Objective: Investigation of new drugs (INDs) is a tremendously inefficient process in terms of time and cost. Drug repositioning is another method used to investigate potential new agents in well-known drugs. This study assessed the survival impact of metformin medication on ovarian cancer. Methods: A national sample cohort of the Korean National Health Insurance Service Data was analyzed. Cox proportional hazards regression was used to analyzing hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for underlying diseases and medications as confounding factors for overall survival (OS) and cancer-specific survival (CSS). Results: A total of 866 eligible patients were included from among 1,025,340 cohort participants. Among them, 101 (11.7%) were metformin users. No difference in OS was observed between non-users and users. No difference in OS was observed according to age and Charlson Comorbidity Index. Long-term metformin use (≥720 days) was associated with better OS (adjusted HR=0.244; 95% CI=0.090–0.664; p=0.006). A multivariate Cox proportional hazards model showed that long-term metformin use was an independent favorable prognostic factor for OS (HR=0.193; 95% CI=0.070–0.528; p=0.001) but not for CSS (HR=0.599; 95% CI=0.178–2.017; p=0.408). Conclusion Long-term metformin use reduced all-cause mortality, but not CSS in ovarian cancer. Whether metformin itself reduces deaths because of ovarian cancer requires further investigation.

The purpose of this study is to evaluate the flow ability of the thermoplasticized Gutta Percha in different temperatures. Four Gutta Percha products were classified by its hardness (soft, medium, and hard) and were experimented by the Rheometer (Melt flow indexer MFI-10, DAVENPORT, England) measuring apparatus, in (23 ± 2) ℃, and in a relative humidity of (50 ± 5) %, following the guidelines of ISO 1133-1:2011. The heating temperature ranged from 108℃, 160℃ to 200℃, and the load at 2.16 kg and 3.8 kg. The Gutta Percha was cut in 5 mm to be suitable for the rheometer pressurization process. After the experiment was conducted with a preheating time of 5 minutes, a cutting time of 5–240 seconds, and a sample of 10 grams, the Gutta Percha did not show any changes in fluidity for 108℃, 160℃, but showed a change in its flow ability in 200℃. Also, the Gutta Percha did not show any changes in its fluidity when it was pressurized by 2.16 and 3.8 kilograms. Therefore, this experiment shows that the heating temperature and the cut-off time showed a significance while measuring the melt flow rate.
Gutta-Percha ; Hardness ; Heating ; Hot Temperature ; Humidity

BACKGROUND: The purpose of this study is to investigate differences of chemical composition between subchondral bone in advanced osteoarthritic (OA) and non-OA distal femur. METHODS: Twenty femurs were harvested, respectively. The subchondral trabeculae were obtained from the middle of medial articular surface of distal femurs. A 10 mm diameter cylindrical saw was used to harvest. Raman spectroscopy, a non-destructive technique, was employed to determine the chemical information of the trabecular bones in the human distal femurs. RESULTS: The maximum intensity of the phosphate peak was 2,376.51+/-954.6 for the non-OA group and 1,936.3+/-831.75 for the OA group. The maximum intensity of the phosphate peak observed between the two groups was significantly different (P=0.017). The maximum intensity of the amide I peak were 474.17+/-253.42 for the nonOA group and 261.91+/-205.61 for the OA group. The maximum intensity of the amide I peak were significantly different between the two groups (P=0.042). Also, among other chemical and matrix components (Hydroxyproline,Carbonate, Amide IIIdisordered;ordered, and CH2), the spectrums showed similar significant differences in the intensity (P=0.027, P=0.014, P=0.012; P=0.038, P=0.029). Area integration were performed to determine disorder in collagen's secondary structure via amide III (alpha helix/random coil). The value of the alpha helix to random coil band area are significantly different (P=0.021) and result showing that there was a trend toward higher collagen maturity for the nonosteoarthritic bone specimens. CONCLUSIONS: The result suggested that OA may affect the chemical compositions of trabecular bone, and such distinctive chemical information may be.
Cartilage ; Collagen ; Femur ; Humans ; Osteoarthritis* ; Spectrum Analysis, Raman

OBJECTIVES: The purpose of this study is to analyze and compare the micro-structural and mechanical properties of subchondral trabecular bone of non-osteoarthritic and osteoarthritic distal femur using micro-images based on finite element analysis. MATERIALS AND METHODS: Twenty distal femurs were harvested from 10 cadavers. The subchondral trabeculae were obtained from the middle of the articular surface of the medial femoral condyle of distal femurs. A total of 20 specimens were scanned using the micro-CT system. Micro-CT images were converted to micro-finite element model using the mesh technique, and micro-finite element analysis was then performed for assessment of the mechanical properties. RESULTS: According to the results, trabecular bone of osteoarthritic distal femur showed a decrease in trabecular thickness, bone volume fraction, structure model index, and yield stress and an increase in trabecular separation and structure model index. CONCLUSIONS: Results of bone morphometry index and strength showed greater deterioration of microstructure and decreased mechanical strength in subchondral trabeculae of the osteoarthritic group.
Cadaver ; Femur ; Humans ; Osteoarthritis

Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.
Aged ; Biopsy ; Diagnosis, Differential ; Fatigue ; Female ; Hodgkin Disease ; Humans ; Lung ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Thorax ; Tuberculosis

BACKGROUND: Decay accelerating factor (DAF/CD55), regulates the complement system by accelerating decay of the C3 convertase, has been described in several malignancies, however, the clinicopathologic significance of CD55 and its receptor CD97 has not been fully investigated. We examined the expression patterns of both CD55 and CD97 and their association with clinicopathologic parameters in colorectal cancers (CRCs). METHODS: Expression patterns of CD55 and CD97 in the stroma and tumor cells at tumor center and invasive front were examined in 130 CRCs, and their significance was statistically evaluated. RESULTS: CD55-high stroma was correlated with tumor border (p=0.006) and invasion depth (p=0.013). CD55-high tumor cells at tumor center and invasive front were correlated with histologic grade, and CD55-high tumor cells at invasive front with tumor, node and metastasis (TNM) stage (p<0.05). CD97-high stroma was correlated with lymph node metastasis (p=0.016) and TNM stage (p=0.030). CD97-high tumor cells at tumor center and invasive front were correlated with tumor size and CD97-high tumor cells at tumor center with tumor border (p<0.05). Patients with CD55-high stroma showed poor overall and recurrence-free survival (p<0.05) in univariate analysis, and were independently associated with short recurrence-free survival (p=0.025) in multivariate analysis. CONCLUSIONS: Stromal CD55 overexpression would be an indicator of adverse clinical outcome and a useful prognostic factor.
Antigens, CD55 ; Calcium Hydroxide ; Colorectal Neoplasms ; Complement C3-C5 Convertases ; Complement System Proteins ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Zinc Oxide

OBJECTIVES: The accuracy of bone strength can be improved for medically treating osteoporosis by diagnosing and predicting fracture risk. In this study, we calculated the material properties of calcaneus bone and evaluated the statistical correlation of the bone mineral density (BMD) with morphometry indices and bone strength. MATERIALS & METHODS: Twelve cored bone samples were obtained from the primary compressive trabeculae of human calcaneus. All samples were scanned with a Lunar PIXImus(R), and two-dimensional serial section images were obtained on a micro-computed tomography system. A mechanical test was performed with an Instron universal testing machine and finite element analysis (FEA) to determine material properties and bone strength. RESULTS: The material property of the samples was 2.97 GPA. BMD was significantly correlated with bone strength and morphometric indices except for Tb.Sp, DA, and Tb.N. The statistical relationship between bone strength and the morphometric indices was significant except for DA. CONCLUSIONS: FEA based on in vivo high resolution serial section images can be used to directly evaluate bone strength and will be a useful tool in clinical practice for diagnosing osteoporosis and predicting fracture risk.
Bone Density ; Calcaneus ; Collodion ; Finite Element Analysis ; Humans ; Osteoporosis

OBJECTIVES: The purpose of this study is to develop a method of evaluation based on finite element analysis (FEA) using micro-CT images for the measurement of trabecular bone strength. METHODS: The primary compressive trabeculae were obtained from the human femoral head of three cadavers (21 year old male (M/21), 51 year old male (M/51), 51 year old female (F/51). All bone specimens were scanned using micro-CT at 24.9microm of spatial resolution under 70 kV's voltage and current of 141microA. The percent bone volume was calculated from the CTAn (SKYSCAN, Belgium) software, it's represented the bone mineral density (BMD). After scanning, the finite element model was reconstructed based on micro-CT images. All models were applied to be linear elastic, isotropic, and uniform with a tissue modulus of 5.17 GPa and a tissue Poisson's ratio of 0.3. RESULTS: The percent bone volume(%) were 31.819 (+/-0.648), 21.513 (+/-2.489), 20.280 (+/-1.891) and Bone strength (MPa) were 187.741 (+/-13.006), 61.585 (+/-11.094), 61.266 (+/-16.744) in M/20, M/51 and F/51. The trabecular bone strength of the primary compressive trabeculae in M/20 was 3 times more than the trabecular bone strength in M/51 and F/51. The percent bone volume in M/20 was 148% and 157% higher than the percent bone volume in M/51 and F/51. CONCLUSIONS: The finite element analysis is more sensitive than the percent bone volume in reflecting the morphometry index of primary compressive trabeculae. The high resolution FEA reconstructed from high resolution MRI or high resolution CT may improve the evaluation of trabecular bone strength in the medical field.
Bone Density ; Cadaver ; Female ; Finite Element Analysis ; Head ; Humans ; Male

PURPOSE: We wanted to evaluate the mechanical strength of proximal tibia as resection distance increased from the joint surface. MATERIALS AND METHODS: We obtained the CT images of twenty knee osteoarthritis patients undergoing total knee arthroplasty. The finite element models were created based on the computed tomography images. The 8-node hexahedron element was made from BIONIX(TM) (CANTIBio. Co, Suwon, Korea), which is automatic mesh generation software program. The finite element model of the proximal tibia was resected at 6 mm, 8 mm, 10 mm, 12 mm, 15 mm and 18 mm from the lateral joint surface. A 1% strain rate was applied to a model by using HyperMesh(TM) software (Altair Engineering. Inc, Seattle, USA). The ultimate stress was calculated from the finite element analysis with using ANSYS 9.0 (ANSYS. Inc, Orlando, USA). RESULTS: The mean ultimate stress was 906.84 MPa, 877.22 MPa, 895.93 Mpa, 852.70 MPa, 742.90 Mpa and 585.51 Mpa at the 6 mm, 8 mm, 10 mm, 12 mm, 15 mm and 18 mm resection levels. As compare to the 6 mm resection level, the bone strengths at 15 mm and 18 mm were decreased with statistical significance (15 mm: p=0.005, 18 mm: p=0.000). CONCLUSION: The ultimate stress was decreased as the resection distance increased from the joint surface. But within a 12 mm resection distance from the lateral condyle articular surface of the tibia, the ultimate stress was not significantly decreased (p>0.05).
Arthroplasty ; Finite Element Analysis ; Humans ; Joints ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Sprains and Strains ; Tibia

BACKGROUND: A paradoxical response is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion after initial improvement during theprocess of antituberculous treatment. The related factors for the development of a paradoxical response in patients with tuberculous pleurisy are not certain. METHODS: We selected patients with tuberculous pleurisy who had been treated for more than 4 months. The changes onthe serial chest X-ray findings before and after treatment were reviewed. Paradoxical responses were regarded as any worsening or development of new lesion at least 2 weeks after the initiation of treatment. The baseline clinical characteristics and laboratory findings of the peripheral blood and pleural fluid were compared between the patients with a paradoxical response and the patients without a paradoxical response. RESULTS: Paradoxical responses appeared in sixteen patients (21%) among the 77 patients.It took a mean of 38.6 days after the treatment and the time to resolve the paradoxical response was a mean of 32.1 days. For the patients with a paradoxical response, the median age was younger (30.5 years vs 39.0 years, respectively) and the lymphocytic percentage of white blood cells in the pleural fluid was higher (82.1% vs 69.6%, respectively) than for the patients without a paradoxical response. CONCLUSION: The development of a paradoxical response during the treatment of patients with tuberculous pleurisy was not rare and this was related with the age of the patients and the percentage of lymphocytic white blood cells in the pleural fluid.
Antitubercular Agents ; Humans ; Leukocytes ; Thorax ; Tuberculosis, Pleural