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The Paeonia suffruticosa ANDR. (P. suffruticosa) is commonly used in traditional medicine for various purposes. Suffruticosol A (Suf-A), isolated from P. suffruticosa, is a beneficial compound with antibiofilm, antivirulence, and anti-inflammatory properties. The aim of the present study was to investigate the biological effects of Suf-A on osteogenic processes in pre-osteoblasts. It was determined here in that Suf-A (98.02%), isolated from P. suffruticosa, showed no cytotoxicity at 0.1-30 μM; however, it induced cytotoxicity at 50-100 μM in pre-osteoblasts. Suf-A increased osteogenic alkaline phosphatase activity and expression levels of noncollagenous proteins. Adhesion and trans-migration on the extracellular matrix were potentiated by Suf-A, but not by wound-healing migration. Suf-A did not affect autophagy or necroptosis during osteoblast differentiation. We found that Suf-A increased runt-related transcription factor 2 (RUNX2) levels and mineralized matrix formation. RUNX2 expression was mediated by Suf-A-induced BMP2-Smad1/5/8 and mitogen-activated protein kinase signaling, as demonstrated by Noggin, a BMP2 inhibitor. These results suggest that Suf-A is a potential natural osteogenic compound.

Living donor liver transplantation (LDLT) has been associated with massive transfusion. However, information on indicators predicting transfusion in LDLT is limited. This study investigates the association between red blood cell distribution width (RDW) and intraoperative transfusion in LDLT recipients.This study analyzed 2546 patients who underwent LDLT between January 2010 and October 2019. The patients were divided into two groups based on preoperative RDW cutoff level (14.4 and ≥14.4). We performed multivariate regression analysis to assess the association between RDW and intraoperative transfusion. We also performed propensity score matching analysis to compare the incidence of intraoperative transfusion between the two groups. The predictive power of RDW was assessed through receiver operating characteristic (ROC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) analysis.In the multivariate logistic analysis, RDW ≥14.4 was significantly associated with intraoperative transfusion (adjusted odds ratio [OR]: 1.53, 95% confidence interval [CI]: 1.13-2.06, P = .005). There were significant differences in incidence of intraoperative transfusion between the two groups before (54.1% vs 91.6%, P .001) and after (71.6% vs 79.8%, P = .004) matching. RDW had predictive power for intraoperative transfusion (P .001 in NRI, P = .035 in IDI).Preoperative RDW is a potential predictor of intraoperative transfusion in LDLT recipients.

Endoscopic retrograde cholangiopancreatography (ERCP) requires radiation. This study aimed to assess the clinical factors influencing radiation exposure and devise a scoring model for predicting high-dose radiation exposure.Endoscopic retrograde cholangiopancreatography cases recorded between 2016 and 2019 in a single tertiary teaching hospital were retrospectively reviewed. A scoring model was created by bootstrap method in a derivation cohort (2016-2018) and was assessed in a validation cohort (2019).Out of 4223 ERCPs, 2983 and 1240 cases were included in the derivation and validation cohorts, respectively. In the derivation cohort, 746 cases (top 25%) comprised the high-dose exposure group, and 2237 cases (bottom 75%) comprised the low-dose exposure group. Nine clinical parameters associated with high-dose exposure were male, pancreatic sphincterotomy, balloon dilatation, biliary or pancreatic drainage, procedures with contrast dye, endoscopist, in-hospital ERCP, and spot image. Stone removal was included by bootstrap analysis. As presented in a nomogram, the weight score of each variable was as follows: male, 1; pancreatic sphincterotomy, 3; balloon dilatation, 7; stone removal, 3; biliary or pancreatic drainage, 5; procedures with contrast dye, 1; endoscopist B, 4; endoscopist C, 5; in-hospital procedure, 3; and spot image, 3. A total score ≥ 15 suggested a high-dose radiation exposure. The sensitivity and specificity of the model for high-dose exposure were 0.562 and 0.813, respectively. In the validation cohort, the model showed reasonable predictability.Various factors were associated with radiation exposure. The simple scoring system in this study could guide endoscopists in predicting the risk of high-dose radiation exposure.

Metastasis of ductal carcinoma of the breast to the thyroid gland is uncommon and usually detected at autopsy. The incidences of metastases to the thyroid have been reported at 3%, and the most common primary malignancy is renal cell carcinoma. We report a rare case of intrathyroid metastatsis of breast ductal carcinoma in a patient who was treated for breast cancer 15 years earlier.

Background and aim The proportional increase of corrected QT interval (QTc) along end-stage liver disease (ESLD) severity may lead to inconsistent outcome reporting if based on conventional threshold of prolonged QTc. We investigated the comprehensive QTc distribution among ESLD patients and assessed the association between QTc > 500 ms, a criterion for diagnosing severe long-QT syndrome, and the 30-day major adverse cardiovascular event (MACE) after liver transplantation (LT) and identified the risk factors for developing QTc > 500 ms. Methods Data were collected prospectively from the Asan LT Registry between 2011 and 2018, and outcomes were retrospectively reviewed. Multivariable analysis and propensity score-weighted adjusted odds ratios (ORs) were calculated. Thirty-day MACEs were defined as the composite of cardiovascular mortality, arrhythmias, myocardial infarction, pulmonary thromboembolism, and/or stroke. Results Of 2579 patients, 194 (7.5%) had QTc > 500 ms (QTc500_Group), and 1105 (42.8%) had prolonged QTc (QTcP_Group), defined as QTc > 470 ms for women and >450 ms for men. The 30-day MACE occurred in 336 (13%) patients. QTc500_Group showed higher 30-day MACE than did those without (20.1% vs 12.5%, P = 0.003), with corresponding adjusted OR of 1.24 (95% CI: 1.06-1.46, P = 0.007). However, QTcP_Group showed comparable 30-day MACE (13.3% vs 12.8% without prolonged QTc, P = 0.764). Significant risk factors for QTc > 500 ms development were advanced liver disease, female sex, hypokalemia, hypocalcemia, high left ventricular end-diastolic volume, and tachycardia. Conclusion Our results revealed that, among ESLD patients, a novel threshold of QTc > 500 ms was associated with post-LT 30-day MACE but not with conventional threshold, indicating that a longer QTc threshold should be considered for this unique patient population.

Background Ablative CO2 fractional laser (AFL) is a common cosmetic procedure to improve skin laxity. However, due to prolonged downtime and the risk of postinflammatory hyperpigmentation, laser-assisted delivery of active ingredients as post-laser treatment has gained interest in past years. Among various active ingredients, human umbilical cord blood-derived mesenchymal stem cells (hUCBMSCs) can be a promising agent promoting skin regeneration. Aims We evaluated the efficacy and safety of a human cord blood cell-conditioned media containing serum and cream on patients who underwent AFL treatment. A randomized, investigator-blinded, prospective, split-face comparison study was conducted. Materials and methods Twenty-three patients who underwent AFL on both cheeks applied a human umbilical cord blood-derived mesenchymal stem cell (hUCBMSC)-conditioned media containing cream with or without stem cell containing serum application. As a primary outcome measure, we evaluated the total area of microcrusts and post-treatment erythema using digital photographs. Additionally, skin biophysical parameters (corneometer, TEWL) and global improvement scores for skin texture were assessed. Results The area of total microcrusts was reduced in the study group which applied both serum and cream. The global improvement score of the post-treatment erythema was significantly reduced. Investigator-assessed global improvement scores were higher in the combination treatment group. Additionally, there was no adverse event, which was associated with the use of either hUCBMSCs containing serum or cream. Conclusion The application of human cord blood cell containing serum and cream resulted in accelerated wound healing and reduced post-treatment erythema, which effectively reduced recovery time after ablative laser treatment.

We consistently observed a bias in the results for determination of chloramphenicol (CAP) in infant formula by isotope dilution-liquid chromatography/mass spectrometry (ID-LC/MS). Various matrix interferences from infant formula eventually can result in bias during the ID-LC/MS analysis. We tried to optimize LC conditions to minimize matrix effects by separating significant matrix interferences from the analyte and the internal standard, but some level of bias remained. To eliminate the bias due to the matrix effects, we used a standard addition-isotope dilution-liquid chromatography/mass spectrometry (SA-ID-LC/MS) method for CAP analysis. In the SA-ID-LC/MS method, standard addition techniques were combined with IDMS for exact matrix matching while keeping the isotope dilution techniques as a tool for accurate correction of recovery in sample preparation processes. The method provided accurate analytical results for target analyte in the range of 1 µg/kg with a relative expanded uncertainty of 3%.

Background and Aim The aim of this study was to evaluate the validity of the parameters of conventional white-light endoscopy and magnifying endoscopy with narrow-band imaging (MENBI) for the prediction of discrepancies between pre- and post-resectional histology in cases of gastric adenoma with low-grade dysplasia (LGD) that were diagnosed based on endoscopically biopsied specimens. Methods The medical records of 266 lesions with gastric LGD that were diagnosed by endoscopic forceps biopsies were retrospectively reviewed. The Vienna classification was used for histologic diagnosis. These patients all underwent MENBI examinations followed by analyses of the incidence of histologic discrepancies and histologic heterogeneity. The relationship between white-light endoscopic/MENBI parameters and the presence of histologic discrepancies was also analyzed. Results Discrepancies between the pre- and post-resectional histologies were found in 74 cases (27.9%). Among those cases, the histology was upgraded in 71 cases, whereas the histology was downgraded in three cases. The presence of erythema and positive MENBI findings were independent factors for the prediction of upgraded histologic discrepancies (P-values = 0.008

Robust photonic microcapsules are created by microfluidic encapsulation of cholesteric liquid crystals with a hydrogel membrane. The membrane encloses the cholesteric core without leakage in water and the core exhibits pronounced structural colors. The photonic ink capsules, which have a precisely controlled bandgap position and size, provide new opportunities in colorimetric micro-thermometers and optoelectric applications.

Biodegradable microcapsules with a large aqueous lumen and ultrathin membrane are microfluidically designed for sustained release of hydrophilic bioactives using water-in-oil-in-water double-emulsion drops as a template. As a shell phase, an organic solution of poly(lactic-co-glycolic acid) is used, which is consolidated to form a biodegradable membrane. The encapsulants stored in the lumen are released over a long period of time as the membranes degrade. The period can be controlled in a range of -three to five months at neutral pH condition by adjusting membrane thickness, providing highly sustained release and potentially enabling the programed release of multiple drugs. At acidic or basic condition, the degradation is accelerated, leading to the release in the period of approximately two months. As the membrane is semipermeable, the microcapsules respond to the osmotic pressure difference across the membrane. The microcapsules are inflated in hypotonic condition and deflated in hypertonic condition. Both conditions cause cracks on the membrane, resulting in the fast release of encapsulants in a day. The microcapsules implanted in mice also show sustained release, despite the period is decreased to a month. It is believed that the microcapsules are promising for the in vivo sustained release of drugs for high and long-term efficacy.

A Pd-catalyzed direct cross-coupling of 3-bromocoumarins with heteroarenes provided an efficient route to synthesizing 3-heteroarylcoumarins. The reaction scope for the transformation was fairly broad, affording modest to good yields of various 3-heteroarylcoumarin scaffolds, which are privileged structures and prevalent motifs in many biologically active compounds and fluorophores.

Among a variety of azaindoles the derivative (I) exhibits strong antiangiogenic effects on cancer cells.