Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis and lacks clinical biomarkers. Exosomes are extracellular vesicles that facilitate cell–cell communication by distributing macromolecules, such as small RNAs (smRNAs). We assessed the potential of exosome-derived small RNAs (Ex-smRNAs) as PDAC biomarkers. Methods: Peripheral blood was collected from 51 patients with PDAC and 15 control individuals. Exosomes were isolated using an aqueous two-phase system. Ex-smRNAs were analyzed using smRNA sequencing. smRNA-mediated target gene regulation was verified via The Cancer Genome Atlas analysis and in vitro transfection and wound-healing assays using PDAC organoids. Results: The total Ex-smRNA count was substantially reduced in patients with PDAC compared with that in control individuals. The levels of microRNAs (miRNAs) miR-125a-5p, miR-30e-5p, miR-16-2-3p, miR-98-5p, and the let-7 family were significantly suppressed, whereas that of miR-6731-5p was significantly elevated. Let-7c-5p and miR-98-5p were found to interact with the long non-coding RNA OLMALINC to regulate their common target genes, BACH1 and CCND1, thus controlling PDAC proliferation and migration. The expressions of CARS1-AS1 and miR-142-5p were upregulated in treatment-responsive patients.Multivariable Cox regression analyses, adjusting for potential prognostic factors such as sex, Eastern Cooperative Oncology Group performance status, and tumor size and stage, revealed that CARS1-AS1 (adjusted hazard ratio [HR] 0.33; 95% confidence interval [CI], 0.15–0.73; P = 0.0061) and miR-142-5p (adjusted HR 0.79; 95% CI, 0.61–1.01; P = 0.0581) were associated with improved overall survival. Conclusions We identified potential Ex-smRNA biomarkers involved in PDAC progression and prognosis that reflect key molecular alterations in PDAC and may serve as clinically relevant biomarkers for disease monitoring.

The diagnosis of acute ischemic stroke (AIS) can be challenging when neuroimaging findings are normal or equivo‑ cal. Neutrophil extracellular traps (NETs), particularly histone H3.1, have potential as biomarkers for AIS. This study evaluated NETs, specifically histone H3.1, as diagnostic biomarkers for AIS. This prospective study included 89 patients with AIS and 20 healthy controls. Plasma histone H3.1 levels were measured using the Nu.Q® H3.1 enzyme-linked immunosorbent assay (ELISA). Seven cytokines were analyzed using a bead-based immunoassay. Statistical analy‑ ses were used to compare histone H3.1 levels between groups and evaluate correlations with clinical parameters and cytokines. Histone H3.1 levels were significantly higher in patients with AIS (271.05 ± 33.40 ng/mL) versus controls (95.33 ± 12.86 ng/mL, p < 0.001). Multivariable logistic regression identified H3.1 as an independent risk factor for AIS (p = 0.006), with an area under the curve of 0.907. Significant correlations were found between H3.1, interleukin-6 (0.290, p = 0.013) and vascular cell adhesion molecule 1 (0.297, p = 0.011). In conclusion, the NETs H3.1 ELISA test is a reliable new diagnostic option that supports the diagnosis of AIS.

The diagnosis of acute ischemic stroke (AIS) can be challenging when neuroimaging findings are normal or equivo‑ cal. Neutrophil extracellular traps (NETs), particularly histone H3.1, have potential as biomarkers for AIS. This study evaluated NETs, specifically histone H3.1, as diagnostic biomarkers for AIS. This prospective study included 89 patients with AIS and 20 healthy controls. Plasma histone H3.1 levels were measured using the Nu.Q® H3.1 enzyme-linked immunosorbent assay (ELISA). Seven cytokines were analyzed using a bead-based immunoassay. Statistical analy‑ ses were used to compare histone H3.1 levels between groups and evaluate correlations with clinical parameters and cytokines. Histone H3.1 levels were significantly higher in patients with AIS (271.05 ± 33.40 ng/mL) versus controls (95.33 ± 12.86 ng/mL, p < 0.001). Multivariable logistic regression identified H3.1 as an independent risk factor for AIS (p = 0.006), with an area under the curve of 0.907. Significant correlations were found between H3.1, interleukin-6 (0.290, p = 0.013) and vascular cell adhesion molecule 1 (0.297, p = 0.011). In conclusion, the NETs H3.1 ELISA test is a reliable new diagnostic option that supports the diagnosis of AIS.

The diagnosis of acute ischemic stroke (AIS) can be challenging when neuroimaging findings are normal or equivo‑ cal. Neutrophil extracellular traps (NETs), particularly histone H3.1, have potential as biomarkers for AIS. This study evaluated NETs, specifically histone H3.1, as diagnostic biomarkers for AIS. This prospective study included 89 patients with AIS and 20 healthy controls. Plasma histone H3.1 levels were measured using the Nu.Q® H3.1 enzyme-linked immunosorbent assay (ELISA). Seven cytokines were analyzed using a bead-based immunoassay. Statistical analy‑ ses were used to compare histone H3.1 levels between groups and evaluate correlations with clinical parameters and cytokines. Histone H3.1 levels were significantly higher in patients with AIS (271.05 ± 33.40 ng/mL) versus controls (95.33 ± 12.86 ng/mL, p < 0.001). Multivariable logistic regression identified H3.1 as an independent risk factor for AIS (p = 0.006), with an area under the curve of 0.907. Significant correlations were found between H3.1, interleukin-6 (0.290, p = 0.013) and vascular cell adhesion molecule 1 (0.297, p = 0.011). In conclusion, the NETs H3.1 ELISA test is a reliable new diagnostic option that supports the diagnosis of AIS.

OBJECTIVES: The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. METHODS: From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interviews. Cognitive functions were measured using the MMSE-K (Korean Version of the Mini-Mental State Examination) and the Korean Version of the Montreal Cognitive Assessment (MoCA-K) tests. Severity of depression was evaluated by the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). RESULTS: 1) Among eighty type 2 diabetics, 13.75% were below 24 on the MMSE-K, while 38.8% were below 22 on the MoCA-K. 2) The total scores and subtest scores of the MoCA-K including visuospatial/executive, attention, language, delayed recall and orientation were significantly lower in type 2 diabetics with cognitive dysfunction (N=31) than those without cognitive dysfunction (N=49) (p < 0.001, respectively). 3) There were significant difference between type 2 diabetics with and those without cognitive dysfunction in age, education, economic status, body mass index, duration of diabetes, total scores of the K-HDRS, the MMSE-K and the MoCA-K (p < 0.05, respectively). 4) The total scores of the MoCA-K had significant correlation with age, education, body mass index, family history of diabetes, duration of diabetes, total scores of the K-HDRS (p < 0.05, respectively). 5) The risks of cognitive dysfunction in type 2 diabetics were significantly influenced by sex, education, fasting plasma glucose and depression. CONCLUSIONS: The cognitive dysfunction in type 2 diabetics seemed to be related to multiple factors. Therefore, more comprehensive biopsychosocial approaches needed for diagnosis and management of type 2 diabetes.
Blood Glucose ; Body Mass Index ; Cognition ; Depression ; Diagnosis ; Education ; Fasting ; Humans ; Male

BACKGROUND: An association has been reported between CYP2C19 polymorphism and the altered antiplatelet activity of clopidogrel. We investigated this association using the newly introduced platelet function analyzer (PFA)-200 (INNOVANCE PFA-200 System; Siemens Healthcare, Germany) P2Y test. METHODS: Polymorphisms of CYP2C19*2, *3, *17 and the degree of inhibition of platelet function were determined in 83 patients. Three different platelet function tests were used to evaluate the degree of platelet inhibition and to check the association with genotype. RESULTS: The post-procedure PFA-200 values of extensive metabolizers (EM) patients (285.3+/-38.8) were higher than those of intermediate metabolizers (IM) and poor metabolizers (PM) patients (227.7+/-98.3 and 133.7+/-99.2, respectively; P=0.024). Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4+/-15.7, 34.1+/-17.6, and 42.2+/-16.9, respectively, P<0.001; VerifyNow: 133.2+/-60.5, 171.5+/-42.6, and 218.7+/-59.3, respectively, P<0.001). The high residual platelet reactivity (HPR) rates were significantly different among the EM, IM, and PM groups using PFA-200 (PM:IM:EM=82.4:40.6:11.8, P<0.001). CONCLUSIONS: Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people. The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.
Aged ; Cardiovascular Diseases/blood/*drug therapy ; Cytochrome P-450 CYP2C19/*genetics/metabolism ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Phenotype ; Platelet Aggregation Inhibitors/*therapeutic use ; Platelet Function Tests/instrumentation ; Polymorphism, Genetic ; Ticlopidine/*analogs & derivatives/therapeutic use

BACKGROUND: Detection of antiphospholipid antibodies (aPL) can be considered problematic due to assay variability and reagent sensitivity, high false-positive and false-negative rates, and lack of assay standardization. Therefore, utilizing an automated system can improve reproducibility and reduce interlaboratory variation. Here, we evaluated the analytical performance of the new automated ACL AcuStar chemiluminescence assay (Instrumentation Laboratory, USA). This was compared to the results of a panel analyzed with the QUANTA Lite ELISA (INOVA Diagnostics Inc., USA). METHODS: We evaluated the inter-assay precision, linearity, and carry-over between the two methods, ACL and ELISA. A reference range study for each of the anticardiolipin (aCL) and anti-beta2 glycoprotein-I (abeta2GPI) IgG and IgM antibodies were performed using 135 healthy patient samples, which served as controls. We then compared the accuracy among the AcuStar and ELISA systems via four aPL tests. For this comparison, 69 patient samples suspected of an autoimmune disorder were used as the experimental panel. RESULTS: The AcuStar analyzer showed excellent precision, linearity, and carry-over for all four assays. The calculated cutoff values were 20.3 U/mL for aCL IgG, 20.3 U/mL for aCL IgM, 26.3 U/mL for abeta2GPI IgG, and 11.9 U/mL for abeta2GPI IgM. The consensus between AcuStar and ELISA results were generally comparable. Total agreement varied between 82.6% and 95.7%, and kappa values showed moderate to good agreement. CONCLUSIONS: Our study demonstrates that the new AcuStar chemiluminescence assay showed better performance. This automated system leads to improved reproducibility and reduces interlaboratory variability.
Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Automation ; Consensus ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Luminescence* ; Reference Values

With the growth of aging population in Korea, a better care of chronic and other degenerative illnesses is urgently needed. Evidences suggest that this can be achieved through incorporating a wide range of care options, expanding beyond medical interventions. The aim of this study is to analyze the distribution of publically funded research to understand if the Korean research and development funding system matches various approaches and purposes to successfully tackle the chronic care needs of an aging society. We complied the list of funded projects to be analyzed by searching the National Technical Information Service database with key words such as aging society/senescence, chronic diseases, disability, and health promotion. Most projects were based on the biomedical approach with the purpose of establishing the etiology and clinical (treatment) interventions. Health promotion projects showed a distinctive distribution with more percentage of projects based on psycho-behavioral approaches while research on chronic diseases predominantly biomedical. It would be necessary to diversify publically-funded research projects to develop effective and efficient care technologies for the future.
Aging ; Chronic Disease ; Financial Management ; Health Promotion ; Information Services* ; Korea

The preoperative hearing status is one of the important factors to determine the method of surgical approach to the vestibular schwannoma. It has been widely recognized that the hearing preservation surgery is not valuable if the patient has no serviceable hearing. The worldwide reported cases of hearing improvement after surgical removal of vestibular schwannoma with profound hearing disturbance are extremely rare, and so far, there have been no domestic cases reported. The authors have experienced a case of significant hearing improvement after surgical removal of vestibular schwannoma with preoperative unilateral total deafness but with normal otoacoustic emission response. We report this case with literature review.
Deafness ; Hearing Loss* ; Hearing* ; Humans ; Neuroma, Acoustic*

We report a case of complicated temporal lobe abscess following mastoidectomy. The patient complained of a headache after surgery, however, he was discharged as his symptom was considered to be a common postoperative headache. He revisited our due to a generalized tonic-clonic seizure, and the CT and MRI findings suggested the diagnosis of temporal lobe abscess. The patient was successfully treated with antibiotics instead of surgical treatment. Although the cerebral abscess following mastoidectomy is extremely rare, it is necessary to pay attention to it. Particularly when the patient complains of a headache, it is important to consider the aspects of headache carefully. Bone defect in tegmen tympani and exposure of dura will increase the risk of cerebral abscess, therefore careful caution is required in the presence of lower dura mater.
Abscess* ; Anti-Bacterial Agents ; Brain Abscess ; Diagnosis ; Dura Mater ; Headache ; Humans ; Magnetic Resonance Imaging ; Seizures ; Temporal Lobe*