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Abstract Background Parkinson’s disease (PD) is a common and costly progressive neurodegenerative disease of unclear etiology. A disease-modifying approach that can directly stop or slow its progression remains a major unmet need in the treatment of PD. A clinical pharmacology-based drug repositioning strategy is a useful approach for identifying new drugs for PD. Methods We analyzed claims data obtained from the National Health Insurance Service (NHIS), which covers a significant portion of the South Korean population, to investigate the association between antihistamines, a class of drugs commonly used to treat allergic symptoms by blocking H1 receptor, and PD in a real-world setting. Additionally, we validated this model using various animal models of PD such as the 6-hydroxydopmaine (6-OHDA), α-synuclein preformed fibrils (PFF) injection, and Caenorhabditis elegans (C. elegans) models. Finally, whole transcriptome data and Ingenuity Pathway Analysis (IPA) were used to elucidate drug mechanism pathways. Results We identified fexofenadine as the most promising candidate using National Health Insurance claims data in the real world. In several animal models, including the 6-OHDA, PFF injection, and C. elegans models, fexofenadine ameliorated PD-related pathologies. RNA-seq analysis and the subsequent experiments suggested that fexofenadine is effective in PD via inhibition of peripheral immune cell infiltration into the brain. Conclusion Fexofenadine shows promise for the treatment of PD, identified through clinical data and validated in diverse animal models. This combined clinical and preclinical approach offers valuable insights for developing novel PD therapeutics.

Background: We investigated the feasibility of a deep learning algorithm (DLA) based on apparent diffusion coefficient (ADC) maps for the segmentation and discrimination of clinically significant cancer (CSC, Gleason score ≥ 7) from non-CSC in patients with prostate cancer (PCa). Methods: Data from a total of 149 consecutive patients who had undergone 3T-MRI and been pathologically diagnosed with PCa were initially collected. The labelled data (148 images for GS6, 580 images for GS7) were applied for tumor segmentation using a convolutional neural network (CNN). For classification, 93 images for GS6 and 372 images for GS7 were used. For external validation, 22 consecutive patients from five different institutions (25 images for GS6, 70 images for GS7) representing different MR machines were recruited. Results: Regarding segmentation and classification, U-Net and DenseNet were used, respectively. The tumor Dice scores for internal and external validation were 0.822 and 0.7776, respectively. As for classification, the accuracies of internal and external validation were 73 and 75%, respectively. For external validation, diagnostic predictive values for CSC (sensitivity, specificity, positive predictive value and negative predictive value) were 84, 48, 82 and 52%, respectively. Conclusions: Tumor segmentation and discrimination of CSC from non-CSC is feasible using a DLA developed based on ADC maps (b2000) alone.

Purpose To compare small bowel distension and side effects between a diluted polyethylene glycol (PEG) solution and a low-density (0.1% w/v) barium sulfate suspension (LDBSS) for CT enterography (CTE) preparation. Materials and Methods Total 173 consecutive patients who underwent CTE were enrolled in this study. The LDBSS (1 L) was used in 50 patients, and the diluted iso-osmotic PEG solution (1 L) was used in 123 patients. Two blinded radiologists independently scored jejunal and ileal distensions on a 5-point scale. To compare side effects between the two groups, the patients reported whether they had immediate complications after the administration of the oral contrast media. Results For ileal and jejunal distension, the diluted PEG solution showed no difference from the LDBSS for either reader (ileum: reader 1, median, 4; 4, interquartile range, 3–4; 3–4, p = 0.997; reader 2, median, 4; 4, interquartile range, 3.3–4.0; 3–4, p = 0.064; jejunum: reader 1, median, 2; 2, interquartile range, 2–3; 2–3, p = 0.560; reader 2, median, 3; 2, interquartile range, 2–3; 2–3, p = 0.192). None of the patients complained of immediate complications following administration of either of the oral contrast media. Conclusion The diluted PEG solution showed comparable bowel distension compared to LDBSS and no immediate side effects; thus, it can be a useful alternative.

Background and Objectives: We hypothesized that an individual’s personality traits would have an impact on the distress of subjective tinnitus. To investigate this, 32 participants were recruited; we followed up with this cohort. This study is a cross-sectional analysis of a part of this cohort, identifying how their personality traits make a difference in the severity of tinnitus distress. Materials and Methods: Thirty-two participants completed a personality test based on the Big Five theory, consisting of 160 items. Additionally, the severity of tinnitus was assessed using the Tinnitus Handicap Inventory (THI), and the accompanying level of depression was measured using the Beck Depression Inventory (BDI). Audiometry tests, including pure-tone audiometry, were also conducted. Participants were categorized into the ‘mild group’ if their total THI score was 36 or below, and into the ‘severe group’ if their score was 38 or above. Results: In the traditional five domains of the Big Five Inventory (Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism), only the ‘Neuroticism’ domain showed a difference between the two groups (25.1 ± 21.0 in the mild group and 43.1 ± 18.2 in the severe group, p = 0.014). Among ego-related factors, the ‘Helplessness’ domain (26.3 ± 22.9 in the mild group and 62.3 ± 27.9 in the severe group, p < 0.001) and the communication-related factor of ‘Listening’ (58.7 ± 18.8 in the mild group and 37.8 ± 27.9 in the severe group, p = 0.020) showed differences between the two groups. In the multivariate analysis, ‘Helplessness’ (estimate 0.419, 95% confidence interval 0.249–0.589, p < 0.001), ‘Emotional Trauma’ (0.213, 0.020–0.406, p = 0.032), and ‘Pure-tone threshold at 2000 Hz’ (0.944, 0.477–1.411, p < 0.001) were identified as factors influencing the severity of tinnitus distress. Conclusions: Ego-related factors, particularly Helplessness and Emotional Trauma, can influence tinnitus distress and should be considered in the management of tinnitus.

Hyperproduction of immune cell-derived inflammatory molecules and recruitment of immune cells promote the development of allergic asthma (AA). Aromadendrin (ARO) has various biological properties including anti-inflammatory effects. In this study, we evaluated the ameliorative effects of ARO on the development of AA in vitro and in vivo. Phorbol 12-myristate 13-acetate (PMA, 100 nM) was used to induce inflammation in A549 airway epithelial cells. The cohesion of A549 and eosinophil EOL-1 cells was studied. Ovalbumin (30 or 60 μg)/Alum (3 mg) mixture was adapted for AA induction in mice. ARO (5 or 10 mg/kg, p. o.) was administered to mice to investigate its ameliorative effect on AA development. Enzyme-linked immunosorbent assay, western blotting, and hematoxylin and eosin/periodic acid Schiff staining were performed to study the ameliorative effect of ARO on bronchial inflammation. In PMA-stimulated A549 cells, the upregulation of cytokines (interleukin [IL]-1β/IL-6/tumor necrosis factor alpha [TNF-α]/monocyte chemoattractant protein [MCP]-1]) and nuclear factor kappa B (NF-κB) activation was effectively reduced by ARO pretreatment. ARO suppressed the adhesion of A549 cells and eosinophils. In ovalbumin-induced AA mice, the levels of cells, such as eosinophils, Th2 cytokines, MCP-1 in bronchoalveolar lavage fluid, IgE in serum, and inducible nitric oxide synthase/cyclooxygenase-2 expression in the lung tissue were upregulated, which were all suppressed by ARO. In addition, the increase in cell inflow and mucus formation in the lungs of AA mice was reversed by ARO as per histological analysis. ARO also modulated NF-κB activation in the lungs of AA mice. Overall, the anti-inflammatory properties of ARO in vitro/in vivo studies of AA were notable. Thus, ARO has a modulatory effect on bronchial inflammation and may be a potential adjuvant for AA treatment.

Background: To evaluate the association between perfusion parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with prognostic factors in primary rectal cancer patients. Methods: A sample of 51 patients with pathologically proven rectal adenocarcinoma through surgery were retrospectively enrolled. All the patients underwent preoperative DCE-MRI including 3D-spoiled gradient echo. Two radiologists determined the tumor border after radiologic–pathologic correlation and drew regions of interest. The perfusion parameters, including the volume transfer constant (Ktrans), were calculated under the extended Toft model. The prognostic factors included TN stage, circumferential resection margin, extramural venous invasion, Kirsten-ras mutation, tumor size, carcinoembryonic antigen, and tumor differentiation. The association was assessed via correlation or t-test. For significant prognostic factors, receiver operating characteristic (ROC) curve analyses were performed to estimate the diagnostic predictive values. Results: Ktrans only showed a significant difference according to tumor differentiation, between the well-differentiated (n = 6) and moderately differentiated (n = 45) groups (0.127 ± 0.032, 0.084 ± 0.036, p = 0.036). The AUC was 0.838 (95% CI, 0.702–0.929), and the estimated accuracy, sensitivity, and specificity were 87%, 90%, and 60%, respectively. Conclusions: Ktrans showed a significant difference based on tumor differentiation, which may be conducive to prediction of prognosis in primary rectal cancer.

Purpose To compare the sensitivity of tumor detection and inter-observer agreement between acquired diffusion-weighted imaging (aDWI) b2000 and computed DWI (cDWI) b2000 in patients with prostate cancer (PCa). Materials and Methods Eighty-eight patients diagnosed with PCa by radical prostatectomy and having undergone pre-operative 3 Tesla-MRI, including DWI (b, 0, 100, 1000, 2000 s/mm2), were included in the study. cDWI b2000 was obtained from aDWI b0, b100, and b1000. Two independent reviewers performed a review of the aDWI b2000 and cDWI b2000 images in random order at 4-week intervals. A region of interest was drawn for the largest tumor on each dataset, and a Prostate Imaging-Reporting and Data System (PI-RADS) score based on PI-RADS v2.1 was recorded. Histologic topographic maps served as the reference standard. Results The study population’s Gleason scores were 6 (n = 16), 7 (n = 53), 8 (n = 9), and 9 (n = 10). According to the reviewers, the sensitivities of cDWI b2000 and aDWI b2000 showed no significant differences (for reviewer 1, both 94% [83/88]; for reviewer 2, both 90% [79/88]; p = 1.000, respectively). The kappa values of cDWI b2000 and aDWI b2000 for the PI-RADS score were 0.422 (95% confidence interval [CI], 0.240–0.603) and 0.495 (95% CI, 0.308–0.683), respectively. Conclusion cDWI b2000 showed comparable sensitivity with aDWI b2000, in addition to sustained moderate inter-observer agreement, in the detection of PCa.

OBJECTIVES This study was conducted to figure out the effects of kendo training on the activity of brainwaves by analyzing changes in brainwaves during chudan-no-kamae and three-movement-striking, which are basic movements of kendo, in elementary school students who undergo kendo training and comparing left and right side brainwave activities to find out differences. METHODS This study was conducted with 29 male elementary school students living in K City who were experts in kendo with a career as an athlete or a kendo training period not shorter than six months. The brainwave activity was measured by measuring and analyzing brainwaves at eight regions at the prefrontal lobe, the frontal lobe, the temporal lobe, and the occipital lobe using brainwave measuring equipment. Brainwaves were measured for 5 minutes in a sitting position in a stable state and were also measured for 5 minutes after 15 minutes of the chudan-no-kamae movement, which is aiming at the opponent with the point of the sword while moving along eight moving lines of the opponents, and for 5 minutes after 15 minutes of three striking movements. RESULTS Alpha waves showed higher brainwave activity during the stable state than during the kendo movements (three striking movements, chudan-no-kamae) while SMR, M-beta, and H-beta showed higher brainwave activity after kendo movements than during the resting state. The asymmetry between the left and right sides increased after the movements compared to during the resting state. CONCLUSIONS These results are considered attributable to kendo training that partly increased their concentration thereby increasing brainwave activity. However, it is unclear that kendo training will be helpful for concentration through physical activities and brain activity in this study. Therefore, further study should be conducted with the measurement of factors related to emotional aspects, concentration, and brainwaves according to kendo training.

In recent years, various methods of measuring body temperature have been developed using wireless biosensors to facilitate an early detection of pregnancy and parturition in cows. However, there are no studies on real-time monitoring of cattle body temperature throughout pregnancy. Therefore, we investigated the daily mean ruminal temperature in pregnant cows throughout pregnancy using a ruminal bio-capsule sensor and then evaluated the temperature variation between pregnant and non-pregnant cows. In pregnant cows, the mean and standard deviation of ruminal temperature was 38.86 ± 0.17℃. Ruminal temperature in pregnant cows slowly decreased until 180 to 190 days after artificial insemination and after that, the temperature increased dramatically until just before parturition. Furthermore, the means ruminal temperature was significantly different between pregnant and nonpregnant cows. The mean and standard deviation of ruminal temperature were as follows: 38.68 ± 0.01℃ from days 80 to 100, 38.78 ± 0.02℃ from days 145 to 165, 38.99 ± 0.45℃ from days 200 to 220, 39.14 ± 0.38℃ from days 250 to 270 before parturition. Therefore, our results could provide useful data for early detection of pregnancy and parturition in Korean cows.

Purpose To evaluate the association between magnetic resonance imaging (MRI)-based texture parameters and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in patients with non-mucinous rectal cancer. Materials and Methods Seventy-nine patients who had pathologically confirmed rectal nonmucinous adenocarcinoma with or without KRAS-mutation and had undergone rectal MRI were divided into a training (n = 46) and validation dataset (n = 33). A texture analysis was performed on the axial T2-weighted images. The association was statistically analyzed using the Mann-Whitney U test. To extract an optimal cut-off value for the prediction of KRAS mutation, a receiver operating characteristic curve analysis was performed. The cut-off value was verified using the validation dataset. Results In the training dataset, skewness in the mutant group (n = 22) was significantly higher than in the wild-type group (n = 24) (0.221 ± 0.283; -0.006 ± 0.178, respectively, p = 0.003). The area under the curve of the skewness was 0.757 (95% confidence interval, 0.606 to 0.872) with a maximum accuracy of 71%, a sensitivity of 64%, and a specificity of 78%. None of the other texture parameters were associated with KRAS mutation (p > 0.05). When a cut-off value of 0.078 was applied to the validation dataset, this had an accuracy of 76%, a sensitivity of 86%, and a specificity of 68%. Conclusion Skewness was associated with KRAS mutation in patients with non-mucinous rectal cancer.

Purpose To evaluate the feasibility of texture analysis of gray-scale ultrasound (US) images for staging of hepatic fibrosis. Materials and Methods Altogether, 167 patients who had undergone routine US and laboratory tests for a fibrosis-4 (FIB-4) index were included. Texture parameters were measured using a dedicated in-house software. Regions of interest were placed in five different segments (3, 5, 6, 7, 8) for each patient. The FIB-4 index was used as the reference standard for hepatic fibrosis grade. Comparisons of the texture parameters between different fibrosis groups were performed with the Student’s t-test or Mann-Whitney U-test. Diagnostic performance was evaluated by receiver operating curve analysis. Results The study population comprised of patients with no fibrosis (FIB-4 < 1.45, n = 50), mild fibrosis (1.45 ≤ FIB-4 ≤ 2.35, n = 37), moderate fibrosis (2.35 < FIB-4 ≤ 3.25, n = 27), and severe fibrosis (FIB-4 > 3.25, n = 53). Skewness in hepatic segment 5 showed a difference between patients with no fibrosis and mild fibrosis (0.2392 ± 0.3361, 0.4134 ± 0.3004, respectively, p = 0.0109). The area under the curve of skewness for discriminating patients with no fibrosis from those with mild fibrosis was 0.660 (95% confidence interval, 0.551–0.758), with an estimated accuracy, sensitivity, specificity of 64%, 87%, 48%, respectively. Conclusion A significant difference was observed regarding skewness in segment 5 between patients with no fibrosis and patients with mild fibrosis.

Inserting a suspended line is a widely used technique to reduce the envelope correlation coefficients (ECC) of multiple-input multiple-output (MIMO) antennas, but its ECC reduction mechanism has not been carefully investigated so far. In this paper, MIMO antenna pairs connected with different suspended lines were evaluated using a full-wave simulation and measurement results. We calculated the surface current density at the center of the suspended line inserted between the antenna elements and found that the derivative of the surface current density was closely related to the ECC values. Furthermore, parametric studies showed that the suspended line length determines the ECC reduction bandwidth of the MIMO antenna, and the antenna length controls the ECC minimum frequency point. These guidelines provide useful insights into designing a low ECC MIMO antenna employing a suspended line.

Earlier studies reported that the occurrence of sudden sensorineural hearing loss (SSNHL) is associated with chronic metabolic disorders such as hypertension, diabetes, and hyperlipidemia. Instead of focusing on the relationship between SSNHL and each metabolic disorder, this study aimed to identify the association with metabolic syndrome as a whole, including either prehypertension or prediabetes. As a case-control study, we reviewed 239 patients who experienced SSNHL, and compared them with the same number of healthy subjects (N = 478). Metabolic syndrome-related variables of SSNHL patients were compared to those of healthy control subjects. In addition, patients with SSNHL were classified into two subgroups: the first subgroup showed improvement in hearing (‘response group’), and the second did not present significant improvement (‘non-response group’). Metabolic syndrome was diagnosed according to the US National Heart, Lung, and Blood Institute’s National Cholesterol Education Program Adult Treatment Panel III criteria. The risk for SSNHL was 4.3 times higher in patients with metabolic syndrome compared with patients without the syndrome (95% confidence interval, 1.98 to 9.33), even after adjusting for variables that showed significant between-group differences. The likelihood of being unresponsive to treatment was higher in those with metabolic syndrome (1.21 to 3.93; adjusted odds ratio = 2.18), and when the initial hearing loss pattern on a pure-tone audiometry was high tone or flat. Metabolic syndrome appears to be an independent risk factor for SSNHL and, simultaneously, a predictor of poor prognosis.

After the Korean War, human access to the Korean Demilitarized Zone (DMZ) was highly restricted. However, limited agricultural activity was allowed in the Civilian Control Zone (CCZ) surrounding the DMZ. In this study, land cover and vegetation changes in the western DMZ and CCZ from 1919 to 2017 were investigated. Coniferous forests were nearly completely destroyed during the war and were then converted to deciduous forests by ecological succession. Plains in the DMZ and CCZ areas showed different patterns of land cover changes. In the DMZ, pre-war rice paddies were gradually transformed into grasslands. These grasslands have not returned to forest, and this may be explained by wildfires set for military purposes or hydrological fluctuations in floodplains. Grasslands near the floodplains in the DMZ are highly valued for conservation as a rare land type. Most grasslands in the CCZ were converted back to rice paddies, consistent with their previous use. After the 1990s, ginseng cultivation in the CCZ increased. In addition, the landscape changes in the Korean DMZ and CCZ were affected by political circumstances between South and North Korea. Our results provide baseline information for the development of ecosystem management and conservation plans for the Korean DMZ and CCZ. Given the high biodiversity and ecological integrity of the Korean DMZ region, transboundary governance for conservation should be designed.

Idiopathic retroperitoneal fibrosis (RPF) is a rare disease entity and its etiology is uncertain. We report two similar cases which showed an uncommon presentation of idiopathic RPF. A 66-year-old woman and an 80-year-old man presented with incidental findings of left renal pelvic mass-like lesions. Computed tomography revealed a soft tissue density mass replacing the left renal pelvis, which was suspicious for renal pelvic cancer, and the diagnosis of idiopathic RPF was surgically confirmed. To the best of our knowledge, a few cases of idiopathic RPF presenting with features of a localized unilateral renal pelvic mass mimicking renal pelvic cancer have been reported.

Objective: To evaluate the association between Non-alcoholic fatty liver disease (NAFLD) with renal stone disease detected on computed tomography (CT). Method: A total 1812 patients who underwent abdomen-pelvis CT in July 2015 were included in this study. The inclusion criteria for NAFLD were as follows: (i) lower average Hounsfield unit (HU) of hepatic right lobe, left medial and lateral segment when compared with that of spleen, (ii) patients who having urolithiasis in kidneys, ureters and urinary bladder, and (iii) patients underwent abdomen-pelvis CT including noncontrast image. The statistical significance of the association between NAFLD and renal stone disease was assessed using Chi Square Test. The Odds ratios and 95% CI were calculated to assess the propensity of renal stones disease for NAFLD by using Logistic Regression analysis. Results: The frequency of renal stone disease in patients with NAFLD was higher approximately 19% than those who having renal stone disease without NAFLD. In addition, the presence of NAFLD was linked with renal stone disease showing that detection rate of renal stone disease in patients with NAFLD was markedly high (odds ratio: 5, 95% CI, 3–8.2) (p