Immediate Laparoscopic Nontransvesical Repair without Omental Interposition for Vesicovaginal Fistula Developing after Total Abdominal Hysterectomy

Immediate laparoscopic nontransvesical repair for vesicovaginal fistula may be an effective and feasible alternative to traditional repair in select patients

The Korean Mistletoe (Viscum album coloratum) Extract Has an Antiobesity Effect and Protects against Hepatic Steatosis in Mice with High-Fat Diet-Induced Obesity

This study investigates the inhibitory effects of Korean mistletoe extract (KME) on adipogenic factors in 3T3-L1 cells and obesity and nonalcoholic fatty liver disease (NAFLD) in mice fed a high-fat diet. Male C57Bl/6 mice fed a high-fat diet were treated with KME (3 g/kg/day) for 15 weeks for the antiobesity and NAFLD experiments. Body weight and daily food intake were measured regularly during the experimental period. The epididymal pad was measured and liver histology was observed. The effects of KME on thermogenesis and endurance capacity were measured. The effects of KME on adipogenic factors were examined in 3T3-L1 cells. Body and epididymal fat pad weights were reduced in KME-treated mice, and histological examination showed an amelioration of fatty liver in KME-treated mice, without an effect on food consumption. KME potently induces mitochondrial activity by activating thermogenesis and improving endurance capacity. KME also inhibited adipogenic factors in vitro. These results demonstrate the inhibitory effects of KME on obesity and NAFLD in mice fed a high-fat diet. The effects appear to be mediated through an enhanced mitochondrial activity. Therefore, KME may be an effective therapeutic candidate for treating obesity and fatty liver caused by a high-fat diet

Transduction of the MPG-tagged fusion protein into mammalian cells and oocytes depends on amiloride-sensitive endocytic pathway

BACKGROUND: MPG is a cell-permeable peptide with proven efficiency to deliver macromolecular cargoes into cells. In this work, we examined the efficacy of MPG as an N-terminal tag in a fusion protein to deliver a protein cargo and its mechanism of transduction. RESULTS: We examined transduction of MPG-EGFP fusion protein by live imaging, flow cytometry, along with combination of cell biological and pharmacological methods. We show that MPG-EGFP fusion proteins efficiently enter various mammalian cells within a few minutes and are co-localized with FM4-64, a general marker of endosomes. The transduction of MPG-EGFP occurs rapidly and is inhibited at a low temperature. The entry of MPG-EGFP is inhibited by amiloride, but cytochalasin D and methyl-β-cyclodextrin did not inhibit the entry, suggesting that macropinocytosis is not involved in the transduction. Overexpression of a mutant form of dynamin partially reduced the transduction of MPG-EGFP. The partial blockade of MPG-EGFP transduction by a dynamin mutant is abolished by the treatment of amiloride. MPG-EGFP transduction is also observed in the mammalian oocytes. CONCLUSION: The results show that the transduction of MPG fusion protein utilizes endocytic pathway(s) which is amiloride-sensitive and partially dynamin-dependent. Collectively, the MPG fusion protein could be further developed as a novel tool of "protein therapeutics", with potentials to be used in various cell systems including mammalian oocytes

Results of immediate loading for implant restoration in partially edentulous patients: a 6-month preliminary prospective study using SinusQuick™ EB implant system

STATEMENT OF PROBLEM. Many dental clinicians are concerned about immediate loading of inserted implants. However, there have been few clinical studies surveying the success rates of immediate loading, based on Korean implant systems. PURPOSE. The aim of this study was to evaluate the outcome of immediate functional loading of the implant (SinusQuickTM EB, Neobiotech Co., Seoul, Korea) in partially edentulous maxilla or mandible. MATERIAL AND METHODS. Total 15 implants were placed. Within 2 weeks after implant insertion, provisional implant-supported fixed partial dentures were delivered to the patients. Quantitatively, marginal bone loss was measured at the time of immediate loading, after 3-months of continued loading and at the last follow-up. The mean follow-up period was 4.8 months. RESULTS. Mean marginal bone loss from implant surgery to early loading, 3-months follow-up and last follow-up was 0.03 ± 0.07 mm, 0.16 ± 0.17 mm and 0.29 ± 0.19 mm. No implant failed up to 6 months after insertion, resulting in a 100% survival rate. CONCLUSION. Immediate loading exhibited high success rate in partial edentulism for up to 6 months. Well-controlled long term clinical studies with large sample size are necessary to confirm this finding

Absorbable Plate as a Perpendicular Strut for Acute Saddle Nose Deformities

BackgroundNasal pyramid fractures accompanied by saddle nose deformities are not easily corrected by closed reduction. We used an absorbable plate as a perpendicular strut to support the collapsed "keystone area" and obtained good results.MethodsBetween September 2008 and June 2011, 18 patients who had nasal pyramid fractures with saddle nose deformities underwent surgery. Pre- and postoperative facial computed tomographic images and photographs were taken to estimate outcomes. The operative technique included the mucoperichondrial dissection of the nasal septum, insertion of an absorbable plate prepared to an appropriate length to support the "keystone area", and fixation of the absorbable plate strut to the cartilaginous septum.ResultsFunctional and esthetic outcomes were satisfactory in all patients. Eleven patients assessed the postoperative appearance of the external nose as 'markedly improved' and 7 patients as 'improved'. The 5 surgeons scored the results as a mean of 4.5 on a 5-point scale.ConclusionsThe use of an absorbable plate as a perpendicular strut requires no additional procedures because the plate is gradually absorbed. The mechanical strength provided by a buttress between the "keystone area" and the maxillary crest lasts for a long time before the strut is absorbed

Melatonin restores Muc2 depletion induced by V. vulnificus VvpM via melatonin receptor 2 coupling with Gαq

Background Melatonin (5-methoxy-N-acetyltryptamine), a hormone produced in the pineal gland, has a variety of biological functions as an antioxidant, but a functional role of melatonin in the regulation of intestinal mucin (Muc) production during bacterial infection has yet to be described in detail. In this study, we investigate the effects of melatonin during Muc2 repression elicited by the Gram-negative bacterium V. vulnificus. Methods Mucus-secreting human HT29-MTX cells were used to study the functional role of melatonin during Muc2 depletion induced by the recombinant protein (r) VvpM produced by V. vulnificus. The regulatory effects of melatonin coupling with melatonin receptor 2 (MT2) on the production of reactive oxygen species (ROS), the activation of PKCδ and ERK, and the hypermethylation of the Muc2 promoter as induced by rVvpM were examined. Experimental mouse models of V. vulnificus infection were used to study the role of melatonin and how it neutralizes the bacterial toxin activity related to Muc2 repression. Results Recombinant protein (r) VvpM significantly reduced the level of Muc2 in HT29-MTX cells. The repression of Muc2 induced by rVvpM was significantly restored upon a treatment with melatonin (1 μM), which had been inhibited by the knockdown of MT2 coupling with Gαq and the NADPH oxidase subunit p47 phox. Melatonin inhibited the ROS-mediated phosphorylation of PKCδ and ERK responsible for region-specific hypermethylation in the Muc2 promoter in rVvpM-treated HT29-MTX cells. In the mouse models of V. vulnificus infection, treatment with melatonin maintained the level of Muc2 expression in the intestine. In addition, the mutation of the VvpM gene from V. vulnificus exhibited an effect similar to that of melatonin. Conclusions These results demonstrate that melatonin acting on MT2 inhibits the hypermethylation of the Muc2 promoter to restore the level of Muc2 production in intestinal epithelial cells infected with V. vulnificus.This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2016R1D1A1B03930458)

Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

Background We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components. Methods 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image. Results The superoinferior and anteroposterior offset in the glenoid component were 0.42 ± 0.07, 0.50 ± 0.08 in the conventional group and 0.45 ± 0.03, 0.46 ± 0.02 in the PSG group. The inclination and version angles were -1.93° ± 4.31°, 2.27° ± 5.91° and 0.46° ± 0.02°, 3.38° ± 2.79°. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were 0.45 ± 0.12, 0.48 ± 0.15 in the conventional group and 0.46 ± 0.59 (p=0.794), 0.46 ± 0.06 (p=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment. Conclusions The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA

Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis

Background/AimsPatients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.MethodsWe retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×105 polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.ResultsA total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).ConclusionsThe CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia