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Purpose: We report a bitemporal visual field defect accompanied by optic chiasmal enhancement in a patient with ethambutol (EMB)-induced toxic optic neuropathy.Case summary: A 53-year-old woman presented with bilateral visual disturbance that had gradually worsened over the prior 2 months. She had been prescribed 800 mg EMB daily to treat pulmonary tuberculosis for the past 10 months but had stopped EMB 1 month prior because of visual disturbance. She had been prescribed 600 mg rifampicin and 1,000 mg clarithromycin daily for 11 months. Her visual acuity was 0.2 in the right eye and 0.1 in the left. Color vision was reduced. Automated perimetry demonstrated a bitemporal visual field defect, which was more severe in the left eye. Magnetic resonance imaging (MRI) of the optic chiasm revealed contrast enhancement in the body of the chiasm. The optic nerve of the left eye evidenced a higher signal intensity than did that of the right, consistent with the visual field test results. One month after her initial visit, the visual symptoms deteriorated further. We delivered high-dose, intravenous steroid pulse therapy (methylprednisolone 1,000 mg daily for 3 days). At the 1-year follow-up, the visual acuity was 0.4 in the right eye and 0.1 in the left.Conclusions: Bitemporal hemianopia may develop in patients with EMB-induced toxic optic neuropathy. Enhancement of the optic chiasm, consistent with the visual field defect, could be observed in MRI.

Purpose: We investigated the association between the level of control and exodeviation after the monocular occlusion test (MO) in pediatric patients with intermittent exotropia.Methods: We retrospectively reviewed the records of pediatric patients with intermittent exotropia who visited Yeungnam University Hospital between September 2015 and December 2020. The largest exodeviation obtained before and after 1 hour of MO were compared. The LACTOSE (Look And Cover, then Ten seconds of Observation Scale for Exotropia) control scoring system was used to measure the level of control. Controllability was defined when the patient had the subjective awareness of exotropia and the instinctive ability to correct ocular deviation.Results: Five hundred and three consecutive patients (260 male and 243 female patients; mean age, 7.8 years) were included. In all control scores, exodeviation significantly increased after the MO (p < 0.001). However, the patients with an increase in exodeviation ≥5 prism diopters (PD) after the test did not show any significant association with the control scores. The presence of controllability was significantly associated with an increase of ≥5 PD at near (p = 0.034).Conclusions: Exodeviation showed significant increase after the MO, regardless of the level of control, in pediatric patients with intermittent exotropia. There was no significant association between the control scores and an increase of ≥5 PD after the MO. Patients with controllability were more likely to show increase in exodeviation after the MO.

Background/aims We evaluate the clinical characteristics of intermittent exotropia with controllability and compare surgical outcomes between patients with and without controllability. Methods We reviewed the medical records of patients aged 6–18 years with intermittent exotropia who underwent surgery between September 2015 and September 2021. Controllability was defined as the patient’s subjective awareness of exotropia or diplopia associated with the presence of exotropia and ability to instinctively correct the ocular exodeviation. Surgical outcomes were compared between patients with and without controllability, with a favorable surgical outcome defined as an ocular deviation between ≤ 10 PD of exotropia and ≤ 4 PD of esotropia at distance and near. Results Among 521 patients, 130 (25%, 130/521) had controllability. The mean age of onset (7.7 years) and surgery (9.9 years) were higher in patients with controllability than in those without controllability (p Conclusions Patients with controllability showed better surgical outcomes, later exotropia onset, and better level of control than patients without controllability. Preoperative ocular exodeviation was a significant factor influencing favorable outcomes in patients with controllable exotropia.

Toll-like receptors (TLRs) make a crucial contribution to the innate immune response. TLR5 was expressed in embryoid body derived from mouse embryonic stem cells (mESCs) and βIII-tubulin-positive cells under all-trans retinoic acid-treated condition. TLR5 was upregulated during neural differentiation from mESCs and augmented the neural differentiation of mESCs via nuclear factor-κB and interleukin 6/CREB pathways. Besides, TLR5 was expressed in SOX2- or doublecortin-positive cells in the subgranular zone of the hippocampal dentate gyrus where adult neurogenesis occurs. TLR5 inhibited the proliferation of adult hippocampal neural stem cells (NSCs) by regulating the cell cycle and facilitated the neural differentiation from the adult hippocampal NSCs via JNK pathway. Also, TLR5 deficiency impaired fear memory performance in mice. Our data suggest that TLR5 is a crucial modulator of neurogenesis from mESCs and adult hippocampal NSCs in mice and represents a new therapeutic target in neurological disorders related to cognitive function.

Background:During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon’s preference. However, it is still unclear whether transection of sMCL increases valgus laxity.Purpose:We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability.Study Design:Case series; Level of evidence, 4.Methods:Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs.Results:All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment ( P < .001). The postoperative HKA angle significantly differed from the preoperative one, and no significant valgus progression was observed during follow-up (preoperative, 8.5°± 2.7°; 3 months, –3.5°± 2.0°; 6 months, –3.2°± 2.3°; 1 year, –3.1°± 2.3°; 2 years, –2.9°± 2.5°; P < .001) The mean WBL ratio was 62.5% ± 9.0% at 2 years postoperatively. The postoperative valgus JLCA at all follow-up points did not significantly change compared with the preoperative valgus JLCA (preoperative, –0.1°± 2.1°; 3 months, –0.2°± 2.4°; 6 months, –0.1°± 2.5°; 1 year, 0.1°± 2.5°; 2 years, 0.2°± 2.2°) The postoperative MJO at all follow-up points did not significantly change compared with the preoperative MJO (preoperative, 7.1 ± 1.7 mm; 3 months, 7.0 ± 1.7 mm; 6 months, 6.9 ± 1.9 mm; 1 year, 6.7 ± 1.8 mm; 2 years, 6.8 ± 1.8 mm).Conclusion:Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.

A few studies have focused on factors predisposing to retear after arthroscopic revision rotator cuff repair (ARRCR). This study aimed to retrospectively evaluate (1) the structural and clinical outcomes of ARRCR and (2) pre- and intraoperative factors affecting the integrity of the rotator cuff (RC) tendon by focusing on preoperative RC tendon integrity, tear size, muscle hypotrophy and fatty infiltration. Patients who underwent ARRCR between 2006 and 2016 were reviewed. Preoperative variables included demographic data, RC tendon integrity, tear size, and muscle hypotrophy and fatty infiltration on preoperative magnetic resonance imaging (MRI). Intraoperative variables included repair technique and completeness of repair. The visual analog scale for pain (PVAS), functional VAS (FVAS), American Shoulder and Elbow Surgeons scores, and shoulder range of motion (ROM) were assessed. Postoperative tendon integrity was evaluated using over 6-month follow-up MRI. Patients were classified into groups A (healed) and B (retear), and their variables were compared. Overall 65 patients with a mean follow-up of 49.5 ± 30.2 (range, 24.0–148.9) months were analyzed. Fifty-six of 65 (86.2%) patients underwent MRI at 9.1 ± 9.7 (range, 4.4–40.2) months after ARRCR, and 20 of 56 (35.7%) patients (group B) exhibited retear. Group A (36/56, 64.3%) showed higher functional scores and ROMs than group B at the final follow-up, with significant differences in the FVAS scores (Group A versus B: FVAS, 7.6 ± 1.8 versus 6.4 ± 1.9, p = 0.036). Intraoperative variables, including preoperative tendon integrity (p = 0.021), tear size (p = 0.007), supraspinatus and infraspinatus muscle hypotrophy and fatty infiltration (p

Background Hair cortisol concentration (HCC) has received attention as a useful marker of stress, but evidence on associations between psychological factors and cortisol concentration is inconsistent. The purpose of this study was to investigate the sex differences in the relationship between cortisol concentration and psychological factors in healthy young adults. Methods A total of 205 (103 females, 102 males) healthy young adults participated. HCC and various stress-related psychological measures were compared between sexes. Multiple linear regression analyses were performed to assess associations between HCC and stress-related psychological measures for all participants and for each sex. Results The difference in HCC according to sex was not significant. The reported number of stressful life events in the past year, stress perception, depressive and anxiety-related symptoms, and emotion dysregulation were not different between sexes, either. The association between HCC and emotion dysregulation was significant in females but not males. Conclusion We observed a sex-specific association between HCC and psychological factors. Our findings may imply that HCC could be a useful biomarker of stress and stress-related emotion dysregulation in healthy young women., Highlights Associations between hair cortisol level and psychological factors have been inconclusive.In healthy young adults, the hair cortisol concentration was not significantly different between sexes.The association between emotion dysregulation and hair cortisol was only found in women, but not in men.The role of sex should be considered in utilizing hair cortisol as a biomarker for psychological stress response.

Background Periodontitis is an inflammatory disease caused by multiple disease-associated bacterial species in periodontal tissues. Autophagy is known to modulate various inflammation-driven diseases and inflammatory responses, but the role of autophagy related to the pathogenesis of periodontitis is not fully established. We investigated whether autophagic flux regulated the expression of inflammatory cytokines in the gingiva of periodontitis patients and lipopolysaccharide (LPS)-stimulated human gingival fibroblasts (HGFs) and the underlying mechanism. Methods The mRNA and protein expression of pro-inflammatory cytokines was assessed in human gingival tissues collected from patients with periodontitis and HGFs treated with LPS. The expression of signaling molecules related to autophagy was evaluated by immunofluorescence and Western blot analyses. Results The expression of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and intercellular adhesion molecule-1 (ICAM-1) was increased in the gingival tissues of patients with periodontitis. LC3B-positive cells, a typical autophagic marker, were increased in the gingival tissues of periodontitis patients and LPS-treated HGFs. The conversion ratio of LC3-I to LC3-II was higher in the gingival tissues associated with periodontitis and LPS-treated HGFs compared to the controls. The autophagy inhibitor 3-methyladenine (3MA) significantly abrogated the LPS-sustained inflammatory effect by reducing the expression of IL-6, TNF-α, COX-2, and ICAM-1 in HGFs. The phosphorylation of protein kinase B (AKT) and protein S6K1 (S6), signals involved in the mTOR-dependent mechanism, was decreased in gingiva derived from periodontitis patients and LPS-treated HGFs. Conclusions Autophagy augmented the production of inflammatory cytokines by mTOR inactivation via the AKT signaling pathway in the gingival tissues of patients with periodontitis and LPS-stimulated HGFs. These findings would provide a better understanding of the mechanism by which autophagy regulates the inflammatory response associated with periodontal pathogenesis. This article is protected by copyright. All rights reserved.

Background/purpose Autophagy is involved in controlling differentiation of various cell types. The present study aimed to investigate the mechanism related to autophagy in regulating odontogenic differentiation of dental pulp cells. Materials and methods Human dental pulp cells (HDPCs) were cultured in differentiation inductive medium (DM) and odontoblastic differentiation and mineralization were evaluated by alkaline phosphatase (ALP) staining and Alizarin red S staining, respectively. Tooth cavity preparation was made on the mesial surface of lower first molars in rat. The expression of autophagy-related signal molecules was detected using Western blot analysis and Immunohistochemistry. Results HDPCs cultured in DM showed increased autophagic flux and declined phosphorylation of phosphoinositide 3-kinases (PI3K), protein kinase B (Akt), and mTOR. Dentin matrix protein-1 (DMP-1) and dentin sialoprotein (DSP), markers of odontoblastic differentiation, were upregulated and autophagic activation showing increased LC3-II and decreased p62 levels was observed during odontogenic differentiation of HDPCs. However, PI3K blocker 3-methyladenine (3MA), lentiviral shLC3 and Akt activator SC79 attenuated the expression of LC3II as well as DMP-1, ALP activity and mineralization enhanced in HDPCs under DM condition. In addition, 3MA, shLC3 and SC79 recovered the expression of pluripotency factor CD146, Oct4 and Nanog downregulated in DM condition. In rat tooth cavity preparation model, the expression of LC3B and DMP-1 was elevated near odontoblast-dentin layer during reparative dentin formation, whereas 3MA significantly reduced the expression of LC3B and DMP-1. Conclusion These findings indicated autophagy promotes the odontogenic differentiation of dental pulp cells modulating stemness via PI3K/Akt inactivation and the repair of pulp.

To describe clinical manifestations and short-term prognosis of ocular motility disorders following coronavirus disease-2019 (COVID-19) vaccination.Ocular motility disorders were diagnosed by clinical assessment, high-resolution magnetic resonance imaging, and laboratory testing. Clinical manifestations, short-term prognosis, and rate of complete recovery were analyzed.Sixty-three patients (37 males, 26 females) with a mean age of 61.6 ± 13.3 years (range, 22-81 years) were included in this study. Among 61 applicable patients with sufficient information regarding medical histories, 38 (62.3%) had one or more significant underlying past medical histories including vasculopathic risk factors. The interval between initial symptoms and vaccination was 8.6 ± 8.2 (range, 0-28) days. Forty-two (66.7%), 14 (22.2%), and 7 (11.1%) patients developed symptoms after the first, second, and third vaccinations, respectively. One case of internuclear ophthalmoplegia, 52 cases of cranial nerve palsy, two cases of myasthenia gravis, six cases of orbital diseases (such as myositis, thyroid eye disease, and IgG-related orbital myopathy), and two cases of comitant vertical strabismus with acute onset diplopia were found. Among 42 patients with follow-up data (duration: 62.1 ± 40.3 days), complete improvement, partial improvement, no improvement, and exacerbation were shown in 20, 15, 3, and 4 patients, respectively.This study provided various clinical features of ocular motility disorders following COVID-19 vaccination. The majority of cases had a mild clinical course while some cases showed a progressive nature. Close follow-up and further studies are needed to elucidate the underlying mechanisms and long-term prognosis.

Purpose This study aimed to evaluate the surgical outcomes of unilateral medial rectus recession and lateral rectus resection (RaR) for patients with large-angle deviations of acute acquired concomitant esotropia (AACE) without a neurological disease. Further, we have also suggested the surgical dosage of RaR for large-angle deviations of AACE. Methods This was a retrospective study of patients with AACE who underwent surgery and followed up after surgery for at least 6 months between September 2016 and March 2020. Among them, patients with ocular deviations of ≥30 prism diopters (PD) who underwent unilateral RaR were included. Results Seventeen patients with AACE were enrolled in this study (mean age, 23.5 years; four females). The mean amount of deviation was 40.00 PD at distance and near (range, 30-55 PD). Fifteen patients (88.2%) had myopia. The mean interval between the initial visit and surgery was 7.7 months (range, 4-20 months). All included patients had resolved diplopia after the surgery. Most patients with decreased stereoacuity displayed stereoacuity recovery after surgical treatment. At the final visit (mean follow-up period, 12.8 months), the mean angle of esodeviation was 0.82 PD (range, 6-0 PD) at distance and 0.47 PD (range, 4-0 PD) near. No patient displayed over-correction or adduction limitations in the operated eye. Conclusions The unilateral RaR procedure presented favorable surgical outcomes for patients with large-angle deviations of AACE. These results and proposed surgical dosage guidelines may be useful for surgeons in planning the surgical treatment of large-angle deviations of AACE.

L-ascorbic acid (L-AA; vitamin C) induces apoptosis in cancer cells. This study aimed to elucidate the molecular mechanisms of L-AA-induced apoptosis in human laryngeal epidermoid carcinoma Hep-2 cells. L-AA suppressed the viability of Hep-2 cells and induced apoptosis, as shown by the cleavage and condensation of nuclear chromatin and increased number of Annexin V-positive cells. L-AA decreased Bcl-2 protein expression but upregulated Bax protein levels. In addition, cytochrome c release from the mitochondria into the cytosol and activation of caspase-9, -8, and -3 were enhanced by L-AA treatment. Furthermore, apoptosis-inducing factor (AIF) and endonuclease G (EndoG) were translocated into the nucleus during apoptosis of L-AA-treated Hep-2 cells. L-AA effectively inhibited the constitutive nuclear factor-κB (NF-κB) activation and attenuated the nuclear expression of the p65 subunit of NF-κB. Interestingly, L-AA treatment of Hep-2 cells markedly activated Akt and mitogen-activated protein kinase (MAPK; extracellular signal-regulated kinase 1/2, p38, and c-Jun N-terminal kinase [JNK]) and and LY294002 (Akt inhibitor), SB203580 (p38 inhibitor) or SP600125 (a JNK inhibitor) decreased the levels of Annexin V-positive cells. These results suggested that L-AA induces the apoptosis of Hep-2 cells via the nuclear translocation of AIF and EndoG by modulating the Bcl- 2 family and MAPK/Akt signaling pathways.

In this paper, Artificial Neural Networks (ANNs) for diagnosing multiple open-switch faults in three-phase PWM (Pulse Width Modulation) converters are designed. For single and double open-switch faults in the converters, there are 21 types of fault modes, causing distorted phase currents. Since these abnormal currents can induce secondary faults in peripherals, the open-fault diagnosis is essentially required. In this paper, a two-step technique based on ANNs is utilized for the diagnosis of the multiple open-switch fault. First, dc and harmonic components of the currents are extracted by using an ADALINE (Adaptive Linear Neuron). In the first step, the ANN categorizes fault modes into six sectors by using dc components in the three-phase plane. In the second step, the ANN localizes fault modes by using dc components and the ratio of d–q axes currents THDs (Total Harmonics Distortions) in each sector. Especially, both switches open-faults in the same legs are localised by counting the sampled zero current of the fault currents. The proposed two-step technique allows a simple design of the ANNs for the diagnosis, and a short execution time about 22 s. Simulations and experiments for a 3.7 kW three-phase PWM converter confirmed the validity of the proposed diagnostic method.

AIM: To compare the changes in excyclotorsion after inferior oblique (IO) recession in patients with primary and secondary inferior oblique overaction (IOOA). METHODS: We retrospectively analyzed the data obtained from patients with IOOA who underwent graded IO recession. The patients were followed up for at least 3mo after surgery. Fundus photographs were taken pre- and postoperatively, and the sum of the angles of torsion in both eyes was used to analyze changes in excyclotorsion. Patients were divided into two groups: those diagnosed with primary IOOA were enrolled in the 1'IOOA group, and those diagnosed with secondary IOOA caused by superior oblique palsy (SOP) were enrolled in the 2'IOOA group. Excyclotorsion before and after surgery were compared between the two groups. RESULTS: A total of 78 patients were enrolled in this study: 34 eyes in the 1'IOOA group and 44 eyes in the 2'IOOA group. In the 78 patients, torsional angle significantly decreased from 15.31°±7.40° to 12.11°±6.53° after IO recession (P

Purpose: To compare parental observations with the clinical evaluation findings in pediatric patients with intermittent exotropia and evaluate the clinical factors associated with the parental observations. Methods: This prospective study included either one or both parents of pediatric patients with intermittent exotropia who visited the clinic between January and May 2019. The parental observations were assessed through a questionnaire that included questions on the age of onset, usually deviated eye, degree of awareness, and frequency of exotropia. These findings were compared with those of the clinical evaluations, including the amount of ocular deviation and level of control. Results: A total of 100 parents (mean age: 39.7 years; 78 women) of 95 pediatric patients (mean age: 8.2 years; 47 girls) with intermittent exotropia participated in the study. The parental observation and clinical evaluation findings on the usually deviated eye showed good concordance (74%). The degree of parental awareness did not show any association with the amount of deviation. However, it showed a statistically significant increase associated with the worsening level of distance control ( P = .04). The parental observations of the frequency of exotropia significantly increased with the worsening of the level of near ( P = .037) and overall ( P = .019) control. Conclusions: Parental observations are more likely to correlate with the level of control than with the amount of ocular deviation in pediatric patients with intermittent exotropia. [ J Pediatr Ophthalmol Strabismus . 2020;57(3):199–203.]

In this paper, an Maximum Torque Per Ampere (MTPA) operation scheme with current feedback to improve the driving efficiency in the V/f control for Permanent-Magnet Synchronous Motor (PMSM) drives is proposed. In the V/f control for PMSM drives, the proper current distribution of the MTPA currents is not assured depending on the magnitude of the stator voltage. Moreover, PMSM drives become unstable due to an absence of damper windings. In this paper, for both MTPA operation and stabilization, a scheme of using only a single Proportional Integral (PI) controller is proposed. The magnitude of the stator voltage, for the MTPA, is adjusted by employing the information of the load acquired from the PI controller, which uses the d-axis current deviation from the required MTPA current. For stable operation, the stator frequency is adjusted using the information on the rotor speed variation extracted from the proportional part of the controller. To obtain this information from the PI controller, its gains are designed through an analysis of the whole drive system. Simulation and experimental results confirm the effectiveness of the proposed scheme.

In this study, mechanical characteristics of tensile strength ratio (TSR) were evaluated by comparing it to other methods in evaluating moisture sensitivity of asphalt mixtures. Twenty types of asphalt mixtures with and without anti-stripping additives were prepared and tested in the laboratory. Uniaxial compressive strength (UCS) and indirect tensile (IDT) testing were conducted to determine the mixture's tensile strength ratio and cohesion ratio (CR). Determining TSR alone was found to be insufficient when evaluating moisture resistance. There is a need to consider both TSR and wet IDT strength to properly evaluate moisture behavior of asphalt mixtures. Moreover, it was found that the cohesion and the IDT strength have a good relation in which the minimum condition of the slope, must be met. However, it was observed that β values change depending on material type and temperature. Hence, there is a need to evaluate these β values for varying material and testing temperature. In addition, it was found that the TSR and CR results are highly correlated with an average difference of 1.5%. Furthermore, other tests such as Marshall stability and dynamic immersion were also conducted. It was found that Marshall stability ratio (MSR) and Marshall stability to flow ratio (MSFR) values are less sensitive to moisture effect when measuring moisture resistance compared to TSR values. Finally, the 48 h testing result of the dynamic immersion test showed better correlation with TSR values. Keywords: Asphalt mixtures, Moisture damage, Anti-stripping additives, Tensile strength ratio, Cohesion strength ratio

During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon's preference. However, it is still unclear whether transection of sMCL increases valgus laxity.We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability.Case series; Level of evidence, 4.Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs.All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment (Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.

Automatic, precise, and accurate heart rate control during treadmill exercise is an interesting topic among researchers. The human heart is a highly nonlinear system. Conventional control techniques are not sufficient and it is difficult to accurately model the human heart. Two different robust controllers were designed for this nonlinear system. Firstly, sliding mode control (SMC) was implemented; SMC is robust against parametric uncertainties and external disturbance but its robustness is not guaranteed during the reaching phase, especially in heart rate control, and implementation of SMC requires the linear parameters of the system (human heart rate model). In this research, the signal compression method (SCM) was used for approximately linearized modeling of the human heart rate. The extraction of the human heart rate model using SCM requires experiment and computation. Furthermore, it was observed in this research that SCM is not a precise method. Therefore, integral sliding mode control (ISMC) was designed and implemented to overcome these difficulties. By introducing an auxiliary sliding surface, the reaching phase and effect of the perturbation on an actual sliding surface were eliminated; furthermore, implementation of ISMC does not require the linear parameters of the system. Simulations were performed in MATLAB/Simulink and experiments were conducted in a hospital. Six clinical subjects participated in this experiment. Both forms of control logic were implemented during the desired heart rate tracking test. Results showed that the desired heart rate tracking of ISMC is better than that of SMC. The tracking error of ISMC is smaller than that of SMC. However, ISMC control output has chattering, which needs to be reduced.

Purpose: This study evaluated the prognosis of patients with traumatic unilateral superior oblique palsy (SOP) and clinical factors associated with spontaneous resolution.Methods: Medical records of patients with traumatic unilateral SOP who visited two hospitals (Yeungnam University Hospital and Daegu Catholic University Medical Center) between January 2015 and June 2020 were reviewed retrospectively. When traumatic unilateral SOP did not recover within at least 1 year of follow-up, no spontaneous resolution was considered. Both traumatic and ocular factors were evaluated to evaluate their association with spontaneous recovery.Results: Fifty-nine patients (mean age, 52.6 years; 48 male patients) were enrolled in this study. The mean interval from trauma to initial presentation was 3.9 months. The mean vertical deviation at initial presentation was 6.34 ± 5.22 prism diopters (PD) (range, 0–25 PD). During the mean 24.1-month follow-up period, 28 patients (47.5%) achieved spontaneous resolution of SOP. Thirteen patients underwent surgical treatment for SOP. Vertical deviation

Detection of specific DNA is important in many fields. Label-free DNA sensing performed by electrochemical impedance spectroscopy (EIS) or using a quartz crystal microbalance (QCM) is widely employed for this purpose. Gold electrodes are mainly used for these techniques due to their chemical stability. However, ferro/ferricyanide used as a redox couple was found to etch the gold electrode and this significantly limited the repeatability of the EIS measurement. Inductively coupled plasma mass spectrometry (ICP-MS) and QCM experiments provided important clues about the gold dissolution mechanism and revealed that phosphate buffer promotes the dissolution of gold in the presence of the ferri/ferrocyanide redox couple. Tris buffered conditions, which provide the most stable environment, enabled the investigation of experimental parameters with a Q-sense electrochemistry module (QEM), which can perform QCM and EIS measurements simultaneously and revealed the principal factors that influence changes in the impedance. With the reproducible measurements, the estimation of an optimum probe-DNA concentration for detecting complementary DNA is demonstrated. In order to amplify the detection signal of target DNA, we sought to maximize the difference in response between the probe-only and target DNA by controlling the concentration of probe DNA. We showed that an intermediate probe-DNA concentration yields optimum signal amplification.

Microglia-mediated neuroinflammatory responses are well known to inhibit neurogenesis in the dentate gyrus (DG) of the adult hippocampus, and growing evidence indicates that therapeutic intervention to suppress microglial activation could be an effective strategy for restoring the impaired neurogenesis and memory performance. In the present study, we investigated the effects of water-soluble arginyl-diosgenin analog (Arg-DG) on the adult hippocampal neurogenesis using a central LPS-induced inflammatory mice model, along with the fundamental mechanisms in vivo and in vitro using LPS-stimulated microglial BV2 cells. Arg-DG (0.6 mg/kg) attenuates LPS-impaired neurogenesis by ameliorating the proliferation and differentiation of neural stem cells (NSCs), and prolonging their survival. The impaired neurogenesis in the hippocampal DG triggered the cognitive function, and that treatment of Arg-DG led to the recovery of cognitive decline. Arg-DG also suppressed the production of LPS-induced pro-inflammatory cytokines in hippocampal DG by blocking microglial activation. In in vitro study, Arg-DG inhibited the production of nitric oxide (NO), nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) expression, and prostaglandin D2 production (PGD2), as well as the pro-inflammatory cytokines, such as interleukin (IL)-6, IL-1β, and tumor necrosis factor alpha (TNF-α). The anti-inflammatory effect of Arg-DG was regulated by NF-κB and MAPK JNK signaling both in vivo, and in LPS-stimulated microglial BV2 cells. Taken together, these results suggest that Arg-DG might have the potential to treat various neurodegenerative disorders resulting from microglia-mediated neuroinflammation.

The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

Bitemporal hemianopia is a significant pathological hallmark of a pituitary lesion; however, binasal hemianopia is rarely reported, except for its known association with other ocular diseases rather than with brain lesions. We report a 24-year-old male with binasal hemianopia caused by pneumosinus dilatans of the sphenoid sinuses.

BackgroundAccumulating evidence suggests that alterations in inflammatory biomarkers are important in depression. However, previous meta-analyses disagree on these associations, and errors in data extraction may account for these discrepancies.MethodsPubMed/MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from database inception to 14 January 2020. Meta-analyses of observational studies examining the association between depression and levels of tumor necrosis factor-α (TNF-α), interleukin 1-β (IL-1β), interleukin-6 (IL-6), and C-reactive protein (CRP) were eligible. Errors were classified as follows: incorrect sample sizes, incorrectly used standard deviation, incorrect participant inclusion, calculation error, or analysis with insufficient data. We determined their impact on the results after correction thereof.ResultsErrors were noted in 14 of the 15 meta-analyses included. Across 521 primary studies, 118 (22.6%) showed the following errors: incorrect sample sizes (20 studies, 16.9%), incorrect use of standard deviation (35 studies, 29.7%), incorrect participant inclusion (7 studies, 5.9%), calculation errors (33 studies, 28.0%), and analysis with insufficient data (23 studies, 19.5%). After correcting these errors, 11 (29.7%) out of 37 pooled effect sizes changed by a magnitude of more than 0.1, ranging from 0.11 to 1.15. The updated meta-analyses showed that elevated levels of TNF- α, IL-6, CRP, but not IL-1β, are associated with depression.ConclusionsThese findings show that data extraction errors in meta-analyses can impact findings. Efforts to reduce such errors are important in studies of the association between depression and peripheral inflammatory biomarkers, for which high heterogeneity and conflicting results have been continuously reported.

AIM To investigate the role of autophagy in MTA-induced odontoblastic differentiation of human dental pulp cells (HDPCs). METHODOLOGY In MTA-treated HDPCs, odontoblastic differentiation was assessed based on expression levels of dentine sialophosphoprotein (DSPP) and dentine matrix protein 1 (DMP1), alkaline phosphatase activity (ALP) activity by ALP staining and the formation of mineralized nodule by Alizarin red S staining. Expression of microtubule-associated protein 1A/1B-light chain3 (LC3), adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) signalling molecules and autophagy-related genes was analysed by Western blot analysis and Acridine orange staining was used to detect autophagic lysosome. For in vivo experiments, tooth cavity preparation models on rat molars were established and the expression of proteins-related odontogenesis and autophagy markers was observed by Immunohistochemistry and Western blot analysis. Kruskal-Wallis with Dunn's multiple comparison was used for statistical analysis. RESULTS Mineral trioxide aggregate (MTA) promoted odontoblastic differentiation of HDPCs, accompanied by autophagy induction, including formation of autophagic lysosome and cleavage of LC3 to LC3II (P

BACKGROUND: Autophagy plays important roles in odontogenic differentiation of dental pulp cells (DPCs) in the developmental stage of tooth bud. Few studies have reported the role of autophagy during reparative dentin formation process. The objective of this study was to discover gene expression pattern correlated to autophagy and their role during odontogenic differentiation process in DPCs. METHODS: After tooth cavities were prepared on the mesial surface of lower first molar crown of rats. Odontogenic differentiation and reparative dentin formation were assessed based on detection of morphology change with hematoxylin and eosin staining. RESULTS: After tooth cavities were prepared on the mesial surface of lower first molar crown of rats, odontogenic differentiation and reparative dentin formation were assessed based on detection of morphology change with hematoxylin and eosin staining and dentin sialophosphoprotein (DSPP), whereas autophagy inhibitor 3-methyladenine (3MA) reversed. Results of quantitative polymerized chain reaction array of autophagosome formation related genes revealed that GABARAPL2 was prominently upregulated while expression of other ATG8 family members were moderately increased after tooth cavity preparation. In addition, human DPCs incubated in differentiation medium predominantly upregulated MAP1LC3C, which selectively decreased by 3MA but not by autophagy enhancer trehalose. Knock-down of MAP1LC3C using shRNA resulted in strong downregulation of dentin matrix protein 1 and DSPP as well-known odontogenic marker compared to knock-down of MAP1LC3B during odontogenic differentiation process of human DPCs. CONCLUSION: Our results suggest that MAP1LC3C plays a crucial role in odontogenic differentiation of human DPCs via regulating autophagic flux. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13770-020-00310-3) contains supplementary material, which is available to authorized users.

Purpose We investigated the changes in ocular deviation after the monocular occlusion test in adults with intermittent exotropia and evaluated its association with the level of control. Methods We retrospectively enrolled adults (aged ≥18 years) with intermittent exotropia who visited our clinic between September 2015 and May 2019. Patients with basic intermittent exotropia with a distant deviation within 10 prism diopters (PD) of the near deviation were included. The largest ocular deviations obtained before and after 1 hour of monocular occlusion were compared. The level of control was measured using the LACTOSE (Look and Cover, then Ten seconds of Observation Scale for Exotropia) control scoring system. Results Forty-six consecutive adult patients (28 males, 18 females; mean age, 34.3 years) were enrolled. The mean ocular deviation was 36.3 PD (range, 18 to 5 PD) at distant fixation and 38.5 PD (range, 18 to 80 PD) at near fixation, which increased significantly to 38.5 PD (p = 0.043) and 41.1 PD (p = 0.011), respectively, after monocular occlusion. The mean ocular deviation increased ≥5 PD in 14 (30.4%) and 15 (32.6%) patients at distant and near fixation, respectively. The level of control was measured in 30 patients. A higher degree of near control was significantly associated with an increase of ≥5 PD in near fixation after the test (p = 0.009 for a near control score ≤2). Conclusions The monocular occlusion test may help to determine the largest ocular deviation in adults with intermittent exotropia. Approximately one-third of patients exhibited an increase in ocular deviation ≥5 PD. Patients exhibiting good control were more likely to manifest an increase in the ocular deviation.