Purpose: In chronic inflammatory diseases, neutrophils release NETs (neutrophil extracellular traps), web-like structures composedof DNA and citrullinated histones, to eliminate bacteria and regulate the inflammatory response. In periodontitis, NETosis acts asa crucial defense mechanism, characterized by the expression of citrullinated histones. This study aims to evaluate the impact ofage and smoking on the expression of citrullinated histones in patients with periodontitis and the feasibility of using saliva for their detection. Materials and Methods: A total of 19 patients participated in the experiment. Among them, 15 were grouped accord-ing to smoking status and age, with 5 patients assigned to each group. After clinical and radiographic examinations, blood sampleswere collected from the subjects, and serum was separated. For 4 subjects, both blood and saliva samples were collected. Thelevels of citrullinated histones in the samples were quantified using an ELISA kit, and the results were compared and statisticallyanalyzed. Results: The concentration of citrullinated histones was significantly higher in younger individuals (P < 0.05). Although the expression of citrullinated histones was higher in the smoking group compared to the non-smoking group, the difference was not statistically significant. In patients with periodontitis, the levels of citrullinated histones detected in saliva were comparable to those found in serum. Conclusion Age may be potential risk factors influencing the expression of citrullinated histones in patients with periodontitis. Additionally, saliva, which is easier to collect, could be used as a viable sample for detecting citrullinated histones in periodontitis patients.

Purpose: In chronic inflammatory diseases, neutrophils release NETs (neutrophil extracellular traps), web-like structures composedof DNA and citrullinated histones, to eliminate bacteria and regulate the inflammatory response. In periodontitis, NETosis acts asa crucial defense mechanism, characterized by the expression of citrullinated histones. This study aims to evaluate the impact ofage and smoking on the expression of citrullinated histones in patients with periodontitis and the feasibility of using saliva for their detection. Materials and Methods: A total of 19 patients participated in the experiment. Among them, 15 were grouped accord-ing to smoking status and age, with 5 patients assigned to each group. After clinical and radiographic examinations, blood sampleswere collected from the subjects, and serum was separated. For 4 subjects, both blood and saliva samples were collected. Thelevels of citrullinated histones in the samples were quantified using an ELISA kit, and the results were compared and statisticallyanalyzed. Results: The concentration of citrullinated histones was significantly higher in younger individuals (P < 0.05). Although the expression of citrullinated histones was higher in the smoking group compared to the non-smoking group, the difference was not statistically significant. In patients with periodontitis, the levels of citrullinated histones detected in saliva were comparable to those found in serum. Conclusion Age may be potential risk factors influencing the expression of citrullinated histones in patients with periodontitis. Additionally, saliva, which is easier to collect, could be used as a viable sample for detecting citrullinated histones in periodontitis patients.

Purpose: In chronic inflammatory diseases, neutrophils release NETs (neutrophil extracellular traps), web-like structures composedof DNA and citrullinated histones, to eliminate bacteria and regulate the inflammatory response. In periodontitis, NETosis acts asa crucial defense mechanism, characterized by the expression of citrullinated histones. This study aims to evaluate the impact ofage and smoking on the expression of citrullinated histones in patients with periodontitis and the feasibility of using saliva for their detection. Materials and Methods: A total of 19 patients participated in the experiment. Among them, 15 were grouped accord-ing to smoking status and age, with 5 patients assigned to each group. After clinical and radiographic examinations, blood sampleswere collected from the subjects, and serum was separated. For 4 subjects, both blood and saliva samples were collected. Thelevels of citrullinated histones in the samples were quantified using an ELISA kit, and the results were compared and statisticallyanalyzed. Results: The concentration of citrullinated histones was significantly higher in younger individuals (P < 0.05). Although the expression of citrullinated histones was higher in the smoking group compared to the non-smoking group, the difference was not statistically significant. In patients with periodontitis, the levels of citrullinated histones detected in saliva were comparable to those found in serum. Conclusion Age may be potential risk factors influencing the expression of citrullinated histones in patients with periodontitis. Additionally, saliva, which is easier to collect, could be used as a viable sample for detecting citrullinated histones in periodontitis patients.

Background/Aims: The ursodeoxycholic acid (UDCA) response score (URS) was developed to identify poor responders to UDCA before treatment, in order to offer timely and proactive intervention. However, validation of the URS in Asian population is warranted. Methods: A total of 173 Asian patients diagnosed with primary biliary cholangitis (PBC) between 2007 and 2016 at seven academic institutions in Korea who started UDCA treatment were analyzed to validate the performance of URS. UDCA response was defined as an alkaline phosphatase level less than 1.67 times the upper limit of normal after 1-year of UDCA treatment. In addition, prognostic performance of URS for liver-related events, defined as newly developed hepatic decompensation or hepatocellular carcinoma was evaluated. Results: After 1 year of UDCA treatment, 133 patients (76.9%) achieved UDCA response. UDCAresponse rate was 98.7% for those with URS ≥1.41 (n=76) and 58.8% for those with URS <1.41(n=97). The area under the receiver operating characteristic curve of URS in predicting UDCAresponse was 0.84 (95% confidence interval, 0.78 to 0.88). During a median follow-up of 6.5years, liver-related events developed in 18 patients (10.4%). Among 117 patients with PBC stage I-III by histological evaluation, the 5-year liver-related event-free survival rate differed accordingto the URS; 100% for URS ≥1.41 and 86.5% for URS <1.41 (p=0.005). Conclusions URS demonstrated good performance in predicting a UDCA treatment response in Asian PBC patients. In addition, the risk of liver-related events differed according to the URS for the PBC stage. Thus, URS can be used to predict the response and clinical outcome in patients with PBC.

Objective: This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation. Materials and Methods: Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. After three dimensional T1-based brain segmentation, the average MVF was analyzed at the bilateral cerebral white matter (WM), bilateral cerebral gray matter (GM), corpus callosum, and brainstem. The Mann–Whitney U-test was performed to compare MVF and myelin volume between patients with mTBI and controls. Myelin volume was correlated with neuropsychological test scores using the Spearman rank correlation test. Results: The average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS (median [interquartile range], 25.2% [22.6%–26.4%]) than that in controls (26.8% [25.6%–27.8%]) (p = 0.004). The region-of-interest myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (1.87 cm3 [1.70–2.05 cm3 ] vs. 2.21 cm3 [1.86– 3.46 cm3 ]; p = 0.003) and brainstem (9.98 cm3 [9.45–11.00 cm3 ] vs. 11.05 cm3 [10.10–11.53 cm3 ]; p = 0.015). The total myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (0.45 cm3 [0.39–0.48 cm3 ] vs. 0.48 cm3 [0.45–0.54 cm3 ]; p = 0.004) and brainstem (1.45 cm3 [1.28–1.59 cm3 ] vs. 1.54 cm3 [1.42–1.67 cm3 ]; p = 0.042). No significant correlation was observed between myelin volume parameters and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall) (r = 0.425; p = 0.048). Conclusion MVF quantified from the MDME sequence was decreased at the bilateral cerebral WM in mTBI patients with PCS. The total myelin volumes at the corpus callosum and brainstem were decreased in mTBI patients with PCS due to atrophic changes.

Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at −70°C until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire® ME panel testing. Conclusions Compared with the currently available etiologic tests for CNS infection, BioFire® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire® ME panel testing in children must be evaluated for its wider application.

Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at −70°C until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire® ME panel testing. Conclusions Compared with the currently available etiologic tests for CNS infection, BioFire® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire® ME panel testing in children must be evaluated for its wider application.

Background: and Purpose: The Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) is widely used for estimating the symptoms of Parkinson’s disease. Translation and validation of the MDS-UPDRS is necessary for non-English speaking countries and regions. The aim of this study was to validate the Korean version of the MDS-UPDRS. Methods: Altogether, 362 patients in 19 centers were recruited for this study. We translated the MDS-UPDRS to Korean using the translation-back translation method and cognitive pretesting. We performed both confirmatory and exploratory factor analyses to validate the scale.We calculated the comparative fit index (CFI) for confirmatory factor analysis, and used unweighted least squares for exploratory factor analysis. Results: The CFI was higher than 0.90 for all parts of the scale. Exploratory factor analysis also showed that the Korean MDS-UPDRS has the same number of factors in each part as the English version. Conclusions The Korean MDS-UPDRS has the same overall structure as the English MDSUPDRS. Our translated scale can be designated as the official Korean MDS-UPDRS.