Adolescents diagnosed with polycystic ovary syndrome under the Rotterdam criteria but not meeting the diagnosis under the updated guideline

STUDY QUESTION

What are the characteristics of adolescents diagnosed with polycystic ovary syndrome (PCOS) based on the 2003 Rotterdam criteria, but who do not meet the diagnosis according to the international evidence-based guideline?

SUMMARY ANSWER

Adolescents who had features of PCOS but did not meet the evidence-based guideline adolescent criteria exhibited unfavorable metabolic profiles compared to controls and shared considerable metabolic and hormonal features with adolescents who did meet the adolescent criteria.

WHAT IS KNOWN ALREADY

The international evidence-based PCOS guideline recommended that ultrasound should not be used for the diagnosis of PCOS in girls with a gynecological age of <8 years. Thus far, few studies have evaluated the clinical characteristics of the girls diagnosed with PCOS based on the Rotterdam criteria but who do not meet the diagnosis according to the updated guideline.

STUDY DESIGN, SIZE, DURATION

This is a retrospective study, and subjects attended for care from 2004 to 2022.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Adolescent girls with PCOS diagnosed according to the 2003 Rotterdam criteria and healthy controls. All participants were between 2 and 8 years since menarche.

MAIN RESULTS AND THE ROLE OF CHANCE

Of the 315 girls diagnosed with PCOS according to the Rotterdam criteria, those with irregular menstruation (IM)/hyperandrogenism (HA)/polycystic ovary (PCO), IM/HA, HA/PCO, and IM/PCO phenotypes accounted for 206 (65.4%), 30 (9.5%), 12 (3.8%), and 67 (21.3%) participants, respectively. According to the evidence-based guideline, 79 girls (25.1%) with the HA/PCO or IM/PCO phenotypes were not diagnosed with PCOS, and aligned to the international guideline; they were designated as the 'at-risk' group. As expected, the girls meeting the evidence-based guideline adolescent criteria showed the worst metabolic profiles (degree of generalized or central obesity, frequency of insulin resistance, prediabetes or diabetes, and metabolic syndrome) and higher hirsutism scores than the at-risk group or controls. Approximately 90% of the at-risk group were not overweight or obese, which was similar to the controls. However, they showed worse metabolic profiles, with higher blood pressure, triglyceride, and insulin resistance parameters than controls; furthermore, these profiles were similar to those of the girls meeting the adolescent criteria. The at-risk group showed similarly elevated serum LH levels and LH/FSH ratio with the girls meeting adolescent criteria.

LIMITATIONS, REASONS FOR CAUTION

We could not evaluate hormonal or ultrasound parameters in controls.

WIDER IMPLICATIONS OF THE FINDINGS

Compared to the conventional Rotterdam criteria, the recent international evidence-based guideline-avoiding ultrasound in PCOS diagnosis in adolescents-still gives the opportunity to identify young girls at risk, aligned to the findings in this study. A practical approach to this adolescent population would involve establishing IM or HA (with ultrasound not indicated) and designating 'at-risk' PCOS status with regular check-ups for newly developed or worsening PCOS-related symptoms or metabolic abnormalities, with subsequent reassessment including ultrasound or anti-Müllerian hormone, once 8 years post-menarche.

STUDY FUNDING/COMPETING INTEREST(S)

No funding was received in support of this study. The authors have no conflicts of interest to disclose.

TRIAL REGISTRATION NUMBER

N/A.

Diagnostic utility, disease activity, and disease phenotype correlation of serum ASCA, pANCA, and PR3-ANCA in pediatric inflammatory bowel disease

OBJECTIVE

This study aimed to evaluate the diagnostic utility, disease activity, and phenotypic association of serum anti-Saccharomyces cerevisiae antibody (ASCA), perinuclear anti-neutrophil cytoplasmic antibody (pANCA), PR3-ANCA, and MPO-ANCA in pediatric patients with inflammatory bowel disease (IBD).

METHODS

Pediatric patients diagnosed with IBD were recruited and classified as Crohn's disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U) through full investigation. The Paris classification was used to evaluate disease phenotypes of pediatric CD and UC.

RESULTS

In all, 229 pediatric patients with IBD (CD 147, UC 53, IBD-U 29) were included. The ASCA IgG seropositivity significantly differed among the three groups (CD 75.4%, UC 17.5%, and IBD-U 60.0%; p < 0.001). PR3-ANCA positive rates were the highest in UC (24.0%), followed by IBD-U (17.6%), and none in CD (p = 0.002); pANCA-positive rates were higher in IBD-U (33.6%), followed by UC (28.0%) than in CD (1.4%) (p < 0.001). Regarding disease phenotype, perianal disease revealed higher serum ASCA IgG titers (median 36.7 U/mL in P1 vs. 25.2 U/mL in P0, p = 0.019). Serum ASCA IgG and IgA cutoff values to distinguish CD were 32.7 (U/mL) and 11.9 (U/mL), respectively, with a specificity of 80.0%.

CONCLUSION

Serological biomarkers of ASCA IgG and IgA were effective for differentiating CD in pediatric IBD patients, and serum pANCA and PR3-ANCA, but not MPO-ANCA, were effective in distinguishing UC and IBD-U. Furthermore, measuring serological titers of ASCA IgG and IgA may help differentiate CD and evaluate the disease activity and phenotype of pediatric IBD in practice.

Aerobic Exercise Improves Radiation Therapy Efficacy in Non-Small Cell Lung Cancer: Preclinical Study Using a Xenograft Mouse Model

The "oxygen effect" improves radiation efficacy; thus, tumor cell oxygen concentration is a crucial factor for improving lung cancer treatment. In the current study, we aimed to identify aerobic exercise-induced changes in oxygen concentrations in non-small cell lung cancer (NSCLC) cells. To this end, an NSCLC xenograft mouse model was established using human A549 cells. Animals were subsequently subjected to aerobic exercise and radiation three times per week for 2 weeks. Aerobic exercise was performed at a speed of 8.0 m/m for 30 min, and the tumor was irradiated with 2 Gy of 6 MV X-rays (total radiation dose 12 Gy). Combined aerobic exercise and radiation reduced NSCLC cell growth. In addition, the positive effect of aerobic exercise on radiation efficacy through oxygenation of tumor cells was confirmed based on hypoxia-inducible factor-1 and carbonic anhydrase IX expression. Finally, whole-transcriptome analysis revealed the key factors that induce oxygenation in NSCLC cells when aerobic exercise was combined with radiation. Taken together, these results indicate that aerobic exercise improves the effectiveness of radiation in the treatment of NSCLC. This preclinical study provides a basis for the clinical application of aerobic exercise to patients with NSCLC undergoing radiation therapy.

Greater numbers and sizes of muscle bundles in the breast and leg muscles of broilers compared to layer chickens

Meat-type (broiler) and egg-type (layer) chickens were bred by intensive selection over the years, resulting in more numbers and larger sizes of myofibers. Although the characteristics are important parameters in muscle growth and meat quality, muscle bundle characteristics have not been studied in poultry. Therefore, this study aimed to compare the histological characteristics of myofibers and muscle bundles in muscles between male broiler (Ross broiler breed) chickens and layer (Hy-Line) chickens. Chicken muscles, pectoralis major (PM) and gastrocnemius (GM), were sampled at the age of 49 days and stained to analyze histological characteristics. Expectedly, body weights (BWs) and weights of PM and GM muscles in 49-day-old broilers were significantly heavier than those in layers. Within PM, broilers exhibited greater number and cross-sectional area (CSA) of myofibers than layers (3.3- and 3.3-fold, respectively). The total number and CSA of PM muscle bundles were approximately 1.5 and 6.6 times greater, respectively, in broilers than layers. Moreover, broilers exhibited 2 times greater number of myofibers per bundle of PM muscle than layers. Within GM, myofiber number and CSA were 2.3- and 2.4-fold greater, respectively, in broilers than layers. In addition, the total number of muscle bundles and bundle CSA were 2.5- and 2.1-fold greater, respectively, in broilers than in the layers. The novel findings of the current study provide evidence that greater muscle mass of broilers occurs by both hyperplasia and hypertrophy of muscle bundles and myofibers.

Vertebral compression fracture after stereotactic ablative radiotherapy in patients with oligometastatic bone lesions from hepatocellular carcinoma

Background and purpose

Stereotactic ablative radiotherapy (SABR) is popularly used to treat bone metastasis. Despite its efficacy, adverse events, including vertebral compression fracture (VCF), are frequently observed. Here, we investigated VCF risk after SABR for oligometastatic vertebral bone metastasis from hepatocellular carcinoma.

Materials and methods

A total of 84 patients with 144 metastatic bone lesions treated at three institutions between 2009 and 2019 were retrospectively reviewed. The primary endpoint was VCF development, either new or progression of a pre-existing VCF. VCFs were assessed using the spinal instability neoplastic score (SINS).

Results

Among 144 spinal segments, 26 (18%) had pre-existing VCF and 90 (63%) had soft tissue extension. The median biologically effective dose (BED) was 76.8 Gy. VCF developed in 14 (12%) of 118 VCF-naïve patients and progressed in 20 of the 26 with pre-existing VCF. The median time to VCF development was 6 months (range, 1-12 months). The cumulative incidence of VCF at 12 months with SINS class I, II and III was 0%, 26% and 83%, respectively (p < 0.001). Significant factors for VCF development were pre-existing VCF, soft tissue extension, high BED, and SINS class in univariate analysis, and pre-existing VCF in multivariate analysis. Of the six components of SINS, pain, type of bone lesion, spine alignment, vertebral body collapse, and posterolateral involvement were identified as predictors of VCF development.

Conclusion

SABR for oligometastatic vertebral bone lesions from HCC resulted in a substantial rate of new VCF development and pre-existing VCF progression. Pre-existing VCF was significant risk factor for VCF development, which require special attention in patient care. Patients with SINS class III should be considered surgical treatment rather than upfront SABR.

Effects of apoptotic factor levels on palatability variation during postmortem aging of Holstein longissimus thoracis muscles classified as Warner-Bratzler shear force change value

This study compared the caspase levels and myofibrillar protein degradation of longissimus thoracis muscles between the two groups with varying extents of tenderization during postmortem aging to investigate the cause of tenderness variation between aged beef from Holstein-Friesian steers. The change value (CV) of Warner-Bratzler shear force (WBS) was determined as the difference in WBS between 0 and 14 d of aging. The higher change (HC) value group exhibited lower WBS and higher initial tenderness values than the lower change (LC) value group aged 14 and 28 d (P < 0.05), even though there was no difference between the CV groups aged 0 d (P > 0.05). The higher tenderness improvement in the HC group at 14 d might be related to the lower cytochrome C and caspase values and higher degradation of desmin and troponin T compared to the LC group (P < 0.05).

Effects of a myostatin mutation in Japanese quail (Coturnix japonica) on the physicochemical and histochemical characteristics of the pectoralis major muscle

The aim of this study was to compare the carcass, meat quality, and histochemical characteristics of pectoralis major (PM) muscle between wild type (WT) and myostatin (Mstn) homozygous mutant (HO) quail lines. The HO quail line exhibited significantly heavier body weight (HO vs. WT, 115.7 g vs. 106.2 g, approximately 110%) and PM muscle weight (HO vs. WT, 18.0 g vs. 15.2 g, approximately 120%) compared to the WT (p &lt; 0.001). However, the two groups had similar traits (pH, redness, yellowness, and drip loss) for meat quality, although slightly higher lightness and cooking loss were observed in the mutant quail (103% and 141%, respectively, p &lt; 0.05). For histochemical traits of PM muscle, Mstn mutant quail exhibited lower type IIA and higher type IIB percentage in the deep region than WT quail (p &lt; 0.05), indicating a fiber conversion from the type IIA to IIB. However, the two quail lines had comparable histochemical traits in the superficial region (p &gt; 0.05). These data suggest that Mstn mutation greatly increases muscle mass without significantly affecting meat quality.

Research Note: Expression levels of collagen-related genes in PSE conditions and white striping features of broiler pectoralis major muscle

The objective of this study was to compare the meat quality characteristics and collagen-related gene expression levels in the broiler pectoralis major (PM) muscle among the meat quality groups, including normal, pale, soft, and exudative (PSE), and white striping (WS) groups. The group was classified by their WS degree (moderate or severe striping) and quality traits including pH and lightness values at 24 h postmortem (normal group: pH_{24 h} ≥5.7, 48≤L*≤53, without WS features; PSE group: pH_{24 h} <5.7, L* >53, without WS features; WS group: pH_{24 h} ≥5.7, 48≤L*≤53, with moderate or severe striping). The WS group revealed no differences in all measured meat quality traits compared to the normal group (P > 0.05). PM muscles exhibiting PSE conditions without WS indicated lower pH_{15 min} and pH_{24 h} values (P < 0.05). Whereas, lower lightness and cooking loss values were observed in the normal and WS groups compared to the PSE group (P < 0.05). No significant difference was observed in the level of type I collagen among the groups (P > 0.05), whereas a higher type III collagen level was observed in the WS group than in the other groups (P < 0.05). Additionally, the WS group showed a higher type IV collagen level compared to the normal group (P < 0.05) and a level not different from that of the PSE group (P > 0.05). In contrast, the expression levels of matrix metalloproteinase (MMP) 2, involved in type IV collagen degradation, and angiopoietin-like protein 7, associated with collagen accumulation, were higher in the WS group compared to the normal group (P < 0.05). However, no difference was detected in the MMP1 level among the all groups (P > 0.05). These results suggest that the occurrence of WS features in broiler PM muscle, unlike PSE and normal conditions, can be influenced by the expression levels of collagen-related genes associated with abnormalities in extracellular matrix components.

The Asian Society of Endometriosis and Adenomyosis guidelines for managing adenomyosis

This is the first guidelines for adenomyosis from the Asian Society of Endometriosis and Adenomyosis.

Standardized ileal digestible lysine requirements based on growth performance and histochemical characteristics of male broilers from 10 to 21 d of age

The growth performance and histochemical characteristics of breast muscle fibers were used to estimate the standardized ileal digestible (SID) Lys requirements for 10- to 21-d-old male broilers. Three hundred and sixty 10-d-old Ross 308 broilers (290 ± 16.6 g) were allocated to 6 diets in a randomized complete block design with 6 replicate cages per treatment and 10 birds per cage. The 6 experimental diets were formulated to contain equally spaced increasing levels of SID Lys from 0.86% to 1.36%. The data were analyzed using the MIXED procedure of SAS. The Lys requirements were estimated by the NLIN procedure of SAS. An increase in dietary SID Lys from 0.86% to 1.36% resulted in a quadratic increase (P < 0.05) in body weight gain (BWG), gain to feed ratio (G:F), breast weight, muscle cross-sectional area (MCSA), and fiber area. The SID Lys requirements based on the one-slope broken-line, quadratic line, the first intercept between the plateau of the one-slope broken-line and quadratic-line models and 95% of the upper asymptote of the quadratic-line model were estimated to be 1.01%, 1.19%, 1.08%, and 1.13% for BWG, 1.06%, 1.22%, 1.11%, and 1.16% for G:F, 1.10%, 1.29%, 1.19%, and 1.22% for breast weight, 1.06%, 1.22%, 1.12%, and 1.16% for MCSA, and 1.14%, 1.22%, 1.16%, and 1.16% for breast muscle fiber area, respectively. It was concluded that the SID Lys requirements for broilers at the age of 10 to 21 d depended on the response variables used for estimation, and that histochemical characteristics of breast muscle fibers could be good indicators for estimating SID Lys requirements.

Research Note: Growth promoting potential in Mstn mutant quail dependent and independent of increased egg size

In avian species, positive relationships between egg weight (EW) and body weight (BW) have been reported. However, the correlation between the body growth rate and different weights of eggs from genetically mutated avian species was not studied yet. Myostatin (Mstn), an anti-myogenic factor, mutant quail were recently developed, and it was reported that EW produced from Mstn homozygous mutant quail (HO) was heavier compared to those from wild-type quail (WT). In the current study, distributions of pre-incubated EW and associations between EW and BW were compared between the Mstn mutant and WT quail lines. Average egg weight for the HO group was significantly heavier than the WT (P < 0.001) and the number of eggs having heavier EW (over 11 g) was higher in the HO compared to the WT (P < 0.01). BWs at wk (W) 0, 4, and 6 after hatch were also significantly greater in the HO (P < 0.001 in all groups). In addition, linear regression analyses revealed positive relationships between EW and BW from W0 to W6, regardless of sexes and genotypes. Furthermore, Mstn mutant quail were a heavier BW compared to the WT quail originated from eggs with similar weights. These data indicate that increased BW by Mstn mutation is contributed by increased EW and/or growth promoting activity of Mstn mutation independent of increasing egg sizes. These findings provide Mstn as a desirable genetic factor for selection of poultry breeds with superior growth. In addition, the knowledge gained from this study could inspire similar proof-of-concept studies involving standard and commercial lines of poultry.

PSE condition is associated with increased apoptotic potential in broiler pectoralis major muscle

This study compared the meat quality and sensory quality characteristics of broiler pectoralis major (PM) muscle between meat quality classes, including reddish, firm, and non-exudative (RFN) and pale, soft, and exudative (PSE) conditions. Additionally, we also investigated the associations between the meat quality classes and expression levels of cytochrome c, initiator (caspase 9), and effector caspases (caspase 3 and 7) at the early postmortem period. A total of 135 PM muscles from broilers were used, and meat quality classes were determined according to the pH_{24 h} and lightness values and classified into the RFN (N = 81) and PSE (N = 54) conditions. The PSE breasts showed lower muscle pH_{15 min} and pH_{24 h} values compared to the RFN breasts (P < 0.05). A lower lightness value was observed in the RFN group compared to the PSE group (P < 0.001), whereas there were no significant differences in redness and yellowness between the groups (P > 0.05). The PSE group exhibited higher extent of water loss, including drip loss and cooking loss, compared to the RFN group (P < 0.05). For these reasons, samples from the RFN group required less force to breakdown the cooked meat with more moisture in the mouth after chewing compared to samples from the PSE group (P < 0.001); however, flavor intensity did not differ between the groups (P > 0.05). At 15 min postmortem, all apoptosis-related molecules, including cytochrome c, caspase 9, caspase 3, and caspase 7, were present at higher levels in the PSE group than in the RFN group (P < 0.05). These results indicated that higher apoptotic potentials were associated with the development of PSE chicken breasts. Therefore, the variation of meat quality in chicken breast can be explained as being affected by the expression levels of apoptosis-related factors at the early postmortem period.

Generation of αMHC-EGFP knock-in in human pluripotent stem cell line, SNUe003-A-3 using CRISPR/Cas9-based gene targeting

The cardiac muscle-specific protein, α-myosin heavy chain (αMHC), is a major component of cardiac muscle filaments involved in cardiac muscle contraction. Here, we established an αMHC-enhanced fluorescent protein (EGFP) knock-in human pluripotent stem cell (hPSC) line by linking the EGFP gene to the C-terminal region of αMHC via a 2A non-joining peptide using CRISPR/Cas9 nuclease. The EGFP reporter precisely reflected the endogenous level of αMHC upon the induction of cardiac differentiation. This reporter cell line will be a valuable platform for cardiotoxicity tests, drug screening, and investigating the pathological mechanisms of cardiomyocytes.

Density-Dependent Differentiation of Tonsil-Derived Mesenchymal Stem Cells into Parathyroid-Hormone-Releasing Cells

Mesenchymal stem cells (MSCs) can differentiate into endoderm lineages, especially parathyroid-hormone (PTH)-releasing cells. We have previously reported that tonsil-derived MSC (T-MSC) can differentiate into PTH-releasing cells (T-MSC-PTHCs), which restored the parathyroid functions in parathyroidectomy (PTX) rats. In this study, we demonstrate quality optimization by standardizing the differentiation rate for a better clinical application of T-MSC-PTHCs to overcome donor-dependent variation of T-MSCs. Quantitation results of PTH mRNA copy number in the differentiated cells and the PTH concentration in the conditioned medium confirmed that the differentiation efficiency largely varied depending on the cells from each donor. In addition, the differentiation rate of the cells from all the donors greatly improved when differentiation was started at a high cell density (100% confluence). The large-scale expression profiling of T-MSC-PTHCs by RNA sequencing indicated that those genes involved in exiting the differentiation and the cell cycle were the major pathways for the differentiation of T-MSC-PTHCs. Furthermore, the implantation of the T-MSC-PTHCs, which were differentiated at a high cell density embedded in hyaluronic acid, resulted in a higher serum PTH in the PTX model. This standardized efficiency of differentiation into PTHC was achieved by initiating differentiation at a high cell density. Our findings provide a potential solution to overcome the limitations due to donor-dependent variation by establishing a standardized differentiation protocol for the clinical application of T-MSC therapy in treating hypoparathyroidism.

Sensory Quality and Histochemical Characteristics of Longissimus Thoracis Muscles between Hanwoo and Holstein Steers from Different Quality Grades

This study compared the meat quality characteristics, palatability, and histochemical characteristics of low-marbled Hanwoo and Holstein steers of different beef quality grades (1, 2, and 3). No differences were observed in muscle pH_{24 h} and cooking loss between the groups (p>0.05); however, quality grade 1 of Hanwoo steers (HA1) showed a darker muscle surface compared to grade 1 of Holstein steers (HO1) (30.9 vs. 33.9, p<0.05). The HA2 group exhibited a lower value of Warner-Bratzler shear force compared to the HO1 and HO3 groups (60.8 vs. 69.2 and 87.8 N, p<0.001). For sensory quality attributes, steaks from the HA1 group showed higher scores of softness, initial tenderness, and amount of perceptible residue than steaks from the HO1 group (p<0.001). Within the quality grade 2, Hanwoo steers had a higher score of softness compared to Holstein steers (p<0.001). There were no differences in juiciness and flavor intensity between Hanwoo and Holstein steers at the same quality grade (p>0.05). This difference in tenderness attributes between the breeds within the quality grade was associated with morphological traits of muscle bundle, and Hanwoo steers had smaller bundle area (0.37 vs. 0.50 mm², p<0.05) and higher fiber number per bundle (88.2 vs. 121, p<0.05) compared to Holstein steers. Therefore, bundle characteristics of longissimus thoracis muscle can be crucial for explaining factor for the explanation of tenderness variations between different breeds at the same beef quality grade or marbling.

PSVI-22 Comparison of quality characteristics, palatability, and serum biochemical parameters between normal and PSE-like condition chickens

The objective of this study was to compare the meat quality traits, palatability, and serum biochemical parameters between normal and pale, soft, and exudative (PSE)-like condition chickens to better understand the mechanisms leading to impairment of meat quality. A total of 60 commercial broilers were obtained at the same slaughterhouse in three batches (20 chickens per batch). During exsanguination, the blood glucose (BG) levels were immediately measured and obtained plasma samples were used for the measurements of serum biochemical parameters, including calcium, cortisol, aspartate aminotransferase (AST), and serotonin. After 24 h postmortem, the meat quality measurements were conducted using the whole left pectoralis major (PM) muscles, and chickens were then classified into normal and PSE-like condition (L* &gt; 53 and pH24 h &lt; 5.7) groups. The right PM muscles were used for the sensory quality evaluation. As expected, marked differences were observed in pH 24 h (5.86 vs. 5.63, P &lt; 0.001) and lightness (50.9 vs. 57.0, P &lt; 0.001) between the Normal and PSE-like conditions. Moreover, the PSE group showed a higher cooking loss compared to the Normal group (13.9 vs. 12.8%, P &lt; 0.05). For the organoleptic characteristics, chicken breast from the PSE group exhibited a lower score of tenderness conducted by trained panelists compared to breast from the Normal group (5.38 vs. 5.82%, P &lt; 0.05), even though there were no differences in values of juiciness, flavor, and off-flavor intensity between the groups (P &gt; 0.05). The PSE-like group had significantly higher values of BG (266.7 vs. 256.2 mg/dl, P &lt; 0.05) and calcium (11.4 vs. 10.9 mg/dl, P &lt; 0.05) and lower value of AST (228.3 vs. 247.5 U/l, P &lt; 0.05) compared to the Normal group. Thus, the occurrence of PSE-like condition could be related to serum biochemical parameters, especially BG, calcium, and AST.

Research Note: Expression level of heat shock protein 27 in PSE-like and fast-glycolyzing conditions of chicken pectoralis major muscle

This study compared the meat quality traits, histochemical characteristics, and heat shock protein (HSP) 27 expression levels of the broiler Pectoralis major (PM) muscles in groups classified by pale, soft, and exudative (PSE)-like and fast-glycolyzing conditions using the lightness and muscle pH change values. Chicken PM muscles showing higher pH change value and paler meat surface (as HP group) could be associated with the PSE-like condition, and exhibited a lower pH_{24 h} value and higher cooking loss compared to PM muscles showing lower pH change value and normal color (as LN group) (P < 0.05). Greater PM muscle weight and fiber area were observed in the HP group compared to the other groups (P < 0.05); meanwhile, the PM muscles showing higher pH change value with normal color (as HN group) and the PM muscles showing lower pH change value with paler color (as LP group) did not differ in the water holding capacity, Warner-Bratzler shear force, and muscle fiber characteristics (P > 0.05). Muscle samples showing a higher pH change value exhibited a greater level of HSP27 compared to muscle samples showing a lower pH change value (P < 0.05). Therefore, the current findings suggested that the expression level of HSP27 can be a useful indicator for explaining variations in the glycolytic rate of chicken breast muscle.

Correction: Migrations of young spotted seals (Phoca largha) from Peter the Great Bay, Sea of Japan/East Sea, and the pattern of their use of seasonal habitats

[This corrects the article DOI: 10.1371/journal.pone.0244232.].

Effects of Astragalus membranaceus, Adenophora triphylla, and Ulmus pumila Extracts on Quality Characteristics and Storage Stability of Sous-Vide Cooked Chicken Breasts

This study aimed to investigate the influence of Astragalus membranaceus (AM), Adenophora triphylla (AT), and Ulmus pumila (UP) extracts on the quality traits, palatability, and storage stability of sous-vide (SV) cooked chicken breasts. Chicken breasts were marinated in AM, AT, or UP extracts for 1 h, and then consistently cooked at a constant temperature of 60°C for 2 h. SV cooked chicken breasts with the UP extract exhibited lower lightness and higher yellowness values on the surface region compared to those with the AM and AT extracts (p<0.05). The control and UP groups displayed a similar overall visual acceptability (p>0.05), although the UP group had lower color acceptability (p<0.01). The UP group also had higher flavor and lower off-flavor intensities compared to the control group (p<0.05), although similar scores were observed in tenderness attributes and juiciness among the groups (p>0.05). Owing to these results regarding overall sensory acceptability, samples from the UP group were more preferred by the trained panelists compared to samples from the control group (p<0.001). On 14 d of cold storage, all the groups with herbal medicinal extracts exhibited a lower concentration of thiobarbituric acid-reactive substances than the control group (p<0.05), and the AT and UP groups showed lower values compared to the AM group due to their higher flavonoid contents (p<0.001). Therefore, meat marination with herbal plant extracts before SV cooking can be effective for enhancing the overall quality of SV cooked chicken breast.

Association Between Polycystic Ovary Syndrome and the Polymorphisms of Aryl Hydrocarbon Receptor Repressor, Glutathione-S-transferase T1, and Glutathione-S-transferase M1 Genes

OBJECTIVE

To investigate the association between the aryl hydrocarbon receptor repressor (AhRR) C/G polymorphisms and glutathione-S-transferase M1 (GSTM1) and GSTT1 null mutation and the risk of polycystic ovary syndrome (PCOS) in Korean women.

METHODS

This was a case-control study of 478 women with PCOS and 376 aged-matched healthy controls. Genotyping of the AhRR C/G polymorphism and GSTM1 and GSTT1 were performed using real-time PCR analysis and multiplex PCR, respectively.

RESULTS

The genotype distribution of the AhRR C/G polymorphisms and GSTM1/GSTT1 null mutations did not differ between women with PCOS and controls. Using the wild-type combined AhRR CC and GSTT1 present genotype as a reference, the odds that a woman had PCOS were 1.54 (95% CIs 1.04-2.29) times higher if she had a combined AhRR CG or GG and GSTT1 null genotype. The odds that a woman had PCOS was 1.48 (95% CIs 1.08-2.04) times higher if she had a combined GSTM1/GSTT1 null genotype compared with the wild-type combined GSTM1/GSTT1 present genotype. However, there were no significant associations between the risk of PCOS and any combined AhRR and GSTM1.

CONCLUSIONS

Our data suggest that a combined AhRR CG or GG and GSTT1 null genotype or a combined GSTT1/GSTM1 null genotype might be associated with an increased risk of PCOS.

Prevention of Cholesterol Gallstone Formation by Lactobacillus acidophilus ATCC 43121 and Lactobacillus fermentum MF27 in Lithogenic Diet-Induced Mice

The objective of this study was to evaluate the effects of Lactobacillus acidophilus ATCC 43121 and L. fermentum MF27 on biochemical indices in the serum, cholesterol metabolism in the liver and mucin expression in the gallbladder in lithogenic diet (LD)-induced C57BL/6J mice to determine the preventive effects of lactobacilli on gallstone formation. By the end of 4 wk of the experimental period, mice fed on a LD with high-fat and high-cholesterol exhibited higher levels of total and low-density lipoprotein cholesterol in the serum compared to mice fed on control diet or LD with L. acidophilus ATCC 43121 (LD+P1; p<0.05). Cholesterol-lowering effects observed in the LD+P1 and LD with L. fermentum MF27 (LD+P2) groups were associated with reduced expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase in the liver compared to the LD group (p<0.05). Furthermore, expression of the gel-forming mucin, including MUC5AB and MUC5B, was suppressed in the LD+P1 and LD+P2 groups compared to the LD group (p<0.05). Therefore, steady intake of both L. acidophilus ATCC 43121 and L. fermentum MF27 may have the ability to prevent the formation of cholesterol gallstones in LD-induced C57BL/6J mice.

Progression to prediabetes or diabetes in young Korean women with polycystic ovary syndrome: A longitudinal observational study

OBJECTIVE

To investigate changes in glycaemic status in women with polycystic ovary syndrome (PCOS).

DESIGN

Longitudinal observational study.

PATIENTS

Women with PCOS who underwent baseline and follow-up screening tests for diabetes (n = 262). Four patients with type 2 diabetes (T2DM) at baseline and 6 patients who were taking drugs at the final follow-up were excluded.

MEASUREMENTS

Changes in glycaemic classification based on fasting glucose, haemoglobin A1c and oral glucose tolerance test.

RESULTS

The median length of follow-up was 2.9 years. The mean age and body mass index in the normoglycaemia group (n = 202) were 23.0 years and 21.6 kg/m² , while it was 23.6 years and 22.9 kg/m² in the prediabetes group (n = 50). In the normoglycaemia group, 38 (18.8%) and 2 (1.0%) developed prediabetes and T2DM, respectively. In the prediabetes group, 22 (44.0%) remained in the same category, 6 (12.0%) developed T2DM, while 22 (44.0%) achieved normoglycaemia. The incidence rate of T2DM was 9.3 per 1,000 person-years, which was significantly higher than that of the female population of similar age, and the incidence was higher in women with fasting glucose ≥ 5.6 mmol/L at baseline than in women with < 5.6 mmol/L.

CONCLUSIONS

About 20% of normoglycaemic women had developed prediabetes or T2DM after a median time of 2.9 years. Meanwhile, nearly half of prediabetes women achieved normoglycaemia. Higher baseline fasting glucose levels were associated with an increased incidence of T2DM. Our results are the first to evaluate glycaemic status changes using all three parameters in patients with PCOS.

Impact of the newly recommended antral follicle count cutoff for polycystic ovary in adult women with polycystic ovary syndrome

STUDY QUESTION

What is the impact of the newly recommended antral follicle count (AFC) cutoff for polycystic ovary (PCO) on the diagnostic status of polycystic ovary syndrome (PCOS)?

SUMMARY ANSWER

Among patients with phenotypes requiring the presence of PCO for diagnosis, approximately half (48.2%) were excluded from having PCOS based on the new AFC cutoff, although these excluded women had worse metabolic and hormonal profiles than the controls and were indistinguishable from the remaining patients with regard to major hormonal and metabolic parameters.

WHAT IS KNOWN ALREADY

In the Rotterdam criteria, PCO is defined as either 12 or more follicles measuring 2-9 mm in diameter or an increased ovarian volume >10 cm3. Recently, an international PCOS guideline development group recommended an AFC threshold for PCO of ≥20 in adult women when using transducers with a high-resolution frequency, including 8 MHz.

STUDY DESIGN, SIZE, DURATION

The current study used a case control design.

PARTICIPANTS/MATERIALS, SETTING, METHODS

PCOS was diagnosed according to the Rotterdam criteria. Ultrasonography examinations were conducted with wide band frequency (5-9 MHz) transvaginal transducers and the centre frequency was 8 MHz. In patients who show both irregular menstruation and hyperandrogenism (HA), a diagnosis of PCOS can be made irrespective of the ovarian criteria change. Patients who were diagnosed according to HA and PCO (n = 86) or irregular menstruation and PCO (n = 443) were initially included among a total of 1390 adult women with PCOS (aged 20-40 years). Regardless of the AFC, if the ovarian volume is ≥10 cm3, a diagnosis of PCO can still be made. Thus, only patients who had an ovarian volume of <10 cm3 were analysed. Subjects who had an AFC of 12-19 and an ovarian volume <10 cm3 were designated as the 'low AFC group' (n = 255) and were the main focus of the study because they were excluded from having PCOS based on the new cutoff. Subjects with an AFC ≥20 and an ovarian volume <10 cm3 were designated as the 'high AFC group' (n = 101). A total of 562 premenopausal women without PCOS were enrolled as controls.

MAIN RESULTS AND THE ROLE OF CHANCE

Among patients with irregular menstruation and PCO or HA and PCO phenotypes, approximately half (48.2%, 255/529) were excluded from having PCOS, which corresponded to one-fifth (18.3%, 255/1390) of the total adult patients. However, compared to the control group, these excluded women had worse metabolic profiles and were more androgenised. Notably, they were indistinguishable from the 'high AFC group' with regard to major hormonal and metabolic parameters (BMI and diabetic classification status, and the prevalence of insulin resistance, metabolic syndrome and HA).

LIMITATIONS, REASONS FOR CAUTION

We cannot exclude the possibility of inter- and intraobserver variation in the evaluation of AFC.

WIDER IMPLICATIONS OF THE FINDINGS

With the newly recommended follicle count cutoff, a substantial proportion of women with PCOS might be classified as not having PCOS despite visiting a hospital due to irregular menstruation or hyperandrogenic symptoms. A practical approach to them would involve controlling the menstrual or hyperandrogenic symptoms in hand and regularly evaluating them regarding newly developed or worsening PCOS-related symptoms or metabolic abnormalities.

STUDY FUNDING/COMPETING INTEREST(S)

This study was supported by a grant from the Seoul National University Hospital Research Fund (No. 2520140090), Republic of Korea. The authors have no conflicts of interest to disclose.

TRIAL REGISTRATION NUMBER

Not applicable.

Muscle fiber and fresh meat characteristics of white-striping chicken breasts, and its effects on palatability of sous-vide cooked meat

The aim of this study was to compare the histochemical and meat quality characteristics between the normal and white-striping (WS) pectoralis major muscles. Additionally, this study investigated the effects of oven cooking (OV) and sous-vide (SV) cooking methods on objective texture parameters and sensory quality characteristics of the normal and WS chicken breast meats. Results showed that the WS condition broilers had higher body and breast weights (P < 0.001), and a greater area of muscle fiber than the normal broilers (P < 0.001). The WS fresh fillets exhibited a lower preference of visual appearance compared to the normal fillets (P < 0.05), although no differences were detected in the characteristics of meat quality between the groups (P > 0.05). After cooking, there was greater cooking loss, Warner-Bratzler shear force, and texture parameter analysis-hardness values for breast fillets cooked by OV treatment at 180°C for reached core temperature to 71°C compared to the fillets cooked by SV treatment at 60°C for 2 h (P < 0.05), whereas the normal and WS groups were exhibited similar values within each cooking methods (P > 0.05). Regarding sensory quality characteristics, WS breast fillets cooked by SV (SV+WS) were rated as tenderer and juicier, and given a higher overall acceptability score compared to normal and WS fillets cooked by OV (P < 0.05). However, owing to a lesser developed flavor in SV+WS fillets, the panelists assigned a lower overall acceptability rating in these fillets compared to SV+Normal fillets (P < 0.05). Overall, the SV cooking can be an effective method for improving the sensory quality characteristics of WS and normal chicken breast.

Transient receptor potential vanilloid 2 mediates the inhibitory effect of far-infrared irradiation on adipogenic differentiation of tonsil-derived mesenchymal stem cells

AIMS

Far-infrared (FIR) irradiation inhibits adipogenic differentiation of tonsil-derived mesenchymal stem cells (TMSCs) by activating Ca²⁺-dependent protein phosphatase 2B (PP2B), but it stimulates osteogenic differentiation in a PP2B-independent pathway. We investigated the potential involvement of transient receptor potential vanilloid (TRPV) channels, a well-known Ca²⁺-permeable channel, in the effects of FIR irradiation on adipogenic or osteogenic differentiation of TMSCs.

METHODS

TMSCs, in the absence or presence of activators or inhibitors, were exposed to FIR irradiation followed by adipogenic or osteogenic differentiation, which was assessed using Oil red O or Alizarin red S staining, respectively. RT-PCR, qRT-PCR, and Western blotting were used to determine gene and protein expression of calcium channels and adipocyte-specific markers.

RESULTS

Treatment with the calcium ionophore ionomycin simulated the inhibitory effect of FIR irradiation on adipogenic differentiation but had no effect on osteogenic differentiation, indicating the involvement of intracellular Ca²⁺ in adipogenic differentiation. Inhibition of pan-TRP channels using ruthenium red reversed the FIR irradiation-induced inhibition of adipogenic differentiation. Among the TRP channels tested, inhibition of the TRPV2 channel by tranilast or siRNA against TRPV2 attenuated the inhibitory effect of FIR irradiation on adipogenic differentiation, accompanied by a decrease in intracellular Ca²⁺ levels. By contrast, activation of the TRPV2 channel by probenecid simulated FIR irradiation-induced inhibition of adipogenic differentiation. Expectedly, the stimulatory effect of FIR irradiation on osteogenic differentiation was independent of the TRPV2 channel.

CONCLUSION

Our data demonstrate that the TRPV2 channel is a sensor/receptor for the inhibited adipogenic differentiation of TMSCs associated with FIR irradiation.

Comparison of Quality Characteristics and Palatability between Sous-Vide Cooked Pork Loin Patties with Different Searing Treatments

This study compared the quality, cooking, textural, and palatability characteristics between sous-vide (SV) cooked pork loin patties with different searing treatments (ST). Before SV cooking, STs were conducted on each side of the pork loin patties for 0 (control) to 120 s (ST120), and all patties were then cooked using an SV cooker at 75°C for 120 min. Noticeable differences were observed in quality properties between the groups. The seared SV loin patties exhibited lower lightness and higher browning index values compared to the unseared SV loin patties (p<0.001). Cooking loss gradually increased with increasing ST times, and the control group had a lower percentage compared to the ST60 group (19.5 vs. 25.7%, p<0.001). Changes in cooking properties were associated with the extent of ST, and the ST groups exhibited a higher hardness value compared to the control group (p<0.001). Regarding palatability, loin patties from the control group scored lower in appearance acceptability compared to patties from the ST groups (p<0.05) due to extent of browning on the surface. Moreover, the ST groups did exhibit a higher flavor intensity compared to the control group, but no differences were observed in tenderness and juiciness scores between the control and ST60 groups. Due to these results, the ST60 group exhibited a greater score in overall acceptability compared to the other groups except for the ST90 group. Therefore, an additional ST before SV cooking can achieve a more appealing appearance and palatability as well as to enhance the availability of pork loin.

Research Note: Increased myostatin expression and decreased expression of myogenic regulatory factors in embryonic ages in a quail line with muscle hypoplasia

Genetic selection of quail for a low body weight for more than 80 generations established a low-weight (LW) Japanese quail line that has been previously characterized to have a muscle hypoplasia phenotype. The aim of this study is to investigate the relationship of temporal expression levels of myostatin (Mstn) and myogenic regulatory factors (MRFs) with hypoplastic muscle growth in the LW line. During embryonic day (E) 13 to 15, gain of embryo weight was 2-fold lower (P < 0.001) in the LW line than that in the random bred control (CON). Gains in body weight and pectoralis muscle weight from hatch to posthatch day (P) 28 were also significantly lower (P < 0.01) in the LW line but increased by 4-fold (P < 0.05) during P42 to P75. PCR analysis showed that expression levels of Mstn were greater in the LW at embryonic stage (E12 to E14, P < 0.05), but there was no difference after hatch. In addition, expression levels of Pax7 and myogenin (MyoG) at E12 were 23-fold (P < 0.05) and 3.4-fold (P < 0.05) lesser in the LW line, respectively. At E14, expression of Pax3, Pax7, and MyoG gene was 3.5-fold (P < 0.05), 6.5-fold (P = 0.065), and 4.4-fold (P < 0.01) less than that in the CON. Taken together, high expression levels of Mstn and low expression of MRFs during embryonic stages can be associated with development of muscle hypoplasia and delayed muscle growth in the LW quail line. These data provide evidence that genetic selection for a low body weight resulting in an avian model with muscle hypoplasia has altered the expression profiles of myogenic factors.

Influence of Piezoelectric Properties on the Ultrasonic Dispersion of TiO2 Nanoparticles in Aqueous Suspension

In this study, the soft-type and hard-type lead zirconate titanate (PZT) ceramics were compared in order to create an optimal system for ultrasonic dispersion of nanoparticles, and sound pressure energy for each PZT ceramic was analyzed and closely examined with ultrasonic energy. TiO₂ was water-dispersed using the soft-type and hard-type PZT transducer, possessing different characteristics, and its suspension particle size and distribution, polydispersity index (PDI), zeta potential, and dispersion were evaluated for 180 days. Furthermore, it was confirmed that the particles dispersed using the hard-type PZT transducer were smaller than the particles dispersed using the soft-type PZT by 15 nm or more. Because the hard-type PZT transducer had a lower PDI, uniform particle size distribution was also confirmed. In addition, by measuring the zeta potential over time, it was found that the hard-type PZT transducer has higher dispersion safety. In addition, it was confirmed that the ultrasonically dispersed TiO₂ suspension using a hard-type PZT transducer maintained constant particle size distribution for 180 days, whereas the suspension from the soft-type PZT aggregated 30 days later. Therefore, the hard-type PZT is more suitable for ultrasonic dispersion of nanoparticles.

Migrations of young spotted seals (Phoca largha) from Peter the Great Bay, Sea of Japan/East Sea, and the pattern of their use of seasonal habitats

We studied the migrations of young spotted seals during their annual cycle. In May 2017, we attached satellite tags (SPOT-293A) to three individuals (two underyearlings and one yearling) captured at their breeding ground in Peter the Great Bay, western Sea of Japan/East Sea. The operational time of the installed tags ranged from 207 to 333 days; a total of 27195 locations were uploaded. All three seals migrated east and further north along the coast of the mainland. The average daily migration speed of the seals ranged between 70 and 135 km/day. The yearling moved faster than the underyearlings. During early August, they arrived at their summer habitats, which were located in the northern part of the Tatar Strait (Sea of Japan/East Sea) for the underyearling seals and in Aniva Bay (Sea of Okhotsk) for the yearling seal. While moving from the place of tagging to the summer feeding grounds, the seals covered a distance of 2300 to 3100 km. From August to October, each seal permanently stayed within the same isolated area. The reverse migration of all three seals began in November. When the seals traveled south, they used the same routes by which they had moved north in the spring, but they moved at a faster speed. By December, two seals returned to their natal islands, where both stayed until their transmitters stopped sending signals (in March 2018).

The effects of luteinising hormone gene polymorphism on the outcomes of in vitro fertilisation and embryo transfer

Trp8Arg polymorphism of the LH beta gene has decreased bioactivity in vivo and previous studies showed conflicting data on the effect of LH beta gene polymorphism on the IVF outcome. In this study, 591 IVF patients were recruited. Patients with the variant allele(s) were the carrier group. In GnRH antagonist cycles, the clinical pregnancy rate was significantly lower in the carrier group (18.9%) than in the noncarrier group (37.1%). In long GnRH agonist cycles, the clinical pregnancy rate was comparable between both groups. To clarify the effect of COH protocols, IVF outcomes in the GnRH antagonist and long GnRH agonist protocol groups in carriers were analysed. Among carriers, the clinical pregnancy rate was significantly lower in the GnRH antagonist protocol group (18.9%) than in the long GnRH agonist protocol group (45.2%). Single nucleotide polymorphism analysis may contribute to the individualisation of COH protocols for each patient in the future.Impact StatementWhat is already known on this subject? Trp8Arg polymorphism of the LH beta gene is known to have decreased bioactivity in vivo. Previous studies have demonstrated hypo-sensitivity in the patients with the variant LH beta protein, while other study showed similar carrier frequency between the poor and the normal response group.What the results of this study add? The variant LH beta gene was associated with a lower clinical pregnancy rate in GnRH antagonist cycles but not in long GnRH agonist cycles.What the implications are of these findings for clinical practice and/or further research? Single nucleotide polymorphism analysis may contribute to the individualisation of COH protocols for each patient in the future.

Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer

Purpose

This study was performed to investigate the effect of the interval between the start of gonadotropin-releasing hormone agonist (GnRHa) and the start of chemotherapy on ovarian protection in patients with breast cancer.

Methods

This was a prospective observational cohort study that included 136 patients with breast cancer below 40 years who received GnRHa during chemotherapy for fertility preservation. Plasma anti-Müllerian hormone (AMH) levels were measured before chemotherapy (baseline) and after chemotherapy. Subjects were divided into 3 groups according to the interval between the start of GnRHa and the start of chemotherapy for analysis: 1–6 days, 7–13 days, and ≥ 14 days. The ratio of the post-chemotherapy AMH value to the baseline AMH (pcAMH) at each time point were compared among the 3 groups. Ranked analysis of covariance was used for statistical analysis, adjusted for age, body mass index (BMI), and the existence of polycystic ovaries (PCOs). In addition, recovery of ovarian function (AMH ≥ 1 ng/mL) at 12 months was evaluated.

Results

The median age of the patients was 32 years. There was no difference in the baseline AMH levels among the 3 groups (mean ± standard error: 5.0 ± 0.4 ng/mL [1–6 days], 5.3 ± 0.7 ng/mL [7–13 days], and 8.1 ± 1.3 ng/mL [≥ 14 days]; p = 0.250). The pcAMH at 3, 6, 12, 24, and 36 months were not significantly different among the 3 groups (p-values were 0.332, 0.732, 0.830, 0.148, and 0.393, respectively). In multivariate analysis, young age (p = 0.024), low BMI (p = 0.013), and the existence of PCO (p = 0.015) were predictors for AMH ≥ 1 ng/mL at 12 months.

Conclusion

There was no difference in the ovarian protective effect according to the difference in the timing of administration of GnRHa.

Successful Pregnancy and Delivery with Intracytoplasmic Sperm Injection in HIV-Serodiscordant Couple: the First Case in Korea

With highly active antiretroviral therapy, human immunodeficiency virus (HIV) infection is considered to be a manageable chronic disease. The improved prognosis increases the desire of individuals with HIV to have biological offspring. With the establishment of washing protocol, no HIV transmission has been reported among more than 11,000 assisted reproduction technology (ART) cycles. Although the Acquired Immunodeficiency Syndrome Prevention Act in Korea prevents the use of HIV-infected blood, organs, tissues and semen, we recently obtained the authentic approval from the Korea Centers for Disease Control and Prevention for the practice of ART in HIV-serodiscordant couples. We report a 32-year-old HIV-seronegative female with her husband who was HIV-1 seropositive. After semen washing was performed by means of a density gradient and the swim-up technique, HIV-1 ribonucleic acid was not detected in the semen. An aliquot of processed semen was cryopreserved before ART. None of 3 cycles of intrauterine insemination was successful. After the third frozen-thawed embryo transfer following two cycles of intracytoplasmic sperm injection, an intrauterine singleton pregnancy was identified. She gave birth to a normal healthy male baby at full term by Cesarean section. She and her baby were tested for HIV during pregnancy and after delivery and the results were negative. Semen washing may be a safe ART method for HIV-serodiscordant couples who desire to have a baby in Korea.

Research Note: Association of temporal expression of myostatin with hypertrophic muscle growth in different Japanese quail lines

Myostatin (MSTN) negatively regulates in muscle growth and development. Among alternative splicing isoforms of avian MSTN, MSTN-A has antimyogenic activities and MSTN-B functions as a promyogenic factor. In this study, different lines of Japanese quail were used: a random bred control (RBC) and a heavy weight (HW) quail line with muscle hypertrophy. The objectives of the current study are to compare temporal expression of the MSTN isoforms in pectoralis major muscle (PM) between 2 quail lines and to relate MSTN expression with temporal changes in muscle growth and total amounts of DNA in PM. Gains of body weight (BW) and PM weight were greater until posthatch day (D) 28 (P < 0.001), and the fold increases in total DNA contents of PM were greater in the HW line compared with the RBC line during D7 to D28 (P < 0.05). PCR analysis showed that MSTN-A expression was greater at 14 D (E14) of embryonic age (P < 0.01), D7 (P = 0.052), and D14 (P < 0.01) in the RBC line compared with the HW line. At D28 and D75, expression of MSTN-A was greater in the HW line compared with the RBC line (P < 0.05). MSTN-B expression was barely detectable from E14 to D14 and measurable from D28 to D75 in the muscle of both lines. Ratios of the MSTN-B/-A form ranging from 0.15 to 0.29 indicate a minor expression of the B form. Taken together, the lesser expression levels of MSTN-A at E14, D7, and D14 are associated with the fast growth of PM, and greater MSTN-A expression at D28 and D75 are associated with a slowdown of PM growth in the HW line. These data indicate a negative association of MSTN expression with PM growth and provide a scientific basis for potential usage of MSTN expression as a selection marker for greater muscle growth in poultry.

Combined effects of sous-vide cooking conditions on meat and sensory quality characteristics of chicken breast meat

This study investigated the combined effects of cooking temperature and time on the meat and eating quality characteristics of the sous-vide chicken breast. For the control group, chicken breast samples were cooked in a convection oven until the internal temperature reached 71°C. Each sample for sous-vide cooking was vacuum packaged and then cooked under continuous thermocontrolled conditions in a water bath at 6 combinations of cooking temperature (60 and 70°C) and time (1, 2, and 3 h). Sous-vide cooked chicken meat at 60°C for 1 h (SV60-1h) showed lower cooking loss (6.58 vs. 26.5%, P < 0.05), Warner-Bratzler shear force (21.7 vs. 29.1 N, P < 0.05), and hardness (9.40 vs. 17.3 N, P < 0.05) than meat cooked by conventional oven. Similar to the objective tenderness parameters, cooked chicken meat from the SV60 treatments for all cooking times showed higher scores in all the tenderness attributes than the control group (P < 0.05). However, a higher flavor intensity was observed in the SV70-3h and control groups than in the SV60 treatments (P < 0.05). Owing to a lesser developed flavor in chicken meat from the SV60-1h treatment, the SV60-2h and 3h treatments were assigned a higher acceptability rating for overall impression (P < 0.05). Therefore, cooking temperature and time of sous-vide significantly influenced the physicochemical and palatability characteristics of chicken breast. In this study, the optimum conditions for the sous-vide chicken breast are to continuously cook at 60°C for 2 to 3 h to improve sensory quality characteristics without reducing the water-holding capacity.

Comparison of Beef Palatability Characteristics between Longissimus Thoracis and Vastus Lateralis Muscles from Different Grades during Postmortem Aging

The objectives of this study was to compare palatability changes of the longissimus thoracis (LT) and vastus lateralis (VL) muscles of Hanwoo steers from different beef quality grades (1⁺ and 1) during 28 d of wet-aging in order to improve the utilization of the VL muscle as a steak. The VL muscle showed a higher collagen content and a lower intramuscular fat content than the LT muscle (p<0.05). As expected, the Warner-Bratzler shear force value was greater in the LT 1 grade (LT-1) muscle than the LT-1⁺ muscle (p<0.05); whereas no difference was observed between the grades in the VL muscle at 24 h postmortem. Compared to 0 d of aging, tenderness scores significantly increased after 14 and 21 d of aging in the LT and VL muscles, respectively (p<0.05). Additionally, there was no difference in tenderness score between the VL-1⁺ aged for 21 d and the LT-1 at 24 h postmortem, although tenderness score was greater in the LT than the VL at each period (p<0.05). Moreover, the VL-1⁺ steak exhibited a higher tenderness score than the VL-1 steak at 21 and 28 d of aging (p<0.05). On the other hand, the effect of aging time on juiciness and flavor in the VL muscle was somewhat limited unlike the LT muscle. Taken together, the VL muscle requires a longer aging time than the LT muscle to improve consumer preference. Considering the tenderness, using a higher quality grade for aging is more useful in the VL muscle.

Amenorrhea and Menopause in Patients with Breast Cancer after Chemotherapy

Purpose

The probability of ovarian failure after cytotoxic chemotherapy in patients with breast cancer has not been well established in Korea. This study aimed to assess the rate of ovarian failure in a large cohort of Korean premenopausal patients with breast cancer 12 months after chemotherapy.

Methods

This retrospective cohort study included premenopausal women (aged 20−44 years) with breast cancer who underwent chemotherapy after surgery. The rates of treatment-related amenorrhea (TRA) and chemotherapy-induced menopause (CIM) at 12 months after chemotherapy were analyzed.

Results

A total of 237 patients met the inclusion criteria. The rate of TRA was 61.6% and that of CIM was 13.1% at 12 months after chemotherapy. The rates of TRA and CIM were 28.0% and 4.0%, respectively, in women aged 25−34 years, and they gradually increased up to 75.9% (TRA) and 15.8% (CIM), respectively, in women aged 40−44 years. The frequency of CIM was significantly lower than that of TRA in both age groups. In multivariate analyses, only tamoxifen use was significantly associated with a decreased risk of CIM (p < 0.001). Age of 40 years or higher and the regimens of doxorubicin plus cyclophosphamide followed by docetaxel or paclitaxel were associated with increased risk of TRA (p = 0.001 and p = 0.002, respectively).

Conclusion

Marked discrepancy in the rates of CIM and TRA was observed in this study. Further, the age-specific frequency of CIM and TRA observed in this study is a reliable and practical estimate of the risks of CIM and TRA in the absence of gonadal protection.

Phenotype and genotype of polycystic ovary syndrome in Asia: Ethnic differences

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, and ethnic diversity has been reported in its manifestation. This review addressed phenotype and genetic studies in Asian women with PCOS. Generally, East Asians are less hirsute, and the hirsutism score cutoff is lower than the Caucasian counterpart. It is not clear whether there are any significant differences in the prevalence or severity of irregular menstruation (IM) or characteristics of polycystic ovary (PCO) across ethnicities. Interestingly, the IM/PCO subgroup is a relatively common phenotype in East Asian patients but not in Caucasian patients. The prevalence of insulin resistance in PCOS patients varies depending on the index used and the cutoff, but women with PCOS showed a higher degree of insulin resistance than those of controls across ethnicities. Lower body mass index (BMI) and lower prevalence of metabolic syndrome were reported in East Asian patients, but despite lower BMI, a comparative study reported that Asian women with PCOS were more likely to have diabetes compared with Caucasian patients, suggesting they also have metabolic complications. Unlike East Asian patients, South Asian patients showed an increased degree of hirsutism, early onset of symptoms, and severe insulin resistance and metabolic risks compared with Caucasians. Genetic components play important roles in the pathogenesis of PCOS, and genome-wide association studies of PCOS suggest that similar genetic risk factors exist between Asian and Caucasian patients. Continuous comparative studies are needed to standardize the diagnosis and management of PCOS across different ethnicities.

Application of Tonsil-Derived Mesenchymal Stem Cells in Tissue Regeneration: Concise Review

Since the discovery of stem cells and multipotency characteristics of mesenchymal stem cells (MSCs), there has been tremendous development in regenerative medicine. MSCs derived from bone marrow have been widely used in various research applications, yet there are limitations such as invasiveness of obtaining samples, low yield and proliferation rate, and questions regarding their practicality in clinical applications. Some have suggested that MSCs from other sources, specifically those derived from palatine tonsil tissues, that is, tonsil‐derived MSCs (TMSCs), could be considered as a new potential therapeutic tool in regenerative medicine due to their superior proliferation rate and differentiation capabilities with low immunogenicity and ease of obtaining. Several studies have determined that TMSCs have differentiation potential not only into the mesodermal lineage but also into the endodermal as well as ectodermal lineages, expanding their potential usage and placing them as an appealing option to consider for future studies in regenerative medicine. In this review, the differentiation capacities of TMSCs and their therapeutic competencies from past studies are addressed. stem cells2019;37:1252–1260

Correlations of Sensory Quality Characteristics with Intramuscular Fat Content and Bundle Characteristics in Bovine Longissimus Thoracis Muscle

The aim of this study was to investigate the relation of sensory quality traits of cooked beef to fresh meat quality and histochemical characteristics, especially muscle bundle traits, in the longissimus thoracis muscle of Hanwoo steers. Cooking loss negatively correlated with softness, initial tenderness, chewiness, rate of breakdown (RB), and amount of perceptible residue (AR) after chewing (p<0.05), and drip loss showed negative correlation with RB and AR (p<0.05). All the attributes of tenderness exhibited negative correlation with the Warner-Bratzler shear force value (p<0.05). Marbling score and the intramuscular fat (IMF) content showed positive correlation with all the organoleptic characteristics, including tenderness attributes, juiciness, and flavor (p<0.05). Regarding histochemical characteristics, muscle fiber size did not have a significant correlation with all the sensory quality traits, although the area percentage of type I fiber was related with softness, initial tenderness, and chewiness (p<0.05). On the contrary, the characteristics of muscle bundle were related to all the sensory tenderness attributes (p<0.05), and the sensory tenderness increased with smaller muscle bundle size (p<0.05). These results suggest that the IMF content and bundle characteristics can be used as indicators for explaining the variations in sensory tenderness in well-marbled beef.

Arterial stiffness measured by cardio-ankle vascular index in Korean women with polycystic ovary syndrome

Many studies have reported an increased arterial stiffness using pulse wave velocity (PWV) in women with polycystic ovary syndrome (PCOS). However, PWV is essentially dependent on blood pressure (BP) at the time of measurement. The cardio-ankle vascular index (CAVI) is a relatively new index for measuring arterial stiffness, and its conspicuous feature is its independency from the BP at the time of measurement. The aim of this study was to evaluate arterial stiffness by CAVI in PCOS patients (n = 26) and in the age-matched controls (n = 59). The CAVI was measured by a single medical professional. The mean age of the women with PCOS was 33.3 (±6.6) years, and that of the matched controls was 33.1 (±5.9) years (p = .861). The mean CAVIs were similar between the patients and controls (6.49 ± 0.41 and 6.39 ± 0.65, respectively, p = .452). The CAVI increased linearly with age in both groups, but in the women with PCOS, CAVI showed relatively strong negative correlations with body mass index (BMI) in both the unadjusted (r = -0.537, p = .005) and adjusted models (r = -0.474, p = .003 after age and BMI adjustment and r = -0.604, p = .033 after age, BMI, sitting auscultatory systolic BP and square root hs-CRP adjustment). In conclusion, relatively young women with PCOS may not have increased arterial stiffness. A negative correlation between CAVI and BMI in women with PCOS requires further study to determine whether vascular adaptation to adiposity occurred in these women. Impact Statement What is already known on this subject? Increased arterial stiffness is one of the earliest adverse structural and functional alterations in blood vessels, potentially leading to later cardiovascular disease. Many studies have reported an increased arterial stiffness using pulse wave velocity (PWV) in women with polycystic ovary syndrome (PCOS). However, PWV is essentially dependent on blood pressure (BP) at the time of measurement. The cardio-ankle vascular index (CAVI) is a relatively new index for measuring arterial stiffness, and its conspicuous feature is its independency from the BP at the time of measurement. What do the results of this study add? The CAVIs were similar between the women with PCOS and the age-matched controls. The CAVI increased linearly with age in both groups, but in women with PCOS, CAVI showed a relatively strong negative correlation with the body mass index (BMI). What are the implications of these findings for clinical practice and/or further research? Relatively young women with PCOS may not have increased arterial stiffness. However, CAVI showed a negative correlation with BMI only in the women with PCOS, suggesting that adiposity itself is associated with the decreased arterial stiffness in these women. This finding requires a replication, and whether adaptation to the hemodynamic consequences of adiposity occurred in the PCOS patients remains to be established. Further longitudinal studies are needed to verify the relationships among vascular stiffness, adiposity and PCOS.

Sun heated surfaces are an environmental hazard for young children

AIMS

Children commonly sustain heat contact type burn injuries from sun heated surfaces during the summer months in hot, sunny climates. The aim of this study was to review the causes and outcomes in a series of heat contact type burns sustained by children who touched hot sun heated surfaces.

METHODS

A retrospective chart review was performed to identify all children who sustained burn injuries due to naturally heated surfaces and were treated between January 2012 and December 2017 at Children's Hospital Colorado. Demographics of the subjects and clinical data regarding their burn injuries were collected.

RESULTS

A total of 58 children were identified over the study period, involving 118 burn wounds. The median age was 17 months (interquartile range = 14-23), and 33 were male (57%). Mean total body surface area (TBSA) was 1.4% (standard deviation = 1). A foot was the most commonly involved area, affecting 36 subjects (62%). The most common causes of these burn injuries were metal thresholds (n = 7, 12%) and metal covers or lids (n = 5, 9%) outside the home. The depth of the burn injury was partial thickness in 57 children (98%). The mean time to heal was 12 ± 6 days, and the majority of injuries occurred in June (n = 28, 48%).

CONCLUSION

Heat contact type burn injuries from sun heated surfaces commonly affect children ⩽2 years of age during the summer months, and the majority of these injuries occur around the home environment. They are preventable injuries, and this information should be used for prevention and education materials for parents and healthcare providers, who reside in hot, sunny climates.

Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy after In Vitro Fertilization and Embryo Transfer

PURPOSE

To elucidate the correlation between ovarian reserve and the incidence of ectopic pregnancy (EP) following in vitro fertilization and embryo transfer (IVF/ET) cycles.

MATERIALS AND METHODS

In this observational study, 430 fresh IVF/ET cycles were examined from patient data of two university hospital infertility clinics. All included patients were positive for β-human chorionic gonadotropin (hCG) at 2 weeks after oocyte retrieval via controlled ovarian stimulation. For each cycle, information on age, duration of infertility, basal follicle stimulating hormone (FSH), anti-Müllerian hormone (AMH), days of ovarian stimulation, numbers of retrieved oocytes and transferred embryos, and pregnancy outcomes was collected. Patients with AMH lower than 1.0 ng/dL or basal FSH higher than 10 mIU/mL were classified into the decreased ovarian reserve (DOR) group, and the remaining patients were classified into the normal ovarian reserve (NOR) group.

RESULTS

In total, 355 cycles showed NOR, and 75 cycles DOR. There were no significant differences between the DOR and NOR groups regarding intrauterine (74.7% vs. 83.4%, respectively) or chemical (14.7% vs. 14.1%, respectively) pregnancies. The DOR group had a higher EP than that of NOR group [10.7% (8/75) vs. 2.5% (9/355), p=0.004]. In both univariate [odds ratio (OR) 5.6, 95% confidence interval (CI) 1.4-9.6, p=0.011] and multivariate (adjusted OR 5.1, 95 % CI 1.1-18.7, p=0.012) analysis, DOR was associated with a higher risk of EP.

CONCLUSION

DOR may be associated with a higher risk of EP in IVF/ET cycles with controlled ovarian stimulation. More careful monitoring may be necessary for pregnant women with DOR.

Correlation of Marbling Characteristics with Meat Quality and Histochemical Characteristics in Longissimus Thoracis Muscle from Hanwoo Steers

The objective of this study was to investigate the correlations of marbling characteristics, including marbling score, intramuscular fat (IMF) content, and fleck traits, with meat quality traits and histochemical characteristics of the longissimus thoracis muscle from Hanwoo steers. Marbling fleck characteristics, especially area, number, and fineness (F) index, measured by computerized image analysis were strongly correlated with marbling score and IMF content (p<0.05). However, coarseness (C) index and F/C ratio were somewhat limited relationships with marbling score. In contrast, the IMF content and the number of smaller white flecks increased with increasing lightness value (p<0.05). Moreover, beef with higher marbling scores showed lower cooking loss and Warner-Bratzler shear force value compared to beef with lower marbling scores (p<0.05). Regarding the muscle bundle traits, as number of bundle increased, number of marbling flecks increased (p<0.05), although most marbling characteristics did not have significant correlation with muscle fiber or bundle characteristics.

Comparison of marbling fleck characteristics between beef marbling grades and its effect on sensory quality characteristics in high-marbled Hanwoo steer

The aim of this study was to compare the intramuscular fat (IMF) content and marbling fleck characteristics measured by computerized image analysis among the eight grades of Korean beef marbling standard (BMS). Additionally, this study examined the effects of the marbling fleck characteristics on objective tenderness parameters and sensory quality characteristics in high-marbled Hanwoo steers (BMS grades 7 to 9). Marked differences were observed in marbling fleck characteristics among the BMS grades (P < .05), whereas the coarseness was similar in high-marbled beef (P > .05). Due to a greater extent of coarse marbling fleck, coarse marbled steaks from high-marbled cattle were assigned higher scores of tenderness attributes, including softness, initial tenderness, and chewiness, as well as mouth coating, but were assigned lower acceptability ratings for IMF content and overall impression compared to fine marbled steaks (P < .05). Taken together, considering the marbling fleck traits can be an effective tool for improving the accuracy of beef grading systems.

Clinical features and outcomes of abdominal tuberculosis in southeastern Korea: 12 years of experience

Background

Abdominal tuberculosis (TB) is an uncommon form of infection with Mycobacterium tuberculosis in Korea. In this study, we aimed to highlight the clinical features, diagnostic methods, and outcomes of abdominal TB over 12 years in Southeastern Korea.

Methods

A total of 139 patients diagnosed as having abdominal TB who received anti-TB medication from January 2005 to June 2016 were reviewed. Among them, 69 patients (49.6%) had luminal TB, 28 (20.1%) had peritoneal TB, 7 (5.0%) had nodal TB, 23 (16.5%) had visceral TB, and 12 (8.6%) had mixed TB.

Results

The most frequent symptoms were abdominal pain (34.5%) and abdominal distension (21.0%). Diagnosis of abdominal TB was confirmed using microbiologic and/or histologic methods in 76 patients (confirmed diagnosis), while the remaining 63 patients were diagnosed based on clinical presentation and radiologic imaging (clinical diagnosis). According to diagnostic method, frequency of clinical diagnosis was highest in patients with luminal (50.7%) or peritoneal (64.3%) TB, while frequency of microscopic diagnosis was highest in patients with visceral TB (68.2%), and frequency of histologic diagnosis was highest in patients with nodal TB (85.2%). Interestingly, most patients, except those with nodal TB, showed a good response to anti-TB agents, with 84.2% showing a complete response. The mortality rate was only 1.4% in the present study.

Conclusions

Most patients responded very well to anti-TB therapy, and surgery was required in only a minority of cases of suspected abdominal TB.

Early gonadotropin-releasing hormone antagonist protocol in women with polycystic ovary syndrome: A preliminary randomized trial

Objective

To prospectively evaluate the efficacy and safety of a fixed early gonadotropin-releasing hormone (GnRH) antagonist protocol compared to a conventional midfollicular GnRH antagonist protocol and a long GnRH agonist protocol for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS).

Methods

Randomized patients in all three groups (early antagonist, n=14; conventional antagonist, n=11; long agonist, n=11) received 21 days of oral contraceptive pill treatment prior to stimulation. The GnRH antagonist was initiated on the 1st day of stimulation in the early antagonist group and on the 6th day in the conventional antagonist group. The GnRH agonist was initiated on the 18th day of the preceding cycle. The primary endpoint was the number of oocytes retrieved, and the secondary endpoints included the rate of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and the clinical pregnancy rate.

Results

The median total number of oocytes was similar among the three groups (early, 16; conventional, 12; agonist, 19; p=0.111). The early GnRH antagonist protocol showed statistically non-significant associations with a higher clinical pregnancy rate (early, 50.0%; conventional, 11.1%; agonist, 22.2%; p=0.180) and lower incidence of moderate-to-severe OHSS (early, 7.7%; conventional, 18.2%; agonist, 27.3%; p=0.463), especially among subjects at high risk for OHSS (early, 12.5%; conventional, 40.0%; agonist, 50.0%; p=0.324).

Conclusion

In PCOS patients undergoing IVF, early administration of a GnRH antagonist may possibly lead to benefits due to a reduced incidence of moderate-to-severe OHSS in high-risk subjects with a better clinical pregnancy rate per embryo transfer. Further studies with more subjects are required.