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Objective Human microRNA-185 (miR-185) has been reported to act as a regulator of fibrosis and angiogenesis in cancer. However, miR-185 has not been investigated in patients with ST-segment elevation myocardial infarction (STEMI). We hypothesized that the changes in miR-185 levels in STEMI patients are related to the processes of myocardial healing and remodeling. Methods Between January 2011 and December 2013, 145 patients with STEMI (65.9±11.6 years old; 41 women) were enrolled. Initial and discharge serum samples collected from 20 patients with STEMI and mixed sera from 8 healthy controls were analyzed by a microarray. A quantitative reverse transcription polymerase chain reaction (RT-qPCR) analysis of miR-185 was performed in all 145 patients. The correlation between the miR-185 levels and the clinical, laboratory, angiographic, and echocardiographic parameters was analyzed. Results The microarray analysis revealed a biphasic pattern in miR-185 levels, with an initial decrease followed by an increase at discharge. The miR-185 levels at discharge were significantly correlated with the troponin-I, CK-MB, and area under the curve of CK-MB levels. There was a positive correlation between the transforming growth factor-β and miR-185 levels at discharge (ρ=0.242, p=0.026). A high wall motion score index and a low ejection fraction, as measured by echocardiography, and high B-type natriuretic peptide level at one month after STEMI were related to high miR-185 levels. Conclusion Our results showed that elevated miR-185 levels at the late stage of STEMI were related to a large amount of myocardial injury and adverse remodeling.

Necrotizing fasciitis of the lower extremities results in large tissue defects, and most cases require reconstruction using skin grafts or flaps. We describe a 61-year-old man who developed necrotizing fasciitis of the right lower leg and septic shock, following a traumatic injury to his leg. Wound culture yielded methicillin-resistant Staphylococcus aureus. Extensive debridement was performed four times along with the use of appropriate antibiotics. After 2 weeks, physical examination showed an open wound (approximately 30×20 cm in size) with partial tibial bone exposure. Subsequently, the patient underwent successful reconstruction using a tibialis anterior musculofascial flap and split-thickness skin grafting. The tibialis anterior muscle was bihalved and pivoted to cover the exposed bone surface. The patient was without pain and was able to successfully perform daily activities at the 15-month follow-up. This case report highlights the utility of a bihalved tibialis anterior musculofascial flap for lower extremity reconstruction, particularly in patients for whom free flap transfers are unviable.

Performing a concurrent gynecologic operation and mastectomy with immediate breast reconstruction using a free transverse rectus abdominis myocutaneous flap may increase the risk of complications such as umbilical necrosis due to vascular compromise. Imaging studies such as preoperative computed tomography angiography and intraoperative indocyanine green testing can provide information regarding the umbilical blood supply, facilitating decision-making for pedicle selection. Therefore, in situations where a coordinated operation is unavoidable, a thorough preoperative and intraoperative evaluation of the umbilical blood supply is recommended to avoid complications.

Excision is the gold standard for lipomas. Patients desire minimal scars, but minimal incisions can increase complications and produce hypertrophic scars. We propose an algorithmic method named the minimal one-third incision and four-step extraction method (MOTIF) for lipoma excision. This retrospective study analyzed lipomas surgically excised using the MOTIF method at our institution between January 2016 and December 2018. A total of 112 lipomas were included. The complication rates and Vancouver Scar Scale (VSS) for three different size groups (6 cm) were compared. Complete excision of all palpable lipomas was achieved with this approach. There were two seromas, two hematomas, and one postoperative nerve injury. There was no difference in complication rates and VSS between the three size groups. The MOTIF method is a cost-effective, reliable, and cosmetically pleasing method that can be applied to all lipomas regardless of size and location.

The goal of this study was to examine if motor timing training alters the variability of the upper extremity movement during the golf putt. To improve motor timing, we utilised Interactive Metronom...

To investigate the difference in the rate of myopia progression between the dominant and non-dominant eye in patients with intermittent exotropia (IXT). We retrospectively reviewed the medical records of 33 patients who underwent surgery and later reoperation for IXT. We included only patients whose spherical equivalent refractive errors (SER) were ≤ − 0.50 diopter (D) in at least one eye at the time of reoperation. The main outcome measurement was the rate of myopia progression, which was defined as the mean annual change in SER between the first and second surgery. We classified patients into two groups: group A, which comprised 25 patients whose non-dominant eyes showed a faster myopia progression than their dominant eyes, and group B, which comprised the remaining 8 patients showing the opposite. Mean age of the patients at the time of the initial surgery was 5.64 years. Mean interval between the initial and second surgery was 4.45 years. Mean rate of myopia progression over the interval was − 0.37 D/year in the dominant eyes and − 0.50 D/year in the non-dominant eyes (P

BACKGROUND AND OBJECTIVE The role of endothelial progenitor cells in patients with cirrhosis has seldom been investigated. This study was conducted to assess the clinical significance of circulating endothelial progenitor cells in patients with liver cirrhosis with or without hepatocellular carcinoma. METHODS A blood sample was collected once from patients with cirrhosis alone (n = 34) or cirrhosis and hepatocellular carcinoma (n = 46) and healthy controls (n = 27) for assessing levels of endothelial progenitor cells and vascular endothelial growth factor. Blood cells staining positive for CD34/CD133/KDR using flow cytometry were characterized as endothelial progenitor cells. Plasma vascular endothelial growth factor was quantified by ELISA. RESULTS The levels of CD34/KDR-positive endothelial progenitor cells, CD133/KDR-positive endothelial progenitor cells, and vascular endothelial growth factor were higher in patients with cirrhosis ± hepatocellular carcinoma than in healthy controls (P = 0.017, P < 0.001 and P < 0.001, respectively). The levels of endothelial progenitor cells and vascular endothelial growth factor did not show statistical difference according to Child-Turcotte-Pugh class. There was a moderately significant correlation between vascular endothelial growth factor levels and hepatocellular carcinoma stage (ρ = 0.464, P = 0.001). Smoking, ascites, and portal vein thrombosis were independently related to lower levels of circulating CD34/KDR-positive endothelial progenitor cells, higher levels of CD133/KDR-positive endothelial progenitor cells, and higher levels of vascular endothelial growth factor, respectively (P = 0.041, P = 0.023, and P < 0.001, respectively). CONCLUSION Circulating endothelial progenitor cells and plasma vascular endothelial growth factor levels were higher in patients with liver cirrhosis ± hepatocellular carcinoma compared to healthy controls. The increase in endothelial progenitor cells and vascular endothelial growth factor may have a possible role in the development of complications, especially ascites and portal vein thrombosis, or in progression of hepatocellular carcinoma.

Meningitis is an inflammatory process involving meninges. It is difficult to diagnose because of the absence of a diagnostic biomarker. We first report here the possibility of cerebrospinal fluid (CSF) vitamin D-binding protein (VDBP) as a new biomarker for the diagnosis of meningitis. This prospective study enrolled a total of 102 subjects (58 patients with non-neurologic disease, 17 patients with meningitis, and 27 patients with other neurologic diseases) from 2017 to 2018. CSF and blood samples were collected in pairs. Total 25(OH)D in CSF and serum and VDBP levels in serum were measured. GC genotyping was also performed to determine polymorphisms of rs4588 and rs7041. CSF total 25(OH)D and VDBP levels were compared with serum total 25(OH)D and VDBP levels according to disease (meningitis vs. non-meningitis). Receiver operating characteristic (ROC) analysis for the diagnosis of meningitis using CSF VDBP level was performed. Mean CSF VDBP and serum VDBP levels of all patients were 1.48 ± 1.32 and 181.28 ± 56.90 μg/mL, respectively. CSF VDBP level in the meningitis disease group (3.20 ± 1.49 μg/mL) was significantly (P

OBJECTIVES Poor wound healing as reflected by the development of synechia and osteitis after endoscopic sinus surgery may trigger disease recurrence. Animal models provide insights into the pathogenesis of poor wound healing and may aid in the development of new therapeutics. Here, we established a mouse model of nasal wound healing and confirmed its utility. STUDY DESIGN Animal study. METHODS Unilateral intranasal wounds were induced using a small interdental brush in 6-week-old C57BL/6 mice. Forty-five mice were divided into three groups (each n = 15): one control and two experimental groups (intranasal vs. intraperitoneal dexamethasone). Mice were sacrificed on days 2, 14, and 28 after injury (each n = 5). Serial changes in nasal wound histopathology were described, and intergroup differences were analyzed. RESULTS On day 2, mucosal detachment, hemorrhage, and exudate were observed. On day 14, synechiae featuring neo-osteogenesis (bone lacunae, osteoblasts, and multinucleated osteoclasts) between the septum and the maxilloturbinate were prominent, followed by wound maturation on day 28: fewer lacunae and smaller osteoblasts. Macrophages were evident only on day 2, and lymphocytes were predominant on day 28. The amount of exudate on day 2 and the synechial area on day 28 were significantly reduced in mice that received dexamethasone systemically compared with control mice, with similar trends in those treated intranasally. CONCLUSION Our mouse model of nasal wound healing was characterized by the development of bony synechia and neo-osteogenesis, not soft-tissue synechia. The model may be useful in the assessment of novel therapeutics to prevent those wounds. LEVEL OF EVIDENCE NA Laryngoscope, 129:E266-E271, 2019.

Background. Bioavailable 25-hydroxy vitamin D (25(OH)D) has been suggested for the accurate determination of vitamin D status. The purpose of this study was to determine the utility of bioavailable 25(OH)D in assessing vitamin D status when vitamin D-binding protein (VDBP) was significantly altered by pregnancy and liver cirrhosis (LC). The role of genotyping of GC, a gene encoding VDBP, in the determination of bioavailable 25(OH)D concentration in a Korean population was also evaluated. Methods. This prospective study enrolled a total of 136 subjects (53 healthy controls, 45 patients with LC, and 38 pregnant women) from 2017 to 2018. The concentrations of total 25(OH)D and VDBP were measured, and bioavailable 25(OH)D concentrations were calculated. GC genotyping was performed to determine rs4588 and rs7041 polymorphisms. Clinical and laboratory data were compared among the three groups of subjects. Results. Median VDBP and total 25(OH)D concentrations were 165.2 μg/ml and 18.5 ng/ml in healthy controls, 76.9 μg/ml and 10.5 ng/ml in patients with LC, and 368.9 μg/ml and 17.7 ng/ml in pregnant women, respectively. Compared with controls, patients diagnosed with LC had significantly lower VDBP and total 25(OH)D concentrations (all P<0.001) while pregnant women had significantly higher VDBP concentrations (P<0.001). Although total 25(OH)D concentrations in pregnant women were similar to those in controls (P=0.394), their bioavailable 25(OH)D concentrations were significantly lower (1.2 vs. 3.0 ng/ml; P<0.001). Among all the three groups combined, the genotype-specific bioavailable 25(OH)D and the genotype-independent bioavailable 25(OH)D concentrations did not differ significantly (P=0.299). Conclusions. Our study has demonstrated that bioavailable 25(OH)D concentration reflects vitamin D status more accurately than the total 25(OH)D concentration, especially in pregnant women. In addition, GC genotyping did not significantly affect bioavailable 25(OH)D concentration. Therefore, if VDBP concentration is significantly altered, the measurement of bioavailable 25(OH)D concentration might facilitate the accurate determination of vitamin D status. However, GC genotyping might be unnecessary.

There are few studies on the effects of dipeptidyl peptidase-4 inhibitors on steatohepatitis. We explored whether evogliptin (Evo), a dipeptidyl peptidase-4 inhibitor, protects against steatohepatitis in a high-fat diet (HFD)-fed mice and whether these effects involve modulation of mitophagy. Adult male C57BL/J mice were divided into the normal diet (ND), HFD (45% of energy from fat) with Evo (250 mg/kg) (HFD + Evo), and HFD groups at 4 weeks of age and were sacrificed at 20 weeks of age. The HFD group showed hepatic lipid accumulation, this was decreased in the Evo + HFD group. There was an increased 8-hydroxydeoxyguanosine (8-OHDG) expression in the HFD group compared to ND mice. However, 8-OHDG expression levels were significantly decreased in the HFD + Evo group. Expressions of the mitophagy markers PTEN-induced kinase 1 (PINK1), Parkin, and BNIP-3 (BCL2 Interacting Protein 3) were significantly increased in the HFD group. However, the expressions of these markers were lower in the HFD + Evo group than that in the HFD group. Phospho-Akt was upregulated and p53 was downregulated in the HFD + Evo group compared to the HFD group. Evogliptin may alleviate steatohepatitis in HFD-fed mice by ameliorating steatosis and oxidative stress and by modulating mitophagy in the liver.

Radioiodine (RI) therapy is known to cause salivary gland (SG) dysfunction. The effects of antioxidants on RI-induced SG damage have not been well described. This study was performed to investigate the radioprotective effects of alpha lipoic acid (ALA) administered prior to RI therapy in a mouse model of RI-induced sialadenitis. Four-week-old female C57BL/6 mice were divided into four groups (n = 10 per group): group I, normal control, group II, ALA alone (100 mg/kg), group III, RI alone (0.01 mCi/g body weight, orally), and group IV, ALA + RI (ALA at 100 mg/kg, 24 h and 30 min before RI exposure at 0.01 mCi/g body weight). The animals in these groups were divided into two subgroups and euthanized at 30 or 90 days post-RI treatment. Changes in salivary 99mTc pertechnetate uptake and excretion were tracked by single-photon emission computed tomography. Salivary histological examinations and TUNEL assays were performed. The 99mTc pertechnetate excretion level recovered in the ALA treatment group. Salivary epithelial (aquaporin 5) cells of the ALA + RI group were protected from RI damage. The ALA + RI group exhibited more mucin-containing parenchyma and less fibrotic tissues than the RI only group. Fewer apoptotic cells were observed in the ALA + RI group compared to the RI only group. Pretreatment with ALA before RI therapy is potentially beneficial in protecting against RI-induced salivary dysfunction.

Background: Endothelial progenitor cells (EPCs) have the potential to protect against atherothrombotic event occurrences. There are no data to evaluate the impact of cilostazol on EPC levels in high-risk patients. Methods: We conducted a randomized, double-blind, placebo-controlled trial to assess the effect of adjunctive cilostazol on EPC mobilization and platelet reactivity in patients with acute myocardial infarction (AMI). Before discharge, patients undergoing percutaneous coronary intervention (PCI) were randomly assigned to receive cilostazol SR capsule (200-mg) a day (n = 30) or placebo (n = 30) on top of dual antiplatelet therapy (DAPT) with clopidogrel and aspirin. Before randomization (baseline) and at 30-day follow-up, circulating EPC levels were analyzed using flow cytometry and hemostatic measurements were evaluated by VerifyNow and thromboelastography assays. The primary endpoint was the relative change in EPC levels between baseline and 30-day. Results: At baseline, there were similar levels of EPC counts between treatments, whereas patients with cilostazol showed higher levels of EPC counts compared with placebo after 30 days. Cilostazol versus placebo treatment displayed significantly higher changes in EPC levels between baseline and follow-up (&Delta, CD133+/KDR+: difference 216%, 95% confidence interval (CI) 44~388%, p = 0.015, &Delta, CD34+/KDR+: difference 183%, 95% CI 25~342%, p = 0.024). At 30-day follow-up, platelet reactivity was lower in the cilostazol group compared with the placebo group (130 &plusmn, 45 versus 169 &plusmn, 62 P2Y12 Reaction Unit, p = 0.009). However, there were no significant correlations between the changes of EPC levels and platelet reactivity. Conclusion: Adjunctive cilostazol on top of clopidogrel and aspirin versus DAPT alone is associated with increased EPC mobilization and decreased platelet reactivity in AMI patients, suggesting its pleiotropic effects against atherothrombotic events (NCT04407312).

Objectives The aim of this study was to evaluate the effect of ticagrelor versus clopidogrel on left ventricular (LV) remodeling after reperfusion of ST-segment elevation myocardial infarction (STEMI) in humans. Background Animal studies have demonstrated that ticagrelor compared with clopidogrel better protects myocardium against reperfusion injury and improves remodeling after myocardial infarction. Methods In this investigator-initiated, randomized, open-label, assessor-blinded trial performed at 10 centers in Korea, patients were enrolled if they had naive STEMI successfully treated with primary percutaneous coronary intervention (PCI) and at least 6-month planned duration of dual-antiplatelet treatment. The coprimary endpoints were LV remodeling index (LVRI) (a relative change of LV end-diastolic volume) measured on 3-dimensional echocardiography and N-terminal pro–B-type natriuretic peptide level at 6 months. Results Among initially enrolled patients with STEMI (n = 336), 139 in each group completed the study. LVRI at 6 months was numerically lower with ticagrelor versus clopidogrel (0.6 ± 18.6% vs. 4.5 ± 16.5%; p = 0.095). Ticagrelor significantly reduced the 6-month level of N-terminal pro–B-type natriuretic peptide (173 ± 141 pg/ml vs. 289 ± 585 pg/ml; p = 0.028). These differences were prominent in patients with pre-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade 0. By multivariate analysis, ticagrelor versus clopidogrel reduced the risk for positive LV remodeling (LVRI >0%) (odds ratio: 0.56; 95% confidence interval: 0.33 to 0.95; p = 0.030). The LV end-diastolic volume index remained unchanged during ticagrelor treatment (from 54.7 ± 12.2 to 54.2 ± 12.2 ml/m2; p = 0.629), but this value increased over time during clopidogrel treatment (from 54.6 ± 11.3 to 56.4 ± 13.9 ml/m2; p = 0.056) (difference −2.3 ml/m2; 95% confidence interval: −4.8 to 0.2 ml/m2; p = 0.073). Ticagrelor reduced LV end-systolic volume index (from 27.0 ± 8.5 to 24.7 ± 8.4 ml/m2; p Conclusions Ticagrelor was superior to clopidogrel for LV remodeling after reperfusion of STEMI with primary PCI. (High Platelet Inhibition With Ticagrelor to Improve Left Ventricular Remodeling in Patients With ST Segment Elevation Myocardial Infarction [HEALING-AMI]; NCT02224534 )

Radiation therapy is a standard treatment for patients with head and neck cancer. However, radiation exposure to the head and neck induces salivary gland (SG) dysfunction. Alpha lipoic acid (ALA) has been reported to reduce radiation-induced toxicity in normal tissues. In this study, we investigated the effect of ALA on radiation-induced SG dysfunction. Male Sprague&ndash, Dawley rats were assigned to the following treatment groups: control, ALA only (100 mg/kg, intraperitoneally), irradiation only, and ALA administration 24 h or 30 min prior to irradiation. The neck area, including SGs, was irradiated evenly at 2 Gy/min (total dose, 18 Gy) using a photon 6 MV linear accelerator. The rats were sacrificed at 2, 6, 8, and 12 weeks after irradiation. Radiation decreased SG weight, saliva secretion, AQP5 expression, parasympathetic innervation (GFR&alpha, 2 and AchE expression), regeneration potentials (Shh and Ptch expression), salivary trophic factor levels (brain-derived neurotrophic factor and neurturin), and stem cell expression (Sca-1). These features were restored by treatment with ALA. This study demonstrated that ALA can rescue radiation-induced hyposalivation by preserving parasympathetic innervation and regenerative potentials.

During putting in golf, the direction and velocity of the club head should be consistent across swings. In order to maintain consistency in swing timing, the cerebellum provides temporal information, motor timing, control of rhythm, and timing of movements. We utilized Interactive Metronome (IM), a brain training software program that combines the concepts of neurotechnology with the abilities of a computer, to improve an individual's rhythm and timing. We propose that IM would activate neural networks involved in decreasing variation in putt swing. Twenty professional female golfers (KLPGA) were randomly assigned to either an IM training group (n = 10, 35-40 min per session, twice a week for 6 weeks) or a control group (n = 10). The golf putting movements and brain activity were analyzed using Kinovea Software and resting state functional MRI, respectively. Consistency was measured as the standard deviation of mean swing speed (SSD) during three sections of the swing: backswing (AD-BS), backswing-impact (BS-IMP), and impact-finish (IMP-FIS). Our results show that the consistency of the IM group improved in the time between the back swing and impact in the 2 m putt and 5 m putt compared to the control group. Using functional MRI, after the training period, the IM group showed increased functional connectivity from the superior cerebellar vermis to the right medial frontal gyrus, left superior temporal gyrus, right middle occipital gyrus, right middle temporal gyrus, right cingulate gyrus, and right supramarginal gyrus (uncorrected p 0.001, voxels 40). These findings suggest that IM training in professional female golf players may improve consistency in putt timing. In addition, IM training may increase brain connectivity from the cerebellum to the frontal cortex, which plays an important role in motor control and timing.

Patients suffering from idiopathic Parkinson's disease (PD) are unable to steadily generate regular steps due to an impairment of the basal ganglia that do not cue the supplementary motor area properly (Iansek, Bradshaw, Phillips, Cunnington, & Morris, 1995). This results in the main hallmarks of parkinsonian gait: reduced step cadence, reduced velocity, and shortened stride length. In the 1990s the use of acoustic stimulation for the rehabilitation of gait disorders in PD was developed under the concept of rhythmic auditory stimulation (RAS). RAS consists of a clear accentuated, either metronomic or musical rhythm that stimulates the production of rhythmical movements (Thaut, 2005), especially with respect to their timing. The consistent coupling between steady tempo of the acoustic stimulation (bpm, beats per minute) and walking cadence (spm, steps per minute) of PD patients has This been systematically investigated and the effectiveness of RAS broadly attested (for reviews see Lim et al., 2005; Nombela, Hughes, Owen, & Grahn, 2013; Tomlinson et al., 2013).In the standard RAS protocol, stimulation tempo usually corresponds to baseline cadence increased by 10% (Arias & Cudeiro, 2008; Freedland et al., 2002; Hausdorff, Lownthal, Herman, Gruendlinger, Peretz, & Giladi, 2007; Willems et al., 2006). RAS exerts a direct effect upon cadence and a consequent effect upon stride length. Because stride length in PD patients is lower than in healthy people at any given velocity (Ebersbach et al., 1999), it may be beneficial for the patient to address it specifically, as an independent therapy goal.Our choice of using musical instead of metronomic stimuli follows music therapist Michael Thaut's approach, where rhythmic stimuli are embedded in a musical structure. The approach is based on findings that rhythmic patterns within a musical context reduce response variability and synchronization offset more effectively than do single-pulse pattern in the frequency range of 60 to 120 spm (Thaut et al., 1996). Moreover, it has been demonstrated that healthy subjects synchronize more precisely (i.e., with lower negative mean asynchrony) with musical rather than metronomic stimuli (Repp, 2005). In the early studies with PD patients, RAS consisted of instrumental pieces in 2/4 or 4/4 m with rhythmic on-beats enhanced by a metronome (McIntosh, Brown, Rice, & Thaut, 1997; Miller, Thaut, McIntosh, & Rice, 1996; Thaut et al., 1996), and it was suggested that, compared with metronome, musical texture provides additional timing information and may therefore facilitate detection, anticipation, and synchronization to the beat (Thaut, Rathbun, & Miller, 1997). Moreover, music facilitates emotional involvement and motivates engagement in a task, and might therefore be a more efficient stimulation than the plain metronome beat. Recently, attention to the comparison between metronomic and musical stimulation and to the specific features that would account for the effectiveness of music seems to be increasing (Buhmann, Desmet, Moens, Van Dyck, & Leman, 2016; Styns, van Noorden, Moelants, & Leman, 2007; Wittwer, Webster, & Hill, 2013). Moreover, the specific effectiveness of music-based movement therapy on PD has been investigated in a meta-analysis (de Dreu, van der Wilk, Poppe, Kwakkel, & van Wegen, 2012).The fundamental advantage of the RAS approach is that it is able to replace the impaired internal stimuli of a parkinsonian brain. However, as stimulation proceeds independently from movement execution, there is no feedback mechanism that helps evaluate movements' adequacy. The potential of concurrent sensory feedback for enhancing motor learning has been extensively studied on healthy subjects (Sigrist, Rauter, Riener, & Wolf, 2013) and an interactive, feedback-like version of RAS has been recently proposed for the training of stride time in PD patients (Hove1, Suzuki, Uchitomi, Orimo, & Miyake, 2012). …

Objective Vitamin D-binding protein (VDBP) mediates various biological processes in humans. The goal of this study was to investigate whether VDBP gene polymorphisms could predispose Korean women to endometriosis. Methods We prospectively enrolled women with endometriosis (n = 16) and healthy controls (n = 16). Total serum 25-hydroxyl vitamin D (25(OH)D) concentrations were measured using an Elecsys vitamin D total kit. Levels of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using a vitamin D BP Quantikine ELISA kit. DNA was extracted using a DNeasy blood & tissue kit. Two singlenucleotide polymorphisms (SNPs; rs4588 and rs7041) in GC, the gene that codes for VDBP, were analyzed using a TaqMan SNP genotyping assay kit. The functional variant of VDBP was determined based on the results of the two SNPs. Results Gravidity and parity were significantly lower in the endometriosis patients than in the control group, but serum CA-125 levels and the erythrocyte sedimentation rate were significantly higher. Total serum 25(OH)D levels in the endometriosis patients were significantly lower than in the control group. However, serum bioavailable 25(OH)D, free 25(OH)D, and VDBP levels did not differ significantly between the endometriosis and control groups. The genotypes and allele frequencies of GC were similar in both groups. Conclusion Korean women with endometriosis had lower total serum 25(OH)D concentrations than controls. Neither serum VDBP concentrations nor polymorphisms in the gene coding for VDBP were associated with endometriosis. Further studies are needed to investigate the pathophysiology and clinical implications of 25(OH)D and VDBP in endometriosis.

The immunologic aspects of radiation pneumonitis (RP) are unclear. We analyzed variations in cytokine profiles between patients with grade (Gr) 0–1 and Gr ≥ 2 RP. Fifteen patients undergoing concurrent chemoradiotherapy for non-small cell lung cancer were included. Blood samples of 9 patients with Gr 0–1 and 6 with Gr ≥ 2 RP were obtained from the Biobank. Cytokine levels were evaluated using an enzyme linked immunosorbent assay at before radiotherapy (RT) initiation, 1, 3, and 6 weeks post-RT initiation, and 1 month post-RT completion. Concentrations of granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-6, IL-10, IL-13, IL-17, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β were analyzed, none were related to the occurrence of Gr ≥ 2 RP at pre-RT initiation. At 3 weeks, relative changes in the G-CSF, IL-6, and IFN-γ levels differed significantly between the groups (p = 0.026, 0.05 and 0.026, respectively). One month post-RT completion, relative changes of IL-17 showed significant differences (p = 0.045), however, relative changes in TNF-α, IL-10, IL-13, and TGF-β, did not differ significantly. Evaluation of changes in IL-6, G-CSF, and IFN-γ at 3 weeks after RT initiation can identify patients pre-disposed to severe RP. The mechanism of variation in cytokine levels in relation to RP severity warrants further investigation.

[Purpose] The biomechanical effects of foot orthoses on malalignment syndrome have not been fully clarified. This experimental investigation was conducted to evaluate the effects of orthoses on the gait patterns of patients with malalignment syndrome. [Subjects and Methods] Ten patients with malalignment syndrome were recruited. For each participant, kinematic and kinetic data were collected under three test conditions: walking barefoot, walking with flat insoles in shoes, and walking with a biomechanical foot orthosis (BFO) in shoes. Gait patterns were analyzed using a motion analysis system. [Results] Spatiotemporal data showed the step and stride lengths when wearing shoes with flat insoles or BFO were significantly greater than when barefoot, and that the walking speed when wearing shoes with BFO was significantly faster than when walking barefoot or with shoes with flat insoles. Kinetic data, showed peak pelvic tilt and obliquity angle were significantly greater when wearing BFO in shoes than when barefoot, and that peak hip flexion/extension angle and peak knee flexion/extension and rotation angles were significantly greater when wearing BFO and flat insoles in shoes than when barefoot. [Conclusion] BFOs can correct pelvic asymmetry while walking.

There is evidence that pepsin can aggravate tonsil hypertrophy. Pepstatin is a potent inhibitor of pepsin activity and could protect patients against reflux tonsil hypertrophy by inhibiting pepsin. We examined the effects of pepstatin on the development of tonsil hypertrophy to investigate pepsin's role in the pathogenesis of tonsil lesions. We investigated whether pepstatin suppresses pepsin-mediated lymphocyte proliferation in tonsil hypertrophy. Forty-nine children with tonsil hypertrophy and twenty-two adults with tonsillitis were recruited to the study prior to surgery. Tonsil tissue from each patient was harvested and assessed for changes in the number of lymphocytes and macrophages in the presence of pepsin and pepstatin. We found that the proportions of CD4- and CD14-positive cells were significantly lower (p < 0.05), but that the proportions of CD19- and CD68-positive cells were significantly higher (p < 0.05), in children than in adults. There were significantly more CD4-positive cells after pepsin treatment, but these numbers were reduced by pepstatin. The levels of both interleukin-2 (IL-2) and interferon gamma (IFN-γ) increased significantly in response to pepsin, but were reduced when pepsin was inhibited by pepstatin. The level of IL-10 is reduced in pepsin-treated CD4 cells and the level is restored by pepstatin. IL-2 blocking reduced the increased CD4 cell number by pepsin. But, an additive or a synergic effect is not founded in combined with IL-2 blocking and pepstatin. Pepsin-positive cells did not co-localize with CD20 and CD45 cells, but they were found surrounding CD20- and CD45-positive hypertrophic tonsil cells. Pepsin-positive cells co-localized with CD68-positive cells. It is probable that pepsin from extraesophageal reflux aggravates tonsil hypertrophy and pepstatin exerts a protective effect by inhibiting pepsin activity.

Little is known about the pathogenetic etiology of central pain in patients with traumatic brain injury (TBI). We investigated the relation between injury of the spinothalamocortical tract (STT) and chronic central pain in patients with mild TBI.Retrospective survey.We recruited 40 consecutive chronic patients with mild TBI and 21 normal control subjects: 8 patients were excluded by the inclusion criteria and the remaining 32 patients were finally recruited. The patients were classified according to 2 groups based on the presence of central pain: the pain group (22 patients) and the nonpain group (10 patients).Diffusion tensor tractography for the STT was performed using the Functional Magnetic Resonance Imaging of the Brain Software Library. Values of fractional anisotropy (FA), mean diffusivity (MD), and tract volume of each STT were measured.Lower FA value and tract volume were observed in the pain group than in the nonpain group and the control group (P.05). By contrast, higher MD value was observed in the pain group than in the nonpain group and the control group (P.05). However, no significant differences in all diffusion tensor imaging parameters were observed between the nonpain group and the control group (P.05).Decreased FA and tract volume and increased MD of the STTs in the pain group appeared to indicate injury of the STT. As a result, we found that injury of the STT is related to the occurrence of central pain in patients with mild TBI. We believe that injury of the STT is a pathogenetic etiology of central pain following mild TBI.

The objective of this study was to determine the effect of a home-based exercise program on fatigue, anxiety, quality of life (QoL), and immune function of thyroid cancer patients taking thyroid hormone replacement after thyroidectomy.This quasi-experimental study with a non-equivalent control group included 43 outpatients taking thyroid hormone replacement after thyroidectomy (22 in the experimental group and 21 in the control group). After education about the home-based exercise program, subjects in the experimental group underwent 12 weeks of aerobic, resistance, and flexibility exercise. A comparative analysis was conducted between the two groups.Patients in the experimental group were significantly less fatigued or anxious (p 0.01). They reported significantly improved QoL (p 0.05) compared to those in the control group. Natural killer cell activity was significantly higher in the exercise group compared to that in the control group (p 0.05).A home-based exercise program is effective in reducing fatigue and anxiety, improving QoL, and increasing immune function in patients taking thyroid hormone replacement after thyroidectomy. Therefore, such a home-based exercise program can be used as an intervention for patients who are taking thyroid hormone replacement after thyroidectomy.

Interleukin-7 (IL-7), which is required for the development and survival of T cells in the thymus and periphery, plays a role in joint destruction. However, it remains unclear how IL-7 affects osteoclast formation. Thus, we investigated the mechanism by which IL-7 induced osteoclast formation through IL-7 receptor α (IL-7Rα) in osteoclast precursors. We cultured peripheral blood mononuclear cells or synovial fluid mononuclear cells with IL-7 in the presence or absence of an appropriate inhibitor to analyze osteoclast formation. We also constructed IL-7Rα-expressing RAW264.7 cells to uncover the mechanism(s) by which IL-7 induced osteoclast formation differed from that of receptor activator of nuclear factor κB ligand (RANKL). We found that IL-7 induced osteoclast formation of human monocytes from peripheral blood or synovial fluid in a RANKL-independent and a signal transducer and activator of transcription 5 (STAT5)-dependent manner. IL-7-induced osteoclasts had unique characteristics, such as small, multinucleated tartrate-resistant acid phosphatase positive cells and no alterations even when RANKL was added after IL-7 pretreatment. RAW264.7 cells, if overexpressing IL-7Rα, also were able to differentiate into osteoclasts by IL-7 through a STAT5 signaling pathway. Furthermore, IL-7-induced osteoclast formation was repressed by inhibitors of the IL-7R signaling molecules Janus kinase and STAT5. Our findings demonstrate that IL-7 is a truly osteoclastogenic factor, which may induce osteoclast formation via activation of STAT5, independent of RANKL. We also suggest the possibility that an IL-7R pathway blocker could alleviate joint damage by inhibiting osteoclast formation, especially in inflammatory conditions.

// Jin Hyun Kim 1, 2 , Myeong Hee Jung 1 , Jin Pyeong Kim 2, 3 , Hyun-Jung Kim 2, 4 , Jung Hwa Jung 2, 4 , Jong Ryeal Hahm 2, 4 , Ki Mun Kang 2, 5 , Bae-Kwon Jeong 2, 5 and Seung Hoon Woo 2, 3, 6 1 Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Gyeongnam, Republic of Korea 2 Institute of Health Science, Gyeongsang National University, Jinju, Gyeongnam, Republic of Korea 3 Department of Otolaryngology, Gyeongsang National University, Jinju, Gyeongnam, Republic of Korea 4 Department of Internal Medicine, Gyeongsang National University, Jinju, Gyeongnam, Republic of Korea 5 Department of Radiation Oncology, Gyeongsang National University, Jinju, Gyeongnam, Republic of Korea 6 Beckman Laser Institute, University of California, Irvine, California, USA Correspondence to: Seung Hoon Woo, email: lesaby@hanmail.net Keywords: alpha lipoic acid, oral mucosa, radiation, Hif-1a, complications Received: May 05, 2017 Accepted: July 25, 2017 Published: August 16, 2017 ABSTRACT Purpose: Radiotherapy is currently one of the main treatment modalities for head and neck cancer; however, it also results in severe toxicity to the normal tissue, to the detriment of patients. This study aimed to investigate whether alpha lipoic acid (ALA) could protect against radiation-induced oral mucositis in a rat model. Results: On post-irradiation days 4 and 7, the epithelial layer on oral mucosa showed pronounced injury (shortening of the layer) and it is diminished by ALA pretreatment before radiation. Hif-1a expression was significantly induced in the radiation group on days 4, 7, and 28. GLUT1 expression was also induced by radiation at all time points, and the expression levels peaked on day 28. Phosphorylated p53 level was significantly higher in the radiation group on days 4 and 7, and Bax protein expression was significantly higher in the same group on day 4 than ALA-pretreated radiation group. TUNEL-positive staining was significantly lower in the ALA-pretreated radiation group. Materials and methods: Rats were assigned to one of the following four groups: control, ALA only (100 mg/kg, i.p.), irradiated, and ALA administered 24 h and 30 min prior to irradiation, with the neck area including the oral mucosa evenly irradiated with 2 Gy per minute (total dose, 18 Gy) using a photon 6-MV linear accelerator. Rats were sacrificed 4, 7, 28, or 56 days after radiation. Conclusions: The results show that ALA can be used to ameliorate radiation-induced oral mucositis with head and neck cancer.

Background: Less mature athletes exhibit biomechanical parameters during cutting maneuvers that may place these athletes at greater risk for injury than their more mature counterparts, especially if the maneuvers are unanticipated. However, most studies on risk factors for anterior cruciate ligament (ACL) injury have focused on neuromuscular and knee kinematic differences between the sexes, not on the biomechanical parameters between specific sporting maneuvers. Hypotheses: (1) Anticipation will have a greater effect than the type of cutting maneuver (side- vs cross-cutting) in terms of the biomechanical risk factors for ACL injuries, and (2) the biomechanical risk factors will be different between the 2 types of maneuvers. Study Design: Controlled laboratory study. Methods: Thirty-seven young, male middle school soccer players participated in this study. Three-dimensional motion analysis featuring ground-reaction force and electromyography of the right leg was used. Kinematics, kinetics, and electromyography data for each athlete were analyzed during anticipated and unanticipated side- and cross-cutting maneuvers. The differences between anticipated and unanticipated states as well as between side- and cross-cutting maneuvers were calculated and compared. Results: After unanticipated side-cutting, the time to peak ground-reaction force was longer and peak values were smaller compared with anticipated side-cutting. Flexion, valgus, and internal rotations in the knee joint were larger, and greater flexion and valgus moments were observed. The vastus lateralis and vastus medialis showed lower activity, and the lateral gastrocnemius showed higher activity after unanticipated side-cutting maneuvers. With unanticipated cross-cutting, the time to peak ground-reaction force was longer and peak values were smaller compared with anticipated cross-cutting, and the lateral gastrocnemius showed higher activity. Differences in the peak values of the mediolateral and vertical forces were smaller in the cross-cutting maneuver than in side-cutting. Changes in flexion and adduction of the hip joint, flexion of the knee joint, and inversion of the ankle joint were larger during side-cutting. Conclusion: Although there were some interactions between direction and anticipation, anticipating a cutting maneuver generally had a greater effect than the type of maneuver when there was no significant interaction. Clinical Relevance: Increases in the valgus angle and moment of the knee joint and higher lateral gastrocnemius activity during the late period showed an association with ACL injury risk factors during side-cutting, and higher lateral gastrocnemius activity during the early period showed an association with injury risk factors during cross-cutting.

Two Hahns Macaws (Ara nobilis nobilis), three and nine-month-old, with a three-weeks history of weight loss and anorexia were diagnosed presumptively with proventricular dilatation disease (PDD) by radiographic examination. The birds were treated with antimicrobials, analgesics, and fluid administration. However, these birds died three weeks after the first signs of PDD. At necropsy, the birds had severely dilated proventriculus, severe pectoral muscles atrophy, and blood vessels congestion on cortex of cerebrum. The partial matrix gene of avian bornavirus (ABV) was detected by RT-PCR from tissues of the brain, feather calami, and proventiculus of each PDD-suspected birds. This report describes the first detection of ABV in PDD-suspected Hahns Macaw in Korea.

The aim of this study was to examine the effects of human umbilical cord blood-derived CD34-positive endothelial progenitor cells (CD34+ EPCs) on osteoblastic differentiation of cultured human periosteal-derived osteoblasts (POs). CD34+ cells from human umbilical cord blood were sorted to purify more EPCs in characterization. These sorted cells showed CD31, VE-cadherin, and KDR expression as well as CD34 expression and formed typical tubes in Matrigel. These sorted cells were referred to as human cord blood-derived CD34+ EPCs. In in vivo bone formation using a miniature pig model, the newly formed bone was clearly examined in defects filled with polydioxanone/pluronic F127 (PDO/Pluronic F127) scaffolds containing either human umbilical cord blood-derived CD34+ EPCs and POs or human umbilical vein endothelial cells (HUVEC) and POs; however, the new bone had the greatest density in the defect treated with CD34+ EPCs and POs. Osteoblastic phenotypes of cultured human POs using ALP activity and von Kossa staining were also more clearly found in CD34+ EPC-conditioned medium than CD34-negative (CD34-) cell-conditioned medium, whereas HUVEC-conditioned medium had an intermediate effect. PCR array for common cytokines and growth factors showed that the secretion of interleukin (IL)-1β was significantly higher in CD34+ EPCs than in HUVEC, followed by level in CD34- cells. In addition, IL-1β also potently and dose dependently increased ALP activity and mineralization of POs in culture. These results suggest that human umbilical cord blood-derived CD34+ EPCs stimulates osteoblastic differentiation of cultured human POs. The functional role of human umbilical cord blood-derived CD34+ EPCs in increasing the osteogenic phenotypes of cultured human POs may depend on IL-1β secreted from human umbilical cord blood-derived CD34+ EPCs.

The objective was to investigate if high cadence cycling altered non-motor cognition and depression symptoms in individuals with Parkinson&rsquo, s disease (PD) and whether exercise responses were influenced by brain-derived neurotrophic factor (BDNF) Val66Met polymorphism. Individuals with idiopathic PD who were &ge, 50 years old and free of surgical procedures for PD were recruited. Participants were assigned to either a cycling (n = 20) or control (n = 15) group. The cycling group completed three sessions of high cadence cycling on a custom motorized stationary ergometer. The primary outcome was cognition (attention, executive function, and emotion recognition were assessed via WebNeuro&reg, and global cognition via Montreal Cognitive Assessment). Depression symptoms were assessed via Beck Depression Inventory-II. There was a main effect of time for emotional recognition (p = 0.048), but there were no other changes in cognition or depression symptoms. Regardless of intervention or Val66Met polymorphism, high cadence cycling does not alter cognition or depression symptoms after three sessions in one week.

Epidemiological investigations have suggested that serum 25-hydroxyvitamin D [25(OH)D] level has significantly inverse associations with various neurological and neurodegenerative diseases. However, little is known about 25(OH)D level in human cerebrospinal fluid (CSF). Thus, the aim of this study was to determine correlations of 25(OH)D level in CSF with serum total, bioavailable, and free 25(OH)D levels. This observational study enrolled a total of 117 subjects (58 patients with non-neurologic disease and 59 patients with neurologic disease) from 2017 to 2018. CSF and blood samples were collected in pairs. Total 25(OH)D levels in CSF and serum and vitamin D binding protein (VDBP) levels in serum were measured. We also performed GC genotyping for polymorphisms of rs4588 and rs7041 to calculate bioavailable and free 25(OH)D levels. CSF total 25(OH)D levels were compared with serum total, bioavailable, and free 25(OH)D levels. Mean total 25(OH)D concentrations in CSF and serum of all patients were 37.14 ± 7.71 and 25.72 ± 12.37 ng/mL, respectively. The mean total 25(OH)D concentration in CSF was generally 1.4-fold higher than that in the serum. Total 25(OH)D concentrations in CSF showed weakly positive but significant correlations with serum total, bioavailable, and free 25(OH)D concentrations (P = 0.022, P = 0.033, and P = 0.026, respectively). Serum total 25(OH)D concentration was also correlated with serum VDBP concentration (P = 0.017). However, total 25(OH)D levels in CSF of non-neurologic disease group and neurologic disease group were similar. Total 25(OH)D level in CSF has weakly positive but significant correlations with serum total, bioavailable, and free 25-hydroxy vitamin D levels in the Korean population. The distribution of CSF total 25(OH)D in Korean neurologic and non-neurologic disease patients was presented.

The postoperative infectious spondylitis has been reported to occur among every 1% to 12%. It is difficult to early diagnose in some cases. If the diagnosis is delayed, it can be a life-threatening condition. We report a 32-year-old male patient with postoperative infectious spondylitis. He had surgical treatments for traumatic intervertebral disc herniations in L3-4 and L4-5. Three weeks after surgery, he complained for fever and paraplegia. Cervicothoracic magnetic resonance imaging showed the collapsed T2 and T3 vertebral body with changes of bone marrow signal intensity. Moreover, it showed anterior and posterior epidural masses causing spinal cord compressions which suggested infectious spondylitis. After the use of antibiotics and surgical decompressions T2-T3, his general conditions were improved and muscle power of lower extremities began to be gradually restored. However, we could not identify the exact organisms that may be the cause of infectious spondylitis. It could be important that the infectious spondylitis, which is presented away from the primary operative level, should be observed in patients with fevers of unknown origin and paraplegia.

Background Although elevated levels of lactoferrin provide a biomarker for inflammatory bowel diseases and colorectal cancer, the clinical significance of these elevated levels in ascitic fluid of patients with ascites caused by liver cirrhosis is limited. The aims of our study were to investigate the usefulness of ascitic fluid lactoferrin levels for the diagnosis of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and to evaluate the association between lactoferrin levels and the development of hepatocellular carcinoma (HCC). Methods A total of 102 patients with ascites caused by cirrhosis were consecutively enrolled into the study, from December 2008 to December 2011. Ascitic fluid lactoferrin levels were quantified using a human lactoferrin enzyme-linked immunosorbent assay kit. Results The median ascitic fluid lactoferrin levels were significantly higher in patients with SBP than in those without SBP (112.7 ng/mL vs. 0.6 ng/mL; p

Background Gastroesophageal reflux is associated with numerous pathologic conditions of the upper aerodigestive tract. Gastric pepsin within reflux contributes to immunologic reactions in the tonsil. In this study, we aimed to find the relationships between pepsin and tonsillar hypertrophy. Methods and finding We explored the notion whether tonsillar hypertrophy was due to pepsin-mediated gastric reflux in tonsil hypertrophy. Fifty-four children with tonsil hypertrophy and 30 adults with tonsillitis were recruited before surgical treatment. Blood and tonsil tissues from each patient were harvested for analysis of changes in lymphocyte and macrophage numbers coupled with histological and biochemical analysis. Pepsin was expressed at different levels in tonsil tissues from each tonsillar hypertrophy. Pepsin-positive cells were found in the crypt epithelium, surrounding the lymphoid follicle with developing fibrosis, and also surrounding the lymphoid follicle that faced the crypt. And also, pepsin staining was well correlated with damaged tonsillar squamous epithelium and TGF-β1 and iNOS expression in the tonsil section. In addition, pepsin and TGF-β1-positive cells were co-localized with CD68-positive cells in the crypt and surrounding germinal centers. In comparison of macrophage responsiveness to pepsin, peripheral blood mononuclear cells (PBMNCs) were noticeably larger in the presence of activated pepsin in the child group. Furthermore, CD11c and CD163-positive cells were significantly increased by activated pepsin. However, this was not seen for the culture of PBMNCs from the adult group. Conclusions The lymphocytes and monocytes are in a highly proliferative state in the tonsillar hypertrophy and associated with increased expression of pro-inflammatory factors as a result of exposure to stomach reflux pepsin.

It is well-known that an improper lifestyle such as overeating, lack of exercises and imbalance of body postures is regarded as the main cause of abdominal obesity which could cause various complications such as high blood pressure, diabetes, heart failure, and so on. There have been tremendous efforts to improve such a lifestyle and reduce abdominal obesity. One of the results suggests that a correct posture could lead the reduction of the abdominal obesity. However, it is difficult for users to measure, record and correct their postures by themselves. Therefore, it is required to have a tool to enhance the situation. It is assumed that wearable devices can be used for supporting the efforts of reducing the abdominal obesity. In this paper, it is proposed to develop a wearable device, called Smart Belt, for life-logging, monitoring and analyzing living body data with personal big data processing.

Objectives/Hypothesis Several genes have been reported to be upregulated in human nasal polyps in previous genetic analyses. Among these genes, periostin is known to be overexpressed in nasal polyps obtained from aspirin-sensitive patients. Using periostin-null mice, we investigated the role of periostin in a murine model of eosinophilic rhinosinusitis with nasal polyps. Study Design Animal study. Methods Eosinophilic rhinosinusitis was induced in both periostin-null and wild-type mice according to previously established protocols. In brief, ovalbumin (OVA) was used for sensitization and prolonged intranasal stimulation. Staphylococcus aureus enterotoxin B was applied intranasally to develop polyplike lesions. To examine the inflammation and mucosal lesions, hematoxylin and eosin, Sirius red, and Giemsa staining were performed. Results There was no definite difference in the maximal mucosal thickness between periostin-null and wild-type mice. In contrast, some parameters of inflammation, including the number of polyplike lesions and mast cells, were aggravated in the periostin-null mice compared to wild type. Eosinophilic infiltration was aggravated in the OVA-stimulated periostin-null mice, compared to OVA-stimulated wild-type mice, whereas there was no apparent difference between wild-type and periostin-null mice challenged with additional S aureus enterotoxin B. Conclusions The loss of periostin appears to enhance polyplike lesion formation and mast cell infiltration in a mouse model of eosinophilic rhinosinusitis with nasal polyps.

Backgroud: Obesity, postdiagnosis weight gain, and presence of metabolic syndrome in breast cancer are reported to adversely affect survival among breast cancer survivors. Most of the studies on weight gain and metabolic syndrome in breast cancer are from Western countries and few information is available on Asian population. We designed this prospective observational study to characterize weight and metabolic changes during adjuvant treatment in women with early breast cancer and to identify factors associated with occurrence of metabolic syndrome, focusing on dietary pattern. Methods: Patients aged 18–75 who underwent curative surgery with stage I-III invasive breast cancer were enrolled from 2008 to 2010. We measured glucose (FBS), hemoglobin A1c (HbA1c), total cholesterol (TC), HDL cholesterol, and triglyceride (TG) level in fasting serum samples before starting adjuvant therapy, at 6 months and 12 months after enrollment. Body weight, body mass index (BMI), body fat mass, and percent body fat at baseline, 6 months, and 12 months were also measured. Dietary intake was assessed using valid semi-quantitative Food frequency questionnaire (FFQ). Results: Total of 63 patients were enrolled. Median age of the enrolled patients were 48 (range, 25–68), with premenopausal/postmenopausal 40 (63.5%)/ 23 (36.5%). Fifty (82.0%) and 10 (16.4%) received adjuvant chemotherapy followed by hormone therapy and hormone therapy alone. Hormone receptor positive (ER+/PR+) and HER2 positive cancer accounted for 52 (83.9%) and 7 (12.1%). Mean FBS, HbA1c, TC, HDL, and TG level was 99.9 mg/dL (range, 83–159), 5.59 mg/dL (range, 4.8−7.5), 197.4 mg/dL (125-298), 51.9 mg/dL (range, 30–90), and 119.7 mg/dL (42-371). Mean height, weight, and BMI was 158 cm (range, 149–169), 61.7kg (range, 46.2−96.0), and 24.7 kg/m2 (range, 18.7−35.7), respectively. According to the WHO and NTH guidelines for Asian, normal (BMI 18.5−22.9), overweight (BMI 23–24.9), and obesity (BMI≥25) was 18 (28.6%), 13 (20.6%), and 32 (50.8%), respectively. Number of patients with metabolic syndrome was 18 (34%). Mean BMI (26.1 vs 24.0, p=0.021) and TG (180.6 vs 92.0, p6.0) (p=0.071). The TG level of patients who indigested high carbohydrate was significantly higher (143.8 vs 102.9, p=0.023). The HDL level of patients who took high fat diet (>20% of total calorie) was lower (45.3 vs 53.5, p=0.045). Conclusion: In our cohort of Korean breast cancer patients, 34% had metabolic syndrome at baseline. Those patients with metabolic syndrome consumed higher proportion of carbohydrate, which resulted in significantly higher level of TG. Our data suggest that composition of calorie intake is different in Asian population compared to Western countries, warranting for reappraisal on the recommendation on life style modification and diet. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-11-20.

Chronic airway inflammation is a characteristic feature of destructive cigarette smoking (CS)-induced lung disease, particularly in patients with emphysema. Celecoxib, a specific cyclooxygenase-2 (COX-2) inhibitor, is widely used to treat inflammation. However, the exact mechanisms underlying this drug's anti-inflammatory effects have not yet been determined in pulmonary emphysema. Here, we explore whether celecoxib attenuates CS-induced inflammation in rat lungs. Rats were exposed to smoke and received celecoxib via intragastric feeding daily for 20 wk. We found that celecoxib inhibited interalveolar wall distance and pulmonary inflammation in the lungs of CS-treated rats. Celecoxib inhibited serum NO production, iNOS, COX-2 expression, and PGE2production in CS-treated lung tissues. Our immunohistochemical data showed that CS-induced CD68 and COX-2 expression were inhibited by celecoxib. Furthermore, celecoxib attenuated the activation of phospho-IκBα and NF-κB in CS-treated rat lung. In addition, there was an inhibitory effect of celecoxib on the COX-2 expression and NF-κB activation in LPS-stimulated RAW 264.7 macrophages. Celecoxib also attenuated NF-κB activation in COX-2 siRNA-transfected RAW 264.7 macrophages. Thus, our findings suggest that the anti-inflammatory effects of celecoxib are mediated by its effects on NF-κB-regulated gene expression, which ultimately reduces the progression of CS-induced pulmonary emphysema.

In order to achieve the growth of traditional Chinese medicine, the chinese government has annually released "China Statistical Yearbook of Chinese Medicine" to the world since "State Administration of Traditional Chinese Medicine of the People`s Republic of China" established in 1988. It is believed that the chinese government intends to secure the early dominance of the global medical market by systematic management of its own medicine infrastructures. Although the statistics of "China Statistical Yearbook of Chinese Medicine" weren`t systematically organized at the beginning, it has becoming richer, more systematic, and more standardized in the data construction and system as time has passed. Furthermore, we can take a look at China`s effort to take the initiative of oriental medicine by expanding investment in several core areas - medicine resources, operation of medical instruments, service, medicine education, medicine science research, and working expenses. This article will show how china has been trying to develop the chinese medicine, focusing on two parts. One is specific analysis of the book "China Statistical Yearbook of Chinese Medicine". It is divided into analysis of its construction system, the degree of data construction, and its statistical system. The other is analysis of annual changes in areas of medicine resources, operation of medical instruments, service, medicine education, medicine science research, and working expenses.