When a ribosome complex is stalled during the translation elongation process in eukaryotes, the mono-ubiquitination of Rps3 has recently been shown to be critical to ribosome quality control. We have discovered that the regulatory role of Rps3 mono-ubiquitination is controlled by a deubiquitinase. We also showed that an autophagic signal appears to be coupled to the mono-ubiquitination of Rps3p through the entrance of Ubp3p into the autophagosome in yeasts. The mono-ubiquitination of the Rps3 protein is tightly modulated by reciprocal action between the Hel2p E3 ligase and the Ubp3p deubiquitinase in yeasts and the reciprocal action between the RNF123 E3 ligase and the USP10 deubiquitinase in mammalian cells. We also found that the Ubp3p/USP10 deubiquitinases critically modulate Hel2p/RNF123-mediated Rps3p mono-ubiquitination. In addition, we found that Hel2p/RNF123 and Ubp3p/USP10 appeared to be differently localized in the ribosome complex after ultraviolet irradiation. Together, our results support a model in which coordinated ubiquitination and deubiquitination activities can finely balance the level of regulatory Rps3p mono-ubiquitination in ribosome-associated quality control and autophagy processes.
Autophagy ; Eukaryota ; Quality Control* ; Ribosomes ; Ubiquitin ; Ubiquitin-Protein Ligases* ; Ubiquitin-Specific Proteases ; Ubiquitination ; Yeasts

OBJECTIVES: The aims of this study were 1) to evaluate the effect of isolated uvulopalatopharyngoplasty (UPPP) on subjective obstructive sleep apnea (OSA) symptoms in adult patients regardless of the response to surgery, and ultimately 2) to investigate the differences in changes in subjective OSA symptoms between successful and unsuccessful surgery groups. METHODS: Twenty consecutive adult patients who underwent isolated UPPP were enrolled. Pre- and postoperative subjective OSA symptoms (snoring, witnessed apnea, daytime sleepiness, morning headache, daytime fatigue, restless sleep, difficulty with morning arousal) and polysomnographic data were evaluated in all subjects. Changes in subjective OSA symptoms before and after surgery were investigated in the successful (n=11) and unsuccessful (n=9) groups. Surgical success was defined as a reduction of at least 50% in the preoperative apnea-hypopnea index (AHI) and a postoperative AHI less than 20 per hour. RESULTS: After isolated UPPP, all subjective OSA symptoms changed significantly in the patients, especially in the successful group. In the unsuccessful group, snoring, witnessed apnea and daytime fatigue changed significantly, while other symptoms did not change significantly after surgery. CONCLUSION: Isolated UPPP may improve subjective OSA symptoms in adult patients whom surgery was successful or unsuccessful. However, after isolated UPPP, the improvements in subjective OSA symptoms in the unsuccessful group may be different from those in the successful group.
Adult ; Apnea ; Fatigue ; Headache ; Humans ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring ; Wit and Humor as Topic

OBJECTIVES/HYPOTHESIS: Prostasin is a protease that activates epithelial sodium channels (ENaC), which mediate Na+ absorption across epithelial surfaces. Human nasal polyps absorb more ENaC-mediated Na+ than normal mucosa. We investigated the expression and distribution of prostasin in normal mucosa and nasal polyp. STUDY DESIGN: This was a controlled, prospective study. METHODS: The distribution patterns and levels of expression of prostasin in normal sinus mucosa and nasal polyps were evaluated using real-time polymerase chain reaction (PCR), immunohistochemical staining and western blotting. RESULTS: Real-time PCR revealed that the mRNA expression of prostasin was higher in nasal polyps than in normal sinus mucosa. The expression of prostasin was faint in immunohistochemical staining of superficial epithelial cells and submucosal glandular epithelial cells of normal sinus mucosa, but was intense in superficial epithelial cells and submucosal glandular epithelial cells in nasal polyps. Inflammatory cells infiltrating into the nasal mucosa also showed prostasin immunoreactivity in nasal polyps. Western blot analysis with prostasin antiserum detected prostasin protein in normal sinus mucosa and nasal polyps. The expression levels of prostasin were increased in nasal polyps compared with normal sinus mucosa. CONCLUSIONS: The levels of expression of prostasin were upregulated in nasal polyps compared to normal sinus mucosa, suggesting a role in the pathogenesis of nasal polyps. However, the exact pathophysiologic function of prostasin in nasal epithelium warrants further investigation.
Absorption ; Blotting, Western ; Epithelial Cells ; Epithelial Sodium Channels ; Humans ; Mucous Membrane ; Nasal Mucosa ; Nasal Polyps ; Prospective Studies ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Serine Endopeptidases ; Up-Regulation

PURPOSE: The aim of this study was to evaluate the quality of the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency intensive care unit (ICU) in consultation with intervention radiologists and surgeons. METHODS: This was a retrospective observational study conducted in an emergency ICU of a tertiary referral hospital. We enrolled consecutive patients who had been admitted to our emergency ICU with major trauma from March 2007 to September 2010. We collected data with respect to demographic findings, mechanisms of injury, the trauma and injury severity score (TRISS), emergency surgery, angiographic intervention, and 6-month mortality. Then, we compared the observed and predicted survivals of the patients. The Hosmer-Lemeshow test and calibration plots by using 10 groups, one for each decile, of predicted mortality were used to evaluate the fitness of TRISS. P-values of greater than 0.05 represent a fair calibration. RESULTS: Among 116 patients, 12 (10.34%) were dead within 6 months after admission to the ICU, and 29 (25.00%) and 38 (32.80%) patients received emergency surgery and angiographic intervention, respectively. The mean injury severity score and revised trauma score were 36.97+/-17.73 and 7.84+/-6.75, respectively. The observed survival and the predicted survival of the TRISS were 89.66% (95% confidence interval [CI]: 84.03~95.28%) and 69.85% (95% CI: 63.80~75.91%), respectively. The calibration plots showed that the observed survival of our patients was consistently higher than the predicted survival of the TRISS (p<0.001). CONCLUSION: The observed survival for the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency ICU in consultation with intervention radiologists and surgeons, was higher than the predicted survival of the TRISS.
Calibration ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Injury Severity Score ; Intensive Care Units ; Radiology, Interventional ; Retrospective Studies ; Tertiary Care Centers

BACKGROUND AND OBJECTIVES: This study was done to evaluate the safety of Gore-Tex as a nasal implant. Materials and METHOD: A retrospective multicenter study was carried out on 15 surgeons from 11 general hospitals and 4 private practice clinics regarding the safety of the Gore-Tex as a nasal implant. The study involved 853 patients, of whom 656 received primary surgery and 197 revision surgery. Gore-Tex was mainly used as a dorsal implant in a form of sheet or as a reinforced nasal implant. RESULTS: The overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases ; 2.1%) followed by 2 cases of seroma and 1 case of persistent nasal swelling. In 19 out of 21 complication cases, the graft needed removal to control the infection or seroma (91% removal rate). Nine cases of infection developed in both primary cases (1.37%) and in revision cases (4.57%), which suggests a higher association rate between infection and revision cases (p=0.0062). Infection developed within 1 month in 5 cases while 9 cases developed infection after 6 months of operation. Other complications such as aesthetic problems (malpositioning of the implant or dorsal irregularities) were found in 15 cases (1.8%) and hematoma in 1 case. CONCLUSION: The infection rate of Gore-Tex used in rhinoplasty was about 2% and it rose significantly in the revision cases. If infected, almost all of the implanted Gore-Tex needs removal; therefore, we suggest judicious use of Gore-Tex in rhinoplasty.
Hematoma ; Hospitals, General ; Humans ; Polytetrafluoroethylene* ; Private Practice ; Retrospective Studies ; Rhinoplasty* ; Seroma ; Transplants

PURPOSE: To evaluate the osseointegration of different dense ceramics. MATERIALS AND METHODS: Twenty-eight New Zealand white male rabbits were divided into 4 groups by implant materials: Cerabone(R)-AW, CaO-SiO2- B2O3 glass ceramics (CS10B), CaO-SiO2- B2O3 glass (CS5B glass) and Cerabone(R)- A W + A l2O3 glass ceramics. We implanted the dense ceramics into the tibia of rabbits with external fixator and checked the radiographs every 4 weeks. The union rate, histology and SEM were evaluated 8 weeks after surgery. RESULTS: The union rates were 85.7% (6 of 7) in Cerabone(R)-AW, 85.7% (6 of 7) in CS10B, 71.4% (5 of 7) in CS5B glass and 28.6% (2 of 7) in Cerabone(R)-AW+Al2O3 by simple radiographs. The union rates of Cerabone (R)-AW and CS10B were statistically higher than that of Cerabone(R)-AW+Al2O3 (p=0.031). Histologically, the Cerabone(R)-AW had fused with tibia without biodegradation, CS10B, CS5B glass had fused with tibia in some portion but resorbed in others. Cerabone(R)-AW+Al2O3 had not fused with bony tissue. CONCLUSION: We confirmed the osseointegration and insolubility of Cerabone(R)-AW. We also confirmed the osseointegration and partial solubility of CaO-SiO2-B2O3 glass ceramics. These findings suggest that Cerabone (R)-AW can be used as an insoluble artificial bone and CaO-SiO2-B2O3 glass ceramics as biodegradable bone replacement materials.
Bone Substitutes ; Ceramics* ; External Fixators ; Glass ; Humans ; Male ; New Zealand ; Osseointegration* ; Rabbits ; Solubility ; Tibia

STUDY DESIGN: A retrospective study OBJECTIVE: To analyze the clinical and radiological findings, and the results of the surgical treatment of osteoid osteomas and osteoblastomas of the spine. SUMMARY OF LITERATURE REVIEW: With the development of new imaging techniques, earlier diagnoses have been reported. However, a few reports of unexpected misdiagnosis, and postoperative results, have also been published. MATERIALS AND METHODS: Between January 1980 and September 2002, twelve patients were diagnosed with an osteoid osteoma or osteoblastoma of the spine, and were surgically treated. The average preoperative symptom-duration and follow-up period were 20 and 33 months, with ranges from 6weeks to 96 months, and 4 to 120 months, respectively. All the patients were younger than 30 years old, with the majority being of growing age, and underwent at least a bone scan, CT or MRI, as part of the diagnostic procedures. RESULTS: The most common symptom was pain at the lesion, with 2 torticollis and 4 scoliosis observed as combined spine deformities, respectively. Neurological abnormalities were seen more often in the osteoblastomas (80%) than in the osteoid osteomas (43%). From the radiological findings, a CT scan was a more effective procedure than any of the other diagnostic modalities in differentiating an osteosclerotic bony lesion and a nidus. In three out of the five MRI, 2 cases were misdiagnosed as infections and the other as a malignant tumor, with no significant abnormal findings in the simple roentgenogram. A wide excision was performed in all patients, and a fusion, with a bone graft, was also performed in 8. There were no postoperative spinal instabilities or complications. CONCLUSION: In a differential diagnosis, careful history taking for pain, and a physical examination for spine deformity, are required. Without any clinical information, these tumors can be misdiagnosed as malignant tumors, or other infectious diseases, in a MRI. With regard to the surgical treatment, there were no cases of recurrence reported due to the wide excision, but a fusion, both with or without instrumentation, can be considered to prevent postoperative spine instability.
Adult ; Communicable Diseases ; Congenital Abnormalities ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Osteoblastoma* ; Osteoma, Osteoid* ; Physical Examination ; Recurrence ; Retrospective Studies ; Scoliosis ; Spine* ; Tomography, X-Ray Computed ; Torticollis ; Transplants

BACKGROUND AND OBJECTIVES: A heparin-binding polypeptide called midkine is a family of secreted growth/differentiation cytokines and has a role in tumor growth by enhancing endothelial proliferation, vascular density and angiogenesis. In this respect, midkine may be involved in the pathogenesis of nasal polyposis. The aim of the present study is to evaluate the expression of midkine mRNA in the human nasal mucosa and polyps. MATERIALS AND METHOD: The total RNA was isolated from freshly disected inferior turbinate of patients who underwent rhinoplasty and from nasal polyps of chronic rhinosinusitis patients. The expression and distribution of midkine mRNA was investigated by reverse transcriptse- polymerase chain reaction (RT-PCR) and in situ hybridization. The midkine mRNA expression in nasal mucosa and polyps were semi-quantitatively evaluated by Southern blot hybridization. RESULTS: The expression of midkine mRNA was identified in both normal inferior turbinate and nasal polyp. Histochemistry of in situ hybridization revealed that midkine mRNA in normal inferior turbinate was intensely expressed in the surface epithelium, submucosal glands, vascular endothelium, and inflammatory cells scattered in submucosal tissues. Midkine mRNA was expressed in the nasal polyps, many inflammatory cells and newly formed vascular endothelium, but not in the newly formed glandular epithelium. In semi-quantitative southern blot hybridization, midkine mRNAs did not have different expression levels between inferior turbinate and nasal polyps. CONCLUSION: These results indicate that midkine mRNA is innately expressed in human nasal mucosa, playing a role in nasal physiology. Also, the results show that midkine may be involved in the pathogenesis of nasal polyps via angiogenesis, tissue growth, and inflammatory process.
Blotting, Southern ; Cytokines ; Endothelium, Vascular ; Epithelium ; Humans* ; In Situ Hybridization ; Nasal Mucosa* ; Nasal Polyps ; Physiology ; Polymerase Chain Reaction ; Polyps ; Rhinoplasty ; RNA ; RNA, Messenger* ; Turbinates

OBJECT: The nonstress test(NST) and complete biophysical profile(BPP) were compared with the rapid biophysical profile(BPP) in order to evaluate the efficacy of the rapid BPP, namely, the combination of amniotic fluid index(AFI) and sound-provoked fetal movement(SPFM) detected by ultrasound, in predicting intrapartum fetal distress in high-risk pregnancies. STUDY DESIGN: From JAN 9th 2000, through JAN 5th 2001, the prospective study of diagnostic tests was conducted on a total of 91 high-risk singleton pregnancies, undergoing antepartum assessment both the standard NST and the new rapid BPP(including other indices of complete BPP). The diagnostic indices of the NST, rapid BPP and complete BPP were calculated in term of predicting intrapartum fetal distress. RESULT: The sensitivity, specificity, negative predictive value, and positive predictive value of NST were 50.00, 94.81, 96.05, and 42.86% respectively, and those of rapid BPP were 75.00, 98.53, 98.53, and 75.00%, and those of complete BPP were 83.33, 98.72, 98.72, and 83.33%, as well. In addition, the efficiency of NST, rapid BPP, and complete BPP were 91.57%, 97.22% and 97.62% respectively. CONCLUSIONS: The rapid BPP is an effective and reliable predictor of intrapartum fetal distress with high-risk pregnancies. Moreover, it may be inexpensive and less time-consuming method.
Amniotic Fluid ; Diagnostic Tests, Routine ; Female ; Fetal Distress ; Pregnancy ; Pregnancy, High-Risk ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVE: This study investigated changes of voice and hearing in premenopausal and postmenopausal woman METHODS: We studied forty postmenopausal and forty premenopausal women. Each women was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The phonated sound in each case was recorded and analysed by the computerized speech lab (LSL 4300B, KAY Elemetrics Corp. USA). we also conducted audiometric pure-tone threshold testing on the same group. Statistical analysis of voice and hearing parameters was done by paired T test RESULTS: Jitter in menopausal group was significantly increased compared with premenopausal group, but other voice parameters showed no significant differences. There were no significant changes of vocal parameters between menopausal patients with or without vocal symptoms. And there were no significant changes of hearing parameters, either CONCLUSION: The change of voice parameters was objectively identified in menopausal women, and so therapist of menopausal symptoms must take the voice changes into consideration.
Female ; Hearing* ; Humans ; Menopause ; Voice*