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A novel β-glucosidase was purified from pumpkin (Cucurbita moschata) seed by anion exchange chromatography and gel permeation chromatography, and its molecular mass was determined to be 42.8 kDa by gel permeation chromatography. The heterodimeric structure consisting of two subunits, free from disulfide bonds, was determined by native-PAGE analysis followed by zymography. The enzyme was maximally active at pH 4.0 and 70°C, and Vmax, Km, and kcat values were 0.078 units mg−1 protein, 2.22 mM, and 13.29 min−1, respectively, employing p-nitrophenyl-β- d -glucopyranoside as the substrate. The high content of glycine determined by amino acid analysis implies that the enzyme possesses flexible conformations and interacts with cell membranes and walls in nature. Circular dichroism studies revealed that the high stability of the enzyme within the pH range of 2.0–10.0 is due to its reversible pH-responsive characteristics for α-helix–antiparallel β-sheet interconversion.

Background: Lenvatinib, an oral multikinase inhibitor, is the latest addition to the treatment options for radioactive iodine (RAI)-refractory progressive differentiated thyroid carcinoma (DTC). Th...

BACKGROUND The frequency of patients undergoing musculoskeletal surgery has been increasing with the increase in average life expectancy of the population. An aging population with sustained musculoskeletal pain and disability is the main complaint of Korean medical institutions. Recently, Korean medicine clinicians have addressed the collection and analysis of the medical utilization pattern of patients with musculoskeletal discomfort after surgery, to identify the current demographics of patients and to provide empirical evidence for Korean medicine postoperative rehabilitation strategies as well as political decisions on the healthcare coverage of Korean medicine. OBJECTIVE Overall, the aims of Korean Medicine Patient Registry of Postoperative Therapy for Musculoskeletal Disorders (KPOP-MD) are to (1) explore the general characteristics of postoperative patients with musculoskeletal discomfort and (2) evaluate the overall improvement after performing various Korean medicine treatment regimens for musculoskeletal disorders, based on a process involving the collection of nationwide registry outcomes. METHODS KPOP-MD will collaborate with 17 traditional Korean medical institutions and register postoperative patients with musculoskeletal discomfort. A total of 150 patients who meet the eligibility criteria will be registered in the study. After registration, we will collect personal health information from each patient, such as general socio-demographics, surgical site discomfort, anthropometrics, and health-related quality of life (HRQoL) at each assessment. The primary endpoint will be a change in the numeric rating scale for pain at the surgical location. The additional evaluation variables will be a change in the site-specific patient-reported questionnaires, recovery status questionnaires, other discomfort assessments, and cost data. RESULTS not applicable CONCLUSIONS This is the first prospective, multicenter, patient-based registry of postoperative patients with musculoskeletal disorders in various traditional Korean medical institutions. The results of this registry will provide valuable information on the current status of postoperative patients who receive Korean medicine treatments and evidence for reasonable decision-making in the Korean medicine healthcare system in the future. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT03842098.

This essay examines Ntozake Shange’s critique of identity politics in Sassafrass, Cypress & Indigo. The multiple foci of the novel allow Shange to examine the pitfalls of identity politics and suggest an alternative politics of identification. The stories of the elder sisters, Sassafrass and Cypress, dovetail into each other. Sassafrass struggles against the misogyny within the Black Arts Movement, while Cypress gains insight into the inhumanity at the heart of gender separatism. Indigo, the youngest, stays in the South and trains as a healer and a midwife. Indigo shows a great capacity for identification from an early age. Her violin playing serves as an intersubjective medium, allowing her to identify with and heal her listeners. This psychic process enables Indigo to forge new alliances across culturally constructed lines of identity while widening the imagination of social justice. Shange ends her novel by celebrating the everyday as the site where identities are constantly made and remade in search of a broader community.

This essay examines the sociological insight embedded in James Baldwin’s “Sonny’s Blues.” Due to Baldwin’s compelling portrayal of brotherly estrangement and the difficult process of reconc...

This article explores James Baldwin`s engagement with the generic possibilities of the essay. Theodore W. Adorno`s theorization of the essay is utilized to examine how Baldwin exploits the formal possibilities offered by the genre. In “Autobiographical Notes,” Baldwin wrests space for reflection and analysis by maximizing the essay`s antisystemic impulse. The essay as form provides Baldwin with the method necessary to counter the objectifying force of race. Baldwin furthermore merges the essay with the African American aesthetic of the cut. It is this aesthetic tradition that sensitizes Baldwin to the tension between notes and gaps, articulation and implication. This can be most clearly observed in the Paris essays. Each essay is written from a different identity position, but instead of resolving the tension created by the four essays, Baldwin demands that the readers hold multiple elements in mind. An investigation of Baldwin`s art reveals him to be a true master of the essay form, an inheritor and an innovator of the genre.

Background/Aims There have been controversial reports linking Helicobacter pylori infection to autoimmune thyroid disease (AITD). However, data regarding the relationship are limited for Asian populations, which have an extremely high prevalence of H. pylori infection. We performed this study to investigate the association between H. pylori infection and AITD in Koreans. Methods This study involved adults aged 30 to 70 years who had visited a health promotion center. A total of 5,502 subjects were analysed. Thyroid status was assessed by free thyroxine, thyroid stimulating hormone, and anti-thyroid peroxidase antibody (TPO-Ab). Immunoglobulin G (IgG) antibodies to H. pylori were measured as an indication of H. pylori infection. We compared the prevalence of TPO-Ab in subjects with and without H. pylori infection. Results H. pylori IgG antibodies were found in 2,875 subjects (52.3%), and TPO-Ab were found in 430 (7.8%). Individuals positive for H. pylori Ab were older than those negative for H. pylori Ab (p < 0.01). The proportion of females was significantly higher in the TPO-Ab positive group (41.0% vs. 64.2%, p < 0.01). Prevalence of TPO-Ab positivity was higher in subjects with H. pylori infection (8.6% vs. 7.00%, p = 0.03), and this association was significant after adjusting for age, sex, and body mass index (odds ratio, 1.02; 95% confidence interval, 1.00 to 1.03; p = 0.04). Conclusions In our study, prevalence of TPO-Ab positivity is more frequent in subjects with H. pylori infection. Our findings suggest H. pylori infection may play a role in the development of autoimmune thyroiditis.

Background: Treatment for patients with radioactive iodine (RAI)-refractory differentiated thyroid carcinoma (DTC) is challenging. Recently, two tyrosine kinase inhibitors (sorafenib and lenvatinib...

A repeat fine needle aspiration (FNA) is recommended for thyroid nodules diagnosed as atypia of undetermined significance (AUS) in a previous cytology. We evaluated the utility of NRAS codon 61 (NRAS61) mutation analysis and core needle biopsy (CNB) for the diagnosis of thyroid nodules previously diagnosed as AUS. This study enrolled 236 patients who underwent both NRAS61 mutation analysis and CNB of thyroid nodules previously diagnosed as AUS at cytology. The NRAS61 mutation was detected in 36 nodules and was more frequently detected in the AUS and follicular neoplasm (FN)/suspicious for follicular neoplasm (SFN) categories, as determined by histological analysis of CNB, than in the benign group (p = 0.005). Sixty-one patients underwent surgery, and 29 nodules were finally diagnosed as malignant after surgery. Among 61 patients who underwent surgery, nodules with the NRAS61 mutation (42-65 %) had a significantly higher malignancy rate than nodules with wild-type NRAS61 (7-37 %, p = 0.038). The association between malignancy and the NRAS61 mutation was significant after adjusting for age, sex, nodule size, and histological diagnosis of CNB (p = 0.01). NRAS61 mutation analysis together with CNB could be helpful for arriving at a clinical decision in patients with thyroid nodules showing AUS in a previous cytology.

The agricultural soil, meets soil environmental standards whereas agricultural product from the same soil does not meet permissible level of contaminants, is identified in the vicinity of the abandoned mine in Korea. This study estimated the stabilization efficiency of Cd and Pb using limestone through the flood pot test for this kind of agricultural paddy soil. We had the concentration of the monitored contaminants in soil solution for 4 months and analyzed fractionations in soil and concentrations in rice plant. In soil solution of plow layer, the reductive Mn had been detected constantly unlike Fe. The concentrations of Mn in limestone amended soil was relatively lower than that in control soil. This reveals that the reductive heavy metals which become soluble under flooded condition can be stabilized by alkali amendment. This also means that Cd and Pb associated with Mn oxides can be precipitated through soil stabilization. Pb concentrations in soil solution of amended conditions were lower than that of control whereas Cd was not detected among all conditions including control. In contaminants fractionation of soil analysis, the decreasing exchangeable fraction and the increasing carbonates fraction were identified in amended soil when compared to control soil at the end of test. These results represent the reduction of contaminants mobility induced by alkali amendment. The Cd and Pb contents of rice grain from amended soil also lower than that of control. These result seems to be influenced by reduction of contaminants mobility represented in the results of soil solution and soil fractionation. Therefore contaminants mobility (phytoavailability) rather than total concentration in soil can be important factor for contaminants transition from soil to agricultural products. Because reduction of heavy metal transition to plant depends on reduction of bioavailability such as soluble fraction in soil.

The characteristics of As and heavy metals depend on the oxidation/reduction condition of the soil environment. The mostheavy metals are immobilized by the reduction condition whereas As, Fe and Mn become more soluble. Therefore thisstudy estimated the stabilization efficiency of the agricultural paddy soil in the vicinity of the abandoned mine using aflooded column test including analysis of the soil solution, contaminants fractionation and rice grain. Limestone andsteelmaking slag were used as amendments for stabilization of the contaminated soil. In an analysis of the soil solution, themobile characteristics of Fe and Mn, which were used as electron acceptors of the microorganisms, were controlled byincreasing the pH by adding alkali amendments. This means that the contaminants combined with Fe and Mn can be stableunder flooded reduction condition. However, the concentrations of cationic heavy metals (Cd, Pb, and Zn) were alsodecreased without amendments because the carbonates produced from microbial respiration increased the pH of the soilsolution. In the amended soil, the specific sorbed fraction of As and carbonates fraction of heavy metals were increasedwhen compared to the control soil at the end of the column test. Especially in heavy metals, the increase of carbonatesfraction seems to be influenced by alkali amendments rather than microbial respiration. Because of the stabilization effect inthe flooded paddy soil, the contents of As and Zn in rice grain from amended soil were lower than that of the control soil.But additional research is needed because of the relatively higher Pb content identified in the rice grain from the amended.Key words :As, Heavy metal, Stabilization, Paddy, Rice grain

Type 2 diabetes is known to increase the risk and progression of certain types of cancer. Metformin treatment of diabetic patients is reported to have beneficial effects on some cancers. We evaluated the clinical outcome of diabetic patients with differentiated thyroid cancer (DTC) according to metformin treatment.We reviewed 943 patients diagnosed with DTC after total thyroidectomy between 1995 and 2005 in a tertiary hospital. The study involved 60 diabetic patients and 210 control patients matched for age, sex, body mass index (BMI), and tumor size.There were no differences in the clinicopathological features and disease-free survival (DFS) between diabetic patients and the control group over 8.9 years of follow-up. Of the diabetic patients with DTC, 35 patients (58%) were treated with metformin. There were no differences in age, sex, BMI, tumor size, antidiabetic medication, glycated hemoglobin, or C-peptide levels in metformin and nonmetformin groups. However, cervical lymph node (LN) metastasis was more prevalent in the metformin group than in the nonmetformin group (OR 3.52, p = 0.035). Among diabetic patients with cervical LN metastasis of DTC, the metformin subgroup (17.1 years) was associated with longer DFS than the nonmetformin subgroup (8.6 years) (HR 0.16, p = 0.021); metformin treatment was also associated with longer DFS in this subgroup in multivariate analysis after adjusting age, BMI, duration of diabetes, presence of tumor at resection margin, and serum thyroglobulin level at ablation (HR 0.03, p = 0.035).Metformin treatment is associated with low recurrence in diabetic patients with cervical LN metastasis of DTC.

Measurement of the serum thyroglobulin (Tg) level with TSH stimulation (sTg) is the cornerstone of monitoring for the recurrence or persistence of differentiated thyroid cancer (DTC) in patients who have undergone surgery and remnant ablation. However, there have been several reports that an undetectable sTg could not predict the absence of future recurrence. The aim of this study was to evaluate the long-term outcome of DTC patients who achieved biochemical remission (BR, defined as sTg1 ng/mL) after initial treatment, and to determine the role of repeated sTg measurement in detecting a clinical recurrence.This is a retrospective observational cohort study in a tertiary referral hospital. There were 1010 DTC patients who achieved BR at 12 months after the initial treatment (surgery and ablation), and they were eligible for analysis. Among them, 787 patients had values of repeated sTg.Thirteen out of 1010 (1.3%) patients had clinical recurrences during a median 84 months of follow-up. All of the clinical recurrences were limited to the cervical lymph nodes without clinical evidence of distant metastasis. Among 787 patients with available repeated sTg, 10 had clinical recurrences (5 out of 750 patients with repeated sTg1 ng/mL and 5 out of 37 patients with repeated sTg ≥ 1 ng/mL). Patients with repeated sTg ≥ 1 ng/mL had a much greater chance of disease recurrence (log-rank statistics=43.7, df=1, p0.001).About 1% of DTC patients who had sTg1 ng/mL 12 months after initial treatment had a clinical recurrence. All of clinical recurrences were loco-regional recurrences. Although repeated sTg measurement can be helpful to predict recurrence, we could not recommend it for surveillance in patients with BR due to its very low yield.

The study of security personnel and psychological empowerment and organizational commitment to investigate the relationship between prosocial behavior in 2011 in Seoul, served in the private security companies after being selected as a security guard purposive sampling method using a 300 extracted samples, but the number of cases used in the study a total of 282 people. This study SPSSWIN 18.0 using factor analysis, reliability analysis, multiple regression analysis, path analysis, the following conclusions were obtained. First, psychological empowerment on organizational commitment affects. In other words, self-determination, job performance, impact, meaning a higher level of calculation ever higher levels of commitment and affective commitment. Second, the psychological empowerment influences prosocial behavior. In other words, self-determination, meaningfulness, influence job performance higher level of customer service and increases coordination Third, organizational commitment affects the prosocial behavior. In other words, the calculation ever commitment, emotional commitment, the higher the customer service, increases the level of coordination. Fourth, psychological empowerment and organizational commitment prosocial behavior direct and indirect impacts.

With the development of tangible interface in recent years, the interest in interactive exercise games to improve health-related physical fitness has been increased. We believe that this kind of serious game should provide not only motion sensing of the action required to play sports but also a specific effectiveness of exercise. This paper will show how a serious exercise game affects theirs heart rate and preference. For the experiments, we used an exercise game named GalaxyBike for aerobics exercise which is developed by the Interaction Media Research Center of Hoseo University. In the experiments, players` heart rate was measured during the warming-up, exercise and cooling-down periods by a wireless heart-rate measuring instrument. After they played the exercise game, a survey was conducted to see how they like this serious exercise game. The findings of the study suggest that the serious exercise game providing both video game and exercise would make a contribution to the improvement of health-related physical fitness since it serves to increase the heart rate and motivation.

Some patients have elevated stimulated thyroglobulin (sTg) concentrations after reoperation for locoregionally recurrent/persistent papillary thyroid cancer (PTC). Little is known, however, about the efficacy of adjuvant radioactive iodine (RAI) therapy in these patients.The objective of the study was to evaluate the efficacy of adjuvant RAI therapy in patients with elevated sTg after reoperation for locally recurrent/persistent PTC.This was a retrospective observational cohort study in a tertiary referral hospital.We evaluated 45 consecutive patients with sTg greater than 2 ng/ml after reoperation for locoregionally recurrent PTC, all of whom had previously undergone initial total thyroidectomy followed by high-dose RAI remnant ablation. Of these 45 patients, 23 received adjuvant RAI therapy (adjuvant group) and 22 did not (control group).Main outcome measures included changes in sTg concentration after reoperation and disease-free survival.Over time, there were no significant differences in mean sTg concentration in the adjuvant (P = 0.35) and control (P = 0.74) groups. Only 15% of patients in the adjuvant group and 33% in the control group showed a greater than 50% decrease in sTg level from baseline. There were no between-group differences in changes (P = 0.83) or percent decrease (P = 0.97) in sTg concentration and no difference in clinical recurrence-free survival (P = 0.20).In patients who still have elevated sTg after reoperation for locally recurrent/persistent PTC, adjuvant RAI therapy compared with no additional RAI therapy resulted in no significant differences in the subsequent sTg changes or the recurrence-free survival.

OBJECTIVES The aim of this study was to compare ablation success and disease-free survival (DFS) on the basis of different ablation doses. METHODS This retrospective study enrolled differentiated thyroid carcinoma patients who underwent total thyroidectomy and radioactive remnant ablation at the Asan Medical Center between January 2000 and December 2004. Radioactive iodine doses of 30 mCi (group A), 80 mCi (group B), and 150 mCi (group C) were administered according to the patients' risk of recurrences based on the clinicopathologic parameters at the time of surgery. Ablation success was defined as absence of abnormal uptake on diagnostic whole-body scan. RESULTS Among 1024 patients, successful ablation was achieved in 81.7% in group A, in 89.5% in group B, and in 94.8% in group C (P

The usefulness of limestone, red mud, and furnace slag on the in situ stabilization of arsenic (As) and heavy metals was evaluated relative to different endpoints (microorganisms, plants, and humans). Individually or combined treatment of iron-rich amendments were effectively lowered the availability of trace elements. Compared to control soil, Ca(NO3)2-eatractable As, Cd, Pb, and Zn was reduced by 58%, 98%, 98%, and 99%, respectively, by combined treatment of limestone and red mud. The decreased availability of trace elements was accompanied by increased microbial activity (respiration, glucose mineralization, and soil enzyme activity) and decreased plant uptake of trace elements. Compared to non amended control soil, only 13%, 28%, 47%, and 12% of the As, Cd, Pb, and Zn, respectively, detected in combined treatment of limestone and red mud. These results suggest that iron-rich industrial by-products could be used for remediation of soils co-contaminated with metals and arsenic.

Some patients with elevated serum thyroglobulin (Tg) but a negative diagnostic whole body scan (WBS) after initial therapy for differentiated thyroid carcinoma may benefit from empirical radioactive iodine (RAI) therapy. However, previous studies enrolled patients with negative diagnostic WBS, regardless of neck ultrasonography (USG) and/or (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET), which have become the preferred diagnostic procedures in such patients.The aim of this study was to evaluate the usefulness of empirical RAI therapy in patients with elevated stimulated Tg level and negative USG/FDG-PET findings after initial therapy for papillary thyroid carcinoma (PTC).This comparative study enrolled 39 patients with elevated stimulated Tg, negative diagnostic WBS, and negative USG/FDG-PET 1 yr after initial treatment. Empirical RAI therapy was performed in 14 patients (treatment group), whereas 25 patients were followed up without therapy (control group).There was no significant between-group difference in basal clinicopathological parameters. None of the 14 patients in the treatment group showed iodine uptake on posttreatment WBS. Five of 14 patients (36%) in the treatment group and eight of 25 (32%) in the control group had recurrence during the median 37 months of follow-up (P = 0.99). Changes in serum stimulated Tg concentrations did not differ between the two groups.Empirical RAI therapy and posttreatment WBS were not useful diagnostically or therapeutically in patients with positive serum stimulated Tg if such patients had negative USG and negative FDG-PET findings after initial treatment of PTC.

Contrary to bulk material, quantum effect founded in extremely small crystals(range of nanometer). This feature comes from energy structure of nano-sized material(nano particle) has intermediated character between isolated atom and bulk material. Particularly, quantum effect is shown well in nano particles composed of semiconductor material. Quantum dot is a spherical-shaped crystal which consists of several dozens or

Summary Objective The effect of coexistent chronic lymphocytic thyroiditis (CLT) on prognosis in papillary thyroid carcinoma (PTC) patients remains controversial. We evaluated the influence of coexistent CLT on prognostic outcome and the association of coexistent CLT with clinicopathological parameters. Design A retrospective study with a median follow-up of 70 months. Patients and measurements Patients with PTC who underwent total thyroidectomy followed by 131I remnant ablation between 1995 and 2003 at Asan Medical Center, Seoul, Korea were enrolled. CLT was diagnosed histopathologically. Results Among 1441 patients, 214 (14·9%) had coexistent CLT. A greater female preponderance was noted in the patients with CLT compared with those without CLT (P

Radioiodine (I-131) therapy is of proven efficacy for treatment of differentiated thyroid carcinoma (DTC). However, loss of differentiation in recurrent or metastatic DTC which decrease I-131 uptake may decrease the efficacy of I-131 therapy. Therefore, strategies to improve I-131 uptake are mandatory. This study is an open label clinical study to evaluate the effectiveness of 13-cis retinoic acid (13-cis RA) for improving I-131 uptake in recurrent or metastatic of DTC with defective I-131 uptake. Eleven patients (Age 27-66 years, M : F=4 : 7) were given 13-cis RA (1.5 mg/kg daily for 5 weeks), followed by 200 mCi (7.4 GBq) I-131 treatment. The differences of serum thyroglobulin (Tg) level and I-131 uptake on the post-treatment whole body scan (RxWBS) were compared before and after 13-cis RA therapy. Six out of 11 patients showed significantly increased (above 50%) Tg levels just after RA therapy. However, Tg levels a year after I-131 therapy were increased, stable and decreased in 7, 2 and 1 patients, respectively. Iodine uptake on RxWBS showed marginal improvement in only 2 patients and their Tg levels after one year follow-up increased. Most frequent adverse events were dry skin and lips. 13-cis RA partially restores I-131 uptake in few patients with recurrent or metastatic DTC. The use of 13-cis RA in current protocol has only limited usefulness and is not routinely recommended as currently used protocol.

The author wishes to thank Professors Chung-In Moon, Stephan Haggard, and John C. Campbell for reviewing and providing comments on earlier versions of this paper.

Introduction The technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage, and for benign and malignant tumors. Some hypervascular skeletal metastases are prone to massive hemorrhage. Case presentation We describe the cases of two patients with thyroid carcinoma presenting with neuromuscular symptoms due to large skeletal metastases in the shoulder and sternum respectively. Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam. The procedures were technically successful in both patients without adverse effects or bleeding. Complete resections of the skeletal metastases were then performed without substantial bleeding. Conclusion Selective embolization is an effective treatment for bony metastases from thyroid cancer.

Serum thyroglobulin (Tg) is the most sensitive biomarker for recurrence of differentiated thyroid cancer (DTC). We have assessed the changing pattern of stimulated Tg (sTg) and the clinical course of patients with no structural evidence of disease (NSED), based on imaging studies such as neck ultrasonography (US), fluorodeoxyglucose positron emission tomography, and/or chest computed tomogram (CT). We sought to determine if, in patients with DTC who had been treated with bilateral thyroidectomy and remnant ablation with radioactive iodine, sTg 1 year (sTg1) after initial treatment and repeated sTg measurements, 1-2 years after sTg1, helped predict the long-term outcome with respect to structural recurrence and biochemical remission (BR), which is defined as sTg1 ng/mL.We retrospectively assessed the records of patients with DTC who had been treated with bilateral thyroidectomy and remnant ablation with radioactive iodine between 1995 and 2004. The study included 186 patients who had NSED with sTg1 ≥2 ng/mL and subsequent sTg measurements (sTg2) without additional treatment. Patients were classified into three groups based on their sTg1 measurements: Group A, 2-4.9 ng/mL; Group B, 5-19.9 ng/mL; and Group C, ≥20 ng/mL. Patients were also classified into two groups based on whether sTg2, 1-2 years after sTg1, had decreased by ≥50% (Group 1) or had either decreased by50% or increased (Group 2). sTg was measured every 1-2 years until structural recurrence or BR.Patients remaining in NSED showed a decrease in serial sTg. Of patients in Groups A, B, and C, 41%, 17%, and 1%, respectively, achieved BR, and there was a significant difference in the BR rate between Groups 1 and 2 (p0.001). In patients with structural recurrence, serial sTg generally did not decrease from sTg1. There was a significant difference in the recurrence rate among Groups A, B, and C (p=0.005) and between Groups 1 and 2 (p0.001).We found that 41% of patients with sTg1 in the range 2-5 ng/mL achieved BR, and that sTg1 and percent change of subsequent sTg were predictive of BR. Repeated sTg measurements are useful for predicting patient prognosis in patients with DTC.