• Archives of Plastic Surgery
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• v.51 no.2
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• pp.234-250
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• 2024

Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.30.1-30.13
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• 2023

Background: Dysmenorrhea and menstrual cycle changes occur in women working shifts. Circadian rhythm disruption and sleep disturbances associated with shift work leads to health problems. We identified chronotypes and the occurrence of insomnia among newly employed university hospital nurses and investigated the association of these factors with menstrual problems. Methods: We conducted pre-placement health examinations for shift workers using self-reported questionnaires between 2018 and 2020. A total of 463 nurses were included in the study. Sociodemographic data, shift work experience, and information on insomnia were collected from health examination data. In addition, details regarding chronotype, dysmenorrhea, irregular and abnormal menstrual cycles, amenorrhea, and contraceptive use were obtained from the questionnaire. Multiple logistic regression analysis was performed to study the association between chronotype, insomnia, and menstrual problems after controlling for age, body mass index, contraceptive use, amenorrhea, and prior shift work. Results: The prevalence rates of dysmenorrhea, irregular menstrual cycles, and longer menstrual cycles were 23.8%, 14.9%, and 4.1%, respectively. The risk of dysmenorrhea increased in the evening-type (odds ratio [OR]: 3.209; 95% confidence interval [CI]: 1.685-6.113) and those with insomnia (OR: 1.871; 95% CI: 1.074-3.261). Additionally, the risk of an irregular menstrual cycle (OR: 2.698; 95% CI: 1.167-6.237) increased in the evening-type, and the risk of a longer menstrual cycle (OR: 4.008; 95% CI: 1.354-11.864) increased in individuals with insomnia. Conclusions: Our findings suggest that dysmenorrhea is promoted in the evening-type and insomnia individuals. There may be an increased risk of irregular menstrual cycles among evening-type nurses and an increased risk of longer menstrual cycles among those with insomnia. Therefore, factors such as evening-type and insomnia should be considered for the prevention of menstrual problems in women performing shift work.

• Parasites, Hosts and Diseases
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• v.62 no.1
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• pp.53-63
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• 2024

The intracellular parasite Babesia microti is among the most significant species causing human babesiosis and is an emerging threat to human health worldwide. Unravelling the pathogenic molecular mechanisms of babesiosis is crucial in developing new diagnostic and preventive methods. This study assessed how priming with B. microti surface antigen 1 (BHSA 1) and seroreactive antigen 5-1-1 (BHSA 5-1-1) mediate protection against B. microti infection. The results showed that 500 ㎍/ml rBMSA1 and rBMSA5-1-1 partially inhibited the invasion of B. microti in vitro by 42.0±3.0%, and 48.0±2.1%, respectively. Blood smears revealed that peak infection at 7 days post-infection (dpi) was 19.6%, 24.7%, and 46.7% in the rBMSA1, rBmSA5-1-1, compared to the control groups (healthy mice infected with B. microti only), respectively. Routine blood tests showed higher white blood cell, red blood cell counts, and haemoglobin levels in the 2 groups (BMSA1 and BMSA5 5-1-1) than in the infection control group at 0-28 dpi. Moreover, the 2 groups had higher serum interferon-γ, tumor necrosis factor-α and Interleukin-17A levels, and lower IL-10 levels than the infection control group throughout the study. These 2 potential vaccine candidate proteins partially inhibit in vitro and in vivo B. microti infection and enhance host immunological response against B. microti infection.

• International Journal of Stem Cells
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• v.15 no.3
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• pp.301-310
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• 2022

Background and Objectives: RUNX2 plays an essential role during the odontoblast differentiation of dental pulp stem cells (DPSCs). RUNX2 Exon 5 is an alternative exon and essential for RUNX2 transcriptional activity. This study aimed to investigate the regulatory mechanisms of RUNX2 exon 5 alternative splicing in human DPSCs. Methods and Results: The regulatory motifs of RUNX2 exon 5 were analyzed using the online SpliceAid program. The alternative splicing of RUNX2 exon 5 in DPSCs during mineralization-induced differentiation was analyzed by RT-PCR. To explore the effect of splicing factor YBX1 on exon 5 alternative splicing, gaining or losing function of YBX1 was performed by transfection of YBX1 overexpression plasmid or anti-YBX1 siRNA in DPSCs. Human RUNX2 exon 5 is evolutionarily conserved and alternatively spliced in DPSCs. There are three potential YBX1 binding motifs in RUNX2 exon 5. The inclusion of RUNX2 exon 5 and YBX1 expression level increased significantly during mineralization-induced differentiation in DPSCs. Overexpression of YBX1 significantly increased the inclusion of RUNX2 exon 5 in DPSCs. In contrast, silence of YBX1 significantly reduced the inclusion of exon 5 and the corresponding RUNX2 protein expression level. Knockdown of YBX1 reduced the expression of alkaline phosphatase (ALP) and osteocalcin (OC) and the mineralization ability of DPSCs, while overexpression of YBX1 increased the expression of ALP and OC and the mineralization ability of DPSCs. Conclusions: Human RUNX2 exon 5 is conserved evolutionarily and alternatively spliced in DPSCs. Splicing factor YBX1 promotes the inclusion of RUNX2 exon 5 and improves the mineralization ability of DPSCs.

• Composites Research
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• v.37 no.4
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• pp.343-349
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• 2024

The use of composite materials for structural fasteners is increasingly common, making it crucial to assess the deformation of these fasteners under fatigue behavior. In this study, clamp-type fasteners were manufactured using carbon fiber reinforced composites, and their structural stability and sectional damage rates were evaluated using electrical resistance measurement during fatigue behavior. While clamp-type composite fasteners exhibited minimal deformation in flat sections, significant deformation occurred in the bent sections due to fatigue. It was observed that insufficient angular stability led to concentrated damage in the bent sections. The dynamic fatigue behavior showed that the length change rate of the composite fasteners was within 0.6%, but the angular change rate reached up to 6%, indicating that the bent sections are the most critical areas. By utilizing the self-sensing capability of the composite fasteners, sectional damage behavior was assessed through electrical resistance measurement. Significant damage was noted in the bent sections due to fatigue, and 3D-CT results revealed substantial deformation and interfacial damage when the initial bend angle of the fasteners was less than 90 degrees. These findings highlight the importance of reinforcing the stiffness of the bent sections and establishing systematic angular standards in the development of composite fasteners.

• Journal of the Korean Society of Food Science and Nutrition
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• v.45 no.2
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• pp.261-268
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• 2016

This study was conducted to establish roasting conditions for optimization of Citri Unshii Pericarpium antioxidant activity using response surface methodology (RSM). A central composite design was applied to investigate the effects of two independent variables, namely roasting temperature ($40{\sim}100^{\circ}C$; $X_1$) and roasting time ($5{\sim}15min$; $X_2$), on responses such as electron donating ability ($Y_1$), total phenolic content ($Y_2$), total flavonoid content ($Y_3$), and hydroxyl radical scavenging activity ($Y_4$). The maximum electron donating ability was 72.38% at a roasting temperature of $71.12^{\circ}C$ and roasting time of 9.39 min. The maximum total phenolic content was 10.76 mg tannic acid equivalents/g at a roasting temperature of $69.71^{\circ}C$ and roasting time of 8.39 min. The maximum total flavonoid content was 105.99 mg quercetin equivalents/100 g at $72.54^{\circ}C$ and 8.64 min. The maximum hydroxyl radical scavenging activity was 60.33% at $68.97^{\circ}C$ and 9.84 min. Based on the superimposition of three dimensional RSM with respect to electron donating ability, total phenolic content, total flavonoid content, and hydroxyl radical scavenging activity under various conditions, optimum conditions were established as follows: roasting temperature of $70.90^{\circ}C$ and roasting time of 9.03 min.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.11
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• pp.1674-1680
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• 2014

The aim of this study was to investigate the protective effects of methanolic extracts of cooked mixed grain rice samples, including grain rice (sorghum, black bean, proso millet, and Job's tears) mixed with fermented brown rice (GR), GR added with 0.5% water extract of Sanghwang mushroom (GRS) or 0.1% curry (GRK), and traditional five grain mixed rice (TMR, Ohgokbap), on $H_2O_2$-induced oxidative injury in LLC-PK1 pig renal epithelial cells. White rice (WR) was used as a positive control. Cells were first exposed to $H_2O_2$ ($250{\mu}M$) for 4 hr, followed by treatment with $100{\mu}g/mL$ of different GR extracts for 24 hr. $H_2O_2$ significantly induced cell damage (P<0.05). Cellular levels of reactive oxygen species (ROS), lipid peroxidation, and antioxidant enzymes, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-px), were measured. In addition, mRNA levels of antioxidant enzymes were determined by RT-PCR assay. Mixed grain rice, particularly GRS and GRK, were able to reduce cellular levels of ROS, decrease lipid peroxidation, and also increase mRNA expression of antioxidant enzymes compared to other samples. These results suggest that mixed grain rice, specifically GRS and GRK, have strong protective effects against $H_2O_2$-induced oxidative injury in LLC-PK1 cells through inhibition of lipid peroxidation, reduction of ROS levels, and elevation of antioxidant enzyme activities.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10445-10449
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• 2015

Objective: To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain. Methods: Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment. Results: In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P>0.05). Baseline pain score of patients with moderate pain in treatment and control group was $4.9{\pm}0.8$ and $5.1{\pm}0.8$, respectively; and decreased to $1.8{\pm}1.1$ and $1.2{\pm}1.1$ after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P=0.028). Average daily consumption of oxycodone prolonged-release tablets was ($54.0{\pm}19.6$) mg and ($44.7{\pm}18.7$) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were $8.3{\pm}1.1$ and $8.3{\pm}1.1$, respectively; and pain intensity after treatment decreased to $2.9{\pm}1.0$ and $2.3{\pm}1.0$. Pain intensity was significantly reduced in the treatment group, with statistical significance (P=0.026). Average daily consumption of oxycodone prolonged-release tablets was ($132.0{\pm}42.2$) mg and ($110.7{\pm}33.9$) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026). Conclusion: Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4603-4608
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• 2015

Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.50-55
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• 2013

Purpose: The purpose of this study was to compare the clinical results of absorbable knot-tying and absorbable knotless suture anchors in arthroscopic Bankart repair. Materials and Methods: This study compared the patients who underwent arthroscopic Bankart repairs using absorbable knottying suture anchors (59 patients: KT Group), and absorbable knotless suture anchors (52 patients: KL Group). Preoperative and postoperative evaluations were performed by Rowe scores, patient satisfaction score, visual analogue scale (VAS), American shoulder and elbow surgeons (ASES) score, range of motion (ROM), and re-dislocation rate. Results: Postoperative VAS, Rowe scores, ASES score were significantly not different between the 2 groups (VAS: p=0.250, Rowe score: p=0.412, ASES: p=0.052). Mean postoperative VAS was 0.5 in KT Group and 0.8 in KL Group (p=0.250), and limited ROM was noted only in one patient in KL Group. Mean Rowe score was 94.3 in KT Group and 96.3 in KL Group (p=0.412), and mean ASES score was 97.3 in KT Group and 94.0 in KL Group (p=0.052). Re-dislocation rate were no different between the 2 groups. Conclusion: There were no differences in clinical outcomes and re-dislocation rate between Knot-Tying and Knotless repairs.