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Radiation exposure is a well-known risk factor for thyroid cancer. However, the specific effects of diagnostic radiation exposure on thyroid cancer risk are controversial. The purpose of this study was to perform a systematic review and meta-analysis to assess the effects of diagnostic radiation exposure on thyroid cancer risk.The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and confidence intervals (CIs) were used to compute the risk of thyroid cancer using fixed- and random-effects models. Subgroup and sensitivity analyses were performed to evaluate the potential heterogeneity.Nine studies from 12 publications were included in the meta-analysis. Overall exposure to diagnostic radiation exposure was associated with a significantly increased thyroid cancer risk (OR = 1.52 [CI 1.13-2.04]). The subgroup and sensitivity analyses revealed similar results. By type of exposure, exposure to computed tomography scans (OR = 1.46 [CI 1.27-1.68]) or dental x-rays (OR = 1.69 [CI 1.17-2.44]) were associated with an increased thyroid cancer risk. Head and neck (OR = 1.31 [CI 1.02-1.69]) and chest (OR = 1.71 [CI 1.09-2.69]) exposure to diagnostic radiation was associated with an increased thyroid cancer risk.The results of this meta-analysis indicate that diagnostic radiation exposure is associated with an increased thyroid cancer risk. Therefore, to the extent that it will not compromise the information being sought, radiation exposure to the thyroid should be minimized during diagnostic examinations.

Scabies is a re-emerging parasitic disease, particularly in hospitalized patients. This is a retrospective study analyzing adult patients with scabies admitted to a referral university hospital between 2008 and 2018. All patients were treated an average of 3times using scabicides; the median isolation period and time to cure were 14 and 15days, respectively.

In 2017, the Korean Diabetes Association (KDA) published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). The KDA regularly updates its Clinical Practice Guidelines, but since the last update in 2015, many results from clinical trials have been introduced, and domestic data from studies performed in Korean patients with T2DM have been published. Recently, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorpo rated into the recommendations. Additionally, new data from clinical trials using dipeptidyl peptidase 4 inhibitors and thiazolidinediones in Korean patients with T2DM were added. Following a systematic review and assessment of recent evi dence, the KDA updated and modified its clinical practice recommendations re garding the use of antihyperglycemic agents and revised the treatment algorithm for Korean adult patients with T2DM.

In order to improve the quality of life and to prevent chronic complications re lated to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its ex cellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain. If metformin is difficult to use as a first-line treatment, other appropriate medications should be selected in view of the clinical situation. If the goal of achieving glycemic control is not achieved by monotherapy, a combination therapy with different mechanisms of action should be initiated promptly.

문서 분류 문제는 오랜 기간 동안 자연어 처리 분야에서 연구되어 왔다. 우리는 기존 컨볼루션 신경망을 이용했던 연구에서 나아가, 순환 신경망에 기반을 둔 문서 분류를 수행하였고 그 결과를 종합하여 제시하려 한다. 컨볼루션 신경망은 단층 컨볼루션 신경망을 사용했으며, 순환 신경망은 가장 성능이 좋다고 알려져 있는 장기-단기 기억 신경망과 회로형 순환 유닛을 활용하였다. 실험 결과, 분류 정확도는 Multinomial Naive Bayesian Classifier < SVM < LSTM < CNN < GRU의 순서로 나타났다. 따라서 텍스트 문서 분류 문제는 시퀀스를 고려하는 것 보다는 문서의 feature를 추출하여 분류하는 문제에 가깝다는 것을 확인할 수 있었다. 그리고 GRU가 LSTM보다 문서의 feature 추출에 더 적합하다는 것을 알 수 있었으며 적절한 feature와 시퀀스 정보를 함께 활용할 때 가장 성능이 잘 나온다는 것을 확인할 수 있었다.

The objective of the present meta-analysis was to evaluate the clinicopathological significance and prognosis of micro-MTC compared to macro-MTC. Relevant articles were obtained by searching the PubMed and MEDLINE databases. A meta-analysis was performed using 15 eligible studies. In addition, subgroup analysis based on heredity was performed in patients diagnosed with micro-MTC. The rate of extrathyroidal extension of micro-MTC [0.118 (95% CI 0.073–0.185)] was significantly lower than that of macro-MTC [0.303 (95% CI 0.224–0.395)]. Micro-MTC [0.229 (95% CI 0.161–0.314)] had a significantly lower rate of cervical lymph node (LN) metastasis compared to macro-MTC [0.595 (95% CI 0.486–0.694)]. The rate of multifocality was not significantly different between micro-MTC and macro-MTC [0.394 (95% CI 0.244–0.566) vs. 0.320 (95% CI 0.234–0.421), respectively]. The rate of distant metastasis did not differ significantly between micro-MTC [0.082 (95% CI 0.017–0.314)] and macro-MTC [0.068 (95% CI 0.009–0.376)]. Patients with micro-MTC showed significantly higher disease-free survival rates [hazard ratio [HR] 0.406 (95% CI 0.288–0.575), I 2 = 40.563%] compared to patients with macro-MTC. Micro-MTC has aggressive features, such as multifocality and distant metastasis, similar to macro-MTC and a non-negligible rate of extrathyroidal extension and cervical LN metastasis. We suggest that treatment of micro-MTC should be approached with a similar focus as that of macro-MTC. Considering that less extrathyroidal extension and cervical LN metastasis occur in patients with micro-MTC compared to macro-MTC, we propose that treatment of micro-MTC, which has a relatively low disease burden status, should be viewed as an opportunity for improving prognosis.

Introduction A meta-analysis was done to investigate the clinicopathological significance of the loss of p27kip1 expression in papillary thyroid carcinoma (PTC). Methods The meta-analysis involving 17 studies included 1,652 PTC and 328 benign cases. The rate of p27kip1 expression loss in PTC and benign lesions, and the correlations between p27kip1 expression loss and clinicopathological characteristics of PTC were determined. Results The estimated rate of p27kip1 expression loss was 0.557 (95% confidence interval [CI] 0.443-0.665) and 0.139 (95% CI 0.062-0.283) in PTC and benign lesions, respectively. In subgroup analysis, the rates of p27kip1 expression loss were 0.683, 0.393, and 0.414 in the classical variant, follicular variant, and papillary thyroid microcarcinoma, respectively. Loss of p27kip1 expression was significantly correlated with lymph node metastasis and distant metastasis (odds ratio 3.559, 95% CI 1.146-11.056 and 4.735, 95% CI 1.322-16.960, respectively). Extrathyroidal extension was correlated with loss of p27kip1 expression, but not in a statistically significant way (p = 0.051). There were no significant correlations between loss of p27kip1 expression and sex, tumor size, BRAFV600E mutation, and tumor multifocality. Conclusions Loss of p27kip1 expression is frequently found in PTC compared with benign lesions and normal thyroid tissue. When present in PTC, it is correlated with aggressive tumor behavior.

Parity has been implicated in many health consequences for women in later life.To determine whether there is an association between parity and body size phenotypes in postmenopausal women.This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted during 2010-2012. Of the 25 534 participants, data from 3347 postmenopausal women were included in the analysis.In analyses stratified by the metabolically abnormal obese (MAO) and metabolically healthy and normal weight phenotypes, women with parities of 3-4 births or more than or equal to 5 births were significantly associated with the MAO phenotype (odds ratio [OR] 1.396 [95% confidence interval (CI) 1.077-1.810] and OR 1.978 [1.392-2.811], respectively) compared with those with a parity of 1-2 births after adjusting for age, sociodemographic factors, lifestyle behaviors, and reproductive factors. A similar significant association of parity with the MAO phenotype was also found when we analyzed the parity number as a continuous variable in a comparison of the MAO and metabolically abnormal but normal weight phenotypes (OR 1.116 [1.012-1.232]). In grouping of the MAO and metabolically healthy but obese phenotypes, women who had experienced a parity of 3-4 births or more than or equal to 5 births were significantly associated with the MAO phenotype (OR 1.459 [1.025-2.076] and OR 1.989 [1.211-3.265], respectively) after adjustment for the above covariates.Parity influenced the body size phenotype in postmenopausal women, and higher parity was independently associated with a higher risk of the MAO phenotype in postmenopausal women.

Background: Early-onset diabetes results in longer lifetime hyperglycemic exposure that consequently leads to earlier chronic diabetes complications and premature death. The aim of this study was to quantify the prevalence and risk factors of undiagnosed diabetes and undiagnosed prediabetes in apparently healthy young adults aged Methods: This study used data from the Korean National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey conducted by the Korean Ministry of Health and Welfare from 2014 to 2017. A total of 4442 apparently healthy young adults enrolled in this study. Multivariate logistic regression analyses were conducted separately to evaluate associated risk factors with undiagnosed diabetes and undiagnosed prediabetes in groups stratified by sex. Results: The prevalence of undiagnosed diabetes and undiagnosed prediabetes was 1.2% and 25.0%, respectively. Obesity (body mass index ≥ 30.0 kg/m2) was a significant risk factor of undiagnosed diabetes regardless of sex (men, odds ratio (OR): 9.808, 95% confidence interval (CI): 1.619−59.412; women, OR: 7.719, 95% CI: 1.332−44.747). Family history of diabetes was significantly associated with undiagnosed diabetes (OR: 3.407, 95% CI: 1.224−9.481) in women only. Increased age, obesity status, and family history of diabetes were significant risk factors for undiagnosed prediabetes. Alcohol consumption was found to be negatively associated with undiagnosed prediabetes in women. Conclusions: Increased attention and implementation of precise strategies for identifying young adults at high risk for undiagnosed diabetes would allow for increased wellbeing as well as reduced healthcare burdens associated with diabetes.

The aim of this study was to determine factors influencing the hand hygiene compliance of a physician. We found a strong correlation between a leader’s (staff member’s or fellow’s) and a follower’s (resident’s) hand hygiene compliance. Followers’ appropriate hand hygiene compliance was significantly associated with the compliance of the leader (P = .01).

Background In-hospital detection of newly diagnosed active pulmonary tuberculosis (TB) is important for prevention of potential outbreaks. Here, we report our experience of the aggressive contact investigation strategy in a university hospital in the Republic of Korea after healthcare workers (HCWs), patients, and visitors experience an in-hospital exposure to active pulmonary TB. Methods A contact investigation after the unexpected detection of newly diagnosed active pulmonary TB (index patients) was performed in a university hospital from August 2016 to April 2017. Initial and 3-month-post-exposure chest radiographs were advised for all patients, visitors, and HCWs in close contact with the index patients. An additional tuberculous skin test or interferon gamma releasing assay was performed at the time of exposure and 3 months post-exposure in HCWs in close contact with the index patients. Results Twenty-four index patients were unexpectedly diagnosed with active pulmonary TB after admission to the hospital with unassociated diseases. The median time from admission to TB diagnosis was 5 days (range, 1–22 days). In total, 1,057 people were investigated because of contact with the index patients, 528 of which had close contact (206 events in 157 HCWs, 322 patients or visitors). Three months post exposure, 9 (9.2%) among 98 TB-naïve close contact HCWs developed latent tuberculosis infections (LTBIs). Among the 65 close contact patients or visitors, there was no radiological or clinical evidence of active pulmonary TB. Conclusion An aggressive contact investigation after an unexpected in-hospital diagnosis of active pulmonary TB revealed a high incidence of LTBI among TB-naïve HCWs who had contact with the index patients., Graphical Abstract

In image classification, recent CNNs compete with human performance. However, there are limitations in more general recognition. Herein we deal with indoor images that contain too much information to be directly processed and require information reduction before recognition. To reduce the amount of data processing, typically variational inference or variational Bayesian methods are suggested for object detection. However, these methods suffer from the difficulty of marginalizing over the given space. In this study, we propose an image-text integrated recognition system using active vision based on Spatial Transformer Networks. The system attempts to efficiently sample a partial region of a given image for a given language information. Our experimental results demonstrate a significant improvement over traditional approaches. We also discuss the results of qualitative analysis of sampled images, model characteristics, and its limitations.

Purpose: The purpose of present study was to develop a method for assessing the chronological age of Korean adults based on the relationship between age and size of pulp cavity using dental radiographs of mandibular first molars. Methods: A total of 325 dental radiographs of Korean adults with known age and gender were selected for the study (199 males and 126 females) which were taken in the period between January 2009 and June 2014 at the Pusan National University Dental Hospital. The measurements were carried out on both orthopantomographs (OPGs) and intraoral periapical radiographs (IOPRs) of mandibular first molar and the following ratios were calculated: pulp chamber floor height ratio (F/L), pulp chamber ceiling height ratio (R/L), and pulp chamber depth ratio (D/L). Results: The ratios of measurements on intraoral periapical images of mandible first molar generally produce more reliable data than the measurements on OPGs. The pulp chamber floor height ratio and pulp chamber depth ratio showed significant correlation with age, whereas the pulp chamber ceiling height ratios showed weak correlation with age. It was found that the best correlations between the ratios and age were found for pulp chamber depth ratios (r= -0.732 to -0.751). The multiple regression models were derived using 3 ratios that were significantly correlated with age. The determination coefficients (R²) of the models ranged from 0.556 to 0.596. Conclusions: Our results indicate that the pulp chamber depth and pulp chamber floor height in mandibular first molar are an age-dependent variable in adults which can be used to estimate age with reasonable accuracy. The higher image quality of dental radiographs will probably narrow the age estimation error and improve dental age estimation.

Background Skin aging, potentially caused by exposure to particulate matter (PM)2.5, is characterized by wrinkling, abnormal pigmentation, and skin dryness triggered by several keratinocyte-derived paracrine factors. Sulforaphane (4-methylsulfinylbutyl isothiocyanate, SFN), commonly found in cruciferous vegetables, has diverse biological effects on skin tissue. Purpose In the present study, we have investigated whether SFN may alleviate PM2.5-induced premature skin aging. Methods We used keratinocyte/melanocyte or keratinocyte/fibroblast coculture models of skin cells and measured the parameters of melanogenesis, collagen homeostasis and inflammation. Results SFN inhibited the development of reactive oxygen species in keratinocytes exposed to PM2.5. In keratinocyte/melanocyte cocultures, it significantly inhibited the upregulation of melanogenic paracrine mediators (including endothelin-1 and prostaglandin E2) in keratinocytes exposed to PM2.5; the synthesis of melanogenic proteins including microphthalmia-associated transcription factor, tyrosinase-related protein 1, and tyrosinase; and the levels of melanin in melanocytes. SFN treatment of keratinocyte/fibroblast cocultures significantly reduced the PM2.5-induced expression of NF-κB-mediated cytokines including interleukin-1β, interleukin-6, tumor necrosis factor α, and cyclooxygenase-2. In fibroblasts of the keratinocyte/fibroblast coculture system, the expression levels of phospho-NF-κB, cysteine-rich protein 61, and matrix metalloproteinase-1 were significantly decreased whereas procollagen type I synthesis was significantly increased. Conclusion Collectively, our results suggest that SFN mitigates PM2.5-induced premature skin aging by suppressing melanogenesis and maintaining collagen homeostasis. It acts by regulating the release of paracrine factors from keratinocytes.

We propose a video story question-answering (QA) architecture, Multimodal Dual Attention Memory (MDAM). The key idea is to use a dual attention mechanism with late fusion. MDAM uses self-attention to learn the latent concepts in scene frames and captions. Given a question, MDAM uses the second attention over these latent concepts. Multimodal fusion is performed after the dual attention processes (late fusion). Using this processing pipeline, MDAM learns to infer a high-level vision-language joint representation from an abstraction of the full video content. We evaluate MDAM on PororoQA and MovieQA datasets which have large-scale QA annotations on cartoon videos and movies, respectively. For both datasets, MDAM achieves new state-of-the-art results with significant margins compared to the runner-up models. We confirm the best performance of the dual attention mechanism combined with late fusion by ablation studies. We also perform qualitative analysis by visualizing the inference mechanisms of MDAM.

In this work, we propose a goal-driven collaborative task that combines language, perception, and action. Specifically, we develop a Collaborative image-Drawing game between two agents, called CoDraw. Our game is grounded in a virtual world that contains movable clip art objects. The game involves two players: a Teller and a Drawer. The Teller sees an abstract scene containing multiple clip art pieces in a semantically meaningful configuration, while the Drawer tries to reconstruct the scene on an empty canvas using available clip art pieces. The two players communicate with each other using natural language. We collect the CoDraw dataset of ~10K dialogs consisting of ~138K messages exchanged between human players. We define protocols and metrics to evaluate learned agents in this testbed, highlighting the need for a novel "crosstalk" evaluation condition which pairs agents trained independently on disjoint subsets of the training data. We present models for our task and benchmark them using both fully automated evaluation and by having them play the game live with humans., ACL 2019

The purpose of this study is, in the situation that consumers use not only online news but social media as information delivery media, based on web data, to examine the effect of touch point activities in two media different according to product types on consumer search activities. To do this, we traced the patterns of information diffusion according to time, by extracting the number of the web postings of the information about the products from on-line news and blogs on a weekly or monthly basis, and identified consumer search activities about the goods by using their search traffics provided on a weekly basis by portal sites As a result of the study, it turned out that touch point activities and consumer search activities are different from each other in two media different according to product types. Specifically speaking, as for utilitarian goods, it appeared that there were correlations between the touch points and consumer search activities of the two different information media. In particular, more similarity in the patterns of information diffusion was found in the news sites than in the blogs. In the case of hedonic goods, the correlations between touch points and consumer search activities showed different results according to the time intervals. A monthly analysis showed that the consumer search activities had correlations not with on-line news, but with blogs. On the contrary, a weekly analysis showed that they had higher correlations with blogs than with on-line news sites though having correlations with both the two.

The tin metal could be retractable from wasted tin scrap, sludge, and wasted electroplated solution hydrometallurgical treatment, and purification process. In order to be used as resource of electronic devices, the retracted crude metal should be purified to the extent of higher than 99.9%. In this study, tin electro-refining process was performed to purify the casted tin crude metal at various experimental conditions: at the current density of 3, 5A/dm2, and in various electrolytes such as hydrochloric acid, sulfuric acid and methansulfonic acid. Additional experiment was conducted using Rotating Disk Electrode (RDE) in order to investigate the rate determining step of tin electro-refining process. The current efficiency, 65.6%, was achievable at the condition of current density, 5A/dm2, and in the electrolyte of Hydrochloric acid. During tin electro-refining process, impurity dissolved from tin crude metal into the electrolyte was analyzed using Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES), and the result showed the concentration of impurity metal gradually increased. Quantitative analysis on casted tin crude metal showed that it consists of tin with 93.9 wt.% and several impurity metals of Ag, Bi, Pb, Cu, and etc. After tin electro-refining process, the purity of tin increased up to 99.985 wt.%.

Tyrosinase is the rate-limiting enzyme critical for melanin synthesis. It controls pigmentation in the skin. Activation of tyrosinase is currently the most common approach in the development of tanning and haircare products. Pratol is a 7-hydroxy-4-methoxyflavone found in Trifolium pratense. In this study, we investigated the effects of pratol on melanogenesis. We also studied the mechanism of action of pratol in B16F10 mouse melanoma cells. The cells were treated with various concentrations (6.25, 12.5, 25, and 50 μM) of pratol to observe its effects. The results showed that pratol significantly increased melanin content and tyrosinase activity in the cells without being cytotoxic. In addition, pratol strongly increased the expression of tyrosinase and tyrosinase-related protein-1 and 2 by enhancing the expression of microphthalmia-associated transcription factor. Furthermore, pratol stimulated melanogenesis via the phosphorylation of p38, c-Jun N-terminal kinases (JNK), and extracellular signal–regulated kinase (ERK). The findings from an assay searching for the inhibitor revealed that SB203580 (a specific p38 inhibitor) or SP600125 (a p-JNK inhibitor) attenuated pratol-induced cellular tyrosinase activity whereas PD98059 (an ERK inhibitor) did not. Additionally, pratol interfered with the phosphorylation of p-AKT. We also found that pratol-induced melanogenesis was reversed by H89, which is a specific protein kinase A inhibitor. The results suggest that, owing to its multi-functional properties, pratol may be a potential tanning agent or a therapeutic agent for hair depigmentation in the cosmetic industry.

An inverse association has been reported between coffee consumption and the risk of several cancers. However, the association between coffee and thyroid cancer is controversial. Thus, this study aimed to evaluate the association between coffee consumption and the risk of thyroid cancer through a systematic review and meta-analysis. Published studies were examined from PubMed, Embase, Cochrane Central, and the reference lists of the retrieved articles. The summary odds ratio (OR) for the association between coffee consumption was categorized as highest versus lowest consumption, and thyroid cancer risk was calculated using a fixed effects model. Subgroup analyses by study design, geographic location, source of controls, and adjusted variables were performed. A total of 1039 thyroid cancer cases and 220,816 controls were identified from five case-control studies and two cohort studies. The summary OR for the association between coffee consumption and thyroid cancer risk was 0.88 (95% confidence interval (CI) = 0.71-1.07). There was no significant heterogeneity among the study results (I² = 0%, p = 0.79). However, the beneficial effect of coffee consumption on thyroid cancer was found only in hospital-based case-control studies (OR= 0.59, 95% CI= 0.37-0.93). There was no significant association between coffee consumption and thyroid cancer risk according to our meta-analysis results. These findings should be interpreted with caution because of potential biases and confounding variables. Further prospective studies with a larger number of cases are encouraged to confirm these results.

2,3,5-Triphenyltetrazolium chloride (TTC) is used as a redox indicator in culture media. It is colorless in the oxidized form and is reduced to formazan, an insoluble pigment, by dehydrogenases in actively growing microbial cells. The aim of this study was to assess by microbial test of the pathogenic microorganisms using TTC reduction. The pathogenic microorganisms were reduced in medium by dehydrogenase to produce insoluble red formazan. We observed that the optimization method of TTC allowed more than 12 h incubation in 0.04% concentration. Also, the growth of microorganisms with media was increased formazan production. We confirmed that microorganisms were quickly observed to grow colonies cultured red color without affecting the growth of microorganisms. It is suggested that the microbial test using TTC can provide better and quicker test method in cosmetics development.

Nickel, cobalt and manganese-based(NCM, ) cathode active materials of spent lithium-ion batteries contained valuable metals such as cobalt(15 ~ 20%), nickel(25 ~ 30%), manganese(10 ~ 15%) and lithium(5 ~ 10%). It was investigated the eco-friendly leaching process for the recovery of valuable metal from spent lithium-ion battery NCM cathode active materials by DL-malic acid() as an organic leachant in this research. The experiments were carried out to optimize the process parameters for the recovery of cobalt, nickel and lithium by varying the concentration of lixivant, reductant concentration, solid/liquid ratio and temperature. The leaching solution was analyzed using ICP-OES(Inductively Coupled Plasma Optic Emission Spectrometer). Cathode active materials of 5 wt. % were introduced into the leaching solution which was 2 M DL-malic acid in addition of 5 vol. % at and it resulted in the recovery of 99.10% cobalt, 99.80% nickel and 99.75% lithium in 120 min. in DL-malic acid solution acts as an effective reducing agents, which enhance the leaching of metals.

Purpose The administration of recombinant human growth hormone in adults with growth hormone deficiency has been known to improve metabolic impairment and quality of life. Patients, however, have to tolerate daily injections of growth hormone. The efficacy, safety, and compliance of weekly administered sustained-release recombinant human growth hormone (SR-rhGH, Declage™) supplement in patients with growth hormone deficiency were evaluated. Materials and Methods This trial is 12-week prospective, single-arm, open-label trial. Men and women aged ≥20 years with diagnosed growth hormone deficiency (caused by pituitary tumor, trauma and other pituitary diseases) were eligible for this study. Each subject was given 2 mg (6 IU) of SR-rhGH once a week, subcutaneously for 12 weeks. Efficacy and safety at baseline and within 30 days after the 12th injection were assessed and compared. Score of Assessment of Growth Hormone Deficiency in Adults (AGHDA score) for quality of life and serum IGF-1 level. Results The IGF-1 level of 108.67±74.03 ng/mL was increased to 129.01±68.37 ng/mL (p=0.0111) and the AGHDA QoL score was decreased from 9.80±6.51 to 7.55±5.76 (p

BACKGROUND Previous studies have generated conflicting evidence regarding associations between family history and survival after gastric cancer surgery. In this study, we investigated this question using a meta-analysis. MATERIALS AND METHODS To identify relevant studies, PubMed and Embase databases were searched up to June 2013. Two reviewers independently assessed search results and data extraction of included studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) were calculated based on fixed- or random- effects models. Homogeneity of effects across studies was assessed using x2 test statistics and quantified by I2. RESULTS A total of five studies were selected according to the inclusion criteria. The total number of patients included was 2,030, which ranged from 145 to 598 per study. There was no significant difference in OS by family history of cancer (HR=0.83, 95%CIs=0.50-1.38), but subgroup analysis of patients with a first-degree family history of cancer (HR=0.74, 95%CIs=0.60-0.93) and gastric cancer family history (HR=0.56, 95%CIs=0.41-0.76) tended to show better OS in these patients. CONCLUSIONS This meta-analysis suggests that a first-degree family history of cancer or gastric cancer family history is associated with better survival of gastric cancer patients after surgery, after a systematic review of five previous studies. These results can be applied by clinicians when counselling patients regarding their risk of death from gastric cancer. Further study is needed to investigate the underlying mechanism between family history and survival in gastric cancer patients.

Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital and were diagnosed with TMJ OA by clinical exam, X-ray and cone-beam computed tomography (CBCT) from 2010 to 2011. We investigated 93 adolescent patients (12-19 years) and 53 middle-old aged (>45 years) patients who observed the erosive bony changes in TMJ. CBCT scans were retaken at intervals at an average of 8 months. Results: The adolescent patients showed unilateral degenerative changes more often, and the middle-old aged patients showed degenerative changes more frequently on both sides. The transition of bone changes to the improved group occurred most commonly in both the adolescent and middle-old aged patients. The adolescent patients were more likely to improve than middle-old aged patients. In the adolescent patients, loss of erosion and subjective symptoms occurred in shorter periods than in the middle-old aged patients. In the adolescent patients, the transition of erosion was distributed into proliferative, normal, and shortening in order. In the middle-old aged patients, the transition of erosion was distributed into shortening, proliferative, and normal in order. Conclusions: The clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. Moreover, the difference by age of the adaptive and regenerative capacity of TMJ affects the prognosis of TMJ OA and adolescent patients have a better prognosis after treatment.

OBJECTIVE The objective of the current study was to determine whether there was an association between age at first childbirth and glucose tolerance status in postmenopausal women. RESEARCH DESIGN AND METHODS This study was based on the data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008–2011. Of 37,753 participants, data for 4,965 postmenopausal women were included in the analysis. Subjects were subdivided according to the age at first childbirth as follows: ≤19, 20–24, 25–29, and ≥30 years. Multivariate logistic regression analyses were used to identify whether there was an independent association between age at first childbirth and glucose tolerance status by adjusting for potential confounding factors. RESULTS The prevalence of impaired fasting glucose (IFG) and diabetes was 21.8% (1.066 of 4.965) and 15.3% (774 of 4,965), respectively. Diabetes prevalence differed significantly between the subgroups and was higher with earlier age at first childbirth: it was 10.9% in subjects aged ≥30 years and 23.8% in subjects aged ≤19 years at first childbirth. After fully adjusting for potential confounding factors, including lifestyle, sociodemographic factors, known diabetes risk factors, and reproductive factors, age at first childbirth ≤19 years was significantly associated with diabetes (odds ratio 1.492 [95% CI 1.005–2.215]). No significant associations were found between age at first childbirth and IFG. CONCLUSIONS Age at first childbirth influenced diabetes risk in postmenopausal women, and adolescent pregnancy was independently associated with a higher risk of diabetes in postmenopausal women.

Plastoglobules (PGs) are thylakoid membrane microdomains within plastids that are known as specialized locations of carotenogenesis. Three rice phytoene synthase proteins (OsPSYs) involved in carotenoid biosynthesis have been identified. Here, the N-terminal 80-amino-acid portion of OsPSY2 (PTp) was demonstrated to be a chloroplast-targeting peptide by displaying cytosolic localization of OsPSY2(Delta PTp): mCherry in rice protoplast, in contrast to chloroplast localization of OsPSY2: mCherry in a punctate pattern. The peptide sequence of a PTp was predicted to harbor two transmembrane domains eligible for a putative PG-targeting signal. To assess and enhance the PG-targeting ability of PTp, the original PTp DNA sequence (PTp) was modified to a synthetic DNA sequence (stPTp), which had 84.4% similarity to the original sequence. The motivation of this modification was to reduce the GC ratio from 75% to 65% and to disentangle the hairpin loop structures of PTp. These two DNA sequences were fused to the sequence of the synthetic green fluorescent protein (sGFP) and drove GFP expression with different efficiencies. In particular, the RNA and protein levels of stPTp-sGFP were slightly improved to 1.4-fold and 1.3-fold more than those of sGFP, respectively. The green fluorescent signals of their mature proteins were all observed as speckle-like patterns with slightly blurred stromal signals in chloroplasts. These discrete green speckles of PTp-sGFP and stPTp-sGFP corresponded exactly to the red fluorescent signal displayed by OsPSY2: mCherry in both etiolated and greening protoplasts and it is presumed to correspond to distinct PGs. In conclusion, we identified PTp as a transit peptide sequence facilitating preferential translocation of foreign proteins to PGs, and developed an improved PTp sequence, a stPTp, which is expected to be very useful for applications in plant biotechnologies requiring precise micro-compartmental localization in plastids.

Background Hospitals are undesirable reservoirs for a respiratory outbreak. Active pulmonary tuberculosis (TB) can be readily transmitted among hospitalized patients. Early recognition of pulmonary TB is an essential priority against transmission. The aim of this study was to evaluate factors associated with delayed identification of pulmonary TB in hospital settings. Methods Medical records of newly diagnosed TB patients admitted to a referral hospital from January 2015 through December 2017 were reviewed. Delayed recognition of pulmonary TB was defined as failure to initiate airborne isolation within the first 3 days after admission. We analyzed clinical, microbiological, radiological, and healthcare factors associated with delayed recognition of pulmonary TB. Patients who were not suspected of having active pulmonary TB had no remarks about TB on their initial chest radiograph interpretation by radiologists. Multivariate logistic regression analysis was performed with significant factors included. Results A total of 136 patients were analyzed who had positive sputum acid-fast bacilli (AFB) cultures. Of these, 45 (33%) patients were isolated 3 days after admission and had longer days of exposure before isolation (median 9, interquartile range [IQR] 6–14, P < 0.001) in comparison to others (median 0, IQR 0–1). Patients with older age (odds ratio [OR] = 1.04, 95% confidence interval [CI] 1.01–1.08, P = 0.01), patients who were admitted to departments other than infectious diseases or pulmonology (OR = 6.23, 95% CI 2.17–17.89, P = 0.001) and patients who were not suspected of having active pulmonary TB by radiologists (OR = 11.36, 95% CI 4.11–31.39, P < 0.001) were more likely to have delayed recognition of pulmonary TB. Conclusion In a country with intermediate TB prevalence, better awareness for pulmonary TB is required for all hospitalized patients who are admitted to departments other than infectious diseases or pulmonology. Although active pulmonary TB is not suspected by a radiologist, sputum AFB smear, and culture are necessary when new lesions are present in chest radiographs. Disclosures All authors: No reported disclosures.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulating protein that promotes degradation of the low density lipoprotein receptor. PCSK9 has emerged as a target for lipid-lowering therapy, but the predictive value of the serum level of PCSK9 for the severity of coronary disease is largely unknown.From December 2009 to July 2012, 121 individuals who underwent coronary angiography (CAG) because of clinically suspected acute coronary syndrome were enrolled in this study. Serum levels of PCSK9 and metabolic parameters were measured. SYNTAX (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) and GRACE (Global Registry of Acute Coronary Events) scores were calculated.Individuals with CAG lesions (n=100) had significantly higher levels of PCSK9 than those without lesions (n=21). The study population was stratified into three groups according to serum levels of PCSK9. The odds radio for occurrence of one or more CAG lesions was significantly higher in the group with the highest level of PCSK9 (odds ratio, 7.468; P=0.011) than in the group with the lowest level of PCSK9. Serum PCSK9 was positively associated with the number of involved coronary arteries. Multivariable linear regression indicated that levels of PCSK9 were positively correlated with GRACE risk scores and SYNTAX scores.Serum PCSK9 concentrations are higher in patients with coronary artery lesions, and are associated with SYNTAX and GRACE scores, suggesting that PCSK9 is a potential biomarker of the severity of coronary artery disease.

The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.

and Hyeong Bae PyoRD Revised July 2, 2013; Accepted July 18, 2013)요 약: 본 연구에서는 예로부터 민간에서 사용되어진 약초인 토인삼 추출물의 피부보호 효과를 측정하기위해 항산화, 자외선에 의해 유도된 matrix metalloproteinases-1 (MMP-1) 발현저해효과, 자외선에 대한 세포보호효과, 노화세포를 이용한 senescence-associated β-galactosidase (SA-β-gal) 활성을 사람 섬유아세포(HDF)를 이용하여 확인하였다. 그 결과, 토인삼 추출물의 free radical과 superoxide radical 소거효과는 처리농도가 증가함에 따라 농도 의존적으로 나타났으며, 토인삼 잎, 줄기 추출물(LSE) 500 μg/mL 에서 98.45%와 97.01%의 DPPH와 superoxide radical 을 소거하여 우수한 항산화 효과를 나타내었다 . 토인삼 잎, 줄기 추출물(LSE)의 MMP-1의 발현 저해효과는 섬유아세포에서 UVA조사 실험에서 우수하게 나타났으며, UVB 조사에 의한 세포보호 효과도 우수하게 나타났다. 또한 노화세포를 이용한 SA-β-gal활성은 토인삼 잎, 줄기 추출물(LSE)을 처리하였을 시 염색된 세포의 수가 감소하여 세포내 senescence를 억제하는 것을 확인할 수 있었다. 이상의 결과들을 종합해 보면, 토인삼의 지상부분인 잎, 줄기 추출물(LSE)은 항노화 및 항산화제로서의 우수한 특성으로 피부손상에 의한 산화적 스트레스에 대응하는 새로운 기능성 소재로서의 가능성을 가지는 것으로 평가된다.Abstract: Ultraviolet irradiation in the cells and skin produces reactive oxygen species (ROS), which induces the syn-thesis of matrix metalloproteinases (MMPs) causing skin photoaging. Using the human dermal fibroblast (HDF), we in-vestigated the antioxidative and anti-aging effects of the extracts from Talinum paniculatum. Talinum paniculatum leaf and stem extracts (LSE) showed free radical scavenging effect by 98.45% at 500 μg/mL and superoxide radical scav-enging effect by 97.01% at 500 μg/mL in the xanthine/xanthine oxidase system. The photoprotective potential of LSE was tested in HDF exposed to ultraviolet irradiation. It was revealed that LSE had an inhibitory effect on MMP-1 ex-pression in UVA-irradiated HDF without any significant cytotoxicity. The treatment of UVA-irradiated HDF with LSE resulted in dose-dependent decreases in the expression levels of MMP-1 mRNA and protein. Also, UVB-induced cyto-toxicity and cell death were effectively suppressed by treatment of LSE. Additionally, the senescence-associated β- gal-actosidase (SA-β-gal) activity was decreased in the presence of LSE. These results suggest that Talinum paniculatum leaf and stem extracts (LSE) may have anti-aging effects and can be used as new functional materials against oxidative stress-mediated skin damages.Keywords: Talinum paniculatum, antioxidation, MMP, anti-aging, ultraviolet

11β hydroxylase deficiency (OHD) is one of the main causes of congenital adrenal hyperplasia. There have been only a few reported cases of nonclassic 11β OHD, a milder form of the disease. It is difficult to detect occult nonclassic 11β OHD because patients present with no or mild symptoms. We herein present a case of thyrotoxic periodic paralysis (TPP) with Graves' disease leading to the discovery of a hidden nonclassic 11β OHD. In this case, increased levels of thyroid hormone seem to have induced symptoms of occult nonclassic 11β OHD and aggravated TPP.