Purpose: There are few reports on the therapeutic effects of gonadotropin-releasing hormone agonists in boys with central precocious puberty, and studies reported in Korea are very rare. We aimed to assess the significance of clinical factors and the effects of gonadotropin-releasing hormone agonist treatment on final adult height in boys diagnosed with central precocious puberty. Methods: We retrospectively evaluated the medical records of 18 boys treated for idiopathic central precocious puberty between 2007 and 2018 at Chosun University Hospital. Gestational age, birth weight, and parental height were assessed at the initial visit. Chronological age, bone age, bone age/chronological age ratio, height and height standard deviation scores, predicted adult height, body mass index, and hormone levels were assessed during the treatment period. Results: At the time of diagnosis, the chronological age was 9.9±0.6 years, the bone age was 11.6±1.0 years, and the bone age/chronological age ratio was 1.20±0.1. The bone age/chronological age ratio decreased significantly to 1.12±0.1 at the end of treatment (P<0.05). The luteinizing hormone/follicular stimulating hormone ratios were 3.4±1.2, 0.6±0.4, and 0.6±1.0 at the start of treatment, after 1 year of treatment, and at the end of treatment, respectively. After gonadotropin-releasing hormone agonist treatment, the final adult height reached 172.0±4.8 cm compared to the target height range of 171.0±4.0 cm. Conclusion In boys with central precocious puberty, gonadotropin-releasing hormone agonist treatment improved growth potential.

Purpose: The clinical significance of birth weight relative to gestational age in girls with central precocious puberty is unclear. This study sought to compare clinical parameters such as final adult height (FAH) and menarche onset after treatment with gonadotropin-releasing hormone agonist (GnRHa) on birth weight in girls with central precocious puberty treated. Methods: This retrospective study reviewed data of 69 girls with precocious puberty who had reached their FAH in a long-term trial of GnRHa treatment between January 2007 and December 2017. The subjects were divided into small for gestational age (SGA) (n=19) and appropriate for gestational age (AGA) (n=50) groups. Results: When starting GnRHa treatment, bone age was 10.9±0.9 and 10.3±0.8 years in the SGA and AGA groups, respectively (P<0.05). The predicted adult height (PAH) (established according to the Bayley-Pinneau average table) and advanced PAH (established according to the Bayley-Pinneau advanced table) were 151.5±4.8 cm and 155.8±4.9 cm in the SGA group, respectively, and 153.4±5.3 cm and 159.0±6.0 cm in the AGA group. After treatment, no significant difference in bone age was found between the groups. The time to menarche after treatment was 12.5±7.6 and 21.1±12.3 months in the SGA and AGA groups, respectively (P<0.05). FAH in the SGA and AGA groups was 161.0±4.7 cm and 161.6±5.0 cm, respectively, without a significant difference. Conclusion SGA girls with precocious puberty have increased bone age and earlier menarche relative to AGA girls. However, no difference in FAH after treatment was found between these groups.

Neural stem cells (NSCs) have been suggested as a groundbreaking solution for stroke patients because they have the potential for self-renewal and differentiation into neurons. The differentiation of NSCs into neurons is integral for increasing the therapeutic efficiency of NSCs during inflammation. Apoptosis signal-regulating kinase 1 (ASK1) is preferentially activated by oxidative stress and inflammation, which is the fundamental pathology of brain damage in stroke. ASK1 may be involved in the early inflammation response after stroke and may be related to the differentiation of NSCs because of the relationship between ASK1 and the p38 mitogen-activated protein kinase pathway. Therefore, we investigated whether ASK1 is linked to the differentiation of NSCs under the context of inflammation. On the basis of the results of a microarray analysis, we performed the following experiments: western blot analysis to confirm ASK1, DCX, MAP2, phospho-p38 expression; fluorescence-activated cell sorting assay to estimate cell death; and immunocytochemistry to visualize and confirm the differentiation of cells in brain tissue. Neurosphere size and cell survival were highly maintained in ASK1-suppressed, lipopolysaccharide (LPS)-treated brains compared with only LPS-treated brains. The number of positive cells for MAP2, a neuronal marker, was lower in the ASK1-suppressed group than in the control group. According to our microarray data, phospho-p38 expression was inversely linked to ASK1 suppression, and our immunohistochemistry data showed that slight upregulation of ASK1 by LPS promoted the differentiation of endogenous, neuronal stem cells into neurons, but highly increased ASK1 levels after cerebral ischemic damage led to high levels of cell death. We conclude that ASK1 is regulated in response to the early inflammation phase and regulates the differentiation of NSCs after inflammatory-inducing events, such as ischemic stroke.
Animals ; Cell Death ; Infarction, Middle Cerebral Artery/*metabolism ; Lipopolysaccharides/pharmacology ; MAP Kinase Kinase Kinase 5/genetics/*metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Microtubule-Associated Proteins/genetics/metabolism ; Neural Stem Cells/cytology/drug effects/*metabolism ; *Neurogenesis ; Neuropeptides/genetics/metabolism ; p38 Mitogen-Activated Protein Kinases/genetics/metabolism

OBJECTIVES: To clarify the association between dust from large construction sites and allergic and respiratory conditions among residents in Sejong city. METHODS: We included 379 individuals older than 50 years from three areas of Sejong city; two areas near construction sites and one area for a comparison. Prevalence of self-reported allergic and respiratory conditions was compared across the three areas using logistic regression to adjust for covariates including age, gender, smoking, and educational attainment. A total of 16 individuals were interviewed to take details of the residents' experiences of construction work. RESULTS: Those living in the nearby areas around construction sites were generally found to have the increased prevalence for all allergic and respiratory conditions. Odds Ratio(OR)s for cough and sneezing among the six symptoms and allergic rhinitis among the three diagnosed diseases reached statistical significance but only OR for cough remained significant after adjustment: adjusted OR for cough was 2.63 (95% CI, 1.07-6.46). Two relevant themes emerged from semi-structured interview were; 1) most residents from the affected area reported a considerable level of exposure to construction dust, 2) about half of them noted that construction dust influences allergic- and respiratory health. CONCLUSIONS: General pattern provides suggestive evidence that living close to construction sites may be positively associated with elevated risks of allergic and respiratory conditions. Efforts should be made to establish preventive measures and a comprehensive in-depth health impact assessment on this issue.
Construction Industry ; Cough ; Dust ; Focus Groups ; Health Impact Assessment ; Logistic Models ; Prevalence* ; Qualitative Research ; Rhinitis ; Smoke ; Smoking ; Sneezing

BACKGROUND/AIMS: The effect of dietary micronutrients on non-erosive reflux disease (NERD) and reflux esophagitis is unclear. We aim to evaluate the gender-specific effect of micronutrient on erosive esophagitis and NERD. METHODS: A total of 11 690 participants underwent endoscopy and completed 3-day recordings for dietary intake and questionnaires for reflux symptoms from 2004 to 2008. To evaluate the effect of dietary micronutrients on NERD or erosive esophagitis, adjusted regression analysis with odds ratio (OR) and 95% confidence interval (CI) was used. In addition, we performed gender-specific analysis. RESULTS: Prevalence of NERD and erosive esophagitis was 6.8% and 11.2% in men and 9.1% and 2.4% in women. In adjusted analysis, high intake of vitamin A (OR, 0.78; 95% CI, 0.64–0.96), retinol (OR, 0.73; 95% CI, 0.59–0.90), vitamin B2 (OR, 0.68; 95% CI, 0.54–0.87), vitamin B6 (OR, 0.75; 95% CI, 0.58–0.96), folic acid (OR, 0.77; 95% CI, 0.62–0.96), calcium (OR, 0.66; 95% CI, 0.53–0.82), and iron (OR, 0.68; 95% CI, 0.53–0.87) had an inverse association with NERD. However, erosive esophagitis has no relationship with micronutrients except vitamin C (OR, 0.78; 95% CI, 0.62–0.98). High dietary intake of calcium reduced the risk of NERD in men and high dietary intake of many micronutrients reduced NERD in women. CONCLUSIONS: While many dietary micronutrients reduced NERD, they had no effect on erosive esophagitis. The effect of micronutrient on NERD was more prominent in women than men.
Ascorbic Acid ; Calcium ; Endoscopy ; Esophagitis ; Esophagitis, Peptic ; Female ; Folic Acid ; Gender Identity ; Humans ; Iron ; Male ; Micronutrients ; Odds Ratio ; Prevalence ; Riboflavin ; Vitamin A ; Vitamin B 6

Overnight fasting before elective surgery has been the routine to reduce the risk of pulmonary aspiration. Recently, several international guidelines for preoperative fasting recommend to intake carbohydrate-containing fluids up to 2 to 3 hours before the induction of anesthesia to improve postoperative recovery. Based on the recommendations, we developed a "preoperative carbohydrate diet" provided for the preoperative patients. The purpose of this case report is to share our experience of applying preoperative carbohydrate loading prior to surgery.
Anesthesia ; Fasting ; Humans ; Insulin Resistance ; Pancreaticoduodenectomy*

The enhanced recovery after surgery (ERAS) program aims to maximize the recovery of patients by minimizing pre- and postoperative complications and stress. The program recommends providing preoperative carbohydrate (CHO) supplements and starting an early postoperative diet to reduce the fasting duration. Based on these recommendations, we implemented preoperative CHO supplementation and initiated an early postoperative diet in patients undergoing laparoscopic colorectal resection. We observed 3 patients as follows: a non-ERAS case, preoperative ERAS case, and pre- and postoperative ERAS case. The preoperative well-being and compliance of patients improved after implementation of the ERAS program. Moreover, the length of hospital stay was reduced. Therefore, we consider that the ERAS program may be helpful for the recovery of patients undergoing laparoscopic colorectal resection.
Colorectal Surgery ; Compliance ; Diet* ; Fasting ; Food Habits* ; Humans ; Length of Stay ; Postoperative Complications

The principal objective of this study was to investigate the prevalence of toxoplasmosis in household and stray cats in Seoul, Republic of Korea. We collected blood samples from 72 stray and 80 household cats, and all samples were examined by ELISA and nested PCR. The overall positive rates of Toxoplasma gondii in stray cats were 38.9% (28/72), with 15.3% (11/72) in ELISA and 30.6% (22/72) in PCR. The positive rate in male stray cats was slightly higher than that of female stray cats. The highest positive rate of T. gondii infection was noted in Gangnam and Songpa populations in ELISA and in Gwangjin population in PCR. In household cats, however, we could not detect any specific antibodies or DNA for T. gondii. In conclusion, we recognized that the infection rate of toxoplasmosis in stray cats in Seoul was considerably high but household cats were free from infection.
Animals ; Animals, Domestic/parasitology ; Antibodies, Protozoan/blood ; Cat Diseases/*epidemiology/immunology/parasitology ; Cats ; Female ; Male ; Prevalence ; Republic of Korea/epidemiology ; Toxoplasma/genetics/immunology/*isolation & purification ; Toxoplasmosis, Animal/*epidemiology/immunology/parasitology

Exosomes are small membrane vesicles secreted from various types of cells. Tumor-derived exosomes contain MHC class I molecules and tumor-specific antigens, receiving attention as a potential cancer vaccine. For induction of efficient anti-tumor immunity, CD4+ helper T cells are required, which recognize appropriate MHC class II-peptide complexes. In this study, we have established an MHC class II molecule-expressing B16F1 murine melanoma cell line (B16F1-CIITA) by transduction of the CIITA (Class II transactivator) gene. Exosomes from B16-CII cells (CIITA-Exo) contained a high amount of MHC class II as well as a tumor antigen TRP2. When loaded on dendritic cells (DCs), CIITA-Exo induced the increased expression of MHC class II molecules and CD86 than the exosomes from the parental cells (Exo). In vitro assays using co-culture of immunized splenocytes and exosome-loaded DCs demonstrated that CIITA-Exo enhanced the splenocyte proliferation and IL-2 secretion. Consistently, compared to B16-Exo, CIITA-Exo induced the increased mRNA levels of inflammatory cytokines such as TNF-alpha, chemokine receptor CCR7 and the production of Th1-polarizing cytokine IL-12. A tumor preventive model showed that CIITA-Exo significantly inhibited tumor growth in a dose-dependent manner. Ex vivo assays using immunized mice demonstrated that CIITA-Exo induced a higher amount of Th1-polarized immune responses such as Th1-type IgG2a antibodies and IFN-gamma cytokine as well as TRP2-specific CD8+ T cells. A tumor therapeutic model delayed effects of tumor growth by CIITA-Exo. These findings indicate that CIITA-Exo are more efficient as compared to parental Exo to induce anti-tumor immune responses, suggesting a potential role of MHC class II-containing tumor exosomes as an efficient cancer vaccine.
Animals ; Cancer Vaccines/genetics/immunology ; Cell Line, Tumor ; Cell Proliferation ; Dendritic Cells/immunology ; Exosomes/genetics/*metabolism ; Gene Expression Regulation ; Gene Transfer Techniques ; Immunity, Cellular/immunology ; Immunity, Humoral/immunology ; Immunotherapy ; Lymphocyte Activation/immunology ; Melanoma, Experimental/mortality/pathology/*physiopathology ; Mice ; Mice, Inbred C57BL ; Nuclear Proteins/*genetics/*metabolism ; Survival Analysis ; T-Lymphocytes/immunology/metabolism ; Trans-Activators/*genetics/*metabolism ; Transduction, Genetic

STUDY DESIGN: Tissues were obtained from the endometrium of the posterior hmdus in 42 women (proliferative phase-25 cases, secretory phase-17 cases) with normal menstrual cycles(28-32days interval). The specimens were stained with H&E stain and classified according to the method by Noyes et al(1950) into early proliferative phase(-5~-10days from ovulation), late proliferative phase(-4days~ovulation), early secretory phase (ovulation ~5days), mid-secretory phase(6~10days from ovulation), and late secretory phase(11-14days from ovulation). Immunohistochemical staining of integrin a1, a4, b3, COX-1,-2, ER, PR expression was performed. RESULT: The expression of ER was high in the proliferative phase and low during the secretory phase. The late proliferative phase showed the highest intensity(p<0.05). On the other hand, the expression of PR in stromal cells was relatively uniform during the entire menstrual cycle. However, in epithelial cells, there was a characteristic peak intensity in the late proliferative phase and low intensity in the secretory phase.The expression of integrin a1, a4, b3 in epithelial cells showed no particular pattern in the proliferative phase but showed specific findings in the secretory phase. In the epithelial cells, the intensity of a I staining was increased after the early proliferative phase and sustained during the whole secretory phase(p<0.05), a4 was increased in the early and mid-secretory phases, b3 was increased in the mid-secretory phase to late secretory phase. But the strumal cells were weakly expressed in the whole menstrual cycle but showed no particular pattern, In glandular epithelial cells and stromal cells, COX-1 showed a cyclic pattem according to menstrual cycle; it was strongly expressed in the mid-secretory phase in glandular epithelial cells and mid-secretory and menstrual phase in stromal cells(p<0.05). But in luminal epithelial cells, COX-1 was expressed in the entire menstrual cycle but had no particular pattern. In glandular epithelial cells, stromal cells, and luminal epithelial cells, COX-2 was not expressed during the secretory phase but strongly expressed in the mid-secretory phase(p<0.05). CONCLUSION: The expression of a1, a4, b3, and COX-2 showed as stonng staining during the mid secretory phase which represents the implantation period. The PR expression in epitbelial cells was decreased during same period. These characteristic findings will provide helpful information far histological methods of endormetrial dating and will be useful in the measurement of endometrial maturation during the implantation period.
Endometrium* ; Epithelial Cells ; Female ; Hand ; Humans* ; Integrins* ; Menstrual Cycle* ; Phenobarbital ; Prostaglandin-Endoperoxide Synthases* ; Receptors, Progesterone ; Stromal Cells