Extracting lung cancer staging descriptors from pathology reports: A generative language model approach.

BACKGROUND: In oncology, electronic health records contain textual key information for the diagnosis, staging, and treatment planning of patients with cancer. However, text data processing requires a lot of time and effort, which limits the utilization of these data. Recent advances in natural language processing (NLP) technology, including large language models, can be applied to cancer research. Particularly, extracting the information required for the pathological stage from surgical pathology reports can be utilized to update cancer staging according to the latest cancer staging guidelines. OBJECTIVES: This study has two main objectives. The first objective is to evaluate the performance of extracting information from text-based surgical pathology reports and determining pathological stages based on the extracted information using fine-tuned generative language models (GLMs) for patients with lung cancer. The second objective is to determine the feasibility of utilizing relatively small GLMs for information extraction in a resource-constrained computing environment. METHODS: Lung cancer surgical pathology reports were collected from the Common Data Model database of Seoul National University Bundang Hospital (SNUBH), a tertiary hospital in Korea. We selected 42 descriptors necessary for tumor-node (TN) classification based on these reports and created a gold standard with validation by two clinical experts. The pathology reports and gold standard were used to generate prompt-response pairs for training and evaluating GLMs which then were used to extract information required for staging from pathology reports. RESULTS: We evaluated the information extraction performance of six trained models as well as their performance in TN classification using the extracted information. The Deductive Mistral-7B model, which was pre-trained with the deductive dataset, showed the best performance overall, with an exact match ratio of 92.24% in the information extraction problem and an accuracy of 0.9876 (predicting T and N classification concurrently) in classification. CONCLUSION: This study demonstrated that training GLMs with deductive datasets can improve information extraction performance, and GLMs with a relatively small number of parameters at approximately seven billion can achieve high performance in this problem. The proposed GLM-based information extraction method is expected to be useful in clinical decision-making support, lung cancer staging and research.

iSCNT embryo culture system for restoration of Cervus nippon hortulorum, presumed to be sika deer in the Korean Peninsula.

Sika deer inhabiting South Korea became extinct when the last individual was captured on Jeju Island in Korea in 1920 owing to the Japanese seawater relief business, but it is believed that the same subspecies (Cervus nippon hortulorum) inhabits North Korea and the Russian Primorskaya state. In our study, mt-DNA was used to analyze the genetic resources of sika deer in the vicinity of the Korean Peninsula to restore the extinct species of continental deer on the Korean Peninsula. In addition, iSCNT was performed using cells to analyze the potential for restoration of extinct species. The somatic cells of sika deer came from tissues of individuals presumed to be Korean Peninsula sika deer inhabiting the neighboring areas of the Primorskaya state and North Korea. After sequencing 5 deer samples through mt-DNA isolation and PCR, BLAST analysis showed high matching rates for Cervus nippon hortulorum. This shows that the sika deer found near the Russian Primorsky Territory, inhabiting the region adjacent to the Korean Peninsula, can be classified as a subspecies of Cervus nippon hortulorum. The method for producing cloned embryos for species restoration confirmed that iSCNT-embryos developed smoothly when using porcine oocytes. In addition, the stimulation of endometrial cells and progesterone in the IVC system expanded the blastocyst cavity and enabled stable development of energy metabolism and morphological changes in the blastocyst. Our results confirmed that the individual presumed to be a continental deer in the Korean Peninsula had the same genotype as Cervus nippon hortulorum, and securing the individual's cell-line could restore the species through replication and produce a stable iSCNT embryo.

Functional and morphological maturation of the full-sized and mini-pig corpus luteum by programmed cell death mechanism.

Introduction: The formation and function of the corpus luteum (CL) increase the likelihood of pregnancy and efficiently manage implantation. Apoptosis must occur at an appropriate time in the formation of the CL. This also affects its function. However, it is still unclear if the type of apoptosis affects the function. Material and Methods: We conducted morphological analysis of the CL collected on day 15 between the middle and late oestrous phases of Yorkshire pigs and mini-pigs, and measured the difference in hormone expression and apoptosis using an immunoassay method and messenger RNA level. Results: The CL cells were more uniform in the Yorkshire pigs than in the mini-pigs, and the composition of the CL was also fuller. The expression of luteinising hormone was higher in the Yorkshire pigs. Apoptosis and the rate of action of matrix metalloproteinases (MMPs) were different between the two pig types. Expression of MMPs was higher in the Yorkshire pigs than in the mini-pigs. However, the expression of caspase 3 and 20alpha-hydroxysteroid dehydrogenase, a progesterone inhibitor, was potentiated in the mini-pigs. Conclusion: Autophagy throughout the CL was more extensive in the Yorkshire pigs than in the mini-pigs, suggesting that autophagy and cell reorganisation by MMPs were highly correlated. The occurrence of autophagy in the formation and function of the CL may affect the action of hormones and expression of cell reconstitution factors.

Reconstitution of Caruncle Placenta through the 20α-HSD/Casp-3 Apoptotic Pathway during Early Pregnancy in Bovines.

Trophoblast cells of endometrium during bovine pregnancy with different characteristics undergo dynamic changes during uterine remodeling, which can be observed as continuous changes, as P4 secreted by the mother is replaced by placental hormones. In this context, the present study analyzed tissues' morphological changes through uterine apoptosis during early pregnancy. In addition, the expression pattern associated with apoptosis genes and 20α-HSD was determined in the endometrium and caruncle tissues. The localization of 20α-HSD, VEGF, Casp3, and mTOR protein was also determined in endometrium and caruncle during early pregnancy. From around 30 days, caruncle trophoblast cells with very high invasiveness expanded the villus section as the gestation period progressed. The surrounding cells detached and reorganized into new cells. In addition, an analysis of the effect of apoptosis on cell reorganization in the caruncle revealed that the expression of 20α-HSD/Casp-3 signals in the villus section gradually increased from 30 to 90 days. However, on the 30th day, glandular epithelial cells occurred sporadically in the trophoblast cell section. Moreover, the apoptosis of trophoblast cells increased at 90 days. Taken together, the results of the present study show that changes in the uterus during early pregnancy promote changes during later pregnancy by inducing the reorganization through the stimulation of 20α-HSD and Casp-3, promoting uterine and caruncle tissues, unlike cell development mediated by hormone signaling.

The role of TNFTNFα/p53 pathway in endometrial cancer mouse model administered with apple seed extract.

Recent studies regarding the ability to relieve and reconstitute the endometrium in the treatment of endometrial cancer are limited. In this study, to analyze endometrial cancer, early endometrial cancer was induced by injecting a colon cancer cell line into the lower abdominal cavity of mice. Subsequently, the apple seed extract was administered orally to determine if the extract could affect the endometrial cancer. Administration of apple seed extract to the endometrial cancer model confirmed that the apoptosis suppressing mechanism was downregulated concurrently with the reduced expression of NF-κB. In contrast, the TNFα/p53 pathway upregulated the apoptosis. A number of clinical inferences could be derived from the results of this study; moreover, the administration of apple seed extract in a cancer metastasis model has not been reported in earlier toxicity induction studies. The results of this study indicated that the apple seed extract partially enhances apoptosis and the immune function related factors in endometrial cells. By improving tissue remodeling, the extract may help to restore the endometrium.

Porcine endometrial 3D co-culture: Morphological changes in 3D endometrium tissues according to hormonal changes.

Cells cultured as monolayers proliferate well, but do not sustain their differentiation characteristics. Previous studies have investigated the interactions between cells and growth factors or cytokines by establishing either in vivo or in vitro three-dimensional (3D) cultures. Using porcine uterine epithelial cells and endometrial cells, the current study was designed to develop a 3D uterine culture system and investigate the response to hormone treatment. Formation of the 3D uterine model was similar to that of uterus from the group supplemented with calcium and magnesium, and the addition of these ions altered the spectrum of basement membrane degrading enzyme expression and activity. In particular, the epithelial cell junctions in the 3D model most closely resembled those of an actual uterus when the medium was supplemented with calcium and magnesium; the intercellular basement membrane structure was also tall under these conditions. The study confirmed that Casp-3 expression was lowest in the P4 (progesterone) treatment group, and this hormone was the most potent stimulus for formation of the endometrial cell layer. Therefore, the addition of calcium and magnesium plays an important role in the formation of a 3D uterine model, and the addition of P4 hormone mimics uterine thickening by stimulating growth of the epithelial cell layer.

Morphological changes in mouse ovary due to hormonal hypersecretion and matrix metalloproteinase -2 activity.

We analyzed whether aberrant gonadotropin secretion affects the morphological remodeling of murine ovarian tissues facilitated by activated matrix metalloproteinase (MMP) enzymes. Six mice were intraperitoneally injected with 5 IU of pregnant mare serum gonadotropin (PMSG) or human chorionic gonadotropin (HCG) every two days after estrus synchronization. Morphology and expression of various MMPs were assessed following the successful induction of hormonal secretion in these tissues. HCG treatment, but not PMSG treatment, resulted in the expanded production of granulose second follicular cells. In addition, the number of developing follicular cells in the HCG group increased compared with that in the PMSG group. Ovarian diameters were also very small in the PMSG group. Immunohistochemistry revealed decreased MMP-2 protein activity in the HCG group and increased MMP-2 activity in the PMSG group. Activity was particularly high in theca and granulose cells of the PMSG group, but only partial activity was observed in the theca cells of the HCG group. Vascular endothelial growth factor activity was increased in both the external and internal theca cell walls in the PMSG group while the HCG group showed high overall expression of this protein in the internal theca cells. These data indicate that follicular cell activity and remodeling of the ovaries differ based on the type of secretory hormone signals they receive. Inappropriate gonadotropin secretion may induce functional changes in the ovaries, and follicular remodeling may be facilitated by the activity of various MMPs.

CMOS Depth Image Sensor with Offset Pixel Aperture Using a Back-Side Illumination Structure for Improving Disparity.

This paper presents a CMOS depth image sensor with offset pixel aperture (OPA) using a back-side illumination structure to improve disparity. The OPA method is an efficient way to obtain depth information with a single image sensor without additional external factors. Two types of apertures (i.e., left-OPA (LOPA) and right-OPA (ROPA)) are applied to pixels. The depth information is obtained from the disparity caused by the phase difference between the LOPA and ROPA images. In a CMOS depth image sensor with OPA, disparity is important information. Improving disparity is an easy way of improving the performance of the CMOS depth image sensor with OPA. Disparity is affected by pixel height. Therefore, this paper compared two CMOS depth image sensors with OPA using front-side illumination (FSI) and back-side illumination (BSI) structures. As FSI and BSI chips are fabricated via different processes, two similar chips were used for measurement by calculating the ratio of the OPA offset to pixel size. Both chips were evaluated for chief ray angle (CRA) and disparity in the same measurement environment. Experimental results were then compared and analyzed for the two CMOS depth image sensors with OPA.

Effects of Offset Pixel Aperture Width on the Performances of Monochrome CMOS Image Sensors for Depth Extraction.

This paper presents the effects of offset pixel aperture width on the performance of monochrome (MONO) CMOS image sensors (CISs) for a three-dimensional image sensor. Using a technique to integrate the offset pixel aperture (OPA) inside each pixel, the depth information can be acquired using a disparity from OPA patterns. The OPA is classified into two pattern types: Left-offset pixel aperture (LOPA) and right-offset pixel aperture (ROPA). These OPAs are divided into odd and even rows and integrated in a pixel array. To analyze the correlation between the OPA width and the sensor characteristics, experiments were conducted by configuring the test elements group (TEG) regions. The OPA width of the TEG region for the measurement varied in the range of 0.3-0.5 µm. As the aperture width decreased, the disparity of the image increased, while the sensitivity decreased. It is possible to acquire depth information by the disparity obtained from the proposed MONO CIS using the OPA technique without an external light source. Therefore, the proposed MONO CIS with OPA could easily be applied to miniaturized devices. The proposed MONO CIS was designed and manufactured using the 0.11 µm CIS process.

Averaging Pixel Current Adjustment Technique for Reducing Fixed Pattern Noise in the Bolometer-Type Uncooled Infrared Image Sensor.

In this paper, we propose an averaging pixel current adjustment technique for reducing fixed pattern noise (FPN) in the bolometer-type uncooled infrared image sensor. The averaging pixel current adjustment technique is composed of active pixel, reference pixel, and calibration circuit. Polysilicon resistors were used in each active pixel and reference pixel. Resistance deviation among active pixels integrated with the same resistance value cause FPN. The principle of the averaging pixel current adjustment technique for removing FPN is based on the subtraction of dark current of the active pixel from the dark current of the reference pixel. The subtracted current is converted into the voltage, which contains pixel calibration information. The calibration circuit is used to adjust the calibration current. After calibration, the nano-ampere current is output with small deviation. The proposed averaging pixel current adjustment technique is implemented by a chip composed of a pixel array, a calibration circuit, average current generators, and readout circuits. The chip was fabricated using a standard 0.35 µm CMOS process and its performance was evaluated.

Analysis of Disparity Information for Depth Extraction Using CMOS Image Sensor with Offset Pixel Aperture Technique.

A complementary metal oxide semiconductor (CMOS) image sensor (CIS), using offset pixel aperture (OPA) technique, was designed and fabricated using the 0.11-µm CIS process. In conventional cameras, an aperture is located on the camera lens. However, in a CIS camera using OPA technique, apertures are integrated as left-offset pixel apertures (LOPAs) and right-offset pixel apertures (ROPAs). A color pattern is built, comprising LOPA, blue, red, green, and ROPA pixels. The disparity information can be acquired from the LOPA and ROPA channels. Both disparity information and two-dimensional (2D) color information can be simultaneously acquired from the LOPA, blue, red, green, and ROPA channels. A geometric model of the OPA technique is constructed to estimate the disparity of the image, and the measurement results are compared with the estimated results. Depth extraction is thus achieved by a single CIS using the OPA technique, which can be easily adapted to commercial CIS cameras.

Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study.

BACKGROUND: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ≤ 50 years old. METHODS: We retrospectively analyzed a consecutive cohort of 150 patients (≤ 50 years old) with chronic hip pain (≥ 6 weeks), which was not diagnosed or misdiagnosed based on the information provided on the referral form. RESULTS: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. CONCLUSION: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.

Validity and reliability of a structured-light 3D scanner and an ultrasound imaging system for measurements of facial skin thickness.

Three-dimensional (3 D)-scanning-based morphological studies of the face are commonly included in various clinical procedures. This study evaluated validity and reliability of a 3 D scanning system by comparing the ultrasound (US) imaging system versus the direct measurement of facial skin. The facial skin thickness at 19 landmarks was measured using the three different methods in 10 embalmed adult Korean cadavers. Skin thickness was first measured using the ultrasound device, then 3 D scanning of the facial skin surface was performed. After the skin on the left half of face was gently dissected, deviating slightly right of the midline, to separate it from the subcutaneous layer, and the harvested facial skin's thickness was measured directly using neck calipers. The dissected specimen was then scanned again, then the scanned images of undissected and dissected faces were superimposed using Morpheus Plastic Solution (version 3.0) software. Finally, the facial skin thickness was calculated from the superimposed images. The ICC value for the correlations between the 3 D scanning system and direct measurement showed excellent reliability (0.849, 95% confidence interval = 0.799-0.887). Bland-Altman analysis showed a good level of agreement between the 3 D scanning system and direct measurement (bias = 0.49 ± 0.49 mm, mean±SD). These results demonstrate that the 3 D scanning system precisely reflects structural changes before and after skin dissection. Therefore, an in-depth morphological study using this 3 D scanning system could provide depth data about the main anatomical structures of face, thereby providing crucial anatomical knowledge for utilization in various clinical applications. Clin. Anat. 30:878-886, 2017. © 2017 Wiley Periodicals, Inc.

White blood cell counts, insulin resistance, vitamin D levels and sarcopenia in Korean elderly men.

Sarcopenia is a major determinant of frailty, disability and mortality in the elderly. Whether low-grade inflammation, insulin resistance and vitamin D are independently associated with sarcopenia remains unclear. In our study, sarcopenia was defined as an appendicular skeletal muscle mass divided by height squared (ASM/Ht2) that was <2 SD below the normal means for young adults. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR) index [(insulin (IU/mL) × fasting glucose (mg/dL)/18)/22.5]. Data of white blood cell counts and serum 25-hydroxyvitamin D (25-(OH)D) levels were collected in the second and third year (2008-2009) of Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). The results showed that the prevalence of sarcopenia in Korean elderly men aged more than 65 years was 11.2%. ASM/Ht2 were positively associated with vitamin D levels, but negatively associated with white blood cell counts and HOMA-IR by multiple regression analysis. After adjustment for covariables, sarcopenia was associated with the highest quartile of WBC counts (OR = 2.93, 95% CI = 1.21-7.14) and the highest quartile of serum vitamin D levels (OR = 0.38, 95% CI = 0.15-0.95). In conclusion, the study findings suggest that higher WBC counts and lower vitamin D levels are independently associated with the presence of sarcopenia in community-dwelling elderly men. They also provide a basis for further studies of the complex immune-endocrine network in sarcopenia.

Behavioral and Psychological Symptoms of Dementia and Antipsychotic Drug Use in the Elderly with Dementia in Korean Long-Term Care Facilities.

BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are known predictors of institutionalization, lower quality of life, and caregiver distress. Guidelines recommend initial management with non-pharmacological means, but antipsychotic drugs are widely used for the treatment of certain BPSD. OBJECTIVES: The objective of the current study is to analyze the prevalence of BPSD and antipsychotic drug use in long-term care facilities in Korea. METHODS: Retrospective chart review and cross-sectional analysis was conducted with 529 residents diagnosed with dementia out of a total 835 residents in 20 long-term care facilities from October 2011 to April 2012. Basic characteristics of residents such as prevalence of BPSD and antipsychotic prescriptions were analyzed. BPSD was determined using the Neuropsychiatric Inventory-Questionnaire (NPI-Q) assessment tool, and associations with the use of antipsychotic drugs were investigated. RESULTS: The mean age of the 529 residents was 81.16 ± 8.73 years; 410 (77.5 %) were female. The mean length of stay in long-term care facilities was 24.19 ± 23.06 months. The primary outcome was a prescription rate of antipsychotic medications. Of the 529 dementia residents, 143 (27 %) were prescribed antipsychotic medications (quetiapine, risperidone, and olanzapine). Agitation was the most common symptom of BPSD. Disinhibition and irritability were associated with the use of antipsychotics in a multiple logistic regression analysis [respectively P = 0.007 and 0.016 and adjusted odds ratio (range) = 0.51 (0.31-0.83) and 0.57 (0.36-0.90)]. CONCLUSION: BPSD are common in long-term care facilities in Korea. Twenty-seven percent of dementia residents in long-term care facilities in Korea were prescribed antipsychotic medications. Furthermore, antipsychotic drug use was significantly associated with disinhibition and irritability in those patients.

Potentially Inappropriate Medications in the Elderly in Korean Long-Term Care Facilities.

BACKGROUND: Elderly residents of long-term care facilities are more vulnerable to being prescribed inappropriate medications because of the high incidence of co-medication in this population resulting from the presence of multiple chronic diseases and also age-related changes in pharmacokinetics and pharmacodynamics. OBJECTIVE: We evaluated the frequency of potentially inappropriate medications and factors influencing their frequency. METHODS: A retrospective cross-sectional study was conducted in 20 long-term care facilities located in the northwest regions of South Korea for 824 patients aged 65 years and older who were assessed between January and February of 2012. Potentially inappropriate medications were identified using the 2012 American Geriatric Society's Beers Criteria. We assessed the relationship between the frequency of potentially inappropriate medications prescribed and patient age, sex, co-medications, comorbidity, activities of daily living, length of stay, grade of long-term care insurance for seniors, and the bed size and business type of the long-term care facility. RESULTS: Of the 529 participants who satisfied our inclusion criteria, 308 (58.2 %) had received at least one inappropriate medication according to the 2012 Beers Criteria. The most frequently prescribed classes of inappropriate medications were central nervous system drugs (58.7 %), anti-cholinergics (21.2 %), and cardiovascular medications (10.8 %). The most commonly used drugs were quetiapine (28.4 %), chlorpheniramine (15.8 %), risperidone (6.5 %), and zolpidem (5.8 %). Inappropriate medication use was associated with the number of co-medications and long-term care insurance grade 3, which means less dependence and a requirement of low-level care. CONCLUSIONS: Central nervous system drugs (58.7 %) were the most prescribed class of inappropriate medications. Quetiapine was the drug most often given inappropriately (28.4 %). There was a relationship between inappropriate medication use and the number of co-medications. The frequency of inappropriate medication prescriptions was higher among patients whose long-term care insurance for seniors was grade 3, which means less dependence and a requirement of low-level care.

The association among three aspects of physical fitness and metabolic syndrome in a Korean elderly population.

BACKGROUND: The purpose of current study is to evaluate the association between physical fitness level and the prevalence of metabolic syndrome (MS) in a Korean elderly population. METHODS: A cross-sectional study measuring physical fitness and components of MS in a health promotion center of a general hospital for routine health check-ups. A total of 227 subjects >60 years old agreed to participate. A lifestyle questionnaire that included cigarette smoking, alcohol consumption, and physical activity was checked. Body weight, height, blood pressure, fasting glucose, total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, C-reactive protein, and glycated hemoglobin were measured. Muscular strength was assessed by measuring grasping power. Muscular endurance was evaluated using a sit-up test. Cardiopulmonary fitness was assessed via the Tecumseh step test (measuring hear rates at 1 min post-exercise). RESULTS: The highest tertile muscular endurance group (sit-ups >15 in men, >10 in women) was 0.37 times less likely to have MS [95 % confidence interval (CI) 0.17-0.84; p = 0.036] compared to that in the lowest tertile group (<11 in men, 0 in women), and the highest tertile in the cardiopulmonary fitness group (heart rate at rest >91/min in men, >92/min in women) was 2.81 times more likely to have MS (95 % CI 1.27-6.18; p = 0.038) compared to that in the lowest tertile group (<81/min in men, <80/min in women). CONCLUSIONS: Cardiopulmonary fitness and muscular endurance were related to MS in a Korean elderly population after adjusting for age, sex, current smoker, current alcohol drinking, and physical activity. Older adults should be encouraged to increase their cardiopulmonary fitness and muscular endurance.

Effect of 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol on Immune Functions in Healthy Adults in a Randomized Controlled Trial.

We previously reported that 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) accelerates hematopoiesis and has an improving effect on animal disease models such as sepsis and asthma. The effects of PLAG supplementation on immune modulation were assessed in healthy men and women. The objective was to evaluate the effects of PLAG supplementation on immune regulatory functions such as activities of immune cells and cytokine production. A randomized double blind placebo-controlled trial was conducted. Seventy-five participants were assigned to one of two groups; all participants had an appropriate number of white blood cells on the testing day. The PLAG group (n=27) received oral PLAG supplements and the control group (n=22) received oral soybean oil supplements. IL-4 and IL-6 production by peripheral blood mononuclear cells (PBMC) were lower (p<0.001 and p<0.001, respectively) with PLAG than with soybean oil. However, the production of IL-2 and IFN-γ by PBMC was unaltered with PLAG supplementation. The B cell proliferation decreased significantly in the PLAG group compared to the soybean oil control (p<0.05). The intake of PLAG in healthy adults for 4 weeks was deemed safe. These data suggest that PLAG has an immunomodulatory function that inhibits the excessive immune activity of immunological disorders such as atopic and autoimmune diseases. PLAG could improve the condition of these diseases safely as a health food supplement.

Cementless bipolar hemiarthroplasty using a micro-arc oxidation coated stem in patients with displaced femoral neck fractures.

Femoral stem fixation for displaced femoral neck fractures in osteoporotic patients is an ongoing debate. We evaluated the outcome of 136 cementless bipolar hemiarthroplasty using a Micro-arc oxidation (MAO) coated stem. All patients survived the procedure and were discharged from the hospital. Thirty- and 90-day mortality rates were 0.7% and 2.2%, respectively. Ninety-eight hips were followed for a minimum of 2years (mean, 44months) postoperatively. Three stems were revised because of a periprosthetic fracture. Although cortical stress shielding around the stem was observed in 3 hips, there was no loosening or osteolysis. Cementless bipolar hemiarthroplasty using a MAO-coated stem is a useful and safe option to treat displaced femoral neck fractures.

Relationship between serum ferritin levels and sarcopenia in Korean females aged 60 years and older using the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-2, 3), 2008-2009.

CONTEXT: It has been suggested that elevated serum ferritin is associated with several metabolic disorders. However, there is no reported study assessing any association between serum ferritin and sarcopenia despite the close relationship between sarcopenia and metabolic disorders. OBJECTIVE: We investigated whether serum ferritin was associated with sarcopenia in older Koreans. DESIGN AND SETTING: We conducted a cross-sectional study based on data acquired in the second and third years (2008-9) of the fourth Korean National Health and Nutrition Examination Survey. PARTICIPANTS: In total, 952 men (mean age 69.0 years) and 1,380 women (mean age 69.3 years) aged 60 years and older completed a body composition study using dual energy X-ray absorptiometry. MEASUREMENTS: Serum ferritin levels were measured. Sarcopenia was defined as an appendicular skeletal mass as a percentage of body weight that was less than two standard deviations below the gender-specific mean for young adults. RESULTS: Serum ferritin levels were lower in women than in men. Women with sarcopenia showed a higher level of serum ferritin than women without sarcopenia (men: without sarcopenia 115.7 ng/mL and with sarcopenia 134.4 ng/mL vs. women: without sarcopenia 70.7 ng/mL and with sarcopenia 85.4 ng/mL). The prevalence of sarcopenia increased as the tertile of serum ferritin increased. However, statistical significance was only seen in elderly women (1(st) tertile 6.3%, 2(nd) tertile 8.0%, 3(rd) tertile 12.0%; p = 0.008). Without adjustment, compared with those in the lowest tertile of serum ferritin level, participants in the highest tertile had an odds ratio of 2.02 (95% confidence interval = 1.26-3.23) for sarcopenia in women. After adjusting for known risk factors, the OR for sarcopenia was 1.74 (95% CI = 1.02-2.97) in women. There was no statistically significant association between sarcopenia and serum ferritin tertiles in men. CONCLUSIONS: Elevated serum ferritin levels were associated with an increased prevalence of sarcopenia in women but not in men from a representative sample of elderly Koreans.