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The cellular activation of the NLRP3 inflammasome is spatiotemporally orchestrated by various organelles, but whether lysosomes contribute to this process remains unclear. Here, we show the vital role of the lysosomal membrane-tethered Ragulator complex in NLRP3 inflammasome activation. Deficiency of Lamtor1, an essential component of the Ragulator complex, abrogated NLRP3 inflammasome activation in murine macrophages and human monocytic cells. Myeloid-specific Lamtor1-deficient mice showed marked attenuation of NLRP3-associated inflammatory disease severity, including LPS-induced sepsis, alum-induced peritonitis, and monosodium urate (MSU)-induced arthritis. Mechanistically, Lamtor1 interacted with both NLRP3 and histone deacetylase 6 (HDAC6). HDAC6 enhances the interaction between Lamtor1 and NLRP3, resulting in NLRP3 inflammasome activation. DL-all-rac-α-tocopherol, a synthetic form of vitamin E, inhibited the Lamtor1-HDAC6 interaction, resulting in diminished NLRP3 inflammasome activation. Further, DL-all-rac-α-tocopherol alleviated acute gouty arthritis and MSU-induced peritonitis. These results provide novel insights into the role of lysosomes in the activation of NLRP3 inflammasomes by the Ragulator complex.

Background and purpose Obstructive sleep apnea (OSA) is a modifiable risk factor for stroke, but there are limited data on which stroke subtypes are associated with OSA. The aim of this study was to assess the risk for wake-up stroke (WUS) associated with OSA according to each etiologic subtype to elucidate the pathophysiologic mechanism of OSA-associated stroke. Method We investigated 557 consecutive patients who were admitted with acute ischemic stroke in two regional comprehensive stroke centers using a standardized protocol including the Berlin questionnaire to identify symptoms of OSA prior to stroke. The collected stroke data included the time of onset, risk factors, and etiologic subtype. Stratified analysis according to sex was conducted because sex has been reported to be an effect modifier of OSA on cardiovascular outcomes. The association between preexisting OSA symptoms and WUS depending on etiologic subtypes was assessed using multivariate logistic regression analysis. Results Preexisting OSA symptoms were associated with the risk of overall WUS in men. Snoring was associated with WUS in large artery atherosclerosis [adjusted odds ratio, 2.67 (1.15–6.23)], and apnea was associated with WUS in small vessel occlusion [adjusted odds ratio, 8.21 (1.15–58.53)], whereas OSA symptoms were not significantly associated with WUS in cardioembolism. Associations between OSA and WUS were not found in women. Conclusion This study demonstrated the differential influences of OSA on WUS depending on etiologic subtypes, suggesting more vulnerability in large artery atherosclerosis and small vessel occlusion. Sex is a significant effect modifier of the association between OSA and WUS.

The purpose of this study is to predict the collision clearance distance of stereotactic cones with treatment setup devices in cone‐based stereotactic radiosurgery (SRS). The BrainLAB radiosurgery system with a Frameless Radiosurgery Positioning Array and dedicated couch top was targeted in this study. The positioning array and couch top were scanned with CT simulators, and their outer contours of were detected. The minimum clearance distance was estimated by calculating the Euclidian distances between the surface of the SRS cones and the nearest surface of the outer contours. The coordinate transformation of the outer contour was performed by incorporating the Beam's Eye View at a planned arc range and couch angle. From the minimum clearance distance, the collision‐free gantry ranges for each couch angle were sequentially determined. An in‐house software was developed to calculate the clearance distance between the cone surface and the outer contours, and thus determine the occurrence of a collision. The software was extensively tested for various combinations of couch and arc angles at multiple isocenter locations for two combinations of cone‐couch systems. A total of 50 arcs were used to validate the calculation accuracies of the software for each system. The calculated minimum distances and collision‐free angles from the software were verified by physical measurements. The calculated minimum distances were found to agree with the measurements to within 0.3 ± 0.9 mm. The collision‐free arc angles from the software also agreed with the measurements to within 1.1 ± 1.1° with a 5‐mm safety margin for 20 arcs. In conclusion, the in‐house software was able to calculate the minimum clearance distance with

Imatinib (Gleevec) is a multiple tyrosine kinase inhibitor that decreases the activity of the fusion oncogene called BCR-ABL (breakpoint cluster region protein-Abelson murine leukemia viral oncogene homolog) and is clinically used for the treatment of chronic myelogenous leukemia and acute lymphocytic leukemia. Small molecule drugs, such as imatinib, can bind to several cellular proteins including the target proteins in the cells, inducing undesirable effects along with the effects against the disease. In this study, we report the synthetic optimization for 14 C-labeling and radiosynthesis of [14 C]imatinib to analyze binding with cellular proteins using accelerator mass spectroscopy. 14 C-labeling of imatinib was performed by the synthesis of 14 C-labeld 2-aminopyrimidine intermediate using [14 C]guanidine·HCl, which includes an in situ reduction of an inseparable byproduct for easy purification by HPLC, followed by a cross-coupling reaction with aryl bromide precursor. The radiosynthesis of [14 C]imatinib (specific activity, 631 MBq/mmol; radiochemical purity, 99.6%) was achieved in six steps with a total chemical yield of 29.2%.

Layered double hydroxide is a family of two-dimensional materials with wide range of compositions. Recently, its ability to accommodate various chemical species and biocompatibility have been attracted in the biomedical applications to develop drug delivery system and nanodiagnostics. In this review, we categorized biomedical approaches of layered double hydroxide with respect to the three topologies of, namely, interlayer space, outer surface with particle edge, and the lattice points. There have been extensive researches on the intercalation of drug or tracing to make use of interlayer space of layered double hydroxide for drug stabilization, sustained release, cellular delivery and etc. Outer surface or edge has been utilized to immobilization of large therapeutic moieties and to attach tracing moiety. Lattice points consisting of various metal species could be utilized for the specific metal species like paramagnetic elements or radioisotopes. Based on these topologies in layered double hydroxide, both the synthetic routes and the achieved functionalities in terms of biomedical application will be discussed.

Elderly living alone in South Korea report higher rates of psychological distress compared to the population at large. Using a person-centered approach, the aim of the present study was to identify the latent profiles of South Korean elderly living alone based on self-esteem, life satisfaction, and depression. Latent profile analysis (LPA) was conducted based on data of 1545 older age individuals living alone. In addition, we examined significant factors that differentiate the observed profiles using multinomial logistic regression analysis. We identified five profiles: “extremely depressed (n = 44, 2.9%),” “severely depressed (n = 169, 10.9%),” “mildly depressed (n = 529, 34.2%),” “low life satisfaction (n = 128, 8.3%),” and “positive adaptation (n = 675, 43.7%).” In addition, results of multinomial logistic regression analysis indicated that males (OR: 1.69; 95% CI: 1.02–2.81), and elderly with lower income (OR: 0.86; 95% CI: 0.81–0.91), lower level of physical health (OR: 0.43; 95% CI: 0.33–0.57), and lower social relationship satisfaction (OR: 0.25; 95% CI: 0.18–0.35) were more likely to fall in the “low life satisfaction” rather than the “positive adaptation” profile. In addition, being female (OR: 0.48; 95% CI: 0.30–0.79), of older age (OR: 1.04; 95% CI: 1.01–.1.07), and higher income (OR: 1.14; 95% CI: 1.08–1.20) were related to classification in the “mildly depressed” rather than the “low life satisfaction” profile. The “severely depressed” group was differentiated by older age (OR: 1.05; 95% CI: 1.01–1.08), lower level of physical health (OR: 0.49; 95% CI: 0.34–0.71), and lower satisfaction with social relationship (OR: 0.54; 95% CI: 0.38–0.76). The results highlight the need for welfare policies that secure income and physical health in elderly living alone to enhance their quality of life. Furthermore, interventions that aim to maintain social networks are tantamount in order to prevent isolation in the elderly living alone.

In this study, we investigated the tumor targeting effect in cancer cells using triphenylphosphonium (TPP) cations, which are accumulated by differences in membrane potential, and folic acid (FA), which is selectively bound to overexpressed receptors on various cancer cells. We used Food and Drug Administration (FDA)-approved silica nanoparticles (SNPs) as drug carriers, and SNPs conjugated with TPP and FA (STFs) samples were prepared by introducing different amounts of TPP and FA onto the nanoparticle surfaces. STF-1, 2, 3, 4 and 5 are named according to the combination ratio of TPP and FA on the particle surface. To confirm the tumor targeting effect, 89Zr (t1/2 = 3.3 days) was coordinated directly to the silanol group of SNP surfaces without chelators. It was shown that the radiochemical yield was 69% and radiochemical purity was &gt, 99%. In the cellular uptake evaluation, SNPs with the most TPP (SFT-5) and FA (SFT-1) attached indicated similar uptake tendencies for mouse colon cancer cells (CT-26). However, the results of the cell internalization assay and measurement of positron emission tomography (PET) images showed that SFT-5 had more affinity for the CT-26 tumor than other samples the TPP ratio of which was lower. Consequently, we confirmed that TPP ligands affect target cancer cells more than FA, which means that cell membrane potential is significantly effective for tumor targeting.

BACKGROUND Although depression is very common in patients with Parkinson disease (PD), only a few studies have investigated the longitudinal effects of initial depression on cognitive decline in these patients. The purpose of this study was to investigate the effect of depression on cognitive functions in patients with PD. METHODS We used data from the Parkinson Progression Markers Initiative (PPMI) to investigate the relationship between depression and PD. Depressive symptoms were measured in patients with PD based on the Geriatric Depression Scale (GDS) or Neuropsychiatric Inventory-Questionnaire (NPI-Q) scores obtained at baseline. We evaluated cognitive decline as whether a patient with PD progressed to PD with mild cognitive impairment (MCI) during a 4-year follow-up period. Multivariate Cox regression analysis was done to know whether depression can predict the conversion to MCI. In addition, a voxel-based morphometric analysis using volumetric brain magnetic resonance imaging was used to compare structural changes related to future cognitive decline as well as to reveal longitudinal effect of baseline depression on cortical atrophy. RESULTS Data from 263 patients with cognitively normal de novo PD who were available for longitudinal cognitive testing were analysed. The multivariate Cox regression analysis revealed that the depressive symptoms were independent risk factors for conversion to MCI in patients with de novo PD after adjusting for covariates (hazards ratio (95% CI)) of depression defined by the GDS (1.753 (1.084-2.835)) and the NPI (1.815 (1.083-3.042)) scores, respectively. The significant structural changes in PD with MCI as well as longitudinal effect of baseline depression on subsequent cortical atrophy were found in multiple areas on the voxel-based morphometric analysis (P

Radioactive isotopes are used as drugs or contrast agents in the medical field after being conjugated with chelates such as DOTA, NOTA, DTPA, TETA, CyDTA, TRITA, and DPDP. The N-terminal sequence of human serum albumin (HSA) is known as a metal binding site, such as for Co2+, Cu2+, and Ni2+. For this study, we designed and synthesized wAlb12 peptide from the N-terminal region of HSA, which can bind to cobalt, to develop a peptide-based chelate. The wAlb12 with a random coil structure tightly binds to the Co(II) ion. Moreover, the binding property of wAlb12 toward Co(II) was confirmed using various spectroscopic experiments. To identify the binding site of wAlb12, the analogs were synthesized by alanine scanning mutagenesis. Among them, H3A and Ac-wAlb12 did not bind to Co(II). The analysis of the binding regions confirmed that the His3 and α-amino group of the N-terminal region are important for Co(II) binding. The wAlb12 bound to Co(II) with Kd of 75 μM determined by isothermal titration calorimetry when analyzed by a single-site binding model. For the use of wAlb12 as a chelate in humans, its cytotoxicity and stability were investigated. Trypsin stability showed that the wAlb12 − Co(II) complex was more stable than wAlb12 alone. Furthermore, the cell viability analysis showed wAlb12 and wAlb12 + Co(II) to be non-toxic to the Raw 264.7 and HEK 293T cell lines. Therefore, a hot radioactive isotope such as cobalt-57 will have the same effect as a stable isotope cobalt. Accordingly, we expect wAlb12 to be used as a peptide chelate that binds with radioactive isotopes.

Sung-Chan Jang,1,2,* Sung-Min Kang,1,* Jun Young Lee,3,* Seo Yeong Oh,1 AT Ezhil Vilian,4 Ilsong Lee,1,2 Young-Kyu Han,4 Jeong Hoon Park,3 Wan-Seob Cho,5,* Changhyun Roh,2,6 YunSuk Huh1 1Department of Biological Engineering, Biohybrid Systems Research Center (BSRC), Inha University, Incheon, 2Biotechnology Research Division, 3Radiation Instrumentation Research Division, Advanced Radiation Technology Institute (ARTI), Korea Atomic Energy Research Institute (KAERI), Jeongeup, 4Department of Energy and Materials Engineering, Dongguk University, Seoul, 5Laboratory of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, 6Radiation Biotechnology and Applied Radioisotope Science, University of Science and Technology (UST), Daejeon, Republic of Korea *These authors contributed equally to this work Introduction: Positron emission tomography (PET) tracers has the potential to revolutionize cancer imaging and diagnosis. PET tracers offer non-invasive quantitative imaging in biotechnology and biomedical applications, but it requires radioisotopes as radioactive imaging tracers or radiopharmaceuticals. Method: This paper reports the synthesis of 18F-nGO-PEG by covalently functionalizing PEG with nano-graphene oxide, and its excellent stability in physiological solutions. Using a green synthesis route, nGO is then functionalized with a biocompatible PEG polymer to acquire high stability in PBS and DMEM. Results and discussion: The radiochemical safety of 18F-nGO-PEG was measured by a reactive oxygen species and cell viability test. The biodistribution of 18F-nGO-PEG could be observed easily by PET, which suggested the significantly high sensitivity tumor uptake of 18F-nGO-PEG and in a tumor bearing CT-26 mouse compared to the control. 18F-nGO-PEG was applied successfully as an efficient radiotracer or drug agent in vivo using PET imaging. This article is expected to assist many researchers in the fabrication of 18F-labeled graphene-based bio-conjugates with high reproducibility for applications in the biomedicine field. Keywords: graphene oxide, nanocomposite, imaging, radiotracer

Purpose This study retrospectively evaluated the clinical outcomes and complications of proton beam therapy (PBT) in a single institution in Korea and quantitatively analyzed the change in tumor volume after PBT using magnetic resonance imaging (MRI). Materials and methods Twenty-four treatment-naive patients who underwent PBT for choroidal melanoma between 2009 and 2015 were reviewed. Dose fractionation was 60-70 cobalt gray equivalents over 5 fractions. Orbital MRIs were taken at baseline and 3, 6, and 12 months after PBT and annually thereafter. The tumor volume was reconstructed and evaluated by stacking the tumor boundary in each thin-sliced axial T1-weighted image using MIM software. Results The median follow-up duration was 36.5 months (range, 9 to 82 months). One patient had suspicious local progression and two patients had distant metastasis. The 3-year local progression-free survival, distant metastasis-free survival, and overall survival rates were 95.8%, 95.8%, and 100%,respectively. Five Common Terminology Criteria for Adverse Event ver. 4.03 grade 3-4 toxicities were observed in four patients (16.7%), including one with neovascular glaucoma. The mean tumor volume at the baseline MRI was 0.565±0.084 mL (range, 0.074 to 1.610 mL), and the ratios of the mean volume at 3, 6, and 12 months to that at baseline were 81.8%, 67.3%, and 60.4%, respectively. Conclusion The local controlrate and complication profile after PBT in patientswith choroidal melanoma in Korea were comparable with those reported in a previous PBT series. The change in tumor volume after PBT exhibited a gradual regression pattern on MRI.

Prostate cancer is one of the most frequently found cancers in men worldwide. Prostate-specific membrane antigen (PSMA) is typically highly expressed in prostate cancer, and the Glu-Urea-Lys (GUL) structure has recently received considerable attention as a key unit of PSMA-targeting agents. Additionally, one of the common characteristics of many solid tumors, such as prostate cancer, is hypoxia. In this study, novel multifunctional PSMA inhibitors containing a PSMA-targeting moiety either with or without a hypoxia-sensitive moiety (

The degree of emotional labor in nurses has been associated with negative physical and psychological health indices. The purpose of this study was to examine the relationship between emotional labor and depressive and anxiety symptoms in nurses. Specifically, the study addressed the question of whether anger suppression and anger rumination sequentially mediated the relationship. A total of 99 nurses was recruited from a university hospital in Korea. The questionnaires included instruments assessing emotional labor, anger suppression, anger rumination, as well as depressive and anxiety symptoms. Consistent with our hypothesis, there was a significant indirect effect of anger suppression and anger rumination on the relationship between emotional labor and depressive symptoms, as well as on the relationship between emotional labor and anxiety symptoms. The nurses&rsquo, degree of emotional labor, anger suppression, and anger rumination was associated with psychological adjustment. Thus, the impact of nurses&rsquo, negative affect needs to be adequately addressed, as inadequate resolution of anger may increase their vulnerability to experience depressive and anxiety symptoms. These findings may contribute to developing a strategy for enhancing nurses&rsquo, psychological health.

This study describes the development and evaluation of a new dosimetric system for proton therapy using an array of fiber-optic Cerenkov radiation sensors (AFCRS). The AFCRS was superior to a conventional, multi-layer ion chamber (MLIC) system in real-time data acquisition and cost effectiveness.

Heat-shock protein 90 (HSP90) is a molecular chaperone that activates oncogenic transformation in several solid tumors, including lung and breast cancers. Ganetespib, a most promising candidate among several HSP90 inhibitors under clinical trials, has entered Phase III clinical trials for cancer therapy. Despite numerous evidences validating HSP90 as a target of anticancer, there are few studies on PET agents targeting oncogenic HSP90. In this study, we synthesized and biologically evaluated a novel

BACKGROUND:Numerous efforts have been made to identify biomarkers for predicting the progression of dementia in patients with mild cognitive impairment (MCI), and recently, a comprehensive visual rating scale (CVRS) based on magnetic resonance imaging (MRI) has been validated to assess structural changes in the brain of elderly patients. Based on this, the present study investigated the use of CVRS for predicting dementia and elucidated its association with cognitive change in patients with MCI over a three-year follow-up. METHODS:We included 340 patients with MCI with more than one follow-up visit. Data were obtained from the Alzheimer's disease Neuroimaging Initiative study. We assessed all the patients using CVRS and determined their progression to dementia during a follow-up period of over 3 years. The cox proportional hazards model was used to analyze hazard ratios (HRs) of CVRS for disease progression. Further, multiple cognitive measures of the patients over time were fitted using the random effect model to assess the effect of initial CVRS score on subsequent cognitive changes. RESULTS:Of 340 patients, 69 (20.2%) progressed to dementia and the median baseline score (interquartile range) of CVRS significantly differed between stable MCI and progressive MCI (9 (5-13) vs 13 (8-17), p

Carbonic anhydrase IX is overexpressed in many solid tumors including hypoxic tumors and is a potential target for cancer therapy and diagnosis. Reported imaging agents targeting CA-IX are successful mostly in clear cell renal carcinoma as SKRC-52 and no candidate was approved yet in clinical trials for imaging of CA-IX. To validate CA-IX as a valid target for imaging of hypoxic tumor, we designed and synthesized novel [

The

The benefits of proton beam craniospinal irradiation (PrBCSI) in children have been extensively reported in dosimetric studies. However, there is limited clinical evidence supporting the use of PrBCSI. We compared the acute toxicity of PrBCSI relative to that of conventional photon beam CSI (PhBCSI) in children with brain tumours.We prospectively evaluated the haematological and gastrointestinal toxicities in 30 patients who underwent PrBCSI between April 2008 and December 2012. As a reference group, we retrospectively evaluated the medical records of 13 patients who underwent PhBCSI between April 2003 and April 2012. The median follow-up time from starting CSI was 22 months (range 2-118 months). The mean irradiation dose was 32.1 Gy (range 23.4-39.6 Gy) and 29.4 CGE (cobalt grey equivalents; range 19.8-39.6), in the PrBCSI and PhBCSI groups, respectively (p = 0.236).There was no craniospinal fluid space relapse after curative therapy in either group of patients. Thrombocytopenia was less severe in the PrBCSI group than in the PhBCSI group (p = 0.012). The recovery rates of leukocyte and platelet counts measured one month after treatment were significantly greater in the PrBCSI group than in the PhBCSI group (p = 0.003 and p = 0.010, respectively). Diarrhoea was reported by 23% of patients in the PhBCSI group versus none in the PrBCSI group (p = 0.023).The incidence rates of thrombocytopenia and diarrhoea were lower in the PrBCSI group than in the PhBCSI group. One month after completing treatment, the recovery from leukopenia and thrombocytopenia was better in patients treated with PrBCSI than in those treated with PhBCSI.

In Gamma Knife radiosurgery, the occurrence of reapplying the stereotactic frame leads to re-examination and re-planning. To avoid undergoing invasive second angiography examination for the treatment of vascular lesions, and reduce re-planning time, a mathematical coordinate transformation method using the anatomical information has been developed. The MR or CT images of a human brain before and after frame reapplication were correlated with each other using the Affine transformation. The transformation parameters which minimize the RMS error of the original and transformed coordinates between the images were determined using a genetic algorithm. Three CT image studies of skull phantom and five MR image studies of patients were used for the evaluation. The RMS error in the coordinate transformation of skull phantom and clinical images was 0.3 ± 0.1 mm and 0.6 ± 0.1 mm, respectively. The original treatment plans of patients were converted to new plans using the transformation matrix. For total 9 treatment lesions of 0.2-14.1 cc, 3% and 11% RMS error in the irradiation time and target coverage were found respectively. The deeply-located lesions showed a better RMS error of 3% in the conformity index and similar dose distribution than superficial lesions close to the skull.

The aim of this work was to study the feasibility of proton radiography (pRad) as a patient-specific range compensator (RC) quality assurance (QA) tool and to validate its clinical utility by performing QA on RCs having three kinds of possible defects. In order to achieve pRad for a single EBT film, proton beam currents were modulated with new weighting factors, maximizing the linearity of optical-density-to-thickness ratio. Two RCs, examined to be accurately manufactured as planned, were selected to estimate the feasibility of our pRad. The optical densities of the EBT film on which the RC was irradiated with the modulated proton beam were digitized to pixel values (pv) and then converted to thickness using a thickness-pv calibration curve. The thickness information on the pRad was compared with plan data that had been extracted from treatment planning system. The mean thickness difference (TD) over the flat RC regions was calculated as 0.39 mm, and the standard deviation as 0.22 mm, and the proton scattering effect was analyzed by step phantom measurement. Even proton scattering effected a TD of over 1 mm in the large gradient region, the percentage of pixels over the acceptance criterion was only within 1.11% and 3.49%, respectively, when a 1 mm distance to agreement tolerance limit was applied. The QA results for both precisely and imprecisely manufactured RCs demonstrated the high potential utility and clinical applicability of the pRad-based RC QA tool.

A convolution algorithm that takes into account electron-density inhomogeneity was recently introduced to calculate dose distributions for the Gamma Knife (GK) Perfexion™ treatment planning program. The accuracies of the dose distributions computed using the convolution method were assessed using an anthropomorphic phantom and film dosimetry.Absorbed-dose distributions inside a phantom (CIRS Radiosurgery Head Phantom, Model 605) were calculated using the convolution method of the GK treatment-planning software (Leksell Gamma PlanThe film-dose calibration data were well fitted with third-order polynomials (RThe measured accuracies of the dose distributions calculated by the convolution algorithm of the LGP were within the clinically acceptable range (GIPR ≥ 96.9%) for various configurations of collimator size, location, direction of calculation plane, and number of shots. Due to the intrinsic asymmetry in the dose distribution along the z-axis, the treatment plan should also be verified in coronal or sagittal plane.

To identify the effect of brain atrophy on the development of symptomatic communicating hydrocephalus (SCHCP) after stereotactic radiosurgery (SRS) for sporadic unilateral vestibular schwannomas (VS).A total of 444 patients with VS were treated with SRS as a primary treatment. One hundred eighty-one patients (40.8%) were male, and the mean age of the patients was 53±13 years (range, 11-81 years). The mean follow-up duration was 56.8±35.8 months (range, 12-160 months). The mean tumor volume was 2.78±3.33 cm3 (range, 0.03-23.30 cm3). The cross-sectional area of the lateral ventricles (CALV), defined as the combined area of the lateral ventricles at the level of the mammillary body, was measured on coronal T1-weighted magnetic resonance images as an indicator of brain atrophy.At distant follow-up, a total of 25 (5.6%) patients had SCHCP. The median time to symptom development was 7 months (range, 1-48 months). The mean CALV was 334.0±194.0 mm2 (range, 44.70-1170 mm2). The intraclass correlation coefficient was 0.988 (95% confidence interval [CI], 0.976-0.994; p0.001). In multivariate analysis, the CALV had a significant relationship with the development of SCHCP (p0.001; odds ration [OR]=1.005; 95% CI, 1.002-1.007). Tumor volume and female sex also had a significant association (p0.001; OR=1.246; 95% CI, 1.103-1.409; p0.009; OR=7.256; 95% CI, 1.656-31.797, respectively). However, age failed to show any relationship with the development of SCHCP (p=0.364).Brain atrophy may be related to de novo SCHCP after SRS, especially in female patients with a large VS. Follow-up surveillance should be individualized, considering the risk factors involved for each patient, for prompt diagnosis of SCHCP.

Purpose This study was performed to assess the radiosurgical results of meningiomas extending into the internal acoustic canal (para-IAC meningiomas), with a particular focus on the effect of radiation dose to the cochlea on hearing outcome. Methods and Materials A total of 50 patients who underwent radiosurgery for para-IAC meningiomas between 1998 and 2009, which were followed for 2 years, were enrolled. The mean age was 55.8 years (range, 15–75). The mean tumor volume was 6.1 cm 3 (range, 1.0–19.0), the mean tumor length in the IAC was 6.9 mm (range, 1.3–13.3), and the mean prescribed marginal dose was 13.1 Gy (range, 10–15) at an isodose line of 50%. The mean follow-up duration was 46 months (range, 24–122). Results Eight (16.0%) patients had nonserviceable hearing at the time of surgery. At the last follow-up, the tumor control rate was 94%; unchanged in 17 patients, decreased in 30 patients, and increased in 3 patients. Among 42 patients with serviceable hearing at the time of radiosurgery, it was preserved in 41 (97.6%) patients at the last follow-up. The maximal and mean radiation doses to the cochleae of these 41 patients were 5.8 Gy ± 0.3 (range, 3.1–11.5) and 4.3 Gy ± 0.2 (range, 2.2–7.5), respectively. The maximal dose to the cochlea of the patient who lost hearing after radiosurgery was 4.7 Gy. Conclusions The radiation dose to the cochlea may have the minimal toxic effect on the hearing outcome in patients who undergo radiosurgery for para-IAC meningiomas.

Amyloid plaques, which are primarily composed of aggregated amyloid-beta (Aβ) peptide, are the neuropathological hallmarks of Alzheimer’s disease (AD). Fluorescent markers containing 2-styrylpyridazin-3( 2H )-ones were developed to detect intracellular aggregated Aβ peptides. Nine compounds exhibited a greater than 10-fold increase of in emission spectra before and after mixing with Aβ aggregates compared with before mixing. Among these compounds, compound 9n exhibited the highest affinity for Aβ aggregates ( K d = 1.84 μM) and selectively stained both aggregated intracellular Aβ and Aβ plaques in the transgenic AD model mice (APP/PS1). These preliminary results indicate that 2-styrylpyridazin-3(2 H )-one derivatives are promising alternative fluorescence imaging agent for the study of AD.

We retrospectively evaluated the relationship between the response of lung lesions and distant progression-free survival (DPFS) after radiosurgery in patients with brain metastases. A total of 47 consecutive patients were treated with radiosurgery for brain metastases. Distant progression was defined as a new enhancing intracranial tumor or leptomeningeal enhancement noted on follow-up magnetic resonance imaging. Progression of lung lesions was defined as follows: (1) a 20% increase in the summed diameter of the target lesions; (2) an absolute increase of 5 mm when the summed diameter was very small; or (3) detection of new lesions in the lung. Distant progression after radiosurgery was observed for twenty-one (44.7%) patients; we observed development of new distant metastases in nine patients, development of leptomeningeal seeding in eight patients, and combined failure of distant progression and local control failure in four patients. Forty-two (89.4%) patients had lung lesions at the time of radiosurgery, and progression of their lung lesions during the post-radiosurgery follow-up period was observed for 18 (38.3%) of these. The median DPFS was 7.00 months (95% CI, 6.153-7.847). Actuarial DPFS 3, 6, and 12 months after radiosurgery was 81.5, 61.3, and 36.7%, respectively. In multivariate analysis, only the criterion progression of lung lesions reached statistical and independent significance (P = 0.021, OR = 3.372, 95% CI, 1.200-9.480). The response of lung lesions after radiosurgery is likely to be a good predictor of DPFS after radiosurgery in patients with brain metastases.

Purpose The goal of this study was to determine the role of radiotherapy after curative-intent surgery in the management of extrahepatic bile duct (EHBD) cancers. Methods and Materials From 1997 through 2005, 78 patients with EHBD cancer were surgically staged. These patients were stratified by the absence of adjuvant radiation ( n = 47, group I) versus radiation ( n = 31, group II) after resection. Pathology examination showed 27 cases in group I and 20 cases in group II had microscopically positive resection margins. The patients in group II received 45 to 54 Gy of external beam radiotherapy. The primary endpoints of this study were overall survival, disease-free survival, and prognostic factors. Results There were no differences between the 5-year overall survival rates for the two groups (11.6% in group I vs. 21% in group II). However, the patients with microscopically positive resection margins who received adjuvant radiation therapy had higher median disease-free survival rates than those who underwent surgery alone (21 months vs. 10 months, respectively, p = 0.042). Decreasing local failure was found in patients who received postoperative radiotherapy (61.7% in group I and 35.6% in group II, p = 0.02). Outcomes of the patients with a positive resection margin and lymph node metastasis who received postoperative radiation therapy were doubled compared to those of patients without adjuvant radiotherapy. Resection margin status, lymph node metastasis, and pathology differentiation were significant prognostic factors in disease-free survival. Conclusions Adjuvant radiotherapy might be useful in patients with EHBD cancer, especially for those patients with microscopic residual tumors and positive lymph nodes after resection for increasing local control.

Background Endoscopic treatment of a pedunculated submucosal tumor (SMT) has not been well established. In particular, endoscopic cautery snare resection of a large pedunculated SMT is discouraged because of the increased risk of bowel perforation. Objective To report the clinical outcome of endoloop ligation for the treatment of various pedunculated SMTs with a clip-marking technique. Design Prospective evaluation of 10 patients who, between June 2005 and May 2006, received endoloop ligation with a clip-marking technique. Setting At a tertiary-care, academic medical center. Patients Ten patients with various pedunculated SMTs with either symptomatic lesions or large-sized lesions (>4 cm). Main Outcome Measurements Clinical procedural success, reported adverse events. Results Nine cases were successfully treated, with tumor removal within 4 weeks. In contrast, only 1 patient needed a second session of loop ligation. Only 6 specimens were retrieved. There were no procedure-related complications, such as bleeding or perforation. Limitations Retrieval by the patient of a specimen from stool was possible in only 60% of cases; a limited number of 10 patients; by oncology standards, not the correct treatment for nonlipomatous lesions, which limits its application to surgical risk candidates. Conclusions Endoloop ligation of large pedunculated SMTs seemed to be technically feasible and appeared to be safe in this case series. Further controlled clinical trials have to be conducted before application of this technique to a large submucosal lipoma or other SMTs in surgical high-risk candidates can be generally recommended.

Eight d - ribo -phytosphingosine derivatives were synthesized from d - ribo -phytosphingosine and diverse acyl chlorides with N , N -diisopropylethylamine in tetrahydrofuran for 1 h at room temperature. Effect of these compounds on IR-induced cell death was evaluated on blood cancer cells (Jurkat). Among these, 3d showed the highest enhancement of radiosensitizing effect.

Background and purpose The present study aims to investigate the feasibility of two-dimensional (2D) in vivo rectal dosimetry using an endorectal balloon for the radiotherapy of prostate cancer. Materials and methods The endorectal balloon was equipped with an unfoldable radiochromic film. The film was unrolled as the balloon was inflated, and rolled as it was deflated. Its mechanical and imaging properties were tested, and the dosimetric effectiveness was evaluated in clinical photon and proton beams. Results The size of the endorectal balloon including the film was linearly proportional to the volume of water filled in the balloon, and its position could be identified by X-ray radiography. The loss of dose information due to film cutting was within ±1mm from the cutting line. Applying linear interpolation on cut film, the gamma passing rate was more than 95% for 2%/2mm criteria. The measured dose profiles agreed with the plan within 3% and 4% for the photon and proton beams, respectively. A dose–volume histogram of the anterior rectal wall could be obtained from the measured dose distribution in the balloon, which also agreed well with the plan. Conclusions 2D in vivo rectal dosimetry is feasible using the endorectal balloon with a radiochromic film in the radiotherapy of prostate cancer.

Background We performed dosimetric comparisons between proton beam therapy and intensity modulated radiotherapy (IMRT) of intracranial germ cell tumors (ICGCTs) arising in various locations of the brain. Materials IMRT, passively scattered proton therapy (PSPT), and spot scanning proton therapy (SSPT) plans were performed for four different target volumes: the whole ventricle (WV), pineal gland (PG), suprasellar (SS), and basal ganglia (BG). Five consecutive clinical cases were selected from the patients treated between 2011 and 2014 for each target volume. Total 20 cases from the 17 patients were included in the analyses with three overlap cases which were used in plan comparison both for the whole ventricle and boost targets. The conformity index, homogeneity index, gradient index, plan quality index (PQI), and doses applied to the normal substructures of the brain were calculated for each treatment plan. Results The PQI was significantly superior for PSPT and SSPT than IMRT for ICGCTs in all locations (median; WV: 2.89 and 2.37 vs 4.06, PG: 3.38 and 2.70 vs 4.39, SS: 3.92 and 2.49 vs 4.46, BG: 3.01 and 2.49 vs 4.45). PSPT and SSPT significantly reduced the mean dose, and the 10 and 15 Gy dose volumes applied to the normal brain compared with IMRT (p ≤ 0.05). PSPT and SSPT saved significantly greater volumes of the temporal lobes and hippocampi (p

Background It is difficult to estimate the safe upper margin and the proper direction of endoscopic biliary sphincterotomy (EBS) in cases of choledocholithiasis complicated by periampullary diverticulum (PAD) or previous EBS. Objective This study evaluated the clinical usefulness of an inflated-balloon-pulling (IBP) technique for assessing the safe margin and the proper direction of EBS in affected patients. Design Prospective feasibility study. Setting Academic tertiary center. Patients From March 2003 to November 2003, the IBP technique was applied to patients with choledocholithiasis in whom EBS was difficult because of concomitant PAD or previous EBS. Interventions and Main Outcome Measurements After the endoscopically visible papillary roof of the ampulla of Vater was fully dissected, an inflated 11.5- or 15-mm retrieval balloon was inserted in the bile duct and was pulled toward the duodenal lumen, creating an artificial bulge. This bulge was considered an endoscopic landmark to indicate the residual intramural portion and the direction of the bile duct. Results A total of 19 patients (12 men, 7 women), with a mean age of 61.5 years, were consecutively enrolled. Of these patients, 7 had PAD, 7 had recurrent choledocholithiasis, and 5 had both conditions. The mean length of the IBP-induced residual intramural bile duct was 6.6 mm (range, 3-15 mm). The previous EBS was not oriented toward the bile duct in 4 of 12 patients with recurrent choledocholithiasis (33.3%). After EBS extended completely, choledocholithiases were successfully removed in all patients (1 by mechanical lithotripsy). Of the 19 patients, 2 had complications (11%; 1 mild hemorrhage, 1 mild pancreatitis), which were managed medically. There was no case of perforation. Conclusions The IBP technique is a feasible and a reliable method for safe and effective EBS in patients with choledocholithiasis in whom EBS is difficult because of PAD or/and previous EBS. The clinical significance of the direction of previous EBS needs to be defined.

Submucosal injection is essential to performing EMR easily, and various solutions have been proposed to create a long-lasting submucosal fluid cushion.To assess the efficacy of a fibrinogen mixture (FM) as a submucosal injection solution.A prospective, randomized, controlled trial.At a tertiary care, academic medical center.A total of 72 patients with early gastric neoplasm were randomly assigned to receive EMR with submucosal injection of normal saline solution (NS) or an FM.We performed EMR only with a conventional method.En bloc resection rate, complete resection rate, complications, and other procedure-related outcomes.No significant differences were observed between the 2 groups (the FM group vs the NS group) in the rates of en bloc resection (80.6% vs 88.9%), complete resection rate (86.1% vs 80.6%), and recurrence rate (3% vs 6.1%). Mean procedure time was significantly shorter in the FM group vs the NS group (11.39 +/- 3.07 minutes vs 13.93 +/- 3.26 minutes; P.05). Mean submucosal injection volume of the FM group was significantly less than that of the NS group (9.81 +/- 2.26 mL vs 14.32 +/- 2.35 mL; P.05). Also, additional submucosal injection to maintain elevation of the lesion was less frequently required in the FM group than in the NS group (5.6% vs 33.3%; P.05).The main limitations were the method of EMR (only included the conventional method) and the size of lesions (30 mm), because a long-lasting submucosal fluid cushion was more important in the dissection method and larger tumors.The FM is a reliable submucosal injection solution for conventional EMR.

BACKGROUND Axillary osmidrosis and hyperhidrosis are distressing social problems, particularly in Asian societies. Various treatment methods have been developed for removal of the apocrine and eccrine glands. But conventional surgical methods often lead to significant scarring and frequent recurrence. OBJECTIVE To evaluate the effect of liposuction with curettage using a new device, the Fatemi cannula, in the treatment of axillary osmidrosis and hyperhidrosis. METHODS From August 2003 through December 2004, 25 patients (15 women and 10 men) with axillary osmidrosis or hyperhidrosis were treated by tumescent liposuction and curettage. The results of malodor elimination were graded by the patients as excellent, good, fair, and poor. Changes in axillary sweating and hair growth, postoperative scarring, patient satisfaction degree, and complications were also evaluated. Biopsies of the axillary skin were performed in 14 patients. RESULTS Of the 50 axillae, 38 (76.0%) were graded as excellent results, 11 (22.0%) were good, and one (2.0%) was fair. No serious complications were noted except temporary ecchymosis and local infection in minor cases. The preoperative histologic examinations showed large and numerous apocrine glands and postoperative significant decrease and degeneration of them. CONCLUSION Tumescent liposuction with dermal curettage using the Fatemi cannula is an effective and safe method in the treatment of axillary osmidrosis and hyperhidrosis.

The aim of this study is to develop a new method to align the patient setup lasers in a radiation therapy treatment room and examine its validity and efficiency. The new laser alignment method is realized by a device composed of both a metallic base plate and a few acrylic transparent plates. Except one, every plate has either a crosshair line (CHL) or a single vertical line that is used for alignment. Two holders for radiochromic film insertion are prepared in the device to find a radiation isocenter. The right laser positions can be found optically by matching the shadows of all the CHLs in the gantry head and the device. The reproducibility, accuracy, and efficiency of laser alignment and the dependency on the position error of the light source were evaluated by comparing the means and the standard deviations of the measured laser positions. After the optical alignment of the lasers, the radiation isocenter was found by the gantry and collimator star shots, and then the lasers were translated parallel to the isocenter. In the laser position reproducibility test, the mean and standard deviation on the wall of treatment room were 32.3±0.93 mm for the new method whereas they were 33.4±1.49 mm for the conventional method. The mean alignment accuracy was 1.4 mm for the new method, and 2.1 mm for the conventional method on the walls. In the test of the dependency on the light source position error, the mean laser position was shifted just by a similar amount of the shift of the light source in the new method, but it was greatly magnified in the conventional method. In this study, a new laser alignment method was devised and evaluated successfully. The new method provided more accurate, more reproducible, and faster alignment of the lasers than the conventional method. PACS numbers: 87.56.Fc, 87.53.Bn, 87.53.Kn, 87.53.Ly, 87.55.Gh

Background: Although T-cell immunity is thought to be involved in the prognosis of epithelial ovarian cancer (EOC) patients, immunosuppressive conditions hamper antitumour immune responses. Thus, their mechanisms and overcoming strategies need to be investigated. Methods: The role of NF-κB in human EOC cells and macrophages was evaluated by in vitro production of immunosuppressive IL-6 and IL-8 by EOC cells and in vivo analysis of immune responses in nude mice implanted with human EOC cells using an NF-κB inhibitor DHMEQ. Results: In EOC patients, increased plasma IL-6, IL-8, and arginase were observed. The NF-κB inhibitor DHMEQ inhibited the production of IL-6 and IL-8 by EOC cell lines. Immunosuppression of human DCs and macrophages by culture supernatant of EOC cells was reversed with the pretreatment of DHMEQ. Administration of DHMEQ to nude mice implanted with human EOC resulted in the restoration of T-cell stimulatory activity of murine DCs along with the reduction of tumour accumulation and arginase expression of MDSCs. Nuclear factor-κB inhibition in tumour-bearing mice also enhanced antitumour effects of transferred murine naive T cells. Conclusions: NF-κB is involved in the immunosuppression induced by human EOC, and its inhibitor may restore antitumour immune responses, indicating that NF-κB is an attractive target for EOC treatment.

OBJECTIVE. Benign airway strictures refractory to balloon dilatation or stent placement remain a challenge in interventional radiology. This article describes the successful use of a cutting balloon to treat three cases of recurrent tuberculous bronchial strictures.CONCLUSION. In three patients, cutting balloon dilatation was found to be safe and effective and did not cause complications. Although the dilated lumen showed partial reduction over the 6- to 12-month follow-up, subjective functional symptoms and dyspnea grade improved.

Visualization may be difficult, and intraopera-tive endoscopy can be helpful. Treatment with segmentalresection and amputation or invagination with oversewinghave been used.In summary, bleeding gastric diverticulum representsararecauseofGIhemorrhage.Thediagnosisismadeendo-scopically, but treatment has not been clearly established.Because of difficulty with visualization of the area and therisk of perforation, bleeding gastric diverticula may requiresurgical referral for open or laparoscopic treatment.DISCLOSUREThe authors report that there are no disclosures rele-vant to this publication.

Immunological status in tumor tissues varies among patients. Infiltration of memory-type CD8(+) T cells into tumors correlates with prognosis of patients with various cancers. However, the mechanism of the differential CD8(+) T cell infiltration has not been well investigated. In general, tumor-associated microenvironments, including tumor and sentinel lymph nodes, are under immunosuppressive conditions such that the immune system is not able to eliminate cancer cells without immune-activating interventions. Constitutive activation of various signaling pathways in human cancer cells triggers multiple immunosuppressive cascades that involve various cytokines, chemokines, and immunosuppressive cells. Signaling pathway inhibitors could inhibit these immunosuppressive cascades by acting on either cancer or immune cells, or both. In addition, common signaling mechanisms are often utilized for multiple hallmarks of cancer (e.g., cell proliferation/survival, invasion/metastasis, and immunosuppression). Therefore, targeting these common signaling pathways may be an attractive strategy for cancer therapy including immunotherapy.

Purpose We evaluated the prognostic factors for hearing outcomes after stereotactic radiosurgery (SRS) for unilateral sporadic intracanalicular vestibular schwannomas (IC-VSs) as a clinical homogeneous group of VSs. Methods and Materials Sixty consecutive patients with unilateral sporadic IC-VSs, defined as tumors in the internal acoustic canal, and serviceable hearing (Gardner-Roberson grade 1 or 2) were treated with SRS as an initial treatment. The mean tumor volume was 0.34 ± 0.03 cm 3 (range, 0.03-1.00 cm 3 ), and the mean marginal dose was 12.2 ± 0.1 Gy (range, 11.5-13.0 Gy). The median follow-up duration was 62 months (range, 36-141 months). Results The actuarial rates of serviceable hearing preservation were 70%, 63%, and 55% at 1, 2, and 5 years after SRS, respectively. In multivariate analysis, transient volume expansion of ≥20% from initial tumor size was a statistically significant risk factor for loss of serviceable hearing and hearing deterioration (increase of pure tone average ≥20 dB) (odds ratio=7.638; 95% confidence interval, 2.317-25.181; P =.001 and odds ratio=3.507; 95% confidence interval, 1.228-10.018; P =.019, respectively). The cochlear radiation dose did not reach statistical significance. Conclusions Transient volume expansion after SRS for VSs seems to be correlated with hearing deterioration when defined properly in a clinically homogeneous group of patients.

Gamma Knife (GK) radiosurgery is a minimally invasive surgical technique for the treatment of intracranial lesions. To minimize neurological deficits, submillimeter accuracy is required during treatment delivery. In this paper, the delivery accuracy of GK radiosurgery was assessed with the gamma evaluation method using planning dose distribution and film measurement data.Single 4, 8, and 16 mm and composite shot plans were developed for evaluation using the GK Perfexion (PFX) treatment planning system (TPS). The planning dose distributions were exported as digital image communications in medicine - radiation therapy (DICOM RT) files using a new function of GK TPS. A maximum dose of 8 Gy was prescribed for four test plans. Irradiation was performed onto a spherical solid water phantom using Gafchromic EBT2 films in the axial and coronal planes. The exposed films were converted to absolute dose based on a 4th-order polynomial calibration curve determined using ten calibration films. The film measurement results and planning dose distributions were registered for further analysis in the same Leksell coordinate using in-house software. The gamma evaluation method was applied to two dose distributions with varying spatial tolerance (0.3-2.0 mm) and dosimetric tolerance (0.3-2.0%), to verify the accuracy of GK radiosurgery. The result of gamma evaluation was assessed using pass rate, dose gamma index histogram (DGH), and dose pass rate histogram (DPH).The 20, 50, and 80% isodose lines found in film measurements were in close agreement with the planning isodose lines, for all dose levels. The comparison of diagonal line profiles across the axial plane yielded similar results. The gamma evaluation method resulted in high pass rates of95% within the 50% isodose line for 0.5 mm∕0.5% tolerance criteria, in both the axial and coronal planes. They satisfied 1.0 mm∕1.0% criteria within the 20% isodose line. Our DGH and DPH also showed that low isodose lines exhibited inferior gamma indexes and pass rates compared with higher isodose lines.The gamma evaluation method was applicable to GK radiosurgery. For all test plans, planning dose distribution and film measurement met the tolerance criteria of 0.5 mm∕0.5% within the 50% isodose line which are used for marginal dose prescription.

A series of 1,3-diarylprop-2-en-1-one derivatives 3a-v have been synthesized and evaluated for their ability to inhibit neuraminidase (NA). Among the prepared compounds, the less lipophilic derivative 3k showed the most potent in vitro inhibitory activity against NA with an IC(50) value of 1.5 μM.

Purpose: With the introduction of flattening filter free (FFF) linear accelerators to radiation oncology, new analytical source models for a FFF beam applicable to current treatment planning systems is needed. In this work, a multisource model for the FFF beam and the optimization of involved model parameters were designed. Methods: The model is based on a previous three source model proposed byYang et al. [“A three-source model for the calculation of head scatter factors,” Med. Phys.29, 2024–2033 (2002)]. An off axis ratio (OAR) of photon fluence was introduced to the primary source term to generate cone shaped profiles. The parameters of the source model were determined from measured head scatter factors using a line search optimization technique. The OAR of the photon fluence was determined from a measured dose profile of a 40 × 40 cm 2 field size with the same optimization technique, but a new method to acquire gradient terms for OARs was developed to enhance the speed of the optimization process. The improved model was validated with measured dose profiles from 3 × 3 to 40 × 40 cm 2 field sizes at 6 and 10 MV from a TrueBeam™ STx linear accelerator. Furthermore, planar dose distributions for clinically used radiation fields were also calculated and compared to measurements using a 2D array detector using the gamma index method. Results: All dose values for the calculated profiles agreed with the measured dose profiles within 0.5% at 6 and 10 MV beams, except for some low dose regions for larger field sizes. A slight overestimation was seen in the lower penumbra region near the field edge for the large field sizes by 1%–4%. The planar dose calculations showed comparable passing rates ( > 98 % ) when the criterion of the gamma index method was selected to be 3%/3 mm. Conclusions: The developed source model showed good agreements between measured and calculated dose distributions. The model is easily applicable to any other linear accelerator using FFF beams as the required data include only the measured PDD, dose profiles, and output factors for various field sizes, which are easily acquired during conventional beam commissioning process.

The aim of this study was to examine the effect of fluoride application on 37% phosphoric acid-etching by atomic force microscopy (AFM) in primary tooth samples based on a clinical protocol used in a pediatric dental hospital. Enamel samples were prepared from 36 exfoliated and non-carious primary teeth. Primary tooth samples were randomly assigned to one of the four groups based on the timing of acid-etching with 37% phosphoric acid after an acidulated phosphate fluoride (APF) pre-treatment. Group 1 received no fluoride application, Group 2 was pre-treated with fluoride and then received acid-etching 2 weeks later. One week separated the fluoride treatment and the acid-etching in Group 3, while Group 4 received acid-etching immediately after the fluoride treatment. The vestibular enamel surfaces of each primary tooth sample were scanned in air at a resolution of 512 × 512 pixels and a scan speed of 0.8 line/s. On the enamel surfaces of the primary teeth after APF pre-treatment, debris were observed although the teeth were smoother than they were prior to APF. As a result, it was concluded that APF treatment is responsible for decreased primary tooth surface roughness. The enamel surfaces etched for 20 s showed that acid-etching was effective not only in removing scratches and debris, but also for evaluating enamel rod characteristics. Primary tooth enamel surfaces after etching showed minute structures caused by the decreased hydroxyapatite nanoparticle space, compared to those before etching. Also, acid-etching showed significantly increased roughness effects ( p n = 9). Finally, as more time elapsed after APF pre-treatment, the roughness was decreased to a lesser degree ( p = 0.005, n = 9). We suggest that primary teeth etching 2 weeks after APF pre-treatment used clinically in pediatric hospitals may be effective to obtain properly etched enamel surfaces.

Glomerular mesangial cells (MCs) are centrally located in the glomerulus. MCs control not only glomerular filtration, but also the response to local injury, including cell proliferation and basement membrane remodeling. Angiotensin II (Ang II) plays an important role in kidney function regulation, and participates in the progression of renal damage, as well as mesangial injury. However, studies on Ang II effects on MCs have used indirect methods, such as gene and protein expression after MC injury. In this study, we visually observed structural and mechanical changes to MC after Ang II treatment using atomic force microscopy (AFM). We obtained AFM topography and deflection images of live MCs, as well as fixed MCs in liquid, before and after Ang II treatment. Real-time imaging showed the dynamic movement of live MCs induced by Ang II. Changes in MC elastic property after Ang II treatment were measured using force-distance curves. AFM images of fixed and live MCs showed that cells contracted after Ang II exposure, with the nucleus height increasing within 20 min of Ang II stimulation. Force-distance analysis showed that Ang II caused MCs to stiffen (p < 0.0001). In conclusion, we demonstrated that AFM is an effective tool for real-time monitoring of live cell responses to drugs and stimuli.

Hydatid disease is a parasitic infestation caused by the larval form of the cestode worms Echinococcus. In humans, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. The incidence of hydatid disease is high in the Middle East, Australia, East and South Africa and Central Europe. In Korea, hydatid disease is rare and has been reported in a few cases. We experienced a case of multiple intraperitoneal cysts from ruptured hepatic hydatid cysts in a 35-year old man. His complaint was palpable abdominal mass and discomfort. Abdominal ultrasound and CT scan revealed multiple hepatic and intraperitoneal cysts. The surgical findings showed multiple cysts and daughter cysts. The pathologic finding of resected cyst was the characteristic pattern of outer thick laminated membrane and inner thin germinal layer. Albendazole was administrated for prophylatic purpose.