Mask-induced dermatoses during the COVID-19 pandemic: a questionnaire-based study in 12 Korean hospitals.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM: To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS: From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS: Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION: Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.

Comparison of various anthropometric indices for the identification of a predictor of incident hypertension: the ARIRANG study.

We compared the predictive capability of weight, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), body mass index (BMI), body roundness index (BRI), and a body shape index (ABSI) to identify incident hypertension, and to determine whether any of these indices may be used as a better single predictor of incident hypertension. A total of 1718 participants aged 39-72 years were collected  in a longitudinal study. Logistic regression models were used to evaluate various anthropometric indices as significant predictors of hypertension. During 2.8 years of follow-up, 185 new cases of hypertension (10.8%) were reported. The BRI and ABSI were significantly higher in the participants who had developed hypertension than in those who had not (4.15 ± 1.01 vs. 3.57 ± 1.03, 0.80 ± 0.04 vs. 0.78 ± 0.05; respectively, p < 0.001). After adjusting for confounding variables, logistic regression analysis indicated that participants within the highest quartile of WC and WHtR were 4.79 and 4.51 times more likely to have hypertension than those within the lowest quartile (OR 4.79, 95% CI 2.49-9.20 vs. OR 4.51, 95% CI 2.41-8.43, respectively, p < 0.0001); in contrast, no such correlation was found for BMI, WHR, BRI, and ABSI. WC (AUC: 0.672) showed a more powerful predictive ability for hypertension (p < 0.0001) than BMI (AUC: 0.623), and an equal predictive power for hypertension as WHtR (AUC: 0.662) and BRI (AUC: 0.662) in the general population. We concluded that WC and/or WHtR but not BMI, showed superior prediction capability compared to WHR, BRI, and ABSI, for determining the incidence of hypertension in a community-based prospective study.

A direct role for hepatitis B virus X protein in inducing mitochondrial membrane permeabilization.

Hepatitis B virus X protein (HBx) acts as a multifunctional protein that regulates intracellular signalling pathways during HBV infection. It has mainly been studied in terms of its interaction with cellular proteins. Here, we show that HBx induces membrane permeabilization independently of the mitochondrial permeability transition pore complex. We generated mitochondrial outer membrane-mimic liposomes to observe the direct effects of HBx on membranes. We found that HBx induced membrane permeabilization, and the region comprising the transmembrane domain and the mitochondrial-targeting sequence was sufficient for this process. Membrane permeabilization was inhibited by nonselective channel blockers or by N-(n-nonyl)deoxynojirimycin (NN-DNJ), a viroporin inhibitor. Moreover, NN-DNJ inhibited HBx-induced mitochondrial depolarization in Huh-7 cells. Based on the results of this study, we can postulate that the HBx protein itself is sufficient to induce mitochondrial membrane permeabilization. Our finding provides important information for a strategy of HBx targeting during HBV treatment.

Mental Health Medication Use Correlates with Poor Outcome After Femoroacetabular Impingement Surgery in a Military Population.

BACKGROUND: Femoroacetabular impingement is a common cause of hip pain in young adults. Several preoperative risk factors for poor outcomes with surgery have been identified; however, to our knowledge, no study has attempted to determine the effect of psychiatric comorbidity on outcomes with femoroacetabular impingement surgery. METHODS: A retrospective review was performed on active-duty patients at one institution undergoing surgery for femoroacetabular impingement over five years. Medical records were reviewed for demographic characteristics, radiographic data, and history of mental health medication use. Return-to-duty status was considered the primary outcome measure. Outcome scores obtained included modified Harris hip scores, Single Assessment Numeric Evaluation scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, patient satisfaction, and Veterans RAND-12 scores. Patients taking mental health medication were compared with those who were not with regard to return to duty and validated patient-reported outcome measures. RESULTS: Ninety-three patients (mean age, 32.2 years) were available for follow-up at a mean duration of 3.6 years. Of the seventeen patients discharged from service postoperatively, twelve (71%) were taking mental health medications. One-third (twenty-five) of seventy-six patients who returned to duty were taking mental health medication and this difference was significant (p < 0.006). Patients taking mental health medication had significantly poorer modified Harris hip scores (p < 0.02), WOMAC scores (p < 0.0008), and Veterans RAND-12 mental scores (p < 0.001). Antidepressant, antipsychotic, and multiple mental health medication use were all predictive of medical discharge due to hip pain. CONCLUSIONS: Psychiatric comorbidities are an important risk factor in active-duty military personnel undergoing surgery for femoroacetabular impingement. Mental health medication use is associated with poorer outcome scores and can significantly lower the possibility of returning to active-duty status.

Gender differences in clinical and angiographic findings of patients with Takayasu arteritis.

OBJECTIVES: Because Takayasu arteritis (TA) predominantly affects females, few data regarding gender differences have been reported. The aim of the present study is to describe clinical features and angiographic findings of patients with TA according to gender. METHODS: According to the 1990 American College of Rheumatology criteria, 294 patients were diagnosed with TA between September 1994 and April 2014 at a single tertiary hospital. We reviewed clinical, laboratory, and radiologic data at the time of diagnosis. RESULTS: Among the 294 patients studied, 257 (87.4%) were female (male:female ratio=1:6.9). Female patients had a higher tendency to exhibit blood pressure differences between arms (p=0.595) and a weak pulse at the brachial artery (p=0.063). In male patients, we observed higher serum creatinine levels (p=0.038) and hypertension more frequently (p=0.061) than in females. Females exhibited more common lesions in the thoracic aorta and its branches, while males had more frequent lesions in the abdominal aorta and its branches. An analysis of angiographic classification according to the International TA Conference in Tokyo 1994 classification revealed that male patients had a higher incidence of type IV and females showed a higher incidence of types I, IIa, and IIb. CONCLUSIONS: Female patients with TA have more frequent involvement of the thoracic aorta and its branches, whereas involvement of the abdominal aorta and its branches is more common in males. Considering these gender-specific differences, adjustment of diagnostic criteria for TA according to gender may be necessary.

Usefulness of high-sensitivity troponin I for the monitoring of subclinical acute cellular rejection after cardiac transplantation.

BACKGROUND: There are conflicting data about the role of cardiac troponin I (cTnI) as determined by means of conventional methods for the prediction of acute rejection after heart transplantation (HT). The purpose of this study was to evaluate whether cTnI as measured by means of the early prototype high-sensitivity assay (hs-cTnI) can predict acute rejection episode after HT compared with grade of rejection in endomyocardial biopsy (EMB). METHODS: This was a single-center cross-sectional study evaluating cTnI levels with the use of both hs-cTnI and current less sensitive conventional cTnI (conv-cTnI) assays measured at the time of EMB after HT. We calculated an index ratio of observed cTnI to expected mean cTnI for each individual patient defined as the mean cTnI measurements at EMB 60 days after HT. RESULTS: A total of 252 biopsies from 47 patients were included in this study. In the multivariable mixed model analysis in relation to the presence of acute rejection 60 days after HT, hs-cTnI level was significantly related to the presence of rejection (P = .010). The hs-cTnI ratio index was significantly higher at the time of rejection (median, 1.37; interquartile range [IQR], 1.23-2.88) compared with those without rejection (median, 0.90; IQR, 0.51-1.16; P < .001). In receiver operating characteristic curve analysis, an hs-cTnI ratio index of ≥1.17 could predict the acute rejection with a sensitivity of 82.4% and a specificity of 77.1%. CONCLUSIONS: An increased hs-cTnI ratio index was significantly related to rejection episodes. Serial monitoring of hs-cTnI and comparing it with the values without rejection might be useful for the detection of acute rejection after HT.

Comparison of outcomes between endovascular treatment and bypass surgery in Takayasu arteritis.

OBJECTIVES: There is currently a lack of evidence regarding the optimal revascularization method for Takayasu arteritis (TA). This study compares outcomes between endovascular treatment and surgical therapy in TA patients requiring revascularization. METHOD: From September 1994 to January 2011, 235 patients were diagnosed with TA according to the diagnostic criteria of the 1990 American College of Rheumatology, and of these, arterial revascularizations were performed in 65 (27.7%). Symptomatic or angiographic recurrence and peri-operative use of immunosuppressive drugs were investigated by retrospectively reviewing medical records. RESULTS: A total of 111 arterial lesions in the 65 (27.7%) patients were revascularized during the follow-up period (median 3.2 years, range 0.01-12.7 years). At the 2-year follow-up, the symptomatic recurrence rate was significantly higher in the endovascular treatment group (32.3% vs. 11.5%, p = 0.016), as was the incidence of angiographic recurrence (32.1% vs. 11.1%, p = 0.026). The symptomatic recurrence rate was not influenced by the need for peri-operative immunosuppressive drugs (20% vs. 34.1%, p = 0.34). CONCLUSIONS: In TA patients, surgical revascularization seems to be superior to endovascular treatment with regard to patency. Further investigation to identify novel and optimal arterial revascularization methods for TA patients should be undertaken.

Evaluation of Anti-SE Bacteriophage as Feed Additives to Prevent Salmonella enteritidis (SE) in Broiler.

This experiment was conducted to evaluate anti-Salmonella enteritidis (anti-SE) bacteriophage as feed additives to prevent Salmonella enteritidis in broilers. The experimental diets were formulated for 2 phases feeding trial, and 3 different levels (0.05, 0.1 and 0.2%) of anti-SE bacteriophage were supplemented in basal diet. The basal diet was regarded as the control treatment. A total of 320 1-d-old male broilers (Ross 308) were allotted by randomized complete block (RCB) design in 8 replicates with 10 chicks per pen. All birds were raised on rice hull bedding in ambient controlled environment and free access to feed and water. There were no significant differences in body weight gain, feed intake and feed conversion ratio (FCR) at terminal period among treatments (p>0.05). Relative weights of liver, spleen, abdominal fat and tissue muscle of breast obtained from each anti-SE bacteriophage treatment were similar to control, with a slightly higher value in anti-SE bacteriophage 0.2%. In addition, a numerical difference of glutamic-oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT) and LDL cholesterol level was observed in the 0.2% anti-SE bacteriophage application even though blood profiles were not significantly affected by supplemented levels of anti-SE bacteriophage (p>0.05). In the result of a 14 d record after Salmonella enteritidis challenge of 160 birds from 4 previous treatments, mortality was linearly decreased with increasing anti-SE bacteriophage level (p<0.05), and Salmonella enteritidis concentration in the cecum was decreased with increasing levels of anti-SE bacteriophage (p<0.05). Based on the results of this study, it is considered that supplementation of 0.2% anti-SE bacteriophage may not cause any negative effect on growth, meat production, and it reduces mortality after Salmonella enteritidis challenge. These results imply to a possible use of anti-SE bacteriophage as an alternative feed additive instead of antibiotics in broilers diet.

Diagnostic yield of fluoroscopy-guided biopsy for infectious spondylitis.

BACKGROUND AND PURPOSE: CT is currently the method of choice for guiding biopsy of lesions of the spine. However, in our hospital, fluoroscopy-guided percutaneous biopsy has been preferred for several years because of equipment availability and easy craniocaudal angulation. The aim of this study was to evaluate the efficacy of fluoroscopy-guided percutaneous biopsy in a clinical setting for diagnosing infectious spondylitis. MATERIALS AND METHODS: A retrospective study was performed to evaluate 170 fluoroscopy-guided percutaneous biopsies in 140 patients (male/female = 70:70; mean age, 65.1 years; range, 16-89 years) in a clinical setting who were suspected of having infectious spondylitis between July 2003 and March 2010. Diagnosis was based on pathologic confirmation by tissue or culture from biopsy. The percentage of adequate specimens for diagnosis, histopathologic diagnosis for infectious spondylitis, and positive cultures for causative organisms were evaluated by retrospective review of medical records. RESULTS: Adequate specimens for diagnosis were obtained in 165 of 170 cases (97.1%). The diagnosis of infectious spondylitis resulted in 134 of 170 cases confirmed through histopathology or clinical outcome (78.8%). In 51 of 134 cases (38.1%), the causative organism was confirmed by specimens from percutaneous bone biopsy. There were no biopsy-related major complications. The most common organism isolated was Mycobacterium tuberculosis (24 cases), followed by Staphylococcus aureus, Streptococcus agalactiae, and Streptococcus viridans. CONCLUSIONS: Fluoroscopy-guided percutaneous biopsy is as accurate and effective as CT-guided biopsy for diagnosing infectious spondylitis.

Technical note: Mice produced by intracytoplasmic sperm injection using a modified conventional method.

A piezo-driven pipette that includes a small amount of mercury to enhance efficiency is widely used for mouse intracytoplasmic sperm injection (ICSI). Unfortunately, the use of toxic mercury is not permitted in hospital facilities and alternatives to mercury that enhance performance of the device do not work as well in the mouse. We have eliminated mercury toxicity and obtained acceptable ICSI efficiency using a modified conventional method. With this technique, oocyte survival, fertilization (number of 2-cell) and blastocyst rates were 77/126 (61.1%), 65/77 (84.4%), and 45/65 (69.2%), respectively. Eleven live pups were born from the transfer of thirty-two 2- to 4-cell embryos to 2 surrogate mothers. This conventional method is efficient, simple, and does not need the assistance of piezo-driven devices.

The effect of a 1550 nm fractional erbium-glass laser in female pattern hair loss.

BACKGROUND: Female pattern hair loss (FPHL) is the most common cause of hair loss in women, and its prevalence increases with advancing age. Affected women may experience psychological distress and social withdrawal. A variety of laser and light sources have been tried for treatment of hair loss, and some success has been reported. OBJECTIVE: The purpose of this study was to determine the efficacy and safety of a 1550 nm fractional erbium-glass laser in treatment of female pattern hair loss. PATIENTS AND METHODS: Twenty eight ethnic South Korean patients with varying degrees of FPHL were enrolled in the study. Patients received ten treatments with a 1550 nm fractional Er:Glass Laser (Mosaic, Lutronic Co., Ltd, Seoul, South Korea) at 2-weeks intervals using the same parameters (5-10 mm tip, 6 mJ pulse energy, 800 spot/cm(2) density, static mode). Phototrichogram and global photographs were taken at baseline and at the end of laser treatment, and analysed for changes in hair density and hair shaft diameter. Global photographs underwent blinded review by three independent dermatologists using a 7-point scale. Patients also answered questionnaires assessing hair growth throughout the study. All adverse effects were reported during the study. RESULTS: Twenty seven patients completed a 5-month schedule of laser treatment. One patient was excluded during treatment due to occurrence of alopecia areata. At the initial visit, mean hair density was 100 ± 14/cm(2) , and mean hair thickness was 58 ± 12 µm. After 5 months of laser treatment, hair density showed a marked increase to 157 ± 28/cm(2) (P < 0.001), and hair thickness also increased to 75 ± 13 µm (P < 0.001). Global photographs showed improvement in 24 (87.5%) of the 27 patients. Two patients (7.4%) reported mild pruritus after laser treatment; however, these resolved within 2 h. CONCLUSION: A 1550 nm fractional erbium-glass laser irradiation may be an effective and safe treatment option for women with female pattern hair loss.

Simultaneous repair of two large cranial defects using rapid prototyping and custom computer-designed titanium plates: a case report.

Custom titanium cranioplasty plates, manufactured by a variety of techniques, have been used to repair a range of cranial defects. The authors present a case where two relatively large, adjacent cranial defects were repaired by custom computer-designed titanium plates. The two plates were designed and fabricated simultaneously using a unique methodology. A 28-year-old woman underwent a corpus callosotomy for medically intractable epilepsy. The surgery was complicated by unexpected haemorrhage which necessitated a second craniotomy. Subsequent deep infection required the removal of bilateral bone flaps, presenting a challenge in the reconstruction of extensive, bilateral but asymmetrical cranial defects. The patient underwent a head computed tomography scan, from which a rapid-prototype model of the skull was produced. The surfaces for the missing cranial segments were generated virtually using a combination of software products and two titanium plates that followed these virtual contours were manufactured to cover the defects. The cranioplasty procedure to implant both titanium cranial plates was performed efficiently with no intra-operative complications. Intra-operatively, an excellent fit was achieved. The careful planning of the plates enhanced the relative ease with which the cranial defects were repaired with an excellent cosmetic outcome.

Therapeutic trial of fluoroscopic interlaminar epidural steroid injection for axial low back pain: effectiveness and outcome predictors.

BACKGROUND AND PURPOSE: An ESI for managing LBP is one of the most commonly performed interventions. The purpose of this observational study was to assess the effect of a therapeutic trial of a fluoroscopic interlaminar ESI for axial LBP and to analyze the outcome predictors. MATERIALS AND METHODS: All patients who received an interlaminar ESI for axial LBP at our facility in 2007 and 2008 were included. Initial short-term follow-up was done at <1 month after ESI. ESI was considered effective if patients had a reduction of >50% in their pain scores. In July 2009, telephone interviews were conducted by using formatted questions including the NASS patient-satisfaction index. The symptom-free interval was computed by the Kaplan-Meier method. Outcome predictors such as age, sex, duration of LBP, and MR imaging findings were statistically analyzed by the Mann-Whitney U and the Fisher exact tests. RESULTS: Eighty-one patients (male/female = 16:65; mean age, 49.9 years; range, 17-77 years) were included in the study. The interlaminar ESI was effective in 63 of the 81 patients (77.8%) at initial short-term follow-up. For the 63 patients in whom ESI was effective, the median symptom-free interval was 154 days (95% CI, 96-212 days). Among 68 patients for whom telephone interviews were possible, 44 patients (64.7%) replied positively to the NASS patient satisfaction index (NASS patient-satisfaction index, 1 or 2). There were no significant outcome predictors. CONCLUSIONS: The therapeutic trial of a fluoroscopic interlaminar ESI was effective for axial LBP without significant outcome predictors.

Distracción osteogénica vertical de injerto microvascularizado de peroné para reconstrucción mandibular y optimización de la rehabilitación implantológica / Vertical distraction osteogenesis of microvascularised fibular grafts for mandibular reconstruction and optimisation of rehabilitation implantology

Introducción: En la actualidad, se considera que el injerto microvascularizado de peroné es la mejor opción de tratamiento para las reconstrucciones mandibulares de defectos óseos mayores de 6 cm. No obstante, debido a su limitada altura, presenta una importante desventaja en cuanto a la rehabilitación protésica, particularmente en aquellos casos de resecciones mandibulares parciales con una hemimandíbula contralateral dentada. Material y métodos: Presentamos un caso clínico de mixoma mandibular tratado mediante resección quirúrgica y reconstrucción mandibular primaria mediante injerto microvascularizado de peroné, al que se sometió a distracción osteogénica vertical para optimizar la posterior rehabilitación implantológica. Resultados: La discrepancia de altura se solucionó completamente y se colocaron tres implantes osteointegrados en el área distraída, lo cual permitió una rehabilitación protésica muy satisfactoria, tanto estética como funcionalmente. Conclusiones: La distracción osteogénica vertical de peroné constituye una excelente opción terapéutica para igualar la altura del peroné a la del reborde alveolar de la hemimandíbula dentada contralateral, tras la reconstrucción de defectos mandibulares extensos, de cara a una posterior rehabilitación implantológica, lo que permite llevar a cabo ésta con resultados, tanto funcionales como estéticos, muy satisfactorios. Además, no presenta los inconvenientes de otras técnicas empleadas en estos pacientes, como el peroné en doble barra (mayor dificultad técnica y mayor riesgo de trombosis en el pedículo) y el empleo de injertos “onlay” (morbilidad añadida en la zona de toma del injerto)(AU)

Introduction: Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it doesn’t offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. Materials and methods: We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma. The distraction device was applied intraorally. Distraction of 0.5 mm per day was performed followed by 3 months of consolidation period. Results: The vertical discrepancy between the fibula and the native hemimandible was corrected. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. Conclusions: We believe that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumour surgery(AU)

Deformability study of breast cancer cells using microfluidics.

Cell deformability is an important biomarker which can be used to distinguish between healthy and diseased cells. In this study, microfluidics is used to probe the biorheological behaviour of breast cancer cells in an attempt to develop a method to distinguish between non-malignant and malignant cells. A microfabricated fluidic channel design consisting of a straight channel and two reservoirs was used to study the biorheological behaviour of benign breast epithelial cells (MCF-10A) and non-metastatic tumor breast cells (MCF-7). Quantitative parameters such as entry time (time taken for the cell to squeeze into the microchannel) and transit velocity (speed of the cell flowing through the microchannel) were defined and measured from these studies. Our results demonstrated that a simple microfluidic device can be used to distinguish the difference in stiffness between benign and cancerous breast cells. This work lays the foundation for the development of potential microfluidic devices which can subsequently be used in the detection of cancer cells.

Transoral endoscopic-assisted management of subcondylar fractures in 17 patients: an alternative to open reduction with rigid internal fixation and closed reduction with maxillomandibular fixation.

The authors evaluate the results of transoral endoscopic-assisted open reduction and miniplate fixation of subcondylar fractures. Seventeen patients were treated from August 2005 to April 2007. Inclusion criteria were: adult patients, inability to achieve adequate occlusion with closed reduction, dislocation of the condylar fragment between 10 and 45 degrees , and 2-mm inter-fragment overlapping. Regular panoramic radiographs were taken postoperatively. Transbuccal incisions were used to place the screws for fixation in 15 patients. Pure intraoral access and angulated drills and screwdrivers were used in 2 patients. The condyle was placed into the condylar fossa in all cases. No damage to the facial nerve was observed. No visible scars were present. Mean surgical time was 80.36 minutes. Transitory hyposthesia was observed in 3 cases. Adequate reduction and consolidation of the fracture was achieved in 16 patients. No condylar reabsortion was present at the end of the follow-up period. The authors consider that transoral endoscopic-assisted open reduction constitutes a valid alternative to a transcutaneous approach for the reduction and fixation of subcondylar fractures in selected cases. It provides the benefits of open reduction and internal fixation without the potential complications. Advice is given on how to achieve adequate reduction and stability of the proximal fragment.

AFM indentation study of breast cancer cells.

Mechanical properties of individual living cells are known to be closely related to the health and function of the human body. Here, atomic force microscopy (AFM) indentation using a micro-sized spherical probe was carried out to characterize the elasticity of benign (MCF-10A) and cancerous (MCF-7) human breast epithelial cells. AFM imaging and confocal fluorescence imaging were also used to investigate their corresponding sub-membrane cytoskeletal structures. Malignant (MCF-7) breast cells were found to have an apparent Young's modulus significantly lower (1.4-1.8 times) than that of their non-malignant (MCF-10A) counterparts at physiological temperature (37 degrees C), and their apparent Young's modulus increase with loading rate. Both confocal and AFM images showed a significant difference in the organization of their sub-membrane actin structures which directly contribute to their difference in cell elasticity. This change may have facilitated easy migration and invasion of malignant cells during metastasis.

Emergency transcatheter embolization of ruptured hepatocellular carcinomas with tortuous conventional or aberrant hepatic vascular anatomy, or parasitic supply.

Emergency transcatheter embolization is a well-recognized measure to manage patients with life-threatening haemoperitoneum due to spontaneous ruptured hepatocellular carcinoma. Traditional embolization technique is to embolize the proper hepatic artery or the segmental hepatic artery by femoral approach using gelfoam pledgets. From 1997 to 2004, in 19 out of 96 embolizations, the embolization technique had to be modified because of tortuous conventional or aberrant hepatic vascular anatomy or parasitic supply to achieve successful embolization.

Placenta hominis protects osteoporosis in ovariectomized rats.

In China, Japan, and Korea, placenta hominis extracts (PHEs) are used clinically for the treatment of osteoporosis. The anti-osteoporotic effect of PHEs was studied. The trabecular bone area and thickness in OVX rats decreased by 50% from those in sham-operated rats; these decreases were completely inhibited by administration of PHEs for 7 weeks. Osteoclast numbers and the osteoblast surface were enhanced in OVX rats, but PHEs had no effect on these phenomena. Serum phosphorus and alkaline phosphatase in OVX rats increased compared to those in sham-operated rats, but the increases were not affected by the administration of PHEs. Thyroxine (T4) level was stimulated in OVX rats. The extracts inhibited the T4 level in the OVX rats. These results strongly suggest that PHEs be effective in preventing the development of bone loss induced by OVX in rats.