Culture filtrates of six different edible mushroom species were screened for antimicrobial activity against tomato wilt bacteria Ralstonia solanacearum B3. Hericium erinaceus, Lentinula edodes (Sanjo 701), Grifola frondosa, and Hypsizygus marmoreus showed antibacterial activity against the bacteria. Water, n-butanol, and ethyl acetate extracts of spent mushroom substrate (SMS) of H. erinaceus exhibited high antibacterial activity against different phytopathogenic bacteria: Pectobacterium carotovorum subsp. carotovorum, Agrobacterium tumefaciens, R. solanacearum, Xanthomonas oryzae pv. oryzae, X. campestris pv. campestris, X. axonopodis pv. vesicatoria, X. axonopodis pv. citiri, and X. axonopodis pv. glycine. Quantitative real-time PCR revealed that water extracts of SMS (WESMS) of H. erinaceus induced expressions of plant defense genes encoding beta-1,3-glucanase (GluA) and pathogenesis-related protein-1a (PR-1a), associated with systemic acquired resistance. Furthermore, WESMS also suppressed tomato wilt disease caused by R. solanacearum by 85% in seedlings and promoted growth (height, leaf number, and fresh weight of the root and shoot) of tomato plants. These findings suggest the WESMS of H. erinaceus has the potential to suppress bacterial wilt disease of tomato through multiple effects including antibacterial activity, plant growth promotion, and defense gene induction.
1-Butanol ; Agaricales* ; Agrobacterium tumefaciens ; Bacteria ; Glycine ; Grifola ; Lycopersicon esculentum* ; Oryza ; Pectobacterium carotovorum ; Plants ; Ralstonia solanacearum ; Real-Time Polymerase Chain Reaction ; Seedlings ; Shiitake Mushrooms ; Water* ; Xanthomonas

BACKGROUND AND OBJECTIVES: Despite aggressive medical therapy and previous endoscopic sinus surgery, there are a subset of patients suffering from recalcitrant, persistent chronic isolated maxillary sinusitis which results from impaired mucocilliary clearance caused by long-standing inflammation. The corresponding patients underwent our newly devised Modified Inferior Meatal Mega-Antrostomy (Modified IMMA). The objective of this study was to review the clinical efficacy and complication after Modified IMMA in patients who had suffered from intractable maxillary sinusitis after endoscopic sinus surgery. SUBJECTS AND METHOD: Fourteen patients suffering from recalcitrant chronic isolated maxillary sinusitis underwent Modified IMMA between May 2010 and April 2013. The mean follow-up period was an average of about 13 months and regular intervals of postoperative 3-, 6-, 9-, 12-months were set. A retrospective review was performed to analyze the preoperative & postoperative Visual Analogue Scale score (VAS score) and Lund-Kennedy endoscopy score at each interval. VAS scores and endoscopic findings were processed statistically at the time of third postoperative month. The exclusion criteria were an obstructed ostiums, osteitis, systemic disease such as Ig A/G immunodeficiency, primary ciliary dyskinesia. RESULTS: The postoperative VAS scores and Lund-Kennedy scores, when compared with those prior to Modified IMMA, decreased from 16.5 to 2.5 and 5.0 to 1.0, respectively. Also, there was no serious complication or recurrence associated with the procedures. CONCLUSION: Our newly devised Modified IMMA could be a much effective option for surgical treatments in patients with recalcitrant chronic isolated maxillary sinusitis.
Endoscopy ; Follow-Up Studies ; Humans ; Inflammation ; Maxillary Sinus ; Maxillary Sinusitis ; Osteitis ; Recurrence ; Retrospective Studies ; Stress, Psychological

The COVID-19 pandemic has had a major impact worldwide, making it difficult to transplant unrelated hematopoietic stem cells. On the other hand, cord blood transplantations in Korea increased during the pandemic. In 2021, the release of 110 cord blood units and 83 cord blood transplantations were performed. Cord blood transplants have increased by 35% compared to the pre-pandemic period (average of 58 cases over four years vs. 78 cases over two years). This phenomenon is not only occurring in Korea. In France, cord blood transplantation in 2020 increased by 19% compared to the previous year. The cord blood is the blood in the umbilical cord and placenta that would be discarded during childbirth but can be used as a useful source of hematopoietic stem cells in the COVID-19 pandemic. In addition, it is essential to collect and store high-quality cord blood continuously because of the high likelihood of developing various therapeutic agents using cord blood.

PURPOSE: We wanted to evaluate the risk factors for developing lymphedema following axillary lymph node dissection in breast cancer patients. METHODS: Ninety-six patients who underwent axillary dissection for breast cancer were followed-up for up to 1 year. Lymphedema was assessed using a serial circumferential measurement method. More than a 2 cm difference in circumference was considered as clinically significant lymphedema. The effects of age, the body mass index (BMI), the cancer stage, chemotherapy, radiotherapy, the location of cancer and creating a latissimus dorsi (LD) flap on the development of lymphedema were analyzed. RESULTS: The incidence of lymphedema was increased with the advancing cancer stage. Radiotherapy was found to increase the incidence of lymphedema. Patients who had received an LD flap showed a lower incidence of lymphedema. CONCLUSION: These results could be useful as a clinical guideline for creating a management plan for postoperative lymphedema. Because there are some differences in the results between all the relevant reports, including ours, further research is needed in the form of a large, multi-center, long-term study.
Body Mass Index ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema* ; Radiotherapy ; Risk Factors* ; Superficial Back Muscles

BACKGROUND: Alstrom syndrome and Bardet-Biedl syndrome are autosomal recessively inherited ciliopathies with common characteristics of obesity, diabetes, and blindness. Alstrom syndrome is caused by a mutation in the ALMS1 gene, and Bardet-Biedl syndrome is caused by mutations in BBS1-16 genes. Herein we report genetically confirmed cases of Alstrom syndrome and Bardet-Biedl syndrome in Korea using whole exome sequencing. METHODS: Exome capture was done using SureSelect Human All Exon Kit V4+UTRs (Agilent Technologies). HiSeq2000 system (Illumina) was used for massive parallel sequencing. Sanger sequencing was used for genotype confirmation and familial cosegregation analysis. RESULTS: A 21-year old Korean woman was clinically diagnosed with Alstrom syndrome. She had diabetes, blindness, obesity, severe insulin resistance, and hearing loss. Whole exome sequencing revealed a nonsense mutation in exon 10 of ALMS1 (c.8776C>T, p.R2926X) and a seven base-pair deletion resulting in frameshift mutation in exon 8 (c.6410_6416del, p.2137_2139del). A 24-year-old Korean man had Bardet-Biedl syndrome with diabetes, blindness, obesity, and a history of polydactyly. Whole exome sequencing revealed a nonsynonymous mutation in exon 11 of the BBS1 gene (c.1061A>G, p.E354G) and mutation at the normal splicing recognition site of exon 7 of the BBS1 gene (c.519-1G>T). CONCLUSION: We found novel compound heterozygous mutations of Alstrom syndrome and Bardet-Biedl syndrome using whole exome sequencing. The whole exome sequencing successfully identified novel genetic variants of ciliopathy-associated diabetes.
Alstrom Syndrome ; Bardet-Biedl Syndrome ; Blindness ; Codon, Nonsense ; Diabetes Mellitus ; Exome* ; Exons ; Female ; Frameshift Mutation ; Genotype ; Hearing Loss ; Humans ; Insulin Resistance ; Korea ; Obesity ; Obesity, Morbid ; Polydactyly ; Young Adult

BACKGROUND: The identification of a marker for hypoglycemia could help patients achieve strict glucose control with a lower risk of hypoglycemia. 1,5-Anhydro-D-glucitol (1,5-AG) reflects postprandial hyperglycemia in patients with well-controlled diabetes, which contributes to glycemic variability. Because glycemic variability is related to hypoglycemia, we aimed to evaluate the value of 1,5-AG as a marker of hypoglycemia. METHODS: We enrolled 18 adults with type 2 diabetes mellitus (T2DM) receiving insulin therapy and assessed the occurrence of hypoglycemia within a 3-month period. We measured 1,5-AG level, performed a survey to score the severity of hypoglycemia, and applied a continuous glucose monitoring system (CGMS). RESULTS: 1,5-AG was significantly lower in the high hypoglycemia-score group compared to the low-score group. Additionally, the duration of insulin treatment was significantly longer in the high-score group. Subsequent analyses were adjusted by the duration of insulin treatment and mean blood glucose, which was closely associated with both 1,5-AG level and hypoglycemia risk. In adjusted correlation analyses, 1,5-AG was negatively correlated with hypoglycemia score, area under the curve at 80 mg/dL, and low blood glucose index during CGMS (P=0.068, P=0.033, and P=0.060, respectively). CONCLUSION: 1,5-AG level was negatively associated with hypoglycemia score determined by recall and with documented hypoglycemia after adjusting for mean glucose and duration of insulin treatment. As a result, this level could be a marker of the risk of hypoglycemia in patients with well-controlled T2DM receiving insulin therapy.
Adult ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia* ; Insulin*

PURPOSE: The purpose of this pilot study was to investigate the effects of mechanical interventions for deep vein thrombosis (DVT) prophylaxis in surgical intensive care unit (SICU) patients. METHODS: The participants were assigned to the intermittent pneumatic compression (IPC) and graduated compression stocking (GCS) intervention. Patients who met the criteria were selected for comparison from our previous study. Data for 140 patients were included in the final analysis. RESULTS: The mean age was 57.5 (+/-15.7) and 61.4% were men. About forty-seven percent of the participants were 61 years or over. In the second duplex scan, 3, 2 and 1 critically ill patients developed deep vein thrombosis in the control, GCS, and IPC groups, respectively. Incidences of DVT were 6.0%, 5.0%, and 2.0% for the control, GCS, and IPC groups, respectively. This difference was not significant. Relative risks of no intervention were 3.0 and 1.2 compared with IPC and GCS application. There were no significantly different variables among the three groups before the intervention except for diagnosis on admission. CONCLUSION: Although it may difficult to conclude that mechanical prophylaxis effectively prevents DVT among SICU patients because there was no statistical significance in this study, but incidence rates among the three groups differed greatly. The findings reveal that further study should be conducted with larger samples and randomized controlled trial for SICU patients.
Critical Care ; Critical Illness ; Diagnosis ; Humans ; Incidence ; Critical Care ; Intermittent Pneumatic Compression Devices ; Male ; Pilot Projects* ; Stockings, Compression* ; Venous Thrombosis*

OBJECTIVE: Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker. MATERIALS AND METHODS: A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications. RESULTS: Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient's medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours. CONCLUSIONS: Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.
Angiography ; Burns ; Carbon Monoxide Poisoning ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Cardiomyopathies* ; Charcoal* ; Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Death, Sudden ; Diagnosis ; Electrocardiography ; Emergency Service, Hospital ; Food Services ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; Occupational Health ; Occupational Health Services ; Reference Values ; Restaurants* ; Syncope

BACKGROUND: Aircraft noise is a major environmental noise problem. This study was conducted in order to investigate the relationship between sleep disturbance and exposure to aircraft noise on the residents who are living near an airport. METHODS: There were 3308 residents (1403 in the high exposure group, 1428 in the low exposure group, and 477 in the non-exposure group) selected as the subjects for this study. The Insomnia severity Index (ISI) and Epworth Sleepiness Scale (ESS) questionnaires were used to evaluate sleep disturbance. RESULTS: The mean ISI and ESS scores were 6.9 ± 6.4 and 5.5 ± 3.7, respectively, and the average scores were significantly greater in the aircraft noise exposure group, as compared to the non-exposure group. The percentage of the abnormal subjects, which were classified according to the results of the ISI and ESS, was also significantly greater in the noise exposure group, as compared to the control group. The odd ratios for insomnia and daytime hypersomnia were approximately 3 times higher in the noise exposure group, as compared to the control group. CONCLUSIONS: The prevalence of insomnia and daytime hypersomnia was higher in the aircraft noise exposure group, as compared to the control group. Further study is deemed necessary in order to clarify the causal relationship.
Aircraft* ; Airports* ; Cross-Sectional Studies* ; Disorders of Excessive Somnolence ; Noise* ; Prevalence ; Sleep Initiation and Maintenance Disorders

We hereby report a case of a 62-year-old male patient who was misdiagnosed with adrenal insufficiency during the course of protein-losing enteropathy caused by superior mesenteric arterial thrombosis. The patient was suspected to have adrenal insufficiency due to hyponatremia and severe weakness. The cortisol responses to the initial challenge of 250microgram ACTH were inadequate (maximum serum cortisol level after ACTH challenge was 10.9microgram/dL), while the serum albumin concentration was 1.9g/dL. Subsequently, intravenous steroid therapy was given to the patient. However, after bowel resection, the serum albumin level increased to 3.4g/dL and the cortisol response to the follow-up rapid ACTH stimulation was completely normal. Accordingly, we discontinued steroid replacement and discharged the patient without any problem. In conclusion, measuring total serum cortisol in a patient with hypo-pro-teinemia may lead to misdiagnosis of adrenal insufficiency. In such cases, caution should be exercised in interpreting the results in terms of total serum cortisol level or measurement of serum free cortisol levels should be considered.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Diagnostic Errors ; Follow-Up Studies ; Humans ; Hydrocortisone* ; Hyponatremia ; Male ; Middle Aged ; Protein-Losing Enteropathies* ; Serum Albumin ; Thrombosis