Publications by authors named "Jiyoung Kim"

430 Publications

SGK1 inhibition in glia ameliorates pathologies and symptoms in Parkinson disease animal models.

EMBO Mol Med 2021 Mar 1:e13076. Epub 2021 Mar 1.

Department of Biochemistry and Molecular Biology, College of Medicine, Hanyang University, Seoul, Korea.

Astrocytes and microglia are brain-resident glia that can establish harmful inflammatory environments in disease contexts and thereby contribute to the progression of neuronal loss in neurodegenerative disorders. Correcting the diseased properties of glia is therefore an appealing strategy for treating brain diseases. Previous studies have shown that serum/ glucocorticoid related kinase 1 (SGK1) is upregulated in the brains of patients with various neurodegenerative disorders, suggesting its involvement in the pathogenesis of those diseases. In this study, we show that inhibiting glial SGK1 corrects the pro-inflammatory properties of glia by suppressing the intracellular NFκB-, NLRP3-inflammasome-, and CGAS-STING-mediated inflammatory pathways. Furthermore, SGK1 inhibition potentiated glial activity to scavenge glutamate toxicity and prevented glial cell senescence and mitochondrial damage, which have recently been reported as critical pathologic features of and therapeutic targets in Parkinson disease (PD) and Alzheimer disease (AD). Along with those anti-inflammatory/neurotrophic functions, silencing and pharmacological inhibition of SGK1 protected midbrain dopamine neurons from degeneration and cured pathologic synuclein alpha (SNCA) aggregation and PD-associated behavioral deficits in multiple in vitro and in vivo PD models. Collectively, these findings suggest that SGK1 inhibition could be a useful strategy for treating PD and other neurodegenerative disorders that share the common pathology of glia-mediated neuroinflammation.
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http://dx.doi.org/10.15252/emmm.202013076DOI Listing
March 2021

Is mastectomy with immediate reconstruction safe for patients undergoing neoadjuvant chemotherapy? A nationwide study from Korean Breast Cancer Society.

Breast Cancer 2021 Feb 14. Epub 2021 Feb 14.

Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

Purpose: In this study, we compared the prognoses of patients who underwent mastectomy with immediate breast reconstruction (IBR) after neoadjuvant chemotherapy with those who underwent mastectomy.

Methods: This retrospective study included 87,995 patients who were surgically treated for primary breast cancer between 2008 and 2014. We compared the three groups of patients who were divided based on the following surgeries: breast-conserving surgery (BCS), mastectomy, and mastectomy with IBR.

Results: Of the 3295 patients who were treated with neoadjuvant chemotherapy, 482 patients achieved a pathological complete response (pCR) and 2813 patients did not (non-pCR). In survival analysis of the pCR patients, the 5-year Overall Survival (5 yr OS) between those who underwent mastectomy with IBR and mastectomy (P = 0.639) In the non-pCR group, 5 yr OS of the mastectomy with IBR group was 90.0%, while those of the mastectomy group was 84.4% in patients with clinical stage II (P = 0.032). In a multivariate analysis by Cox regression method revealed that the prognoses of the patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy group in both groups (the pCR group and the non-pCR group).

Conclusion: In the pCR group, the prognoses of patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy. In the non-pCR group, women in the mastectomy with IBR group had shown worse prognoses than the mastectomy group in advanced clinical stage. Appropriate operation should be determined depending on the status of individualized patients.
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http://dx.doi.org/10.1007/s12282-021-01223-2DOI Listing
February 2021

Evaluation for Parkinsonian Bradykinesia by deep learning modeling of kinematic parameters.

J Neural Transm (Vienna) 2021 Feb 28;128(2):181-189. Epub 2021 Jan 28.

School of Mechanical Engineering, Pusan National University, Busan, Republic of Korea.

A wearable sensor system is available for monitoring of bradykinesia in patients with Parkinson's disease (PD), however, it remains unclear whether kinematic parameters would reflect clinical severity of PD, or would help clinical diagnosis of physicians. The present study investigated whether the classification model using kinematic parameters from the wearable sensor may show accordance with clinical rating and diagnosis in PD patients. Using the Inertial Measurement Units (IMU) sensor, we measured the movement of finger tapping (FT), hand movements (HM), and rapid alternating movements (RA) in 25 PD patients and 21 healthy controls. Through the analysis of the measured signal, 11 objective features were derived. In addition, a clinician who specializes in movement disorders viewed the test video and evaluated each of the Unified Parkinson's Disease Rating Scale (UPDRS) scores. In all items of FT, HM, RA, the correlation between the linear regression score obtained through objective features (angle, period, coefficient variances for angle and period, change rates of angle and period, angular velocity, total angle, frequency, magnitude, and frequency × magnitude) and the clinician's UPDRS score was analyzed, and there was a significant correlation (rho > 0.7, p < 0.001). PD patients and controls were classified by deep learning using objective features. As a result, it showed a high performance with an area under the curve (AUC) about as high as 0.9 (FT Total = 0.950, HM Total = 0.889, RA Total = 0.888, ALL Total = 0.926. This showed similar performance to the classification result of binary logistic regression and neurologist, and significantly higher than that of family medicine specialists. Our results suggest that the deep learning model using objective features from the IMU sensor can be usefully used to identify and evaluate bradykinesia, especially for general physicians not specializing in neurology.
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http://dx.doi.org/10.1007/s00702-021-02301-7DOI Listing
February 2021

Clinical significance of Epstein-Barr virus in the cerebrospinal fluid of immunocompetent patients.

Clin Neurol Neurosurg 2021 Jan 19;202:106507. Epub 2021 Jan 19.

Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Republic of Korea.

Introduction: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) samples has greatly facilitated the diagnosis of central nervous system (CNS) infections. However, the clinical significance of Epstein-Barr virus (EBV) DNA in CSF of individuals with suspected CNS infection remains unclear. We wanted to gain a better understanding of EBV as an infectious agent in immunocompetent patients with CNS disorders.

Methods: We identified cases of EBV-associated CNS infections and reviewed their clinical and laboratory characteristics. The study population was drawn from patients with EBV PCR positivity in CSF who visited Pusan National University Hospital between 2010 and 2019.

Results: Of the 780 CSF samples examined during the 10-year study period, 42 (5.4 %) were positive for EBV DNA; 9 of the patients (21.4 %) were diagnosed with non-CNS infectious diseases, such as optic neuritis, Guillain-Barré syndrome, and idiopathic intracranial hypotension, and the other 33 cases were classified as CNS infections (22 as encephalitis and 11 as meningitis). Intensive care unit admission (13/33 patients, 39.3 %) and presence of severe neurological sequelae at discharge (8/33 patients, 24.2 %) were relatively frequent. In 10 patients (30.3 %), the following pathogens were detected in CSF in addition to EBV: varicella-zoster virus (n = 3), cytomegalovirus (n = 2), herpes simplex virus 1 (n = 1), herpes simplex virus 2 (n = 1), Streptococcus pneumomiae (n = 2), and Enterococcus faecalis (n = 1). The EBV-only group (n = 23) and the co-infection group (n = 10) did not differ in age, gender, laboratory data, results of brain imaging studies, clinical manifestations, or prognosis; however, the co-infected patients had higher CSF protein levels.

Conclusion: EBV DNA in CSF is occasionally found in the immunocompetent population; the virus was commonly associated with encephalitis and poor prognosis, and frequently found together with other microbes in CSF.
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http://dx.doi.org/10.1016/j.clineuro.2021.106507DOI Listing
January 2021

Cancer coping, healthcare professionals' support and posttraumatic growth in brain-tumor patients.

Psychol Health Med 2021 Jan 25:1-8. Epub 2021 Jan 25.

Department of Nursing, CHA University, Bundang CHA Medical Center , Seongnamsi, Republic of Korea.

The purpose of this study was to explore the influence of cancer coping and healthcare professionals' support on posttraumatic growth in patients with brain tumors. A cross-sectional, correlational design was used, in which a structured questionnaire was administered to 114 patients at a tertiary university hospital. Data were analyzed using descriptive statistics, independent -test or one-way ANOVA, Pearson correlation, and hierarchical multiple regression analysis. Cancer coping ( = .33, < .001) and healthcare professionals' support ( = .28, = .002) correlated with posttraumatic growth. Among predictors, primary caregivers (brothers and sisters;  = .28), interpersonal coping ( = .26), and healthcare professionals' support ( = .20) had statistically significant influences on posttraumatic growth. The regression model explained approximately 22.0% of posttraumatic growth. These results contribute to cancer coping and healthcare professionals' support to significantly influence posttraumatic growth.
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http://dx.doi.org/10.1080/13548506.2021.1876890DOI Listing
January 2021

Ectopic expression of human thymosin β4 confers resistance to during pulmonary and systemic infection in mice.

Infect Immun 2021 Jan 19. Epub 2021 Jan 19.

Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul 02841, Korea

Thymosin beta-4 (Tβ4) is an actin-sequestering peptide that plays important roles in regeneration and remodeling of injured tissues. However, its function in naturally occurring pathogenic bacterial infection model has remained elusive. We adopted Tβ4-overexpressing transgenic (Tg) mice to investigate the role of Tβ4 in acute pulmonary infection and systemic sepsis caused by Upon infection, Tβ4-Tg mice demonstrated significantly lower bacterial loads in the lung, less hyaline membranes and necrotic abscess, with lower interstitial infiltration of neutrophils, CD4 and CD8 T cells. Bronchoalveolar lavage of Tβ4-Tg mice possessed higher bactericidal activity against exogenousely added , suggesting that constitutive expression of Tβ4 could efficiently control Furthermore, qPCR analysis of lung homogenates demonstrated significant reduction of IL-1β and TNF-α in Tβ4-Tg mice after pulmonary infection, which was primarily originated from lung macrophages. Upon challenge of bone marrow derived macrophages (BMDM) in vitro, secretion of IL-1β and TNF-α proteins are also reduced in Tβ4-Tg macrophages, without affecting their survival. The anti-inflammatory features of BMDM in Tβ4-Tg mice on each cytokines was affected when triggering with tlr2, tlr4, tlr5 or tlr9 ligands, suggesting that anti-inflammatory effects of Tβ4 are likely mediated by the reduced activation of TLR receptors. Finally, Tβ4-Tg mice from systemic sepsis model were protected from induced lethality compared to wild-type controls. Therefore, Tβ4 confers effective resistance against via two pathways: bactericidal and anti-inflammatory pathways, that can be harnessed to treat acute pneumonia and septic conditions caused by in humans.
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http://dx.doi.org/10.1128/IAI.00735-20DOI Listing
January 2021

Glycyrrhetinic Acid-Modified Silicon Phthalocyanine for Liver Cancer-Targeted Photodynamic Therapy.

Biomacromolecules 2021 Feb 28;22(2):811-822. Epub 2020 Dec 28.

Department of Biomedical-Chemical Engineering, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do 14662, Republic of Korea.

To supplement shortcomings of existing treatments and enhance the therapeutic effect for liver cancer, a novel photosensitizer is designed using silicon phthalocyanine (SiPC) and a unique targeting moiety, glycyrrhetinic acid (GA). The SiPC is modified with a hydrophilic polymer and finally bound with GA. The solubility, fluorescence, singlet oxygen generation, and UV-vis absorbance are analyzed, and receptor-dependent intracellular influx is estimated in various cell lines. Using flow cytometry and confocal microscopy, intracellular fluorescence was detected in liver cancer because of GA receptor overexpression. To prove photodynamic therapeutic effects, the sample treated cells are irradiated and viability of liver cancer cells decreases in proportion to laser power. Then, it is confirmed that GA-modified SiPC effectively accumulated in liver cancer of HepG2 tumor-bearing mouse. Additionally, the PDT-combined therapeutic effect of GA-modified SiPC is observed in the tumor model and shown to have a tumor growth inhibition effect (60.36 times higher than the control group) and supported by histological analyses. These results demonstrate that the newly modified SiPC can be applied to liver cancer-specific treatment with high therapeutic efficacy. Consequently, novel SiPC has the potential to alter conventional liver cancer-targeted therapy and chemotherapy in clinical use.
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http://dx.doi.org/10.1021/acs.biomac.0c01550DOI Listing
February 2021

Hysteresis Modulation on Van der Waals-Based Ferroelectric Field-Effect Transistor by Interfacial Passivation Technique and Its Application in Optic Neural Networks.

Small 2020 12 17;16(49):e2004371. Epub 2020 Nov 17.

Department of Semiconductor Systems Engineering, Korea University, Seoul, 02841, South Korea.

2D semiconductor-based ferroelectric field effect transistors (FeFETs) have been considered as a promising artificial synaptic device for implementation of neuromorphic computing systems. However, an inevitable problem, interface traps at the 2D semiconductor/ferroelectric oxide interface, suppresses ferroelectric characteristics, and causes a critical degradation on the performance of 2D-based FeFETs. Here, hysteresis modulation method using self-assembly monolayer (SAM) material for interface trap passivation on 2D-based FeFET is presented. Through effectively passivation of interface traps by SAM layer, the hysteresis of the proposed device changes from interface traps-dependent to polarization-dependent direction. The reduction of interface trap density is clearly confirmed through the result of calculation using the subthreshold swing of the device. Furthermore, excellent optic-neural synaptic characteristics are successfully implemeted, including linear and symmetric potentiation and depression, and multilevel conductance. This work identifies the potential of passivation effect for 2D-based FeFETs to accelerate the development of neuromorphic computing systems.
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http://dx.doi.org/10.1002/smll.202004371DOI Listing
December 2020

Heterogeneity of CEACAM5 in breast cancer.

Oncotarget 2020 Oct 27;11(43):3886-3899. Epub 2020 Oct 27.

Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

CEACAM5 is overexpressed in many primary breast carcinomas. However, the exact role of CEACAM5 in breast cancer tumorigenesis remains unresolved. Here, we examined a repository of 110 cryopreserved primary breast carcinomas by immunohistochemistry to assess the distribution of CEACAM5 in tumor subtypes. The majority of estrogen receptor-positive and HER2-overexpressing tumors were CEACAM5-positive, whereas most of Triple-negative tumors were negative. Assessing sample sets of paired primary breast cancers and corresponding lymph node lesions from a total of 59 patients revealed a high correlation between primary tumor and lymph node with regard to CEACAM5-status. However, a notable subset of sample sets demonstrated intratumoral heterogeneity in the primary tumor, the metastatic lesion or both, suggesting that both CEACAM5-positive and -negative cells can play a role in tumor dissemination. When examining the consequence of expression of CEACAM5 in breast cancer cell lines in culture assays we found that CEACAM5-expressing cells were less invasive. In survival analysis, using cohort studies of breast cancer, expression of CEACAM5 predicted different clinical outcomes depending on molecular subtypes. Altogether, our analysis suggests that CEACAM5 plays a context-dependent role in breast cancer that warrants further investigation.
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http://dx.doi.org/10.18632/oncotarget.27778DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597409PMC
October 2020

Ketohexokinase-A acts as a nuclear protein kinase that mediates fructose-induced metastasis in breast cancer.

Nat Commun 2020 10 28;11(1):5436. Epub 2020 Oct 28.

Department of Pharmacology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 03080, Korea.

Harmful effects of high fructose intake on health have been widely reported. Although fructose is known to promote cancer, little is known about the underlying mechanisms. Here, we found that fructose triggers breast cancer metastasis through the ketohexokinase-A signaling pathway. Molecular experiments showed that ketohexokinase-A, rather than ketohexokinase-C, is necessary and sufficient for fructose-induced cell invasion. Ketohexokinase-A-overexpressing breast cancer was found to be highly metastatic in fructose-fed mice. Mechanistically, cytoplasmic ketohexokinase-A enters into the nucleus during fructose stimulation, which is mediated by LRRC59 and KPNB1. In the nucleus, ketohexokinase-A phosphorylates YWHAH at Ser25 and the YWHAH recruits SLUG to the CDH1 promoter, which triggers cell migration. This study provides the effect of nutrition on breast cancer metastasis. High intake of fructose should be restricted in cancer patients to reduce the risk of metastasis. From a therapeutic perspective, the ketohexokinase-A signaling pathway could be a potential target to prevent cancer metastasis.
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http://dx.doi.org/10.1038/s41467-020-19263-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595112PMC
October 2020

Modeling-based identification of a Raptor-binding motif present in Arabidopsis ABA receptor PYL1.

Biochem Biophys Res Commun 2020 Dec 16;533(4):1303-1308. Epub 2020 Oct 16.

Department of Biological Science, Sookmyung Women's University, Seoul, 04310, South Korea. Electronic address:

By employing molecular modeling of interaction simulation combined with a confirmatory yeast two-hybrid analysis, we identified the Raptor-binding region in an ABA receptor PYL1 protein of Arabidopsis. The region was a part of the C-terminal alpha-helix structure of the protein within which a phenylalanine and an aspartate in the sequence of FADTV are predicted to form critical interactions with the Raptor. Although the sequence deviates a little from the plant TOS consensus that we previously identified and defined (FSD [V/I]F) from AtS6Ks and its orthologues as well as AtATG13, the modeling data indicate that the sequence and its neighboring area are structurally capable of establishing the interaction with the Raptor in the same mode as those of other TOS motif-containing structures. This finding provides a new insight into the understanding of plant TOS motif, based upon which a putative Raptor-binding region in TAP46, another TOR substrate, is proposed.
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http://dx.doi.org/10.1016/j.bbrc.2020.10.009DOI Listing
December 2020

Beneficial effects of weekend catch-up sleep on metabolic syndrome in chronic short sleepers.

Sleep Med 2020 12 30;76:26-32. Epub 2020 Sep 30.

Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, South Korea. Electronic address:

Objectives: Short sleep duration has been known to be related to metabolic syndrome (MetS) . The aim of this study was to investigate the beneficial effects of weekend catch-up sleep (WCUS) on MetS in the Korean middle-aged population.

Methods: For this cross-sectional study, 1,812 participants aged 35-60 years were selected from the 2016-2018 Korean National Health and Nutrition Examination Survey (mean age 46.94 years, 49% male). Short sleep duration was defined as <6hrs on weekdays, and participants were divided into two groups: WCUS group and no weekend catch-up sleep group. Multiple logistic regression was performed to determine the association between WCUS and MetS prevalence. The covariates included age, sex, education, income, occupation, smoking, alcohol consumption, and physical activity.

Results: WCUS was significantly associated with lower MetS prevalence in the unadjusted model and in the model adjusted for socioeconomic and health behavior factors.

Conclusion: These results support the beneficial effects of WCUS on lowering the risk of MetS among middle-aged chronic short sleepers.
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http://dx.doi.org/10.1016/j.sleep.2020.09.025DOI Listing
December 2020

Fibroblasts direct differentiation of human breast epithelial progenitors.

Breast Cancer Res 2020 09 29;22(1):102. Epub 2020 Sep 29.

Section for Cell Biology and Physiology, Department of Biology, University of Copenhagen, Copenhagen, Denmark.

Background: Breast cancer arises within specific regions in the human breast referred to as the terminal duct lobular units (TDLUs). These are relatively dynamic structures characterized by sex hormone driven cyclic epithelial turnover. TDLUs consist of unique parenchymal entities embedded within a fibroblast-rich lobular stroma. Here, we established and characterized a new human breast lobular fibroblast cell line against its interlobular counterpart with a view to assessing the role of region-specific stromal cues in the control of TDLU dynamics.

Methods: Primary lobular and interlobular fibroblasts were transduced to express human telomerase reverse transcriptase (hTERT). Differentiation of the established cell lines along lobular and interlobular pathways was determined by immunocytochemical staining and genome-wide RNA sequencing. Their functional properties were further characterized by analysis of mesenchymal stem cell (MSC) differentiation repertoire in culture and in vivo. The cells' physiological relevance for parenchymal differentiation was examined in heterotypic co-culture with fluorescence-activated cell sorting (FACS)-purified normal breast primary luminal or myoepithelial progenitors. The co-cultures were immunostained for quantitative assessment of epithelial branching morphogenesis, polarization, growth, and luminal epithelial maturation. In extension, myoepithelial progenitors were tested for luminal differentiation capacity in culture and in mouse xenografts. To unravel the significance of transforming growth factor-beta (TGF-β)-mediated crosstalk in TDLU-like morphogenesis and differentiation, fibroblasts were incubated with the TGF-β signaling inhibitor, SB431542, prior to heterotypic co-culture with luminal cells.

Results: hTERT immortalized fibroblast cell lines retained critical phenotypic traits in culture and linked to primary fibroblasts. Cell culture assays and transplantation to mice showed that the origin of fibroblasts determines TDLU-like and ductal-like differentiation of epithelial progenitors. Whereas lobular fibroblasts supported a high level of branching morphogenesis by luminal cells, interlobular fibroblasts supported ductal-like myoepithelial characteristics. TDLU-like morphogenesis, at least in part, relied on intact TGF-β signaling.

Conclusions: The significance of the most prominent cell type in normal breast stroma, the fibroblast, in directing epithelial differentiation is largely unknown. Through establishment of lobular and interlobular fibroblast cell lines, we here demonstrate that epithelial progenitors are submitted to stromal cues for site-specific differentiation. Our findings lend credence to considering stromal subtleties of crucial importance in the development of normal breast and, in turn, breast cancer.
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http://dx.doi.org/10.1186/s13058-020-01344-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526135PMC
September 2020

Discovery and preclinical efficacy of HSG4112, a synthetic structural analog of glabridin, for the treatment of obesity.

Int J Obes (Lond) 2021 Jan 17;45(1):130-142. Epub 2020 Sep 17.

Glaceum Inc., Suwon, Republic of Korea.

Background: HSG4112 is a clinical-stage drug candidate for the treatment of obesity. Here, we report its discovery and preclinical efficacy.

Methods: In high-fat diet (HFD)-induced obese male C57BL/6J mice, we tested the weight loss effect of synthetic compounds derived from a structure-activity relationship (SAR) study of glabridin, a natural compound known to reduce body weight and influence energy homeostasis. After selecting HSG4112 as our optimized compound from this discovery method, we characterized its pharmacological effects on parameters related to obesity through in vivo metabolic and biochemical measurements, histology and gene expression analysis, and indirect calorimetry.

Results: Through the SAR study, we identified four novel components of glabridin pertinent for its anti-obesity activity, and found that HSG4112, an optimized structural analog of glabridin, markedly supersedes glabridin in weight reduction efficacy and chemical stability. Six-week administration of HSG4112 to HFD-induced obese mice led to dose-dependent normalization of obesity-related parameters, including body weight, muscle and adipose tissue weight, adipocyte size, and serum leptin/insulin/glucose levels. The weight reduction induced by HSG4112 was partially mediated by decreased food intake and mainly mediated by increased energy expenditure, with no change in physical activity. Accordingly, the pattern of transcriptional changes was aligned with increased energy expenditure in the liver and muscles. Following significant body weight reduction, robust amelioration of histopathology and blood markers of fatty liver were also observed.

Conclusions: Our study demonstrates the key chemical components of glabridin pertinent to its weight loss effects and suggests HSG4112 as a promising novel drug candidate for the pharmacological treatment of obesity.
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http://dx.doi.org/10.1038/s41366-020-00686-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752758PMC
January 2021

[Effects of BeHaS Program on Health Behavior, Physiologic Index and Self-Esteem of the Elderly Living Alone with Metabolic Syndrome Based on Community Based Participatory Research].

J Korean Acad Nurs 2020 Aug;50(4):571-582

Department of Internal Medicine, College of Medicine, Chungnam, Korea.National University, Daejeon, Korea.

Purpose: This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR).

Methods: A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test.

Results: The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, = .028 and t = 3.91, < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem.

Conclusion: The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.
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http://dx.doi.org/10.4040/jkan.19261DOI Listing
August 2020

The clinical performance of human papillomavirus genotyping using PANArray HPV chip: Comparison to ThinPrep cytology alone and co-testing.

Pathol Res Pract 2020 Sep 13;216(9):153121. Epub 2020 Jul 13.

Department of Pathology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.

Recently, a high-risk human papillomavirus (HR-HPV) detecting assay alone could be used as a first-line screening tool for cervical cancer, although the test system has been limited to the Cobas 4800 HPV test. However, the screening efficiency of the HPV chip, which is widely used in Eastern Asia because of the high prevalence of non16/18 HR-HPV genotypes, has not been well elucidated. After selecting 300 women who were co-tested using the PANArray HPV chip and the ThinPrep assay and had confirmed histological diagnoses, we evaluated the diagnostic accuracy of the PANArray HPV test based on direct sequencing and clinical performance compared to the ThinPrep alone and co-testing. HR-HPVs were identified in 212 (70.7 %) patients by the PANArray HPV test. The results of the PANArray HPV test and direct sequencing for detecting HR-HPVs were in almost perfect agreement, consistent in 95.3 % of the cases (k = 0.89). HR-HPVs were more commonly detected by the PANArray HPV assay in patients with high-grade squamous intraepithelial lesions (HSILs) or worse (p < 0.001, both) by cytological and histological examinations. The PANArray HPV test had higher sensitivity (91.7 %) than the ThinPrep (52.6 %) but co-testing increased the sensitivity for predicting HSIL or worse cervical lesions to 99.2 %. In conclusion, the PANArray HPV test accurately detected HR-HPVs determined by cytological and histological examinations to be HSIL or worse cervical lesions. The PANArray HPV assay alone was more sensitive than the ThinPrep alone for detecting HSIL or worse cervical lesions, however, co-testing enhanced the sensitivity. Co-testing is more useful for screening HSIL or worse lesions than use of either the ThinPrep or PANArray HPV genotyping alone.
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http://dx.doi.org/10.1016/j.prp.2020.153121DOI Listing
September 2020

Characteristics and prognosis of 17 special histologic subtypes of invasive breast cancers according to World Health Organization classification: comparative analysis to invasive carcinoma of no special type.

Breast Cancer Res Treat 2020 Nov 13;184(2):527-542. Epub 2020 Aug 13.

Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, 02841, Seoul, Republic of Korea.

Background: Breast cancer is a heterogeneous disease with various histopathologic subtypes. Except for invasive carcinoma of no special type (NST), other subtypes are rare with limited data. The purpose of this study was to analyze the characteristics and prognosis of special histopathologic subtypes of breast cancer compared to NST.

Methods: A total of 136,140 patients were analyzed using the Korean Breast Cancer Society Registry database between January 1996 and March 2019. The clinicopathologic features and survival outcomes of special type breast carcinoma were compared with those of NST.

Results: The prevalence of special subtypes other than NST was 13.7% (n = 18,633). Compared to NST, patients with lobular, medullary, metaplastic, and micropapillary carcinoma had larger tumors (p < 0.001). Patients with mucinous, tubular, medullary, metaplastic, and cribriform carcinoma presented with less node metastasis (p < 0.001), contrary to patients with micropapillary carcinoma. Patients with lobular, mucinous, tubular, papillary, and cribriform carcinoma presented as luminal A subtype much more often (p < 0.001). Micropapillary carcinoma included more luminal B subtype (p < 0.001). Typically, medullary and metaplastic carcinoma included more triple-negative subtypes (p < 0.001). In survival analysis, only medullary (Hazard Ratio (HzR) 0.542, 95% CI 0.345 to 0.852, p = 0.008) and metaplastic carcinoma (HzR 1.655, 95% CI 1.317 to 2.080, p < 0.001) showed significantly different overall survival from NST by multivariate analysis.

Conclusion: Breast cancer had distinct clinicopathologic features according to histopathologic subtype. However, special types of breast cancer had similar survival outcomes compared to NST when adjusting for other prognostic factors, except for metaplastic carcinoma and medullary carcinoma.
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http://dx.doi.org/10.1007/s10549-020-05861-6DOI Listing
November 2020

LDL receptor-related protein LRP6 senses nutrient levels and regulates Hippo signaling.

EMBO Rep 2020 09 7;21(9):e50103. Epub 2020 Aug 7.

Department of Life Science, University of Seoul, Seoul, Korea.

Controlled cell growth and proliferation are essential for tissue homeostasis and development. Wnt and Hippo signaling are well known as positive and negative regulators of cell proliferation, respectively. The regulation of Hippo signaling by the Wnt pathway has been shown, but how and which components of Wnt signaling are involved in the activation of Hippo signaling during nutrient starvation are unknown. Here, we report that a reduction in the level of low-density lipoprotein receptor-related protein 6 (LRP6) during nutrient starvation induces phosphorylation and cytoplasmic localization of YAP, inhibiting YAP-dependent transcription. Phosphorylation of YAP via loss of LRP6 is mediated by large tumor suppressor kinases 1/2 (LATS1/2) and Merlin. We found that O-GlcNAcylation of LRP6 was reduced, and the overall amount of LRP6 was decreased via endocytosis-mediated lysosomal degradation during nutrient starvation. Merlin binds to LRP6; when LRP6 is less O-GlcNAcylated, Merlin dissociates from it and becomes capable of interacting with LATS1 to induce phosphorylation of YAP. Our data suggest that LRP6 has unexpected roles as a nutrient sensor and Hippo signaling regulator.
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http://dx.doi.org/10.15252/embr.202050103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507029PMC
September 2020

Can we predict drug response by functional connectivity in patients with juvenile myoclonic epilepsy?

Clin Neurol Neurosurg 2020 Nov 31;198:106119. Epub 2020 Jul 31.

Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. Electronic address:

Objectives: We investigated functional connectivity based on EEG using graph theoretical analysis in patients with newly diagnosed juvenile myoclonic epilepsy (JME), and whether it could play a role as a biomarker predicting antiepileptic drug (AED) response.

Methods: We consecutively enrolled 38 patients with JME and 40 normal controls. The initial EEG was undertaken at the time of diagnosis of JME in a drug-naïve state. The second EEG was done after at least 12 months from the time of the initial EEG. We classified the patients with JME into two groups according to AED response at the time of taking the second EEG. We investigated functional connectivity based on graph theoretical analysis using connectivity measures of the coherence and phase locking value.

Results: In the analysis of functional connectivity using coherence as a connectivity measure, the global efficiency and local efficiency in the AED poor responders (N = 4) decreased, whereas the small-worldness index increased. In the analysis of functional connectivity using phase locking value as a connectivity measure, the global efficiency and local efficiency in the AED poor responders decreased. However, in the AED good responders (N = 34), none of the network measures were different from those in healthy controls.

Conclusions: We newly found that there were significant differences of functional connectivity based on initial EEG according to AED response in the patients with JME. This suggests that brain connectivity could play a role as a new biomarker predicting AED response in patients with JME.
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http://dx.doi.org/10.1016/j.clineuro.2020.106119DOI Listing
November 2020

Low Temperature Thermal Atomic Layer Deposition of Aluminum Nitride Using Hydrazine as the Nitrogen Source.

Materials (Basel) 2020 Jul 31;13(15). Epub 2020 Jul 31.

Department of Materials Science and Engineering, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080, USA.

Aluminum nitride (AlN) thin films were grown using thermal atomic layer deposition in the temperature range of 175-350 °C. The thin films were deposited using trimethyl aluminum (TMA) and hydrazine (NH) as a metal precursor and nitrogen source, respectively. Highly reactive NH, compared to its conventionally used counterpart, ammonia (NH), provides a higher growth per cycle (GPC), which is approximately 2.3 times higher at a deposition temperature of 300 °C and, also exhibits a low impurity concentration in as-deposited films. Low temperature AlN films deposited at 225 °C with a capping layer had an Al to N composition ratio of 1:1.1, a close to ideal composition ratio, with a low oxygen content (7.5%) while exhibiting a GPC of 0.16 nm/cycle. We suggest that NH as a replacement for NH is a good alternative due to its stringent thermal budget.
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http://dx.doi.org/10.3390/ma13153387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436040PMC
July 2020

Immune expression signatures as candidate prognostic biomarkers of age and gender survival differences in cutaneous melanoma.

Sci Rep 2020 07 23;10(1):12322. Epub 2020 Jul 23.

Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea.

This study aims to investigate the difference of gene expression and its prognostic significance in younger women with melanoma. Significantly upregulated genes in tumors compared to normal skin tissues were extracted. Among these genes, genes that significantly affected survival according to expression level were selected, and pathway annotation was performed. The patient proportion with high/low expression of the most significant pathways was analyzed in each age (< 50, 50-59, ≥ 60) and gender group. Survival was analyzed according to age, gender, and pathways. The most significant pathways that were upregulated in tumor tissues and also had impacts on survival were programmed cell death protein [PD]-1, interferon-γ, and interferon-α/β pathways. In women, the immune signaling rate in patients was higher than men and decreased with age (63.5%, 53.8%, and 47.6%). In men, the decreasing tendency was minimal (47.6%, 50.0%, and 41.6%). In patients aged < 60 years, women had a favorable survival rate than men (p = 0.055). Except for patients with high immune signaling, no survival difference was observed between genders (p = 0.6). In conclusion, younger female melanoma patients had high immune signaling than older women and men. This immune signaling improved survival of the younger female patients.
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http://dx.doi.org/10.1038/s41598-020-69082-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378165PMC
July 2020

Atomic Layer Deposition of Layered Boron Nitride for Large-Area 2D Electronics.

ACS Appl Mater Interfaces 2020 Aug 29;12(32):36688-36694. Epub 2020 Jul 29.

Department of Materials Science and Engineering, The University of Texas at Dallas, 800 West Campbell Road, Richardson, Texas 75080, United States.

Hexagonal boron nitride (-BN) has been considered a promising dielectric for two-dimensional (2D) material-based electronics due to its atomically smooth and charge-free interface with an in-plane lattice constant similar to that of graphene. Here, we report atomic layer deposition of boron nitride (ALD-BN) using BCl and NH precursors directly on thermal SiO substrates at a relatively low temperature of 600 °C. The films were characterized by X-ray photoelectron spectroscopy, atomic force microscopy, and transmission electron microscopy wherein the uniform, atomically smooth, and nanocrystalline layered-BN thin film growth is observed. The growth rate is ∼0.042 nm/cycle at 600 °C, a temperature significantly lower than that of -BN grown by chemical vapor deposition. The dielectric properties of the ALD-BN measured from Metal Oxide Semiconductor Capacitors are comparable with that of SiO. Moreover, the ALD-BN exhibits a 2-fold increase in carrier mobility of graphene field effect transistors (G-FETs/ALD-BN/SiO) due to the lower surface charge density and inert surface of ALD-BN in comparison to that of G-FETs fabricated on bare SiO. Therefore, this work suggests that the transfer-free deposition of ALD-BN on SiO may be a promising candidate as a substrate for high performance graphene devices.
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http://dx.doi.org/10.1021/acsami.0c07548DOI Listing
August 2020

A Comprehensive Study on the Effect of TiN Top and Bottom Electrodes on Atomic Layer Deposited Ferroelectric HfZrO Thin Films.

Materials (Basel) 2020 Jul 2;13(13). Epub 2020 Jul 2.

Department of Materials Science and Engineering, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080, USA.

The discovery of ferroelectricity in HfO-based materials in 2011 provided new research directions and opportunities. In particular, for atomic layer deposited HfZrO (HZO) films, it is possible to obtain homogenous thin films with satisfactory ferroelectric properties at a low thermal budget process. Based on experiment demonstrations over the past 10 years, it is well known that HZO films show excellent ferroelectricity when sandwiched between TiN top and bottom electrodes. This work reports a comprehensive study on the effect of TiN top and bottom electrodes on the ferroelectric properties of HZO thin films (10 nm). Investigations showed that during HZO crystallization, the TiN bottom electrode promoted ferroelectric phase formation (by oxygen scavenging) and the TiN top electrode inhibited non-ferroelectric phase formation (by stress-induced crystallization). In addition, it was confirmed that the TiN top and bottom electrodes acted as a barrier layer to hydrogen diffusion into the HZO thin film during annealing in a hydrogen-containing atmosphere. These features make the TiN electrodes a useful strategy for improving and preserving the ferroelectric properties of HZO thin films for next-generation memory applications.
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http://dx.doi.org/10.3390/ma13132968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372450PMC
July 2020

The Expression Pattern of Epidermal Differentiation Marker Keratin 10 in the Normal Human Breast and Breast Cancer Cells.

J Histochem Cytochem 2020 08 3;68(8):561-570. Epub 2020 Jul 3.

Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark.

Cells of the human breast gland express an array of keratins, of which some are used for characterizing both normal and neoplastic breast tissue. However, the expression pattern of certain keratins has yet to be detailed. Here, the expression of a differentiation marker of epidermal epithelium, keratin 10 (K10), was investigated in the human breast gland. While in normal breast tissue generally less than 1% of luminal epithelial cells expressed K10, in women >30 years of age glandular structures with K10-positive (K10) cells were found at higher frequency than in younger women. K10 cells belong to a mature luminal compartment as they were negative for cKIT, positive for Ks20.8, and mostly non-cycling. In breast cancer, around 16% of primary breast carcinomas tested were positive for K10 by immunohistochemistry. Interestingly, K10 tumor cells generally exhibit features of differentiation similar to their normal counterparts. Although this suggests that K10 is a marker of tumor differentiation, data based on gene expression analysis imply that high levels of K10 dictate a worse outcome for breast cancer patients. These findings can form the basis of future studies that should unravel which role K10 may play as a marker of breast cancer.
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http://dx.doi.org/10.1369/0022155420940220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400668PMC
August 2020

Effects of Gender and Age on Dietary Intake and Body Mass Index in Hypertensive Patients: Analysis of the Korea National Health and Nutrition Examination.

Int J Environ Res Public Health 2020 06 22;17(12). Epub 2020 Jun 22.

College of Nursing, Ewha Womans University, Seoul 03760, Korea.

Controlling weight and dietary intake are important for hypertensive patients to manage their blood pressure. However, the interaction effect of gender and age on weight and dietary intake is not well known. The aim of this study was to examine the main and interaction effects of age and gender on body mass index (BMI) and dietary intake in hypertensive patients. We analyzed data from 4287 participants with hypertension (1600 participants 45-64 years old and 2687 participants 65 years or older) who participated in the Korea National Health and Nutrition Examination Survey (2013-2016). Two-way ANOVAs were conducted to examine the main and interaction effects of age and gender on BMI and dietary intake. Gender and age had significant main effects on BMI, intake of energy, cholesterol, sodium, and potassium. However, both gender and age illustrated interaction effects on BMI (F = 8.398, = 0.004), energy intake (F = 12.882, < 0.001), and cholesterol intake (F = 6.107, = 0.014), while not showing any significant interaction effects on sodium (F = 3.547, = 0.060) and potassium (F = 3.396, = 0.066). Compared to the middle-aged group, BMI, energy intake, and cholesterol intake decreased in the older-aged group. However, the declines were steeper in men than in women. Therefore, both gender and age need to be considered for weight and dietary intake management for hypertensive patients.
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http://dx.doi.org/10.3390/ijerph17124482DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345329PMC
June 2020

Relationship between Metabolic Syndrome and Hearing Loss: Korea National Health and Nutritional Survey.

Korean J Fam Med 2021 Jan 11;42(1):53-58. Epub 2020 Jun 11.

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: We aimed to evaluate the association between metabolic syndrome (MetS) and hearing loss (HL) in light of noise exposure in Korean middle-aged adults.

Methods: Subjects were 10,356 adults (4,509 males, 5,847 females) aged 40-80 years, who completed audiometric tests and laboratory examinations as part of the Korea National Health and Nutrition Examination Survey between 2010 and 2012. MetS was defined according to the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP III) and International Diabetes Federation (IDF). Low-frequency HL was defined as pure tone averages >25 decibels (dB) at low frequencies (0.5, 1, and 2 kilohertz [kHz]). High-frequency HL was defined as pure tone averages >25 dB at high frequencies (3, 4, and 6 kHz). Odd ratios (OR) and 95% confidence intervals (CI) of MetS associated with each HL type were estimated using multiple logistic regression analysis after adjusting for covariates and taking into consideration sampling weight.

Results: Thirty eight point one percent and 28.6% met the MetS by NCEP III and IDF criteria, respectively. Prevalence of HL was 29.3% and 63.9% for low- and high-frequency HL, respectively. MetS defined by NCEP III was associated with higher risk of high-frequency HL (OR, 1.35; 95% CI, 1.05-1.73), while MetS by IDF criteria was not. The interaction by the noise exposure on the MetS and high-frequency HL was not significant (P-interaction=0.100). There was no association between MetS and low-frequency HL, regardless of applied diagnostic criteria for MetS.

Conclusion: Our findings suggest MetS is associated with high-frequency HL in people with exposure to noise.
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http://dx.doi.org/10.4082/kjfm.19.0131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884893PMC
January 2021

MAML1/2 promote YAP/TAZ nuclear localization and tumorigenesis.

Proc Natl Acad Sci U S A 2020 06 1;117(24):13529-13540. Epub 2020 Jun 1.

Department of Life Science, University of Seoul, 02504 Seoul, Republic of Korea;

The Hippo pathway plays a pivotal role in tissue homeostasis and tumor suppression. YAP and TAZ are downstream effectors of the Hippo pathway, and their activities are tightly suppressed by phosphorylation-dependent cytoplasmic retention. However, the molecular mechanisms governing YAP/TAZ nuclear localization have not been fully elucidated. Here, we report that Mastermind-like 1 and 2 (MAML1/2) are indispensable for YAP/TAZ nuclear localization and transcriptional activities. Ectopic expression or depletion of MAML1/2 induces nuclear translocation or cytoplasmic retention of YAP/TAZ, respectively. Additionally, mutation of the MAML nuclear localization signal, as well as its YAP/TAZ interacting region, both abolish nuclear localization and transcriptional activity of YAP/TAZ. Importantly, we demonstrate that the level of messenger RNA (mRNA) is regulated by microRNA-30c (miR-30c) in a cell-density-dependent manner. In vivo and clinical results suggest that MAML potentiates YAP/TAZ oncogenic function and positively correlates with YAP/TAZ activation in human cancer patients, suggesting pathological relevance in the context of cancer development. Overall, our study not only provides mechanistic insight into the regulation of YAP/TAZ subcellular localization, but it also strongly suggests that the miR30c-MAML-YAP/TAZ axis is a potential therapeutic target for developing novel cancer treatments.
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http://dx.doi.org/10.1073/pnas.1917969117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306791PMC
June 2020

Validation of CDr15 as a new dye for detecting neutrophil extracellular trap.

Biochem Biophys Res Commun 2020 06 15;527(3):646-653. Epub 2020 May 15.

Department of Tumor Biology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Biomedical Sciences, BK21-plus Education Program, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Pharmacology, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Ischemic/Hypoxic Disease Institute, and Institute of Infectious Diseases, Seoul National University College of Medicine, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address:

Neutrophil extracellular trap (NET) is one of the first-line defenses against microbes. Under certain circumstances, however, it also plays an aggravating factor in diverse inflammation-related diseases including cancers and vascular diseases. Our aim is to develop a new method to detect NET in cells and tissues using a DNA-specific fluorescence probe CDr15. CDr15 was characterized to be impermeable to the cell membranes and to emit a strong fluorescence in association with extracellular DNAs in NET. Due to these properties, CDr15 was successfully shown to quantify NETs in vitro and to be applicable for real-time monitoring NET formation in PMA-stimulated neutrophils. Even in formaldehyde-fixed tumor specimens, CDr15 could detect NETs spreading around cancer cells. Compared with DAPI and SYTOX DNA dyes, CDr15 showed a lower level of background fluorescence and a higher specificity in NET detection. Based on these results, we propose CDr15 as a novel marker of NET to be applicable in experimental and clinical studies.
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http://dx.doi.org/10.1016/j.bbrc.2020.04.153DOI Listing
June 2020

Galuteolin, identified in the extract of thymus quinquecostatus flowers, is involved in inhibiting melanin biosynthesis in B16/F10 melanoma cells.

Nat Prod Res 2020 May 18:1-3. Epub 2020 May 18.

Jeonju AgroBio-Materials Institute, Jeonju-si, Korea.

To enhance the skin whitening effect, tyrosinase activity and melanin biosynthesis needs to be suppressed in the skin. To achieve this goal, we examined the extract of flowers, and identified a functional ingredient, galuteolin. Galuteolin effectively inhibited melanin biosynthesis in B16/F10 cells, partially suppressing tyrosinase activity. Therefore, this study suggests that galuteolin can be used as a cosmetic ingredient for skin whitening.
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http://dx.doi.org/10.1080/14786419.2020.1768091DOI Listing
May 2020

Surgical impact on anxiety of patients with breast cancer: 12-month follow-up prospective longitudinal study.

Ann Surg Treat Res 2020 May 28;98(5):215-223. Epub 2020 Apr 28.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: Breast cancer diagnosis and treatment often produce stress in patients. Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment.

Methods: This is prospective cohort study. Between July 2010 and July 2011, we recruited patients with nonmetastatic breast cancer who were expected to receive adjuvant chemotherapy (n = 411) from 2 cancer hospitals in Seoul, Korea. Anxiety was measured using the Hospital Anxiety and Depression Scale.

Results: The mean age of the participants was 46.4 ± 7.9 years. Preoperatively, 44.5% (183 of 411) of the patients showed abnormal anxiety. The proportion of the abnormal anxiety group significantly decreased after surgery (P < 0.01) and this phenomenon continued until the 12-month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative months 6 and 12.

Conclusion: Surgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient's physical symptoms is important.
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http://dx.doi.org/10.4174/astr.2020.98.5.215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200606PMC
May 2020