Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse ...Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.展开更多
Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilizatio...Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilization of a camera without a separate external light, and instruments with different lengths has brought the favorable environment for SPLS. However, performing SPLS still creates several hardships compared to multiport laparoscopic surgery; a single-port system inevitably leads to clashing of surgical instruments due to crowding. To overcome such difficulties, investigators has developed novel concepts and maneuvers, including the concept of inverse triangulation and the maneuvers of pivoting, spreading out dissection, hanging suture, and transluminal traction. The final destination of SPLS is expected to be a completely seamless operation, maximizing the minimal invasiveness. Specimen extraction through the umbilicus can undermine cosmesis by inducing a larger incision. Therefore, hybrid laparoscopic technique, which combined laparoscopic surgical technique with natural orifice specimen extraction (NOSE) - i.e., transvaginal or transanal route-, has been developed. SPLS and NOSE seemed to be the best combination in pursuit of minimal invasiveness. In the near future, robotic SPLS with natural orifice transluminal endoscopic surgery’s way of specimen extraction seems to be pursued. It is expected to provide a completely or nearly complete seamless operation regardless of location of the lesion in the abdomen.展开更多
AIM: To improve the diagnostic accuracy in patients with symptoms and signs of appendicitis, but without confirmative computed tomography (CT) findings.
With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery(SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, t...With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery(SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed singleport solo surgery(SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanicaldevices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator's eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.展开更多
Sex and sex hormones play a major role in lung physiology. It has been proposed that the ratio of the second to fourth digits （digit ratio） is correlated with fetal sex hormones. We therefore hypothesized that digit...Sex and sex hormones play a major role in lung physiology. It has been proposed that the ratio of the second to fourth digits （digit ratio） is correlated with fetal sex hormones. We therefore hypothesized that digit ratio might help predict lung function. We investigated the relationship between digit ratio and pulmonary function test （PFT） findings. A total of 245 South Korean patients （162 male, 83 female） aged from 34 to 90 years who were hospitalized for urological surgery were prospectively enrolled. Before administering the PFTs, the lengths of the second and fourth digits of the right hand were measured by a single investigator using a digital Vernier caliper. In males （n = 162）, univariate and multivariate analysis using linear regression models showed that digit ratio was a significant predictive factor of forced vital capacity （FVC） and forced expiratory volume in I second （FEV1） （FVC： r = 0.156, P = 0.047; FEVI： r = 0.160, P = 0.042）. In male ever-smokers （n = 69）, lung functions （FVC and FEV1） were correlated with smoking exposure rather than digit ratio. In female never-smokers （n = 83）, lung functions （FEV1 and FEVI/FVC ratio） were positively correlated with digit ratio on univariate analysis （FEVI： r = 0.242, P = 0.027; FEVI/FVC ratio： r = 0.245, P = 0.026）. Patients with lower digit ratios tend to have decreased lung function. These results suggest that digit ratio is a predictor of airway function.展开更多
AIM:To identify risk factors of actual appendiceal perforation when computed tomography(CT)scans suggest nonperforated appendicitis and accordingly determine surgical priority.METHODS:We collected database of 1362 pat...AIM:To identify risk factors of actual appendiceal perforation when computed tomography(CT)scans suggest nonperforated appendicitis and accordingly determine surgical priority.METHODS:We collected database of 1362 patients who underwent an appendectomy for acute appendicitis between 2006 and 2013.A single radiologist selected1236 patients whose CT scans were suggestive ofnonperforated appendicitis.Patients were divided into 2 groups:actual nonperforation group and actual perforation group according to intraoperative and pathologic features.Comparison of the 2 groups were made using binary logistic regression.RESULTS:Of 1236 patients,90(7.3%)were found to have actual appendiceal perforation.Four risk factors related with actual appendiceal perforation were identified:body temperature≥37.6℃(HR=1.912,95%CI:1.161-3.149;P=0.011),out-ofhospital symptom duration≥72 h(HR=2.454,95%CI:1.292-4.662;P=0.006),age≥35 years(HR=3.358,95%CI:1.968-5.728;P<0.001),and appendiceal diameter on CT scan≥8 mm(HR=4.294,95%CI:1.034-17.832;P=0.045).Actual appendiceal perforation group showed longer operation time,later initiation of diet,longer use of parenteral narcotics,longer hospital stay,and higher incidence of postoperative complications(P<0.05).CONCLUSION:We proposed here new criteria to select patients with adverse clinical outcomes after appendectomy among the patients with radiologically nonperforated appendicitis.Surgical appendectomy outcomes could be improved by determining the surgical priority according to our criteria.展开更多
BACKGROUND Recently,the exclusive use of mesenchymal stem cell(MSC)-secreted molecules,called secretome,rather than cells,has been evaluated for overcoming the limitations of cell-based therapy,while maintaining its a...BACKGROUND Recently,the exclusive use of mesenchymal stem cell(MSC)-secreted molecules,called secretome,rather than cells,has been evaluated for overcoming the limitations of cell-based therapy,while maintaining its advantages.However,the use of na?ve secretome may not fully satisfy the specificity of each disease.Therefore,it appears to be more advantageous to use the functionally reinforced secretome through a series of processes involving physico-chemical adjustments or genetic manipulation rather than to the use na?ve secretome.AIM To determine the therapeutic potential of the secretome released from miR-122-transfected adipose-derived stromal cells(ASCs).METHODS We collected secretory materials released from ASCs that had been transfected with antifibrotic miR-122(MCM)and compared their antifibrotic effects with those of the na?ve secretome(CM).MCM and CM were intravenously administered to the mouse model of thioacetamide-induced liver fibrosis,and their therapeutic potentials were compared.RESULTS MCM infusion provided higher therapeutic potential in terms of:(A)Reducing collagen content in the liver;(B)Inhibiting proinflammatory cytokines;and(C)Reducing abnormally elevated liver enzymes than the infusion of the na?ve secretome.The proteomic analysis of MCM also indicated that the contents of antifibrotic proteins were significantly elevated compared to those in the na?ve secretome.CONCLUSION We could,thus,conclude that the secretome released from miR-122-transfected ASCs has higher antifibrotic and anti-inflammatory properties than the na?ve secretome.Because miR-122 transfection into ASCs provides a specific way of potentiating the antifibrotic properties of ASC secretome,it could be considered as an enhanced method for reinforcing secretome effectiveness.展开更多
BACKGROUND The use of methyl-tertiary butyl ether(MTBE)to dissolve gallstones has been limited due to concerns over its toxicity and the widespread recognition of the safety of laparoscopic cholecystectomy.The adverse...BACKGROUND The use of methyl-tertiary butyl ether(MTBE)to dissolve gallstones has been limited due to concerns over its toxicity and the widespread recognition of the safety of laparoscopic cholecystectomy.The adverse effects of MTBE are largely attributed to its low boiling point,resulting in a tendency to evaporate.Therefore,if there is a material with a higher boiling point and similar or higher dissolubility than MTBE,it is expected to be an attractive alternative to MTBE.AIM To determine whether tert-amyl ethyl ether(TAEE),an MTBE analogue with a relatively higher boiling point(102°C),could be used as an alternative to MTBE in terms of gallstone dissolubility and toxicity.METHODS The in vitro dissolubility of MTBE and TAEE was determined by measuring the dry weights of human gallstones at predetermined time intervals after placing them in glass containers with either of the two solvents.The in vivo dissolubility was determined by comparing the weights of solvent-treated gallstones and control(dimethyl sulfoxide)-treated gallstones,after the direct infusion of each solvent into the gallbladder in both hamster models with cholesterol and pigmented gallstones.RESULTS The in vitro results demonstrated a 24 h TAEE-dissolubility of 76.7%,56.5%and 38.75%for cholesterol,mixed,and pigmented gallstones,respectively,which represented a 1.2-,1.4-,and 1.3-fold increase in dissolubility compared to that of MTBE.In the in vitro experiment,the 24 h-dissolubility of TAEE was 71.7%and 63.0%for cholesterol and pigmented gallstones,respectively,which represented a 1.4-and 1.9-fold increase in dissolubility compared to that of MTBE.In addition,the results of the cell viability assay and western blot analysis indicated that TAEE had a lower toxicity towards gallbladder epithelial cells than MTBE.CONCLUSION We demonstrated that TAEE has higher gallstone dissolubility properties and safety than those of MTBE.As such,TAEE could present an attractive alternative to MTBE if our findings regarding its efficacy and safety can be consistently reproduced in further subclinical and clinical studies.展开更多
BACKGROUND Recently,the exclusive use of mesenchymal stem cell(MSC)-secreted molecules,named as the secretome,have been evaluated for overcoming the limitations of cell-based therapy while maintaining its advantages.A...BACKGROUND Recently,the exclusive use of mesenchymal stem cell(MSC)-secreted molecules,named as the secretome,have been evaluated for overcoming the limitations of cell-based therapy while maintaining its advantages.AIM To improve cell-free therapy by adding disease-specificity through stimulation of MSCs using disease-causing materials.METHODS We collected the secretory materials(named as inducers)released from AML12 hepatocytes that had been pretreated with thioacetamide(TAA)and generated the TAA-induced secretome(TAA-isecretome)after stimulating adipose-derived stem cells with the inducers.The TAA-isecretome was intravenously administered to mice with TAA-induced hepatic failure and those with partial hepatectomy.RESULTS TAA-isecretome infusion showed higher therapeutic potential in terms of(1)restoring disorganized hepatic tissue to normal tissue;(2)inhibiting proinflammatory cytokines(interleukin-6 and tumor necrosis factor-α);and(3)reducing abnormally elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase)compared to the naïve secretome infusion in mice with TAA-induced hepatic failure.However,the TAA-isecretome showed inferior therapeutic potential for restoring hepatic function in partially hepatectomized mice.Proteomic analysis of TAA-isecretome identified that antioxidant processes were the most predominant enriched biological networks of the proteins exclusively identified in the TAA-isecretome.In addition,peroxiredoxin-1,a potent antioxidant protein,was found to be one of representative components of TAA-isecretome and played a central role in the protection of TAA-induced hepatic injury.CONCLUSION Appropriate stimulation of adipose-derived stem cells with TAA led to the production of a secretome enriched with proteins,especially peroxiredoxin-1,with higher antioxidant activity.Our results suggest that appropriate stimulation of MSCs with pathogenic agents can lead to the production of a secretome specialized for protecting against the pathogen.This approach is expected to open a new way of developing various specific therapeutics based on the high plasticity and responsiveness of MSCs.展开更多
AIM:To report our experience with single-port laparoscopic surgery(SPLS)for sigmoid volvulus(SV).METHODS:Between October 2009 and April 2013,10patients underwent SPLS for SV.SPLS was performed transumbilically or thro...AIM:To report our experience with single-port laparoscopic surgery(SPLS)for sigmoid volvulus(SV).METHODS:Between October 2009 and April 2013,10patients underwent SPLS for SV.SPLS was performed transumbilically or through a predetermined stoma site.Conventional straight and rigid-type laparoscopic instruments were used.After intracorporeal,segmental resection of the affected sigmoid colon,the specimen was extracted through the single-incision site.Patientdemographics and perioperative data were analyzed.RESULTS:SPLS for SV was successful in all 10 patients(4,resection and primary anastomosis;6,Hartmann’s procedure).The median operative time and postoperative hospitalization period were 168(range,85-315)min and 6.5(range,4-29)d,respectively.No intraoperative complications were noted;there were 2 postoperative complications,including 1 anastomotic leak.CONCLUSION:SPLS was a safe and feasible therapeutic approach for SV,when performed by a surgeon experienced in conventional laparoscopic surgery.展开更多
Background There are not many studies about treatment of shoulder spasticity. Although botulinum toxin injection has been reported to be effective for shoulder spasticity, the effectiveness was judged by pain and limi...Background There are not many studies about treatment of shoulder spasticity. Although botulinum toxin injection has been reported to be effective for shoulder spasticity, the effectiveness was judged by pain and limited motion change, but not the spasticity itself. Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder. However, the subscapularis muscle, unlike the pectoralis major muscle, is located deep beneath scapula, where conventional injection is difficult to perform. As extracorporeal shock wave therapy （ESWT） has been reported to be effective for spasticity relief, and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment. This study was to evaluate the beneficial effects of radial ESWT （rESWT） on spastic subscapularis muscle in stroke patients. Methods This is an uncontrolled, prospective, unicenter, clinical pilot study. Stroke patients （n=57; mean age 55.4 years） with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital. rESWT was administered to each patient every two or three days for two weeks （five total treatments）. Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks. Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale （MAS）, and passive range of motion （ROM） of the shoulder in external rotation was recorded. Pain was measured using a visual analogue scale （VAS） during passive ROM of the shoulder in external rotation, and was additionally recorded for patients who preserved cognitive and communicative ability （Pain group）. Results Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline. The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the treatment decreased afterward. Conclusion rESWT will be able to provide stroke patients with an effective and safe procedure for the reduction of spasticity and pain as well as for the improvement of ROM of spastic shoulders.展开更多
Surface-enhanced Raman scattering(SERS)enables rapid detection of single molecules with high specificity.However,quantitative and sensitive SERS analysis has been a challenge due to the lack of reliable SERS-active ma...Surface-enhanced Raman scattering(SERS)enables rapid detection of single molecules with high specificity.However,quantitative and sensitive SERS analysis has been a challenge due to the lack of reliable SERS-active materials.In this study,we developed a quantitative SERS-based immunoassay using enzyme-guided Ag growth on Raman labeling compound(RLC)-immobilized gold nanoparticle(Au NP)-assembled silica NPs(SiO2@Au-RLC@Ag).The enzyme amplified Ag+reduction as well as Ag growth on the RLC-immobilized Au NP-assembled silica NPs(SiO2@Au-RLC),which resulted in a significant increase in SERS signal.In the presence of target antigens such as immunoglobulinG(IgG)or prostate-specific antigen(PSA),Ab1-Antigen-Ab2 immune complex with alkaline phosphatase triggered an enzyme-catalyzed reaction to convert 2-phospho-L-ascorbic acid(2-phospho-L-AA)to ascorbic acid(AA).As produced AA reduced Ag+to Ag,forming an Ag hot spot on the surface of SiO2@Au-RLC,which enhanced the SERS signal of SiO2@Au-RLC@Ag in a solution with a target antigen concentration.The plasmonic immunoassay for IgG detection showed a high linearity of SERS intensity in the range of 0.6 to 9.0 ng/mL with a detection limit(LOD)of 0.09 ng/mL,while an LOD of 0.006 ng/mL was obtained for PSA.The results indicate that the sensitivity of our novel SERS-based immunoassay is higher than that of conventional enzyme-based colorimetric immunoassays.展开更多
Background Although some studies measured the burden of caregivers and the factors that influenced their feelings of burden, few studies have measured the quality of life （QOL） for primary caregivers of patients wit...Background Although some studies measured the burden of caregivers and the factors that influenced their feelings of burden, few studies have measured the quality of life （QOL） for primary caregivers of patients with muscular dystrophy （MD）. We assessed the QOL for primary caregivers of patients with MD in South Korea and identified factors associated with caregivers＇ QOL. Methods Ninety dyads of patients with MD and their primary caregivers were enrolled in this study. The QOL of caregivers of patients with MD was assessed subjectively using the World Health Organization Quality of Life Assessment, Life Brief Form. Caregivers＇ emotional status was assessed using the Beck Depression Inventory （BDI） and family function level was evaluated using the Family APGAR scale. Patients reported their emotional status using the BDI or the Children＇s Depression Inventory. The functional levels of patients were evaluated by the modified Barthel Index. Results Caregivers＇ QOL was statistically associated with family income, family function, emotional status of patients, level of education, and emotional status of caregivers （P 〈0.05）. Caregivers who were employed had a significantly higher QOL than those who were not （P 〈0.05）. In multiple regression analyses, emotional and employment status of caregivers was strongly associated with caregivers＇ QOL. Conclusion Rehabilitation teams should consider not only the physical factors of patients but also the psychological and demographic factors of primary caregivers of patients with MD.展开更多
文摘Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.
文摘Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilization of a camera without a separate external light, and instruments with different lengths has brought the favorable environment for SPLS. However, performing SPLS still creates several hardships compared to multiport laparoscopic surgery; a single-port system inevitably leads to clashing of surgical instruments due to crowding. To overcome such difficulties, investigators has developed novel concepts and maneuvers, including the concept of inverse triangulation and the maneuvers of pivoting, spreading out dissection, hanging suture, and transluminal traction. The final destination of SPLS is expected to be a completely seamless operation, maximizing the minimal invasiveness. Specimen extraction through the umbilicus can undermine cosmesis by inducing a larger incision. Therefore, hybrid laparoscopic technique, which combined laparoscopic surgical technique with natural orifice specimen extraction (NOSE) - i.e., transvaginal or transanal route-, has been developed. SPLS and NOSE seemed to be the best combination in pursuit of minimal invasiveness. In the near future, robotic SPLS with natural orifice transluminal endoscopic surgery’s way of specimen extraction seems to be pursued. It is expected to provide a completely or nearly complete seamless operation regardless of location of the lesion in the abdomen.
文摘AIM: To improve the diagnostic accuracy in patients with symptoms and signs of appendicitis, but without confirmative computed tomography (CT) findings.
文摘With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery(SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed singleport solo surgery(SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanicaldevices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator's eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.
文摘Sex and sex hormones play a major role in lung physiology. It has been proposed that the ratio of the second to fourth digits （digit ratio） is correlated with fetal sex hormones. We therefore hypothesized that digit ratio might help predict lung function. We investigated the relationship between digit ratio and pulmonary function test （PFT） findings. A total of 245 South Korean patients （162 male, 83 female） aged from 34 to 90 years who were hospitalized for urological surgery were prospectively enrolled. Before administering the PFTs, the lengths of the second and fourth digits of the right hand were measured by a single investigator using a digital Vernier caliper. In males （n = 162）, univariate and multivariate analysis using linear regression models showed that digit ratio was a significant predictive factor of forced vital capacity （FVC） and forced expiratory volume in I second （FEV1） （FVC： r = 0.156, P = 0.047; FEVI： r = 0.160, P = 0.042）. In male ever-smokers （n = 69）, lung functions （FVC and FEV1） were correlated with smoking exposure rather than digit ratio. In female never-smokers （n = 83）, lung functions （FEV1 and FEVI/FVC ratio） were positively correlated with digit ratio on univariate analysis （FEVI： r = 0.242, P = 0.027; FEVI/FVC ratio： r = 0.245, P = 0.026）. Patients with lower digit ratios tend to have decreased lung function. These results suggest that digit ratio is a predictor of airway function.
文摘AIM:To identify risk factors of actual appendiceal perforation when computed tomography(CT)scans suggest nonperforated appendicitis and accordingly determine surgical priority.METHODS:We collected database of 1362 patients who underwent an appendectomy for acute appendicitis between 2006 and 2013.A single radiologist selected1236 patients whose CT scans were suggestive ofnonperforated appendicitis.Patients were divided into 2 groups:actual nonperforation group and actual perforation group according to intraoperative and pathologic features.Comparison of the 2 groups were made using binary logistic regression.RESULTS:Of 1236 patients,90(7.3%)were found to have actual appendiceal perforation.Four risk factors related with actual appendiceal perforation were identified:body temperature≥37.6℃(HR=1.912,95%CI:1.161-3.149;P=0.011),out-ofhospital symptom duration≥72 h(HR=2.454,95%CI:1.292-4.662;P=0.006),age≥35 years(HR=3.358,95%CI:1.968-5.728;P<0.001),and appendiceal diameter on CT scan≥8 mm(HR=4.294,95%CI:1.034-17.832;P=0.045).Actual appendiceal perforation group showed longer operation time,later initiation of diet,longer use of parenteral narcotics,longer hospital stay,and higher incidence of postoperative complications(P<0.05).CONCLUSION:We proposed here new criteria to select patients with adverse clinical outcomes after appendectomy among the patients with radiologically nonperforated appendicitis.Surgical appendectomy outcomes could be improved by determining the surgical priority according to our criteria.
基金Supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT),No.NRF-2015R1D1A1A01060721
文摘BACKGROUND Recently,the exclusive use of mesenchymal stem cell(MSC)-secreted molecules,called secretome,rather than cells,has been evaluated for overcoming the limitations of cell-based therapy,while maintaining its advantages.However,the use of na?ve secretome may not fully satisfy the specificity of each disease.Therefore,it appears to be more advantageous to use the functionally reinforced secretome through a series of processes involving physico-chemical adjustments or genetic manipulation rather than to the use na?ve secretome.AIM To determine the therapeutic potential of the secretome released from miR-122-transfected adipose-derived stromal cells(ASCs).METHODS We collected secretory materials released from ASCs that had been transfected with antifibrotic miR-122(MCM)and compared their antifibrotic effects with those of the na?ve secretome(CM).MCM and CM were intravenously administered to the mouse model of thioacetamide-induced liver fibrosis,and their therapeutic potentials were compared.RESULTS MCM infusion provided higher therapeutic potential in terms of:(A)Reducing collagen content in the liver;(B)Inhibiting proinflammatory cytokines;and(C)Reducing abnormally elevated liver enzymes than the infusion of the na?ve secretome.The proteomic analysis of MCM also indicated that the contents of antifibrotic proteins were significantly elevated compared to those in the na?ve secretome.CONCLUSION We could,thus,conclude that the secretome released from miR-122-transfected ASCs has higher antifibrotic and anti-inflammatory properties than the na?ve secretome.Because miR-122 transfection into ASCs provides a specific way of potentiating the antifibrotic properties of ASC secretome,it could be considered as an enhanced method for reinforcing secretome effectiveness.
文摘BACKGROUND The use of methyl-tertiary butyl ether(MTBE)to dissolve gallstones has been limited due to concerns over its toxicity and the widespread recognition of the safety of laparoscopic cholecystectomy.The adverse effects of MTBE are largely attributed to its low boiling point,resulting in a tendency to evaporate.Therefore,if there is a material with a higher boiling point and similar or higher dissolubility than MTBE,it is expected to be an attractive alternative to MTBE.AIM To determine whether tert-amyl ethyl ether(TAEE),an MTBE analogue with a relatively higher boiling point(102°C),could be used as an alternative to MTBE in terms of gallstone dissolubility and toxicity.METHODS The in vitro dissolubility of MTBE and TAEE was determined by measuring the dry weights of human gallstones at predetermined time intervals after placing them in glass containers with either of the two solvents.The in vivo dissolubility was determined by comparing the weights of solvent-treated gallstones and control(dimethyl sulfoxide)-treated gallstones,after the direct infusion of each solvent into the gallbladder in both hamster models with cholesterol and pigmented gallstones.RESULTS The in vitro results demonstrated a 24 h TAEE-dissolubility of 76.7%,56.5%and 38.75%for cholesterol,mixed,and pigmented gallstones,respectively,which represented a 1.2-,1.4-,and 1.3-fold increase in dissolubility compared to that of MTBE.In the in vitro experiment,the 24 h-dissolubility of TAEE was 71.7%and 63.0%for cholesterol and pigmented gallstones,respectively,which represented a 1.4-and 1.9-fold increase in dissolubility compared to that of MTBE.In addition,the results of the cell viability assay and western blot analysis indicated that TAEE had a lower toxicity towards gallbladder epithelial cells than MTBE.CONCLUSION We demonstrated that TAEE has higher gallstone dissolubility properties and safety than those of MTBE.As such,TAEE could present an attractive alternative to MTBE if our findings regarding its efficacy and safety can be consistently reproduced in further subclinical and clinical studies.
基金Supported by National Research Foundation of Korea,No.NRF-2015R1C1A1A02036931
文摘BACKGROUND Recently,the exclusive use of mesenchymal stem cell(MSC)-secreted molecules,named as the secretome,have been evaluated for overcoming the limitations of cell-based therapy while maintaining its advantages.AIM To improve cell-free therapy by adding disease-specificity through stimulation of MSCs using disease-causing materials.METHODS We collected the secretory materials(named as inducers)released from AML12 hepatocytes that had been pretreated with thioacetamide(TAA)and generated the TAA-induced secretome(TAA-isecretome)after stimulating adipose-derived stem cells with the inducers.The TAA-isecretome was intravenously administered to mice with TAA-induced hepatic failure and those with partial hepatectomy.RESULTS TAA-isecretome infusion showed higher therapeutic potential in terms of(1)restoring disorganized hepatic tissue to normal tissue;(2)inhibiting proinflammatory cytokines(interleukin-6 and tumor necrosis factor-α);and(3)reducing abnormally elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase)compared to the naïve secretome infusion in mice with TAA-induced hepatic failure.However,the TAA-isecretome showed inferior therapeutic potential for restoring hepatic function in partially hepatectomized mice.Proteomic analysis of TAA-isecretome identified that antioxidant processes were the most predominant enriched biological networks of the proteins exclusively identified in the TAA-isecretome.In addition,peroxiredoxin-1,a potent antioxidant protein,was found to be one of representative components of TAA-isecretome and played a central role in the protection of TAA-induced hepatic injury.CONCLUSION Appropriate stimulation of adipose-derived stem cells with TAA led to the production of a secretome enriched with proteins,especially peroxiredoxin-1,with higher antioxidant activity.Our results suggest that appropriate stimulation of MSCs with pathogenic agents can lead to the production of a secretome specialized for protecting against the pathogen.This approach is expected to open a new way of developing various specific therapeutics based on the high plasticity and responsiveness of MSCs.
文摘AIM:To report our experience with single-port laparoscopic surgery(SPLS)for sigmoid volvulus(SV).METHODS:Between October 2009 and April 2013,10patients underwent SPLS for SV.SPLS was performed transumbilically or through a predetermined stoma site.Conventional straight and rigid-type laparoscopic instruments were used.After intracorporeal,segmental resection of the affected sigmoid colon,the specimen was extracted through the single-incision site.Patientdemographics and perioperative data were analyzed.RESULTS:SPLS for SV was successful in all 10 patients(4,resection and primary anastomosis;6,Hartmann’s procedure).The median operative time and postoperative hospitalization period were 168(range,85-315)min and 6.5(range,4-29)d,respectively.No intraoperative complications were noted;there were 2 postoperative complications,including 1 anastomotic leak.CONCLUSION:SPLS was a safe and feasible therapeutic approach for SV,when performed by a surgeon experienced in conventional laparoscopic surgery.
文摘Background There are not many studies about treatment of shoulder spasticity. Although botulinum toxin injection has been reported to be effective for shoulder spasticity, the effectiveness was judged by pain and limited motion change, but not the spasticity itself. Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder. However, the subscapularis muscle, unlike the pectoralis major muscle, is located deep beneath scapula, where conventional injection is difficult to perform. As extracorporeal shock wave therapy （ESWT） has been reported to be effective for spasticity relief, and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment. This study was to evaluate the beneficial effects of radial ESWT （rESWT） on spastic subscapularis muscle in stroke patients. Methods This is an uncontrolled, prospective, unicenter, clinical pilot study. Stroke patients （n=57; mean age 55.4 years） with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital. rESWT was administered to each patient every two or three days for two weeks （five total treatments）. Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks. Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale （MAS）, and passive range of motion （ROM） of the shoulder in external rotation was recorded. Pain was measured using a visual analogue scale （VAS） during passive ROM of the shoulder in external rotation, and was additionally recorded for patients who preserved cognitive and communicative ability （Pain group）. Results Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline. The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the treatment decreased afterward. Conclusion rESWT will be able to provide stroke patients with an effective and safe procedure for the reduction of spasticity and pain as well as for the improvement of ROM of spastic shoulders.
基金This research was supported by the KU Research Professor Program of Konkuk University&funded by the Korean Health Technology R&D Project,Ministry of Health&Welfare(No.HI17C1264)Ministry of Science and ICT(No.NRF-2019R1G1A1006488).
文摘Surface-enhanced Raman scattering(SERS)enables rapid detection of single molecules with high specificity.However,quantitative and sensitive SERS analysis has been a challenge due to the lack of reliable SERS-active materials.In this study,we developed a quantitative SERS-based immunoassay using enzyme-guided Ag growth on Raman labeling compound(RLC)-immobilized gold nanoparticle(Au NP)-assembled silica NPs(SiO2@Au-RLC@Ag).The enzyme amplified Ag+reduction as well as Ag growth on the RLC-immobilized Au NP-assembled silica NPs(SiO2@Au-RLC),which resulted in a significant increase in SERS signal.In the presence of target antigens such as immunoglobulinG(IgG)or prostate-specific antigen(PSA),Ab1-Antigen-Ab2 immune complex with alkaline phosphatase triggered an enzyme-catalyzed reaction to convert 2-phospho-L-ascorbic acid(2-phospho-L-AA)to ascorbic acid(AA).As produced AA reduced Ag+to Ag,forming an Ag hot spot on the surface of SiO2@Au-RLC,which enhanced the SERS signal of SiO2@Au-RLC@Ag in a solution with a target antigen concentration.The plasmonic immunoassay for IgG detection showed a high linearity of SERS intensity in the range of 0.6 to 9.0 ng/mL with a detection limit(LOD)of 0.09 ng/mL,while an LOD of 0.006 ng/mL was obtained for PSA.The results indicate that the sensitivity of our novel SERS-based immunoassay is higher than that of conventional enzyme-based colorimetric immunoassays.
文摘Background Although some studies measured the burden of caregivers and the factors that influenced their feelings of burden, few studies have measured the quality of life （QOL） for primary caregivers of patients with muscular dystrophy （MD）. We assessed the QOL for primary caregivers of patients with MD in South Korea and identified factors associated with caregivers＇ QOL. Methods Ninety dyads of patients with MD and their primary caregivers were enrolled in this study. The QOL of caregivers of patients with MD was assessed subjectively using the World Health Organization Quality of Life Assessment, Life Brief Form. Caregivers＇ emotional status was assessed using the Beck Depression Inventory （BDI） and family function level was evaluated using the Family APGAR scale. Patients reported their emotional status using the BDI or the Children＇s Depression Inventory. The functional levels of patients were evaluated by the modified Barthel Index. Results Caregivers＇ QOL was statistically associated with family income, family function, emotional status of patients, level of education, and emotional status of caregivers （P 〈0.05）. Caregivers who were employed had a significantly higher QOL than those who were not （P 〈0.05）. In multiple regression analyses, emotional and employment status of caregivers was strongly associated with caregivers＇ QOL. Conclusion Rehabilitation teams should consider not only the physical factors of patients but also the psychological and demographic factors of primary caregivers of patients with MD.
