Equivalent dipole source localization is a well-established approach to localizing the electrical activity in electroencephalogram (EEG). So far, source localization has been used primarily in localizing the epileptic source in human epileptic patients. Currently, source localization techniques have been applied to account for localizing epileptic source among the epileptic patients. Here, we present the first application of source localization in the field of sleep spindle in mouse brain. The spatial distribution of cortical potential was obtained by high density EEG and then the anterior and posterior sleep spindles were classified based on the K-mean clustering algorithm. To solve the forward problem, a realistic geometry brain model was produced based on boundary element method (BEM) using mouse MRI. Then, we applied four different source estimation algorithms (minimum norm, eLORETA, sLORETA, and LORETA) to estimate the spatial location of equivalent dipole source of sleep spindles. The estimated sources of anterior and posterior spindles were plotted in a cine-mode that revealed different topographic patterns of spindle propagation. The characterization of sleep spindles may be better be distinguished by our novel visualization method.
Animals ; Brain ; Electroencephalography* ; Humans ; Insulator Elements ; Magnetic Resonance Imaging ; Methods* ; Mice

Disasters are unpredictable and unavoidable. The definition of disaster is a serious disruption of the functioning of society, causing widespread human, material, or environmental losses that exceed the ability of affected society to cope using only its own resources. Disaster medicine is a discipline resulting from combination of emergency medicine and disaster management. The field of disaster medicine involves the study of subject matter from multiple medical disciplines, and disaster medicine presents unique ethical situations not seen in other areas of medicine. Disaster can be classified into two categories, natural disaster and manmade disaster, each type of disaster has its own characteristics. Disaster management has a cycle of 4 activities, preparedness, response, recovery, and prevention/mitigation. Disaster medicine specialists have a role in each part of this cycle. To achieve effective disaster response, the National Disaster Life Support Foundation suggests the DISASTER Paradigm(TM), which consists of detection, incident command, safety and security, assess hazards, support, triage and treatment, evacuation, and recovery.
Disaster Medicine ; Disaster Planning ; Disasters* ; Emergencies ; Emergency Medicine ; Humans ; Mass Casualty Incidents ; Specialization ; Triage

No abstract available.
Acupuncture* ; Mycobacterium*

Inappropriate shocks from an implantable cardioverter defibrillator (ICD) can cause potentially dangerous ventricular arrhythmias and impaired quality of life. We describe a case in which a dislodged lead caused inappropriate ICD shocks through simultaneous sensing of atrial and ventricular signals. Interestingly, repeated short-long R-R sequences were recorded, but ICD interrogation parameters were usually unchanged.
Arrhythmias, Cardiac ; Defibrillators ; Quality of Life ; Shock

An algific talus slope is composed of broken rocks with vents connected to an ice cave, releasing cool air in summer and relatively warmer air in winter to maintain a more stable microclimate all year round. Such geological features create a very unusual and delicate ecosystem. Although there are around 25 major algific talus slopes in Korea, lichen ecology of these areas had not been investigated to date. In this study, we report the first exploration of lichen diversity and ecology at an algific talus slope, Jangyeol-ri, in Korea. A total of 37 specimens were collected over 2017–2018. Morphological and sequencing analysis revealed 27 species belonging to 18 genera present in the area. Of particular interest among these species was Solorina saccata, as it has previously not been reported in Korea and most members of genus Solorina are known to inhabit alpine regions of the Northern Hemisphere. We provide here a taxonomic key for S. saccata alongside molecular phylogenetic analyses and prediction of potential habitats in South Korea. Furthermore, regions in South Korea potentially suitable for Solorina spp. were predicted based on climatic features of known habitats around the globe. Our results showed that the suitable areas are mostly at high altitudes in mountainous areas where the annual temperature range does not exceed 26.6 °C. Further survey of other environmental conditions determining the suitability of Solorina spp. should lead to a more precise prediction of suitable habitats and trace the origin of Solorina spp. in Korea.

Peptidoglycan (PG), the gram positive bacterial pathogen-associated molecular patterns (PAMP), is detected in a high proportion in macrophage-rich atheromatous regions, and expression of chemokine CXCL8, which triggers monocyte arrest on early atherosclerotic endothelium, is elevated in monocytes/macrophages in human atherosclerotic lesion. The aim of this study was to investigate whether PG induced CXCL8 expression in the cell type and to determine cellular signaling pathways involved in that process. Exposure of THP-1 cell, human monocyte/macrophage cell line, to PG not only enhanced CXCL8 release but also profoundly induced il8 gene transcription. PG-induced release of CXCL8 and induction of il8 gene transcription were blocked by OxPAPC, an inhibitor of TLR-2/4 and TLR4, but not by polymyxin B, an inhibitor of LPS. PG-mediated CXCL8 release was significantly attenuated by inhibitors of PI3K-Akt-mTOR pathways. PKC inhibitors, MAPK inhibitors, and ROS quenchers also significantly attenuated expression of CXCL8. The present study proposes that PG contributes to inflammatory reaction and progression of atherosclerosis by inducing CXCL8 expression in monocytes/macrophages, and that TLR-2, PI3K-Akt-mTOR, PKC, ROS, and MAPK are actively involved in the process.
Atherosclerosis ; Cell Line ; Endothelium ; Humans ; Interleukin-8 ; Monocytes ; Peptidoglycan* ; Polymyxin B

Thoracic endovascular aortic repair (TEVAR) has emerged as an effective therapy for a variety of thoracic aortic pathologies. However, various types of endoleak remain a major concern, and its treatment is often challenging. We report a case of type I endoleak occurring 19 months after zone II hybrid TEVAR. The endoleak was successfully repaired by the frozen elephant trunk technique, without removal of a previous stent graft, combined with ascending aorta and total arch replacement.
Aneurysm ; Aorta ; Blood Vessel Prosthesis ; Elephants* ; Endoleak* ; Pathology

An extended-release (ER) fixed-dose combination (FDC) of tramadol 37.5 mg/acetaminophen 325 mg was developed due to the demand for varying dosages. This study aimed to evaluate the pharmacokinetics (PKs) for two tablets of the new developed tramadol 37.5 mg/acetaminophen 325 mg ER FDC (DW-0920, Wontran Semi ER®) as test formulation compared to one tablet of the tramadol 75 mg/acetaminophen 650 mg ER FDC (DW-0919, Wontran ER®) as reference formulation. A randomized, open-label, 2-way crossover study was conducted in 30 healthy subjects. Subjects were orally administered one of 2 formulations followed by an alternate formulation with a 7-day washout period. Blood samples were collected up to 36 hours post-dose. Plasma concentrations of tramadol and acetaminophen were determined using a validated high-performance liquid chromatography with tandem mass spectrometric method. The geometric mean ratios (GMRs) and their 90% confidence intervals (90% CIs) of test formulation to reference formulation were calculated for the maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve from zero to the last measurable time point (AUClast). The PK profiles of 2 formulations were comparable. The GMRs (90% CI) of Cmax and AUClast for tramadol were 1.086 (1.047–1.127) and 1.008 (0.975–1.042), respectively. The corresponding values for acetaminophen were 0.956 (0.897–1.019) and 0.986 (0.961–1.011), respectively. All the values were within the bioequivalence range of 0.80–1.25. Two tablets of DW-0920 were comparable to one tablet of DW-0919. The DW-0920 may be used for optimal pharmacotherapy for pain control with a lower dose.

Herein, we report a case of uncomplicated falciparum malaria with late parasitological failure in a 45-year-old businessman returning from Ghana. The patient visited the emergency department with high fever, headache, and dizziness. He traveled without antimalarial chemoprophylaxis. Laboratory tests led to the diagnosis of uncomplicated falciparum malaria with an initial density of 37,669 parasites per μL of blood (p/μL). The patient was treated with intravenous artesunate followed by atovaquone/proguanil. He was discharged with improved condition and decreased parasite density of 887 p/μL. However, at follow-up, parasite density increased to 7,630 p/μL despite the absence of any symptoms. Suspecting treatment failure, the patient was administered intravenous artesunate and doxycycline for seven days and then artemether/lumefantrine for three days. Blood smear was negative for asexual parasitemia after re-treatment but positive for gametocytemia until day 101 from the initial diagnosis. Overall, this case highlights the risk of late parasitological failure in patients with imported uncomplicated falciparum malaria.

A patient presented with loss of consciousness and conversion. During an exercise test, catecholaminergic polymorphic ventricular tachycardia (CPVT) resulted in cardiac arrest. He started taking medication (a beta-blocker and flecainide) and an implantable cardioverter defibrillator (ICD) was inserted, but the ventricular tachycardia did not resolve. Left cardiac sympathetic denervation (LCSD) was then performed under general anesthesia, and the patient was discharged on the second postoperative day without complications. One month after the operation, no shock had been administered by the ICD, and an exercise stress test did not induce ventricular tachycardia. Although beta-blockers are the gold standard of therapy in patients with CPVT, thoracoscopic LCSD is safe and can be an effective alternative treatment option for patients with intractable CPVT.
Anesthesia, General ; Defibrillators ; Defibrillators, Implantable* ; Exercise Test ; Heart Arrest ; Humans ; Shock* ; Sympathectomy* ; Tachycardia, Ventricular* ; Unconsciousness