Transoral robotic thyroidectomy (TORT) is well consistent with the primary goal of remote-access thyroid surgery, which is to avoid a visible cervical scar. Additionally, the extent of transoral thyroidectomy dissection is less than that of other remote-access surgical procedures. Owing to these merits of the transoral approach, several institutions around the world are now performing this procedure. Since transoral thyroidectomy is performed in a confined, narrow space, and is characterized by a close distance from the ports to the working space, more benefits can be derived from multiarticulation of robotic instruments. Especially when performing left lobectomy by TORT, the surgeon can use right-handed robotic instruments over the thyroid cartilage with the merits of multiarticulation. In this study, we present our unique procedure of left lobectomy by TORT in detail.
Cicatrix ; Liability, Legal ; Thyroid Cartilage ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

The ethyl acetate fractions prepared from the leaves of Thuja orientalis significantly inhibited nitric oxide (NO) production in lipopolysaccharide-stimulated BV2 microglial cells. According to bioassay-coupled LC-QTOF MS/MS, the components near 22 and 25 mins in the mass chromatogram highly inhibited NO production and were expected to be labdane diterpenes, and the active components were characterized via further isolation. The results of the NO production inhibitory assay of the isolated compounds correlated well with the results of bioassay-coupled LC-QTOF MS/MS. Among the identified constituents, NO production inhibitory activities of 16-hydroxy-labda-8(17),13-diene-15,19-dioic acid butenolide (2) and 15-hydroxypinusolidic acid (3) were newly reported. Taken together, these results demonstrated that LC-QTOF MS/MS coupled with NO production inhibition assay was a powerful tool for accurately predicting new anti-inflammatory constituents in the extracts from natural products. Moreover, it provided a potential basis for broadening the application of bioassay-coupled LC-QTOF MS/MS in natural product research.

Purpose: This study examines the effectiveness of personalized goal setting and smartphonebased nutrition counseling among adults in their 20s and 30s. Methods: Nutrition counseling was conducted for a total of 30 adults through a 1:1 chat room of a mobile instant messenger, once a week for 8 weeks. The first week of counseling included a preliminary online questionnaire survey and a dietary intake survey. Based on the results of the preliminary survey, 2 dietary goals were set in the second week and the participants were asked to record their achievements on a daily checklist. From the third week onwards, counselors sent feedback messages based on the checklist and provided information on dietary guidelines in a card news format every week. Post-counseling questionnaires and dietary intake surveys were conducted in the seventh week. Changes in dietary habits during the counseling were reviewed in the eighth week, followed by a questionnaire survey on the evaluation of the counseling process. Results: The nutrition quotient (NQ) scores and self-efficacy scores were significantly higher after nutrition counseling. The NQ scores of consumption frequencies of fruits, milk and dairy products, nuts, fast food, Ramyeon, sweet and greasy baked products, sugarsweetened beverages, the number of vegetable dishes at meals, and breakfast frequency were significantly higher after nutrition counseling. The intake of protein, vitamin A, thiamin, riboflavin, folate, calcium, and iron, and the index of nutritional quality of vitamin A, riboflavin, folate, calcium, and iron were higher after nutrition education. The participants were satisfied with the nutrition counseling program and the provided nutrition information. Conclusion Personalized goal setting and smartphone-based nutrition counseling were found to be effective in improving the quality of diet and self-efficacy in young adults. Similar results were obtained in both the underweightormal weight and the overweight/obese groups.

The proliferation, migration, cytokine release, and contraction of airway smooth muscle cells are key events in the airway remodeling process that occur in lung disease such as asthma, chronic obstruction pulmonary disease, and cancer. These events can be modulated by a number of factors, including cigarette smoke extract (CSE). CSE-induced alterations in the viability, migration, and contractile abilities of normal human airway cells remain unclear. This study investigated the effect of CSE on cell viability, migration, tumor necrosis factor (TNF)-alpha secretion, and contraction in normal human bronchial smooth muscle cells (HBSMCs). Treatment of HBSMCs with 10% CSE induced cell death, and the death was accompanied by the generation of reactive oxygen species (ROS). CSE-induced cell death was reduced by N-acetyl-l-cysteine (NAC), an ROS scavenger. In addition, CSE reduced the migration ability of HBSMCs by 75%. The combination of NAC with CSE blocked the CSE-induced reduction of cell migration. However, CSE had no effect on TNF-alpha secretion and NF-kappaB activation. CSE induced an increase in intracellular Ca2+ concentration in 64% of HBSMCs. CSE reduced the contractile ability of HBSMCs, and the ability was enhanced by NAC treatment. These results demonstrate that CSE treatment induces cell death and reduces migration and contraction by increasing ROS generation in normal HBSMCs. These results suggest that CSE may induce airway change through cell death and reduction in migration and contraction of normal HBSMCs.
Acetylcysteine ; Airway Remodeling ; Asthma ; Bronchioles ; Cell Death ; Cell Movement ; Cell Survival ; Contracts ; Emigration and Immigration ; Humans ; Lung Diseases ; Muscle, Smooth ; Myocytes, Smooth Muscle ; NF-kappa B ; Reactive Oxygen Species ; Smoke ; Tobacco Products ; Tumor Necrosis Factor-alpha

Transoral approach for thyroidectomy recently gains a lot of attention among the thyroid surgeons, with definite merits over previously developed remote-access approaches. The approach not only resulted in the ideal cosmetic outcome but less postoperative pain with smaller dissection plane in comparison with other approaches. We have successfully introduced the robotic surgical system and its related techniques to this transoral surgical approach for thyroidectomy, which enables the surgeon to have the three-dimentional operative vision and to use the articulating instruments to enhance th eoptimal surgical outcomes. Herein, our unique procedures of transoral robotic thyroidectomy (TORT) are described, and possible advantages and disadvantages of the operation are discussed.
Pain, Postoperative ; Surgeons ; Thyroid Gland ; Thyroidectomy

TWIK-related K+ channel-2 (TREK-2) and TWIK-related spinal cord K+ (TRESK) channel are members of two-pore domain K+ channel family. They are well expressed and help to set the resting membrane potential in sensory neurons. Modulation of TREK-2 and TRESK channels are involved in the pathogenesis of pain, and specifi c activators of TREK-2 and TRESK may be benefi cial for the treatment of pain symptoms. However, the effect of commonly used analgesics on TREK-2 and TRESK channels are not known. Here, we investigated the effect of analgesics on TREK-2 and TRESK channels. The effects of analgesics were examined in HEK cells transfected with TREK-2 or TRESK. Amitriptyline, citalopram, escitalopram, and fluoxetine significantly inhibited TREK-2 and TRESK currents in HEK cells (p<0.05, n=10). Acetaminophen, ibuprofen, nabumetone, and bupropion inhibited TRESK, but had no effect on TREK-2. These results show that all analgesics tested in this study inhibit TRESK activity. Further study is needed to identify the mechanisms by which the analgesics modulate TREK-2 and TRESK differently.
Acetaminophen ; Amitriptyline ; Analgesics* ; Antidepressive Agents* ; Bupropion ; Citalopram ; Fluoxetine ; Humans ; Ibuprofen ; Membrane Potentials ; Potassium Channels, Tandem Pore Domain ; Sensory Receptor Cells ; Spinal Cord

PURPOSE: An oxaliplatin-based regimen is the most common adjuvant chemotherapy for patients with stage II/III colorectal cancer, but many patients experience dose reduction or early termination of chemotherapy due to side effects. We conducted this study to verify the range of reduction with oncologic safety. METHODS: Patients with stage II/III colorectal cancer who received adjuvant FOLFOX chemotherapy were enrolled in this study. The total amount of oxaliplatin administered per patient was calculated as a percentile based on 12 cycles of full-dose FOLFOX as a standard dose. The cutoff values showing significant differences in survival were calculated, and the clinicopathologic outcomes of patient groups classified by the value were compared. RESULTS: Among a total of 611 patients, there were 107 stage II patients, and 504 stage III patients. At 60% of the standard dose of oxaliplatin, the patients in the dose reduction group were older (62 years vs. 58 years, P = 0.003), had lower body mass index (BMI) (23.1 kg/m2 vs. 24.0 kg/m2, P = 0.005), and were more exposed to neoadjuvant treatment (18.0% vs. 9.1%, P = 0.003) in comparison to the standard group. At 60% of the standard dose, there were no significant differences in 5-year disease-free survival (DFS) and overall survival (OS) between the 2 groups (5-year DFS: 73.5% vs. 74.2%, P = 0.519; 5-year OS: 71.9% vs. 81.5%, P = 0.256, respectively). CONCLUSION: Patients with old age, low BMI, and more frequent exposure to neoadjuvant treatment tended to show lower compliance with chemotherapy. More than 60% dose should be administered to patients with stage II/III colorectal cancer as adjuvant chemotherapy to achieve acceptable oncologic outcomes.
Body Mass Index ; Chemotherapy, Adjuvant ; Colorectal Neoplasms* ; Compliance ; Disease-Free Survival ; Drug Therapy* ; Humans ; Neoadjuvant Therapy

Transoral approach for thyroidectomy recently gains a lot of attention among the thyroid surgeons, with the merits of cosmetic outcomes and minimal flap dissection. We've successfully introduced the robotic surgical system to the transoral approach for thyroidectomy. For transoral robotic thyroidectomy, we made 3 incisions in the gingival-buccal sulcus for three intraoral ports. An additional axilla port was inserted for counter-traction and later drain insertion. Herein, our unique procedures of transoral robotic thyroidectomy (TORT) are described in the treatment of a patient with papillary thyroid carcinoma.
Axilla ; Humans ; Neck Dissection ; Neck ; Surgeons ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Endometritis is one of the primary reasons for reproductive failure. In order to investigate endometritis-associated marker proteins, proteomic analysis was performed on bovine endometrium with endometritis. In bovine endometritis, desmin, alpha-actin-2, heat-shock protein (HSP) 27, peroxiredoxin-6, luteinizing hormone receptor isoform 1, collectin-43 precursor, deoxyribonuclease-I (DNase-I), and MHC class I heavy chain (MHC-Ih) were up-regulated. In contrast, transferrin, interleukin-2 precursor, hemoglobin beta subunit, and potassium channel tetramerisation domain-containing 11 (KCTD11) were down-regulated in comparison to normal endometrium. The proteomic results were validated by semiquantitative-PCR and immunoblot analysis. The mRNA levels of desmin, transferrin, alpha-actin-2, HSP27, KCTD11, and MHC-Ih were up-regulated by over 1.5-fold, and showed a pattern similar to their proteomic profiles. Desmin and alpha-actin-2 protein showed positive correlations between proteomic analysis and immunoblot analysis. These results suggest that desmin and alpha-actin-2 may play important roles in endometritis-related function, and could be useful markers for the diagnosis of bovine endometritis.
Actins ; Collectins ; Desmin ; Endometritis ; Endometrium ; Female ; Heat-Shock Proteins ; Hemoglobins ; Interleukin-2 ; Potassium Channels ; Proteins ; Proteomics ; Receptors, LH ; RNA, Messenger ; Transferrin

Single-channel recordings of TASK-1 and TASK-3, members of two-pore domain K+ channel family, have not yet been reported in dorsal root ganglion (DRG) neurons, even though their mRNA and activity in whole-cell currents have been detected in these neurons. Here, we report single-channel kinetics of the TASK-3-like K+ channel in DRG neurons and up-regulation of TASK-3 mRNA expression in tissues isolated from animals with spinal cord injury (SCI). In DRG neurons, the single-channel conductance of TASK-3-like K+ channel was 33.0+/-0.1 pS at -60 mV, and TASK-3 activity fell by 65+/-5% when the extracellular pH was changed from 7.3 to 6.3, indicating that the DRG K+ channel is similar to cloned TASK-3 channel. TASK-3 mRNA and protein levels in brain, spinal cord, and DRG were significantly higher in injured animals than in sham-operated ones. These results indicate that TASK-3 channels are expressed and functional in DRG neurons and the expression level is up-regulated following SCI, and suggest that TASK-3 channel could act as a potential background K+ channel under SCI-induced acidic condition.
Acidosis ; Animals ; Brain ; Clone Cells ; Diagnosis-Related Groups ; Ganglia, Spinal ; Humans ; Hydrogen-Ion Concentration ; Kinetics ; Neurons ; Rats ; RNA, Messenger ; Spinal Cord ; Spinal Cord Injuries ; Spinal Nerve Roots ; Up-Regulation