Search Results (1,347)

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease with limited therapeutic options and increasing global incidence, with a median survival of only 2–5 years. The clinical utility of macrophage polarization to regulate the progression of pulmonary fibrosis remains understudied. This study determined the efficacy of nintedanib and pexidartinib (PLX3397) combination therapy for treating IPF. Combination treatment effectively inhibited the progression of radiation-induced pulmonary fibrosis (RIPF) and prolonged survival in bleomycin-treated mice. Micro-CT analysis revealed a significant tissue repair efficacy. The therapy significantly normalized the abnormal vascular structure observed during RIPF and bleomycin-induced pulmonary fibrosis progression and was accompanied by a decrease in the M2 population. Polarized M1 macrophages enhanced normalized tube formation of irradiated endothelial cells (ECs) in vitro; M2 macrophages increased adhesion in irradiated ECs and abnormal tube formation. Single-cell RNA sequencing data from patients with IPF further supports colony stimulating factor (CSF) 1 upregulation in macrophages and downregulation of capillary EC markers. This study highlights a promising combination strategy to overcome the therapeutic limitations of monotherapy with nintedanib for the treatment of IPF. Full article

To improve collision risk prediction in high-traffic coastal waters and support real-time decision-making in maritime navigation, this study proposes a regional collision risk prediction system integrating the Computed Distance at Collision (CDC) method with an Adaptive Neuro-Fuzzy Inference System (ANFIS). Unlike Distance at Closest Point of Approach (DCPA), which depends on the position of Global Positioning System (GPS) antennas, Computed Distance at Collision (CDC) directly reflects the actual hull shape and potential collision point. This enables a more realistic assessment of collision risk by accounting for the hull geometry and boundary conditions specific to different ship types. The system was designed and validated using ship motion simulations involving bulk and container ships across varying speeds and crossing angles. The CDC method was used to define collision, almost-collision, and near-collision situations based on geometric and hydrodynamic criteria. Subsequently, the FIS–CDC model was constructed using the ANFIS by learning patterns in collision time and distance under each condition. A total of four input variables—ship speed, crossing angle, remaining time, and remaining distance—were used to infer the collision risk index (CRI), allowing for a more nuanced and vessel-specific assessment than traditional CPA-based indicators. Simulation results show that the time to collision decreases with higher speeds and increases with wider crossing angles. The bulk carrier exhibited a wider collision-prone angle range and a greater sensitivity to speed changes than the container ship, highlighting differences in maneuverability and risk response. The proposed system demonstrated real-time applicability and accurate risk differentiation across scenarios. This research contributes to enhancing situational awareness and proactive risk mitigation in Maritime Autonomous Surface Ship (MASS) and Vessel Traffic System (VTS) environments. Future work will focus on real-time CDC optimization and extending the model to accommodate diverse ship types and encounter geometries. Full article

Background/Objectives: Providing appropriate treatment for pediatric patients after traffic accidents remains a significant challenge. Furthermore, limited studies have validated the long-term effectiveness and safety of integrative Korean medicine treatment (IKMT) based on follow-up periods of 6 months or longer for pediatric patients. Methods: A retrospective chart review was conducted, focused on children aged 0–6 years who visited one of seven Korean medicine hospitals after traffic accident injuries and received IKMT between 1 January 2019 and 30 June 2023. The primary outcome was the Numeric Rating Scale (NRS) scores of chief complaints, and the secondary outcomes were quality of life, adverse events, and satisfaction with IKMT. Statistical analyses were conducted using paired t-tests and descriptive statistics, with a significance level of 5%. Results: Sixty-four participants were included in the retrospective chart review, and fifty-seven guardians responded to the surveys (mean age: 4.84 ± 1.26 years; mean duration of treatment: 19.20 ± 25.38 days). Among the immediate symptoms after the accidents, flashbacks and intrusive symptoms as well as nightmares and crying were the most common (50.9%). Following treatment, the NRS scores for flashbacks and intrusive symptoms and for nightmares and crying showed meaningful improvements from the time right after the accidents to the survey period. Follow-up confirmed that quality of life scores on all dimensions corresponded with those of healthy children. Nine adverse events were reported, and the participants fully recovered without the need for additional treatment. Furthermore, 91.2% of the survey respondents were satisfied with IKMT. Conclusions: IKMT was effective and safe for alleviating the post-accident symptoms in infants and young children aged 0–6 years involved in traffic accidents. Full article

Background and Objectives: During pandemics, emergency departments face the challenge of managing critically ill patients with limited resources. Point-of-Care Ultrasound (POCUS) has emerged as a crucial diagnostic tool in such scenarios. This study aimed to develop a standardized POCUS protocol using expert consensus via a modified Delphi survey to guide physicians in managing these patients more effectively. Materials and Methods: A committee of emergency imaging experts and board-certified emergency physicians identified essential elements of POCUS in the treatment of patients under investigation (PUI) with shock, sepsis, or other life-threatening diseases. A modified Delphi survey was conducted among 39 emergency imaging experts who were members of the Korean Society of Emergency Medicine. The survey included three rounds of expert feedback and revisions, leading to the development of a POCUS protocol for critically ill patients during a pandemic. Results: The developed POCUS protocol emphasizes the use of POCUS-echocardiography and POCUS-lung ultrasound for the evaluation of cardiac and respiratory function, respectively. The protocol also provides guidance on when to consider additional tests or imaging based on POCUS findings. The Delphi survey results indicated general consensus on the inclusion of POCUS-echocardiography and POCUS-lung ultrasound within the protocol, although there were some disagreements regarding specific elements. Conclusions: Effective clinical practice aids emergency physicians in determining appropriate POCUS strategies for differential diagnosis between life-threatening diseases. Future studies should investigate the effectiveness and feasibility of the protocol in actual clinical scenarios, including its impact on patient outcomes, resource utilization, and workflow efficiency in emergency departments. Full article

The use of chloride-based deicing salts, particularly sodium chloride (NaCl) and calcium chloride (CaCl₂), is a common practice in cold regions for maintaining road safety during winter. However, the accumulation of salt residues in adjacent soils poses serious environmental threats, including reduced pH, increased electrical conductivity (EC), disrupted soil structure, and plant growth inhibition. This study aimed to evaluate the combined effect of activated carbon (AC) and Pennisetum alopecuroides, a salt-tolerant perennial grass, in alleviating salinity stress under deicer-treated soils. A factorial greenhouse experiment was conducted using three fixed factors: (i) presence or absence of Pennisetum alopecuroides, (ii) deicer type (NaCl or CaCl₂), and (iii) activated carbon mixing ratio (0, 1, 2, 5, and 10%). Soil pH, EC, and ion concentrations (Na⁺, Cl⁻, Ca²⁺) were measured, along with six plant growth indicators. The results showed that increasing AC concentrations significantly increased pH and reduced EC and ion accumulation, with the 5% AC treatment being optimal in both deicer systems. Plant physiological responses were improved in AC-amended soils, especially under CaCl₂ treatment, indicating less ion toxicity and better root zone conditions. The interaction effects between AC, deicer type, and plant presence were statistically significant (p < 0.05), supporting a synergistic remediation mechanism involving both adsorption and biological uptake. Despite the limitations of short-term controlled conditions, this study offers a promising phytomanagement strategy using natural adsorbents and salt-tolerant plants for sustainable remediation of salt-affected soils in road-adjacent and urban environments. Full article

This study investigates how root color in soybeans affects isoflavone composition, rhizosphere bacterial diversity, total phenolics, total flavonoids, and antioxidant activity under a hydroponic cultivation system. Notably, soybean-brown roots (SBRs) accumulated significantly higher contents of isoflavones, exhibiting approximately a 14.9-fold increase in total glycosides (141.75 to 2121.59 µg/g), 7.3-fold increase in total malonyl-β-glycosides (127.52 to 930.45 µg/g), 2.8-fold increase in total aglycones (1825.90 to 5145.21 µg/g), and 3.9-fold increase in total isoflavones (2095.16 to 8197.26 µg/g) than soybean-white roots (SWRs). Isolated rhizosphere bacteria profiling revealed γ-Proteobacteria as the predominant class in both root types, constituting 77.6% and 73.9% of the bacterial community in SWRs and SBRs, respectively. However, SBRs supported a more diverse bacterial ecosystem, harboring thirteen genera compared to only eight genera in SWRs. Enhanced total phenolics, total flavonoids, and radical scavenging activity were also associated with the SBRs. These findings shed light on the dynamic interplay between root traits, bacterial interactions, and secondary metabolite biosynthesis in hydroponically grown soybeans. This work not only advances our understanding of plant root–microbiome–metabolite relationships but also offers a novel approach to exploring the potential of enhancing secondary metabolites in soybean plants through precision cultivation. Full article

Polymorphous Light Eruption (PLE) is a prevalent UV-induced photodermatosis characterized by abnormal immune responses, oxidative stress, and cutaneous inflammation. Alpha-glucosylrutin (AGR), a chemically modified flavonoid widely used for its antioxidant and photoprotective effects, has shown clinical efficacy; however, its synthetic origin and classification as a potential skin sensitizer and aquatic toxin raise safety and environmental concerns. These limitations underscore the need for safer, naturally derived alternatives. In this study, we investigated the comparative efficacy of quercetin (QC) and hesperidin (HPN)—two plant-based flavonoids—against AGR in in vitro and ex vivo models of sun-induced skin damage. An optimized QC:HPN 8:1 (w/w) complex significantly restored antioxidant enzyme activities (SOD: 4.11 ± 0.32 mU/mg; CAT: 1.88 ± 0.04 mU/mg) and suppressed inflammatory cytokine production (IL-6: 155.95 ± 3.17 pg/mL; TNF-α: 62.34 ± 0.72 pg/mL) more effectively than AGR. β-hexosaminidase secretion, a marker of allergic response, was reduced to 99.02 ± 1.45% with QC:HPN 8:1, compared to 121.33 ± 1.15% with AGR. QC alone exhibited dose-dependent cytotoxicity at ≥10 μg/mL, whereas HPN maintained >94% cell viability at all tested concentrations. These findings highlight the QC:HPN 8:1 complex as a safe, natural, and effective alternative to synthetic AGR for preventing and managing PLE and UV-induced dermal inflammation. Further research should focus on clinical validation and formulation development for topical use. Full article

Background/Objectives: Accurate determination of malignancy in pancreatic masses through endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is crucial for appropriate clinical management and prognostic assessment. However, the diagnostic sensitivity of conventional cytology using Papanicolaou (Pap) staining remains limited, often leading to inconclusive results. In this study, we investigated the diagnostic utility of methionyl-tRNA synthetase 1 (MARS1) through immunohistochemical (IHC) and immunofluorescence (IF) staining as a potential biomarker for pancreatic cancer. IHC analysis was conducted on resected tissue samples from 10 patients, including both pancreatic ductal adenocarcinoma and corresponding non-neoplastic pancreatic tissue. Additionally, cytologic samples were obtained from 198 patients with pancreatic masses who underwent EUS-FNA for diagnostic evaluation. Pap staining and MARS1 IF staining were performed on liquid-based cytology slides derived from EUS-FNA specimens. Results: MARS1 was detected by IHC staining in the 10 surgical specimens diagnosed with pancreatic adenocarcinomas. After Pap staining, 37 patients were excluded because of unsuitable specimens, leaving 161 patients who underwent both Pap and MARS1 IF staining. EUS-FNA specimens from the 151 patients with pancreatic ductal adenocarcinoma were classified by Pap staining as atypia (n = 36), suspicious for malignancy (n = 55), or malignancy (n = 60). MARS1 IF staining was positive in 147 of these patients and negative in 4. MARS1 IF staining distinguished pancreatic cancer in specimens with atypia on Pap staining. The sensitivity for detecting pancreatic cancer was significantly higher for MARS1 IF staining than for conventional Pap staining (97.4% vs. 79.1%, p < 0.0001). Conclusions: The high sensitivity of MARS1 IF staining improved malignancy detection in pancreatic masses. Further prospective studies are required to validate our findings. Full article

Background: The Korean Pediatric Emergency Tape (KPET), developed using 2005 anthropometric data, aims to improve weight estimation in Korean children. However, its validity has not been evaluated using recent large-scale data. This study evaluates the accuracy of the KPET compared with the latest version of the Broselow Tape (BT) using contemporary national anthropometric datasets. Methods: A cross-sectional analysis was conducted using pooled data from the 2019 National Health Screening Program for Infants and Children (NHSPIC, age 0–5) and the 2018–2019 Student Health Examination Sample Survey in Korea (SHESS, age 6–12). Accuracy was assessed by the proportion of estimates within 10% (PW10) and 20% (PW20) of measured weight, and by concordance between estimated and measured weight color zones. Results: Data from 1,992,646 (KPET) and 1,987,504 (BT) children were analyzed. In NHSPIC, the KPET showed slightly lower overall accuracy than the BT (PW10: 72.7% vs. 74.0%) but outperformed the BT in infants (PW10: 72.1% vs. 67.4%). In SHESS, the KPET consistently underperformed compared with the BT (PW10: 49.5% vs. 52.9%). The KPET showed higher concordance only in infants. Both tapes showed a trend of underestimation with increasing age, more pronounced in the KPET. Conclusion: The KPET showed lower overall performance than the BT but outperformed the BT in infants. Its accuracy declines in older children and tends to underestimate weight. Regular updates using recent anthropometric data are necessary to ensure accurate weight estimation and reflect current growth trends in Korean children. Full article

Background/Objectives: Vitamin D (VD) is metabolized in the body and plays a crucial role in regulating the antioxidant system. While exposure to heavy metals (HMs) inhibits VD activity, HMs can also be absorbed following VD stimulation. Despite differing views on the interaction between HM and VD activity, the effects of HM exposure on VD-related pathways have not been examined using metabolomics. This study aimed to investigate the impact of HM exposure on VD-related antioxidant activity under VD deficiency conditions using untargeted metabolic profiling. Methods: In this retrospective cohort study, 46 plasma samples were analyzed using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS). Metabolic profiling was performed on two groups: individuals with severe VD deficiency and low HM exposure (SVDD–LHM) and those with VD deficiency and high HM exposure (VDD–HHM). Results: As a compensatory response to oxidative stress induced by HMs, VD-related antioxidant pathways may be associated with elevated levels of antioxidants, including bilirubin, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). In-creases in EPA and DHA were also linked to alterations in lipid metabolism, including diacylglycerol and phosphatidylcholine levels. DHA showed an area under the curve (AUC) of 0.850 (95% CI: 0.651–0.990), suggesting that DHA could serve as a potential biomarker for VD activity in response to HM exposure. Conclusions: The identified metabolites and metabolic pathways suggest that HM exposure may stimulate VD-related antioxidant activity, even under VD-deficient conditions. Full article

Introduction: In Haemophilia B, guideline-level factor IX (FIX) prophylaxis is recommended, but real-world dosing and adherence vary. Aim: To assess treatment patterns, adherence, FIX dosing, and their associations with bleeding events in Korean patients. Methods: We conducted a retrospective chart review and one-time survey of 130 Korean patients with haemophilia B treated with FIX for ≥12 months at 12 centers (June 2022–May 2023). A total of forty-seven patients (36.2%) received prophylaxis (≥90 IU/kg/week for ≥45 weeks); the remainder were managed non-prophylactically. Annualized bleeding events (ABEs) were analyzed using negative binomial regression, and monthly bleeds with a generalized linear mixed model. Covariates with p < 0.10 and clinical relevance were included in multivariable models. Results: The prophylaxis group showed significantly fewer ABEs (incidence rate ratio [IRR]: 0.383, p = 0.011). Each 100 IU/kg monthly dose increment reduced bleed risk (IRR: 0.692, p < 0.001). Adherence showed no independent association with bleeding in adjusted models. Conclusions: Bleed prevention in haemophilia B is driven more by delivered FIX exposure than by regimen label. Study-defined sustained prophylaxis remains underused and under-dosed. Individualized dosing and continuous adherence monitoring are essential to close this treatment gap and improve outcomes. Full article

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect of cancer treatment, which is more common in patients with ovarian cancer who are receiving paclitaxel and carboplatin treatment. Although prior studies have explored the association between obesity and CIPN, most relied on subjective grading systems. This study aims to evaluate the relationship between being overweight and CIPN using the Total Neuropathy Score (TNS), a more objective and comprehensive assessment tool. The purpose of this study is to investigate the relationship between being overweight and the onset and severity of CIPN in a cohort of South Korean patients with ovarian cancer who were treated with paclitaxel and carboplatin. Methods: The study was conducted retrospectively at a single tertiary hospital in South Korea from March 2013 to February 2022. Included in this study were forty-two individuals who were diagnosed with epithelial ovarian cancer and who had developed neuropathic symptoms following chemotherapy. Patient characteristics, laboratory findings, and disease-specific TNS were analyzed. Results: Overweight patients showed significantly more severe CIPN, with higher Total Neuropathy Scores (TNS; p = 0.019) and earlier symptom onset (p < 0.05) compared to normal-weight patients. Causal mediation analysis also revealed a significant direct effect of BMI on TNS (p = 0.006). However, no significant correlation was found between BMI and TNS using Kendall’s rank correlation, and other neuropathic symptoms or laboratory parameters did not show statistically significant group differences. Conclusions: The study suggests that overweight may be associated with the severity and onset of CIPN in patients with ovarian cancer who are receiving paclitaxel and carboplatin chemotherapy. While the results are preliminary, they underscore the importance of addressing this modifiable risk factor in clinical care. Further research is needed to better understand the underlying mechanisms and to inform future therapeutic strategies. Full article

Exercise-induced hypertension (EIH) has increasingly been observed among middle-aged long-distance runners, raising concerns about cardiovascular risk. This study aimed to investigate acute changes in cardiovascular biomarkers associated with vascular inflammation, oxidative stress, antioxidant defense, endothelial function, and myocardial burden in runners with EIH. Thirty-seven middle-aged male runners (aged 40–65 years) were categorized into a normal blood pressure group (NBPG; systolic blood pressure <210 mmHg, n = 23) and an EIH group (EIHG; ≥210 mmHg, n = 14) based on maximal systolic blood pressure during a graded exercise test (GXT). Participants performed a 30 min treadmill run at 80% heart rate reserve, and blood samples were collected before and after exercise. The biomarkers analyzed included high-sensitivity C-reactive protein (hs-CRP), derivatives of reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), nitric oxide (NO), superoxide dismutase (SOD), and N-terminal pro-brain natriuretic peptide (NT-proBNP). The results show that the EIHG exhibited increased NT-proBNP and SOD levels, along with a reduced NO response, indicating elevated myocardial stress and impaired vasodilation. hs-CRP was positively correlated with multiple hemodynamic indices, and SOD levels were associated with maximal systolic pressure and myocardial burden. These findings highlight the need for individualized monitoring and cardiovascular risk management in runners with EIH. Full article

Background/Objectives: This study aimed to investigate the effect of age at symptom onset on rapid eye movement (REM) sleep latency and sleep-onset REM period (SOREMP) distribution in multiple sleep latency tests (MSLTs) in patients with narcolepsy. Methods: This was a retrospective multicenter chart review of 135 newly diagnosed drug-naïve patients with narcolepsy who underwent MSLT and fulfilled the diagnostic criteria for narcolepsy. The age at onset was defined as the first occurrence of excessive daytime sleepiness or cataplexy. We investigated sleep onset latency, REM sleep latency, and the presence of SORMEP in each nap trial of the MSLT. The clinical, polysomnography, and MSLT findings were compared between the early- and late-onset groups. Correlation and linear regression analyses were used to assess the effect of age at onset as a continuous variable, and survival analyses confirmed its impact on the MSLT parameters. Results: The mean age at onset was 18.3 ± 8.8 years. Patients with early onset had a higher rate of SOREMPs than late-onset patients in the first MSLT nap (81.9% vs. 63.3%, p = 0.031). However, the severity of the narcolepsy symptoms did not differ between the groups. In linear regression analysis, age at onset was significantly associated with MSLT REM sleep latency (β = 0.049, p = 0.033) after adjusting for confounders. Survival analysis confirmed that an early onset of narcolepsy was associated with a higher probability of SOREMPs in the first MSLT nap (hazard ratio 0.955, p = 0.001). Conclusions: A younger age at narcolepsy onset was associated with shorter REM sleep latency and higher SOREMP probability in MSLT. These findings indicate that the early onset of narcolepsy may be linked to greater disease severity in terms of REM sleep dysregulation. Full article

Plasma, an ionized gas composed of charged particles, has shown therapeutic potential in enhancing biological processes such as wound healing and tissue integration. Implants, such as silicone and human acellular dermal matrix (hADM), are commonly used in reconstructive surgery, but improving their biocompatibility and integration remains a challenge. This study investigated the effects of vacuum plasma treatment on silicone and hADM implants using an in vivo rat model. Plasma-treated and untreated implants were inserted subcutaneously, and tissue samples were collected at 1, 4, and 8 weeks post-implantation. Histological and immunohistochemical analyses were performed to assess inflammation, cellular infiltration, collagen formation (neocollagenesis), and angiogenesis. Results showed that plasma-treated silicone and hADM implants had significantly reduced capsule thickness at weeks 4 and 8 compared to untreated controls, indicating a lower chronic inflammatory response. Plasma treatment also promoted greater fibroblast infiltration and enhanced neocollagenesis within the hADM implants. Furthermore, immunohistochemical staining revealed a notable increase in blood vessel formation around and within the plasma-treated hADM implants, suggesting improved vascularization. In conclusion, vacuum plasma treatment enhances the biocompatibility and tissue integration of implants by reducing inflammation and promoting cellular and vascular responses, offering promising potential for improving outcomes in reconstructive surgery. Full article