Novel role of LLGL2 silencing in autophagy: reversing epithelial-mesenchymal transition in prostate cancer.

PURPOSE: Prostate cancer (PCa) is a major urological disease that is associated with significant morbidity and mortality in men. LLGL2 is the mammalian homolog of Lgl. It acts as a tumor suppressor in breast and hepatic cancer. However, the role of LLGL2 and the underlying mechanisms in PCa have not yet been elucidated. Here, we investigate the role of LLGL2 in the regulation of epithelial-mesenchymal transition (EMT) in PCa through autophagy in vitro and in vivo. METHODS: PC3 cells were transfected with siLLGL2 or plasmid LLGL2 and autophagy was examined. Invasion, migration, and wound healing were assessed in PC3 cells under autophagy regulation. Tumor growth was evaluated using a shLLGL2 xenograft mouse model. RESULTS: In patients with PCa, LLGL2 levels were higher with defective autophagy and increased EMT. Our results showed that the knockdown of LLGL2 induced autophagy flux by upregulating Vps34 and ATG14L. LLGL2 knockdown inhibits EMT by upregulating E-cadherin and downregulating fibronectin and α-SMA. The pharmacological activation of autophagy by rapamycin suppressed EMT, and these effects were reversed by 3-methyladenine treatment. Interestingly, in a shLLGL2 xenograft mouse model, tumor size and EMT were decreased, which were improved by autophagy induction and worsened by autophagy inhibition. CONCLUSION: Defective expression of LLGL2 leads to attenuation of EMT due to the upregulation of autophagy flux in PCa. Our results suggest that LLGL2 is a novel target for alleviating PCa via the regulation of autophagy.

Succession of particle-attached and free-living bacterial communities in response to microalgal dynamics induced by the biological cyanocide paucibactin A.

Microalgae, including cyanobacteria and eukaryotic algae, are hotspots of primary production and play a critical role in global carbon cycling. However, these species often form blooms that poses a threat to aquatic ecosystems. Although the use of bacteria-derived cyanocides is regarded as an environmentally friendly method for controlling cyanobacterial blooms, only a few studies have examined their potential impact on ecosystems. This study is the first to explore the response of particle-attached (PA) and free-living (FL) bacteria to the dynamics of microalgal communities induced by the biological cyanocide paucibactin A. The microalgal community dynamics were divided into two distinct phases [phase I (days 0-2) and phase II (days 3-7)]. In phase I, paucibactin A caused a sudden decrease in the cyanobacterial concentration. Phase II was characterized by increased growth of eukaryotic microalgae (Scenedesmus, Pediastrum, Selenastrum, and Coelastrum). The stability of the bacterial community and the contribution of stochastic processes to community assembly were more pronounced in phase II than in phase I. The microalgal dynamics triggered by paucibactin A coincided with the succession of the PA and FL bacterial communities. The lysis of cyanobacteria in phase I favored the growth of microbial organic matter degraders in both the PA (e.g., Aeromonas and Rheinheimera) and FL (e.g., Vogesella) bacterial communities. In phase II, Lacibacter, Phycisphaeraceae, and Hydrogenophaga in the PA bacterial community and Lacibacter, Peredibacter, and Prosthecobacter in the FL bacterial community showed increased relative abundances. Overall, the FL bacterial community exhibited greater sensitivity to the two sequential processes compared with the PA bacterial community. These results highlight the need for studies evaluating the impact of biological cyanocides on aquatic ecosystems when used to control natural cyanobacterial blooms.

Effect of rainfall in shaping microbial community during Microcystis bloom in Nakdong River, Korea.

Various environmental factors play a role in the formation and collapse of Microcystis blooms. This study investigates the impact of heavy rainfall on cyanobacterial abundance, microbial community composition, and functional dynamics in the Nakdong River, South Korea, during typical and exceptionally rainy years. The results reveal distinct responses to rainfall variations, particularly in cyanobacterial dominance and physicochemical characteristics. In 2020, characterized by unprecedented rainfall from mid-July to August, Microcystis blooms were interrupted significantly, exhibiting lower cell densities and decreased water temperature, compared to normal bloom patterns in 2019. Moreover, microbial community composition varied, with increases in Gammaproteobacteria and notably in genera of Limnohabitans and Fluviicola. These alterations in environmental conditions and bacterial community were similar to those of the post-bloom period in late September 2019. It shows that heavy rainfall during summer leads to changes in environmental factors, consequently causing shifts in bacterial communities akin to those observed during the autumn-specific post-bloom period in typical years. These changes also accompany shifts in bacterial functions, primarily involved in the degradation of organic matter such as amino acids, fatty acids, and terpenoids, which are assumed to have been released due to the significant collapse of cyanobacteria. Our results demonstrate that heavy rainfall in early summer induces changes in the environmental factors and subsequently microbial communities and their functions, similar to those of the post-bloom period in autumn, leading to the earlier breakdown of Microcystis blooms.

Development of Wafer-Type Plasma Monitoring Sensor with Automated Robot Arm Transfer Capability for Two-Dimensional In Situ Processing Plasma Diagnosis.

In this work, we propose our newly developed wafer-type plasma monitoring sensor based on a floating-type double probe method that can be useful for two-dimensional (2D) in situ plasma diagnosis within a semiconductor processing chamber. A key achievement of this work is the first realization of an ultra-thin plasma monitoring sensor with a system thickness of ~1.4 mm, which supports a fully automated robot arm transfer capability for in situ plasma diagnosis. To the best of our knowledge, it is the thinnest accomplishment among all wafer-type plasma monitoring sensors. Our proposed sensor is assembled with two Si wafers and SiO2-based probes; accordingly, it makes it possible to monitor the actual dynamics of processing plasmas under electrostatic chucking (ESC) conditions. Also, it allows for the prevention of chamber contamination issues after continuously exposing the radio frequency (RF) to various processing gases. Using a test-bed chamber, we successfully demonstrated the feasibility and system performance of the proposed sensor, including robot arm transfer capability, vacuum and thermal stress durability, and data integrity and reproducibility. Consequently, compared with the conventional plasma diagnostic tools, we expect that our proposed sensor will be highly beneficial for tool-to-tool matching (TTTM) and/or for studying various plasma-related items by more accurately providing the parameters of processing plasmas, further saving both time and manpower resources required for preventive maintenance (PM) routines as well.

Fulvestrant alleviates cisplatin-induced acute kidney injury via repression of BNIP3-mediated apoptosis and autophagy.

Cisplatin-induced acute kidney injury (AKI) is a clinical disease characterized by a sudden loss of renal function within a few hours or days, due to cisplatin uptake. Fulvestrant is an oestrogen receptor alpha (ERα) antagonist used for endocrine therapy. However, the role of fulvestrant in cisplatin-induced AKI remains unclear. In this study, we investigated the effects of fulvestrant on the regulation of apoptotic cell death and autophagic response in cisplatin-induced AKI. The human kidney proximal tubule epithelial cell line (HK-2) was co-treated with fulvestrant and cisplatin. C57BL/6 mice were subcutaneously injected with fulvestrant and cisplatin was administered via intraperitoneal injection. First, cisplatin treatment increased ERα expression, apoptosis, and autophagy in HK-2 cells. Fulvestrant treatment decreased apoptosis and autophagy, which were accompanied by cisplatin treatment in HK-2 cells. Consistent with in vitro results, cisplatin treatment significantly increased ERα expression in vivo. Additionally, cisplatin treatment increased renal injury, apoptosis, and autophagy. Surprisingly, compared to that in the cisplatin-treated mice group, reduced cisplatin-induced renal injury, apoptosis, and autophagy was observed in the cisplatin+fulvestrant-treated mice group. In summary, these results suggest that fulvestrant plays an important role in cisplatin-induced AKI by decreasing apoptosis and autophagy.

Muricauda myxillae sp. nov., isolated from a marine sponge (Myxilla rosacea), and reclassification of Flagellimonas hymeniacidonis as Muricauda symbiotica nom. nov.

A Gram-stain-negative, aerobic and non-motile rods strain, designated as strain 2012CJ39-3T, was isolated from a marine sponge, Myxilla rosacea, collected on Chuja Island, Republic of Korea. Optimal growth of strain 2012CJ39-3T was observed at 25 °C, pH 7.0 and in the presence of 2.0-3.0 % (w/v) NaCl. Strain 2012CJ39-3T contained menaquinone-6 as the respiratory quinone, iso-C15 : 1 G, iso-C15 : 0, and iso-C17 : 0 3-OH as the predominant fatty acids, and phosphatidylethanolamine, an unidentified phospholipid, an unidentified glycolipid, three unidentified aminolipids and nine unidentified lipids as major polar lipids. The genomic DNA G+C content was 38.4 mol%. Results of phylogenetic analyses based on the 16S rRNA gene and whole-genome sequences revealed that strain 2012CJ39-3T formed a distinct phyletic lineage in the genus Muricauda. Strain 2012CJ39-3T was most closely related to Flagellimonas hymeniacidonis 176CP5-101T, Muricauda spongiicola 2012CJ35-5T, Muricauda algicola AsT0115T, Muricauda flava DSM 22638T and Muricauda parva SW169T with 96.5, 96.4, 96.3, 95.8 and 95.6 % 16S rRNA gene sequence similarity, respectively. The average nucleotide identity and digital DNA-DNA hybridization values between strain 2012CJ39-3T and M. spongiicola 2012CJ35-5T, F. hymeniacidonis 176CP5-101T, M. algicola AsT0115T, M. flava DSM 22638T and M. parva SW169T were 75.6, 74.2, 78.6, 75.3 and 74.8 % and 27.4, 19.9, 36.3, 24.2 and 18.9 %, respectively. Based on these results, strain 2012CJ39-3T represents a novel species of the genus Muricauda, for which the name Muricauda myxillae sp. nov. is proposed. The type strain is 2012CJ39-3T (=KACC 22644T= LMG 32582T). In addition, Flagellimonas hymeniacidonis is reclassified as Muricauda symbiotica nom. nov.

Ensemble Machine Learning of Gradient Boosting (XGBoost, LightGBM, CatBoost) and Attention-Based CNN-LSTM for Harmful Algal Blooms Forecasting.

Harmful algal blooms (HABs) are a serious threat to ecosystems and human health. The accurate prediction of HABs is crucial for their proactive preparation and management. While mechanism-based numerical modeling, such as the Environmental Fluid Dynamics Code (EFDC), has been widely used in the past, the recent development of machine learning technology with data-based processing capabilities has opened up new possibilities for HABs prediction. In this study, we developed and evaluated two types of machine learning-based models for HABs prediction: Gradient Boosting models (XGBoost, LightGBM, CatBoost) and attention-based CNN-LSTM models. We used Bayesian optimization techniques for hyperparameter tuning, and applied bagging and stacking ensemble techniques to obtain the final prediction results. The final prediction result was derived by applying the optimal hyperparameter and bagging and stacking ensemble techniques, and the applicability of prediction to HABs was evaluated. When predicting HABs with an ensemble technique, it is judged that the overall prediction performance can be improved by complementing the advantages of each model and averaging errors such as overfitting of individual models. Our study highlights the potential of machine learning-based models for HABs prediction and emphasizes the need to incorporate the latest technology into this important field.

A child who presented with cerebral infarction: Clipping combined with bypass surgery of a thrombosed giant aneurysm.

Background: Cerebral aneurysms are not common among children and most of them are presented with subarachnoid hemorrhage or mass effect. Here, we describe a rare case of a pediatric giant aneurysm presented with cerebral infarction. Case Description: A 38-month-old boy visited the emergency room due to left hemiparesis and left central type facial palsy. Initial magnetic resonance imaging showed acute cerebral infarction on the right basal ganglia and coronal radiata. Furthermore, a thrombosed aneurysm with a diameter of 30.57 mm at the frontal branch of the right middle cerebral artery was observed. A right pterional craniotomy with Sylvian dissection was performed. Superior and inferior divisions of the frontal branch originating from the aneurysm were identified. The superior division was cutoff from an aneurysm and clipping saving the inferior division was done. Subsequently, end-to-end anastomosis was done between a parietal branch of the superficial temporal artery and a superior division from the aneurysm. No acute complication from the operation was observed. Motor power of the left upper extremity recovered after rehabilitation, while fine motor impairment remained 6 months after the surgery. Conclusion: This case illustrates successful treatment of a pediatric giant aneurysm with extremely rare presentation of cerebral infarction, under a meticulous surgical plan and ad hoc modification.

Risk factors for unplanned reoperation after corrective surgery for adult spinal deformity.

To determine the major risk factors for unplanned reoperations (UROs) following corrective surgery for adult spinal deformity (ASD) and their interactions, using machine learning-based prediction algorithms and game theory. Patients who underwent surgery for ASD, with a minimum of two-year follow-up, were retrospectively reviewed. In total, 210 patients were included and randomly allocated into training (70% of the sample size) and test (the remaining 30%) sets to develop the machine learning algorithm. Risk factors were included in the analysis, along with clinical characteristics and parameters acquired through diagnostic radiology. Overall, 152 patients without and 58 with a history of surgical revision following surgery for ASD were observed; the mean age was 68.9 years (SD 8.7) and 66.9 years (SD 6.6), respectively. On implementing a random forest model, the classification of URO events resulted in a balanced accuracy of 86.8%. Among machine learning-extracted risk factors, URO, proximal junction failure (PJF), and postoperative distance from the posterosuperior corner of C7 and the vertical axis from the centroid of C2 (SVA) were significant upon Kaplan-Meier survival analysis. The major risk factors for URO following surgery for ASD, i.e. postoperative SVA and PJF, and their interactions were identified using a machine learning algorithm and game theory. Clinical benefits will depend on patient risk profiles.

A Self-Crystallized Nanofibrous Ni-GDC Anode by Magnetron Sputtering for Low-Temperature Solid Oxide Fuel Cells.

The optimum composition ratio of the anode cermet (Ni-GDC) for solid oxide fuel cells (SOFCs) varies because the electron-collecting mechanism is different depending on its applications. A Co-sputtering method facilitates ratio control with sputtering power adjustment. However, there is a practical issue with fabricating anode cermet with various ratios attributed to the large sputtering yield gap of the metal target, Ni, and the ceramic target, gadolinia-doped ceria (GDC). Therefore, in this study, a Gd-Ce metal alloy was applied instead of GDC to match the sputtering rate with that of Ni, which enables a wide ratio range achievement. A thin film of Gd-Ce oxidized after deposition and successfully transformed to crystallized GDC under a SOFC operation environment. X-ray diffraction (XRD) and high-resolution transmission electron microscopy (HRTEM) confirmed its crystallinity, and the film deposited with various power ratios was sputtered on the ScSZ electrolyte pellet to clarify the optimum Ni-GDC ratio for thin-film SOFCs. Last, the Ni-GDC was applied to anodized aluminum oxide (AAO)-supported SOFCs to maximize the performance. The performance change according to the thickness of Ni-GDC was identified, and the best performance among them was 638 mW/cm2 at 500 °C.

Clinical Effect of Transverse Process Hook with K-Means Clustering-Based Stratification of Computed Tomography Hounsfield Unit at Upper Instrumented Vertebra Level in Adult Spinal Deformity Patients.

OBJECTIVE: This study aimed to investigate the efficacy of transverse process (TP) hook system at the upper instrumented vertebra (UIV) for preventing screw pullout in adult spinal deformity surgery using the pedicle Hounsfield unit (HU) stratification based on K-means clustering. METHODS: We retrospectively reviewed 74 patients who underwent deformity correction surgery between 2011 and 2020 and were followed up for >12 months. Pre- and post-operative data were used to determine the incidence of screw pullout, UIV TP hook implementation, vertebral body HU, pedicle HU, and patient outcomes. Data was then statistically analyzed for assessment of efficacy and risk prediction using stratified HU at UIV level alongside the effect of the TP hook system. RESULTS: The screw pullout rate was 36.4% (27/74). Perioperative radiographic parameters were not significantly different between the pullout and non-pullout groups. The vertebral body HU and pedicle HU were significantly lower in the pullout group. K-means clustering stratified the vertebral body HU ≥205.3, <137.2, and pedicle HU ≥243.43, <156.03. The pullout rate significantly decreases in patients receiving the hook system when the pedicle HU was from ≥156.03 to < 243.43 (p<0.05), but the difference was not statistically significant in the vertebra HU stratified groups and when pedicle HU was ≥243.43 or <156.03. The postoperative clinical outcomes improved significantly with the implementation of the hook system. CONCLUSION: The UIV hook provides better clinical outcomes and can be considered a preventative strategy for screw-pullout in the certain pedicle HU range.

Predictive risk factors for mechanical complications after multilevel posterior cervical instrumented fusion.

OBJECTIVE: Mechanical complications should be considered following the correction of multilevel posterior cervical instrumented fusion. This study aimed to investigate clinical data on the patients' pre- and postoperative cervical alignment in terms of the incidence of mechanical complications after multilevel posterior cervical instrumented fusion. METHODS: Between January 2008 and December 2018, 156 consecutive patients who underwent posterior cervical laminectomy and instrumented fusion surgery of 4 or more levels and were followed up for more than 2 years were included in this study. Age, sex, bone mineral density (BMD), BMI, mechanical complications, and pre- and postoperative radiographic factors were analyzed using multivariate logistic regression analysis to investigate the factors related to mechanical complications. RESULTS: Of the 156 patients, 114 were men and 42 were women; the mean age was 60.38 years (range 25-83 years), and the mean follow-up duration of follow-up was 37.56 months (range 24-128 months). Thirty-seven patients (23.7%) experienced mechanical complications, and 6 of them underwent revision surgery. The significant risk factors for mechanical complications were low BMD T-score (-1.36 vs -0.58, p = 0.001), a large number of fused vertebrae (5.08 vs 4.54, p = 0.003), a large preoperative C2-7 sagittal vertical axis (SVA; 32.28 vs 23.24 mm, p = 0.002), and low preoperative C2-7 lordosis (1.85° vs 8.83°, p = 0.001). The clinical outcomes demonstrated overall improvement in both groups; however, the neck visual analog scale, Neck Disability Index, and Japanese Orthopaedic Association scores after surgery were significantly worse in the mechanical complication group compared with the group without mechanical complications. CONCLUSIONS: Low BMD, a large number of fused vertebrae, a large preoperative C2-7 SVA, and low C2-7 lordosis were significant risk factors for mechanical complications after posterior cervical fusion surgery. The results of this study could be valuable for preoperative counseling, medical treatment, or surgical planning when multilevel posterior cervical instrumented fusion surgery is performed.

Decreased mitophagy aggravates benign prostatic hyperplasia in aged mice through DRP1 and estrogen receptor α.

Benign prostatic hyperplasia (BPH) is an age-related disease, whose etiology largely remains unclear. The regulation of mitophagy plays a key role in aging and associated diseases, however, its function in BPH has not been studied. Although the expression of the androgen receptor is primarily implicated in BPH, the estrogen receptor (ER) has been reported to be involved in the development of BPH by mediating the proliferation of prostate cells. Here, we studied the involvement of mitophagy and ERs in spontaneous BPH in aging mice and investigated their functions. To identify the activation of mitophagy and expression of ERs, 8-week, 12-month, and 24-month-old mice were used. Mice were treated with mitochondrial division inhibitor mdivi-1, a dynamin-related protein 1 (Drp1) inhibitor, to examine the expression of mitophagy-related proteins and the development of BPH. In addition, prostate stromal cells were treated with an ER antagonist to investigate the regulation of mitophagy following the expression of ERs. With aging, the Drp1 and phosphorylation of parkin reduce. Electron microscopy revealed reduced mitochondrial fission and mitophagy. In addition, the expression of androgen receptor was decreased and that of ERα was increased in aged mice with BPH. Treatment with mdivi-1 exacerbated BPH and increased cell proliferation. In addition, blockade of ERα increased mitophagy and decreased cell proliferation. In conclusion, mitophagy is reduced with aging during the development of BPH. We speculate that spontaneous BPH progresses through the reduction in the expression of ERα in aged mice by downregulating mitophagy.

Silencing of LLGL2 Suppresses the Estradiol-Induced BPH-1 Cell Proliferation through the Regulation of Autophagy.

Lethal giant larvae (Lgl) is an apical-basal polarity gene first identified in Drosophila. LLGL2 is one of the mammalian homologs of Lgl. However, little is known about its function in the prostate. In this study, to explore the new role of LLGL2 in the prostate, we examined the proliferative activity of a BPH-1 cell line, a well-established model for the human prostate biology of benign prostatic hyperplasia (BPH). The expression of LLGL2 was dose-dependently increased in BPH-1 cells after treatment with 17ß-estradiol (E2). Additionally, E2 treatment increased the proliferation of the BPH-1 cells. However, the knockdown of LLGL2 with siRNA significantly suppressed the proliferation of the E2-treated BPH-1 cells. Moreover, si-llgl2 treatment up-regulated the expression of LC-3B, ATG7, and p-beclin, which are known to play a pivotal role in autophagosome formation in E2-treated BPH-1 cells. Overexpression of LLGL2 was able to further prove these findings by showing the opposite results from the knockdown of LLGL2 in E2-treated BPH-1 cells. Collectively, our results suggest that LLGL2 is closely involved in the proliferation of prostate cells by regulating autophagosome formation. These results provide a better understanding of the mechanism involved in the effect of LLGL2 on prostate cell proliferation. LLGL2 might serve as a potential target in the diagnosis and/or treatment of human BPH.

The extract of Celtis choseniana Nakai alleviates testosterone-induced benign prostatic hyperplasia through inhibiting 5α reductase type 2 and the Akt/NF-κB/AR pathway.

Benign prostatic hyperplasia (BPH) is a chronic male disease characterized by the enlarged prostate. Celtis chosenianaNakai (C. choseniana) is medicinally used to alleviate pain, gastric disease, and lung abscess. In this study, the effect of C. choseniana extract on BPH was investigated using testosterone-induced rats. Sprague Dawley rats were divided into five groups: control, BPH (testosterone 5 mg·kg-1), Fina (finasteride 2 mg·kg-1), and C. choseniana (50 and 100 mg·kg-1). After four weeks of TP treatment with finasteride or C. choseniana, prostate weights and DHT levels were measured. In addition, the prostates were histopathologically examined and measured for protein kinase B (Akt)/nuclear factor-κB (NF-κB)/AR signaling, proliferation, apoptosis, and autophagy. Prostate weight and epithelial thickness were reduced in the C. choseniana groups compared with that in the BPH group. The extract of C. choseniana acted as a 5α reductase inhibitor, reducing DHT levels in the prostate. Furthermore, the extract of C. choseniana blocked the activation of p-Akt, nuclear NF-κB activation and reduced the expression of AR and PSA compared with BPH. Moreover, the expression of Bax, PARP-1, and p53 increased, while the expression of bcl-2 decreased. The present study demonstrated that C. choseniana extract alleviated testosterone-induced BPH by suppressing 5α reductase and Akt/NF-κB activation, reducing AR signaling and inducing apoptosis and autophagy in the prostate. These results suggested that C. choseniana probably contain potential herbal agents to alleviate BPH.

Impact assessment of on-site swine wastewater treatment facilities on spatiotemporal variations of nitrogen loading in an intensive livestock farming watershed.

Excess nitrogen (N) resulting from human activity causes environmental issues, including eutrophication in agricultural watersheds with intensive livestock farming. Among the N sources in Korea, on-site swine wastewater treatment facilities (OSWTFs) tend to be densely distributed in watersheds with intensive livestock farming. Therefore, it is critical to sustainably manage livestock excreta. This study used the Soil and Water Assessment Tool (SWAT) to investigate the effects of various pollution sources, including OSWTFs, on N loads in rivers in the Cheongmi watershed, which is an intensive livestock farming and agricultural area in Korea. The simulated hydrological and water quality outputs were calibrated and validated for 2012-2019 using Sequential Uncertainty Fitting ver. 2 in the SWAT-Calibration and Uncertainty Program. The hydrological simulations agreed with the observations, with a correlation coefficient (R2) of ≥ 0.8 and Nash-Sutcliffe coefficient of 0.67-0.86. The simulated total N (TN) was also strongly correlated with the observed monthly average loading (R2, 0.36-0.73) and annual average concentration (R2 ≥ 0.5), demonstrating the reliability of the model constructed herein. A simulation of management scenarios indicates that, if the permissible N concentration in effluent from OSWTFs was reduced to 60 mg N/L, the TN concentrations in rivers would decrease by up to 50%. The findings of this study indicate that more stringent effluent water quality standards are required for OSWTFs to protect water quality and aquatic ecosystems in intensive swine farming watersheds.

Does Graft Position Affect Subsidence After Anterior Cervical Discectomy and Fusion?

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Implant subsidence is an important prognostic factor after anterior cervical discectomy and fusion (ACDF). Our purpose in this study was to investigate whether graft position affects subsidence after ACDF and to determine if there is a difference in clinical results based on allograft subsidence and position. METHODS: We reviewed 92 patients who underwent single-level ACDF with allograft and plate between January 2012 and October 2018. Treatment levels were divided based on allograft position within 2 mm of the posterior margin of the augmented plate (Anterior group) or at greater than 2 mm (Center group). Subsidence was defined as segmental vertebral body height decrease of 2 mm or more at 1 year compared to 1 week after surgery. RESULTS: Overall subsidence prevalence was 15 (16%) cases. Subsidence was 11% in the Anterior group (8/73) and 39% in the Center group (7/19; P = .012). The subsidence group showed smaller graft footprint size (graft/endplate ratio) compared with the nonsubsidence group, and pseudarthrosis occurred frequently in the subsidence. There was no significant difference in clinical results according to graft position. These findings indicate that anterior graft position reduces risk of subsidence (95% confidence interval = 0.085-0.949). CONCLUSION: To minimize risk of subsidence, the graft should be positioned on the anterior position of the surgical-level endplate. In addition, using a graft appropriate for endplate size will further reduce subsidence.

Stauntonia hexaphylla Extract Ameliorates Androgenic Alopecia by Inhibiting Androgen Signaling in Testosterone-induced Alopecia Mice.

Background: Stauntonia hexaphylla has been a traditional folk remedy for alleviating fever and providing anti-inflammatory properties. Androgenetic alopecia (AGA) is the most common form mediated by the presence of the dihydrotestosterone (DHT). Objectives: In this study, we evaluated the effects of an extract of S. hexaphylla on AGA models and its mechanisms of action. Methods: We studied S. hexaphylla extract to evaluate 5α-reductase and androgen receptor (AR) levels, apoptosis, and cell proliferation in vitro and in vivo. In addition, paracrine factors for androgenic alopecia, such as transforming growth factor beta-1 (TGF-ß1) and dickkopf-a (DKK-1), were examined. Apoptosis was investigated, and the evaluation of proliferation was examined with cytokeratin 14 (CK-14) and proliferating cell nuclear antigen (PCNA). Results: In human follicular dermal papilla cells, the 5α-reductase and AR were decreased following S. hexaphylla treatment, which reduced the Bax/Bcl-2 ratio. Histologically, the dermal thickness and follicle number were higher in the S. hexaphylla groups compared with the AGA group. In addition, the DHT concentration, 5α-reductase, and AR were decreased, thereby downregulating TGF-ß1 and DKK-1 expression and upregulating cyclin D in S. hexaphylla groups. The numbers of keratinocyte-positive and PCNA-positive cells were increased compared to those in the AGA group. Conclusions: The present study demonstrated that the S. hexaphylla extract ameliorated AGA by inhibiting 5α-reductase and androgen signaling, reducing AGA paracrine factors that induce keratinocyte (KC) proliferation, and inhibition apoptosis and catagen prematuration.

Which Is More Predictive Value for Mechanical Complications: Fixed Thoracolumbar Alignment (T1 Pelvic Angle) Versus Dynamic Global Balance Parameter (Odontoid-Hip Axis Angle).

OBJECTIVE: In this study, we investigate about relationship between postoperative global sagittal imbalance and occurrence of mechanical complications after adult spinal deformity (ASD) surgery. In global sagittal balance parameters, odontoid-hip axis (OD-HA) angle and T1 pelvic angle (TPA) were analyzed. METHODS: Between January 2009 and December 2016, 199 consecutive patients (26 males and 173 females) with ASD underwent corrective fusion of more than 4 levels and were followed up for more than 2 years. Immediate postoperative and postoperative 2 years whole spine x-rays were checked for evaluating immediate postoperative OD-HA, TPA, and other parameters. In clinical outcomes, back and leg pain visual analogue scale, Scoliosis Research Society-22 spinal deformity questionnaire (SRS-22), Oswestry Disability Index (ODI), 36- item Short Form Health Survey (SF-36) were evaluated. RESULTS: Based on the occurrence of mechanical complications, a comparative analysis was performed for each parameter. In univariable analysis, mechanical complications were significantly much more occurred in OD-HA abnormal group (odds ratio [OR], 3.296; p < 0.001; area under the curve [AUC] = 0.645). In multivariable analysis, the result was much more related (OR, 2.924; p = 0.001; AUC = 0.727). In contrast, there was no significant difference between normal and the occurrence of mechanical complications in TPA. In clinical outcomes (normal vs. abnormal), the differences of SRS-22 (0.88 ± 0.73 vs. 0.68 ± 0.64, p = 0.042), ODI (-24.72 ± 20.16 vs. -19.01 ± 19.95, p = 0.046), SF-36 physical composite score (19.33 ± 18.55 vs. 12.90 ± 16.73, p = 0.011) were significantly improved in OD-HA normal group. CONCLUSION: The goal of ASD surgery is to improve patient life quality through correction. In our study, TPA was associated with spinopelvic parameter and OD-HA angle was associated with health-related quality of life and complications. OD-HA angle is predictable factor for mechanical complications after ASD surgery.