Search

Determine whether the twice daily (BID) regimen is superior to the once daily (QD) regimen for managing glycemic variability by comparing the effects of anagliptin 100 mg BID versus sitagliptin 100 mg QD.A double-blinded, randomized, multicenter study was performed in 89 patients with type 2 diabetes treated with metformin alone (6.5%HbA1c 8.5%). Subjects were randomly assigned to anagliptin 100 mg BID or sitagliptin 100 mg QD in a 1:1 ratio for 12 weeks. Continuous glucose monitoring (CGM) was used to measure the mean amplitude of glycemic excursion (MAGE) and postprandial time in range (TIR) before and after DPP-4 inhibitor treatment to compare glycemic variability.The decrease from baseline in MAGE at 12 weeks after DPP-4 inhibitor treatment was significantly greater in the anagliptin BID group than in the sitagliptin QD group (p0.05); -30.4 ± 25.6 mg/dL (p0.001) in the anagliptin group versus -9.5 ± 38.0 mg/dL (p=0.215) in the sitagliptin group. The TIR after dinner increased by 33.0 ± 22.0% (p0.001) in the anagliptin group and by 14.6 ± 28.2% (p=0.014) in the sitagliptin group, with a statistically significant difference (p=0.009). No statistically significant differences were observed between the groups in the changes in HbA1c and fasting plasma glucose (FPG).The anagliptin BID regimen for the treatment of type 2 diabetes was superior in blood glucose control after dinner to improve glycemic variability, as indicated by MAGE and TIR but equivalent to the QD regimen in terms of HbA1c and FPG. This article is protected by copyright. All rights reserved.

Nano-formulated CrkII siRNA improves bone microenvironment via simultaneous regulation of the formation and function of both osteoclasts and osteoblasts.

Objective To evaluate the efficacy and safety of laparoscopic major hepatectomy for hepatocellular carcinoma patients. Summary of background data Despite the popularity of laparoscopic hepatectomy, it is still in need of further evidence to assess its safety and efficacy for the treatment of hepatocellular carcinoma. Methods From 2008 to 2017, 149 patients (laparoscopic right hepatectomy [LRH], 28 patients; open right hepatectomy [ORH], 121 patients) were included. Baseline characteristics, including tumor characteristics, perioperative outcomes, and survival outcomes, were compared between the 2 groups. For group comparisons, one-to-one propensity score matching was used to minimize selection biases. Results After one-to-one propensity score matching, 25 LRHs were compared to 25 ORHs. Operative time was significantly shorter for the ORH group than for the LRH group (mean, 322.5 versus 379.5 minutes; P = 0.015), whereas the LRH group showed less intraoperative blood loss (P = 0.02) and lower intraoperative transfusion (P = 0.02). Postoperative hospital stays were significantly shorter for the LRH group (mean, 14.5 days versus 20.2 days; P = 0.004). Overall morbidities were significantly lower in the LRH group (1:13, P = 0.00). The cumulative 1-, 3-, and 5-year overall survival rates were 100%, 92.0%, and 92.0%, respectively, for the LRH group, and 84.0%, 80.0%, and 64.0%, respectively, for the ORH group. Furthermore, the cumulative 1-, 3-, and 5-year disease-free survival rates were 96.0%, 80.0%, and 75.3%, respectively, for the LRH group, and 72.0%, 48.0%, and 40.0%, respectively, for the ORH group. The LRH group showed significantly longer disease-free survival (P = 0.009) and overall survival (P = 0.028) than the ORH group. Conclusion LRH can be safely performed for hepatocellular carcinoma. LRH was associated with more favorable oncologic outcomes.

Antigen presenting cell (APC) targeting amphiphilic cationic nanoadjuvant induced a significant antitumor immune response which supressed both primary and secondary tumor growth in TC-1 tumor model.

Novel co-operative immuno-photodynamic therapy nanoparticles, targeting tumor-associated macrophages, modulating the tumor microenvironment, and preventing tumor metastasis by skewing TAMs to M1-like cells, have been developed.

Background and Objectives The head and neck multidisciplinary team (MDT) approach plays a crucial role in bringing together the ideas of various medical professionals. This study aimed to evaluate the early characteristics of the MDT approach for head and neck cancer and analyzed patients’ satisfaction.Subjects and Method We analyzed 450 head and neck cancer patients who received MDT care from August 2014 to June 2022. Patient satisfaction with MDT care was evaluated by selfadministered questionnaires consisting of 9 questions.Results Of 450, 298 (66.2%) were male and 152 (33.8%) were female. The mean age was 60.8±14.7 year. The most common primary site was the larynx (17.3%), followed by the oral cavity and oropharynx. A total of 726 cases of the MDT approach were performed in 266 MDT sessions, and the mean number of patients per MDT session was 2.74. The number of medical professionals participating in MDT ranged from a minimum of 3 to a maximum of 9, with a mean of 5.11. The mean running time of MDT meetings per case was 19.51 minutes. The time of the 2nd MDT was significantly shorter than that of the 1st or 3rd MDT. The mean score was close to very satisfactory in each of the 9 patient satisfaction questions.Conclusion We believe that the MDT approach is feasible and recommend its introduction for the treatment of head and neck cancer as most patients have shown very high satisfaction. Further studies on the role and efficacy of MDT care for head and neck cancer are necessary.

Aims In patients with acute myocardial infarction (MI) and multivessel coronary artery disease, percutaneous coronary intervention (PCI) of non-infarct-related artery reduces death or MI. However, whether selective PCI guided by fractional flow reserve (FFR) is superior to routine PCI guided by angiography alone is unclear. The current trial sought to compare FFR-guided PCI with angiography-guided PCI for non-infarct-related artery lesions among patients with acute MI and multivessel disease. Methods and results Patients with acute MI and multivessel coronary artery disease who had undergone successful PCI of the infarct-related artery were randomly assigned to either FFR-guided PCI (FFR ≤0.80) or angiography-guided PCI (diameter stenosis of >50%) for non-infarct-related artery lesions. The primary end point was a composite of time to death, MI, or repeat revascularization. A total of 562 patients underwent randomization. Among them, 60.0% underwent immediate PCI for non-infarct-related artery lesions and 40.0% were treated by a staged procedure during the same hospitalization. PCI was performed for non-infarct-related artery in 64.1% in the FFR-guided PCI group and 97.1% in the angiography-guided PCI group, and resulted in significantly fewer stent used in the FFR-guided PCI group (2.2 ± 1.1 vs. 2.5 ± 0.9, P < 0.001). At a median follow-up of 3.5 years (interquartile range: 2.7–4.1 years), the primary end point occurred in 18 patients of 284 patients in the FFR-guided PCI group and in 40 of 278 patients in the angiography-guided PCI group (7.4% vs. 19.7%; hazard ratio, 0.43; 95% confidence interval, 0.25–0.75; P = 0.003). The death occurred in five patients (2.1%) in the FFR-guided PCI group and in 16 patients (8.5%) in the angiography-guided PCI group; MI in seven (2.5%) and 21 (8.9%), respectively; and unplanned revascularization in 10 (4.3%) and 16 (9.0%), respectively. Conclusion In patients with acute MI and multivessel coronary artery disease, a strategy of selective PCI using FFR-guided decision-making was superior to a strategy of routine PCI based on angiographic diameter stenosis for treatment of non-infarct-related artery lesions regarding the risk of death, MI, or repeat revascularization.

This study aimed to investigate how bone transparency affects loosening of the cementless femoral component by serially analyzing radiologic images in hybrid total knee arthroplasty (TKA).A total of 214 cases of TKA performed using the hybrid technique that were followed up for at least 6 years were retrospectively investigated. Bone transparency around the femoral component during the follow up period was evaluated. All TKA cases were divided into two groups and compared: those with radiologic bone transparency (bone transparency group, n = 51) and those without radiologic bone transparency (no bone transparency group, n = 163).The incidence of revision TKA in all patients was 6.1%, and obesity, preoperative and postoperative mechanical alignment did not affect surgical outcomes. All bone transparency cases were asymptomatic, and only 8/51 cases (15.7%) of bone transparency spontaneously resolved. Between the bone transparency and no bone transparency groups, there was no difference found in the preoperative and postoperative radiologic parameters and clinical outcomes. During the follow up period, there were four (1.9%) cases with a definite radiolucent line in the femoral component, all of which belonged to the bone transparency group.The bone transparency around the femoral component that appears on radiography after hybrid TKA could be an early sign of aseptic loosening; therefore, follow up serial radiography is essential.

70-weeks-old female C57BL6 senescence marker protein 30 knock out mice exhibited anorexia, lethargy and enlarged abdomen because of an intraperitoneal mass. On necropsy, the mouse revealed a large brown-whitish mass located on the mesentery. The mass also exhibited systemic metastasis and spread over in various organs. On microscopic findings, the neoplastic masses were mainly composed of neoplastic round cells characterized by severe anisokaryosis, narrow cytoplasm, round nuclei, prominent nucleoli, and numerous mitotic figures (13-15 in a 400X field). Consequently, the present case was diagnosed as a metastatic lymphoma arising from a mesenteric lymph node, the tumor spread to other organs such as the intestine, kidney and thoracic cavity. According to previous studies, SMP30 plays an important role in inhibiting cancer in both human and mouse. Taken together, it seems that the present case can be used as a valuable asset for evaluating the potential risks of SMP30 depletion in developing lymphoma.

Although several studies have focused on cancer diagnosis and therapy, prostate cancer (PC) remains an intractable disease. Androgen deprivation therapy (ADT), which is used to treat early stage PC can lead to the development of castration-resistant prostate cancer (CRPC), which is highly associated with androgen receptor (AR) mutations. Nucleolar and coiled-body phosphoprotein 1 (NOLC1) is a chaperone that shuttles between the nucleus and the cytoplasm. Studies suggest that NOLC1 regulates PC progression; however, the underlying mechanisms remain unclear. Herein, we showed that NOLC1 knockdown suppresses PC cell proliferation by altering the signaling pathways and the expression of various proteins involved in DNA replication, amino acid metabolism, and RNA processing. Mechanistically, NOLC1 knockdown suppressed cell cycle progression by inhibiting AKT phosphorylation and β-catenin accumulation. Finally, we showed that NOLC1 expression is higher in human PC than in human hyperplastic prostate tissues. Altogether, we demonstrated that NOLC1 knockdown suppresses the progression of both AR-positive and AR-negative PC cells by inducing changes in the expression of several genes leading to cell cycle arrest. Thus, NOLC1 might be a novel and promising therapeutic target for PC.

Background: Thiazolidinediones (TZDs) have been associated with various safety concerns including weight gain, bladder cancer, and congestive heart failure (CHF). This study evaluated the efficacy and safety of lobeglitazone, a novel TZD in patients with type 2 diabetes mellitus (T2DM) in real practice.Methods: In this non-interventional, multi-center, retrospective, and observational study conducted at 15 tertiary or secondary referral hospitals in Korea, a total of 2,228 patients with T2DM who received lobeglitazone 0.5 mg for more than 1 year were enrolled.Results: Overall adverse events (AEs) occurred in 381 patients (17.10%) including edema in 1.97% (n=44). Cerebrovascular and cardiovascular diseases were identified in 0.81% (n=18) and 0.81% (n=18), respectively. One case of CHF was reported as an AE. Edema occurred in 1.97% (n=44) of patients. Hypoglycemia occurred in 2.47% (n=55) of patients. Fracture occurred in 1.17% (n=26) of all patients. Lobeglitazone significantly decreased HbA1c level, resulting in a mean treatment difference of -1.05%± 1.35% (P

Triboelectric nanogenerators (TENGs) have been widely investigated to harness mechanical energy that is driven by repetitive human motion. Conventional human motion-driven TENGs are mostly based on contact–separation (CS) mode, but their energy harvesting performance is limited due to the high crest factor (the ratio of the peak to the RMS value of output voltage). Here, we demonstrate a new rolling type triboelectric nanogenerator (RL-TENG), exhibiting the lower crest factor than CS mode TENGs, using a metal layer and graphene nanoplatelets-doped PDMS. These additions helped improve the dielectric constant and the charge storage capacity of the TENG, which led to a high electrical output while minimizing surface damage. As compared to a pristine TENG, our device, a RL-TENG, generated an open-circuit peak voltage of 75.2 V, which was almost 15 times higher than that of the pristine device, and a short-circuit peak current of 7.36μA, which was 12 times higher. With a dual-side double-belt TENG (DB-TENG), these values were improved to 164 V and 10μA. Lastly, our device was used in a real-life application, to harvest mechanical energy from the movement of the human elbow while walking, and was able to produce a high voltage output of up to 821 V. These results show that the DB-TENG can be used for high-efficiency harvesting of energy from human motion.

Introduction Immature teratomas are very rare tumors, representing only 1% of ovarian cancers. Distant metastases to the liver effect late disease manifestation, rendering chemotherapy the only viable option. Case presentation Here, we report the successful surgical management of stage IVB immature teratoma after cisplatin-based chemotherapy. A 20-year-old woman presented with a huge abdominal palpable mass and dyspnea. Postoperative pathology confirmed immature teratoma with metastases to the liver, diaphragm, and thoracic cavity (stage IVB). The patient underwent right hemihepatectomy, diaphragm resection, thoracic mass resection, and diaphragm repair using aortic artificial graft. She did not receive postoperative adjuvant chemotherapy. After the complete surgical resection of the tumor, the patient had no recurrence during the 44-month follow-up period. Conclusion No established treatment modalities have been developed for further treatment, once the first-line combination chemotherapy achieves unfavorable results in stage IVB immature teratoma. Surgical resection may offer hope for excellent disease control in this dismal stage. To obtain best possible outcomes, coordinated care between oncologists and general surgeons is required.

The effectiveness of gamma knife radiosurgery (GKRS) for the management of trigeminal schwannomas (TS) has been established. Although GKRS has been shown to inhibit tumor growth, the effect of GKRS on the symptoms caused by TS has not been sufficiently studied. In this study, symptomatic changes following GKRS for the management of symptomatic TS were investigated using long-term follow-up results.A retrospective analysis was performed on 32 patients with TS who underwent GKRS between May 1994 and December 2016. Clinical charts, radiographic results, and surgical records were reviewed. To evaluate whether symptoms improved after GKRS, patient demographics, GKRS profile, radiological tumor size change, and tumor location were analyzed.Tumor control after GKRS for symptomatic TS was 87%. The improvement rates for facial pain at 6, 12, and 24 months after GKRS were 46%, 72%, and 86%, respectively. For the same time intervals, facial hypesthesia improved by 12%, 46%, and 52%, respectively. Of the patients with diplopia, 17% had improved symptoms 12 months after GKRS, and 50% of the patients improved after 24 months.GKRS can be an effective treatment modality for TS tumor control and shows favorable results in improving TS-related symptom, especially facial pain.

Heterotopic ossification is defined as the development of mature bone tissue outside normal bone. Osteomyelitis is an infection-related inflammatory disorder of the bones. Although pressure sores accompanied by heterotopic ossification have been reported, there have been no reports of osteomyelitis occurring in proximity to heterotopic ossification. Herein, we report a rare case of osteomyelitis in heterotopic ossification after trochanteric pressure sore reconstruction. We also emphasize the importance of proper diagnosis and surgical approach for this infected heterotopic ossification lesion.