• Journal of Medicine and Life Science
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• v.20 no.4
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• pp.158-165
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• 2023

This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.287-295
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• 2023

Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.

• Journal of Animal Science and Technology
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• v.66 no.1
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• pp.204-218
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• 2024

Elsholtzia fruticosa (EF) is present in tropical regions throughout South Asian countries as well as the Himalayas. Although it has been used as a traditional medicine to treat digestive, respiratory, and inflammatory issues, its effect on preadipocyte differentiation is unknown. In this study, we examined the effects of a methanol extract prepared from EF on the differentiation of 3T3-L1 preadipocytes. Cell differentiation was assessed by microscopic observation and oil-red O staining. The expression of adipogenic and lipogenic genes, including PPARγ and C/EBPα, was measured by western blot analysis and quantitative real-time polymerase chain reaction (qRT-PCR), to provide insight into adipogenesis and lipogenesis mechanisms. The results indicated that EF promotes the differentiation of 3T3-L1 preadipocytes, with elevated lipid accumulation occurring in a concentration-dependent manner without apparent cytotoxicity. EF enhances the expression of adipogenic and lipogenic genes, including PPARγ, FABP4, adiponectin, and FAS, at the mRNA and protein levels. The effect of EF was more pronounced during the early and middle stages of 3T3-L1 cell differentiation. Treatment with EF decreased C/EBP homologous protein (CHOP) mRNA and protein levels, while increasing C/EBPα and PPARγ expression. Treatment with EF resulted in the upregulation of cyclin E and CDK2 gene expression within 24 h, followed by a decrease at 48 h, demonstrating the early-stage impact of EF. A concomitant increase in cyclin-D1 levels was observed compared with untreated cells, indicating that EF modulates lipogenic and adipogenic genes through intricate mechanisms involving CHOP and cell cycle pathways. In summary, EF induces the differentiation of 3T3-L1 preadipocytes by increasing the expression of adipogenic and lipogenic genes, possibly through CHOP and cell cycle-dependent mechanisms.

• Journal of the Korean Society for information Management
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• v.41 no.1
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• pp.59-83
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• 2024

The directions of recent library construction and operation reflect people's changed lifestyle and suggest innovative spaces specialized on the basis of the local environment. Hence, as the goals of the operation of (tentatively named) Songdaeso Library to be constructed within the Hantangang River UNESCO Global Geopark, this study proposes 'acting as complex cultural facilities,' 'operating stay-type reading culture space which is a shrine for workcation,' and 'acting as the landmark of A-gun (郡, county).' And this study works out strategies for its operation, which includes 'securing the validity of the construction of (tentatively named) Songdaeso Library,' 'linking to library policy as the driving force behind its operation,' and 'demonstrating the necessity for the existence of the library arising from the operation of the geological specialized library through landscape architecture.' It also presents concomitant operating plans, which are categorized into plans for manpower, library books, services, and budget.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1146-1151
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• 2023

Medullary thyroid carcinoma (MTC) is a rare malignancy that originates from the parafollicular cells of the thyroid gland. Hashimoto's thyroiditis (HT) is an autoimmune thyroid disease and is the most common cause of hypothyroidism. Previous studies have frequently discussed the association among HT, papillary thyroid carcinoma, and thyroid lymphoma. However, there have been few reports on the ultrasonographic findings of concomitant HT and MTC. In the present case, a heterogeneous hypoechoic background parenchymal echogenicity, with intraglandular echogenic strands, and increased vascularity were observed. A concurrent, ill-defined, parallel-oriented, heterogeneous hypoechoic mass with central microcalcifications was located at the left thyroid gland, consistent with reported US findings of medullary thyroid carcinoma except for an ill-defined margin in our case.

• The korean journal of orthodontics
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• v.54 no.4
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• pp.247-256
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• 2024

Objective: This retrospective study evaluated the mandibular condyle position before and after bimaxillary orthognathic surgery performed with the mandibular condyle positioned manually in patients with mandibular prognathism using cone-beam computed tomography. Methods: Overall, 88 mandibular condyles from 44 adult patients (20 female and 24 male) diagnosed with mandibular prognathism due to skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I performed using the manual condyle positioning method were included. Cone-beam computed tomography images obtained 1-2 weeks before (T0) and approximately 6 months after (T1) surgery were analyzed in three planes using 3D Slicer software. Statistical significance was set at P < 0.05 level. Results: Significant inward rotation of the left mandibular condyle and significant outward rotation of the right mandibular condyle were observed in the axial and coronal planes (P < 0.05). The positions of the right and left condyles in the sagittal plane and the distance between the most medial points of the condyles in the coronal plane did not differ significantly (P > 0.05). Conclusions: While the change in the sagittal plane can be maintained as before surgery with manual positioning during the BSSRO procedure, significant inward and outward rotation was observed in the axial and coronal planes, respectively, even in the absence of concomitant temporomandibular joint disorder before or after the operation. Further long-term studies are needed to correlate these findings with possible clinical consequences.

• Journal of Microbiology and Biotechnology
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• v.34 no.6
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• pp.1214-1221
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• 2024

The accumulating evidence substantiates the indispensable role of gut microbiota in modulating the pathogenesis of type 2 diabetes. Uncovering the intricacies of the mechanism is imperative in aiding disease control efforts. Revealing key bacterial species, their metabolites and/or metabolic pathways from the vast array of gut microorganisms can significantly contribute to precise treatment of the disease. With a high prevalence of type 2 diabetes in Inner Mongolia, China, we recruited volunteers from among the Mongolian population to investigate the relationship between gut microbiota and the disease. Fecal samples were collected from the Volunteers of Mongolia with Type 2 Diabetes group and a Control group, and detected by metagenomic analysis and untargeted metabolomics analysis. The findings suggest that Firmicutes and Bacteroidetes phyla are the predominant gut microorganisms that exert significant influence on the pathogenesis of type 2 diabetes in the Mongolian population. In the disease group, despite an increase in the quantity of most gut microbial metabolic enzymes, there was a concomitant weakening of gut metabolic function, suggesting that the gut microbiota may be in a compensatory state during the disease stage. β-Tocotrienol may serve as a pivotal gut metabolite produced by gut microorganisms and a potential biomarker for type 2 diabetes. The metabolic biosynthesis pathways of ubiquinone and other terpenoid quinones could be the crucial mechanism through which the gut microbiota regulates type 2 diabetes. Additionally, certain Clostridium gut species may play a pivotal role in the progression of the disease.

• Korean Circulation Journal
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• v.52 no.12
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• pp.878-886
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• 2022

Background and Objectives: Moderate aortic stenosis (AS) confers a surprisingly adverse prognosis, approaching that of severe AS. The objective of this study was to describe the clinical course of patients with moderate AS with evidence of concomitant heart failure manifesting as elevated brain natriuretic peptide (BNP) levels. Methods: This is a single-center, retrospective cohort study of 332 patients with elevated BNP. 165 patients with moderate AS were compared with 167 controls with none-mild AS. The Median follow-up duration was 3.85 years. The primary outcome was a composite endpoint of all-cause hospitalizations and all-cause mortality. Results: BNP levels were 530 and 515 pg/mL in the study and the control groups, respectively. Moderate AS had significantly higher rates of primary composite endpoint in both univariate analysis (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.14-1.97; p=0.004) and adjusted analysis (HR, 1.45; 95% CI, 1.05-2.01; p=0.02). Moderate AS had 1.41 (95% CI, 1.18-1.69; p<0.001) times more all-cause hospitalization per patient-year of follow-up compared to controls in the univariate model. After adjustment for significant covariates, moderate AS remained an independent predictor of all-cause hospitalizations (incidence rate ratio [IRR], 1.45; 95% CI, 1.18-1.79; p=0.005). Furthermore, moderate AS was significantly associated with higher all-cause hospitalization rates in both heart failure with reduced ejection fraction (IRR, 1.33; 95% CI, 1.02-1.75; p=0.038) and heart failure with preserved ejection fraction [IRR], 1.31; 95% CI, 1.03-1.67; p=0.026). Conclusions: Moderate AS in conjunction with elevated BNP portends a significantly worse prognosis than those without moderate AS and should be followed closely.

• Journal of Digestive Cancer Research
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• v.9 no.1
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• pp.8-18
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• 2021

Although many guidelines for pancreatic cystic neoplasms focus on the management of intraductal papillary mucinous neoplasm of the pancreas (IPMN) at the highest oncological risk, there are many issues that surgeons need to consider at the time to plan the surgical procedures based on characteristics of IPMN subtypes, such as multiplicity of branch duct-IPMN (BD-IPMN) and intraductal spreading of main duct-IPMN (MD-IPMN). For multifocal BD-IPMN, partial pancreatectomy would be selected to remove BD-IPMN with predictors of malignancy, while the other lesions without risk factors can be left, although total pancreatectomy might be considered if the patients have a strong family history of pancreatic cancer. Partial pancreatectomy would be also adequate procedure for MD-IPMN if negative surgical margin for high-grade dysplasia or invasive carcinoma were achieved. It has become to be well-known that patients with BD-IPMN are at increased risk for developing not only IPMN-associated pancreatic ductal adenocarcinoma (PDAC) but also PDAC independent from the IPMN. Hence, the detection of a concomitant PDAC is also an important focus for strategies after resection of BD-IPMNs. Our recent analysis of patients after partial pancreatectomy for MD-IPMN with negative surgical margin identified an unexpected recurrence pattern, which we called "monoclonal skip" recurrence. MD-IPMN seems to be disseminated in the pancreatic ductal systems and MD-IPMN with identical genetic background was detected in the remnant pancreas even in a long time after index surgery. We proposed strategies of postoperative surveillance based on characteristics and natural history of each morphological subtype.

• Journal of Trauma and Injury
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• v.37 no.3
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• pp.192-200
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• 2024

Purpose: Traumatic peripheral nerve injury (PNI), which occurs in up to 3% of trauma patients, is a devastating condition that often leads to permanent disability. However, knowledge of traumatic PNI is limited. We describe epidemiology and clinical characteristics of traumatic PNI in Korea and identify the predictors of traumatic complete PNI. Methods: A list of enlisted soldier patients who were discharged from military service due to PNI over a 10-year period (2012-2021) was obtained, and their medical records were reviewed. Patients were classified according to the causative events (traumatic vs. nontraumatic) and injury severity (complete vs. incomplete). Of traumatic PNIs, we compared the clinical variables between the incomplete and complete PNI groups and identified predictors of complete PNI. Results: Of the 119 young male patients who were discharged from military service due to PNI, 85 (71.4%) were injured by a traumatic event; among them, 22 (25.9%) were assessed as having a complete injury. The most common PNI mechanism (n=49, 57.6%), was adjacent fractures or dislocations. Several injury-related characteristics were significantly associated with complete PNI: laceration or gunshot wound, PNI involving the median nerve, PNI involving multiple individual nerves (multiple PNI), and concomitant muscular or vascular injuries. After adjusting for other possible predictors, multiple PNI was identified as a significant predictor of a complete PNI (odds ratio, 3.583; P=0.017). Conclusions: In this study, we analyzed the characteristics of enlisted Korean soldiers discharged due to traumatic PNI and found that the most common injury mechanism was adjacent fracture or dislocation (57.6%). Patients with multiple PNI had a significantly increased risk of complete injury. The results of this study contribute to a better understanding of traumatic PNI, which directly leads to a decline in functioning in patients with trauma.