Publications by authors named "Yoon Cho"

542 Publications

Recruitment and enrollment of participants in an online diabetes self-management intervention in a virtual environment.

Contemp Clin Trials 2021 Apr 12:106399. Epub 2021 Apr 12.

Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710I, USA; Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston, School of Biomedical Informatics, 6901 Bertner Ave. SON-539D, Houston, TX 77030, USA.

Effective recruitment of research participants is essential for successful randomized controlled trials and remains one of the most challenging and labor-intensive aspects of conducting research. The purpose of this manuscript is to describe recruitment methods for this two-group, internet-based intervention trial and enrollment status in relation to recruitment methods, accounting for accrual rates and recruitment costs and to discuss our recruitment results and limitations informed by the Clinical Trials Transformation Initiative (CTTI) team's evidence and expert-based recommendations for recruitment. The primary study was a two-group randomized controlled trial designed to evaluate the efficacy of a virtual environment, Diabetes LIVE©, compared to a traditional website format to provide diabetes self-management education and support to adults with type 2 diabetes. Our recruitment experience was labor-intensive, multimodal, and required multiple iterations throughout the study to meet recruitment goals. To allow for more efficient and realistic budgets aligned with funding, researchers should engage stakeholders in recruitment planning and monitor and report personnel time and cost by recruitment methods. To allow for more efficient and effective recruitment into meaningful clinical trials and of interest to participants, researchers should use a participative approach during all study phases, including question development.
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http://dx.doi.org/10.1016/j.cct.2021.106399DOI Listing
April 2021

MYC single-hit large B-cell lymphoma: clinicopathologic difference from MYC-negative large B-cell lymphoma and MYC double-hit/triple-hit lymphoma.

Hum Pathol 2021 Mar 23. Epub 2021 Mar 23.

Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:

MYC-rearranged large B-cell lymphoma with BCL2 and/or BCL6 rearrangement, double-hit (DH) or triple-hit (TH) lymphoma, is associated with poor survival after standard treatment. To investigate the clinical impact of single-hit (SH) MYC rearrangement, we analyzed 241 cases of DLBCL for MYC, BCL2, and BCL6 rearrangement by fluorescence in situ hybridization. Fifty-five of 241 (22.8%) cases showed MYC rearrangements. Twenty-three cases were diagnosed as DLBCL; 18 as high-grade B-cell lymphoma (HGBCL)-DH; 3 as HGBCL-TH; and 11 as HGBCL, not otherwise specified (NOS). Both DH and TH lymphomas showed high-grade morphology (P = 0.002), higher stage (P = 0.022), and more frequent germinal center B-cell-like (GCB) phenotype (P = 0.008). SH lymphomas displayed high-grade morphology (P = 0.002) but were not different from MYC-negative lymphomas in cell of origin, clinical stage, international prognostic index (IPI), or extranodal involvement. Patients with DH/TH lymphomas had worse overall survival (OS) (P = 0.016) and progression-free survival (PFS) (P < 0.001), while OS and PFS of SH lymphomas were not different from those of MYC-negative lymphomas. There was no survival difference between cases of BCL2 and BCL6 rearrangements. Poorer prognostic factors included higher ECOG class, higher IPI, and DH or TH translocation for OS, and higher IPI and DH or TH translocation for PFS. Higher IPI was an independent prognostic factor for OS and PFS. In conclusion, large B-cell lymphomas with single MYC rearrangement showed high-grade morphology but were otherwise not different from MYC-negative lymphomas.
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http://dx.doi.org/10.1016/j.humpath.2021.03.006DOI Listing
March 2021

STK3/STK4 signalling in adipocytes regulates mitophagy and energy expenditure.

Nat Metab 2021 03 23;3(3):428-441. Epub 2021 Mar 23.

College of Pharmacy, Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.

Obesity reduces adipocyte mitochondrial function, and expanding adipocyte oxidative capacity is an emerging strategy to improve systemic metabolism. Here, we report that serine/threonine-protein kinase 3 (STK3) and STK4 are key physiological suppressors of mitochondrial capacity in brown, beige and white adipose tissues. Levels of STK3 and STK4, kinases in the Hippo signalling pathway, are greater in white than brown adipose tissues, and levels in brown adipose tissue are suppressed by cold exposure and greatly elevated by surgical denervation. Genetic inactivation of Stk3 and Stk4 increases mitochondrial mass and function, stabilizes uncoupling protein 1 in beige adipose tissue and confers resistance to metabolic dysfunction induced by high-fat diet feeding. Mechanistically, STK3 and STK4 increase adipocyte mitophagy in part by regulating the phosphorylation and dimerization status of the mitophagy receptor BNIP3. STK3 and STK4 expression levels are elevated in human obesity, and pharmacological inhibition improves metabolic profiles in a mouse model of obesity, suggesting STK3 and STK4 as potential targets for treating obesity-related diseases.
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http://dx.doi.org/10.1038/s42255-021-00362-2DOI Listing
March 2021

Danshen Extracts Prevents Obesity and Activates Mitochondrial Function in Brown Adipose Tissue.

Endocrinol Metab (Seoul) 2021 Feb 24;36(1):185-195. Epub 2021 Feb 24.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Background: Danshen has been widely used in oriental medicine to improve body function. The purpose of this study is to investigate the effect of water-soluble Danshen extract (DE) on weight loss and on activation proteins involved in mitochondrial biogenesis in brown adipose tissue (BAT) in obese mice.

Methods: BAT was isolated from 7-week-old male Sprague-Dawley rats, and expression of proteins related to mitochondrial biogenesis was confirmed in both brown preadipocytes and mature brown adipocytes treated with DE. For the in vivo study, low-density lipoprotein receptor knock out mice were divided into three groups and treated for 17 weeks with: standard diet; high fat diet (HFD); HFD+DE. Body weight was measured every week, and oral glucose tolerance test was performed after DE treatment in streptozotocin-induced diabetic mice. To observe the changes in markers related to thermogenesis and adipogenesis in the BAT, white adipose tissue (WAT) and liver of experimental animals, tissues were removed and immediately frozen in liquid nitrogen.

Results: DE increased the expression of uncoupling protein 1 and peroxisome proliferator-activated receptor gamma coactivator 1-alpha in brown preadipocytes, and also promoted the brown adipocyte differentiation and mitochondrial function in the mature brown adipocytes. Reactive oxygen species production in brown preadipocytes was increased depending on the concentration of DE. DE activates thermogenesis in BAT and normalizes increased body weight and adipogenesis in the liver due to HFD. Browning of WAT was increased in WAT of DE treatment group.

Conclusion: DE protects against obesity and activates mitochondrial function in BAT.
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http://dx.doi.org/10.3803/EnM.2020.835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937848PMC
February 2021

Hammock plating for comminuted inferior sleeve avulsion fractures of the patella: A surgical technique and clinical results.

Orthop Traumatol Surg Res 2021 Mar 4:102866. Epub 2021 Mar 4.

Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University Hospital, Busan, Korea. Electronic address:

Comminuted inferior sleeve avulsion fractures of the patella is a surgical challenge owing to the lack of directly purchasable bone fragments and the vulnerable patellar tendon below the displaced lip fragments. Despite the reports of various techniques to treat this fracture, still there is need for a new surgical technique to improve the reduction construct. The purpose of this article is to introduce Hammock plating, which is a surgical technique for comminuted inferior sleeve avulsion patella fractures that utilizes synthetic suture and a low-profile mini plate. The reduction construct provides an indirect reduction of the inferior sleeve fragments to form a hammock-like construct that embraces and lifts the lip fragments upward altogether that enables a firm bone-to-bone union. The advantages also include relatively simple and easy procedure with less injury to the fractured bone fragments and patellar tendon.
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http://dx.doi.org/10.1016/j.otsr.2021.102866DOI Listing
March 2021

Comparison between the portable pressure measuring device and PicoPress® for garment pressure measurement on hypertrophic burn scar during compression therapy.

Burns 2021 Feb 9. Epub 2021 Feb 9.

Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea. Electronic address:

Purpose: The current standard treatment for hypertrophic scars following burn injury is pressure garment therapy. The experimenters developed the novel portable pressure measuring device using silicon piezoresistive sensors. As PicoPress® is the most accurate (i.e., lowest variation and error) manometric sensor for pressure measurement, we sought to compare and examine the accuracy of the novel device regarding in vitro pressure measurements at the hypertrophic scar-pressure garment interface.

Methods: The novel device was designed to operate in non-corrosive media, such as air. The device can use up to six pressure sensing points and was developed to adjust the number of pressure sensors according to the size of the scar. Pressure measurements were acquired through a readout circuit consisting of an analog-to-digital converter, a microprocessor, and a Bluetooth transmission module for wireless data transmission to an external device. All signals were converted into mean pressure expressed in millimeters of mercury (mmHg). The mean pressure values measured by the sensors were compared to those obtained from PicoPress®. 55 garment pressures recordings were obtained from the sensors over this study conducted in 2018-February 2020. We then analyzed the test-retest reliability using the intraclass correlation coefficients (ICC). PicoPress® was also employed in the same pressure garments for obtaining similar measurements. A two way random effects model ICC with 95% confidence intervals was used to compare the mean pressure values obtained from the silicon piezoresistive sensors to the PicoPress® measurements.

Results: The test-retest reliability of the pressure sensors was close to the acceptable level for clinical use regarding stationary interface pressure measurement (ICC = 0.99, 95% CI 0.990-0.997). The mean pressure obtained from the silicon piezoresistive pressure sensors showed an accordance with the measurements from PicoPress® (ICC = 0.97, 95% CI 0.947-0.985).

Conclusion: The novel device may present a viable alternative to PicoPress® for garment pressure measurements. In addition, the novel device improves adaptability to the hypertrophic scar shape and size. Complementary characteristics such as wireless transmission to an external device may allow burn patients to continuously wear the device for real-time measurements during pressure garment therapy, thus improving existing devices including PicoPress®.
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http://dx.doi.org/10.1016/j.burns.2021.01.018DOI Listing
February 2021

Cancer-preventive effect of phenethyl isothiocyanate through tumor microenvironment regulation in a colorectal cancer stem cell xenograft model.

Phytomedicine 2021 Apr 4;84:153493. Epub 2021 Feb 4.

Smart Farm Research Center, Korea Institute of Science and Technology (KIST) Gangneung Institute of Natural Products, Gangneung, Gangwon-do 25451, Republic of Korea; Division of Bio-Medical Science &Technology, KIST School, Korea University of Science and Technology, Seoul 02792, Republic of Korea. Electronic address:

Background: Phenethyl isothiocyanate (PEITC) is a glucosinolate derived from cruciferous vegetables and is a cancer-chemopreventive reagent. Cancer stem cells (CSCs) have roles in cancer chemoresistance, invasion, metastasis, and recurrence. Here, we investigated whether PEITC can suppress the properties of CSCs using NCCIT cells and HCT116-derived cancer stem-like cells. Furthermore, we established a CSC xenograft prevention model using nude mice.

Purpose: The purpose of this study was to examine the actual cancer-preventive effects of PEITC in vitro and in a xenograft prevention model.

Study Design: We assessed the cancer-preventive effects of PEITC on CSCs using a novel xenograft prevention model.

Methods: NCCIT cells were treated with PEITC, and the expression of pluripotent markers was confirmed by reporter assays, western blotting, and qRT-PCR. In addition, to evaluate the effects of PEITC on CSC properties, sphere cells, which exhibit CSC properties, were established from the HCT116 cells. Furthermore, to examine the inhibitory effects and the underlying mechanism following daily intake of PEITC on CSCs, we performed an animal study in a mouse xenograft model and RNA-sequencing analysis.

Results: PEITC significantly reduced the CSC properties, including clonogenicity and the expression of pluripotent factors. Prior to CSC inoculation in vivo, the PEITC pre-treatment group showed a more effective reduction in the tumor growth rate and expression of CSC markers compared to the post-treatment groups. Furthermore, RNA-sequencing results showed that PEITC pre-treatment remarkably suppressed genes related to inflammatory and immune responses and chemokine-related signaling.

Conclusion: PEITC might contribute to the prevention or delay of colorectal cancer growth by inhibiting CSCs via the regulation of inflammatory chemokines, which can affect the tumor microenvironment. Thus, our study suggests that the daily intake of phytochemicals derived from vegetables or dietary supplements could have cancer-preventive effects through regulation of the host-tumor microenvironment.
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http://dx.doi.org/10.1016/j.phymed.2021.153493DOI Listing
April 2021

DNA methylome signatures as epigenetic biomarkers of hexanal associated with lung toxicity.

PeerJ 2021 4;9:e10779. Epub 2021 Feb 4.

Korea Institute of Science and Technology, Seoul, Republic of Korea.

Background: Numerous studies have investigated the relationship of environmental exposure, epigenetic effects, and human diseases. These linkages may contribute to the potential toxicity mechanisms of environmental chemicals. Here, we investigated the epigenetic pulmonary response of hexanal, a major indoor irritant, following inhalation exposure in F-344 rats.

Methods: Based on DNA methylation profiling in gene promoter regions, we identified hexanal-characterized methylated sites and target genes using an unpaired t-test with a fold-change cutoff of ≥ 3.0 and a -value < 0.05. We also conducted an integrated analysis of DNA methylation and mRNA expression data to identify core anti-correlated target genes of hexanal exposure. To further investigate the potential key biological processes and pathways of core DNA methylated target genes, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were performed.

Results: Thirty-six dose-dependent methylated genes and anti-correlated target genes of DNA methylation and mRNA in lung tissue of hexanal exposed F-344 rats were identified. These genes were involved in diverse biological processes such as neuroactive ligand-receptor interaction, protein kinase cascade, and intracellular signaling cascade associated with pulmonary toxicity. These results suggest that novel DNA methylation-based epigenetic biomarkers of exposure to hexanal and elucidate the potential pulmonary toxicological mechanisms of action of hexanal.
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http://dx.doi.org/10.7717/peerj.10779DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868067PMC
February 2021

Clinical significance of potential drug-drug interactions in a pediatric intensive care unit: A single-center retrospective study.

PLoS One 2021 8;16(2):e0246754. Epub 2021 Feb 8.

Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Despite the high prevalence of potential drug-drug interactions in pediatric intensive care units, their clinical relevance and significance are unclear. We assessed the characteristics and risk factors of clinically relevant potential drug-drug interactions to facilitate their efficient monitoring in pediatric intensive care units. This retrospective cohort study reviewed the medical records of 159 patients aged <19 years who were hospitalized in the pediatric intensive care unit at Seoul National University Hospital (Seoul, Korea) for ≥3 days between August 2019 and February 2020. Potential drug-drug interactions were screened using the Micromedex Drug-Reax® system. Clinical relevance of each potential drug-drug interaction was reported with official terminology, magnitude of severity, and causality, and the association with the patient's clinical characteristics was assessed. In total, 115 patients (72.3%) were exposed to 592 potential interactions of 258 drug pairs. In 16 patients (10.1%), 22 clinically relevant potential drug-drug interactions were identified for 19 drug pairs. Approximately 70% of the clinically relevant potential drug-drug interactions had a severity grade of ≥3. Exposure to potential drug-drug interactions was significantly associated with an increase in the number of administrated medications (6-7 medications, p = 0.006; ≥8, p<0.001) and prolonged hospital stays (1-2 weeks, p = 0.035; ≥2, p = 0.049). Moreover, clinically relevant potential drug-drug interactions were significantly associated with ≥8 prescribed drugs (p = 0.019), hospitalization for ≥2 weeks (p = 0.048), and ≥4 complex chronic conditions (p = 0.015). Most potential drug-drug interactions do not cause clinically relevant adverse outcomes in pediatric intensive care units. However, because the reactions that patients experience from clinically relevant potential drug-drug interactions are often very severe, there is a medical need to implement an appropriate monitoring system for potential drug-drug interactions according to the pediatric intensive care unit characteristics.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246754PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870058PMC
February 2021

The burden of rare damaging variants in hereditary atypical parkinsonism genes is increased in patients with Parkinson's disease.

Neurobiol Aging 2021 Apr 24;100:118.e5-118.e13. Epub 2020 Nov 24.

Department of Computer Engineering, Hallym University, Chuncheon, South Korea. Electronic address:

Increased burdens of rare coding variants in genes related to lysosomal storage disease or mitochondrial pathways were reported to be associated with idiopathic Parkinson's disease. Under a hypothesis that the burden of damaging rare coding variants is increased in causative genes for hereditary parkinsonism, we analyzed the burdens of rare coding variants with a case-control design. Two cohorts of whole-exome sequencing data and a cohort of genome-wide genotyping data of clinically validated idiopathic Parkinson's disease cases and controls, which were open to the public, were used. The sequence kernel association test-optimal was used to analyze the burden of rare variants in the hereditary parkinsonism gene set, which was constructed from the Online Mendelian Inheritance in Man database through manual curation. The hereditary parkinsonism gene set consisted of 17 genes with a locus symbol prefix for familial Parkinson's disease and 75 hereditary atypical parkinsonism genes. We detected a significant association of enriched burdens of predicted damaging rare coding variants in hereditary parkinsonism genes in all three datasets. Meta-analyses of the rare variant burden test in a subgroup of gene sets revealed an association between burdens of rare damaging variants with PD in a hereditary atypical parkinsonism gene set, but not in a subgroup gene set with a locus symbol prefix for familial Parkinson's disease. Our results highlight the roles of rare damaging variants in causative genes for hereditary atypical parkinsonian disorders. We propose that Mendelian genes associated with hereditary disorders accompanying parkinsonism are involved in Parkinson's disease-related genetic networks.
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http://dx.doi.org/10.1016/j.neurobiolaging.2020.11.011DOI Listing
April 2021

Association of exposure to polycyclic aromatic hydrocarbons and heavy metals with thyroid hormones in general adult population and potential mechanisms.

Sci Total Environ 2021 Mar 13;762:144227. Epub 2020 Dec 13.

Department of Environmental Health Sciences, Soonchunhyang University, Asan, Republic of Korea. Electronic address:

Air pollution and fuel emissions are the common sources of human exposure to polycyclic aromatic hydrocarbons (PAHs) and heavy metals. Several studies have suggested potential associations between PAHs/heavy metals and thyroid hormones, however, reports have been inconsistent. In this study, we employed a subpopulation of the adults (n = 1254) who participated in the Korean National Environmental Health Survey 2015-2017, and investigated the association of PAHs and major heavy metals with thyroid hormones, and explored the underlying mechanisms of thyroid disruption. Four PAH metabolites and three heavy metals of lead (Pb), mercury (Hg), and cadmium (Cd) were measured either in urine or in total blood. In addition, thyroid hormones (T3 and T4), TSH, thyroxine-binding globulin (TBG), and thyroid autoantibodies were measured, and peripheral deiodinase activity (G) and thyroid's secretory capacity (G) were calculated. Urinary Hg was negatively associated with total T3 in both males and females, while it was positively associated with total T4 among females only. Urinary Hg was related to decreased G and increased G in both sexes. In contrast, urinary Cd was positively associated with total T3 and G in both male and female populations. Urinary Cd also showed a positive association with thyroid autoantibodies, but only in males. A multi-factor model considering co-exposure to multiple chemicals also resulted in similar associations. Among the measured PAH metabolites, only urinary 1-hydroxypyrene showed a negative association with total T3 in males. However, this association was marginal, and disappeared in a multi-chemical model. The present observations are suggestive that exposures to Hg and Cd might disrupt thyroid hormones, possibly through an alteration of deiodinase activity. Association of PAH exposure with thyroid hormone appears to be insignificant.
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http://dx.doi.org/10.1016/j.scitotenv.2020.144227DOI Listing
March 2021

Aquaporins and (in)fertility: More than just water transport.

Biochim Biophys Acta Mol Basis Dis 2021 Mar 16;1867(3):166039. Epub 2020 Dec 16.

QOPNA & LAQV, Department of Chemistry, University of Aveiro, Portugal. Electronic address:

Aquaporins (AQPs) are a family of channel proteins that facilitate the transport of water and small solutes across biological membranes. They are widely distributed throughout the organism, having a number of key functions, some of them unexpected, both in health and disease. Among the various diseases in which AQPs are involved, infertility has been overlooked. According to the World Health Organization (WHO) infertility is a global public health problem with one third of the couples suffering from subfertility or even infertility due to male or female factors alone or combined. Thus, there is an urgent need to unveil the molecular mechanisms that control gametes production, maturation and fertilization-related events, to more specifically determine infertility causes. In addition, as more couples seek for fertility treatment through assisted reproductive technologies (ART), it is pivotal to understand how these techniques can be improved. AQPs are heterogeneously expressed throughout the male and female reproductive tracts, highlighting a possible regulatory role for these proteins in conception. In fact, their function, far beyond water transport, highlights potential intervention points to enhance ART. In this review we discuss AQPs distribution and structural organization, functions, and modulation throughout the male and female reproductive tracts and their relevance to the reproductive success. We also highlight the most recent advances and research trends regarding how the different AQPs are involved and regulated in specific mechanisms underlying (in)fertility. Finally, we discuss the involvement of AQPs in ART-related processes and how their handling can lead to improvement of infertility treatment.
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http://dx.doi.org/10.1016/j.bbadis.2020.166039DOI Listing
March 2021

Associations of Relative Humidity and Lifestyles with Metabolic Syndrome among the Ecuadorian Adult Population: Ecuador National Health and Nutrition Survey (ENSANUT-ECU) 2012.

Int J Environ Res Public Health 2020 12 3;17(23). Epub 2020 Dec 3.

Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.

The effects of the physical environment on metabolic syndrome (MetS) are still largely unexplained. This study aimed to analyze the associations of relative humidity of residence, lifestyles, and MetS among Ecuadorian adults. Data from 6024 people aged 20 to 60 years were obtained from an Ecuador national population-based health and nutrition survey (i.e., ENSANUT-ECU, 2012) and the mean annual relative humidity (%) from the Ecuador National Institute for Meteorology and Hydrology (2012). Odds ratio (OR) with 95% confidence intervals (CI) for MetS according to groups of relative humidity were calculated using multiple logistic regression. Living in high relative humidity (>80%) increased ORs of reduced high-density lipoprotein (HDL) cholesterol (1.25; 95 % CI, 1.06-1.56) and MetS (OR = 1.20; 95 % CI,1.01-1.42) in women. Furthermore, physically active men living in high relative humidity showed lower OR of elevated triglycerides (0.56; 95 % CI,0.37-0.85) while menopausal women living in high relative humidity showed increased ORs of MetS (5.42; 95 % CI, 1.92-15.27), elevated blood pressure (3.10; 95 % CI, 1.15-8.35), and increased waist circumference (OR = 1.34; 95 % CI, 1.09-1.63). Our results show that residence in high relative humidity and menopausal status increase ORs of MetS and its components in Ecuadorian women; however, physical activity significantly reduces the OR of elevated triglycerides in men. The obtained findings may help make public health policies regarding environmental humidity management, nutritional education, menopausal care, and physical activity promotion to prevent the onset of MetS among Ecuadorian adults.
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http://dx.doi.org/10.3390/ijerph17239023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731373PMC
December 2020

Author Correction: NOVA1 induction by inflammation and NOVA1 suppression by epigenetic regulation in head and neck squamous cell carcinoma.

Sci Rep 2020 Nov 30;10(1):21299. Epub 2020 Nov 30.

Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, South Korea.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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http://dx.doi.org/10.1038/s41598-020-77481-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704637PMC
November 2020

Preferred Endocytosis of Amyloid Precursor Protein from Cholesterol-Enriched Lipid Raft Microdomains.

Molecules 2020 Nov 24;25(23). Epub 2020 Nov 24.

Department of Physiology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea.

Amyloid precursor protein (APP) at the plasma membrane is internalized via endocytosis and delivered to endo/lysosomes, where neurotoxic amyloid-β (Aβ) is produced via β-, γ-secretases. Hence, endocytosis plays a key role in the processing of APP and subsequent Aβ generation. β-, γ-secretases as well as APP are localized in cholesterol-enriched lipid raft microdomains. However, it is still unclear whether lipid rafts are the site where APP undergoes endocytosis and whether cholesterol levels affect this process. In this study, we found that localization of APP in lipid rafts was increased by elevated cholesterol level. We also showed that increasing or decreasing cholesterol levels increased or decreased APP endocytosis, respectively. When we labeled cell surface APP, APP localized in lipid rafts preferentially underwent endocytosis compared to nonraft-localized APP. In addition, APP endocytosis from lipid rafts was regulated by cholesterol levels. Our results demonstrate for the first time that cholesterol levels regulate the localization of APP in lipid rafts affecting raft-dependent APP endocytosis. Thus, regulating the microdomain localization of APP could offer a new therapeutic strategy for Alzheimer's disease.
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http://dx.doi.org/10.3390/molecules25235490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727664PMC
November 2020

Anti-Melanogenic Effects of Ethanol Extracts of the Leaves and Roots of (Thunb.) Juss through Their Inhibition of CREB and Induction of ERK and Autophagy.

Molecules 2020 Nov 17;25(22). Epub 2020 Nov 17.

Department of Integrative Biotechnology and Biomedical, Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea.

(Thunb.) Juss is a traditional herb commonly used in East Asia including Korea, Japan, and China. It has been administered to reduce and treat inflammation in Donguibogam, Korea. The mechanism for its anti-inflammatory effects has already been reported. In this study, we confirmed the efficacy of (Thunb.) Juss ethanol extract (Pv-EE) for inducing autophagy and investigate its anti-melanogenic properties. Melanin secretion and content were investigated using cells from the melanoma cell line B16F10. Pv-EE inhibited melanin in melanogenesis induced by α-melanocyte-stimulating hormone (α-MSH). The mechanism of inhibition of Pv-EE was confirmed by suppressing the mRNA of microphthalmia-associated transcription factor (MITF), decreasing the phosphorylation level of CREB, and increasing the phosphorylation of ERK. Finally, it was confirmed that Pv-EE induces autophagy through the autophagy markers LC3B and p62, and that the anti-melanogenic effect of Pv-EE is inhibited by the autophagy inhibitor 3-methyl adenine (3-MA). These results suggest that Pv-EE may be used as a skin protectant due to its anti-melanin properties including autophagy.
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http://dx.doi.org/10.3390/molecules25225375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698407PMC
November 2020

Identification of Genetic Variants for Female Obesity and Evaluation of the Causal Role of Genetically Defined Obesity in Polycystic Ovarian Syndrome.

Diabetes Metab Syndr Obes 2020 12;13:4311-4322. Epub 2020 Nov 12.

Department of Biomedical Science, Hallym University, Chuncheon, Gangwon-do, Republic of Korea.

Purpose: Observational studies have demonstrated an increased risk of polycystic ovarian syndrome (PCOS) in obese women. This study aimed to identify genetic variants influencing obesity in females and to evaluate the causal association between genetically defined obesity and PCOS in Korean women.

Methods: Two-stage GWAS was conducted to identify genetic variants influencing obesity traits (such as body mass index [BMI], waist-hip ratio [WHR], and waist circumference [WC]) in Korean women. Two-sample Mendelian randomization (MR) analysis was employed to evaluate the causal effect of variants as genetic instruments for female obesity on PCOS.

Results: Meta-analysis of 9953 females combining discovery (N = 4658) and replication (N = 5295) stages detected four (rs11162584, rs6760543, rs828104, rs56137030), six (rs139702234, rs2341967, rs73059848, rs5020945, rs550532151, rs61971548), and two genetic variants (rs7722169, rs7206790) suggesting a highly significant association ( < 1×10) with BMI, WHR, and WC, respectively. Of these, an intron variant rs56137030 in achieved genome-wide significant association ( = 3.39×10) with BMI in females. Using variants for female obesity, their effect on PCOS in 946 cases and 976 controls was evaluated by MR analysis. MR results indicated no significant association between genetically defined obesity and PCOS in Korean women.

Conclusion: This study, for the first time, revealed genetic variants for female obesity in the Korean population and reported no causal association between genetically defined obesity and PCOS in Korean women.
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http://dx.doi.org/10.2147/DMSO.S281529DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670174PMC
November 2020

Associations of urinary concentrations of phthalate metabolites, bisphenol A, and parabens with obesity and diabetes mellitus in a Korean adult population: Korean National Environmental Health Survey (KoNEHS) 2015-2017.

Environ Int 2021 Jan 2;146:106227. Epub 2020 Nov 2.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Devision of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. Electronic address:

Phthalates and bisphenol A (BPA) have been suspected as risk factors for obesity and diabetes mellitus (DM) among humans. However, associations between phthalates and environmental phenols are often inconsistent across different populations. In this study, we recruited the adult population (n = 3782) of the Korean National Environmental Health Survey (KoNEHS) 2015-2017 (Cycle 3) and assessed the associations between urinary biomarkers of phthalate, BPA, and paraben exposure with obesity and DM. A potential collider issue with the use of urinary creatinine (Cr) or specific gravity (SG) exists when adjusting urinary dilution; therefore, a covariate-adjusted standardization (CAS) was employed for adjustment, and the results were compared. In the present population, the direction of the association often varied depending on the choices made to adjust urinary dilution. When using CAS, the direction of association resembled those of previously reported experimental observations. With Cr or SG adjustment, ORs for obesity decreased in the highest quartiles of monocarboxyoctyl phthalate (MCOP) [OR (95% CI) = Cr: 0.71 (0.54, 0.93); SG: 0.68 (0.52, 0.90)], monocarboxy-isononyl phthalate (MCNP) [OR (95% CI) = Cr: 0.67 (0.52, 0.87); SG: 0.68 (0.52, 0.89)], and mono(3-carboxylpropyl) phthalate (MCPP) in the urine [OR (95% CI) = Cr: 0.60 (0.47, 0.76); SG: 0.61 (0.48, 0.77)]; however, with CAS, these negative associations disappeared. Instead, mono-benzyl phthalate (MBzP) [OR (95% CI) = 1.31 (1.03, 1.66)], BPA [OR (95% CI) = 1.62 (1.27, 2.06)], or ethyl paraben (EtP) [OR (95% CI) = 1.51 (1.19, 1.91)] concentrations in the highest quartile showed positive associations with a higher risk of obesity. On the other hand, for DM, an overall decrease in ORs was observed for phthalate metabolites and BPA following SG adjustment and disappeared with CAS adjustment. In addition, the highest quartiles of BPA, methyl paraben (MeP), and ethyl paraben (EtP) showed a significantly higher risk of DM than those in the lowest quartiles following CAS [OR (95% CI) = BPA: 1.65 (1.06, 2.59); MeP: 1.68 (1.08, 2.60); and EtP: 2.74 (1.77, 4.24), respectively]. The present observations outline the importance of using an appropriate adjustment method for urinary dilution in association studies on obesity and DM. In addition, several phthalates, BPA, and parabens were identified as potential chemical risk factors for these outcomes. Further studies are warranted in other populations to confirm these observations.
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http://dx.doi.org/10.1016/j.envint.2020.106227DOI Listing
January 2021

Association of risk factors and bleeding complications in Asian patients taking edoxaban.

Br J Clin Pharmacol 2021 Apr 15;87(4):2121-2127. Epub 2020 Nov 15.

College of Pharmacy, Chungbuk National University, Cheongju, Republic of Korea.

Aims: Asian patients are known to be more prone to bleeding complications than patients of other ethnicities. Therefore, there are possibilities of other risk factors that should be given special consideration for dosage adjustment in this specific ethnic group. This study aimed to investigate the risk factors for bleeding complications in Asian patients under appropriate edoxaban dosage regimens.

Methods: Data on patients taking proper dosages, based on the Lixiana package insert, were analysed. Univariate and multivariable analyses were conducted to evaluate associations between risk factors and bleeding outcomes. Subgroup analysis was performed on high-risk patients for bleeding complications whose edoxaban dose was reduced according to the package insert.

Results: In total, 346 patients were included. Among them, 32 patients experienced bleeding complications. Patients with weight ≤60 kg and with cancer showed around 3.3- and 3.4-fold increased risk of bleeding complications compared to heavier patients (>60 kg) and those without cancer, respectively. In subgroup analysis with high-risk patients who took low-dose edoxaban (15 and 30 mg), weight ≤60 kg remained a significant factor for bleeding outcomes.

Conclusion: This study showed that weight ≤60 kg and the presence of cancers could affect bleeding complications, which occurred despite proper edoxaban treatment in Asian patients. Therefore, more strict dosage guideline could be considered in populations with high proportions of Asian ethnicities.
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http://dx.doi.org/10.1111/bcp.14623DOI Listing
April 2021

Metformin and Gastrointestinal Cancer Development in Newly Diagnosed Type 2 Diabetes: A Population-Based Study in Korea.

Clin Transl Gastroenterol 2020 11;11(11):e00254

Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Introduction: Clinical studies have produced conflicting results on the effects of metformin on gastrointestinal cancer development. We aimed to investigate the association between metformin use and stomach, colon, liver, and pancreatic cancer development among patients with newly diagnosed, drug-naïve type 2 diabetes.

Methods: This retrospective study evaluated propensity score-matched patients with newly diagnosed type 2 diabetes from the Korean National Health Insurance Service database. Metformin users were categorized into tertiles according to the cumulative dose or duration of metformin treatment, and the risks of gastrointestinal cancers were compared.

Results: Metformin users had reduced risks of developing stomach cancer (hazard ratio [HR]: 0.841, 95% confidence interval [CI]: 0.797-0.887), colon cancer (HR: 0.865, 95% CI: 0.822-0.91), and liver cancer (HR: 0.709, 95% CI: 0.675-0.746; P < 0.001). However, metformin users did not have a reduced overall risk of pancreatic cancer (HR: 1.335, 95% CI: 1.209-1.475; P < 0.001). The risks tended to decrease at higher cumulative doses and durations of metformin use, with significantly reduced risks of all 4 cancers at the highest cumulative dose (≥1,200,000 mg) and the longest duration (≥2,000 days) of metformin use.

Discussion: This population-based data suggest that metformin could be associated with reductions in the risks of stomach, colon, and liver cancers, as well a reduced risk of pancreatic cancer in some subgroups. Metformin has benefit as a first-line treatment for type 2 diabetes mellitus. A further role in cancer risk reduction could be studied in controlled trials.
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http://dx.doi.org/10.14309/ctg.0000000000000254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587422PMC
November 2020

Expression of Pregnancy Up-regulated Non-ubiquitous Calmodulin Kinase (PNCK) in Hepatocellular Carcinoma.

Cancer Genomics Proteomics 2020 Nov-Dec;17(6):747-755

Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

Background/aim: Pregnancy up-regulated non-ubiquitous calmodulin kinase (PNCK) is a member of calmodulin kinase, and overexpression of PNCK with involvement in carcinogenesis have been reported in HER-2 amplified breast cancer, clear cell renal cell carcinoma and nasopharygeal carcinoma. However, the expression of PNCK and its clinical implication have not been elucidated in hepatocellular carcinoma (HCC).

Materials And Methods: We investigated PNCK expression at both the protein and mRNA level using immunohistochemistry (IHC) and microarray gene expression profiling in HCC tissue samples, and evaluated its association with clinicopathological parameters and their potential prognostic significance.

Results: High PNCK protein expression and high PNCK mRNA level was observed in 61.7% and 34.7% of total HCC cases, respectively. PNCK mRNA level was higher in tumor tissues than in background non-tumor tissues, and significantly correlated with protein expression by IHC. High PNCK expression was associated with higher Edmondson grade, intrahepatic metastasis, microvascular invasion and higher AFP levels. Patients with high PNCK expression showed shorter recurrence-free survival and disease-specific survival, and high mRNA expression of PNCK was an independent prognostic factor in disease-specific survival.

Conclusion: Up-regulation of PNCK expression as well as its association with poor prognosis was demonstrated in HCC. PNCK might be a prognostic biomarker of HCC, and could be a potential candidate therapeutic target.
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http://dx.doi.org/10.21873/cgp.20229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675661PMC
August 2020

Epigallocatechin-3-Gallate Reduces Visceral Adiposity Partly through the Regulation of Beclin1-Dependent Autophagy in White Adipose Tissues.

Nutrients 2020 Oct 8;12(10). Epub 2020 Oct 8.

College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea.

Epigallocatechin-3-gallate (EGCG) is a primary bioactive phytochemical in green tea. Its therapeutic potential in metabolic diseases has been reported; however, the molecular mechanisms of the anti-obesity effect of EGCG have not been fully elucidated. In this study, we examined the effects of EGCG on lipid metabolism and autophagy in adipose tissue. After 8 weeks of high-fat diet feeding, mice were treated with EGCG (20 mg/kg/day) for 2 weeks to test in vivo anti-obesity effects of EGCG. EGCG treatment improved glucose tolerance and caused body weight loss. Interestingly, reduced adipose tissue mass was more prominent in visceral compared to subcutaneous white adipose tissue. Mechanistically, EGCG treatment increased autophagic flux in white adipose tissue through the AMP-activated protein kinase-mediated signaling pathway. Adipocyte-specific knockout of Beclin1 mitigated the effects of EGCG on visceral adipose tissue mass and glucose tolerance, indicating that the anti-obesity effect of EGCG requires Beclin1-dependent autophagy. Collectively, our data demonstrated that EGCG has anti-obesity effects through the upregulation of Beclin1-dependent autophagy and lipid catabolism in white adipose tissue (WAT).
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http://dx.doi.org/10.3390/nu12103072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600517PMC
October 2020

Clinicopathological characteristics of primary lung nuclear protein in testis carcinoma: A single-institute experience of 10 cases.

Thorac Cancer 2020 11 3;11(11):3205-3212. Epub 2020 Oct 3.

Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Nuclear protein in testis (NUT) carcinoma is a rare tumor associated with NUT rearrangement that can present as poorly differentiated to undifferentiated carcinoma, with or without abrupt squamous differentiation. It is often misdiagnosed as poorly differentiated carcinoma or undifferentiated carcinoma if NUT is not suspected. In this study, we retrospectively analyzed pulmonary NUT carcinoma cases diagnosed with NUT immunohistochemical staining and discuss the differential diagnosis to provide information for this rare and aggressive entity.

Methods: Cases, diagnosed as "NUT carcinoma" in lung pleura and "metastatic NUT carcinoma from the lung" in lymph nodes were diagnosed between 2017 and 2019 at the Samsung Medical Center (SMC). Clinical features such as age, sex, treatment and follow-up period, and pathological reports were obtained by reviewing patients' electronic medical records.

Results: A total of 10 NUT carcinoma cases were found in the SMC pathology database. Seven patients were men and six were non-smokers. Tumor cells showed various cellular features such as round, squamoid, and spindle. Some cases had initially been misdiagnosed as spindle cell neoplasm, round cell sarcoma, squamous cell carcinoma and small cell carcinoma. All cases showed diffuse strong nuclear expression of NUT immunohistochemical staining, and some were positive for p63 staining and negative for CD56 staining.

Conclusions: NUT carcinoma is often misdiagnosed because of its various morphologies. It is important to consider NUT as one of the differential diagnoses when encountering lung biopsy with undifferentiated morphology.

Key Points: Due to various morphological features, NUT carcinoma can be misdiagnosed It is important to consider NUT carcinoma when diagnosing a poorly differentiated or undifferentiated tumor.
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http://dx.doi.org/10.1111/1759-7714.13648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606005PMC
November 2020

Anti-Obesity Effects of Soybean Embryo Extract and Enzymatically-Modified Isoquercitrin.

Biomolecules 2020 09 30;10(10). Epub 2020 Sep 30.

College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea.

Soy isoflavones are bioactive phytoestrogens with known health benefits. Soybean embryo extract (SEE) has been consumed as a source of isoflavones, mainly daidzein, glycitein, and genistein. While previous studies have reported the anti-obesity effects of SEE, this study investigates their molecular mechanisms and the synergistic effects of co-treatment with SEE and enzymatically modified isoquercitrin (EMIQ). SEE upregulated genes involved in lipolysis and brown adipocyte markers and increased mitochondrial content in differentiated C3H10T1/2 adipocytes in vitro. Next, we use a high-fat diet-induced obesity mouse model to determine the anti-obesity effect of SEE. Two weeks of single or combined treatment with SEE and EMIQ significantly reduced body weight gain and improved glucose tolerance. Mechanistically, SEE treatment increased mitochondrial content and upregulated genes involved in lipolysis in adipose tissue through the cAMP/PKA-dependent signaling pathway. These effects required a cytosolic lipase adipose triglyceride lipase (ATGL) expression, confirmed by an adipocyte-specific ATGL knockout mouse study. Collectively, this study demonstrates that SEE exerts anti-obesity effects through the activation of adipose tissue metabolism and exhibits a synergistic effect of co-treatment with EMIQ. These results improve our understanding of the mechanisms underlying the anti-obesity effects of SEE related to adipose tissue metabolism.
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http://dx.doi.org/10.3390/biom10101394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601939PMC
September 2020

A Crosstalk on Codon Usage in Genes Associated with Leukemia.

Biochem Genet 2021 Feb 28;59(1):235-255. Epub 2020 Sep 28.

Department of Zoology, Moinul Hoque Choudhury Memorial Science College, Algapur, Hailakandi, Assam, 788150, India.

Leukemia is the outcome of aggregation of damaged white blood cells. Several genes were reported to be associated with the pathogenesis of leukemia. These genes were computationally analyzed to decipher their codon usage bias (CUB) and to identify the prime factors influencing the codon usage profile as no work was reported yet. The mean values of synonymous codon usage order (SCUO) parameter indicated low CUB of the genes. Significant positive association of SCUO with overall GC and positional GCs might signal the presence of mutational pressure. However, neutrality plot suggested the dominant role of natural selection across the genes. Along with natural selection, the role of mutation pressure was also prominent and that might be responsible for lower CUB (SCUO = 0.19) of genes. Low translational speed might permit accuracy in the process. A strong inverse relationship of translational rate was observed with CUB of genes and folding energy.
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http://dx.doi.org/10.1007/s10528-020-10000-3DOI Listing
February 2021

Relationship of Sarcopenia with Microcirculation Measured by Skin Perfusion Pressure in Patients with Type 2 Diabetes.

Endocrinol Metab (Seoul) 2020 09 22;35(3):578-586. Epub 2020 Sep 22.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Background: Few studies have examined the relationship of sarcopenia with the microcirculation. The current study investigated the relationship of sarcopenia with microcirculatory function, as assessed by skin perfusion pressure (SPP), in type 2 diabetes mellitus (T2DM) patients.

Methods: In total, 102 T2DM patients who underwent SPP measurements and bioelectrical impedance analysis (BIA) were enrolled in this cross-sectional study. SPP was assessed using the laser Doppler technique. Sarcopenia was defined as low height-adjusted appendicular muscle mass (men, <7 kg/m2; women, <5.7 kg/m2) using BIA. We divided the participants into two groups based on SPP (≤50 and >50 mm Hg), and an SPP below 50 mm Hg was considered to reflect impaired microcirculation.

Results: Fourteen patients (13.7%) were diagnosed with impaired microcirculatory function of the lower limb based on SPP. The prevalence of sarcopenia in all subjects was 11.8%, but the percentage of patients with an SPP ≤50 mm Hg who had sarcopenia was more than triple that of patients with an SPP >50 mm Hg (28.6% vs. 9.1%, P=0.036). A significant positive correlation was found between SPP and appendicular muscle mass adjusted for height (P=0.041 for right-sided SPP). Multiple logistic regression analysis showed that patients with sarcopenia had an odds ratio of 4.1 (95% confidence interval, 1.01 to 24.9) for having an SPP ≤50 mm Hg even after adjustment for confounding factors.

Conclusion: These results suggest that sarcopenia may be significantly associated with impaired microcirculation in patients with T2DM. Nonetheless, the small number of patients and wide CI require cautious interpretation of the results.
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http://dx.doi.org/10.3803/EnM.2020.679DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520593PMC
September 2020

Synonymous codon usage and context analysis of genes associated with pancreatic cancer.

Mutat Res 2020 May - Dec;821:111719. Epub 2020 Aug 11.

Department of Zoology, Moinul Hoque Choudhury Memorial Science College, Algapur, Hailakandi 788150, Assam, India.

Pancreatic cancer is a fatal disorder which originates in pancreas. Its mortality rate is increasing with time. Some studies also reported that pancreatic cancer would be ranked 2nd by the year 2030. Codon usage bias (CUB) arises when synonymous codons for each amino acid are not used randomly in the coding sequences of genes. We used bioinformatic methods to analyze the compositional properties, codon context and codon usage trend of the genes associated with pancreatic cancer as no work was reported yet. From the base composition analysis, the pancreatic cancer genes were found to be GC-rich and at the 3rd codon position the G/C ending codons were more preferred to A/T ending ones. The CUB was low in genes associated with pancreatic cancer. Correspondence analysis proposed that other than base constraints, CUB might also be affected by some other factors such as natural selection. Moreover, results of correlation analysis indicated that CUB and various GC contents i.e. GC, GC1, GC2, GC3 played important role in the release of free energy by transcripts of the genes associated with pancreatic cancer. The low compAI values of coding sequences suggested a low translation rate of the genes.
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http://dx.doi.org/10.1016/j.mrfmmm.2020.111719DOI Listing
December 2020

Effect of extracorporeal shock wave therapy for burn scar regeneration: A prospective, randomized, double-blinded study.

Burns 2020 Aug 29. Epub 2020 Aug 29.

Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea. Electronic address:

Purpose: This study aimed to investigate the regeneration effect of extracorporeal shock wave therapy (ESWT) on hypertrophic scar regeneration using objective measurements.

Methods: This was a double-blinded, randomized, controlled trial of 48 participants who had undergone autologous split-thickness skin grafting (STSG) with same artificial dermis. The ESWT group (n=25) received shock waves with low-energy flux density (0.05-0.30mJ/mm). The interval between treatments is a 1-week. The ESWT group also received recommended treatment. The control group (n=23) only received standard treatment. We measured skin characteristics before treatment and after 6 weeks for both groups.

Results: No significant intergroup difference was noted at the initial evaluations (p>0.05). The pre- to post-treatment change in the scar thickness (p=0.03) and erythema (p=0.03), greater reduction was found in the ESWT group than control group. The pre- to post-treatment change in the sebum level (p=0.02), more increase was found in the ESWT group. We found no significant differences in the change measurements between the two groups for melanin levels (p=0.62) and transepidermal water loss (TEWL) (p=0.94). The changes (skin distensibility, biological skin elasticity, gross skin elasticity, and skin viscoelasticity) measured with the Cutometer showed no significant differences between the two groups (p=0.87, p=0.32, p=0.37, and p=0.29, respectively).

Conclusion: This is the first report of ESWT on hypertrophic scar after burn using objective tools (melanin, erythema, sebum, TEWL, elasticity and thickness). ESWT has objective beneficial effects on burn-associated scar characteristics.
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http://dx.doi.org/10.1016/j.burns.2020.08.009DOI Listing
August 2020

Frontal lobe oxyhemoglobin levels in patients with lower extremity burns assessed using a functional near-Infrared spectroscopy device during usual walking: a pilot study.

Comput Methods Biomech Biomed Engin 2020 Sep 11:1-7. Epub 2020 Sep 11.

Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

Background: Understanding the mechanisms associated with locomotor networks may be of benefit for rehabilitation of burn victims with neurological locomotor deficits. A wearable functional near-infrared spectroscopy (fNIRS) device has been developed for studying cortical hemodynamics.

Objectives: To investigate cortical brain activity during usual walking, we examined patterns of cortical activation using fNIRS device (NIRSIT®; OBELAB Inc., Seoul, Korea), in patients with neurological injury caused by lower extremity burns.

Methods: This cross-sectional study assessed 15 patients with lower extremity burns, 10 patients with upper extremity burns, and 11 healthy controls. We measured walking-related cortical activity using an fNIRS device at baseline and during usual walking.

Results: There was no significant difference between the burns groups in terms of age (43.50 ± 14.08 and 44.67 ± 6.92 years,  = 1.00), pain score of NRS (Numeric rating scale) (5.83 ± 1.19 and 6.67 ± 1.21,  = 0.18) or the mean time since injury (228.50 ± 83.43 and 199.33 ± 68.84 days,  = 0.78). Measures showed increased cortical activation in the prefrontal cortex in patients with lower extremity burns than in patients with healthy controls( = 0.015). The measured HbO datas of the regions during usual walking in patients with lower extremity burn were insignificantly higher compared with the datas in patient with upper extremity burn (P = 0.302).

Conclusions: The patients with neurological injury due to lower extremity burns significantly rely more on cognitive resources even when performing a usual walking task.
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http://dx.doi.org/10.1080/10255842.2020.1812583DOI Listing
September 2020

Effects of Robot-Assisted Gait Training in Patients with Burn Injury on Lower Extremity: A Single-Blind, Randomized Controlled Trial.

J Clin Med 2020 Aug 31;9(9). Epub 2020 Aug 31.

Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07247, Korea.

This study investigated the effects of robot-assisted gait training (RAGT) on gait function in burn patients. Briefly, 40 burn patients were randomly divided into an RAGT group or a conventional training (CON) group. SUBAR (Cretem, Korea) is a wearable robot with a footplate that simulates normal gait cycles. The RAGT group underwent 30 min of robot-assisted training using SUBAR with 30 min of conventional physiotherapy once a day, 5 days a week for 12 weeks. Patients in the CON group received 30 min of overground gait training and range-of-motion (ROM) exercises twice a day for 5 days a week for 12 weeks. The RAGT group and the CON group underwent 60 min of training per day. The intervention frequency and duration did not differ between the RAGT group and the CON group. The main outcomes were functional ambulatory category (FAC); 6-min walking test (6MWT); visual analogue scale (VAS) during gait movement; ROM; and isometric forces of bilateral hip, knee, and ankle muscles before and after 12 weeks of training. The results of the VAS, FAC, and 6MWT (8.06 ± 0.66, 1.76 ± 0.56, and 204.41 ± 85.60) before training in the RAGT group improved significantly (4.41 ± 1.18, 4.18 ± 0.39, and 298.53 ± 47.75) after training (p < 0.001, p < 0.001, and p < 0.001). The results of the VAS, FAC, and 6MWT (8.00 ± 1.21, 1.75 ± 0.58, and 220.94 ± 116.88) before training in the CON group improved significantly (5.00 ± 1.03, 3.81 ± 1.05, and 272.19 ± 110.14) after training (p < 0.001, p < 0.001, and p = 0.05). There were differences in the improvement of results of the VAS, FAC, and 6MWT between groups after training, but they were not statistically significant (p = 0.23, p = 0.14, and p = 0.05). The isometric strengths of the right hip extensor (p = 0.02), bilateral knee flexor (p = 0.04 in the right, and p = 0.001 in the left), bilateral knee extensor (p = 0.003 in the right, and p = 0.002 in the left), bilateral ankle dorsiflexor (p = 0.04 in the right, and p = 0.02 in the left), and bilateral ankle plantarflexor (p = 0.001 in the right, and p = 0.008 in the left) after training were significantly improved compared with those before training in the RAGT group. The ROMs of the right knee extension (p = 0.03) and bilateral ankle plantarflexion (p = 0.008 in the right, and p = 0.03 in the left) were significantly improved compared with measurements before training in the RAGT. There were no significant differences of the isometric strengths and ROMs of the bilateral hip, knee, and ankle muscles after training in the CON group. There were significant improvements in the isometric strengths of the left knee flexor ( = 0.01), left ankle dorsiflexor ( = 0.01), and left ankle plantarflexor ( = 0.003) between the two groups. The results suggested that RAGT is effective to facilitate early recovery of muscles strength after a burn injury. This is the first study to evaluate the effectiveness of RAGT in patients with burns compared with those receiving conventional training. The absence of complications in burn patients provides an opportunity to enlarge the application area of RAGT.
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http://dx.doi.org/10.3390/jcm9092813DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563213PMC
August 2020