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Adhesive capsulitis, the so-called 'frozen shoulder', is one of the common causes of pain with a limited range of motion in the shoulder joint. The condition is usually diagnosed through the clinical course and physical examinations; however, several studies on imaging findings of adhesive capsulitis using sonography, MRI, and MR angiography have been reported. In this article, various imaging findings for the diagnosis of adhesive capsulitis-related anatomy are reviewed.

To examine whether

Background: Non-alcoholic fatty liver disease (NAFLD) is regarded as a risk factor for type 2 diabetes mellitus (DM). Menopausal status also influences T2DM risk, where estrogen is presumed to play a protective role by decreasing insulin resistance. As such, we investigated the association between NAFLD and DM risk according to menopausal status. Objectives: We sought to examine the association between NAFLD and DM incidence in pre- and post-menopausal women. Methods: A total of 842,772 pre-menopausal and 1,074,767 post-menopausal women who underwent health examinations between 2009 and 2014 were included from the Korean National Health Insurance Service database. Multivariate Cox proportional hazard analyses were performed to evaluate the association between the risk of DM according to menopausal status and NAFLD, defined by a fatty liver index >60. Results: During the mean follow-up period (7.8 years), DM was diagnosed in 33,461 (4.0%) of pre-menopausal women and 121,102 (9.4%) post-menopausal women. A stronger association between NAFLD and the risk of DM was found in pre-menopausal women (multivariable-adjusted hazard ratio [aHR], 3.60; 95% confidence interval [CI], 3.48–3.71) than in post-menopausal women (aHR, 2.24; 95% CI, 2.21–2.28) (P-interaction < 0.01). Subgroup analyses among women aged 45 to 55 years also showed a stronger association in pre-menopausal (aHR, 3.35; 95% CI, 3.21–3.49) than in post-menopausal women (aHR, 2.83; 95% CI, 2.68–2.98) (P-interaction < 0.01). Conclusions: The association between NAFLD and DM was stronger in pre-menopausal women than in post-menopausal women. This might be due to the protective effect of estrogen, which is possibly in higher production in the peripheral fat tissue of post-menopausal women with NAFLD.

Context There are relatively few data on noncardiovascular (non-CV) long-term clinical outcomes of dipeptidyl peptidase 4 inhibitor (DPP4i) treatment. Objective We aimed to evaluate some non-CV effects of DPP4is in patients with diabetes. Methods Based on data from the National Health Insurance Service database in Korea (2007-2018), we conducted 3 pairwise comparisons of metformin-combined antidiabetic therapies in adult patients with diabetes: DPP4is vs (1) all other oral antidiabetic agents, (2) sulfonylureas/glinides, and (3) thiazolidinediones (TZDs). Major outcomes were liver cirrhosis, end-stage renal disease (ESRD), and cancers in the liver, kidney, and pancreas. Adjusted hazard ratios (HRs) and 95% CIs for the outcomes were estimated using an adjusted Cox model. Results Of the 747 124 patients included, 628 217 had received DPP4i therapy for a mean duration of 33.8 ± 25.0 months. Compared with TZD therapy, DPP4i therapy was associated with higher adjusted HRs [95% CIs] for liver cirrhosis (1.267 [1.108-1.449]), ESRD (1.596 [1.139-2.236]), liver cancer (1.117 [1.011-1.235]), and pancreatic cancer (1.158 [1.040-1.290]). Furthermore, apart from liver cirrhosis, a higher risk of each of these outcomes was associated with DPP4i use than with non-DPP4i use. The higher adjusted HRs associated with DPP4i use further increased when patients with long-term exposure to DPP4is were analyzed. Conclusion DPP4i therapy in patients with diabetes was associated with a higher risk of liver cirrhosis and cancer, ESRD, and pancreatic cancer than TZD therapy and, except for liver cirrhosis, the risk of these outcomes was greater with DPP4i treatment than with non-DPP4i treatment.

A variety of natural compounds have been used to reduce the oxidative stress associated with Alzheimer's disease, and many of these defend cells from oxidative stress-induced neuronal toxicity. In this study, the protective effect of radish (Raphanus raphanistrum) extract was investigated in mice and PC12 cells. In vivo behavioral tests were completed to examine the protective effects of the extract on amyloid beta (Aβ)-peptide1-42-induced learning and memory impairment in a mouse model. The extract increased spontaneous alternation behaviors and step-through latency in mice. We discovered that administration of the extract reduced lipid peroxidation and Aβ aggregation in a biochemical study of mice brain tissues. Treatment with the extract also increased acetylcholine and catalase activity in the brain. Furthermore, the radish extract attenuated H2O2-induced oxidative stress in cells. Through sequential fractionation of the radish extract, the active compound was identified as oleamide. These results suggest that the radish extract could have a protective role against oxidative stress-induced neuronal toxicity, possibly owing to the antioxidative activity of oleamide.

Background: The intracompartmental septum isolating the extensor pollicis brevis (EPB) has been reported to affect the patient’s response to nonsurgical treatment in de Quervain’s disease. A simple physical test called the modified staged Finkelstein test was developed to evaluate the septum; the result of this test was compared with those of the pre-existing physical test (EPB entrapment test) and ultrasonographic (US) examination of the septum. Methods: We retrospectively analyzed 52 patients who underwent two clinical tests, including the modified staged Finkelstein test and the EPB entrapment test, and US examination for de Quervain’s disease. The correlation between the clinical test results and US findings was evaluated; sensitivity, specificity, and positive and negative predictive values were calculated. Results: The proportion of wrists with a separate septum was 50% (26 patients) in the US examination. The sensitivity and specificity of the modified staged Finkelstein test were 88.5% and 73.1%, respectively; those of EPB entrapment test were 71.4% and 84.2%, respectively. The positive and negative predictive values of the modified staged Finkelstein test were 76.7% and 86.4%, respectively. Conclusions: The modified staged Finkelstein test showed acceptable diagnostic values for the diagnosis of septum compared with pre-existing physical tests. Knowledge about the existence of septum could be helpful in treating patients and expecting prognosis.

Although both obesity and menopause are associated with increased risk of diabetes mellitus (DM), the association between obesity and DM according to menopausal status remains uncertain. Therefore, we conducted a study to examine the relationship between obesity and incidence of diabetes mellitus (DM) in premenopausal and postmenopausal women. Total of 926,196 premenopausal and 1,193,881 postmenopausal women who underwent health examinations from 2009 to 2014 were identified using the database of the Korean National Health Insurance Service. We compared the incidence and risk of DM according to body mass index (BMI) and waist circumference (WC) in the two groups of women. Cox proportional hazards analyses were performed to evaluate the association between the presence of obesity and risk of DM according to menopausal state. During the 7.8-year follow-up period, 37,736 (4.1%) premenopausal women and 121,102 (10.1%) postmenopausal women were diagnosed with DM. Compared to the reference group (BMI 18.5–23), a stronger association between obesity and risk of DM was observed in both pre- and postmenopausal women: multivariable-adjusted hazard ratios and 95% confidence intervals for BMI subgroups &lt, 18.5, 23–25, 25–30, and &gt, 30 were 0.62 (0.54, 0.70), 1.91 (1.85, 1.97), 3.38 (3.28, 3.47), and 6.25 (6.02, 6.48), respectively (p trend &lt, 0.001) in premenopausal women and 0.87 (0.82, 0.92), 1.44 (1.41, 1.46), 2.00 (1.97, 2.03), and 2.96 (2.89, 3.02) in postmenopausal women (p trend &lt, 0.001, p-interaction &lt, 0.001). A similar trend was observed for WC. Subgroup analyses of women aged 45 to 55 also showed a stronger association with DM in premenopausal than in postmenopausal women. In conclusion, the association between obesity and DM was stronger in premenopausal women than in postmenopausal women. As estrogens are synthesized in adipose tissue by aromatization of androgens after menopause, increased estrogen levels in obese postmenopausal might have a protective effect against DM.

IntroductionDespite extensive studies on the relationship between diabetes mellitus (DM) and depression, the associations of depressive symptom severity with prevalence, awareness, treatment, and control of diabetes remain unclear. We aimed to investigate changes in these outcomes of diabetes as depressive symptoms aggravate.Research design and methodsWe conducted a cross-sectional analysis of 14 328 participants in the 2011–2016 National Health and Nutrition Examination Survey. Participants were classified into depressive symptom groups of none, mild, moderate, moderately severe, and severe depending on their Patient Health Questionnaire-9 scores. Multivariate logistic regression analyses were conducted in three models adjusted for expanding confounders to evaluate the associations between severity of depressive symptoms and prevalence, awareness, treatment, and control of DM.ResultsAs depressive symptom severity worsened, both prevalence and awareness of DM increased regardless of models (p value for trend ConclusionsThe gap between patients’ higher awareness and lower treatment rate or control of diabetes among individuals with severe depressive symptoms highlights the unmet needs for postdiagnostic multidisciplinary care for patients with comorbid depression and DM.

Background and Objectives Muscle strength is associated with adverse mental health outcomes in adults; however, few studies have examined this association among adolescents. This study investigated the association between handgrip strength and mental health in a nationally representative sample of Korean adolescents. Methods We performed a cross-sectional study of 3530 adolescent (12–18 years old) from the 2014–2017 Korean National Health and Nutrition Survey. Handgrip strength was defined as the maximum measurement in kilograms from the dominant hand. Adverse mental health included the presence of perceived stress, depressive mood and suicidal ideation. Logistic regression models were used with adjustment for potential confounders. Results The mean age ± SD of the study participants was 14.9 ± 2.0 years. Girls (47.5% of participants) had poorer mental health than boys. For boys, each 1-kg increase in handgrip strength was associated with a 3% decrease in the odds of having perceived stress and depressive moods. For girls, there was a positive association between handgrip strength and perceived stress. The relationship between handgrip strength and perceived stress was dose dependent for both sexes. Conclusions Low handgrip strength was associated with poor mental health among boys. Future research is required to validate our findings and to establish whether interventions to increase muscular strength can reduce the prevalence of perceived stress and depressive mood in boys.

Objective The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. Methods This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. Results We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). Conclusion Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

Background: Data on the association between suicide and kidney function in the general population are scarce. This study evaluated albuminuria across suicidal ideation in Korean adults. Methods: We performed a cross-sectional study using data from the 2011 to 2013 Korean National Health and Nutrition Examination Survey. Overall, 14,101 adults were included in an examination of the amount of albuminuria associated with suicidal ideation. Suicidal ideation was measured using a self-reported questionnaire and albuminuria was assessed using the urinary albumin-to-creatinine ratio (ACR). Results: Various factors, including suicidal ideation, were associated with ACR. Multivariate regression analyses were stratified by age group and type 2 diabetes due to their strong relation to ACR. In the non-diabetic young group, individuals with suicidal ideation presented ACR 11.4 mg/g higher than those without suicidal ideation (P=0.038). Conclusion: In healthy young people, suicidal ideation is associated with increased albuminuria.

This study aimed to establish the normal values for knee patellofemoral alignment as measured using 3-dimensional computed tomography (3D CT), to standardize the technique, and to show the inter- and intra-observer reliability of this measurement. The present study included 62 asymptomatic volunteers (124 knees). 3D CT scanning was performed with each volunteer in the supine position with 15° of knee flexion, and consistent 3D axial images of the patellofemoral joint were obtained with alignment in the desired stereographic baseline direction in anterior–posterior, lateral, and axial rotations. Two independent observers measured patellofemoral alignment parameters, including the sulcus angle, congruence angle, lateral patellofemoral angle, condyle-patellar angle, and lateral trochlear inclination angle. Based on 3D CT measurement, the mean values of the parameters were 145.9° ± 9.2° for the sulcus angle, 12.6° ± 22.6° for the congruence angle, 9.2° ± 4.6° for the lateral patellofemoral angle, 14.1° ± 6.4° for the condyle-patellar (lateral facets) angle, − 8.5° ± 8.4° for condyle-patellar (patellar axis) angle, and 16.5° ± 6.3° for the lateral trochlear inclination angle. A statistically significant difference was observed between men and women in the sulcus and condyle-patellar (patellar axis) angles (p = 0.045, 0.011, respectively). All parameters showed excellent inter- and intra-observer reliability. The normal values and ranges for patellofemoral alignment parameters were evaluated using 3D CT. The results of this study provide reference information that may facilitate diagnosis and treatment planning of patellofemoral disorders in skeletally mature non-pathologic patients. II

Phellinus linteus is a well-known medicinal mushroom that is widely used in Asian countries. In several experimental models, Phellinus linteus extracts were reported to have various biological effects, including anti-inflammatory, anti-cancer, hepatoprotective, anti-diabetic, neuroprotective, and anti-angiogenic activity. In the present study, several bioactive compounds, including palmitic acid ethyl ester and linoleic acid, were identified in Phellinus linteus. The intermediate-conductance calcium-activated potassium channel (IKCa) plays an important role in the regulation of the vascular smooth muscle cells&rsquo, (VSMCs) contraction and relaxation. The activation of the IKCa channel causes the hyperpolarization and relaxation of VSMCs. To examine whether Phellinus linteus extract causes vasodilation in the mesenteric arteries of rats, we measured the isometric tension using a wire myograph. After the arteries were pre-contracted with U46619 (a thromboxane analogue, 1 &micro, M), Phellinus linteus extract was administered. The Phellinus linteus extract induced vasodilation in a dose-dependent manner, which was independent of the endothelium. To further investigate the mechanism, we used the non-selective K+ channel blocker tetraethylammonium (TEA). TEA significantly abolished Phellinus linteus extract-induced vasodilation. Thus, we tested three different types of K+ channel blockers: iberiotoxin (BKca channel blocker), apamin (SKca channel blocker), and charybdotoxin (IKca channel blocker). Charybdotoxin significantly inhibited Phellinus linteus extract-induced relaxation, while there was no effect from apamin and iberiotoxin. Membrane potential was measured using the voltage-sensitive dye bis-(1,3-dibutylbarbituric acid)-trimethine oxonol (DiBAC4(3)) in the primary isolated vascular smooth muscle cells (VSMCs). We found that the Phellinus linteus extract induced hyperpolarization of VSMCs, which is associated with a reduced phosphorylation level of 20 KDa myosin light chain (MLC20).

A single stranded (ss) DNA aptamer, specific to members of Listeria genus, was used to develop a two-site binding sandwich assay for capture and detection of L. monocytogenes. Antibody-immobilized immunomagnetic beads were used to capture L. monocytogenes, followed by their exposure to the aptamer detector. Detection was achieved by amplification of cell-bound aptamers by qPCR. The lower limit of detection for the combined assay was 2.5 CFU L. monocytogenes in 500 μl buffer. This is juxtaposed to a detection limit of 2.4 log10 CFU in 500 μl buffer for immunomagnetic separation coupled with qPCR detection of L. monocytogenes targeting the hly gene. When applied to turkey deli meat, subjected to 24 h of non-selective enrichment, the two-site binding sandwich assay showed positive results at initial inoculum levels of 1–2 log10 CFU per 25 g sample. Because of its lower limit of detection, the assay reported here could be useful for detection of L. monocytogenes in foods and environmental samples.

In this study, we investigated a potent acetylcholinesterase inhibitor that was isolated from radish leaf (Raphanus sativus L.) extracts. Through sequential fractionation of radish leaf extract, the active constituent was identified as cis-13-docosenamide (erucamide). To validate the potency, erucamide derived from radish leaves was supplemented in diets and then fed to trimethyltin (TMT)-exposed mice. Specifically, mice had free access to a control diet or diets containing different concentrations of erucamide for 3 weeks, followed by an injection of TMT (2.5 mg/kg body weight). Our results showed that pretreatment of mice with erucamide (20 and 40 mg/kg body weight per day) significantly attenuated the TMT-induced learning and memory deficits that were assessed by Y-maze and passive avoidance tests. These findings suggest that radish leaves, and possibly its isolated erucamide, may have preventive effects against memory deficits related to Alzheimer's disease by modulation of cholinergic functions.

To suggest different ultrasound-guided steroid injection (USI) techniques based on anatomical variations of the first extensor compartment (FEC), and to evaluate the usefulness of it, in patients with de Quervain’s disease. Twenty-eight patients who underwent USI for de Quervain’s disease were included. Anatomical variations were classified into complete sub-compartmentalization (n = 11), distal incomplete sub-compartmentalization (n = 5), and no sub-compartmentalization (n = 12) on ultrasound. Involved sub-compartments were recorded in patients with complete sub-compartmentalization. USIs were performed based on the anatomical variations: in both sub-compartments (n = 2) or only in the affected sub-compartment (n = 9) depending on the location of tenosynovitis involvement, in patients with complete sub-compartmentalization; in proximal FEC in patients with distal incomplete sub-compartmentalization (n = 5); in the common compartment in patients with no sub-compartmentalization (n = 12). Medical charts were retrospectively reviewed for evaluation of clinical outcome at follow-up visits. Twenty-three out of 28 patients were followed up with a mean period of 31.2 days after injection (6~87 days). Mean VAS was 7.96 before injection (range: 4 to 10), which was significantly reduced to 0.65 at rest and 1.57 during activity at follow-up visits (p

Many edible plant extracts exhibit biological activities. For example, the ethanol extract of Pueraria montana var. lobata (P. montana) inhibits acetylcholinesterase (AChE), and red ginseng is well known for promoting health. In this study the authors investigated the synergistic effect of P. montana and red ginseng extracts on AChE activity in vitro and in mouse brain tissues and trimethyltin (TMT)-induced cognitive impairment in a mouse model of TMT-induced neurodegeneration. A diet containing a mixture of P. montana and red ginseng extracts reversed learning and memory impairments in Y-maze and passive avoidance behavioral tests. In addition, the mixture inhibited AChE activity and lipid peroxidation synergistically.

Background: A critical features of Alzheimer’s disease (AD) is cognitive dysfunction, which partly arises from decreased in acetylcholine levels. AD afftected brains are characterized by extensive oxidative stress, which is thought to be primarily induced by the amyloid beta (Aβ) peptide. In a previous study, Cinnamomum loureiroi tincture inhibited acetylcholinesterase (AchE) activity. That study identified AChE inhibitor in the C. loureiroi extract. Furthermore, the C. loureiroi extract enhanced memory in a trimethyltin (TMT)-induced model of cognitive dysfunction, as assessed via two behavioral tests. Rosa laevigata extract protected against oxidative stress-induced cytotoxicity. Administrating R. laevigata extracts to mice significantly reversed Aβ-induced learning and memory impairment, as shown in behavioral tests. Methods and Results: We conducted behavioral to examine the synergistic effects of C. loureiroi and R. laevigata extracts in inhibiting AChE and counteracting TMT-induced learning and memory losses. We also performed biochemical assays. The biochemical results showed a relationship between increased oxidative stress and cholinergic neurons damage in TMT-treated mice. Conclusions: A diet containing C. loureiroi and R. laevigata extracts ameliorated learning and memory impairments in the Y-maze and passive avoidance tests, and exerted synergistic inhibitory effect against AChE and lipid peroxidation.

Growing evidence indicates that norepinephrine promotes cancer growth and metastasis whereas β-blockers decrease these risks. This study aimed to examine the clinical impact of β-blockers and other hypertensive drugs on disease recurrence and survival in patients with head and neck squamous cell carcinoma (HNSCC). This study analyzed a cohort of 1274 consecutive patients who received definitive treatments for previously untreated HNSCC at our tertiary referral center between January 2001 and December 2012. Antihypertensive use was considered positive if patients were on medication from HNSCC diagnosis to at least 1 year after treatment initiation. Cox proportional hazard models were utilized to determine associations between antihypertensive drugs and recurrence, survival, and second primary cancer (SPC) occurrence. Hypertension itself was not a significant variable of recurrence and survival and no antihypertensive drug use affected SPC occurrence (all P > 0.1). After controlling for clinical factors, calcium-channel blocker use remained an independent variable for index cancer recurrence, and β-blocker use was significantly associated with poor cancer-specific mortality, competing mortality, and all-cause mortality (all P

We previously reported that the extract of Cinnamomum loureirii (C. loureirii) significantly inhibited acetylcholinesterase (AChE), and identified 2,4-bis(1,1-dimethylethyl)phenol (BP) from C. loureirii as a potential AChE inhibitor. The present study, therefore was undertaken to demonstrate the effects of BP from C. loureirii on learning and memory impairment in trimethyltin (TMT)-treated ICR mice. Y-maze and passive avoidance tests were used to test cognitive ability. Further, changes in biochemical parameters in the brain tissue were also assessed in response to TMT injection and BP intervention. BP pre-administration (20, 40 mg/kg/d) in mice significantly protected cognitive dysfunction induced by TMT (p

We propose the use of a rosin-embedded poly(acrylic acid) binder, PAA-Rosin, to improve the cycling performance of silicon/graphite composites in lithium-ion batteries. Rosin, which is a natural product derived from pine trees, is chemically bonded with a rigid PAA polymer, which affords additional adhesion and elasticity of the PAA backbone, resulting in an effective binder with optimal properties. The hybridization of PAA-Rosin is achieved through an efficient one-step process, and the chemical structures of the components are systematically confirmed. In terms of the cycling performance, the cell based on PAA-Rosin shows excellent specific capacity retention (65.2%) with superior utilization of silicon/graphite composites even after 200 cycles. In addition, the PAA-Rosin electrode exhibits excellent specific capacity as well as remarkable capacity retention in bending tests. We demonstrate that the remarkable electrochemical characteristics of PAA-Rosin can be attributed to improved electrode uniformit...

Many studies have shown that oxidative stress induced by hydrogen peroxide can lead to neuronal cell death. In this study, protective effects of the ethanol extract of A. lappa L. roots against oxidative stress in PC12 cells were measured by 2′, 7′-dichlorofluorescein diacetate and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays. Oxidative stress contributes to the memory deficits induced by Beta-amyloid1-42 in mice. Treatment with the ethanol extract of A. lappa L. roots improved working and reference memory in mice in the Y-maze and passive avoidance tests. To detect the lipid peroxidation levels, malondialdehyde was measured. To purify the bioactive compound, active fractions and components of A. lappa L. roots were isolated by partitioning, open column chromatography, TLC, high-performance liquid chromatography, electron ionization mass spectrometry, and 1H/13C-nuclear magnetic resonance. We identified the bioactive compound as quinic acid, which is a powerful antioxidant agent. Ultimately, the roots of A. lappa L. may become available as an antioxidant food for Alzheimer’s disease patients and those with other oxidative stress-induced disorders.

Choi, Soo Jung; Shin, Dong Wook; Park, Hyun Jung et al..February, 2016.Potential barriers limiting Myanmar migrant workers from using healthcare services in South Korea,Article,[Seoul]Korean Academy of Family Medicine,6

Background Treating Mycobacterium abscessus infections with antimicrobials remains difficult, possibly due to drug resistance. Objective To investigate the subspecies distribution of M. abscessus and its correlation with antibiotic susceptibility and the genetics of antibiotic resistance, focusing on macrolides and fluoroquinolones, in the Republic of Korea. Design A total of 53 M. abscessus isolates were identified to the subspecies level by sequencing of hsp65 and erm(41). The minimal inhibitory concentrations (MICs) of clarithromycin (CLM) and ciprofloxacin (CFX) were determined using Sensititre™ RAPMYCO plates. The rrl, gyrA and gyrB genes were sequenced to elucidate the molecular mechanisms of macrolide and fluoroquinolone resistance. Results Isolates included 22 M. abscessus subsp. abscessus and 31 M. abscessus subsp. bolletii. erm(41) sequences showing subspecies-specific deletions and sequence variations in the 28th nucleotide were concordant with inducible CLM resistance; however, mutations in rrl were not detected. Low- and high-level CFX resistance was observed in respectively 19 (35.8%) and 10 (18.9%) of the 53 clinical isolates, regardless of subspecies. However, no non-synonymous mutations were detected in gyrA or gyrB. Conclusion Sequencing of the erm gene and subspeciation of M. abscessus may be used to predict inducible macrolide susceptibility. Further studies of the relationship between specific mutations in gyrA or gyrB to MIC change are required.

The pathogenesis of Alzheimer's disease (AD) has been linked to the deficiency of neurotransmitter acetylcholine (ACh) in the brain, and the main treatment strategy for improving AD symptoms is the inhibition of acetylcholinesterase (AChE) activity. In the present study, we aimed to identify potent AChE inhibitors from Cinnamomum loureirii extract via bioassay-guided fractionation. We demonstrated that the most potent AChE inhibitor present in the C. loureirii extract was 2,4-bis(1,1-dimethylethyl)phenol. To confirm the antiamnesic effects of the ethanol extract of C. loureirii, mice were intraperitoneally injected with the neurotoxin trimethyltin (2.5 mg/kg) to induce cognitive dysfunction, and performance in the Y-maze and passive avoidance tests was assessed. Treatment with C. loureirii extract significantly improved performance in both behavioral tests, suggesting that this extract may be neuroprotective and therefore beneficial in preventing or ameliorating the degenerative processes of AD, potentially by restoring cholinergic function.

Introduction Camellia japonica L. (Theaceae) is an evergreen shrub, which is cultivated as a popular ornamental tree in Korea, China, and Japan and its seeds have been used as a source of cooking oil, in cosmetics and as a traditional medicine. Intensive phytochemical works have revealed that oleanane-type saponins are the characteristic compounds of the seeds of C. japonica. Objective The purpose of the present study is to isolate and determine oleanane-type saponins from C. japonica using high-performance countercurrent chromatography (HPCCC) coupled with reversed-phase high-performance liquid chromatography (RP-HPLC) and spectroscopic evidences, respectively. Methodology HPLC electrospray ionisation quadrupole time-of-flight mass spectrometry (ESI-Q-TOF-MS) was applied to profile the saponin composition of an enriched saponin extract of C. japonica seeds. The enriched saponin extract was separated by HPCCC using a dichloromethane/methanol/isopropanol/water (9:6:1:4, v/v/v/v) system and RP-HPLC. The structures of the isolates were determined utilising ESI-Q-TOF-MS, one-dimensional and two-dimensional NMR and optical rotation. Results HPCCC on enriched saponin extract of C. japonica yielded four saponin fractions in the order of the number of sugars attached to the triterpene aglycone, and preparative RP-HPLC on each saponin fraction led to the isolation of nine novel saponins, namely camoreoside A-I, along with six known ones. Conclusions This study indicates that combination of HPLC-ESI-Q-TOF-MS analysis and HPCCC coupled with RP-HPLC are excellent tools for discovering saponins from natural sources.

Early detection of synchronous esophageal squamous cell neoplasm (ESCN) in head and neck squamous cell carcinoma (HNSCC) patients can significantly affect their prognosis. We investigated the prevalence of synchronous ESCN and the risk factors for developing ESCN in patients with HNSCC, and evaluated the effect of routine endoscopic screening in these patients. Subjects who were diagnosed as HNSCC from May 2010 to January 2014 were eligible. All patients underwent conventional white light endoscopic examinations with narrow band imaging and Lugol chromoendoscopy. Among 458 subjects screened, 28 synchronous ESCN were detected in 24 patients (5.2%). The prevalence of ESCN was greatest in patients with hypopharyngeal cancer (20.9%). In multivariate analysis, pyriform sinus involvement was independent risk factor for developing synchronous ESCN (odds ratio 171.2, P < 0.001). During the follow-up period (median, 24 months), the 3-year overall survival rates was significantly lower in patients with ESCN than in patients without ESCN (54.2% vs. 78.3%, P = 0.0013). Routine endoscopic screening for detecting synchronous ESCN should be recommended for patients with HNSCC, especially those with pyriform sinus involvement.

This study describes the rapid separation of mulberry anthocyanins; namely, cyanidin-3-glucoside and cyanidin-3-rutinoside, using high-performance countercurrent chromatography, and the establishment of a volumetric scale-up process from semi-preparative to preparative-scale. To optimize the separation parameters, biphasic solvent systems composed of tert-butyl methyl ether/n-butanol/acetonitrile/0.01% trifluoroacetic acid, flow rate, sample amount and rotational speed were evaluated for the semi-preparative-scale high-performance countercurrent chromatography. The optimized semi-preparative-scale high-performance countercurrent chromatography parameters (tert-butyl methyl ether/n-butanol/acetonitrile/0.01% trifluoroacetic acid, 1:3:1:5, v/v; flow rate, 4.0 mL/min; sample amount, 200-1000 mg; rotational speed, 1600 rpm) were transferred directly to a preparative-scale (tert-butyl methyl ether/n-butanol/acetonitrile/0.01% trifluoroacetic acid, 1:3:1:5, v/v; flow rate, 28 mL/min; sample amount, 5.0-10.0 g; rotational speed, 1400 rpm) to achieve separation results identical to cyanidin-3-glucoside and cyanidin-3-rutinoside. The separation of mulberry anthocyanins using semi-preparative high-performance countercurrent chromatography and its volumetric scale-up to preparative-scale was addressed for the first time in this report.

Here, we describe a popliteal mass that was initially misdiagnosed as a simple popliteal cyst, which finally turned out to be osteochondrolipoma. A 63-year-old housewife presented with sustained knee pain in association with a palpable mass on the popliteal fossa. The mass was in the posteromedial area and soft, non-tender, non-movable in the posteromedial area. Using plain radiography, the mass appeared as a round, soft tissue density lesion containing bony fragments. We performed an ultrasound-guided needle biopsy in conjunction with magnetic resonance imaging, followed by an open excisional biopsy. Microscopically, histological sections showed a lipoma with cartilaginous and osseous differentiation, finally diagnosed as osteochondrolipoma. In conclusion, popliteal masses are not always simple cysts, and the evaluation of masses in the popliteal fossa is always necessary.

Objectives/Hypothesis Organized hematoma (OH) is a rare non-neoplastic disease. We studied the clinical characteristics of 17 patients with sinonasal OH and those of 75 cases in the English literature. Study Design Retrospective review of medical records and systematic review of the literature on OH. Methods Comprehensive review of the English-language literature on OH was performed. We screened all eligible cases based on initial features, and 75 eligible cases found in 15 publications were analyzed. We also retrospectively analyzed and compared medical records of 17 patients diagnosed with pathologically proven sinonasal OH. Data such as demographics, clinical characteristics, pathologic features, radiologic findings, treatment modalities, and follow-up results were compared to the 75 previously mentioned cases. Results Fifteen cases involved the maxillary sinus, one case involved the frontal sinus, and one case involved the sphenoid sinus. There were six patients over 60 years old, and all were taking an antiplatelet agent. The paranasal sinus computed tomography (CT) of seven patients showed bony destruction of the involved sinus. A review of the available literature revealed mostly similar results with our cases, except for the proportion of patients taking aspirin (5.3%) and sex distribution (male:female = 49:25). Conclusions We reported 17 cases of OH, including a case of frontal sinus and a case of sphenoid sinus lesion. A large proportion of OH patients had bony destruction of the affected sinus on CT. In these patients, a careful diagnosis should be made to distinguish them from a malignant tumor or other expansile diseases. Level of Evidence 4. Laryngoscope, 125:2027–2033, 2015

The objective of our study was to compare the multiacquisition variable-resonance image combination selective (MAVRIC SL) sequence with the 2D fast spin-echo (FSE) sequence for metal artifact reduction on 3-T MRI in patients with hip arthroplasty (HA).Matched 2D FSE and MAVRIC SL images of 21 hips (19 patients with HA) were included in the study group. Paired image sets, composed of 13 coronal and 12 axial slices (total, 25 image sets), of the 21 hips were evaluated. For quantitative analysis, the artifact area was measured at the level of the hip and femur. For qualitative analysis, two musculoskeletal radiologists independently compared paired 2D FSE and MAVRIC SL sets in terms of artifacts, depiction of anatomic detail, level of diagnostic confidence, and detection of abnormal findings.The measured artifact area was significantly smaller (p0.05) on MAVRIC SL than 2D FSE at both the level of hip (59.9% reduction with MAVRIC SL) and femur (31.3% reduction with MAVRIC SL). The artifact score was also significantly decreased (p0.0001) with MAVRIC SL compared with 2D FSE for both reviewers. The hip joint capsule and the muscle and tendon attachment sites of the obturator externus and iliopsoas muscles were better depicted with MAVRIC SL than 2D FSE (p0.0125). Abnormal findings were significantly better shown on MAVRIC SL imaging compared with 2D FSE imaging (p0.0001).The MAVRIC SL sequence can significantly reduce metal artifact on 3-T MRI compared with the 2D FSE sequence and can increase diagnostic confidence of 3-T MRI in patients with total HA.