Identification of Primo-Vascular System in Abdominal Subcutaneous Tissue Layer of Rats

The primo-vascular system (PVS) is a novel network identified in various animal tissues. However, the PVS in subcutaneous tissue has not been well identified. Here, we examined the putative PVS on the surface of abdominal subcutaneous tissue in rats. Hemacolor staining revealed dark blue threadlike structures consisting of nodes and vessels, which were frequently observed bundled with blood vessels. The structure was filled with various immune cells including mast cells and WBCs. In the structure, there were inner spaces (20–60 µm) with low cellularity. Electron microscopy revealed a bundle structure and typical cytology common with the well-established organ surface PVS, which were different from those of the lymphatic vessel. Among several subcutaneous (sc) PVS tissues identified on the rat abdominal space, the most outstanding was the scPVS aligned along the ventral midline. The distribution pattern of nodes and vessels in the scPVS closely resembled that of the conception vessel meridian and its acupoints. In conclusion, our results newly revealed that the PVS is present in the abdominal subcutaneous tissue layer and indicate that the scPVS tissues are closely correlated with acupuncture meridians. Our findings will help to characterize the PVS in the other superficial tissues and its physiological roles

Extensive Emphysematous Pyelonephritis in a Nondiabetic Female Cat - Treatment with Unilateral Nephroureterectomy

Background: Emphysematous pyelonephritis (EPN) is an acute, severe necrotizing infection of the renal parenchyma and surrounding tissues that results in gas formation in the kidney, collecting system, or surroundings. EPN is a rare condition in veterinary medicine and occurs most frequently in dogs with diabetes mellitus. Although the prognosis of medical management in animals is poor, the standardized treatment protocol according to EPN severity is unclear. This report describes the first case of a nondiabetic female cat with extensive EPN and good prognosis following direct nephroureterectomy (NU). Case: A 10-year-old spayed female cat presented with the chief complaint of an acute loss of weight within 1 week, vomiting, and disorientation including stumbling, discoordination, circling, wobbling, head tilting, and difficulties in standing. At presentation, the patient had a body condition score of 1/9 and weighed 2.6 kg. Blood examination revealed leukocytosis, anemia, and hypoproteinemia. Abdominal radiography revealed severely decreased serosal details. A massive gas silhouette observed in the peritoneal and retroperitoneal cavities, was diagnosed as abdominal free gas. Abdominal ultrasound showed an accumulation of moderately anechoic fluid mixed with gas and cyst-like capsules around the left kidney. Left partial ureteral obstruction and dilation were also observed. Computed tomography (CT) was performed without sedatives or anesthetic drugs. The findings showed severe inflammatory changes in the peritoneum and a loss of the normal inner structure in the left kidney. A pyelogram of the left kidney was not observed after injection of the contrast material. Diffuse fat stranding and free gas observed in the mesentery of the entire abdominal cavity and around the left kidney were considered septic peritonitis. Urinalysis revealed proteinuria and hematuria. Numerous neutrophils with rod-type bacteria were observed in the ascites. Following diagnostic examinations, the patient was diagnosed with extensive left EPN, including inflammatory ascites and abdominal free gas. Therefore, emergency NU of the nonfunctional left kidney and ruptured ureter and thorough abdominal lavage were conducted. Diffuse inflammation and a nephrolith were observed in the section of the harvested kidney. The nephrolith was composed of 100% calcium oxalate monohydrate. The real-time polymerase chain reaction (RT-PCR) test for feline infectious peritonitis (FIP) was negative. Escherichia coli was detected in the ascites, and antibiotic therapy was administered following the antibiotic sensitivity test. The histological findings from the left kidney and ureter included marked chronic inflammation and fibrosis. The patient was discharged 4 days after surgery. During the 8-month follow-up period, the patient’s condition improved. Discussion: This was a unique case of EPN in a nondiabetic cat and the first reported case of EPN with a ruptured ureter, including abdominal free gas, inflammatory ascites, and peritonitis. This patient had a bacterial urinary tract infection with E. coli, which is the most frequently isolated pathogen in humans. This gas-forming bacteria produced a massive amount of gas and inflammation that were considered to have ruptured the urinary tract, so that the gas was released into the abdomen. This case corresponded to class 3B, with two risk factors according to the human EPN classification system. Direct NU and abdominal lavage were performed as emergency surgeries. The patient stabilized gradually and showed a good prognosis. Immediate surgical intervention is recommended in animal patients showing the extensive EPN stage. Keywords: kidney, nephroureterectomy, emphysematous pyelonephritis, peritonitis, cat, E. coli.

Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery

Study DesignA retrospective clinical case series.PurposeTo determine the strength of association between cage retropulsion and its related factors.Overview of LiteratureLumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging.MethodsFrom January 2006 to June 2016, 1,047 patients with lumbar degenerative disc disease who underwent posterior lumbar interbody fusion or transforaminal interbody fusion at Gyeongsang National University Hospital were enrolled. Medical records and pre- and postoperative radiographs were reviewed to identify significant cage retropulsion-related factors. The associations between cage retropulsion with various risk factors were evaluated by calculating odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis.ResultsOf 1,229 disc levels, 16 cases (1.3%, 10 men and 6 women) had cage retropulsion. Univariate analysis revealed no significant differences between the cage retropulsion group and the no cage retropulsion group with regard to demographic data such as age, sex, weight, height, body mass index (BMI), smoking habits, presence of osteoporosis, and duration of follow-up. Multivariate analysis revealed that low BMI (OR, 0.875; 95% CI, 0.771–0.994; p=0.040), presence of screw loosening (OR, 27.400; 95% CI, 7.818–96.033; p<0.001), and pear-shaped disc (OR, 9.158; 95% CI, 2.455–34.160; p=0.001) were significantly associated with cage retropulsion.ConclusionsThis study demonstrated that low BMI, loosening of posterior instrumentation, and pear-shaped disc were associated with cage retropulsion after lumbar interbody fusion. Therefore, when performing lumbar interbody fusion with a cage, surgeons should have skillful surgical techniques for firm fixation to prevent cage retropulsion, particularly in non-obese patients

EFFECTIVE DOSE MEASUREMENT FOR CONE BEAM COMPUTED TOMOGRAPHY USING GLASS DOSIMETER

During image-guided radiation therapy, the patient is exposed to unwanted radiation from imaging devices built into the medical LINAC. In the present study, the effective dose delivered to a patient from a cone beam computed tomography (CBCT) machine was measured. Absorbed doses in specific organs listed in ICRP Publication 103 were measured with glass dosimeters calibrated with kilovolt (kV) X-rays using a whole body physical phantom for typical radiotherapy sites, including the head and neck, chest, and pelvis. The effective dose per scan for the head and neck, chest, and pelvis were 3.37±0.29, 7.36±0.33, and 4.09±0.29 mSv, respectively. The results highlight the importance of the compensation of treatment dose by managing imaging dose

Metformin acts as a dual glucose regulator in mouse brain

Aims: Metformin improves glucose regulation through various mechanisms in the periphery. Our previous study revealed that oral intake of metformin activates several brain regions, including the hypothalamus, and directly activates hypothalamic S6 kinase in mice. In this study, we aimed to identify the direct effects of metformin on glucose regulation in the brain.Materials and methods: We investigated the role of metformin in peripheral glucose regulation by directly administering metformin intracerebroventricularly in mice. The effect of centrally administered metformin (central metformin) on peripheral glucose regulation was evaluated by oral or intraperitoneal glucose, insulin, and pyruvate tolerance tests. Hepatic gluconeogenesis and gastric emptying were assessed to elucidate the underlying mechanisms. Liver-specific and systemic sympathetic denervation were performed.Results: Central metformin improved the glycemic response to oral glucose load in mice compared to that in the control group, and worsened the response to intraperitoneal glucose load, indicating its dual role in peripheral glucose regulation. It lowered the ability of insulin to decrease serum glucose levels and worsened the glycemic response to pyruvate load relative to the control group. Furthermore, it increased the expression of hepatic G6pc and decreased the phosphorylation of STAT3, suggesting that central metformin increased hepatic glucose production. The effect was mediated by sympathetic nervous system activation. In contrast, it induced a significant delay in gastric emptying in mice, suggesting its potent role in suppressing intestinal glucose absorption.Conclusion: Central metformin improves glucose tolerance by delaying gastric emptying through the brain-gut axis, but at the same time worsens it by increasing hepatic glucose production via the brain-liver axis. However, with its ordinary intake, central metformin may effectively enhance its glucose-lowering effect through the brain-gut axis, which could surpass its effect on glucose regulation via the brain-liver axis

Locally-applied 5-fluorouracil-loaded slow-release patch prevents pancreatic cancer growth in an orthotopic mouse model

To obtain improved efficacy against pancreatic cancer, we investigated the efficacy and safety of a locally-applied 5-fluorouracil (5-FU)-loaded polymeric patch on pancreatic tumors in an orthotopic nude-mouse model. The 5-FU-releasing polymeric patch was produced by 3D printing. After application of the patch, it released the drug slowly for 4 weeks, and suppressed BxPC-3 pancreas cancer growth. Luciferase imaging of BxPC3-Luc cells implanted in the pancreas was performed longitudinally. The drug patch delivered a 30.2 times higher level of 5-FU than an intra-peritoneal (i.p.) bolus injection on day-1. High 5-FU levels were accumulated within one week by the patch. Four groups were compared for efficacy of 5-FU. Drug-free patch as a negative control (Group I); 30% 5-FU-loaded patch (4.8 mg) (Group II); 5-FU i.p. once (4.8 mg) (Group III); 5-FU i.p. once a week (1.2 mg), three times (Group IV). The tumor growth rate was significantly faster in Group I than Group II, III, IV (p=0.047 at day-8, p=0.022 at day-12, p=0.002 at day-18 and p=0.034 at day-21). All mice in Group III died of drug toxicity within two weeks after injection. Group II showed more effective suppression of tumor growth than Group IV (p=0.018 at day-12 and p=0.017 at day-21). Histological analysis showed extensive apoptosis in the TUNEL assay and by Ki -67 staining. Western blotting confirmed strong expression of cleaved caspase-3 in Group II. No significant changes were found hematologically and histologically in the liver, kidney and spleen in Groups I, II, IV but were found in Group III.113Ysciescopu

The Prevalence of Knee Osteoarthritis in Elderly Community Residents in Korea

The purpose of this study was to estimate the prevalence of radiographic and symptomatic knee osteoarthritis (OA) among community residents and to elucidate the relevant risk factors. This prospective, population-based study was conducted on residents over 50 yr of age in Chuncheon. Subjects completed an interview based on a standardized questionnaire and clinical evaluation including standardized weight bearing semiflexed knee A-P radiographs. We defined a subject with the Kellgren and Lawrence grade ≥2 as having radiographic knee OA (ROA). Symptomatic knee OA (SOA) was defined by the presence of both ROA and knee pain. We obtained symptom information and radiographs from 504 subjects. The prevalence of ROA and SOA was 37.3% and 24.2%, respectively. The prevalence of both ROA and SOA was significantly higher among women than among men. Multivariate analysis revealed that the presence of hypertension, and a manual occupation were significantly associated with the presence of ROA and SOA. Lower level of education was significantly associated with the presence of ROA, and female sex with the presence of SOA. In conclusion, both ROA and SOA are common in the aged adult population of Korea, with preponderance for women