandible - a different anatomic location, in a different species. METHODS: IMDDS was installed at the mesial root of the second premolar site in the mandibles of six beagle dogs. After complete healing, 10 mg dexamethasone was administered through the IMDDS. The same amount of drug was administered to five control animals by intramuscular injection. The release pattern was monitored for 2 weeks by measuring plasma drug concentrations. RESULTS: A sustained plasma dexamethasone concentration was detected after a peak at 6 hours until the end of the observation period, despite individual variations. The concentration was lower than reported in the rabbit tibia model. In contrast, plasma concentration of the control group showed an early peak at 2 hours and decreased rapidly. CONCLUSION: Dexamethasone was effectively released from the IMDDS for a prolonged time in the canine mandible model.

Wrinkling of a sol-gel-derived thin film.

We report on the wrinkle formation in a thin film produced by the sol-gel method. Through the relaxation of stress, which results from the removal of the solvent during the drying process, an isotropic wavy pattern is generated in the form of skeletal branches. The patterns have a dominant wavelength satisfying a relationship of three-fourths order of thickness. Densification of the gelated film is enhanced by an increase in the volumetric strain caused by the evaporation of the remaining solvent from the film. The number of skeletal branches and surface roughness increases as the annealing time progresses, without any change in the skeletal wavelength.

Allelic dimorphism in the merozoite surface protein-3alpha in Korean isolates of Plasmodium vivax.

To study the genetic diversity of re-emerging Plasmodium vivax in the Republic of Korea, nucleotide sequence variations at the merozoite surface protein-3alpha (PvMSP-3alpha) locus were analyzed using 24 re-emerging isolates and 4 isolates from imported cases. Compared with the well known Belem strain (Brazil), a large number of amino acid substitutions, deletions, and insertions were found at the locus of the isolates examined. The Korean isolates were divided into two allelic types; type I (15 isolates), similar to the Belem strain, and type II (9), similar to the Chess strain (New Guinea). Isolates from imported cases were classified into three types; type III (1 from Malaysia), similar to type B from western Thailand, type IV (1 each from Indonesia and India), and type V (1 from Pakistan), both being new types. Our results have shown that the MSP-3alpha locus of re-emerging Korean P. vivax is dimorphic with two allelic types coexisting in the endemic area.

An outbreak of gnathostomiasis among Korean emigrants in Myanmar.

Thirty-eight (designated as cases) of 60 Korean emigrants who consumed raw fresh water fish in Yangon, Myanmar developed migratory swellings and creeping eruptions on the back, abdomen, flank, and other cutaneous areas 1-10 weeks later. The symptoms included itching, nodule formation, fatigue, urticaria, fever, pain on the skin, and erythematous plaques. Skin biopsies of two cases revealed no parasites. However, the mean +/- SD peripheral blood eosinophilia among the cases was 6.3 +/- 6.5% (n = 29) and 9.0 +/- 9.8% (n = 26) in two examinations. An enzyme-linked immunosorbent assay of their serum samples, using Gnathostoma doloresi adult worms as the antigen, showed mean +/- SD optical densities of 0.47 +/- 0.29 (n = 28) and 0.32 +/- 0.20 (n = 30) in two examinations and 0.12 +/- 0.09 (n = 50) in healthy controls. Two advanced third-stage larvae of G. spinigerum were found in two of six catfish purchased at a local market in Yangon. The outbreak of the human infection is suggested to have been due to G. spinigerum, which is known to live out its life cycle in the Yangon area of Myanmar.

Prevalence of Heterophyes nocens and Pygydiopsis summa infections among residents of the western and southern coastal islands of the Republic of Korea.

To determine the distribution and prevalence of heterophyid fluke infections on coastal islands of the Republic of Korea, fecal specimens were collected from 4,179 people residing on 45 islands in the West (Yellow) and South Seas and examined using the formalin-ether and Kato-Katz techniques. Eggs of Heterophyes nocens were found in 459 (11.0%) residents of 42 islands, with an average number of eggs per gram (epg) of feces of 79.6. Eggs of Pygidiopsis summa were found in 49 (1.2%) on 12 islands, with an average epg of 253.0. The egg-positive rate for H. nocens was the highest on Chungdo (32.6%), followed by Imchado (27.3%); P. summa was most prevalent on Imchado (15.2%). The majority (78.9% [362 of 549] of those infected with H. nocens and 81.6% [40 of 49] of those infected with P. summa) of those infected were adults more than 40 years old. Adult flukes of these species were recovered from residents of Imchado by treatment with praziquantel and purgation. Our results indicate that H. nocens and P. summa are indigenous to the southern and western coastal islands of the Republic of Korea.

Use of monoclonal antibodies for flow cytometric detection of intracellular Toxoplasma gondii in murine splenic lymphocytes.

Various monoclonal antibodies (mAbs) against Toxoplasma gondii RH tachyzoites were used for flow cytometric detection of intracellular parasites in murine splenic lymphocytes. Tg110 and Tg563 (reacting with the major surface protein SAG1), Tg505 (with another surface protein SAG2), Tg695 and Tg786 (with rhoptry proteins), Tg507, Tg621, and Tg317 (with dense granule proteins), Tg536 (with a microneme protein), and Tg685 (with a cytosol antigen) were the mAbs used. After an in vitro infection of lymphocytes with tachyzoites and reactions with the different mAbs, flow cytometry was performed using an indirect immunofluorescent technique. The proportions of whole infected lymphocytes and of each infected lymphocyte phenotype, CD4+ T cells, CD8+ T cells, and B cells, were determined, and their fluorescent intensities were quantified. The best reaction was seen when Tg110 or Tg695 was used as the mAbs. The results suggest that mAbs against surface or rhoptry proteins are highly useful for the flow cytometric detection of intracellular T. gondii in host cells.

SnO2 nanowire gas sensor operating at room temperature.

The NO2 gas sensor based on SnO2 semiconducting nanowires workable at room temperature has been investigated. The network structure of SnO2 nanowires was fabricated on the electrodes by a simple thermal evaporation process from Sn metal powders and oxygen gas. The diameter of the nanowires was 20-60 nm depending on the processing conditions. When the concentration of NO2 was 10 ppm, the sensitivity of 43, the response time of 38 s, and the recovery time of 25 s were observed at the operating temperature of 200 degrees C. In particular, the operating temperature of the sensor could be decreased down below 50 degrees C by controlling the properties of the nanowires and the structures of the electrodes. The sensitivities were 10-15 when the NO2 concentrations were 10-50 ppm at the operating temperature of 50 degrees C.

Effects of the anti-sepsis drug, (S)-1-(α-naphthylmethyl)-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline (CKD-712), on mortality, inflammation, and organ injuries in rodent sepsis models.

CKD-712 is a 1-naphthyl analog of higenamine that has been reported to have potent antiinflammatory and thus anti-sepsis effects. The purpose of this study was to investigate the potential of CKD-712 as a medicine for sepsis and to confirm its protective effects on organs in animal sepsis models. Pretreatment with CKD-712 dose-dependently increased survival rate in a lipopolysaccharide-induced sepsis model in mice. Body temperature decrease, an important pre-symptom of septic death, was also prevented by CKD-712. CKD-712 still significantly increased survival rate even when administered one and four hours after lipopolysaccharide injection. Therapeutic efficacy of CKD-712 was also confirmed against sepsis following zymosan-induced endotoxemia and in cecal ligation and puncture surgery in mice. In a disseminated intravascular coagulation model in rats, CKD-712 showed organ-protective effect by reducing serum glutamate-oxaloacetate transaminase, glutamate-pyruvate transferase, blood urea nitrogen, and creatinine levels. CKD-712 also prevented histological damage to the lung and liver. In this same model, CKD-712 showed anti-inflammatory effects through decreases in tumor necrosis factor-α and interleukin-6 in the blood and reduced translocation of nuclear factor-κB to the nuclei of lung cells. CKD-712 administration also diminished infiltration of leukocytes into the lung and liver. Taken together, these results show that CKD-712 has excellent potential as an effective medicine for sepsis.

Alleviation of doxorubicin-induced toxicities by anthocyanin-rich bilberry (Vaccinium myrtillus L.) extract in rats and mice.

The objective of this study was to investigate the effects of anthocyanin-rich bilberry extract (BE) with highly antioxidative potential against doxorubicin (Dox)-induced toxicity in rat and mouse models. Sprague-Dawley rats treated with Dox (15 mg/kg intraperitoneally) showed marked body weight loss, increased abdominal ascites and serum glutamate oxaloacetate transaminase (GOT) level, serum and cardiac lipid peroxidation, myocardial histopathological damage, and depletion of cardiac glutathione (GSH). Dietary supplementation with 1% BE significantly reduced serum lipid peroxidation and increased cardiac creatine phosphokinase activity and total GSH level compared with the levels in the Dox control rats (P < 0.05). Serum GOT and cardiac lipid peroxide levels did not change significantly after BE treatment. Morphologic examination revealed that Dox-induced myocardial damage was also significantly suppressed in rats fed with the 1% BE diet. Oral administration of 500 mg/kg of BE for 10 days to mice treated with Dox (10 mg/kg) partially restored the Dox-induced changes by increasing red blood cell and bone marrow cell counts, and hemoglobin level. Although the protective effects of BE were insufficient to completely counteract the toxic effects of Dox, these results suggest that BE supplementation provides moderate protection against Dox-induced cardiac and hematopoietic damage.