Comparison of clinical outcomes of patients with serial negative surveillance cultures according to a subsequent polymerase chain reaction test for carbapenemase-producing Enterobacterales

BACKGROUND

Carbapenemase-producing Enterobacterales (CPE) are of serious concern worldwide due to high morbidity and mortality.

AIM

To evaluate the impact of the result of a subsequent polymerase chain reaction (PCR) test for carbapenemase after serial negative surveillance cultures on positive culture conversion in patients with three consecutive negative surveillance cultures for CPE, and to identify risk factors for conversion.

METHODS

A retrospective study of patients with positive CPE cultures on CHROMagar KPC medium was performed in a Korean tertiary hospital from October 2018 to December 2022. PCR for blaKPC, blaNDM, blaIMP, blaVIM, blaGES, and blaOXA-48 was performed after three consecutive negative rectal swab cultures. Clinical characteristics and outcomes of patients were compared according to whether follow-up PCR was positive (CNPP) or negative (CNPN).

FINDINGS

Of 1075 patients with positive CPE cultures, 150 (14.0%) yielded three consecutive negative rectal swab cultures. Of these, 50 (33.3%) were CNPP, and 100 (66.7%) were CNPN. Risk factors associated with a positive PCR result on multivariate analysis were: age, central venous catheter, and Escherichia coli infection. CNPP patients were more likely to have positive culture conversion for CPE than CNPN patients (39/44 (88.6%) vs 21/50 (42.0%), P<0.001). In multivariate analysis, independent risk factors for culture conversion were: a positive PCR result after surveillance cultures, diabetes mellitus, central venous catheter, and Klebsiella pneumoniae.

CONCLUSION

CNPP patients have higher rates of culture conversion than CNPN patients, and a follow-up PCR test after serial negative surveillance cultures is useful in deciding whether or not to discontinue contact precautions.

High-efficiency picosecond mode-locked laser using a thulium-doped nanoengineered yttrium-alumina-silica fiber as the gain medium

We report the theoretical and experimental investigation of a self-starting mode-locked fiber laser with a nanoengineered Tm³⁺-doped yttrium-alumina-silica (YAS) fiber as the gain medium. The YAS fiber exhibits a higher capability of Tm³⁺ cluster elimination than commercial silica fibers. The Tm³⁺ fluorescence properties and YAS dispersion are well characterized. As a result, an efficient picosecond mode-locked fiber laser is demonstrated with a slope efficiency of 14.14% and maximum pulse energy of 1.27 nJ. To the best of our knowledge, this is the first mode-locked fiber laser based on a Tm³⁺-doped YAS fiber. The experimental observation is also supported by the numerical analysis.

Randomized, double-blind, active-controlled, multicentre, phase III clinical trial with two stages to assess the safety and efficacy of letibotulinum toxin a vs. onabotulinum toxin a for subjects with moderate to severe crow's feet

BACKGROUND

Letibotulinum toxin A (LeBA) was approved by the Ministry of Food and Drug Safety (known as the Korea Food & Drug Administration) for cosmetic indications in 2012. However, the efficacy and safety of this newly introduced LeBA have not been investigated in crow's feet lines (CFL) treatment and standardization before its universal use.

OBJECTIVE

The aim of this multicentre, double-blind, randomized, parallel, active-controlled Phase III clinical trial with two stages (ClinicalTrials.gov identifier: NCT03408236) was to investigate the non-inferiority of LeBA vs. the existing onabotulinum toxin A (OnBA) for the treatment of CFL.

METHODS

A total of 240 subjects were randomized to either the test (LeBA) or control (OnBA) group. At the baseline and at weeks 4 while maximum smiling (primary efficacy assessment), 8, 12 and 16, investigator's on-site evaluation, independent evaluator, evaluation by the subjects, subjects' satisfaction assessment and safety assessment were performed.

RESULTS

At week 4, the response rate of primary efficacy assessment was 69.75% and 68.33% in the test (LeBA) and control (OnBA) groups, respectively, without a significant difference. Other minor secondary evaluation results showed significant differences suggesting that LeBA offered better improvement than OnBA, but the overall results did not show significant differences between the two groups.

CONCLUSION

This study showed that LeBA was as effective and safe as OnBA for the treatment of CFL at the same doses.

Raman modes and dielectric relaxation properties of epitaxial BaBiO3 thin films

Perovskite BaBiO3 films are grown on MgO (100) substrate and SrTiO3 (001) and (110) substrates using pulsed laser deposition. The thickness of the films ranges from ∼10 nm up to 200 nm. X-ray diffraction and reciprocal space mapping show that the thin films are grown epitaxially but relaxed considerably particularly for the films on SrTiO3. The topography of the film surfaces are obtained with AFM and found to be atomically flat with the step and terrace structure of unit cell step height. Raman spectroscopy is performed on the BaBiO3 films in the temperature range from 50 K to 300 K. The phonon modes related to octahedral breathing, bond bending, and bond stretching are detected in the Raman spectra, and the distinctive features are found in the phonon modes below and above a structural transition around 140 K. Out-of-plane dielectric measurements are also carried out from 10 K to 400 K for the films on SrTiO3 with different orientations. In particular, the dielectric measurements demonstrate frequency as well as orientation dependent anisotropic dielectric relaxation behaviors in BaBiO3 films.

Intra-articular injection of magnesium chloride attenuates osteoarthritis progression in rats

OBJECTIVE

To explore the effects of Mg²⁺ on the expression of osteoarthritic markers in human cartilage and synovium tissue explants. To investigate the therapeutic effect of intra-articular injection of Mg²⁺ in an established rat OA (Osteoarthritis) model of anterior cruciate ligament transection with partial medial meniscectomy (ACLT + PMM).

DESIGN

Human cartilage and synovium explants were collected from total knee replacement surgeries and incubated with MgCl₂ (20 mmol/L) in vitro. A rat OA model was established by ACLT + PMM surgery in 450-500 g male Sprague Dawley (SD) rats. To select the optimal dose, intra-articular injections of MgCl₂ (0.05, 0.5, 5 mol/L) were performed at 4 weeks after the surgery every 3 days for 2 weeks. The effect of optimized MgCl₂ was further determined by histology, immunohistochemistry, and quantitative real-time polymerase chain reaction.

RESULTS

The expressions of osteoarthritic markers in human cartilage and synovium explants were inhibited by Mg²⁺in vitro. Immunohistochemical analysis further suggested the inhibitory effects of Mg²⁺ on the expression of MMP-13 and IL-6 in the human tissue explants. Cartilage degeneration and synovitis in ACLT + PMM rats were significantly improved by intra-articular injections of Mg²⁺ (0.5 mol/L). Immunohistochemical analysis also showed the regulatory effects of Mg²⁺ on osteoarthritic markers in both cartilage and synovium in rats, consistent with in vitro results.

CONCLUSION

Intra-articular injections of Mg²⁺ at 0.5 mol/L attenuate the progression of OA in the ACLT + PMM rat model. Such effect was at least in part explained by the promotion of cartilage matrix synthesis and the suppression of synovial inflammation.

Serum 25-Hydroxyvitamin D deficiency in Malaysian children with severe atopic dermatitis

BACKGROUND

Vitamin D deficiency has been shown to be a determinant of disease severity in patients with atopic dermatitis (AD). There is a lack of information on the prevalence of vitamin D deficiency in Malaysian children with AD. The objective of this study was to determine the association of vitamin D deficiency with AD severity, to compare vitamin D deficiency between children with and without AD and to determine prevalence of vitamin D deficiency in children with AD.

METHODS

A case-control study to examine serum 25- hydroxyvitamin D [25(OH)D] levels in children with and without AD was done. Serum 25-hydroxyvitamin D [25(OH)D] level was measured by immunoassay. AD severity was evaluated using the SCORing Atopic Dermatitis (SCORAD) index.

RESULTS

The serum levels of 25(OH)D, measured in 135 children with AD was not statistically different from 65 children without AD [median (IQR): 25.2ng/mL (15.45) vs 25.9ng/mL (15.87), p=0.616]. However, serum vitamin D levels were significantly lower in children with severe AD compared to those with mild-to-moderate AD [median (IQR): 16.0ng/mL (19.32) vs 26.3ng/mL (15.56), p=0.021]. The odds of having vitamin D deficiency in children with severe AD was 3.82 times that of children with non-severe AD (95% confidence level: 1.13, 12.87).

CONCLUSION

This study suggests that there is an inverse association between vitamin D level and the severity of AD in Malaysian children.

Efficacy and safety of PAC-14028 cream - a novel, topical, nonsteroidal, selective TRPV1 antagonist in patients with mild-to-moderate atopic dermatitis: a phase IIb randomized trial

Background

Transient receptor potential vanilloid subfamily, member 1 (TRPV1) may play an important role in pruritus and inflammation induction in atopic dermatitis (AD). The treatment effect of TRPV1 antagonist via topical application in patients with AD remains unknown.

Objectives

To assess the clinical efficacy and safety of PAC‐14028, a TRPV1 antagonist, via topical application in patients with AD.

Methods

In this 8‐week, phase IIb, randomized, double‐blind, multicentre, vehicle‐controlled study, patients with mild‐to‐moderate AD were randomized to receive PAC‐14028 cream 0·1%, 0·3%, 1·0% or vehicle cream twice daily. The primary efficacy end point was the Investigator's Global Assessment (IGA) success rate defined as the percentage of patients with an IGA score of 0 or 1 at week 8. The secondary efficacy end points included the severity Scoring of Atopic Dermatitis (SCORAD) index and Eczema Area and Severity Index (EASI) 75/90.

Results

A total of 194 patients were enrolled. IGA success rates at week 8 were 14·58% for vehicle cream, 42·55% for PAC‐14028 cream 0·1% (P = 0·0025 vs. vehicle), 38·30% for PAC‐14028 cream 0·3% (P = 0·0087 vs. vehicle) and 57·45% for PAC‐14028 cream 1·0% (P < 0·001 vs. vehicle). In particular, statistically significant differences were found between the vehicle and treatment groups in the IGA success rates with two‐grade improvement. The SCORAD index, EASI 75/90, sleep disturbance score and pruritus visual analogue scale showed a trend towards improvement. No significant safety issues were reported.

Conclusions

PAC‐14028 cream may be an effective and safe treatment modality for the treatment of patients with mild‐to‐moderate AD.

What is already known about this topic?

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases characterized by pruritic erythematous skin lesions and barrier dysfunction.

Transient receptor potential vanilloid subfamily, member 1 (TRPV1) antagonists suppress the release of pruritic and proinflammatory mediators.

The preclinical results demonstrate the feasibility of TRPV1 as a potential therapeutic target for the treatment of AD.

What does this study add?

TRPV1 regulates inflammation and pruritus in patients with AD.

PAC‐14028 cream, a novel TRPV1 antagonist, was superior to vehicle in improving clinical symptoms and signs with a favourable safety profile in adults with mild‐to‐moderate AD.

TRPV1 antagonism may play a role as a promising nonsteroidal topical treatment target for AD with a new mechanism of action.

Linked Editorial:https://doi.org/10.1111/bjd.17777.

https://doi.org/10.1111/bjd.17802 available online

https://www.bjdonline.com/article/

Ex vivo magnetic resonance imaging using hyaluronic acid fillers: Differences between monophasic and biphasic fillers

BACKGROUND/PURPOSE

Hyaluronic acid (HA) is an anionic, non-sulfated glycosaminoglycan distributed throughout the human skin and injectable HA fillers are the most commonly used in aesthetic field. This study aimed to determine if differences in physical characteristics of HA products (monophasic or biphasic fillers) affect the patterns of magnetic resonance imaging (MRI).

METHODS

Twenty biphasic fillers and nine monophasic fillers were obtained from a commercial source, and examined with a 3.0 Tesla MRI scanner. Visual assessments and measurements of signal intensity for region of interest (ROI) were performed. A non-parametric Wilcoxon rank sum test was used to compare the ROI values.

RESULTS

Visual assessments by a radiologist did not show significant differences between the two types of fillers. While the signal intensity between the two types of filler did not differ significantly for T1-weighted images, the signal intensity of the biphasic filler was lower than that of the monophasic filler for T2-weighted images (P<.01).

CONCLUSION

Monophasic and biphasic HA fillers exhibited different MRI properties. Our findings may provide better insights into the use of in vivo MRI to evaluate aesthetic, procedure-related complications.

A preliminary study of new single polymorphisms in the T helper type 17 pathway for psoriasis in the Korean population

Psoriasis is a polygenic and multi-factorial disease showing ethnic differences in terms of its severity and frequency. Therapies targeting interleukin (IL)-17A, IL-17 receptor (IL-17R) and Janus kinases (JAKs) are in clinical development for the treatment of psoriasis, and their success suggests the essential role of these molecules in psoriasis. To investigate the genetic susceptibility in T helper type 17 (Th17) cell signal transduction pathways for promoting psoriasis, we performed candidate gene and linkage disequilibrium analysis. In 208 patients and 266 normal controls, we analysed 31 single nucleotide polymorphisms in 12 genes (CAMP, IL17A, IL17F, IL17RA, IL22, JAK1, JAK2, JAK3, STAT3, TLR7, TLR9 and TYK2; abbreviations: CAMP, human cathelicidin antimicrobial peptide; STAT-3, signal transducer and activator of transcription 3; TLR, Toll-like receptor; TYK2, tyrosine kinase 2). Patients with psoriasis showed a strong association for IL17F rs763780 [odds ratio (OR) = 3·27, P = 0·04], which results in a histidine-to-arginine substitution, and JAK2 rs2274471 (OR = 2·66, P = 0·02). In addition, JAK2 rs7849191 showed a protective pattern, met the significance threshold (OR = 0·77, P = 0·05) and showed a tendency for an inverse association with the frequency of early-onset psoriasis under age 40 years (P = 0·07). In haplotype analysis, JAK1 rs310241A/rs2780889T showed a protective effect (OR = 0·73, P = 0·03) in psoriasis. In conclusion, we report two new psoriasis-susceptibility loci, in IL17F and JAK2, as well as a newly identified late-onset associated protective JAK2 locus and a protective JAK1 haplotype in the Korean population.

139 EFFICIENT CONDITIONS OF CYTOPLASMIC MICROINJECTION OF FOREIGN DNA TO GENERATE PORCINE TRANSGENIC EMBRYOS

To establish the efficient cytoplasmic microinjection system in the porcine embryos, pEGFP-N1 plasmid were microinjected into porcine parthenogenetic (PA) and in vitro-fertilized (IVF) embryos to investigate the optimal injection time, volume, and concentration. In experiment 1, to investigate the optimal injection time, development rates were compared among groups of 4 different time durations (2, 4, 6, and 8 hours) in the PA and IVF embryos with time point after activation and sperm removal, respectively. There were no significant differences (P < 0.05) between the 4 groups regarding the cleavage rates. However, there were significant differences (P < 0.05) in development to the blastocysts (4.4, 8.9, 3.9, 0.6%) and GFP expression in blastocysts (1.3, 5.7, 2.3, 0.0%), which was injected after postactivation of 4 hours compared with another 3 groups. The IVF embryos injected after 2 and 4 hours expressed GFP significantly higher than the other two groups, which injected at 6 and 8 hours (P < 0.05). In experiment 2, EGFP-N1 with 2 different concentrations (20 and 50 ng μL–1) was injected in the PA and IVF embryos to investigate the optimal concentration. In PA embryos, there were significant differences in 20 ng μL–1-injected embryos, which had higher cleavage (58.8 v. 41.9%) than blastocysts (13.0 v. 11.1%) and GFP expression rates (P < 0.05). In IVF embryos, GFP were expressed only in 20 ng μL–1 embryos, GFP (4.2%) in the blastocysts showed no significant difference in the cleavage (77.3 v. 64.7%) and blastocyst rates (26.4 v. 23.5%). In experiment 3, three different volumes (5, 10, and 20 pL) were microinjected into porcine embryos to determine the most appropriate volume. Out of 3 groups, significantly higher development rates of cleavage (68.3, 58.0, 29.3%), blastocysts (11.7, 12.7, 0.5%), and GFP-expressed blastocysts (2.9, 7.8, 0.0%) were shown in the 10-pL group (P < 0.05). In conclusion, these results imply that a 20 ng μL–1 concentration, 10 pL of volume, injection 4 hours after activation for PA embryos, as well as injection 2 and 4 hours after sperm removal, a 20 ng μL–1 concentration, and 10 pL of volume for IVF embryos were more effective cytoplasmic microinjection conditions.

Real time expression of ACC oxidase and PR-protein genes mediated by Methylobacterium spp. in tomato plants challenged with Xanthomonas campestris pv. vesicatoria

Biotic stress like pathogenic infection increases ethylene biosynthesis in plants and ethylene inhibitors are known to alleviate the severity of plant disease incidence. This study aimed to reduce the bacterial spot disease incidence in tomato plants caused by Xanthomonas campestris pv. vesicatoria (XCV) by modulating stress ethylene with 1-aminocyclopropane-1-carboxylate (ACC) deaminase activity of Methylobacterium strains. Under greenhouse condition, Methylobacterium strains inoculated and pathogen challenged tomato plants had low ethylene emission compared to pathogen infected ones. ACC accumulation and ACC oxidase (ACO) activity with ACO related gene expression increased in XCV infected tomato plants over Methylobacterium strains inoculated plants. Among the Methylobacterium spp., CBMB12 resulted lowest ACO related gene expression (1.46 Normalized Fold Expression), whereas CBMB20 had high gene expression (3.42 Normalized Fold Expression) in pathogen challenged tomato. But a significant increase in ACO gene expression (7.09 Normalized Fold Expression) was observed in the bacterial pathogen infected plants. In contrast, Methylobacterium strains enhanced β-1,3-glucanase and phenylalanine ammonia-lyase (PAL) enzyme activities in pathogen challenged tomato plants. The respective increase in β-1,3-glucanase related gene expressions due to CBMB12, CBMB15, and CBMB20 strains were 66.3, 25.5 and 10.4% higher over pathogen infected plants. Similarly, PAL gene expression was high with 0.67 and 0.30 Normalized Fold Expression, in pathogen challenged tomato plants inoculated with CBMB12 and CBMB15 strains. The results suggest that ethylene is a crucial factor in bacterial spot disease incidence and that methylobacteria with ACC deaminase activity can reduce the disease severity with ultimate pathogenesis-related protein increase in tomato.

Erdheim-Chester disease: an uncommon cause of upper urinary tract obstruction

Erdheim-Chester disease is a rare non-Langerhans form of systemic histiocytosis of unknown origin. We describe a 45-year-old man presenting with bilateral hydronephrosis suggestive of extrinsic urinary tract obstruction. Computed tomography revealed extensive hypodense soft tissue infiltration in the retroperitoneum surrounding the kidneys. Needle biopsy of the retroperitoneal soft tissue revealed aggregates of lipid-laden histiocytes expressing CD68 but negative for CD1a and S100 protein. The diagnosis of Erdheim-Chester disease was supported by typical radionuclide bone scinitigraphic findings. Treatment with prednisolone, sirolimus, and regular ureteric stent revision was initiated to achieve adequate urinary tract drainage. To our knowledge, this is the second patient with Erdheim-Chester disease reported in Hong Kong. A high index of suspicion is required to avoid delay in the diagnosis of this rare disease.

Stem Canker of Giant Dogwood (Cornus controversa) Caused by Fusarium lateritium in Korea

In May 2012, a stem canker was observed on a ~20-year-old giant dogwood (Cornus controversa) in Suwon, Gyeonggi Province, South Korea, which consisted of necrotic lesions on stem bark with orange sporodochial fruiting bodies. A single fungal colony was obtained from hyphal tips that were grown out of affected tissues plated on potato dextrose agar (PDA) acidified with 0.1% lactic acid after surface sterilization with 1.0% NaOCl for 30 s and 70% ethanol for 30 s, and incubated at 25°C for 7 days in the dark. The fungal isolate was grown on PDA and carnation leaf agar (CLA) to examine its mycological characteristics. The fungal colonies grown on PDA at 25°C for 7 days had diameters of 31 to 36 mm, with the colony surface sparsely cottony or with little or no aerial mycelium, very pale brown to pink, becoming progressively lighter toward the center; the colony reverse was pinkish-white to reddish-yellow, producing very few hyaline microconidia that were ellipsoidal, mostly 1-celled, and 15.4 to 22.8 × 4.1 to 4.8 μm. It produced hyaline macroconidia that were slightly curved, frequently 3 septate, a hooked or beaked apical cell and a foot-shaped or notched basal cell, 28.0 to 35.5 × 4.0 to 5.5 μm, borne on pink sporodochia. On CLA, the colony surface was lighter toward the center with no or sparse aerial mycelium, growing to 33 to 43 mm diameter at 25°C for 7 days. Microconidia were ellipsoidal, mostly 1-celled, and 9.2 to 17.5 × 2 to 2.5 μm on CLA. Macroconidia were produced on pink sporodochia near or on carnation leaf pieces, falcate to almost straight or slightly curved, frequently 5 to 7 septate, with a hooked or beaked apical cell and a foot-shaped or notched basal cell, and 45.5 to 59 × 5.5 to 6.5 μm. Chlamydospores were rare or absent. Based on these morphological characters, the isolate was identified as Fusarium lateritium (1,2). Sequences of the internal transcribed spacer (ITS) rDNA region of the fungus (GenBank Accession No. KC453998) amplified using primers ITS1/ITS4 had 100% sequence identity to F. lateritium (JN198452). The DNA sequences of translation elongation factor-1α (EF-1α) amplified using primers EF1/EF2 (KC453997) also had 100% sequence identity to F. lateritium (AY707172 and AY707156). The culture was deposited in the Korean Collection for Type Cultures (KCTC 46029). Pathogenicity tests were conducted using 1-year-old giant dogwood seedlings grown for 3 weeks before inoculation in a 1:1:1 mixture of peat moss, perlite, and sand in 10" × 10" × 12" plastic pots. The stems of three seedlings were inoculated with the mycelial plugs from the edge of the fungal culture on PDA grown at 25°C for 7 days, which were placed on three barkless cuts per stem and sealed with Parafilm that was removed 3 weeks later. Canker symptoms on the inoculated seedlings developed after 30 days of incubation at 25 to 32°C and relative humidity of 50 to 60% in a glasshouse, from which the same fungus was isolated. Non-inoculated control seedlings showed no canker development. To our knowledge, this is the first report of stem canker on giant dogwood caused by F. lateritium in Korea and also the family Cornaceae as new host for the fungus. References: (1) D. M. Geiser et al. Mycologia 97:191, 2005. (2) J. F. Leslie and B. A. Summerall. The Fusarium Laboratory Manual. Blackwell Publishing. Ames, Iowa, 2006.

An 8-week face-split study to evaluate the efficacy of cosmeceuticals using non-invasive bioengineering devices

BACKGROUND/AIMS

Even with the increasing demand for functional cosmeceuticals in the recent years, objective standard criteria for assessing their efficacy are currently incomplete at best. In this 8-week face-split study, in which we topically applied high-priced cosmeceuticals on one side and more affordable cosmeceuticals on the other side of the face, we compared the efficacy of these two products using non-invasive bioengineering technology.

METHODS

We assessed the efficacy of a skin-whitening and an anti-wrinkle cosmeceutical product on 25 and 19 healthy female volunteers, respectively. In a single blind split setting, each participant received an 8-week topical application of high-priced cosmeceuticals to the left side of the face, and cheaper cosmeceuticals to the right side. Then, the subjects' biophysical parameters were measured for an objective evaluation of the results. This was followed by a questionnaire to obtain a subjective assessment.

RESULTS

There was no significant difference in the change between the high-priced cosmeceuticals and the more affordable cosmeceuticals. At each measured site, there were variable changes including skin improvement and aggravation at the end of study. The subjective questionnaire demonstrated also that the participants perceived no difference in the efficacy between the two products.

CONCLUSIONS

Our results showed that there were no significant differences in the skin biophysical parameters following the application with high-priced functional cosmeceuticals or less expensive cosmeceuticals. The subject failed to differentiate between the two products. The development of objective standard criteria for assessing its efficacy is essential.

Alendronate reduced peri-tunnel bone loss and enhanced tendon graft to bone tunnel healing in anterior cruciate ligament reconstruction

Peri-tunnel bone loss after anterior cruciate ligament (ACL) reconstruction is commonly observed, both clinically and experimentally. We aimed to study the effect and mechanisms of different doses of alendronate in the reduction of peri-tunnel bone loss and promotion of graft-bone tunnel healing in ACL reconstruction. Eighty-four ACL-reconstructed rats were divided into 4 groups. Alendronate at different dosages, or saline, were injected subcutaneously weekly, for 2 or 6 weeks post-reconstruction, for vivaCT (computed tomography) imaging, biomechanical tests, histology and immunohistochemistry. Alendronate significantly increased bone mass and density of tissue inside bone tunnels except at the epiphyseal region of tibial tunnel. The femoral tunnel diameter decreased significantly in the mid-dose and high-dose alendronate groups compared to that in the saline group at week 6. Alendronate significantly increased the peri-tunnel bone mass and density along all tunnel regions at week 6. Better graft-bone tunnel integration and intra-tunnel graft integrity were observed in the alendronate groups. The ultimate load was significantly higher in the mid-dose and high-dose alendronate groups at week 2, but not at week 6. There was a reduction in matrix metalloprotein (MMP)1, MMP13 and CD68-positive cells at the peri-tunnel region and graft-bone interface in the alendronate-treated group compared to the saline group. Alendronate reduced peri-tunnel bone resorption, increased mineralised tissue inside bone tunnel as well as histologically and biomechanically promoted graft-bone tunnel healing, probably by reducing the expression of MMP1, MMP13 and CD68-positive cells. Alendronate might be used for reducing peri-tunnel bone loss and promoting graft-bone tunnel healing at early stage post-ACL reconstruction.

Increased PHB productivity by high-cell-density fed-batch culture of Alcaligenes latus, a growth-associated PHB producer

Alcaligenes latus, a growth-associated PHB producer, was cultivated by a pH-stat modal fed-batch culture technique to attain high PHB productivity. Both sucrose solution and inorganic medium were fed in conjunction with the supply of ammonia solution which serves as a nitrogen source and as a means of pH control. Compositions of the inorganic medium were formulated by elemental analysis of A. latus cell mass. The effect on inoculum size was examined to reduce culture time. High concentrations of cell (142 g/L) and PHB (68.4 g/L) were obtained in a short culture time (18 h) with an inoculum size of 13.7 g/L. The PHB content and the PHB productivity at the end of the fed-batch culture were 50% of dry cell weight and 4.0 g PHB/(L . h), respectively.

Variation in 8-ketotrichothecenes and zearalenone production by Fusarium graminearum isolates from corn and barley in Korea

A total of 214 Fusarium graminearum isolates were obtained from corn and barley which were collected from Kangwon province and the southern part of Korea, respectively, and were tested for 8-ketotrichothecenes and zearalenone (ZEA) production on rice grains. The incidences of trichothecene production by 105 isolates of F. graminearum from corn were 59.0% for deoxynivalenol (DON), 37.1% for 15-acetyldeoxynivalenol(15-ADON), 13.3% for 3-acetyldeoxynivalenol (3-ADON), 7.6% for 3,15-diacetyldeoxynivalenol (3,15-DADON), 20.0% for nivalenol (NIV), 6.7% for 4-acetylnivalenol (4-ANIV), and 1.0% for 4,15-diacetylnivalenol (4,15-DANIV). DON chemotypes frequently produced 15-ADON as the major isomer rather than 3-ADON and 9 of the 61 DON chemotypes produced low levels of NIV. On the other hand, the incidences of trichothecene production of 109 isolates by F. graminearum from barley were 24.8% for DON, 72.5% for NIV, 62.4% for 4-ANIV, and 10.1% for 4,15-DANIV. Of these isolates, 78 were NIV chemotypes and only one isolate produced DON and 3-ADON as major toxins. In addition, 26 of the 78 NIV chemotypes produced low levels of DON. ZEA was frequently produced by the trichothecene-producing isolates and the incidences of ZEA were 51.4% and 31.2% for the isolates from corn and barley, respectively. There was a great regional difference in trichothecene production by F. graminearum isolates between corn- and barley-producing areas in Korea.

Immunological impact of Taekwondo competitions

Immunological changes in elite adolescent female athletes during Taekwondo competitions were investigated on-field. 6 female athletes (16.7 ± 0.8 year-old) volunteered and performed 5 bouts of demonstration Taekwondo competitions simulating real tournaments in intensity, duration, and break-time intervals on the same day. Blood samples were taken before, after the competitions and during the recovery, respectively. Immunological changes and oxidative stress in peripheral blood mononuclear cells were evaluated by flow-cytometry. During the competitions, exercise intensity was 92.2 ± 3.8% (86.1~95.7) of the maximal heart rate. Blood lactate increased immediately after the competitions (p=0.0165) and decreased to baseline during recovery. Intracellular reactive oxygen species (ROS) in the peripheral blood increased continuously during recovery (p<0.05, respectively). Natural killer cells increased immediately after the competitions (p=0.0006), and decreased during recovery. B and T cells increased immediately after the competitions and remained elevated throughout recovery (p<0.05, respectively). CD4/CD8 ratio after the competitions was decreased (p=0.0091) and returned to baseline during recovery. These results suggest that the immunological function of the elite female adolescent athletes could be attenuated after Taekwondo competitions. Further large-scaled Taekwondo studies on immunologic and apoptotic changes related to oxidative stress should be performed for improving and protecting the health of adolescent athletes.

Optimization of selective emitter fabrication method for solar cells using a laser grooving

In this paper, screen-printing laser grooved buried contact (LGBC) method was applied, which is compatible with the existing screen-printed solar cell equipment and facilities. Experiments were performed in order to optimize short circuit current (I(sc)), open circuit voltage (V(oc)) and fill factor of high efficiency solar cells. To enhance I(sc), V(oc) and efficiency, heavy doping was performed at low sheet resistance in the laser grooved region of the cell. In contrast, light doping was carried out at a high sheet resistance in the non-laser grooved region. To increase fill factor, porous silicon found on the wafer after dipping in an HF solution to remove SiN(x), was cleared. The fabricated screen-printing LGBC solar cell using a 125 mm x 125 mm single crystalline silicon wafer exhibited an efficiency of 17.2%. The results show that screen-printing LGBC method can be applied for high efficiency solar cells.

Mosquitocidal activity of a native Bacillus thuringiensis isolate Bt ReX02 from Gunung Jerai Forest, Malaysia against Culex quinquefasciatus and Aedes albopictus

BACKGROUND AND OBJECTIVE

To evaluate the mosquito larvicidal potential of the native Bacillus thuringiensis isolate BtReXO2, which was isolated from a tropical rain forest ecosystem in Malaysia. This study also aimed at determining the phenotypic and biochemical characteristics of the isolate.

MATERIALS AND METHODS

The phenotypic characterization was carried out by growing the isolate in nutrient broth to observe the colonial morphology, vegetative cells, sporulation, motility and haemolytic activity. The parasporal crystal morphology was determined by Coomassie Brilliant Blue (CBB) staining of the sporulated cells and then observed under light microscope. The mosquito larvicidal assay was conducted with the second instar larvae of Culex quinquefasciatus and Aedes albopictus to determine the entomocidal potency of the isolate. The total protein profile was determined by SDS-PAGE.

RESULTS AND DISCUSSION

Preliminary phenotypic and biochemical characterization showed that the isolate is motile, an indirect indication of the virulence of the strain and exhibited hemolytic activity, an important feature of antidipteran Bacillus thuringiensis strains. Study on the crystal morphology showed the presence of cuboidal crystals, another characteristic feature of a mosquitocidal Bacillus thuringiensis strains. Bioassay with the second instar larvae of Culex quinquefasciatus, Aedes albopictus established the antidipteran activity of this native Bacillus thuringiensis isolate. Protein profile analysis revealed the unique pattern showing high molecular mass as well as low molecular mass proteins corresponding to the Cry and Cyt proteins respectively. The protein profile is strikingly different from other mosquitocidal strains such as Bacillus thuringiensis subsp.israelensis and Bacillus thuringiensis subsp. jegathesan Periodical introduction of such native strains of Bacillus thuringiensis will add a new weapon in the armoury to manage the vector borne diseases and also in the management of insect resistance.

Exercise-induced airway obstruction in young asthmatics measured by impulse oscillometry

BACKGROUND

Impulse oscillometry (IOS) is a good method for measuring airway resistance. It does not require special breathing skills and it can reflect different aspects of airway obstruction to those revealed by spirometry, which is an effort-dependent maneuver.

OBJECTIVE

To evaluate the characteristics of airway obstruction in young asthmatics after an exercise bronchial provocation test (EBPT) using IOS.

METHODS

Forty-seven young adults were enrolled in the study. All the participants underwent a methacholine bronchial provocation test (MBPT) and an EBPT for the evaluation of their asthma. IOS and spirometric parameters were collected at baseline and at 0, 5, 10, 20, and 30 minutes post-EBPT.The participants were divided into 2 groups according to MBPT positivity: an airway hyperresponsiveness (AHR) group and a no-AHR group.

RESULTS

There were differences in the percent decrease in forced expiratory volume in the first second (FEV1) between the 2 groups at 5, 10, and 20 minutes after exercise. Resistance at 5 Hz (R5) increased in the AHR group but not in the no-AHR group at 5 and 10 minutes after exercise. Integration of reactance from 5 Hz to resonance frequency (area of reactance, AX) was also increased in the AHR group at only 5 and 10 minutes post-EBPT. Delta R5 and delta AX at 5 and 10 minutes post-exercise were well correlated with the percent decrease in FEV1.

CONCLUSIONS

IOS parameters, especially delta R5 and delta AX, may be useful for performing objective evaluations and improving our understanding of exercise-induced airway obstruction in young asthmatics.

Generation of intense proton beams from plastic targets irradiated by an ultraintense laser pulse

Proton beams generated from thin aluminum and Mylar foil targets that are irradiated by a 30fs Ti:sapphire laser pulse with an intensity of 2.2x10;{18}Wcm;{2} were investigated. Protons from the Mylar targets were observed to have an energy higher by a factor of 2 and were higher in number by an order of magnitude as compared with those generated from the aluminum targets. The maximum proton energy of 1.3+/-0.12MeV obtained from the Mylar target was found to be similar with previous observations that used laser pulses with different intensities. To address the anomalous behavior of the maximum proton energy for plastic targets, an acceleration model is proposed. In this model, the protons are accelerated by a resistively induced electric field in the front of the target, which can account for the experimental observations.

Change of biophysical properties of the skin caused by ultraviolet radiation-induced photodamage in Koreans

BACKGROUND/PURPOSE

Ultraviolet (UV) irradiation affects the function and complexion of the skin by inducing changes in physical properties through formation of erythema, proliferation of epithelial cells, DNA damage, activation or inactivation of various enzymes and proteins, and free radical formation. In this study, the authors intended to observe the overall course of changes in barrier function and reflectance of the skin induced by photodamage, and healing reaction in the course of time, and alteration of the skin complexion.

METHODS

The subjects were chosen from 15 healthy Korean men 20-35 in age, that fall into the category of Fitzpatrick's skin types II, III, and IV without history of recent exposure to sunlight, photosensitivity, or having taken any drugs that induce phototoxicity or photoallergic reactions. The subjects were artificially exposed to suberythemogenic dose [0.5 minimal erythemal dose (MED), 0.75 MED], 1 MED and high dose (2.5 MED) by solar simulator, and changes in skin barrier function and skin reflectance were assessed with a Tewameter, a Corneometer, and a Colorimeter for 4 weeks.

RESULTS

Transepidermal water loss (TEWL) increased abruptly at Day 1 of single solar UV (SSUV) exposure, and slowly returned to the original level from Day 2/Day 3. In the case of exposure with 0.75 MED, it returned to the original level at Day 4 of exposure, and at Days 7 and 28 in the cases of 1 MED and 2.5 MED exposure, respectively. Water-holding capacity sharply declined at Day 1 of exposure, hitting the lowest point at Day 2, and then slowly recovered starting on Day 3. In the case of exposure with 0.75 MED and 1 MED, it returned to the original level at Days 7 and 28 in the case of 2.5 MED exposure. The a(*) values abruptly increased and reached the peak at Day 1 and slowly returned to the original level at Day 2, while the b(*) values slowly increased at Day 3, peaking at Day 7 and slowly returning to the original level thereafter. The L(*) values abruptly declined at Day 1, maintaining plateau through Day 7 and slowly returning to the baseline level thereafter. The individual typology angle (ITA degrees ) were compatible with L(*) values change. The erythema index increased abruptly at Day 1 of SSUV exposure, peaking at Day 2 and slowly returned to the original level starting at Day 3. Melanin index slowly started to increase on Day 3 of SSUV exposure, peaking at Day 7 and gradually returned to the original level thereafter. However, L(*), a(*), b(*), erythema index, and melanin index did not return to the original level during the 28-day course of this study.

CONCLUSION

This study shows that in the skin of Korean subjects, changes in skin barrier function and delayed melanization do occur even in exposure to a suberythemogenic dose of SSUV. Also, given the fact that restoration of barrier function occurs as the process of melanization begins, melanization is considered to be a useful predictive indicator of the restoration of the skin barrier function after sunburn.

Silver-mirror-based multipass preamplifier for a broadband terawatt Ti:sapphire laser

We have developed a silver-mirror-based multipass preamplifier for a broadband amplification in a terawatt Ti:sapphire laser. With the extremely broad bandwidth of the silver mirrors, a very broad amplified spectrum can be generated at an amplified energy of 4 mJ; the amplified spectral width is 65 nm at half maximum and 160 nm at -25 dB without any spectral shaping technique. Such a broad amplification can be explained well by the simulation that includes gain narrowing and gain saturation. Even after a further amplification to an energy of 600 mJ, the amplified spectrum is broad enough to support an approximately 20 fs transform-limited pulse duration.

Mimulus is an emerging model system for the integration of ecological and genomic studies

The plant genus Mimulus is rapidly emerging as a model system for studies of evolutionary and ecological functional genomics. Mimulus contains a wide array of phenotypic, ecological and genomic diversity. Numerous studies have proven the experimental tractability of Mimulus in laboratory and field studies. Genomic resources currently under development are making Mimulus an excellent system for determining the genetic and genomic basis of adaptation and speciation. Here, we introduce some of the phenotypic and genetic diversity in the genus Mimulus and highlight how direct genetic studies with Mimulus can address a wide spectrum of ecological and evolutionary questions. In addition, we present the genomic resources currently available for Mimulus and discuss future directions for research. The integration of ecology and genetics with bioinformatics and genome technology offers great promise for exploring the mechanistic basis of adaptive evolution and the genetics of speciation.

Development of sequencing batch reactor with step feed and recycle

SBR process shows high nitrogen and phosphorus removal in countries where separated sewers are used. On the other hand, removal efficiency is low in countries where combined sewers are used though the same SBR is applied. This is because the organic concentration (as BOD), which is used as carbon source for denitrification, of combined sewers is much lower than that of separated sewers. Almost all sewers in Korea are combined, and their BOD is low by about 1/2 over the level needed for denitrification. In this study, a SBR process that can optimise organic usage by step feed and recycle is thus developed to increase the removal efficiency of nitrogen and phosphorus, and the results show that the removal rates of BOD, T-N and T-P are 95.4, 81.4 and 86.1%, respectively, though influent BOD is low.

Quantitative investigation on the distribution of Malassezia species on healthy human skin in Korea

This study concerns a culture research based on the data gathered from Korean subjects to examine distribution of Malassezia yeast. Malassezia yeast were cultivated out of samples from scalp, forehead, chest, arm and thigh. Malassezia restricta was recovered more frequently in the teens and young adults, while M. globosa was the predominant species in subjects older than 50 years of age. The population density of Malassezia yeast was significantly higher in the age group (AG) of 21-30 years compared with other AGs (P < 0.05). It was also significantly higher in the chest compared with the forehead, arm and thigh (P < 0.05). The key is to recognise the existence of a difference in the amount and type of Malassezia species in different AGs as well as body areas, which reflects differing skin lipid levels in various AGs and different body areas.

20 W single-mode Yb3+ -doped phosphate fiber laser

We report the demonstration of the first, to our knowledge, cladding-pumped continuous-wave Yb(3+)-doped phosphate-glass fiber laser. Phosphate hosts are of interest because they can be much more heavily doped than silica, and because of the possibility that they may have a higher photodarkening threshold. In an 84.6 cm double-clad fiber doped with 12 wt. % of Yb(2)O(3) and laser-diode pumped at 940 nm, nearly 20 W of single-mode 1.07 microm output power was generated with 60.2 W of absorbed pump power. The measured dependence of the output power on pump power is in excellent agreement with simulations.

Development of soil-covered SBR process for small scale sewage treatment

Nitrogen and phosphorus compounds, mainly from the households in residential areas are responsible for eutrophication occurring in lakes or estuaries. In Korea, there is a growing trend for villages in the countryside, rest areas of express ways, military unit bases, etc. to use small scale sewage treatment plants (SSTPs). However, the technological developments have mainly focused on medium or large scale sewage treatment plants, leaving a gap in the development of technologies for SSTPs without a residing operator. In this study, a soil-covered sequencing batch reactor (SBR) process for SSTPs in combination with a natural purification technology is developed to remove nitrogen and phosphorus as well as organic contamination (BOD), and the results are as follows: (1) the removal rates of BOD, total nitrogen (T-N), total phosphorus (T-P) and suspended solids (SS) are 93%, 74%, 80% and 95%, respectively, (2) the soil-covered SBR process without the decanter used for effluent discharge is similar to other SBR processes in suspended solids removal rate, and (3) the performance of the field pilot plant was monitored by remote sensing system in real time, and the results show that this system can be applied to SSTPs with no residing operators.

Backwash based methodology for the estimation of solids retention time in biological aerated filter

The concept of solids retention time (SRT) was used for describing the growth of biofilm in a biological aerated filter (BAF) system. The SRT profile was obtained from the change in solids accumulation, estimated from the head loss profile data before and after backwash using the Carmen-Kozeny equation. The SRT profile along the filter bed depth showed the SRT of about 2 days for the lower layer and about 6 days for the upper layer. The overall SRT was determined by the direct estimation of excess solids mass during backwash and of solids retained in the filter bed. The ideal characteristic SRT distribution was maintained by regular backwash, for organic removal and nitrification. The SRT for high organic removal and nitrification is demonstrated by the SRT distribution along the filter bed in this BAF process.

Field evaluation of Bacillus thuringiensis H-14 against Aedes mosquitoes

Studies were carried out on the residual efficacy of Bacillus thuringiensis H-14 (water dispersible granule, VectoBac ABG 6511) as direct application in the control of Aedes larvae in the field. Field Aedes sp populations in the earthen and glass jars were predetermined before initiation of the trial. On confirmation of the presence of Aedes species in the designated area, Sungai Nibong Kecil, Penang Island, Malaysia, Bti was introduced in the 55L earthen and 3L glass jars). Two test designs were carried out. The first design had treated water replenished daily with 6L of seasoned water and the second design is without the replenishment of water but evaporated water was replenished. Bti was effective in the field for at least 35 days with more than 80% reduction in the Aedes larvae in the treated containers. For earthen jars with daily replenishment of water, 100% reduction was recorded for the first 3 days, while more than 80% reduction was recorded up to day 40. At day 60, Bti still provided an efficacy of 54.32 +/- 4.61 (%) of reduction. Whilst for earthen jars without daily replenishment of water, 100% reduction was recorded for the first 5 days, while more than 80% of reduction was recorded up to day 40. For the glass jars studied, similar efficacy was observed. In jars with daily replenishment of water a better larval control was observed. Percentage of reduction from day 50 to 60 for replenishment of water was between 50 to 70% compared to without replenishment of water with less than 40%.

Susceptibility of laboratory and field-collected Aedes aegypti and Aedes albopictus to Bacillus thuringiensis israelensis H-14

Susceptibility levels of a few laboratory-cultured and dengue-endemic area field-collected strains of Aedes aegypti and Aedes albopictus to Bacillus thuringiensis israelensis (Bti) at different storage ages were studied. The susceptibility of laboratory-cultured World Health Organization (WHO) Bora Bora reference, Vector Control Research Unit (VCRU), and Fumakilla Malaysia Berhad (FMB) strains of Ae. aegypti to Bti was examined. The sensitivity to Bti decreased with storage age. The median lethal concentration (LC50) for Bti increased by 2-3 times after 2 years compared to a fresh sample (3-6 months of storage). However, after the 2-year storage period, Bti still provided very good efficacy against all laboratory-cultured susceptible strains of Ae. aegypti and Ae. albopictus. The observed 95% lethal concentration values were about 20 times lower than the recommended concentration (6,000 international toxic units (ITU)/liter). Results obtained from the study against the dengue-endemic area field-collected strains of Ae. aegypti and Ae. albopictus confirmed the effectiveness of the Bti after storage for 2 years (18-24 months). For Ae. aegypti, the Ujung Batu strain was the most susceptible to Bti, whereas the Sungai Nibong strain showed the most tolerance. Susceptibility of laboratory-cultured strains varied; the Air Itam strain of Ae. albopictus was the most susceptible to Bti, whereas the Kampung Serani strain was the most tolerant among the field strains. However, the laboratory strain of Ae. albopictus was more susceptible than all the field strains.

Human immunodeficiency virus-1 Tat protein up-regulates interleukin-6 and interleukin-8 expression in human breast cancer cells

OBJECTIVE

To examine whether HIV-1 Tat protein increases the metastatic potential of human breast cancer cells through induction of pro-inflammatory tumor microenvironment.

METHODS

Real-time RT-PCR and ELISA were employed to determine the mRNA and protein expression of IL-6 and IL-8 in highly metastatic human breast cancer cell line, MDA-MB-231. To investigate the transcriptional regulatory mechanisms of Tat-mediated up-regulation of IL-6 and IL-8, EMSA and reporter gene assay were carried out.

RESULTS

Exposure of MDA-MB-231 cells to Tat resulted in a significant and dose-dependent up-regulation of IL-6 and IL-8 mRNA and protein expression. HIV-1 Tat protein also markedly increased NF-kappaB DNA-binding activity and transactivation in MDA-MB-231 cells. Additionally, pretreatment with NF-kappaB inhibitors significantly attenuated the ability of Tat to up-regulate IL-6 and IL-8 expression. It was also found that exposure of MDA-MB-231 cells to Tat induced up-regulation of MMP-9 expression at both mRNA and protein levels.

CONCLUSIONS

These results suggest that HIV-1 Tat protein up-regulates expression of IL-6 and IL-8 in human breast cancer cells by NF-kappaB-dependent pathway. These data may contribute to exploration of the new molecular mechanisms leading to novel approaches for the therapeutic drug developments specifically targeted against the inflammatory pathways of breast cancer metastasis in AIDS patients.

Relationship between arterial and end-tidal carbon dioxide pressures during anesthesia using a laryngeal tube

BACKGROUND

The Laryngeal Tube (LT), (VBM Medizintechnik, Sulz, Germany) is a relatively new supraglottic device for controlling the airway. Arterial carbon dioxide tension (PaCO(2)) can be estimated by monitoring the end-tidal tension of carbon dioxide (PETCO(2)). The relationship between PETCO(2) and PaCO(2) during controlled ventilation via the LT has not been reported.

METHODS

During general anesthesia, 45 patients were mechanically ventilated using an LT. PETCO(2) and PaCO(2) were measured once PETCO(2) had reached a steady state. The LT was then removed and the trachea intubated using an endotracheal tube (ETT), and the identical ventilatory variables were resumed. Following stabilization, PETCO(2) was again determined and PaCO(2) estimated.

RESULTS

The mean PETCO(2) and PaCO(2) values were 4.43 +/- 0.26 kPa and 4.67 +/- 0.32 kPa, respectively, during LT ventilation, and 4.36 +/- 0.23 kPa and 4.61 +/- 0.26 kPa, respectively, during ETT ventilation. Analysis of differences between the PETCO(2) and PaCO(2) values using the Bland and Altman method revealed a bias +/- precision of 0.24 +/- 0.15 kPa for LT and 0.27 +/- 0.15 kPa for ETT. The root mean square error was 0.28 for the LT and 0.30 for the ETT.

CONCLUSION

This study suggests that for healthy adult patients mechanically ventilated via the LT, the PETCO(2) value reflects the PaCO(2) value as closely as when patients are ETT ventilated, allowing capnometry to be used to evaluate the adequacy of ventilation.

Laboratory evaluation of Bacillus thuringiensis H-14 against Aedes aegypti

Laboratory efficacy and residual activity of a water dispersible granule formulation of Bacillus thuringiensis israelensis (Bti) at the dosages of 3000, 6000 and 15000 ITU/L were conducted in this study. The study was conducted in two different size containers, earthen jar (45 L) and glass jar (3 L) with or without daily replenishment of 6 L and 0.3 L of water in the earthen and glass jars, respectively. Results indicate that for both earthen jar and glass jar evaluations, Bti at the tested dosages, performed effectively against Aedes aegypti, giving a minimum of 42 days effective killing activity. When the dosage was increased from 3000 ITU/L to 6000 ITU/L or 15000 ITU/L, the effective periods of the Bti increased by an additional one to three weeks. The Bti water dispersible granule provided better larvicidal activity with replenishment of water compared with non-replenishment of water especially for the higher dosage (15000 ITU/L).

Discrepancy of interleukin-6 levels between end-stage renal disease patients and patients with acute-phase response with increased lipoprotein(a) concentrations

Though the concentration of serum lipoprotein(a) [Lp(a)] is mostly determined by genetic factors, secondary factors such as acute-phase response (APR) and end-stage renal disease (ESRD) also contribute to its increase. Lp(a) is known to be one of the acute-phase reactants and interleukin-6 (IL-6) is the key cytokine in the hepatic synthesis of acute-phase proteins. The serum concentrations of Lp(a) and IL-6 were measured in patients with APR and in patients with ESRD to investigate the relationship between Lp(a) and IL-6. A total of 180 patients were selected for the study: 60 patients were normal controls, 60 were patients with renal disease who had been on hemodialysis for more than 6 months [C-reactive protein (CRP)<4.0 mg/L], and 60 were APR patients who had a erythrocyte sedimentation rate (ESR) of over 50 mm/h. The three groups were age- and sex matched. The serum concentrations of Lp(a) and IL-6 were measured by ELISA. The serum concentrations of Lp(a) [median (interquartile range)] in normal controls, ESRD patients, and APR patients were 0.222 (0.103-0.364) g/L, 0.511 (0.308-0.755) g/L, and 0.546 (0.234-0.747) g/L, respectively; those of IL-6 were 1.0 (0.7-1.3) pg/mL, 2.1 (1.4-3.3) pg/mL, and 26.2 (15.2-35.6) pg/mL. The concentration of IL-6, which increases Lp(a) synthesis, was much lower in ESRD patients than in APR patients (p<0.001). However, there were no significant differences in Lp(a) concentration between the two groups (p=0.88). In APR patients, the increase in Lp(a) synthesis seems to play a significant role in the increase in blood Lp(a), but there might be different mechanisms that regulate the increment of serum Lp(a) concentrations in ESRD patients other than synthesis of Lp(a).