Lymphoid Lineage γδ T Cells Were Successfully Generated from Human Pluripotent Stem Cells via Hemogenic Endothelium

γδ T cells are a rare and unique prototype of T cells that share properties with natural killer cells in secondary lymphoid organs. Although many studies have revealed the function and importance of adult-derived γδ T cells in cancer biology and regenerative medicine, the low numbers of these cells hamper their application as therapeutic cell sources in the clinic. To solve this problem, pluripotent stem cell-derived γδ T cells are considered alternative cell sources; however, few studies have reported the generation of human pluripotent stem cell-derived γδ T cells. In the present study, we investigated whether lymphoid lineage γδ T cells were successfully generated from human pluripotent stem cells via hemogenic endothelium under defined culture conditions. Our results revealed that pluripotent stem cells successfully generated γδ T cells with an overall increase in transcriptional activity of lymphoid lineage genes and cytolytic factors, indicating the importance of the optimization of culture conditions in generating lymphoid lineage γδ T cells. We uncovered an initial step in differentiating γδ T cells that could be applied to basic and translational investigations in the field of cancer biology. Based on our result, we will develop an appropriate method to purify γδ T cells with functionality and it helpful for the study of basic mechanism of γδ T cells in pathophysiologic condition as well as clinic application.

Face Mask Usage, Knowledge and Behavior of Face Mask Usage in Older Adults Living Alone in the COVID-19 Era

Purpose@#This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic. @*Methods@#This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho’s Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach’s α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson’s correlation coefficient, and multiple linear regression. @*Results@#Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (β = - .31, p < .001), living region (β = .13, p = .017), personal income (β = .12, p = .041) significantly affected the face mask usage-related knowledge, and living region (β = .15, p = .010) significantly affected the face mask usage-related behavior. @*Conclusion@#Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas.

Distinct Repopulation Activity in Hu-Mice between CBand LPB-CD34＋ Cells by Enrichment of Transcription Factors

Background and Objectives@#Human CD34＋hematopoietic stem cells can reconstitute the human hematopoietic system when transplanted into immunocompromised mice after irradiation. Human leukapheresis peripheral blood (LPB)-and cord blood (CB)-derived CD34＋ cells have a similar capacity to reconstitute myeloid lineage cells in a humanized mice (hu-mice) model. However, potent stem cells, such as CB-CD34＋ cells, efficiently reconstitute the lymphoid system in vivo compared to LPB-CD34 ＋ cells. Modeling the human hematolymphoid system is vital for studying immune cell crosstalk in human xenografted mice, with CB-CD34＋ cells used as an optimized cell source because they are essential in reconstituting lymphoid lineage cells. @*Methods@#and Results: In this study, we established hu-mice that combined human characteristics with long-term survival and investigated the efficiency of the engraftment of lymphoid lineage cells derived from LPB- and CB-CD34＋cells in the bone marrow, spleen, and LPB. We found an overall increase in the transcriptional activity of lymphoid lineage genes in CB-CD34＋ cells. Our results revealed that potent CB-CD34＋ cells displaying a general upregulation of the expression of genes involved in lymphopoiesis could contribute to the hematolymphoid system in the humanized mice model with longevity. @*Conclusions@#Our data suggest that humanized mouse model by usage of CB-CD34 ＋ cells displaying high expression of TFs for lymphoid lineage cells can contribute to study the immune response against lymphocytes.

Face Mask Usage, Knowledge and Behavior of Face Mask Usage in Older Adults Living Alone in the COVID-19 Era

Purpose@#This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic. @*Methods@#This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho’s Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach’s α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson’s correlation coefficient, and multiple linear regression. @*Results@#Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (β = - .31, p < .001), living region (β = .13, p = .017), personal income (β = .12, p = .041) significantly affected the face mask usage-related knowledge, and living region (β = .15, p = .010) significantly affected the face mask usage-related behavior. @*Conclusion@#Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas.

Distinct Repopulation Activity in Hu-Mice between CBand LPB-CD34＋ Cells by Enrichment of Transcription Factors

Background and Objectives@#Human CD34＋hematopoietic stem cells can reconstitute the human hematopoietic system when transplanted into immunocompromised mice after irradiation. Human leukapheresis peripheral blood (LPB)-and cord blood (CB)-derived CD34＋ cells have a similar capacity to reconstitute myeloid lineage cells in a humanized mice (hu-mice) model. However, potent stem cells, such as CB-CD34＋ cells, efficiently reconstitute the lymphoid system in vivo compared to LPB-CD34 ＋ cells. Modeling the human hematolymphoid system is vital for studying immune cell crosstalk in human xenografted mice, with CB-CD34＋ cells used as an optimized cell source because they are essential in reconstituting lymphoid lineage cells. @*Methods@#and Results: In this study, we established hu-mice that combined human characteristics with long-term survival and investigated the efficiency of the engraftment of lymphoid lineage cells derived from LPB- and CB-CD34＋cells in the bone marrow, spleen, and LPB. We found an overall increase in the transcriptional activity of lymphoid lineage genes in CB-CD34＋ cells. Our results revealed that potent CB-CD34＋ cells displaying a general upregulation of the expression of genes involved in lymphopoiesis could contribute to the hematolymphoid system in the humanized mice model with longevity. @*Conclusions@#Our data suggest that humanized mouse model by usage of CB-CD34 ＋ cells displaying high expression of TFs for lymphoid lineage cells can contribute to study the immune response against lymphocytes.

Peptides Targeting Fms-Related Tyrosine Kinase-4 Activate the Function of Natural Killer Cells in Acute Myeloid Leukemia

Background and Objectives@#The increased expression for the Fms-related tyrosine kinase-4 (FLT-4, known as VEGFR-3) is relevant to dysfunctional natural killer (NK) cells in acute myeloid leukemia (AML). MAZ51 (M), a VEGFR-3 inhibiting chemical, was effectively restored the function of NK cells via the high expression of interferon-gamma (IFN-γ) in NK cells, as shown in our previous study. Although tremendous amount of clinical data using peptides are currently available in real clinic, peptides targeting FLT-4 in modulating immune cells such as NK cells are not fully elucidated. @*Methods@#and Results: In present study, we developed peptides targeting FLT-4 (P), which is inhibiting an affinity for AML-NK expressing FLT-4 in vitro and in vivo. Bone marrow (BM) and peripheral blood (PB) mononuclear cells (MNCs) from AML patients were treated with combinational cocktails of the three agents including P, M, ara-C (A) and FLT-4 expression and IFN-γ release were examined. In an AML mouse model, IFN-γ expression were examined in T and NK cells from mouse BM, spleen, and liver to address relevance between peptides and immune cell activation. We found that AML-NK cells both in human and mouse samples showed a gradual increase the IFN-γ levels compared to the controls. There was a trend toward a reduction in leukemic blasts in the BM, spleen, and liver from the AML mice, when we compared the effects of combinational treatments. @*Conclusions@#Our results suggest that the function of AML-NK cells was synergistically activated by P in combination with M or A.

Hypotriglyceridemic effects of brown seaweed consumption via regulation of bile acid excretion and hepatic lipogenesis in high fat diet-induced obese mice

BACKGROUND/OBJECTIVES@#The present study aimed to further investigate the potential health beneficial effects of long-term seaweed supplementation on lipid metabolism and hepatic functions in DIO mice.MATERIALS/METHODS: Four brown seaweeds (Undaria pinnatifida [UP], Laminaria japonica [LJ], Sargassum fulvellum [SF], or Hizikia fusiforme [HF]) were added to a high fat diet (HFD) at a 5% ratio and supplemented to C57BL/6N mice for 16 weeks. Triglycerides (TGs) and total cholesterol (TC) in the liver, feces, and plasma were measured. Fecal bile acid (BA) levels in feces were monitored. Hepatic insulin signaling- and lipogenesis-related proteins were evaluated by Western blot analysis. @*RESULTS@#Fasting blood glucose levels were significantly reduced in the LJ, SF, and HF groups compared to the HFD group by the end of 16-week feeding period. Plasma TG levels and hepatic lipid accumulation were significantly reduced in all 4 seaweed supplemented groups, whereas plasma TC levels were only suppressed in the UP and HF groups compared to the HFD group. Fecal BA levels were significantly elevated by UP, LJ, and SF supplementation compared to HFD feeding only. Lastly, regarding hepatic insulin signaling-related proteins, phosphorylation of 5′-AMP-activated protein kinase was significantly up-regulated by all 4 types of seaweed, whereas phosphorylation of protein kinase B was up-regulated only in the SF and HF groups. Lipogenesis-related proteins in the liver were effectively down-regulated by HF supplementation in DIO mice. @*CONCLUSIONS@#Brown seaweed consumption showed hypotriglyceridemic effects in the prolonged DIO mouse model. Specifically, combinatory regulation of BA excretion and lipogenesis-related proteins in the liver by seaweed supplementation contributed to the reduction of plasma and hepatic TG levels, which inhibited hyperglycemia in DIO mice. Thus, the discrepant and species-specific functions of brown seaweeds provide novel insights for the selection of future targets for therapeutic agents.

Effects of Korean Dementia Simulation Program for Caregivers of the Elderly with Dementia : A Pilot Study

Full mouth rehabilitation utilizing implant-assisted removable partial denture with a canted occlusal plane: a case report

Implant-assisted removable partial denture (Implant-assisted RPD, IARPD), posterior edentulous extension areas of which obtains additional support and retention from implants, is attracting increasing interest. This case report presents a successful treatment on a partially edentulous patient with a severely canted occlusal plane resulted from a long-term use of posterior extended RPD. The full mouth was rehabilitated through a fixed prosthesis on maxilla and IARPD with zirconia occlusal surface on mandible, which allowed to achieve an esthetic occlusal plane with long-term stability and, ultimately, functionally satisfying outcome.

A technique for fabricating abutment replica with hot melt adhesive material to minimize residual cement in implant restoration: a case report

Removal of excess cement is important to prevent biological complication in cementation of implant restoration with subgingival margin. It can be difficult to completely remove excess cement. Several techniques have been introduced to minimize excess cement using abutment replica. In this case report, a simple method for making abutment replica with hot melt adhesive material in dental office was described. This technique is simple and effective because it can be used for pre-fabricated or custom abutment without additional laboratory procedure. In addition, it can minimize excess cement after cementation of implant restoration.

Characteristics of Visual-Perceptual Function Measured by the Motor-Free Visual Perception Test-3 in Korean Adults

OBJECTIVE: To adapt and standardize the Motor-Free Visual Perception Test-3 (MVPT-3) to Koreans and investigate the change in visual-perceptual function using the MVPT-3 in healthy Korean adults. METHODS: The Korean version of the MVPT-3 was developed through a cross-cultural adaptation process according to 6 steps, including translation, reconciliation, back translation, cognitive debriefing, feedback, and final reconciliation. A total of 321 healthy Korean volunteers (mean age, 51.05 years) were recruited. We collected participant demographic data, such as sex, age, and years of education, and performed the Korean version of the Mini-Mental State Examination (K-MMSE) and MVPT-3. Internal consistency of the MVPT-3 and the relationships between demographic data, K-MMSE and MVPT-3 scores were analyzed. The results of this study were compared with published data from western countries including the United States and Canada. RESULTS: Total score on the MVPT-3 was positively correlated with years of education (r=0.715, p or =80 years and years of education into 4 groups of 0, 1-9, 10-12, > or =13 years. No significant differences in MVPT-3 scores were observed according to sex or country. CONCLUSION: Visual perception was significantly influenced by age, years of education, and cognitive function. Reference values for the MVPT-3 provided in this study will be useful for evaluating and planning a rehabilitation program of visual perceptual function in patients with brain disorders.

Physician Compliance with Tube Feeding Protocol Improves Nutritional and Clinical Outcomes in Acute Lung Injury Patients / 대한구급학회지

BACKGROUND: Nutrition delivery is frequently interrupted or delayed by physicians' ordering patterns. We conducted this study to investigate the effect of physician compliance with tube feeding (TF) protocol on the nutritional and clinical outcomes in acute lung injury (ALI) patients. METHODS: After implementing a TF protocol, 71 ALI patients with mechanical ventilation (MV) for > or = 7 days were observed. A dietician assessed the nutritional status of the patients and established individualized nutrition plans according to the protocol. If the physicians followed the dietician's recommendation within 48 hours, the patients were classified under the compliant group (Group 1). RESULTS: Forty patients (56.3%) were classified into Group 1. Prealbumin was comparable in both groups at ICU admission but higher in Group 1 at the time of discharge from the ICU (228 +/- 81 vs 157 +/- 77 mg/dl, p = 0.025). Nitrogen balance was only improved in Group 1. The time to reach calorie goal was shorter and non-feeding days were reduced in Group 1. The proportion of parenteral nutrition to nutritional support days was lower and delivered calories on the 4th and 7th day of TF were higher in Group 1 (p < 0.001). ICU mortality/stay and hospital mortality failed to show differences but hospital stay was prolonged in the noncompliant group (Group 2) (p = 0.023). Arterial oxygen tension and PaO2/FiO2 were maintained during the 1st week of ICU stay in Group 1 but were decreased in Group 2. CONCLUSIONS: Physicians' compliance with the TF protocol contributed to the likelihood of nutritional improvement and a shorter hospital stay in ALI patients with prolonged MV.

Long-term Treatment Outcomes for Autoimmune Hepatitis in Korea

Immunosuppressive therapy can improve clinical, biochemical and histological features and considerably prolong survival in patients with autoimmune hepatitis. Although ethnicity may affect disease severity and presentation, the long-term outcome of immunosuppression in Korean populations is unknown. This study was aimed to assess the efficacy of immunosuppressive therapy and determine the prognosis of autoimmune hepatitis in Korean populations. We reviewed the medical records of 86 patients diagnosed as having autoimmune hepatitis at the Samsung Medical Center between 1994 and 2008. Seventy-two (83.7%) patients reached remission after a median treatment duration of 3.5 months (range 1 to 44 months). Attempts to withdraw medications were made in 24 cases after the median treatment duration of 36 months (median 6 to 125 months). Thirteen of 24 (54.1%) patients relapsed after treatment withdrawal. Of the 86 patients, 6 (7.2%) experienced disease progression and the overall 5-and 10-yr progression-free survival rates were 91.2% and 85.5%, respectively. In conclusion, immunosuppressive therapy for autoimmune hepatitis results in a favorable rate of remission and excellent progression-free survival, but the relapse rate after treatment withdrawal is high. This suggests that long-term immunosuppressive therapy may be particularly important for treatment of Korean patients.

The Clinicopathological Features of Gastric Hyperplastic Polyps with Neoplastic Transformations: A Suggestion of Indication for Endoscopic Polypectomy

BACKGROUND/AIMS: Although gastric hyperplastic polyps are usually considered as benign lesions, a low risk of carcinomatous conversion is currently recognized. We aimed to identify the characteristics of hyperplastic polyps undergoing neoplastic transformation. METHODS: A total of 269 gastric hyperplastic polyps from 216 patients removed by endoscopic polypectomy (EP) or surgical resection were enrolled in this study, and their endoscopic pictures and pathology slides were reviewed. RESULTS: Neoplastic transformation was detected on forceps biopsy specimen in 11 cases. However, the pathology findings from the EP or surgical specimen revealed neoplastic transformation in 14 cases (5.2%; 4 with dysplasia and 10 with adenocarcinoma). No significant difference was found between hyperplastic polyps with and without neoplastic transformation in age, sex, location, number of polyps or gross appearance. However, neoplastic transformations were more frequently found in gastric hyperplastic polyps >1 cm than in polyps 1 cm. Therefore, EP should be considered for gastric hyperplastic polyps >1 cm for the accurate diagnosis and definitive treatment.

Outcomes of a Modified CALGB 19802 Regimen in Adult Acute Lymphoblastic Leukemia

We analyzed the efficacy and toxicity of a modified Cancer and Leukemia Group B (CALGB) 19802 regimen in adult acute lymphoblastic leukemia (ALL). From February 2002 to August 2005, 25 adults with untreated ALL were enrolled in the study. Compared to the original regimen, the modified CALGB 19802 regimen consisted of a 4-drug induction (cyclophosphamide, daunorubicin, vincristine, and prednisone) instead of a 5-drug induction (L-asparaginase was added to the previous regimen). This was followed by high-dose methotrexate (1,000 mg/m(2)X3 days) and cytarabine (2,000 mg/m(2)X4 days) for the consolidation cycles. High-dose systemic and intrathecal methotrexate was given for central nervous system prophylaxis. Twentythree patients (92%) achieved a complete remission (CR), and two patients (8%) had refractory disease. With a median follow-up of 21.5 months, 10 patients (40%) were alive and continued to be in CR. The 3-yr probability of an event-free survival and the overall survival were 39.0% and 47.4%, respectively. Treatment related mortality and major grade 3 to 4 neurotoxicity occurred in 1 patient and 3 patients, respectively. The modified CALGB 19802 regimen demonstrated a high remission rate and a favorable survival rate.

A Case of Gastric Bezoar Treated by an Endoscopic Coca-Cola Injection / 대한소화기내시경학회지

Bezoars are the most common foreign bodies in the stomach as seen endoscopically with a frequency of approximately 0.4%. They consist of persistent concretions or hard accumulations of non-digestible vegetable matter, hair or more unusual materials. Gastric bezoars develop in patients with previous gastric surgery, gastric outlet obstruction, or poor gastric emptying such as gastroparesis due to hypothyroidism, diabetes mellitus or mixed connective tissue disease. The clinical presentations of gastric bezoars include epigastric pain, a palpable mass, a gastrointestinal obstruction and peptic ulceration. The treatment options include surgery, enzymatic dissolution or endoscopic mechanical fragmentation and/or removal. Recently, the efficacy of the administration or lavage of 'Coca-Cola' for the effective dissolution of gastric bezoars has been reported. We report a case of a 27-year-old woman with a large gastric bezoar that was successfully removed by the direct endoscopic injection of a carbonated beverage ('Coca-Cola light', a sugar free product; Coca cola Co., Seoul, South Korea) into the bezoar, which led to fragmentatio

A Case of Idiopathic Intracranial Hypertension Associated with Obesity

Idiopathic intracranial hypertension, or Pseudotumor cerebri is a disorder characterized by symptoms and signs of a space-occupying intracranial mass without any evidence of mass or ventricular obstruction. We experienced a 28 years old obese woman who was presented with headache and progressive visual disturbance for one month. She presented bilateral papilledema with visual field defect. On MRI investigation no intracranial abnomality were observed. Lumbar puncture showed increased intracranial pressure and normal biochemical and cellular findings. The patient was diagnosed idiopathic intracranial hypertension and treated with therapeutic lumbar puncture, acetazolamide, furosemide, weight control and symptoms resolved gradually. We conclude that weight reduction is difficult to accomplish but always needed in idiopathic intracranial hypertension.

A case of cardiac malignant fibrous histiocytoma treated by cardiac autotransplantation / 대한내과학회지

Primary cardiac tumors are rare findings and they are mostly benign. Malignant primary cardiac tumors make up 25% of the primary cardiac tumors and most of them are sarcomas. Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma in late adulthood, and it is an extremely rare sub-type of cardiac sarcoma. It is known that MFH displays a poor clinical course with complete resection being the most important prognostic factor for survival. We described here the case of a malignant fibrous histiocytoma of the heart in a 54-year-old woman who presented with dyspnea. The tumor was treated by mass excision via cardiac explantation and autotransplantation followed by adjuvant chemotherapy. This is the first report of cardiac autotransplantation in Korea.

D2GSNP: a web server for the selection of Single Nucleotide Polymorphisms within human disease genes

D2GSNP is a web-based server for the selection of single nucleotide polymorph isms (SNPs) within genes related to human diseases. The D2GSNP is based on a relational database created by downloading and parsing OMIM, GAD, and dbSNP, and merging it with positional information of UCSC Golden Path. Totally our server provides 5,142 and 1,932 non-redundant disease genes from OMIM and GAD, respectively. With the D2GSNP web interface, users can select SNPs within genes responding to certain diseases and get their flanking sequences for further genotyping experiments such as association studies.