Expression of CD44 according to Clinicopathologic Characteristics of Gastric Cancer / 이화의대지

OBJECTIVES: Cancer stem cells are defined as focal cluster of cells within a tumor that possess the capacity for self-renewal and differentiation into phenotypically heterogeneous cells. Cluster of differentiation 44 (CD44) is considered one of the gastric cancer stem cell markers. We aimed to investigate how the expression of CD44 varies according to the clinicopathologic characteristics in gastric cancer. METHODS: For this study, 157 patients who received an operation due to gastric cancer between May 1998 and December 2009 were selected. CD44 immunohistochemistry was reviewed using the semi-quantitative scoring of intensity and proportion. The sum of the intensity and proportion scores was calculated, and a score of 2 or less was deemed ‘CD44-negative’ and 3 or more as ‘CD44-positive.’ RESULTS: Among the final 143 subjects, 69 (48.3%) were CD44 positive. Older age, intestinal type gastric cancer, lymphatic invasion, and lymph node metastasis were significantly correlated with expression of CD44. In the multivariate analysis, older age was the only independent factor associated with CD44 expression (P=0.028). CD44 expression was correlated with overall survival, 5-year survival, and disease-free survival. In the multivariate analysis, older age, male gender, and lymphatic invasion were independent predictors of poor overall survival. Also, older age and lymphatic invasion were significant factors in 5-year survival, and lymphatic invasion was an independent factor of poor disease-free survival. CONCLUSION: Older age (≥60 years) was independently associated with CD44 expression in gastric cancer patients. Also, CD44 expression was correlated with poor prognosis in gastric cancer patients.

Quantitative measurement of peri-implant bone defects using optical coherence tomography

PURPOSE: The purpose of this study was to visualize and identify peri-implant bone defects in optical coherence tomography (OCT) images and to obtain quantitative measurements of the defect depth. METHODS: Dehiscence defects were intentionally formed in porcine mandibles and implants were simultaneously placed without flap elevation. Only the threads of the fixture could be seen at the bone defect site in the OCT images, so the depth of the peri-implant bone defect could be measured through the length of the visible threads. To analyze the reliability of the OCT measurements, the flaps were elevated and the depth of the dehiscence defects was measured with a digital caliper. RESULTS: The average defect depth measured by a digital caliper was 4.88±1.28 mm, and the corresponding OCT measurement was 5.11±1.33 mm. Very thin bone areas that were sufficiently transparent in the coronal portion were penetrated by the optical beam in OCT imaging and regarded as bone loss. The intraclass correlation coefficient between the 2 methods was high, with a 95% confidence interval (CI) close to 1. In the Bland-Altman analysis, most measured values were within the threshold of the 95% CI, suggesting close agreement of the OCT measurements with the caliper measurements. CONCLUSIONS: OCT images can be used to visualize the peri-implant bone level and to identify bone defects. The potential of quantitative non-invasive measurements of the amount of bone loss was also confirmed.

Trends in the utilization of dental outpatient services affected by the expansion of health care benefits in South Korea to include scaling: a 6-year interrupted time-series study

PURPOSE: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. METHODS: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs. RESULTS: After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable. CONCLUSIONS: The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.

Monocyte chemoattractant protein-1 polymorphism interaction with spirulina immunomodulatory effects in healthy Korean elderly: A 16 week, double-blind randomized clinical trial

BACKGROUND/OBJECTIVES: Spirulina is a known a functional food related to lipid profiles, immune functions, and antioxidant capacity. Circulating monocyte chemoattractant protein-1 (MCP-1) level is associated with inflammation markers. Single nucleotide polymorphism in the MCP-1 promoter region -2518 have been identified and shown to affect gene transcription. Gene variation may also impact functional food supplementary effects. The current study investigated the interaction of MCP-1 -2518 polymorphism with spirulina supplements on anti-inflammatory capacity in Korean elderly. SUBJECTS/METHODS: After genotyping, healthy elderly subjects (n = 78) were included in a randomized, double blind, and placebo controlled study. Baseline characteristic, body composition, and dietary intake were measured twice (baseline vs. week 16). For 16 weeks, subjects consumed 8 g either spirulina or placebo daily. Plasma MCP-1, interleukin (IL) -2, IL-6, tumor necrosis factor (TNF)-α, complement (C) 3, immunoglobulin (Ig) G, and Ig A concentrations and lymphocyte proliferation rate (LPR) were analyzed as inflammatory markers. RESULTS: In the placebo group with A/A genotype, MCP-1 level was significantly increased, but the spirulina group with A/A genotype was unchanged. IL-2 was significantly increased only in subjects with spirulina supplementation. TNF-α was significantly reduced in subjects with the G carrier. C3 was significantly increased in the placebo group, particularly when A/A increased more than G, but not when spirulina was ingested. LPR was significantly different only in subjects with A/A genotype; there was a significant increase in phytohemagglutinin and lipopolysaccharide induced LPR in the spirulina group. CONCLUSION: In healthy Korean elderly, spirulina supplementation may influence different inflammatory markers by the MCP-1 genotype. These results may be useful for customized dietary guidelines to improve immune function in Koreans.

In Vitro Activity of Diphenyleneiodonium toward Multidrug-Resistant Helicobacter pylori Strains

BACKGROUND/AIMS: The increased resistance of Helicobacter pylori to antibiotics has increased the need to develop new treatments for this bacterium. The aim of our study was to identify new drugs with anti-H. pylori activity. METHODS: We screened a small molecule library—the library of pharmacologically active compounds (LOPAC), which includes 1,280 pharmacologically active compounds—to identify inhibitors of H. pylori growth. The minimal inhibitory concentrations (MICs) of antibiotics against multidrug-resistant H. pylori strains were determined using the agar dilution method. RESULTS: We identified diphenyleneiodonium (DPI) as a novel anti-H. pylori agent. The MIC values for DPI were <0.03 μg/mL against all tested H. pylori strains. DPI also exhibited strong antibacterial activity against common gram-negative and gram-positive pathogenic bacteria. CONCLUSIONS: DPI may be a candidate anti-H. pylori drug for future development.

Effects of temperature-fluctuation in a refrigerator on antioxidative index and storage qualities of various foods / 한국영양학회지

PURPOSE: The objective of this study was to examine the association of temperature-fluctuation with freshness quality in various foods. METHODS: We investigated the effects of storage conditions on antioxidant activities of cherries and romaine lettuce during storage at 0.7 ± 0.6℃, 1.2 ± 1.4℃, and 1.6 ± 2.8℃. Cherries and romaine lettuce were stored for a period of 9 days and 7 days, respectively. We also analyzed the effects of storage conditions on fresh quality of beef and salmon during storage at −0.3 ± 0.8℃, −0.6 ± 2.3℃, and −1.5 ± 4.4℃. Both of them were stored for a period of 14 days. RESULTS: The amount of water loss was highest in beef, and the microbial count was also the highest at −1.5 ± 4.4℃. In the case of salmon, there was no difference in water loss according to storage, and TBA value was significantly increased at −1.5 ± 4.4℃. Moisture retention was the highest at 0.7 ± 0.6℃ in both romaine lettuce and cherry samples. The contents of polyphenol and flavonoid were significantly higher in cherries, and content of polyphenols in romaine lettuce was significantly higher at 0.7 ± 0.6℃ (p 1.2 ± 1.4℃> 1.6 ± 2.8 ℃ over 7 days. CONCLUSION: The results indicate that temperature-fluctuation may affect qualities of foods stored in a refrigerator.

Improved accuracy in periodontal pocket depth measurement using optical coherence tomography

PURPOSE: The purpose of this study was to examine whether periodontal pocket could be satisfactorily visualized by optical coherence tomography (OCT) and to suggest quantitative methods for measuring periodontal pocket depth. METHODS: We acquired OCT images of periodontal pockets in a porcine model and determined the actual axial resolution for measuring the exact periodontal pocket depth using a calibration method. Quantitative measurements of periodontal pockets were performed by real axial resolution and compared with the results from manual periodontal probing. RESULTS: The average periodontal pocket depth measured by OCT was 3.10±0.15 mm, 4.11±0.17 mm, 5.09±0.17 mm, and 6.05±0.21 mm for each periodontal pocket model, respectively. These values were similar to those obtained by manual periodontal probing. CONCLUSIONS: OCT was able to visualize periodontal pockets and show attachment loss. By calculating the calibration factor to determine the accurate axial resolution, quantitative standards for measuring periodontal pocket depth can be established regardless of the position of periodontal pocket in the OCT image.

Systemic Sclerosis Associated with Non-small Cell Lung Cancer and Papillary Thyroid Cancer: Case Report and Literature Review / 대한내과학회지

We report the case of a 52-year-old patient with rheumatic vascular disease (systemic sclerosis), non-small cell lung cancer, and papillary thyroid cancer. Malignant tumors have been described in 3-11% of systemic sclerosis cases. Several studies have demonstrated an increased frequency of cancer, especially lung and breast cancer, in patients with systemic sclerosis, but the association of systemic sclerosis with malignancy is controversial. To our knowledge, however, no case of both lung and thyroid cancer associated with systemic sclerosis has been reported. We present a rare case of double primary cancer in systemic sclerosis, with a literature review.

Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study

OBJECTIVE: To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). METHODS: Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. RESULTS: There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. CONCLUSION: The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.

Changes in dental care access upon health care benefit expansion to include scaling

PURPOSE: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. METHODS: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010–2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. RESULTS: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. CONCLUSIONS: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

The influence of obesity on the effects of spirulina supplementation in the human metabolic response of Korean elderly

BACKGROUND/OBJECTIVES: Spirulina, a blue-green alga, is widely produced and commercialized as a dietary supplement with bio- and immune-modulatory functions. We have previously shown that spirulina had favorable effects on lipid profiles, immune functions, and antioxidant capacity in healthy Korean elderly. Despite favorable effect of spirulina supplementation, some sub-populations have shown a poor response to supplementation. Obesity is a factor related to poor-response. Therefore, the purpose of this study was to determine the immuno-modulation, antioxidant capacity, and lipid-lowering effect of spirulina in obese and non-obese Korean elderly. SUBJECTS/METHODS: The subjects were 78 elderly aged 60-87 years. In a randomized double blind, placebo-controlled study, subjects were fed either placebo or spirulina daily, at 8 g for 12 weeks. Subjects were divided into the non-obese group and the obese group based on body mass index (BMI) criteria for Asians suggested by the International Obesity Task Force: BMI < 25 kg/m² (non-obese) and BMI ≥ 25 kg/m² (obese). RESULTS: In the non-obese group, spirulina supplementation showed a significant lowering effect on plasma concentration of total cholesterol and LDL-cholesterol, a significant increase in interleukin (IL)-2 concentration (P < 0.01) and a significant increment (P < 0.05) in IL-2/IL-6 ratio, and a significant increase in total antioxidant status level and a significant decrease in thiobarbituric acid reactive substances level. However, these effects were not observed in the obese group. CONCLUSIONS: These results demonstrated that blood lipid lowering and immune and antioxidant improving response for spirulina supplement was affected by obesity in Korean elderly.

A Case of Cerebral Venous Thrombosis in a Patient with Graves' Disease / 고신대학교의과대학학술지

Superior sagittal sinus thrombosis is an uncommon disease, and 25% of cases are considered to be idiopathic. Hypercoagulability, local bloodstream stasis, and vessel wall abnormalities may contribute to the development of this condition. The thyrotoxic phase of Graves’ disease is associated with venous thrombosis caused by hypercoagulability, which is in turn induced by increased levels of homocysteine and factor VIII and decreased fibrinolytic activity. Here, we report the case of a 39-year-old male who presented with superior sagittal sinus thrombosis and concomitant hyperthyroidism.

Vitamin C and antioxidant capacity stability in cherry and romaine during storage at different temperatures / 한국영양학회지

PURPOSE: The aim of this work was to study the change in antioxidant activity depending on storage temperature and storage period in romaine and cherry. METHODS: The plant material was stored at 0.7 +/- 0.6degrees C, 3.5 +/- 2.8degrees C, and 4.7 +/- 1.4degrees C. Cherry and romaine were stored for a period of 9 days and 7 days, respectively. The cherry was taken from each group of samples at regular intervals of days and the romaine was taken from each group of samples at regular intervals of 2days. Vitamin C, total polyphenol, and total flavonoid stability and antioxidant capacity including DPPH, total antioxidant capacity (TAC) were measured. RESULTS: For cherry, the levels of TAC and flavonoid were higher at the 0.7 +/- 0.6degrees C condition than other conditions (p 4.7 +/- 1.4degrees C > 3.5 +/- 2.8degrees C. CONCLUSION: The results indicated that the narrow differences and fluctuation in temperature were associated with antioxidant capacity and it might enhance the nutritional shelf life of vegetables and fruits.

Family History and Functional Outcome in Korean Stroke Patients: A Preliminary Study

OBJECTIVE: To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. METHODS: A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage. Stroke severity as assessed with the National Institutes of Health Stroke Scale (NIHSS), functional outcomes using the Korean version of the Modified Barthel index (K-MBI), Functional Independence Measurement (FIM), and cognitive function using the Korean version of Mini-Mental State Examination (K-MMSE) were assessed at admission and discharge. RESULTS: Subjects with a family history of stroke were more likely to have an ischemic stroke (90.7%) than were those without a family history (70.9%). The K-MBI, FIM, NIHSS, and K-MMSE scores did not show significant differences between patients with or without family history. CONCLUSION: Family history of stroke was significantly associated with ischemic stroke, but not with functional outcomes. Other prognostic factors of stroke were not distributed differently between patients included in this study with or without a family history of stroke.

Intrapancreatic ectopic splenic tissue found in a cloned miniature pig

Somatic cell nuclear transfer (SCNT) is a cost-effective technique for producing transgenic pigs. However, abnormalities in the cloned pigs might prevent use these animals for clinical applications or disease modeling. In the present study, we generated several cloned pigs. One of the pigs was found to have intrapancreatic ectopic splenic tissue during histopathology analysis although this animal was grossly normal and genetically identical to the other cloned pigs. Ectopic splenic tissue in the pancreas is very rare, especially in animals. To the best of our knowledge, this is the first such report for cloned pigs.

Microgrooves on titanium surface affect peri-implant cell adhesion and soft tissue sealing; an in vitro and in vivo study

PURPOSE: With the significance of stable adhesion of alveolar bone and peri-implant soft tissue on the surface of titanium for successful dental implantation procedure, the purpose of this study was to apply microgrooves on the titanium surface and investigate their effects on peri-implant cells and tissues. METHODS: Three types of commercially pure titanium discs were prepared; machined-surface discs (A), sandblasted, large-grit, acid-etched (SLA)-treated discs (B), SLA and microgroove-formed discs (C). After surface topography of the discs was examined by confocal laser scanning electron microscopy, water contact angle and surface energy were measured. Human gingival fibroblasts (hGFs) and murine osteoblastic cells (MC3T3-E1) were seeded onto the titanium discs for immunofluorescence assay of adhesion proteins. Commercially pure titanium implants with microgrooves on the coronal microthreads design were inserted into the edentulous mandible of beagle dogs. After 2 weeks and 6 weeks of implant insertion, the animal subjects were euthanized to confirm peri-implant tissue healing pattern in histologic specimens. RESULTS: Group C presented the lowest water contact angle (62.89+/-5.66 theta), highest surface energy (45+/-1.2 mN/m), and highest surface roughness (Ra=22.351+/-2.766 microm). The expression of adhesion molecules of hGFs and MC3T30E1 cells was prominent in group C. Titanium implants with microgrooves on the coronal portion showed firm adhesion to peri-implant soft tissue. CONCLUSIONS: Microgrooves on the titanium surface promoted the adhesion of gingival fibroblasts and osteoblastic cells, as well as favorable peri-implant soft tissue sealing.

Mucoepidermoid Carcinoma on Submandibular Salivary Gland as a Second Malignant Neoplasm after Treatment of Yolk Sac Tumor / 임상소아혈액종양

Malignant salivary gland tumors only represent 0.08% of all childhood tumors and mucoepidermoid carcinoma (MEC) is the most common histologic type. Although there are many reports describing second malignant neoplasm (SMN) in patients treated for childhood cancer, salivary gland tumors rarely appears. In Korea, there has been no report about MEC that developed in children as a SMN. We report a MEC in a 4 years and 8 months old female child that developed after completing treatment for yolk sac tumor of lower abdomen. The primary tumor presented with metastasis at the time of diagnosis, and therefore, the child underwent high-dose chemotherapy with autologous peripheral blood stem cell transplantation along with surgery and radiotherapy. Three years and five months after completing treatment, MEC developed in her submandibular gland. She was treated with surgery and radiotherapy and is in disease free state for 5 months at the time of this writing.

Comparison of alveolar ridge preservation methods using three-dimensional micro-computed tomographic analysis and two-dimensional histometric evaluation

PURPOSE: This study evaluated the efficacy of alveolar ridge preservation methods with and without primary wound closure and the relationship between histometric and micro-computed tomographic (CT) data. MATERIALS AND METHODS: Porcine hydroxyapatite with polytetrafluoroethylene membrane was implanted into a canine extraction socket. The density of the total mineralized tissue, remaining hydroxyapatite, and new bone was analyzed by histometry and micro-CT. The statistical association between these methods was evaluated. RESULTS: Histometry and micro-CT showed that the group which underwent alveolar preservation without primary wound closure had significantly higher new bone density than the group with primary wound closure (P<0.05). However, there was no significant association between the data from histometry and micro-CT analysis. CONCLUSION: These results suggest that alveolar ridge preservation without primary wound closure enhanced new bone formation more effectively than that with primary wound closure. Further investigation is needed with respect to the comparison of histometry and micro-CT analysis.

Mucoepidermoid Carcinoma on Submandibular Salivary Gland as a Second Malignant Neoplasm after Treatment of Yolk Sac Tumor / 임상소아혈액종양

Malignant salivary gland tumors only represent 0.08% of all childhood tumors and mucoepidermoid carcinoma (MEC) is the most common histologic type. Although there are many reports describing second malignant neoplasm (SMN) in patients treated for childhood cancer, salivary gland tumors rarely appears. In Korea, there has been no report about MEC that developed in children as a SMN. We report a MEC in a 4 years and 8 months old female child that developed after completing treatment for yolk sac tumor of lower abdomen. The primary tumor presented with metastasis at the time of diagnosis, and therefore, the child underwent high-dose chemotherapy with autologous peripheral blood stem cell transplantation along with surgery and radiotherapy. Three years and five months after completing treatment, MEC developed in her submandibular gland. She was treated with surgery and radiotherapy and is in disease free state for 5 months at the time of this writing.

The mediation effects of psychological factors in the relationship between mouth dryness and oral health related quality of life / 대한구강보건학회지

OBJECTIVES: The aim of this study was to investigate the role of psychological factors as mediators in the casual relationship between mouth dryness and oral health-related quality of life of adults and to explore gender differences in what psychological factors play an important role in mediating the path of mouth dryness to quality of life. METHODS: Self-administered questionnaires were distributed to 321 adults who are above 20 and under 65 years of age. Collected data were analyzed via statistical packages using a multi-group analysis through the SEM (Structural Equation Model). RESULTS: Based on the statistical analysis, stress was a major psychological factor in male subjects. While depression served as a main mediator in female subjects. We discovered that the path coefficients of the following paths showed significant gender differences: mouth dryness --> depression, depression --> quality of life, stress --> quality of life. CONCLUSIONS: A gender-specific approach regarding effective prevention of stress and depression may be important for understanding the relationship between mouth dryness and quality of life.