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Ju Yup Lee,1,2 Mae-Ja Park3 1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea; 2Institute for Cancer Research, Keimyung University, Daegu, South Korea; 3Department of Anatomy, School of Medicine, Kyungpook National University, Daegu, South KoreaCorrespondence: Mae-Ja Park, Department of Anatomy, School of Medicine, Kyungpook National University, Daegu, South Korea, Tel/Fax +82-53-420-4802, Email mjpark@knu.ac.krPurpose: The value of serum cluster of differentiation 26 (CD26) in gastric cancer remains unknown. We investigated serum CD26 as a non-invasive serological marker for the diagnosis of gastric cancer and its relationship with serum human epidermal growth factor receptor-2 (HER2) levels.Patients and Methods: We enrolled 393 gastric cancer patients treated with endoscopic resection or surgery, and 90 healthy controls. HER2 positivity in tissue was evaluated by immunohistochemistry staining, and the serum CD26 and HER2 levels were measured using an enzyme-linked immunosorbent assay.Results: Serum CD26 levels were significantly lower in gastric cancer patients than in healthy controls (582.2 ± 254.3 vs 862.7 ± 410.6 ng/mL, P< 0.001). Serum CD26 levels were significantly lower in advanced gastric cancer compared to early gastric cancer (642.2 ± 333.9 vs 503.4 ± 332.7 ng/mL, P< 0.001), and tended to decrease with gastric cancer progression. To diagnose gastric cancer, the optimal cut-off value of serum CD26 was 762.7 ng/mL with 75.6% sensitivity and 64.4% specificity. Serum CD26 levels were weakly correlated with serum HER2 levels (rs=0.363, P< 0.001). However, no difference in serum CD26 levels was observed between tissue HER2-negative and HER2-positive gastric cancer groups (586.2 ± 362.1 vs 579.6 ± 264.8 ng/mL, P=0.898).Conclusion: CD26 is a useful non-invasive serological marker for gastric cancer diagnosis; however, its levels do not correlate with HER2 status.Keywords: gastric cancer, biomarker, CD26, HER2

Da-Young Jeong,1 Shin-Hye Kim,1 Moon Young Seo,2 Sin Young Kang,1 Mi Jung Park1 1Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea; 2Department of Pediatrics, Uijeongbu Eulji Medical Center, Gyeonggi-do, KoreaCorrespondence: Mi Jung Park; Shin-Hye KimDepartment of Pediatrics, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, KoreaTel +82 2 950 8826; +82 2 950 4823Fax +82 2 950 1245; +82 2 950 1246Email pmj@paik.ac.kr; s2635@paik.ac.krPurpose: An adverse lipid profile in adolescence often persists into adulthood, resulting in cardiovascular disease. We aimed to investigate the trends in the prevalence of adverse lipid profiles among Korean adolescents from 2007 to 2018.Patients and Methods: The data were obtained from 9044 adolescents aged 10– 19 years who participated in the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2007 to 2018. Fasting serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels were analyzed.Results: Significantly increasing trends in age-standardized prevalence of hypercholesterolemia [from 5.6% to 9.4% in boys (P = 0.004); from 8.1% to 12.4% in girls (P = 0.01)] and hyper-LDL-cholesterolemia [from 4.3% to 8.0% in boys (P = 0.003); from 6.6% to 9.7% in girls (P = 0.035)] were noted in both sexes. In contrast, the prevalence of hypo-HDL-cholesterolemia decreased significantly from 20.0% to 12.5% in boys (< 0.001) and from 12.4% to 6.9% in girls (P < 0.001). There were no significant changes in the prevalence of hypertriglyceridemia and hyper-non-HDL-cholesterolemia in both sexes. Accordingly, the overall prevalence of dyslipidemia showed only a modest decline in boys (from 31.8% to 28.7%) and a stable trend in girls (from 28.9% to 28.2%).Conclusion: The prevalence of hypercholesterolemia and hyper-LDL-cholesterolemia increased and that of hypo-HDL-cholesterolemia decreased among Korean adolescents over the recent 12 years. Further studies are needed to explain these trends and possible associations with lifestyle factors.Keywords: hypercholesterolemia, cholesterol, dyslipidemia, prevalence, KNHANES

Min Ji Park, Chan Woo Bang, Sang Youp HanDepartment of Cornea and Refractive Surgery, Busan Sungmo Eye Hospital, Busan, Republic of KoreaPurpose: To evaluate the use of the precision pulse capsulotomy (PPC) device for challenging cataract surgery cases.Patients and methods: This single-center retrospective case series study comprised of 43 eyes (from 35 patients) that were challenging cataract surgery cases with poorly dilated pupils, anterior subcapsular opacity, white cataract, brunescent cataract, and corneal opacity. This was conducted at the Busan Sungmo Eye Hospital (Busan, Republic of Korea) to assess the performance of the PPC device through a 2.2-mm clear corneal incision width, followed by the phacoemulsification technique and intracapsular intraocular lens fixation. The main outcome measurement was the anterior capsulotomy performance of the PPC device and the development of intraoperative complications. At postoperative 2 months, visual acuity, endothelial cell count, and refractive error were measured.Results: No cases of anterior capsule tears or tags occurred. All 43 eyes received circular, 360-degree, free-floating, and appropriately sized anterior capsulotomies. During 2 months of follow up, no postoperative complications occurred in association with the PPC device.Conclusion: The PPC device facilitated the creation of a precise, round, appropriately sized anterior capsulotomy in challenging cataract surgery cases. Further investigations are required to understand the long-term safety and efficacy of the PPC device.Keywords: Zepto, capsulorhexis, cataract, cataract extraction, phacoemulsification

Ji-Hoon Lee, MinA Park, Myung Jae Park, Yong Suk Jo Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, KyungHee University Hospital, Seoul, Republic of Korea Background and objective: Although depression is considered one of the comorbidities of COPD, the clinical characteristics of depression in patients with early COPD remain unknown. We aimed to use national-level data to identify the clinical features and risk factors of depression in patients with early COPD. Methods: We examined 7,550 subjects who were registered in the Korean National Health and Nutrition Examination Survey database of 2014 because that was the only year in which the Patient Health Questionnaire-9 for depression status was administered. Spirometry was used to identify patients with COPD whose forced expiratory volume in 1 second was 50% or more, and these patients were included in the analysis. Results: Of the 211 subjects with early COPD, 14.2% also had depression, whereas 85.8% did not. The patients with depression were predominantly living alone and had a greater prevalence of diabetes compared with the patients without depression. The overall quality of life of the subjects with depression was lower than that of those without depression, and only the quality of life index correlated significantly with depression severity. In the multivariate regression analysis, female sex (adjusted OR, 1.79; 95% CI, 1.38–2.31; p

Cheong-Ju Kim,1 Hyoung-Kyu Yoon,2 Myung-Jae Park,3 Kwang-Ha Yoo,4 Ki-Suck Jung,5 Jeong-Woong Park,6 Seong Yong Lim,7 Jae Jeong Shim,8 Yong Chul Lee,9 Young-Sam Kim,10 Yeon-Mok Oh,11 Song Kim,12 Chul-Gyu Yoo13 1Department of Internal Medicine, National Health Insurance System Ilsan Hospital, Koyang, 2Division of Pulmonology, Department of Internal Medicine, St Mary’s Hospital, College of Medicine, The Catholic University of Korea, 3Division of Respiratory and Critical Care Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, 4Department of Internal Medicine, Konkuk University School of Medicine, Gwangjin-gu, 5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang-si, 6Division of Pulmonary and Allergy Medicine, Gachon University Gil Medical Center, Incheon, 7Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 8Department of Internal Medicine, Korea University College of Medicine, Seoul, 9Department of Internal Medicine and Research Center for Pulmonary Disorders, Chonbuk National University Medical School, Jeonbuk, 10Department of Internal Medicine, Yonsei University College of Medicine, 11Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 12Clinical Development and Medical Affairs, Novartis Korea Ltd., Seoul, 13Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Background and objective: Pulmonary tuberculosis (TB) is a risk factor for chronic obstructive pulmonary disease (COPD); however, few clinical studies have investigated treatment effectiveness in COPD patients with destroyed lung by TB. The Indacaterol effectiveness in COPD patients with Tuberculosis history (INFINITY) study assessed the efficacy and safety of once-daily inhaled indacaterol 150 µg for the treatment of Korean COPD patients with destroyed lung by TB and moderate-to-severe airflow limitation. Methods: This was a multicenter, double-blind, parallel-group study, in which eligible patients were randomized (1:1) to receive either once-daily indacaterol 150 µg or placebo for 8 weeks. The primary efficacy endpoint was change from baseline in trough forced expiratory volume in 1 s at Week 8; the secondary endpoints included changes in transition dyspnea index score and St George’s Respiratory Questionnaire for COPD score at Week 8. Safety was evaluated over 8 weeks. Results: Of the 136 patients randomized, 119 (87.5%) completed the study treatment. At Week 8, indacaterol significantly improved trough forced expiratory volume in 1 s versus placebo (treatment difference [TD] 140 mL, P

Chin Kook Rhee,1 Jung Hyun Chang,2 Eu gene Choi,3 Hyun kuk Kim,4 Yong-Soo Kwon,5 Sun Young Kyung,6 Ji-Hyun Lee,7 Myung Jae Park,8 Kwang Ha Yoo,9 Yeon Mok Oh10 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University Medical Center, Seoul, 3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Daejeon Hankook Hospital, Daejeon, 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, 5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, 6Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center of CHA University, Seongnam, 8Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, KyungHee University Hospital, Seoul, 9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, 10Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Abstract: A new quinolone, zabofloxacin, has now been developed; hence, a non-inferiority trial is needed to compare this new compound with another widely used quinolone to examine its efficacy and safety for the treatment of chronic obstructive pulmonary disease (COPD) exacerbations. This was a prospective, multicenter, double-blind, double-dummy, randomized, controlled, parallel-group, Phase III, non-inferiority clinical trial designed to compare oral zabofloxacin (367 mg once daily for 5 days) with moxifloxacin (400 mg once daily for 7 days) for the treatment of patients with COPD exacerbation. In all, 345 COPD patients with a moderate COPD exacerbation were enrolled in the study via the outpatient clinics at 31 university hospitals. Clinical per protocol analysis revealed that the clinical cure rate for zabofloxacin was 86.7% and that for moxifloxacin was 86.3% (the rate difference, 0.4%; 95% confidence interval, –7.7%–8.6%). Intention-to-treat analysis revealed clinical cure rates of 77.1% and 77.3% (difference, –0.2%; 95% confidence interval, –9.0%–8.8%), respectively. These results confirm that zabofloxacin is not inferior to moxifloxacin. The favorable microbiological response rate for zabofloxacin was 67.4% and that for moxifloxacin was 79.5% (P=0.22). Patients in the zabofloxacin group showed better patient-oriented outcomes, as measured by EXAcerbations of Chronic Pulmonary Disease Tool-Patient-Reported Outcome and the COPD assessment test scores, than patients in the moxifloxacin group. Adverse drug reactions related to zabofloxacin occurred in 9.7% of cases and those related to moxifloxacin occurred in 9.6% of cases (P=0.97). The dropout rate due to adverse events was 0% (0/175) in the zabofloxacin group and 1.8% (3/167) in the moxifloxacin group (P=0.12). Oral zabofloxacin (367 mg once daily for 5 days) was not inferior to oral moxifloxacin (400 mg once daily for 7 days) for the treatment of patients with COPD exacerbation. Keywords: chronic obstructive pulmonary disease, exacerbation, zabofloxacin, quinolone, EXACT-PRO, CAT

Myung Joo Kang, Sang Han Park, Mean Hyung Kang, Min Jung Park, Young Wook Choi College of Pharmacy, Chung-Ang University, Seoul, Korea Background: A novel dual ligand–modified liposome, folic acid-tethered Pep-1 peptide-conjugated liposomal nanocarrier (FP-Lipo), was designed to overcome the nonselectivity of conventional penetrating peptide-tagged nanoparticulates and to provide the advantage of selective targeting of the folic acid receptor, which is frequently overexpressed on epithelial cancer cells. Methods: FP-Lipo was prepared by a sequential process of formation of a maleimide-derivatized small unilamellar vesicle, postinsertion of distearoyl phosphatidyl ethanolamine-polyethylene glycol 2000–folate to the vesicle, and Pep-1 peptide conjugation via thiol-maleimide linkage. Conformational and physical characteristics of the FP-Lipo nanocarriers were investigated for the extent of Pep-1 peptide and folic acid on the surface, vesicle size, and zeta potential. In vitro cellular uptake behaviors of the novel carrier containing a fluorescein dextran isothiocyanate probe were examined by spectrophotometry or by confocal laser scanning microscopy. Results: A novel nanocarrier bearing approximately 750 folate ligands and 100 penetrating peptides per vesicle was successfully prepared. The physical properties were as follows: 140 nm in size; 5 mV in zeta potential; less than 0.3 in polydispersity index. An in vitro cellular uptake study revealed that the FP-Lipo nanocarrier system exhibited more than twofold enhanced translocation into the folic acid receptor–positive HeLa cells compared with the single Pep-1 peptide–modified liposome. Meanwhile, its cellular association and internalization into the folic acid receptor–negative normal HaCaT cells was comparable with that of Pep-1 peptide–modified liposome. Conclusion: An advanced dual ligand-modified liposome is potentially useful for the treatment of folic acid receptor–positive tumors with high translocation capability of the penetrating peptide–modified liposome. Keywords: liposome, folic acid, Pep-1 peptide, cell-penetrating peptide, intracellular delivery, targeted delivery

Abstract Background Japanese nurses are increasingly required to read published international research in clinical, educational, and research settings. Language barriers are a significant obstacle, and online machine translation (MT) is a tool that can be used to address this issue. We examined the quality of Google Translate® (English to Japanese and Korean to Japanese), which is a representative online MT, using a previously verified evaluation method. We also examined the perceived usability and current use of online MT among Japanese nurses. Findings Randomly selected nursing abstracts were translated and then evaluated for intelligibility and usability by 28 participants, including assistants and research associates from nursing universities throughout Japan. They answered a questionnaire about their online MT use. From simple comparison of mean scores between two language pairs, translation quality was significantly better, with respect to both intelligibility and usability, for Korean-Japanese than for English-Japanese. Most respondents perceived a language barrier. Online MT had been used by 61% of the respondents and was perceived as not useful enough. Conclusion Nursing articles translated from Korean into Japanese by an online MT system could be read at an acceptable level of comprehension, but the same could not be said for English-Japanese translations. Respondents with experience using online MT used it largely to grasp the overall meanings of the original text. Enrichment in technical terms appeared to be the key to better usability. Users will be better able to use MT outputs if they improve their foreign language proficiency as much as possible. Further research is being conducted with a larger sample size and detailed analysis.

Abstract Background Research on health-education programs requires longitudinal data. Loss to follow-up can lead to imprecision and bias, and complete loss to follow-up is particularly damaging. If that loss is predictable, then efforts to prevent it can be focused on those program participants who are at the highest risk. We identified predictors of complete loss to follow-up in a longitudinal cohort study. Methods Data were collected over 1 year in a study of adults with chronic illnesses who were in a program to learn self-management skills. Following baseline measurements, the program had one group-discussion session each week for six weeks. Follow-up questionnaires were sent 3, 6, and 12 months after the baseline measurement. A person was classified as completely lost to follow-up if none of those three follow-up questionnaires had been returned by two months after the last one was sent. We tested two hypotheses: that complete loss to follow-up was directly associated with the number of absences from the program sessions, and that it was less common among people who had had face-to-face contact with one of the researchers. We also tested predictors of data loss identified previously and examined associations with specific diagnoses. Using the unpaired t-test, the U test, Fisher's exact test, and logistic regression, we identified good predictors of complete loss to follow-up. Results The prevalence of complete loss to follow-up was 12.2% (50/409). Complete loss to follow-up was directly related to the number of absences (odds ratio; 95% confidence interval: 1.78; 1.49-2.12), and it was inversely related to age (0.97; 0.95-0.99). Complete loss to follow-up was less common among people who had met one of the researchers (0.51; 0.28-0.95) and among those with connective tissue disease (0.29; 0.09-0.98). For the multivariate logistic model the area under the ROC curve was 0.77. Conclusions Complete loss to follow-up after this health-education program can be predicted to some extent from data that are easy to collect (age, number of absences, and diagnosis). Also, face-to-face contact with a researcher deserves further study as a way of increasing participation in follow-up, and health-education programs should include it.

Objective: To evaluate the risk factors affecting early diffuse recurrence within 1 year of percutaneous ultrasound-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).Methods: Out of 146 patients who received transcatheter arterial chemoembolisation (TACE) for treatment of recurrent HCC after percutaneous ultrasound-guided RFA, we selected 23 patients with early diffuse recurrence. Early diffuse recurrence was defined as three or more new recurrent HCCs within 1 year of initial RFA. As a control group, we selected 23 patients, matched exactly for age and sex, in which there was no local tumour progression or new recurrence after RFA. To analyse the risk factors, we examined patient factors and tumour factors.Results: Recurrent tumours occurred from 30 to 365 days after RFA (median time, 203 days). Univariate analysis indicated that larger tumour size and poorly defined margin were significant risk factors (P < 0.05). Multivariate analysis indicated that poorly defined margin was a significant risk factor (P < 0.05).Conclusion: Larger tumour size and poorly defined margin may be risk factors for early diffuse recurrence of HCC within 1 year of RFA. Tumours with such risk factors should be treated with a combination of TACE to minimise the potential for therapeutic failure. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of alendronate on the expression of Id genes in osteoblast differentiation.Methods: C2C12 cells were treated with alendronate for various concentrations and time periods. For evaluation of alendronate-induced osteoblast differentiation in C2C12 cells, alkaline phosphatase (ALP) activity was measured. The expression of osteoblast differentiation markers such as ALP, type-1 collagen (Col 1), and osteocalcin (OCN), and the expression of Id-1 and Id-2 were measured by RT-PCR. In order to understand the mechanism underlying the regulation of Id genes, the promoter region of the Id-1 gene was identified. Database analysis of the promoter region for Id-1 using known consensus sequences identified several putative response elements, including CCAAT/enhancer-binding protein beta (C/EBPβ).Results: Alendronate treatment significantly increased not only ALP activity but also the expression of ALP, Col 1, and OCN, Id-1 and Id-2. C/EBPβ and alendronate cooperatively increased the promoter activity and expression of Id-1.Conclusions: These results suggest that C/EBPβ-mediated Id-1 transcriptional activation may regulate alendronate-induced osteoblast differentiation of C2C12 cells. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the outcomes of small (5-10 mm), arterially enhancing nodules (SAENs) shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma (HCC) surveillance population and to determine risk factors for developing HCC.Methods: The study population included 112 patients (male:female = 100:12; aged 36-92 years) with 175 SAENs who were at risk of HCC. We evaluated serial changes during follow-up (1.4-41.8 months, mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development.Results: Of 175 SAENs, 101(57.7%) disappeared and 34(19.4%) persisted. Forty SAENs (22.9%) became HCC in 33 patients (29.5%). Presence of HCC treatment history (p = 0.005, risk ratio = 7.429), a larger size of SAEN (p = 0.003, risk ratio = 1.630), presence of coexistent HCC (p = 0.021, risk ratio = 3.777) and absence of coexistent typical arterioportal shunts (p = 0.003, risk ratio = 4.459) turned out to be independently significant risk factors for future development of HCC.Conclusion: SAENs were frequently seen in an HCC surveillance population and have a 22.9% probability of becoming HCC on a per-lesion basis. Risk increased particularly when the lesion was associated with a previous or concurrent HCC, a large size or found without a coexistent typical arterioportal shunt. [ABSTRACT FROM AUTHOR]

The antifungal effects of citral, eugenol, nerolidol and alpha-terpineol on Trichophyton mentagrophytes were investigated. Citral over 0.1 mg/ml strongly inhibited the hyphal growth of T. mentagrophytes, and the antifungal activity of alpha-terpineol was less effective. The morphological changes of the fungus exposed to the terpenes were observed by electron microscopy. The hyphae were distorted and collapsed at 0.2, 0.4 and 1 mg/ml of eugenol, nerolidol and alpha-terpineol respectively, and cell membrane and organelles were irreversibly damaged at 0.2 mg/ml citral. These suggested that four terpenes possess antifungal activity against T. mentagrophytes, and the activity might lead to irreversible cellular disruption. [ABSTRACT FROM AUTHOR]

Kaempferol, one of the phytoestrogens, is found in berries and Brassica and Allium species and is known to have antioxidative and anti-inflammatory properties. In the present study, we examined the molecular mechanisms underlying the anti-inflammation effect of kaempferol in an aged animal model. To examine the effect of kaempferol in aged Sprague-Dawley rats, kaempferol was fed at 2 or 4 mg/kg/day for 10 days. The data show that kaempferol exhibited the ability to maintain redox balance. Kaempferol suppressed nuclear factor-[kappa]B (NF-[kappa]B) activation and expression of its target genes cyclooxygenase-2, inducible nitric oxide synthase, monocyte chemoattractant protein-1, and regulated upon activation, and normal T-cell expressed and secreted in aged rat kidney and in tert-butylhydroperoxide-induced YPEN-1 cells. Furthermore, kaempferol suppressed the increase of the pro-inflammatory NF-[kappa]B cascade through modulation of nuclear factor-inducing kinase (NIK)/I[kappa]B kinase (IKK) and mitogen-activated protein kinases (MAPKs) in aged rat kidney. Based on these results, we concluded that anti-oxidative kaempferol suppressed the activation of inflammatory NF-[kappa]B transcription factor through NIK/IKK and MAPKs in aged rat kidney. [ABSTRACT FROM AUTHOR]