BACKGROUND: The claudins are a family of transmembrane proteins associated with tight junctions and they are critical for maintaining cell-to-cell adhesion in sheets of epithelial cells. However, their role in the progression of cancer remains largely unexplored. The aims of this study were to evaluate the expression patterns of claudin-1 and -4 in benign lesions and invasive ductal carcinomas (IDC) of the breast, and relationships between the expression of these markers and the clinicopathological characteristics in IDC patients. METHODS: We examined the claudin-1 and -4 protein expressions by performing immunohistochemical stainings in 54 benign lesions and 120 IDCs via the tissue microarray method. We evaluated the correlation between the expression of these markers and the clinicopathological characteristics of IDC. RESULTS: The expressions of claudin-1 (p=0.099) and -4 (p=0.000) were up-regulated in IDCs as compared with benign lesions. The claudin-1 expression correlated with the loss of estrogen receptor (p=0.036) and progesterone receptor (p=0.011). The claudin-4 expression correlated with lymph node metastasis (p=0.043), the nuclear grade (p=0.030), the histologic grade (p=0.007), and the loss of estrogen receptor (p=0.001) and progesterone receptor (p= 0.029). CONCLUSIONS: These results suggest that claudin-1 and -4 may play a significant role in the carcinogenesis of IDC of the breast and these may represent novel markers for this disease.
Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Claudin-1* ; Claudin-4 ; Claudins ; Epithelial Cells ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Progesterone ; Tight Junctions

Benign lymph node inclusions are rare, and can be mistaken for metastasis. We report, herein, a case of a 50-year-old woman who underwent a hysterectomy, with a lymphadenectomy, for an endometrial carcinoma. There was no lymph node metastasis; however, the left external and common iliac lymph nodes demonstrated a few glands, consistent with M llerian-type inclusions (endosalpingiosis). Awareness of these lesions is important to avoid either unnecessary therapy or any delay in treatment. Furthermore, pelvic and aortic lymphadenectomies may be warranted, as neoplastic transformation of preexisting metaplastic tubal-type epithelium is strongly suggested. This paper presents a case of intranodal endosalpingiosis mimicking metastasis.
Endometrial Neoplasms ; Epithelium ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes* ; Middle Aged ; Neoplasm Metastasis*

BACKGROUND: Qualitative hepatitis B surface antigen (HBsAg) assay kits are still commonly used in Korea where hepatitis B virus (HBV) infection is endemic. The accurate determination of HBsAg plays a crucial role in the diagnosis and prevention of HBV infection, especially in endemic areas. The aim of this study was to compare the detection sensitivities of 9 qualitative HBsAg assay kits. METHODS: Seven pooled sera with HBsAg concentration ranging from 0.14 IU/mL to 29.96 IU/mL were prepared. The HBsAg concentration of each pooled serum was determined by a quantitative HBsAg assay, Architect HBsAg (Abbott Laboratories, Ireland). The fully automated immunoassay kits included Elecsys HBsAg (Roche Diagnostics, Germany) and Immulite 2000 HBsAg (DPC, USA) and the rapid tests included 5 immunochromatographic assay (ICA) kits and 2 reverse passive hemagglutination assay (RPHA) kits. RESULTS: Elecsys HBsAg (Roche Diagnostics) showed positive result in pooled serum with HBsAg concentration of 0.14 IU/mL, but Immulite 2000 HBsAg (DPC) showed negative result in the same concentration. Although ICA kits showed variable results among different assay kits, all of them showed negative results in pooled sera with HBsAg concentration of < or =1.89 IU/mL. Two RPHA kits showed negative results in pooled sera with HBsAg concentration of < or =7.98 IU/mL. CONCLUSIONS: Although ICAs were more sensitive than RPHAs, they had variable sensitivities for HBsAg and were less sensitive than the automated immunoassay kits. Therefore, ICAs and RPHAs should be used with caution in the screening tests for HBsAg and their sensitivities need to be improved.
Chemiluminescent Measurements ; Electrochemical Techniques ; Enzyme-Linked Immunosorbent Assay ; Genotype ; Hemagglutination Tests ; Hepatitis B/*diagnosis ; Hepatitis B Surface Antigens/*blood ; Humans ; Reagent Kits, Diagnostic

Purpose: The present study examined the associations of Korean Food-based Index of Dietary Inflammatory Potential (FBDI) scores with the prevalence of diabetes and hemoglobin A1c (HbA1c) level of diabetes patients in Korean adults. Methods: The Korean Genome and Epidemiology Study (KoGES) Health Examinee baseline data, collected between 2004 and 2013 and followed up between 2012 and 2016, were used in our study. A total 56,391 participants including diabetes (n = 5,733) and non-diabetes (n = 50,658) were analyzed. The subjects were classified into quartiles of FBDI scores using the semi-quantitative food-frequency questionnaire developed for KoGES. The prevalence rate of diabetes under FBDI scores was assessed by Cox proportional risk models and the severity of the diabetes was analyzed by multiple regression analysis. Results: There were 775 incident cases of diabetes after a mean follow-up of 3.97 years. There was no statistically significant association between FBDI scores and incidence of diabetes.Among diabetes patients at baseline, FBDI scores were related to the risk of progression of diabetes which was represented by greater than 9% HbA1c (Q1 vs. Q4; odds ratio, 1.562 [95% confidence intervals, 1.13–2.15]; p for trend = 0.007). The stratified analysis showed a stronger association in females, irregular exercise group, and higher body mass index group. Conclusion These results suggest that a pro-inflammatory diet is not associated with the incidence of diabetes but is related to the HbA1c level of diabetes patients. Thus, further longitudinal studies with longer periods are required to determine a relationship between dietary inflammatory index and diabetes in Korea.

Digital therapeutics (DTx) is emerging in the field of digital healthcare thanks to the development of ICT (information and communications technology), sensors, and AI (artificial intelligence) technology. A clinical trial-based design and manufacturing process is required for DTx before it can be prescribed in the medical field. The risks, and effectiveness and intended use of DTx must then be approved by regulatory authorities. The digital healthcare apps for musculoskeletal disorders, which had previously concentrated on monitoring and feedback on aerobic exercise, have lately begun to be applied to rehabilitative exercises utilizing AI technologies using convolutional neural networks. The development of DTx focusing on therapeutic rehabilitative exercise is expected in the future.

Purpose: Maintaining or increasing user adherence to digital healthcare services is of great concern to service providers. This study aims to verify whether the donation model is an effective strategy to increase adherence to physical exercise using a mobile application. Materials and Methods: A total of 5618 users of a motion-detecting mobile exercise coaching application participated in a donation or self-reward exercise challenge with the same exercise protocol. The workout consisted of 50 squats daily for 14 days. The user’s exercise was monitored through a smartphone camera, providing real-time visual and audio feedback. In the donation group, 6 USD was donated to the economically disadvantaged if a participant completed their workout each day. In the self-reward group, three people who completed the program and 20 people who completed ≥12 days of exercise were randomly selected and provided with goods worth 60 USD and 4.3 USD of online currency, respectively. Results: The average daily exercise completion rate (% of participants who completed daily exercise) in the donation group was 1.8 times higher than that of the self-reward group (donation, 41.7%; self-reward, 22.7%; p<0.0001). The donation group completed more days of the program (donation, 5.8; self-reward, 3.2; p<0.0001). The completion rate of both groups decreased with time and decreased most on day two (donation, -9.9%; self-reward, -14.5%). Conclusion The donation model effectively promoted adherence to mobile app-based exercise. This donation model is expected to effectively enhance user adherence to digital healthcare services.

Background: The purpose of this study was to evaluate the radiologic results of total shoulder arthroplasty using computerized three-dimensional (3D) templating in preoperative planning. Methods: Ten patients who underwent total shoulder arthroplasty using 3D templating preoperatively were enrolled in this study. A specialized computer program was used to reconstruct the 3D images of the shoulder from the computed tomographic images. The 3D images of various sizes of prostheses were used as the template in surgical planning of the shoulder arthroplasty. The size of the glenoid, humeral head, and stem measured in 3D templating were compared with those used in actual operation. Anatomical parameters, such as humeral head size, radius of curvature, and greater tuberosity to humeral head distance of the replaced shoulder, were measured and compared with those of the contralateral normal shoulder. Results: The agreement rates between the glenoid size, head size, head thickness, and stem size estimated preoperatively by 3D templating and those measured in operation were 100%, 100%, 100%, and 80%, respectively. The difference in humeral head size, radius of curvature, and greater tuberosity to humeral head distance between the replaced shoulder and contralateral shoulder was 1.31 mm, 0.87 mm, and 1.17 mm, respectively. Conclusions In total shoulder arthroplasty, 3D templating seems to enable accurate prediction of sizes of the prostheses to be inserted and thus replication of normal anatomy.

BACKGROUND: The p73 is a recently identified homologue of the tumor suppressor gene, p53, and it has been found to induce apoptosis and inhibit cell proliferation. However, its role in the development of tumors is unclear. This study examined the expression of p73 in patients with non-small cell lung carcinomas (NSCLCs) to determine its clinical significance and association with the expressions of p53, pRb, and mdm2. METHODS: A total of 183 NSCLCs were analyzed immunohistochemically using a tissue microarray. RESULTS: The p73 protein was expressed in the cell nuclei in 156 (85.2%) out of the 183 cases. There was no correlation between the p73 expression and the clinicopathological variables. However, there was a correlation between the p73 expression and the mdm2 and pRb expressions. Multivariate Cox survival analysis identified tumor size and lymph node metastasis to be independent prognostic factors, but the p73 expression was not found to be associated with the patients' survival. CONCLUSIONS: p73 is commonly expressed in NSCLC and it might, in conjunction with pRb and mdm2, be involved in the development of these tumors.
Apoptosis ; Carcinoma, Non-Small-Cell Lung ; Cell Nucleus ; Cell Proliferation ; Genes, Tumor Suppressor ; Humans ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Objective: The aim of this study was to investigate the prevalence of depression and suicidal ideation among older Korean adults and the predictors of suicidal ideation. Methods: We analyzed data from 5,604 Koreans aged 65 or older collected by the Korea National Health and Nutrition Examination Survey in 2012–2016, an annual national, cross-sectional, epidemiologic study of the Korean population. A chi-square test was used to assess differences in socio-demographic characteristics by suicidal ideation. Psychological variables, self-rated physical health, and the five dimensions of the Korean version of the EQ-5D (EuroQoL) were compared between four subgroups categorized according to the presence/absence of suicidal ideation and depression. Multiple logistic regression was used to estimate the predictive power of health-related quality of life variables, as well as physical and psychological factors regarding suicidal ideation. Results: Overall, 11.5% of the sample reported suicidal ideation, and 20.0% of the suicidal ideation group were diagnosed with depression. Respondents with suicidal ideation had significantly lower levels of health-related quality of life than those without suicidal ideation. EQ-5D self-control (OR=1.42), anxiety/depression (OR=2.32), depression (OR=2.07), and self-rated physical health (OR=1.36) were found to significantly predict suicidal ideation. Conclusion Suicidal ideation without depression was prevalent among older Koreans. Self-control, anxiety/depression of EQ-5D, selfrated physical health, and depression predicted suicidal ideation. Interventions to screen older Koreans for early detection of suicide risk and prevention strategies should consider evaluating each EQ-5D dimension.

The main points of issue with the former premedical curriculum of Seoul National University College of Medicine (SNUCM) were the absence of educational objectives, decline in student motivation caused by uniform education, students' lack of a sense of belonging, and lack of humanistic education. In accordance with these issues, there were five aspects considered for the improvement of the premedical curriculum: reform based on the newly established educational objectives that corresponds with the 6-year medical school curriculum as a whole, expansion of elective courses and the development of personalized curriculum for the improvement of students' learning motives, expansion of social sciences and humanities curriculum for the development of students' capabilities as good doctors, active participation of medical professors in premedical education, and expansion of informal education and the student support program. According to the assessment done after the implementation of the reformed curriculum, premedical students were gratified with its establishment and management of multifarious liberal arts and major subjects. In preparation of the more rigorous entrance quota of the premedical school at SNUCM, there is ongoing reform of required major subjects and establishment of new subjects in the premedical curriculum in pursuit of unity with the 6-year medical curriculum. Moreover, there is ongoing development of an e-portfolio system for the association of premedical and medical education, integration of formal and informal curriculum, and reinforcement of student observation and formative evaluation. Further discussion on the assessment and betterment of premedical curriculum is needed.
Clothing ; Curriculum ; Education ; Education, Medical ; Education, Premedical ; Humanities ; Humans ; Learning ; Motivation ; Schools, Medical ; Seoul ; Social Sciences ; Students, Premedical