Risk Factors for Recurrent Lumbar Disc Herniations

The most common complication after lumbar discectomy is reherniation. As the first step in reducing the rate of recurrence, many studies have been conducted to find out the factors that may increase the reherniation risk. Some reported factors are age, sex, the type of lumbar disc herniation, the amount of fragments removed, smoking, alcohol consumption and the length of restricted activities. In this review, the factors studied thus far are summarized, excepting factors which cannot be chosen or changed, such as age or sex. Apart from the factors shown here, many other risk factors such as diabetes, family history, history of external injury, duration of illness and body mass index are considered. Few are agreed upon by all. The reason for the diverse opinions may be that many clinical and biomechanical variables are involved in the prognosis following operation. For the investigation of risk factors in recurrent lumbar disc herniation, large-scale multicenter prospective studies will be required in the future

Dysphagia Secondary to Vocal Cord Paralysis: A Case Report

A 51-year-old man with a 10-day history of acute-onset dysphagia presented with inability to swallow anything orally. The patient was unable to swallow any radiopaque contrast medium; therefore, a videofluoroscopic swallow study could not be performed. Brain imaging, neurological findings, and initial endoscopy findings were normal. Neck computed tomography suggested left vocal cord paralysis. The patient was diagnosed with diabetes one year prior to presentation but did not receive any treatment. Insulin therapy during hospitalization controlled the patient’s blood glucose levels, and his symptoms improved without any sequelae. We present a rare case of vocal cord paralysis secondary to controlled diabetes. The initial endoscopic examination did not include thorough evaluation of the vocal cords; therefore, accurate diagnosis was challenging in this case

Avoid Contamination in Soybean (Glycine Max, L. [Merrill]) Microspores Culture

Microspore culture is done to obtain pure strains. The purpose of soybean microspore culture to obtainquality seeds. Two important step that must be done is isolation of microspores in starvation medium andsubculture into embryogenesis medium. Many factors contributing to the contamination of soybeanmicrospore culture. Contamination in the B medium temperature 34 0C is more common than 4 0C. Vulnerableto contamination because of embryogenesis medium rich in nutrients. Bacterial contaminationcan be caused by internal contaminants such as shape of the anther. Other internal contaminants thatcause diseases such as fungi Colletotrichum truncatum and Phakopsora pachyrhizi. Antagonistic fungiwhich contaminate cultures that Trichoderma spp., Alternaria spp., Fusarium spp. Handling of contaminationis done by selecting the appropriate methods in order to remain viable microspores. Sterilization soybeanflower buds with 20% Tween for 10 minutes and then rinsed with distilled water. Moreover sterilizationwith 4% Hg Cl2 and 10% NaOCl for 10 minutes, rinsed with distilled water times, followed by 96%alcohol for 1 minute, can press up to 70% contamination

Cognitive and behavioral effects of lamotrigine and carbamazepine monotherapy in patients with newly diagnosed or untreated partial epilepsy

AbstractPurposeIn this prospective study, we compared the long-term cognitive and behavioral effects of lamotrigine (LTG) and carbamazepine (CBZ) in patients with newly diagnosed or untreated partial epilepsy.MethodsThis was a multicenter, open-label, randomized study that compared monotherapy with LTG and CBZ in newly diagnosed or untreated patients with partial epilepsy. We employed an 8-week titration period and a 40-week maintenance period. Neuropsychological tests, Symptom Check List-90, and QOLIE-31 were assessed at baseline, 16 weeks, and 48 weeks after drug treatment. A group-by-time interaction was the primary outcome measure and was analyzed by use of the linear mixed model.ResultsA total of 110 patients were eligible and 73 completed the 48-week study (LTG, n=39; CBZ, n=34). Among the cognitive tests, significant group-by-time interaction was identified only in phonemic fluency of Controlled Oral Word Association Task (p=0.0032) and Stroop Color–Word Interference (p=0.0283), with a significant better performance for LTG group. All other neuropsychological tests included did not show significant group-by-time interactions. Among the subscales of Symptom Check List-90, significant group-by-time interactions were identified in Obsessive-Compulsive (p=0.0005), Paranoid Ideation (p=0.0454), Global Severity Index (p=0.0194), and Positive Symptom Total (p=0.0197), with a significant improvement for CBZ group. QOLIE-31 did not show significant group-by-time interactions.ConclusionOur data suggest that epilepsy patients on LTG have better performance on phonemic fluency and the task of Stroop Color–Word Interference than do patients on CBZ, whereas patients on CBZ had more favorable behavioral effects on two subscales and two global scores of Symptom Check List-90 than did patients on LTG

The role of adjuvant pelvic radiotherapy in rectal cancer with synchronous liver metastasis: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Synchronous liver metastases are detected in approximately 25% of colorectal cancer patients at diagnosis. The rates of local failure and distant metastasis are substantial in these patients, even after undergoing aggressive treatments including resection of primary and metastatic liver tumors. The purpose of this study was to determine whether adjuvant pelvic radiotherapy is beneficial for pelvic control and overall survival in rectal cancer patients with synchronous liver metastasis after primary tumor resection.</p> <p>Methods</p> <p>Among rectal cancer patients who received total mesorectal excision (TME) between 1997 and 2006 at Yonsei University Health System, eighty-nine patients diagnosed with synchronous liver metastasis were reviewed. Twenty-seven patients received adjuvant pelvic RT (group S + R), and sixty-two patients were managed without RT (group S). Thirty-six patients (58%) in group S and twenty patients (74%) in group S+R received local treatment for liver metastasis. Failure patterns and survival outcomes were analyzed.</p> <p>Results</p> <p>Pelvic failure was observed in twenty-five patients; twenty-one patients in group S (34%), and four patients in group S+R (15%) (<it>p </it>= 0.066). The two-year pelvic failure-free survival rates (PFFS) of group S and group S+R were 64.8% and 80.8% (<it>p </it>= 0.028), respectively, and the two-year overall survival rates (OS) were 49.1% and 70.4% (<it>p </it>= 0.116), respectively. In a subgroup analysis of fifty-six patients who received local treatment for liver metastasis, the two-year PFFS were 64.9% and 82.9% (<it>p </it>= 0.05), respectively; the two-year OS were 74.1% and 80.0% (<it>p </it>= 0.616) in group S (n = 36) and group S+R (n = 20), respectively.</p> <p>Conclusions</p> <p>Adjuvant pelvic RT significantly reduced the pelvic failure rate but its influence on overall survival was unclear. Rectal cancer patients with synchronous liver metastasis may benefit from adjuvant pelvic RT through an increased pelvic control rate and improved quality of life.</p

In-Flight Transmission of Novel Influenza A (H1N1)

The Korea Centers for Disease Control and Prevention confirmed two patients, who had taken the same plane from Los Angeles to Seoul, with novel influenza A (H1N1). Through contact tracing, we concluded that the second patient was infected during the flight

The origin of proinflammatory cytokines in patients with idiopathic dilated cardiomyopathy.

Proinflammatory cytokines and their receptors are increased in the peripheral blood of patients with heart failure. We measured cytokines and their receptors in systemic artery (SA), coronary sinus (CS) and infra-renal inferior vena cava (IVC), in order to investigate their origin and influential factors. Thirty patients with idiopathic dilated cardiomyopathy were performed echocardiography at admission, and right heart catheterization after stabilization. Blood was drawn from 3 sites for measurement of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and soluble tumor necrosis factor-alpha receptor (sTNFR) I, II. TNF-alpha at CS (3.25 +/- 0.34 pg/mL) was higher than those of SA (1.81 +/- 0.39 pg/mL) and IVC (1.88 +/- 0.38 pg/mL, p<0.05). IL-6 at CS (18.3 +/- 3.8 pg/mL) was higher than that of SA (5.8 +/- 1.2 pg/mL, p<0.01). The levels of sTNFR I, II showed increasing tendency in sequence of SA, IVC and CS. TNF-alpha and sTNFR I, II from all sites were proportional to worsening of functional classes at admission (p<0.05). E/Ea by Doppler study at admission, which reflects left ventricular end-diastolic pressure (LVEDP) was positively correlated with TNF-alpha from SA (R=0.71, p<0.01), CS (R=0.52, p<0.05) and IVC (R=0.46, p<0.05). Thus, elevated LVEDP during decompensation might cause cytokine release from myocardium in patients with idiopathic dilated cardiomyopathy

A single nucleotide polymorphism in CAPN1 associated with marbling score in Korean cattle

<p>Abstract</p> <p>Background</p> <p>Marbling score (MS) is the major quantitative trait that affects carcass quality in beef cattle. In this study, we examined the association between genetic polymorphisms of the micromolar calcium-activated neutral protease gene (micro-calpain, <it>CAPN1</it>) and carcass traits in Korean cattle (also known as Hanwoo).</p> <p>Results</p> <p>By direct DNA sequencing in 24 unrelated Korean cattle, we identified 39 sequence variants within exons and their flanking regions in <it>CAPN1</it>. Among them, 12 common polymorphic sites were selected for genotyping in the beef cattle (<it>n </it>= 421). Statistical analysis revealed that a polymorphism in the 3'UTR (<it>c.2151*479C>T</it>) showed significant association with MS (<it>P</it>^{<it>cor</it>.}= 0.02).</p> <p>Conclusion</p> <p>Our findings suggest that polymorphisms in <it>CAPN1 </it>might be one of the important genetic factors involved in carcass quality in beef cattle, although it could be false positive association.</p