Anatomical proposal of local anesthesia injection for median nerve block in treating hyperhidrosis with botulinum neurotoxin.

INTRODUCTION: Hyperhidrosis, causing excessive sweat, can be treated with Botulinum neurotoxin injection. Botulinum toxin, an effective and safe treatment for hyperhidrosis, unfortunately involves significant pain due to multiple injections. This study aims to propose a more efficient and less painful approach to nerve blocks for relief, by identifying optimal injection points to block the median nerve, thereby enhancing palmar hyperhidrosis treatment. METHODS: This study, involving 52 Korean cadaver arms (mean age 73.5 years), measured the location of the median nerve relative to the transverse line at the pisiform level to establish better nerve block injection sites. RESULTS: In between the extensor carpi radialis and palmaris longus, the median nerve was located at an average distance of 47.39 ± 6.43 mm and 29.39 ± 6.43 mm from the transverse line at the pisiform level. DISCUSSION: To minimize discomfort preceding the botulinum neurotoxin injection, we recommend the optimal injection site for local anesthesia to be located 4 cm distal to the transverse line of the pisiform, within the tendons of the palmaris longus and flexor carpi radialis muscles.

Supramolecular Engineering of Amorphous Porous Polymers for Rapid Adsorption of Micropollutants and Solar-Powered Volatile Organic Compounds Management.

Freshwater shortage is becoming one of the most critical global challenges owing to severe water pollution caused by micropollutants and volatile organic compounds (VOCs). However, current purification technology shows slow adsorption of micropollutants and requires an energy-intensive process for VOCs removal from water. In this study, a highly efficient molecularly engineered covalent triazine framework (CTF) for rapid adsorption of micropollutants and VOC-intercepting performance using solar distillation is reported. Supramolecular design and mild oxidation of CTFs (CTF-OXs) enable hydrophilic internal channels and improve molecular sieving of micropollutants. CTF-OX shows rapid removal efficiency of micropollutants (>99.9% in 10 s) and can be regenerated several times without performance loss. Uptake rates of selected micropollutants are high, with initial pollutant uptake rates of 21.9 g mg-1  min-1 , which are the highest rates recorded for bisphenol A (BPA) adsorption. Additionally, photothermal composite membrane fabrication using CTF-OX exhibits high VOC rejection rate (up to 98%) under 1 sun irradiation (1 kW m-2 ). A prototype of synergistic purification system composed of adsorption and solar-driven membrane can efficiently remove over 99.9% of mixed phenol derivatives. This study provides an effective strategy for rapid removal of micropollutants and high VOC rejection via solar-driven evaporation process.

Development and Effectiveness Verification of an Online Career Adaptability Program for Undergraduate Students.

This study developed an online career adaptability improvement program as part of the undergraduate curriculum to improve college students' career adaptability and verify its effectiveness. This 13-week intervention program, developed using the Korea-Career Adaptability Scale (K-CAS), consists of three domains: (1) knowledge and recognition of the self and work environment, (2) self-directed coping related to career behavior, and (3) environmental interaction for career decisions and adaptation. Two sub-studies were conducted to achieve the research objectives: Study 1 included developing and testing a pilot program and Study 2 quantitatively analyzed the final program to test its effectiveness. In Study 1, preliminary program development and validity were verified, and in Study 2, the effectiveness of the final program was verified. As a strategy to achieve the research purpose, in Study 1, literature review and needs analysis, program design reflecting the results of the needs analysis, validity verification through Delphi survey, preliminary program implementation and evaluation, and the operation of the final program were performed. To test the effectiveness of the program in Study 2, a pre-posttest of career adaptability was conducted on experimental (n = 54), comparison (n = 56), and control groups (n = 53) using the non-equivalent group pretest-posttest design, followed by a program satisfaction survey. This study is meaningful in that it developed an online program to help college students improve career adaptability and identified its effectiveness. This study yielded two results. First, it successfully developed a career adaptability improvement program for undergraduate students, wherein the career development tasks, and the sub-factors of career adaptability were organically interlinked. Second, it verified the statistically significant differences in the career adaptability scores among the experimental, comparison, and control groups. The highest mean score was obtained by participants in the experimental group, followed by the comparison and the control group.

Preliminary investigations for the development of a virtual reality-based English-language communication program: Using the Delphi method.

The purpose of this study was to gather opinions from experts via the Delphi method to inform the future development of a virtual reality based English language communication program for university level students in Korea. The participants, who consisted of a panel of experts and professors who majored in English language and multimedia education, completed three Delphi surveys based on Context, Input, Process, and Product evaluation, which is referred to as CIPP. In the first Delphi survey, the participants answered multiple choice questions and open-ended questions related to four areas relevant to the development of a virtual reality based program. Based on their answers, a second Delphi survey was designed to determine the participants' level of agreement with the appropriateness of the questions related to the four areas. In the third Delphi survey, participants were shown the results (mean, standard deviation, median, interquartile range, consensus chart, and convergence degree) and were asked to confirm or modify their answers based on the other participants' answers. According to the analysis of the Delphi survey results, need for the development of a virtual reality based English language communication program was suggested, and recommendations were made regarding the content and application of the program.

Highly Flexible and Photo-Activating Acryl-Polyurethane for 3D Steric Architectures.

An acryl-functionalized polyurethane (PU) series was successfully synthesized using poly(tetramethylene ether) glycol-methylene diphenyl diisocyanate (PTMG-MDI) oligomer based on urethane methacrylates to control the flexibility of photo-cured 3D printing architectures. The mass ratio of acryl-urethane prepolymer: 1,4-butanediol (BD) chain-extender: diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) photoinitiator was 10:0.25:1. To produce suitably hard and precisely curved 3D architectures, the optimal UV absorbance and exposure energy of the acryl-PTMG-MDI resin were controlled precisely. Owing to the optimized viscosity of the acryl-PTMG-MDI resins, they could be printed readily by digital light processing (DLP) to form precisely curved 3D architectures after mixing with 1,6-hexanediol diacrylate (HDDA). The acryl-PTMG-MDI formulations showed much better flexural resolution than the neat resins. The printed 3D structure exhibited high surface hardness, good mechanical strength, and high elasticity for flexible applications in consumer/industrial and biomedical fields.

R-catcher, a potent molecular tool to unveil the arginylome.

Protein arginylation is a critical regulator of a variety of biological processes. The ability to uncover the global arginylation pattern and its associated signaling pathways would enable us to identify novel disease targets. Here, we report the development of a tool able to capture the N-terminal arginylome. This tool, termed R-catcher, is based on the ZZ domain of p62, which was previously shown to bind N-terminally arginylated proteins. Mutating the ZZ domain enhanced its binding specificity and affinity for Nt-Arg. R-catcher pulldown coupled to LC-MS/MS led to the identification of 59 known and putative arginylated proteins. Among these were a subgroup of novel ATE1-dependent arginylated ER proteins that are linked to diverse biological pathways, including cellular senescence and vesicle-mediated transport as well as diseases, such as Amyotrophic Lateral Sclerosis and Alzheimer's disease. This study presents the first molecular tool that allows the unbiased identification of arginylated proteins, thereby unlocking the arginylome and provide a new path to disease biomarker discovery.

Efficiency of magnetic resonance imaging for diagnosing unstable ligament injuries around the thumb metacarpophalangeal joint: A comparison to arthroscopy.

PURPOSE: This study aimed to assess the accuracy of MRI in identifying ulnar collateral ligament (UCL), radial collateral ligament (RCL), and volar plate (VP) injuries of the metacarpophalangeal joint (MCPJ) of the thumb by comparing with diagnostic arthroscopy. METHODS: A total of 56 consecutive patients (56 thumbs) who underwent arthroscopy of MCPJ of thumb were enrolled. MRI findings reviewed by consensus reading of two blinded radiologists were compared with arthroscopic examination. Statistical data, including sensitivity, specificity, accuracy, were analyzed. Additionally, the performance characteristics between 3.0-tesla (39 thumbs) and 1.5-tesla (17 thumbs) MRI and acute (≤4 weeks after injury) and chronic (>4 weeks) injuries were compared. RESULTS: Of the 56 thumbs, 38 thumbs (67.9%) showed complete correspondence between MRI and arthroscopic findings. The sensitivity, specificity and accuracy of MRI for detecting UCL injuries were 78.8%, 87.0%, and 82.1%, respectively. The sensitivity, specificity and accuracy of MRI for detecting RCL injuries were 85.7%, 91.4%, and 85.7%, respectively. The sensitivity, specificity, and accuracy of MRI for detecting VP injuries were 89.5%, 89.2%, and 81.0%, respectively. 3.0-tesla MRI showed higher correspondence with arthroscopic observation (76.9%) than 1.5-tesla MRI (47.1%) (p = 0.028). For acute injuries, 78.4% showed complete correspondence between MRI and arthroscopic findings, whereas 47.4% with chronic injuries revealed complete agreement (p = 0.019). CONCLUSION: Overall, MRI is moderately effective in evaluating ligamentous lesions around MCPJ of thumb, but MRI is more sensitive in diagnosing acute injuries. Furthermore, 3.0-tesla MRI can provide results with better accuracy for diagnosing ligamentous lesions around MCPJ of thumb. However, the sensitivity and the specificity are not applicable to all ligament injuries, but only the severe one which would agree for surgical options.

Tendon Subluxation After Surgical Release of the First Dorsal Compartment in De Quervain Disease.

We aimed to determine whether dorsoulnar incision elevating radial flap and immobilization for the treatment of de Quervain disease have an advantage over simple midline incision and early mobilization, respectively, in terms of tendon subluxation and clinical outcomes. Forty-six patients with de Quervain disease were randomly divided into 2 groups (midline incision vs dorsoulnar incision) and 2 subgroups (immobilization vs early mobilization). Subluxation of intracompartmental tendons was measured in dynamic wrist positions at 12 and 24 weeks using ultrasonography. The DASH (Disabilities of the Arm, Shoulder, and Hand) and visual analog scale scores and grip and pinch strengths were evaluated. At 24 weeks, the tendons were displaced voloradially in wrist volar flexion (1.25 mm in midline incision vs 0.36 mm in dorsoulnar incision, P = 0.001), whereas the tendons were displaced dorsoulnarly in wrist extension (0.95 mm in midline incision vs 1.78 mm in dorsoulnar incision, P = 0.041). There were no significant differences in tendon displacement between early mobilization and immobilization groups. Clinical outcome measures showed no variation between the groups, and no significant correlation occurred with tendon subluxation. Dorsoulnar incision and postoperative immobilization do not have advantage over midline incision and early mobilization, respectively. However, tendon subluxation after release of the first dorsal compartment for de Quervain disease does not affect clinical outcomes.

Molecular mechanisms of biogenesis of apoptotic exosome-like vesicles and their roles as damage-associated molecular patterns.

Recent research has led to contradictory notions regarding the conventional theory that apoptotic cell death can evoke inflammatory or immunogenic responses orchestrated by released damage-associated patterns (DAMPs). By inducing IL-1ß from bone marrow-derived macrophages in an effort to determine the inflammatory mediators released from apoptotic cells, we found that exosomal fractions called "apoptotic exosome-like vesicles" (AEVs) prepared from apoptotic-conditioned medium were the main inflammatory factors. These AEVs showed characteristics of exosomes in their size, density, morphology, and protein expression but had unique marker proteins, sphingosine-1-phosphate receptors 1 and 3 (S1PR1 and 3). Their biogenesis was completely dependent on cellular sphingosine-1-phosphate (S1P)/S1PRs signaling from multiple fine spindles of plasma membrane accompanied by F-actin, S1PR1, S1PR3, and CD63 at the early apoptotic phase and progressing to the maturation of F-actin-guided multivesicular endosomes mediated by Gßγ subunits of S1PRs downstream. S1P-loaded S1PRs on AEVs were critical factors for inducing IL-1ß via NF-κB transcriptional factor and p38 MAPK, possibly through the RHOA/NOD2 axis, in differentiating macrophages. The AEVs induced genes of proinflammatory cytokines, chemokines, and mediators in both in vitro and in vivo models. In conclusion, AEVs could be key inflammatory mediators, acting as DAMPs that could explain the pathogeneses of various chronic inflammations, autoimmune diseases, or cancers in the future.

Genetic incorporation of Nε-acetyllysine reveals a novel acetylation-sumoylation switch in yeast.

The lysine acetylation of proteins plays a key role in regulating protein functions, thereby controlling a wide range of cellular processes. Despite the prevalence and significance of lysine acetylation in eukaryotes, however, its systematic study has been challenged by the technical limitations of conventional approaches for selective lysine acetylation in vivo. Here, we report the in vivo study of lysine acetylation via the genetic incorporation of Nε-acetyllysine in yeast. We demonstrate that a newly discovered acetylation-sumoylation switch precisely controls the localization and cellular function of the yeast septin protein, Cdc11, during the cell cycle. This approach should facilitate the comprehensive in vivo study of lysine acetylation across a wide range of proteins in eukaryotic organisms. This article is part of a Special Issue entitled "Biochemistry of Synthetic Biology - Recent Developments" Guest Editor: Dr. Ilka Heinemann and Dr. Patrick O'Donoghue.

Development of background-free tame fluorescent probes for intracellular live cell imaging.

Fluorescence labelling of an intracellular biomolecule in native living cells is a powerful strategy to achieve in-depth understanding of the biomolecule's roles and functions. Besides being nontoxic and specific, desirable labelling probes should be highly cell permeable without nonspecific interactions with other cellular components to warrant high signal-to-noise ratio. While it is critical, rational design for such probes is tricky. Here we report the first predictive model for cell permeable background-free probe development through optimized lipophilicity, water solubility and charged van der Waals surface area. The model was developed by utilizing high-throughput screening in combination with cheminformatics. We demonstrate its reliability by developing CO-1 and AzG-1, a cyclooctyne- and azide-containing BODIPY probe, respectively, which specifically label intracellular target organelles and engineered proteins with minimum background. The results provide an efficient strategy for development of background-free probes, referred to as 'tame' probes, and novel tools for live cell intracellular imaging.

Simple and efficient strategy for site-specific dual labeling of proteins for single-molecule fluorescence resonance energy transfer analysis.

Analysis of protein dynamics using single-molecule fluorescence resonance energy transfer (smFRET) is widely used to understand the structure and function of proteins. Nonetheless, site-specific labeling of proteins with a pair of donor and acceptor dyes still remains a challenge. Here we present a general and facile method for site-specific dual labeling of proteins by incorporating two different, readily available, unnatural amino acids (p-acetylphenylalanine and alkynyllysine) for smFRET. We used newly evolved alkynyllysine-specific aminoacyl-tRNA synthetase/tRNA(UCA) and p-acetylphenylalanyl-tRNA synthetase/tRNA(CUA). The utility of our approach was demonstrated by analyzing the conformational change of dual-labeled calmodulin using smFRET measurements. The present labeling approach is devoid of major limitations in conventional cysteine-based labeling. Therefore, our method will significantly increase the repertoire of proteins available for FRET study and expand our ability to explore more complicated molecular dynamics.

N-acetyl lysyl-tRNA synthetases evolved by a CcdB-based selection possess N-acetyl lysine specificity in vitro and in vivo.

Posttranslational modifications play a crucial role in modulating protein structure and function. Genetic incorporation of unnatural amino acids into a specific site of a protein facilitates the systematic study of protein modifications including acetylation. We here report the directed evolution of pyrrolysyl-tRNA synthetase (PylRS) from Methanosarcina mazei to create N-acetyl lysyl-tRNA synthetases (AcKRSs) using a new selection system based on the killing activity of the toxic ccdB gene product. The amino acid specificity of these and of published AckRSs was tested in vitro and in vivo, and the enzyme-kinetic properties of the AckRSs were evaluated for the first time.

Arthroscopically assisted mini-deltopectoral rotator cuff repair.

This study examined the technique and outcome of arthroscopically assisted mini-deltopectoral rotator cuff repair. The mini-deltopectoral approach enables the repair of large or massive rotator cuff tears while preventing injury to the deltoid muscle and axillary nerve often caused by splitting and excessive traction during conventional mini-open repair. This technique also is useful in the repair of subscapularis tears and thus could extend the indications for mini-open repair.