Cystic Dysplasia of the Rete Testis Accompanying an Inguinal Hernia: A 63-Year-Old Man

Cystic dysplasia of the rete testis (CDT) is a very rare congenital benign testicular tumor that is often associated with ipsilateral genitourinary anomalies. It is usually found in the pediatric population and must be differentially diagnosed from a malignant lesion. Here we report the case of a 63-year-old man with a left inguinal hernia who visited our urologic outpatient clinic. Scrotal ultrasonography showed a left direct inguinal hernia in the inguinal area and a well-circumscribed cystic lesion containing multiple minute cysts with echogenic foci occupying almost one-third of the left testicular parenchyma. Testicular tumor markers were within the normal range and a computed tomography scan of the abdomen showed no genitourinary abnormalities. We presumed that the left testicular lesion was malignant, and the patient underwent radical orchiectomy. However, the pathologic examination revealed a CDT. Here we present this case of a 63-year-old man with an inguinal hernia accompanied by multiple cystic lesions on the left testis

The cortical activation pattern by a rehabilitation robotic hand: a functional NIRS study

Introduction: Clarification of the relationship between external stimuli and brain response has been an important topic in neuroscience and brain rehabilitation. In the current study, using functional near infrared spectroscopy (fNIRS), we attempted to investigate cortical activation patterns generated during execution of a rehabilitation robotic hand. Methods: Ten normal subjects were recruited for this study. Passive movements of the right fingers were performed using a rehabilitation robotic hand at a frequency of 0.5 Hz. We measured values of oxy-hemoglobin (HbO), deoxy-hemoglobin (HbR) and total-hemoglobin (HbT) in five regions of interest: the primary sensory-motor cortex (SM1), hand somatotopy of the contralateral SM1, supplementary motor area (SMA), premotor cortex (PMC), and prefrontal cortex (PFC). Results: HbO and HbT values indicated significant activation in the left SM1, left SMA, left PMC, and left PFC during execution of the rehabilitation robotic hand (uncorrected, p < 0.01). By contrast, HbR value indicated significant activation only in the hand somatotopic area of the left SM1 (uncorrected, p < 0.01). Conclusions: Our results appear to indicate that execution of the rehabilitation robotic hand could induce cortical activation. © 2014 Chang, Lee, Gu, Lee, Jin, Yeo, Seo and Jang.1

Reversibly controlled ternary polar states and ferroelectric bias promoted by boosting square???tensile???strain

Interaction between dipoles often emerges intriguing physical phenomena, such as exchange bias in the magnetic heterostructures and magnetoelectric effect in multiferroics, which lead to advances in multifunctional heterostructures. However, the defect-dipole tends to be considered the undesired to deteriorate the electronic functionality. Here, we report deterministic switching between the ferroelectric and the pinched states by exploiting a new substrate of cubic perovskite, BaZrO3, which boosts square-tensile-strain to BaTiO3 and promotes four-variants in-plane spontaneous polarization with oxygen vacancy creation. First-principles calculations propose a complex of an oxygen vacancy and two Ti3+ ions coins a charge-neutral defect-dipole. Cooperative control of the defect-dipole and the spontaneous polarization reveals ternary in-plane polar states characterized by biased/pinched hysteresis loops. Furthermore, we experimentally demonstrate that three electrically controlled polar-ordering states lead to switchable and non-volatile dielectric states for application of non-destructive electro-dielectric memory. This discovery opens a new route to develop functional materials via manipulating defect-dipoles and offers a novel platform to advance heteroepitaxy beyond the prevalent perovskite substrates

Heterologous expression of tylosin polyketide synthase and production of a hybrid bioactive macrolide in Streptomyces venezuelae

Tylosin polyketide synthase (Tyl PKS) was heterologously expressed in an engineered strain of Streptomyces venezuelae bearing a deletion of pikromycin PKS gene cluster using two compatible low-copy plasmids, each under the control of a pikAI promoter. The mutant strain produced 0.5 mg/l of the 16-membered ring macrolactone, tylactone, after a 4-day culture, which is a considerably reduced culture period to reach the maximum production level compared to other Streptomyces hosts. To improve the production level of tylactone, several precursors for ethylmalonyl-CoA were fed to the growing medium, leading to a 2.8-fold improvement (1.4 mg/ml); however, switching the pikAI promoter to an actI promoter had no observable effect. In addition, a small amount of desosamine-glycosylated tylactone was detected from the extract of the mutant strain, revealing that the native glycosyltransferase DesVII displayed relaxed substrate specificity in accepting the 16-membered ring macrolactone to produce the glycosylated tylactone. These results demonstrate a successful attempt for a heterologous expression of Tyl PKS in S. venezuelae and introduce S. venezuelae as a rapid heterologous expression system for the production of secondary metabolites.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45861/1/253_2006_Article_318.pd

Effect of a Combination of Dutasteride and Parenteral Testosterone Undecanoate on Testosterone Deficiency Symptoms and Prostate in Patients with Testosterone Efficiency and Benign Prostatic Hyperplasia

Background and objective The effect of a combination of testosterone and 5-Alpha reductase inhibitors (5-ARIs) on serum tes-tosterone levels, TD symptoms, and the prostate are not sufficiently established. Therefore, we exam-ined the effects of long-acting parenteral testosterone undecanoate (TU) and dutasteride used in combination for the treatment of BPH patients with TD. Subjects and methods We selected 130 patients with a prostate volume (PV) > 30 g from those diagnosed with TD and had received parenteral TU for 1 year. These patients were assigned to the following two groups: Group I, which comprised patients who received TU injections along with dutasteride, and Group II, which included patients with TU-only treatment. Statistical analyses were performed between the two groups to compare the results of serological tests, symptom questionnaire scores, and PV. Results No significant differences were observed in the baseline characteristics such as mean age, comorbidi-ties, testosterone levels, symptom questionnaire scores between the two groups. There were no signifi-cant differences in the testosterone levels or the change in testosterone levels after treatment between the two groups. The PV was significantly increased in Group II and significantly decreased in Group I. Both groups showed a significant increase in the total scores and all subscale scores of the IIEF and AMS after treatment. Group II had a significantly higher total IIEF score than Group I and a signifi-cantly lower score in the sexual function subscale of the AMS after treatment. Conclusions The combination of TU and dutasteride considerably improved serum testosterone levels, alleviated TD symptoms, and effectively reduced PV in patients with TD and BPH. However, compared with the TU-only treatment, the combination was less effective in improving symptoms related to sexual func-tion. Therefore, dutasteride should be used with caution when treating BPH patients with TD, who mainly complain of sexual dysfunction

Analysis of obstacles to lowering demurrage at grain terminals in South Korea

This study aimed to analyze the obstacles to lowering demurrage at a grain terminal. After conducting in-depth interviews with working-level staff in grain terminal, 12 factors were selected to derive key factors for reducing demurrage. The Consistent Fuzzy Preference Relations methodology, which can extract experts’ knowledge and experiences, was employed to rank the obstacles in lowering demurrage. The analysis showed that the number one factor was “inventory requirements of grain shippers” (with an importance of 0.097), followed by “capacity of storage facilities” and “port congestion” as the second and third factors, respectively. As for sub-factors, “climate (e.g., typhoon, rain, etc.)” and “ship size” were ranked 11th and 12th, respectively. The analysis indicates that experts recognized factors that can be changed by shippers and that are difficult to control as more important obstacles than cost-related factors. The findings of this study provide the working-staff of ports, grain terminals, and the government implications for reducing demurrage

Which Exercise Is Better for Increasing Serum Testosterone Levels in Patients with Erectile Dysfunction?

Purpose: We investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency. Materials and Methods: Eighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels. Results: The subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels. Conclusions: Serum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise

The combined use of anti-peptic agents is associated with an increased risk of osteoporotic fracture: a nationwide case-control study

Background/Aims Long-term use of acid suppressants such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonist (H2RA) has been associated with the risk of osteoporotic fracture. Acid suppressants and muco-protective agents (MPAs) are often used together as anti-ulcer agents. We evaluated the association between the risk of osteoporotic fracture and the combined use of these anti-peptic agents. Methods A population-based case-control study was conducted by analyzing the Korean National Health Insurance Data from 2014 to 2020. Patients who had been prescribed anti-peptic agents, such as PPI, H2RA, or MPA, were included. Considering the incidence of osteoporotic fractures, the case group (n = 14,704) and control group (n = 58,816) were classified by 1:4 matching based on age and sex. Results The use of all types of anti-peptic agents was associated with an increased risk of osteoporotic fractures (PPI: hazard ratio [HR], 1.31; H2RA: HR, 1.44; and MPA: HR, 1.33; all p < 0.001). Compared to PPI alone, the combined use of “PPI and H2RA” (HR, 1.58; p = 0.010) as well as “PPI, H2RA, and MPA” (HR, 1.71; p = 0.001) was associated with an increased risk of osteoporotic fracture. However, compared with PPI alone, “MPA and PPI or H2RA” was not associated with an increased risk of osteoporotic fracture. Conclusions This study found that the combined use of “PPI and H2RA” was associated with a higher risk of osteoporotic fractures. In cases where deemed necessary, the physicians may initially consider prescribing the combination use of MPA