Chonnam medical journal最新文献

Roflumilast, a phosphodiesterase 4 (PDE4) inhibitor, reduces neutrophilic airway inflammation and exacerbations in chronic obstructive pulmonary disease (COPD). However, the effect of coexisting bronchiectasis on its efficacy remains unclear. This study evaluates the long-term impact of roflumilast use in this population. A retrospective cohort study was conducted using data from 2,181 COPD patients. Of them, 180 had bronchiectasis confirmed on CT, with 162 not using roflumilast and 18 receiving it. Baseline data, including demographics, symptom scores, pulmonary function, and biomarkers, were collected. Patients were followed for one year to assess exacerbations and mortality, and survivors were monitored for up to three years for symptom and pulmonary function changes. Multivariate logistic regression was performed to determine predictors of exacerbations. Moderate and severe exacerbations occurred more frequently in the roflumilast group, but mortality did not differ between groups. Roflumilast users showed significant improvements in post-bronchodilator forced expiratory volume in one second (FEV₁) (p=0.028), as well as in the ratio of forced expiratory volume in one second to the forced vital capacity (FEV₁/FVC) ratio (p=0.015) compared to no roflumilast group. In multivariate analysis, roflumilast use was independently associated with a higher exacerbation risk (p=0.004, OR=14.643, 95% CI: 2.36-90.848). While roflumilast improved pulmonary function and symptoms in COPD patients with bronchiectasis, it was also linked to a higher risk of exacerbations. These findings suggest caution in its use for this population, and further randomized controlled trials are needed to assess its safety and efficacy.

Nonalcoholic fatty liver disease (NAFLD) refers to a comprehensive range of conditions, encompassing simple steatosis to advancing nonalcoholic steatohepatitis (NASH), hepatic fibrosis, and cirrhosis. While both aerobic exercise and resistance training (RT) have been shown to provide advantages for patients with NAFLD, there is still a need to investigate and delve into the potential effectiveness of exercise mode. The purpose of this study is to investigate the effect of exercise mode in NAFLD-induced rats. Twenty-one male Wistar rats were divided into three groups: 1) normal control, 2) NAFLD, and 3) NAFLD+combined training (CT). The intervention groups received HFFD for 15 weeks to induce NAFLD. After determination of NAFLD, CT was done for 8 weeks. Aspartate transaminase (AST) and triglyceride (TG) were significantly reduced in the NAFLD+CT compare to NAFLD.While there was no significant difference in the Low-density lipoprotein (LDL), AST, and alkaline phosphatase (ALP) in the NAFLD+CT. CT can lead to a reduction in liver fat content, improved liver function, and lowered levels of TG and cholesterol that causes improvement of NAFLD. Therefore, they can be used to reduce the complications of NAFLD. Although more studies are needed to confirm the results.

The close interaction of follicular fluid with oocytes influences their maturation. The presence of the germinal vesicle (GV) has been reported in women with polycystic ovary syndrome (PCOS). The present study aimed to measure sirtuin1 (SIRT1) levels, aromatase activity index and insulin resistance in follicular fluid and to investigate their association with in vitro fertilization (IVF) success in PCOS women. In this case-control study, 35 women with PCOS and 35 healthy women matched for body mass index (BMI) were included. After the collection of the follicular fluid from all participants, concentrations of SIRT1, insulin, and aromatase activity were measured. Retrieved oocyte status, embryo quality, and biochemical pregnancy were monitored during follow-up in the participants. In women with PCOS, there were notable reductions in SIRT1 levels and aromatase activity, along with an increase in the HOMA- Index. Negative correlations were observed between SIRT1 and aromatase activity with the number of GVs. SIRT1 concentration and aromatase activity showed positive correlation with the ratio of available embryos to the number of oocytes in metaphase II. Logistic regression analysis showed that chance of biochemical pregnancy increases significantly with an increase in aromatase activity and SIRT1 level in follicular fluid (p<0.05). Our findings showed that the reduced SIRT1 level and aromatase activity in follicular fluid are involved with the pathogenesis of PCOS. These findings suggest that increasing in aromatase activity and SIRT1 levels may improve oocytes quality and ultimately increase the chances of IVF success in PCOS women.

Subclinical cerebral infarction might be developed even adequate oral anticoagulation after direct current cardioversion (DCCV) in patients with atrial fibrillation (AF). Although apixaban is preferred to prevent thromboembolism and minimize bleeding risk in patients with AF, clinical outcomes after DCCV have not been known well. This study aimed to compare the occurrence of subclinical infarction between apixaban and warfarin in patients with AF after DCCV. A total of 60 patients diagnosed with non-valvular AF were randomized to receive either Apixaban or warfarin. At least 3-week anticoagulation was warranted before DCCV. Brain magnetic resonance image (MRI) was checked 3 days later after DCCV. All of the patients were followed upto 1-month. The primary end-point was the occurrence of subclinical infarction, while secondary end-point included death, stroke, and hospitalization due to heart failure. Safety end-point focused on major bleeding. Micro-embolic infarction causing subclinical infarction were not observed in the warfarin group, while 1 patient (4.3%) in the apixaban group, without statistical difference. Stroke and hospitalization were not developed at both groups. Brain MRI revealed micro-bleeding in 1 patient (4.3%) in the apixaban group, while there was no major or micro-bleeding in the warfarin group. The incidence of micro-embolic events causing subclinical infarction following DCCV was comparable between apixaban and warfarin. Clinical outcomes after DCCV were comparable between the 2 groups. These findings suggest that both apixban and warfarin exhibit similar safety and efficacy profiles during DCCV.

This retrospective study compared cement penetration, the radiolucent line (RLL) incidence, and clinical outcomes in total knee arthroplasty (TKA) using high-viscosity cement (HVC) versus low-viscosity cement (LVC) with a minimum follow-up of two years. We hypothesized that LVC would result in superior cement penetration and a reduced RLL incidence compared with HVC without differences in clinical outcomes. A total of 100 patients (50 HVC, 50 LVC) who underwent TKA with the same implant design were included. Cement penetration was assessed in four tibial and two femoral zones. Clinical outcomes including the VAS, WOMAC, KSS, KOOS and FJS were evaluated preoperatively and at the final follow-up visit. Postoperative complications were recorded. LVC demonstrated significantly greater cement penetration in the posterior tibial zone (3.03 mm vs. vs 2.82 mm; p=0.005) and posterior femoral zone (1.76 mm vs. 1.39 mm; p<0.000) than HVC, and no differences were observed in other zones. The RLL incidence and rates of complications including aseptic loosening and prosthetic joint infection were comparable between groups. Both groups showed significant postoperative improvements in the WOMAC, KSS, and KOOS, with no intergroup differences preoperatively and postoperatively. LVC demonstrated superior cement penetration in select zones, which may enhance implant fixation. However, there were no differences in the RLL incidence or clinical outcomes between the HVC and LVC groups. Both cements provided satisfactory fixation and clinical results, suggesting that either may be appropriate based on surgical preferences and fixation goals.

Rabies continues to pose a serious public health threat worldwide, with vaccination being the most effective means of prevention. However, commercially available inactivated rabies vaccines often require multiple doses and lack potent adjuvants to enhance their efficacy. This study aimed to investigate the coupling of whole inactivated rabies virus to mannan under oxidizing conditions to improve immune responses against a standard rabies vaccine. We explored the conjugation of whole inactivated rabies virus with oxidized mannan (Rab-OxMan) to enhance immune responses. Mice were immunized intraperitoneally with 350 µg of the Rab-OxMan formulation on days 1 and 7. Two weeks after immunization, serum samples were collected to measure levels of IgG, IgM, and TNF-α using ELISA. The vaccine's potency was also evaluated using the National Institutes of Health (NIH) assay. Our findings showed a significant increase in IgG levels and a decrease in IgM levels in the Rab-OxMan group compared to the Alum-adjuvanted vaccine group (p<0.05). Additionally, TNF-α levels were notably higher in the Rab-OxMan group (p<0.05). Statistical analysis revealed that IgG levels had the highest sensitivity and specificity, with a significant correlation between the measured variables. Importantly, the Rab-OxMan formulation provided 1.8 times greater protection in challenge tests compared to the alum-adjuvanted group. This study is the first to demonstrate that oxidized mannan can serve as a novel adjuvant for veterinary rabies vaccines. The results highlight significant improvements in the immunogenicity and efficacy of rabies vaccines, suggesting a promising strategy for enhancing rabies prevention and potentially reducing the incidence of this deadly disease.