Effectiveness and safety of traditional herbal medicine on cardiac arrhythmic condition: A systematic review and meta-analysis of randomized control clinical trial.

INTRODUCTION: The prevalence of cardiac arrhythmia, which can lead to cardiac death, heart failure, and cardioembolic stroke, is increasing. Although various Western medicines for cardiac arrhythmias have been developed, there are still various difficulties in the management of arrhythmias. Traditional herbal medicines (THM) are widely used to manage arrhythmia in East Asia. Therefore, this study aimed to assess the effectiveness and safety of THM in the treatment of arrhythmia. METHOD: Using a systematic review methodology, we searched for randomized clinical trials on herbal medicines for arrhythmia without complications in 4 databases up to September 2022. The literature search was carried out again, targeting papers published until April 2024.We conducted a risk-of-bias assessment and meta-analysis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Eighty-two randomized clinical trials were included in this meta-analysis. Total effective rate was significantly better in unspecified arrhythmia (risk ratio [RR]: 1.20, 95% confidence interval [CI]: 1.13-1.26), premature ventricular contraction (RR: 1.29, 95% CI: 1.29-1.33), sinus bradycardia (RR: 1.26, 95% CI: 1.17-1.36), tachycardia (RR: 1.23 95% CI: 1.15-1.32), and atrial fibrillation (RR: 1.17, 95% CI: 1.07-1.27). No severe adverse events were associated with THM. The overall risk of bias was relatively high. The total effective rate was the most frequently assessed clinical outcome variable. Most outcomes were surrogates and not clinical endpoints. CONCLUSION: THM, alone or in combination with Western medicine, has therapeutic effects on cardiac arrhythmic diseases. However, additional disease-specific clinical outcome variables are required for further studies on THM. Owing to the low quality of the included studies and their small sample sizes, additional large-scale, long-term follow-up, and well-designed randomized controlled clinical trials are required. SYSTEMATIC REVIEW REGISTRATION NUMBER: Details of the protocol for this systematic review and meta-analysis were registered on the Open Science Framework (OSF. io). (https://osf.io/7r8kn/).

Risk of urolithiasis associated with allopurinol versus benzbromarone among patients with gout: a population-based cohort study.

OBJECTIVES: To compare the risk of urolithiasis in gout patients initiating allopurinol, a xanthine oxidase inhibitor, vs benzbromarone, a uricosuric. METHODS: Using the 2011-2020 Korea National Health Insurance Service database, we conducted a cohort study on gout patients initiating allopurinol vs benzbromarone as the 1st-line urate-lowering treatment (ULT). The primary outcome was a new onset urinary stone. The secondary outcome was a stone requiring intervention. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard models with a 5:1 ratio propensity-score matching on > 80 variables. Subgroup analyses were done by age, sex, thiazide use, and cardiovascular (CV) risk. RESULTS: 61 300 allopurinol initiators PS-matched on 12 260 benzbromarone initiators were included (mean age 59 years, 79% male). During a mean follow-up of 322 days, 619 urolithiasis cases occurred with an incidence rate of 0.87 per 100 person-years in allopurinol and 1.39 in benzbromarone initiators, showing a HR of 0.64 (95% CI, 0.51-0.80). ∼44% of urinary stones required intervention with a HR of 0.61 (95% CI 0.43-0.88). The lower risk associated with allopurinol compared with benzbromarone persisted across subgroups but was greater in the high than non-high CV risk subgroup (p for interaction = 0.02). CONCLUSION: This population-based cohort study found that allopurinol compared with benzbromarone was associated with a substantially lower risk of urolithiasis particularly in the presence of the high CV risk. This finding provides important safety information for clinicians' decision-making on ULTs of different mechanisms of action.

Capsaicin induces ATP-dependent thermogenesis via the activation of TRPV1/ß3-AR/α1-AR in 3T3-L1 adipocytes and mouse model.

Capsaicin (CAP) is a natural bioactive compound in chili pepper that activates the transient receptor potential vanilloid subfamily 1 (TRPV1) and is known to stimulate uncoupling protein 1 (UCP1)-dependent thermogenesis. However, its effect on ATP-dependent thermogenesis remains unknown. In this study, we employed qRT-PCR, immunoblot, staining method, and assay kit to investigate the role of CAP on ATP-dependent thermogenesis and its modulatory roles on the TRPV1, ß3-adrenergic receptor (ß3-AR), and α1-AR using in vitro and in vivo models. The studies showed that CAP treatment in high-fat diet-induced obese mice resulted in lower body weight gain and elevated ATP-dependent thermogenic effectors' protein and gene expression through ATP-consuming calcium and creatine futile cycles. In both in vitro and in vivo experiments, CAP treatment elevated the protein and gene expressions of sarcoendoplasmic/endoplasmic reticulum calcium ATPase 2 (SERCA2), ryanodine receptor 2 (RYR2), creatine kinase B (CKB), and creatine kinase mitochondrial 2 (CKMT2) mediated by the activation of ß3-AR, α1-AR, and TRPV1. Our study showed that CAP increased intracellular Ca2+ levels and the expression of voltage-dependent anion channel (VDAC) and mitochondrial calcium uniporter (MCU) which indicates that increased mitochondrial Ca2+ levels lead to increased expression of oxidative phosphorylation protein complexes as a result of ATP-futile cycle activation. A mechanistic study in 3T3-L1 adipocytes revealed that CAP induces UCP1- and ATP-dependent thermogenesis mediated by the ß3-AR/PKA/p38MAPK/ERK as well as calcium-dependent α1-AR/TRPV1/CaMKII/AMPK/SIRT1 pathway. Taken together, we identified CAP's novel functional and modulatory roles in UCP1- and ATP-dependent thermogenesis, which is important for developing therapeutic strategies for combating obesity and metabolic diseases.

Adipose Tissue Quantification Improves the Prognostic Value of GLIM Criteria in Advanced Gastric Cancer Patients.

The present study investigated whether the risk of recurrence after curative surgery could be further stratified by combining the Global Leadership Initiative on Malnutrition (GLIM) criteria and changes in subcutaneous (SAT) and visceral (VAT) adipose tissue mass after surgery in patients with advanced gastric cancer (AGC). This study retrospectively analyzed 302 patients with AGC who underwent curative surgery. Based on the GLIM criteria, patients were classified into malnourished and non-malnourished groups. The cross-sectional areas of SAT and VAT were measured from preoperative and 6-month post-operative computed tomography (CT) images. Multivariate survival analyses demonstrated that GLIM-defined malnutrition (p = 0.008) and loss of VAT after surgery (p = 0.008) were independent risk factors for recurrence-free survival (RFS). Evaluation of the prognostic value of combining the two independent predictors showed that malnourished patients with a marked loss of VAT had the worst 5-year RFS rate of 35.2% (p < 0.001). Preoperative GLIM-defined malnutrition and a loss of VAT during the first 6 months after surgery were independent predictors for RFS in patients with AGC. Changes in the VAT area after surgery could further enhance the prognostic value of the GLIM criteria for predicting the risk of gastric cancer recurrence.

All-cause and cause-specific mortality in patients with Behçet disease versus the general population.

BACKGROUND: The comparative risk of cause-specific mortality in patients with Behçet disease (BD) vs. the general population is not known. OBJECTIVES: To compare the risk of all-cause and cause-specific mortality in patients with BD vs. the general population. METHODS: Using data from the Korea National Health Insurance Service database for the period 2002-20, we conducted a cohort study comparing patients with BD with the general population, matched according to age and sex (1 : 4 ratio). We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality. Subgroup analyses by age and sex were done. RESULTS: We included 24 669 patients with BD and 98 676 age- and sex-matched controls [mean (SD) age 40.5 (12.9) years; 34% male]. During a mean follow-up of 11.9 years, the incidence rate (IR) of death per 100 person-years was 0.36 in patients with BD and 0.29 in controls [hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.20-1.38]. The risk of mortality was highest in the first year after BD diagnosis (HR 2.66, 95% CI 2.09-3.40). Patients with BD died more often in this period as a result of malignancy (HR 1.96, 95% CI 1.30-2.98); cardiovascular (HR 2.68, 95% CI 1.45-4.97), gastrointestinal (HR 3.50, 95% CI 1.35-9.07) and respiratory disease (HR 5.00, 95% CI 1.34-18.62); and infection (HR 3.33, 95% CI 1.02-10.92). Mortality as a result of neurological (HR 1.58, 95% CI 1.06-2.35) or genitourinary disease (HR 2.20, 95% CI 1.43-3.37) was also more common in patients with BD during the overall follow-up. Subgroup analyses showed consistent results. The risk of cardiovascular mortality vs. the general population was higher in younger patients (P = 0.006) and the risk of gastrointestinal mortality was increased in women vs. men (P = 0.04). CONCLUSIONS: This population-based cohort study revealed that the first year after diagnosis is the highest risk period for excess mortality in people with BD. The mortality burden in BD derives from a wide spectrum of organ involvement and should serve as a warning to clinicians about the systemic nature of the disease.

Behçet disease (BD) is a multisystem vasculitis (inflammation of the blood vessels) of unknown origin that commonly results in oral and genital ulcers, uveitis (eye inflammation) and skin lesions. BD is most prevalent in people from the Mediterranean to East Asia, affecting 0.4% of people in this area. Most lesions go away with time, but more severe forms that involve the cardiovascular and neurological systems can lead to death. It is estimated that people with BD have 1.4 times the risk of dying than the general population. Using large insurance databases in Korea, we investigated the risk of death in people with BD versus age- and sex-matched controls (i.e. people without the disease) from the general population. We found that patients with BD had a 28% greater risk of death than controls over 11.9 years of follow-up, with the highest risk being in first year after diagnosis. Top causes of death in people with BD included cancer, and cardiovascular, gastrointestinal, neurological, genitourinary, respiratory and infectious disease. Further analyses of the data showed that the risk of death in BD is affected by age and sex. In particular, younger patients were more susceptible to death as a result of cardiovascular disease and women were more susceptible to dying of gastrointestinal disease. Our study suggests that there could be an increased risk of death within the first year of being diagnosed with BD and highlights how BD is a systemic disease (i.e. the involvement of any internal organ system could lead to an increase in mortality). Finally, there were unique patterns of cause-specific deaths across subgroups of people with BD.

Attention-guided jaw bone lesion diagnosis in panoramic radiography using minimal labeling effort.

Developing a deep-learning-based diagnostic model demands extensive labor for medical image labeling. Attempts to reduce the labor often lead to incomplete or inaccurate labeling, limiting the diagnostic performance of models. This paper (i) constructs an attention-guiding framework that enhances the diagnostic performance of jaw bone pathology by utilizing attention information with partially labeled data; (ii) introduces an additional loss to minimize the discrepancy between network attention and its label; (iii) introduces a trapezoid augmentation method to maximize the utility of minimally labeled data. The dataset includes 716 panoramic radiograph data for jaw bone lesions and normal cases collected and labeled by two radiologists from January 2019 to February 2021. Experiments show that guiding network attention with even 5% of attention-labeled data can enhance the diagnostic accuracy for pathology from 92.41 to 96.57%. Furthermore, ablation studies reveal that the proposed augmentation methods outperform prior preprocessing and augmentation combinations, achieving an accuracy of 99.17%. The results affirm the capability of the proposed framework in fine-grained diagnosis using minimally labeled data, offering a practical solution to the challenges of medical image analysis.

Comparative Analysis of Integrated Filtering Methods Using UWB Localization in Indoor Environment.

This research delves into advancing an ultra-wideband (UWB) localization system through the integration of filtering technologies (moving average (MVG), Kalman filter (KF), extended Kalman filter (EKF)) with a low-pass filter (LPF). We investigated new approaches to enhance the precision and reduce noise of the current filtering methods-MVG, KF, and EKF. Using a TurtleBot robotic platform with a camera, our research thoroughly examines the UWB system in various trajectory situations (square, circular, and free paths with 2 m, 2.2 m, and 5 m distances). Particularly in the square path trajectory with the lowest root mean square error (RMSE) values (40.22 mm on the X axis, and 78.71 mm on the Y axis), the extended Kalman filter with low-pass filter (EKF + LPF) shows notable accuracy. This filter stands out among the others. Furthermore, we find that integrated method using LPF outperforms MVG, KF, and EKF consistently, reducing the mean absolute error (MAE) to 3.39% for square paths, 4.21% for circular paths, and 6.16% for free paths. This study highlights the effectiveness of EKF + LPF for accurate indoor localization for UWB systems.

Impact of socioeconomic status on biologics utilization in rheumatoid arthritis: revealing inequalities and healthcare efficiency.

Background/Aims: This cross-sectional study aimed to investigate biologics treatment disparities in rheumatoid arthritis (RA) patients based on socioeconomic status (SES). Methods: Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis. Results: Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60-0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use. Conclusions: The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.

Is the double-ligation method safe and effective in laparoscopic paediatric inguinal hernia repair? A retrospective cohort study.

INTRODUCTION: Laparoscopic paediatric hernia repair has since been performed more frequently. Recently, a double-ligation method was introduced to prevent recurrence in laparoscopic surgery. The objective of our study was to compare the postoperative outcomes of patients who underwent double and single ligations. PATIENTS AND METHODS: We performed a retrospective review of patients with inguinal hernia who underwent laparoscopic paediatric inguinal hernia repair from 2014 to 2018 at our institution. Patients were divided into two groups and underwent single ligation and double ligation. RESULTS: Three hundred and six patients (single-ligation group: 142 and double-ligation group: 164) were included. Four patients experienced recurrence, and the recurrence rate was 1.29%. The recurrence rate was significantly higher in the single-ligation group. There were no statistically significant differences in the postoperative complications between the two groups. CONCLUSION: Double-ligation method in laparoscopic paediatric hernia repair was relatively safe and helpful.

Resolving the non-uniformity in the feature space of age estimation: A deep learning model based on feature clusters of panoramic images.

Age estimation is important in forensics, and numerous techniques have been investigated to estimate age based on various parts of the body. Among them, dental tissue is considered reliable for estimating age as it is less influenced by external factors. The advancement in deep learning has led to the development of automatic estimation of age using dental panoramic images. Typically, most of the medical datasets used for model learning are non-uniform in the feature space. This causes the model to be highly influenced by dense feature areas, resulting in adequate estimations; however, relatively poor estimations are observed in other areas. An effective solution to address this issue can be pre-dividing the data by age feature and training each regressor to estimate the age for individual features. In this study, we divide the data based on feature clusters obtained from unsupervised learning. The developed model comprises a classification head and multi-regression head, wherein the former predicts the cluster to which the data belong and the latter estimates the age within the predicted cluster. The visualization results show that the model can focus on a clinically meaningful area in each cluster for estimating age. The proposed model outperforms the models without feature clusters by focusing on the differences within the area. The performance improvement is particularly noticeable in the growth and aging periods. Furthermore, the model can adequately estimate the age even for samples with a high probability of classification error as they are located at the border of two feature clusters.

Fanning the Flames of Endoplasmic Reticulum (ER) Stress: Can Sphingolipid Metabolism Be Targeted to Enhance ER Stress-Associated Immunogenic Cell Death in Cancer?

The three arms of the unfolded protein response (UPR) surveil the luminal environment of the endoplasmic reticulum (ER) and transmit information through the lipid bilayer to the cytoplasm to alert the cell of stress conditions within the ER lumen. That same lipid bilayer is the site of de novo synthesis of phospholipids and sphingolipids. Thus, it is no surprise that lipids are modulated by and are modulators of ER stress. Given that sphingolipids have both prosurvival and proapoptotic effects, they also exert opposing effects on life/death decisions in the face of prolonged ER stress detected by the UPR. In this review, we will focus on several recent studies that demonstrate how sphingolipids affect each arm of the UPR. We will also discuss the role of sphingolipids in the process of immunogenic cell death downstream of the protein kinase RNA-like endoplasmic reticulum kinase (PERK)/eukaryotic initiating factor 2α (eIF2α) arm of the UPR. Furthermore, we will discuss strategies to target the sphingolipid metabolic pathway that could potentially act synergistically with agents that induce ER stress as novel anticancer treatments. SIGNIFICANCE STATEMENT: This review provides the readers with a brief discussion of the sphingolipid metabolic pathway and the unfolded protein response. The primary focus of the review is the mechanism(s) by which sphingolipids modulate the endoplasmic reticulum (ER) stress response pathways and the critical role of sphingolipids in the process of immunogenic cell death associated with the ER stress response.

Compensating isotope effect on molecular emission of hydroxyl and imidogen isotopologues in laser-induced plasma.

BACKGROUND: The molecular isotopologues in laser-induced plasma exhibit riddling emission behaviors in terms of wavelength, intensity, and temporal evolution of spectra due to the isotope effect. Although this phenomenon introduces uncertainty to isotope analyses based on molecular spectra, its underlying mechanism remains undisclosed. RESULTS: In this study, laser-induced breakdown spectroscopy (LIBS) is employed to identify the emission behavior of hydrogen, oxygen, and nitrogen isotopologues in a plasma plume. The goal is to discern the details of the isotope effect and mitigate resulting uncertainty. The molecular emissions of hydroxyl (OH) and imidogen (NH) were measured from plasma ablated on isotopically enriched water samples. Time-resolved detection clearly reveals distinct isotopic disparities in intensity variation and optimum gate delay, which were attributed to plasma thermo-hydrodynamics. Lighter isotopologues exhibit earlier and faster associations than their heavier counterparts due to their fast reaction rates and expansion velocities. The extent of the isotope effect hinged on plasma characteristics governed by measurement conditions. Consequently, comparing spectral intensity between molecular isotopologues cannot directly indicate the nominal isotope abundance of the sample. To address it, a compensation strategy has been devised, quantifying isotope effects through parameters like the slope and optimum delay of time-resolved detection. The approach successfully predicts nominal isotope abundance using compensated intensity ratios, with an absolute bias of less than 3 %. SIGNIFICANCE: This study not only offered fundamental insights into the isotope effect in laser-induced plasma but also proposed an alternative method for isotope quantification that circumvents complicated calibration processes.

Echinacoside stimulates myogenesis and ATP-dependent thermogenesis in the skeletal muscle via the activation of D1-like dopaminergic receptors.

Recent studies have shown that some natural compounds from plants prevent obesity and related disorders, including the loss of skeletal muscle mass and strength. In this study, we investigated the effect of echinacoside (ECH), a caffeic acid glycoside from the phenylpropanoid class, on myogenesis and ATP-dependent thermogenesis in the skeletal muscle and its interaction with the dopaminergic receptors 1 and 5 (DRD1 and DRD5). We applied RT-PCR, immunoblot analysis, a staining method, and an assay kit to determine the effects of ECH on diverse target genes and proteins involved in skeletal muscle myogenesis and ATP-consuming futile processes. Our study demonstrated that ECH enhanced myogenic differentiation, glucose, and fatty acid uptake, as well as lipid catabolism, and induced ATP-dependent thermogenesis in vitro and in vivo. Moreover, ECH upregulated mitochondrial biogenesis proteins, mitochondrial oxidative phosphorylation (OXPHOS) complexes, and intracellular Ca2+ signaling as well as thermogenic proteins. These findings were further elucidated by mechanistic studies which showed that ECH mediates myogenesis via the DRD1/5 in C2C12 muscle cells. In addition, ECH stimulates α1-AR-mediated ATP-dependent thermogenesis via the DRD1/5/cAMP/SLN/SERCA1a pathway in C2C12 muscle cells. To the best of our knowledge, this is the first report that demonstrates the myogenic and thermogenic potential of ECH activity through the dopaminergic receptors. Understanding the novel functions of ECH in terms of its ability to prevent skeletal muscle loss and energy expenditure via ATP-consuming futile processes could help to develop potential alternative strategies to address muscle-related diseases, including combating obesity.

Pyrogenic and inflammatory mediators are produced by polarized M1 and M2 macrophages activated with D-dimer and SARS-CoV-2 spike immune complexes.

Lung macrophages are the first line of defense against invading respiratory pathogens including SARS-CoV-2, yet activation of macrophage in the lungs can lead to hyperinflammatory immune response seen in severe COVID-19. Here we used human M1 and M2 polarized macrophages as a surrogate model of inflammatory and regulatory macrophages and explored whether immune complexes (IC) containing spike-specific IgG can trigger aberrant cytokine responses in macrophages in the lungs and associated lymph nodes. We show that IC of SARS-CoV-2 recombinant S protein coated with spike-specific monoclonal antibody induced production of Prostaglandin E2 (PGE2) in non-polarized (M0) and in M1 and M2-type polarized human macrophages only in the presence of D-dimer (DD), a fibrinogen degradation product, associated with coagulopathy in COVID-19. Importantly, an increase in PGE2 was also observed in macrophages activated with DD and IC of SARS-CoV-2 pseudovirions coated with plasma from hospitalized COVID-19 patients but not from healthy subjects. Overall, the levels of PGE2 in macrophages activated with DD and IC were as follows: M1≫M2>M0 and correlated with the levels of spike binding antibodies and not with neutralizing antibody titers. All three macrophage subsets produced similar levels of IL-6 following activation with DD+IC, however TNFα, IL-1ß, and IL-10 cytokines were produced by M2 macrophages only. Our study suggests that high titers of spike or virion containing IC in the presence of coagulation byproducts (DD) can promote inflammatory response in macrophages in the lungs and associated lymph nodes and contribute to severe COVID-19.

Is wide excision really needed? Correlation between resection margin and recurrence in benign phyllodes tumors of the breast.

Purpose: Phyllodes tumors are similar to fibroadenomas in imaging and in pathological characteristics and are difficult to identify preoperatively. The purpose of this study was to analyze the recurrence rate after excision stratified by the surgical margin width and to propose and emphasize the "wait and watch" treatment strategy for benign phyllodes tumors. Methods: We performed a retrospective cohort study of patients diagnosed with benign phyllodes tumors by surgical excision between January 2000 and December 2022 at our institution. The medical and histopathological records were reviewed. Results: The results were obtained using the Cox proportional hazard regression and logistic regression. Resection margin status and recurrence were the independent variables. In each variable selection model, the resection margin was positive or less than 1 cm, and the recurrence rate was 3.7 and 1.04 times higher than the control group, but the difference was not statistically significant in 2 analyses. Conclusion: The surgical resection margin status of benign phyllodes tumors did not significantly affect locoregional recurrence. Therefore, follow-up imaging at short intervals without additional surgery is a feasible clinical option when the surgical resection margin is positive or less than 1 cm.

Estimating chronological age through learning local and global features of panoramic radiographs in the Korean population.

This study suggests a hybrid method based on ResNet50 and vision transformer (ViT) in an age estimation model. To this end, panoramic radiographs are used for learning by considering both local features and global information, which is important in estimating age. Transverse and longitudinal panoramic images of 9663 patients were selected (4774 males and 4889 females with a mean age of 39 years and 3 months). To compare ResNet50, ViT, and the hybrid model, the mean absolute error, mean square error, root mean square error, and coefficient of determination (R2) were used as metrics. The results confirmed that the age estimation model designed using the hybrid method performed better than those using only ResNet50 or ViT. The estimation is highly accurate for young people at an age with distinct growth characteristics. When examining the basis for age estimation in the hybrid model through attention rollout, the proposed model used logical and important factors rather than relying on unclear elements as the basis for age estimation.

Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction.

Purpose: To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. Materials and Methods: This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. Results: During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, p = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Conclusion: Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

Effective Properties for the Design of Basalt Particulate-Polymer Composites.

In this study, preliminary simulations were performed to manufacture thermoplastic composites that can be processed by injection. For analysis, a basalt particulate-polymer composite model was manufactured and its elastic modulus, shear modulus, thermal expansion coefficient, and thermal conductivity were predicted using finite-element analysis (FEA) and micromechanics. Polypropylene (PP), polyamide 6, polyamide 66, and polyamide (PA) were employed as the polymer matrix, with the variations in their properties investigated based on the volume fraction of basalt. The polymer-basalt composite's properties were analyzed effectively using FEA and the micromechanics model. FEA was performed by constructing a 3D model based on the homogenization technique to analyze the effective properties. The micromechanics model was analyzed numerically using the mixture rule, and the Mital, Guth, and Halpin-Tsai models. As a result, it is best to analyze the effective properties of polymer-basalt composites using the Halpin-Tsai model, and it is necessary to conduct a comparative analysis through actual experiments. In the future, actual composite materials need to be developed and evaluated based on the findings of this study.

Recurrent focal myofasciitis of Behçet syndrome mimics infectious myofasciitis: a case report.

Behçet syndrome (BS) is a chronic inflammatory disease with multiorgan manifestations. However, muscular involvement in BS has rarely been reported. Herein, we report the case of a 30-year-old male with BS who had recurring pain and swelling of the lower legs. The patient was administered antibiotics on several occasions as the condition was misinterpreted to be infectious myositis. Magnetic resonance imaging revealed myofascial involvement with focal necrotic lesions, and muscle biopsy revealed acute suppurative myositis with perivascular infiltration of polymorphonuclear leukocytes. His symptoms improved after treatment with corticosteroids. Azathioprine and colchicine therapy was beneficial for preventing further relapse after short-term corticosteroid treatment. Therefore, BS should be considered in the differential diagnosis of focal suppurative myofasciitis.

Characterization of Anticancer Effects of the Analogs of DJ4, a Novel Selective Inhibitor of ROCK and MRCK Kinases.

The Rho associated coiled-coil containing protein kinase (ROCK1 and ROCK2) and myotonic dystrophy-related Cdc-42 binding kinases (MRCKα and MRCKß) are critical regulators of cell proliferation and cell plasticity, a process intimately involved in cancer cell migration and invasion. Previously, we reported the discovery of a novel small molecule (DJ4) selective multi-kinase inhibitor of ROCK1/2 and MRCKα/ß. Herein, we further characterized the anti-proliferative and apoptotic effects of DJ4 in non-small cell lung cancer and triple-negative breast cancer cells. To further optimize the ROCK/MRCK inhibitory potency of DJ4, we generated a library of 27 analogs. Among the various structural modifications, we identified four additional active analogs with enhanced ROCK/MRCK inhibitory potency. The anti-proliferative and cell cycle inhibitory effects of the active analogs were examined in non-small cell lung cancer, breast cancer, and melanoma cell lines. The anti-proliferative effectiveness of DJ4 and the active analogs was further demonstrated against a wide array of cancer cell types using the NCI-60 human cancer cell line panel. Lastly, these new analogs were tested for anti-migratory effects in highly invasive MDA-MB-231 breast cancer cells. Together, our results demonstrate that selective inhibitors of ROCK1/2 (DJE4, DJ-Allyl) inhibited cell proliferation and induced cell cycle arrest at G2/M but were less effective in cell death induction compared with dual ROCK1/2 and MRCKα/ß (DJ4 and DJ110).