Search

Purpose This study aimed to report the projected cancer incidence and mortality for the year 2023 to estimate Korea’s current cancer burden.Materials and Methods Cancer incidence data from 1999 to 2020 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2021 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2023. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend.Results In total, 273,076 new cancer cases and 81,818 cancer deaths are expected to occur in Korea in 2023. The most common cancer site is expected to be the lung, followed by the thyroid, breast, colon and rectum, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and gallbladder cancers.Conclusion The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume.Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression.Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96).Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

Due to the low incidence and histologic diversity of salivary gland cancer, analyzing the incidence of salivary gland cancer is necessary to understand the macroscopic aspects. We intend to investigate the international trend of the reported incidence rate of salivary gland cancer. Using the Korea Central Cancer Registry data, the domestic change in the incidence rate was examined. As a result, a significant increasing trend was confirmed, consistent with the United States and Japan trends. The etiology of the change is unclear, and various factors that may influence the direction are reported. Additional research is needed to understand the pathophysiology of salivary gland cancer, and further efforts are required to understand salivary gland cancer.

Effective management of gout includes the following: appropriate control of gout flares; lifestyle modifications; management of comorbidities; and long-term urate-lowering therapy (ULT) to prevent subsequent gout flares, structural joint damage, and shortening of life expectancy. In addition to traditional treatments for gout, novel therapies have been introduced in recent years. Indeed, new recommendations for the management of gout have been proposed by various international societies. Although effective and safe medications to treat gout have been available, management of the disease has continued to be suboptimal, with poor patient adherence to ULT and failure to reach serum urate target. This review outlines recent progress in gout management, mainly based on the latest published guidelines, and specifically provides an update on efficient strategies for implementing treatment, efficacy and safety of specific medications for gout, and cardiovascular outcomes of ULT. In particular, we reviewed gout management approaches that can be applied to a Korean population.

SUMMARYCellular-resolution manipulation technologies like optogenetics enable so-called causal engram-cell experiments in which learning-activated neurons are tagged with a light-responsive protein (opsin) such that subsequent photostimulation elicits memory behavior. The opsin-tagged neurons are considered key neural circuit elements with photostimulation demonstrating their sufficiency for memory expression. Can the sufficiency interpretation be correct if the brain is a complex dynamical system with adaptive, non-linear, and homeostatic interactions? We find that during photostimulation of place avoidance memory-tagged neurons, mouse CA1 hippocampus activity maintains intrinsic ensemble discharge relationships and the low-dimensional manifold organization of the population dynamics. Although the photostimulation causes spatially-precise conditioned avoidance, such manipulations, are better interpreted as eliciting the endogenous population dynamics of a complex system, rather than the causal demonstration of neural circuit function.

BackgroundPhencyclidine (PCP) causes psychosis, is abused with increasing frequency, and was extensively used in antipsychotic drug discovery. PCP discoordinates hippocampal ensemble action potential discharge and impairs cognitive control in rats, but how this uncompetitive N-methyl-D-aspartate receptor (NMDAR) antagonist impairs cognition remains unknown.MethodsThe effects of PCP were investigated i) on hippocampal CA1 ensemble action potential dischargein vivoin urethane-anesthetized rats and during awake behavior in mice; ii) on synaptic responses inex vivomouse hippocampus slices; iii) in mice on a hippocampus-dependent active place avoidance task that requires cognitive control; and iv) on activating the molecular machinery of translation in acute hippocampus slices. Mechanistic causality was assessed by comparing the PCP effects to the effects of inhibitors of protein synthesis, group-1-type metabotropic glutamate receptors (mGluR1/5), and subunit-selective NMDARs.ResultsConsistent with ionotropic actions, PCP discoordinated CA1 ensemble action potential discharge. PCP caused hyperactivity, and impaired active place avoidance, despite learning the task before PCP. Consistent with metabotropic actions, PCP exaggerated protein-synthesis dependent DHPG-induced mGluR1/5-stimulated long-term synaptic depression (LTD). Pretreatment with anisomycin or the mGluR1/5-antagonist MPEP, both of which repress translation, prevented the PCP-induced discoordination, and the cognitive and sensorimotor impairments. PCP as well as the NR2A-containing NMDAR-antagonist NVP-AAM077 unbalanced translation that engages the AKT, mTOR and 4EBP1 translation machinery and increased protein synthesis, whereas the NR2B-containing antagonist Ro25-6981 did not.ConclusionsPCP dysregulates translation, acting through NR2A-containing NMDAR subtypes, recruiting mGluR1/5 signaling pathways, leading to the neural discoordination that is central to the cognitive and sensorimotor impairments.

Motor-sparing regional anesthesia modalities, such as periarticular infiltration (PAI) and pericapsular nerve group (PENG) block, have become the mainstay of multimodal approaches used during total hip arthroplasty (THA). We hypothesized that the postoperative analgesia of the PENG block was non-inferior to that of the PAI.Sixty patients were randomly allocated into two groups. The PAI group were injected with 100 mL of cocktail solution (ropivacaine 20 mL, ketorolac 2 mL, and epinephrine 1 mL mixed with normal saline) in periarticular tissues directly by the surgeon. The PENG group were injected with 30 mL of 0.5% ropivacaine in the iliopubic eminence plane by ultrasound. The primary outcome was the resting pain score 12 h after surgery, and the prespecified non-inferiority was 1. Additionally, the cumulative opioid consumption and quality of recovery were evaluated.The mean difference in pain score 12 h postoperatively between the PENG and PAI groups was 0.6 [95% confidence interval (CI): -0.8 to 2.0]. The upper 95% CI exceeded the non-inferiority margin of 1 at all postoperative time points. There was no difference in opioid consumptions and quality of recovery scores.PENG block provided comparable analgesia with PAI following THA. It is not conclusive that PENG is inferior or non-inferior to PAI based on our study.Clinical Research information Service (CRIS, https://cris.nih.go.kr, KCT0006049).

Studies on the cutting propagation of plants belonging to the genus Rhododendron are limited to R. mucronulatum and R. yedoense, which are mainly used as ornamental flowering trees, and additional studies on a greater variety of species are required. This study examined the characterisitics of cutting propagation according to treatment with growth regulators indole-3-butyric acid (IBA) and α-naphthaleneacetic acid (NAA) to generate basic data on the methods of reproducing R. micarnthum Turcz.. The number of roots (r=0.740**), length of root (r=0.844**), and number of leaves (r=0.649**) affected the rooting rate of R. micarnthum Turcz., and the number of roots (r=0.646**), length of roots (r=0.673**), number of leaves (r=0.738**), and chlorophyll content (r=0.710**) affected the survival rate. Further, the rooting and survival rates were highly correlated (r=0.794**). The growth characteristics of underground sections after growth regulator treatment were as follows: the number of formed roots was 7.0 and 7.2, and the length of roots was 6.2 cm and 5.3 cm in 150 mg·L-1 and 250 mg·L-1 NAA treatment groups, respectively. The rooting rate was 60% or above in the growth regulator treatment groups compared to that in the control group. Particularly, the rooting rates of 150 mg·L-1 and 250 mg·L-1 NAA treatment groups were 90% or above, and the latent period before rooting was shorter than other treatment groups at approximately 14 days, which was considered to be effective for root growth. The aboveground growth characteristics after propagating the cuttings showed that groups treated with 150 mg·L-1 and 250 mg·L-1 NAA showed a significantly higher plant length (5.2-5.8 cm), number of leaves (6.2 and 6.9), and leaf-length and leaf-width as compared to other treatment groups. Moreover, the survival rates of 150 mg·L-1 and 250 mg·L-1 NAA treatment groups were 80% or above, and the sound root growth manifested in the tendency of good aboveground growth. Additionally, IBA and NAA were highly correlated to the rooting and survival rates during cutting propagation of R. micarnthum Turcz.. The rooting and survival rates increased with the increase in growth regulator concentration. Particularly, NAA had a higher correlation to the rooting and survival rates than IBA (r=0.7316**, 0.7013**). Thus, R. micarnthum Turcz. could be propagated through cutting. Growth regulator treatment with 150 mg·L-1 and 250 mg·L-1 of NAA was effective for rooting and root growth of cutting, and these treatments were considered appropriate because the effects of aboveground growth were positive.

This study investigated the effects of a brief video intervention on attitudes toward counseling services. Two hundred and seventy-seven participants were divided into four groups (anxious-preoccupied, dismissive-avoidant, fearful-avoidant, and secure) by their attachment scores. Then, the participants of each group were randomly assigned to three conditions (stigma-reducing, utility-enhancing, and control). A split-plot factorial design was performed to examine the intervention effects. The results indicate that the stigma-reducing video intervention was more effective for the anxious-preoccupied group, whereas the utility-enhancing video intervention was more effective for the dismissive-avoidant group than other groups. These results suggest the importance of implementing strategies tailored to each attachment group.

Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs).Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression.Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS.Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

Heart failure (HF) is a frequent consequence of myocardial infarction (MI). Identification of the precise, time-dependent composition of inflammatory cells may provide clues for the establishment of new biomarkers and therapeutic approaches targeting post-MI HF. Here, we investigate the spatiotemporal dynamics of MI-associated immune cells in a mouse model of MI using spatial transcriptomics and single-cell RNA-sequencing (scRNA-seq). We identify twelve major immune cell populations; their proportions dynamically change after MI. Macrophages are the most abundant population at all-time points (>60%), except for day 1 post-MI. Trajectory inference analysis shows upregulation of Trem2 expression in macrophages during the late phase post-MI. In vivo injection of soluble Trem2 leads to significant functional and structural improvements in infarcted hearts. Our data contribute to a better understanding of MI-driven immune responses and further investigation to determine the regulatory factors of the Trem2 signaling pathway will aid the development of novel therapeutic strategies for post-MI HF.

Background/aims Because ankylosing spondylitis (AS) mainly affects sacroiliac joints, special attention should be given to normal labour and pregnancy outcomes. Here, we investigate pregnancy outcomes in Korean women with AS. Methods Based on data from the Korean Health Insurance Review and Assessment Service claims database since July 2007, maternal complications were compared between women with AS and 1:10 matched general population by maternal age and year of delivery. Additionally, the 27 deliveries from 21 patients with AS who were seen at a tertiary hospital were retrospectively evaluated using 1:4 matched control group by maternal and gestational age. Results In the population-based cohort, there were 1,293 deliveries in 996 patients with AS. Higher maternal age and more comorbidities were reported than in the general population. However, compared to age and delivery-year matched population, only the rate of Caesarean section (CS) was higher in women with AS (odds ratio, 1.52; 95% confidence interval, 1.36 to 1.70). Incidence of other maternal complications was comparable between women with AS and control subjects. In the hospital-based cohort, the CS rate was higher in women with AS (44.4% vs. 20.4%, p = 0.002). Causes of CS was not different in both groups, including previous uterine surgery. There were no significant differences in foetal outcomes, including growth restriction, foetal malformations and Apgar score. Conclusion CS deliveries were performed more often in women with AS. However, other maternal complications and offspring complications were similar between women with AS and healthy control subjects.

The present study compared the effects of pectoral nerve block II (PECS II) and erector spinae plane (ESP) block for postoperative analgesia in patients who underwent modified radical mastectomy by performing a network meta-analysis (NMA) using indirect comparison with systemic analgesia. Studies comparing the analgesic effects of PECS II and ESP block were searched on MEDLINE, PubMed, EMBASE and the Cochrane Library. The primary outcome of this study was cumulative opioid consumption for 24 h postoperatively. Pain score during this period was also assessed. NMA was performed to compare the postoperative analgesic effects of plane blocks and systemic analgesia. A search of databases identified 17 studies, with a total of 1069 patients, comparing the analgesic efficacies of PECS II block, ESP block, and systemic analgesia. Compared with systemic analgesia, mean difference of opioid consumption was − 10 mg (95% credible interval [CrI] − 15.0 to − 5.6 mg) with PECS II block and − 5.7 mg (95% CrI − 11.0 to − 0.7 mg) with ESP block. Relative to systemic analgesia, PECS II block showed lower pain scores over the first postoperative 24 h, whereas ESP block did not. PECS II block showed the highest surface under the cumulative ranking curves for both opioid consumption and pain score. Both PECS II and ESP blocks were shown to be more effective than systemic analgesia regarding postoperative analgesia following modified radical mastectomy, and between the two blocks, PECS II appeared to have favorable analgesic effects compared to ESP block.

Objectives To investigate longitudinal changes of the EULAR SS Patient-Reported Index (ESSPRI) and EULAR SS Disease Activity Index (ESSDAI), and identify factors associated with patient acceptable symptom state (PASS) in patients with primary SS (pSS). Methods We assessed ESSPRI, ESSDAI, clinical ESSDAI (ClinESSDAI), EULAR Sicca Score, EuroQoL 5-dimension (EQ-5D), Fatigue Severity Score, Beck Depression Inventory, and patient global assessment (PGA) for pSS, and visual analogue scale (VAS) scores for glandular and extra-glandular symptoms at baseline and follow-up. The responses to the currently available standards of care were evaluated by the PASS, the minimal clinically important improvement (MCII) of ESSPRI and ESSDAI, and a modified SS Responder Index-30 (mSSRI-30) response. Results Among 115 patients enrolled, 102 (88.7%) completed a median 3-year follow-up. The ESSPRI, ClinESSDAI and EQ-5D levels remained stable, although the PGA and ESSDAI significantly improved (both P Conclusion Although longitudinal changes in ESSPRI and ClinESSDAI are stable in pSS, baseline ESSPRI and ESSDAI could provide prognostic information on the subsequent achievement of PASS, using currently available treatments. A categorization model using ESSPRI and ESSDAI may have clinical implications.

This study was conducted to investigate the effects of boiling water, sulfuric acid, and KOH as a pretreatment to improve the germination of two Acacia species, Acacia floribunda and Acacia retinodes. In the case of boiling water, the seeds were immersed at 80°C and 100°C for 30 minutes and 60 minutes, respectively. For sulfuric a cid, t he s eeds w ere immersed a t 50% a nd 98% concentrations for 10, 20, and 40 minutes, respectively. For KOH, the seeds were immersed in 15%, 20%, and 25% concentrations for 10, 20, and 30 minutes, respectively. Seed germination characteristics such as germination percentage, germination energy, germination rate, mean daily germination, and mean germination time were investigated. For A. floribunda, the boiling water showed higher germination percentages than the control (16.0%), with the highest germination percentage observed for 84.0% at 100°C for 5 minutes. This resulted in good germination energy, germination rate, and mean daily germination, but mean germination time was lower than the control. When exposed to sulfuric acid, the control showed a germination percentage of 30.0%, with the highest germination percentage measured at 76.0% in 98%sulfuric acid for 40 minutes. In the case of A. retinodes, boiling water at 80°C for 30 minutes showed the highest germination percentage of 68.0%, compared to the control (20.0%). The germination energy, germination rate, mean daily germination, and mean germination time were also better than the control. The highest germination percentage was 49.3% when exposed to a 98% sulfuric acid solution for 40 minutes. The germination percentages when exposed to KOH were found to be 36% in a 15% KOH solution for 10 minutes in A. floribunda, and 34.6% in A. retinodes in a 15% KOH solution and in a 25% KOH solution for 10 minutes, respectively, but there was no effect compared to the control. The results of this study suggest that boiling water pretreatments are the most suitable for enhancing the germination percentage of A. floribunda and A. retinodes.

The use of magnetic resonance imaging (MRI) and positron emission tomography (PET) in rheumatology allows a better understanding of the pathophysiology of the disease as well as early diagnosis and appropriate evaluation of the disease status and treatment responses. Despite the limited availability because of the high cost, there is growing evidence for the advantages and clinical application of these modalities to various rheumatic diseases. This review discusses the basic mechanisms and clinical applications of MRI and PET in certain rheumatic diseases, including rheumatoid arthritis, axial spondyloarthritis, idiopathic inflammatory myopathies, large vessel vasculitis, central nervous system disease associated with rheumatic diseases, polymyalgia rheumatica, adult-onset Still’s disease, and immunoglobulin G4-related disease. (J Rheum Dis 2020;27:136-151)

In this population-based cohort study on comparative osteoporotic fracture risks between different biologic disease-modifying drugs among patients with rheumatoid arthritis (RA), we did not find a significant difference in the risk of osteoporotic fractures between RA patients receiving TNF inhibitors versus abatacept or tocilizumab. We aimed to investigate the comparative risk of osteoporotic fractures between rheumatoid arthritis (RA) patients who initiated TNF inhibitors (TNFis) versus abatacept or tocilizumab. Using the Korea National Health Insurance Service datasets from 2002 to 2016, RA patients who initiated TNFis, abatacept, or tocilizumab were identified. The primary outcome was a composite end point of non-vertebral fractures and hospitalized vertebral fractures; secondary outcomes were two components of the primary outcome and fractures occurring at the humerus/forearm. Propensity score (PS) matching with a variable ratio up to 10 TNFi initiators per 1 comparator drug initiator was used to adjust for > 50 baseline confounders. We estimated hazard ratios (HRs) and 95% confidence interval (CI) of fractures comparing TNFi initiators to abatacept and to tocilizumab by Cox proportional hazard models stratified by a matching ratio. After PS-matching, 2307 TNFi initiators PS-matched on 588 abatacept initiators, and 2462 TNFi initiators on 640 tocilizumab initiators were included. A total of 77 fractures occurred during a mean follow-up of 454 days among TNFi and abatacept initiators and 83 fractures during 461 days among TNFi and tocilizumab initiators. The PS-matched HR (95% CI) was 0.91 (0.48–1.71) comparing TNFi versus abatacept initiators, and 1.00 (0.55–1.83) comparing TNFi versus tocilizumab initiators. Analysis on vertebral and non-vertebral fractures showed similar results. In this nationally representative cohort, we did not find a significant difference in the risk of fractures between TNFi initiators versus abatacept or tocilizumab among RA patients.

Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting primarily joints and an increased risk of developing malignant lymphomas in RA has been well reported. However, primary lymphoma in a joint in RA patient is rare. We report the case of a 65-year-old man with RA suffering from pain and swelling of left sternoclavicular (SC) joint, which was not relieved by adding low-dose glucocorticoid. Magnetic resonance imaging (MRI) showed a para-osseous soft tissue swelling around the SC joint and a fracture of proximal clavicle. Histology of the soft tissue demonstrated diffuse large B-cell lymphoma and the patient subsequently underwent R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy. He was successfully treated with six cycles of R-CHOP chemotherapy, with discontinuation of MTX, resulting in a complete response. We performed a literature review and identified nine cases of lymphoma which involved joints in patients with rheumatoid arthritis. This is the first described case of a primary large B-cell lymphoma involving the unilateral SC joint in a patient with RA, which was initially confused with aggravation of RA. Therefore, malignant lymphoma should be considered in the differential diagnosis when a RA patient develops monoarthritis with spontaneous fracture, even without B symptoms.

본 연구의 목적은 무용연구는 물론이고 관련 법제에서도 중요한 ‘무용가 정의’에 대해 탐색하는 것이다. 이를 위해 학술연구와 제도에 나타난 담론을 살펴보고, 국내 무용연구자들이 생각하는 무용가의 정의에 대해 알아보 았다. 연구방법으로는 광범위한 문헌조사와 심층면접을 활용하였다. 그 결과, 첫째, 학술담론 속에서의 무용가 는 명확한 정의보다 암묵적 합의에 의해 다루어지고 있었다. 둘째, 예술가의 지위와 권리를 보장해 주어야 한 다는 사회적 합의에 따라 무용가 역시 제도에 포함되고 있었으며, 공연활동을 하는 실기무용가들이 중심에 위 치해 있는 것으로 나타났다. 셋째, 무용전문연구자들은 사회문화의 변화에 따라 무용가정의에도 변화가 있어야 한다는 데 동의하면서도, 제도와 관련해서는 비상업적인 예술활동에 집중하는 무용가들을 우선적으로 수용해 야 한다고 주장하는 것으로 나타났다. 본 연구는 그동안 간과되어온 무용가정의에 대한 본격적 연구임과 동시 에 관련 법제마련을 위한 초석이라는 점에서 의의를 지닌다.

Current stem cell-based therapy for cardiac repair and regeneration after myocardial infarction (MI) is not readily translatable into clinical scenarios due to the low retention and survival of the transplanted cells. Here, we evaluated a simple and feasible design of gelatin-hydroxyphenyl propionic acid (GH) hydrogel as an in situ cross-linkable and injectable cell delivery platform for cardiac tissue regeneration. The GH hydrogel exhibited improved cell retention and survival in vitro and in vivo when encapsulating mouse bone marrow-derived mesenchymal stem cells (MSCs) that were used as promising therapeutic candidates for stem cell therapy. Moreover, we demonstrated that MSC-encapsulating GH hydrogels led to a significant improvement in cardiac functional metrics, such as the fractional shortening (FS), ejection fraction (EF), and end-systolic volume (ESV). Similarly, MSC-encapsulating GH hydrogels induced favorable effects in the cardiac structures of the infarcted heart, producing less fibrosis and thicker infarcted walls. These results suggest that GH hydrogels can be used as an instructive cell delivery platform to provide a suitable microenvironment for transplanted cells; therefore, their in vivo applications combined with MSCs may provide great potential for repair and regeneration of injured cardiac tissues after MI.

Patients scheduled for cardiac surgery often have anemia and iron deficiency. We investigated the effect of the preoperative administration of intravenous ferric carboxymaltose (IVFC) in patients with iron deficiency anemia (IDA) who were due to undergo off-pump coronary artery bypass grafting (OPCAB). Patients who were due to undergo elective OPCAB between February 2019 and March 2022 who had IDA (n = 86) were included in this single center, randomized, parallel-group controlled study. The participants were randomly assigned (1:1) to receive either IVFC or placebo treatment. Postoperative hematologic parameters [hemoglobin (Hb), hematocrit, serum iron concentration, total iron-binding capacity, transferrin saturation, transferrin concentration, and ferritin concentration] and the changes in these parameters during the follow-up period were the primary and secondary outcomes, respectively. The tertiary endpoints were early clinical outcomes, such as the volume of mediastinal drainage and the need for blood transfusions. IVFC treatment significantly reduced the need for red blood cell (RBC) and platelet transfusions. Despite receiving fewer RBC transfusions, patients in the treatment group had higher levels of Hb, hematocrit, and serum iron and ferritin concentrations during weeks 1 and 12 after surgery. No serious adverse events occurred during the study period. Preoperative IVFC treatment in patients with IDA undergoing OPCAB improved the values of the hematologic parameters and iron bioavailability. Therefore, is a useful strategy for stabilizing patients prior to OPCAB.

ObjectivesTo assess the differences in clinical outcomes between patients with rheumatoid arthritis (RA) with early menopause (EM) (MethodsWe recruited 2878 postmenopausal women with RA from the Korean Observational Study Network for Arthritis. Patients were examined at baseline and for 5 consecutive years using the Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire–Disability Index (HAQ-DI) and other PROs. Generalised estimating equation (GEE) analyses were performed among patients with a baseline SDAI of >11 to evaluate the impact of EM on longitudinal changes in RA activity and PROs.ResultsThe EM group (n=437) was younger than the UM group (n=2441), but the RA duration was similar between the two groups. The EM group was more educated and more likely to be seronegative at enrolment. Moreover, the EM group demonstrated higher disease activity and worse PROs for global assessment, fatigue, sleep disturbance and health-related quality of life (HRQoL) (all pConclusionPatients with RA and EM demonstrate higher disease activity and poorer HRQoL. Furthermore, EM significantly affects the longitudinal changes in disease activity and PROs in patients with RA.

Hippocampus is comprised of ∼20% place cells, discharging in cell-specific locations (“place fields”), standardly interpreted as a dedicated neuronal code for space. However, place cell discharge is temporally unreliable across seconds and days, and place fields are multimodal, suggesting an alternative “ensemble cofiring” spatial code with manifold dynamics that does not require reliable spatial tuning. We evaluated these hypotheses using GCaMP6f and miniature microscopes to image mouse CA1 ensemble activity in two environments, across 3 weeks. Both place fields and ensemble coactivity relationships appear to “remap,” being distinct between, and (weakly) similar within environments. Decoding location as well as environment from 1-s ensemble location-specific discharge is effective and improves with experience. Decoding the environment (but not location) from cell-pair coactivity relationships is also effective and improves with experience, even after removing place tuning. Discriminating environments from 1-s ensemble coactivity relies crucially on the cells with the most anti-cofiring cell-pair relationships because ensemble activity is internally-organized on a low-dimensional manifold of non-linear cofiring relationships that intermittently reregisters to environments according to the anti-cofiring subpopulation activity.

목적: 과거 연구들에서 내독소혈증이 간경변증의 병인과 합병증에 연관되어 있음이 보고되었다. 내독소는 염증성 사이토카인 분비를 촉진시키고, 이는 간경변증에서 합병증의 발생에 기여한다. 간경변증에서는 문맥 고혈압 장병증으로 인하여 장투과율이 증가하고, 내독소는 장벽 방어 시스템을 쉽게 침범하게 된다. 본 연구에서는 간경변증 환자에서 사이토카인 및 장투과율의 변화를 확인하고 초음파를 이용하여 장벽의 두께 그리고 탄성도를 측정하고자 하였다. 방법: 저자들은 Child-Pugh B와 C로 분류된 간경변증 환자 40명과 건강한 대조군 20명을 모집하였다. 복부 초음파검사를 통하여 상행결장 및 말단 회장에서 장벽 지표를 측정하였다. 장투과율은 락툴로오스와 만니톨을 이용한 이중 설탕 흡수 테스트를 이용하였다. TNF-α 및 IL-10을 측정하기 위하여 혈액 샘플을 수집하였다. 이 지표들에 대하여 간경변증 환자군와 대조군 간의 결과 및 Child-Pugh B와 C 환자군 간의 결과를 비교하였다. 또한 사이토카인, 장투과율과 장벽 지표의 상관관계를 확인해 보았다. 결과: 간경변 환자에서 상행결장의 장벽 탄성은 감소되었으며(20.4 vs. 10.9 kPa, p = 0.048), 말단 회장의 장벽 두께는 증가되었다(4.2 vs. 1.9 mm, p < 0.001). 장 투과율 및 사이토카인(TNF-α 및 IL-10)은 증가되었다(0.219 vs. 0.017, p < 0.001; 22.47 vs. 13.48 pg/mL, p < 0.001; 14.91 vs. 8.57 pg/mL, p = 0.019). 그러나 Child-Pugh B와 C군 간의 유의한 차이는 없었고, 장벽 지표와 장투과율 또는 사이토카인 간의 유의한 상관관계가 없었다. 결론: 간경변증 환자에서 초음파 검사를 통하여 장벽이 두꺼워지고 탄성도가 감소하는 것을 확인하였다. 또한 장투과율 및 사이토카인은 건강한 대조군과 비교하여 유의하게 증가하였다.

The benefits afforded by tocilizumab (TCZ) in patients with adult-onset Still's disease (AOSD) and systemic juvenile idiopathic arthritis (SJIA) have been described in previous studies. However, few reports have evaluated severe hypersensitivity reactions (HSRs) to TCZ in patients with AOSD or SJIA. We describe three instances of TCZ-induced anaphylactic reactions in AOSD/SJIA patients, and review relevant prior reports on patients with various rheumatic diseases. Two of our cases exhibited shock and cardiovascular collapse; TCZ was discontinued in all three cases. All events occurred within 20 min of TCZ infusion, after at least three prior infusions, indicating an IgE-mediated mechanism and previous sensitization to TCZ. In all three cases, mild HSRs had been observed about 1 month before the anaphylactic events, but pre-medication with antihistamines and corticosteroids failed to prevent anaphylaxis. All three cases had active AOSD or SJIA disease, and were refractory to other immunosuppressive agents. It is essential to be aware that severe anaphylaxis to TCZ can develop in patients with active refractory AOSD or SJIA, and to be cautious when medicating certain patients. Anaphylaxis is a serious condition that can be fatal; TCZ infusion should not be re-challenged via pre-medication in patients who exhibited mild HSRs before TCZ without desensitization.