Solution structures of RseA and its complex with RseB

Conformational changes of RseA and RseB were observed by circular dichroism and small-angle X-ray scattering upon the formation of their complex

Full-endoscopic Foraminotomy in Degenerative Spondylolisthesis: A “Module-based” Approach for Surgical Planning and Execution

Objective Degenerative Lumbar Spondylolisthesis (DSL) is a common spinal pathology characterized by the anterior slippage of one vertebral body on another. DSL is caused mainly by degeneration of the intervertebral disc in the first place, with subsequent degeneration of the facet joints that end causing the slippage. As the disease evolves, stability is restored as a result of advanced degeneration and disc collapse. But while this natural evolution takes place, DSL may produce radicular symptoms by different mechanisms. To present a “module-based” approach for the surgical planning and execution of full-endoscopic foraminotomy in DSL, combined with case examples of the most common surgical scenarios. Methods We propose a “module-based surgery” using the standard endoscopic foraminotomy technique as a baseline. According to the patient’s clinical and imaging characteristics, several “modules” can be added. The resulting endoscopic surgery is a summation of the basic endoscopic foraminotomy plus all the additional required modules. Results Surgical modules description and case examples are provided. Conclusion Transforaminal lumbar endoscopic foraminotomy represents a minimally invasive technique to treat foraminal and combined foraminal-lateral recess stenosis. DSL and its multiple scenarios represent a challenge to the endoscopic surgeon. Module-based approach can help systematize and execute these demanding endoscopic procedures

An Arrhythmia Classification-Guided Segmentation Model for Electrocardiogram Delineation

Accurate delineation of key waveforms in an ECG is a critical initial step in extracting relevant features to support the diagnosis and treatment of heart conditions. Although deep learning based methods using a segmentation model to locate P, QRS and T waves have shown promising results, their ability to handle signals exhibiting arrhythmia remains unclear. In this study, we propose a novel approach that leverages a deep learning model to accurately delineate signals with a wide range of arrhythmia. Our approach involves training a segmentation model using a hybrid loss function that combines segmentation with the task of arrhythmia classification. In addition, we use a diverse training set containing various arrhythmia types, enabling our model to handle a wide range of challenging cases. Experimental results show that our model accurately delineates signals with a broad range of abnormal rhythm types, and the combined training with classification guidance can effectively reduce false positive P wave predictions, particularly during atrial fibrillation and atrial flutter. Furthermore, our proposed method shows competitive performance with previous delineation algorithms on the Lobachevsky University Database (LUDB)

Comparison of short-term clinical outcomes between Resolute Onyx zotarolimus-eluting stents and everolimus-eluting stent in patients with acute myocardial infarction: Results from the Korea Acute Myocardial infarction Registry (KAMIR)

Background: There are few studies which compare the efficacy and safety of the Resolute Onyx zotarolimus-eluting stent (O-ZES) and everolimus-eluting stent (EES) in patients with acute myocardial infarction (AMI). Therefore, the present study aimed to compare clinical outcomes of O-ZES and EES in patients with AMI undergoing successful percutaneous coronary intervention (PCI). Methods: From January 2016 to December 2016, the Korea Acute Myocardial Infarction Registry (KAMIR) enrolled 3,364 consecutive patients. Among them, O-ZES was used in 402 patients and EES was used in 1,084 patients. The primary endpoint was target lesion failure (TLF), as defined by composite of cardiac death, target vessel myocardial infarction (TV-MI), and ischemic driven-target lesion revascularization (ID-TLR) at 6 month clinical follow-up. Results: At 6 months, the incidence of TLF was not significantly different between O-ZES and EES group (4.0% vs. 3.9%, adjusted hazard ratio [HR] 1.17, 95% confidential interval [CI] 0.58–2.35, p = 0.665). O-ZES also showed similar results of cardiac death (3.7% vs. 3.4%, adjusted HR 1.25, 95% CI 0.59–2.63, p = 0.560), TV-MI (0.2% vs. 0.6%, adjusted HR 0.56, 95% CI 0.07–4.85, p = 0.600), ID-TLR (0.0% vs. 0.3%, p = 0.524), and definite or probable stent thrombosis (0.2% vs. 0.3%, adjusted HR 0.63, 95% CI 0.06–6.41, p = 0.696) when compared with EES. Conclusions: The present study shows that implantation of O-ZES or EES provided similar clinical outcomes with similar risk at 6-month of TLF and definite/probable ST in patients with AMI undergoing successful PCI

Molecular basis for SMC rod formation and its dissolution upon DNA binding.

SMC condensin complexes are central modulators of chromosome superstructure in all branches of life. Their SMC subunits form a long intramolecular coiled coil, which connects a constitutive "hinge" dimerization domain with an ATP-regulated "head" dimerization module. Here, we address the structural arrangement of the long coiled coils in SMC complexes. We unequivocally show that prokaryotic Smc-ScpAB, eukaryotic condensin, and possibly also cohesin form rod-like structures, with their coiled coils being closely juxtaposed and accurately anchored to the hinge. Upon ATP-induced binding of DNA to the hinge, however, Smc switches to a more open configuration. Our data suggest that a long-distance structural transition is transmitted from the Smc head domains to regulate Smc-ScpAB's association with DNA. These findings uncover a conserved architectural theme in SMC complexes, provide a mechanistic basis for Smc's dynamic engagement with chromosomes, and offer a molecular explanation for defects in Cornelia de Lange syndrome

A wide variation of the quality of colonoscopy reporting system in the real clinical practice in southeastern area of Korea

Background/AimsEstablishment of a colonoscopy reporting system is a prerequisite to determining and improving quality. This study aimed to investigate colonoscopists' opinions and the actual situation of a colonoscopy reporting system in a clinical practice in southeastern area of Korea and to assess the factors predictive of an inadequate reporting system.MethodsPhysicians who performed colonoscopies in the Daegu-Gyeongbuk province of Korea and were registered with the Korean Society of Gastrointestinal Endoscopy (KSGE) were interviewed via mail about colonoscopy reporting systems using a standardized questionnaire.ResultsOf 181 endoscopists invited to participate, 125 responded to the questionnaires (response rate, 69%). Most responders were internists (105/125, 84%) and worked in primary clinics (88/125, 70.4%). Seventy-one specialists (56.8%) held board certifications for endoscopy from the KSGE. A median of 20 colonoscopies (interquartile range, 10–47) was performed per month. Although 88.8% of responders agreed that a colonoscopy reporting system is necessary, only 18.4% (23/125) had achieved the optimal reporting system level recommended by the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. One-third of endoscopists replied that they did not use a reporting document for the main reasons of "too busy" and "inconvenience." Non-endoscopy specialists and primary care centers were independent predictive factors for failure to use a colonoscopy reporting system.ConclusionsThe quality of colonoscopy reporting systems varies widely and is considerably suboptimal in actual clinical practice settings in southeastern Korea, indicating considerable room for quality improvements in this field