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We aimed to investigate the effects of 8-week circuit weight training by intensity on blood stress hormones and antioxidant capacity in high-school wrestlers. This study involved 27 male wrestlers with >2 years of wrestling experience who were randomly assigned to either a low intensity (n=13) or a high-intensity circuit weight training group (n=14). The participants performed circuit weight training for 60 min per session, 3 times per week for 8 weeks. The low- and high-intensity circuit weight training exercises were performed at 50%-60% and 70%-80% of one-repetition maximum for 10 stations, respectively, and 8-15 repeated sessions per station were performed in order. No changes were observed in adrenocorticotropic hormone (ACTH), cortisol, epinephrine, and norepinephrine levels between the two training groups. When compared to levels before the training, ACTH and epinephrine levels decreased, whereas cortisol levels increased. However, no difference was observed in norepinephrine levels. Further, no differences were observed in malondialdehyde (MDA) and glutathione peroxidase (GPX) levels between the two groups. However, MDA and GPX levels were increased from those before training. Changes in superoxide dismutase levels were observed between the two groups, but the change was significant only in the high-intensity circuit weight training group. Long-term training did not increase lipid peroxidation, but increased the activity of antioxidant enzymes that defend against oxidative stress. The antioxidant defense system in tissues can be regulated by exercise intensity as well as physical training status., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2024 Korean Society of Exercise Rehabilitation.)

Background: Complex decongestive therapy (CDT) is being used in breast cancer-related lymphedema (BCRL). The degree of initial edema and bioimpedance analysis (BIA) are known to be related with the therapeutic effect of CDT. D-dimer can indirectly reflect lymphangiogenesis because IL-6 regulates D-dimer and vascular endothelial growth factor, which is the most important lymphangiogenic factor. We assessed whether D-dimer could be used for the prediction of therapeutic effect of CDT, as well as BIA and initial edema. Methods: The participants were patients who took inpatient treatment for BCRL from July 2016 to May 2020. Percent excess volume (PEV) was calculated by dividing the difference in volume of both arms by the edema arm, and the difference in PEV before and after 2 weeks of CDT was defined as the CDT effect. BIA and D-dimer tests were performed before treatment. Results: The single frequency bioimpedance analysis (SFBIA) ratio and D-dimer showed significant correlations with β coefficients of 0.581 and 0.402 ( p < 0.01), respectively, and the explanatory power of these models was confirmed to be 0.704.The areas under the curve of initial PEV, SFBIA ratio, D-dimer for determining the CDT effect were identified as 0.849, 0.795, and 0.725, respectively. Conclusions: Initial PEV, SFBIA ratio, and blood D-dimer levels could be used as predictors for CDT treatment effect. Their usefulness order was in the order of initial PEV, SFBIA ratio, and D-dimer. These factors could be used as predictors to establish therapeutic plan in patients with mild lymphedema.

Background: Dementia is a global public health challenge. Evidence suggests that individuals from South Asian communities are an at-risk group for dementia, partly as a result of early and cumulative exposure to known dementia risk factors, such as obesity and type 2 diabetes. There needs to be more culturally appropriate community engagement to increase awareness of dementia and identify better strategies to encourage participation in dementia-related research., Methods: We aimed to better understand the barriers and facilitators towards engaging with, and participating in, diet and dementia related research among British South Asians. This was achieved using a public and patient involvement (PPI) approach. A community-based, engagement event involving information sharing from experts and roundtable discussions with South Asian communities (n = 26 contributors) was held in June 2023 in Newcastle-upon-Tyne, UK. Collaboration from preidentified PPI representatives (n = 3) informed the content and structure of PPI activities, as well as recruitment. Data were synthesised using template analysis, a form of codebook thematic analysis. This involved deductively analysing data using relevant a priori themes, which were expanded upon, or modified, via inductive analysis., Results: The findings highlighted the importance of trust, representation and appreciation of cultural barriers as facilitators to engagement in diet and dementia risk reduction research. Consideration of language barriers, time constraints, social influences and how to embed community outreach activities were reported as driving factors to maximise participation., Conclusions: This PPI work will inform the design and co-creation of a culturally adapted dietary intervention for brain health in accordance with the Medical Research Council and National Institute for Health and Care Research guidance for developing complex interventions., (© 2024 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Breast cancer-related lymphedema (BCRL) occurs usually on the affected side, and its cause and pathophysiology are well known. However, the cause of edema of the upper extremity on the unaffected side is barely known. It is often considered to be chemotherapy-induced general edema, and clinical evaluation is rarely performed in these patients. This study aimed to present the clinical characteristics of unilateral breast cancer patients with edema of upper extremity on the unaffected side, and to emphasize the importance of early diagnosis and medical interventions. This study retrospectively analyzed the medical records of unilateral breast cancer patients complaining edema of upper extremity on the unaffected side, from January 2020 to May 2021. Lymphoscintigraphy was used to assist in confirming the diagnosis of lymphedema, and Doppler ultrasonography or 3D computed tomography angiography were performed to differentiate vascular problems. Fourteen patients were enrolled in the study. Seven, 3, and 4 patients had edema of both upper extremities, edema of the upper extremity on the unaffected side only, and edema of all extremities, respectively. None of the 4 patients with edema of all extremities showed abnormal findings on examination. In patients with edema in the upper extremity on the unaffected side alone, lymphatic flow dysfunction was seen in 2 patients, and deep vein thrombosis (DVT) was diagnosed in 1. In patients with edema of both upper extremities, lymphatic flow dysfunction was seen in 2 patients, and DVT was diagnosed in 3. One patient had DVT and accompanying lymphatic flow dysfunction. Lymphedema and DVT were diagnosed in a number of patients with edema of the upper extremity on the unaffected side, and lymphedema can occur without direct injury to the lymphatic flow system. Therefore, clinicians should not overlook the fact that diseases that require early diagnosis and treatment can occur in patients with edema of the unaffected upper extremity., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study aims to reveal the substitution impact of fish meal (FM) with the combined meat meal and chicken by-product meal (CMC) in the olive flounder ( P. olivaceus ) feeds on growth and feed availability. Seven experimental feeds were formulated. The control (CMC0) diet included 65% FM. In the CMC0 diet, the various (10%, 20%, 40%, 60%, 80%, and 100%) levels of FM were replaced with CMC, named as the CMC10, CMC20, CMC40, CMC60, CMC80, and CMC100 diets, respectively. The total number of 525 juvenile fish (9.2 ± 0.01 g; mean ± SD) was placed into 21 50-L flow-through tanks (25 juveniles/tank) with three replicates. Fish were hand-fed to apparent satiation for 8 weeks. After the 8-week feeding experiment, olive flounder fed the CMC10 (40.0 ± 0.60 g/fish, 2.99 ± 0.021%/day, and 39.57 ± 0.542 g/fish; mean ± SD), CMC20 (47.3 ± 2.58 g/fish, 3.24 ± 0.082%/day, and 45.16 ± 0.760 g/fish), and CMC40 (40.2 ± 1.17 g/fish, 3.00 ± 0.040%/day, and 39.43 ± 0.930 g/fish) diets attained superior ( p < 0.0001 for all) weight gain, specific growth rate (SGR), and feed consumption compared to olive flounder fed the CMC0 (35.1 ± 0.96 g/fish, 2.81 ± 0.039%/day, and 33.75 ± 0.544 g/fish), CMC60 (31.7 ± 1.62 g/fish, 2.66 ± 0.068%/day, and 31.60 ± 1.080 g/fish), CMC80 (24.7 ± 0.63 g/fish, 2.33 ± 0.033%/day, and 25.27 ± 0.689 g/fish), and CMC100 (17.8 ± 0.32 g/fish, 1.92 ± 0.021%/day, and 18.99 ± 0.592 g/fish, respectively) diets. Weight gain, SGR, and feed consumption of olive flounder fed the CMC60 diet were comparable to olive flounder fed the CMC0 diet. Feed efficiency and protein efficiency ratio of olive flounder fed the CMC60 diet (1.02 ± 0.007 and 1.79 ± 0.034) were comparable to fish fed the CMC0 diet (1.04 ± 0.012 and 1.85 ± 0.021, respectively). None of the plasma and serum measurements, proximate composition, amino acid profiles, or survival of olive flounder after S. iniae infection were influenced by dietary treatments. In conclusion, CMC can substitute FM up to 60% (39% FM protein in the diet) without deteriorating growth performance, feed availability, or the survival of fish after S. iniae infection., Competing Interests: The authors have no conflict of interest to declare.

We aimed to determine the association between changes in bone mineral density (BMD) of the lumbar spine, bilateral femoral necks and clinical parameters in ambulatory older adult patients with stroke who were diagnosed with osteopenia. This retrospective study included ambulatory patients older than 65 years diagnosed with stroke between January 2019 and June 2021. Osteopenia was diagnosed within 1 month after stroke diagnosis. Subsequently, follow-up BMD was performed within 12 to 14 months. The manual muscle test and modified Barthel index were measured as clinical parameters, and bone turnover markers were measured as biochemical markers. The Wilcoxon signed-rank test was used to compare whether a significant difference in the change in BMD was noted at each site measured at 1-year intervals. The BMD of the paretic and non-paretic femoral necks decreased significantly over time, but no significant change was observed in the BMD of the lumbar spine. Bone turnover markers were significantly changed at follow-up. Patients with modified Barthel index of less than 82 had significant bone loss only on the paretic side of the femoral neck. The BMD of the paretic side of the femoral neck was significantly decreased regardless of the strength of the hip and knee extensors. Although older adult patients with stroke and osteopenia can walk independently, more active osteoporosis treatment is needed to prevent bone loss and fractures, including improvement in daily living function and bilateral lower extremity strength training., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Urinary tract infections (UTI) are common in patients with stroke. The colonization of multidrug-resistant organisms (MDR) has recently become a global issue, and infection with MDR is associated with a poorer prognosis. This study aimed to investigate the uropathogenic distribution in stroke patients according to MDR colonization and investigate the infection risk and antibiotic resistance of each uropathogen to help determine initial antibiotic treatment. This study is a retrospective study conducted on patients who underwent inpatient treatment for stroke at Kosin University Gospel Hospital in 2019 to 2021. The participants were classified into Group VRE if vancomycin-resistant Enterococcus (VRE) colonization was confirmed, Group CRE if carbapenem-resistant Enterobacteriaceae (CRE) colonization was confirmed, and Group Negative if no MDR colonization was confirmed. Urine culture was performed if symptomatic UTI was suspected. Uropathogenic distribution, antibiotic resistance patterns were assessed by one-way analysis of variance, independent t-test, and Pearson chi-square test. And the infection risk factors for each uropathogen were assessed by multinomial logistic regression analysis. Six hundred thirty-three participants were enrolled. The mean age of all participants was 69.77 ± 14.91, with 305 males and 328 females, including 344 hemorrhagic strokes and 289 ischemic strokes. No growth in urine culture was the most common finding (n = 281), followed by Escherichia coli (E.coli) (n = 141), and Enterococcus spp. (n = 80). Group Negative had significantly more cases of no growth in urine culture than Group VRE (Odds ratio [OR], 11.698; 95% confidence interval [CI], 3.566-38.375; P < .001) and than Group CRE (OR, 11.381; 95% CI, 2.665-48.611; P < .001). Group VRE had significantly more E.coli (OR, 2.905; 95% CI, 1.505-5.618; P = .001), and more Enterococcus (OR, 4.550; 95% CI, 2.253-9.187; P < .001) than Group Negative. There was no statistical difference in antibiotic resistance according to MDR colonization in E coli, but for Enterococcus spp., Group VRE and CRE showed significantly more resistance to numerous antibiotics than Group Negative. MDR colonization increases the risk of UTI and is associated with greater antibiotic resistance. For appropriate administration of antibiotics in UTI, continuous monitoring of the latest trends in uropathogenic distribution is required, and clinicians should pay more attention to the use of initial empirical antibiotics in patients with MDR colonization., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study aimed to investigate the effect of a 12-week accelerated rehabilitation exercise program on isokinetic strength and dynamic balance ability of thighs in 20 adult men who underwent anterior cruciate ligament reconstruction (ACLR) or posterior cruciate ligament reconstruction (PCLR) and to analyze intergroup differences in recovery patterns. In this study, we examined 10 patients who underwent ACLR and 10 who underwent PCLR. These patients participated in an accelerated rehabilitation exercise program 5 times weekly for 12 weeks. The participants' isokinetic strength, muscular endurance, and dynamic balance ability of the femoral muscles were measured before and 12 weeks after reconstruction surgery. Isokinetic knee muscle function showed no significant difference between the ACLR and PCLR groups at 60°/sec. Both the groups demonstrated significant increases in muscle strength between the flexors and extensors. However, a between-group difference was noted in knee muscular endurance at 180°/sec, with ACLR patients showing significant differences between extensors and flexors, unlike PCLR patients. Assessment of the dynamic balance ability revealed that overall knee stability did not significantly differ between groups, and both the ACLR and PCLR groups exhibited improved dynamic balance ability. However, significant differences were found in anteroposterior and left-right stabilities. Patients who underwent ACLR had significantly improved anteroposterior and left-right stability, wherever patients who underwent PCLR showed no significant difference. This accelerated rehabilitation exercise program improved the muscle strength and muscular endurance of patients who underwent ACLR and PCLR, suggesting its potential efficacy in recovering dynamic balance ability, particularly after ACLR., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2023 Korean Society of Exercise Rehabilitation.)

To examine the effect of 10-week interval training (IT) at varying intensities on serum muscle damage indicators and antioxidant capacity and determine its effect on the 800-m records of adolescent middle-distance runners. Twenty male high-school middle-distance runners were randomized between the high-intensity IT (HIIT; n=10) and the medium-intensity IT (MIIT; n=10) groups. Three sessions/week for 10 weeks (total of 30 sessions) were performed; one session of IT was for 60 min. The high and medium exercise intensities were set at 90%-95% and 60%-70% heart rate reserve (HRR), respectively. Intensity at rest was 40% HRR for both groups. Weight training was performed at 60%-70% of one repetition maximum for two sessions/week. The changes in serum muscle damage indicators and antioxidant capacity in the two groups were measured, and their effects on the 800-m records were analyzed. The 10-week training reduced serum muscle damage indicators in middle-distance runners, but only the HIIT group displayed a decrease in creatine kinase. For the change in antioxidant capacity, the two groups demonstrated no significant change in malondialdehyde (MDA), whereas the HIIT group exhibited a significant increase in super-oxide dismutase (SOD). IT also reduced the 800-m records in middle-distance running, and the effect was stronger in the HIIT group. In conclusion, 10-week HIIT can have a positive effect on muscle damage indicators, showed a significant increase in SOD as a key indicator of anti-oxidant capacity, and improved the 800-m records in middle-distance runners., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2023 Korean Society of Exercise Rehabilitation.)

This study assessed changes in blood muscle damage indicators and DNA damage indicators in lymph and urine after 8 weeks of high-intensity intermittent running and weight training in male and female college students majoring in skiing. This study aimed to find an effective training method by investigating differences in the effectiveness between men and women. A total of 20 male and female ski major college students conducted short-term high-intensity intermittent running and weight training in the morning and afternoon, respectively, 3 days a week for 8 weeks for 24 times in total. After 8 weeks of high-intensity intermittent running and weight training, changes in DNA damage indicators in the lymph and urine and muscle damage indicators in the blood were analyzed. The creatine kinase level significantly differed at rest pre-graded exercise testing (GXT) and 60 min of recovery post-GXT after training from that before training between the male and female groups. Although lactate dehydrogenase (LDH) levels decreased in both groups over time, no significant differences in LDH were found between the two groups. Second, DNA 8-hydroxydeoxyguanosine (8-OHdG) in the lymph was significantly different between the two groups at rest pre-GXT and 60 min of recovery post-GXT. 8-OHdG in the urine was significantly lower in the female group only at 60 min of recovery post-GXT. Partial sex differences were found in the reduction of muscle damage and DNA damage after 8 weeks of high-intensity intermittent running and weight training., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest to this article was reported., (Copyright © 2022 Korean Society of Exercise Rehabilitation.)

The purpose of this study was to investigate lymphoscintigraphy pattern according to the presence or absence of axillary site radiation therapy (aRTx) in breast cancer-related lymphedema (BCRL) patients who underwent sentinel lymph node dissection (SLND). The participants were patients who visited our facility from July 2014 to June 2021 due to upper extremity edema. Among them, patients who underwent SLND after the diagnosis of breast cancer were included. The participants were divided into a group without aRTx (group A) and a group with aRTx (group B). In each patient's lymphoscintigraphy, axillary lymph node uptake (ALNU), lymphatic flow delay, dermal back flow, and the presence of any collateral pathway were checked. Thirty-three patients were enrolled. In all, 27 patients were classified in Group A, and 6 patients were classified in Group B. Between the 2 groups, we found a significant difference (P value < .05) between groups at ALNU and lymphatic flow delay. However, there was no significant difference between groups at the dermal backflow and the presence of a collateral pathway (P value > .05). And 24.2% of patients who developed lymphedema after SLND showed normal lymphoscintigraphy. In this study we suggest that SLND and aRTx affects the activity of the axillary lymph node and ultimately adversely affects lymphatic flow, becoming a risk factor for lymphedema. In addition, regardless of SLND or aRTx, lymphedema may eventually occur in the patient with normal lymphoscintigraphy., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study sought to determine whether the C-MAC video laryngoscope (VL) performed better than a direct laryngoscope (DL) when attempting endotracheal intubation (ETI) in the emergency department (ED) while wearing personal protective equipment (PPE). This was a retrospective single-center observational study conducted in an academic ED between February 2020 and March 2022. All emergency medical personnel who participated in any ETI procedure were required to wear PPE. The patients were divided into the C-MAC VL group and the DL group based on the device used during the first ETI attempt. The primary outcome measure was the first-pass success (FPS) rate. A multiple logistic regression was used to determine the factors associated with FPS. Of the 756 eligible patients, 650 were assigned to the C-MAC group and 106 to the DL group. The overall FPS rate was 83.5% (n = 631/756). The C-MAC group had a significantly higher FPS rate than the DL group (85.7% vs. 69.8%, p < 0.001). In the multivariable logistic regression analysis, C-MAC use was significantly associated with an increased FPS rate (adjusted odds ratio, 2.86; 95% confidence interval, 1.69−4.08; p < 0.001). In this study, we found that the FPS rate of ETI was significantly higher when the C-MAC VL was used than when a DL was used by emergency physicians constrained by cumbersome PPE.

The purpose of this study was to confirm the association between the serum vitamin D levels and ischemic stroke lesion size, functional ability, and cognitive function in elderly ischemic stroke patients. This study included Korean ischemic stroke patients aged 65 to 85 years. The size of the lesion was measured in brain images taken within 24 hours of hospitalization. The level of 25-(OH) Vitamin D (ng/mL), a metabolite of vitamin D, in the serum collected within 48 hours of hospitalization, and the modified Barthel index (MBI), gait performance, the muscle power of hip and knee extensors on the hemiplegic side, and mini-mental status examination (MMSE) were recorded within 1 week of the onset of the disease. Each factor was compared through correlation analysis, and the significance was confirmed using the Spearman correlation coefficient method. The association between the serum vitamin D levels and the size of the ischemic stroke lesion, the MBI, gait performance, the muscle power of hip and knee extensors on the hemiplegic side, and the MMSE were analyzed. It was confirmed that there was a significant correlation between all the factors (P < .005). In patients with serum vitamin D levels of ≥ 30 ng/mL, both the functional ability and cognitive functions were better than in patients lower than 30 ng/mL. We confirmed the lower the level of serum vitamin D levels, the larger the size of the ischemic stroke lesion when it occurred in elderly Koreans. And we confirmed that serum vitamin D levels affected the functional ability and cognitive function. And we recommend that elderly Koreans should maintain their blood vitamin D level above 30 ng/mL. We believe that this will help preserve the functional ability and cognitive function when ischemic stroke occurred., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: This retrospective observational study aimed to evaluate the lymphedema index ratio to predict the effect of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL) and to establish a lymphedema index ratio cutoff value for the extent of CDT effect. Materials and Methods: All 108 enrolled patients with BCRL underwent volume measurements and bioelectrical impedance analysis before and after CDT. The difference in percent excess volume (PEV) before and after CDT was defined as the therapeutic effect, and each patient was assigned to Groups A, B, or C based on therapeutic effects of 0%-5%, 5%-10%, and 10%-20%, respectively. Results: The mean lymphedema index ratios of Groups A, B, and C were 1.27, 1.38, and 1.46, respectively, with significant differences between the groups ( p  < 0.01). The cutoff lymphedema index ratio values for diagnosis between Groups A and B and between Groups B and C were 1.277 (sensitivity: 71.7%, specificity: 61.8%) and 1.357 (sensitivity: 76.9%, specificity: 62.1%), respectively. The Spearman coefficients for the linear relationship between lymphedema index ratio and initial PEV and between lymphedema index ratio and therapeutic effect were found to be significant at 0.615 and 0.360, respectively ( p  < 0.01). Conclusion: The results of this study found that the lymphedema index ratio may predict the volume reduction in patients with BCRL. A less reduction (therapeutic effect <5%) was predicted in patients with a lymphedema index ratio of <1.277, while a greater reduction (therapeutic effect >10%) was predicted in patients with a lymphedema index ratio of >1.357.

Comparative proteomic profiling of human follicular fluid (HFF) from polycystic ovary syndrome (PCOS) and non-PCOS patients who displayed low levels of fertility was carried out via two-dimensional gel electrophoresis (2-DE) combined with mass spectrometry. HFF, an important reproductive fluid, was used for the proteomic analysis of PCOS patients to determine the effect of PCOS on folliculogenesis. HFF was obtained from 10 women (average age, 35 years) undergoing in vitro fertilization at two hospitals. The proteins of HFF were separated using 2-DE analysis and validated by Western blot assay. Approximately 250 protein spots were separated on the 2-DE gel. Among them, the expression levels of seven proteins were found to change at least 1.5-fold in the PCOS patient group. Three protein spots, albumin, uncharacterized protein 1, and uncharacterized protein 2, were downregulated in PCOS patients. However, four protein spots, gelsolin, vitamin D binding protein, serum albumin, and complement factor B, were upregulated in PCOS patient group. These proteins may serve as a panel of potential pathological biomarkers during fertilization and oocyte development., (© 2021 International Union of Biochemistry and Molecular Biology, Inc.)

To improve the poor survival rate of lung cancer patients, we investigated the role of HDGF-related protein 3 (HRP-3) as a potential biomarker for lung cancer. The expression of endogenous HRP-3 in human lung cancer tissues and xenograft tumor models is indicative of its clinical relevance in lung cancer. Additionally, we demonstrated that HRP-3 directly binds to the E2F1 promoter on chromatin. Interestingly, HRP-3 depletion in A549 cells impedes the binding of HRP-3 to the E2F1 promoter; this in turn hampers the interaction between Histone H3/H4 and HDAC1/2 on the E2F1 promoter, while concomitantly inducing Histone H3/H4 acetylation around the E2F1 promoter. The enhanced Histone H3/H4 acetylation on the E2F1 promoter through HRP-3 depletion increases the transcription level of E2F1. Furthermore, the increased E2F1 transcription levels lead to the enhanced transcription of Cyclin E, known as the E2F1-responsive gene, thus inducing S-phase accumulation. Therefore, our study provides evidence for the utility of HRP-3 as a biomarker for the prognosis and treatment of lung cancer. Furthermore, we delineated the capacity of HRP-3 to regulate the E2F1 transcription level via histone deacetylation., (© 2021 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)

The adverse effects of radiation are proportional to the total dose and dose rate. We aimed to investigate the effects of radiation dose rate on different organs in mice. The mice were subjected to low dose rate (LDR, ~3.4 mGy/h) and high dose rate (HDR, ~51 Gy/h) radiation. LDR radiation caused severe tissue toxicity, as observed in the histological analysis of testis. It adversely influenced sperm production, including sperm count and motility, and induced greater sperm abnormalities. The expression of markers of early stage spermatogonial stem cells, such as Plzf, c-Kit, and Oct4, decreased significantly after LDR irradiation, compared to that following exposure of HDR radiation, in qPCR analysis. The compositional ratios of all stages of spermatogonia and meiotic cells, except round spermatid, were considerably reduced by LDR in FACS analysis. Therefore, LDR radiation caused more adverse testicular damage than that by HDR radiation, contrary to the response observed in other organs. Therefore, the dose rate of radiation may have differential effects, depending on the organ; it is necessary to evaluate the effect of radiation in terms of radiation dose, dose rate, organ type, and other conditions.

This study aimed to examine the changes in the blood fatigue indicators, inflammatory markers, and stress hormones following an 8-week intensity interval training in sprinters, and to investigate the effects on changes in the 100-m sprint records. Twenty sprinters from a boys' high school were equally assigned to high-intensity and medium-intensity interval training groups, and three 60-min interval training sessions were performed per week for 8 weeks, for a total of 24 sessions. Exercise intensity was defined as 85%-95% and 75%-85% of heart rate reserve for high- and medium-intensity training, respectively. At rest, both groups had an exercise intensity of 60% of the heart rate reserve. Our results showed decreased fatigue indicators, inflammatory markers, and stress hormone levels after high-intensity and medium-intensity interval training, with no difference between the training levels. In addition, the 100-m sprint records were different in high- and medium-intensity interval training groups, based on the lactate dehydrogenase and adrenocorticotropic hormone levels. In conclusion, medium-intensity interval training with a reserve heart rate of ≥75% can have a positive effect on blood fatigue indicators, inflammatory markers, and stress hormones in sprinters. Specifically, the changes in adrenocorticotropic hormone level seen in the high-intensity interval training group were found to have a significant effect on the 100-m sprinting records., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest to this article was reported., (Copyright © 2021 Korean Society of Exercise Rehabilitation.)

Abstract: To investigate the factors affecting the duration of vancomycin-resistant enterococci (VRE) colonization in stroke patients.A total of 52 stroke patients with VRE colonization were enrolled. We divided the groups into several factors and confirmed whether each factor affected VRE colonization. Independent t test, bivariate correlation analysis, and Cox proportional hazards model were used to confirm statistical significance.Among 52 patients, 28 were ischemic stroke and 24 were hemorrhagic stroke. The mean duration of the VRE colonization was 39.08 ± 44.22 days. The mean duration of VRE colonization of the ischemic stroke patients was 25.57 ± 30.23 days and the hemorrhagic stroke patients was 54.83 ± 52.75 days. The mean intensive care unit (ICU) care period was 15.23 ± 21.98 days. Independent sample t test showed the hemorrhagic stroke (P < .05), use of antibiotics (P < .01), oral feeding (P < .01) were associated with duration of VRE colonization. Bivariate correlation analysis showed duration of ICU care (P < .001) was associated with duration of VRE colonization. Cox proportional hazard model showed oral feeding (P = .001), use of antibiotics (P = .003), and duration of ICU care (P = .001) as independent factors of duration of VRE colonization.Careful attention should be given to oral feeding, duration of ICU care, and use of antibiotics in stroke patients, especially hemorrhagic stroke patients, for intensive rehabilitation at the appropriate time., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: Exercise is known to reduce proinflammatory cytokines production and apoptosis. We investigated the effect of treadmill running on spatial learning memory in terms of activation of nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathway in Alzheimer disease (AD) rats. We also evaluated the effect of treadmill running on proinflammatory cytokine production and apoptosis., Methods: Using the stereotaxic frame, amyloid-β (Aβ) was injected into the lateral ventricle of the brain. The rats belong to treadmill running groups were forced to run on a motorized treadmill for 30 minutes per a day during 4 weeks, starting 3 days after Aβ injection. Morris water maze task was done for the determination of spatial learning memory. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, immunohistochemistry for cleaved caspase-3, and western blot for NF-κB, inhibitory protein of NF-κB (IκB), MAPK signaling pathway, tumor necrosis factor (TNF)-α, interleukin (IL)-1β were done., Results: Induction of AD increased proinflammatory cytokine secretion by activating the NF-κB/MAPK signaling pathway. These changes induced apoptosis in the hippocampus and reduced spatial learning memory. In contrast, treadmill running inactivated the NF-κB/MAPK signaling pathway and suppressed proinflammatory cytokine production. These changes inhibited apoptosis and improved spatial learning memory., Conclusion: Current results showed that treadmill running promoted spatial learning memory through suppressing proinflammatory cytokine production and apoptosis via inactivation of NF-κB/MAPK signaling pathway. Treadmill exercise can be considered an effective intervention for symptom relieve of AD.

Objective: To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke., Methods: This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients' demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated., Results: There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634-0.987) and PAS scores (OR=0.205; 95% CI, 0.059-0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively., Conclusion: In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

Physical fitness tests are important to maintain and promote the health status of people. The purpose of this study was to develop health-related fitness evaluation norms according to the age and gender of Nepalese older adults. One thousand nine subjects (449 males, 560 females) above 60 years, residing in 19 wards (rural and urban) of Dhangadhi Sub-Metropolitan City participated in this study. The test included the PAR-Q (Physical Activity Readiness Questionnaire), social aspects questionnaire, blood pressure test, height, weight, BMI (body mass index), percent body fat, and four physical fitness components (grip strength, 1-minute sit-to-stand, sit and reach, and 2-minute step tests). Mean, SD, and fitness evaluation norms for each component were obtained after the main test and statistical analyses. This study showed higher BMI and percent body fat in female age groups than in male age groups. Grip strength, relative grip strength, sit-to-stand, and 2-minute steps scores were better in male age groups than in female age groups, but in contrast, flexibility was better in female age groups. This study may help the related sectors to assess physical fitness, identify fitness levels, and develop appropriate physical activities or exercise programs for older adults based on age.

To analyze the effects of 10-week combined training (aerobic and resistance exercise) in three groups that were divided according to the total exercise dose per week and elucidate its effects on insulin and leptin (lipid metabolic regulatory hormones) and metabolic syndrome index. We included 24 obese male college students with body mass index ≥25 kg/m 2 . Each 8 subjects were randomly assigned according to the total exercise dose per week into the 150-, 270-, and 450-min/wk exercise groups, which performed 50-, 90-, and 90-min exercise per day for 3, 3, and 5 times a week, respectively. To maintain a constant level of exercise intensity, aerobic exercises were performed while maintaining 60%-70% of the maximal heart rate and resistance exercise at 60%-70% load of the initial 1 repetition maximum; 1 repetition maximum was measured every 2 weeks. Training effects on lipid metabolic regulatory hormones in the blood and metabolic syndrome index according to the total exercise dose/week were analyzed. Insulin and leptin levels decreased in the 270- and 450-min/wk exercise groups but no significant difference was observed in the 150-min/wk exercise group. Waist circumference showed a significant decrease in all groups, but blood pressure did not change. Fasting blood glucose levels significantly decreased in the 270- and 450-min/wk exercise groups. Triglyceride and high-density lipoprotein-cholesterol levels significantly decreased in the 450-min/wk exercise group. Combined training with an appropriate total exercise dose may prevent diseases caused by obesity by improving energy expenditure and insulin sensitivity and triggering positive changes in glucose and lipid metabolism., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2020 Korean Society of Exercise Rehabilitation.)

Sildenafil citrate is a potent and selective inhibitor of phosphodiesterase type-5 used to treat erectile dysfunction. We investigated the effects of sildenafil citrate treatment on peripheral fatigue and exercise performance after exhaustive swimming exercise in rats. The rats in the sildenafil citrate-treated groups received sildenafil citrate orally once a day for 14 consecutive days at respective dosage. On the 14 days after starting experiment, each animal was submitted to swimming test with intensity equivalent to overload. The exhaustion was defined as a state in which coordinated movements did not return to the water surface for breathing within 10 sec. Western blot for monocarboxylate transporter (MCT)1, MCT4, and neuronal nitric oxide synthase (nNOS) were performed. Exhaustive swimming exercise decreased time of exhaustion and increased lactate concentration, however, sildenafil citrate enhanced time of exhaustion and decreased lactate concentration. Exhaustive swimming exercise increased MCT1 and MCT4 expressions in the gastrocnemius muscles and sildenafil citrate further enhanced MCT1 and MCT4 expressions in the exhaustive swimming exercise rats. Exhaustive swimming exercise decreased nNOS expression in the gastrocnemius muscles and sildenafil citrate enhanced nNOS expression in the exhaustive swimming exercise rats. The most potent effect appeared in the 20-mg/kg sildenafil citrate. Sildenafil citrate might be proposed as a potential ergogenic aid through antiperipheral fatigue., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2019 Korean Society of Exercise Rehabilitation.)

Objective: To compare the treatment effects, satisfaction with the treatment, and performance improvement following bandage treatment using the spiral method and spica method for breast cancer-related lymphedema (BCRL)., Methods: A prospective study with 46 patients with BCRL was conducted. All patients were divided into either the spiral or spica group for non-elastic bandage therapy and received the same treatment for 2 weeks, apart from the group-specific bandaging method used. For both groups, the Quality of Life Instrument score before treatment, changes in the volume of lymphedema limb and the Disability of the Arm, Shoulder, and Hand (DASH) score before and after treatment, and treatment satisfaction after treatment were compared. The Student t-test was used to compare the parameters between the two different bandage methods., Results: With respect to the treatment outcomes, total volume reduction and proximal part volume reduction after treatment were 98.0±158.3 mL and 56.0±65.4 mL in the spiral method group and 199.0±125.1 mL and 106.1±82.2 mL in the spica method group, respectively. Therefore, the spica method group showed a significantly better improvement (p<0.05). The DASH score changes after treatment showed that the spiral group score increased by 3.8±5.4 and the spica group score increased by 7.7±6.1; thus, a significantly better improvement was noted in the spica group (p<0.05)., Conclusion: The spica method indicated better volume reduction and DASH score improvement than the spiral method. Therefore, the spica method may be more effective for treating patients with BCRL.

The Fullerton Advanced Balance (FAB) scale is a multi-item balance assessment test designed to measure balance in relatively higher functioning individuals. The purpose of this study was to examine the reliability and validity of the Korean version of the FAB in children with cerebral palsy (CP). A total of 40 children with CP participated in this study. The internal consistency of the FAB was performed using the Cronbach alpha coefficient and the test-retest reliability was assessed. To verify the concurrent validity, scores on the FAB were compared with the pediatric balance scale (PBS) using the Spearman correlation coefficient. In addition, exploratory factor analysis was measured to explore the construct validity. The FAB showed satisfactory internal consistency (Cronbach's alpha value = 0.92) and excellent test-retest reliability (ICC = 0.99). Concurrent validity was positively correlated with the FAB and PBS ( r  = 0.60, p  < 0.001). Exploratory factor analysis revealed two dominant factors that explained 69.85% of the total variance of the scale. The FAB is a reliable and valid tool that can be used to measure the balance abilities in children with CP.

Sildenafil citrate, a potent and selective inhibitor of phosphodiesterase type-5, is used clinically to treat erectile dysfunction and pulmonary arterial hypertension. We investigated the effect of sildenafil citrate on brain central fatigue through serotonin (5-hydroxytryptamine, 5-HT) synthesis after exhaustive swimming exercise in rats. The rats in the sildenafil citrate-treated groups received sildenafil citrate orally once a day for 14 consecutive days at respective dosage. On the 14 days after starting experiment, each animal was submitted to swimming test with intensity equivalent to overload. The exhaustion was defined as a state in which coordinated movements did not return to the water surface for breathing within 10 sec. Immunohistochemistry for 5-HT, tryptophan hydroxylase (TPH), and western blot for serotonergic type 1A (5-HT1 A ) receptor and 5-HT transporter (5-HTT) were performed. Exhaustive swimming exercise increased 5-HT and TPH expressions in the dorsal raphe and sildenafil citrate suppressed 5-HT and TPH expressions in the exhaustive swimming exercise rats. Exhaustive swimming exercise increased 5-HT1 A receptor and 5-HTT expressions in the dorsal raphe and sildenafil citrate suppressed 5-HT1 A receptor and 5-HTT expressions in the exhaustive swimming exercise rats. The significant suppressing effect appeared in the 20-mg/kg sildenafil citrate. Sildenafil citrate might be proposed as a potential ergogenic aid through anticentral fatigue., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2019 Korean Society of Exercise Rehabilitation.)

This study aimed to investigate the effects of static rest, massage, aromatherapy, and acupoint acupressure on the levels of fatigue substances and stress hormones produced after a session of boxing sparring. The study was conducted on female adolescent boxers (n=12) who underwent four recovery methods with a 7-day rest period between each session. The order of these methods was decided randomly. Prior to each method, the participants performed five rounds of 4-min boxing sparring, and the maximal intensity was set as 70%-80% of the maximal heart rate. The effects of the four recovery methods on the blood levels of fatigue substances and stress hormones after boxing sparring were investigated. Static rest, massage, aromatherapy, and acupoint acupressure significantly decreased the lactic acid levels. The creatine phosphokinase levels decreased in the aromatherapy and acupoint acupressure groups, while the lactate dehydrogenase levels significantly decreased in the massage, aromatherapy, and acupoint acupressure groups. Further, the levels of stress hormones, cortisol, and epinephrine, showed no significant changes after massage and acupoint acupressure. However, a significant decrease in the cortisol level was observed in the aromatherapy group and an increasing trend was observed in the cortisol level in the static rest group. The adrenocorticotropic hormone level significantly decreased in the aromatherapy group and showed a decreasing trend after the participants received massage or acupoint acupressure. High-intensity exercise results in not only physical, but also psychological fatigue. Massage and aromatherapy can improve the physical and psychological stabilities and performances of athletes., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Objective: To investigate association between lesion location on magnetic resonance imaging (MRI) performed after an infarction and the duration of dysphagia in middle cerebral artery (MCA) infarction., Methods: A videofluoroscopic swallowing study was performed for 59 patients with dysphagia who were diagnosed as cerebral infarction of the MCA territory confirmed by brain MRI. Lesions were divided into 11 regions of interest: primary somatosensory cortex, primary motor cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule (PLIC), thalamus, basal ganglia (caudate nucleus), and basal ganglia (putamen). Recovery time was defined as the period from the first day of L-tube feeding to the day that rice porridge with thickening agent was prescribed. Recovery time and brain lesion patterns were compared and analyzed., Results: The mean recovery time of all patients was 26.71±16.39 days. The mean recovery time was 36.65±15.83 days in patients with PLIC lesions and 32.6±17.27 days in patients with caudate nucleus lesions. Only these two groups showed longer recovery time than the average recovery time for all patients. One-way analysis of variance for recovery time showed significant differences between patients with and without lesions in PLIC and caudate (p<0.001)., Conclusion: Injury to both PLIC and caudate nucleus is associated with longer recovery time from dysphagia.

Objective: To find out whether levels of fibrin degradation products (FDP) and D-dimer are increased in breast cancer-related lymphedema (BCRL) as in many vascular diseases. FDP and D-dimer have been used in blood tests to help differentiate deep vein thrombosis in the diagnosis of lymphedema. Levels of FDP and D-dimer are often elevated in patients with BCRL., Methods: Patients with BCRL (group I), non-lymphedema after breast cancer treatment (group II), and deep venous thrombosis (group III) from January 2012 to December 2016 were enrolled. Levels of FDP and D-dimer were measured in all groups and compared among groups., Results: Mean values of FDP and D-dimer of group I were 5.614±12.387 and 1.179±2.408 μg/μL, respectively. These were significantly higher than their upper normal limits set in our institution. Levels of FDP or D-dimer were not significantly different between group I and group II. However, values of FDP and D-dimer in group III were significantly higher than those in group I., Conclusion: Values of FDP and D-dimer were much higher in patients with thrombotic disease than those in patients with lymphedema. Thus, FDP and D-dimer can be used to differentiate between DVT and lymphedema. However, elevated levels of FDP or D-dimer cannot indicate the occurrence of lymphedema.

Type 1 and type 2 diabetes mellitus is a serious and lifelong condition commonly characterised by abnormally elevated blood glucose levels due to a failure in insulin production or a decrease in insulin sensitivity and function. Over the years, prevalence of diabetes has increased globally and it is classified as one of the leading cause of high mortality and morbidity rate. Furthermore, diabetes confers a huge economic burden due to its management costs as well as its complications are skyrocketing. The conventional medications in diabetes treatment focusing on insulin secretion and insulin sensitisation cause unwanted side effects to patients and lead to incompliance as well as treatment failure. Besides insulin and oral hypoglycaemic agents, other treatments such as gene therapy and induced β-cells regeneration have not been widely introduced to manage diabetes. Therefore, this review aims to deliver an overview of the current conventional medications in diabetes, discovery of newer pharmacological drugs and gene therapy as a potential intervention of diabetes in the future., (Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Brain inflammation is involved in many brain disorders, such as brain ischemic injury, Alzheimer diseases, and Parkinson disease. Physical exercise has been recommended for the prevention and treatment of many brain inflammatory diseases. In the present study, the effects of exercise on motor function in relation with apoptotic neuronal cell death following neuroinflammation were investigated. Moreover, we compared the effect of forced exercise with voluntary exercise on neuroinflammation-induced motor malfunction. For this study, rota-rod test, vertical pole test, foot fault test, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, immunohistochemistry for caspase-3, and western blot for Bcl-2 and Bax were performed. Lipopolysaccharide was intraventricular infused for induction of brain inflammation. Treadmill exercise and wheel exercise were conducted during 6 weeks. In the present results, Treadmill exercise and wheel exercise alleviated brain inflammation-induced motor impairments by suppressing apoptotic neuronal cell death in the motor cortex. These effects of treadmill exercise and wheel exercise were similarly appeared., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Objective: To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke., Methods: This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups., Results: The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups., Conclusion: Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.

We present the experimental results of an optimal recycling method for waste carbon fibre reinforced plastics (CFRPs) that is based on the application of a set of unit mechanochemical processes. The objectives of this study were to highlight the influence of process factors that are inherent in the chemical recycling process of waste CFRP. We investigated the influence of the soaking period, the application of a catalyst and impurities on the recycling process and recovery efficiency of the waste CFRP. Different combinations of the unit mechanochemical processes were investigated, and the effectiveness of the combination was analysed. The chemical recycling process was conducted using benzyl alcohol under ordinary pressure at initial solvent temperatures lower/equivalent to its flash point temperature. Experimental results showed that the solvent temperature increased up to boiling temperature levels when the mechanochemical process was initiated, thereby enhancing the mechanochemical process. The presence of impurities did not influence the recovery rate. Likewise, this experimental study highlighted the importance of accounting for the soaking period during the chemical recycling process: an extended soaking period resulted in a higher recovery rate, a lower portion of undissolved solids and recovered fibres of better quality. This research highlighted the significance of choosing the proper combination for the chemical recycling process as well as the benefits of recycling the waste CFRP with negligible application of the catalyst.

Objective: To investigate the differences in hyolaryngeal kinematics at rest and during swallowing in the upright sitting (UP) and the lateral decubitus (LD) postures in healthy adults, and delineating any potential advantages of swallowing while in the LD posture., Methods: Swallowing was videofluoroscopically evaluated in 20 healthy volunteers in UP and LD postures, based on the movements of hyoid bone, vocal folds, and the bolus head. Parameters included the Penetration-Aspiration Scale (PAS), horizontal and vertical displacement, horizontal and vertical initial position, horizontal and vertical peak position, time to peak position of the hyoid bone and vocal folds, and pharyngeal transit time (PTT)., Results: Nine participants were rated PAS 2 in the UP and 1 was rated PAS 2 in the LD (p=0.003) at least 1 out of 3 swallows each posture. The hyoid and vocal folds showed more anterior and superior peak and initial positions in the LD. In addition, swallowing resulted in greater vertical and smaller horizontal displacement of the hyoid in LD posture compared with UP. Time to peak position of the hyoid was shorter in LD. The maximal vertical and horizontal displacement of the vocal folds, and PTT were comparable between postures., Conclusion: The results showed that the peak and initial positions of the hyoid and larynx and the pattern of hyoid movement varied significantly depending on the body postures. This study suggests that the LD posture was one of the safe feeding postures without any increased risk compared with UP posture.

Objective: To investigate appropriate treatment time and useful bone turnover markers (BTMs) for monitoring bone turnover during the postmenopausal period, we analyzed changes of two bone resorption markers; serum carboxyterminal telopeptide of collagen I (s-CTX), urine deoxypyridinoline (u-DPD), one bone formation marker; serum osteocalcin (s-OC), and bone mineral density (BMD) in Korean postmenopausal women., Methods: Seventy-eight menopausal women were divided into three groups according to postmenopausal period: group I (0-5 years), group II (6-10 years), group III (≥10 years). All groups were subdivided into an osteoporosis group (T-score≤-2.5) and a non-osteoporosis group (T-score>-2.5). BTMs such as s-CTX, u-DPD, s-OC, and BMD (g/cm 2 ) were measured by dual-energy X-ray absorptiometry (DXA) in all patients. Analysis of variables among groups based on the postmenopausal period was performed using ANOVA., Results: There was significant negative correlation between BMD and postmenopausal period. The levels of all BTMs including s-CTX, u-DPD, and s-OC were highest in group II and the increased levels of all BTMs subsequently declined in group III. The levels of BTMs were higher in the osteoporosis groups than in the non-osteoporosis groups in all subjects. It was statistically significant that the level of s-CTX in group I was higher in the osteoporosis group than in the non-osteoporosis group., Conclusion: This study showed that bone resorption and bone formation were the highest 5-10 years after menopause, and s-CTX is more useful than u-DPD among the bone resorption markers. It's important to measure serially both BMD and BTM within 10 years after menopause for accurate diagnosis and management for postmenopausal osteoporosis.

[Purpose] The aim was to investigate the effects of university students' smoking and aerobic exercise on metabolic syndrome risk factors. [Subjects and Methods] Twenty-three male students were randomly assigned to the following groups: exercise smoker (n=6), non-exercise smoker (n=6), exercise non-smoker (n=6), and non-exercise non-smoker (n=5). A basketball exercise program was conducted three times per week (70 minutes per session) for 8 weeks with exercise intensity set at 50-80% of heart rate reserve. After 8 weeks, the variables of risk factors for metabolic syndrome were obtained. [Results] Systolic blood pressure and diastolic blood pressure were significantly decreased in the exercise non-smoker group and significantly increased in the non-exercise smoker group. Waist circumference was significantly reduced in both exercise groups regardless of smoking and significantly increased in the non-exercise smoker group. Triglyceride, high-density lipoprotein-cholesterol, and fasting plasma glucose showed no differences between the groups. [Conclusion] Obesity and smoking management should be conducted together for students as well as for those with metabolic syndrome risk factors. It is recommended that more students participate in such programs, and exercise programs should be further developed and diversified to prevent metabolic syndrome and cardiovascular diseases.

Pazopanib is a relatively new compound to be introduced into the chemotherapy field. It is thought to have decent anti-angiogenic properties, which gives an additional hope for the treatment of certain types of cancers. A systematic review solely discussing about pazopanib and its anti-angiogenic effect is yet to be published to date, despite several relevant clinical trials being conducted over the recent years. In this review, we aim to investigate the mechanism of pazopanib's anti-angiogenic effect and its effectiveness in treating several cancers. We have included, in this study, findings from electronically searchable data from randomized clinical trials, clinical studies, cohort studies and other relevant articles. A total of 352 studies were included in this review. From the studies, the effect of pazopanib in various cancers or models was observed and recorded. Study quality is indefinite, with a few decent quality articles. The most elaborately studied cancers include renal cell carcinoma, solid tumors, advanced solid tumors, soft tissue sarcoma, breast cancer and gynecological cancers. In addition, several less commonly studied cancers are included in the studies as well. Pazopanib had demonstrated its anti-angiogenic effect based on favorable results observed in cancers, which are caused by angiogenesis-related mechanisms, such as renal cell carcinoma, solid tumors, advanced solid tumors and soft tissue sarcoma. This review was conducted to study, analyze and review the anti-angiogenic properties of pazopanib in various cancers. The results obtained can provide a decent reference when considering treatment options for angiogenesis-related malignancies. Furthermore, the definite observations of the anti-angiogenic effects of pazopanib could provide newer insights leading to the future development of drugs of the same mechanism with increased efficiency and reduced adverse effects., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: To identify the usefulness of both the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) and Denver Developmental Screening Test II (DDST-II) in preterm babies with neurodevelopmental impairment, considering the detection rate as regulation of criteria., Methods: Retrospective medical chart reviews which included the Bayley-III and DDST-II, were conducted for 69 preterm babies. Detection rate of neurodevelopmental impairment in preterm babies were investigated by modulating scaled score of the Bayley-III. The detection rate of DDST-II was identified by regarding more than 1 caution as an abnormality. Then detection rates of each corrected age group were verified using conventional criteria., Results: When applying conventional criteria, 22 infants and 35 infants were detected as preterm babies with neurodevelopmental impairment, as per the Bayley-III and DDST-II evaluation, respectively. Detection rates increased by applying abnormal criteria that specified as less than 11 points in the Bayley-III scaled score. In DDST-II, detection rates rose from 50% to 68.6% using modified criteria. The detection rates were highest when performed after 12 months corrected age, being 100% in DDST II. The detection rate also increased when applying the modified criteria in both the Bayley-III and DDST-II., Conclusion: Accurate neurologic examination is more important for detection of preterm babies with neurodevelopmental impairment. We suggest further studies for the accurate modification of the detection criteria in DDST-II and the Bayley-III for preterm babies., Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Mouse embryonic stem cells (ESCs) are maintained in serum with leukemia inhibitory factor (LIF) to maintain self-renewal and pluripotency. Recently, a 2i culture method was reported using a combination of MEK inhibition (MEKi) and GSK3 inhibition (GSK3i) with LIF to maintain ESCs in a naive ground state. How 2i maintains a ground state of ESCs remains elusive. Here we show that MEKi and GSK3i maintain the ESC ground state by downregulating global DNA methylation through two distinct mechanisms. MEK1 phosphorylates JMJD2C for ubiquitin-mediated protein degradation. Therefore, MEKi increased JMJD2C protein levels but decreased DNMT3 expression. JMJD2C promotes TET1 activity to increase 5-hydroxymethylcytosine (5hmC) levels. GSK3i suppressed DNMT3 expression, thereby decreasing DNA methylation without affecting 5hmC levels. Furthermore, 2i increased PRDM14 expression to inhibit DNMT3A/B protein expression by promoting G9a-mediated DNMT3A/B protein degradation. Collectively, 2i allows ESCs to maintain a naive ground state through JMJD2C-dependent TET1 activation and PRDM14/G9a-mediated DNMT3A/B protein degradation., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

Central pontine myelinolysis (CPM) is a demyelinating disorder characterized by the loss of myelin in the center of the basis pons, and is mainly caused by the rapid correction of hyponatremia. We report the case of a young woman who presented with gait disturbance and alcohol withdrawal, and who was eventually diagnosed with CPM. Generally, the cause and pathogenesis of CPM in chronic alcoholics remain unclear. In this cases, the CPM may be unrelated to hyponatremia or its correction. However, it is possible that the osmotic pressure changes due to refeeding syndrome after alcohol withdrawal was the likely cause in this case. This case illustrates the need for avoiding hasty, and possibly incomplete diagnoses, and performing more intensive test procedures to ensure a correct diagnosis., Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Objective: To investigate the clinical characteristics that significantly contribute to a decreased bone mineral density (BMD), the BMD changes and clinical characteristics of men who experienced a stroke between the ages of 50 years and 65 years were studied between 3 months and 4 months after the stroke., Methods: Subjects had a brain hemorrhage or a cerebral infarction. Only men aged 50 years to 65 years were included to eliminate postmenopausal osteoporosis and to eliminate the influence of senile osteoporosis. All subjects underwent a BMD test between 3 months and 4 months after their strokes. Also, patients with a medication history that might have caused a secondary osteoporosis before a stroke were excluded., Results: The BMD for the lumbar spine and hemiplegic side of the femoral neck correlated significantly with the results of the manual muscle test (MMT) of the hemiplegic lower extremity and the Modified Barthel Index (MBI) score. This result suggests that the immobility from the decreased muscle strength and the weakened daily functionality might have reduced the BMD. According to a multiple linear regression analysis, the MBI score is significantly correlated with the lumbar BMD. The BMD of the hemiplegic femoral neck is significantly correlated with the MMT and the MBI score., Conclusion: This study showed that BMD monitoring should be considered in male stroke patients, especially for patients with a high dependency in daily functions and a decreased muscle strength in the hemiplegic lower extremity., Competing Interests: No potential conflict of interest relevant to this article was reported.

Water-dispersible ZnS:Mn nanocrystals were prepared by capping their surface with polar glycolic acid molecules at three different pH conditions. The produced ZnS:Mn-GA nanocrystals were characterized by XRD, HR-TEM, ICP-AES, and FT-IR spectroscopy. The optical properties were also measured by UV-Visible and room temperature photoluminescence (PL) spectroscopy. In the PL spectra, theses ZnS:Mn-GA nanocrystals showed broad emission peaks around 595 nm, and the calculated relative quantum efficiencies against an organic dye standard were in the range from 2.16 to 5.52%. The measured particle size from the HR-TEM images was about 3.7 nm on average, which were also supported by the calculations with the Debye-Scherrer methods. In addition, the surface charges of the nanocrystals were determined by an electrophoretic method, which showed pH dependent charge values of the nanocrytals: +0.88 mV (pH 2), +0.82 mV (pH 7), and -0.59 mV (pH 12) respectively. In addition, the degrees of aggregation of the nanocrystals in aqueous solutions were determined by a hydrodynamic light scattering method. As a result, formations of micrometer size agglomerates for all the ZnS:Mn-GA nanocrystals in water was observed at room temperature. This was probably caused by intermolecular attraction between the capping molecules. In addition, the ZnS:Mn-GA with the negative surface charge was presumed to be suitable for further coordination to a transition metal ion on the surface of the nanocrystal. As a result, fast luminescence quenching was observed after addition of aqueous solution containing Cu2+ ions.

Objective: To evaluate the prevalence and associated factors involved in cellulitis with lymphangitis among a group of Korean patients who were being treated for lymphedema. We present our epidemiologic research and we also report a systematic review of these types of cases., Methods: This was a retrospective medical record study among 1,246 patients diagnosed with lymphedema. The study was carried out between January 2006 and December 2012 at the Kosin University Gospel Hospital and Seoul National University Bundang Hospital. Cases were examined for onset time, affected site, seasonal trend, and recurrence pattern of lymphedema, lymphangitis, and cellulitis. We also evaluated the history of blood-cell culture and antibiotic use., Results: Ninety-nine lymphedema patients experienced complications such as cellulitis with accompanying lymphangitis. Forty-nine patients had more than two recurrences of cellulitis with lymphangitis. The incidence and recurrence of cellulitis with lymphangitis were significantly higher in the patients with lower-extremity lymphedema. There was a significant trend toward higher cellulitis prevalence in the lower-extremity lymphedema group according to the time of lymphedema onset. Among the cellulitis with lymphangitis cases, 62 cases were diagnosed through blood-cell culture; 8 of these 62 cultures were positive for β-hemolytic streptococci., Conclusion: The prevalence rate of cellulitis with lymphangitis in patients with lymphedema was 7.95%, and the prevalence of recurrent episodes was 3.93%. Especially, there was high risk of cellulitis with lymphangitis after occurrence of lower-extremity lymphedema with passage of time. Lymphedema patients should be fully briefed about the associated risks of cellulitis before treatment, and physicians should be prepared to provide appropriate preventive education.

Purpose : To observe the effects of whole-body vibration (WBV) training in conjunction with conventional physical therapy (PT) on joint-position sense (JPS), balance, and gait in children with cerebral palsy (CP). Methods: In this randomized controlled study, 24 children with CP were randomly selected either to continue their conventional PT or to receive WBV in conjunction with their conventional PT programme. Exposure to the intervention was intermittent (3 min WBV, 3 min rest) for 20 minutes, twice weekly for 3 weeks. JPS, balance, and gait were evaluated before and after treatment. Results: Ankle JPS was improved after 3 weeks of WBV training ( p =0.014). Participants in the WBV group showed greater improvements in speed ( F 1,21 =5.221, p =0.035) and step width ( F 1,21 =4.487, p =0.039) than participants in the conventional PT group. Conclusion: Three weeks of WBV training was effective in improving ankle JPS and gait variables in children with CP.

Objective: To support the establishment of lymphedema education plans and the actual practice of education by investigating the current lymphedema awareness status of Korean breast cancer patients., Methods: cross-sectional population survey was conducted in 116 breast cancer patients in the Busan-Gyeongnam area. The survey included questions regarding demographic characteristics, breast cancer-related lymphedema (BCRL) risk factors, and characteristics and treatments of the disease. Some of the items were scored to determine the level of awareness. The items that affect the awareness of lymphedema were investigated by statistical analysis., Results: Eighty-one of the 116 patients answered that they had heard of lymphedema, and 30 of them (25.86%) had received explanations about the possibility of lymphedema before surgery. Only 20 patients (17.25%) knew that lymphedema is not a completely curable disease, 24 patients (20.68%) thought that lymphedema does not require any treatment, and only 56 patients (48.27%) knew that lymphedema is treated in the Department of Rehabilitation Medicine. The main factors that affected patients' awareness of lymphedema were their age, chemotherapy, duration of breast cancer, and lymphedema treatment history., Conclusion: The majority of survey participants who were breast cancer patients either lacked awareness of BCRL or had false ideas about it, indicating the inadequate level of education provided for lymphedema. In the case of breast cancer diagnosis, early and continuous education for future management is essential, and the framework for the provision of education including education protocols related to age, disease duration, and lymphedema treatment is needed.

Skeletal muscle cell differentiation requires a family of proteins called myogenic regulatory factors (MRFs) to which MyoD belongs. The activity of MyoD is under epigenetic regulation, however, the molecular mechanism by which histone KMTs and KDMs regulate MyoD transcriptional activity through methylation remains to be determined. Here we provide evidence for a unique regulatory mechanism of MyoD transcriptional activity through demethylation by Jmjd2C demethylase whose level increases during muscle differentiation. G9a decreases MyoD stability via methylation-dependent MyoD ubiquitination. Jmjd2C directly associates with MyoD in vitro and in vivo to demethylate and stabilize MyoD. The hypo-methylated MyoD due to Jmjd2C is significantly more stable than hyper-methylated MyoD by G9a. Cul4/Ddb1/Dcaf1 pathway is essential for the G9a-mediated MyoD degradation in myoblasts. By the stabilization of MyoD, Jmjd2C increases myogenic conversion of mouse embryonic fibroblasts and MyoD transcriptional activity with erasing repressive H3K9me3 level at the promoter of MyoD target genes. Collectively, Jmjd2C increases MyoD transcriptional activity to facilitate skeletal muscle differentiation by increasing MyoD stability through inhibiting G9a-dependent MyoD degradation., (Copyright © 2015 Elsevier B.V. All rights reserved.)