Implant selection for successful reverse total shoulder arthroplasty

Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.Level of evidence: IV

Clinical determinants of recurrence in pTa bladder cancer following transurethral resection of bladder tumor

Non-muscle invasive bladder cancer can be controlled by transurethral resection of bladder (TURB), but suffers from frequent recurrences in 60–70% of cases. Although, recurrence interval after TURB influences treatment course and prognosis, its implication and risk factors have not been fully elucidated. We evaluated the risk factors of early (within 1yr) and late (after 1yr) recurrence of pTa bladder cancer and clinical significance of recurrence interval on disease progression and overall survival. In this study, pTa bladder cancer patients enrolled in prospective patient registry system of Seoul National University, SUPER-UC, were retrospectively examined to determine the clinical risk factors for recurrence and its significance regarding to recurrence interval. A total of 1067 bladder cancer patients who underwent TURB between March 20 and June 2021 were included and classified into three groups of no recurrence, early, or late recurrence to be comparatively analyzed. Early recurrence was associated with poorer cystectomy-free survival and overall survival than late recurrence. Risk factors for early recurrence included a high number of previous TURB, tumor multiplicity, tumor location, tumor shape, incompleteness of TURB, and high tumor grade. Otherwise, late recurrence was associated with low-grade tumors with insufficient TURB depth. Patients with risk factors for early recurrence should be closely followed up with special cautions

Session D5: Current Status of Fish Passages in South Korea

Abstract: Weirs are important for countries that agriculture is the primary industry due to the stable supply of water to agricultural fields. Because agriculture is still important in Korean peninsula, weirs have been constructing until now from small streams to large rivers. However, only limited fish passages were installed in weirs, and there were no managements. As a results, streams and rivers have become highly fragmented, with fish migration being severely impeded. Thus, ministry of agriculture, food and rural affairs investigated entire fish passages in Korea in 2010-2011, and estimated current status and problems. A total of 33,718 weirs were installed (until year 2012), and this means that weirs are arithmetically located every 0.81km of the total stream length in Korea. Fish passages, however, were constructed only in 4,496 weirs (13.3% of installation rate). The weir type fish passages with Ice- Harbor type fishways (8.1%) which are favoured nowadays was showed the greatest number (36%), and the vertical slot type passages was in the second place (31%). The denil type and nature-like type were rarely installed. Only 18.1% of installed fish passages were left whole, and urgent repair is needed for 56.7%. Fish passages of 31.3% were incorporated into the recommended slope range of Korea (1:20). Most of problems are related discharge, poor entrance, breakage and sedimentation. With these structural problems, discontinuous installation of fish passages generates poor continuity of streams. Currently, to improve stream connectivity many projects from Korean government are now conducting and preparing, and additionally development of fish passages specialized for Korean fishes are required

Association between decreased ipsilateral renal function and aggressive behavior in renal cell carcinoma

Background To assess prognostic value of pre-operative ipsilateral split renal function (SRF) on disease-free survival (DFS) and its association with aggressive pathological features in renal cell carcinoma (RCC) patients.  Methods We examined patients registered in SNUG-RCC-Nx who underwent partial or radical nephrectomy at Seoul National University Hospital between January 1, 2010 and December 31, 2020. Patients with the following criteria were excluded from the study. 1) non-kidney origin cancer or benign renal tumor, 2) no pre-operative Tc 99 m-DTPA renal scan, 3) single kidney status or previous partial or radical nephrectomy, and 4) bilateral renal mass. Finally, 1,078 patients were included. Results Among 1,078 patients, 899 (83.4%) showed maintained ipsilateral SRF on DTPA renal scan; 179 patients (16.6%) showed decreased SRF. The decreased SRF group showed significantly large tumor size (maintained vs. decreased SRF; 3.31 ± 2.15 vs. 6.85 ± 3.25, p < 0.001), high Fuhrman grade (grade 3–4) (41.7% vs. 55.6%, p < 0.001), and high T stage (T stage 3–4) (9.0% vs. 20.1%, p < 0.001). Pathological invasive features, including invasion of the renal capsule, perirenal fat, renal sinus fat, vein, and collecting duct system, were associated with low SRF of the ipsilateral kidney. Univariate Cox regression analysis identified higher SSIGN (The stage, size, grade, and necrosis) score and decreased ipsilateral SRF as significant risk factors, while multivariate analysis showed SSIGN (5–7) (hazard ratio [HR] 11.9, p < 0.001) and SSIGN (8–10) (HR 69.2, p < 0.001) were significantly associated with shortened DFS, while decreased ipsilateral SRF (HR 1.75, p = 0.065) showed borderline significance. Kaplan–Meier analysis showed that decreased ipsilateral SRF (< 45%) group had shorter DFS than the other group (median DFS: 90.3 months vs. not reached, p < 0.001). Conclusions Among unilateral RCC patients, those with low ipsilateral SRF showed poor prognosis with pathologically invasive features. Our novel approach may facilitate risk stratification in RCC patients, helping formulate a treatment strategy

Role of lymphatic invasion in predicting biochemical recurrence after radical prostatectomy

ObjectiveLymphatic invasion in prostate cancer is associated with poor prognosis. However, there is no consensus regarding the clinical and prognostic value of lymphatic invasion. This study aimed to investigate the prognostic value of lymphatic invasion in biochemical recurrence (BCR) and compare the recurrence rates between patients with lymphatic invasion and lymph node metastasis.MethodsWe retrospectively analyzed 2,207 patients who underwent radical prostatectomy (RP) without pelvic lymph node dissection (PLND) and 742 patients who underwent RP with PLND for clinically localized or locally advanced prostate cancer, between 1993 and 2020, at Seoul National University Hospital. Kaplan–Meier analysis was performed to estimate BCR-free survival (BCRFS) using the log-rank test. The Cox proportional hazards model was used to identify the significant factors for BCR. Propensity score matching was performed with a 1:2 ratio to match age, initial PSA level, pathological T stage, and Gleason score to exclude confounding effects.ResultsOf the 2,207 patients who underwent RP without PLND, lymphatic invasion (L1Nx) was observed in 79 (3.5%) individuals. Among the 742 patients who underwent RP with PLND, lymph node metastases were found in 105 patients (14.2%). In patients with lymph node metastasis, lymphatic invasion was observed in 50 patients (47.6%), whereas lymphatic invasion was observed in 53 patients (8.3%) among those without lymph node metastasis. In patients who underwent RP without PLND, Kaplan–Meier analysis showed significantly poorer BCR-free survival in the L1Nx group than in the L0Nx group (p &lt; 0.001). In patients who underwent RP with PLND, the L1N0, L0N1, and L1N1 groups showed significantly worse prognoses than the L0N0 group (p &lt; 0.001). However, there was no significant difference in BCRFS between the L1N0 and lymph node metastasis groups, including the L0N1 and L1N1 groups. After propensity score matching at a 1:2 ratio, the L1Nx group showed significantly poorer outcomes in terms of BCRFS than the L0Nx group (p = 0.05). In addition, the L1N0 group showed a significantly worse prognosis than the L0N0 group after propensity score matching.ConclusionLymphatic invasion in radical prostatectomy specimens is an independent prognostic factor, which can complement lymph node status for predicting biochemical recurrence. Considering lymphatic invasion as an adverse pathological finding, similar to lymph node metastasis, adjuvant therapy could be considered in patients with lymphatic invasion

Age-dependent resistance of a perennial herb, Aristolochia contorta against specialist and generalist leaf-chewing herbivores

Plants need to balance investments in growth and defense throughout their life to increase their fitness. To optimize fitness, levels of defense against herbivores in perennial plants may vary according to plant age and season. However, secondary plant metabolites often have a detrimental effect on generalist herbivores, while many specialists have developed resistance to them. Therefore, varying levels of defensive secondary metabolites depending on plant age and season may have different effects on the performance of specialist and generalist herbivores colonizing the same host plants. In this study, we analyzed concentrations of defensive secondary metabolites (aristolochic acids) and the nutritional value (C/N ratios) of 1st-, 2nd- and 3rd-year Aristolochia contorta in July (the middle of growing season) and September (the end of growing season). We further assessed their effects on the performances of the specialist herbivore Sericinus montela (Lepidoptera: Papilionidae) and the generalist herbivore Spodoptera exigua (Lepidoptera: Noctuidae). Leaves of 1st-year A. contorta contained significantly higher concentrations of aristolochic acids than those of older plants, with concentrations tending to decrease over the first-year season. Therefore, when first year leaves were fed in July, all larvae of S. exigua died and S. montela showed the lowest growth rate compared to older leaves fed in July. However, the nutritional quality of A. contorta leaves was lower in September than July irrespective of plant age, which was reflected in lower larval performance of both herbivores in September. These results suggest that A. contorta invests in the chemical defenses of leaves especially at a young age, while the low nutritional value of leaves seems to limit the performance of leaf-chewing herbivores at the end of the season, regardless of plant age

Breeding of Sweet Shinhong pepper by Marker-assisted backcrossing (MABC)

Capsinoids is unique compound of pepper, which have similar biological effect to apsaicinoids like anticancer and anti-obesity. However, because the characteristic of capsinoids is non-pungency contrary to capsaicinoids, it has been studied to investigate genetic factor related to biosynthesis of capsinoids and to breed pepper variety producing capsinoids. Two pathway are known to be involved in capsaicinoids synthesis, phenylpropanoid and valine pathway. Capsinoids biosynthesis pathway is common to capsaicinoids, but putative-aminotransferase (pAMT) gene mutation in phenylpropanoid pathway cause capsinoids production instead of capsaicinoids. SNU11-001 which have pAMT gene mutation produce high level of capsinoids and Shinhong is Korean chili pepper. In previous research, pAMT mutation in SNU11-001 have been introgressed to Shinhong to breed novel Shinhong pepper containing high contents of capsinoids by Marker-Assisted Backcrossing (MABC) method. Recessive homozygous pAMT allele was selected by genotyping with KASP marker for foreground selection and 8 to 10 plants which recovered by Shinhong genome highly were selected by Fluidigm high-throughput genotyping analysis. Shinhong C × SNU11-001 (SSHC) BC2F1-40 was selected by MABC with 198 SNP markers and recovery rate was 96.3%. In this study, MABC of SNU11-001 × Shinhong C (SSHC) BC3F1 and SNU11-001 × Shinhong B (SSHB) BC2F1 was proceeded. 202 and 102 markers were used for background selection, respectively. 10 SSHC BC3F1 progenies showed the highest recovery rate, 99.5%. The range of recovery rate in SSHB BC2F1 was 89.6 to 96.7%. SSHC BC2F2 was from self-crossing of SSHC BC2F1-40 and several pamt/pamt plants were selected. We will develop SSHB BC2F2 line which have pAMT mutation allele and high recovery rate of Shinhong B. This SSHB BC2F2 progeny will have cytoplasmic male sterility by being crossed with Shinhong A. Finally we will be able to breed sweet Shinhong F1 hybrid containing high level of capsinoids.OAIID:RECH_ACHV_DSTSH_NO:A201625343RECH_ACHV_FG:RR00200003ADJUST_YN:EMP_ID:A076900CITE_RATE:FILENAME:20161027_원예학회 포스터_장시영(ARC2-1).pdfDEPT_NM:식물생산과학부EMAIL:[email protected]_YN:FILEURL:https://srnd.snu.ac.kr/eXrepEIR/fws/file/e1d431a8-f997-43db-85e2-5ccb8e76020e/linkCONFIRM:

The Effects of Gymnema sylvestre in High-Fat Diet-Induced Metabolic Disorders

This study used an integrated approach to investigate the effects of Gymnema sylvestre (GS) extract as a functional dietary supplement with a high-fat diet. This approach examined insulin resistance, the dysfunction of adipose tissue, and liver steatosis. Male C57BL/6J mice were fed a normal chow or high-fat diet (HFD) for the acute and chronic study, in addition to GS in different doses (100, 250 and 500 mg/kg body weight). Their body composition changes, serum lipid and glucose parameters, adipose and liver tissue histology, and gene expression were measured. It was found that GS significantly suppressed the increase of body weight, serum levels of lipid, insulin and leptin, and adipose tissue, and liver inflammation. GS also demonstrated hypoglycemic effects due to the amylase inhibition activity. Our results support the existence of a relationship between the HFD induced insulin resistance, adipose dysfunction and liver steatosis. In conclusion, GS works as a functional dietary supplement with preventative effects against metabolic disorder.