Prevalence of Neuropathic Pain and Patient-Reported Outcomes in Korean Adults with Chronic Low Back Pain Resulting from Neuropathic Low Back Pain

Study DesignA noninterventional, multicenter, cross-sectional study.PurposeWe investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP).Overview of LiteratureAmong patients with CLBP, 20%–55% had NP.MethodsPatients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4<4) groups.ResultsA total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p<0.01), in patients who had pain based on radiological and neurological findings (59.0%; p<0.01), and in patients who had severe pain (49.0%; p<0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p<0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p<0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p<0.01) and higher QBPDS (β=7.0; p<0.01) scores than those without NP.ConclusionsNP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP

Malignant fibrous histiocytoma arising in the area of total hip replacement

A patient developed a rapidly progressive and extensive periprosthetic osteolysis after a cemented total hip arthroplasty for postradiation necrosis of pelvic bone and femoral head. Malignant tumor is one of the causes of periprosthetic bone loss. The biopsy confirmed the malignant fibrous histiocytoma (MFH). However, majority of periprosthetic bone loss is due to wear debris induced osteolysis. Usually, wear debris induced periprosthetic osteolysis is developed later and the progression is much slower than there of malignant tumor. Also wear debris induced osteolysis is confirmed by chronic inflammation with macrophages containing wear particles. When there is a rapidly progressive and extensive osteolysis a prosthesis following hip replacement arthroplasty, the physician should suspect the possibility of malignant tumor

Glutaredoxin2 isoform b (Glrx2b) promotes RANKL-induced osteoclastogenesis through activation of the p38-MAPK signaling pathway

Receptor activator of NF-κB ligand (RANKL) triggers thedifferentiation of bone marrow-derived monocyte/macrophageprecursor cells (BMMs) of hematopoietic origin into osteoclaststhrough the activation of mitogen-activated protein (MAP) kinasesand transcription factors. Recently, reactive oxygen species (ROS)and antioxidant enzymes were shown to be closely associated withRANKL-mediated osteoclast differentiation. Although glutaredoxin2(Glrx2) plays a role in cellular redox homeostasis, its role inRANKL-mediated osteoclastogenesis is unclear. We found thatGlrx2 isoform b (Glrx2b) expression is induced during RANKLmediatedosteoclastogenesis. Over-expression of Glrx2b stronglyenhanced RANKL- mediated osteoclastogenesis. In addition,Glrx2b-transduced BMMs enhanced the expression of key transcriptionfactors c-Fos and NFATc1, but pre-treatment withSB203580, a p38-specific inhibitor, completely blocked thisenhancement. Conversely, down-regulation of Glrx2b decreasedRANKL- mediated osteoclastogenesis and the expression of c-Fosand NFATc1 proteins. Also, Glrx2b down-regulation attenuated theRANKL-induced activation of p38. Taken together, these resultssuggest that Glrx2b enhances RANKL-induced osteoclastogenesisvia p38 activation. [BMB reports 2012; 45(3): 171-176

Development of PAL-XFEL undulator system

Pohang Accelerator Laboratory (PAL) have developed a 0.1 nm SASE based FEL based on 10 GeV S-band linear accelerator named PAL-XFEL. At the first stage, PAL-XFEL needs two undulator lines for photon source. The hard X-ray undulator line requires 20 units of 5 m long hybrid-type conventional planar undulator and soft X-ray line requires 7 units of 5 m long hybrid type planar undulators. PAL have developed undulator magnetic structure based on EU-XFEL concepts. In this report, the impact of the background field, alignment issues, the results of pole height tuning, and final magnetic measurement results are summarized.111sciescopuskc