Background: and Purpose Premanifest mutation carriers with spinocerebellar ataxia (SCA) can exhibit subtle abnormalities before developing ataxia. We summarized the preataxic manifestations of SCA1, -2, -3, and -6, and their associations with ataxia onset. Methods: We included studies of the premanifest carriers of SCA published between January 1998 and December 2019 identified in Scopus and PubMed by searching for terms including ‘spinocerebellar ataxia’ and several synonyms of ‘preataxic manifestation’. We systematically reviewed the results obtained in studies categorized based on clinical, imaging, and laboratory markers. Results: We finally performed a qualitative analysis of 48 papers. Common preataxic manifestations appearing in multiple SCA subtypes were muscle cramps, abnormal muscle reflexes, instability in gait and posture, lower Composite Cerebellar Functional Severity scores, abnormalities in video-oculography and transcranial magnetic stimulation, and gray-matter loss and volume reduction in the brainstem and cerebellar structures. Also, decreased sensory amplitudes in nerve conduction studies were observed in SCA2. Eotaxin and neurofilament lightchain levels were revealed as sensitive blood biomarkers in SCA3. Concerning potential predictive markers, hyporeflexia and abnormalities of somatosensory evoked potentials showed correlations with the time to ataxia onset in SCA2 carriers. However, no longitudinal data were found for the other SCA gene carriers. Conclusions Our results suggest that preataxic manifestations vary among SCA1, -2, -3, and -6, with some subtypes sharing specific features. Combining various markers into a standardized index for premanifest carriers may be useful for early screening and assessing the risk of disease progression in SCA carriers.

Background: and Purpose Premanifest mutation carriers with spinocerebellar ataxia (SCA) can exhibit subtle abnormalities before developing ataxia. We summarized the preataxic manifestations of SCA1, -2, -3, and -6, and their associations with ataxia onset. Methods: We included studies of the premanifest carriers of SCA published between January 1998 and December 2019 identified in Scopus and PubMed by searching for terms including ‘spinocerebellar ataxia’ and several synonyms of ‘preataxic manifestation’. We systematically reviewed the results obtained in studies categorized based on clinical, imaging, and laboratory markers. Results: We finally performed a qualitative analysis of 48 papers. Common preataxic manifestations appearing in multiple SCA subtypes were muscle cramps, abnormal muscle reflexes, instability in gait and posture, lower Composite Cerebellar Functional Severity scores, abnormalities in video-oculography and transcranial magnetic stimulation, and gray-matter loss and volume reduction in the brainstem and cerebellar structures. Also, decreased sensory amplitudes in nerve conduction studies were observed in SCA2. Eotaxin and neurofilament lightchain levels were revealed as sensitive blood biomarkers in SCA3. Concerning potential predictive markers, hyporeflexia and abnormalities of somatosensory evoked potentials showed correlations with the time to ataxia onset in SCA2 carriers. However, no longitudinal data were found for the other SCA gene carriers. Conclusions Our results suggest that preataxic manifestations vary among SCA1, -2, -3, and -6, with some subtypes sharing specific features. Combining various markers into a standardized index for premanifest carriers may be useful for early screening and assessing the risk of disease progression in SCA carriers.

BACKGROUND: Transforaminal epidural steroid injection is one of the effective treatments in managing radicular pain. There have been some prospective studies on the depth to the epidural space with the transforaminal approach. However, there have been no studies about the depth in Asians, especially Koreans. This study was carried out in order to evaluate the depth to the epidural space and the oblique angle and factors that influence the depth to the epidural space during lumbar transforaminal epidural injection. METHODS: A total of 248 patients undergoing fluoroscopically guided transforaminal epidural steroid injections were evaluated. At the L3-4, L4-5, L5-S1, and S1 levels, we measured the oblique angle and depth to the epidural space. RESULTS: Needle depth was positively associated with body mass index (correlation coefficient 0.52, P = 0.004). The median depths (in centimeters) to the epidural space were 6.13 cm, 6.42 cm, and 7.13 cm for 50-60 kg, 60-70 kg, and 70-80 kg groups, respectively, at L5-S1. Age and height were not significantly associated with the needle depth. CONCLUSIONS: There is a positive association between the BMI (and weight) and transforaminal epidural depth but not with age, sex, and height.
Asian Continental Ancestry Group ; Body Mass Index ; Epidural Space ; Humans ; Needles

BACKGROUND: The indocyanine green (ICG) finger monitoring method is a newly developed noninvasive method for the ICG clearance test. This study was performed to determine its clinical usefulness compared with the conventional blood sampling method. METHODS: The ICG clearance test was performed on 270 patients using both the conventional blood sampling method and the finger monitoring method simultaneously. The plasma disappearance rate of the ICG and the 15-minute retention ratio (ICG R15) were analyzed and compared with the conventional blood sampling method. RESULTS: The plasma disappearance rate using the finger monitoring method was slightly lower than that of the conventional blood sampling method with good correlation (r=0.840, P<0.001). ICG R15 using finger monitoring method was slightly higher than that of the conventional blood sampling method with good correlation (r=0.839, P<0.001). CONCLUSIONS: As there was a good correlation between the conventional blood sampling method and the finger monitoring method, the latter method seemed to be clinically useful due to its convenience and accuracy.
Fingers* ; Humans ; Indocyanine Green* ; Plasma

BACKGROUND: The objective of this study was to assess the serum 25-hydroxyvitamin D (25OHD) status and evaluate the associated factors in a Korean pediatric population aged 0-18 yr. METHODS: Serum 25OHD levels were retrospectively analyzed in 13,236 Korean children and adolescents. 25OHD tests by chemiluminescent immunoassay were requested from 332 medical institutions nationwide in Korea between January 2014 and December 2014. Prevalence of vitamin D deficiency (VDD) and insufficiency (VDI) and the associated factors were analyzed. VDD and VDI were defined as serum 25OHD levels of <20.0 ng/mL and 20.0-29.9 ng/mL, respectively. RESULTS: The 25OHD levels negatively correlated with age (r=-0.4033, P<0.001). Overall, 79.8% boys and 83.8% girls had hypovitaminosis D (VDI or VDD). The Odds ratios (ORs) of being in the VDD/VDI category as against the reference category of VDS (vitamin D sufficiency) were as follows: increase in age by 1 yr (OR=1.42/1.25, all P<0.001); girls (OR=1.32/1.16, P<0.001/P=0.004) compared to boys, spring (OR=1.61/1.80), fall (OR=1.31/1.28), and winter (OR=1.44/2.03, all P<0.001) compared to summer season; living in urban areas (OR=1.23, P<0.001) compared to rural areas. CONCLUSIONS: VDD and VDI are highly prevalent in children and adolescents in Korea. Serum 25OHD levels decreased significantly according to increasing age. Winter and spring seasons, increasing age, female sex, and living in urban areas are the factors associated with a high risk of VDD or VDI.
Adolescent* ; Child* ; Female ; Humans ; Immunoassay ; Korea ; Odds Ratio ; Prevalence* ; Retrospective Studies ; Seasons ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

The purpose of this study was to evaluate the effect of chlorhexidine (CHX) on microtensile bond strength (microTBS) of dentin bonding systems. Dentin collagenolytic and gelatinolytic activities can be suppressed by protease inhibitors, indicating that MMPs (Matrix metalloproteinases) inhibition could be beneficial in the preservation of hybrid layers. Chlorhexidine (CHX) is known as an inhibitor of MMPs activity in vitro. The experiment was proceeded as follows: At first, flat occlusal surfaces were prepared on mid-coronal dentin of extracted third molars. GI (Glass Ionomer) group was treated with dentin conditioner, and then, applied with 2% CHX. Both SM (Scotchbond Multipurpose) and SB (Single Bond) group were applied with CHX after acid-etched with 37% phosphoric acid. TS (Clearfil Tri-S) group was applied with CHX, and then, with adhesives. Hybrid composite Z-250 and resin-modified glass ionomer Fuji-II LC was built up on experimental dentin surfaces. Half of them were subjected to 10,000 thermocycle, while the others were tested immediately. With the resulting data, statistically two-way ANOVA was performed to assess the microTBS before and after thermocycling and the effect of CHX. All statistical tests were carried out at the 95% level of confidence. The failure mode of the testing samples was observed under a scanning electron microscopy (SEM). Within limited results, the results of this study were as follows; 1. In all experimental groups applied with 2% chlorhexidine, the microtensile bond strength increased, and thermocycling decreased the microtensile bond strength (P > 0.05). 2. Compared to the thermocycling groups without chlorhexidine, those with both thermocycling and chlorhexidine showed higher microtensile bond strength, and there was significant difference especially in GI and TS groups. 3. SEM analysis of failure mode distribution revealed the adhesive failure at hybrid layer in most of the specimen, and the shift of the failure site from bottom to top of the hybrid layer with chlorhexidine groups. 2% chlorhexidine application after acid-etching proved to preserve the durability of the hybrid layer and microtensile bond strength of dentin bonding systems.
Acrylic Resins ; Adhesives ; Chimera ; Chlorhexidine ; Dentin ; Glass ; Matrix Metalloproteinases ; Microscopy, Electron, Scanning ; Molar, Third ; Phosphoric Acids ; Protease Inhibitors ; Silicon Dioxide

Proteoglycan is highly hydrophilic and negatively charged which enable them attract the water. The objective of study was to investigate the effects of Proteoglycan on microtensile bond strength of dentin adhesives and on architecture of dentin collagen matrix of acid etched dentin by removing the chondroitin sulphate attached on Proteoglycan. A flat dentin surface in mid-coronal portion of tooth was prepared. After acid etching, half of the specimens were immersed in 0.1 U/mL chondroitinase ABC (C-ABC) for 48 h at 37degrees C, while the other half were stored in distilled water. Specimens were bonded with the dentin adhesive using three different bonding techniques (wet, dry and re-wet) followed by microtensile bond strength test. SEM examination was done with debonded specimen, resin-dentin interface and acid-etched dentin surface with/without C-ABC treatment. For the subgroups using wet-bonding or dry-bonding technique, microtensile bond strength showed no significant difference after C-ABC treatment (p > 0.05). Nevertheless, the subgroup using rewetting technique after air dry in the Single Bond 2 group demonstrated a significant decrease of microtensile bond strength after C-ABC treatment. Collagen architecture is loosely packed and some fibrils are aggregated together and relatively collapsed compared with normal acid-etched wet dentin after C-ABC treatment. Further studies are necessary for the contribution to the collagen architecture of noncollagenous protein under the various clinical situations and several dentin conditioners and are also needed about long-term effect on bond strength of dentin adhesive.
Adhesives ; Bisphenol A-Glycidyl Methacrylate ; Chondroitin ; Chondroitin ABC Lyase ; Chondroitin Sulfates ; Collagen ; Dentin ; Proteoglycans ; Tooth ; Water

The objectives of this study was to evaluate the durability of 4 resin cements by means of microtensile bond strength test combined with thermocycling method and fractographic FE-SEM analysis. Experimental groups were prepared according to thermocycling (0, 1,000, 5,000) and the kind of resin cements, those were Variolink II, Multilink, Panavia F 2.0, Rely X Unicem. Flat dentin surfaces were created on mid-coronal dentin of extracted third molars. Then fresh dentin surface was grounded with 320-grit silicon carbide abrasive papers to create uniform smear layers. Indirect composite block (Tescera, Bisco Inc., Schaumburg, IL, USA) was fabricated (12 x 12 x 6 mm3). It's surface for bonding to tooth was grounded with silicon carbide abrasive papers from 180- to 600-grit serially, then sandblasted with 20 - 50 microm alumina oxide. According to each manufacturer's instruction, dentin surface was treated and indirect composite block was luted on it using each resin cement. For Rely X Unicem, dentin surface was not treated. The bonded tooth-resin block were stored in distilled water at 37degrees C for 24 hours. After thermocycling, the bonded tooth-resin block was sectioned occluso-gingivally to 1.0 mm thick serial slabs using an Isomet slow-speed saw (Isomet, Buehler Ltd, Lake Bluff, IL, USA). These sectioned slabs were further sectioned to 1.0 x 1.0 mm2 composite-dentin beams. The specimens were tested with universal testing machine (EZ-Test, Shimadzu, Japan) at a crosshead speed of 1.0 mm/min with maximum load of 500 N. The data was analyzed using one-way ANOVA and Duncan's multiple comparison test at p < or = 0.05 level. Within the limited results, we conclude as follows; 1. The bond strength of Variolink II was evaluated the highest among experimental groups and was significantly decreased after 1,000 thermocycling (p < 0.05). 2. The bond strength of Multilink was more affected by thermocycling than the other experimental groups and significantly decreased after 1,000 thermocycling (p < 0.05). 3. Panavia F 2.0 and Rely X Unicem showed the gradually decreased tendency of microtensile bond strength according to thermocycling but there was no significant difference (p > 0.05). 4. Adhesive based-resin cements showed lower bond strength with or without thermocycling than composite based-resin cements. 5. Variolink II & Multilink showed high bond strength and mixed failure, which was occurred with a thin layer of luting resin cement before thermocycling and gradually increased adhesive failure along the dentin surface after thermocycling. The bonding performance of resin cement can be affected by application procedure and chemical composition. Composite based-resin cement showed higher bond strength and durability than adhesive based-resin cement.
Adhesives ; Aluminum Oxide ; Dentin ; Lakes ; Molar, Third ; Resin Cements* ; Tooth ; Water

Mycobacterium neoaurum is rapidly growing mycobacteria that can cause human infections. It commonly causes bloodstream infections in immunocompromised hosts, and unlike other mycobacteria species, it rarely causes pulmonary infections. We confirmed the first pulmonary infection case in Korea caused by M. neoaurum using full-length 16S rRNA gene sequencing.
Adult ; Female ; Humans ; Lung Diseases/*diagnosis/microbiology ; Mycobacterium/genetics/*isolation & purification ; Mycobacterium Infections/*diagnosis/microbiology ; Nontuberculous Mycobacteria/genetics/isolation & purification ; RNA, Ribosomal, 16S/genetics ; Republic of Korea ; Sequence Analysis, RNA

PURPOSE: To study the safety of more aggressive parenteral amino acid supplementation on liver functions during parenteral nutrition in preterm infants. METHODS: Medical records of preterm infants (n=58) treated in the neonatal intensive care unit from 2004 through 2008 with birth weight less than 2,000 g and exposure to parenteral nutrition (PN) for more than 7 days were reviewed. Patients were divided into two groups; low amino acid intake group (LAA, n=32) admitted from January 2004 to May 2006 and high amino acid intake group (HAA, n=26) admitted from June 2006 to July 2008. The incidence of cholestasis was compared between the two groups and the liver functions in infants with cholestasis were evaluated. RESULTS: Mean protein intake was significantly higher in HAA (1.0+/-0.2 g/kg/day vs 2.1+/-0.6 g/kg/day, P=0.001). But there were no differences in the incidence and duration of cholestasis between the groups. And peak total bilirubin (T.bil), peak direct bilirubin (D.bil), peak alanine aminotransferase (ALT), peak asparate aminotransferase (AST), and peak alkaline phosphatase (ALP) in infants with cholestasis were not significantly different. CONCLUSION: Aggressive parenteral amino acid supplementation in preterm infants were not associated significantly with the liver functions in this study.
Alanine Transaminase ; Alkaline Phosphatase ; Bilirubin ; Birth Weight ; Cholestasis ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Liver ; Medical Records ; Parenteral Nutrition