Relationship between Change in Physical Activity and Risk of Metabolic Syndrome: A Prospective Cohort Study.

Background: This study investigates the relationship between changes in physical activity levels and risk of metabolic syndrome. Methods: This study examined 1,686 adults aged 40 to 69 years from a community-based cohort study with complete 1st to 4th follow-up data between 2011 and 2020. Changes in physical activity were evaluated through baseline and follow-up surveys using physical activity questionnaires. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. A survival analysis was conducted using a multivariate extended Cox regression model with a significance level set at P<0.05. Results: Participants were divided into groups according to physical activity levels. The newly inactive group (vigorous physical activity ≤150 minutes at first follow-up) had a 36% increase in the hazard ratio (HR) for metabolic syndrome compared with the consistently inactive group (≤150 minutes at both baseline and first follow-up) (HR, 1.36; 95% confidence interval [CI], 1.04 to 1.79). The newly active group (walking ≤420 minutes per week at baseline and >420 minutes per week at first follow-up) had a 25% decrease in the HR for metabolic syndrome compared with the consistently inactive group (walking ≤420 minutes per week at both baseline and first follow-up) (HR, 0.75; 95% CI, 0.57 to 0.98). Conclusion: Changes in physical activity levels are associated with risk of metabolic syndrome. These results provide important insights for future investigations into the link between physical activity changes and disease occurrence.

Mume Fructus reduces interleukin-1 beta-induced cartilage degradation via MAPK downregulation in rat articular chondrocytes.

Osteoarthritis is the most prevalent type of degenerative arthritis. It is characterized by persistent pain, joint dysfunction, and physical disability. Pain relief and inflammation control are prioritised during osteoarthritis treatment Mume Fructus (Omae), a fumigated product of the Prunus mume fruit, is used as a traditional medicine in several Asian countries. However, its therapeutic mechanism of action and effects on osteoarthritis and articular chondrocytes remain unknown. In this study, we analyzed the anti-osteoarthritis and articular regenerative effects of Mume Fructus extract on rat chondrocytes. Mume Fructus treatment reduced the interleukin-1ß-induced expression of matrix metalloproteinase 3, matrix metalloproteinase 13, and a disintegrin and metalloproteinase with thrombospondin type 1 motifs 5. Additionally, it enhanced collagen type II alpha 1 chain and aggrecan accumulation in rat chondrocytes. Furthermore, Mume Fructus treatment regulated the inflammatory cytokine levels, mitogen-activated protein kinase phosphorylation, and nuclear factor-kappa B activation. Overall, our results demonstrated that Mume Fructus inhibits osteoarthritis progression by inhibiting the nuclear factor-kappa B and mitogen-activated protein kinase pathways to reduce the levels of inflammatory cytokines and prevent cartilage degeneration. Therefore, Mume Fructus may be a potential therapeutic option for osteoarthritis.

Anti-Obesity Effect of Lactobacillus acidophilus DS0079 (YBS1) by Inhibition of Adipocyte Differentiation through Regulation of p38 MAPK/PPARγ Signaling.

Obesity is spawned by an inequality between the portion of energy consumed and the quantity of energy expended. Disease entities such as cardiovascular disease, arteriosclerosis, hypertension, and cancer, which are correlated with obesity, influence society and the economy. Suppression of adipogenesis, the process of white adipocyte generation, remains a promising approach for treating obesity. Oil Red O staining was used to differentiate 3T3-L1 cells for screening 20 distinct Lactobacillus species. Among these, Lactobacillus acidophilus DS0079, referred to as YBS1, was selected for further study. YBS1 therapy decreased 3T3-L1 cell development. Triglyceride accumulation and mRNA expression of the primary adipogenic marker, peroxisome proliferator-activated receptor gamma (PPARγ), including its downstream target genes, adipocyte fatty acid binding protein 4 and adiponectin, were almost eliminated. YBS1 inhibited adipocyte differentiation at the early stage (days 0-2), but no significant difference was noted between the mid-stage (days 2-4) and late-stage (days 4-6) development. YBS1 stimulated the activation of p38 mitogen-activated protein kinase (p38 MAPK) during the early stages of adipogenesis; however, this effect was eliminated by the SB203580 inhibitor. The data showed that YBS1 administration inhibited the initial development of adipocytes via stimulation of the p38 MAPK signaling pathway, which in turn controlled PPARγ expression. In summary, YBS1 has potential efficacy as an anti-obesity supplement and requires further exploration.

Veillonella faecalis sp. nov., a propionic acid-producing bacterium isolated from the faeces of an infant.

A strictly anaerobic, Gram-stain-negative, catalase-negative, cocci-shaped, and propionate-producing bacterial strain, named Ds1651T was isolated from the fecal sample collected from a South Korean infant. Through a comparison of 16S rRNA gene sequences, it was revealed that Ds1651T had the highest phylogenetic affinity with Veillonella nakazawae KCTC 25297 T (99.86%), followed by Veillonella infantium KCTC 25370 T (99.80%), and Veillonella dispar KCTC 25309 T (99.73%) in the family Veillonellaceae. Average nucleotide identity values between Ds1651T and three reference species were 95.48% for Veillonella nakazawae KCTC 25297 T, 94.46% for Veillonella infantium KCTC 25370 T, and 92.81% for Veillonella dispar KCTC 25309 T. The G + C content of Ds1651T was 38.58 mol%. Major fermentation end-products were acetic and propionic acids in Trypticase peptone glucose yeast extract broth with 1% (v/v) sodium lactate. The predominant cellular fatty acids that account for more than 10% were summed in Feature 8 (C17:1 ω8c and/or C17:2) and C13:0. Based on the findings from phylogenetic, genomic, phenotypic, and chemotaxonomic studies, we propose that the type strain Ds1651T (= KCTC 25477 T = GDMCC 1.3707 T) represents a novel bacterial species within the genus Veillonella, with the proposed name Veillonella faecalis sp. nov.

Temperament Clusters in Patients With Panic Disorder in Relation to Character Maturity.

OBJECTIVE: This study explored whether temperament profiles are associated with psychological functioning and whether character maturity affects this association in patients with panic disorders (PD). METHODS: A total of 270 patients with PD were enrolled in this study. Measurements included the Temperament and Character Inventory-revised-short (TCI-RS), a self-report version of the Panic Disorder Severity Scale (PDSS-SR), Beck Depression Inventory-II (BDI-II), and Spielberger State-Trait Anxiety Inventory (STAI). Cluster analysis was used to define the patients' temperament profiles, and the differences in discrete variables among temperament clusters were calculated using a one-way analysis of variance. An analysis of covariance was conducted to control for the impact of character maturity on psychological functioning among clusters. RESULTS: We identified four temperament clusters of patients with PD. Significant differences in the PDSS-SR, BDI-II, STAI-state, and STAI-trait scores among the four clusters were detected [F(3, 262)=9.16, p<0.001; F(3, 266)=33.78, p<0.001; F(3, 266)=19.12, p<0.001; F(3, 266)=39.46, p<0.001]. However, after controlling for the effect of character maturity, the effect of cluster type was either eliminated or reduced ([STAI-state] cluster type: F(3, 262)=0.94, p>0.05; SD+CO: F(1, 262)=65.95, p<0.001, ηp2 =0.20). CONCLUSION: This study enabled a more comprehensive and integrated understanding of patients by exploring the configuration of all temperament dimensions together rather than each temperament separately. Furthermore, we revealed that depending on the degree of character maturity, the psychological functioning might differ even within the same temperament cluster. These results imply that character maturity can complement inherently vulnerable temperament expression.

Fine dust inflow paths and heating load variation based on field measurement of air tightness in two Korean schools.

This study aimed to determine the effects of fine dust reduction, as well as the energy load reduction in association with the improvement plans by measuring the airtightness and indoor and outdoor fine dust concentrations in middle and high school classrooms and by identifying the fine dust inflow paths. The air tightness and indoor and outdoor fine dust concentrations were measured at two schools, and the paths of outdoor fine dust inflow were identified for an extensive analysis of the effects of fine dust reduction and the energy load reduction in association with improvement plans. Air tightness in the classroom at school A and B was improved by 32.26% and 38.58% with sealing, respectively. Analyzing the outdoor air inflow paths at school B according to the variation in air tightness, the probability of outdoor air inflow increased in the following order from the highest to the lowest: corridor windows, corridor doors, exterior windows, supply and exhaust units. For the rate of reduction in heating load, the highest rate was shown to be 27% at school A with improved air tightness at the exterior windows and 32% at school B with improved air tightness at the interior doors. This is expected to be reflected in the selection of equipment such as heat pumps and show cost-saving effects such as capacity reduction.

Disruptive Effects of Two Curcuminoids (Demethoxycurcumin and Bisdemethoxycurcumin) on the Larval Development of Drosophila melanogaster.

Juvenile hormones (JHs) play a central role in insect development, reproduction, and various physiological functions. Curcuminoids generally exhibit a wide range of biological activities, such as antioxidant, anti-inflammatory, antibacterial, and insecticidal, and they exhibit insect growth inhibitory effects. However, research on insecticidal properties of curcuminoids has been limited. Moreover, to the best of our knowledge, studies on JHs of insects and curcuminoids are lacking. Therefore, this study aimed to identify the substances that act as JH disruptors (JHDs) from edible plants. Demethoxycurcumin (DMC) and bisdemethoxycurcumin (BDMC), two curcuminoids from the turmeric plant Curcuma longa L. inhibited the formation of a methoprene-tolerant (Met)-Taiman (Tai) heterodimer complex in Drosophila melanogaster, as shown through in vitro yeast two-hybrid assays. An artificial diet containing 1% (w/v) DMC or BDMC significantly reduced the number of D. melanogaster larvae in a concentration-dependent manner; larval development was disrupted, preventing the progression of larvae to pupal stages, resulting in an absence of adults. Building on the results obtained in this study on curcuminoids, researchers can use our study as a reference to develop eco-friendly pesticides.

Development of Anti-OSCAR Antibodies for the Treatment of Osteoarthritis.

Osteoarthritis (OA) is the most common joint disease that causes local inflammation and pain, significantly reducing the quality of life and normal social activities of patients. Currently, there are no disease-modifying OA drugs (DMOADs) available, and treatment relies on pain relief agents or arthroplasty. To address this significant unmet medical need, we aimed to develop monoclonal antibodies that can block the osteoclast-associated receptor (OSCAR). Our recent study has revealed the importance of OSCAR in OA pathogenesis as a novel catabolic regulator that induces chondrocyte apoptosis and accelerates articular cartilage destruction. It was also shown that blocking OSCAR with a soluble OSCAR decoy receptor ameliorated OA in animal models. In this study, OSCAR-neutralizing monoclonal antibodies were isolated and optimized by phage display. These antibodies bind to and directly neutralize OSCAR, unlike the decoy receptor, which binds to the ubiquitously expressed collagen and may result in reduced efficacy or deleterious off-target effects. The DMOAD potential of the anti-OSCAR antibodies was assessed with in vitro cell-based assays and an in vivo OA model. The results demonstrated that the anti-OSCAR antibodies significantly reduced cartilage destruction and other OA signs, such as subchondral bone plate sclerosis and loss of hyaline cartilage. Hence, blocking OSCAR with a monoclonal antibody could be a promising treatment strategy for OA.

A case of vocal cord gnathostomiasis diagnosed with sectional morphologies in a histopathological specimen from a Chinese woman living in Korea.

This study aimed to describe a rare case of gnathostomiasis in the vocal cord. A 54-year-old Chinese woman living in Korea visited with a chief complaint of voice change at the outpatient department of otorhinolaryngology in Hallym Sacred Heart Hospital, Hallym University on August 2, 2021. She had eaten raw conger a few weeks before the voice change developed, but her medical history and physical examinations demonstrated neither gastrointestinal symptoms nor other health problems. A round and red cystic lesion, recognized in the anterior part of the right vocal cord, was removed using forceps and scissors through laryngeal microsurgery. The histopathological specimen of the cyst revealed 3 cross-sections of a nematode larva in the lumen of the cyst wall composed of inflammatory cells and fibrotic tissues. They differ in diameter, from 190 µm to 235 µm. They showed characteristic cuticular layers with tegumental spines, somatic muscle layers, and gastrointestinal tracts such as the esophagus and intestine. Notably, intestinal sections consisted of 27-28 lining cells containing 0-4 nuclei per cell. We tentatively identified the nematode larva recovered from the vocal cord cystic lesion as the third-stage larva of Gnathostoma, probably G. nipponicum or G. hispidum, based on the sectional morphologies.

Performance and economic efficiency analysis of an integrated, outdoor fan-ventilated cooling device.

Recently, the importance of mechanical facilities in charge of the safety and comfort of occupants in buildings has once again been highlighted in accordance with global social issues such as the spread of COVID-19. In response, various ventilation systems are being developed to improve indoor air quality, and efforts are being made to satisfy the indoor comfort of the occupants. Such advanced facilities allow occupants to secure indoor air quality, while frequent ventilation systems can affect the cooling and heating load in the building, and there is also a problem that it can occupy a relatively large amount of space in the building. This study proposes an integrated, outdoor fan-ventilated cooling device and analyzes its performance and economic efficiency. The EnergyPlus simulation program was used to model two types of systems for comparison: an existing (base) model with a condenser located in the outdoor unit, and a developed model with the condenser integrated within the cooling system. The state of the air passing through the condenser was analyzed prior to comparing the efficiency of the integrated, outdoor fan-ventilated cooling device, followed by an in-depth analysis of the performance and economic efficiency based on total energy consumption. In Case 1, the air passing through the cooling system was approximately 5  °C lower than the base model and showed 11% peak load reduction in comparison to the maximum energy consumption. Additionally, a comparison between regions with different outdoor air temperatures showed an average cost reduction of 16% in Daejeon and Busan City.

Postoperative Handheld Gastric Point-of-Care Ultrasound and Delayed Bowel Function.

BACKGROUND: Delayed bowel function (DBF) following intra-abdominal surgery is a common problem that contributes to postoperative complications and prolonged length of stay. Use of a handheld gastric point-of-care ultrasound (GPOCUS) can identify a full vs empty stomach in the postoperative period. We hypothesized that the findings of a full stomach identified on a postoperative day 1 (POD1) GPOCUS exam would predict an increased risk of delayed bowel function. STUDY DESIGN: A blinded, prospective cohort study was performed. Postoperative colorectal surgery patients were identified as having either a full or empty stomach based on previously published definitions. GPOCUS examinations were performed on POD1 using a handheld ultrasound device, and the clinicians were blinded to the results. Demographic and perioperative data were collected. The primary outcome variable was gastrointestinal-3 (GI-3) recovery, defined as time to tolerance of diet and either flatus or bowel movement. RESULTS: Fifty-six patients agreed to participate in the study; fifty were eligible and included. Eighteen patients' stomachs were identified as full on POD1 GPOCUS examination, and thirty-two were identified as empty. No significant demographic or perioperative differences existed between groups. Patients with full stomachs had significantly delayed GI-3 recovery (4 vs 1 days, p < 0.0001) and longer length of stay (5 vs 3 days, p < 0.0001). Full-stomach patients also had significantly more emesis and nasogastric tube (NGT) placement (both p < 0.05). CONCLUSIONS: GPOCUS performed on POD1 can predict DBF, length of stay, likelihood of emesis, and NGT placement. Use of handheld devices for GPOCUS showed promise for the identification of patients at high risk for DBF and could provide an opportunity for pre-emptive intervention.

Bifidobacterium bifidum DS0908 and Bifidobacterium longum DS0950 Culture-Supernatants Ameliorate Obesity-Related Characteristics in Mice with High-Fat Diet-Induced Obesity.

Probiotic supplements have promising therapeutic effects on chronic diseases. In this study, we demonstrated the anti-obesity effects of two potential probiotics, Bifidobacterium bifidum DS0908 (DS0908) and Bifidobacterium longum DS0950 (DS0950). Treatment with DS0908 and DS0950 postbiotics significantly induced the expression of the brown adipocyte-specific markers UCP1, PPARγ, PGC1α, PRDM16 and beige adipocyte-specific markers CD137, FGF21, P2RX5, and COX2 in C3H10T1/2 mesenchymal stem cells (MSCs). In mice with high-fat diet (HFD)-induced obesity, both potential probiotics and postbiotics noticeably reduced body weight and epididymal fat accumulation without affecting food intake. DS0908 and DS0950 also improved insulin sensitivity and glucose use in mice with HFD-induced obesity. In addition, DS0908 and DS0950 improved the plasma lipid profile, proved by reduced triglyceride, low-density lipoprotein, and cholesterol levels. Furthermore, DS0908 and DS0950 improved mitochondrial respiratory function, confirmed by the high expression of oxidative phosphorylation proteins, during thermogenesis induction in the visceral and epididymal fat in mice with HFD-induced obesity. Notably, the physiological and metabolic changes were more significant after treatment with potential probiotic culture-supernatants than those with the bacterial pellet. Finally, gene knockdown and co-treatment with inhibitor-mediated mechanistic analyses showed that both DS0908 and DS0950 exerted anti-obesity-related effects via the PKA/p38 MAPK signaling activation in C3H10T1/2 MSCs. Our observations suggest that DS0908 and DS0950 could potentially alleviate obesity as dietary supplements.

Systematic evaluation of genome-wide metabolic landscapes in lactic acid bacteria reveals diet- and strain-specific probiotic idiosyncrasies.

Lactic acid bacteria (LAB) are well known to elicit health benefits in humans, but their functional metabolic landscapes remain unexplored. Here, we analyze differences in growth, intestinal persistence, and postbiotic biosynthesis of six representative LAB and their interactions with 15 gut bacteria under 11 dietary regimes by combining multi-omics and in silico modeling. We confirmed predictions on short-term persistence of LAB and their interactions with commensals using cecal microbiome abundance and spent-medium experiments. Our analyses indicate that probiotic attributes are both diet and species specific and cannot be solely explained using genomics. For example, although both Lacticaseibacillus casei and Lactiplantibacillus plantarum encode similarly sized genomes with diverse capabilities, L. casei exhibits a more desirable phenotype. In addition, "high-fat/low-carb" diets more likely lead to detrimental outcomes for most LAB. Collectively, our results highlight that probiotics are not "one size fits all" health supplements and lay the foundation for personalized probiotic design.

The Reciprocal Relationship between Osteoporosis and Renal Stones.

Previous studies have proposed an association between osteoporosis and renal stones. The current analyses intended to investigate the bidirectional relationship between osteoporosis and renal stones. The ≥40-year-old population in the National Health Insurance Service-Health Screening cohort (2002-2015) was analyzed. In study I, 67,811 patients with osteoporosis and 67,811 control I participants were matched. The hazard ratio (HR) of osteoporosis for renal stones was calculated using stratified Cox proportional hazard models. In study II, 25,261 patients with renal stones and 101,044 control II participants were matched. The HR of renal stones for osteoporosis was estimated using stratified Cox proportional hazard models. In study I, 3.4% (2276/67,811) of osteoporosis patients and 2.5% (1696/67,811) of control I participants had renal stones. Osteoporosis patients had a 1.36 times higher HR for renal stones than control I participants (95% confidence intervals [CI] = 1.28-1.45). In study II, 9.2% (2319/25,261) of renal stone patients and 7.6% (7658/101,044) of control II participants had osteoporosis. Renal stone patients had a 1.26 times higher HR for osteoporosis than control II participants (95% CI = 1.21-1.32). Adults with osteoporosis had a higher risk of renal stones. Moreover, adults with renal stones had a higher risk of osteoporosis.

Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey.

BACKGROUND: Understanding the extent of tumor spread to local lymph nodes is critical to managing early-stage gastric cancer. Recently, fluorescence imaging with indocyanine green has been used to identify and characterize sentinel lymph nodes during gastric cancer surgery, but no published guidelines exist. We sought to identify areas of consensus among international experts in the use of fluorescence imaging with indocyanine green for mapping sentinel lymph nodes during gastric-cancer surgery. METHODS: In this 2-round, online Delphi survey, 27 international experts voted on 79 statements pertaining to patient preparation and contraindications to fluorescence imaging with indocyanine green during gastric cancer surgery; indications; technical aspects; advantages/disadvantages and limitations; and training and research. Methodological steps were adopted during survey design to minimize bias. RESULTS: Consensus was reached on 61 of 79 statements, including giving single injections of indocyanine green into each of the 4 quadrants peritumorally, administering indocyanine green on the same day as surgery, injecting a total of 1 to 5 mL of 5 mg/mL indocyanine green, injecting endoscopically into submucosa, and repeating indocyanine green injections a second time if sentinel lymph node visualization remains inadequate. Consensus also was reached that fluorescence imaging with indocyanine green is an acceptable single-agent modality for sentinel lymph node identification and that the sentinel lymph node basin method is preferred. However, sentinel lymph node dissection should be limited to T1 gastric cancer and tumors ≤4 cm in diameter, and further research is necessary to optimize the technique and render fluorescence-guided sentinel lymph nodes dissection acceptable for routine clinical use. CONCLUSION: Although considerable consensus was achieved, further research is necessary before this technology should be used in routine practice.

Association between Heart Rate Variability Indices and Depressed Mood in Patients with Panic Disorder.

Objective: Heart rate variability (HRV) reflects the regulation of the autonomic nervous system. Panic disorder is highly associated with autonomic dysfunction, and is often accompanied by depression. The aim of this study is to determine the association between depression and HRV indices in patients with panic disorder. Methods: A total of 110 outpatients diagnosed with panic disorder participated in this study. The medical records of patients with panic disorder who visited the outpatient clinic of Konkuk University Hospital between December 2018 and March 2020 were retrospectively reviewed. Measurements used in this study include the Panic Disorder Severity Scale-Self Report, Beck Depression Inventory (BDI-II), Insomnia Severity Index, and HRV. Patients were divided into depressive and non-depressive groups based on their BDI-II scores. The association between HRV indices and depressive symptoms was statistically analyzed. Results: The low frequency/high frequency (LF/HF) ratio was reduced in patients with depression (mean = -0.095, p = 0.004 in the above moderate depressive group, mean = -0.120, p = 0.020 in the severe depressive group). Significant correlations were found between depressive symptoms and standard deviation of NN interval (SDNN) (ms) (-0.19, p = 0.044), very low frequency (VLF) (ms2/Hz) (-0.22, p = 0.021), LF (-0.25, p = 0.008), HF (-0.19, p = 0.043), and LF/HF (-0.25, p = 0.009). Multiple linear regression analysis showed that BDI predicted SDNN (ms), VLF (ms2/Hz), LF, HF, and LF/HF. Conclusion: We confirmed that the LF/HF ratio decreases when depression is accompanied by panic disorder. HRV indices may be useful markers for detecting depressive symptoms in patients with panic disorder.

Developing energy based benchmark model and detailed energy analysis through school statistical data and field surveys.

Approximately 20% of all school facilities, i.e., 7,980 buildings, are at least 40 years old in Korea. As the number of aged buildings is expected to rapidly increase, it is necessary to improve such facilities to protect safe learning environments and save energy. This study aims to develop the energy based benchmark model (EBBM) and utilization for energy saving in school. EBBM can be operated for school buildings, a category encompassing complex buildings with different systems and large gaps between them. To utilization of EBBM allows us to obtain knowledge from the school facility, in order to define and tune data driven analysis rules. Data driven energy analysis also allows ascertaining their expected energy consumption and estimating the possible saving systems by using the building energy flow chart. In this research, Korea education data-base was analyzed to classify energy based benchmark model. Applicability review is conducted through detailed system analysis of 10 schools. The difference between the benchmark model calculated value and the actual value was confirmed to be within 10%. Through the benchmarking model, it is possible to compare energy consumption for buildings of different sizes. Energy consumption by energy source and room type was analyzed through an in-depth status survey. Most of School Classrooms consume the largest amount of energy, with cooling and heating energy constituting the largest proportion.

Polygonatum sibiricum improves menopause symptoms by regulating hormone receptor balance in an ovariectomized mouse model.

Female menopause is a hormone deficiency phenomenon that causes hot flashes, vaginal dryness, depression, nervous tension, insomnia, obesity, and bone loss. There are various hormone replacement therapy (HRT)-based menopausal treatments, but they are accompanied by side effects such as endometrial cancer and hyperplasia. To confirm the menopausal improvement effect of Polygonatum sibiricum (PS), we prepared an ovariectomized animal model, administered 17ß-estradiol (E2) and PS, and analyzed various menopausal symptoms. PS restored vaginal epithelium thickness, by increasing the expression of estrogen receptors ERα (ESR1) and ERß (ESR2), and increased serotonin concentration by reducing serotonin receptor 1 A (5-HT1A) and glucocorticoid receptor (Gr) expression. In addition, PS suppressed obesity by increasing HDL-C and decreasing LDL-C levels and improved the osteoporosis induced by ovariectomy. In particular, by controlling Hand2, Fgf2, and Faf9 expression through PR, the antiproliferative signal was suppressed in uterine epithelium, thereby reducing the risk of side effects of the administration of E2 alone. These results demonstrate that PS alleviates menopausal symptoms without causing endometrial hyperplasia.