Clinical Efficacy of Cervical Length and Volume for Prediction of Labor Onset in VBAC Candidates

Background: The purpose of this research is to discover whether measurement of cervical length and cervical volume at term is helpful in predicting the onset of labor in VBAC candidates.Methods: Transvaginal sonographic evaluations of the cervixes of pregnant women who desired to undergo VBAC were performed between 36 - 40 weeks gestation. Clinical information such as labor onset time, gestational age at delivery and delivery mode was gathered from medical records.Results: A total of 514 pregnant women participated in this study. Cervical length was significantly longer in the group that delivered 7 days or more after measurement than in the group that delivered within 7 days of measurement (43±0.77 cm vs. 2.99±0.72 cm, p< 0.001). Cervical volume was significantly larger in the group that delivered at and after 7 days than in the group that delivered within 7 days (29.21±11.62 cm³ vs. 34.07±13.41 cm³, p=0.014). The cervical length ROC curve was significantly more predictive than the cervical volume ROC curve (AUC: 0.711 vs 0.594, p= 0.001). There were no significant differences between the combined cervical length/volume ROC curve and the cervical length ROC curve alone (p= 0.565). The AUC of the cervical length ROC curve to predict postterm pregnancy was 0.729.Conclusion: Measuring cervical length is helpful in predicting the onset of spontaneous labor within 7 days and posterm delivery in VBAC candidates.     

Clevudine for chronic hepatitis B: antiviral response,predictors of response,and development of myopathy

Summary. Clevudine has been approved for the treatment of chronic hepatitis B (CHB) in South Korea. However, its long‐term antiviral effect and safety awaits more study. The aim of this study was to evaluate antiviral efficacy, predictors of virologic response, and development of myopathy after clevudine therapy for CHB. The study included 102 nucleoside naïve CHB patients who had received clevudine for more than 6 months with good compliance. The median duration of clevudine treatment was 53 weeks (range, 25–90 weeks). A retrospective analysis of data retrieved from medical records was performed. The cumulative rate of virologic response [hepatitis B virus (HBV) DNA level <2000 copies/mL] at 48 weeks of clevudine therapy was 81%, and cumulative rate of clevudine resistance was 11% at 60 weeks of treatment. Independent predictors of virologic response to clevudine therapy were hepatitis B e antigen (HBeAg) negativity and rapid decrease of viral load during the early phase of treatment. The clevudine‐related myopathy developed in 3.9% of patients, and was reversible after discontinuation of clevudine. Clevudine showed a potent antiviral response, and its effect was higher in HBeAg‐negative patients, with rapid viral load reduction after therapy. However, long‐term therapy for more than 1 year resulted in the development of considerable resistance and myopathy. Therefore, we should consider alternative antiviral agents if clevudine resistance or clevudine‐induced myopathy is developed in patients on clevudine for the treatment of CHB.     

Trifloxystrobin induces tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-mediated apoptosis in HaCaT,human keratinocyte cells

As the outermost layer of the body, the skin plays an important role in exposure to pesticides, which could have negative impacts on human health. Trifloxystrobin is a widely used fungicide of the strobilurin class, however, there is little information regarding the skin contact-associated toxic mechanism. Therefore, the present study was performed in order to identify the skin toxicity mechanism of trifloxystrobin using HaCaT (keratinocyte of human skin) cells. Following 24 or 48?h treatment, cell viability, and subsequent Annexin V-FITC/propidium iodide assay, TUNEL assay and Western blotting were performed to investigate the cell death mechanism of trifloxystrobin. Exposure to trifloxystrobin resulted in diminished viability of HaCaT cells in both a time- and concentration-dependent manner. The cell death was derived through apoptotic pathways in the HaCaT cells. Furthermore, we explored the effect of trifloxystrobin on TRAIL-mediated extrinsic apoptosis using siRNA transfection. Knockdown of death receptor 5 suppressed trifloxystrobin-provoked apoptosis. These results indicate that trifloxystrobin induces TRAIL-mediated apoptosis and has an inhibitory effect in keratinocytes that can interfere with the barrier function and integrity of the skin. This could be proposed as a mechanism of skin toxicity by trifloxystrobin and considered in the management of pesticide exposure.     

Self-rated Physical,Mental, Oral,and Cognitive Health in Older Korean Immigrants: The Role of Health Indicators and Sociocultural Factors

Journal of Immigrant and Minority Health - Guided by the models of health assessment and social determinants of health, we examined predictors of self-rated physical, mental, oral, and cognitive...     

The mediating role of interpersonal needs on attitude towards ageing and its relationship with community sense and depression among community-dwelling older adults

This study aimed to determine the impact of community sense, depression and interpersonal needs on attitude towards ageing among older adults. This is a cross-sectional and correlational study. From December 2018 to June 2019, 211 community-dwelling older adults from a mid-sized city in Korea participated in the study. The results showed a significant interpersonal needs path from depression and community sense to attitude towards ageing. When interpersonal needs were mediated, the indirect effect of both depression and community sense on attitude towards ageing was significant. Interpersonal needs had a significant mediating effect on the relationships between attitude towards ageing and community sense and depression. The results of this study showed the effects of socio-psychological factors on attitude towards ageing, which is a known indicator of successful ageing and quality of life improvement in older adults. Based on this study, we suggest that the development of programs to promote successful ageing should include strategies to improve community sense, interpersonal needs fulfilment and interventions to reduce depression.     

Recovery of injured cingulum in a patient with traumatic brain injury

<正>The cingulum is the neural fiber bundle that connects the basal forebrain and medial temporal lobe.The cingulum contains the medial cholinergic pathway,which originates from the basalis nucleus of Meynert in the basal forebrain.Therefore,it is important for memory function(Malykhin et al.,2008;Hong and Jang,2010).In the past,identification of the cingulum on conventional brain MRI has been impossible     

Evaluation of the angiographic outcomes after clipping of intracranial aneurysms: determination of predisposing factors for occurrence of aneurysm remnants

ABSTRACT

Objectives: Aneurysm remnants after microsurgical clipping have a risk of regrowth and rupture and have not been validated in the era of three-dimensional angiography. Therefore, this study aimed to evaluate the angiographic outcome using three-dimensional rotational images and determine the predictors for remnants after microsurgical clipping.

Methods: Between January 2014 and May 2017, 139 aneurysms in 106 patients who were treated with microsurgical clipping, were eligible for this study. For the determination of aneurysm remnants after microsurgical clipping, the angiographic outcomes were evaluated using follow-up digital subtraction angiography within 7 days for unruptured aneurysms or within 2 weeks for ruptured aneurysms. According to the Sindou classification, the aneurysm remnants were dichotomized, and subgroup analysis was performed to identify the predictors of aneurysm remnants after clipping with various imaging parameters and clinical information.

Results: The overall rate of aneurysm remnants was 29.5% (41/139), in which retreatments were needed in 6.5% (9/139). The neck size and maximum diameter of aneurysms were independent predisposing factors for the aneurysm remnants that need retreatment (OR: 2.30; p < 0.001; OR: 1.38; p < 0.001, respectively).

Conclusions: This study demonstrated a low incidence of aneurysm remnants after microsurgical clipping which need to retreatment. However, selective postoperative angiography could provide us clear information of surgical result and evidence for long-term follow-up for some aneurysms with larger neck size (>5.7 mm) and maximum diameter (>7.1 mm).