No abstract available.
Rheumatic Fever*

PURPOSE: To identify novel proteins which bind to myocilin, using a yeast two-hybrid screening system. METHODS: A bait plasmid of myocilin was constructed, and then transformed into yeast AH109. The transformed yeast cells were mated with yeast Y187 containing human skeletal muscle cDNA library plasmids in 2 X YPD medium. Mated diploid yeasts were plated on synthetic dropout medium (SD/-Trp-Leu-His and SD/-Trp-Leu-His-Ade). The positive clones grown on the selective medium were amplified, sequenced, and analyzed using the database of GenBank. The expression of selected genes in trabecular meshwork (TM) cells was detected by RT-PCR. RESULTS: The expression of bait protein in yeast was confirmed by Western blot analysis. Extensive screening of a cDNA library led to the selection of twenty-four positive clones which represent eight genes, including six of cytoskeleton associated proteins such as alpha-actin, myosin regulatory light chain 2A, dynactin, syntrophin alpha1, microtubule associated protein 1B, and myosin binding protein C. CONCLUSIONS: Myocilin may interact with cytoskeleton associated proteins in TM cells. Further studies on their interactions will provide functional clues of myocilin.
Actins ; Blotting, Western ; Carrier Proteins ; Clone Cells ; Cytoskeleton ; Databases, Nucleic Acid ; Diploidy ; Gene Library ; Humans ; Mass Screening* ; Microtubules ; Muscle, Skeletal ; Myosin Light Chains ; Myosins ; Patient Dropouts ; Plasmids ; Trabecular Meshwork ; Yeasts

One-lung anesthesia can be very helpful to the surgeon during operations on the lung, mediastinum, esophagus, and thoracic aorta The standard method for one-lung anesthesia uses a double-lumen tube (Carlens, Robertshaw, etc). However, these tubes are diffieult to place and may not remain in a correct position. In addition, the lumen of each channel is inevitably too smaU for proper ventilation and suctioning. We have designed a new device for one-lung anesthesia which overcomes these disadvantages. This new device, named SLT (single-lumen tube), was made by amoured wire tube, the proximal end of which was connected to the Rusch rubber tube. So, this tube is larger in diameter, available in various sizes and very economic. We intubated 25 cardiothoracic patients with SLT under the fiberoptic guidance (Group A), and the other 25 cardiothoracic patients were intubated with Bobertshaw double-lumen tube by the direct laryngoscopy (Group B). There were no significant differences in heart rate, blood pressure, PH, PaCO2, PaO2 BE, HCO3, SaO2 and ETCO2 between the two groups compared with induction, one-lung ventilation, and two-lung ventilation values.
Anesthesia ; Aorta, Thoracic ; Blood Gas Analysis* ; Blood Pressure ; Esophagus ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Laryngoscopy ; Lung ; Mediastinum ; One-Lung Ventilation* ; Rubber ; Suction ; Ventilation

BACKGROUND AND OBJECTIVES: We evaluated the short-term treatment outcomes of combined bifrontal transcranial direct current stimulation (tDCS) and tailor-made notched music training (TMNMT) in tinnitus patients. The associations of patient characteristics with treatment responsiveness were investigated. SUBJECTS AND METHODS: Four sessions of bifrontal tDCS (F4: anode, F3: cathode) and TMNMT were conducted over a 2-week period in tinnitus patients. For tDCS, the stimulation intensity was 1.5 mA and the duration was approximately 20 min. During tDCS, patients listened to music lacking the frequency band within 1 octave of the tinnitus frequency. Patients were also instructed to listen to this music at home for at least 2 hours per day. One month after the final tDCS session, loudness (LD), awareness (AW), annoyance (AN), and effect on life (EL) of tinnitus were assessed subjectively using a visual analog scale. RESULTS: A total of 14 patients were enrolled in this study. After treatment, a 50% or greater improvement in AN, AW, EL, and LD was observed in 57.1, 42.9, 35.7, and 28.6% of patients, respectively. Furthermore, 78.6% of patients showed a 50% or greater improvement in their tinnitus handicap inventory scores. For AN, the absence of sleep disturbance was significantly associated with treatment responsiveness (p=0.041, OR=24.0). CONCLUSIONS: Combined bifrontal tDCS and TMNMT is a promising treatment for chronic tinnitus. To maximize the treatment outcomes of this therapy, sleep disturbances should also be addressed in candidate patients.
Electrodes ; Humans ; Music* ; Prognosis ; Tinnitus* ; Transcranial Direct Current Stimulation* ; Visual Analog Scale

PURPOSE: We evaluated the hypothesis that the telomerase expression is associated with c-Myc and peroxiredoxin I (Prx I) in patients with prostate cancer. The study determined the link between Prx I, c-Myc and human telomerase reverse transcriptase (hTERT) in prostate cancer cells. MATERIALS AND METHODS: The cDNA of the Prx I gene was obtained by reverse-transcriptase polymerase chain reaction (RT-PCR) amplification. Cotransfections were performed by using a hTERT luciferase reporter plasmid and each expression vector as indicated (c-Myc or Prx I). Empty vectors were used as controls for determining the basal promoter activity. RT-PCR was performed to evaluate the effect of the DEM-induced Prx I mRNA expression. Luciferase assay was performed to evaluate the inhibitory effect of transfected Prx I and the DEM induced Prx I on the transcriptional activity of hTERT in the human prostatic cancer cell lines PC-3 and DU-145. RESULTS: In this study, we found that Prx I could inhibit hTERT expression through direct interaction with c-Myc protein in the prostate cancer cell lines. In addition, it was obvious that Prx I could interact with c-Myc protein. We also found that DEM could induce upregulation of the Prx I mRNA expression and that the increased expression of Prx I could downregulate the expression of hTERT. CONCLUSIONS: Our results demonstrated a direct link between Prx I, c-Myc and hTERT, and we suggest that Prx I regulates cellular immortalization through c-Myc and hTERT, which is activation step in carcinogenesis.
Carcinogenesis ; Cell Line ; DNA, Complementary ; Humans* ; Luciferases ; Peroxiredoxins* ; Plasmids ; Polymerase Chain Reaction ; Prostatic Neoplasms* ; RNA, Messenger ; Telomerase* ; Up-Regulation

PURPOSE: The increased tolerability of enteric-coated mycophenolate sodium (EC-MPS), compared to mycophenolate mofetil, among kidney transplant recipients has the potential to facilitate cyclosporine (CsA) minimization. Therefore, a prospective trial to determine the optimum EC-MPS dose in CsA-based immunosuppression regimens is necessary. MATERIALS AND METHODS: A comparative, parallel, randomized, open-label study was performed for 140 patients from four centers to compare the efficacy and tolerability of low dose CsA with standard dose EC-MPS (the investigational group) versus standard dose CsA with low dose EC-MPS (the control group) for six months in de novo kidney transplant recipients. Graft function, the incidence of efficacy failure [biopsy-confirmed acute rejection (BCAR), death, graft loss, loss to follow-up], and adverse events were compared. RESULTS: The mean estimated glomerular filtration rate (eGFR) of the investigational group at six months post-transplantation was non-inferior to that of the control group (confidence interval between 57.3 mL/min/1.73m² and 67.4 mL/min/1.73 m², p<0.001). One graft loss was reported in the control group, and no patient deaths were reported in either group. The incidence of BCAR of the investigational group was 8.7%, compared to 18.8% in the control group (p=0.137), during the study period. There were no significant differences (p>0.05) in the incidence of discontinuations and serious adverse events (SAE) between the groups. CONCLUSION: CsA minimization using a standard dose of EC-MPS kept the incidence of acute rejection and additional risks as low as conventional immunosuppression and provided therapeutic equivalence in terms of renal graft function and safety issues.
Adult ; Aged ; Cyclosporine/*administration & dosage ; Female ; Graft Rejection/*prevention & control ; Humans ; Immunosuppressive Agents/*administration & dosage ; Incidence ; Kidney Transplantation ; Male ; Middle Aged ; Mycophenolic Acid/*administration & dosage ; Prospective Studies ; Tablets, Enteric-Coated ; Time Factors

BACKGROUND AND OBJECTIVES: Recently, the swinging door and grafting techniques have been heavily used for straightening and holding the caudal septum. However, reconstructive septoplasties require more extensive dissection of septal structures. Extensive anatomical dissection and complicated procedures may affect the probability of postoperative bleeding and infection. MATERIALS AND METHOD: We retrospectively reviewed the records of 141 consecutive patients who underwent septal surgeries from February 2013 to December 2015. The patients were classified into two groups according to surgical technique: those who underwent submucous resection with or without endoscopy were classified as the “resection” group, while those who underwent the swinging door or batten graft technique were classified as the “reconstruction” group. The resection and reconstruction groups were matched using the propensity score. The incidence of postoperative septal abscesses (PSAs) was analyzed between the two groups. RESULTS: For the two groups, 36 patients were matched with 36 patients (1:1) using the propensity score. Of the 72 patients, PSAs developed in 5 patients (6.9%). One patient was in the resection group (2.8%), while the other four patients were in the reconstruction group (11.1%). However, the incidence of PSAs was not significantly higher in the reconstruction group according to Fisher's exact test (p=0.164). CONCLUSION: Reconstructive septoplasty resulted in more septal abscesses than resection, but the difference was not significant.
Abscess* ; Endoscopy ; Hemorrhage ; Humans ; Incidence ; Methods ; Nasal Septum ; Postoperative Complications ; Propensity Score ; Retrospective Studies ; Transplants ; Wound Infection

Background and Objectives: Parapharyngeal space abscess (PPSA) may cause severe complications such as, airway obstruction, jugular thrombophlebitis, and mediastinitis unless early diagnosed and properly treated. Transoral drainage is known to reduce morbidity and hospital stays compared to the external drainage. The aim of this study is to assess the effect of endoscope when draining of PPSA via transoral approach.Subjects and Method We retrospectively reviewed charts of patients who were diagnosed with PPSA and treated surgically between February 2013 and September 2018. We included in the study 39 patients who underwent incisional drainage via transoral approach. Pateints were excluded had they undergo drainage via external approach or who treated with medication alone or operated for parapharyngeal space tumor. Thirty-nine patients were classified into two groups according to whether an endoscope was used or not when draining PPSA. We compared the hospital stays, estimated blood loss (EBL), operating time, revision rate, depth of abscess, and postoperative complications between two groups. Results: Of the 39 patients [22 males (M), 17 females (F)], 13 patients (M:F=7:6) were classified as an endoscope group (EG) and 26 (M:F=15:9) as without endoscope group (WEG). The mean hospital stays of the EG and WEG were 7.6±4.6 and 9.8±4.8 days, respectively (p=0.188); the mean EBL of the EG and WEG were 222.2 and 254.0 mL, respectively (p=0.595); the mean operating time of the EG and WEG were 40.0±22.5 and 35.4±14.5 minutes, respectively (p= 0.457); the mean depth of PPSA of the EG and WEG were 4.5±0.9 and 4.0±0.7 c-spine level, respectively (p=0.043), and the revision cases of the EG and WEG were 1 and 2, respectively (p=1.000). Conclusion Endoscopes enabled the draining of PPSA to sit more deeply in the neck compared without it.

Objective: To conduct a simulation study to determine whether artificial intelligence (AI)-aided mammography reading can reduce unnecessary recalls while maintaining cancer detection ability in women recalled after mammography screening. Materials and Methods: A retrospective reader study was performed by screening mammographies of 793 women (mean age ± standard deviation, 50 ± 9 years) recalled to obtain supplemental mammographic views regarding screening mammographydetected abnormalities between January 2016 and December 2019 at two screening centers. Initial screening mammography examinations were interpreted by three dedicated breast radiologists sequentially, case by case, with and without AI aid, in a single session. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and recall rate for breast cancer diagnosis were obtained and compared between the two reading modes. Results: Fifty-four mammograms with cancer (35 invasive cancers and 19 ductal carcinomas in situ) and 739 mammograms with benign or negative findings were included. The reader-averaged AUC improved after AI aid, from 0.79 (95% confidence interval [CI], 0.74–0.85) to 0.89 (95% CI, 0.85–0.94) (p < 0.001). The reader-averaged specificities before and after AI aid were 41.9% (95% CI, 39.3%–44.5%) and 53.9% (95% CI, 50.9%–56.9%), respectively (p < 0.001). The reader-averaged sensitivity was not statistically different between AI-unaided and AI-aided readings: 89.5% (95% CI, 83.1%–95.9%) vs.92.6% (95% CI, 86.2%–99.0%) (p = 0.053), although the sensitivities of the least experienced radiologists before and after AI aid were 79.6% (43 of 54 [95% CI, 66.5%–89.4%]) and 90.7% (49 of 54 [95% CI, 79.7%–96.9%]), respectively (p = 0.031). With AI aid, the reader-averaged recall rate decreased by from 60.4% (95% CI, 57.8%–62.9%) to 49.5% (95% CI, 46.5%–52.4%) (p < 0.001). Conclusion AI-aided reading reduced the number of recalls and improved the diagnostic performance in our simulation using women initially recalled for supplemental mammographic views after mammography screening.

Radiofrequency ablation (RFA) has been widely used for treating localized hepatocellular carcinoma (HCC). Metastasis to the chest wall through the tract during performing RFA may occur uncommonly. However, it is extremely rare that massive hematochezia occurs by colonic invasion of metastatic focus on chest wall. A 48-year-old man was presented with approximately 500 cc of hematochezia. He was diagnosed as having HCC 6 years ago, and underwent RFA 3 times over a period of 5 years. Twelve months ago, right lobectomy was done on recurred lesion. 5 months ago, HCC recurred through invasion to the chest wall involving the right 5th rib, but there have been no recurrent tumor masses on the liver on CT until admission. Emergent colonoscopy demonstrated a 3 x 3 cm sized extrinsic mass on proximal transverse colon that had a blood clot. Pathology from colonic mass revealed pseudoglandular type of HCC.
Carcinoma, Hepatocellular* ; Catheter Ablation ; Colon* ; Colon, Transverse ; Colonoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Liver ; Middle Aged ; Neoplasm Metastasis* ; Pathology ; Ribs ; Thoracic Wall* ; Thorax*