Therapeutic efficacy of mesenchymal stem cells (MSCs) is determined by biodistribution and engraftment in vivo.Compared to intravenous infusion, biodistribution of locally transplanted MSCs are partially understood. Here, we performed a pharmacokinetics (PK) study of MSCs after local transplantation. We grafted human MSCs into the brains of immune-compromised nude mice. Then we extracted genomic DNA from brains, lungs, and livers after transplantation over a month. Using quantitative polymerase chain reaction with human Alu-specific primers, we analyzed biodistribution of the transplanted cells. To evaluate the role of residual immune response in the brain, MSCs expressing a cytosine deaminase (MSCs/CD) were used to ablate resident immune cells at the injection site. The majority of the Alu signals mostly remained at the injection site and decreased over a week, finally becoming undetectable after one month. Negligible signals were transiently detected in the lung and liver during the first week. Suppression of Iba1-positive microglia in the vicinity of the injection site using MSCs/CD prolonged the presence of the Alu signals.After local transplantation in xenograft animal models, human MSCs remain predominantly near the injection site for limited time without disseminating to other organs. Transplantation of human MSCs can locally elicit an immune response in immune compromised animals, and suppressing resident immune cells can prolong the presence of transplanted cells. Our study provides valuable insights into the in vivo fate of locally transplanted stem cells and a local delivery is effective to achieve desired dosages for neurological diseases.

Objectives: This study examined ways to promote desirable eating habits by choosing foods with low sugar contents and provide nutrition education in adolescents. Methods: This study was a cross-sectional survey. The sugar reduction perception and knowledge, sugary food preference, and intake frequency of 487 male and female high school students in Incheon were analyzed comparatively. Results: Approximately 94.9% and 94.5% of the subjects were unaware of the promotion of a sugar reduction policy and the sugar reduction in the basic guidelines for school meals, respectively. Approximately 95% of them had not received any sugar reduction nutrition education, and 90% were not interested in sugar reduction. The perception for sugar reduction was significantly higher in girls (3.43 out of 5 points) than in boys (3.16 out of 5 points) (P < 0.001). Knowledge about sugar was 3.65 out of 6 points in girls and 3.04 points in boys (P < 0.001). The preference and intake frequency for fruits of the total students were 4.24 out of 5 points and 2.56, respectively.For beverages, the preference was significantly higher in boys (3.97 points) than in girls (3.70 points) (P < 0.001), and the intake frequency was significantly higher in boys (2.26 points) than in girls (2.08 points) (P < 0.001). The preference for snacks was significantly higher for girls (4.19 points) than boys (4.02 points) (P < 0.01), and the intake frequency was 2.22 points in boys and 2.17 in girls, showing no significant difference. Sugar reduction perception and knowledge about sugar showed significant negative correlations with the snack intake frequency (r = -0.11, P < 0.05; -0.13, P < 0.05) after adjusting for gender, grade, and body mass index. Conclusions The high school students' perception of sugar reduction was very low, and there was a significant correlation with sugary food intake, suggesting that the sugary food intake will decrease as the sugar reduction perception and knowledge about sugar increase.

Objectives: This study examined ways to promote desirable eating habits by choosing foods with low sugar contents and provide nutrition education in adolescents. Methods: This study was a cross-sectional survey. The sugar reduction perception and knowledge, sugary food preference, and intake frequency of 487 male and female high school students in Incheon were analyzed comparatively. Results: Approximately 94.9% and 94.5% of the subjects were unaware of the promotion of a sugar reduction policy and the sugar reduction in the basic guidelines for school meals, respectively. Approximately 95% of them had not received any sugar reduction nutrition education, and 90% were not interested in sugar reduction. The perception for sugar reduction was significantly higher in girls (3.43 out of 5 points) than in boys (3.16 out of 5 points) (P < 0.001). Knowledge about sugar was 3.65 out of 6 points in girls and 3.04 points in boys (P < 0.001). The preference and intake frequency for fruits of the total students were 4.24 out of 5 points and 2.56, respectively.For beverages, the preference was significantly higher in boys (3.97 points) than in girls (3.70 points) (P < 0.001), and the intake frequency was significantly higher in boys (2.26 points) than in girls (2.08 points) (P < 0.001). The preference for snacks was significantly higher for girls (4.19 points) than boys (4.02 points) (P < 0.01), and the intake frequency was 2.22 points in boys and 2.17 in girls, showing no significant difference. Sugar reduction perception and knowledge about sugar showed significant negative correlations with the snack intake frequency (r = -0.11, P < 0.05; -0.13, P < 0.05) after adjusting for gender, grade, and body mass index. Conclusions The high school students' perception of sugar reduction was very low, and there was a significant correlation with sugary food intake, suggesting that the sugary food intake will decrease as the sugar reduction perception and knowledge about sugar increase.

Background: and Purpose To evaluate the outcome events and bleeding complications of the European Society of Cardiology (ESC) guideline-matched oral anticoagulant therapy for patients with acute ischemic stroke and atrial fibrillation (AF). Methods: Patients with acute ischemic stroke and AF from a nationwide multicenter registry (Korean ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts [K-ATTENTION]) between January 2013 and December 2015 were included in the study. Patients were divided into the ESC guideline-matched and the non-matched groups. The primary outcome was recurrence of any stroke during the 90-day follow-up period. Secondary outcomes were major adverse cerebrovascular and cardiovascular events, ischemic stroke, intracranial hemorrhage, acute coronary syndrome, allcause mortality, and major hemorrhage. Propensity score matching and logistic regression analyses were performed to assess the effect of the treatments administered. Results: Among 2,321 eligible patients, 1,126 patients were 1:1 matched to the ESC guidelinematched and the non-matched groups. As compared with the non-matched group, the ESC guideline-matched group had a lower risk of any recurrent stroke (1.4% vs. 3.4%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.18 to 0.95). The risk of recurrent ischemic stroke was lower in the ESC guideline-matched group than in the non-matched group (0.9% vs. 2.7%; OR, 0.32; 95% CI, 0.11 to 0.88). There was no significant difference in the other secondary outcomes between the two groups. Conclusions ESC guideline-matched oral anticoagulant therapy was associated with reduced risks of any stroke and ischemic stroke as compared with the non-matched therapy.

Purpose: The aim of this study was to investigate celiac plexus neurolysis (CPN) for the treatment of cancerous upper abdominal pain in a tertiary university hospital in Korea. Methods: At the tertiary university hospital in Korea, electronic medical records of cancer patients who underwent CPN and died in the hospital from November 2009 to June 2018 were retrospectively analyzed. Results: The total number of subjects was 51. The 17 patients were from the Department of Gastroenterology (33.0%), followed by 11 patients from the Department of Hemato-oncology (21.6%), 11 patients from the Department of Anesthesia and Pain Medicine (21.6%), 9 patients from the Department of General Surgery (17.6%). The diagnosis was pancreatic cancer in 15 patients (29.4%), stomach cancer in 8 patients (15.7%), hepatobiliary cancer in 20 patients (39.2%), colon cancer in 1 patient (2.0%), esophageal cancer in 2 patient (3.9%) and intra-abdominal metastasis in 5 patients (9.8%). The mean survival time after the surgery was 66.4±55.0 days. The pain intensity before and 1 week after the procedure significantly decreased, but the amounts of opioids consumed before and 1 week after the procedure were not statistically significant. Side effects occurred after the procedure including temporary localized pain in 24 patients (47.0%), hypotension in 12 (23.5%), and diarrhea in 6 (11.8%). Conclusion CPN is an effective and safe procedure for reducing upper abdominal pain caused by cancer, and it is necessary to perform CPN within the appropriate time by establishing a system of interdepartmental cooperation.

Purpose: Preoperative tumor size is associated with clinical stage, treatment plan and even survival rate of patient. We investigated the accuracy of tumor size estimation between magnetic resonance imaging (MRI) and ultrasonography (US) findings, comparing these with pathologic tumor size in the diagnosis of early breast carcinoma. Methods: Between 2011 and 2016, 136 patients with early breast cancer were analyzed and their tumor size on US and MRI findings were compared with their pathologic tumor size retrospectively. The background parenchymal enhancement of MRI was categorized as minimal, mild, moderate, and extreme. The patients who underwent neoadjuvant chemotherapy, had positive resection margins, underwent excisional biopsy for cancer diagnosis, and had non-mass lesions on MRI scans, were excluded. Results: In all, 83.1% of the cases showed concordance between MRI findings and pathologic tumor size within 0.5cm. MRI overestimated the findings by 10.3% and underestimated them by 6.6%; 78.7% showed concordance between US findings and pathologic tumor size within 0.5cm. US overestimated the findings by 5.9% and underestimated them by 15.4%. The tumor size on MRI (r=0.87) showed a stronger correlation to the pathologic tumor size than that on US (r=0.64) in early breast cancer patients. US had a tendency to underestimate the tumor size. The degree of breast parenchyma did not affect the accuracy of the measurement of preoperative tumor size. Conclusion MRI is relatively more accurate than US for assessing preoperative tumor size in breast cancer patients. US tends to underestimate tumor size.

Background: Intravenous dexmedetomidine has been reported to potentiate the anesthetic effect of local anesthetics and improve the quality of postoperative analgesia when used as an adjuvant in neuraxial block. We compared the effects of intravenous dexmedetomidine and midazolam for sedation on combined spinal-epidural (CSE) anesthesia. Methods: This study included 50 patients undergoing total knee arthroplasty. CSE anesthesia was given using 10 mg bupivacaine for all patients. After checking the maximum sensory and motor levels, the patients were randomly allocated into two groups of 25 each to receive intravenous continuous infusion of dexmedetomidine (Group D) or midazolam (Group M) for sedation during surgery. Regression block level, hemodynamic changes, and sedation score were compared between the groups when the patients entered the postanesthetic care unit (PACU). For patient-controlled epidural analgesia, 0.2% levobupivacaine with 650 μg of fentanyl (150 ml in total) was infused at a rate of 1 ml/h, in addition to a 3-ml bolus dose with a 30-min lockout time. The visual analogue scale scores, additional analgesic demand, patient satisfaction, and adverse events between the two groups were also compared postoperatively. Results: A significant difference was observed in relation to the sensory block level in the PACU (Group D: 6.3 ± 2.1; Group M: 3.2 ± 1.9) (P = 0.002). The motor block level and other outcomes showed no significant intergroup differences. Conclusions Intravenous injection of dexmedetomidine, rather than midazolam, for procedural sedation is associated with prolonged sensory block, with comparable incidences of adverse events during CSE anesthesia.

BACKGROUND: AMP-activated protein kinase (AMPK) is a serine/threonine protein kinase that plays a pivotal role in the balance of cellular energy metabolism. Recent studies have reported that AMPK has numerous roles in physiological conditions, and dysregulation of AMPK induces pathological processes and diseases. However, the role of AMPK and its activators have not yet been studied in the context of hair growth regulation. OBJECTIVE: To investigate the effects of metformin on dermal papilla (DP) and outer root sheath (ORS) cells, as well as the role of the AMPK pathway in hair growth. METHODS: We evaluated whether metformin, a well-known AMPK activator, had any beneficial effects on hair growth. In addition, to evaluate the molecular and cellular mechanisms that were involved, protein levels of AMPK and β-catenin were analyzed. RESULTS: Metformin increased the cellular proliferation of human DP and ORS cells. Ki-67 expression was also significantly increased after metformin treatment in the ex vivo hair follicle organ culture. Furthermore, DP and ORS cells treated with metformin had a significant increase in AMPK phosphorylation, which in turn suppressed β-catenin degradation and enhanced its nuclear accumulation. CONCLUSION: We demonstrated that metformin promoted hair growth via the AMPK/β-catenin signaling pathway in vitro with DP and ORS cells. The hair-promoting effects of AMPK activators may potentially be used for the treatment of alopecia, and further investigation will be needed in the future.
Alopecia ; AMP-Activated Protein Kinases ; beta Catenin ; Cell Proliferation ; Energy Metabolism ; Hair Follicle ; Hair ; Humans ; In Vitro Techniques ; Metformin ; Organ Culture Techniques ; Pathologic Processes ; Phosphorylation ; Protein Kinases

OBJECTIVES: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. METHODS: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants’ frailty. RESULTS: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. CONCLUSIONS More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

The aim of this study was to measure and compare polyphenol content, antioxidant, and anti-inflammatory activity of six halophytes (Limonium tetragonum, Suaeda glauca, Suaeda japonica, Salicornia europaea, Triglochin maritimum, and Sonchus brachyotus). Depending on the total polyphenol content, the plants were categorized into two groups: (1) a high total polyphenol content group that included L. tetragonum, S. brachyotus, and S. europaea, and, (2) a low total polyphenol content group consisting of S. glauca, T. maritima, and S. japonica. Antioxidant activity was evaluated using DPPH and hydroxyl radical scavenging assays, and by measuring ROS. Anti-inflammatory activity was evaluated by measuring NO and PGE₂. L. tetragonum and S. brachyotus, that have high polyphenol content, also showed strong antioxidant activity. In addition, L. tetragonum, S. brachyotus, and S. europaea showed good anti-inflammatory activity. Consequently, the total polyphenol content was thought to be related to antioxidant and anti-inflammatory activity. Therefore, S. brachyotus and L. tetragonum are good candidates for use in pharmaceuticals and functional foods.
Chenopodiaceae ; Functional Food ; Hydroxyl Radical ; Korea ; Salt-Tolerant Plants ; Sonchus