Background Kidney renal clear cell carcinoma (KIRC) is one of the most common renal malignancies with a high mortality rate. Cuproptosis, a novel form of cell death, is strongly linked to mitochondrial metabolism and is mediated by protein lipoylation, leading to a proteotoxic stress response and cell death. To date, few studies have ellucidated the holistic role of cuproptosis-related genes (CRGs) in the pathogenesis of KIRC.Methods We comprehensively and completely analyzed the RNA sequencing data and corresponding clinical information from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. We screened for differentially expressed CRGs and constructed a prognostic risk model using univariate and multivariate Cox proportional regression analyses. Kaplan-Meier analysis was performed and receiver operating characteristic (ROC) curves were plotted to predict the prognosis of KIRC patients. Functional enrichment analysis was utilized to explore the internal mechanisms. Immune-related functions were analyzed using single-sample gene set enrichment analysis (ssGSEA), tumour immune dysfunction and exclusion (TIDE) scores, and drug sensitivity analysis.Results We established a concise prognostic risk model consisting of four CRGs (DBT, DLAT, LIAS and PDHB) to predict the overall survival (OS) in KIRC patients. The results of the survival analysis indicated a significantly lower OS in the high-risk group as compared to the patients in the low-risk group. The area under the time-dependent ROC curve (AUC) at 1, 3, and 5 year was 0.691, 0.618, and 0.614 in KIRC. Functional enrichment analysis demonstrated that CRGs were significantly enriched in tricarboxylic acid (TCA) cycle-related processes and metabolism-related pathways. Sorafenib, doxorubicin, embelin, and vinorelbine were more sensitive in the high-risk group.Conclusions We constructed a concise CRGs risk model to evaluate the prognosis of KIRC patients and this may be a new direction for the diagnosis and treatment of KIRC.
Humans ; Carcinoma, Renal Cell/genetics* ; Immunotherapy ; Kidney ; Kidney Neoplasms/genetics* ; Prognosis ; Copper ; Apoptosis

Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

BACKGROUND: Previous Caucasian studies have described venous thromboembolism in pregnancy; however, little is known about its incidence during pregnancy and early postpartum period in the Chinese population. We investigated the risk of venous thromboembolism in a “real-world” cohort of pregnant Chinese women with no prior history of venous thromboembolism. METHODS: In this observational study, 15,325 pregnancies were identified in 14,162 Chinese women at Queen Mary Hospital, Hong Kong between January 2004 and September 2016. Demographic data, obstetric information, and laboratory and imaging data were retrieved and reviewed. RESULTS: The mean age at pregnancy was 32.4±5.3 years, and the median age was 33 years (interquartile range, 29–36 yr). Pre-existing or newly diagnosed diabetes mellitus was present in 627 women (4.1%); 359 (0.7%) women had pre-existing or newly detected hypertension. There was a small number of women with pre-existing heart disease and/or rheumatic conditions. Most deliveries (86.0%) were normal vaginal; the remaining were Cesarean section 2,146 (14.0%). The incidence of venous thromboembolism was 0.4 per 1,000 pregnancies, of which 83.3% were deep vein thrombosis and 16.7% were pulmonary embolism. In contrast to previous studies, 66.7% of venous thrombosis occurred in the first trimester. CONCLUSION: Chinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization.
Asian Continental Ancestry Group ; Cesarean Section ; Cohort Studies ; Diabetes Mellitus ; Early Ambulation ; Female ; Heart Diseases ; Hong Kong ; Humans ; Hypertension ; Incidence ; Observational Study ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First ; Pregnant Women ; Pulmonary Embolism ; Venous Thromboembolism ; Venous Thrombosis

PURPOSE: The objective of the present study was to predict the gestational age at preterm birth using artificial neural networks for singleton pregnancy. METHODS: Artificial neural networks (ANNs) were used as a tool for the prediction of gestational age at birth. ANNs trained using obstetrical data of 125 cases, including 56 preterm and 69 non-preterm deliveries. Using a 36-variable obstetrical input set, gestational weeks at delivery were predicted by 89 cases of training sets, 18 cases of validating sets, and 18 cases of testing sets (total: 125 cases). After training, we validated the model by another 12 cases containing data of preterm deliveries. RESULTS: To define the accuracy of the developed model, we confirmed the correlation coefficient (R) and mean square error of the model. For validating sets, the correlation coefficient was 0.839, but R of testing sets was 0.892, and R of total 125 cases was 0.959. The neural networks were well trained, and the model predictions were relatively good. Furthermore, the model was validated with another dataset of 12 cases, and the correlation coefficient was 0.709. The error days were 11.58±13.73. CONCLUSION: In the present study, we trained the ANNs and developed the predictive model for gestational age at delivery. Although the prediction for gestational age at birth in singleton preterm birth was feasible, further studies with larger data, including detailed risk variables of preterm birth and other obstetrical outcomes, are needed.
Dataset ; Gestational Age ; Parturition ; Pregnancy ; Premature Birth

PURPOSE: Current studies have demonstrated the neuroprotective effects of dizocilpine (MK-801) in many animal models of brain injury, including hypoxic-ischemic (HI) encephalopathy, trauma and excitotoxicity, but limited data are available for those during the neonatal periods. Here we investigated whether dizocilpine can protect the developing rat brain from HI injury via mediation of nitric oxide synthase. METHODS: In an in vivo model, left carotid artery ligation was done in 7-day-old Sprague-Dawley (SD) rat pups. The animals were divided into three groups; normoxia, hypoxia with operation (HO), and HO treated with dizocilpine at a dose of 10 mg/kg. Hypoxia was made by exposure to a 2 hours period of hypoxic incubator (92% N2, 8% O2). In an in vitro model, embryonic cortical neuronal cell culture of SD rats at 18-day gestation was done. The cultured cells were divided into three groups: normoxia, hypoxia, and hypoxia treated with dizocilpine. The N group was prepared in 5% CO2 incubators and the other groups were placed in 1% O2 incubators (94% N2, 5% CO2) for 16 hours. RESULTS: Dizocilpin treatment significantly reduced the size of brain infarct in the neonatal rat model of HI. Both in the animal and in vitro experiments, expression of iNOS and eNOS were lower in the hypoxia group than in the normoxia group. Meanwhile, the nNOS expression was greater in the hypoxia group. Dizocilpine treatment attenuated these aberrant expressions of NOSs following hypoxic injury. CONCLUSION: Dizocilpine has neuroprotective property over perinatal HI brain injury via mediation of nitric oxide synthase.
Animals ; Anoxia ; Brain ; Brain Injuries ; Carotid Arteries ; Cell Culture Techniques ; Cells, Cultured ; Dizocilpine Maleate ; Incubators ; Ligation ; Models, Animal ; Negotiating ; Neurons ; Neuroprotective Agents ; Nitric Oxide ; Nitric Oxide Synthase ; Pregnancy ; Rats

In diamnionic dichorionic twins, the type of placenta consists of fused and separate types. The expansion of one twin placenta often occurs in the direction of the other implantation site in fused type. Placental development often leads to collision, and the growth of one or both placentas may be hindered, which can cause intrauterine growth restriction (IUGR). We represent a single case of one placental implantation above the another which caused IUFD in one fetus in diamnionic dichorionic twin pregnancy with a brief review of literatures.
Fetal Death* ; Fetus ; Humans ; Placenta ; Placentation ; Pregnancy, Twin ; Twins*

Uterine papillary serous carcinoma (UPSC) has been recognized as an aggresive tumor with early and deep myometrial invasion, frequent lympho-vascular space involvement, and a high relapse rate. It has also been shown that deep myometrial invasion cannot predict the risk of extrauterine disease. UPSC accounts for 2-10% of all endometrial cancer and generally occurs in postmenopausal women (mean age 66 years) who usually present with abnormal vaginal bleeding. Obesity, diabetes, hypertension, or a history of previous hormone replacement treatment, known as risk factors of endometrial cancer, are not usually seen in women with UPSC. In this paper, we present a case of uterine papillary serous carcinoma with obesity, hypertension, diabetes. The initial endometrial biopsy showed an endometrioid adenocarcinoma but the result of postoperative pathologic finding revealed UPSC with extension to less than half thickness of the muscle layer and involvement of pelvic lymph node.
Biopsy ; Carcinoma, Endometrioid ; Endometrial Neoplasms* ; Female ; Humans ; Hypertension ; Lymph Nodes ; Obesity ; Recurrence ; Risk Factors ; Uterine Hemorrhage

Intrauterine devices (IUDs) have a low complication rate and minimal side effects and are pervaded contraceptive method. Perforation of the uterus by an IUD is very rare. But perforation of the uterus is one of the most serious complications associated with insertion of IUD. During the puerperium when the uterus is small and the uterine wall is thin the risk of perforation increase. The frequency has been estimated between 0.05 and 13 per 1000 insertions. When the IUD strings are not visible during pelvic examination, physicians make efforts to locate the IUD. We experienced a laparosopic removal of perforated intrauterine device, which had been inserted on postpartum 5 th week, at posterior lower segment of uterus with intrauterine pregnancy. So we report a case with a brief review of the literature.
Contraception ; Gynecological Examination ; Intrauterine Devices ; Laparoscopy ; Postpartum Period ; Pregnancy ; Uterus

BACKGROUND/AIMS: The nonspecific esophageal motility disorder (NEMD) has been reported to be related to gastroesophageal reflux disease (GERD) in some cases. However, the pathophysiologic mechanism of NEMD has not been estabilished. The aim of this study was to assess the prevalence of esophagitis and gastric acid reflux following abnormal contractions in patients with NEMD. METHODS: 122 NEMD patients were enrolled (76 male and 46 female) and their endoscopic findings and 24 hour esophageal pH data were compared with 24 healthy subjects. The abnormal contractions were classified as 1) non-transmitted contraction, 2) low amplitude contraction, 3) non-transmitted and low amplitude contraction, and 4) others. RESULTS: Among the 122 patients with NEMD, 62 patients (50.8%) had GERD, 53 patients (43.4%) had endoscopic reflux esophagitis, and 41 patients (33.6%) had both. Acid exposed time studied by 24 hour pH monitoring was more increased in NEMD patients than in healthy controls (7.48 +/- 10.68 vs 1.42 +/- 1.17), but there were no differences among abnormal contraction patterns. Moderate to severe reflux esophagitis were frequently seen in patients with combined abnormal contractions as the results of endoscopic findings. Pre-existing factors for the gastric acid reflux in NEMD patients were male and esophageal hiatal hernia. CONCLUSIONS: Large numbers of NEMD patients were found to have concurrent GERD in our study. However, the esophageal peristaltic dysfunction was more closely related to the severity of esophagitis rather than to the amount of refluexed gastric acid itself.
Esophageal Motility Disorders* ; Esophagitis ; Esophagitis, Peptic ; Gastric Acid ; Gastroesophageal Reflux* ; Hernia, Hiatal ; Humans ; Hydrogen-Ion Concentration ; Male ; Prevalence*