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Background: Some patients with lumbar herniated intervertebral disc disease (HIVD) suffer from both pain and lateral shift or trunk list. In addition to pain, patients have concerns regarding whether trunk list is reversible. Surgical treatment is performed when pain is intractable to conservative management, but a reversal of trunk list is an incidental outcome. Percutaneous lumbar endoscopic discectomy (PELD) is one of the surgical treatment options for lumbar HIVD, but no results concerning its effect on trunk list have been reported. Objectives: The objectives of the present study were to determine the incidence of, and risk factors for, trunk list scoliosis or lateral shift and to report the outcomes of trunk list after PELD. Study Design: Retrospective case study. IRB No. H 1111-025-384 Setting; University medical Center, Seoul, Korea. Methods: We selected 164 patients who were less than 60 years old, complained of unilateral leg pain, and underwent PELD. We measured the maximum trunk shift from the central sacral vertical line (CSVL-max) on preoperative whole spine radiographs and classified trunk list as CSVL-max ≥ 10 mm. CSVL-max was measured on serial radiographs taken at one, 3, 6, and 12 months postoperatively in patients with trunk list. Results: Twenty-nine patients (17.9%) had trunk list (M:F=10:19; mean age, 37.1 ± 11.24 years). Female gender (OR 4.28; 95% CI, 1.49 – 12.3) and HIVD at L4-5 (OR 5.6; 95% CI, 1.8 - 16.7) were risk factors for trunk list. Trunk list was normalized (CSVL-max < 10 mm) in 15 (52%) patients after PELD, and the median time for normalization was 3 – 6 months. Prognostic factors for the recovery of trunk list were not identified. Limitations: Selection bias should be considered in interpreting these results. Conclusion: Trunk list, scoliosis or lateral shift, was observed in 18% of the patients at the time of surgery. Female gender and L4-5 disc herniation were risk factors for trunk list. Trunk list was reversible in more than 50% of patients within 6 months of PELD. Key words: Lumbar, scoliosis, lumbar/sciatic, trunk list, endoscope, disc, discectomy, sciatica, spine, percutaneous endoscopic discectomy

There are seven antigenically distinct serotypes of foot-and-mouth disease virus (FMDV), each of which has intratypic variants. In the present study, we have developed methods to efficiently generate promising vaccines against seven serotypes or subtypes. The capsid-encoding gene (P1) of the vaccine strain O1/Manisa/Turkey/69 was replaced with the amplified or synthetic genes from the O, A, Asia1, C, SAT1, SAT2, and SAT3 serotypes. Viruses of the seven serotype were rescued successfully. Each chimeric FMDV with a replacement of P1 showed serotype-specific antigenicity and varied in terms of pathogenesis in pigs and mice. Vaccination of pigs with an experimental trivalent vaccine containing the inactivated recombinants based on the main serotypes O, A, and Asia1 effectively protected them from virus challenge. This technology could be a potential strategy for a customized vaccine with challenge tools to protect against epizootic disease caused by specific serotypes or subtypes of FMDV. IMPORTANCE Foot-and-mouth disease (FMD) virus (FMDV) causes significant economic losses. For vaccine preparation, the selection of vaccine strains was complicated by high antigenic variation. In the present study, we suggested an effective strategy to rapidly prepare and evaluate mass-produced customized vaccines against epidemic strains. The P1 gene encoding the structural proteins of the well-known vaccine virus was replaced by the synthetic or amplified genes of viruses of seven representative serotypes. These chimeric viruses generally replicated readily in cell culture and had a particle size similar to that of the original vaccine strain. Their antigenicity mirrored that of the original serotype from which their P1 gene was derived. Animal infection experiments revealed that the recombinants varied in terms of pathogenicity. This strategy will be a useful tool for rapidly generating customized FMD vaccines or challenge viruses for all serotypes, especially for FMD-free countries, which have prohibited the import of FMDVs.

The immunity and protective capability produced by vaccines can vary remarkably according to the kinds of adjuvants being used. In the case of foot-and-mouth disease (FMD) vaccines in pigs, only oil-adjuvant vaccines have been used, and these tend to show lower immunity in pigs than in cattle. New adjuvants for these vaccines are therefore needed. We made different experimental FMD vaccines using new adjuvants (ISA 201, Carbigen, Emulsigen-D) and well-known adjuvants (ISA 206, aluminum hydroxide gel) and then conducted tests to compare the enhancement in pig immunity. More effective immune responses and protection against challenge were observed with the new adjuvants Emulsigen-D and ISA 201 compared to existing adjuvants. In the case of dairy goats, a mixture of Emulsigen-D and aluminum hydroxide gel produced rapid neutralizing antibody responses that were similar to results from tests conducted with pigs.

Foot-and-mouth disease (FMD) is a highly contagious infectious disease, and the use of vaccines is known to be effective for its prevention. In 2010/2011, there was an epidemic of the South East Asia (SEA) topotype in East Asian countries. We adapted the SEA topotype virus isolated in November 2010 in Korea in cells to analyze the characteristics of the virus and evaluate its possibility as a vaccine. After cell culture adaptation, the FMD virus particle 146S was purified to develop an inactivated oil vaccine for SEA or other topotypes. To measure its immunogenicity, pigs were inoculated with the experimental vaccine at different concentrations of the antigen. The results indicated that the groups immunized with at least 7.5 μg antigen were protected from homologous challenge. The immunized pigs were also protected against heterologous virus (ME-SA topotype) challenge. The genetic variations between the two field isolates and the adapted vaccine strains were identified in six amino acids by complete genome sequencing.

Neurofibromas are benign tumors of the peripheral nerve sheath, which occur as either a soli tary mass or multiple tumors in association with neurofibromatosis. Solitary vagal neurofibro ma in the cervical region is very rare among neurogenic tumors. Unlike schwannomas, neurofi bromas have been known to express progesterone receptor and tend to fluctuate during periods of hormonal imbalance. We report a case of a 27-year-old pregnant woman who presented with neck swelling with tenderness. The mass was more enlarged during the gestational period, and she underwent neck surgery after giving birth. At surgery, the mass was found to be originating from the cervical vagus nerve. We exerted to preserve the continuity of vagus nerve during tumor resection. Pathological examination revealed a neurofibroma. It occurred sporadically, not associated with neurofibromatosis. We should be informed that neurofibroma in pregnant woman may be more rapidly enlarged due to pregnancy-associated hormones such as progesterone.

Background and Objectives: The aim of this study was to evaluate the relationship between salivary alpha-amylase (sAA) and heart rate variability (HRV) indices in SDB children based on objective parameters of polysomnography (PSG). Materials and Method: This prospective study enrolled 67 children who underwent a physical examination and full-attended in-lab PSG with continuous electrocardiographic signal. The sAA were measured at night before PSG and in the early morning after PSG. Results: The subjects were divided into control [n=26, apnea-hypopnea index (AHI)≤1] and obstructive sleep apnea syndrome (OSAS, n=41, AHI＞1) groups; the OSAS group was subdivided into mild (1＜AHI≤5), moderate (5＜AHI≤10), and severe (10＜AHI) groups. The severe OSAS group was significantly different from the control and other OSAS subgroups in terms of the ratio between the low- and high-frequency components (LF/HF ratio) among the HRV indices. The LF/HF ratio was positively correlated with the sAA ratio and sAA subtraction (r=0.271; r=0.347). Conclusion: TAlthough both HRV and sAA were useful methods of predicting severe OSAS in children, a weak correlation between HRV and sAA was shown in pediatric OSAS subjects. Therefore, HRV and sAA may be independent parameters revealing different aspects of pediatric OSAS.