OBJECTIVES: To compare the diagnostic performance of ultrasound, contrast-enhanced computed tomography (CT) and (18)F-FDG positron emission tomography (PET)/CT for detecting recurrent differentiated thyroid cancer in the neck. METHODS: Twenty patients who had undergone previous surgery for differentiated thyroid cancer (19 papillary carcinomas; 1 medullary carcinoma) and presented with pathologically proven recurrence in the neck were included. All patients had undergone ultrasound, CT and PET/CT in the 2 months before further surgery. In each patient, ultrasound, CT and PET/CT images were retrospectively reviewed to determine the presence of loco-regional recurrence by level-by-level analysis. Imaging results were correlated with the histological evaluation of the neck dissection as a standard of reference. RESULTS: Recurrences were found at 52 out of 110 cervical nodal levels surgically explored. The sensitivity, specificity and accuracy were 69.2 %, 89.7 % and 80.0 % for ultrasound; 63.5 %, 94.8 % and 80.0 % for CT; and 53.8 %, 79.3 % and 67.3 % for PET/CT, respectively. ROC analysis revealed higher diagnostic performance with ultrasound than with PET/CT for detecting recurrent tumour. CONCLUSIONS: Although no significant difference was found among the three techniques, the sensitivity and specificity of ultrasound and CT were higher than those of PET/CT for the evaluation of cervical recurrence in patients with differentiated thyroid cancer. KEY POINTS : • Ultrasound, CT and ( 18 ) F-FDG PET/CT can all detect recurrent thyroid cancer. • Ultrasound and CT have higher sensitivity and specificity. • Ultrasound, CT and ( 18 ) F-FDG PET/CT frequently demonstrated discordant findings.

ABSTRACT: BACKGROUND: Cytokines may be elevated in tumor and normal tissues following irradiation. Cytokine expression in these tissues may predict for toxicity or tumor control. The purpose of this pilot study was to determine the feasibility of measuring local salivary cytokine levels using buccal sponges in patients receiving chemo-radiation for head and neck malignancies. Patients and Methods 11 patients with epithelial malignancies of the head and neck were recruiting to this study. All patients received radiotherapy to the head and neck region with doses ranging between 60 - 67.5 Gy. Chemotherapy was delivered concurrently with radiation in all patients. Salivary samples were obtained from high dose and low dose regions prior to treatment and at three intervals during treatment for assessment of cytokine levels (IL-4, IL-6, IL-8, IL-10, EGF, MCP-1, TNF-alpha, and VEGF). RESULTS: Cytokine levels were detectable in the salivary samples. Salivary cytokine levels of IL-4, IL-6, IL-8, EGF, MCP-1, TNF- alpha , and VEGF were higher in the high dose region compared to the low dose region at all time points (p < 0.05). A trend toward an increase in cytokine levels as radiation dose increased was observed for IL-6, IL-8, MCP-1, and TNF-alpha. CONCLUSION: Assessment of salivary cytokine levels may provide a novel method to follow local cytokine levels during radiotherapy and may provide a mechanism to study cytokine levels in a regional manner.

Hemolytic anemia is recognized as a rare complication of mitral valve replacement or repair. We report on a 44-year-old man with shortness of breath and hemolytic anemia, 23 years after mitral valve replacement (Hall-Kaster), and a 63-year-old woman diagnosed of hemolytic anemia, 4 years after mitral and tricuspid annuloplasty (Tailor ring, An-core ring). Routine 2-dimensional transthoracic echocardiography revealed paravalvular leakage around the prosthesis. Subsequent real-time 3-dimensional (3D)transesophageal echocardiography helped the perceptional appreciation of the leakage and the measuring of the regurgitant orifice area using the anatomically correct plane. Surgical findings of each case fit those of 3D volumetric images.

PURPOSE: The correct position of double-lumen tubes (DLTs) is customarily confirmed after tracheal intubation by bronchoscopy with the patient supine on a headrest. However, displacement of DLTs usually occurs during lateral positioning because of neck extension. This study was undertaken to determine whether displacement of DLTs could be minimized during lateral positioning if DLTs were positioned without a headrest. METHODS: One hundred patients scheduled for thoracic surgery were randomized into two groups (n = 50 each). After tracheal intubation using a headrest, adjustment of DLT position was performed according to group assignment, i.e., either with the headrest in place or without the headrest. Using a bronchoscope, distances from the tracheal opening to the main carina and from the bronchial opening to the left bronchial carina were measured in both the supine and lateral positions. RESULTS: Displacement of DLTs [mean (standard deviation)] during lateral positioning was greater in the headrest group than in the no-headrest group [12.3 (6.5) mm vs 6.8 (5.5) mm, respectively, in the trachea; 11.6 (6.7) mm vs 6.0 (4.6) mm, respectively, in the bronchus; P < 0.001]. The incidence of significant displacement, defined as > 10 mm from initial correct position, was greater in the headrest group than in the no-headrest group (64% vs 28%, respectively, in the trachea; 58% vs 20%, respectively, in the bronchus; P < 0.001). CONCLUSION: Displacement of DLTs during lateral positioning appears to be caused primarily by extension of the neck. Correct adjustment of DLT position without a headrest in the supine position is an easy and effective method to minimize DLT displacement during lateral positioning (ClinicalTrials.gov number, NCT01413347).

A novel bacterial strain, YC7001(T), was isolated from the rhizosphere soil of rice collected at Jinju, Korea and was characterized using a polyphasic approach. Cells of strain YC7001(T) were Gram-negative, yellow-pigmented, rod-shaped, aerobic, heterotrophic and non-motile. Strain YC7001(T) grew optimally at 25-30 °C, pH 5.0-8.0 and degraded gelatin, cellulose and chitin. The phylogenetic analyses based on 16S rRNA gene sequences indicated that strain YC7001(T) belongs to the genus Chitinophaga in the family Chitinophagaceae. Most closely related species are Chitinophaga sancti NBRC 15057(T)(96.9 %), Chitinophaga ginsengisoli Gsoil 052(T)(95.9 %), Chitinophaga pinensis DSM 2588(T)(95.7 %), Chitinophaga filiformis IFO 15056(T)(95.7 %), and Chitinophaga niabensis JS13-10(T)(95.0 %). DNA-DNA relatedness value of strain YC7001(T) with C. sancti NBRC 15057(T) was 15.2±0.6 %. Strain YC7001(T) contained MK-7 as the major menaquinone and homospermidine as the major polyamine. The major fatty acids of strain YC7001(T) were C(15 : 0) iso, C(16 : 1)ω5c and C(17 : 0) iso 3-OH. The polar lipids were phosphatidylethanolamine, unknown aminolipids and unknown lipids. The total genomic DNA G+C content was 41.3 mol%. On the basis of phenotypic, chemotaxonomic and phylogenetic analysis, strain YC7001(T) represents a novel species of the genus Chitinophaga in the family Chitinophagaceae, for which the name Chitinophaga oryziterrae sp. nov. is proposed. The type strain is YC7001(T)(= KACC 14533(T)= JCM 16595(T)).

Purpose:This study investigated the effects of the tumor suppressor protein PTEN on transforming growth factor (TGF)-β1-mediated signaling pathways and the transdifferentiation of human subconjunctival fibroblasts (SCF) following the transduction of this protein containing a Tat domain.Methods:The Tat-PTEN expression vector was constructed to express the Tat domain of HIV-1 fused to PTEN. Following transduction of the fusion protein and TGF-β1 stimulation, the dose-dependent effect of the transduced Tat-PTEN fusion protein on Akt phosphorylation as well as the stability of the Tat-PTEN fusion protein in SCF cells was evaluated by Western blot. The effect of the Tat-PTEN fusion protein on the TGF-β1-stimulated expression of a-SMA and fibronectin was also evaluated by Western blot and immunocytochemistry.Results:To increase the efficiency of enzyme activity and to successfully deliver this protein to cells, we used a PTEN fusion protein that contained the transduction domain of the Tat protein from HIV-1. By Western blot analysis, the transduced Tat-PTEN fusion protein was found to modulate TGF-β1 signaling in SCF cells and result in the suppression of Akt phosphorylation. Furthermore, the transduction of the Tat-PTEN fusion protein was found to suppress the TGF-β1-stimulated expression of a-SMA and fibronectin by Western blot analysis and immunocytochemical staining, and the effects of the transduced fusion protein could be controlled in a dose-dependent manner.Conclusions:The Tat-PTEN fusion proteins were successfully transduced into the SCF cells and induced the suppression of transdifferentiation and fibrosis through the regulation of TGF-β-mediated signaling. The ability of the Tat-PTEN fusion protein to regulate cell survival could potentially be applied to protein therapy to counteract postoperative scarring in glaucoma surgery.

The class III β-tubulin isotype (β(III)) is expressed exclusively by neurons within the normal human retina and is not present in normal retinal pigment epithelial (RPE) cells in situ or in the early phase of primary cultures. However, aberrant expression of class III β-tubulin has been observed in passaged RPE cells and RPE cells with dedifferentiated morphology in pathologic epiretinal membranes from idiopathic macular pucker, proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR). Transforming growth factor-β (TGF-β) has been implicated in dedifferentiation of RPE cells and has a critical role in the development of proliferative vitreoretinal diseases. Here, we investigated the potential effects of TGF-β on the aberrant expression of class III β-tubulin and the intracellular signaling pathway mediating these changes. TGF-β-induced aberrant expression and O-linked-β-N-acetylglucosamine (O-GlcNac) modification of class III β-tubulin in cultured RPE cells as determined using Western blotting, RT-PCR and immunocytochemistry. TGF-β also stimulated phosphorylation of ERK. TGF-β-induced aberrant expression of class III β-tubulin was significantly reduced by pretreatment with U0126, an inhibitor of ERK phosphorylation. Our findings indicate that TGF-β stimulated aberrant expression of class III β-tubulin via activation of the ERK signaling pathway. These data demonstrate that mature RPE cells have the capacity to express a neuron-associated gene in response to TGF-β stimulation and provide useful information towards understanding the pathogenesis of proliferative vitreoretinal diseases.

During a study of endophytic bacteria from coastal dune plants, a bacterial strain, designated YC6881T, was isolated from the root of Rosa rugosa collected from the coastal dune areas of Namhae Island. The bacterium was found to be Gram-negative, motile, halophilic and heterotrophic with a polar single flagellum. Strain YC6881T exhibited growth at temperature 4-37 °C (optimum at 28-32 °C), pH 6.0-9.0 (optimum at pH 7.0-8.0) and was able to grow at NaCl concentrations in the range of 0-7.5 %(w/v) with optimum growth at 4-5 % NaCl. Strain YC6881T was catalase and oxidase positive and negative for nitrate reduction. According to the 16S rRNA genes phylogenetic analysis, strain YC6881T belonged to the genus Rhizobium and shared highest 16S rRNA gene sequence similarity of 96.9 % with R. rosettiformans, 96.3 % with R. borbori, followed by R. radiobacter (96.1 %), R. daejeonense (95.9 %), R. larrymoorei (95.6 %) and R. giardinii (95.4 %). Phylogenetic analysis of the strain YC6881T by recA, atpD, glnII and 16S-23S intergenic spacer (ITS) all confirmed the phylogenetic arrangements obtained by using 16S rRNA gene sequences. Cross nodulation tests showed that strain YC6881T was a symbiotic bacterium that nodulated Vigna unguiculata and Pisum sativum. The major components of the cellular fatty acids were C12 : 0 (8.1 %), C19 : 0 cyclo ω8c (12.6 %) and C18 : 1ω7c (53.7 %). The DNA G+C content was 52.8 mol%. Phenotypic and physiological tests with respect to substrate utilization as a carbon source, antibiotic resistance, growth conditions, phylogenetic analyses of housekeeping genes recA, atpD, glnII and fatty acids could be used to discriminate strain YC6881T from Rhizobium species in the same sublineage. Based on the results obtained in this study, strain YC6881T is considered to be representative of a novel species of Rhizobium, for which the name Rhizobium halophytocola sp. nov. is proposed. The type strain is YC6881T (= KACC 13775T = DSM 21600T).

Abstract Objective: This article aimed to develop the "forest therapy" program, which is a cognitive behavior therapy (CBT)-based intervention program using forest environment, and investigate its effects on blood pressure (BP), salivary cortisol, and quality of life (QoL) measures in patients with hypertension. Methods: A total of 56 men and women were enrolled for this study, being referred from local health centers in Republic of Korea, from April to October 2009. They were conveniently assigned to either "forest" group participating in the forest therapy program or control group doing self-monitoring of BP. Measurements of salivary cortisol level and QoL were done at initial visits and at 8-week final visits. Results: Both groups did not differ significantly in baseline clinical characteristics. The BP change at week 4 and week 8 did not differ between the two groups. Salivary cortisol level reduction was significantly larger and QoL measures improved significantly more in the forest group at week 8 compared with the control group. Conclusions: The forest therapy program did not induce prolonged systolic blood pressure (SBP) reduction. However, considering the significant decrease in cortisol level and improvement in QoL measures, this may be a useful model of community hypertension management program.

PURPOSE: To evaluate the utility of preoperative optical coherence tomography (OCT) and multifocal electroretinography (mfERG) in prediction of visual outcomes after idiopathic epiretinal membrane (ERM) surgery. DESIGN: Retrospective, observational case series. METHODS: One hundred eyes of 100 patients with idiopathic unilateral ERM who underwent vitrectomy for ERM removal were retrospectively reviewed. Correlations between preoperative data (OCT and mfERG) and final best-corrected visual acuity (BCVA) were investigated using Pearson correlation analysis. One-way analysis of variance (ANOVA) was used to determine whether final BCVA and mfERG values differed among subgroups varying in photoreceptor integrity status. Receiver operating characteristic (ROC) curve analysis was performed to obtain a cutoff value of the P1 implicit time predicting visual recovery (final BCVA ≥20/25). RESULTS: BCVA significantly improved, and 65 of 84 eyes (77%) achieved visual recovery of more than 2 Snellen lines after ERM surgery. Final BCVA was significantly correlated with preoperative photoreceptor integrity and P1 implicit time. The area under the ROC (AUROC) curve was statistically significant when P1 implicit time was examined, and the cutoff value for good visual prognosis was 40.81 msec (sensitivity: 72.7%; specificity: 81.3%). CONCLUSION: Photoreceptor disruption detected by OCT and P1 implicit time delay on mfERG were significant predictors of poor visual recovery after ERM surgery.