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This review aims to enrich our understanding of Chiari-like malformation (CLM) by combining human and veterinary insights, and providing a detailed cross-species overview. CLM is a developmental abnormality characterised by caudal displacement of the hindbrain into the foramen magnum due to an entire brain parenchymal shift caused by insufficient skull volume. This malformation leads to a progressive obstruction at the craniocervical junction, which disrupts the normal cerebrospinal fluid flow, leading to secondary syringomyelia. The clinical signs of CLM and syringomyelia include phantom scratching, head tilt, head tremor, ataxia, tetraparesis, pain, muscle atrophy, and scoliosis or torticollis. Magnetic resonance imaging remains the gold standard for diagnosing CLM, since it allows the visualisation of abnormal findings such as the caudal cerebellar herniation, caudal cerebellar compression from occipital dysplasia, and attenuated cerebrospinal fluid cisternae. Although various medical and surgical interventions, including foramen magnum decompression, can provide temporary symptomatic/clinical sign relief, current literature shows a lack of sustained long-term efficacy. Therefore, additional research is needed to evaluate the long-term effects of existing treatment strategies and to compare different techniques utilised in conjunction with foramen magnum decompression.
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Oral biofilms or dental plaques are one of the major etiological factors for diverse oral diseases. We aimed to evaluate the effect of a multichannel oral irrigator (MCOI) on periodontal health in 29 participants randomly divided into two groups: the MCOI group and the control group. To evaluate the effect of the MCOI on periodontal health, the modified Quigley Hein Plaque Index (PI), Mühlemann-Son Sulcus Bleeding Index (SBI), bleeding on probing (BOP), and swelling were evaluated and compared before and after MCOI use for 3 days. Although PI and SBI showed statistically significant increases in the control group, the MCOI group showed no significant changes in either parameter. Moreover, the percentage of BOP was significantly lower in the MCOI group. Saliva samples were analyzed by 16s rRNA amplicon sequencing to investigate changes in the oral microbiome. Sequencing results showed that Porphyromonas spp. were significantly increased in the control group, whereas no significant change was detected in the MCOI group. Using the MCOI, enriched populations and functional pathways were detected in pioneer species comprising non-mutans streptococci. These findings provide evidence of the effectiveness of the MCOI in maintaining periodontal health and a healthy microbial ecology in the oral cavity.
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Microbiota , Enfermedades Periodontales , Humanos , Administración Oral , Índice de Placa Dental , ARN Ribosómico 16S/genéticaRESUMEN
Vasopressins are evolutionarily conserved peptide hormones. Mammalian vasopressin functions systemically as an antidiuretic and regulator of blood and cardiac flow essential for adapting to terrestrial environments. Moreover, vasopressin acts centrally as a neurohormone involved in social and parental behavior and stress response. Vasopressin synthesis in several cell types, storage in intracellular vesicles, and release in response to physiological stimuli are highly regulated and mediated by three distinct G protein coupled receptors. Other receptors may bind or cross-bind vasopressin. Vasopressin is regulated spatially and temporally through transcriptional and post-transcriptional mechanisms, sex, tissue, and cell-specific receptor expression. Anomalies of vasopressin signaling have been observed in polycystic kidney disease, chronic heart failure, and neuropsychiatric conditions. Growing knowledge of the central biological roles of vasopressin has enabled pharmacological advances to treat these conditions by targeting defective systemic or central pathways utilizing specific agonists and antagonists.
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BACKGROUND: PfFAD3 transgenic soybean expressing omega-3 fatty acid desaturase 3 of Physaria produces increased level of α-linolenic acid in seed. Composition data of non-transgenic conventional varieties is important in the safety assessment of the genetically-modified (GM) crops in the context of the natural variation. RESULTS: The natural variation was characterized in seed composition of 13 Korean soybean varieties grown in three locations in South Korea for 2 years. Univariate analysis of combined data showed significant differences by variety and cultivation environment for proximates, minerals, anti-nutrients, and fatty acids. Percent variability analysis demonstrated that genotype, environment and the interaction of environment with genotype contributed to soybean seed compositions. Principal component analysis and orthogonal projections to latent structure discriminant analysis indicated that significant variance in compositions was attributable to location and cultivation year. The composition of three PfFAD3 soybean lines for proximates, minerals, anti-nutrients, and fatty acids was compared to a non-transgenic commercial comparator (Kwangankong, KA), and three non-transgenic commercial varieties grown at two sites in South Korea. Only linoleic and linolenic acids significantly differed in PfFAD3-1 lines compared to KA, which were expected changes by the introduction of the PfFAD3-1 trait in KA. CONCLUSION: Genotype, environment, and the interaction of environment with genotype contributed to compositional variability in soybean. PfFAD3-1 soybean is equivalent to the conventional varieties with respect to these components. © 2020 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Brassicaceae/enzimología , Ácido Graso Desaturasas/genética , Glycine max/química , Glycine max/genética , Proteínas de Plantas/genética , Plantas Modificadas Genéticamente/química , Aminoácidos/análisis , Aminoácidos/metabolismo , Brassicaceae/genética , Brassicaceae/metabolismo , Ácido Graso Desaturasas/metabolismo , Ácidos Grasos/análisis , Ácidos Grasos/metabolismo , Minerales/análisis , Minerales/metabolismo , Valor Nutritivo , Proteínas de Plantas/metabolismo , Plantas Modificadas Genéticamente/genética , Plantas Modificadas Genéticamente/metabolismo , República de Corea , Glycine max/clasificación , Glycine max/metabolismoRESUMEN
PURPOSE: To examine the perioperative outcomes following robot-assisted partial nephrectomy (RAPN) in patients with localized renal cell carcinoma (RCC) and to identify the predictors of Pentafecta achievement following RAPN. MATERIALS AND METHODS: We retrospectively analyzed the data from 362 patients with RCC who underwent RAPN from 2008 to 2016. The criteria for Pentafecta achievement were defined as the Trifecta [warm ischemic time (WIT) ≤25 minutes, negative surgical margin, and no significant perioperative complications]; with the addition of renal function preservation, including over 90% preservation of the estimated glomerular filtration rate (e-GFR); and no stage upgrade of chronic kidney disease at 1 year after surgery. Multivariate logistic regression analysis was performed to determine the predictors of the Pentafecta outcomes. RESULTS: Among 362 patients, 82.3% (n = 298) had clinical T1a tumors. The median tumor size was 2.9 cm [interquartile range (IQR) = 2.1-3.6] and median nephrometry score was 7 (IQR = 6-8). The median operative time was 220 minutes (IQR = 185-270) and median estimated blood loss was 150 mL (IQR = 100-200). The median WIT was 20 minutes (IQR = 16-26). The overall rate of postoperative complications was 18.8% (n = 68). The rates of Trifecta and Pentafecta achievement were 66.6% (n = 241/362) and 33.9% (n = 121/303), respectively. Notably, the preoperative e-GFR, hypertension, tumor size, L-component of the R.E.N.A.L score, and surgeon's experience were identified as the significant predictors of Pentafecta achievement. Additionally, patients with T1a tumors showed higher rates of Pentafecta achievement (45.7% vs 25.9%) compared with those of patients with T1b tumors. However, there was no significant difference in the Pentafecta accomplishment rates between the transperitoneal and retroperitoneal approaches. CONCLUSIONS: In summary, our data highlighted that tumor size and nephrometry score, which are tumor-related factors, as well as the surgeon's experience, a surgeon-related factor, appear to be the critical predictive factors for Pentafecta achievement following RAPN.
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Carcinoma de Células Renales/cirugía , Neoplasias Renales/cirugía , Nefrectomía/métodos , Complicaciones Posoperatorias/epidemiología , Insuficiencia Renal Crónica/epidemiología , Procedimientos Quirúrgicos Robotizados/métodos , Adulto , Pérdida de Sangre Quirúrgica , Carcinoma de Células Renales/epidemiología , Carcinoma de Células Renales/patología , Comorbilidad , Femenino , Tasa de Filtración Glomerular/fisiología , Humanos , Hipertensión/epidemiología , Neoplasias Renales/epidemiología , Neoplasias Renales/patología , Modelos Logísticos , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Tempo Operativo , Insuficiencia Renal Crónica/fisiopatología , Estudios Retrospectivos , Cirujanos , Resultado del Tratamiento , Carga Tumoral , Isquemia Tibia/estadística & datos numéricosRESUMEN
The aim of this study was to determine the performance of shear wave elastography (SWE) with a propagation map in the diagnosis of hepatic fibrosis, and to assess its reliability with transient elastography (TE) as the reference standard. Our prospective study included 115 consecutive patients with suspected or alleged chronic hepatitis. Patients underwent SWE by two different operators and TE by sonographers on the same day. The correlation coefficient of the intra-class correlation test between an experienced radiologist and a third-year radiology resident was 0.878. There was a moderate correlation between SWE and TE (r = 0.511) in the diagnosis of hepatic fibrosis. The best cutoff values predicting significant hepatic fibrosis and liver cirrhosis by SWE were >1.78 m/s (area under the receiver operating characteristic curve [AUROC] = 0.777) and >2.24 m/s (AUROC = 0.935), respectively. SWE with a propagation map is a reliable method for predicting hepatic fibrosis regardless of operator experience.
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Diagnóstico por Imagen de Elasticidad/métodos , Hepatitis Crónica/diagnóstico por imagen , Hepatitis Crónica/fisiopatología , Cirrosis Hepática/diagnóstico por imagen , Cirrosis Hepática/fisiopatología , Hígado/diagnóstico por imagen , Hígado/fisiopatología , Adulto , Anciano , Diagnóstico Diferencial , Módulo de Elasticidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Resistencia al Corte , Estadística como Asunto , Estrés MecánicoRESUMEN
PURPOSE: To evaluate the differences in visualization of a normal appendix between regular-dose (RD) and low-dose (LD) unenhanced CT. MATERIAL AND METHODS: 179 patients underwent both RDCT and LDCT for urolithiasis. Two reviewers evaluated the appendiceal visualization on a three-point scale. Sensitivities and interobserver agreement were measured. RESULTS: There were no significant differences between RDCT and LDCT in sensitivity, regardless of the reviewer. Interobserver agreement was excellent in both RDCT and LDCT. CONCLUSION: Unenhanced LDCT is a good tool for detecting a normal appendix and is also useful for less experienced interpreters who are unfamiliar with using LDCT images.
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Apendicitis/diagnóstico , Apéndice/diagnóstico por imagen , Dosis de Radiación , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Apendicitis/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Cintigrafía , Valores de Referencia , Urolitiasis/diagnóstico , Urolitiasis/diagnóstico por imagen , Adulto JovenRESUMEN
Abnormalities in the inguinal region are varied. The most common abnormality in the inguinal region is the hernia: direct or indirect inguinal hernia and femoral hernia. There are many hernia-mimicking lesions, such as spermatic cord hydrocele, undescended testis, hematoma, inflammation, abscess, benign or malignant tumors, metastatic or benign lymph node enlargement, round ligament varicosities or mesothelial cyst, and herniated ovary. Ultrasonography is currently the primary imaging modality used in assessing inguinal lesions and helpful for the differential diagnosis of a broad spectrum of these diseases. Familiarity with clinical setting and certain ultrasonography details will facilitate prompt and accurate diagnosis and treatment.
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Hernia Inguinal/diagnóstico por imagen , Diagnóstico Diferencial , Hernia Inguinal/diagnóstico , Humanos , Valor Predictivo de las Pruebas , Ultrasonografía Doppler en ColorRESUMEN
Various amounts of Nb(2)O(5) in the (Na(0.5)K(0.5)) NbO(3) (NKN) ceramic were replaced by V(2)O(5) to decrease its sintering temperature to below 950 degrees C. A small V(2)O(5) content resulted in a dense microstructure with an increased grain size for the specimen sintered at 900 degrees C due to the presence of a liquid phase. When V(2)O(5) was added to the NKN ceramics, their orthorhombic-to-tetragonal transition temperature increased from 178 degrees C to around 200 degrees C. However, their Curie temperature decreased from 402 degrees C to around 330 degrees C. The k(p), epsilon(3) (T)/epsilon(0), and Q(m) values increased with V(2)O(5) addition, probably due to the increased density and poling state, which was identified by the phase angle. The specimen with x = 0.05, sintered at 900 degrees C for 8 h, exhibited the following piezoelectric properties: k(p) = 0.32, epsilon(3) (T)/epsilon(0) = 245, d(33) = 120 (pC/N), and Q(m) = 232.
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Cerámica/química , Sistemas Microelectromecánicos/instrumentación , Transductores , Compuestos de Vanadio/química , Diseño de Equipo , Análisis de Falla de Equipo , Ensayo de Materiales , VibraciónRESUMEN
Over 50% of women with polycystic ovary syndrome (PCOS) have been reported to have varying degree of insulin resistance and it may contribute to hyperandrogenism. The aim of the study is to identify whether the insulin resistance is present in non-obese Korean women with PCOS and whether the phenotype is different according to insulin sensitivity. Seventy-three non-obese (BMI<23 kg/m(2)) women with PCOS and 34 age and BMI comparable control women with regular menstrual cycles were examined. Standard 75 g OGTT was performed to determine the status of glucose tolerance. Insulin sensitivity was measured by euglycemic hyperinsulinemic clamp technique. The fasting plasma glucose (p<0.01) and post-glucose load plasma insulin (p<0.01) of women with PCOS were higher than those of controls. Glucose disposal rate (M-value) was lower in women with PCOS compared to controls (p<0.05). Insulin resistant (IR) and insulin sensitive (IS) PCOS were divided by the M-value of 25-percentile (5.5mg/kg min) in controls. Between IR and IS groups, DHEAS (p<0.01), post-glucose load plasma insulin (p<0.05) showed differences after the adjustment for BMI. Our non-obese women with PCOS showed significant insulin resistance compared to their age and BMI comparable control subjects and their insulin resistance may contribute to hyperandrogenism especially via adrenal androgen overproduction.
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Resistencia a la Insulina/genética , Insulina/fisiología , Síndrome del Ovario Poliquístico/genética , Adulto , Índice de Masa Corporal , Peso Corporal , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Corea (Geográfico) , Ciclo Menstrual , Fenotipo , Síndrome del Ovario Poliquístico/sangre , Valores de ReferenciaRESUMEN
Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and consequent hyperinsulinemia. Insulin resistance also plays an important role in the metabolic syndrome (MS). We conducted a cross-sectional study to determine the prevalence of the MS in young Korean women with PCOS and whether it is associated insulin resistance. One hundred and seventeen young women with PCOS (age: 26+/-5, 16-39 years) were evaluated for the frequency of MS according to the modified Adult Treatment Panel III. Total testosterone (T), free T, androstenedione, dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were measured, and insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp technique. The prevalence of MS in women with PCOS was 14.5%, nearly 3.5-fold higher than in age-matched women in Korean urban population (4.3%) [J.-Y. Oh, Y.-A. Sung, Y.S. Hong, E. Barrett-Conner, Prevalence and factor analysis of metabolic syndrome in an urban Korean population, Diabetes Care 27 (2004) 2027-2032]. The most frequently occurring component of MS was low HDL cholesterol (45%), and the least frequent was high fasting serum glucose level (0.9%). PCOS women with MS had significantly higher free T, and lower SHBG compared with those without MS. And women with MS showed significantly lower M-value and higher fasting/post-glucose load insulin levels. M-value was still significantly lower in women with MS even after the adjustment for BMI. MS is frequent in young Korean women with PCOS and it reflects more severe insulin resistance. These results suggest the importance of early and regular screening of metabolic disturbance in even young women with PCOS.