Can we recommend surgical treatment to the octogenarian with periampullary cancer?: National database analysis in South Korea.

BACKGROUND: The incidence of periampullary cancer in the elderly is increasing. Safety and oncologic effectiveness of pancreaticoduodenectomy in elderly patients is still controversial. MATERIALS AND METHODS: From 2002 to 2016, patients with periampullary cancer were evaluated. Customised health information data provided by the National Health Insurance Corporation (NHIS-2018-1-157) were used for analysis. Chronological changes in the incidence of periampullary cancer and long-term survival outcomes were estimated according to patients' age. RESULT: A total of 148,080 patients were found to have periampullary cancer. Chronologically, the incidence of periampullary cancer increased, and the proportion of elderly patients with periampullary cancer prominently increased (about 2.1 times in patients in their 70s and about 4.7 times in those older than 80 years). The number of patients with pylorus-preserving pancreaticoduodenectomy in their 70s (about 5.6 times, p < 0.001) and over 80 years of age (about 8.9 times, p < 0.001) was much higher than the number of patients aged younger than 50 years (about 1.7 times) and in their 60s (about 2.5 times). Long-term survival was different as per diagnosis (p < 0.001). In addition, it was observed that age was a factor attenuating the survival of patients with resected periampullary cancers (p < 0.001). However, in case of patients older than 80 years, those who underwent surgical treatment showed a higher survival rate than those who did not undergo surgical treatment. CONCLUSION: We can recommend surgical treatment for elderly patients with resectable periampullary cancer. The survival data in this study can be useful references especially in making treatment plan for octogenarians diagnosed with periampullary cancer.

Effects of Exercise on Sport Concussion Assessment Tool-Third Edition Performance in Women.

OBJECTIVE: The purpose of this study was to examine the influence of a brief exercise protocol on Sport Concussion Assessment Tool-Third Edition (SCAT3) performance in amateur women athletes. DESIGN: Cross-over repeated-measures design. SETTING: Off-season, uninjured community amateur athletes. PARTICIPANTS: We examined 87 amateur women athlete volunteers (age = 29.9, SD = 6.9 years). INDEPENDENT VARIABLES: Participants were assessed using the SCAT3 under 2 conditions: at rest and after a 5-minute physical exertion protocol, completed in a counterbalanced order. MAIN OUTCOME MEASURES: Participants' performance on the various components of the SCAT3 under the 2 conditions: at rest and after a 5-minute physical exertion protocol. RESULTS: No significant differences were detected between at-rest and postexercise conditions for the balance, orientation, or cognitive components of the SCAT3. There were no significant differences in the proportion of participants who endorsed specific symptoms at rest compared with the postexercise condition (P > 0.05). However, women athletes who rated their exertion after exercise as "hard" or greater (Borg scale rating 13-20) reported significantly greater blurred vision (M = 0.25, SD = 0.62 vs M = 0.00, SD = 0.00; P = 0.006) and fatigue/low energy (M = 1.38, SD = 1.17 vs M = 0.66, SD = 0.91; P = 0.002) symptoms after exercise than those who rated their exertion as "light" or lower (Borg scale rating 6-12). CONCLUSIONS: In this study of women athletes, a brief bout of exercise did not seem to adversely affect SCAT3 performance and had only small effects on self-reported symptoms. There were differences in symptom reporting, however, in the subgroup of women who rated their exertion levels as "hard" or greater; they reported more blurred vision and fatigue/low energy.

New scoring system for resectable hepatocellular carcinoma with a maximum tumor size of ≤5 cm based on preoperative tumor factors.

BACKGROUND: The aim of this study was to establish a new scoring system for hepatocellular carcinoma (HCC) that can be used to predict the postoperative prognosis of HCC patients. METHODS: A total of 359 HCC patients who underwent hepatectomy were included in this study. All eligible patients were randomly allocated to derivation cohort or validation cohort samples. We assigned one point each for preoperative factors identified in the derivation cohort, and the sum of the scores was used to classify the patients into high-risk and low-risk groups. The scoring system established using the derivation cohort was fitted to the validation cohort. RESULTS: The prognosis of the high-risk group was significantly poorer than that of the low-risk group in both the derivation and validation samples (p = 0.04, p < 0.01, respectively). In the high-risk group, major hepatectomy resulted in a significantly better prognosis than minor hepatectomy in both samples (p = 0.04, p = 0.03, respectively). On the other hand, the extent of hepatectomy did not influence the prognosis of the low-risk group in either sample (p = 0.14, p = 0.34, respectively). CONCLUSION: Our new scoring system can predict the treatment outcome of patients undergoing curative hepatectomy for HCC and could help determine the optimal extent of resection.

Effects of Exercise on Sport Concussion Assessment Tool-Third Edition Performance in Professional Athletes.

BACKGROUND: The Sport Concussion Assessment Tool-Third Edition (SCAT3) is currently considered the standard sideline assessment for concussions. In-game exercise, however, may affect SCAT3 performance and the diagnosis of concussions. PURPOSE: To examine the influence of exercise on SCAT3 performance in professional male athletes. STUDY DESIGN: Controlled laboratory study. METHODS: We examined the SCAT3 performance of 82 professional male athletes under 2 conditions: at rest and after exercise. RESULTS: Athletes reported significantly fewer total symptoms (mean, 1.0 ± 1.5 vs 1.6 ± 2.3 total symptoms, respectively; P = .008; Cohen d = 0.34), committed significantly fewer errors on the modified Balance Error Scoring System (mean, 3.5 ± 3.5 vs 4.6 ± 4.1 errors, respectively; P = .017; d = 0.31), and required significantly less time to complete the tandem gait test (mean, 9.5 ± 1.4 vs 9.9 ± 1.7 seconds, respectively; P = .02; d = 0.30) during the at-rest condition compared with the postexercise condition. CONCLUSION: The interpretation of in-game (sideline) SCAT3 results should consider the effects of postexercise fatigue levels on an athlete's performance, particularly if preseason baseline data have been collected when the athlete was well rested. CLINICAL RELEVANCE: Exercise appears to affect symptom burden and physical abilities, such as balance and tandem gait, more so than the cognitive components of the SCAT3.

Efficacy and Safety of Modified Pranlukast (Prakanon(®)) Compared with Pranlukast (Onon(®)): A Randomized, Open-Label, Crossover Study.

INTRODUCTION: Pranlukast is a leukotriene receptor antagonist (LTRA) that is used as an additional controller of mild to moderate asthma. This study compared the efficacy and side effects of two bioequivalent preparations of pranlukast: original pranlukast (Onon(®); Ono Pharmaceutical, Japan) and a modified formulation of pranlukast (Prakanon(®); Yuhan Co, Korea) in patients with mild to moderate asthma. METHODS: Of the 34 subjects screened, 30 patients who were using standard medication to control asthma and scored less than 20 points on the Asthma Control Test(™) (ACT) were assigned randomly to one of the two groups in a prospective, open label, crossover study: group 1 received Prakanon(®) (150 mg/day) and group 2 received Onon(®) (450 mg/day) for 8 weeks each; after a 1-week rest period, the groups were switched to the alternative medication for further 8 weeks and monitored for 2 more weeks without study medication. Evaluation parameters included the ACT, quality of life questionnaire adult Korean asthmatics (QLQAKA), pulmonary function tests, peripheral blood tests, vital signs, and adverse events. RESULTS: Thirty patients were enrolled and 21 completed the trial: 10 in group 1 and 11 in group 2. The baseline data of the two groups did not differ. No statistical significant differences were observed in efficacy and lung function at each time and in changes from baseline value between the two kinds of pranlukast. The final asthma control rate was 81% with Prakanon(®) and 76% with Onon(®). There were no differences in vital signs and laboratory data at each time and in changes from baseline value between the two drugs. There were no differences in adverse events between the two drugs. The most common side effect was abdominal pain. Drug compliance was high, without differences between the two drugs. CONCLUSION: These findings suggest that Prakanon(®) which is an improved formulation of pranlukast at a lower dose than the original formulation, Onon(®), has a similar efficacy and side effect profile in the control of persistent asthma.

The usefulness of low-dose CT scan in elderly patients with suspected acute lower respiratory infection in the emergency room.

OBJECTIVE: To evaluate the usefulness of low-dose CT (LDCT) for the diagnosis of acute lower respiratory infection (ALRI) in elderly patients in the emergency room (ER). METHODS: A total of 160 consecutive patients (mean age: 75.9 ± 9.2 years; range: 60-97 years), who were diagnosed to have ALRI by LDCT in the ER, were enrolled in this study. Initial chest radiograph (CR) and CT patterns of ALRI were analysed, and clinical courses of patients were assessed. RESULTS: 49 patients showed negative CR, in whom the main CT patterns were diffuse bronchial wall thickening (n = 23), ground-glass opacity (n = 6), mixed centrilobular nodules and ground-glass opacity (n = 3), small consolidation (n = 8) or consolidation in the dependent lung (n = 9), while the other 111 patients with the main CT pattern of consolidation demonstrated pulmonary abnormality on CR. Pulmonary oedema (12.5%) and pleural effusion (23.1%) were associated. The rate of hospitalization, care in the intensive care unit, mortality and comorbidity were significantly higher in the CR(+)LDCT(+) group (88.3%, 36.1%, 18.2% and 59.5%) than in the CR(-)LDCT(+) group (55.1%, 8.2%, 2.0% and 38.8%; p ≤ 0.05). CONCLUSION: LDCT was useful for the early diagnosis of ALRI in elderly patients who showed negative initial CR. The patients with negative initial CR had main CT patterns of diffuse bronchial wall thickening, ground-glass opacity, centrilobular nodules, small consolidation or consolidation in the dependent lung on LDCT. ADVANCES IN KNOWLEDGE: The use of LDCT may be considered for the early diagnosis of ALRI in elderly patients who have high comorbidity.

Triple-layered polyurethane prosthesis with wrinkles for repairing partial tracheal defects.

OBJECTIVES/HYPOTHESIS: The purpose of this study was to develop a triple-layered artificial polyurethane (PU) scaffold with a wrinkled layer for reconstruction of partial tracheal defects. STUDY DESIGN: Animal experiment. METHODS: PU/Pluronic F127 solution was transformed into an asymmetrically porous PU membrane by an immersion precipitation method. The nonporous wrinkled film was prepared by a simple casting of the PU solution on a grooved mold. The triple-layered wrinkled PU scaffolds were fabricated by simple inosculating between the wrinkled film and the porous membranes as in a sandwich (porous/wrinkled/porous structure). Scaffolds were transplanted into 10 New Zealand rabbits after creating tracheal windows. Endoscopic and histological examinations and mechanical tests were performed. RESULTS: The thickness and outer pore size of the prepared triple-layered PU scaffold were ∼1.95 mm and ∼200 µm, respectively. The wrinkled PU scaffold showed better maximum flexural strength compared to the nonwrinkled scaffold (1.03 ± 0.19 vs. 0.56 ± 0.09 MPa). Eight of 10 rabbits survived through all of the examinations and procedures. Endoscopic findings revealed that respiratory mucosa was observed over the scaffold at 3 weeks, and it was an entirely covered scaffold at 6 weeks. The circular framework of the tracheal lumen was maintained in seven of 10 rabbits. Histologic findings showed that ciliated respiratory mucosa covered the surface of the scaffolds. The tensile strength of the scaffold-implanted trachea was lower than that of the normal control. CONCLUSIONS: A wrinkled, triple-layered PU scaffold can be used as a ready-made scaffold for reconstruction of partial tracheal defects. LEVEL OF EVIDENCE: NA.

Adipose-derived stem cell-containing hyaluronic acid/alginate hydrogel improves vocal fold wound healing.

OBJECTIVES/HYPOTHESIS: The purpose of this study was to investigate the regenerative efficacy of an injectable hyaluronic acid/mildly cross-linked alginate hydrogel (HA/ALG hydrogel) containing human adipose-derived mesenchymal stem cells (hAdMSCs) for vocal fold (VF) wound healing. STUDY DESIGN: Animal research. METHODS: HA/ALG hydrogel containing hAdMSCs was injected into the VFs of rabbits immediately after direct injury. Endoscopic evaluations were performed at 1 and 3 months after injury, and functional evaluations of mucosal vibration and viscoelastic properties were carried out posteuthanization at 3 months after injury. Histopathologic and immunohistochemical evaluations of extracellular matrix (ECM) components and of hepatocyte growth factor (HGF) activity were conducted in injured VFs. The engraftment of implanted hAdMSCs was investigated by detecting fluorescent-labeled cells. RESULTS: The administration of hAdMSCs and hAdMSCs in HA/ALG hydrogel produced better macroscopic morphologies than the injection of phosphate-buffered saline (PBS). Histologic evaluations revealed that treatment with hAdMSCs in HA/ALG produced more favorable ECM changes than hAdMSC. In particular, the treatment of hAdMSCs in HA/ALG hydrogel ameliorated excessive deposition of collagen type I and increased HGF activity in regenerating VFs. hAdMSCs in HA/ALG-treated VFs also exhibited functional improvements in viscoelastic properties. hAdMSCs in HA/ALG remained viable in recipient VFs at 1 month after transplantation, and some were observed to be fostered to differentiate into fibroblasts. CONCLUSIONS: The findings of the present study suggest that HA/ALG hydrogel is a promising biomaterial for prolonging the retention time of stem cells in VFs and for promotion of VF wound healing.

Angiosarcoma presenting with spontaneous hydropneumothorax: report of a case and review of the literature.

Angiosarcoma is a rare malignant tumor of soft tissue. Because angiosarcoma originates from endothelial cells, it can occur in any organ and shows aggressive clinical features. Most commonly, angiosarcoma initially presents as a cutaneous lesion. Lung metastasis from scalp angiosarcoma can develop pneumothorax. We report a case of multiorgan involvement of an angiosarcoma, including the scalp, initially presenting with hydropneumothorax. Immunohistochemistry analysis of the cells obtained from the study confirmed the pleural invasion of the angiosarcoma.

Hierarchical recruitment of Plk4 and regulation of centriole biogenesis by two centrosomal scaffolds, Cep192 and Cep152.

Centrosomes play an important role in various cellular processes, including spindle formation and chromosome segregation. They are composed of two orthogonally arranged centrioles, whose duplication occurs only once per cell cycle. Accurate control of centriole numbers is essential for the maintenance of genomic integrity. Although it is well appreciated that polo-like kinase 4 (Plk4) plays a central role in centriole biogenesis, how it is recruited to centrosomes and whether this step is necessary for centriole biogenesis remain largely elusive. Here we showed that Plk4 localizes to distinct subcentrosomal regions in a temporally and spatially regulated manner, and that Cep192 and Cep152 serve as two distinct scaffolds that recruit Plk4 to centrosomes in a hierarchical order. Interestingly, Cep192 and Cep152 competitively interacted with the cryptic polo box of Plk4 through their homologous N-terminal sequences containing acidic-α-helix and N/Q-rich motifs. Consistent with these observations, the expression of either one of these N-terminal fragments was sufficient to delocalize Plk4 from centrosomes. Furthermore, loss of the Cep192- or Cep152-dependent interaction with Plk4 resulted in impaired centriole duplication that led to delayed cell proliferation. Thus, the spatiotemporal regulation of Plk4 localization by two hierarchical scaffolds, Cep192 and Cep152, is critical for centriole biogenesis.

Organochlorine pesticides and polychlorinated biphenyls in Korean human milk: contamination levels and infant risk assessment.

The levels of persistent organic pollutants (POPs) were determined in 50 samples of Korean human milk. POPs include organochlorine pesticides (OCPs) [aldrin, chlordanes, dieldrin, dichlorodiphenyltrichloroethanes (DDTs), endrins, heptachlors, hexachlorobenzene (HCB), hexachlorocyclohexanes (HCHs), mirex, and toxaphenes] and marker PCBs (PCB28, PCB52, PCB101, PCB138, PCB153 and PCB180). In all samples, p,p'-DDE were determined as 75.5-1115.3 ng/g fat. The compounds ß-HCH and p,p'-DDT were detected at 72% and 60% of the samples, respectively. Chlordanes (nd-84.9 ng/g fat) heptachlors (nd-40.1 ng/g fat), HCB (nd-42.9 ng/g fat) and PCBs (nd-38.3 ng/g fat) were detected in several samples. The ratio of dichlorodiphenyltrichloroethylene (DDE)/DDT was 6.8, which explained that exposure of volunteers to DDT did not occur recently. Compared with the previous monitoring data, the level of marker PCBs generally decreased in the milk samples. The levels of OCPs are significantly correlated to the residential periods of the mothers but not with their dietary habits. Considering the daily intake of each OCPs, 18% of infants would ingest the amount of heptachlor exceeding the acceptable daily intake (ADI) proposed by World Health Organization (WHO). There was no sample surpassing the WHO ADI for DDTs, HCB and chlordanes.

Bilateral herpetic keratitis presenting with unilateral neurotrophic keratitis in pemphigus foliaceus: a case report.

INTRODUCTION: We report a case of bilateral herpetic keratitis developing after rapid oral corticosteroid tapering in a patient with pemphigus foliaceus, which was followed by unilateral neurotrophic keratitis that was treated with amniotic membrane transplantation. CASE PRESENTATION: A 71-year-old Korean man developed bilateral herpetic keratitis one week after rapid tapering of systemic corticosteroid. He had been on high-dose oral corticosteroid and azathioprine therapy for six months for treatment of pemphigus foliaceus. Topical acyclovir ointment was prescribed. A week later, our patient's right eye had healed, but his left eye showed increased stromal edema with enlarged epithelial defects. He was prescribed oral acyclovir with topical broad-spectrum antibiotics applied to his left eye. The stromal edema cleared within a week but the epithelial defect remained unchanged. An amniotic membrane transplantation was performed on our patient's left eye, and his epithelial defect had totally healed three weeks later. CONCLUSIONS: Patients with autoimmune disease or who are on immunosuppressive therapy have a higher chance of developing bilateral herpetic keratitis. Although rare, the condition may be followed by unilateral neurotrophic keratitis. Rapid corticosteroid tapering may act as a triggering factor for viral infection or reactivation of herpes.

Chondrogenesis of adipose stem cells in a porous PLGA scaffold impregnated with plasmid DNA containing SOX trio (SOX-5,-6 and -9) genes.

We developed a chondrogenic scaffold system in which plasmid DNA (pDNA) containing SOX trio (SOX-5, -6, and -9) genes was incorporated into a PLGA scaffold and slowly released to transfect adipose stem cells (ASCs) seeded in the scaffold. The purpose of this study was to test the in vitro and in vivo efficacy of the system to induce chondrogenic differentiation of ASCs. The pDNA/PEI-PEG complex-incorporated PLGA/Pluronic F127 porous scaffolds were fabricated by a precipitation/particulate leaching method. The following five kinds of pDNA were incorporated into the scaffolds: 1) pECFP-C1 vector without an interposed gene (control group); 2) SOX-5 plasmids; 3) SOX-6 plasmids; 4) SOX-9 plasmids; and 5) one-third doses of each plasmid (SOX-5, -6, and -9). ASCs were seeded on pDNA-incorporated PLGA scaffolds and cultured in chondrogenic media for 21 days. ASCs were also isolated from rabbits, seeded in pDNA-incorporated PLGA scaffolds, and then implanted in the osteochondral defect created on the patellar groove. The rabbits were sacrificed and analyzed grossly and microscopically 8 weeks after implantation. The percentage of transfected cells was highest on day 14, around 70%. After 21 days, PLGA scaffolds incorporated with each gene showed markedly increased expression of the corresponding gene and protein. Glycosaminoglycan (GAG) assay and Safranin-O staining showed an increased proteoglycan production in SOX trio pDNA-incorporated scaffolds. The COL2A1 gene and protein were notably increased in SOX trio pDNA-incorporated scaffolds than in the control, while COL10A1 protein expression decreased. Gross and histological findings from the in vivo study showed enhanced cartilage regeneration in ASCs/SOX trio pDNA-incorporated PLGA scaffolds.

SNR dependence of optimal parameters for apparent diffusion coefficient measurements.

Optimizing the diffusion-weighted imaging (DWI) parameters (i.e., the b-value and the number of image averages) to the tissue of interest is essential for producing high-quality apparent diffusion coefficient (ADC) maps. Previous investigation of this optimization was performed assuming Gaussian noise statistics for the ADC map, which is only valid for high signal-to-noise ratio (SNR) imaging. In this work, the true statistics of the noise in ADC maps are derived, followed by an optimization of the DWI parameters as a function of the imaging SNR. Specifically, it is demonstrated that the optimum b-value is a monotonically increasing function of the imaging SNR, which converges to the optimum b-value from previously proposed approaches for high-SNR cases, while exhibiting a significant deviation from this asymptote for low-SNR situations. Incorporating the effects of T(2) weighting further increases the SNR dependence of the optimal parameters. The proposed optimization scheme is particularly important for high-resolution DWI, which intrinsically suffers from low SNR and therefore cannot afford the use of the conventional high b-values. Comparison scans were performed for high-resolution DWI of the spinal cord, demonstrating the improvements in the resulting images and the ADC maps achieved by this method.

The association of serum vitamin D level with presence of metabolic syndrome and hypertension in middle-aged Korean subjects.

OBJECTIVE: To examine the association of serum vitamin D level with metabolic syndrome (MetS) and hypertension (HTN) in middle-aged Korean subjects. DESIGN AND SUBJECTS: We conducted a population-based, cross-sectional survey of 1330 participants aged over 40 years (median age 65.8 years) in Chungju, Korea, in 2007. The 324 subjects, who were normotensive in 2003 and who attended a follow-up visit 4 years later, were included in an analysis of the association of serum vitamin D level with the risk of HTN. MEASUREMENTS: Serum 25-hydroxy-vitamin D [25(OH)D] and PTH were measured in a central laboratory, using chemiluminescence assays. RESULTS: The overall prevalence of the MetS in participants of this study was 45.3%. After adjusting for various covariates, subjects in the highest quintile group (61.4-116.8 nmol/l) compared with the lowest quintile group (10.0-29.7 nmol/l) of 25(OH)D had an odds ratio (OR) for having MetS of 0.35 (95% confidence intervals, CI, 0.22-0.56; P for trend <0.001). The median level of 25(OH)D was 46.8 nmol/l among 324 subjects who were normotensive in 2003. After multiple adjustment, the OR was substantially higher for new HTN (OR 2.74; 95% CI 1.40-5.34) in subjects with serum 25(OH)D levels below the median value compared with those above median. The inverse associations of vitamin D and MetS/HTN were unchanged after adjustment for PTH and serum calcium levels. There was no association between PTH and MetS. CONCLUSIONS: We found a strong inverse association of 25(OH)D levels with MetS and HTN in this middle-aged Korean population. Having vitamin D deficiency was associated with an increased risk of having MetS and HTN in this demographic group.

Non-contrast-enhanced flow-independent peripheral MR angiography with balanced SSFP.

Flow-independent angiography is a non-contrast-enhanced technique that can generate vessel contrast even with reduced blood flow in the lower extremities. A method is presented for producing these angiograms with magnetization-prepared balanced steady-state free precession (bSSFP). Because bSSFP yields bright fat signal, robust fat suppression is essential for detailed depiction of the vasculature. Therefore, several strategies have been investigated to improve the reliability of fat suppression within short scan times. Phase-sensitive SSFP can efficiently suppress fat; however, partial volume effects due to fat and water occupying the same voxel can lead to the loss of blood signal. In contrast, alternating repetition time (ATR) SSFP minimizes this loss; however, the level of suppression is compromised by field inhomogeneity. Finally, a new double-acquisition ATR-SSFP technique reduces this sensitivity to off-resonance. In vivo results indicate that the two ATR-based techniques provide more reliable contrast when partial volume effects are significant.

Association between CRHR1 polymorphism and improved lung function in response to inhaled corticosteroid in patients with COPD.

BACKGROUND AND OBJECTIVE: Inhaled corticosteroids are used to treat COPD and asthma. An association between sequence variants in the corticotrophin-releasing hormone receptor 1 (CRHR1) gene and improved lung function in asthmatics treated with inhaled corticosteroids was reported recently. This study investigated the association between the change in lung function in response to inhaled corticosteroids and single-nucleotide CRHR1 polymorphisms in patients with COPD. METHODS: COPD patients (n = 87) with a positive smoking history were recruited from the pulmonary clinics of 11 hospitals in Korea. Patients were treated with fluticasone propionate and salmeterol for 12 weeks and lung function was measured at baseline and after the 12-week treatment. Eighty-four of the 87 subjects were successfully genotyped. RESULTS: Seventy-one patients with the wild-type GG genotype and 13 patients with the heterozygous GT genotype in rs242 941 were evaluated. After 12-week treatment, the change in FEV(1) was significantly higher in patients with wild-type GG genotype (6.0 +/- 0.8% of predicted FEV(1)) than in GT heterozygotes (-0.8 +/- 1.8, P = 0.003). CONCLUSIONS: Improved FEV(1) following inhaled corticosteroid and a long-acting beta2-agonist was associated with CRHR1 genetic polymorphism in patients with COPD.

Identification of structural protein-protein interactions of herpes simplex virus type 1.

In this study we have defined protein-protein interactions between the structural proteins of herpes simplex virus type 1 (HSV-1) using a LexA yeast two-hybrid system. The majority of the capsid, tegument and envelope proteins of HSV-1 were screened in a matrix approach. A total of 40 binary interactions were detected including 9 out of 10 previously identified tegument-tegument interactions (Vittone, V., Diefenbach, E., Triffett, D., Douglas, M.W., Cunningham, A.L., and Diefenbach, R.J., 2005. Determination of interactions between tegument proteins of herpes simplex virus type 1. J. Virol. 79, 9566-9571). A total of 12 interactions involving the capsid protein pUL35 (VP26) and 11 interactions involving the tegument protein pUL46 (VP11/12) were identified. The most significant novel interactions detected in this study, which are likely to play a role in viral assembly, include pUL35-pUL37 (capsid-tegument), pUL46-pUL37 (tegument-tegument) and pUL49 (VP22)-pUS9 (tegument-envelope). This information will provide further insights into the pathways of HSV-1 assembly and the identified interactions are potential targets for new antiviral drugs.

Photodynamic therapy using verteporfin-induced minimal change nephrotic syndrome.

PURPOSE: To report a case of minimal change nephrotic syndrome (MCNS) after photodynamic therapy using verteporfin. DESIGN: Interventional case report. METHODS: After four cycles of photodynamic therapy, general weakness with generalized edema developed in an otherwise healthy 66-year-old woman, resulting in dyspnea and ascites. Urinalysis showed heavy proteinuria (4+) with decreased serum total protein and albumin, and increased total cholesterol levels, suggesting nephrotic syndrome. Renal biopsy and pathologic diagnosis were performed. RESULTS: Renal biopsy revealed normal glomeruli and tubulointerstitium by light microscopy, with no immunoglobin or complement deposition. Transmission electron microscopy showed diffuse effacement of the foot processes of visceral epithelial cells, which is the characteristic finding of minimal change nephrotic syndrome. CONCLUSIONS: We herein report a case of minimal change nephrotic syndrome after photodynamic therapy using verteporfin.

Noninvasive measurement of extraction fraction and single-kidney glomerular filtration rate with MR imaging in swine with surgically created renal arterial stenoses.

PURPOSE: To test whether magnetic resonance (MR) imaging enables accurate measurement of extraction fraction (EF) in swine with unilateral renal ischemia and to evaluate effects of renal arterial stenosis on EF and single-kidney glomerular filtration rate. MATERIALS AND METHODS: High-grade unilateral renal arterial stenoses were surgically created in eight pigs. Direct measurements of renal venous and arterial inulin concentration provided reference standard estimates of single-kidney EF. Pigs were imaged with a 1.5-T imager to estimate EF, renal blood flow, and glomerular filtration rate. A breath-hold inversion-recovery spiral sequence was used to measure T1 of blood in the infrarenal inferior vena cava and renal veins after intravenous administration of gadopentetate dimeglumine, and these data were used to calculate EF. Cine-phase contrast material-enhanced imaging of the renal arteries provided quantitative renal blood flow measurements. Bilateral single-kidney glomerular filtration rate was then determined: glomerular filtration rate = renal blood flow x (1 - hematocrit level) x EF. RESULTS: A statistically significant linear correlation was found between EF, as determined with MR imaging, and inulin (r = 0.77). As compared with kidneys without renal arterial stenosis, kidneys with renal arterial stenosis showed 50% (0.14/0.28) EF reduction (P <.01) and 59% glomerular filtration rate reduction (P <.01). CONCLUSION: MR imaging shows promise for in vivo measurement of EF and glomerular filtration rate, which may be useful in assessing the clinical importance of renal arterial stenosis.