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Purpose: We aimed to investigate the association between serum lipid level and tinnitus risk in Korean older adults. Materials and Methods: This study used data from the 2016--2018 Korea National Health and Nutrition Examination Survey. Overall, 6021 subjects aged ≥60 years were included. Hypertriglyceridemia was defined as a serum triglyceride level of ≥200 mg/dL. The high-risk threshold of the total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio was defined as above 5.0. The presence of tinnitus was assessed via health interviews. Tinnitus severity was classified as "not annoying," "irritating," and "severely annoying and causing sleep problems." Multivariate logistic regression analysis was performed to examine the association between serum lipid level and tinnitus risk. Results: The odds ratio (OR) of tinnitus was 1.27-times higher in the group with hypertriglyceridemia than in the group without hypertriglyceridemia after adjusting for age, sex, hypertension, diabetes, dyslipidemia, anemia, current smoking, obesity, noise exposure, stress cognition, and depressive mood or anxiety [95% confidence interval (CI) 1.04-1.56, p=0.022]. The OR of tinnitus was 1.21-times higher in the group with a high TC/HDL-C ratio than in the group without a high TC/HDL-C ratio after adjusting for the same variables as above (95% CI 1.02-1.44, p=0.025). Conclusion: This study revealed that hypertriglyceridemia and high TC/HDL-C ratio were significantly associated with an increased OR of tinnitus in Korean older adults. [ABSTRACT FROM AUTHOR]

Purpose: With the revision of the Organ and Transplantation Act in 2018, the hand has become legal as an area of transplantable organs in Korea. In January 2021, the first hand allotransplantation since legalization was successfully performed, and we have performed a total of three successful hand transplantation since then. By comparing and incorporating our experiences, this study aimed to provide a comprehensive reconstructive solution for hand amputation in Korea. Materials and Methods: Recipients were selected through a structured preoperative evaluation, and hand transplantations were performed at the distal forearm level. Postoperatively, patients were treated with three-drug immunosuppressive regimen, and functional outcomes were monitored. Results: The hand transplantations were performed without intraoperative complications. All patients had partial skin necrosis and underwent additional surgical procedures in 2 months after transplantation. After additional operations, no further severe complications were observed. Also, patients developed acute rejection within 3 months of surgery, but all resolved within 2 weeks after steroid pulse therapy. Motor and sensory function improved dramatically, and patients were very satisfied with the appearance and function of their transplanted hands. Conclusion: Hand transplantation is a viable reconstructive option, and patients have shown positive functional and psychological outcomes. Although this study has limitations, such as the small number of patients and short follow-up period, we should focus on continued recovery of hand function, and be careful not to develop side effects from immunosuppressive drugs. Through the present study, we will continue to strive for a bright future regarding hand transplantation in Korea. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to identify the prevalence and clinical characteristics of borderline personality disorder (BPD) in South Korea using the Korean National Health Insurance database (DB). Materials and Methods: We used the National Health Insurance Service (NHIS)’s research DB (NHIS-2021-1-790) from January 1, 2010 to December 31, 2019, to make customized DB including sociodemographic information and absence or presence of BPD and other psychiatric disorders. The prevalence and the age of onset of BPD was estimated. To compare medical service utilization between the BPD group and the control group, a 1:1:1 propensity score matching was employed, and the regression analysis was conducted. Results: The prevalence of BPD per 10000 people was 0.96 in 2010 and 1.06 in 2019. The prevalence ratio of males to females was 1:1.38 in 2010 and 1:1.65 in 2019, showing that BPD was more prevalent in females. The patients’ overall average age of onset was 33.19±14.6 years, with the highest prevalence shown in 8503 people in their 20s. By administrative district, the highest prevalence of BPD per 10000 people was shown in Seoul with 8.71 and the lowest in Jeollanam-do with 2.35. The BPD patients showed a pattern of extensive use of general and mental healthcare services. Conclusion: This study identified the prevalence of BPD on a national DB set in South Korea. Although the prevalence of BPD in South Korea was relatively low compared to other countries, there was a steady increase in the number of BPD patients over a decade, which may be possibly due to an increased awareness of mental health and campaigns among healthcare providers and users in the country. [ABSTRACT FROM AUTHOR]

BACKGROUND: Recent evidence suggests a correlation between modified Rankin Scale-based measures, an outcome measure commonly used in acute stroke trials, and mortality-based measures used by health agencies in the evaluation of hospital performance. We aimed to examine whether the 2 types of measures are interchangeable in relation to evaluation of hospital performance in acute ischemic stroke. METHODS: Five outcome measures, unfavorable functional outcome (3-month modified Rankin Scale score ≥2), death or dependency (3-month modified Rankin Scale score ≥3), 1-month mortality, 3-month mortality, and 1-year mortality, were collected for 8292 individuals who were hospitalized for acute ischemic stroke between January 2014 and May 2015 in 14 hospitals participating in the Clinical Research Collaboration for Stroke in Korea -- National Institute of Health registry. Hierarchical regression models were used to calculate per-hospital risk-adjusted outcome rates for each measure. Hospitals were ranked and grouped based on the risk-adjusted outcome rates, and the correlations between the modified Rankin Scalebased and mortality-based ranking and their intermeasure reliability in categorizing hospital performance were analyzed. RESULTS: The comparison between the ranking based on the unfavorable functional outcome and that based on 1-year mortality resulted in a Spearman correlation coefficient of -0.29 and Kendall rank coefficient of -0.23, and the comparison of grouping based on these 2 types of ranks resulted in a weighted kappa of 0.123 for the grouping in the top 33%/middle 33%/bottom 33% and 0.25 for the grouping in the top 20%/middle 60%/bottom 20%, respectively. No significant correlation or similarity in grouping capacities were found between the rankings based on the functional outcome measures and those based on the mortality measures. CONCLUSIONS: This study shows that regardless of clinical correlation at an individual patient level, functional outcome-based measures and mortality-based measures are not interchangeable in the evaluation of hospital performance in acute ischemic stroke. [ABSTRACT FROM AUTHOR]

Purpose: To examine the refractive errors, retinal manifestations, and genotype in tuberous sclerosis complex (TSC) patients in a Korean population. Materials and Methods: A total of 98 patients with TSC were enrolled in Severance Hospital for a retrospective cohort study. The number of retinal astrocytic hamartoma and retinal achromic patch within a patient, as well as the size, bilaterality, and morphological type were studied. In addition, the refractive status of patients and the comorbidity of intellectual disability and epilepsy were also examined. Results: Retinal astrocytic hamartoma was found in 37 patients, and bilateral invasion was observed in 20 patients (54%). TSC1 mutation was associated with myopia (p=0.01), while TSC2 mutation was associated with emmetropia (p=0.01). Retinal astrocytic hamartoma was categorized into three morphological types and examined as follows: type I (87%), type II (35%), and type III (14%). Single invasion of retinal astrocytic hamartoma was identified in 32% of the patients, and multiple invasions in 68%. The TSC1/TSC2 detection rate was 91% (41/45). Among them, TSC1 variant was detected in 23 patients (54%), whereas TSC2 variant was detected in 18 patients (40%). The results showed that TSC2 mutations are correlated with a higher rate of retinal astrocytic hamartoma involvement (all p<0.05), and multiple and bilateral involvement of retinal hamartomas (all p<0.05). However, the size of retinal astrocytic hamartomas, comorbidity of epilepsy, or intellectual disability did not show correlation with the genetic variant. Conclusion: TSC1 variant patients were more myopic, while TSC2 variant patients showed association with more extensive involvement of retinal astrocytic hamartoma. [ABSTRACT FROM AUTHOR]

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Purpose: Erlotinib has been the only targeted agent to show significantly improved outcomes in pancreatic adenocarcinoma when combined with gemcitabine. We aimed to evaluate whether the addition of oxaliplatin to a combination gemcitabine/erlotinib treatment conferred a clinical benefit in patients with locally advanced unresectable or metastatic pancreatic cancer. Materials and Methods: Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned to receive GEMOX-T [gemcitabine 1000 mg/m2 and oxaliplatin 50 mg/m2 on day 1 (D1) and D8 plus erlotinib 100 mg daily for 3 weeks] or GT (gemcitabine 1000 mg/m2 on D1 and D8 plus erlotinib 100 mg daily for 3 weeks). The primary endpoint was the overall response rate (ORR). Results: Between 2013 and 2016, 65 patients were assigned to a treatment group (33 in the GEMOX-T arm, 32 in the GT arm). The ORR was 18.2% [95% confidence interval (CI), 8.82-27.58] in the GEMOX-T arm and 6.2% (95% CI, 0.34-12.06) in the GT arm (p=0.051). The disease control rate was significantly superior in the GEMOX-T arm compared to the GT arm (72.7% vs. 43.8%, p=0.019). After a median follow-up of 19.7 months, the median progression-free survival (PFS) was 3.9 months for the GEMOX-T arm and 1.4 months for the GT arm (p=0.033). However, this did not translate to an improvement in overall survival. The most common grade 3 or higher hematologic adverse events were neutropenia (16.9%) and anemia (13.8%). Conclusion: The addition of oxaliplatin to a first-line gemcitabine/erlotinib regimen demonstrated higher response rates and significantly improved PFS in patients with locally advanced or metastatic pancreatic cancer. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the association between daily sunlight exposure duration and fractures in older Korean adults with osteoporosis. Materials and Methods: We utilized data from the 2008-2011 Korea National Health and Nutrition Examination Survey. Osteoporosis was diagnosed based on a T-score of =-2.5 using dual energy X-ray absorptiometry. The duration of daily sunlight exposure and fracture were assessed via intensive health interviews by trained staff using standardized health questionnaires. Fracture was defined as one or more fractures of the femur, wrist, and spine. Results: A total of 638 patients with osteoporosis aged =65 years were included. The odds ratio (OR) of total fractures was 0.55 times lower in the group with =5 h of daily sunlight exposure than in the group with <5 h of exposure after adjusting for age, sex, family history of osteoporosis or fracture, body mass index, bone mineral density of the femoral neck, serum 25-hydroxyvitamin D, current smoking, alcohol intake, daily calcium intake, and physical activity [95% confidence interval (CI) 0.31-0.97, p=0.040]. In patients with vitamin D insufficiency, the OR of total fracture was 0.52 times lower in the group with =5 h of daily sunlight exposure than in the group with less exposure after adjusting the above variables (95% CI 0.28-0.97, p=0.041). Conclusion: Sunlight exposure for =5 h a day was significantly associated with a decreased OR of fracture in older Korean adults with osteoporosis. This association was also significant in patients with vitamin D insufficiency. [ABSTRACT FROM AUTHOR]

Background: Increased resting heart rate (RHR) is a predictor of mortality. RHR is influenced by cardiorespiratory fitness (CRF). Little is known about the combined associations of RHR and CRF on cancer mortality. Methods: 50,108 men and women (mean age 43.8 years) were examined between 1974 and 2002 at the Cooper Clinic in Dallas, Texas. RHR was measured by electrocardiogram and categorized as <60, 60-69, 70-79, or =80 beats/minute. CRF was quantified by maximal treadmill test and dichotomized as unfit and fit corresponding to the lower 20% and the upper 80%, respectively, of the age- and sex-specific distribution of treadmill exercise duration. The National Death Index was used to ascertain vital status. Cox regression was used to compute HRs and 95% confidence intervals (CI) for cancer mortality across RHR categories. Results: During a mean follow-up of 15.0 ± 8.6 years, 1,090 cancer deaths occurred. Compared with RHR <60 beats/minute, individuals with RHR =80 beats/minute had a 35% increased risk of overall cancer mortality (HR, 1.35; 95% CI, 1.06-1.71) after adjusting for confounders, including CRF. Compared with "fit and RHR <80 beats/minute", HRs (95% CI) for cancer mortality were 1.41 (1.20-1.66), 1.51 (1.11-2.04), and 1.78 (1.30-2.43) in "unfit and RHR <80," "fit and RHR =80," and "unfit and RHR =80 beats/minute," respectively. Conclusions: RHR =80 beats/minute is associated with an increased risk of overall cancer mortality. High CRF may help lower the risk of cancer mortality among those with high RHR. [ABSTRACT FROM AUTHOR]

Background: Direct oral anticoagulants (DOACs) have replaced vitamin K antagonists as the standard of care for stroke prevention in patients with atrial fibrillation (AF). However, DOAC prescriptions at dosages that do not adhere to labeling are common in daily practice. This analysis from the observational Global Edoxaban Treatment in routiNe clinical prActice (ETNA)-AF program focuses on edoxaban-treated patients from South Korea and Taiwan to identify patient baseline characteristics that may be associated with non-recommended dosing. Methods: We report baseline data from ETNA-AF, including patient demographics, clinical characteristics, and bleeding/stroke history of patients receiving recommended or non-recommended edoxaban dosing. Results: A total of 2677 patients were enrolled. Among 1543 patients who did not meet dose-reduction criteria, 1033 (66.9%) were prescribed the recommended 60-mg dose, and 510 (33.1%) were prescribed the non-recommended 30-mg dose. Among 1134 patients meeting ≥1 of the dose-reduction criteria, 863 (76.1%) were prescribed the recommended 30-mg dose; 271 (23.9%) were prescribed the nonrecommended 60-mg dose. Compared with the recommended 60-mg group, the nonrecommended 30-mg group had a higher proportion of patients aged ≥75 years, higher stroke and bleeding risks, and a history of major bleeding. The non-recommended 60-mg group had a lower proportion of patients aged ≥75 years, a higher history of stroke, and lower history of bleeding compared with the recommended 30-mg group. Conclusion: The baseline data from ETNA-AF indicate that physicians take patient clinical characteristics (e.g., bleeding risks) into consideration when deviating from the dosing recommendation per label. [ABSTRACT FROM AUTHOR]

Objective: To compare short-term perioperative outcomes of single-port laparoscopic surgery (SPLS) and multiport laparoscopic surgery (MPLS) for colon cancer. Summary Background Data: Although many studies reported short- and long-term outcomes of SPLS for colon cancer compared with MPLS, few have reported results of randomized controlled trials. Methods: This was a multicenter, prospective, randomized controlled trial with a noninferiority design. It was conducted between August 2011 and June 2017 at 7 sites in Korea. A total of 388 adults (aged 19-85 yrs) with clinical stage I, II, or III adenocarcinoma of the ascending or sigmoid colon were enrolled and randomized. The primary endpoint was 30-day postoperative complication rates. Secondary endpoints were the number of harvested lymph nodes, length of the resection margin, postoperative pain, and time to functional recovery (bowel movement and diet). Patients were followed for 30 days after surgery. Results: Among 388 patients, 359 (92.5%) completed the study (SPLS, n - 179; MPLS, n - 180). The 30-day postoperative complication rate was 10.6% in the SPLS group and 13.9% in the MPLS group (95% confidence interval, 10.05 to 3.05 percentage points; P < 0.0001). Total incision length was shorter in the SPLS group than in the MPLS group (4.6 cm vs 7.2 cm, P < 0.001), whereas the length of the specimen extraction site did not differ (4.4 cm vs 4.6 cm, P - 0.249). There were no significant differences between groups for all secondary endpoints and all other outcomes. Conclusions: Even though there was no obvious benefit to SPLS over MPLS when performing colectomy for cancer, our data suggest that SPLS is noninferior to MPLS and can be considered an option in selected patients, when performed by experienced surgeons. Trial registration: ClinicalTrials.gov Identifier: NCT01480128. [ABSTRACT FROM AUTHOR]

Fenvalerate is widely used insecticide that severely causes toxicological effects in various aquatic organisms especially in fish. Physiochemical factors of water influenced fenvalerate toxicity. This study investigated physiochemical content of water, the effects of fenvalerate on mortality, changes in protein profile in the gut of Zebra fish and digestive enzymatic changes after 28 days of exposure. Zebra fish was exposed to ranges of fenvalerate and LC50 value was determined. Alkaline pH of the water and high temperature critically influenced mortality. The sub lethal concentration of fenvalerate decreased total protein content in various organs and induced elevated level of free aminoacids. Fenvalerate affected major digestive enzymes activity in the gut of Zebra fish. Protease and amylase assay revealed 39 ± 2.4% protease activity loss and 24.5 ± 5.5% amylase activity loss due to fenvalerate toxicity. Fenvalerate induced disintegration of enzymes from the gut at sub lethal concentration. Fenvalerate reduce the enzyme activity of proteases and amylases significantly. The present finding suggests that accumulation of fenvalerate critically alter not only the biochemical changes in the intestine, but also the specificity of protease and amylase towards various substrates. [ABSTRACT FROM AUTHOR]

The present study evaluated the anti-inflammatory effect of horse oil in 2, 4-dinitrochlorobenzene (DNCB)-treated BALB/c mice. After the application of DNCB, the mice showed atopic dermatitis symptoms, including severe erythema, hemorrhage, and erosion, whereas those symptoms were alleviated by treatment with horse oil. To explain the anti-dermatitis effect of horse oil, the gene expression levels in the healing process in dorsal skin were observed using a cDNA microarray. The cDNA microarray analysis revealed that the expression levels of 30 genes related to the inflammation, including Ccr1, Ccr2, Ccl20, Anxa1, and Hc genes, were up-regulated (higher than 2.0-fold) in the DNCB group compared to the levels in the control group, whereas the levels were restored to the control level in the DNCB + horse oil-treated group. In contrast, the gene expression levels of 28 genes related to inflammation, including chemokine genes Ccl5, Ccl7, Ccl8, Cxcl10, and Cxcl13 genes, were down-regulated (lower than 0.5-fold) in the DNCB group compared to the levels in the control group, whereas the levels were restored to the control level in the DNCB + horse oiltreated group. Overall, the results show that horse oil restores the expression levels of genes related to inflammation that were perturbed by DNCB treatment. [ABSTRACT FROM AUTHOR]

[Display omitted] • Nanoparticles from Boehmeria japonica (BJ-NPs) show promise in treating IBD. • BJ-NPs induced IL-10 in dendritic cells, suppressing pro-inflammatory cytokines. • BJ-NPs improved disease activity index and tissue health in an animal model. • BJ-NPs could treat various inflammatory diseases by inducing immune tolerance. Despite the recent advances in treatment, some patients with inflammatory bowel disease (IBD) experience insufficient disease management and adverse side effects, necessitating the development of novel therapeutic strategies. We investigated the therapeutic efficacy of exosome-like nanoparticles (NPs) derived from Boehmeria japonica (BJ-NPs) in treating IBD. These BJ-NPs increased immunosuppressive cytokine IL-10 production (p < 0.001) in mature dendritic cells (DCs) and reduced the levels of pro-inflammatory cytokines and surface molecules. Moreover, BJ-NP-treated DCs exhibited decreased immunostimulatory capacity for inducing activation of Th1 and Th17 subsets while promoting regulatory T cell activity. In a colitis animal model, BJ-NP administration mitigated weight loss (p < 0.001 at 4–10 days), improved disease activity index scores (p < 0.001 at 6–10 days), reduced colon length (p < 0.001), and ameliorated histological features. These findings suggest that BJ-NPs can be used as nutraceutical or therapeutic agent for various inflammatory diseases, including IBD. [ABSTRACT FROM AUTHOR]

The recent emergence and re-emergence of porcine epidemic diarrhea virus (PEDV) underscore the urgent need for the development of novel, safe, and effective vaccines against the prevailing strain. In this study, we generated a cold-adapted live attenuated vaccine candidate (Aram-P29-CA) by short-term passage of a virulent PEDV isolate at successively lower temperatures in Vero cells. Whole genome sequencing identified 12 amino acid changes in the cold-adapted strain with no insertions and deletions throughout the genome. Animal inoculation experiments confirmed the attenuated phenotype of Aram-P29-CA virus in the natural host. Pregnant sows were orally administered P29-CA live vaccines two doses at 2-week intervals prior to parturition, and the newborn piglets were challenged with the parental virus. The oral homologous prime-boost vaccination of P29-CA significantly improved the survival rate of the piglets and notably mitigated the severity of diarrhea and PEDV fecal shedding after the challenge. Furthermore, strong antibody responses to PEDV were detected in the sera and colostrum of immunized sows and in the sera of their offspring. These results demonstrated that the cold-adapted attenuated virus can be used as a live vaccine in maternal vaccination strategies to provide durable lactogenic immunity and confer passive protection to litters against PEDV. [ABSTRACT FROM AUTHOR]

Oral allergy syndrome (OAS) is the most common food allergy-related condition in adults. This study aimed to investigate whether subcutaneous immunotherapy (SCIT) with Fagales pollen-containing extracts can improve the clinical symptoms of OAS in Korea. In total, 56 OAS patients were included: 19 subjects treated with SCIT, which included Fagales pollen extracts, and 37 not treated with immunotherapy (IT). We reviewed the patients' medical records and administered a telephone questionnaire at one point to assess baseline OAS features and changes in the patients' OAS and allergic rhinoconjunctivitis (ARC) symptoms after treatment. Only 12 patients who received SCIT and 15 patients that did not receive SCIT could report on changes in OAS symptoms after treatment because the other patients practiced strict avoidance of their culprit fruits and vegetables, and they could not respond to the status of OAS. SCIT reduced the severity of OAS (p=0.005). Nine of the 12 patients (75%) that received SCIT reported a more than 50% reduction in OAS symptoms. In contrast, only three of the 15 patients (20%) that did not receive IT reported more than a 50% reduction in OAS symptoms. SCIT also reduced the severity of ARC symptoms (p<0.001). The results indicate that SCIT with Fagales pollen-containing extracts is associated with improved OAS symptoms in Korea. [ABSTRACT FROM AUTHOR]

When do sanctions succeed in nuclear inhibition? Is there a generalizable framework to estimate sanction effectiveness against nuclear aspirants? Instead of relying on partial equilibrium analysis, we conceptualize sanctions as three sequential phases--imposition of economic pain, conversation to political pressure, and creation (or failure thereof) of zone of possible agreement (ZOPA). The effectiveness of each phase is subject to phase-specific contextual variables, an aggregation of which helps measure individual sanction's effectiveness, conduct cross-case comparison, and estimate one's replicability in other cases. To illustrate its analytical utility, we analyze the divergent sanction outcomes between Iran in 2012-2015 and North Korea in 2013-2017. Iran was economically more vulnerable and politically less resilient, and its bargaining position was closer to a ZOPA than North Korea was. Our analysis questions the utility of economic sanctions against North Korea and helps expand the discussion away from the policy obsession with the role of China. Theoretically, it rectifies an imbalance against qualitative and holistic approach in the sanction literature and contributes to discussions about nuclear inhibition strategies. [ABSTRACT FROM AUTHOR]

The porcine reproductive and respiratory syndrome virus (PRRSV) is a globally ubiquitous swine viral pathogen that causes major economic losses worldwide. We previously reported an over-attenuated phenotype of cell-adapted PRRSV strain CA-2-P100 in vivo. In the present study, CA-2-P100 was serially propagated in cultured porcine alveolar macrophage (PAM) cells for up to 20 passages to obtain the derivative strain CA-2-MP120. Animal inoculation studies revealed that both CA-2-P100 and CA-2-MP120 had decreased virulence, eliciting weight gains, body temperatures, and histopathologic lesions similar to those in the negative control group. However, compared to CA-2-P100 infection, CA-2-MP120 yielded consistently higher viremia kinetics and enhanced antibody responses in pigs. All pigs inoculated with CA-2-MP120 developed viremia and seroconverted to PRRSV. During 20 passages in PAM cells, CA-2-MP120 acquired 15 amino acid changes that were mostly distributed in nsp2 and minor structural protein-coding regions. Among these changes, 6 mutations represented reversions to the sequences of the reference CA-2 and parental CA-2-P20 strains. These genetic drifts may be hypothetical molecular markers associated with PRRSV macrophage tropism and virulence. Our results indicate that the PAM-passaged CA-2-MP120 strain is a potential candidate for developing a live, attenuated PRRSV vaccine. [ABSTRACT FROM AUTHOR]

Indoor animal husbandry environments are inevitably contaminated with endotoxins. Endotoxin exposure is associated with various inflammatory illnesses in animals. This cross-sectional study evaluated the relationship between the degree of endotoxin exposure and the cellular and humoral immune profiles of fattening pigs. Blood samples were taken from the jugular vein of 47 pigs from ten pig farms in Korea. Whole blood cell counts and plasma immunoglobulin (Ig) classes were determined. Peripheral-blood mononuclear cells were stimulated in vitro with concanavalin A for 48 h, and cytokines released into culture supernatants were measured. The barns in which the pigs lived were assessed for endotoxin levels in the total and respirable dust by using the limulus amebocyte lysate kinetic QCL method. Low and high endotoxin exposures were defined as ≤ 30 and > 30 EU/m3, respectively. Compared to pigs with low endotoxin exposure (n = 19), highly exposed pigs (n = 28) had higher circulating neutrophil and lymphocyte (particularly B cells) counts, IgG and IgE levels, interferon-gamma (IFNγ and interleukin (IL)-4 productions, and lower IgA levels and tumor necrosis factor-alpha (TNFα production. The IL-4, IFNγ, and TNFα levels significantly correlated with endotoxin level and/or pig age. Constant exposure of pigs to high levels of airborne endotoxins can lead to aberrant immune profiles. [ABSTRACT FROM AUTHOR]

The porcine reproductive and respiratory syndrome virus (PRRSV) is a globally ubiquitous swine viral pathogen that causes major economic losses worldwide. We previously reported an over-attenuated phenotype of cell-adapted PRRSV strain CA-2-P100 in vivo. In the present study, CA-2-P100 was serially propagated in cultured porcine alveolar macrophage (PAM) cells for up to 20 passages to obtain the derivative strain CA-2-MP120. Animal inoculation studies revealed that both CA-2-P100 and CA-2-MP120 had decreased virulence, eliciting weight gains, body temperatures, and histopathologic lesions similar to those in the negative control group. However, compared to CA-2-P100 infection, CA-2-MP120 yielded consistently higher viremia kinetics and enhanced antibody responses in pigs. All pigs inoculated with CA-2-MP120 developed viremia and seroconverted to PRRSV. During 20 passages in PAM cells, CA-2-MP120 acquired 15 amino acid changes that were mostly distributed in nsp2 and minor structural protein-coding regions. Among these changes, 6 mutations represented reversions to the sequences of the reference CA-2 and parental CA-2-P20 strains. These genetic drifts may be hypothetical molecular markers associated with PRRSV macrophage tropism and virulence. Our results indicate that the PAM-passaged CA-2-MP120 strain is a potential candidate for developing a live, attenuated PRRSV vaccine. [ABSTRACT FROM AUTHOR]

Indoor animal husbandry environments are inevitably contaminated with endotoxins. Endotoxin exposure is associated with various inflammatory illnesses in animals. This cross-sectional study evaluated the relationship between the degree of endotoxin exposure and the cellular and humoral immune profiles of fattening pigs. Blood samples were taken from the jugular vein of 47 pigs from ten pig farms in Korea Whole blood cell counts and plasma immunoglobulin (Ig) classes were determined. Peripheral-blood mononuclear cells were stimulated in vitro with concanavalin A for 48 h, and cytokines released into culture supernatants were measured. The bams in which the pigs lived were assessed for endotoxin levels in the total and respirable dust by using the limulus amebocyte lysate kinetic QCL method. Low and high endotoxin exposures were defined as < 30 and > 30 EU/m3, respectively. Compared to pigs with low endotoxin exposure (n = 19), highly exposed pigs (n = 28) had higher circulating neutrophil and lymphocyte (particularly B cells) counts, IgG and IgE levels, interferon-gamma (IFNy) and interleukin (IL)-4 productions, and lower IgA levels and tumor necrosis factor-alpha (TNFa) production. The IL-4, IFNy, and TNFa levels significantly correlated with endotoxin level and/or pig age. Constant exposure of pigs to high levels of airborne endotoxins can lead to aberrant immune profiles. [ABSTRACT FROM AUTHOR]

Initial embryological development in avian species, consisting of cleavage and area pellucida formation, occurs prior to oviposition. In chickens, the first lineage segregation is known to occur during the last 10 hours of intrauterine development, a finding which has primarily been identified on the basis of morphological perspectives. We traced the early expression of the transcription factors NANOG, POUV and EOMES at Eyal-Giladi and Kochav (EGK) stages VI through X using in situ hybridization. At EGK.VI, NANOG and EOMES were heterogeneously expressed in a saltand- pepper manner. From EGK.VIII to EGK.X, NANOG- or EOMES-positive cells were predominantly located in the epiblast or area opaca regions, respectively. POUV-expressing cells were found in the upper layer at EGK.VIII. After oviposition, POUV mRNA was strongly expressed in the epiblast, but weakly expressed in the hypoblast at EGK.X. Furthermore, NANOG- and POUV-negative cells were located in the subgerminal cavity where layer reduction occurs during area pellucida formation. Those cells were larger and did not seem to contribute to epithelialization until EGK.X. Our results on the spatiotemporal expression of transcription factors contribute to a greater understanding of the dynamic process of intrauterine development in chickens. [ABSTRACT FROM AUTHOR]

Running is a popular and convenient leisure-time physical activity (PA) with a significant impact on longevity. In general, runners have a 25%-40% reduced risk of premature mortality and live approximately 3 years longer than non-runners. Recently, specific questions have emerged regarding the extent of the health benefits of running versus other types of PA, and perhaps more critically, whether there are diminishing returns on health and mortality outcomes with higher amounts of running. This review details the findings surrounding the impact of running on various health outcomes and premature mortality, highlights plausible underlying mechanisms linking running with chronic disease prevention and longevity, identifies the estimated additional life expectancy among runners and other active individuals, and discusses whether there is adequate evidence to suggest that longevity benefits are attenuated with higher doses of running. [ABSTRACT FROM AUTHOR]

Over the last fifty years, cardiorespiratory fitness (CRF) has been firmly established as an important risk factor for cardiovascular disease (CVD) and all-cause mortality. Mounting evidence supports a strong and inverse association between baseline CRF and the risk of developing hypertension (HTN) and dyslipidemia. Accumulating evidence also suggests that improving or maintaining a certain level of CRF over time leads to lower incidence of HTN and dyslipidemia and improves survival. These findings are promising, with significant public health importance, and warrant further evaluation to elucidate the role of longitudinal changes in CRF during the lifespan on CVD morbidity and mortality, as well as all-cause survival. [ABSTRACT FROM AUTHOR]

Purpose: The AdvanSure™ AlloScreen assay is an advanced multiplex test that allows for simultaneous detection of specific IgE (sIgE) against multiple allergens. For precise identification of causative allergens in allergic patients, we compared this new multiplex sIgE assay with the ImmunoCAP assay, which is currently the gold-standard method for sIgE detection. Materials and Methods: Serum samples from 218 Korean allergic disease patients were used to compare the ImmunoCAP and AlloScreen assays with respect to the following 13 allergens: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat and dog dander, Alternaria, birch, oak, ragweed, mugwort, rye grass, and food allergens (egg white, cow's milk, peanuts). Results: A total of 957 paired tests using the 13 allergens were compared. The total agreement ratio ranged from 0.74 (oak) to 0.97 (Alternaria). With respect to class association analyses, the gamma index ranged from 0.819 (rye grass) to 0.990 (Alternaria). The intra-class correlation coefficients for house dust mites, cat and dog dander, Alternaria, birch, ragweed, egg white, cow's milk, and peanut sIgE titers were >0.8. Conclusion: The AlloScreen and ImmunoCAP assays exhibited similar diagnostic performance. However, due to methodological differences between the two systems, careful interpretation of their results is needed in clinical applications. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of extracorporeal shock wave therapy (ESWT) for healthy participants with hamstring tightness. Materials and Methods: This study was performed at a university rehabilitation hospital. Twenty nine healthy adults with hamstring tightness were enrolled and randomly allocated into four groups (ESWT, stretching exercise, ESWT with stretching exercise, and control). The effects of individual treatments were compared by the finger-to-floor test and popliteal angle. Results: The ESWT group, stretching exercise group and ESWT with stretching exercise group had decreased finger-to-floor distances and right popliteal angles immediately after intervention, compared with the control group (p<0.05). At 4 weeks after completion of the interventions, finger-to-floor distances and the right popliteal angle in only the ESWT with stretching exercise group showed a significant improvement, compared with the control group (p=0.008 and 0.023). Conclusion: While ESWT and stretching both reduced hamstring tightness immediately after interventions, only ESWT with stretching exercise maintained the significantly improved relief of hamstring tightness significantly after 4 weeks. [ABSTRACT FROM AUTHOR]

Purpose: CD93 is receiving renewed attention as a biomarker of inflammation. We aimed to evaluate the potential for serum sCD93 to serve as a novel biomarker for allergic inflammation. Materials and Methods: We enrolled 348 subjects with an allergic disease [allergic rhinitis (AR), chronic spontaneous urticaria (CSU), or bronchial asthma (BA)], including 14 steroid-naïve BA patients who were serially followed-up. Results: The serum sCD93 levels (ng/mL) in patients with exacerbated AR (mean±standard deviation, 153.1±58.4) were significantly higher than in patients without AR (132.2±49.0) or with stable AR (122.3±42.1). Serum sCD93 levels in exacerbated CSU (169.5±42.8) were also significantly higher than those in non-CSU (132.4±51.6) and stable CSU (122.8±36.2). This trend was also seen in BA. Serum levels in patients with ICS-naïve BA (161.4±53.1) were significantly higher than those in healthy controls without BA (112.2±30.8), low- and medium-dose ICS users. Serum sCD93 levels in high-dose ICS users (72.2±20.6) were significantly lower than those in low- and medium-dose users. The serum sCD93 levels in steroid-naïve patients with BA (195.1±72.7) decreased after ICS use for 4 weeks (134.4±42.8) and 8 weeks (100.7±13.4), serially. Conclusion: Elevated serum sCD93 levels reflected exacerbated status of allergic diseases, including CSU, AR, and asthma. ICS use significantly diminished serum sCD93 levels in steroid-naïve patients with BA. This result may suggest sCD93 in serum as a therapeutic marker for allergic inflammation. [ABSTRACT FROM AUTHOR]

Purpose The combination of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) has been widely adopted to overcome functional and cosmetic limitations of conventional STSG. In this study, we evaluated the efficacy of this combination using 2 types of ADM: cadaveric acellular dermal matrix (CDM) and bovine acellular dermal matrix (BDM). Methods We recruited 72 patients undergoing autologous STSG to cover radial forearm free flap donor sites. They were included in 1 of 3 therapeutic groups: group 1, STSG using CDM (n = 29); group 2, STSG using BDM (n = 20); and group 3, STSG only (n = 23). Functional skin values for skin elasticity, humidification, transepidermal water loss, and color were determined. Values were compared between graft sites and adjacent normal (control) skin, and between grafted areas of each group. Results All skin defects were successfully reconstructed without graft loss. Groups 1 and 2 demonstrated better elasticity than did group 3, based on the analysis using the ratio of grafted area to control. Grafted areas in all 3 groups exhibited less moisture than did control normal skin. There was less transepidermal water loss in group 1 than in group 3, which implied that CDM application had better barrier capacity against water evaporation. Graft sites of groups 1 and 3 exhibited darker and redder color compared with control areas. Conclusions Composite forearm defects were successfully restored and exhibited acceptable quality after treatment with an ADM plus STSG. Applying either CDM or BDM under a STSG was a suitable procedure, as verified by objective measurements. Elasticity was well preserved in CDM and BDM groups. However, both ADMs revealed functional impairment of humidification. Type of study/level of evidence Therapeutic IV. [ABSTRACT FROM AUTHOR]

Purpose: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperlactatemia in patients with type 2 diabetes. Materials and Methods: This was a cross-sectional study from a tertiary university-affiliated medical center. A total of 1954 type 2 diabetes patients were recruited in 2007-2011, and stratified according to the estimated glomerular filtration rate of 60 mL/ min/1.73 m2. Lactic acidosis was defined as plasma lactate levels >5 mmol/L and arterial pH <7.35. Results: Metformin was used in 61.4% of the patients with type 2 diabetes mellitus. Plasma lactate levels were not different in the patients with and without metformin use. There was no difference in prevalence of hyperlactatemia and lactic acidosis between the patients with and without metformin use (18.9% vs. 18.7%, p=0.905 for hyperlactatemia and 2.8% vs. 3.3%, p=0.544 for lactic acidosis). Similar results were observed in the patients with estimated glomerular filtration rate <60 mL/min/1.73 m2. Most patients with lactic acidosis had at least one condition related to hypoxia or poor tissue perfusion. Multiple regression analysis indicated no association between metformin use and lactic acidosis, whereas tissue hypoxia was an independent risk factor for lactic acidosis [odds ratio 4.603 (95% confidence interval, 1.327-15.965)]. Conclusion: Metformin use was not associated with hyperlactatemia or lactic acidosis in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Several studies have used functional magnetic resonance imaging (fMRI) to show that neural activity is associated with driving. fMRI studies have also elucidated the brain responses associated with driving while performing sub-tasks. It is important to note that these studies used computer mouses, trackballs, or joysticks to simulate driving and, thus, were not comparable to real driving situations. In order to overcome these limitations, we used a driving wheel and pedal equipped with an MR-compatible driving simulator (80 km/h). The subjects drove while performing sub-tasks, and we attempted to observe differences in neuronal activation. Methods: The experiments consisted of three blocks and each block consisted of both a control phase (1 min) and a driving phase (2 min). During the control phase, the drivers were instructed to look at the stop screen and to not perform driving tasks. During the driving phase, the drivers either drove (driving only condition) or drove while performing an additional sub-task (driving with sub-task condition) at 80 km/h. Results: Compared to when the drivers were focused only on driving, when the drivers drove while performing a sub-task, the number of activation voxels greatly decreased in the parietal area, which is responsible for spatial perception. Task-performing areas, such as the inferior frontal gyrus and the superior temporal gyrus, showed increased activation. Performing a sub-task simultaneously while driving had affected the driver's driving. The cingulate gyrus and the sub-lobar region (lentiform nucleus, caudate, insula, and thalamus), which are responsible for error monitoring and control of unnecessary movements (e.g., wheel and pedal movements), showed increased activation during driving with sub-task condition compared to driving only condition. Conclusions: Unlike simple driving simulators (joysticks, computer mouses, or trackballs) used in previous research, the addition of a driving wheel and pedals (accelerator and brake) to the driving simulator used in this study closely represents real driving. Thus, the number of processed movements was increased, which led to an increased number of unnecessary movements that needed to be controlled. This in turn increased activation in the corresponding brain regions. [ABSTRACT FROM AUTHOR]