Search

Background and Objectives Several studies have assessed the impact of laryngopharyngeal reflux disease (LPRD) on the health-related quality of life (HR-QoL), showing significant impairment of HR-QoL. This study aims to assess the impact of proton pump inhibitor (PPI) treatment of LPRDs to enhance HR-QoL.Subjects and Method We prospectively collected data from LPRD patients from April 2017 to July 2019. Patients who have reflux symptom index (RSI) of ≥13 or reflux finding score (RFS) of ≥7 were enrolled in this study. We assessed HR-QoL using a questionnaire with EORTC QLQ-H&N35, -C30 on the first visit. Patients were treated with PPI (Ilaprazole 20 mg/day) on their visits at 4, 8, and 12 weeks. RSI and RFS were measured at each visit and HR-QoL was reevaluated on the last visit.Results Ninety-five patients completed the 3-months follow-up and were enrolled in this study. Female : male ratio was 71:24 and the mean age was 57.0±11.9 (27-80). The initial RSI and RFS were 16.3±8.8 and 12.6±2.9, respectively, but were changed to 11.1±9.7 and 9.7±2.6 (p

Sox2 is a core transcription factor in embryonic stem cells (ESCs), and O-GlcNAcylation is a type of post-translational modification of nuclear-cytoplasmic proteins. Although both factors play important roles in the maintenance and differentiation of ESCs and the serine 248 (S248) and threonine 258 (T258) residues of Sox2 are modified by O-GlcNAcylation, the function of Sox2 O-GlcNAcylation is unclear. Here, we show that O-GlcNAcylation of Sox2 at T258 regulates mouse ESC self-renewal and early cell fate. ESCs in which wild-type Sox2 was replaced with the Sox2 T258A mutant exhibited reduced self-renewal, whereas ESCs with the Sox2 S248A point mutation did not. ESCs with the Sox2 T258A mutation heterologously introduced using the CRISPR/Cas9 system, designated E14-Sox2TA/WT, also exhibited reduced self-renewal. RNA sequencing analysis under self-renewal conditions showed that upregulated expression of early differentiation genes, rather than a downregulated expression of self-renewal genes, was responsible for the reduced self-renewal of E14-Sox2TA/WT cells. There was a significant decrease in ectodermal tissue and a marked increase in cartilage tissue in E14-Sox2TA/WT-derived teratomas compared with normal E14 ESC-derived teratomas. RNA sequencing of teratomas revealed that genes related to brain development had generally downregulated expression in the E14-Sox2TA/WT-derived teratomas. Our findings using the Sox2 T258A mutant suggest that Sox2 T258 O-GlcNAc has a positive effect on ESC self-renewal and plays an important role in the proper development of ectodermal lineage cells. Overall, our study directly links O-GlcNAcylation and early cell fate decisions., Stem cell development: hold the sugar Cells that can grow into any type of cell, called embryonic stem cells (ESCs), are signaled to stay in stem cell mode (maintain stemness) by addition of a single sugar molecule to Sox2, a regulatory protein coded for by a developmental gene. Sugar modification of Sox2 was known to be involved in maintaining stemness and sometimes implicated in cancer, but the mechanism was poorly understood. When Hyonchol Jang at the National Cancer Center in South Korea and co-workers prevented sugar modification of Sox2 by changing an amino acid at the sugar-binding site, ESCs showed reduced self-renewal. Rather than repressing genes related to stemness, the modification failed to repress developmental genes, permitting cells to grow into other cell types. These results illuminate both the role of Sox2 in cancer and the importance of sugar modification in stemness.

Germ cell tumours (GCTs) are one of the most threatening malignancies in young men and women. Although several reports have suggested the importance of OCT4 in human GCTs, its role has not been clearly investigated on a molecular level. In this study, we revealed GCT-specific direct transcriptional target genes of OCT4. Conditional knockdown of OCT4 in GCT cell lines reduced cell proliferation by affecting both cell cycle and death. Knockdown of OCT4 also reduced stemness of GCTs, as assessed by the expression of other stemness factors, alkaline phosphatase staining, and tumour sphere formation ability. Analysis of whole mRNA expression patterns among GCT cells harbouring endogenous, depleted, and rescued OCT4 revealed 1133 OCT4 target genes in GCT. Combined analysis of both the chromatin binding signature of OCT4 and the genes whose expression levels were changed by OCT4 revealed 258 direct target genes of OCT4 in GCTs. In a similar way, 594 direct target genes in normal embryonic stem cells (ESCs) were identified. Among these two sets of OCT4 direct target genes, 38 genes were common between GCTs and ESCs, most of which were related to regulation of pluripotency, and 220 genes were specific to GCTs, most of which were related to focal adhesion and extracellular matrix organisation. These results provide a molecular basis for how OCT4 regulates GCT stemness and will aid our understanding of the role of OCT4 in other cancers.

This study investigated patterns of probable posttraumatic stress disorder (PTSD) and their predictors among 2,431 Asian American and 31,455 non-Hispanic White World Trade Center (WTC) Registry participants 2-3 years and 5-6 years after the WTC attack. Participants were divided into four PTSD pattern groups: resilient, remitted, delayed onset, and chronic. Asians had a lower proportion in the resilient group (76.5% vs. 79.8%), a higher proportion in the chronic (8.6% vs. 7.4%) and remitted (5.9% vs. 3.4%) groups, and a similar proportion in the delayed onset group (about 9%) compared to Whites. In multinomial logistic regression analyses, disaster exposure, immigrant status, lower income, pre-attack depression/anxiety, and lower respiratory symptoms were associated with increased odds of chronic and delayed onset PTSD (vs. resilience) among both races. Education and employment were protective against chronic and delayed onset PTSD among Whites only. These results can inform targeted outreach efforts to enhance prevention and treatment for Asians affected by future events.

Objective Bitter taste receptors (TAS2Rs) are expressed in the extraoral tissues, where they possess various physiological functions. This study is to characterize TAS2Rs expression in normal and allergic nasal mucosa and analyse nasal symptom after challenge with bitter tastes to evaluate their pathophysiological function in normal and allergic nasal mucosa. Methods The expression levels of TAS2Rs (TAS2R4, 5, 7, 10, 14, 39, and 43) in nasal mucosa were investigated by real-time PCR, Western blot, and immunohistochemistry. The expression levels of TAS2Rs and Ca(2+) imaging in cultured epithelial cells were measured after stimulation with type 2 cytokines (IL-4, IL-5, and IL-13) or bitter tastes. Nasal symptoms in control subjects and allergic rhinitis patients using visual analogue score and acoustic rhinometry were evaluated before and after stimulation with bitter tastes. Vascular diameter of rat nasal septum was measured before and after treatment with bitter tastes. Results TAS2Rs tested here were expressed in nasal mucosa where they were commonly distributed in superficial epithelium, submucosal glands, and endothelium. Their expression levels are increased in allergic nasal mucosa and up-regulated in cultured epithelial cells simulated with type 2 cytokines. After treatment with bitter tastes, intracellular Ca(2+) signalling was increased in cultured epithelial cells, and vascular constriction was found in rat nasal septum. Increased nasal patency was observed in human nasal mucosa without pain or sneezing. Conclusion and clinical relevance TAS2Rs are constitutively expressed in human nasal mucosa and their expression levels are increased in allergic nasal mucosa, where they could potentially contribute to shrinkage of normal and allergic nasal mucosa.

Simple Summary Octamer-binding transcription factor 4 (OCT4) plays an important role in early embryonic development, but is rarely expressed in adults. However, in many cancer cells, this gene is re-expressed, making the cancer malignant. This present study revealed that inhibiting OCT4 transcriptional activity induces cancer cell differentiation and growth retardation. Specifically, when the phosphorylation of OCT4 serine 236 increases by interfering with the binding of protein phosphatase 1 (PP1) to OCT4, OCT4 loses its transcriptional activity and cancer cells differentiate. Therefore, this study presents the basis for the development of protein-protein interaction inhibitors that inhibit the binding of OCT4 and PP1 for cancer treatment. Abstract Octamer-binding transcription factor 4 (Oct4) plays an important role in maintaining pluripotency in embryonic stem cells and is closely related to the malignancies of various cancers. Although posttranslational modifications of Oct4 have been widely studied, most of these have not yet been fully characterized, especially in cancer. In this study, we investigated the role of phosphorylation of serine 236 of OCT4 [OCT4 (S236)] in human germ cell tumors (GCTs). OCT4 was phosphorylated at S236 in a cell cycle-dependent manner in a patient sample and GCT cell lines. The substitution of endogenous OCT4 by a mimic of phosphorylated OCT4 with a serine-to-aspartate mutation at S236 (S236D) resulted in tumor cell differentiation, growth retardation, and inhibition of tumor sphere formation. GCT cells expressing OCT4 S236D instead of endogenous OCT4 were similar to cells with OCT4 depletion at the mRNA transcript level as well as in the phenotype. OCT4 S236D also induced tumor cell differentiation and growth retardation in mouse xenograft experiments. Inhibition of protein phosphatase 1 by chemicals or short hairpin RNAs increased phosphorylation at OCT4 (S236) and resulted in the differentiation of GCTs. These results reveal the role of OCT4 (S236) phosphorylation in GCTs and suggest a new strategy for suppressing OCT4 in cancer.

Summary Objectives Maximal extrathyroidal extension (ETE) is known to be an important prognostic factor in papillary thyroid carcinoma (PTC). However, the significance of minimal ETE is controversial. The aim of this study was to investigate the clinicopathologic characteristics and prognostic significance of minimal vs maximal ETE in PTC. Materials and methods A group of 967 patients who underwent thyroidectomy for PTC in a tertiary hospital between January 2000 and December 2011 were studied retrospectively. Patients were classified into three groups: absence of ETE, and minimal and maximal ETE. The minimal ETE group was further categorized into two subgroups according to invasion of strap muscles or no invasion (STI+ and STI−). Results Gender did not differ between the three groups of patients. The mean age of the patients with maximal ETE was significantly higher than in those belonging to the other groups. Tumor size, bilaterality, lymph node metastasis and stage increased significantly according to the degree of ETE. Recurrence and survival rates did not differ between the absence and minimal ETE groups, or between the STI− and STI+ subgroups of minimal ETE. However, the maximal ETE group had significantly higher recurrence and lower survival rates than the other groups (P Conclusion Maximal ETE is a significant factor for poor prognosis. However, minimal ETE is not associated with increased recurrence or decreased survival in patients with PTC.

A radiographic analysis with scoliosis patients.To analyze correlations between sagittal spinal alignment and coronal scoliotic curvature.Sagittal spinal alignment and scoliosis may have a significant relationship, and schematic analysis is needed.The study group was comprised of 163 patients with adolescent idiopathic scoliosis. Subjects underwent anteroposterior and lateral radiographs of the whole spine including hip joints. The radiographic parameters used were magnitude, location and direction of curve, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, sagittal balance, sacral slope, and pelvic angle. Subjects were classified into 4 groups according to the severity of coronal curvature: Cobb angle ≤20 degrees, Cobb angle 21-40 degrees, Cobb angle 41-60 degrees, and Cobb angle60 degrees. In addition, subjects were divided into 4 subgroups according to Roussouly's classification (types 1-4) of sagittal spinal shape. Schematic analysis was performed to determine the relationship between coronal and sagittal parameters.Analysis of parameters with severity of coronal curvature, thoracic kyphosis, and sacral slope were significantly higher in high-grade scoliosis (P0.05). However, the pelvic angle was higher in low-grade scoliosis, and sagittal balance showed a significantly higher positive value in low-grade scoliosis (P0.05). In the analysis of sagittal spinal shapes, Roussouly groups 3 and 4 showed more severe scoliosis with higher lumbar lordosis and thoracic kyphosis (P0.05). In addition, Roussouly group 1 demonstrated a significantly higher incidence of low-grade scoliosis, whereas groups 3 and 4 had a higher incidence of high-degree scoliosis by cross-relation analysis (P0.05).A significant relationship exists between sagittal spinal shape and coronal curvature in scoliosis. Understanding the biplanar shapes of scoliosis may be helpful to the surgeons.

Temozolomide is the current first-line treatment for glioblastoma patients but, because many patients are resistant to it, there is an urgent need to develop antitumor agents to treat temozolomide-resistant glioblastoma. Gossypol, a natural polyphenolic compound, has been studied as a monotherapy or combination therapy for the treatment of glioblastoma. The combination of gossypol and temozolomide has been shown to inhibit glioblastoma, but it is not clear yet whether gossypol alone can suppress temozolomide-resistant glioblastoma. We find that gossypol suppresses the growth of temozolomide-resistant glioblastoma cells in both tumor sphere and adherent culture conditions, with tumor spheres showing the greatest sensitivity. Molecular docking and binding energy calculations show that gossypol has a similar affinity to the Bcl2 (B-cell lymphoma 2) family of proteins and several dehydrogenases. Gossypol reduces mitochondrial membrane potential and cellular ATP levels before cell death, which suggests that gossypol inhibits several dehydrogenases in the cell&rsquo, s metabolic pathway. Treatment with a Bcl2 inhibitor does not fully explain the effect of gossypol on glioblastoma. Overall, this study demonstrates that gossypol can suppress temozolomide-resistant glioblastoma and will be helpful for the refinement of gossypol treatments by elucidating some of the molecular mechanisms of gossypol in glioblastoma.

Background and study aims: Endoscopic surgical technology has been developing rapidly. Although several successful endoscopic closure devices have already been introduced, only a few of them have demonstrated improvements in closure strength and reproducibility over conventional endoscopic clip closures or hand sutures. The objective of this study was to test the feasibility of a novel successive suturing device (SSD) by measuring closure strength and reproducibility. Material and methods: Porcine stomach models were used in this study. Endoclips, full-thickness hand sutures, and the novel SSD sutures were used to close a perforation in the stomach wall, with 10 stomachs being tested for each closure method. Endoclips and SSD sutures were performed using a two-channel endoscope, and the hand sutures were performed from outside of the stomach wall. Air leakage pressure was measured to determine the closure strength and reproducibility of each method. Results: The mean air leakage pressure of the SSD closure was 62.7 ± 8.2 mmHg. SSD-treated stomachs exhibited significantly greater air leakage pressure than Endoclip-treated stomachs. The standard deviation of bursting pressure in SSD stomachs was found to be significantly smaller than that of hand-sewn stomachs but was not different from that of Endoclip stomachs. Conclusions: The consistent closure strength of SSD stomachs demonstrated the reliability and reproducibility of this new closure method. These promising results in closure strength and reproducibility suggest the feasibility of the proposed device for clinical applications.

This study deals with the experiments of liquid dampers with multi cells whose vertical tubes are divided into several square columns for easily changing natural frequencies. Shaking table test is performed to verify control effectiveness of the dampers which are installed on a building structure. To design liquid dampers, a 64-story building structure is reduced to a SDOF structure with 1/20 of similitude laws based on acceleration. The structure model is made up to adjust its mass and stiffness easily, with separate mass and drive parts. Mass parts indicate real structure`s weights and drive parts indicate real structure`s stiffness with springs and LM guides. Manufactured liquid damper has 18 cells and its natural frequency ranges are 0.65Hz to 0.81Hz. Shaking table test is carried out with one way excitation to compare with only accelerations of a large-scale structure and a structure installed with liquid dampers. Control performance of the liquid damper is expressed by the transfer function from shaking table accelerations to the large-scale structure ones. Testing results show that the liquid damper reduced a large-scale structure`s response by tuned natural frequencies.

In this study, a cDNA microarray was developed from over 60,000 mRNA readings to analyze the expression profiles of transcriptomes of Haematococcus lacustris under astaxanthin-inducing culture conditions, high irradiance and nitrate starvation. Among 20,033 genes on the cDNA microarray, 2,675 genes exhibited a twofold or greater difference in expression. Of these, 1,333 genes were up-regulated and 1,342 genes were down-regulated. A significant decrease in the expression of chlorophyll biosynthesis and light harvesting complex (LHC) related genes were observed under astaxanthin inducing conditions (forming red cyst cells). On the other hand, respirationrelated genes, lipid metabolism-related genes and stress response-related genes were activated in the red cyst cells under stress conditions. These results enabled a better understanding of the cell responses during stress induction of H. lacustris such as photosynthesis, respiration, and some biopathways.

DNA vaccines have emerged as an attractive approach to generate antigen-specific T-cell immune response. Nevertheless, the potency of DNA vaccines still needs to be improved for cancer immunotherapy. In this study, we explored whether functional linkage of a Th1-polarizing chemokine, IP-10, to a model tumor antigen, human papillomavirus type 16 (HPV-16) E7, enhanced DNA vaccine potency. IP-10 linkage changed the location of E7 from the nucleus to the endoplasmic reticulum and led to the secretion of functionally chemoattractive chimeric IP-10/E7 protein. In addition, this linkage drastically enhanced the endogenous processing of E7 antigen through MHC class I. More importantly, we found that C57BL/6 mice intradermally vaccinated with IP-10/E7 DNA exhibited a dramatic increase in the number of E7-specific CD4(+) Th1 T-cells and CD8(+) T-cells and, consequently, were strongly resistant over the long term to E7-expressing tumors compared to mice vaccinated with wild-type E7 DNA. Thus, because of the increase in tumor antigen-specific T-cell immune responses obtained through both enhanced antigen presentation and chemoattraction, vaccination with DNA encoding IP-10 linked to a tumor antigen holds great promise for treating tumors.

Pem, a member of homeobox genes, is an oncofetal gene which is preferentially expressed in reproductive tissues and in multiple tumor cell lines. However, the function of Pem in tumor cell lines has not been elucidated. Herein we report that the ectopic expression of Pem in TC-1, a human papillomavirus type 16 (HPV-16) E7-expressing surrogate cervical tumor cell line, demonstrated a significant increase in extracellular signal-regulated kinase (ERK) activity and multiple resistance to various apoptotic pressures from an E7-specific CD8(+) T cell-mediated immune response and anticancer drug treatment. The observed resistance to apoptotic death of the Pem-over-expressing TC-1 tumor cells (TC-1/Pem) was associated with the down-regulation of a pro-apoptotic molecule, such as BIM, and up-regulation of an anti-apoptotic molecule, such as Bcl-2 protein, which mediated ERK activation. We also observed that the intratumoral injection of an ERK inhibitor enhanced the therapeutic efficacy of E7-specific CD8(+) T cell adoptive transfer or anticancer drug treatment against the resistant TC-1/Pem tumor. This is the first evidence demonstrating an association between Pem and a signaling pathway, namely the ERK-mediated survival signal transduction pathway. Thus, our data indicate that activation of the ERK pathway represents a new mechanism of Pem-mediated multiple resistances and the present research will contribute to the development of a novel strategy in cancer therapy against Pem-over-expressing tumor cells.

Extrapleural solitary fibrous tumor, formerly referred to as "hemangiopericytoma" is a rare soft tissue vascular tumor which has elevated malignancy potential arising from the capillary pericytes. Extrapleural solitary fibrous tumors, originating from the spleen, are extremely rare. We report on a rare case of a patient presenting with splenic extrapleural solitary fibrous tumors with intratumoral irregular calcification detected by dynamic contrast-enhanced computed tomography.

To evaluate the analgesic efficacy of bilateral superficial cervical plexus block and combined superficial and deep cervical plexus block for incision pain, headache and posterior neck pain after thyroidectomy.Ninety patients were divided into a control group (group C, n = 30), a bilateral superficial cervical plexus group (group S, n = 30) and a bilateral combined superficial and deep cervical plexus block group (group CO, n = 30). Before general anaesthesia, we performed bilateral superficial cervical plexus block (18 ml) and combined superficial (14 ml) and deep (4 ml) cervical plexus block with 0.25% bupivacaine. Anaesthesia was maintained with propofol-remifentanil-N2O-O2.The average concentration of remifentanil was significantly reduced in group S compared with group C and group CO (1.1 +/- 0.3, 1.8 +/- 0.4, 1.8 +/- 0.7 ng ml, respectively; P0.05). The incision pain at rest and on swallowing were significantly reduced at 0, 2 and 4 h in group S compared with group C (P0.05). Headache showed a tendency to be reduced in group S and group CO, but the posterior neck pain was not different among the three groups. After surgery, the opioid and nonopioid requirement was significantly reduced in group S (P0.05). There were fewer side effects and greater patients' satisfaction in group S.Superficial cervical plexus block is a more effective technique than combined superficial and deep cervical plexus block to reduce the pain during and immediately after thyroidectomy.

Recently the role of surgical and interventional therapy has been increasing in the management of ischemic stroke due to carotid artery stenosis or occlusion. Various treatment modalities have been reported to be beneficial if these procedures are performed within therapeutic window and with optimal indication: intravascular thrombolysis for acute carotid occlusion, extracranial–intracranial (EC–IC) bypass surgery for hemodynamic ischemic stroke, and carotid endarterectomy (CEA) or percutaneous transluminal angioplasty and stenting (PTAS) for severe symptomatic carotid artery stenosis or occlusion. Recent management strategies will be described from literature review and our limited experience for enhancing the effectiveness of treatment modalities for carotid artery stenosis or occlusion.

A small proportion of cancer cells have stem-cell-like properties, are resistant to standard therapy and are associated with a poor prognosis. The metabolism of such drug-resistant cells differs from that of nearby non-resistant cells. In this study, the metabolism of drug-resistant lung adenocarcinoma cells was investigated. The expression of genes associated with oxidative phosphorylation in the mitochondrial membrane was negatively correlated with the prognosis of lung adenocarcinoma. Because the mitochondrial membrane potential (MMP) reflects the functional status of mitochondria and metastasis is the principal cause of death due to cancer, the relationship between MMP and metastasis was evaluated. Cells with a higher MMP exhibited greater migration and invasion than those with a lower MMP. Cells that survived treatment with cisplatin, a standard chemotherapeutic drug for lung adenocarcinoma, exhibited increased MMP and enhanced migration and invasion compared with parental cells. Consistent with these findings, inhibition of mitochondrial activity significantly impeded the migration and invasion of cisplatin-resistant cells. RNA-sequencing analysis indicated that the expression of mitochondrial complex genes was upregulated in cisplatin-resistant cells. These results suggested that drug-resistant cells have a greater MMP and that inhibition of mitochondrial activity could be used to prevent metastasis of drug-resistant lung adenocarcinoma cells.

Trifluoroacylated, trimethylsilylated and methylated mesocarb (3-(1-methyl-2-phenylethyl)-5-[[(phenylamino) carbonyl]amino]-1,2,3-oxadiazolium) were analyzed by gas chromatography/mass spectrometry (GC/MS). In trifluoroacylation, N-trifluoroacylated sydnophen (SP-NTFA), where the exocyclic nitrogen atom of the sydnonimine ring attacks N-methylbis(trifluoroacetamide), was identified by GC/MS. However, in trimethylsilylation, C-trimethylsilylated sydnophen (SP-CTMS), where the C-4 atom of the sydnonimine ring attacks N-methyl-N-trimethylsilyltrifluoroacetamide, was detected. SP-NTFA and SP-CTMS are intermediates of mesocarb in pyrolysis, and retain an intact sydnonimine ring. In methylation, a ketene form of mesocarb reacts as a nucleophile with methyl iodide to produce methylated N-nitroso-N-cyanomethylamphetamine. Thus, depending on the reaction substituents, the intermediate of mesocarb in pyrolysis was identified to be either an intact sydnonimine ring skeleton or an open-ring compound using GC/MS. Copyright © 1999 John Wiley & Sons, Ltd.

The corrosion of chromium species in molten (Li/K) 2 CO 3 and (Li/Na/K) 2 CO 3 are investigated by spectrophotometry. A strong charge-transfer absorption band is observed in the ultraviolet region with λ max =372 nm, and the molar absorptivity of CrO 4 2− in molten (Li/K) 2 CO 3 is calculated. The corrosion rates are investigated by means of increasing the concentration of CrO 4 2− in the melts. Under an air atmosphere, the corrosion rate is slower in molten (Li/K) 2 CO 3 than in molten (Li/Na/K) 2 CO 3 and Cr 2 O 3 corrodes more easily in molten (Li/K) 2 CO 3 than Cr. With an atmosphere of CO 2 =1 atm, there is no increase in the CrO 4 2− concentration in the solution phase during a period of 5 h.

Using 2.5-dinitrophenol as an optical indicator, the pKa of cacodylic acid were spectrophotometrically determined at elevated temperatures under saturation vapor pressures. The result is pKa = -26.41 + 1296/T + 4.973 InT whereT is in Kelvin. In a similar way, the pKa ofp-nitrophenol were obtained up to 200‡C giving pKa = -24.82 + 2135/T + 4.353 InT From these results, several thermodynamic functions of cacodylic acid andp- nitrophenol were calculated.

This research aims to develop Korean traditional culture’s learning system. This system was processed using internet. And the target is folk literature, Pansori. Actually, in spite of Pansori is one of famous folk literature, it is not familiarly area on peoples due to difficult learning and understanding them. Our system attempt to provide Pansori’s learning materials to user very easily and conveniently. The learning materials were managed by learning meta data in LCMS and learning process data was controlled by LMS.

Dendritic cell (DC)-based cancer vaccines have become important as an immunotherapeutics in generating anti-tumor immune responses. Due to a short lifespan of DCs, however, clinical application of current DC vaccines has been limited. Recently, activation of AKT/protein kinase B (PKB), a major effector of phosphatidylinositol 3-kinase (PI3K), has been reported as a critical factor in both activation and survival of DCs. We here improved the potency of a DC vaccine with a small interfering RNA (siRNA) targeting phosphatase and tensin homologue (PTEN), which is known to be a central negative regulator of the PI3K/AKT signal transduction cascade. Down-regulation of PTEN in DCs resulted in AKT dependent maturation, which in turn caused a significant up-regulation of surface expression in co-stimulatory molecules and the chemokine receptor, CCR7, leading to an increase of in vitro T cell activation activity and in vivo migration to a draining lymph node, respectively. Moreover, these PTEN siRNA-transfected DCs (DC/siPTEN) acquired an increased survival from the apoptotic death caused by GM-CSF deprivation or antigen-specific CD8 + T cell killing. Most importantly, DC/siPTEN generated more tumor antigen-specific CD8 + T cells and stronger anti-tumor effects in vaccinated mice than did control DCs (DC/siGFP). Thus, our data indicate that manipulation of the PI3K/AKT pathway via siRNA system could improve the efficacy of a DC-based tumor vaccine.

The object of this study is to demonstrate that angled sagittal magnetic resonance imaging (MRI) enables the precise diagnosis of herniated disc and stenosis in the cervical foramen, which is not available with conventional MRI. Due to both the anatomic features of the cervical foramen and the limitations of conventional MR techniques, it has been difficult to identify disease in the lateral aspects of the spinal canal and foramen using only conventional MRI. Angled sagittal MRI oriented perpendicular to the true course of the foramina facilitates the identification of the lateral disease. A review of 43 patients, who underwent anterior cervical discectomy and interbody fusion, is presented with a herniated disc and/or stenosis in the cervical foramen. They all had undergone conventional MRI and angled sagittal MRI. Fifty levels were surgically explored for evidence of foraminal herniated disc and stenosis. The results of each test were correlated with what was found at each explored surgical level. The sensitivity, specificity, and accuracy of both examinations for making the diagnosis of foraminal herniated disc and stenosis were compared. During the diagnosis of foraminal herniated disc, the sensitivity, specificity, and accuracy of angled sagittal MRI were 96.7, 95.0, and 96.0%, respectively, compared with 56.7, 85.0, and 68.0% for conventional MRI. In making the diagnosis of foraminal stenosis, the sensitivity, specificity, and accuracy of angled sagittal MRI were 96.3, 95.7, and 96.0%, respectively, compared with 40.7, 91.3, and 66.0% for conventional MRI. In the above groups, the difference between the tests for making the diagnosis of both foraminal herniated disc and stenosis was found to be statistically significant in sensitivity and accuracy. Angled sagittal MRI was a more accurate test compared to conventional MRI for making the diagnosis of herniated disc and stenosis in the cervical foramen. It can be utilized for the precise diagnosis of foraminal herniated disc and stenosis difficult or ambiguous in conventional MRI.

분리종이란 조직학적으로 정상인 조직이 본래의 위치가 아 닌 다른 곳에서 존재하는 것으로 정의하며, 비정상조직과 정 상조직이 혼합되어 있는 하마종과는 구분된다. 중이 내에서는 침샘 분리종, 교세포 분리종이 발생할 수 있으며, 이 중 중이 침샘 분리종은 정상적인 침샘이 중이공간에 존재하는 것을 의 미한다. 이러한 분리종은 병리학적으로만 진단이 가능하다. 중이 내 침샘 분리종은 매우 드문 질환으로 1961년 Taylor 와 Martin이 처음 보고한 이후 세계적으로 30여 예만이 보 고되고 있다. 일반적으로 전도성 난청을 동반한 중이강내 종물로 관찰되며, 선천성 진주종, 고실 사구종, 안면신경 신 경수초종 등 다른 중이 종물들과 감별되어야 한다. 하지만 중이 침샘 분리종에 대한 술전 진단 방법, 영상의학적 소견 에 대해서는 알려진 바가 없다. 저자들은 이내시경 소견과 자기공명영상 검사 결과상 고실 사구종으로 의심되었던 중이 침샘 분리종 1예를 이내접근법 으로 성공적으로 제거하였기에 문헌고찰과 함께 보고하는 바이다.

Received September 25, 2014 Revised December 1, 2014 Accepted December 16, 2014 Address for correspondence Kyung Tae, MD Department of OtorhinolaryngologyHead and Neck Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 133-817, Korea Tel +82-2-2290-8585 Fax +82-2-2293-3335 E-mail kytae@hanyang.ac.kr Background and ObjectivesZZModified Blair incision (MBI) and Modified facelift incision (MFI) are mainly used for paroidectomy. MBI can provide a wide surgical view for parotidectomy. MFI was designed for better cosmesis by hiding the incision behind the auricle and hair line. This study was performed to evaluate surgical outcomes, functional and cosmetic results after parotidectomy using MBI and MFI. Subjects and MethodZZWe retrospectively reviewed medical records of 120 patients who underwent parotidectomy from September 2005 to April 2012. Tumor characteristics, operative outcome, and cosmetic outcome according to incision method were investigated. Cosmetic satisfaction was assessed using a questionnaire 12-18 months after surgery. ResultsZZTumor characteristics such as size, location and pathologic features did not differ between the two groups. The extent of parotidectomy, operation time, amout of drainage, and complications were also not different between the two groups. Cosmetic satisfaction was significantly supeior in the MFI group than that of the MBI group. ConclusionZZMFI is superior to MBI for parotidectomy for having similar surgical outcome but better esthetical success compared to MBI. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(5):337-40

This study was aimed to evaluate renal dysfunction during three weeks after the burn injuries in 12 patients admitted to the Hallym University Hankang Medical Center with flame burn injuries (total body surface area, 20-40%). Parameters assessed included 24-hr urine volume, blood urea nitrogen, serum creatinine, creatinine clearance, total urinary protein, urinary microalbumin, 24-hr urinary N-acetyl-beta-D-glucosaminidase (NAG) activity, and urinary malondialdehyde (MDA). Statistical analysis was performed using repeated measures ANOVA test. The 24-hr urine volume, creatinine clearance, and urinary protein significantly increased on day 3 post-burn and fell thereafter. The urine microalbumin excretion showed two peak levels on day 0 post-burn and day 3. The 24-hr urinary NAG activity significantly increased to its maximal level on day 7 post-burn and gradually fell thereafter. The urinary MDA progressively increased during 3 weeks after the burn injury. Despite recovery of general renal function through an intensive care of burn injury, renal tubular damage and lipid peroxidation of the renal tissue suggested to persist during three weeks after the burn. Therefore, a close monitoring and intensive management of renal dysfunction is necessary to prevent burn-induced acute renal failure as well as to lower mortality in patients with major burns.

Takayasu's arteritis is a chronic inflammatory disease that produces a narrowing of the aorta and its major branches. Fibrosis and thickening of the arterial wall often occur in later stages, resulting in a cerebrovascular accident. The authors report two young women patients who presented with subarachnoid hemorrhage (SAH) and occlusive cerebrovasular disease associated with Takayasu's arteritis. Both patients had sudden headache and hemiparesis. Physical examination showed weak radial pulse, carotid bruit, and asymmetrical blood pressure. Erythrocyte sedimentation rate (ESR) was elevated in both patients. SAH was confirmed by brain computerized tomography (CT) or lumbar puncture. Occlusive cerebrovascular disease was diagnosed by brain magnetic resonance imaging (MRI), brain magnetic resonance angiography (MRA), and cerebral angiography. The findings of aortography and cerebral angiography were compatible with Takayasu's arteritis, but intracranial aneurysm was not found in either patient.