Background: Citrobacter spp. are known opportunistic pathogens. Recent reports have indicated concerningly high rates of carbapenem resistance in long-term care hospitals. In this study, we investigated the characteristics of carbapenemase genotypes in carbapenem-resistant Citrobacter spp. (CR-Citrobacter spp.) isolated from clinical and surveillance specimens. Methods: CR-Citrobacter spp. isolates were collected from Seoul Clinical Laboratories in 2023. The isolates underwent multiplex polymerase chain reaction (PCR) analysis for the detection of six carbapenemase genotypes (KPC, GES, IMP, NDM, VIM, and OXA-48-like) using the PANA Real Typer CRE Kit (PANAGENE, Korea). Results: Among 329 CR-Citrobacter spp. isolates, 289 (87.9%) were from patients aged 60 years or older, with the majority isolated from long-term care hospitals (255, 77.5%). C. koseri was predominant in both the clinical and surveillance isolates at 84.7 % (72/85) and 67.6 % (165/244), respectively. KPC (76.5%) was the most common carbapenemase genotype detected in the clinical isolates, followed by OXA-48-like (11.8%) and NDM (8.2%). Double carbapenemase genotypes were detected in eight isolates (2.4%). Conclusion This study revealed a high prevalence of CR-Citrobacter spp., particularly C. koseri, in long-term care hospitals. The predominance of KPC-producing C. koseri highlights the need for enhanced surveillance and infection control in long-term care hospitals.

Medial patellar luxation is a common orthopedic disorder in dogs, and advanced cases with severe skeletal deformities or femoropatellar osteoarthritis are often unresponsive to conventional techniques. Patellar groove replacement (PGR) has been proposed as an alternative surgical option; however, systematic comparisons of coating technologies for veterinary PGR implants remain limited. This study aimed to evaluate the physicochemical properties, biological compatibility, and functional performance of a newly developed titanium nitride (TiN)–coated PGR system compared with a clinically available amorphous diamond-like carbon (ADLC)–coated device. TiN-coated prototypes were fabricated using Ti-6Al-4V alloy by injection molding combined with arc ion plating, which requires simpler equipment and lower production costs than the vacuum plasma deposition used for ADLC. Physicochemical evaluations, including corrosion resistance, hardness, surface roughness, and coating thickness, were conducted following International Organization for Standardization (ISO) and Korean Industrial Standards (KS) guidelines. In vitro biocompatibility was assessed using MTT andcell adhesion assays with L-929 fibroblasts, while inflammatory cytokine profiling (interleukin [IL]-1β and IL-6) in a rat subcutaneous model was used to evaluate local tissue responses.Functional feasibility was examined in a canine femoral model bilaterally implanted with TiNor ADLC-coated PGR systems and monitored for one year through clinical, radiographic, computed tomography (CT), magnetic resonance imaging , and micro-CT assessments. Both coatings demonstrated excellent corrosion resistance and absence of cytotoxicity. TiN-coated implants showed slightly greater hardness and coating thickness, with comparable surfaceroughness and biocompatibility. All implants maintained stable fixation, proper patellar tracking, and satisfactory bone–implant integration. These findings indicate that TiN-coated PGRimplants achieve biological and mechanical performance equivalent to ADLC devices while offering advantages in manufacturing simplicity, scalability, and cost-efficiency, supporting their clinical applicability in veterinary orthopedics.

Ginkgo biloba is a dioecious tree that has been used in traditional Chinese medicine for about 5,000 years. In previous studies on Ginkgo biloba extract (EGb761) using in vitro systems, we confirmed that EGb761 has biphasic effects on estrogenicity. In this study, we evaluated the agonistic and antagonistic activities of EGb761 using a uterotrophic assay in immature female rats. To evaluate agonistic and antagonistic effects of EGb761 on uterus, 21-day-old immature Sprague-Dawley (SD) female rats were treated with EGb761 (100, 200, or 400 mg/kg) by oral gavage, 10 μg/kg of estradiol (E2) or 1 mg/kg tamoxifen (TM) by subcutaneous injection, or with EGb761 plus E2 or TM for 3 consecutive days. At the end of the treatment period, animals were sacrificed and their body weights and organ weights (liver, lung, spleen and kidney) were measured. In addition, estrogen-related gene expressions (IGFBP-1 in liver and CaBP-9 in uterus) were determined. During the experiment, no animal showed clinical signs, a change in body weight or died. EGb761 treatment alone had no effect on absolute/relative uterine weight, luminal epithelial cell height (LECH, μm), or luminal circumference (LC, μm). In addition, uterine weights, LECHs, and LC induced by E2 or TM were not significantly changed by EGb761 at any dose. These results collectively suggested EGb761 has no agonistic/antagonistic effects in utero.
Animals ; Body Weight ; Epithelial Cells ; Estradiol ; Estrogens ; Female ; Gene Expression ; Ginkgo biloba ; Humans ; In Vitro Techniques ; Injections, Subcutaneous ; Liver ; Lung ; Medicine, Chinese Traditional ; Organ Size ; Phenobarbital ; Rats ; Rats, Sprague-Dawley ; Spleen ; Tamoxifen ; Trees ; Uterus ; Weights and Measures

Ginkgo biloba is a dioecious tree that has been used in traditional Chinese medicine for about 5,000 years. In previous studies on Ginkgo biloba extract (EGb761) using in vitro systems, we confirmed that EGb761 has biphasic effects on estrogenicity. In this study, we evaluated the agonistic and antagonistic activities of EGb761 using a uterotrophic assay in immature female rats. To evaluate agonistic and antagonistic effects of EGb761 on uterus, 21-day-old immature Sprague-Dawley (SD) female rats were treated with EGb761 (100, 200, or 400 mg/kg) by oral gavage, 10 μg/kg of estradiol (E2) or 1 mg/kg tamoxifen (TM) by subcutaneous injection, or with EGb761 plus E2 or TM for 3 consecutive days. At the end of the treatment period, animals were sacrificed and their body weights and organ weights (liver, lung, spleen and kidney) were measured. In addition, estrogen-related gene expressions (IGFBP-1 in liver and CaBP-9 in uterus) were determined. During the experiment, no animal showed clinical signs, a change in body weight or died. EGb761 treatment alone had no effect on absolute/relative uterine weight, luminal epithelial cell height (LECH, μm), or luminal circumference (LC, μm). In addition, uterine weights, LECHs, and LC induced by E2 or TM were not significantly changed by EGb761 at any dose. These results collectively suggested EGb761 has no agonistic/antagonistic effects in utero.
Animals ; Body Weight ; Epithelial Cells ; Estradiol ; Estrogens* ; Female ; Gene Expression ; Ginkgo biloba* ; Humans ; In Vitro Techniques ; Injections, Subcutaneous ; Liver ; Lung ; Medicine, Chinese Traditional ; Organ Size ; Phenobarbital ; Rats* ; Rats, Sprague-Dawley ; Spleen ; Tamoxifen ; Trees ; Uterus ; Weights and Measures

OBJECTIVES: Aromatase inhibitors that block estrogen synthesis are a proven first-line hormonal therapy for postmenopausal breast cancer. Although it is known that standardized extract of Ginkgo biloba (EGb761) induces anti-carcinogenic effects like the aromatase inhibitors, the effects of EGb761 on steroidogenesis have not been studied yet. Therefore, the effects of EGb761 on steroidogenesis and aromatase activity was studied using a H295R cell model, which was a good in vitro model to predict effects on human adrenal steroidogenesis. METHODS: Cortisol, aldosterone, testosterone, and 17β-estradiol were evaluated in the H295R cells by competitive enzyme-linked immunospecific assay after exposure to EGb761. Real-time polymerase chain reaction were performed to evaluate effects on critical genes in steroid hormone production, specifically cytochrome P450 (CYP11/17/19/21) and the hydroxysteroid dehydrogenases (3β-HSD2 and 17β-HSD1/4). Finally, aromatase activities were measured with a tritiated water-release assay and by western blotting analysis. RESULTS: H295R cells exposed to EGb761 (10 and 100 μg/mL) showed a significant decrease in 17β-estradiol and testosterone, but no change in aldosterone or cortisol. Genes (CYP19 and 17β-HSD1) related to the estrogen steroidogenesis were significantly decreased by EGb761. EGb761 treatment of H295R cells resulted in a significant decrease of aromatase activity as measured by the direct and indirect assays. The coding sequence/ Exon PII of CYP19 gene transcript and protein level of CYP19 were significantly decreased by EGb761. CONCLUSIONS: These results suggest that EGb761 could regulate steroidogenesis-related genes such as CYP19 and 17β-HSD1, and lead to a decrease in 17β-estradiol and testosterone. The present study provides good information on potential therapeutic effects of EGb761 on estrogen dependent breast cancer.
Adrenocortical Carcinoma* ; Aldosterone ; Anticarcinogenic Agents ; Aromatase Inhibitors ; Aromatase* ; Blotting, Western ; Breast Neoplasms ; Clinical Coding ; Cytochrome P-450 Enzyme System ; Estrogens ; Exons ; Ginkgo biloba* ; Humans* ; Hydrocortisone ; Hydroxysteroid Dehydrogenases ; In Vitro Techniques ; Real-Time Polymerase Chain Reaction ; Testosterone ; Therapeutic Uses

OBJECTIVES: It has been reported that caregivers of patients with chronic mental illness including schizophrenia are in higher risk for psychological and physical health problem. This study was performed to evaluate the depressive symptoms and associated factors in caregivers of patients with chronic mental illness. METHODS: The subjects were 77 unaffected caregivers (30 parents, 30 siblings, 10 offspring, and 7 spouses) of patients with chronic mental illness (62 schizophrenia, 4 schizoaffective disorder, 11 bipolar disorder) and 100 healthy controls. Depressed mood was assessed by Beck Depression Inventory (BDI) in all subjects. For their sick family members, clinical factors including psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS), duration of illness, number of admission were assessed. RESULTS: The mean BDI score of the caregivers was significantly higher than that of control subjects (11.2+/-11.6 and 8.0+/-7.5). Given that 23.4% of family group and 23.0% of control group are attributed to mild to moderate depressed state and 22.0% of family group and 8.0% of control group to above moderate depressed state, significant depressive symptom is more frequently observed in family group. The mean BDI score of parent group was higher than that of sibling group controlling for sex and age. In the parent group, BDI scores are positively correlated with age while the offspring and spouse group had negative correlation between BDI scores and age. Higher age, lower socioeconomic state, more severe positive symptom scores of patients were potential predictors for BDI scores of caregivers. CONCLUSION: This study showed that caregivers of patients with chronic mental illness have significant depressive symptoms. It may be suggested that depressive symptoms of caregivers are associated with aging, low socioeconomic state, and severe positive symptom rather than chronicity of their sick family members.
Aging ; Caregivers ; Depression ; Humans ; Parents ; Psychotic Disorders ; Schizophrenia ; Siblings ; Spouses