Arterial oxygen desaturation rate following obstructive apnea in parturients.

This study was attempted to observe the rate of oxygen desaturation after full oxygenation in six parturients scheduled for Cesarean sections and six patients scheduled for transabdominal hysterectomies. We calculated the mean rate of fall of arterial saturation (slope of desaturation: less than SaO2 (t2)-SaO2(t1) greater than/t2-t1) and changes in arterial blood gases were observed. All subjects were denitrogenated then a single isolated apnea was carried out. The mean time to obtain 90% saturation was longer in the nonpregnant group (7.5 min vs 3.6 min in parturients). The mean slope of desaturation was steeper in the parturients (-3.34) than the nonpregnant group (-1.52). As far as the oxygen reserve is concerned, the parturients had a lesser margin of safety than the nonpregnant women. It was concluded that the lower the thoracic gas volume (parturients), the lower the alveolar O2 stores and, the more rapidly these stores are depleted.     

Effect of the lower molecular capsule released from the cell surface of Bacillus anthracis on the pathogenesis of anthrax

Bacillus anthracis enters the body as an endospore, and encapsulation and toxin production occur after germination. Capsule is proposed to be an antiphagocytic factor, and toxin induces cytokine production for systemic shock. The dep gene, adjacent to the cap region for the encapsulation, degrades the high-molecular weight capsule (H-capsule) to the lower-molecular weight capsule (L-capsule), which releases into the culture supernatant. This study analyzed the biological function of the cap-dep region. The dep null mutant Sm-1, which formed H-capsule but not L-capsule, was avirulent. However, Sm-1 with an intact dep gene or with purified L-capsule recovered its pathogenicity. Sm-1 was subjected to phagocytosis by macrophages more easily than its parent strain, Sm, in vitro; in vivo, it cleared without L-capsule and grew well with L-capsule, which suggests that L-capsule is essential for in vivo multiplication. Moreover, a new name, capD, might be appropriate, because of the part of the cap operon involved in both polymerization and depolymerization of the capsule.     

Isolated relative afferent pupillary defect secondary to contralateral midbrain compression

BACKGROUND: Relative afferent pupillary defects are typically related to ipsilateral lesions within the anterior visual pathways. OBJECTIVE: To describe a patient who had a workup for headache and was found to have an isolated left relative afferent pupillary defect without any other neurological findings. DESIGN: We review the neuroanatomy of the pupillary light reflex pathway and emphasize the nasotemporal bias of decussating fiber projections, which accounts for the relative afferent pupillary defect contralateral to the described lesion.Result Magnetic resonance imaging of the brain revealed a pineal tumor compressing the right rostral midbrain. CONCLUSION: While rare, a relative afferent pupillary defect can occasionally occur secondary to lesions in the postchiasmal pathways. In these circumstances, the pupillary defect will be observed to be contralateral to the side of the lesion.     

Application of a channel biosensor for toxicity measurements in cultured Alexandrium tamarense

The purpose of this study is to examine the toxicity of Alexandrium tamarense strains using a channel biosensor. With this biosensor, we were able to measure very small quantities of PSP toxin contained within an individual plankton cell. However, measurement of at least 100 cells is more desirable for increasing the sensitivity of the assay. Therefore, in the near future, the proposed biosensor system may be used for monitoring the STX (saxitoxin) produced by a few naturally toxic phytoplankton, and also measuring small amounts of toxin in shellfish.     

Nerve ultrasound in electrophysiologically verified tarsal tunnel syndrome

Introduction: Tarsal tunnel syndrome (TTS) arises from tibial nerve damage under the flexor retinaculum of the fibro‐osseus tunnel at the medial malleolus. It is notoriously difficult to diagnose, as many other foot pathologies result in a similar clinical picture. We examined the additional value of nerve ultrasound in patients with tarsal tunnel syndrome confirmed by nerve conduction. Methods: We performed a retrospective analysis of nerve ultrasound changes in electrophysiologically confirmed TTS spanning our records from 2007 to 2015. Results: Nine feet with TTS were identified, all of which showed abnormal nerve ultrasound findings, which in 6 feet, led to identification of the underlying cause. Conclusions: This study shows that nerve ultrasound is abnormal in all cases of electrophysiologically verified TTS. The pattern of nerve abnormality is varied. This, and the fact that in the majority of patients causation was identified, suggests nerve ultrasound should form part of standard work‐up for TTS. Muscle Nerve 53 : 906–912, 2016     

Clinical Features of Breast Cancer in South Korean Patients with Germline TP53 Gene Mutations

PurposeLi-Fraumeni syndrome (LFS) is a rare autosomal cancer syndrome caused by a germline mutation in the TP53 gene. Breast cancer in LFS patients is of various subtypes; however, limited data are available on the clinicopathological features of these subtypes and their appropriate treatments. This study aimed to review the clinical features and treatments for breast cancer in South Korean patients with germline TP53 mutations.MethodsData on the clinicopathological features and treatment of all breast cancer patients with LFS were collected retrospectively from the available database of 4 tertiary hospitals in the Republic of Korea.ResultsTwenty-one breast cancer cases in 12 unrelated women with confirmed germline TP53 mutations were included in the study. The median age at diagnosis was 33.5 years. The histopathological diagnosis included invasive ductal carcinoma (n = 16), ductal carcinoma in situ (n = 3), and malignant phyllodes tumor (n = 2). While 42% and 31% of the cases were positive for estrogen and progesterone receptors, respectively, 52.6% were human epidermal growth factor receptor 2 (HER2) positive, and 21% were triple-negative. The treatments included mastectomy (52%) and breast-conserving surgery (38%). Five patients underwent radiotherapy (RT). The median follow-up period was 87.5 (8–222) months. There were 3 ipsilateral and 4 contralateral breast recurrences during the follow-up, and 8 patients developed new primary cancers. In the post-RT subgroup, there were 2 ipsilateral and 2 contralateral breast recurrences in 1 patient, and 4 patients had a new primary cancer.ConclusionAs reported in other countries, breast cancer in LFS patients in South Korea had an early onset and were predominantly but not exclusively positive for HER2. A multidisciplinary approach with adherence to the treatment guidelines, considering mastectomy, and avoiding RT is encouraged to prevent RT-associated sequelae in LFS patients.     

Live birth from vitrified–warmed human oocytes fertilized with frozen–thawed testicular spermatozoa

A couple with male infertility due to non-obstructive azoospermia were referred to the fertility centre for treatment. Testicular biopsy was performed on the male partner and testicular samples were frozen. The female partner underwent ovarian stimulation and 31 mature oocytes were recovered by ultrasound-guided vaginal aspiration. Twelve oocytes were cryopreserved by the Cryotop vitrification method and 19 oocytes were inseminated by intracytoplasmic sperm injection (ICSI) using frozen–thawed testicular spermatozoa. Nine out of 19 oocytes were fertilized and the resulting embryos were cryopreserved by slow freezing. Four months later, two out of six thawed embryos were transferred, but no pregnancy resulted. One year later, the couple decided to attempt pregnancy using vitrified oocytes and frozen testicular spermatozoa. Six vitrified–warmed oocytes were injected with frozen–thawed testicular spermatozoa and four were fertilized. On the day of transfer, two cleavage stage embryos (4-cell, 2-cell) were obtained. Serum β-HCG test 14 days after embryo transfer was positive. Hormonal support for the established pregnancy was maintained with oestradiol and progesterone orally until 12 weeks of gestation. A healthy baby boy weighing 3.09 kg was delivered by elective Caesarean section at 38 weeks of gestation. This case report demonstrates that oocyte cryopreservation by the Cryotop vitrification method does not compromise oocyte developmental competence.     

Effect of dissolved organic matter on the growth of algae, Pseudokirchneriella subcapitata, in Korean lakes: the importance of complexation reactions

The objective of this study was to investigate the effect of dissolved organic ligands, such as EDTA, humic acids, hydrophobic and hydrophilic fractions of dissolved organic matter (DOM), on the growth of Pseudokirchneriella subcapitata in cultured media and natural lake waters. The growth of algae was gradually increased on the addition of dissolved organic ligands, but markedly declined at high concentrations, due to reduced bioavailable iron concentrations (e.g., Fe3+ and Fe'--inorganic ferric iron). The results demonstrated that the high growth rates of P. subcapitata were correlated with the hydrophobic, but not hydrophilic, DOM from five lakes, spiked under the nutrients-controlled conditions. This was attributed to the role of DOM in controlling the bioavailable iron due to complexation of Fe(III) with -COOH and -OH functional groups on the hydrophobic DOM. Therefore, the hydrophobic DOM, as chelating agent, is a biologically important component in the lake waters, which affects the algal growth by interacting with bioavailable iron in the lake water and can change the results of bioassay experiments.     

Elimination of lymphatic filariasis in the Republic of Korea: an epidemiological survey of formerly endemic areas, 2002–2006

Objectives  To determine the current status of lymphatic filariasis (LF) in Korea.
Methods  Epidemiological surveys between 2002 and 2006 in areas where LF was previously endemic: remote and coastal areas Jeollanam-do, Gyeongsangnam-do, and Jeju-do, and inland Gyeongsangbuk-do. We took night blood smears from 9426 people for microfilaria testing and assayed samples from 3049 children (10- to 13-year-olds) and 1526 adults for Brugia malayi antibodies.
Results  We found two cases (0.01%) with low microfilaria density in their peripheral blood (1–2/20 μl) on the remote island of Jeollanam-do in the southern part of the Korean peninsula. These patients, males over 60-years old, were treated with diethylcarbamazine (DEC). None of the 4575 people surveyed tested positive for specific B. malayi antibodies.
Conclusion  Lymphatic filariasis appears to have been eliminated in Korea.