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Objective To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke. Methods This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients' demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated. Results There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634--0.987) and PAS scores (OR=0.205; 95% CI, 0.059--0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively. Conclusion In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning. [ABSTRACT FROM AUTHOR]

In order to obtain optimum growth conditions for desired thickness and more effective silicon feedstock usage, effects of processing parameters such as preheated substrate temperatures, time intervals, moving velocity of substrates, and Ar gas blowing rates on silicon ribbon thickness were investigated in the horizontal growth process. Most of the parameters strongly affected in the control of ribbon thickness with columnar grain structure depended on the solidification rate. The thickness of the silicon ribbon decreased with an increasing substrate temperature, decreasing time interval, and increasing moving velocity of the substrate. However, the blowing of Ar gas onto a liquid layer existing on the surface of solidified ribbon contributed to achieving smooth surface roughness but did not closely affect the change of ribbon thickness in the case of a blowing rate of ≥ 0.65 Nm³/h because the thickness of the solidified layer was already determined by the exit height of the reservoir. [ABSTRACT FROM AUTHOR]

Background: Akt regulates various cellular processes, including cell growth, survival, and metabolism. Recently, Akt's role in neurite outgrowth has also emerged. We thus aimed to identify neuronal function-related genes that are regulated by Akt. Methods: We performed suppression subtractive hybridization on two previously established PC12 sublines, one of which overexpresses the wild-type (WT) form and the other, the dominant-negative (DN) form of Akt. These sublines respond differently to NGF's neuronal differentiation effect. Results: A variety of genes was identified and could be classified into several functional groups, one of which was developmental processes. Two genes involved in neuronal differentiation and function were found in this group. v-Maf musculoaponeurotic fibrosarcoma oncogene homolog K (MafK) induces the neuronal differentiation of PC12 cells and immature telencephalon neurons, and synaptotagmin I (SytI) is essential for neurotransmitter release. Another gene, syntenin-1 (Syn-1) was also recognized in the same functional group into which MafK and SytI were classified. Syn-1 has been reported to promote the formation of membrane varicosities in neurons. Quantitative reverse transcription polymerase chain reaction analyses show that the transcript levels of these three genes were lower in PC12 (WT-Akt) cells than in parental PC12 and PC12 (DN-Akt) cells. Furthermore, treatment of PC12 (WT-Akt) cells with an Akt inhibitor resulted in the increase of the expression of these genes and the improvement of neurite outgrowth. These results indicate that dominant-negative or pharmacological inhibition of Akt increases the expression of MafK, SytI, and Syn-1 genes. Using lentiviral shRNA to knock down endogenous Syn-1 expression, we demonstrated that Syn-1 promotes an increase in the numbers of neurites and branches. Conclusions: Taken together, these results indicate that Akt negatively regulates the expression of MafK, SytI, and Syn-1 genes that all participate in regulating neuronal integrity in some way or another. [ABSTRACT FROM AUTHOR]

Pulmonary neuroendocrine tumors, especially small cell carcinoma and typical carcinoids, are the most common cause of ectopic Cushing syndrome (CS). Sometimes these adrenocorticotropic hormone (ACTH)-producing tumors are too small to localize, and it may take a long time to identify them. This report describes the case of a 27-year-old-man with CS. This CS was due to the ectopic ACTH produced by the pulmonary atypical carcinoids, which were recognized at the disseminated stage 5 years after the initial presentation of CS. Microscopically, multiple whitish nodules (up to 1.0 cm in diameter) of the wedge-resected lung were composed of small round cells appearing to be typical neuroendocrine but were diagnosed as atypical carcinoid, based on the findings of focal necrosis, high mitotic rates and multiple endolymphatic tumor emboli. Immunohistochemically, tumor cells robustly stained for ACTH. The delay of diagnosis is, in part, attributable to the pulmonary tuberculosis (one of the complications of hypercortisolism), because the pulmonary tuberculosis presented in the form of multiple nodules throughout the lung. In addition, this patient had a Crooke's cell hyperplasia of the pituitary gland, which represents the reactive change of corticotrophs exposed to the excess cortisol rather than neoplastic change leading to CS. [ABSTRACT FROM AUTHOR]

Paleostress of the Joseon Supergroup in the northeastern part of the Ogcheon Belt, South Korea, is reconstructed in the Jecheon–Danyang area with the help of calcite twinning. In the study area, the average twin thickness and intensity increase with the total twin strain increase. From the appearance of twins, the average twin thickness and intensity, and the total twin strain, it is estimated that calcite twins were produced under temperatures lower than 200°C. The maximum shortening axis in the study area changes orientation from northeast–southwest to NNW–SSE or northwest–southeast, and finally to north–south. We suggest these three distinct stages with different orientations of the maximum shortening axis can be correlated with: (i) the Paleozoic to Early Jurassic Songrim orogeny; (ii) the Early Jurassic to Late Jurassic Daebo orogeny; and (iii) the Cretaceous Bulgugsa orogeny. [ABSTRACT FROM AUTHOR]

A series of tour asymmetrically awl-substituted 9,9'-spiro-9-silabifluorene (SSF) derivatives, 2,2'- di-tert-butyl-7,7'-diphenyl-9,9'-spiro-9-silabifluorene (PhSSF), 2,2'-di-tert-butyl-7,7'-dipyridin-2-yl-9,9'-spiro- 9-silabifluorene (PySSF), 2,2'-di-tert-butyl-7,7'-dibiphenyl-4-yl-9,9'-spiro-9-silabitluorene (BPhSSF), and 2,2'- di-tert-butyl-7,7'-bis(2',2"-bipyridin-6-yl)-9,9'-spiro-9-silabitluorene (BPySSF) are prepared through the cyclization of the corresponding 2,2'-dilithiobiphenyls with silicon tetrachloride. These novel spiro-linked silacyclopentadienes (siloles) form transparent and stable amorphous films with relatively high glass transition temperatures (Tg = 203-228 °C). The absorbance spectrum of each compound shows a significant bathochromic shift relative to that of the corresponding carbon analogue as a result of the effective α* - π* conjugation between the α* orbital of the exocyclic Si-C bond and the π* orbital of the oligoarylene fragment. Solid-state films exhibit intense violet-blue emission (λPL = 398-415 nm) with high absolute photoluminescence quantum yields (ΦPL = 30-55%). [ABSTRACT FROM AUTHOR]

BaTi4O9 thin films were grown on a Pt/Ti/SiO2/Si substrate using rf magnetron sputtering and the structure of the thin films were then investigated. For the films grown at low temperature (≤350°C), an amorphous phase was formed during the deposition, which then changed to the BaTi5O11 phase when the annealing was conducted below 950°C. However, when the annealing temperature was higher than 950°C, a BaTi4O9 phase was formed. On the contrary, for the films grown at high temperature (>450°C), small BaTi4O9 grains were formed during the deposition, which grew during the annealing. The homogeneous BaTi4O9 thin films were successfully grown on Pt/Ti/SiO2/Si substrate when they were deposited at 550°C and subsequently rapid thermal annealed at 900°C for 3 min. [ABSTRACT FROM AUTHOR]

The dielectric and electrical properties of a BaTi4O9 film were investigated in order to evaluate its potential use in metal-insulator-metal (MIM) capacitors for rf/mixed signal integrated circuits. A high capacitance density of 4.62 fF/μm2 along with a low tan δ of 0.0025 were obtained at 100 kHz. A high capacitance density of 4.12 fF/μm2 and a high quality factor of 322 were also achieved at 2 GHz. The leakage current density was approximately 1 nA/cm2 at ±2 V. Small linear and quadratic voltage coefficients of capacitance of 110 ppm/V and 40.05 ppm/V2, respectively, and a small temperature coefficient of capacitance of -92.157 ppm/°C at 100 kHz were obtained. These results demonstrate that the BaTi4O9 film is a good candidate material for MIM capacitors. [ABSTRACT FROM AUTHOR]

Background/aim: Preoperative intravenous oxycodone may help to prevent or attenuate intubation-related hemodynamic responses (IRHRs), but its pharmacokinetics differs according to age and sex. Therefore, we investigated the 95% effective dose (ED95) of intravenous oxycodone for attenuating all IRHRs, depending on the age and sex of the study population. Materials and methods: All patients were allocated to one of 6 groups: 1) 20--40 year old males, 2) 41--65yearold males, 3) 66--80 year old males, 4) 20--40 year old females, 5) 41--65yearold females, and 6) 66--80 year old females (groups YM, OM, EM, YF, OF, and EF, respectively). Using Dixon's up-and-down method, the first patient in each group was slowly injected with intravenous oxycodone (0.1 mg kg--1) 20 min before intubation. The subsequent patient received the next oxycodone dose, which was decreased or increased by 0.01 mg kg--1, depending on the "success" or "failure" of attenuation of all IRHRs to within 20% of the baseline values at 1 min after intubation in the previous patient. After obtaining 8 crossover points, predictive ED95 was estimated with probit regression analysis. Results: ED95 varied greatly according to age and sex. ED95was 0.133 mg kg--1, 0.181 mg kg--1, 0.332 mg kg--1, 0.183 mg kg--1, 0.108 mg kg--1, and 0.147 mg kg--1in groups YM, OM, EM, YF, OF, and EF, respectively. Conclusion: ED95 is higher in males with increasing age but is ambiguous for females. ED95 is higher in males than in females over 40 years of age but is higher in females than in males under 41 years of age. However, after considering the age and sex of the study population, these results can be used as reference doses for further studies to verify the clinical effects of oxycodone for attenuating all IRHRs. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is vulnerable to fracture, and the missed diagnosis can lead to neurological deterioration. Herein, we present the conus medullaris syndrome due to aggravation of the missed spinal fracture in an 85-year-old woman with AS who underwent hip surgery. She underwent osteosynthesis in a supine position with supports under her shoulders and head due to spine deformity with AS, but was fully supine without supports after surgery. She showed complete paraplegia at postoperative 12 h. The re-reading radiological imaging showed the missed spinal fracture, of which the deteriorated dislocation was revealed on the re-examined radiological evaluation. This deterioration was not recovered ultimately despite an emergent surgery. A thorough preoperative assessment is essential to prevent the missed diagnosis of spinal fracture and minimise deterioration due to its dislocation, with specific spine precaution during transport, transfer and positioning. [ABSTRACT FROM AUTHOR]

Iron oxide is a key compound to understand the state of the deep Earth. It has been believed that previously known oxides such as FeO and Fe2O3 will be dominant at the mantle conditions. However, the recent observation of FeO2 shed another light to the composition of the deep lower mantle (DLM), and thus understanding of the physical properties of FeO2 will be critical to model the DLM. Here, we report the electronic structure and structural properties of FeO2 by using density functional theory and dynamic mean-field theory. The crystal structure of FeO2 is composed of Fe2+ and O22- dimers, where the Fe ions are surrounded by the octahedral O atoms. We found that FeO2 shows a metal-insulator transition (MIT) under high pressure. The MIT is not a Mott type but a band insulator type which is driven by the O2 dimer bond length change. However, the correlation effect of Fe 3d orbitals should be considered to correctly describe O2 dimer bond length of FeO2 and the MIT. [ABSTRACT FROM AUTHOR]

Real time sensing of crop yield is critical for a successful implementation of precision agriculture. Yield monitoring system is an optional component of a 55 kW multi-purpose combine harvester, developed in Korea, for both domestic and global markets, especially Asian countries where field sizes are relatively small. The aim of the present study was to fabricate and evaluate the performance of a grain flow sensor suitable to the mid-sized full-feed type combine for rice, soybean, and barley. Firstly, commercially available non-contact type sensing modules (optical, ultrasonic, laser, and microwave modules) were chosen for alternative candidates, to be further tested in a laboratory bench. Through the laboratory tests, the ultrasonic module was selected as a potential approach and the performance was improved by increasing the number of modules and their layout. Finally, the improved grain flow sensor was evaluated during field harvesting operation. Field tests with the improved grain flow sensor showed a good potential for rice (R²=0.85, RMSE=126.14 g/s), soybean (R²=0.78, RMSE=43.87 g/s), and barley (R²=0.83, RMSE=37.39 g/s). Further research would be necessary for improvement and commercialization, through various signal processing and field tests under different field and crop conditions. [ABSTRACT FROM AUTHOR]

Objectives: Although Korean Medicine (KM) is an important part of the Korean healthcare system and plays a significant role in chronic and incurable diseases, there is insufficient information about KM utilization. The aim of the study was to identify KM utilization patterns using a national representative sample data. Methods: KM users aged 0–80 years and older from the nationally representative sample in the National Health Insurance Service–National Sample Cohort of 778,506KM users between 2002 and 2013 (were analyzed. Annual changes in utilization patterns were analyzed by sex, nine age groups, five income levels, and numbers of visits and hospitalizations. Utilization patterns by the type of healthcare institution and the top 10 major diseases were studied. Results: Frequencies of KM use differed according to analyses of patients and claims. Women used KM 1.5 times more than did men. Patients in their 40s and 50s made up one third of KM users. In contrast to other studies, high-income groups used KM more than did low-income groups. More than 96% of ambulatory patients used mostly KM clinics, and more than 76% of inpatients used KM hospitals. Musculoskeletal disorders were the main disease treated, which conformed to the results of previous studies. Conclusion: The results suggest that women, people in their 40s and 50s, and people with a relatively high income use KM more often than other patients. Further comparison studies of both Western medicine in Korea and other countries should be conducted. [ABSTRACT FROM AUTHOR]

A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years. [ABSTRACT FROM AUTHOR]

The time-dependent deformation and long-term strength of rock mass are generally controlled by the mechanical properties of discontinuity, in particular, creep properties. By using the samples based on various JRC values, a series of shear tests and shear creep tests were carried out. The mechanical properties of discontinuity under shear stress were investigated. The creep properties under shearing condition were analyzed. Results showed that both the sliding and cutting behavior can be observed during the shear tests. The sliding effect and cutting effect can obviously change the shear strength parameters. The transient and steady creep appeared in shear creep tests, but accelerating creep was not observed. The long-term strength can be identified by using the variation of creep rate and the transition of different creep stages. The long-term strength is approximately 60-70% of the conventional shear strength. [ABSTRACT FROM AUTHOR]

We investigate the evolution of the electronic structure of NiS2-x Sex alloys with varying temperature and composition x by using the combined approach of density-functional theory and dynamical mean-field theory. Adopting realistic alloy structures containing S and Se dimers, we map their electronic correlation strength on the phase diagram and observe the metal-insulator transition (MIT) at the composition x=0.5, which is consistent with the experimental measurements. The temperature dependence of the local magnetic susceptibility is found to show a typical Curie-Weiss-like behavior in the insulating phase while it shows a constant Pauli-like behavior in the metallic phase. A comparison of the electronic structures for NiS2 and NiSe2 in different lattice structures suggests that the MIT in this alloy system can be classified as of bandwidth-control type, where the change in the hybridization strength between Ni d and chalcogen p orbitals is the most important parameter. [ABSTRACT FROM AUTHOR]

Paleostress fields of the Late Paleozoic to Early Mesozoic Pyeongan Supergroup that is distributed along the northeastern part of the Ogcheon Belt in South Korea were investigated using the calcite strain gauge (CSG) technique. Combining the results of this study with those of other studies investigating the relationship between twin strain, twin density and width, which are used as indicators of deformation conditions in the natural low-temperature deformation of limestone, it was estimated that calcite twins in the study area were probably formed at temperatures lower than 170°C. From two samples, two different principal paleostress directions were inferred from calcite twins, while only one direction was inferred from two other samples. This result suggests that deformation occurred during two or more different tectonic events in the Pyeongan Supergroup during the Mesozoic era. The maximum shortening axis was oriented in two directions, northeast–southwest and northwest–southeast, respectively, which coincide well with the paleostress directions inferred from the stress inversion for many fault sets. Combining the results of the paleostress analysis from this and other studies, we hypothesize that the directions of the maximum shortening axis in the Pyeongan Supergroup changed from northeast–southwest during the pre-Daebo orogeny period (Late Triassic period) to northwest–southeast during the syn-Daebo orogeny period (Early Jurassic to Early Cretaceous period) in the Mesozoic era. [ABSTRACT FROM AUTHOR]

The temperature-dependent evolution of the Kondo lattice is a long-standing topic of theoretical and experimental investigation and yet it lacks a truly microscopic description of the relation of the basic f-c hybridization processes to the fundamental temperature scales of Kondo screening and Fermi-liquid lattice coherence. Here, the temperature dependence of f-c hybridized band dispersions and Fermi-energy f spectral weight in the Kondo lattice system CeCoIn5 is investigated using f-resonant angle-resolved photoemission spectroscopy (ARPES) with sufficient detail to allow direct comparison to first-principles dynamical mean-field theory (DMFT) calculations containing full realism of crystalline electric-field states. The ARPES results, for two orthogonal (001) and (100) cleaved surfaces and three different f-c hybridization configurations, with additional microscopic insight provided by DMFT, reveal f participation in the Fermi surface at temperatures much higher than the lattice coherence temperature, T∗≈45 K, commonly believed to be the onset for such behavior. The DMFT results show the role of crystalline electric-field (CEF) splittings in this behavior and a T-dependent CEF degeneracy crossover below T∗ is specifically highlighted. A recent ARPES report of low T Luttinger theorem failure for CeCoIn5 is shown to be unjustified by current ARPES data and is not found in the theory. [ABSTRACT FROM AUTHOR]

The article presents two-dimensional van der waals crystals constitute a promising material class for spin transport or effective spin manipulation at room temperature. Topic include spin-momentum locking in the surface state of bismuth chalcogenide–based topological insulators provides unprecedented electrical optical spin control by their strong spin-orbit coupling.

Overcoming drug resistance is an important task for investigators and clinician to achieve successful chemotherapy in cancer patients. Drug resistance is caused by various factors, including the overexpression of P-glycoprotein (P-gp, MDR1). The development of new, useful compounds that overcome drug resistance is urgent. SH003 is extracted from the mixture of three different herbs, and its anticancer effect has been revealed in different cancer cell types. In the present study, we investigated whether SH003 is able to reverse drug resistance using paclitaxel-resistant breast cancer cells (MCF-7/PAC). In our experiments, SH003 significantly decreased cell growth and colony formation in MCF-7/PAC cells and parental MCF-7 cells. This growth inhibition was related to the accumulation of cells in the sub-G0/G1 apoptotic population and an increase in the number of apoptotic cells. SH003 reduced the mRNA expression of multidrug resistance 1 (MDR1) and multidrug resistance-associated proteins (MRPs) in MCF-7/PAC cells. SH003 also down-regulated the expression of P-gp. SH003 reversed drug efflux from MCF-7/PAC cells, resulting in rhodamine123 (Rho123) accumulation. Inhibition of drug resistance by SH003 is related to the suppression of the signal transducer and activator of transcription 3 (STAT3) signaling pathway. SH003 decreased STAT3 activation (p-STAT3) and its nuclear translocation and inhibited the secretion of VEGF and MMP-2, which are STAT3 target genes. An STAT3 inhibitor, JAK inhibitor I and an HIF-1α inhibitor decreased cell growth in MCF-7 and MCF-7/PAC cells. Taken together, these results demonstrate that SH003 can overcome drug resistance, and SH003 might be helpful for chemotherapy in cancer patients. [ABSTRACT FROM AUTHOR]

Background: 'Work related musculoskeletal disorders (WRMSDs)' have been mostly reported in the manufacturing industry but recently the occurrence of industrial injuries has been constantly increasing in the service industry. This research is going to analyze the data about workers' compensation for WRMSDs in five different service sectors and identify characteristics of occupations with the highest approved occupations. Methods: According to the data released from the Korea Worker's Compensation & Welfare Service, the overview of 12,730 cases of workers' compensation for WRMSDs in five service sectors from 2004 to 2013 is going to be analyzed and the source data is going to be classified by the Korean Standard Classification of Occupations to select the top five occupations that have the highest number of approval. Results: After selecting each five occupations from the service sector that have work related musculoskeletal disorders, the result showed that the occupation with the highest number of approval in the health and social care sector were the early childhood educators, cooks in the school canteens in education services sector, garbage collectors in the sanitation and similar services sector, deliverymen in wholesale and retail, consumer goods repair and building cleaners in general management businesses such as those in building maintenance. The major event observed in the top five occupations was the overexertion and reaction as a cause of WRMSDs. The day when the WRMSDs mostly occurred was on Monday and the most likely time was 10 am. The median days away from work and lost working days are 29–90 days and 0–50 days respectively. The difference in each occupation was observed in year of service, age, and gender. Conclusions: 83.21% of the approved cases of workers' compensation for WRMSDs occurred in the top 25 occupations in all of the five service sectors, which meant that the approval of workers' compensation is concentrated in specific occupations. This research is going to suggest preventive measures for work related musculoskeletal disorders in the service industry and to help prioritize the preventive measures. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Obesity is a public health concern in many countries due to its increasing prevalence. Euiiyin-tang is an herbal medicine formula often used as a clinical treatment for obesity. It acts to eliminate humidity and purify the blood, the causes of obesity identified by the theoretical framework of Korean medicine. The purpose of this study is to evaluate the efficacy and safety of Euiiyin-tang in treating obesity.Methods/design: This study is a randomised, double-blinded and placebo-controlled, multicentre trial. It has two parallel arms: the Euiiyin-tang group and the placebo group. A total of 160 obese adult women will be enrolled in the trial. The participants will be randomly divided at a 1:1 ratio at visit 2 (baseline). The participants will be administered Euiiyin-tang or placebo for 12 weeks. The primary endpoint is the change in weight occurring between baseline and post-treatment. The secondary outcomes include average weight reduction, changes in body fat, waist and hip circumferences, body mass index, and lipid profile, and the results of questionnaires such as the Korean version of Obesity-related Quality of Life, the Korean version of Eating Attitudes Test, the Social Readjustment Rating Scale, and the Stress Reaction Inventory.Discussion: The present study will provide research methodologies for evaluating the efficacy and safety of Euiiyin-tang in patients with obesity. In addition, it will provide evidence of correlation between obesity and Sasang constitutional medicine.Trial Registration: ClinicalTrials.gov, NCT01724099 . Registered on 2 November 2012. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a common pruritic inflammatory skin disease with increasing prevalence. It can manifest with many different clinical phenotypes; however, in its chronic stage, hyperpigmentation, excoriation, lichenification, and dryness are the main symptoms. Jaungo comprises two herbs, Lithospermi radix and Angelica gigantis radix, and three carrier oils, and is an approved herbal ointment for xerosis cutis in Korea. In past studies, we demonstrated that Jaungo had anti-inflammatory and antiallergic activity in in vitro and in vivo AD models; however, there are few relevant randomized controlled clinical trials on Jaungo in AD.Methods/design: A randomized, double-blind, placebo-controlled, single-center, phase IIa clinical trial was designed to investigate the safety, preliminary efficacy, and dose response of Jaungo in AD. The study protocol was approved by the Institutional Review Boards of the Kyung Hee University Korean Medicine Hospital (No. KOMCIRB-160617-HR-027) and the Korea Food and Drug Administration (No. 30907). The study aims to enroll 34 AD patients to be randomly distributed among three parallel groups: treatment 1, treatment 2, and the placebo group. Treatment group 1 applies Jaungo twice a day, while treatment group 2 applies Jaungo and the placebo ointment once a day, separately, and the placebo group applies the placebo ointment twice a day, for a total of 3 weeks each. Participants will be evaluated for eczema before and after the application of the ointments based on several parameters including the Eczema Area and Severity Index, the SCORing of Atopic Dermatitis Index, the Dermatology Life Quality Index, transepidermal water loss, total IgE level, eosinophil count, and IL-17, IL-22, and IFN-γ levels.Discussion: The trial is currently ongoing and the enrollment of subjects has been initiated. There is an urgent need to develop a drug for the treatment of dry, hyperpigmented, scaly, and thickened skin in chronic-stage AD. This study will determine the efficacy and safety of Jaungo in AD, providing evidence for specific AD symptoms treated by Jaungo.Trial Registration: Clinical Trials.gov, identifier: NCT02900131 . Registered on 2 September 2016. Korea Clinical Research Information Service, identifier: KCT0002060 . Registered on 22 July 2016. [ABSTRACT FROM AUTHOR]

Background: Since the biological function of c-Jun N-terminal kinase (JNK) in gastric cancer remains unclear, we investigated the clinical significance of JNK activation and its association with FOXO1 activation. Methods: Immunohistochemical tissue array analysis of 483 human gastric cancer specimens was performed, and the results of the immunostaining were quantified. The correlation between JNK activation (nuclear staining for pJNK) and clinicopathological features, the proliferation index, prognosis or FOXO1 inactivation (cytoplasmic staining for pFOXO1) was analyzed. The SNU-638 gastric cancer cell line was used for in vitro analysis. Results: Nuclear staining of pJNK was found in 38 % of the gastric carcinomas and was higher in the early stages of pTNM (P < 0.001). pJNK staining negatively correlated with lymphatic invasion (P = 0.034) and positively correlated with intestinal type by Lauren's classification (P = 0.037), Ki-67-labeling index (P < 0.001), cyclin D1 (P = 0.045), cyclin E (P < 0.001) and pFOXO1 (P < 0.001). JNK activation correlated with a longer patients survival (P =0.008) and patients with a JNK-active and FOXO1-inactive tumor had a higher survival rate than the remainder of the population (P = 0.004). In vitro analysis showed that JNK inhibition by SP600125 in SNU-638 cells decreased cyclin D1 protein expression and increased FOXO1 activation. Further, JNK inhibition markedly suppressed colony formation, which was partially restored by FOXO1 shRNA expression. Conclusions: Our results indicate that JNK activation may serve as a valuable prognostic factor in gastric cancer, and that it is implicated in gastric tumorigenesis, at least in part, through FOXO1 inhibition. [ABSTRACT FROM AUTHOR]

Phytoestrogen intake is known to be beneficial to decrease breast cancer incidence and progression. But its molecular mechanisms of action are still unknown. The present study aimed to examine the effect of apigenin on proliferation and apoptosis in HER2-expressing breast cancer cells. In our experiments, apigenin inhibited the proliferation of BT-474 cells in a dose- and time-dependent manner. Apigenin also inhibited clonogenic survival (anchorage-dependent and -independent) of BT-474 cells in a dose-dependent manner. These growth inhibitions were accompanied with an increase in sub-G0/G1 apoptotic populations. Apigenin-induced extrinsic a caspase-dependent apoptosis up-regulating the levels of cleaved caspase-8 and cleaved caspase-3, and inducing the cleavage of poly (ADP-ribose) polymerase (PARP). Whereas, apigenin did not induce apoptosis via intrinsic mitochondrial apoptosis pathway since this compound did not decrease mitochondrial membrane potential without affecting the levels of B-cell lymphoma 2 (Bcl-2) and Bcl- 2-associated X protein (BAX). Apigenin reduced the expression of phospho-JAK1, phospho-JAK2 and phospho-STAT3 and decreased signal transducer and activator of transcription 3 (STAT3) dependent luciferase reporter gene activity in BT-474 cells. Apigenin inhibited CoCl2-induced VEGF secretion and decreased the nuclear translocation of STAT3. Our study indicates that apigenin induces apoptosis through inhibition of STAT3 signalling and could serve as a useful compound to prevent or treat HER2-overexpressing breast cancer. [ABSTRACT FROM AUTHOR]

Phytoestrogens have been demonstrated to inhibit tumor induction; however, their molecular mechanisms of action have remained elusive. The present study aimed to investigate the effects of a phytoestrogen, apigenin, on proliferation and apoptosis of the human epidermal growth factor receptor 2 (HER2)-expressing breast cancer cell line SKBR3. Proliferation assay, MTT assay, fluorescence-activated cell sorting analysis, western blot analysis, immunocytochemistry, reverse transcription-polymerase chain reaction and ELISA assay were used in the present study. The results of the present study indicated that apigenin inhibited the proliferation of SKBR3 cells in a dose- and time-dependent manner. This inhibition of growth was accompanied by an increase in the sub-G0/G1 apoptotic population. Furthermore, apigenin enhanced the expression levels of cleaved caspase-8 and -3, and induced the cleavage of poly(adenosine diphosphate ribose) polymerase in SKBR3 cells, confirming that apigenin promotes apoptosis via a caspase-dependent pathway. Apigenin additionally reduced the expression of phosphorylated (p)-janus kinase 2 and p-signal transducer and activator of transcription 3 (STAT3), inhibited CoCl2-induced vascular endothelial growth factor (VEGF) secretion and decreased the nuclear localization of STAT3. The STAT3 inhibitor S31-201 decreased the cellular proliferation rate and reduced the expression of p-STAT3 and VEGF. Therefore, these results suggested that apigenin induced apoptosis via the inhibition of STAT3 signaling in SKBR3 cells. In conclusion, the results of the present study indicated that apigenin may be a potentially useful compound for the prevention or treatment of HER2-overexpressing breast cancer. [ABSTRACT FROM AUTHOR]

Atypical antipsychotics, which have better efficacy and fewer side effects compared to first-generation antipsychotics, are being used increasingly for the treatment of schizophrenia. However, adverse events such as weight gain, diabetes mellitus and abnormal lipid profile have been reported in patients treated with these agents. Diabetic ketoacidosis (DKA) is a rare side effect of atypical antipsychotics, but deserves attention due to its severity. Although various atypical antipsychotics have been reported as causing DKA, there have been no reports showing an association with DKA and paliperidone, which is a recently developed antipsychotic agent. Here, we report two cases of DKA in patients with paliperidone therapy. Both cases had no history of diabetes before use of paliperidone, and DKA was manifested within 2 years of starting paliperidone therapy. Like other atypical antipsychotics, use of paliperidone warrants monitoring for metabolic derangements including DKA. [ABSTRACT FROM AUTHOR]

Background/Aims: Management of irritable bowel syndrome (IBS) imposes a heavy economic burden. This study was to estimate the epidemiologic features of IBS and to report the IBS burden for the first time in the Korean population. Methods: A cross-sectional study was conducted using the National Health Insurance (NHI) system database, which covers the entire population of Korea. IBS was defined as diagnostic code -10 in adults with any outpatient clinic visits or hospitalization related to IBS. We excluded diseases that mimic IBS symptoms. Results: A total of 2.42 million (58.2% female) individuals were identified as patients with IBS, yielding an age- and gender-adjusted prevalence of 5.1% in males and 6.9% in females. The prevalence of IBS increased proportionally with age, with higher medical costs in middle-aged patients. Outpatient clinics were visited by 98.6% of IBS patients, and 1.9% were treated upon admission. Of these patients, 87.6% were given a prescription. Co-morbidities that commonly accompanied IBS included upper gastrointestinal (36.1%), respiratory (12.3%), musculoskeletal (8.0%) disease, somatoform (4.3%) and depression/anxiety disorders (3.1%). The NHI costs of IBS, which include the NHI covered cost and beneficiary copayment charges, were estimated to be 155 million USD, which accounts for 0.46% of the total NHI costs for the entire Korean population. Conclusions: According to the Korean national claims database, about 6% of the Korean population seeks medical care for IBS at least once per year. This high prevalence places a large economic burden on the Korean healthcare system, accounting for 0.46% of overall national medical expenditure. [ABSTRACT FROM AUTHOR]

Inflammatory response is a major defense mechanism against pathogens and chemical or mechanical injury. Rhus verniciflua Stokes (RVS) has traditionally been used as an ingredient in East Asian medicine for the treatment of gastritis, stomach cancer and atherosclerosis. The aim of the current study was to analyze the effect of RVS on LPS. induced inflammatory responses in the RAW264.7 mouse macrophage cell line. RAW264.7 cells were treated with various concentrations of RVS and LPS at specific time points. WST assay, trypan blue assay and quantification of activated cells revealed that RVS suppressed cell proliferation in a dose-dependent manner. RVS induced G1 cell cycle arrest, suppressed iNOS and COX-2 mRNA expression induced by LPS and decreased intracellular ROS levels induced by LPS. In addition, RVS induced PARP and caspase-3 cleavage suggesting that RVS causes cell death. Results of the present study indicate that RVS may be advantageous in treating inflammatory disease. [ABSTRACT FROM AUTHOR]

Objectives: To develop and validate a new risk-of-bias tool for nonrandomized studies (NRSs). Study Design and Setting: We developed the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). A validation process with 39 NRSs examined the reliability (interrater agreement), validity (the degree of correlation between the overall assessments of RoBANS and Methodological Index for Nonrandomized Studies [MINORS], obtained by plotting the overall risk of bias relative to effect size and funding source), face validity with eight experts, and completion time for the RoBANS approach. Results: RoBANS contains six domains: the selection of participants, confounding variables, the measurement of exposure, the blinding of the outcome assessments, incomplete outcome data, and selective outcome reporting. The interrater agreement of the RoBANS tool except the measurement of exposure and selective outcome reporting domains ranged from fair to substantial. There was a moderate correlation between the overall risks of bias determined using RoBANS and MINORS. The observed differences in effect sizes and funding sources among the assessed studies were not correlated with the overall risk of bias in these studies. The mean time required to complete RoBANS was approximately 10 min. The external experts who were interviewed evaluated RoBANS as a ''fair'' assessment tool. Conclusions: RoBANS shows moderate reliability, promising feasibility, and validity. The further refinement of this tool and larger validation studies are required. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to assess the efficacy and safety of Taeeumjowi-tang (TJ001) as well as to estimate obesity-related factors. Methods. This was a 12-week trial with 5 visits. A total of 102 participants of both genders were randomized to either TJ001 (n = 57) group or the placebo group (n = 55). Subjects were administered 7 g of either TJ001 or placebo 3 times a day. The primary outcome was a rate of subjects who lost 5% or more of initial weight. Secondary outcomes included anthropometric parameters, lipid profiles, and body fat composition. Results. The subject response rate of >5% weight loss compared to baseline was similar in both groups, and no statistically significant difference was observed (P = 0.87). Changes in anthropometric parameters were greater during the first 4 weeks in the treatment group (P < 0.0001). There were no significant changes in both within groups and between groups for lipid profile and body fat composition. No adverse event was reported in either group. Conclusion. Although the difference between the groups regarding a rate of subjects who lost 5% or more of initial weight did not show statistical significance, TJ001 appears to be beneficial in safely controlling weight. [ABSTRACT FROM AUTHOR]

Objective. This study was a multicenter, randomized, double-blind, and controlled trial with two parallel arms: the GJBNH group and the placebo group. This trial recruited 100 women aging 18 to 35 years with primary dysmenorrhea caused by blood stagnation. The investigational drugs, GJBNH or placebo, were administered for two menstrual periods (8 weeks) to the participants three times per day. The participants were followed up for two menstrual cycles after the administration. Results. The results were analyzed by the intention-to-treat (ITT) dataset and the per-protocol (PP) dataset. In the ITT dataset, the change of the average menstrual pain VAS score in the GJBNH group was statistically significantly lower than that in the control group. Significant difference was not observed in the SF-MPQ score change between the GJBNH group and the placebo group. No significant difference was observed in the PP analyses. In the follow-up phase, the VAS scores of the average menstrual pain and the maximum menstrual pain continually decreased in the placebo group, but they increased in the GJBNH group. Conclusion. GJBNH treatment for eight weeks improved the pain of the dysmenorrhea caused by blood stagnation, but it should be successively administered for more than two menstrual cycles. Trial Registration. This trial is registered with Current Controlled Trials no. ISRCTN30426947. [ABSTRACT FROM AUTHOR]

Background: During specimen processing in surgical pathology laboratories, specimen-related adverse events (SRAEs), such as mislabeling and specimen mixed-up might occur. In these situations, molecular techniques using short tandem repeat (STR) loci are required to identify the personal identity. Microsatellite instability (MSI) test is widely used for screening the hereditary non-polyposis colon cancer (Lynch syndrome) in surgical pathologies using polymorphic STR markers. We tried to evaluate the applicability of the MSI test for SRAEs. Methods: We obtained 253 MSI test results to analyze the allele frequencies. After calibrating the estimated nucleotide lengths, we calculated the allele frequencies, a random match probability, and a likelihood ratio (LR) of three dinucleotide STR markers (D5S349, D17S250, and D2S123). Results: The distribution of LR was 136.38 to 5,606,213.10. There was no case of LR<100. In addition, there were 153 cases (60.5%) of LR ranging from 100 to 10,000 and 100 cases (39.5%) of LR>10,000. Furthermore, the combined probability of identity was 9.23x10-4 and the combined power of exclusion was 0.99908. Conclusions: Using the three STR markers that are recommended for MSI test, all the cases were positively identified in 1% range and about one-third cases showed high LR (>10,000). These results showed that MSI tests are useful to screen the personal identity in case of SRAE in pathology laboratories. [ABSTRACT FROM AUTHOR]

Background: Hwa-byung, a Korean culture-bound syndrome with both psychological and somatic symptoms, is also known as 'anger syndrome'. It includes various physical symptoms including anxiety, a feeling of overheating, a sensation of pressure on the chest, heart palpitations, respiratory stuffiness, insomnia, and anxiety. Methods/design: The proposed study is a single-center, double-blind, randomized, controlled trial with two parallel arms: an oriental medicine music therapy (OMMT) group and a control music therapy (CMT) group. In total, 48 patients will be enrolled into the trial. The first visit will be the screening visit. At baseline (visit 2), all participants fulfilling both the inclusion and the exclusion criteria will be split and randomly divided into two equal groups: the OMMT and the CMT (n = 24 each). Each group will receive treatment sessions over the course of 4 weeks, twice per week, for eight sessions in total. The primary outcome is the State-Trait Anxiety Inventory (STAI), and the secondary outcomes are the Hwa-byung scale (H-scale), the Center for Epidemiologic Studies Depression Scale (CES-D), the Hwa-byung visual analogue scale (H-VAS) for primary symptoms, the World Health Organization Quality of Life scale, brief version (WHOQOL-BREF), and levels of salivary cortisol. Patients will be asked to complete questionnaires at the baseline visit (visit 2), after the last treatment session (visit 9), and at 4 weeks after the end of all trial sessions (visit 10). From the baseline (visit 2) through the follow-up (visit 10), the entire proces will take a total of 53 days. Discussion: This proposed study targets patients with Hwa-byung, especially those who have exhibited symptoms of anxiety. Therefore, the primary outcome is set to measure the level of anxiety. OMMT is music therapy combined with traditional Korean medicinal theories. Unlike previously reported music therapies, for which patients simply listen to music passively, in OMMT, patients actively move their bodies and play the music. Because Hwa-byung is caused by an accumulation of blocked emotions and anger inside the body, OMMT, because of its active component, is expected to be more efficacious than pre-existing music therapies. Trial registration: Current Controlled Trials ISRCTN11939282 [ABSTRACT FROM AUTHOR]

Background: Diabetes has already become a threat to the nation and the individual due to its high prevalence rates and high medical expenses. Therefore, preventing diabetes at an earlier stage is very important. Despite advances in antidiabetic agents, we have not yet achieved any satisfying results in treating diabetes. Among various treatments, medicinal herbs and supplements for diabetes are reported to show generally good efficacy and safety data. In particular, PURIAM110, a compound from orange fruits and mulberry leaves, is supposed to prevent the progress of type II diabetes mellitus and improve diabetic symptoms. This is the first reported pilot study about the protective effect of the orange fruits and mulberry leaves mixture against pre-diabetes on Korean adults. Based on these positive results of herb-derived components, extended studies of dietary supplements have to be done to suggest confirmative evidences. Methods/Design: The efficacy and safety study of PURIAM110 is a double-blinded, placebo-controlled, randomized, and multi-center clinical trial. A total of 45 subjects will participate in this study for 6 weeks. Discussion: The present protocol will confirm the efficacy and safety of PURIAM110 for pre-diabetes, suggesting more basic knowledge to conduct further randomized controlled trials (RCT). In addition, PURIAM110 can be an alternative dietary supplemental remedy for diabetes patients. Trial Registration: ISRCTN: ISRCTN44779824 [ABSTRACT FROM AUTHOR]

Septicemia-causing Vibrio vulnificus produces at least three exoproteases, VvpE, VvpS, and VvpM, all of which participate in interactions with human cells. Expression of VvpE and VvpS is induced in the stationary phase by multiple transcription factors, including sigma factor S, SmcR, and the cAMP-cAMP receptor protein (cAMP-CRP) complex. Distinct roles of VvpM, such as induction of apoptosis, lead us to hypothesize VvpM expression is different from that of the other exoproteases. Its transcription, which was found to be independent of sigma S, is induced at the early exponential phase and then becomes negligible upon entry into the stationary phase. SmcR and CRP were studied regarding the control of vvpM expression. Transcription of vvpM was repressed by SmcR and cAMP-CRP complex individually, which specifically bound to the regions -2 to +20 and +6 to +27, respectively, relative to the vvpM transcription initiation site. Derepression of vvpM gene expression was 10-to 40-fold greater in an smcR crp double mutant than in single-gene mutants. Therefore, these results show that the expression of V. vulnificus exoproteases is differentially regulated, and in this way, distinct proteases can engage in specific interactions with a host. [ABSTRACT FROM AUTHOR]