Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Background: Recombinant human follicle-stimulating hormone (rhFSH) is commonly used to treat female infertility, but its short half-life necessitates multiple doses. Even corifollitropin alfa, with an extended half-life, requires supplementary injections of rhFSH after 7 days. This study aimed to develop and evaluate a long-acting follicle-stimulating hormone (FSH) formulation using anti-serum albumin Fab-associated (SAFA) technology to avoid additional injections and enhance ovarian function. Methods: SAFA-FSH was synthesized using a Chinese hamster ovary expression system. Its biological efficacy was confirmed through assays measuring its ability to stimulate cyclic adenosine monophosphate (cAMP) production, estradiol synthesis, and the expression of human cytochrome P450 family 19 subfamily A member 1 (hCYP19α1) and human steroidogenic acute regulatory protein (hSTAR) in human ovarian granulosa (KGN) cells. To evaluate the effects of SAFA-FSH, we compared its impact on serum estradiol levels and ovarian weight increase with that of rhFSH in Sprague-Dawley (SD) rats using the modified Steelman-Pohley test. Results: The results indicated that SAFA-FSH induces cAMP synthesis in KGN cells and upregulates the expression of hCYP19α1 and hSTAR in a dose-dependent manner. Female SD rats, aged 21 days, receiving daily subcutaneous human chorionic gonadotropin injections for 5 days exhibited a significant increase in serum estradiol levels and ovarian weight when administered SAFA-FSH on the first day or when given nine injections of rhFSH over 5 days. Notably, the group receiving SAFA-FSH on the first and third days demonstrated an even greater rise in serum estradiol levels and ovarian weight. Conclusion These findings suggest that SAFA-FSH presents a promising alternative to current rhFSH treatments for female infertility. However, further research is essential to thoroughly assess its safety and efficacy in clinical contexts.

Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Objective: In this study, we aimed to investigate how fetal head and abdominal circumferences are related to the incidence of neonatal complications in mothers with gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM) compared to normal pregnancies. Methods: We retrospectively analyzed data of expectant mothers with GDM, PGDM, and normal pregnancies who delivered singleton full-term infants (≥37 weeks) at a tertiary center from January 2013 to December 2022. Ultrasonography-measured fetal weight, fetal head circumference, fetal abdominal circumference, difference between head and abdominal circumference, and head-to-abdominal circumference ratio were assessed. Neonatal outcomes were evaluated based on the rates of admission to the neonatal intensive care unit, intubation, and hypoglycemia. Statistical analyses, including univariate and multivariate analyses, were performed using the SPSS software (IBM Corp., Armonk, NY, USA). Results: Among the 473 participants, 175 (37.0%) were mothers with diabetes (DM). A head-to-abdominal circumference ratio <0.95 and a difference of ≥2.5 cm were significantly associated with neonatal hypoglycemia in all mothers with DM, with statistical significance noted only in the PGDM group. No significant association was observed in normal pregnancies. Conclusion Our findings indicate that a head-to-abdominal circumference ratio <0.95 and a ≥2.5 cm difference in circumferences are associated with neonatal hypoglycemia in mothers with DM.

Background: Circadian misalignment is associated with metabolic syndrome. This study aimed to examine the association between circadian rhythm-disturbing factors and metabolic syndrome. Methods: We used data from the 7th and 8th Korea National Health and Nutrition Examination Survey conducted between 2016 and 2020, which surveyed 16,253 individuals. Circadian rhythm-disturbing factors were defined as follows: sleep duration outside the reference group (6–8 hours), irregular breakfast, shift work, and physical inactivity. The adjusted odds ratio (aOR) for metabolic syndrome was calculated based on the number of circadian rhythm-disturbing factors present in adults over the age of 19 years. Results: Among a total of 16,253 participants (mean age 48.2±15 years), metabolic syndrome was found in 5,237 participants (29.3 %). The participants were classified into three categories based on the number of circadian rhythm-disturbing factors as follows: 2,627 (15.6%) did not have any factors, 6,406 (38.13%) had one factor, and 7,220 (46.3%) had two or more factors. Participants with a single circadian rhythm-disturbing factor were 21% more likely to have metabolic syndrome (aOR, 1.21; 95% confidence interval [CI], 1.08–1.36), and participants with two or more factors were 27% more likely to have metabolic syndrome (aOR, 1.27; 95% CI, 1.12–1.43). Conclusion Circadian rhythm-disturbing factors were significantly associated with the prevalence of metabolic syndrome in Korean adults. This finding has potential clinical implications for maintaining circadian rhythms by avoiding certain factors to prevent metabolic syndrome. Further studies are required to confirm these findings.

Background: Recombinant human follicle-stimulating hormone (rhFSH) is commonly used to treat female infertility, but its short half-life necessitates multiple doses. Even corifollitropin alfa, with an extended half-life, requires supplementary injections of rhFSH after 7 days. This study aimed to develop and evaluate a long-acting follicle-stimulating hormone (FSH) formulation using anti-serum albumin Fab-associated (SAFA) technology to avoid additional injections and enhance ovarian function. Methods: SAFA-FSH was synthesized using a Chinese hamster ovary expression system. Its biological efficacy was confirmed through assays measuring its ability to stimulate cyclic adenosine monophosphate (cAMP) production, estradiol synthesis, and the expression of human cytochrome P450 family 19 subfamily A member 1 (hCYP19α1) and human steroidogenic acute regulatory protein (hSTAR) in human ovarian granulosa (KGN) cells. To evaluate the effects of SAFA-FSH, we compared its impact on serum estradiol levels and ovarian weight increase with that of rhFSH in Sprague-Dawley (SD) rats using the modified Steelman-Pohley test. Results: The results indicated that SAFA-FSH induces cAMP synthesis in KGN cells and upregulates the expression of hCYP19α1 and hSTAR in a dose-dependent manner. Female SD rats, aged 21 days, receiving daily subcutaneous human chorionic gonadotropin injections for 5 days exhibited a significant increase in serum estradiol levels and ovarian weight when administered SAFA-FSH on the first day or when given nine injections of rhFSH over 5 days. Notably, the group receiving SAFA-FSH on the first and third days demonstrated an even greater rise in serum estradiol levels and ovarian weight. Conclusion These findings suggest that SAFA-FSH presents a promising alternative to current rhFSH treatments for female infertility. However, further research is essential to thoroughly assess its safety and efficacy in clinical contexts.

Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Objective: In this study, we aimed to investigate how fetal head and abdominal circumferences are related to the incidence of neonatal complications in mothers with gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM) compared to normal pregnancies. Methods: We retrospectively analyzed data of expectant mothers with GDM, PGDM, and normal pregnancies who delivered singleton full-term infants (≥37 weeks) at a tertiary center from January 2013 to December 2022. Ultrasonography-measured fetal weight, fetal head circumference, fetal abdominal circumference, difference between head and abdominal circumference, and head-to-abdominal circumference ratio were assessed. Neonatal outcomes were evaluated based on the rates of admission to the neonatal intensive care unit, intubation, and hypoglycemia. Statistical analyses, including univariate and multivariate analyses, were performed using the SPSS software (IBM Corp., Armonk, NY, USA). Results: Among the 473 participants, 175 (37.0%) were mothers with diabetes (DM). A head-to-abdominal circumference ratio <0.95 and a difference of ≥2.5 cm were significantly associated with neonatal hypoglycemia in all mothers with DM, with statistical significance noted only in the PGDM group. No significant association was observed in normal pregnancies. Conclusion Our findings indicate that a head-to-abdominal circumference ratio <0.95 and a ≥2.5 cm difference in circumferences are associated with neonatal hypoglycemia in mothers with DM.

Objective: In this study, we aimed to investigate how fetal head and abdominal circumferences are related to the incidence of neonatal complications in mothers with gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM) compared to normal pregnancies. Methods: We retrospectively analyzed data of expectant mothers with GDM, PGDM, and normal pregnancies who delivered singleton full-term infants (≥37 weeks) at a tertiary center from January 2013 to December 2022. Ultrasonography-measured fetal weight, fetal head circumference, fetal abdominal circumference, difference between head and abdominal circumference, and head-to-abdominal circumference ratio were assessed. Neonatal outcomes were evaluated based on the rates of admission to the neonatal intensive care unit, intubation, and hypoglycemia. Statistical analyses, including univariate and multivariate analyses, were performed using the SPSS software (IBM Corp., Armonk, NY, USA). Results: Among the 473 participants, 175 (37.0%) were mothers with diabetes (DM). A head-to-abdominal circumference ratio <0.95 and a difference of ≥2.5 cm were significantly associated with neonatal hypoglycemia in all mothers with DM, with statistical significance noted only in the PGDM group. No significant association was observed in normal pregnancies. Conclusion Our findings indicate that a head-to-abdominal circumference ratio <0.95 and a ≥2.5 cm difference in circumferences are associated with neonatal hypoglycemia in mothers with DM.

Background: Circadian misalignment is associated with metabolic syndrome. This study aimed to examine the association between circadian rhythm-disturbing factors and metabolic syndrome. Methods: We used data from the 7th and 8th Korea National Health and Nutrition Examination Survey conducted between 2016 and 2020, which surveyed 16,253 individuals. Circadian rhythm-disturbing factors were defined as follows: sleep duration outside the reference group (6–8 hours), irregular breakfast, shift work, and physical inactivity. The adjusted odds ratio (aOR) for metabolic syndrome was calculated based on the number of circadian rhythm-disturbing factors present in adults over the age of 19 years. Results: Among a total of 16,253 participants (mean age 48.2±15 years), metabolic syndrome was found in 5,237 participants (29.3 %). The participants were classified into three categories based on the number of circadian rhythm-disturbing factors as follows: 2,627 (15.6%) did not have any factors, 6,406 (38.13%) had one factor, and 7,220 (46.3%) had two or more factors. Participants with a single circadian rhythm-disturbing factor were 21% more likely to have metabolic syndrome (aOR, 1.21; 95% confidence interval [CI], 1.08–1.36), and participants with two or more factors were 27% more likely to have metabolic syndrome (aOR, 1.27; 95% CI, 1.12–1.43). Conclusion Circadian rhythm-disturbing factors were significantly associated with the prevalence of metabolic syndrome in Korean adults. This finding has potential clinical implications for maintaining circadian rhythms by avoiding certain factors to prevent metabolic syndrome. Further studies are required to confirm these findings.