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Little is known about the prevalence of chronic kidney disease (CKD) during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to investigate the long-term trends in CKD prevalence from South Korea including the early pandemic. We used data from 108,152 Korean adults from 2007 to 2020 obtained from a representative longitudinal serial study. We defined CKD as a condition when the participant's estimated glomerular filtration rate was < 60 mL/min/1.73 m2, or one-time spot proteinuria was ≥ 1 +, and then examined the overall trends in the prevalence of CKD. Among the included adults (n = 80,010), the overall national prevalence of CKD was 6.2%. The trend slope gradually increased from 2007 to 2019, however, there was a sudden decrease in 2020 (2007–2010, 5.1% [95% confidence interval (CI) 4.7–5.5]; 2017–2019, 7.1% [95% CI 6.6–7.6]; pandemic period, 6.5% [95% CI 5.7–7.3]; and βdiff, − 0.19; 95% CI − 0.24 to − 0.13). The prevalence of CKD among younger adults and those with poor medical utilization significantly decreased during the early pandemic. This study was the first large-scale study to investigate the longitudinal prevalence of CKD from 2007 to 2020. Further research is needed to fully understand the exact causes for this decline and to identify healthcare policy strategies for preventing and managing CKD. [ABSTRACT FROM AUTHOR]

Neonatal vitamin D deficiency is common and is associated with development of pulmonary disease in children and adults. While the role of vitamin D in normal lung development is well established, the association between vitamin D deficiency and bronchopulmonary dysplasia (BPD) remains unclear. The present meta-analysis was conducted to evaluate the relationship between vitamin D and BPD. We identified relevant studies (n = 8) using the PubMed, EMBASE, Cochrane Library, and KoreaMed databases and applied the Newcastle–Ottawa Scale to assess the methodological components of each study, and used I2 statistic to evaluate heterogeneity. Comprehensive Meta-Analysis software version 3.3 was used for the statistical analysis. A total of 909 infants were included, of whom 251 (27.6%) were diagnosed with BPD. We found that both vitamin D deficiency at birth (four studies; OR 2.405; 95% CI 1.269 to 4.560; p = 0.007) and low levels of vitamin D at birth (four studies; standardized mean difference -1.463; 95% CI -2.900 to -0.027; p = 0.046) were associated with BPD. The compiled data suggest that antenatal vitamin D deficiency and low vitamin D levels are associated with neonatal BPD. [ABSTRACT FROM AUTHOR]

Background and Aim: The clinical significance of incidental pancreatic cystic lesions (PCLs) remains unclear in those that are not accompanied by worrisome features or high‐risk stigmata. We aimed to investigate the natural course of PCLs without any risk features and examine the clinical factors associated with their progression. Methods: We conducted a retrospective cohort study of 427 patients with PCLs, which were incidentally detected by computed tomography between January 2003 and December 2012. Progression of PCLs without any risk features and the clinical factors associated with their progression were investigated. The length of time to significant growth was also evaluated. Results: Ninety‐four (22.0%) of the 427 patients had asymptomatic PCLs that showed significant growth after a median surveillance period of 5.3 years; approximately 27.7% of the patients showed significant size changes in the first 5 years, while the remaining 72.3% showed significant changes after 5 years. The cumulative rate of patients with significant growth was associated with initial cyst size and high body mass index. In the growth group, additional treatments were required for 12 patients, one of whom developed malignancy. Four patients in the stable group underwent additional treatment and showed no malignant change. Conclusions: One‐fifth of the asymptomatic PCLs significantly increased in size after a long‐term follow‐up period, which was associated with initial cyst size and obesity. The size of PCLs mostly increased after 5 years; although the malignancy risk of PCLs was low, it was still a concern. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sensory drivers of liking in foreign food markets are difficult to identify because the expression of perceived characteristics varies depending on cultural differences. We aimed to identify differences in the perception and expression of a Korean home meal replacement product (Kimchi stew) between 10 Korean trained panelists versus 50 eastern Chinese consumers (EC) and 54 northern Chinese consumers (NC) using descriptive analysis and rate‐all‐that‐apply (RATA) tests. Regional differences between the EC and NC groups were also investigated. RESULTS: Sensory representations of the six Kimchi stew samples were similar between the Korean trained and Chinese consumer panels. Use of simple sensory RATA terms was similar among the groups. However, EC, who have a daily diet with mild flavors, associated consumer terms with negative connotations, such as odd flavor and sharp, with burning sensation and seasoning, implying the influence of regional food cultures. CONCLUSION: RATA could elicit foreign consumers' sensory representations of an unfamiliar ethnic food that was comparable to that from descriptive analysis, assisting researchers in understanding target consumers' sensory perceptions in a more cost‐ and time‐effective manner. The inclusion of consumer terms in a RATA list and its correlation with descriptive analysis by a native descriptive panel can help with the understanding of foreign consumers' verbal expressions. © 2018 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Purpose: To investigate the gender-specific associations between perceived vision impairment and symptoms of depression. Methods: We used the data from the 2012 Korean Longitudinal Study of Aging database of 7448 individuals aged 45 years and older. Questionnaires assessing depression symptoms and perceived visual impairment at near, distance, and in general were administered. Logistic regression analyses were used to evaluate if visual impairment could lead to depression, adjusting for the potential confounders of age, socioeconomic status (household income, education level, marital status, and employment status), and health behaviors (alcohol consumption, smoking, and physical activity level) after gender stratification. Results: Perceived general and near vision impairment were significantly associated with symptoms of depression in males (odds ratio [OR] = 2.78 and 2.54; 95% confidence interval [CI], 1.91-4.04 and 1.78-3.63). Perceived general and distance vision impairment were significantly associated with symptoms of depression in females (OR = 2.16 and 2.08; 95% CI, 1.67-2.79 and 1.61-2.69). General sight with near vision impairment in males and general sight with distance vision impairment in females could be stronger predictors of depression than other vision impairment combinations (area under the receiver operating characteristic curve [AUROC], 0.6461; p = 0.0425 in males; AUROC, 0.6270; p = 0.0318 in females). Conclusion Gender differences were found in the characteristics of visual impairment on symptoms of depression. Ophthalmologists should be aware that near vision impairment in males and distance vision impairment in females have an adjunctive effect that might contribute to symptoms of depression. [ABSTRACT FROM AUTHOR]

High nickel NCM have received much attention due to higher capacity and lower price, whilst it has disadvantages of severe structural change during operation that may lead to micro-crack and pulverization of particles. Recent research endeavors to alleviate the deterioration of the cathode by modifying the particle shapes of NCM materials. Here, we prepare the high nickel NCM precursor via co-precipitation process to understand the correlative physical properties between NCM precursors (Ni x Co y Mn 1-x-y (OH) 2) and NCM cathode materials (LiNi x Co y Mn 1-x-y O 2). Various type of high‑nickel NCM precursors and cathode materials are sequentially synthesized by controlling the operating temperature in Taylor-Couette reactor and sintering the precursors with LiOH. The physical properties of prepared NCM precursors and NCM cathode materials are investigated with various surface and structural analysis method as well as basic electrochemical method. Results indicate that the physical properties of NCM precursors influence the crystal orientation of NCM cathode materials, thereby alters the electrochemical performances. NCM precursor prepared at lower temperature provides excellent cathode performance, indicating feasibility of lowering the operating temperature of precursor synthesis process. [Display omitted] • We prepare the high‑nickel NCM precursor via co-precipitation process using Taylor-Couette reactor. • We characterize the high‑nickel NCM precursor and cathode material with various analysis method. • Physical properties of NCM precursor influences the crystal orientation of NCM material and electrochemical performance. • Precursor prepared at low temperature provides excellent cathode performance. [ABSTRACT FROM AUTHOR]

All-solid-state batteries were fabricated with lithium silicide anodes (Li 4.4 Si), sulfide-based glass electrolyte (Li 2 S-P 2 S 5 ), and titanium disulfide (TiS 2 ) cathodes. Two approaches were taken to improve the properties of the interface between anode and solid electrolyte, and between the anode and the current collector. First, the lithium silicide powder was ball-milled for particle-size reduction, to achieve higher utilization of the active material. Second, the anode layer was designed with gradient structure consisting of lithium silicide + solid electrolyte composite layer (for easy lithium ion transport from anode to electrolyte and vice versa) and lithium silicide layer (for easy electron transport from anode to current collector and vice versa). It was found that the additional ball milling step increased contact area between solid electrolyte and anode active material on the basis of GITT tests using a half cell. This effect was reflected in charge-discharge tests on a cell with the secondary ball-milled lithium silicide, resulting in higher capacities. A cell with the gradient-structured anode also showed 2–3-times higher capacities in comparison with a cell with conventional electrode design. Thus, the present work indicates why design of the electrode layers is a critical factor in determining the performance of solid state batteries. [ABSTRACT FROM AUTHOR]

Background: Chorioamnionitis has recently been reported as a risk factor for various neonatal diseases, including cerebral palsy, bronchopulmonary dysplasia, and necrotizing enterocolitis, but its effect on patent ductus arteriosus (PDA) is unclear. We performed a systematic review and meta-analysis to evaluate the effect of chorioamnionitis on PDA. Methods: We searched PubMed, EMBASE, Cochrane Library, and KoreaMed databases using the terms: “intrauterine infection” or “maternal infection” or “antenatal infection” or “chorioamnionitis” or “placenta inflammation” or “placenta pathology” or “neonatal outcome” or “neonatal morbidity” or “PDA or patent ductus arteriosus” or “ductus arteriosus,” and “prematurity” or “very low birth weight infant.” Studies were included if they were randomized controlled trials, case–control studies, or cohort studies that included information relating to chorioamnionitis and PDA. Results: Among 1,571 studies, a total of 23 studies (17,708 cases) were included in the meta-analysis to analyze the relationship between chorioamnionitis and PDA, except one study that only included PDA requiring surgical ligation. The association between chorioamnionitis and PDA was statistically significant (odds ratio [OR] 1.43; 95% confidence interval [CI] 1.19, 1.72; P < 0.0001). In subgroup analysis, clinical chorioamnionitis was not associated with PDA (OR 1.28; 95% CI 1.00, 1.64, 1.790; P = 0.05), whereas histologic chorioamnionitis (OR 1.54; 95% CI 1.10, 2.15; P = 0.01) and chorioamnionitis diagnosed from both clinical and histologic findings (OR 1.75; 95% CI 1.07, 2.86; P = 0.03) showed significant associations with PDA. Chorioamnionitis did not increase the risk of PDA requiring surgical ligation (OR 1.23; 95% CI 0.69, 2.17; P = 0.48), and antenatal steroid use reduced the risk of PDA (OR 0.62; 95% CI 0.42, 0.90; P = 0.01) after chorioamnionitis. Conclusions: The results from this meta-analysis support an association between maternal chorioamnionitis and PDA in offspring. [ABSTRACT FROM AUTHOR]

In this study, we investigated medically or surgically actionable genes in inherited eye disease, based on clinical phenotype and genomic data. This retrospective consecutive case series included 149 patients with inherited eye diseases, seen by a single pediatric ophthalmologist, who underwent genetic testing between 1 March 2017 and 28 February 2018. Variants were detected using a target enrichment panel of 429 genes and known deep intronic variants associated with inherited eye disease. Among 149 patients, 38 (25.5%) had a family history, and this cohort includes heterogeneous phenotype including anterior segment dysgenesis, congenital cataract, infantile nystagmus syndrome, optic atrophy, and retinal dystrophy. Overall, 90 patients (60.4%) received a definite molecular diagnosis. Overall, NGS-guided precision care was provided to 8 patients (5.4%). The precision care included cryotherapy to prevent retinal detachment in COL2A1 Stickler syndrome, osteoporosis management in patients with LRP5-associated familial exudative vitreoretinopathy, and avoidance of unnecessary phlebotomy in hyperferritinemia-cataract syndrome. A revision of the initial clinical diagnosis was made in 22 patients (14.8%). Unexpected multi-gene deletions and dual diagnosis were noted in 4 patients (2.7%). We found that precision medical or surgical managements were provided for 8 of 149 patients (5.4%), and multiple locus variants were found in 2.7% of cases. These findings are important because individualized management of inherited eye diseases can be achieved through genetic testing. [ABSTRACT FROM AUTHOR]

Abstract: Gaucher''s disease is caused by a deficiency of glucocerebrosidase (GBA) and results in the accumulation of glucocerebroside within macrophages. We report on a 33+2 gestational week premature infant whose family history was significant for a previously undiagnosed premature sibling with similar clinical features, including severe hydrops fetalis, hepatosplenomegaly, skin lesions at birth followed by death. The diagnosis of Gaucher''s disease type 2 in the present case was based on postmortem pathological findings and a subsequent gene analysis that indicated a heterozygous condition for the novel deletion mutation at GBA cDNA nucleotide position 630 resulting in the frameshift (Pro171fsX21) in exon 6 and a G→A transition mutation at GBA cDNA nucleotide position 887 (Arg257Gln) in exon 7. [Copyright &y& Elsevier]

Background. Subtotal nephrectomy (N) in rats results in progressive hypertension, proteinuria and renal lesions. Renin–angiotensin system blockade initiated at N prevents these changes; treatments failing to reduce hypertension and proteinuria do not. Methods. Ten Munich-Wistar rats underwent 1½ surgical N; eight littermates were pretreated with losartan (L) only for 6 weeks prior to 1½ N (N + L). Pretreated (n = 8; C + L) and untreated controls (C; n = 8) had sham operations. Results. Over 6 months, N and N + L rats developed ∼80% increase in glomerular filtration rate per nephron over C and C + L, P < 0.001). Hypertension (intra-arterial mean blood pressure 116 ± 6.8 mmHg in N rats versus 102 ± 3.2 in C, 104 ± 8.4 in C + L, and 104 ± 8.4 in N + L rats, P < 0.001 for all) and proteinuria (120 ± 20 mg/day in N versus 39 ± 10 in C, 34 ± 8 in C + L and 35 ± 8 in N + L, P < 0.001 for all) developed only in N. Focal segmental glomerulosclerosis (FSGS) (%) at 6 months was 20 ± 8 in N and 17.5 ± 8 in N + L (ns) and <1 in C and C + L (P < 0.001 versus N and N + L). Interstitial fractional volume (Vv), 4.0 ± 1.7% in C and 4.4 ± 1.6% in C + L (ns), was similarly increased to 7.5 ± 2.5% in N and 9.0 ± 3.9% in N+L (P < 0.04 versus C and C + L). Atrophic tubule Vv was increased by >300% in N and N + L over C and C + L (P < 0.02 for all). Glomerular volume doubled in N and N + L (P < 0.001). Podocyte foot process effacement was greater in N and NL than in C or C + L (P ≤ 0.02 for all). Thus, L given for 6 weeks prior to 1½ N prevented hypertension and proteinuria over the subsequent 6 months without reducing glomerular hypertrophy, hyperfiltration or interstitial, tubular or FSGS lesions or foot process effacement. Conclusions. These studies dissociated systemic hypertension and proteinuria from the renal lesions in this model. Durable effects of losartan on blood pressure and proteinuria likely represent epigenetic processes. [ABSTRACT FROM PUBLISHER]

ABSTRACT Sodium benzoate (SB) is widely used in food chemistry, cosmetics and the pharmaceutical industry. Previous studies suggest possible toxic effects of SB when used as a food preservative. However, these studies were confined to microbiological systems. Therefore, we investigated the cytotoxic effects of SB in rat-cultured cortical neurons and in human clonal epithelial cells (HeLa cells) using cell death assays and the fluorescent measurements of intracellular Ca 2+ concentration ([Ca 2+ ]i) and mitochondrial transmembrane potential (Δψm). We found that SB induced cell death in a dose-dependent manner. Even 0.1% (w/v) SB, a concentration typically added to soft drinks, produced a significant decrease in cell viability in rat cortical and HeLa cells. We also found that SB caused [Ca 2+ ]i and Δψm increases in a dose-dependent manner. Based on our results, more caution and further cellular studies are required with respect to the use of SB as a food preservative. PRACTICAL APPLICATIONS Our research is mainly focused on the toxic effects of sodium benzoate (SB), a common preservative used in foods, in mammalian cell systems. Recently, there are many mass media reports noticing the damaging effects of SB on vital parts of mitochondrial DNAs, which based on a study, can cause many diseases including Parkinson's and other neurodegenerative disorders. In addition, there is a human study that reports that consumption of certain mixtures of artificial food colors and SB preservative are associated with increases in hyperactive behavior in children. Therefore, our research suggests the necessity of further caution and cellular studies before the continued use of SB as a food preservative can be considered free of risk to human health. [ABSTRACT FROM AUTHOR]

Abstract: Although CaV1.2 and CaV1.3 are two subtypes of L-type Ca2+ channels expressed in the CNS, functions of CaV1.3 have not been well elucidated compared to CaV1.2. Here, we found that CaV1.3-NT associates with GABABR2-CT using yeast two-hybrid, GST pull-down and co-immunoprecipitation assays. We also demonstrated co-localization of CaV1.3 and GABABR2 in HEK293 cells and cultured hippocampal neurons. Whole-cell patch-clamp and Ca2+-imaging experiments revealed that activation of GABABR increases CaV1.3 currents and intracellular Ca2+ via CaV1.3, but not CaV1.2. These results show a physical and functional interaction between CaV1.3 and GABABR, suggesting the potential pivotal roles of CaV1.3 in the CNS. Structured summary: MINT-7975667: Cav1.3 (uniprotkb:P27732) physically interacts (MI:0915) with GABABR2 (uniprotkb:O88871) by two hybrid (MI:0018) MINT-7975740: Cav1.3 (uniprotkb:P27732) and GABABR2 (uniprotkb:O75899) colocalize (MI:0403) by fluorescence microscopy (MI:0416) MINT-7966007, MINT-7966016: Cav1.3 (uniprotkb:P27732) physically interacts (MI:0915) with GABABR2 (uniprotkb:O88871) by anti bait coimmunoprecipitation (MI:0006) MINT-7975712, MINT-7975691: Cav1.3 (uniprotkb:P27732) physically interacts (MI:0915) with GABABR2 (uniprotkb:O88871) by pull down (MI:0096) MINT-7966026: GABABR2 (uniprotkb:O88871) and Cav1.3 (uniprotkb:P27732) colocalize (MI:0403) by fluorescence microscopy (MI:0416) [ABSTRACT FROM AUTHOR]

Abstract: Tau is a main component of the aberrant paired helical filaments (PHF) found in Alzheimer''s disease (AD). It has also been reported to enhance oxidative stress, which is a major factor in the pathogenesis of neurodegenerative diseases. However, protective functions of Tau have recently been reported, including antagonizing apoptosis, in addition to its role in stabilizing microtubules. In this study, the interaction between Tau and triose phosphate isomerase (TPI) in a normal, nondisease state as well as in a neurodegeneration state was examined and demonstrated for the first time. More importantly, we also showed that Tau protects TPI against oxidative damage. An oxidative stress-induced decrease in the activity of TPI was attenuated in Tau-overexpressing cells, indicating that Tau protects TPI against oxidative damage. By contrast, the activity of TPI was decreased in Tau-transgenic (Tg) mice compared to non-Tg (NTg) mice even though protein levels were not changed in both groups. Some TPIs were found on the PHF in Tg mice, which explains the decrease in the activity of TPI. Taken together, we concluded that while Tau binds and protects TPI in normal cells, and conversely, the formation of PHF induced by Tau phosphorylation trap some TPI and trigger the functional loss of TPI in the development of neurodegenerative diseases. Our results provide new insights into understanding the in-depth involvement of Tau in the development of neurodegenerative disorders. [Copyright &y& Elsevier]

The aim of this meta-analysis was to determine the incidence and risk factors of early pulmonary hypertension (PHT) in preterm infants and evaluate the association of early PHT with morbidities such as bronchopulmonary dysplasia (BPD), late PHT, and in-hospital mortality. We searched the PubMed (1980–2021), Embase (1968–2021), CINAHL (2002–2021), Cochrane library (1989–2021), and KoreaMed (1993–2021). Observational studies on the association between early PHT diagnosed within the first 2 weeks after birth and its clinical outcomes in preterm infants born before 37 weeks of gestation or with very low birth weight (< 1500 g) were included. Two authors independently extracted the data and assessed the quality of each study using a modified Newcastle–Ottawa Scale. We performed meta-analysis using Comprehensive Meta-Analysis version 3.3. A total of 1496 potentially relevant studies were found, of which 8 studies (7 cohort studies and 1 case–control study) met the inclusion criteria comprising 1435 preterm infants. The event rate of early PHT was 24% (95% confidence interval [CI] 0.174–0.310). The primary outcome of our study was moderate to severe BPD at 36 weeks postmenstrual age, and it was associated with early PHT (6 studies; odds ratio [OR] 1.682; 95% CI 1.262–2.241; P < 0.001; heterogeneity: I2 = 0%; P = 0.492). Preterm infants with early PHT had higher OR of in-hospital mortality (6 studies; OR 2.372; 95% CI 1.595–3.528; P < 0.001; heterogeneity: I2 = 0%; P = 0.811) and developing late PHT diagnosed after 4 weeks of life (4 studies; OR 2.877; 95% CI 1.732–4.777; P < 0.001; heterogeneity: I2 = 0%; P = 0.648). Infants with oligohydramnios (4 studies; OR 2.134; 95% CI 1.379–3.303; P = 0.001) and those who were small-for-gestational-age (5 studies; OR 1.831; 95% CI 1.160–2.890; P = 0.009) had an elevated risk of developing early PHT. This study showed that early PHT is significantly associated with mortality and morbidities, such as BPD and late PHT. Preterm infants with a history of oligohydramnios and born small-for-gestational-age are at higher risk for developing early PHT; however, high-quality studies that control for confounders are necessary. [ABSTRACT FROM AUTHOR]

This study examines associations between sleep apnea risk and hypertension in a sample of immigrant Chinese and Korean Americans. The dataset included Chinese and Korean patients ages 50–75 recruited from primary care physicians' offices from April 2018 to June 2020 in the Baltimore-Washington DC Metropolitan Area (n = 394). Hypertension risk was determined using a combination of blood pressure measurements, self-reported diagnosis of hypertension by a medical professional, and/or self-reported use of antihypertensive medications. Linear regression models examined the associations between sleep apnea risk and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Poisson regression models examined associations sleep apnea risk and hypertension. Models controlled for body mass index (BMI), demographic, and socioeconomic risk factors. We further examined models for potential effect modification by age, gender, Asian subgroup, and obesity, as well as effect modification of daytime sleepiness on the association between snoring and hypertension risk. High risk of sleep apnea appeared to be associated positively with SBP (β = 6.77, 95% CI: 0.00–13.53), but not with DBP. The association was positive for hypertension, but it was not statistically significant (PR = 1.11, 95% CI: 0.87–1.41). We did not find effect modification of the associations between sleep apnea and hypertension risk, but we did find that daytime sleepiness moderated the effect of snoring on SBP. Snoring was associated with higher SBP, primarily in the presence of daytime sleepiness, such that predicted SBP was 133.27 mmHg (95% CI: 126.52, 140.02) for someone with both snoring and daytime sleepiness, compared to 123.37 mmHg (95% CI: 120.40, 126.34) for someone neither snoring nor daytime sleepiness. Chinese and Korean immigrants living in the U.S. who are at high risk of sleep apnea have higher SBP on average, even after accounting for sociodemographic characteristics and BMI. : NCT03481296, date of registration: 3/29/2018 [ABSTRACT FROM AUTHOR]

Background & Aims: Although non‐alcoholic fatty liver disease (NAFLD) is becoming a leading cause of hepatocellular carcinoma (HCC), HCC risk in non‐cirrhotic NAFLD received little attention. We aimed to develop and validate an HCC risk prediction model for non‐cirrhotic NAFLD. Methods: A nationwide cohort of non‐cirrhotic NAFLD patients in Korea was recruited to develop a risk prediction model and validate it internally (n = 409 088). A model using a simplified point system was developed by Cox proportional hazard model. K‐fold cross‐validation assessed the accuracy, discrimination and calibration. The model was validated externally using a hospital cohort from Asan Medical Center (n = 8721). Results: An 11‐point HCC risk prediction model for non‐cirrhotic NAFLD was developed using six independent factors of age, sex, diabetes, obesity, serum alanine aminotransferase level and gamma‐glutamyl transferase level (c‐index 0.75). The average area under receiver operating curves (AUROCs) of the model was 0.72 at 5 years and 0.75 at 10 years. In the external validation cohort, the AUROCs were 0.79 [95% confidence interval [CI], 0.59–0.95] at 5 years and 0.84 (95% CI, 0.73–0.94) at 10 years. The calibration plots showed the expected risks corresponded well with the observed risks. Risk stratification categorized patients into the low (score 0–6), moderate (7, 8) and high (9–11; estimated incidence rate >0.2%/year) risk groups. Conclusions: A novel HCC risk prediction model for non‐cirrhotic NAFLD patients was developed and validated with fair performance. The model is expected to serve as a simple and reliable tool to assess HCC risk and assist precision screening of HCC. [ABSTRACT FROM AUTHOR]

Background and Aim: Although obesity is a known risk factor for colorectal neoplasms, the correlation between weight change and colorectal neoplasm is unclear. Thus, we aim to evaluate the association between weight change and advanced colorectal neoplasm (ACRN) recurrence during post‐polypectomy surveillance colonoscopy. Methods: This retrospective cohort study included 7473 participants diagnosed with colorectal neoplasms between 2003 and 2010 who subsequently underwent surveillance colonoscopies until 2020. We analyzed the association between the risk of metachronous ACRN and weight change, defining stable weight as a weight change of <3% and weight gain as a weight increase of ≥3% from baseline during the follow‐up period. Results: During a median 8.5 years of follow‐up, 619 participants (8.3%) developed ACRN. Weight gain was reported as an independent risk factor for metachronous ACRN in a time‐dependent Cox analysis. A weight gain of 3–6% and ≥6% had adjusted hazard ratios (AHRs) of 1.48 (95% confidence interval [CI]: 1.19–1.84) and 2.14 (95% CI: 1.71–2.69), respectively. Participants aged 30–49 and 50–75 years with weight gain of ≥6% showed AHRs of 2.88 (95% CI: 1.96–4.21) and 1.90 (95% CI: 1.43–2.51), respectively. In men and women, weight gain of ≥3% was significantly correlated with metachronous ACRN. Conclusions: Weight gain is associated with an increased risk of metachronous ACRN. Furthermore, weight gain is associated with the recurrence of ACRN in both men and women regardless of age. [ABSTRACT FROM AUTHOR]

Introduction: Today, firefighters' work areas are expanding into various fields. The aim of the study was to investigate the effect of mental health on quality of life between firefighters in the capital area and in the growth promotion area. Method: A survey was conducted with 206 firefighters including 110 firefighters in the capital area and 96 firefighters in the growth promotion area through a questionnaire. Result: The differences in mental health based on working areas between firefighter groups have been identified. In addition, among the factors affecting the quality of life among firefighter, the factor most closely associated with quality of life was "sociopsychological health stress," followed by "occupational stress," "depression," and "working area." Conclusion: There is a need for research into mental health interventions appropriate for regional characteristics of each region regarding the implementation of mental health management by working area. [ABSTRACT FROM AUTHOR]

Tight regulation of Toll‐like receptor (TLR)‐mediated inflammatory responses is important for innate immunity. Here, we show that T‐cell death‐associated gene 51 (TDAG51/PHLDA1) is a novel regulator of the transcription factor FoxO1, regulating inflammatory mediator production in the lipopolysaccharide (LPS)‐induced inflammatory response. TDAG51 induction by LPS stimulation was mediated by the TLR2/4 signaling pathway in bone marrow‐derived macrophages (BMMs). LPS‐induced inflammatory mediator production was significantly decreased in TDAG51‐deficient BMMs. In TDAG51‐deficient mice, LPS‐ or pathogenic Escherichia coli infection‐induced lethal shock was reduced by decreasing serum proinflammatory cytokine levels. The recruitment of 14‐3‐3ζ to FoxO1 was competitively inhibited by the TDAG51‐FoxO1 interaction, leading to blockade of FoxO1 cytoplasmic translocation and thereby strengthening FoxO1 nuclear accumulation. TDAG51/FoxO1 double‐deficient BMMs showed significantly reduced inflammatory mediator production compared with TDAG51‐ or FoxO1‐deficient BMMs. TDAG51/FoxO1 double deficiency protected mice against LPS‐ or pathogenic E. coli infection‐induced lethal shock by weakening the systemic inflammatory response. Thus, these results indicate that TDAG51 acts as a regulator of the transcription factor FoxO1, leading to strengthened FoxO1 activity in the LPS‐induced inflammatory response. Synopsis: Toll‐like receptor (TLR) signaling is tightly controlled during inflammatory responses. Here, TDAG51/PHLDA1 is identified as a new interactor and regulator of transcription factor FoxO1, stimulating inflammatory mediator production upon LPS challenge. TDAG51 expression is induced during the LPS‐induced inflammatory response in macrophages.TDAG51 interacts with the transcription factor FoxO1 and competitively inhibits 14‐3‐3흵 bindingTDAG51‐FoxO1 interaction and reduced 14‐3‐3흵 binding enhances FoxO1 nuclear accumulation, thereby promoting inflammatory mediator expression.TDAG51 deficiency attenuates LPS‐induced lethal shock by weakening the inflammatory response in mice. [ABSTRACT FROM AUTHOR]

Background and Aim Current guidelines recommend colon cancer screening for persons aged over 50 years. However, there are few data on colorectal cancer screening in 40- to 49-year-olds. This study assessed the prevalence and risk factors of colorectal neoplasms in 40- to 49-year-old Koreans. Methods We analyzed the results of screening colonoscopies of 6680 persons 40-59 years of age (2206 aged 40-49 and 4474 aged 50-59 years). Results The prevalence of overall and advanced neoplasms in the 40- to 49-year age group was lower than in the 50- to 59-year age group (26.7% and 2.4% vs 37.8% and 3.5%, respectively). However, the prevalence of overall and advanced neoplasms increased to 39.1% and 5.4%, respectively, in 45- to 49-year-old individuals with metabolic syndrome. In the 40- to 49-year age group, age, current smoking, and metabolic syndrome were associated with an increased risk of advanced neoplasms (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04-1.30; OR 3.12, 95% CI 1.20-8.12; and OR 2.00, 95% CI 1.09-3.67, respectively). Conclusions Individuals aged 40-49 years had a lower prevalence of colorectal neoplasms than those aged 50-59 years, but some 40- to 49-year-olds showed a similar prevalence to those aged 50-59 years. Age, current smoking habits, and metabolic syndrome are associated with an increased risk of advanced neoplasms in subjects aged 40-49 years. Further studies are needed to stratify the risks of colon cancer and guide targeted screening in persons younger than 50 years old. [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests an association between the vitamin D levels and respiratory outcomes of preterm infants. The objective of this systematic review and meta-analysis was to explore whether premature neonates with a vitamin D deficiency have an increased risk of respiratory distress syndrome (RDS). Methods: We searched PubMed, EMBASE, and the Cochrane Library up through July 20, 2021. The search terms were 'premature infant', 'vitamin D', and 'respiratory distress syndrome'. We retrieved randomized controlled trials and cohort and case-control studies. For statistical analysis, we employed the random-effects model in Comprehensive Meta-Analysis Software ver. 3.3. We employed the Newcastle-Ottawa Scales for quality assessment of the included studies. Results: A total of 121 potentially relevant studies were found, of which 15 (12 cohort studies and 3 case-control studies) met the inclusion criteria; the studies included 2,051 preterm infants. We found significant associations between RDS development in such infants and vitamin D deficiency within 24 h of birth based on various criteria, thus vitamin D levels < 30 ng/mL (OR 3.478; 95% CI 1.817–6.659; p < 0.001), < 20 ng/mL (OR 4.549; 95% CI 3.007–6.881; p < 0.001), < 15 ng/mL (OR 17.267; 95% CI 1.084–275.112; p = 0.044), and < 10 ng/ml (OR 1.732; 95% CI 1.031–2.910; p = 0.038), and an even lower level of vitamin D (SMD = –0.656; 95% CI –1.029 to –0.283; p = 0.001). Conclusion: Although the vitamin D deficiency definitions varied and different methods were used to measure vitamin D levels, vitamin D deficiency or lower levels of vitamin D within 24 h of birth were always associated with RDS development. Monitoring of neonatal vitamin D levels or the maintenance of adequate levels may reduce the risk of RDS. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is a group of chronic inflammatory diseases of the gastrointestinal tract. Although the multifactorial etiology of IBD pathogenesis is relatively well documented, the regulatory factors that confer a risk of IBD pathogenesis remain less explored. In this study, we report that T-cell death-associated gene 51 (TDAG51/PHLDA1) is a novel regulator of the development of dextran sulfate sodium (DSS)-induced colitis in mice. TDAG51 expression was elevated in the colon tissues of DSS-induced experimental colitis mice. TDAG51 deficiency protected mice against acute DSS-induced lethality and body weight changes and disease severity. DSS-induced structural damage and mucus secretion in colon tissues were significantly reduced in TDAG51-deficient mice compared with wild-type mice. We observed similar results in a DSS-induced chronic colitis mouse model. Finally, we showed that the production of inflammatory mediators, including proinflammatory enzymes, molecules and cytokines, was decreased in DSS-treated TDAG51-deficient mice compared with DSS-treated wild-type mice. Thus, we demonstrated that TDAG51 deficiency plays a protective role against DSS-induced colitis by decreasing the production of inflammatory mediators in mice. These findings suggest that TDAG51 is a novel regulator of the development of DSS-induced colitis and is a potential therapeutic target for IBD. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is a chronic disorder characterized by high plasma glucose level and by the accompanying micro- and macrovascular complications. Abnormal glucose homeostasis is frequently found in patients with chronic liver disease (CLD) and cirrhosis, and high mean plasma glucose levels are common in T2D patients with CLD. Although hyperglycemia may cause or predates microvascular complications, a small proportion of T2D patients, especially those with CLD, do not develop any evidence of diabetic retinopathy (DR). We sought to determine if the regulation of vascular endothelial growth factor (VEGF), which has been implicated in the development of DR differs in those patients who develop DR after many years of diabetes compared with those who do not develop DR. We performed standard 7-field stereoscopic fundus photography on 35 consecutive patients with T2D patients with or without CLD. Patients were categorized into 4 groups according to the presence or absence of DR, CLD and the duration of diabetes: group 1 was defined by CLD(+), DR(+); group 2 was defined by CLD(+), DR(-) after >15 years of diabetes; group 3 was defined by CLD(-), DR(+); and group 4 was defined by CLD(-), DR(-) after >15 years of diabetes. Monocytes from peripheral blood were isolated from all patients, and the hypoxic induction of VEGF was determined in vitro by RT-PCR or ELISA. We found no significant difference in the basal level of VEGF in patients with and without DR. The basal VEGF concentration in patients with CLD is comparable to that without CLD (606±301 vs. 508±262 pg/ml). However, we did find a markedly significant difference in the hypoxic induction of VEGF between patients from group 1 and group 2 (4.3±0.5 vs. 1.7±0.3, P<0.01). From these, we can suggest that at least in part, absence of DR in patients with long-standing diabetes especially in those with CLD might be explained by decreased hypoxic induction of VEGF. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the protective effect of Juglans regia (walnut, Gimcheon 1ho cultivar, GC) on high-fat diet (HFD)-induced cognitive dysfunction in C57BL/6 mice. The main physiological compounds of GC were identified as pedunculagin/casuariin isomer, strictinin, tellimagrandin I, ellagic acid-O-pentoside, and ellagic acid were identified using UPLC Q-TOF/MS analysis. To evaluate the neuro-protective effect of GC, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), 2′,7′-dichlorodihydrofluorecein diacetate (DCF-DA) analysis were conducted in H2O2 and high glucose-induced neuronal PC12 cells and hippocampal HT22 cells. GC presented significant cell viability and inhibition of reactive oxygen species (ROS) production. GC ameliorated behavioral and memory dysfunction through Y-maze, passive avoidance, and Morris water maze tests. In addition, GC reduced white adipose tissue (WAT), liver fat mass, and serum dyslipidemia. To assess the inhibitory effect of antioxidant system deficit, lipid peroxidation, ferric reducing antioxidant power (FRAP), and advanced glycation end products (AGEs) were conducted. Administration of GC protected the antioxidant damage against HFD-induced diabetic oxidative stress. To estimate the ameliorating effect of GC, acetylcholine (ACh) level, acetylcholinesterase (AChE) activity, and expression of AChE and choline acetyltransferase (ChAT) were conducted, and the supplements of GC suppressed the cholinergic system impairment. Furthermore, GC restored mitochondrial dysfunction by regulating the mitochondrial ROS production and mitochondrial membrane potential (MMP) levels in cerebral tissues. Finally, GC ameliorated cerebral damage by synergically regulating the protein expression of the JNK signaling and apoptosis pathway. These findings suggest that GC could provide a potential functional food source to improve diabetic cognitive deficits and neuronal impairments. [ABSTRACT FROM AUTHOR]

Background and Aim: Although metabolic factors such as obesity and hyperlipidemia were reported to be associated with high prevalence of colorectal neoplasm (CRN), their influence on the occurrence of CRN at surveillance colonoscopy has not been clarified. The purpose of this study was to analyze the association between metabolic factors and the risk of CRN at the time of surveillance colonoscopy. Methods: We reviewed the medical records of 1792 asymptomatic subjects (average 52.1 years, 1233 male) who underwent screening and follow-up surveillance colonoscopies. Fasting glucose level, fasting insulin level, hemoglobin A1c (HbA1c), lipid profile, high sensitivity C-reactive protein, and colonoscopic findings at the time of baseline screening were analyzed to find any associations with the occurrence of CRN at the time of surveillance colonoscopy. Results: The median interval between screening and surveillance colonoscopies was 3.34 years. The 3- and 5-year cumulative CRN incidences were 22.3% and 54.8%, respectively. Several metabolic factors such as hypertension, waist circumference, fasting insulin, fasting glucose, HbA1c, and triglyceride were associated with the occurrence of CRN in univariate analysis. Age, current alcohol drinker status, and high-risk colonoscopy findings at baseline remained independent risk factors for CRN occurrence in multivariate analysis. High waist circumference was also an independent risk factor (hazard ratio 1.03, 95% CI 1.02-1.04; P < 0.001). Conclusions: Metabolic factors, especially waist circumference, affect CRN occurrence at the time of surveillance colonoscopy. The surveillance colonoscopy interval may be optimized based on metabolic factors and screening colonoscopy findings. [ABSTRACT FROM AUTHOR]

Objectives: Post‐polypectomy surveillance intervals should be determined based on index colonoscopy findings. However, the risk of metachronous lesions, resulting from the coexistence of adenoma and sessile serrated lesions (SSLs), has rarely been addressed. We evaluated the impact of synchronous SSL on the risk of metachronous lesions within similar adenoma risk groups. Methods: We retrieved individuals with one or more adenomas on index colonoscopy in a single‐center retrospective cohort and stratified them into four groups depending on the presence of SSL and low‐risk/high‐risk adenoma (LRA/HRA). Participants who underwent surveillance colonoscopies at least 12 months apart were included. We compared the risks of metachronous lesions including HRA, advanced adenoma (AA), or SSL within similar adenoma risk groups according to the presence of SSL. Results: Overall 4493 individuals were included in the analysis. The risk of metachronous HRA/AA was not significantly higher in the adenoma with SSL group compared with the adenoma without SSL group, irrespective of LRA (HRA, 6/86 vs. 231/3297, P = 1.00; AA, 0/86 vs. 52/3297, P = 0.64) or HRA (HRA, 11/64 vs. 240/1046, P = 0.36; AA, 3/64 vs. 51/1046, P = 1.00). However, the risk of metachronous SSL in individuals with synchronous SSL was higher than that in those without SSL for both LRA (15/86 vs. 161/3297, P < 0.001) and HRA groups (11/64 vs. 61/1046, P = 0.002). Conclusion: The presence of synchronous SSL did not increase the risk of metachronous HRA/AA, compared with isolated adenoma, but increased the risk of metachronous SSL. [ABSTRACT FROM AUTHOR]

Objectives Thyroid dysfunction affects clinical complications in preterm infants and older children. However, thyroid hormone replacement in preterm infants has no proven benefits, possibly owing to the lack of an appropriate reference range for thyroid hormone levels. We aimed to establish a reference range for triiodothyronine (T3) levels at 1-month postnatal age (PNA) in preterm infants. Methods This retrospective study included preterm infants born at a tertiary referral neonatal center at gestational age (GA) < 35 weeks with no apparent thyroid dysfunction, for 6 consecutive years, with follow-up from PNA 2 weeks to 16 weeks. Using thyroid function tests (TFT), the relationships between T3 levels and thyrotropin (TSH) and free thyroxine (fT4) levels, birth weight, GA, postmenstrual age (PMA), and PNA were examined. The conversion trend for fT4 to T3 was analyzed using the T3/fT4 ratio. Results Overall, 464 TFTs from 266 infants were analyzed, after excluding 65 infants with thyroid dysfunction. T3 levels increased with fT4 levels, birth weight, GA, PMA, and PNA but not with TSH levels. The T3/fT4 ratio also increased with GA, PNA, and PMA. The average T3 level at 1 month PNA was 72.56 ± 27.83 ng/dL, with significant stratifications by GA. Conclusions Relatively low T3 and fT4 levels in preterm infants were considered normal, with T3 levels and conversion trends increasing with GA, PMA, and PNA. Further studies are required to confirm the role of the present reference range in thyroid hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Prior research contends that social support positively influences health by optimizing individuals' psychological processes such as appraisals, emotions, and sense of control—known as stress-buffering effects. This study tests this theoretical concept by examining whether the association between social support and health can be explained by the psychological processes of perceived stress and distress among Chinese and Korean American immigrants. Furthermore, we examine what predicts social support in this population, with a particular focus on factors related to immigration. Using a total sample of 400 Chinese and Korean American immigrants, we examine the association between social support and self-rated health (SRH), accounting for demographic factors, socioeconomic status, perceived stress, and perceived distress using multivariable logistic regression models. We conducted a mediation analysis using the Karlson, Holm, and Breen (KHB) method to determine whether perceived stress and distress partly explained the association between social support and SRH. Findings showed a strong total effect of higher social support on better SRH. Furthermore, mediation was detected, with perceived stress and distress explaining 42.98% of the total effect of social support on SRH. Multivariable linear regression models revealed that social support among Chinese and Korean American immigrants was associated with marital status, employment, ethnic identity, and acculturative stress. This study highlights the centrality of social support for Chinese and Korean American immigrants, which lowers perceived stress and distress, leading to better overall health. By confirming these stress-buffering effects, our findings suggest that bolstering social support among vulnerable Chinese and Korean American immigrant populations can have a positive effect on health by optimizing stress appraisals. • Social support is associated with better health for Chinese and Korean Americans. • Perceived stress and distress explain half the effect of social support on health. • Those with low acculturative stress and high acculturation have more social support. [ABSTRACT FROM AUTHOR]

Abstract: MDK is a heparin-binding growth factor associated with cancer development. Here, we sought to examine the association of MDK expression with resistance and sensitivity to different chemotherapeutic agents. We established stable HeLa cell transfectants (HeLa–MDK) and tested for decreased sensitivity to chemotherapeutic agents (5-FU, doxorubicin, and cisplatin). In addition, we used siRNA to block MDK expression in SNU-638 human gastric cancer cells and examined the chemosensitizing effect. HeLa–MDK cells treated with 5-FU, doxorubicin, and cisplatin showed a fold increase in the average IC50 and an increased cell survival. siRNA-based knockdown of MDK expression in SNU-638 cells decreased the average IC50 by 18–44% in cells treated with three drugs. Further investigations on the molecular mechanism should be clarified, but these results indicate that MDK up- and down-regulation appears to be capable of changing the chemosensitivities of cancer cells and MDK may have possible importance as a candidate therapeutic molecule. [Copyright &y& Elsevier]

Idiopathic pneumoperitoneum has an unknown etiology despite exploratory laparotomy. However, it may occur without definite abdominal symptoms; thus, adequate management could be in clinical dilemma. We experienced three cases of idiopathic nonsurgical pneumoperitoneum in healthy individuals during a health check-up. Their cases were not accompanied by any relevant etiology or definite abdominal symptoms. All of the three cases exhibited a benign clinical course. The three patients underwent an abdominal computed tomography (CT) scan as part of a health check-up program, which incidentally revealed free air in the right paracolic gutter without evidence of visceral perforation or inflammation. Among the three cases, two patients underwent colonoscopy before abdominal CT, whereas one patient did not. Two cases were completely asymptomatic and were observed without any treatment in the outpatient clinic. Only the third case with minimal symptoms was treated conservatively for a short time. If a small amount of free air typically located in the right paracolic gutter is detected in the absence of perforation during colonoscopy, close observation without unnecessary treatment would be sufficient. [ABSTRACT FROM AUTHOR]

Heme oxygenase-1 (HO-1) has been implicated in tumor progression, but the underlying molecular mechanisms remain largely unknown. Transforming growth factor-β1 (TGF-β1) exhibits cytostatic and apoptotic effects in hepatocytes and several types of hepatocellular carcinoma (HCC) cell lines, and deregulation of its signaling pathway is linked to hepatic tumorigenesis. In the present study, we observed that HO-1 is expressed at higher levels in HCC tissues than in paired normal tissues. Moreover, TGF-β1-induced cell cycle arrest and up-regulation of cyclin-dependent kinase inhibitors in HCC cell lines were significantly attenuated by overexpression of HO-1 or treatment with tricarbonyldichlororuthenium(II) dimer ([Ru(CO) 3 Cl 2 ] 2 , suggesting an inhibitory role of the HO-1/CO axis in TGF-β signaling to growth inhibition in HCC cell lines. Interestingly, we observed that [Ru(CO) 3 Cl 2 ] 2 inhibits TGF-β1-induced Smad3-dependent reporter activity without affecting its C-terminus phosphorylation, complex formation with Smad4, and nuclear translocation. Additional experiments revealed that HO-1/CO axis selectively induces phosphorylation of Smad3 at Thr-179 residue in the linker region through activation of extracellular signal-activated kinase (ERK) 1/2. Transfection with a phospho-deficient Smad3 (T179A) mutant or treatment with FR180204, a specific inhibitor for ERK1/2, significantly reversed the inhibitory effects of HO-1 and [Ru(CO) 3 Cl 2 ] 2 on cell cycle arrest induced by TGF-β1. These findings for the first time demonstrate that HO-1/CO axis confer resistance of HCC cells to TGF-β growth inhibitory signal by increasing Smad3 phosphorylation at Thr-179 via ERK1/2 pathway. [ABSTRACT FROM AUTHOR]

Background: The recurrence rate after standard cold forceps polypectomy (CFP) of diminutive polyps of ≤5 mm has not been fully determined. The aim of this study was to analyze the long-term follow-up results and recurrence rate after CFP of diminutive polyps.Methods: We retrospectively reviewed the medical records of 884 (738 men; age 53 years) asymptomatic subjects who underwent surveillance colonoscopy after CFP of 1-2 diminutive adenomatous polyps. Cumulative recurrence at the CFP site and risk factors for recurrence were analyzed.Results: Overall recurrence over 59.7 months was 17 % after CFP of 1111 diminutive polyps. The rate of definite recurrence was 4 %, and probable recurrence was 13 %. Recurrence as advanced adenoma was 0.5 % (5/1111). The cumulative probabilities of recurrence at 3, 5, and 7 years after CFP were 10.0, 16.0, and 21.1 %, respectively. Multivariate analysis revealed that polyp 4-5 mm in size and right colonic polyp were risk factors for recurrence (hazard ratio [HR] 1.37; 95 % confidence interval [CI] 1.01-1.86 and HR 1.49; 95 % CI 1.08-2.04, respectively). The recurrence rate for 10 endoscopists who performed at least 50 CFPs ranged from 11.0 to 25.2 %; the probability of recurrence in those in the top half in terms of recurrence rate was 1.6-fold higher than that of those in the bottom half (95 % CI 1.17-2.19).Conclusions: Although recurrence may develop after standard CFP of diminutive polyps, recurrence as advanced adenoma is rare. Large polyp size, right colon polyp, and endoscopist are risk factors for recurrence after standard CFP. [ABSTRACT FROM AUTHOR]

Background and Aim: This study aimed to develop and validate a risk score model to estimate the probability of a metachronous advanced colorectal neoplasm (ACRN) at surveillance colonoscopy.Methods: A retrospective analysis of a prospectively obtained database of 11,042 asymptomatic subjects who underwent surveillance colonoscopy after a screening colonoscopy was conducted. Subjects were randomly divided into derivation (n = 7730) and validation sets (n = 3312). From the derivation cohort, risk factors for a metachronous ACRN were identified by a multivariable analysis. Risk points were allocated to each risk factor based on the hazard ratio to develop the Metachronous Advanced colorectal neoplasm Prediction Scoring (MAPS) model, the performance of which was assessed in the validation cohort.Results: In the derivation cohort, age, male, sessile serrated adenoma/polyp, and a high-risk CRN (ACRN or ≥3 adenomas) at screening colonoscopy were independent risk factors for a metachronous ACRN. These variables were incorporated into the MAPS model, and the risk score ranged 0-17 (high MAPS risk arbitrarily defined as 10-17). At the 3-year surveillance colonoscopy, ACRN was found in 5.1 % of the high MAPS risk group versus 3.9 % of the high-risk CRN group. The colonoscopy number needed to detect one metachronous ACRN at the 3-year surveillance was 19.5 (95 % CI 11.7-33.2) for the high MAPS risk group versus 25.8 (95 % CI 15.4-44.0) for the high-risk CRN group. These findings were similarly confirmed in the validation cohort.Conclusions: Our MAPS model based on clinical and colonoscopic parameters effectively predicts the risk of a metachronous ACRN. [ABSTRACT FROM AUTHOR]

Aims/Introduction Insulin has been associated with the risk of colorectal cancer ( CRC). However, few studies have evaluated the association between insulin and colorectal adenoma. We investigated the relationship between fasting serum insulin levels or homeostasis model assessment of insulin resistance ( HOMA- IR) and colorectal adenoma. Materials and Methods We retrospectively enrolled 15,427 participants who underwent both fasting serum insulin measurement and colonoscopy for a routine health examination at Asan Medical Center from January 2007 to December 2008. Participants with a history of any cancer, previous colectomy or polypectomy, those taking antidiabetic medications, and inflammatory bowel disease, non-specific colitis, non-adenomatous polyps only or CRC on colonoscopic findings were excluded. Finally, 3,606 participants with histologically confirmed colorectal adenoma and 6,019 controls with no abnormal findings on colonoscopy were included. Participants were categorized into quartiles ( Q) based on fasting serum insulin levels and HOMA- IR. Results Fasting serum insulin and HOMA- IR were significantly higher in participants with colorectal adenomas compared with controls. Multivariate regression analysis adjusting for age, sex, smoking habits, drinking habits and family history of CRC showed that participants with higher quartiles of fasting serum insulin levels (odd ratio [ OR] 1.17 for 2nd Q, 1.19 for 3rd Q, and 1.42 for 4th Q, P < 0.05) or HOMA- IR ( OR 1.18 for 2nd Q and 1.45 for 4th Q, P < 0.05) showed significantly increased ORs of colorectal adenoma compared with the lowest quartiles. Conclusions These findings showed that increased serum insulin levels and insulin resistance were significantly associated with the presence of colorectal adenoma. [ABSTRACT FROM AUTHOR]

Background and Aim: The relationship between age and esophageal motility parameters (i.e. basal and residual pressure of the lower esophageal sphincter [LES]) remains to be established in achalasia patients, possibly because most previous studies did not distinguish between classic and vigorous achalasia patients. We investigated the relationship between age and esophageal motility parameters in both classic and vigorous achalasia patients. Methods: A retrospective review of esophageal manometry data in a single center was undertaken. Basal and residual pressure for LES was analyzed. A total of 103 achalasia patients were enrolled, comprising 84 classic and 19 vigorous types. They were subdivided into three different age groups as follows: 21-40 years old (group A), 41-60 years old (group B), and over 60 years old (group C). Results: In classic achalasia patients (M : F = 27:57, mean age = 44 ± 15 years old) the older age group showed a significantly higher basal LES pressure (49.62 ± 19.63 mmHg) than the younger age group ( P < 0.0001). Moreover, the older age group also showed significantly high residual LES pressure (20.46 ± 8.61 mmHg) than the younger age group ( P = 0.0006). In contrast, in vigorous achalasia patients (M : F = 12:7, mean age: 47 ± 15 years old) there were no difference between age and motility indices (all P > 0.05). Conclusion: In classic achalasia patients there appears to be a correlation between age and esophageal motility indices, especially basal and residual LES pressure. Such correlations do not appear to exist for vigorous achalasia patients. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the effects of an approach towards clauvanic acid (CA) strain and improvement, and enhanced production in Streptomyces clavuligerus. It states that the method involves the use of oils on cell growth and CA production. It also analyzes the profiles of free fatty acid in the fermentation broth. Results show that the selection of an oleic acid resistant mutant is an effective method for increasing CA production.

Abstract: Pulmonary route appears to be an attractive alternative as a non-invasive systemic delivery for peptide and protein drugs. An appropriate formulation, however, is important for increasing their bioavailability in lung. In this study, the human insulin microcrystals were produced. The particle size analysis and scanning electron microscopy (SEM) showed that the microcrystals were uniform and had a monodispersed size distribution (mean diameter=0.95μm) for pulmonary delivery. The physicochemical properties of the microcrystals developed were similar to those of the commercial crystalline powder in powder X-ray diffraction (XRD) and differential scanning calorimetry (DSC) analyses. The percentage of high molecular weight proteins (%HMWP), the percentage of other insulin related compounds (%OIRC) and the percentage of A-21 desamido insulin (%D) of the microcrystals were very low. In addition, the cytotoxicity of microcrystals developed and protease inhibitors (aprotinin, bacitracin and soybean-trypsin inhibitor) was investigated, and the enhancement of insulin absorption in the presence of these protease inhibitors at various concentrations was studied. The cell viability of A549 was over 80% at various concentrations of aprotinin and soybean-trypsin inhibitor, except for bacitracin (below 60%). The percent of decrease in blood glucose (D%) was 42.68±1.62% after intratracheal instillation of insulin microcrystals (5U/kg). An enhancement of hypoglycemic effect with protease inhibitors was also found. Soybean-trypsin inhibitor (48.86±3.24% at 10mg/ml; 55.78±0.71% at 5mg/ml; 51.49±5.27% at 1mg/ml) and aprotinin (52.57±8.78% at 10mg/ml; 51.97±1.98% at 5mg/ml; 56.90±3.42% at 1mg/ml) were effective for absorption enhancement. These findings suggest that the use of insulin microcrystals and protease inhibitors would be useful to improve the hypoglycemic effect in pulmonary route. [Copyright &y& Elsevier]

Mutations inCDH1, which encodes E-cadherin, have been associated with hereditary diffuse gastric cancer (HDGC) in Western populations but have not been shown to play a major role in Asians. Recently, a patient with familial gastric cancer (FGC) was shown to harbor a germline mutation in theTP53gene, which encodes p53 and has been previously associated with Li-Fraumeni Syndrome (LFS). To determine whether mutations inTP53are associated with FGC in Asians, we screened the entire coding region ofTP53in probands from 23 Korean FGC families. We identified a nonsense (E287X)TP53germline mutation in a family whose history is compatible with both HDGC and LFS. Two members of this family (SNU-G2) were afflicted with brain tumors, seven with gastric cancers, two with sarcomas, and one with both gastric cancer and a sarcoma. The E287XTP53mutation segregated with the cancer phenotype in the family members from whom DNA samples were available. To our knowledge, this is the first report of a large family with both HDGC and LFS. Our results suggest thatTP53mutational screening in FGC families should be interpreted with caution because additionalTP53mutation-carrying HDGC families may also show LFS-related phenotypes. [ABSTRACT FROM AUTHOR]

Microsatellite instability (MSI) plays an important biological role in various types of cancers, and especially in colorectal cancers. This study aimed to develop a simple, efficient, new method for robust MSI analysis. DNA was extracted from 175 (105 proximal colon and 70 distal colorectal) cancer samples and matched normal tissues, and five Bethesda microsatellite markers (BAT-25, BAT-26, D5S346, D2S123, and D17S250) were examined for MSI by denaturing high-performance liquid chromatography (DHPLC) analysis at a temperature of 50°C and a flow rate of 0.9 ml/min. It took just 9 min per PCR product to determine MSI or microsatellite stability (MSS) using the new protocol. The DHPLC results were confirmed with conventional gel-based electrophoresis and capillary-based sequencing method. Of 175 samples, 45 (26%) showed high micro-satellite instability (MSI-H), 12 (7%) showed low microsatellite instability (MSI-L), and 118 (67%) showed MSS. All MSI samples were deletion mutants and all 12 MSI-L cases had MSI in dinucleotide markers (D5S346, D2S123, and D17S250). MSI was significantly associated with proximal colon cancers (p<0.0001), as previously reported. The MSI-H tumors were also associated with tumor node metastasis (TNM) I/II stages (p=0.05) and high-grade tumors (p<0.01). Here, we propose a DHPLC-based method as an alternative for MSI analysis. [ABSTRACT FROM AUTHOR]