Background: A Korean Multicenter Prospective cohort study of Active Surveillance or Surgery (KoMPASS) for papillary thyroid microcarcinomas (PTMCs) has been initiated. The aim is to compare clinical outcomes between active surveillance (AS) and an immediate lobectomy for low-risk PTMCs. We here outline the detailed protocol for this study. Methods: Adult patients with a cytopathologically confirmed PTMC sized 6.0 to 10.0 mm by ultrasound (US) will be included. Patients will be excluded if they have a suspicious extra-thyroidal extension or metastasis of a PTMC or multiple thyroid nodules or other thyroid diseases which require a total thyroidectomy. Printed material describing the prognosis of PTMCs, and the pros and cons of each management option, will be provided to eligible patients to select their preferred intervention. For the AS group, thyroid US, thyroid function, and quality of life (QoL) parameters will be monitored every 6 months during the first year, and then annually thereafter. Disease progression will be defined as a ≥3 mm increase in maximal diameter of a PTMC, or the development of new thyroid cancers or metastases. If progression is detected, patients should undergo appropriate surgery. For the lobectomy group, a lobectomy with prophylactic central neck dissection will be done within 6 months. After initial surgery, thyroid US, thyroid function, serum thyroglobulin (Tg), anti-Tg antibody, and QoL parameters will be monitored every 6 months during the first year and annually thereafter. Disease progression will be defined in these cases as the development of new thyroid cancers or metastases. Conclusion KoMPASS findings will help to confirm the role of AS, and develop individualized management strategies, for low-risk PTMCs.

Objective: To evaluate the trueness and precision of full-arch scans acquired using five intraoral scanners and investigate the factors associated with the dimensional accuracy of the intraoral scan data. Methods: Nine adult participants (mean age, 34.3 ± 8.3 years) were recruited. Four zirconium spheres (Ø 6 mm) were bonded to the canines and the molars. Following acquisition of reference scans using an industrial-grade scanner, five intraoral scanners, namely i500, CS3600, Trios 3, iTero, and CEREC Omnicam, were used to scan the arches. Linear distances between the four reference spheres were automatically calculated, and linear mixed model analysis was performed to compare the trueness and precision of the intraoral scan data among the different scanners. Results: The absolute mean trueness and precision values for all intraoral scanners were 76.6 ± 79.3 and 56.6 ± 52.4 µm, respectively. The type of scanner and the measured linear distances had significant effects on the accuracy of the intraoral scan data. With regard to trueness, errors in the intermolar dimension and the distance from the canine to the contralateral molar were greater with Omnicam than with the other scanners. With regard to precision, the error in the linear distance from the canine to the molar in the same quadrant was greater with Omnicam and CS3600 than with the other scanners. Conclusions The dimensional accuracy of intraoral scan data may differ significantly according to the type of scanner, with the amount of error in terms of trueness being clinically significant.

Objective: To evaluate the trueness and precision of full-arch scans acquired using five intraoral scanners and investigate the factors associated with the dimensional accuracy of the intraoral scan data. Methods: Nine adult participants (mean age, 34.3 ± 8.3 years) were recruited. Four zirconium spheres (Ø 6 mm) were bonded to the canines and the molars. Following acquisition of reference scans using an industrial-grade scanner, five intraoral scanners, namely i500, CS3600, Trios 3, iTero, and CEREC Omnicam, were used to scan the arches. Linear distances between the four reference spheres were automatically calculated, and linear mixed model analysis was performed to compare the trueness and precision of the intraoral scan data among the different scanners. Results: The absolute mean trueness and precision values for all intraoral scanners were 76.6 ± 79.3 and 56.6 ± 52.4 µm, respectively. The type of scanner and the measured linear distances had significant effects on the accuracy of the intraoral scan data. With regard to trueness, errors in the intermolar dimension and the distance from the canine to the contralateral molar were greater with Omnicam than with the other scanners. With regard to precision, the error in the linear distance from the canine to the molar in the same quadrant was greater with Omnicam and CS3600 than with the other scanners. Conclusions The dimensional accuracy of intraoral scan data may differ significantly according to the type of scanner, with the amount of error in terms of trueness being clinically significant.

Background: A Korean Multicenter Prospective cohort study of Active Surveillance or Surgery (KoMPASS) for papillary thyroid microcarcinomas (PTMCs) has been initiated. The aim is to compare clinical outcomes between active surveillance (AS) and an immediate lobectomy for low-risk PTMCs. We here outline the detailed protocol for this study. Methods: Adult patients with a cytopathologically confirmed PTMC sized 6.0 to 10.0 mm by ultrasound (US) will be included. Patients will be excluded if they have a suspicious extra-thyroidal extension or metastasis of a PTMC or multiple thyroid nodules or other thyroid diseases which require a total thyroidectomy. Printed material describing the prognosis of PTMCs, and the pros and cons of each management option, will be provided to eligible patients to select their preferred intervention. For the AS group, thyroid US, thyroid function, and quality of life (QoL) parameters will be monitored every 6 months during the first year, and then annually thereafter. Disease progression will be defined as a ≥3 mm increase in maximal diameter of a PTMC, or the development of new thyroid cancers or metastases. If progression is detected, patients should undergo appropriate surgery. For the lobectomy group, a lobectomy with prophylactic central neck dissection will be done within 6 months. After initial surgery, thyroid US, thyroid function, serum thyroglobulin (Tg), anti-Tg antibody, and QoL parameters will be monitored every 6 months during the first year and annually thereafter. Disease progression will be defined in these cases as the development of new thyroid cancers or metastases. Conclusion KoMPASS findings will help to confirm the role of AS, and develop individualized management strategies, for low-risk PTMCs.

Alzheimer’s disease (AD) is a progressive and most frequently diagnosed neurodegenerative disorder. However, there is still no drug preventing the progress of this disorder. β-Amyrin, an ingredient of the surface wax of tomato fruit and dandelion coffee, is previously reported to ameliorate memory impairment induced by cholinergic dysfunction. Therefore, we tested whether β-amyrin can prevent AD-like pathology. β-Amyrin blocked amyloid β (Aβ)-induced long-term potentiation (LTP) impairment in the hippocampal slices. Moreover, β-amyrin improved Aβ-induced suppression of phosphatidylinositol-3-kinase (PI3K)/Akt signaling.LY294002, a PI3K inhibitor, blocked the effect of β-amyrin on Aβ-induced LTP impairment. In in vivo experiments, we observed that β-amyrin ameliorated object recognition memory deficit in Aβ-injected AD mice model. Moreover, neurogenesis impairments induced by Aβ was improved by β-amyrin treatment. Taken together, β-amyrin might be a good candidate of treatment or supplement for AD patients.

Electrochemical skin conductance (ESC) has been suggested as a noninvasive diabetic screening tool. We examined the relevance of ESC method for screening type 2 diabetes. A meal tolerance test (MTT) was conducted for 40 diabetic and 42 control subjects stratifi ed by age, sex and body mass index (BMI). The glucose levels and ESC were measured before the MTT and every 30 min after meal intake up to 120 min. There was no correlation between the blood glucose level and ESC (r = 0.249) or ESC variability (ESCV) (r = −0.173). ESC (ESCV) was higher (lower) in diabetic patients than in normal control (p = 0.02 for ESC and p = 0.06 for ESCV). Receiver operating characteristic analysis showed that the area under the curve (AUC) values of the ESC and ESCV were 0.654 and 0.691, respectively. The novel variable, ESCV, showed 5.7% higher AUC than ESC. Contrary to some previous reports, ESC values in diabetic patients was higher than in age, sex and BMI matched control group. In our study, ESC or ESCV showed a marginal accuracy to be used as a screening tool for diabetes mellitus.
Area Under Curve ; Blood Glucose ; Body Mass Index ; Diabetes Mellitus ; Glucose ; Glucose Tolerance Test ; Humans ; Mass Screening ; Meals ; Methods ; ROC Curve ; Skin

In the present study, we synthesized a series of novel 7-methoxy-N-(substituted phenyl)benzofuran-2-carboxamide derivatives in moderate to good yields and evaluated their neuroprotective and antioxidant activities using primary cultured rat cortical neuronal cells and in vitro cell-free bioassays. Based on our primary screening data with eighteen synthesized derivatives, nine compounds (1a, 1c, 1f, 1i, 1j, 1l, 1p, 1q and 1r) exhibiting considerable protection against the NMDA-induced excitotoxic neuronal cell damage at the concentration of 100 muM were selected for further evaluation. Among the selected derivatives, compound 1f (with -CH3 substitution at R2 position) exhibited the most potent and efficacious neuroprotective action against the NMDA-induced excitotoxicity. Its neuroprotective effect was almost comparable to that of memantine, a well-known NMDA antagonist, at 30 muM concentration. In addition to 1f, compound 1j (with -OH substitution at R3 position) also showed marked anti-excitotoxic effects at both 100 and 300 muM concentrations. These findings suggest that -CH3 substitution at R2 position and, to a lesser degree, -OH substitution at R3 position may be important for exhibiting neuroprotective action against excitotoxic damage. Compound 1j was also found to scavenge 1,1-diphenyl-2-picrylhydrazyl radicals and inhibit in vitro lipid peroxidation in rat brain homogenate in moderate and appreciable degrees. Taken together, our structure-activity relationship studies suggest that the compound with -CH3 substitution at R2 and -OH substitution at R3 positions of the benzofuran moiety might serve as the lead exhibiting potent anti-excitotoxic, ROS scavenging, and antioxidant activities. Further synthesis and evaluation will be necessary to confirm this possibility.
Animals ; Antioxidants* ; Biological Assay ; Brain ; Lipid Peroxidation ; Mass Screening ; Memantine ; N-Methylaspartate ; Neurons ; Neuroprotective Agents ; Rats ; Reactive Oxygen Species ; Structure-Activity Relationship

BACKGROUND: The present study evaluated the efficacy of a combination of ibandronate and cholecalciferol on the restoration of the levels of 25-hydroxyvitamin D (25[OH]D) and various bone markers in postmenopausal women with osteoporosis. METHODS: This was a randomized, double-blind, active-controlled, prospective 16-week clinical trial conducted in 20 different hospitals. A total of 201 postmenopausal women with osteoporosis were assigned randomly to one of two groups: the IBN group, which received a once-monthly pill containing 150 mg ibandronate (n=99), or the IBN+ group, which received a once-monthly pill containing 150 mg ibandronate and 24,000 IU cholecalciferol (n=102). Serum levels of 25(OH)D, parathyroid hormone (PTH), and various bone markers were assessed at baseline and at the end of a 16-week treatment period. RESULTS: After 16 weeks of treatment, the mean serum levels of 25(OH)D significantly increased from 21.0 to 25.3 ng/mL in the IBN+ group but significantly decreased from 20.6 to 17.4 ng/mL in the IBN group. Additionally, both groups exhibited significant increases in mean serum levels of PTH but significant decreases in serum levels of bone-specific alkaline phosphatase and C-telopeptide of type 1 collagen (CTX) at 16 weeks; no significant differences were observed between the groups. However, in subjects with a vitamin D deficiency, IBN+ treatment resulted in a significant decrease in serum CTX levels compared with IBN treatment. CONCLUSION: The present findings demonstrate that a once-monthly pill containing ibandronate and cholecalciferol may be useful for the amelioration of vitamin D deficiency in patients with postmenopausal osteoporosis. Moreover, this treatment combination effectively decreased serum levels of resorption markers, especially in subjects with a vitamin D deficiency, over the 16-week treatment period.
Alkaline Phosphatase ; Cholecalciferol* ; Collagen Type I ; Female ; Humans ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Parathyroid Hormone ; Prospective Studies ; Vitamin D Deficiency

BACKGROUND/AIMS: Follicular thyroid carcinoma (FTC) and Hurthle cell carcinoma (HCC) of the thyroid are relatively uncommon thyroid malignancies in iodine-sufficient areas. In this study we evaluated the clinical behavior, prognostic factors and treatment outcomes of FTC and HCC in Korea. METHODS: This multicenter study included 483 patients with FTC and 80 patients with HCC who underwent an initial surgery between 1995 and 2006 in one of the four tertiary referral hospitals in Korea. We evaluated clinicopathological factors associated with distant metastases and recurrence during a median of 6 years of follow-up. RESULTS: HCC patients were significantly older (49 years vs. 43 years; p < 0.001) and had more lymphovascular invasions (22% vs. 14%; p = 0.03) compared with FTC patients. Distant metastases were confirmed in 40 patients (8%) in the FTC group and in two patients (3%) in the HCC group (p = 0.07). Distant metastases were significantly associated with older age, widely invasive cancer and extrathyroidal invasion. Only 14 patients (3%) had recurrent disease and there was no significant difference between FTC and HCC groups (p = 0.38). Recurrence was associated with larger tumor size and cervical lymph node metastasis. CONCLUSIONS: HCC patients were older and had more lymphovascular invasions than FTC patients. However, FTC and HCC patients had similar initial clinicopathological features. Older age, wide invasiveness and extrathyroidal invasion were independent risk factors for predicting distant metastases in FTC and HCC patients.
Adenocarcinoma, Follicular/*epidemiology/secondary/surgery ; Adult ; Age Factors ; *Diet ; Female ; Humans ; *Iodine ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; *Nutritional Status ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers ; Thyroid Neoplasms/*epidemiology/pathology/surgery ; Thyroidectomy ; Time Factors ; Treatment Outcome