Clinical characteristics and treatment modalities of vulvovaginal atrophy in genitourinary syndrome of menopause

Background: Genitourinary syndrome of menopause (GSM) causes symptoms such as vaginal dryness, dysuria, repetitive urinary tract infection and urinary urgency may affect daily activities, sexual relationships, and overall quality of life. The aim of the study was to provide the clinical characteristics of VVA patients in South Korea and the effectiveness as well as complications of the currently used low dose estrogen vaginal suppository.Methods: 52 women who has visited the outpatient gynecology clinic of the National Health Insurance Service Ilsan Hospital from January 2018 to December 2019 were recruited as study subjects. For the analysis of the clinical characteristics, subjective symptoms described by the patient’s own words such as vaginal dryness, pain, dysuria, dyspareunia, or no symptoms at all were included. Objective signs such as thinning of vaginal rugae, mucosal dryness, and mucosal fragility and the presence of petechiae were recorded.Results: Vaginal dryness was the most common complaint (92.3%). Thinning of the vaginal rugae was the most commonly noted objective sign (73.1%). Of the 52 subjects, 31 (59.6%) refrained from using the low dose estrogen vaginal suppository. The most common reason for not being able to use the suppository was the inability to insert the suppository (32.3%).Conclusions: Although patient-reported symptoms and clinical objectivity through physical examination are two components in diagnosing VVA, further study is warranted for a more objective and discriminatory diagnosis criteria for VVA. As the only available treatment modality was low dose vaginal estrogen suppository, comparison with other treatment modalities were not available

Survival and reproductive outcome of childbearing age ovarian cancer patients taking fertility-sparing surgery

Background: Surgical management of ovarian cancer includes total hysterectomy and bilateral salpingo-oophorectomy which results in the loss of fertility. Fertility-sparing surgery in the reproductive aged women with early-stage ovarian cancer with favourable histology has been proposed by American College of Obstetrics and Gynecology and European Society for Medical Oncology. We sought to access the survival and fertility outcome of Korean women in their reproductive age who undertook fertility-sparing surgery.Methods: Based on the Korean National Insurance Claims Data and the National Health Information Database, 328 women with newly developed ovarian cancer in 2010 were followed up for the survival and pregnancy outcome until 2020. Patients who were diagnosed with cancer or underwent hysterectomy before 2010 were excluded. The control group consisted of 552 women matched by age, economic status and place of living.Results: Out of 120, 10 deaths occurred in the fertility-sparing surgery group showing a survival rate of 91.7%. Women undertaking fertility-sparing surgery had a lower chance of delivering a new-born compared to the control group (OR 0.46; 95% CI 0.26-0.81). Diagnosis of infertility, ectopic pregnancy, and abortion appeared higher in the fertility-sparing surgery group, but it did not reach a statistical significance.Conclusions: The pregnancy rate of the ovarian cancer patients with fertility-sparing surgery was lower than that of women without ovarian cancer. Undergoing fertility-sparing surgery per se should not deter women of trying to get pregnant as the pregnancy outcome indicators do not show statistically significant differences compared to the control group

A comparative study on experimental and simulation responses of CR-39 to neutron spectra from a 252Cf source

A simulation of the interaction of neutrons emitted from a 252Cf source with a CR-39 detector is presented in this paper. Elastic and inelastic neutron interactions occur with the constituent materials of the CR-39 detector. Inelastic scatterings only consider (n, a) and (n, p) reactions. Fast neutrons tracks are, mainly, produced by recoil particle tracks in the plastic nuclear track detector as a result of the elastic scattering reaction of neutrons with the constituent materials of the solid-state nuclear track detectors, especially hydrogen nuclei. The energy of the neutron, incident position, direction, and type of interaction were sampled by the Monte Carlo method. The energy threshold, critical angle and scattering angle to the detector surface normal were the most important factors considered in our calculations. The energy deposited per neutron mass unit was calculated. The angular response was determined by both Monte Carlo simulation and experimental results. The number of visible proton tracks and energy deposited per neutron per visible track were calculated and simulated. The threshold energy of the recoil proton as a function of the thickness and incident proton angles was measured by the etchable range of protons at scattering angles, along with the shape and diameter of the track. Experimental and simulations result were in good agreement

A case of anemia caused by combined vitamin B12 and iron deficiency manifesting as short stature and delayed puberty

Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe anemia with a hemoglobin level of 3.3 g/dL. He had a history of small bowel resection from 50 cm below the Treitz ligament to 5 cm above the ileocecal valve necessitated by midgut volvulus in the neonatal period. Laboratory tests showed deficiencies of both vitamin B12 and iron. A bone marrow examination revealed dyserythropoiesis and low levels of hemosiderin particles, and a cytogenetic study disclosed a normal karyotype. After treatment with parenteral vitamin B12 and elemental iron, both anemia and growth showed gradual improvement. This is a rare case that presented with short stature and delayed puberty caused by nutritional deficiency anemia in Korea

Solubility enhancement of aggregation-prone heterologous proteins by fusion expression using stress-responsive Escherichia coli protein, RpoS

<p>Abstract</p> <p>Background</p> <p>The most efficient method for enhancing solubility of recombinant proteins appears to use the fusion expression partners. Although commercial fusion partners including maltose binding protein and glutathione-<it>S</it>-transferase have shown good performance in enhancing the solubility, they cannot be used for the proprietory production of commercially value-added proteins and likely cannot serve as universal helpers to solve all protein solubility and folding issues. Thus, novel fusion partners will continue to be developed through systematic investigations including proteome mining presented in this study.</p> <p>Results</p> <p>We analyzed the <it>Escherichia coli </it>proteome response to the exogenous stress of guanidine hydrochloride using 2-dimensional gel electrophoresis and found that RpoS (RNA polymerase sigma factor) was significantly stress responsive. While under the stress condition the total number of soluble proteins decreased by about 7 %, but a 6-fold increase in the level of RpoS was observed, indicating that RpoS is a stress-induced protein. As an N-terminus fusion expression partner, RpoS increased significantly the solubility of many aggregation-prone heterologous proteins in <it>E. coli </it>cytoplasm, indicating that RpoS is a very effective solubility enhancer for the synthesis of many recombinant proteins. RpoS was also well suited for the production of a biologically active fusion mutant of <it>Pseudomonas putida </it>cutinase.</p> <p>Conclusion</p> <p>RpoS is highly effective as a strong solubility enhancer for aggregation-prone heterologous proteins when it is used as a fusion expression partner in an <it>E. coli </it>expression system. The results of these findings may, therefore, be useful in the production of other biologically active industrial enzymes, as successfully demonstrated by cutinase.</p

Breakdown of the interlayer coherence in twisted bilayer graphene

Coherent motion of the electrons in the Bloch states is one of the fundamental concepts of the charge conduction in solid state physics. In layered materials, however, such a condition often breaks down for the interlayer conduction, when the interlayer coupling is significantly reduced by e.g. large interlayer separation. We report that complete suppression of coherent conduction is realized even in an atomic length scale of layer separation in twisted bilayer graphene. The interlayer resistivity of twisted bilayer graphene is much higher than the c-axis resistivity of Bernal-stacked graphite, and exhibits strong dependence on temperature as well as on external electric fields. These results suggest that the graphene layers are significantly decoupled by rotation and incoherent conduction is a main transport channel between the layers of twisted bilayer graphene.Comment: 5 pages, 3 figure

Potential role and mechanism of IFN-gamma inducible protein-10 on receptor activator of nuclear factor kappa-B ligand (RANKL) expression in rheumatoid arthritis

Introduction IFN-gamma inducible protein-10 (CXCL10), a member of the CXC chemokine family, and its receptor CXCR3 contribute to the recruitment of T cells from the blood stream into the inflamed joints and have a crucial role in perpetuating inflammation in rheumatoid arthritis (RA) synovial joints. Recently we showed the role of CXCL10 on receptor activator of nuclear factor kappa-B ligand (RANKL) expression in an animal model of RA and suggested the contribution to osteoclastogenesis. We tested the effects of CXCL10 on the expression of RANKL in RA synoviocytes and T cells, and we investigated which subunit of CXCR3 contributes to RANKL expression by CXCL10. Methods Synoviocytes derived from RA patients were kept in culture for 24 hours in the presence or absence of TNF-α. CXCL10 expression was measured by reverse transcriptase polymerase chain reaction (RT-PCR) of cultured synoviocytes. Expression of RANKL was measured by RT-PCR and western blot in cultured synoviocytes with or without CXCL10 and also measured in Jurkat/Hut 78 T cells and CD4+ T cells in the presence of CXCL10 or dexamethasone. CXCL10 induced RANKL expression in Jurkat T cells was tested upon the pertussis toxin (PTX), an inhibitor of Gi subunit of G protein coupled receptor (GPCR). The synthetic siRNA for Gαi2 was used to knock down gene expression of respective proteins. Results CXCL10 expression in RA synoviocytes was increased by TNF-α. CXCL10 slightly increased RANKL expression in RA synoviocytes, but markedly increased RANKL expression in Jurkat/Hut 78 T cell or CD4+ T cell. CXCL10 augmented the expression of RANKL by 62.6%, and PTX inhibited both basal level of RANKL (from 37.4 ± 16.0 to 18.9 ± 13.0%) and CXCL10-induced RANKL expression in Jurkat T cells (from 100% to 48.6 ± 27.3%). Knock down of Gαi2 by siRNA transfection, which suppressed the basal level of RANKL (from 61.8 ± 17.9% to 31.1 ± 15.9%) and CXCL10-induced RANKL expression (from 100% to 53.1 ± 27.1%) in Jurkat T cells, is consistent with PTX, which inhibited RANKL expression. Conclusions CXCL10 increased RANKL expression in CD4+ T cells and it was mediated by Gαi subunits of CXCR3. These results indicate that CXCL10 may have a potential role in osteoclastogenesis of RA synovial tissue and subsequent joint erosion

Wedging graphite into graphene and graphene-like platelets by dendritic macromolecules

We report in situ &apos;direct&apos; grafting of dendritic macromolecular wedges to the edges of &apos;pristine&apos; graphite. Because of the three-dimensional molecular architectures, the solubility of dendritic macromolecules is profoundly improved compared with that of their linear analogues. As a result, the resultant macromolecular wedge grafted graphite disperses well in common solvents. On the basis of results from wide-angle X-ray diffraction (WAXD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and atomic force microscopy (AFM), HPEK is selectively grafted at the edges of graphite. For the efficient delamination of graphite into graphene and graphene-like platelets, the dendritic macromolecules with numerous polar periphery groups not only acts as macromolecular wedges but provides chemical affinity to solvents.close7

Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

BackgroundPediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies.MethodsFrom January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed.ResultsThe mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months.ConclusionsIn the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered