Overexpression of CFH gene in pterygiumv patients

Purpose: To investigate the expression of complement factors in pterygium tissues compared to normal conjunctival samples, using next-generation RNA sequencingMethods: Twenty pterygium and 20 healthy conjunctival samples were obtained from 19 patients who consented to pterygium excision and conjunctival autograft surgery. Tissues (pterygium and normal conjunctiva) were analyzed using next-generation RNA sequencing. Significant gene lists were obtained using DAVID, GSEA, and KEGG for enriched pathway analyses of differentially expressed genes. Realtime polymerase chain reaction was performed to validate differential expressions of complement factors.Results: There was 3.15 ± 2.6, 3.21 ± 4.6, 3.03 ± 1.83, 4.28 ± 6.12, and 4.96 ± 1.89-fold increase in the expression of CFH, C2, C1QB, C1QC, and MASP1, respectively, in pterygium samples compared to normal conjunctival samples. Pterygium size correlated well with the expression of CFH, C1QB, C1QC and MASP1.Conclusion: Alternative and lectin complement systems are activated in pterygia samples compared to normal conjunctival samples.Keywords: Pterygium; Complement factor; RNA sequencin

Factors associated with stroke in patients with paroxysmal atrial fibrillation beyond CHADS2 score

Background: This study was conducted to investigate factors associated with stroke in pa­tients with paroxysmal atrial fibrillation (PAF) beyond CHADS2 score in terms of left ventricular (LV) diastolic function or left atrial (LA) function. Methods: One hundred and sixty-one patients with PAF and age less than 75 (mean age 61 ± 10; 69 male) who underwent transthoracic echocardiography were investigated. Patients were divided into two groups according to the stroke status (group 1 — no stroke vs. group 2 — presence of stroke). Baseline echocardiographic parameters and LA segmental (4 segments: basal septal, lateral, inferior, and anterior) strain rate (SR) during normal sinus rhythm were analyzed. Results: CHAD score (except S2) was similar between the two groups (0.6 ± 0.7 vs. 0.9 ± 0.7, p = 0.125). Patients with stroke had slightly lower body mass index (24.5 ± 2.7 vs. 23.4 ± ± 2.4, p = 0.052). Echocardiographic parameters did not show any differences in both systolic and diastolic functions between the two groups, however elevated E/E’ ratio was noted (9.5 ± ± 3.8 vs. 11.6 ± 3.9, p = 0.010) due to higher E velocity (63.5 ± 15.9 vs. 70.9 ± 16.0 cm/s, p = 0.046). In the analysis of LA SR, there are no differences of SR among the 4 segments. However, standard deviations (SD) of time to peak SR (SD of tA-SR) of the 4 segments were higher in patients with stroke (10.9 ± 9.9 vs. 22.1 ± 18.1 ms, p = 0.009) which indicates dyssynchronous contraction of LA. In multivariate analysis, SD of tA-SR (OR 1.074, CI 1.024–1.128, p = 0.004) and elevated E/E’ (OR 1.189, CI 1.006–1.406, p = 0.048) were independently associated with stroke in patients with PAF. Conclusions: Elevated E velocity, E/E’ and SD of tA-SR were associated with occurrence of stroke in patients with PAF even with similar CHAD scores. Increased SD of tA-SR and E/E’ were independently associated with stroke in patients with PAF.

Primary Squamous Cell Carcinoma in the Testis: A Case Report

A 51-yr-old man presented with an enlarged right testis for two months. The radically resected testis showed a relatively well-circumscribed ovoid mass, nearly replacing the normal architecture with central cystic changes. Microscopically, the mass was composed of ovoid shaped tumor cells of a moderately differentiated squamous cell carcinoma (SCC). The central portion of the mass was filled with well-formed laminated keratinous materials and the remnant cavity lined by dysplastic squamous epithelium, indicated SCC may be derived from an epidermal cyst. SCC is among the most common types of neoplasm afflicting human beings, but it is rare in the testis. To our knowledge, this is the second report of the testicular squamous cell carcinoma occurring in a patient without other primary tumors, and the firstly reported case in Korea

Improved blastocyst development of single cow OPU-derived presumptive zygotes by group culture with agarose-embedded helper embryos

<p>Abstract</p> <p>Background</p> <p>The <it>in vitro </it>culture of presumed zygotes derived from single cow ovum pick-up (OPU) is important for the production of quality blastocysts maintaining pedigree. The aim of the present study was to evaluate the agar chip-embedded helper embryo coculture system for single cow OPU-derived zygotes by assessing embryo quality.</p> <p>Methods</p> <p>Cumulus oocyte complexes (COCs) were collected from Hanwoo cows with high genetic merit twice a week using the ultra-sound guided OPU technique and from slaughterhouse ovaries. The Hanwoo cow COCs and slaughterhouse ovaries were matured <it>in vitro</it>, fertilized <it>in vitro </it>with thawed Hanwoo sperm and cultured for 24 h. The presumed zygotes were subsequently placed in three different culture systems: (1) control OPU (controlOPU) with single cow OPU-derived presumed zygotes (2~8); (2) agar chip-embedded slaughterhouse helper embryo coculture (agarOPU) with ten presumed zygotes including all presumed zygotes from a cow (2~8) and the rest from agar chip-embedded slaughterhouse presumed zygotes (8~2); and (3) slaughterhouse <it>in vitro </it>embryo production (sIVP) with ten slaughterhouse ovary-derived presumed zygotes, each in 50 μL droplets. Day 8 blastocysts were assayed for apoptosis and gene expression using real time PCR.</p> <p>Results</p> <p>The coculture system promoted higher blastocyst development in OPU zygotes compared to control OPU zygotes cultured alone (35.2 vs. 13.9%; P < 0.01). Genes predicted to be involved in implantation failure and/or embryo resorption were down-regulated (P < 0.05) in control OPU zygotes (<it>CD9</it>, 0.4-fold; <it>AKRAB</it>1, 0.3-fold) and in cocultured zygotes (<it>CD9</it>, 0.3-fold; <it>AKRAB</it>1, 0.3-fold) compared to sIVP blastocysts (1.0-fold). Moreover, genes involved in implantation and/or normal calf delivery were up-regulated (P < 0.05 to P < 0.01) in control OPU zygotes (<it>PGSH</it>2, 5.0-fold; <it>TXN</it>, 4.3-fold; <it>PLAU</it>, 1.7-fold) and cocultured zygotes (<it>PGSH</it>2, 14.5-fold; <it>TXN</it>, 3.2-fold; <it>PLAU</it>, 6.8-fold) compared to sIVP (1.0-fold) blastocysts. However, the expression of <it>PLAC8, TGF-β1, ODC1</it>, <it>ATP5A1 </it>and <it>CASP3 </it>did not differ between the three culture groups.</p> <p>Conclusions</p> <p>Results show that the agar chip-embedded helper embryo coculture system enhances developmental competence and embryo quality in cultures of limited numbers of high pedigree single cow OPU presumed zygotes.</p

The Effectiveness of Budesonide Nasal Irrigation After Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Asthma

Objectives Budesonide nasal irrigation was introduced recently for postoperative management of patients with chronic rhinosinusitis. The safety and therapeutic effectiveness of this procedure is becoming accepted by many physicians. The objective of this study was to evaluate the efficacy of postoperative steroid irrigation in patients with chronic rhinosinusitis and asthma. Methods This prospective study involved 12 chronic rhinosinusitis patients with nasal polyps and asthma who received oral steroid treatment for recurring or worsening disease. The 22-item Sinonasal Outcomes Test (SNOT-22) and Lund-Kennedy endoscopy scores were checked before nasal budesonide irrigation, and 1, 2, 4, and 6 months after irrigation. We also calculated the total amount of oral steroids and inhaled steroids in the 6 months before irrigation and the 6 months after it. Results The mean SNOT-22 score improved from 30.8±14.4 before irrigation to 14.2±8.7 after 6 months of irrigation (P=0.030). The endoscopy score also improved from 7.4±4.7 before irrigation to 2.2±2.7 after 6 months (P<0.001). The total amount of oral steroid was decreased from 397.8±97.6 mg over the 6 months before irrigation to 72.7±99.7 mg over the 6 months after irrigation (P<0.001). Conclusion Nasal irrigation with budesonide is an effective postoperative treatment for chronic rhinosinusitis with asthma, which recurs frequently, reducing the oral steroid intake

Subthalamic deep brain stimulation in Parkinson's disease with SNCA mutations: Based on the follow-up to 10 years

Backgrounds: Although the short-term efficacy of bilateral subthalamic deep brain stimulation (DBS) has been reported in a limited number of Parkinson's disease (PD) patients with SNCA mutations, there are no data for long-term outcome. Methods: This multicenter retrospective study investigated previously reported PD patients with SNCA mutations, implanted with bilateral subthalamic DBS. We compared demographic and clinical data at baseline and last follow-up. Clinical data of motor and nonmotor symptoms and motor fluctuation were collected up to 10 years from DBS surgery. Results: Among four subjects, three had SNCA duplication and one had c.158C.A (p.A53E) mutation. The mean post-implantation follow-up duration was 5.4 +/- 3.7 years. All patients with SNCA duplication showed favorable outcome, although one died from breast cancer 1.5 years after DBS. The patient with the missense mutation became wheelchair-bound due to progressed axial, cognitive and psychiatric symptoms after 3.5 years from DBS despite the benefit on motor fluctuation. Conclusion: Based on findings in our small cohort, subthalamic DBS could be beneficial for motor fluctuation in PD patients with SNCA mutations, especially those with SNCA duplication, and cognitive and psychiatric symptoms are important for the long-term outcome of subthalamic DBS.</p

A Case of Pulmonary Vein Tumor Presenting as a Left Atrial Mass

Primary cardiac tumors are extremely rare and can originate within the heart or be the result of tumor spread from other sites. We report a female patient with a pulmonary vein tumor extending into the left atrium that had a suspicious primary malignant origin with a sacral metastatic carcinoma. The patient was admitted complaining of pain in her buttock area as a result of a sacral tumor. It was believed that the sacral tumor was a metastasis from the imaging study and clinical manifestation. The primary malignant origin was evaluated. The chest CT showed a left atrium thrombus-like lesion without a pulmonary abnormality. After a transesophageal echocardiogram, the patient was diagnosed with a pulmonary vein tumor extending to the left atrium. The patient was given palliative radiotherapy for the sacral pain. Initially, the clinical impression was a metastatic sacral tumor with a thromboembolism of the left atrium. However, this patient was finally diagnosed with a pulmonary vein tumor with a left atrium extension by a transesophageal echocardiogram