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Objective: This report describes the case of a patient with essential tremors of the mouth and hands, which were improved by Yeokhan-san treatment.Methods: To relieve the symptoms, Korean medicine treatments, including Yeokhan-san, Ohaeng-Hwa acupuncture, and electronic moxibustion, were performed. To evaluate the effects of the treatments, the visual analog scale and Fahn-Tolosa-Marin clinical rating scale for tremor were used.Results: After the treatment, the patient's clinical symptoms were improved. The visual analog scale score decreased from 10 to 2 for the hand tremor and from 10 to 1 for the mouth tremor. The Fahn-Tolosa-Marin tremor scores decreased from 3 to 1 for both the hand and mouth tremors.Conclusions: The present case suggests that Yeokhan-san and Ohaeng-Hwa acupuncture are effective for the treatment of essential tremor.

Background: Among symptomatic partial-thickness rotator cuff tears (PTRCT) indicated for surgery, both-sided (concurrent articular and bursal side) PTRCT are rarely reported and discussed in the literature. Without clinical data on and definite guidelines for treating these rare partial tears, appropriate management cannot be expected. Purpose: To calculate the prevalence of both-sided PTRCT and to evaluate clinical outcomes after arthroscopic transtendon suture bridge repair of both-sided PTRCT at a minimum 3-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: Among symptomatic PTRCT that required arthroscopic surgery (765 patients) between March 2008 and December 2014, 178 both-sided partial tears were confirmed arthroscopically, and arthroscopic transtendon suture bridge repair was performed in 100 patients enrolled in our study after exclusion criteria were applied. The presence of concurrent articular and bursal side partial tears was confirmed via arthroscopy, with Ellman grade >2 on either the bursal or the articular side of these both-sided partial tears. Without tear completion, transtendon suture bridge repair was performed in all cases. Clinical outcomes including clinical scores and range of motion were evaluated at a mean of 5.3 ± 1.4 years (range, 3-8 years). Follow-up magnetic resonance imaging (MRI) was performed at 6 to 12 months (mean ± SD, 11 ± 5.20 months) after surgery to evaluate the tendon integrity (Sugaya classification) of the repaired rotator cuff. Results: The mean age was 57.5 ± 7.8 years, and 65% of patients were women. Mean preoperative American Shoulder and Elbow Surgeons, University of California Los Angeles, Simple Shoulder Test, and Constant-Murley outcome scores of 52 ± 14, 19 ± 4, 6 ± 2, and 69 ± 10 significantly improved postoperatively to 94 ± 5, 33 ± 2, 11 ± 1, and 93 ± 5, respectively ( P < .001). Mean forward flexion, abduction, external rotation, and internal rotation improved significantly from 148°± 31°, 134°± 39°, 22°± 13°, and L2 preoperatively to 154°± 17°, 151°± 60°, 29°± 14°, and T10 postoperatively, respectively ( P < .001). The retear rate on follow-up MRI scans was 2%. As per Sugaya classification on postoperative MRI scans, type 1 healing was found in 29%; type 2, in 60%; type 3, in 9%; and type 4, in 2%. Conclusion: Among all symptomatic PTRCT that required surgery, both-sided PTRCT were more common than expected. Arthroscopic transtendon suture bridge repair of these both-sided PTRCT showed satisfactory clinical outcomes at a minimum 3-year follow-up.

Introduction The purpose of this study is to report the radiologic and clinical outcomes of arthroscopic intervention for isolated posterosuperior paralabral cysts and simultaneous treatment of cysts combined with associated shoulder pathologies. Materials and methods From March 2008 through December 2016, 70 cases (48 males and 22 females) operated on for symptomatic posterosuperior paralabral cysts were included. Mean age was 45 (range 18-69). These patients were classified into two groups depending on if they had accompanying lesions: Group I (isolated group, 27 patients) and Group II (concomitant group, 43 patients). Arthroscopic cyst decompression with a labral repair or posterior capsulotomy for patients without labral tear were performed. All concomitant pathologies were also operated simultaneously. Follow-up MRI were performed at postoperative 6 months and clinical outcomes were evaluated during the follow-up. Results Arthroscopic all intra-articular cyst decompression and labral repair was performed on 67 patients. In three patients, posterior capsulotomy without labral repair was performed for cyst removal. For 43 patients with concomitant lesions, 31 rotator cuff repairs, three SLAP repairs along with biceps tenodesis, two distal clavicle resections due to A-C joint arthritis, one calcific deposit removal, four Bankart repairs, and two acromioplasties were performed. The follow-up MRI showed complete cyst resorption except for two patients. The mean VAS, ASES, UCLA, SST and CS scores significantly improved at the last follow-up. Although both groups showed significantly improved range of motion after the surgery, improvement of ROM in Group II lagged at early periods of the rehabilitation. Conclusions Arthroscopic labral repair with all intra-articular cysts decompression or simple posterior capsulotomy were both effective treatment modalities. If paralabral cysts were associated with other shoulder lesions, simultaneous treatment of combined lesions could be performed for the improved clinical outcomes at final follow-up with expected lag in the early rehabilitation period. Level of evidence Level III, Retrospective Comparative Trial, Treatment Study.

The stimulation of autophagy or lysosomes has been considered therapeutic for neurodegenerative disorders because the accumulation of misfolded proteins is commonly observed in the brains of individuals with these diseases. Although zinc is known to play critical roles in the functions of lysosomes and autophagy, the mechanism behind this regulatory relationship remains unclear. Therefore, in this study, we examined which mechanism is involved in zinc-mediated activation of autophagy and lysosome. Exposure to zinc at a sub-lethal concentration activated autophagy in a concentration-dependent manner in mRFP-GFP-LC3-expressing H4 glioma cells. Zinc also rescued the blocking of autophagic flux arrested by pharmaceutical de-acidification. Co-treatment with zinc attenuated the chloroquine (CQ)-induced increase in the number and size of mRFP-GFP-LC3 puncta in H4 cells and accumulation of p62 by CQ or ammonium chloride in both H4 and mouse cerebrocortical cultures. Zinc rapidly induced the expression of cathepsin B (CTSB) and cathepsin D (CTSD), representative lysosomal proteases in neurons, which appeared likely to be mediated by transcription factor EB (TFEB). We observed the translocation of TFEB from neurite to nucleus and the dephosphorylation of TFEB by zinc. The addition of cycloheximide, a chemical inhibitor of protein synthesis, inhibited the activity of CTSB and CTSD at 8 h after zinc exposure but not at 1 h, indicating that only late lysosomal activation was dependent on the synthesis of CTSB and CTSD proteins. At the very early time point, the activation of cathepsins was mediated by an increased assembly of V-ATPase on lysosomes and resultant lysosomal acidification. Finally, considering that P301L mutation in tau protein causes frontotemporal dementia through aggressive tau accumulation, we investigated whether zinc reduces the accumulation of protein aggregates in SK-N-BE(2)-C neuroblastoma cells expressing wild-type tau or mutant P301L-tau. Zinc markedly attenuated the levels of phosphorylated tau and total tau as well as p62 in both wild-type and mutant tau-overexpressing cells. We also observed that zinc was more effective than rapamycin at inducing TFEB-dependent CTSB and CTSD expression and V-ATPase-dependent lysosomal acidification and CTSB/CTSD activation. These results suggest that the regulation of zinc homeostasis could be a new approach for developing treatments for neurodegenerative diseases, including Alzheimer’s and Parkinson’s.

Silica–gold nanoshells (SGNSs) were prepared at different concentrations of reducible gold salts (K+AuCl4−) with a toxic formaldehyde (FAH) reducing agent. FAH-induced SGNSs (F-SGNSs) showed not only a distinct red-shift of the plasmon resonance peak but also an increase in the thickness of the gold shell in proportion to the concentration of gold salts (0.38–1.90 mM). However, the excessive addition of reducible gold salts resulted in agglomeration of the SGNSs. The F-SGNSs showed enhanced colloidal stability after the addition of buffer solutions containing different oxyanions in the following order: K2CO3 > citrate > citrate + PBS > PBS. In addition, biocompatible ascorbic acid (ASA) was used to avoid the problem of toxic FAH agents for in vivo applications. The ASA-induced SGNSs showed a smoother surface morphology and more red-shift of the surface plasmon resonance band in comparison to F-SGNSs, probably because of the coalescence of small gold clusters formed under the mild reducing power of ASA. The surface morphologies of the SGNSs and their optical properties were characterized by transmission electron microscopy, scanning electron microscopy, zeta-potential measurement, and UV–visible spectroscopy.

With the development of high-resolution spaceborne synthetic aperture radar (SAR) systems, it has been possible to use SAR data for identifying man-made structures in urban areas. In this letter, a new approach to extract urban areas in the SAR image is presented by using the morphological characteristics of the radar scattering mechanism. In order to detect the shape and location of a building, the radar shadow index and the double-bounce index are proposed. In addition, an automatic urban area extraction method is proposed using the fuzzy-based fusion of the morphological indices. The detection performance is evaluated by two ${X}$ -band SAR data acquired from different systems. Despite the differences in observation and environmental conditions in the two data, the proposed method can provide consistent detection performance with the overall accuracy of about 88% and the Kappa coefficient of about 68%.

Primary neuroendocrine carcinomas of the breast are a rare, distinct category of breast carcinomas that require immunohistochemical staining for diagnosis. Currently, there is not enough evidence on the clinical pattern, prognosis, and proper management of the disease. Only few case series have described the imaging findings of neuroendocrine carcinomas of the breast. We herein present a case of a primary neuroendocrine carcinoma of the breast (small cell) presenting as a locally aggressive tumor with metastatic disease, and describe the radiologic findings.

Ulcerative colitis (UC), a pathological condition of inflammatory bowel disease, is a chronic inflammatory disorder that involves an abnormal immune response and epithelial barrier dysfunction. Although we have previously reported the anti-inflammatory effects of 7-hydroxyl-1-methylindole-3-acetonitrile (7-HMIA), a synthesized analog of arvelexin on macrophages and paw edema, its anti-colitis effect and its mechanism are not known. In this study, colitis was induced in mice model by 4% (w/v) dextran sodium sulfate (DSS) solution in drinking water for 9 days. At the same time, from the first day of administering drinking water containing DSS, the animals were treated with 5-aminosalicylic acid (5-ASA), 75 mg/kg/day, orally) or 7-HMIA (10 or 20 mg/kg/day, intraperitoneally), depending on the experimental group, respectively. The studies were terminated on the tenth day of the experiment. Our data showed that 7-HMIA reduced the disease activity index and spleen/body weight (S/B) ratio, and improved the shortened colon length comparable to the effects of 5-ASA observed in the DSS-exposed mice. 7-HMIA, like 5-ASA, inhibited the histological damage, such as a thickened colonic muscle layer and shortened crypt length in the colon of the mice with DSS-induced colitis. 7-HMIA restored the tight junction-related proteins (occludin, claudin-1, and claudin-2) and epithelial-mesenchymal transition-mediated proteins (E-cadherin, N-cadherin, and vimentin) in the colon tissue of mice with DSS-induced colitis. Additionally, 7-HMIA (20 mg/kg/day) showed the inhibitory effects similar to that of 5-ASA on the myeloperoxidase activity, interleukin (IL)-6 production, and expression levels of inducible nitric oxide synthase (iNOS), and even showed greater inhibition of IL-1β production in the DSS-induced mice. Furthermore, the DSS-induced activation of nuclear factor-kappa B (NF-κB) and signal transducer and activator of transcription 3 (STAT3) were effectively suppressed by 7-HMIA treatment like the effects of 5-ASA. Overall, our findings revealed that 7-HMIA decreased the severity of colitis by protecting the inflamed mucosal barrier by interfering with NF-κB and STAT3 activation.

Polyvinylidene fluoride (PVDF) is biocompatible, easy to fabricate, and has piezoelectric properties; it has been used for many biomedical applications including stem cell engineering. However, long-term cultivation of human embryonic stem cells (hESCs) and their differentiation toward cardiac lineages on PVDF have not been investigated. Herein, PVDF nanoscaled membrane scaffolds were fabricated by electrospinning; a vitronectin-derived peptide-mussel adhesive protein fusion (VNm) was immobilized on the scaffolds. hESCs cultured on the VNm-coated PVDF scaffold (VNm-PVDF scaffold) were stably expanded for more than 10 passages while maintaining the expression of pluripotency markers and genomic integrity. Under cardiac differentiation conditions, hESCs on the VNm-PVDF scaffold generated more spontaneously beating colonies and showed the upregulation of cardiac-related genes, compared with those cultured on Matrigel and VNm alone. Thus, VNm-PVDF scaffolds may be suitable for the long-term culture of hESCs and their differentiation into cardiac cells, thus expanding their application in regenerative medicine.

Due to large temperature variations between the summer and winter seasons the active layer of permafrost undergoes repetitive thawing and freezing, and the increase of global temperature has accelerated permafrost degradation related to surface deformation seasonally and annually. Repeated freezing and thawing causes frost heave and thaw settlement, which results in displacement in the activity layer of permafrost. This surface displacement is also associated with ground ice and soil moisture content, and these factors in permafrost region could be observed through timely-dense SAR data. In particular, since the revisit time of Sentinel-1 (C-band) is relatively dense, timeseries SAR interferometry could be useful tools for monitoring and mapping subsurface soil properties over such a wide area. In this study, since the degree of freezing and thawing is very different spatially and temporally, we propose the method to indirectly estimate the ground ice content of the freezing period and the moisture content of the thawing period by quantifying the displacement using timeseries InSAR measurements in the Lena-river floodplain, Siberia.

Wildfires on permafrost covered with the boreal forest can influence vegetation composition, surface soil moisture, and the active layer. Since wildfires on permafrost occur extensively in unpredictable areas, remote sensing is a useful tool for monitoring burn severity and ecosystem changes. Optical spectral indices such as the differenced normalized burn ratio (dNBR) and normalized difference vegetation index (NDVI) were traditionally used to detect burn severity and vegetation regrowth. However, since optical imagery is significantly affected by cloud cover and weather conditions, there is a limitation in acquiring temporally dense images. Synthetic Aperture Radar (SAR) can obtain images regardless of day/night or weather conditions, so it is possible to densely observe the area of interest spatiotemporally. In addition, SAR images, unlike optical images, can acquire information on the active layer of the permafrost in the winter season. This study aimed to analyze winter season time-series SAR backscattering coefficient change with burn severity in south Northwest Territories, Canada using optical and SAR data. The study area, south Northwest Territories, belongs to the discontinuous permafrost zone and consisted of the taiga. Burn severity and vegetation regrowth were estimated by dNBR and NDVI using optical imagery. To increase the temporal resolution, Landsat-8 OLI and Sentinel-2 MSI were acquired through the cloud-based Google Earth Engine (GEE) in the summer season. C-band dual-polarization Sentinel-1 and X-band single-polarization TerraSAR-X were obtained to understand the multi-frequency backscattering coefficient to fire-induced changes. The changes pattern of the SAR backscattering coefficient varies according to the burn severity, especially in the winter season, not affected by vegetation and soil moisture. It can be seen that the wildfires affected the changes in the scattering mechanism in permafrost on the boreal forests. These results represent that C-band and X-band SAR images have the potential to monitor the changes of the active layer with burn severity.

A multiple receptor tyrosine kinase inhibitor, sunitinib, is a first-line therapy for clear cell renal cell carcinoma (CCRCC). Unfortunately, it has the major challenges of low initial response rate and resistance after about one year of treatment. Here we evaluated a microRNA (miRNA) and its target responsible for sunitinib resistance. Using miRNA profiling, we identified miR-96-5p upregulation in tumors from sunitinib-resistant CCRCC patients. By bioinformatic analysis, PTEN was selected as a potential target of miR-96-5p, which showed low levels in tumors from sunitinib-resistant CCRCC patients. Furthermore, PTEN and miR-96-5p levels were negatively correlated in a large The Cancer Genome Atlas kidney renal clear cell carcinoma cohort and high miR-96 and low PTEN represented poor prognosis in this cohort. Additionally, four-week sunitinib treatment increased miR-96-5p and decreased PTEN only in tumors from a sunitinib-resistant patient-derived xenograft model. We found a novel miR-96-5p binding site in the PTEN 3′ UTR and confirmed direct repression by luciferase reporter assay. Furthermore, we demonstrated that repression of PTEN by miR-96-5p increased cell proliferation and migration in sunitinib-treated cell lines. These results highlight the direct suppression of PTEN by miR-96-5p and that high miR-96-5p and low PTEN are partially responsible for sunitinib resistance and poor prognosis in CCRCC.