A Novel Mobile Acoustic Uroflowmetry: Comparison With Contemporary Uroflowmetry / 대한배뇨장애요실금학회지

Purpose@#This study aimed to evaluate the accuracy and reliability of a new smartphone-based acoustic uroflowmetry compared to conventional uroflowmetry. @*Methods@#This was a prospective validation study enrolling 128 subjects from September 2017 to April 2018 comparing a novel acoustic uroflowmetry to conventional uroflowmetry in an outpatient urologic clinic at Seoul National University Bundang Hospital. Visual comparison of flow patterns and uroflow parameters such as maximum flow rate (Qmax), average flow rate (Qavg), and voided volume were compared between the 2 techniques. Reliability and accuracy of the uroflowmetry results were compared using Pearson correlation coefficient (PCC) and Student t-test, respectively. @*Results@#One hundred twelve participants were included in the study. Of these, 77 had baseline urologic comorbidities while 35 were normal participants. Flow patterns between the 2 uroflowmetry techniques demonstrated strong visual correlation. When compared to conventional uroflowmetry, all 3 parameters of voiding in male participants showed a very robust correlation with PCC of 0.88, 0.91, and 0.95 for Qmax, Qavg, and voided volume, respectively. Among female participants, we observed a PCC of 0.78, 0.93, and 0.96 for Qmax, Qavg, and voided volume, respectively. The Qmax showed a statistically significant difference in both sexes between the 2 methods, although the absolute value was small. @*Conclusions@#Uroflowmetry using acoustic analysis demonstrates comparable findings to conventional uroflowmetry. This provides an opportunity to perform uroflowmetry in the clinic or at home in a reliable, inexpensive manner. Future large-scale prospective studies are required to further validate our results.

A Novel Mobile Acoustic Uroflowmetry: Comparison With Contemporary Uroflowmetry / 대한배뇨장애요실금학회지

Purpose@#This study aimed to evaluate the accuracy and reliability of a new smartphone-based acoustic uroflowmetry compared to conventional uroflowmetry. @*Methods@#This was a prospective validation study enrolling 128 subjects from September 2017 to April 2018 comparing a novel acoustic uroflowmetry to conventional uroflowmetry in an outpatient urologic clinic at Seoul National University Bundang Hospital. Visual comparison of flow patterns and uroflow parameters such as maximum flow rate (Qmax), average flow rate (Qavg), and voided volume were compared between the 2 techniques. Reliability and accuracy of the uroflowmetry results were compared using Pearson correlation coefficient (PCC) and Student t-test, respectively. @*Results@#One hundred twelve participants were included in the study. Of these, 77 had baseline urologic comorbidities while 35 were normal participants. Flow patterns between the 2 uroflowmetry techniques demonstrated strong visual correlation. When compared to conventional uroflowmetry, all 3 parameters of voiding in male participants showed a very robust correlation with PCC of 0.88, 0.91, and 0.95 for Qmax, Qavg, and voided volume, respectively. Among female participants, we observed a PCC of 0.78, 0.93, and 0.96 for Qmax, Qavg, and voided volume, respectively. The Qmax showed a statistically significant difference in both sexes between the 2 methods, although the absolute value was small. @*Conclusions@#Uroflowmetry using acoustic analysis demonstrates comparable findings to conventional uroflowmetry. This provides an opportunity to perform uroflowmetry in the clinic or at home in a reliable, inexpensive manner. Future large-scale prospective studies are required to further validate our results.

Biological efficacy of perpendicular type-I collagen protruded from TiO / 国际口腔科学杂志·英文版

The aim of this study was to evaluate the biological efficacy of a unique perpendicular protrusion of type-I collagen (Col-I) from TiO

Epithelial cell adhesion efficacy of a novel peptide identified by panning on a smooth titanium surface / 国际口腔科学杂志·英文版

Epithelial attachment via the basal lamina on the tooth surface provides an important structural defence mechanism against bacterial invasion in combating periodontal disease. However, when considering dental implants, strong epithelial attachment does not exist throughout the titanium-soft tissue interface, making soft tissues more susceptible to peri-implant disease. This study introduced a novel synthetic peptide (A10) to enhance epithelial attachment. A10 was identified from a bacterial peptide display library and synthesized. A10 and protease-activated receptor 4-activating peptide (PAR4-AP, positive control) were immobilized on commercially pure titanium. The peptide-treated titanium showed high epithelial cell migration ability during incubation in platelet-rich plasma. We confirmed the development of dense and expanded BL (stained by Ln5) with pericellular junctions (stained by ZO1) on the peptide-treated titanium surface. In an adhesion assay of epithelial cells on A10-treated titanium, PAR4-AP-treated titanium, bovine root and non-treated titanium, A10-treated titanium and PAR4-AP-treated titanium showed significantly stronger adhesion than non-treated titanium. PAR4-AP-treated titanium showed significantly higher inflammatory cytokine release than non-treated titanium. There was no significant difference in inflammatory cytokine release between A10-treated and non-treated titanium. These results indicated that A10 could induce the adhesion and migration of epithelial cells with low inflammatory cytokine release. This novel peptide has a potentially useful application that could improve clinical outcomes with titanium implants and abutments by reducing or preventing peri-implant disease.

Preventive effect of Angelica gigas Nakai extract oral administration on dry eye syndrome

Objective:To identify the preventive effect of Angelica gigas Nakai (A. gigas Nakai) extract in a benzalkonium chloride-induced dry eye model.Methods:A total of 28 mice were divided into 4 groups: 1) Normal group: mice received only saline; 2) positive control group: mice received an oral solution without A. gigas Nakai extract at 10:00 a.m. and 0.2% benzalkonium chloride eye drops at 2:00 p.m.; 3) A. gigas Nakai extract (5 mg); 4) A. gigas Nakai extract (10 mg). Both group 3) and group 4) received an oral solution with A. gigas Nakai extract (either 5 mg/kg or 10 mg/kg) at 10:00 a.m. and 0.2% benzalkonium chloride eye drops at 2:00 p.m. After 14 d of follow-up, tear volume measurement and fluorescein staining were evaluated for the recovery effects on ocular surface. Histologic analysis was conducted by hematoxylin and eosin staining. Apoptosis on ocular epithelium layer was examined using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling staining. Expression of TNF- α was also measured using western blot analysis.Results:An increase in both the tear volume and the sustained fluorescein staining scores was observed, demonstrating the preventive effects of A. gigas Nakai extract. Structure changes such as irregularity of the epithelial layer and corneal epithelial cell death were inhibited in the A. gigas Nakai extract groups. Expression of TNF- α moderately declined; however, its expression level was still higher, compared to the normal group.Conclusions:Results from the current study show the significant preventive effect of A. gigas Nakai extract in a mouse model of benzalkonium chloride-induced dry eye syndrome. Thus, A. gigas Nakai extract could be considered as an oral preventive agent for dry eye syndrome in the future.

Dosimetric accuracy of the Acuros XB and Anisotropic analytical algorithm near interface of the different density media for the small fields of a 6- MV flattening-filter-free beam

Background: This study was conducted to assess the accuracy of dose calculation near the air-phantom interface of a heterogeneous phantom for Acuros XB [AXB] and Anisotropic Analytical Algorithm [AAA] algorithm of a 6-MV flattening-filter-free beam, compared with film measurements

Materials and Methods: A phantom included air gap was specially manufactured for this study. In order to evaluate the dose near air gap-phantom interface, Eclipse treatment planning system equipped both AXB and AAA was used for the dose calculations. Measurements in this region were performed with radiochromic film. The central-axis dose [CAD] and off-axis dose [OAD] between calculations and measurements were analyzed for various field sizes and air gaps. The root-mean-square-error [RMSE] was used to evaluate the difference between the calculated and measured OAD. In order to quantify agreement between the calculated and measured dose distributions, the gamma analysis was performed with the 2%/2 mm and 3%/3 mm criteria

Results: For all fields traveling through 1 and 3 cm air gap, the maximum difference in the calculated CAD was -5.3% for AXB and 214.8% for AAA, compared to the measured CAD. For the RMSE between the calculated and measured OAD, the calculated OAD using AXB showed interval in the RMSE [from 4.4 to 12.7] while using AAA indicated broad [from 7.7 to 101.0]. In addition, the gamma passing rates showed that AXB was higher agreement than AAA

Conclusion: This study demonstrated that AXB was more accurate in heterogeneous media near air-phantom interface than AAA when comparing the measured data

Evaluation of Geographic Indices Describing Health Care Utilization / 예방의학회지

OBJECTIVES: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. METHODS: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. RESULTS: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. CONCLUSIONS: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

The Level of Autoantibodies Targeting Eukaryote Translation Elongation Factor 1 α1 and Ubiquitin-Conjugating Enzyme 2L3 in Nondiabetic Young Adults

BACKGROUND: The prevalence of novel type 1 diabetes mellitus (T1DM) antibodies targeting eukaryote translation elongation factor 1 alpha 1 autoantibody (EEF1A1-AAb) and ubiquitin-conjugating enzyme 2L3 autoantibody (UBE2L3-AAb) has been shown to be negatively correlated with age in T1DM subjects. Therefore, we aimed to investigate whether age affects the levels of these two antibodies in nondiabetic subjects. METHODS: EEF1A1-AAb and UBE2L3-AAb levels in nondiabetic control subjects (n=150) and T1DM subjects (n=101) in various ranges of age (18 to 69 years) were measured using an enzyme-linked immunosorbent assay. The cutoff point for the presence of each autoantibody was determined based on control subjects using the formula: [mean absorbance+3×standard deviation]. RESULTS: In nondiabetic subjects, there were no significant correlations between age and EEF1A1-AAb and UBE2L3-AAb levels. However, there was wide variation in EEF1A1-AAb and UBE2L3-AAb levels among control subjects <40 years old; the prevalence of both EEF1A1-AAb and UBE2L3-AAb in these subjects was 4.4%. When using cutoff points determined from the control subjects <40 years old, the prevalence of both autoantibodies in T1DM subjects was decreased (EEFA1-AAb, 15.8% to 8.9%; UBE2L3-AAb, 10.9% to 7.9%) when compared to the prevalence using the cutoff derived from the totals for control subjects. CONCLUSION: There was no association between age and EEF1A1-AAb or UBE2L3-AAb levels in nondiabetic subjects. However, the wide variation in EEF1A1-AAb and UBE2L3-AAb levels apparent among the control subjects <40 years old should be taken into consideration when determining the cutoff reference range for the diagnosis of T1DM.

The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization / 예방의학회지

OBJECTIVES: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. METHODS: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. RESULTS: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. CONCLUSIONS: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

Strategies and Advancement in Antibody-Drug Conjugate Optimization for Targeted Cancer Therapeutics

Antibody-drug conjugates utilize the antibody as a delivery vehicle for highly potent cytotoxic molecules with specificity for tumor-associated antigens for cancer therapy. Critical parameters that govern successful antibody-drug conjugate development for clinical use include the selection of the tumor target antigen, the antibody against the target, the cytotoxic molecule, the linker bridging the cytotoxic molecule and the antibody, and the conjugation chemistry used for the attachment of the cytotoxic molecule to the antibody. Advancements in these core antibody-drug conjugate technology are reflected by recent approval of Adectris(R) (anti-CD30-drug conjugate) and Kadcyla(R) (anti-HER2 drug conjugate). The potential approval of an anti-CD22 conjugate and promising new clinical data for anti-CD19 and anti-CD33 conjugates are additional advancements. Enrichment of antibody-drug conjugates with newly developed potent cytotoxic molecules and linkers are also in the pipeline for various tumor targets. However, the complexity of antibody-drug conjugate components, conjugation methods, and off-target toxicities still pose challenges for the strategic design of antibody-drug conjugates to achieve their fullest therapeutic potential. This review will discuss the emergence of clinical antibody-drug conjugates, current trends in optimization strategies, and recent study results for antibody-drug conjugates that have incorporated the latest optimization strategies. Future challenges and perspectives toward making antibody-drug conjugates more amendable for broader disease indications are also discussed.

Evaluación del screening de perfil lipídico propuesto por la Academia Americana de Pediatría / Usefulness of the American Academy of Pediatrics lipid screening

Objective: To determine if the screening adopted by the American Academy of Pediatrics to search for alterations in lipid profile is useful in the population of Centro Asistencial Norte of Antofagasta. Patients and Method: 61 patients 2 to 14 years of age were screened using the AAP lipid profile (family history of cardiovascular disease, hypercholesterolemia of parents, presence of overweight, arterial hypertension, tobacco addiction, consumption of fats) to evaluate its relationship to laboratory results (total cholesterol, HDL, LDL and triglycerides). Ain analytical study of cross section was used, utilizing /-test and the Fisher's Test were used with alpha = 0.05. Results: A difference in parent hypercholesterolemia (p = 0.013) with sensitivity of 31 percent and specificity of 63 percent was found, with a risk of 6 times higher for dyslipidemia in children with hypercholeste-rolemia in parents (RO with CI of 95 percent of 6.75 (1.18-68.51)). Conclusion: In this sample, utilizing the AAP screening, only the history of hypercholesterolemia in parents was valuable to determine if the patients had a higher risk of presenting dyslipidemia.

Objetivo: Determinar si los criterios de screening adoptados por la American Academy of Pediatrics para pesquisar alteraciones de perfil lipídico son útiles en población consultante del Centro Asistencial Norte de Antofagasta. Pacientes y Método: 61 pacientes entre 2 y 14 años fueron sometidos a screening de perfil lipídico (historia familiar de enfermedad cardiovascular, hipercolesterolemia parental, sobrepeso, hipertensión arterial, tabaquismo, consumo elevado de grasas) para analizar si se relacionaban con los resultados obtenidos del laboratorio. El diagnóstico se realizó considerando los valores de colesterol total, HDL, LDL y triglicéridos. El diseño correspondió a un estudio analítico de corte transversal. Para analizar los grupos se utilizó el /-test y la prueba de Fisher con alfa = 0,05. Resultados: Sólo hubo diferencia significativa en el antecedente de hipercolesterolemia parental (p = 0,013) con sensibilidad del 31 por ciento y especificidad de 63 por ciento, observándose un riesgo de 6 veces más posibilidades de tener dislipidemia en los hijos de padres con hipercolesterolemia (OR con intervalo de confianza al 95 por ciento de 6,75 (1,18 - 68,51). Conclusión: En la muestra, según los criterios de screening, sólo el antecedente de hipercolesterolemia de los padres resultó valioso para determinar si los pacientes tenían más riesgo de presentar dislipidemia.

In the Margins: Writing on Medicine in Korea After 1876 / 의사학

The goals of this article are to survey American scholarship of medicine in Korea during the modern period and to suggest perspectives such studies offer to the fields of Korean history, Asian studies, and "mainstream" history of medicine. Until recently, the history of medicine in modern Korea has been peripheralized in the larger fields within which it is subsumed for various reasons. Earlier researchers tended to operate from "Orientalist" frameworks or were informed by "modernization theory," and thus have focused generally on American interventions in Korean public health and medicine (through missionaries, the US military, and other aid organizations) or that which has been conventionally perceived as "traditional" medicine. Critical scholarship in fields of STS and post-colonial studies, however, have recently inspired new research that reassess polemic issues such as technology transfer, translation of knowledge, cultural encounters, governmentality, processes involved in the revitalization of Hanui, construction of gender, and nexus among medicine, science, and technology. As such the field as expanded beyond Korean history to include anthropology, sociology, STS, and linguistics. Moreover, given the transnational nature of academia and possibilities for productive comparative research, Korean history of medicine may soon no longer remain in the margins.