Objectives: The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea. Methods: A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group. Results: Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40). Conclusions This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.

Objectives: The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea. Methods: A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group. Results: Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40). Conclusions This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa. Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA. Results: The frequency of IL-7Rαlow CX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn’s disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn’s disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001). Conclusion Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7Rαlow CX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa. Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA. Results: The frequency of IL-7Rαlow CX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn’s disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn’s disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001). Conclusion Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7Rαlow CX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa. Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA. Results: The frequency of IL-7Rαlow CX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn’s disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn’s disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001). Conclusion Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7Rαlow CX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

Objectives: The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea. Methods: A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group. Results: Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40). Conclusions This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa. Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA. Results: The frequency of IL-7Rαlow CX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn’s disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn’s disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001). Conclusion Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7Rαlow CX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

Objectives: The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea. Methods: A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group. Results: Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40). Conclusions This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa. Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA. Results: The frequency of IL-7Rαlow CX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn’s disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn’s disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001). Conclusion Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7Rαlow CX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

Purpose: Advances in chemotherapeutic and targeted agents have increased pathologic complete response (pCR) rates after neoadjuvant systemic therapy (NST). Vacuum-assisted biopsy (VAB) has been suggested to accurately evaluate pCR. This study aims to confirm the non-inferiority of the 5-year disease-free survival of patients who omitted breast surgery when predicted to have a pCR based on breast magnetic resonance imaging (MRI) and VAB after NST, compared with patients with a pCR who had undergone breast surgery in previous studies. Methods The Omission of breast surgery for PredicTed pCR patients wIth MRI and vacuumassisted bIopsy in breaST cancer after neoadjuvant systemic therapy (OPTIMIST) trial is a prospective, multicenter, single-arm, non-inferiority study enrolling in 17 tertiary care hospitals in the Republic of Korea. Eligible patients must have a clip marker placed in the tumor and meet the MRI criteria suggesting complete clinical response (post-NST MRI size ≤ 1 cm and lesion-to-background signal enhancement ratio ≤ 1.6) after NST. Patients will undergo VAB, and breast surgery will be omitted for those with no residual tumor. Axillary surgery can also be omitted if the patient was clinically node-negative before and after NST and met the stringent criteria of MRI size ≤ 0.5 cm. Survival and efficacy outcomes are evaluated over five years.Discussion: This study seeks to establish evidence for the safe omission of breast surgery in exceptional responders to NST while minimizing patient burden. The trial will address concerns about potential undertreatment due to false-negative results and recurrence as well as improved patient-reported quality of life issues from the omission of surgery. Successful completion of this trial may reshape clinical practice for certain breast cancer subtypes and lead to a safe and less invasive approach for selected patients.