Escherichia coli cell factories with altered chromosomal replication scenarios exhibit accelerated growth and rapid biomass production.

BACKGROUND: Generally, bacteria have a circular genome with a single replication origin for each replicon, whereas archaea and eukaryotes can have multiple replication origins in a single chromosome. In Escherichia coli, bidirectional DNA replication is initiated at the origin of replication (oriC) and arrested by the 10 termination sites (terA-J). RESULTS: We constructed E. coli derivatives with additional or ectopic replication origins, which demonstrate the relationship between DNA replication and cell physiology. The cultures of E. coli derivatives with multiple replication origins contained an increased fraction of replicating chromosomes and the cells varied in size. Without the original oriC, E. coli derivatives with double ectopic replication origins manifested impaired growth irrespective of growth conditions and enhanced cell size, and exhibited excessive and asynchronous replication initiation. The generation time of an E. coli strain with three replication origins decreased in a minimal medium supplemented with glucose as the sole carbon source. As well as cell growth, the introduction of additional replication origins promoted increased biomass production. CONCLUSIONS: Balanced cell growth and physiological stability of E. coli under rapid growth condition are affected by changes in the position and number of replication origins. Additionally, we show that, for the first time to our knowledge, the introduction of replication initiation sites to the chromosome promotes cell growth and increases protein production.

Disorders of Secondary Neurulation: Suggestion of a New Classification According to Pathoembryogenesis.

Recently, advanced knowledge on secondary neurulation and its application to the clinical experience have led to the deeper insight into the pathoembryogenesis of secondary neurulation with new classifications of the caudal spinal dysraphic entities. Here, we summarize the dynamic changes in the concepts of disordered secondary neurulation over the last two decades. In addition, we suggest our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Disordered secondary neurulation at each phase may cause various corresponding lesions, such as (1) failed junction with the primary neural tube (junctional neural tube defect and segmental spinal dysgenesis), (2) dysgenesis or duplication of the caudal cell mass associated with disturbed activity of caudal mesenchymal tissue (caudal agenesis and caudal duplication syndrome), (3) abnormal continuity of medullary cord to the surrounding layers, namely, failed ingression of the primitive streak to the caudal cell mass (myelomeningocele), focal limited dorsal neurocutaneous nondisjunction (limited dorsal myeloschisis and congenital dermal sinus), and neuro-mesenchymal adhesion (lumbosacral lipomatous malformation), and (4) regression failure spectrum of the medullary cord (thickened filum and filar cyst, retained medullary cord and low-lying conus, terminal myelocele, and terminal myelocystocele). It seems that almost every anomalous entity of the primary neural tube may occur in the area of secondary neurulation. Furthermore, the close association of the caudal cell mass with the activity of caudal mesenchymal tissue involves a wider range of surrounding structures in secondary neurulation than in primary neurulation. Although the majority of the data are from animals and many theories are still conjectural, these changing concepts of normal and disordered secondary neurulation will provoke further advancements in our management strategies as well as in the pathoembryogenetic understanding of anomalous lesions in this area.

Radiographic Follow-up After Normal Ultrasound Screening of the Hip in Breech Infants.

BACKGROUND: Breech presentation is one of the most important risk factors for developmental dysplasia of the hip, and all breech infants should be screened. The necessity of further follow-up of developmental dysplasia of the hip after normal clinical and sonographic screening is a controversial subject. The purpose of this study to identify the incidence of delayed dysplasia in breech infants after normal ultrasound screening and the necessity of further clinical and radiologic follow-up in these patients. METHODS: We included the 292 breech babies (128 boys and 164 girls) who showed normal hip ultrasound screening results. To determine the incidence of delayed radiographic dysplasia, anteroposterior hip radiographs were taken between 12 and 24 months of age to measure the acetabular index (AI). RESULTS: The mean AI values were 22.8±3.4 in boys and 24.9±3.1 in girls. Applying the Tönnis criteria, 29 patients (9.9%) were considered to have delayed radiographic dysplasia (16 boys and 13 girls). No significant difference was found in any demographic variables between babies with and without delayed radiographic dysplasia. None of these 29 infants underwent any treatment for radiographic dysplasia. Applying Kuong's criteria to 292 infants, only 2 patients (0.7%) demonstrated radiographic dysplasia on the hip anteroposterior radiographs taken at 14 months. CONCLUSIONS: The incidence of radiographic dysplasia significantly varied depending on which criteria were applied. In order to find out more accurate incidence rates of delayed radiographic dysplasia, large-scale studies of the normative AI data for Korean infants are required. LEVEL OF EVIDENCE: Prognostic Level III.

Comparison of sacroiliac joint degeneration between patients with sagittal imbalance and lumbar spinal stenosis.

PURPOSE: The purpose of this study was to compare the degeneration of sacroiliac joints (SIJs) between adult spinal deformity (ASD) patients with sagittal imbalance and an age- and sex-matched lumbar spinal stenosis (LSS) patients without sagittal imbalance. MATERIALS AND METHODS: The age- and sex-matched case-control study consists of two groups: the ASD group and the other group consisting of patients with LSS (LSS group). The study population consisted of 98 patients in each group. The spinopelvic parameters such as pelvic incidence (PI), sacral slope, pelvic tilt, lumbar lordosis, and sagittal vertical axis (SVA) were measured. To evaluate degeneration of SIJ, two protocols (Backlund's grade and Eno's classification) were used. RESULT: SIJ degeneration in the ASD group was more severe than that in the LSS group, as assessed by both Backlund's grade and Eno's classification (P < 0.001 for both). Age correlated significantly with PI in both the ASD and LSS groups (r = 0.285; P = 0.005, r = 0.218; P = 0.031, respectively). The total Backlund's grading score and the SVA were significantly correlated with PI in the ASD group (r = 0.344; P < 0.001, r = 0.276; P = 0.007, respectively), but not in the LSS group (r = 0.156; P = 0.126, r = 0.189; P = 0.067, respectively). CONCLUSIONS: ASD patients with sagittal imbalance demonstrated more severe SIJ degeneration compared to the age- and sex-matched LSS group. PI was significantly correlated with both SIJ degeneration and SVA only in the ASD group.

Impacts of the Journal Evaluation Program of the Korean Association of Medical Journal Editors (KAMJE) on the Quality of the Member Journals.

BACKGROUND: In 1997 the Korean Association of Medical Journal Editors (KAMJE) instituted a program to evaluate member journals. Journals that passed the initial evaluation were indexed in the KoreaMed. Here, we report changes in measures of quality of the KAMJE member journals during the last 20 years. METHODS: Quality measures used in the study comprised 3 assessment categories; self-assessment by journal editors, assessment of the journals by KAMJE reviewers, and by Korean health science librarians. Each used detailed criteria to score the journals on a scale of 0 to 5 or 6 in multiple dimensions. We compared scores at baseline evaluation and those after 7 years for 129 journals and compared improvements in journals indexed vs. not-indexed by the Web of Science (Science Citation Index Expanded; SCIE). RESULTS: Among 251 KAMJE member journals at the end of 2015, 227 passed evaluation criteria and 129 (56%) had both baseline and 7-year follow-up assessment data. The journals showed improvement overall (increase in median [interquartile range; IQR] score from baseline, 0.47 [0.64]; 95% confidence interval [CI], 0.44-0.61; P < 0.001) and within each category (median [IQR] increase by editor's assessment, 0.17 [0.83]; 95% CI, 0.04-0.26; P = 0.007; by reviewer's, 0.45 [1.00]; 95% CI, 0.29-0.57; P < 0.001; by librarian's, 1.75 [1.08]; 95% CI, 1.77-2.18, P < 0.001). Before the foundation of KAMJE in 1996, there were only 5 Korean medical journals indexed in the MEDLINE and none in SCIE, but 24 journals in the MEDLINE and 34 journals in SCIE were indexed by 2016. CONCLUSION: The KAMJE journal evaluation program successfully contributes improving the quality of the member journals.

Secondary neurulation of human embryos: morphological changes and the expression of neuronal antigens.

PURPOSE: The morphological changes and expression patterns of neuronal antigens of human embryos, obtained from the therapeutic termination of pregnancy or from surgical procedures, were analyzed in order to characterize the secondary neurulation. METHODS: A total of 21 human embryos from Carnegie stages 12 to 23 and two fetuses in early stages were studied. The markers used for immunohistochemical study were neural cell adhesion molecule (N-CAM), neuronal nuclear antigen (NeuN), neurofilament-associated protein (3A10), synaptophysin, and glial fibrillary acidic protein (GFAP). RESULTS: The formation of the caudal neural tube to the tip of the caudal portion of the embryo was finished at stage 17. The postcloacal gut had completely disappeared at stage 18, and multiple cavities of the caudal neural tube were clearly visible. The caudal portion of the neural tube showed findings suggestive of involution at stage 19. The expression patterns of neuronal antigens were as follows: N-CAM and NeuN showed immunoreactivity at the germinal layer of the spinal cord at stages 17 and 18. Neurofilament-associated protein (3A10) showed persistent immunoreactivity at the caudal cell mass and notochord during the observation period, along with the spinal cord, and the positive reactions were mainly located at the dorsal white matter at stage 17. Synaptophysin showed a weak positive reaction at the caudal cell mass and notochord at stages 13 and 14, evident by staining observed at the spinal cord at stages 15 and 16. There was no definite positive reaction for GFAP. CONCLUSIONS: These characteristic patterns might be helpful for the understanding of human congenital anomalies involving secondary neurulation processes.

How to Achieve Further Progress of Journal of Korean Neurosurgical Society (JKNS) - Improve the Impact Factor (IF) and Maintain It Continuously.

Journal of Korean Neurosurgical Society (JKNS), which has a history of over 50 years, has made great progress recently. In order to continue this progress in the future, we need to think about the strategies we will take and put them into practice. The progress of JKNS is an important opportunity to publicize the achievements of Korean neurosurgery to the world and for Korea to contribute further to global neurosurgery. We also need to think about and implement various measures to improve the inflow of papers of high quality from various countries and to establish an appropriate merit system for reviewers.

Variability of response on prophylactic prasugrel for endovascular treatment of intracranial aneurysms: Clinical implications.

BACKGROUND AND PURPOSE: Prophylactic prasugrel for endovascular treatment of intracranial aneurysms has been introduced and increased, but HTPR (high on-treatment platelet reactivity) or LTPR (low on-treatment platelet reactivity) of prasugrel is not uncommon in clinical circumstances. To investigate the predisposing factors of HTPR and LTPR on prasugrel premedication in the neurointerventional field and to determine its clinical implications. MATERIALS AND METHODS: Between February 2016 and December 2020, 191 patients treated with coil embolization using prophylactic prasugrel in 234 intracranial aneurysms were the final candidates for this study. Patient and aneurysm characteristics, clinical status, and laboratory study values were carefully reviewed retrospectively. We performed risk factor analyses for HTPR and LTPR on prasugrel. RESULTS: Ultimately, 20 patients (10.5%) had HTPR, and 74 patients (38.7%) were categorized as having LTPR. In multivariable analyses, the factors related to HTPR were BMI (adjusted OR 1.21, 95% CI 1.04-1.41, p = 0.01), history of antithrombotics (adjusted OR 3.79, 95% CI 1.39-10.34, p = 0.01), and hematocrit (adjusted OR 0.91, 95% CI 0.84-0.99, p = 0.03). Low BMI was the only risk factor for LTPR (adjusted OR 0.84, 95% CI 0.76-0.94, p = 0.001). CONCLUSION: In the neurointerventional field, high BMI and prior use of antithrombotic agents were related to HTPR, and low BMI was associated with LTPR on prophylactic prasugrel. High hematocrit levels decreased the risk of HTPR. When preparing endovascular treatment for intracranial aneurysms, attention to patients with these clinical features is required to address the possibility of ischemic or bleeding complications.

Epigenetic modification of gene expression in cancer cells by terahertz demethylation.

Terahertz (THz) radiation can affect the degree of DNA methylation, the spectral characteristics of which exist in the terahertz region. DNA methylation is an epigenetic modification in which a methyl (CH3) group is attached to cytosine, a nucleobase in human DNA. Appropriately controlled DNA methylation leads to proper regulation of gene expression. However, abnormal gene expression that departs from controlled genetic transcription through aberrant DNA methylation may occur in cancer or other diseases. In this study, we demonstrate the modification of gene expression in cells by THz demethylation using resonant THz radiation. Using an enzyme-linked immunosorbent assay, we observed changes in the degree of global DNA methylation in the SK-MEL-3 melanoma cell line under irradiation with 1.6-THz radiation with limited spectral bandwidth. Resonant THz radiation demethylated living melanoma cells by 19%, with no significant occurrence of apurinic/apyrimidinic sites, and the demethylation ratio was linearly proportional to the power of THz radiation. THz demethylation downregulates FOS, JUN, and CXCL8 genes, which are involved in cancer and apoptosis pathways. Our results show that THz demethylation has the potential to be a gene expression modifier with promising applications in cancer treatment.

Location of Ulnar Nerve Branches to the Flexor Carpi Ulnaris during Surgery for Cubital Tunnel Syndrome.

OBJECTIVE: Cubital tunnel syndrome, the most common ulnar nerve entrapment neuropathy, is usually managed by simple decompression or anterior transposition. One of the concerns in transposition is damage to the nerve branches around the elbow. In this study, the location of ulnar nerve branches to the flexor carpi ulnaris (FCU) was assessed during operations for cubital tunnel syndrome to provide information to reduce operation-related complications. METHODS: A personal series (HJY) of cases operated for cubital tunnel syndrome was reviewed. Cases managed by transposition and location of branches to the FCU were selected for analysis. The function of the branches was confirmed by intraoperative nerve stimulation and the location of the branches was assessed by the distance from the center of medial epicondyle. RESULTS: There was a total of 61 cases of cubital tunnel syndrome, among which 31 were treated by transposition. Twenty-one cases with information on the location of branches were analyzed. The average number of ulnar nerve branches around the elbow was 1.8 (0 to 3), only one case showed no branches. Most of the cases had one branch to the medial head, and one other to the lateral head of the FCU. There were two cases having branches without FCU responses (one branch in one case, three branches in another). The location of the branches to the medial head was 16.3±8.6 mm distal to the medial epicondyle (16 branches; range, 0 to 35 mm), to the lateral head was 19.5±9.5 mm distal to the medial epicondyle (19 branches; range, -5 to 30 mm). Branches without FCU responses were found from 20 mm proximal to the medial condyle to 15 mm distal to the medial epicondyle (five branches). Most of the branches to the medial head were 15 to 20 mm (50% of cases), and most to the lateral head were 15 to 25 mm (58% of cases). There were no cases of discernable weakness of the FCU after operation. CONCLUSION: In most cases of cubital tunnel syndrome, there are ulnar nerve branches around the elbow. Although there might be some cases with branches without FCU responses, most branches are to the FCU, and are to be saved. The operator should be watchful for branches about 15 to 25 mm distal to the medial epicondyle, where most branches come out.

Numerical Model for Cerebrovascular Hemodynamics with Indocyanine Green Fluorescence Videoangiography.

OBJECTIVE: The use of indocyanine green videoangiography (ICG-VA) to assess blood flow in the brain during cerebrovascular surgery has been increasing. Clinical studies on ICG-VA have predominantly focused on qualitative analysis. However, quantitative analysis numerical modelling for time profiling enables a more accurate evaluation of blood flow kinetics. In this study, we established a multiple exponential modified Gaussian (multi-EMG) model for quantitative ICG-VA to understand accurately the status of cerebral hemodynamics. METHODS: We obtained clinical data of cerebral blood flow acquired the quantitative analysis ICG-VA during cerebrovascular surgery. Varied asymmetric peak functions were compared to find the most matching function form with clinical data by using a nonlinear regression algorithm. To verify the result of the nonlinear regression, the mode function was applied to various types of data. RESULTS: The proposed multi-EMG model is well fitted to the clinical data. Because the primary parameters-growth and decay rates, and peak center and heights-of the model are characteristics of model function, they provide accurate reference values for assessing cerebral hemodynamics in various conditions. In addition, the primary parameters can be estimated on the curves with partially missed data. The accuracy of the model estimation was verified by a repeated curve fitting method using manipulation of missing data. CONCLUSION: The multi-EMG model can possibly serve as a universal model for cerebral hemodynamics in a comparison with other asymmetric peak functions. According to the results, the model can be helpful for clinical research assessment of cerebrovascular hemodynamics in a clinical setting.

Probabilistic graphical modelling using Bayesian networks for predicting clinical outcome after posterior decompression in patients with degenerative cervical myelopathy.

BACKGROUND: Probabilistic graphical modelling (PGM) can be used to predict risk at the individual patient level and show multiple outcomes and exposures in a single model. OBJECTIVE: To develop PGM for the prediction of clinical outcome in patients with degenerative cervical myelopathy (DCM) after posterior decompression and to use PGM to identify causal predictors of the outcome. METHODS: We included data from 59 patients who had undergone cervical posterior decompression for DCM. The candidate predictive parameters were age, sex, body mass index, trauma history, symptom duration, preoperative and last Japanese Orthopaedic Association (JOA) scores, gait impairment, claudication, bladder dysfunction, Nurick grade, American Spinal Injury Association (ASIA) grade, smoking, diabetes mellitus, cardiopulmonary disorders, hypertension, stroke, Parkinson's disease, dementia, psychiatric disorders, arthritis, ossification of the posterior longitudinal ligament, cord signal change, postoperative kyphosis and the cord compression ratio. RESULTS: In regression analyses, preoperative JOA (PreJOA) score, presence of a psychiatric disorder, and ASIA grade were identified as significant factors associated with the last JOS score. Dementia, sex, PreJOA score and gait impairment were causal factors in the PGM. Sex, dementia and PreJOA score were direct causal factors related to the last follow-up JOA (LastJOA) score. Being female, having dementia, and having a low PreJOA score were significantly related to having a low LastJOA score. CONCLUSIONS: The causal predictors of surgical outcome for DCM were sex, dementia and PreJOA score. Therefore, PGM may be a useful personalized medicine tool for predicting the outcome of patients with DCM.

Sex, dementia and preoperative neurological status are causal factors contributing to the postoperative outcome of patients with degenerative cervical myelopathy.The Bayesian network (BN) structure may be useful for predicting the probability for clinical outcomes for each patient who undergoes posterior decompressive surgery.The BN structure may provide a useful model in the current era of personalized medicine.

An innovative method for detecting surgical errors using indocyanine green angiography during carotid endarterectomy: a preliminary investigation.

BACKGROUND: Carotid endarterectomy (CEA) is the most effective treatment method of carotid stenosis or occlusion. Surgeons typically check the blood flow in each vessel using Duplex Doppler ultrasonography or radiocontrast angiography in order to prevent postoperative complications. Embolic cerebral infarction on the ipsilateral side has been reported in 4-7% of patients undergoing CEA despite a tolerable blood flow reported by Duplex ultrasonography. This study was designed to evaluate a new intraoperative method for detecting technical errors during CEA using indocyanine green (ICG) angiography. METHODS: Six consecutive patients with severe carotid stenosis or occlusion underwent CEA. Both ICG angiography and Doppler ultrasonography were performed before the carotid arterial incision and after the carotid arterial suture. After injecting ICG dye via an intravenous route, the internal surface, atheroma, and flow defect were visualized with a microscope. RESULTS: In ICG angiography, stenotic lesions could be identified as regions of relatively dark signal intensity. Magnified real-time images could be created using a microscope with an infrared filter, including three-dimensional images and detailed images of the inner lumen. These images could then be compared with the results of Doppler ultrasonography. In the six cases assessed by both ICG angiography and Doppler ultrasonography, all Doppler results were acceptable. However, one patient underwent revision surgery because a fluttering atheroma was detected by ICG angiography. ICG angiography could assume the extent of severe stenotic area. ICG angiography could also detect mobile lesions such as a fluttering atheroma. CONCLUSIONS: Intraoperative ICG angiography before arteriotomy is useful to determine the precise stenotic area and the shape of the associated plaque. ICG angiography after an arteriotomy site is sutured is also useful for detecting residual stenosis or fluttering atheroma. ICG angiography could be an alternative method to Doppler ultrasonography for ensuring a complete and successful operation and preventing complications.

Surgical outcome of percutaneous endoscopic interlaminar lumbar diskectomy for recurrent disk herniation after open diskectomy.

STUDY DESIGN: Technical report. OBJECTIVE: To present a detailed surgical technique of percutaneous endoscopic interlaminar diskectomy (PEID) for recurrent lumbar disk herniation and present features of postoperative magnetic resonance images that were unavailable in previous studies. SUMMARY OF BACKGROUND DATA: Revision lumbar diskectomy is troublesome because of the difficulty in dissecting a surgical scar. Endoscopic diskectomy is regarded as an alternative method with comparable clinical outcome and less complication. Technically, a transforaminal approach is similar to a virgin operation, whereas an interlaminar approach is not, because of the scar tissue. There have been only 2 papers describing a PEID surgical procedure. Sharing details of the surgical technique is important in furthering the adoption of this technique, when it is indicated. METHODS: We operated on 10 patients (M:F=6:4; mean age, 61.2±11.6 y) with PEID for recurrent lumbar disk herniation after open diskectomy. The level operated was L5-S1 in 5 cases, L4-5 in 4, and L2-3 in 1. During operation, we dissected the scar tissue from the medial facet joint with a working channel and removed the reherniated disk material after retraction of the scar tissue and the neural tissue together. Dissection of the scar tissue from the neural tissue was not attempted. The follow-up period was 14.4±9.9 months. RESULTS: In all 10 patients, the reherniated disk materials were removed successfully. There was no incidence of dural tear. Postoperative magnetic resonance imaging showed good decompression with thecal sac reexpansion irrespective of the attached scar tissue, except in 1 patient. Excellent or good outcome by Macnab criteria was obtained in 6 of 10 patients, fair outcome in 2, and poor in 2 patients. Rerecurrence occurred in 1 patient 1 year after the surgery. CONCLUSIONS: PEID with dissection of the scar tissue from the medial facet joint rather than from the neural tissue may be an effective alternative surgical method for recurrent disk herniation.

Half-Centennial History of Journal of Korean Neurosurgical Society : Midway from Domestic Journal to International Journal with Good Influence in Global Neurosurgery.

October 2022 marks the 50th anniversary of the founding of Journal of Korean Neurosurgical Society (JKNS). Staring as official journal of Korean Neurosurgical Society (KNS) in 1972, JKNS is a journal that is listed in the science citation index (SCI) and its impact factor has been steadily rising in recent years. The past history of JKNS was reviewed with a focus on important milestone, and the direction of future development is suggested.

The complex of miRNA2861 and cell-penetrating, dimeric α-helical peptide accelerates the osteogenesis of mesenchymal stem cells.

BACKGROUND: The restoration of the functional ability of mesenchymal stem cells (MSCs) using epigenetic modification is very promising for patients with weak osteogenesis ability. This study focused on the acceleration of osteogenesis from MSCs using microRNA (miRNA)2861 and a cell-penetrating peptide (CPP), LK. METHODS: We performed MSCs penetration test of complex between the LK peptides and miRNA 2861. Three different experiments were performed to investigate the effects of miRNA 2861 on osteogenic differentiation in MSCs: 1) intensity of alizarin red staining, which reflects the status of mineralization by osteoblasts; 2) gene expression related to osteoblast differentiation; and 3) confirmation of corresponding protein translation for comparison with RNA expression levels. RESULTS: We found that cLK effectively delivered miRNA 2861 into the cytoplasm of human MSCs and accelerated osteogenic differentiation from MSCs, as well as mineralization. CONCLUSION: The complex of miRNA 2861 with LK may have a positive effect on the osteogenic differentiation from MSCs and mineralization. Therapies using miRNAs combined with LK may be good candidates for the augmentation of osteogenesis in patients.

Augmented osteogenesis of mesenchymal stem cells using a fragmented Runx2 mixed with cell-penetrating, dimeric a-helical peptide.

The intracellular delivery of transcription factor/cofactor using cell penetrating peptide (CPP) can lead to selective osteogenesis. The present work investigates the cell-penetrating potential of the a cyclic, α-helical cell-penetrating peptide based on leucine and lysine residues (cLK) for intracellular delivery in MC3T3 cells and the osteogenic effects of a C-terminal proline­serine­threonine-rich (PST) domain of Runx2 using cLK in rat mesenchymal stem cells (MSCs). We confirmed that the combination of cLK and fluorescein 5-isothiocyanate (FITC)-fragmented-Runx2 (fRunx2) showed an enhanced cell-penetrating activity of FITC-fRunx2 compared with FITC-fRunx2 alone. In addition, the fRunx2-cLK group showed strong staining with alizarin red compared with other groups and the degree of alizarin red staining in the fRunx2-cLK group was also 1.2-fold higher than that in the fRunx2-Tat group. The ALP and osteocalcin gene expression levels in the fRunx2-cLK group were higher than those in the other groups. The fRunx2 transferred effectively into the cytoplasm aided by the cLK peptide and augmented the osteogenic differentiation of MSCs.

Pitfalls in assessing limb alignment affected by rotation and flexion of the knee after total knee arthroplasty: Analysis using sagittal and coronal whole-body EOS radiography.

BACKGROUND: Inappropriate posture during radiographic assessment may lead to misunderstanding of postoperative alignment after total knee arthroplasty (TKA). The EOS system assesses coronal and sagittal alignment simultaneously. This study aimed to evaluate the effect of flexion and/or rotation on alignment, and identify the patterns of knee posture with serial follow-up using the EOS system. METHODS: One-hundred and fifteen patients of TKA and serial whole-body EOS were included. The hip-knee-ankle (HKA) angle in the coronal and sagittal planes, femoral component rotation ratio (FCR), tibial component rotation ratio (TCR), and fibular overlap ratio (FO) were measured immediately and at six months and one year postoperatively. Total and partial correlation, using flexion and rotation as a control variable was performed. RESULTS: The mean HKA values and flexion immediately post-operation were different compared with the values noted at six months and one year postoperatively (for all, P < 0.05). The FCR and FO were correlated with the HKA angle during all periods (for both, P < 0.05). The Pearson correlation coefficients of the HKA angle with rotation parameters decreased when flexion was controlled. CONCLUSIONS: Combined rotation and flexion of the knee joint has a greater effect on coronal alignment compared with isolated flexion or rotation and was more frequently observed during the early postoperative period. Therefore, surgeons should be made aware of the potential knee rotation and flexion errors after TKA.

Efficacy of Artemisia annua L. extract for recovery of acute liver failure.

Artemisia annua L. is an annual herb belonging to the Asteraceae family. It is commonly grown in parts of Asia, including Korea and China, and is called by its nickname Gae-ddong-ssuk, or Chung-ho. The herb is well known for its positive effects on fever and hemostasis, as well as its antibiotic effects. To evaluate the protective properties of A. annua L. on the liver, an acute liver failure animal model was set up with intraperitoneal injection of lipopolysaccharide (LPS) and D-galactosamine (D-galN) in C57BL/6J mice, showing increased levels of AST (aspartate transaminase) and ALT (alanine transaminase). Oral administration of the extract of A. annua L. (EAA) for 2 weeks reduced the level of AST and ALT up to 50% of the levels in the negative control group treated with water vehicle. The efficacy of EAA was more effective than that in a comparative positive control group treated with milk thistle extract. Moreover, EAA protected hepatic cells and tissues from oxidative stresses and inflammatory damages, showing downregulation of inflammatory cytokines such as interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). We also found that LPS stimulated the mouse macrophage cell line, Raw264.7, and secreted a tremendous level of proinflammatory cytokines and the secretion of these cytokines was reduced with EAA treatment via downregulation of mitogen-activated protein kinase phosphorylation and p65 translocation. This study demonstrated that A. annua L. extract is a promising treatment for protection against and recovery from liver damage, as well as maintenance of liver health.

Journal of Korean Neurosurgical Society from 2001 to 2006, the Pivotal Period of Transition and Preparation for Making Great Stride.

In the circumstances of overflowing numbers of medical journals, progress of their own medical journal is one of the primary concerns of many medical societies. Among the 46-year-history of Journal of Korean Neurosurgical Society (JKNS), it undertook a period of important transition and preparation to take off for journal with international reputation during the period from 2001 to 2006. The overall process of manuscript handling, peer review, and editorial work has undergone systematic improvement. Workshops for authors, reviewer and editors were held, which were very helpful to improve the quality of submitted manuscript, peer review and editorial processing. Articles on the history, current status of the JKNS, citations and the change of proportion of types of articles were published, which provided insight about present condition and direction for further progress. It was changed into English journal in 2005. These efforts resulted in registration of the journal Chemical Abstract Service in 2005 and Science Citation Index Expanded in 2008 and SCOPUS in 2009. Now JKNS has become international journal, with about half of the submitted manuscripts from abroad, with increasing impact factor. Along with the effort of Korean Neurosurgical Society (KNS) members and support of KNS, dedication of Professor Dong Gyu Kim for the progress of JKNS is worth remembering, who served as Editor-in-Chief of JKNS during this period.