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Introduction: Cataract surgery is one of the most commonly performed surgical procedures worldwide. Intraoperative and postoperative complications of cataract surgery include posterior capsule rupture, retinal detachment, suprachoroidal hemorrhage, cystoid macular edema, endophthalmitis, and intraocular lens dislocation. As corneal perforation is rarely related to cataract surgery, we report a case of intraoperative iatrogenic corneal puncture that led to a full-thickness laceration that was managed without severe complications. Case Presentation: An 81-year-old woman underwent immediate sequential bilateral cataract surgery. Cataract grading of both eyes was nuclear color grade II and cortical cataract grade III, according to the lens opacity classification system III. While performing cataract surgery on her right eye, a corneal puncture with a keratome incidentally occurred just before making the main temporal incision, resulting in a 3-mm full-thickness laceration at the peripheral cornea. One-bite of 10-0 nylon suture was placed, and the remaining procedure was performed through a superior main incision. Three-bites of 10-0 nylon suture were placed at the laceration site at the end of the procedure. The uncorrected visual acuity was 20/40 in both eyes the following day. Corneal astigmatism increased in the right eye, and the refractive error was more myopic than targeted. No leakage was observed. Conclusion: Slight corneal contact with a keratome can lead to full-thickness laceration when the anterior chamber is filled with an ophthalmic viscosurgical device during cataract surgery. Caution should be exercised while manipulating sharp surgical instruments to avoid such complications.

Background We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB). Methods This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy. Results Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P

Purpose This study investigated the clinical and ultrasonographic (US) findings of suture granulomas and recurrent tumors, and aimed to identify specific characteristics of suture granulomas through an experimental study. Methods This retrospective study included 20 pathologically confirmed suture granulomas and 40 recurrent tumors between January 2010 and December 2020. The clinical findings included suture material, surgery, and initial TNM stage. The US findings included shape, size, margin, echogenicity, heterogeneity, vascularity, and internal echogenic foci. The distribution, paired appearance, and "knot-and-ear" appearance of internal echogenic foci were assessed. An experiment using pork meat investigated the US configuration of suture knots. Results Eighteen patients with 20 suture granulomas (15 women; mean age, 52±13 years) and 37 patients with 40 recurrent tumors (24 women; 54±18 years) were included. Patients with suture granulomas exhibited earlier initial T and N stages than those with recurrent tumors. The knot-and-ear appearance, defined as an echogenic dot accompanied by two adjacent echogenic dots or lines based on experimental findings, was observed in 50% of suture granulomas, but not in recurrent tumors (P

Abstract Objectives To use clinical, radiographic, and CT radiomics features to develop and validate a preoperative prediction model for the early recurrence of pancreatic cancer. Methods We retrospectively analyzed 190 patients (150 and 40 in the development and test cohort from different centers) with pancreatic cancer who underwent pancreatectomy between January 2018 and June 2021. Radiomics, clinical-radiologic (CR), and clinical-radiologic-radiomics (CRR) models were developed for the prediction of recurrence within 12 months after surgery. Performance was evaluated using the area under the curve (AUC), Brier score, sensitivity, and specificity. Results Early recurrence occurred in 36.7% and 42.5% of the development and test cohorts, respectively (P = 0.62). The features for the CR model included carbohydrate antigen 19-9 > 500 U/mL (odds ratio [OR], 3.60; P = 0.01), abutment to the portal and/or superior mesenteric vein (OR, 2.54; P = 0.054), and adjacent organ invasion (OR, 2.91; P = 0.03). The CRR model demonstrated significantly higher AUCs than the radiomics model in the internal (0.77 vs. 0.73; P = 0.048) and external (0.83 vs. 0.69; P = 0.038) validations. Although we found no significant difference between AUCs of the CR and CRR models (0.83 vs. 0.76; P = 0.17), CRR models showed more balanced sensitivity and specificity (0.65 and 0.87) than CR model (0.41 and 0.91) in the test cohort. Conclusions The CRR model outperformed the radiomics and CR models in predicting the early recurrence of pancreatic cancer, providing valuable information for risk stratification and treatment guidance.

Purpose This study aimed to evaluate the technical feasibility, efficacy, and safety of anterolateral hydrodissection (ALHD) in radiofrequency ablation (RFA) for benign thyroid nodules. Methods Between November 2019 and April 2020, 39 patients underwent 41 sessions of RFA with the ALHD technique to treat benign thyroid nodules. ALHD was performed with cold (0°C-4°C) 5% dextrose solution during RFA to minimize pain and secure sufficient safety margins from critical neck structures. The initial ablation ratio (IAR) was measured to assess the technique’s efficiency. Ultrasound examinations, symptoms, and cosmetic scores were evaluated pre-procedure and at 6 and 12 months post-procedure. Procedure-related pain during RFA and complications were recorded. Results The mean index nodule volume was 20.5±21.6 mL. ALHD was technically feasible in all patients. The mean IAR was 90.7%±8.3%, and significant reductions in mean nodule volume were noted at 6- and 12-month follow-ups (P

Neutralizing antibodies (NAbs) to multiple epitopes on the HIV-1-envelope glycoprotein (Env) have been isolated from infected persons. The potency of NAbs is measured more often than the size of the persistent fraction of infectivity at maximum neutralization, which may also influence preventive efficacy of active or passive immunization and the therapeutic outcome of the latter. Many NAbs neutralize HIV-1 CZA97.012, a clone of a Clade-C isolate, to ~100%. But here NAb PGT151, directed to a fusion-peptide epitope, left a persistent fraction of 15%. NAb PGT145, ligating the Env-trimer apex, left no detectable persistent fraction. The divergence in persistent fractions was further analyzed by depletion of pseudoviral populations of the most PGT151- and PGT145-reactive virions. Thereby, neutralization by the non-depleting NAb increased, whereas neutralization by the depleting NAb decreased. Furthermore, depletion by PGT151 increased sensitivity to autologous neutralization by sera from rabbits immunized with soluble native-like CZA97.012 trimer: substantial persistent fractions were reduced. NAbs in these sera target epitopes comprising residue D411 at the V4-β19 transition in a defect of the glycan shield on CZA97.012 Env. NAb binding to affinity-fractionated soluble native-like CZA97.012 trimer differed commensurately with neutralization in analyses by ELISA and surface plasmon resonance. Glycan differences between PGT151- and PGT145-purified trimer fractions were then demonstrated by mass spectrometry, providing one explanation for the differential antigenicity. These differences were interpreted in relation to a new structure at 3.4-Å resolution of the soluble CZA97.012 trimer determined by cryo-electron microscopy. The trimer adopted a closed conformation, refuting apex opening as the cause of reduced PGT145 binding to the PGT151-purified form. The evidence suggests that differences in binding and neutralization after trimer purification or pseudovirus depletion with PGT145 or PGT151 are caused by variation in glycosylation, and that some glycan variants affect antigenicity through direct effects on antibody contacts, whereas others act allosterically.

Introduction: Poor liquefaction of pyogenic liver abscesses, which makes drainage impossible at the time of diagnosis, is not infrequent. The impact of poor liquefaction and subsequent drainage failure on clinical outcomes is unknown. Methods: We conducted a retrospective study with all patients diagnosed with liver abscesses from July 2017 through June 2020. Late drainage (LD) was defined as drainage performed ≥48 h after diagnosis due to poor liquefaction. Logistic regression was performed to identify the factors associated with late or non-drainage (LD/ND). The Cox proportional hazard model was used to identify the variables related to abscess recurrence by 90 days after diagnosis. Results: A total of 153 patients were included. Thirty (19.6%) patients underwent LD and 54 (35.3%) did not undergo drainage. Other than non-cystic appearance, LD/ND was associated with smaller size (adjusted odds ratio [aOR] 0.85, 95% confidence interval [CI] 0.73–0.98, p = 0.031) and culture-negativity (aOR 2.69, 95% CI 1.14–6.67, p = 0.027). Current hepatopancreaticobiliary malignancy was the only significant predictor of 90-day recurrence. Neither LD/ND (OR, 0.56; 95% CI, 0.13–2.41; p = 0.426) nor LD (OR, 1.26; 95% CI, 0.23–5.55; p = 0.719) was associated with recurrence by 90 days. The incidence of late complications was reduced by drainage, without a reduction in the duration of hospitalization. Conclusion: Several clinical features were associated with undrainable liver abscesses. Neither LD/ND nor ND had an adverse impact on clinical outcomes.

Purpose The aim of this study was to assess the diagnostic role of fine-needle aspiration cytology (FNAC) and analyze factors associated with false-negative FNAC results in patients with parathyroid incidentaloma who were referred for ultrasonography (US)-guided fine-needle aspiration (FNA) of thyroid nodules. Methods In this study, 121 patients with suspected parathyroid lesions were enrolled. The patients underwent US-guided FNAC with measurements of washout parathyroid hormone (PTH) between January 2015 and May 2020. The diagnostic performance of FNAC for the diagnosis of parathyroid lesions was assessed using surgical results and elevated washout PTH as a reference standard. The clinical and radiologic features associated with false-negative results on FNAC for the diagnosis of parathyroid lesions were evaluated. Results Among the 121 nodules assessed, 38 were parathyroid lesions (31.4%), and 83 were non-parathyroid lesions (68.6%). The diagnostic performance of FNAC for parathyroid incidentaloma showed a sensitivity of 31.6% (12/38), specificity of 100% (83/83), positive predictive values of 100% (12/12), negative predictive values of 76.1% (83/109), and accuracy of 78.5% (95/121). The FNAC results of non-parathyroid lesions included thyroid nodules, lymph nodes, neurogenic tumors, and fat tissue. True-positive results on FNAC were significantly associated with performing FNA twice (58.3% vs. 23.1%, P=0.043). Conclusion Considering the low sensitivity of FNAC, measuring washout PTH in addition to FNAC may help accurately diagnose parathyroid incidentaloma on thyroid US. Further, the falsenegative rate for FNAC can be reduced by obtaining two or more FNA samples.

Background To assess the effects of radiofrequency ablation (RFA) using an internally-cooled wet (ICW) electrode in ex vivo bovine liver and evaluate the feasibility of the ICW electrode for benign thyroid nodules.Methods We developed an 18-gauge ICW electrode with a microhole at the distal tip for tissue infusion of chilled (0 − 4 °C) isotonic saline (rate = 1.5 ml/min). RFA using ICW and IC electrodes were performed in bovine livers (40 pairs, 1-cm active tip, 50 W, 1-min). We compared the morphological characteristics of ablation zones and presence of carbonization. Twenty patients with benign thyroid nodules larger than 5 ml were prospectively enrolled in a clinical study and underwent ultrasound-guided RFA with ICW electrodes. Ultrasound examinations, laboratory data, and symptom and cosmetic scores were evaluated preprocedure and 1 and 6 months after the procedure.Results In the ex vivo study, the ICW achieved significantly larger ablation zones than the IC (p

Background/purpose: Oral wound healing undergoes a dynamic process of oral environment. This study aimed to investigate the effects of hyaluronic acid (HA) film on oral wound healing in a rat model. Materials and methods: A total of 60 rats with tongue wounds (5 mm in diameter) were randomly divided into control (n = 20), HA gel (n = 20), and HA film groups (n = 20). The animals were sacrificed on either 3 or 7 days after the experiment. Clinical, histological, and quantitative reverse transcriptase-polymerase chain reaction analysis were performed to evaluate the healing rate, inflammation, re-epithelialization, and gene expression of wound healing biomarkers. Results: The healing rates of HA gel (84.4 ± 9.2%) and HA film (74.0 ± 15.0%) were significantly higher than that of the control (51.7 ± 16.9%) on day 7 (P

Presumed idiopathic intracranial hypertension (IIH) is a disorder of elevated intracranial pressure with unknown etiology, and 10% of cases occur secondarily to cerebral venous sinus thrombosis (CVST). CVST may be underestimated when findings of IIH are missed in a normal-weight patient without risk factors of coagulopathy. Here, we present a case of CVST that mimics a neurogenic tumor in the hypoglossal canal in a normal-weight patient without risk factors of coagulopathy.

Although differentiated thyroid cancer has an excellent prognosis and low mortality, its recurrence rate has been reported to be very high. While surgery is recommended as the standard treatment for recurrent thyroid cancer, reoperation may increase the incidence of complications due to fibrosis and anatomical distortion. In patients with high surgical risk or those who refuse repeated surgery, ultrasonography-guided ablation techniques including radiofrequency ablation, ethanol ablation, and laser ablation are suggested as alternative treatments. In this manuscript, we introduce an anatomy-based management concept for radiofrequency ablation for recurrent thyroid cancer, and present a review of the relevant literature, including indications, basic techniques, clinical outcomes, and complications.

A selective sequencing method, termed SeeN-Seq, is presented to link morphological phenotypes to single-cell RNAseq using UV laser patterning of hydrogel porosity.

The ability to efficiently isolate antigen-specific B cells in high throughput will greatly accelerate the discovery of therapeutic monoclonal antibodies (mAbs) and catalyze rational vaccine development. Traditional mAb discovery is a costly and labor-intensive process, although recent advances in single-cell genomics using emulsion microfluidics allow simultaneous processing of thousands of individual cells. Here we present a streamlined method for isolation and analysis of large numbers of antigen-specific B cells, including next generation antigen barcoding and an integrated computational framework for B cell multi-omics. We demonstrate the power of this approach by recovering thousands of antigen-specific mAbs, including the efficient isolation of extremely rare precursors of VRC01-class and IOMA-class broadly neutralizing HIV mAbs.

PURPOSE Performing a warm-up prior to a sports competition is essential for preventing injuries and maximizing subsequent performance. Passive warming has therefore received attention because it can effectively maintain an elevated muscle temperature (T m) after a warm-up. The present study aimed to investigate the effects of local passive warming (LPW) administered during the transition phase between active warm-up and isokinetic exercises. METHODS Eleven healthy men participated in this randomized crossover study. During the 30-minute transition period, a customized water-perfused warming pad was placed on the anterior thighs of the dominant legs (+3°C or +6°C based on the baseline skin temperature) or no intervention for the control group (CON). Subsequently, the total work, peak torque, and average power during isokinetic knee extensions (10 repetitions at a speed of 60°/sce) were measured. Using surface electromyography (EMG), the root mean square and mean frequency from the rectus femoris during knee extension were measured to assess neuromuscular activity. RESULTS Total work (+6°C 1,289.8±389.3 vs. CON 1,437.3±408.2 Nm, p =.042), peak torque (+6°C 146.0±33.3 vs. CON 162.9±37.9 Nm, p=.022), and average power (+6°C 77.7±19.8 vs. CON 90.2±25.3 W, p=.012) were lower in the LPW +6°C group than in the CON group. EMG RMS was lower in the LPW +6°C group than in the CON group (+6°C 58.4±22.3 vs. CON 78.6±33.0 % MVC, p =.005). MF was higher in the LPW +6°C group than in the CON group (+6°C 87.5±12.4 vs. CON 81.4±11.0 Hz, p=.016). CONCLUSIONS Local passive warming administered during the transition phase was not an appropriate strategy for boosting the performance of subsequent isokinetic exercises. Accordingly, the application of passive warming should be carefully chosen before exercise commences.

Purpose Radiofrequency ablation (RFA) and ethanol ablation (EA) are effective and safe for benign symptomatic thyroid nodules (BSTNs). However, relatively little is known about the effects of these procedures on patients’ quality of life (QoL). This prospective, multicenter study evaluated the effects of RFA and EA on changes in thyroid-specific QoL in patients with BSTNs and assessed the volume reduction and safety of these procedures. Methods Eighty-six consecutive patients with 86 BSTNs were prospectively included from two medical centers. RFA was performed for 55 BSTNs with solidity ≥50% and EA was performed for 31 BSTNs with solidity

Abstract A successful HIV vaccine eliciting broadly neutralizing antibodies (bnAbs) must overcome the hurdle of being able to activate naive precursor B cells encoding features within their germline B cell receptors (BCR) that allow recognition of broadly neutralizing epitopes. Knowledge of whether bnAb precursor B cells are circulating at sufficient frequencies within individuals in communities heavily impacted by HIV may be important. Using a germline-targeting eOD-GT8 immunogen and high-throughput droplet-based single-cell BCR sequencing, we demonstrate that large numbers of paired BCR sequences from multiple donors can be efficiently screened to elucidate precursor frequencies of rare, naive VRC01-class B cells. Further, we analyzed IGHV1-2 allelic usage among three different cohorts; we find that IGHV1-2 alleles traditionally thought to be incompatible with VRC01-class responses are relatively common in various human populations and that germline variation within IGHV1-2 associates with gene usage frequencies in the naive BCR repertoire.

Abstract Drug repositioning research using transcriptome data has recently attracted attention. In this study, we attempted to identify new target proteins of the urotensin-II receptor antagonist, KR-37524 (4-(3-bromo-4-(piperidin-4-yloxy)benzyl)-N-(3-(dimethylamino)phenyl)piperazine-1-carboxamide dihydrochloride), using a transcriptome-based drug repositioning approach. To do this, we obtained KR-37524-induced gene expression profile changes in four cell lines (A375, A549, MCF7, and PC3), and compared them with the approved drug-induced gene expression profile changes available in the LINCS L1000 database to identify approved drugs with similar gene expression profile changes. Here, the similarity between the two gene expression profile changes was calculated using the connectivity score. We then selected proteins that are known targets of the top three approved drugs with the highest connectivity score in each cell line (12 drugs in total) as potential targets of KR-37524. Seven potential target proteins were experimentally confirmed using an in vitro binding assay. Through this analysis, we identified that neurologically regulated serotonin transporter proteins are new target proteins of KR-37524. These results indicate that the transcriptome-based drug repositioning approach can be used to identify new target proteins of a given compound, and we provide a standalone software developed in this study that will serve as a useful tool for drug repositioning.

Purpose We evaluated the use of three criteria to determine the need for additional treatment of cystic thyroid nodules after their recurrence following ethanol ablation (EA). Methods In total, 154 patients (male:female=30:124; mean age, 53.4 years; range, 23 to 79 years) with 154 thyroid nodules (49 cystic and 105 predominantly cystic nodules) who presented between January 2014 and August 2017 were enrolled. All patients underwent follow-up ultrasonography (US) 1 month after EA, and were divided into therapeutic success and failure groups. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (≥50%) with improvement of nodule-related symptoms. The therapeutic failure was defined according to three previously suggested criteria for recommending additional treatment: nodules with ≥1 mL of remnant fluid (criterion 1), volume reduction

Purpose The diagnostic performance of thyroid biopsy is influenced by several factors, including differences in the Bethesda categorization for malignancy, the inclusion or exclusion of non-diagnostic results, the definition used for the final diagnosis, and the definition of an inconclusive diagnosis. The purpose of this study was to provide an understanding of the factors influencing the diagnostic performance of thyroid biopsy. Methods We collected data retrospectively between January and December 2013 from a cohort of 6,762 thyroid nodules from 6,493 consecutive patients who underwent biopsy. In total, 4,822 nodules from 4,553 patients were included. We calculated the biopsy sensitivity according to the inclusion of different Bethesda categories in the numerator and the exclusion of non-diagnostic results, as well as the diagnostic accuracy according to different definitions of a benign diagnosis. We obtained the conclusive and inconclusive diagnosis rates. Results The sensitivity increased when more Bethesda categories were included in the numerator and when non-diagnostic results were excluded. When a benign thyroid nodule diagnosis was defined as benign findings on surgical resection, concordant benign results on at least two occasions, or an initial benign biopsy result and follow-up for more than 12 months, the accuracy was higher than when the diagnosis was based on surgical resection alone (91.1% vs. 68.7%). A higher conclusive diagnosis rate was obtained when Bethesda categories I and III were considered inconclusive than when Bethesda categories I, III and IV were considered inconclusive (78.3% vs. 72.8%, P

Purpose Thermal ablation is a novel treatment alternative for benign thyroid nodules, and one of the most promising thermal ablation techniques is radiofrequency ablation (RFA). Considering the increasing use of thyroid RFA, some scientific societies have proposed clinical practice guidelines. We systemically reviewed and compared these guidelines for thyroid RFA to identify a standard treatment strategy that represents the positions of most societies. Methods We searched the MEDLINE and EMBASE databases for studies with human participants that were published in English between January 1, 2000 and August 2, 2019. Studies containing clinical practice guidelines for the RFA of benign thyroid nodules were included. We extracted data regarding indications, pre- and post-procedural evaluations, treatment techniques, and the need to obtain informed consent. Results Of the 83 studies found, four studies were included, and one study was added after searching the bibliographies of those articles. The five included studies were guidelines developed by the Korean Society of Thyroid Radiology, a group of experts from Italian scientific societies, the Italian Working Group on Minimally Invasive Treatments of the Thyroid, the United Kingdom’s National Institute for Health and Clinical Excellence, and a group of four professional Austrian thyroid associations. Indications, pre- and post-procedural evaluations, and techniques were similar across studies; however, differences in each of these categories were found. Conclusion While the reviewed guidelines are similar with regard to major categories, international guidelines for the RFA of benign thyroid nodules should be established in the future.

Cerebral autosomal dominant arteriopathy, subcortical infarcts, and leukoencephalopathy (CADASIL) is the most common monogenic form of small vessel disease characterized by migraine with aura, leukoaraiosis, strokes, and dementia. CADASIL mutations cause cerebrovascular dysfunction in both animal models and humans. Here, we showed that 2 different human CADASIL mutations (Notch3 R90C or R169C) worsen ischemic stroke outcomes in transgenic mice; this was explained by the higher blood flow threshold to maintain tissue viability compared with that in wild type (WT) mice. Both mutants developed larger infarcts and worse neurological deficits compared with WT mice, regardless of age or sex after filament middle cerebral artery occlusion. However, full-field laser speckle flowmetry during distal middle cerebral artery occlusion showed comparable perfusion deficits in mutants and their respective WT controls. Circle of Willis anatomy and pial collateralization also did not differ among the genotypes. In contrast, mutants had a higher cerebral blood flow threshold, below which infarction ensued, suggesting increased sensitivity of brain tissue to ischemia. Electrophysiological recordings revealed a 1.5- to 2-fold higher frequency of peri-infarct spreading depolarizations in CADASIL mutants. Higher extracellular K+ elevations during spreading depolarizations in the mutants implicated a defect in extracellular K+ clearance. Altogether, these data reveal a mechanism of enhanced vulnerability to ischemic injury linked to abnormal extracellular ion homeostasis and susceptibility to ischemic depolarizations in CADASIL.

Summary: Elicitation of HIV broadly neutralizing antibodies (bnAbs) is challenging because unmutated bnAb precursors are rare and seldom bind HIV envelope glycoprotein (Env) trimers. One strategy to initiate bnAb responses is to use germline-targeting (GT) immunogens with high affinity to bnAb-class precursor B cells and then shepherd affinity maturation with booster immunogens that successively look more like native Env. In a mouse model where the frequency of VRC01-precursor (VRC01gHL) B cells mimics that of humans, we show that following a GT HIV Env trimer protein prime, VRC01-class B cells in the germinal center (GC) acquire high-affinity VRC01-class B cell somatic hypermutations (SHMs). Many GC-derived VRC01gHL antibodies robustly bind N276 glycan-deficient Env trimers and neutralize several N276 glycan-deficient tier 2 HIV strains. These results are encouraging for GT Env trimer vaccine designs and demonstrate accumulation of substantial SHMs, including deletions, uncommon point mutations, and functional bnAb features, after a single immunization.

AIM: To report CT and MR imaging findings of ocular adnexal mucosa-associated lymphoid tissue lymphoma associated with IgG4-related disease (IgG4-MALT lymphoma), a rare but clinically important complication of ocular adnexal IgG4-related disease. METHODS: We retrospectively reviewed all cases of histologically confirmed ocular adnexal IgG4-related disease at three tertiary and one secondary referral centers, between February 2003 and December 2016. Seven cases of histopathologically diagnosed IgG4-MALT lymphoma were identified. CT and MR images were analyzed by consensus of two experienced head and neck radiologists. RESULTS: Lacrimal glands were the main site of involvement in all seven patients. The lesions typically showed well-demarcated margins, iso- to hyperattenuation on precontrast CT, T2 hypo- to isointensity, T1 isointensity, and homogenous internal architecture with homogenous enhancement pattern. Lesions were mostly hyperdense and isointense to normal extraocular muscles on postcontrast CT and MR images, respectively. CONCLUSION: Unlike in typical ocular adnexal IgG4-related disease, T2 isointensity and hyperattenuation on precontrast CT images were noted in some IgG4-MALT lymphoma cases. Although the findings may be nonspecific, the possibility of accompanying MALT lymphoma may need to be considered, when ocular adnexal lesions in patients clinically suspected of having IgG4-related disease are refractory to glucocorticoids and show T2 isointensity and hyperattenuation on precontrast CT for the optimal management of the patients. However, this is a case series of a very rare complication of ocular adnexal IgG4-related disease, and thus caution is warranted to generalize the conclusion.

Background Ultrasound-guided thermal ablations have become one of the main options for treating benign thyroid nodules. To determine efficacy of thermal ablation of benign thyroid nodules, we performed a meta-analysis of studies with long-term follow-up of more than 3 years. Methods Databases were searched for studies published up to August 25, 2019, reporting patients with benign thyroid nodules treated with thermal ablation and with follow-up data of more than 3 years. Data extraction and quality assessment were performed according to PRISMA guidelines. The analysis yielded serial volume reduction rates (VRRs) of ablated nodules for up to 3 years or more, and adverse effect of ablation during follow-up. Radiofrequency ablation (RFA) and laser ablation (LA) were compared in a subgroup analysis. Results The pooled VRRs for ablated nodules showed rapid volume reduction before 12 months, a plateau from 12 to 36 months, and more volume reduction appearing after 36 months, demonstrating long-term maintenance of treatment efficacy. Thermal ablation had an acceptable complication rate of 3.8%. Moreover, patients undergoing nodule ablation showed no unexpected delayed complications during the follow-up period. In the subgroup analysis, RFA was shown to be superior to LA in terms of the pooled VRR and the number of patients who underwent delayed surgery. Conclusion Thermal ablations are safe and effective methods for treating benign thyroid nodules, as shown by a long follow-up analysis of more than 3 years. In addition, RFA showed superior VRRs compared with LA for the treatment of benign thyroid nodules, with less regrowth and less delayed surgery.

Background Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA. Methods Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated. Results Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage. Conclusion Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.

Abstract Background In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships. Methods Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient’s foot in an inverted position. Results Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136). Conclusion The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity.

Abstract Background Whole-body MRI (WB-MRI) including diffusion-weighted image (DWI) have been widely used in patients with multiple myeloma. However, evidence for the value of WB-MRI in the evaluation of treatment response remains sparse. Therefore, we evaluated the role of WB-MRI in the response assessment. Methods In our WB-MRI registry, we searched multiple myeloma patients treated with chemotherapy who underwent both baseline and follow-up WB-MRI scans. Clinical responses were categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD), using IMWG criteria. Using RECIST 1.1, MD Anderson (MDA) criteria, and MDA-DWI criteria, imaging responses on WB-MRI were rated as CR, PR, SD, or PD by two radiologists independently. Then, discrepancy cases were resolved by consensus. Weighted Kappa analysis was performed to evaluate agreement between the imaging and clinical responses. The diagnostic accuracy of image responses in the evaluation of clinical CR, objective response (CR and PR), and PD was calculated. Results Forty-two eligible patients were included. There was moderate agreement between imaging and clinical responses (κ = 0.54 for RECIST 1.1, κ = 0.58 for MDA criteria, κ = 0.69 for MDA-DWI criteria). WB-MRI showed excellent diagnostic accuracy in assessment of clinical PD (sensitivity 88.9%, specificity 94.7%, positive predictive value [PPV] 84.2%, negative predictive value [NPV] 96.4% in all three imaging criteria). By contrast, WB-MRI showed low accuracy in assessment of clinical CR (sensitivity 4.5%, specificity 98.1%, PPV 50.0%, NPV 71.2% in all three imaging criteria). As to the clinical objective response, the diagnostic accuracy was higher in MDA-DWI criteria than RECIST 1.1 and MDA criteria (sensitivity/specificity/PPV/NPV, 84.2%/94.4%/98.0%/65.4, 54.4%/100%/100%/40.9, and 61.4%/94.4%/97.2%/43.6%, respectively). Conclusions In the imaging response assessment of multiple myeloma, WB-MRI showed excellent performance in the evaluation of PD, but not in the assessment of CR or objective response. When adding DWI to imaging response criteria, diagnostic accuracy for objective response was improved and agreement between imaging and clinical responses was increased.

BackgroundTo evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy.MethodsThe data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis.ResultsNo atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P

Purpose We compared the efficacy and safety of two ethanol ablation techniques-ethanol aspiration and ethanol retention-for benign cystic thyroid nodules. Methods From October 2008 to September 2013, 113 patients who were treated using the ethanol aspiration technique (February 2008 to December 2010) and 108 patients who were treated using the ethanol retention technique (January 2011 to September 2013) were enrolled (male:female ratio, 53:168; mean age, 48.1 years; range, 18 to 80 years). The patient sample had 94 cystic and 127 predominantly cystic thyroid nodules. The volume reduction ratio (VRR) at the last follow-up, improvements in symptoms and cosmetic scores, vascularity, pain, and major complications were evaluated and compared between the ethanol aspiration group and ethanol retention group. We also performed a subgroup analysis according to the proportion of the solid component, in which VRR, symptom and cosmetic scores, and therapeutic success were compared. Results No statistically significant difference in VRR was found between the ethanol retention group and the ethanol aspiration group (83.2%±32.8% vs. 86.1%±18.4%, P=0.416) while patients who underwent the retention technique were more likely to experience pain after treatment (P=0.001). VRR, symptom and cosmetic scores, and therapeutic success did not significantly differ between techniques in either group in the subgroup analysis. Conclusion The ethanol aspiration technique may be preferable to the ethanol retention technique for treating benign cystic and predominantly cystic thyroid nodules, because a comparable VRR can be expected with less pain.

Objective: The aim of this study was to introduce a management strategy for nerve damage occurring during radiofrequency ablation (RFA). Methods: From January 2016 to October 2017, 17 patients who experienced the symptoms of nerve damage during RFA were enrolled in this study. If damage to nerves was suspected during RFA, ablation was stopped immediately, and a cold solution of 5% dextrose was injected directly into the space where the nerves were located until symptoms improved. Patients were followed up after the procedure until symptoms had resolved. The clinical data of patients who received a cold dextrose solution injection for nerve damage were compared with those who did not receive such an injection. Results: Of 17 patients who experienced nerve damage, 12 received an injection of cold dextrose solution shortly after the emergence of symptoms. While resolution of symptoms was seen in all 17 patients, the mean time to recovery was significantly faster in the 12 patients who received treatment with an injection of cold dextrose solution than in those patients who did not receive such a treatment (p value = .041). Conclusions: In the event of thermal damage to adjacent nerve structures during RFA, the direct injection of a cold dextrose solution is a simple and effective treatment that can result in rapid symptom resolution.

Melanin-concentrating hormone receptor 1 (MCHR1) has been a target for appetite suppressants, which are helpful in treating obesity. However, it is challenging to develop an MCHR1 antagonist because its binding site is similar to that of the human Ether-à-go-go-Related Gene (hERG) channel, whose inhibition may cause cardiotoxicity. Most drugs developed as MCHR1 antagonists have failed in clinical development due to cardiotoxicity caused by hERG inhibition. Machine learning-based prediction models can overcome these difficulties and provide new opportunities for drug discovery. In this study, we identified KRX-104130 with potent MCHR1 antagonistic activity and no cardiotoxicity through virtual screening using two MCHR1 binding affinity prediction models and an hERG-induced cardiotoxicity prediction model. In addition, we explored other possibilities for expanding the new indications for KRX-104130 using a transcriptome-based drug repositioning approach. KRX-104130 increased the expression of low-density lipoprotein receptor (LDLR), which induced cholesterol reduction in the gene expression analysis. This was confirmed by comparison with gene expression in a nonalcoholic steatohepatitis (NASH) patient group. In a NASH mouse model, the administration of KRX-104130 showed a protective effect by reducing hepatic lipid accumulation, liver injury, and histopathological changes, indicating a promising prospect for the therapeutic effect of NASH as a new indication for MCHR1 antagonists.

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Abstract CO2 boilers/direct heating systems used in greenhouses often lead to incomplete combustion, which results in the formation of hazardous gases, such as carbon monoxide (CO), nitroxide (NOX) and other hydrocarbons. In this study, strawberry plants that were grown on rockwool cubes were transferred to airtight bottles and treated with CO, NOX, CH4 and C3H8 gases for 1–48 hours. Oxidative damage due to hazardous gases was observed, as indicated by H2O2 and $${{\bf{O}}}_{{\bf{2}}}^{{\boldsymbol{-}}1}$$ O2−1 determination. Photosynthetic pigments were reduced, and stomatal guard cells were damaged and remained closed compared to the control. The activity of other photosynthetic parameters was negatively related to hazardous gases. Reduction in the expression of multiprotein complexes was highly observed under hazardous gas treatments. This study highlighted that hazardous gases (CO, NOX, CH4 and C3H8) emitted due to incomplete combustion of CO2 fertilization units/or direct heating systems resulted in the formation of ROS in shoots and limited photosynthetic metabolism. We predicted that major steps must be incorporated to improve the efficiency of CO2 boiler/heating systems to decrease the emission of these hazardous gases and other hydrocarbons and to reduce the observed risks that are key to the reduction of crops.

BackgroundTo compare pain, tolerability, and complications associated with fine needle aspiration (FNA) versus core needle biopsy (CNB).MethodsFNAs were performed using 23-gauge needles and CNBs were performed using 18-gauge double-action spring-activated needles in 100 patients for each procedure. Patients were asked to record a pain score using a 10-cm visual analog scale and procedure tolerability. Complications and number of biopsies were recorded.ResultsThe median pain scores were similar for the FNA and CNB approaches during and 20 minutes after the biopsy procedures (3.7 vs. 3.6, P=0.454; 0.9 vs. 1.1, P=0.296, respectively). The procedure was tolerable in all 100 FNA patients and in 97 CNB patients (P=0.246). The mean number of biopsies was fewer in the CNB group (1.4 vs. 1.2, P=0.002). By subgroup analysis (staff vs. non-staff), no significant difference was detected in any parameter. There were no major complications in either group, but three patients who underwent CNB had minor complications (P=0.246).ConclusionFNA and CNB show no significant differences for diagnosing thyroid nodules in terms of pain, tolerability, or complications.

Abstract We compared the efficacy and complications of core-needle biopsy (CNB) with those of fine-needle aspiration (FNA) in a large population of patients with initially detected thyroid nodules via a propensity score analysis. Outpatients with initially detected thyroid nodules, who had undergone CNB or FNA between January 2013 and December 2013, were selected. This study included 4,822 thyroid nodules from 4,553 consecutive patients. Adjustments for significant differences in patients’ baseline characteristics were facilitated via propensity score analysis. Subgroup analyses were performed according to nodule sizes ≥ 1 cm. The non-diagnostic result rate, malignancy rate, complication rate, and diagnostic accuracy were compared. A 1:1 matching of 1,615 patients yielded no significant differences between two groups for any covariate. The non-diagnostic result rate was significantly lower in the core-needle biopsy group than in the fine-needle aspiration group (5.2% vs. 12.1%), while the malignancy rate (23.7% vs. 11.8%) and sensitivity (75.9% vs. 55.6%) were significantly higher. However, the specificities were similar (100% and 99.9%, respectively). Propensity score and subgroup analyses showed similar results. The complication rate was similar between groups in matched cohorts. CNB is a promising and safe diagnostic tool for patients with initially detected thyroid nodules.

Purpose The purpose of this study was to evaluate how the anisotropy and the static stretch stress of the cervical musculature influence the measured shear modulus in a tissue-mimicking phantom and in cervical lymph nodes in vivo by using shear wave elastography (SWE). Methods SWE was performed on a phantom using a pig muscle and on the middle jugular cervical lymph nodes in six volunteers. Tissue elasticity was quantified using the shear modulus and a supersonic shear wave imaging technique. For the phantom study, first, the optimal depth for measurement was determined, and then, SWE was performed in parallel and perpendicular to the muscle fiber orientation with and without strain stress. For the in vivo study, SWE was performed on the cervical lymph nodes in parallel and perpendicular to the sternocleidomastoid muscle fiber direction with and without neck stretching. The mean values of the shear modulus (meanSM) were then analyzed. Results In the phantom study, the measured depth significantly influenced the meanSM with a sharp decrease at the depth of 1.5 cm (P

BackgroundThe clinical course of IPF varies. This study sought to identify phenotyping with quantitative computed tomography (CT) fibrosis and emphysema features using a cluster analysis and to assess prognostic impact among identified clusters in patient with idiopathic pulmonary fibrosis (IPF). Furthermore, we evaluated the impact of fibrosis and emphysema on lung function with development of a descriptive formula.MethodsThis retrospective study included 205 patients with IPF. A texture-based automated system was used to quantify areas of normal, emphysema, ground-glass opacity, reticulation, consolidation, and honeycombing. Emphysema index was obtained by calculating the percentage of low attenuation area lower than -950HU. We used quantitative CT features and clinical features for clusters and assessed the association with prognosis. A formula was derived using fibrotic score and emphysema index on quantitative CT.ResultsThree clusters were identified in IPF patients using a quantitative CT score and clinical values. Prognosis was better in cluster1, with a low extent of fibrosis and emphysema with high forced vital capacity (FVC) than cluster2 and cluster3 with higher fibrotic score and emphysema (p = 0.046, and p = 0.026). In the developed formula [1.5670-fibrotic score(%)*0.04737-emphysema index*0.00304], a score greater ≥ 0 indicates coexisting of pulmonary fibrosis and emphysema at a significant extent despite of normal spirometric result.ConclusionsCluster analysis identified distinct phenotypes, which predicted prognosis of clinical outcome. Formula using quantitative CT values is useful to assess extent of pulmonary fibrosis and emphysema with normal lung function in patients with IPF.

[This corrects the article DOI: 10.1371/journal.pone.0215303.].

Purpose The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. Methods From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. Results All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. Conclusion In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.

The HIV-1 envelope glycoprotein trimer is covered by an array of N-linked glycans that shield it from immune surveillance. The high density of glycans on the trimer surface imposes steric constraints limiting the actions of glycan-processing enzymes, so that multiple under-processed structures remain on specific areas. These oligomannose glycans are recognized by broadly neutralizing antibodies (bNAbs) that are not thwarted by the glycan shield but, paradoxically, target it. Our site-specific glycosylation analysis of a soluble, recombinant trimer (BG505 SOSIP.664) maps the extremes of simplicity and diversity of glycan processing at individual sites and reveals a mosaic of dense clusters of oligomannose glycans on the outer domain. Although individual sites usually minimally affect the global integrity of the glycan shield, we identify examples of how deleting some glycans can subtly influence neutralization by bNAbs that bind at distant sites. The network of bNAb-targeted glycans should be preserved on vaccine antigens.

Ultrasound (US) elastography has been introduced as a noninvasive imaging technique for evaluating cervical lymph nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic lymph nodes demonstrate higher stiffness than benign lymph nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant cervical lymph nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined.

Background: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

BackgroundIt has been recognized that a defect in klotho gene expression accelerates the degeneration of multiple age-sensitive traits. Accumulating evidence indicates that aging is associated with declines in cognitive function and the activity of growth hormone (GH)/insulin-like growth factor-1 (IGF-1).MethodsIn this study, we examined whether a GH-releaser diet could be effective in protecting against cognitive impairment in klotho mutant mice.ResultsThe GH-releaser diet significantly induced the expression of IGF-1 and IGF-1 receptors in the hippocampus of klotho mutant mice. Klotho mutant mice showed significant memory impairments as compared with wild-type mice. In addition, the klotho mutation significantly decreased the expression of cell survival/antiapoptotic factors, including phospho-Akt (p-Akt)/phospho-glycogen synthase kinase3β (p-GSK3β), phospho-extracellular signal-related kinase (p-ERK), and Bcl-2, but significantly increased those of cell death/proapoptotic factors, such as phospho-c-jun N-terminal kinase (p-JNK), Bax, and cleaved caspase-3 in the hippocampus. Treatment with GH-releaser diet significantly attenuated both decreases in the expression of cell survival/antiapoptotic factors and increases in the expression of cell death/proapoptotic factors in the hippocampus of klotho mutant mice. In addition, klotho mutation-induced oxidative stress was significantly attenuated by the GH-releaser diet. Consequently, a GH-releaser diet significantly improved memory function in the klotho mutant mice. GH-releaser diet-mediated actions were significantly reversed by JB-1, an IGF-1 receptor antagonist.ConclusionThe results suggest that a GH-releaser diet attenuates oxidative stress, proapoptotic changes and consequent dysfunction in klotho mutant mice by promoting IGF-1 expression and IGF-1 receptor activation.

Broadly neutralizing antibodies (bNAbs) to HIV-1 envelope glycoprotein (Env) can prevent infection in animal models. Characterized bNAb targets, although key to vaccine and therapeutic strategies, are currently limited. We defined a new site of vulnerability by solving structures of bNAb 8ANC195 complexed with monomeric gp120 by X-ray crystallography and trimeric Env by electron microscopy. The site includes portions of gp41 and N-linked glycans adjacent to the CD4-binding site on gp120, making 8ANC195 the first donor-derived anti-HIV-1 bNAb with an epitope spanning both Env subunits. Rather than penetrating the glycan shield by using a single variable-region CDR loop, 8ANC195 inserted its entire heavy-chain variable domain into a gap to form a large interface with gp120 glycans and regions of the gp120 inner domain not contacted by other bNAbs. By isolating additional 8ANC195 clonal variants, we identified a more potent variant, which may be valuable for therapeutic approaches using bNAb combinations with nonoverlapping epitopes.

Cadmium signifies a severe threat to crop productivity and green gram is a notably iron sensitive plant which shows considerable variation towards cadmium stress. A gel-based proteomics analysis was performed with the roots of green gram exposed to iron and cadmium combined treatments. The resulting data show that twenty three proteins were down-regulated in iron-deprived roots either in the absence (−Fe/−Cd) or presence (−Fe/+Cd) of cadmium. These down-regulated proteins were however well expressed in roots under iron sufficient conditions, even in the presence of cadmium (+Fe/+Cd). The functional classification of these proteins determined that 21% of the proteins are associated with nutrient metabolism. The other proteins in higher quantities are involved in either transcription or translation regulation, and the rest are involved in biosynthesis metabolism, antioxidant pathways, molecular chaperones and stress response. On the other hand, several protein spots were also absent in roots in response to iron deprivation either in absence (−Fe/−Cd) or presence (−Fe/+Cd) of cadmium but were well expressed in the presence of iron (+Fe/+Cd). Results suggest that green gram plants exposed to cadmium stress are able to change the nutrient metabolic balance in roots, but in the mean time regulate cadmium toxicity through iron supplements.

The objective of this study was to investigate the response of light emitting diodes (LEDs) at different light intensities (70 and 80 for green LEDs, 88 and 238 for red LEDs and 80 and 238 μmol m−2 s−1 for blue LEDs) at three wavelengths in lettuce leaves. Lettuce leaves were exposed to (522 nm), red (639 nm) and blue (470 nm) LEDs of different light intensities. Thylakoid multiprotein complex proteins and photosynthetic metabolism were then investigated. Biomass and photosynthetic parameters increased with an increasing light intensity under blue LED illumination and decreased when illuminated with red and green LEDs with decreased light intensity. The expression of multiprotein complex proteins including PSII-core dimer and PSII-core monomer using blue LEDs illumination was higher at higher light intensity (238 μmol m−2 s−1) and was lowered with decreased light intensity (70–80 μmol m−2 s−1). The responses of chloroplast sub-compartment proteins, including those active in stomatal opening and closing, and leaf physiological responses at different light intensities, indicated induced growth enhancement upon illumination with blue LEDs. High intensity blue LEDs promote plant growth by controlling the integrity of chloroplast proteins that optimize photosynthetic performance in the natural environment.

BackgroundRemifentanil is a short-acting drug with a rapid onset that is useful in general anesthesia. Recently, however, it has been suggested that the use of opioids during surgery may cause opioid-induced hyperalgesia (OIH). Researchers have recently reported that esmolol, an ultra-short-acing β1 receptor antagonist, reduces the postoperative requirement for morphine and provides more effective analgesia than the administration of remifentanil and ketamine. Hence, this study was conducted to determine whether esmolol reduces early postoperative pain in patients who are continuously infused with remifentanil for anesthesia during laparoscopic cholecystectomy.MethodsSixty patients scheduled to undergo laparoscopic cholecystectomy were randomly divided into three groups. Anesthesia was maintained with sevoflurane and 4 ng/ml (target-controlled infusion) of remifentanil in all patients. Esmolol (0.5 mg/kg) was injected and followed with a continuous dosage of 10 µg/kg/min in the esmolol group (n = 20). Ketamine (0.3 mg/kg) was injected and followed with a continuous dosage of 3 µg/kg/min in the ketamine group (n = 20), while the control group was injected and infused with an equal amount of normal saline. Postoperative pain score (visual analog scale [VAS]) and analgesic requirements were compared for the first 6 hours of the postoperative period.ResultsThe pain score (VAS) and fentanyl requirement for 15 minutes after surgery were lower in the esmolol and ketamine groups compared with the control group (P < 0.05). There were no differences between the esmolol and ketamine groups.ConclusionsIntraoperative esmolol infusion during laparoscopic cholecystectomy reduced opioid requirement and pain score (VAS) during the early postoperative period after remifentanil-based anesthesia.

A study was conducted to determine the effect of carbon monoxide (CO), nitroxide (NOx) and sulfur dioxide (SO2) on ROS production, photosynthesis and ascorbate–glutathione pathway in strawberry plants. The results showed that both singlet oxygen (O2−1) and hydrogen peroxide (H2O2) content increased in CO, NOx and SO2 treated strawberry leaves. A drastic reduction of primary metabolism of plants (photosynthesis), with the closure of stomata, resulted in a reduction of protein, carbohydrate and sucrose content due to production of reactive oxygen species (ROS) under prolonged exposure of gas stress. The resulting antioxidant enzymes were increased under a low dose of gas stress, whereas they were decreased due to a high dose of gas stress. Our results indicate that increased ROS may act as a signal to induce defense responses to CO, NOx and SO2 gas stress. The increased level of antioxidant enzymes plays a significant role in plant protection due to which strawberry plants can be used as a hyperaccumulator to maintain environmental pollution, however, the defense capacity cannot sufficiently alleviate oxidative damage under prolonged exposure of CO, NOx and SO2 stress.

ObjectivesRectified vestibular evoked myogenic potential (rVEMP) is new method that simultaneously measures the muscle contraction power during VEMP recordings. Although there are a few studies that have evaluated the effect of the rVEMP, there is no study that has evaluated the capacity of rVEMP during asymmetrical muscle contraction.MethodsThirty VEMP measurements were performed among 20 normal subjects (mean age, 28.2±2.1 years; male, 16). VEMP was measured in the supine position. The head was turned to the right side by 0°, 15°, 30°, and 45° and the VEMPs were recorded in each position. The interaural amplitude difference (IAD) ratio was calculated by the conventional non-rectified VEMP (nVEMP) and rVEMP.ResultsThe nVEMP IAD increased significantly according to increasing neck rotation. The IAD in rVEMP was almost similar from 0° to 30°. However, the IAD was significantly larger than the other positions when the neck was rotated 45°. When IAD during 0° was set as a standard, the IAD of the rVEMP was significantly smaller that the nVEMP only during the 30°rotaion.ConclusionRectified VEMP is capable of correcting asymmetrical muscle contraction power. In contrast, it cannot correct the asymmetry if muscle contraction power asymmetry is 44.8% or larger. Also, it is not necessary if muscle contraction power asymmetry is 22.5% or smaller.