Search Results (228)

Background and Objectives: The Naples prognostic score (NPS), which incorporates inflammatory and nutritional indicators, is increasingly used as a prognostic score for various malignancies. Nonetheless, few studies have specifically evaluated the NPS as a prognostic factor for cervical cancer. This study aimed to assess the value of NPS at diagnosis as a predictor of cancer progression. Materials and Methods: This study included patients diagnosed with cervical cancer at Korea University Anam Hospital from January 2019 to December 2023. Patients with incomplete data or those who were lost to follow-up were excluded. The NPS was calculated based on laboratory results at the time of diagnosis, categorizing patients into the low-NPS group (NPS 0–1) and high-NPS group (NPS ≥ 2). Survival analysis was performed using the Kaplan–Meier method and log-rank test. Univariate and multivariate Cox proportional hazards models were used to identify independent prognostic factors. Results: Out of 178 patients, 98 and 80 were categorized into the low-NPS and high-NPS groups, respectively. Kaplan–Meier survival analysis showed that the high-NPS group had significantly lower disease-free survival (DFS) (p < 0.001) and overall survival (OS) (p = 0.02) rates than the low-NPS group. Multivariate Cox regression analysis identified the NPS as an independent prognostic factor for DFS (adjusted hazard ratio, 1.98; p = 0.017), but not for OS. Conclusions: This study demonstrated that the NPS measured at diagnosis may serve as a useful independent prognostic factor for cancer progression in patients with cervical cancer. Full article

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is an uncommon and often underrecognized neurovascular disorder. We aimed to investigate the clinical presentations associated with extracerebral vasoconstriction in patients diagnosed with RCVS. Methods: In this cross-sectional study, we analyzed data from a single-center cohort of patients with RCVS in Korea. Extracerebral vasoconstriction in individuals diagnosed with RCVS was defined by the following criteria: (1) the presence of sudden and severe pain in extracerebral regions (primarily the chest or abdomen) coinciding with the onset of RCVS, (2) resolution of the pain following the administration of vasodilators, and (3) confirmation of vasoconstriction through imaging studies or, at a minimum, the exclusion of other potential causes associated with the pain. Results: Among the 80 eligible patients (median age, 53 years; female sex, 82.5%), 8 patients (10%) experienced extracerebral vasoconstriction. Regarding pain location, four patients reported chest pain, two reported abdominal pain, and two reported pains in both the chest and abdomen. When comparing visit route, the patients were associated with emergency department (odds ratio [OR]: 6; 95% confidence interval [CI]: 1.1–33; reference: outpatient) and inpatient consultation (OR: 25; 95% CI: 1.1–560) compared to those without extracerebral vasoconstriction. Patients with extracerebral vasoconstriction had no prior history of precipitating conditions or medication use before the onset of RCVS. The treatment response to vasodilators was excellent in all patients, and none reported neurovascular or extracerebral complications during the bout of RCVS. Conclusions: A co-occurrence of extracerebral vasoconstriction was not exceptionally uncommon among patients with RCVS. Our findings suggest that extracerebral vasoconstriction may be underrecognized in individuals with RCVS. Full article

Background/Objectives: Most previous studies using artificial intelligence (AI) to detect left ventricular systolic dysfunction (LVSD) from electrocardiograms (ECGs) relied on data obtained near the time of echocardiography or included patients with known cardiac disease, limiting their specificity for screening. We aimed to evaluate whether AI models could predict future LVSD from ECGs interpreted as normal and recorded one to two years before echocardiography. Methods: We retrospectively analyzed 24,203 sinus rhythm ECGs from 11,131 patients. Two convolutional neural network models (DenseNet-121 and ResNet-101) were trained (70%), validated (10%), and tested (20%) to predict LVSD (defined as ejection fraction ≤50%). Survival analysis was performed using Kaplan–Meier curves and the log-rank test. Results: Of the total population, 2734 patients had LVSD and 8397 had preserved EF. DenseNet-121 and ResNet-101 demonstrated excellent discrimination for LVSD with AUROCs of 0.930 and 0.925, accuracies of 0.887 and 0.860, sensitivities of 0.821 and 0.856, and specificities of 0.908 and 0.861, respectively. In the test set, patients predicted to have LVSD showed a significantly higher risk of echocardiographic LVSD (hazard ratio 9.89, 95% CI 8.20–11.92, p = 0.005) and lower 24-month survival (log-rank p < 0.001). Conclusions: AI-enabled ECG models predicted future LVSD from clinically normal ECGs recorded up to two years prior to imaging. These findings suggest a potential role for AI-ECG in the early detection of subclinical LVSD and improved risk stratification in asymptomatic individuals. Full article

Background: Fexofenadine hydrochloride (FEX) is widely used to treat allergic rhinitis. However, poor solubility, high cohesiveness, and risk of polymorphic transformation present significant formulation challenges. Conventional FEX tablet formulations are large and may pose swallowing difficulties for patients with dysphagia. Therefore, a miniaturized FEX tablet that maintained bioequivalence with the marketed product was developed. Methods: An organic solvent-based binder and porous carrier enhanced solubility, flowability, and process efficiency. The formulation was optimized using a design of experiments approach to assess the effects of tablet size and porous carrier incorporation on dissolution and residual solvent content. Scale-up feasibility was evaluated using Froude number-based process optimization, and stability studies were conducted under accelerated conditions (40 °C and 75% relative humidity) to ensure long-term formulation robustness. Results: The miniaturized tablet exhibited dissolution at pH 4.0 and pH 6.8 equivalent to that of the reference product, whereas a faster dissolution rate was observed at pH 1.2. No significant changes were observed in the dissolution rate, crystalline structure, or impurity levels over six months. An in vivo bioequivalence study demonstrated that the test formulation met the bioequivalence criteria, with 90% confidence intervals for the area under the curve and the C_max falling within the regulatory acceptance range. Conclusions: A miniaturized and commercially viable fexofenadine hydrochloride tablet was developed (44% weight reduction and 50% volume reduction compared to the marketed product). The organic solvent-based binder and porous carrier system improved manufacturing efficiency, stability, and solubility, thereby ensuring compliance with regulatory standards. These findings provide valuable insights into size reduction, solubility enhancement, and large-scale production strategies for the development of future pharmaceutical formulations. Full article

This study analyzed the seed germination characteristics and physiological responses of five Korean Veronica species (V. daurica, V. nakaiana, V. kiusiana var. glabrifolia, V. pusanensis, and V. pyrethrina) under salinity stress. Preliminary experiments on five Veronica species using various NaCl concentrations revealed that treatment with 150 mM NaCl almost completely inhibited seed germination, whereas treatment with >50 mM NaCl significantly decreased seed germination rate and index. Therefore, this study focused on the effects of treatment with 0, 50, and 100 mM NaCl for 7 days on the germination rate, germination index, germination energy, germination vigor index, water content, fresh weight, dry weight, and root length of the plants. When treated with 100 mM NaCl, most species had few survivors after 5 days, even if germination had occurred. Almost all parameters significantly decreased with increasing NaCl concentration. Especially, fresh weight and water content decreased with increasing NaCl concentration, while dry weight did not show a significant response to NaCl concentration, suggesting that salinity stress inhibited water uptake, which is crucial for seed germination. Hormonal analysis revealed the presence of indole-3-acetic acid (IAA) and abscisic acid (ABA) and the absence of gibberellic acid. Most species showed no significant changes in IAA and ABA levels with varying NaCl concentrations. However, V. pusanensis showed significantly increased ABA levels with increasing NaCl concentration, and V. daurica showed significantly higher IAA levels at 100 mM NaCl than at other NaCl concentrations. This study demonstrates that salt stress negatively affects Veronica seed germination, with varying intensities among species. Full article

After the transition of coronavirus disease 2019 (COVID-19) from a pandemic to an endemic phase, data on respiratory viral infections remain limited. This study compared the clinical outcomes of SARS-CoV-2, influenza virus (INFV), and respiratory syncytial virus (RSV) infections and investigated how underlying medical conditions influence disease severity. During Omicron subvariant dominant periods, we conducted a multicenter, retrospective cohort study including laboratory-confirmed cases of SARS-CoV-2, INFV, and RSV infections in hospitalized patients aged ≥ 19 years. We compared demographic characteristics and clinical outcomes and analyzed the association between underlying comorbidities and severity of infection. A total of 1850 cases with SARS-CoV-2, 98 with INFV, and 63 with RSV infections were analyzed. Notable differences in the occurrence of fever, cough, sputum, and dyspnea were observed among patients with the three different viral infections. Pneumonia was diagnosed more frequently in patients with RSV infection (65.6%) compared to those with INFV infection (42.9%) and SARS-CoV-2 (34.4%) (p < 0.01). For patients with SARS-CoV-2 infection, the risk of pneumonia increased by 47% in the moderate-risk group and 37% in the high-risk group. Among hospitalized patients, pneumonia was more frequently identified in patients with RSV infection, with statistical significance. Furthermore, the presence of medical conditions significantly increased the risk of developing pneumonia. Full article

Background/Objectives: This study is a pilot evaluation of the applicability of wearable digital healthcare devices for Korean male seafarers. Seafarers are exposed to health risks due to unstable and confined living conditions, and their access to healthcare services becomes significantly challenging, especially with the substantial decrease in physical activity onboard. This study aimed to monitor the physical activity of these seafarers through wearable devices and evaluate the potential of managing their health using these technologies. Methods: During the 12-week study, which included 11 participants, it was confirmed that monitoring physical activity using wearable devices and smartphone applications was effective. Results: Over the 12-week period, the average systolic blood pressure decreased from 137.09 ± 13.05 mmHg to 124.36 ± 5.66 mmHg, and the average diastolic blood pressure decreased from 86.45 ± 10.24 mmHg to 77.45 ± 5.26 mmHg, showing a statistically significant reduction (p = 0.011). Additionally, participants experienced an average weight reduction of 1.19 kg. Satisfaction with the use of wearable devices was reported to be moderate. Conclusions: Such digital healthcare can encourage the maintenance of healthy habits by continuously monitoring physical activity and providing feedback. Considering the difficulties seafarers face in accessing medical services, the adoption of digital healthcare through wearable devices is essential, contributing to the prevention of chronic diseases and overall health improvement of seafarers. Future research should explore the long-term benefits and potential challenges of these digital healthcare solutions on a larger scale. Full article

Hyperglycemia is known to negatively affect various animal species, but data on African pygmy hedgehogs remain limited. This study aimed to investigate the prevalence of hyperglycemia and evaluate the clinical characteristics and prognostic factors of severe hyperglycemia (≥180 mg/dL) in hedgehogs. A retrospective review of medical records from 252 hedgehogs and 579 blood test results collected between 2019 and 2021 was performed. Among the 252 hedgehogs, 28 were identified with severe hyperglycemia, indicating a prevalence of 11.1%. The frequency of hyperglycemic samples among all blood tests was 48.1%, and that of severe hyperglycemia was 11.6%. In hedgehogs with severe hyperglycemia, the mean blood glucose level was 269.1 ± 81.6 mg/dL (range, 186–522), and the mortality rate was 53.6% (15/28). The severity of anorexia on the day of diagnosis was significantly associated with mortality (p = 0.013). Hedgehogs that recovered from hyperglycemia by the next test showed favorable outcomes (p < 0.001). These findings suggest that anorexia severity and early glucose normalization may serve as potential prognostic indicators and provide baseline data for improving the clinical management of hyperglycemia in hedgehogs. Full article

The low-dimensional metal halide Cs₃Cu₂I₅ exhibits unique electrical and chemical properties. Notably, it undergoes a phase transition to CsCu₂I₃ upon exposure to hydroxyl (-OH) gas, resulting in significant changes in its electrical characteristics. In this study, we developed a highly selective semiconductor-based gas sensor utilizing Cs₃Cu₂I₅. The material was synthesized on an Al₂O₃ substrate with carbon electrodes using a solution-based process, enabling gas sensing based on its electrical properties. The sensor was further integrated into an Arduino-based real-time monitoring system for wearable applications. The final system was mounted onto a face mask, enabling the real-time detection of human respiration. This research presents a next-generation sensor platform for real-time respiratory monitoring, demonstrating the potential of Cs₃Cu₂I₅ in advanced wearable bio-gas sensing applications. Full article

Shinorine is a mycosporine-like amino acid isolated from laver (Porphyra dentata), and interest in its functionality has increased recently due to increased production using yeast. There have been few reports on the pharmacological activity of shinorine, and we sought to find the pharmacological significance of shinorine. In the present study, we investigated the pharmacological effects of shinorine purified from Porphyra dentata on ARPE-19 cells. First, when ARPE-19 cells were treated with bis-retinoid N-retinyl-N-retinylidene ethanolamine (A2E) and blue light (BL), cytotoxicity increased, and apoptosis was observed. We investigated the effects of shinorine on A2E- and BL-induced cytotoxicity and changes in apoptotic factors, inflammation, and carbonyl stress. A2E and BL exposure increased ARPE-19 cell apoptosis, but this increase was attenuated by shinorine in a concentration-dependent manner. Treatment with A2E and BL induced ARPE-19 cell apoptosis, but treatment with shinorine decreased the apoptotic factors, such as MAPKs. Shinorine reduced p-JNK and p-P38, which were increased by A2E and BL. In addition, shinorine was found to regulate inflammatory proteins and proteins associated with carbonyl stress. In conclusion, shinorine may suppress cell damage caused by A2E treatment and BL exposure at the cellular level by regulating various cell death and inflammatory response pathways. Full article

Background/Objectives: Cesarean scar pregnancy (CSP) refers to a pregnancy implanted on or within a scar from a previous cesarean birth. This study aims to evaluate the treatment strategies for CSP conducted at a single center and analyze the predictive markers of a single procedure without complications. Methods: A retrospective study was performed on CSP patients who received treatment at Korea University Ansan Hospital from November 2002 to December 2022. The clinical characteristics of CSP and the occurrence of complications based on treatment methods were investigated. Results: A total of 128 patients were included in the study. Among them, 84 patients (65.6%) underwent dilatation and curettage (D&C) only, 12 patients (9.4%) received a combination of methotrexate and D&C, 21 received D&C with Foley catheter ballooning (15.7%), and 11 patients (9%) underwent invasive procedures such as uterine artery embolization, hysterectomy, and open resection. As gestational age increased, the likelihood of opting for invasive procedures (aOR = 3.52, 95% CI 1.74–10.14, p = 0.003) also increased. A total of 84 patients (65.6%) were successfully treated with D&C without transfusion, and it was found that early gestational age and sonographic hypervascularity played a significant role. Conclusions: Early gestational age, younger maternal age, and sonographic hypervascularity were independently associated with favorable treatment without adjuvant therapy and transfusion. Therefore, for a safe and bloodless approach to treatment in cases of CSP, it is advisable to promptly diagnose this condition as early as possible. Full article

To develop and evaluate deep learning models for cardiac arrest rhythm classification during cardiopulmonary resuscitation (CPR), we analyzed 508 electrocardiogram (ECG) segments (each 4 s in duration, recorded at 250 Hz) from 131 cardiac arrest patients. Compression-affected segments were recorded during chest compressions, while non-compression segments were extracted during compression pauses or immediately after return of spontaneous circulation (ROSC) declaration. One-dimensional convolutional neural network (1D-CNN) and recurrent neural network (RNN) models were employed for four binary classification tasks: (1) shockable rhythms (VF and pVT) versus non-shockable rhythms (asystole and PEA) in all ECG segments; (2) the same classification in compression-affected ECG segments; (3) pulse-generating rhythms (ROSC rhythm) versus non-pulse-generating rhythms (asystole, PEA, VF and pVT) in all ECG segments; and (4) the same classification in compression-affected ECG segments. The 1D-CNN model consistently outperformed the RNN model across all classification tasks. For shockable versus non-shockable rhythm classification, the 1D-CNN achieved accuracies of 91.3% and 89.8% for all ECG segments and compression-affected ECG segments, respectively, compared to 50.6% and 54.5% for the RNN. In detecting pulse-generating rhythms, the 1D-CNN demonstrated accuracies of 90.9% and 85.7% for all ECG segments and compression-affected ECG segments, respectively, while the RNN achieved 92.2% and 84.4%. The 1D-CNN model demonstrated superior performance in cardiac arrest rhythm classification, maintaining high accuracy even with compression-affected ECG data. Full article

In recent years, the error-state Kalman filter (ErKF) has been widely employed in various applications, including robotics, aerospace, and localization. However, incorporating state constraints into the ErKF framework using the estimate projection method remains ambiguous. This paper examines this issue in depth, specifically exploring whether constraints should be enforced before or after the ErKF correction step. We adopt a mathematical approach, deriving analytical solutions and analyzing their statistical properties. Our findings prove that, for a linear system with linear constraints, both methods yield statistically equivalent results. However, the filter’s behavior becomes uncertain when dealing with linearized constraints. We further identify a special case of a nonlinear constraint where the results of the linear case remain valid. To support our theoretical analysis and evaluate the filter’s performance under non-ideal conditions, we conduct two Monte Carlo simulations considering increasing initialization errors and constraint incompleteness. The simulation results validate our theoretical insights and suggest that applying constraints to the error state after the correction step may lead to superior performance compared to the alternative approach. Full article

The role of the mitogen-activated protein kinase (MAPK) pathway in choroidal neovascularization (CNV) remains unclear. This study investigates the involvement of extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 pathways in CNV development, as well as the therapeutic potential of sprouty 2 (SPRY2), an MAPK inhibitor, in a laser-induced mouse model. The expressions of ERK, JNK, and p38 proteins were analyzed using Western blotting and immunostaining. Immunofluorescence imaging revealed increased p-ERK and p-JNK expression in the retina, retinal pigment epithelium (RPE), and choroid up to day 7. Co-immunostaining showed p-ERK colocalized with CD31, CD11b, F4/80, cytokeratin, and GFAP in the retina, while p-JNK and p-p38 were associated with angiogenesis and inflammation throughout the retina and choroid. Compared to aflibercept, SPRY2 administration significantly inhibited CNV lesions, endothelial proliferation, fibrosis, and apoptosis, while better-preserving RPE integrity. SPRY2-treated mice showed a stronger reduction in CNV-related inflammation, epithelial–mesenchymal transition, and photoreceptor apoptosis. These results highlight the MAPK pathway’s role in CNV pathogenesis, with ERK primarily mediating Müller cell gliosis and JNK, contributing to angiogenesis and inflammation. SPRY2 effectively suppressed CNV lesions, supporting its potential as a therapeutic target for CNV treatment via MAPK pathway modulation. Full article

Background: During the 2023–2024 season, the influenza epidemic in South Korea peaked earlier, and the influenza vaccination rate among individuals aged ≥ 65 was high (82.2%). However, data on real-world vaccine effectiveness against influenza are lacking. Methods: From November 2023 to April 2024, we conducted a multicenter retrospective case–control study on adult patients aged ≥ 18 years who presented with influenza-like illness at seven medical centers as a part of a hospital-based influenza morbidity and mortality surveillance (HIMM) program in South Korea. Demographic and clinical data were collected from questionnaire surveys and electronic medical records. Using a test-negative design, we assessed the effectiveness of the 2023–2024 seasonal influenza vaccine, with age, sex, and comorbidities included as covariates. Results: A total of 3390 participants were enrolled through the HIMM system, including 1695 patients with either rapid antigen test (RAT) or real-time reverse-transcription polymerase chain reaction (RT-PCR) positive results and controls matched for age, sex, and months of registration. Among the 1696 influenza-positive patients, 1584 (93.5%) underwent RAT, with 88.9% testing positive for influenza A and 11.1% for influenza B. During the study periods, the overall vaccine effectiveness (VE) was 24.3% (95% confidence interval (CI), 11.5 to 35.2). The VE was insignificant when limited to older adults aged ≥ 65 years (13.5%; 95% CI, −17.9 to 36.6). In the subgroup analysis by subtype, the VE was 19.0% (95% CI, 5.0 to 31.0) for influenza A and 56.3% (95% CI, 35.3 to 70.6) for influenza B. Notably, influenza VE was 20.4% (95% CI, 2.9 to 34.8) in the early period (November to December) but decreased to 12.4% (95% CI, −14.9 to 33.2) in the late period (January to April). Conclusion: During the 2023–2024 season, the influenza vaccine showed a modest effectiveness (24.3%) against laboratory-confirmed influenza, which was particularly higher for influenza B. Because the VE was insignificant in older adults, particularly during the late period, better immunogenic influenza vaccines with longer-lasting protection should be considered. Full article