Background: Turner syndrome (TS) is a common chromosomal abnormality, which is caused by loss of all or part of one X chromosome. Hormone replacement therapy in TS is important in terms of puberty, growth and prevention of osteoporosis however, such a study has never been conducted in Korea. Therefore, the purpose of our study was to determine relationship between the starting age, duration of estrogen replacement therapy (ERT) in TS and develop a hormone replacement protocol suitable for the situation in Korea. Methods: This is retrospective study analyzed the medical records in TS patients treated at the Severance hospital, Yonsei University College of Medicine, Seoul, Korea from 1997 to 2019. Total of 188 subjects who had received a bone density test at least once were included in the study. Korean National Health and Nutrition Examination Survey (KNHANES) was used for achieving bone mineral density (BMD) of normal control group. Student’s t-test, MannWhitney U test, ANOVA and correlation analysis were performed using SPSS 18.0. Results: Each BMD measurement was significantly lower in women with TS than in healthy Korean women. Early start and longer duration of ERT is associated with higher lumbar spine BMD but not femur neck BMD. Femur neck BMD, but not lumbar spine BMD was significantly higher in women with mosaicism than 45XO group. Conclusion Early onset and appropriate duration of hormone replacement therapy is important for increasing bone mineral density in patients with Turner syndrome. Also, ERT affects differently to TS patients according to mosaicism.

Purpose: This study aimed to assess stroke knowledge, fear of recurrence, family support, and health-promoting behavior in patients with transient ischemic attacks (TIA) and examine these factors have an effect on health-promoting behavior. Methods: A descriptive survey design was used and included 151 patients diagnosed with a TIA. Participants were recruited from a neurology outpatient clinic at a university hospital in metropolitan city B. Data were collected between February 7 and March 29, 2024, using structured questionnaires and analyzed with the IBM SPSS/WIN 27.0 program. Results: The average scores for the main variables were as follows: stroke knowledge (13.60±3.15), fear of recurrence (24.34±5.57), family support (44.40±6.02), and health-promoting behavior (65.81±6.77). Family support (β=.33, p<.001), fear of recurrence (β=.28, p<.001), and age (β=.19, p=.027) were significant predictors of health-promoting behavior, with family support showing the greatest influence. Together, these factors explained 33.0% of the variance in health-promoting behavior (F=11.72, p<.001). Conclusion These findings highlight the importance of considering the characteristics of age, addressing fear of recurrence and enhancing family support to encourage health-promoting behaviors in patients with TIA. Strengthening these areas may contribute to effective stroke prevention strategies.

Purpose: This study aimed to assess stroke knowledge, fear of recurrence, family support, and health-promoting behavior in patients with transient ischemic attacks (TIA) and examine these factors have an effect on health-promoting behavior. Methods: A descriptive survey design was used and included 151 patients diagnosed with a TIA. Participants were recruited from a neurology outpatient clinic at a university hospital in metropolitan city B. Data were collected between February 7 and March 29, 2024, using structured questionnaires and analyzed with the IBM SPSS/WIN 27.0 program. Results: The average scores for the main variables were as follows: stroke knowledge (13.60±3.15), fear of recurrence (24.34±5.57), family support (44.40±6.02), and health-promoting behavior (65.81±6.77). Family support (β=.33, p<.001), fear of recurrence (β=.28, p<.001), and age (β=.19, p=.027) were significant predictors of health-promoting behavior, with family support showing the greatest influence. Together, these factors explained 33.0% of the variance in health-promoting behavior (F=11.72, p<.001). Conclusion These findings highlight the importance of considering the characteristics of age, addressing fear of recurrence and enhancing family support to encourage health-promoting behaviors in patients with TIA. Strengthening these areas may contribute to effective stroke prevention strategies.

Purpose: This study aimed to assess stroke knowledge, fear of recurrence, family support, and health-promoting behavior in patients with transient ischemic attacks (TIA) and examine these factors have an effect on health-promoting behavior. Methods: A descriptive survey design was used and included 151 patients diagnosed with a TIA. Participants were recruited from a neurology outpatient clinic at a university hospital in metropolitan city B. Data were collected between February 7 and March 29, 2024, using structured questionnaires and analyzed with the IBM SPSS/WIN 27.0 program. Results: The average scores for the main variables were as follows: stroke knowledge (13.60±3.15), fear of recurrence (24.34±5.57), family support (44.40±6.02), and health-promoting behavior (65.81±6.77). Family support (β=.33, p<.001), fear of recurrence (β=.28, p<.001), and age (β=.19, p=.027) were significant predictors of health-promoting behavior, with family support showing the greatest influence. Together, these factors explained 33.0% of the variance in health-promoting behavior (F=11.72, p<.001). Conclusion These findings highlight the importance of considering the characteristics of age, addressing fear of recurrence and enhancing family support to encourage health-promoting behaviors in patients with TIA. Strengthening these areas may contribute to effective stroke prevention strategies.

Purpose: This study aimed to assess stroke knowledge, fear of recurrence, family support, and health-promoting behavior in patients with transient ischemic attacks (TIA) and examine these factors have an effect on health-promoting behavior. Methods: A descriptive survey design was used and included 151 patients diagnosed with a TIA. Participants were recruited from a neurology outpatient clinic at a university hospital in metropolitan city B. Data were collected between February 7 and March 29, 2024, using structured questionnaires and analyzed with the IBM SPSS/WIN 27.0 program. Results: The average scores for the main variables were as follows: stroke knowledge (13.60±3.15), fear of recurrence (24.34±5.57), family support (44.40±6.02), and health-promoting behavior (65.81±6.77). Family support (β=.33, p<.001), fear of recurrence (β=.28, p<.001), and age (β=.19, p=.027) were significant predictors of health-promoting behavior, with family support showing the greatest influence. Together, these factors explained 33.0% of the variance in health-promoting behavior (F=11.72, p<.001). Conclusion These findings highlight the importance of considering the characteristics of age, addressing fear of recurrence and enhancing family support to encourage health-promoting behaviors in patients with TIA. Strengthening these areas may contribute to effective stroke prevention strategies.

Combination therapy with checkpoint inhibitors blocks inhibitory immune cell signaling and improves clinical responses to anticancer treatments. However, continued development of innovative and controllable delivery systems for immune-stimulating agents is necessary to optimize clinical responses. Herein, we engineered Salmonella to deliver recombinant granulocyte macrophage colony stimulating factor (GM-CSF) in a controllable manner for combination treatment with a programmed death-ligand 1 (PD-L1) inhibitor. The engineered Salmonella enabled delivery of recombinant GM-CSF into mouse tumors, activating recruitment of immune cells, such as M1-polarized macrophages, dendritic cells, and CD8⁺ T cells. Combination treatment with the PD-L1 inhibitor and engineered Salmonella increased the survival rate of tumor-bearing mice by 25%. New tumor growth was strongly suppressed, and visible tumors disappeared at 120 days post-infection (dpi) in mice rechallenged with additional tumor implantation at 100 dpi. The number of memory T cells increased >2-fold in tumor-rechallenged mice. Our findings demonstrate superiority of the engineered Salmonella as a cancer therapeutic agent with precise targeting ability, immune-boosting activity, and ease of combination with other therapeutics.

Purpose: Polypharmacy can cause drug-related problems, such as potentially inappropriate medication (PIM) use and medication regimen complexity in the elderly. This study aimed to investigate the feasibility and effectiveness of a collaborative medication review and comprehensive medication reconciliation intervention by a pharmacist and hospitalist for older patients. Materials and Methods: This comprehensive medication reconciliation study was designed as a prospective, open-label, randomized clinical trial with patients aged 65 years or older from July to December 2020. Comprehensive medication reconciliation comprised medication reviews based on the PIM criteria. The discharge of medication was simplified to reduce regimen complexity. The primary outcome was the difference in adverse drug events (ADEs) throughout hospitalization and 30 days after discharge. Changes in regimen complexity were evaluated using the Korean version of the medication regimen complexity index (MRCI-K). Results: Of the 32 patients, 34.4% (n=11/32) reported ADEs before discharge, and 19.2% (n=5/26) ADEs were reported at the 30-day phone call. No ADEs were reported in the intervention group, whereas five events were reported in the control group (p=0.039) on the 30-day phone call. The mean acceptance rate of medication reconciliation was 83%. The mean decreases of MRCI-K between at the admission and the discharge were 6.2 vs. 2.4, although it was not significant (p=0.159). Conclusion As a result, we identified the effect of pharmacist-led interventions using comprehensive medication reconciliation, including the criteria of the PIMs and the MRCI-K, and the differences in ADEs between the intervention and control groups at the 30-day follow-up after discharge in elderly patients.Trial Registration: (Clinical trial number: KCT0005994)

Background: Mass spectrometry methods exhibit higher accuracy and lower variability than immunoassays at low testosterone concentrations. We developed and validated an ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay for quantifying serum total testosterone. Methods: We used an ExionLC UPLC (Sciex, Framingham, MA, USA) system and a Sciex Triple Quad 6500+ (Sciex) MS/MS system in electrospray ionization and positive ion modes with multiple reaction monitoring transitions to evaluate precision, accuracy, linearity, lower limit of quantitation (LLOQ), carryover, ion suppression, stability, and reference intervals. For method comparison, we measured serum testosterone concentrations using this method in 40 subjects whose testosterone concentrations ranged from 0.14 to 55.48 nmol/L as determined using the Architect i2000 immunoassay (Abbott Diagnostics, Abbott Park, IL, USA) and in an additional 160 sera with testosterone concentrations <1.67 nmol/L. Results: The intra- and inter-run precision CVs were <2.81%, and the accuracy bias values were <3.85%, which were all acceptable. The verified linear interval was 0.03–180.84 nmol/L; the LLOQ was 0.03 nmol/L. No significant carryover and ion suppression were observed. The testosterone in serum was stable at 4°C, at –20°C, and after three freeze-thaw cycles. The reference intervals were successfully verified. The correlation was good at testosterone concentrations of 0.14–55.48 nmol/L; however, the Architect assay showed positive percent bias at concentrations <1.67 nmol/L. Conclusions The UPLC-MS/MS assay shows acceptable performance, with a lower LLOQ than the immunoassay. This method will enable the quantitation of low testosterone concentrations.

Background: Adherence to antiretroviral treatment (ART) is crucial for maintaining the HIV-RNA suppression in patients living with HIV/AIDS. This study aims to analyze the risk factors contributing to low medication adherence among individuals with HIV/ AIDS by analyzing data from the Korean HIV/AIDS cohort study. Methods: The dependent variable is ART medication adherence.The depressive symptom and anxiety scores were collected as main independence variables. Covariates included gender, age, transmission route, alcohol and smoking information, and antiviral treatment regimen details. To predict the relationship between ordinal dependent variables and independent variables, an ordered logistic regression analysis was conducted, and odds ratios (OR) were calculated. Results: The results of the ordered logistic regression analysis showed that female was associated with a higher risk of low medication adherence (OR=2.91, 95% CI=1.08, 7.83). Among the subjects who were non-smokers and non-drinkers, the risk of low medication adherence was lower (OR=0.36, 95% CI=0.18, 0.70). Depending on the ART treatment group, individuals taking integrase inhibitor had a lower risk of medication adherence (OR=0.31, 95% CI=0.13, 0.76), and those experiencing depressive symptoms were related with a higher risk of low medication adherence (OR=1.97, 95% CI=1.12, 3.46). Conclusions The encouragement and emotional support of healthcare professionals are essential for patients living with HIV/AIDS who experience depressive symptoms to maintain ART adherence. Additionally, further research is needed to ensure that HIV/AIDS infected female with concurrent depressive symptoms can achieve appropriate ART therapeutic effect.