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Aim: Previous ovarian surgery for endometriosis results in decreased ovarian reserve and poor response to treatment in women with infertility. However, the impact of previous overall ovarian surgery on the incidence of infertility is unclear. Therefore the authors investigated impact of previous ovarian surgery on infertility incidence. Materials and Methods: This is a case-control study using retrospectively collected data in women who received infertility treatment (cases) or delivered babies (controls) at a tertiary center between 2003 and 2012. Results: The frequency of previous ovarian surgery was similar in both groups (p > 0.05) but it was higher in women with tubal infertility than their matched controls (p < 0.05). Also, the frequency of previous reproductive organ surgery was higher in the case group and in women with tubal or unexplained infertility (p < 0.05). Conclusion: Previous ovarian surgery is not associated with entire infertility, but may increase tubal factor infertility through adhesion formation and damage to adjacent tubes.

Objectives Paraquat is commonly used worldwide as major herbicide. The objective of this study was to investigate the association among farmers between occupational paraquat exposure and respiratory health effects. Methods A cross-sectional survey of health effects related to an oil spill was conducted in South Korea from 2008 to 2009. For this analysis, a total of 2882 full-time farmers were selected from the overall sample. Data collection included an interviewer-administered questionnaire and spirometry testing. Logistic regression analysis and linear regression analysis were performed to evaluate the relationship between paraquat exposure and respiratory health outcomes after adjustment for potential confounders. Results The risks of self-reported physician-diagnosed asthma, chronic obstructive pulmonary disease and allergic rhinitis were non-significantly increased among paraquat-applying farmers compared with non-paraquat-applying farmers. Although the results of a pulmonary function test fell within normal limits, a decline in forced vital capacity and forced expiratory volume in one second was apparent among paraquat-applying farmers compared with non-paraquat-applying farmers. Forced vital capacity ([beta]=-5.20, p<0.001) and forced expiratory volume in one second ([beta]=-1.89, p=0.010) significantly decreased with each unit increase in years of paraquat application. Paraquat-applying farmers showed a significant exposure-response relationship between restrictive ventilatory defects and paraquat application years (p trend=0.015) or lifetime days of application (p trend=0.007). Conclusions Our findings suggest a possible association between paraquat application and adverse respiratory health effects among farmers. [ABSTRACT FROM AUTHOR]

Cholinergic dysfunction is well known to significantly contribute to the cognitive decline in Alzheimer's disease (AD). However, it has not been clarified whether the cholinergic dysfunction is a primary event or a retrograde event secondary to neuronal loss of the cholinergic targets. Analysis of the in vivo neuronal activity of the basal forebrain in the early stages of AD could yield more information about this issue. In the present study, uptake of [18F]-fluorodeoxyglucose (FDG) in the basal forebrain was measured in 13 patients with mild cognitive impairment (MCI), 20 with early AD, and 14 healthy subjects using high-resolution research tomograph-PET. The FDG uptake was compared among the groups and correlated with the Mini Mental Status Examination (MMSE) score. The MCI patients showed significantly higher FDG uptake in the basal forebrain than the healthy subjects and the AD patients, and those did not developed dementia after 2 years showed even higher uptake than those developed dementia. The basal forebrain metabolism showed an inverted-U relationship with MMSE score in highly educated subjects, and cross-voxel analysis over the whole brain in MCI patients revealed a significant correlation in uptake between the basal forebrain and the fronto-temporal cortices. These findings indicate that in MCI patients, neuronal activity in the basal forebrain is initially increased over that in normal aging and then decreased only with further cognitive decline. The increase is consistent with a secondary compensation against neurodegeneration at target areas, and may provide brain reserve against functional impairments at incipient stages of dementia. [ABSTRACT FROM AUTHOR]

In a randomised, controlled, single-blind trial, we examined the effect of a pre-emptive alveolar recruitment strategy on arterial oxygenation during subsequent pneumoperitoneum. After intubation, 50 patients were randomly allocated to receive either tidal volume 10 ml/kg with no positive end-expiratory pressure (group C) or alveolar recruitment strategy of 10 manual breaths with peak inspiratory pressure of 40 cmH2O plus positive end-expiratory pressure of 15 cmH2O before gas insufflation (group P). During pneumoperitoneum, group P was ventilated with the same setting as group C (FiO2,= 0.35, tidal volume 10 ml/kg). PaO2, measured during peumoperitoneum was higher in group P than in group C (166 +/- 32 mmHg vs 145 +/- 34 mmHg at 15 minutes, P = 0.028, 155 +/- 30 mmHg vs 136 +/- 32 mmHg at 30 minutes, P = 0.035). Alveolar-arterial oxygen gradient in group P increased less after gas insufflation (13 +/- 9 to 60 +/- 34 mmHg vs 10 +/- 9 to 37 +/- 31 mmHg, P = 0.013). We conclude that the alveolar recruitment strategy we applied before insufflation of the peritoneal cavity may improve oxygenation during laparoscopic hysterectomy [ABSTRACT FROM AUTHOR]

STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the complications and patient satisfaction related to an anterior thoracolumbar approach in the treatment of adult spinal deformity. SUMMARY OF BACKGROUND DATA: There is no long-term follow-up data on the effects of an anterior thoracolumbar approach on adult spinal deformity patients. METHODS: A specific questionnaire was used to evaluate long-term follow-up (average, 10.3 years; range, 5-20.6) of 62 adult patients who underwent spinal deformity surgery performed through an anterior thoracolumbar approach. Twenty-six patients had over 10 years follow-up and 36 were between 5 and 10 years follow-up. The questionnaire was composed of detailed scar-related subquestions for pain, appearance, bulging, daily life, and patient's personal opinion of surgery. Postoperative Oswestry Disability Index (scores) were also obtained. RESULTS: The average age and number of anterior fusion levels were 47.9 (range, 20-74) and 5.6 (range, 2-12), respectively. Although 82.2% patients were satisfied with the results of their surgery, in general, many of the patients were dissatisfied with aspects related to their anterior incision. For the pain domain, 20 patients (32.3%, 6 with >10 years follow-up, 14 patients with 5 years follow-up) had pain over their thoracolumbar scar, which they rated as moderate to severe. Twenty-seven patients (43.5%) had bulging of their scar region, 4 were surgically indicated for repair, and 1 had multiple surgical repairs. Twelve patients (19.4%) felt they had a poor outcome related to the postoperative appearance of their anterior wound. Fifteen patients (24.2%) showed limitations in activities of daily living due to their anterior incision. Three patients with >10 years of follow-up and 4 with >5 years of follow-up felt they were getting worse. The average Oswestry Disability Index score was 25.0 +/- 16.3 (range, 0-52) postoperative. CONCLUSION: This is the first long-term (minimum 5 years) follow-up study focusing on patient outcomes after an anterior thoracolumbar approach for adult spinal deformity treatment. This approach appears to be associated with an appreciable high rate of postoperative pain (32.3%), bulging (43.5%), and functional disturbance (24.2%). Therefore, surgeons should use caution when recommending this approach to future adult spinal deformity patients. [ABSTRACT FROM AUTHOR]

Objective: White adipose tissue is a critical regulator of whole-body glucose metabolism. Preadipocyte factor-1 (Pref-1) is a secreted protein that inhibits adipocyte differentiation, both in vitro and in vivo. In this study, we have investigated the effects of Pref-1 overexpression on whole-body glucose homeostasis and its contribution to the development of insulin resistance.Research Design and Methods: To gain insight into the role of Pref-1 on the onset of insulin resistance and type 2 diabetes, we measured body composition and whole-body insulin-stimulated glucose metabolism during a hyperinsulinemic-euglycemic clamp in Pref-1 transgenic and wild-type control mice fed a high-fat diet.Results: Mice overexpressing Pref-1 were resistant to high-fat diet-induced obesity, as reflected by a marked reduction in adipose tissue mass. However, Pref-1-overexpressing mice were severely insulin resistant, mainly because of a reduction in insulin-stimulated glucose uptake in skeletal muscle and adipose tissue. The aggravated insulin resistance was associated with impaired insulin signaling and increased diacylglycerol content in skeletal muscle.Conclusions: Mice overexpressing Pref-1 are insulin resistant despite being protected from diet-induced obesity and may provide a new rodent model for the study of lipodystrophic disorders. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective study. Objectives: To analyze radiographic and functional outcomes after posterior segmental spinal instrumentation and fusion (PSSIF) with and without an anterior apical release of the lumbar curve in adult scoliosis patients. Summary Of Background Data: No comparison study on PSSIF of adult lumbar scoliosis with apical release versus without has been published. Methods: Forty-eight adult patients with lumbar scoliosis (average age at surgery 49.6 years, average follow-up 3.7 years) who underwent PSSIF were analyzed with respect to radiographic change, perioperative and postoperative complications, and Scoliosis Research Society (SRS) outcome scores. Twenty-three patients underwent an anterior apical release of the lumbar curve via a thoracoabdominal approach followed by PSSIF (Group I). The remaining 25 patients underwent a PSSIF of the lumbar curve followed by anterior column support at the lumbosacral region through an anterior paramedian retroperitoneal or posterior transforaminal approach (Group II). Results: Before surgery, Group I showed a somewhat larger lumbar major Cobb angle (63.2 degrees vs. 55.9 degrees , P = 0.07), and both groups demonstrated significant differences in lumbar curve flexibility (26.9% vs. 37.2%, P = 0.02) and thoracolumbar kyphosis (27.0 degrees vs. 15.0 degrees , P = 0.03). After surgery, at the ultimate follow-up, there were no significant differences in major Cobb angle, C7 plumbline to the center sacral vertical line (P = 0.17), C7 plumbline to the posterior superior endplate of S1 (P = 0.44), and sagittal Cobb angles at the proximal junction (P = 0.57), T10-L2 (P = 0.24) and T12-S1 (P = 0.51). There were 4 pseudarthroses in Group I and one in Group II (P = 0.02). Postoperative total normalized SRS outcome scores at ultimate follow-up were significantly higher in Group II (69% vs. 79%, P = 0.01). Conclusion: Posterior segmental spinal instrumentation and fusion without anterior apical release of lumbar curves in adult scoliosis demonstrated better total SRS outcome scores and no differences in radiographic parameters without differences in clinical complications. However, the use of BMP in some of these patients (44%) may have also contributed to these differences. [ABSTRACT FROM AUTHOR]

To improve the therapeutic effect of antibiotics in the ear cavity postoperatively, a fibrin- and gelatin-based drug delivery system was designed and in vitro efficacy was evaluated. Four kinds of fibrin clot were made from ampicillin, gentamicin, and ofloxacin, and biologic assay was performed using Bacillus subtilis. The fibrin-gelatin-gentamicin mixture demonstrated antibiotic activity for up to 120 hours against B subtilis. Gentamicin was found to be released more slowly from the fibrin-gelatin mixture than from the fibrin mixture in this experiment. These results suggest that this device can be clinically used in a limited field such as postoperative care of ear infection. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: This case report shows primary natural killer (NK)/T-cell lymphoma originating in the spine as the first case of successful treatment with autologous stem cell transplantation, along with case presentation and literature review. OBJECTIVE.: For the proper treatment of this spinal tumor, the pathologic confirmation includes immunophenotypic profiling, the understanding of tumor characteristics, and the consideration of spinal stability are necessary. SUMMARY OF BACKGROUND DATA.: NK/T-cell lymphomas are rare, aggressive neoplastic disorders with a distinctive clinical pathologic profile and an unfavorable clinical prognosis. The extranodal nasal-type NK/T-cell lymphomas, which are characterized by an extranodal presentation and an aggressive clinical course, are prevalent in Asia and Central and South America. METHODS.: A 49-year-old woman presented with thoracic back pain that developed 3 months before she was admitted to Chung-Ang University. The radiological image showed a 6 x 4 x 5-cm mass lesion within the T6-T7 vertebral body. The histopathology was consistent with the finding of NK/T-cell lymphoma. Treatment with chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) in combination with radiotherapy (total dose, 30 Gy) was done, and salvage therapy with autologous stem cell transplantation was performed. RESULTS.: Two-year follow-up magnetic resonance image showed shrinking remnant mass without spinal deformation and/or instability. Rebiopsy for remnant mass, nasal area study, and positron emission tomographic scan were performed to determine the tumor recurrence. There was no evidence of recurrence at the 2-year follow-up evaluations. CONCLUSION.: Some primary NK/T-cell lymphomas that originate at sites other than the nasal cavity/nasopharynx do not present with typical clinical features and symptoms. A primary NK/T-cell lymphoma of the spine should be considered in the differential diagnosis of primary bone tumors. We report the first case of successful treatment with chemoradiotherapy and autologous stem cell transplantation in a patient with a primary spinal NK/T-cell lymphoma. [ABSTRACT FROM AUTHOR]