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    Cryopreservation of primary neonatal rat oligodendrocytes and recapitulation of in vitro oligodendrocyte characteristics

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    Introduction: In vitro, primary rat oligodendrocytes (OLs) are widely used for research on OL development, physiology, and pathophysiology in demyelinating diseases such as multiple sclerosis. Primary culture methods for OLs from rats have been developed and improved over time, but there are still multiple aspects in which efficiency can be boosted. Methods: To make use of excess oligodendrocyte progenitor cells (OPCs) from primary cultures, a cryopreservation process utilizing a commercially available serum-free cryopreservation medium was established to passage and freeze OPCs at −80°C for later use. Results: Cryopreserved OPCs stored for up to 6 months were viable, and retained their OL lineage purity of ~98%. While OPCs cryopreserved for 3–6 months showed a decrease in cell density after two days of proliferation, ~17% of cryopreserved OPCs maintained the potential for proliferation comparable to control OPCs that had not frozen. After induction of differentiation for four days, ~43% of both control and cryopreserved OPCs differentiated into mature OLs, and when differentiation was induced on aligned nanofibers mimicking axonal structure, myelin sheath-like structures indicative of in vitro myelination was observed in all experimental groups. Conclusion: The validation of cryopreserved primary OLs as a functionally robust in vitro model can help improve the efficiency of primary OL culture, expand its applications, and reduce the inevitable sacrifice of animals

    Change of Lip Curvature Through Extraction and Non-Extraction Orthodontic Treatment

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    Backgroud: Orthodontic treatment plans face challenges when deciding on tooth extraction, particularly when the retraction of incisors leads to a flattening of the lip curvature. Despite the significance of this issue, quantitative measurements of curvature have not been previously undertaken. This study presents novel soft tissue measurements, namely SAL (A’toSn-Ls) depth, SAL angle, PBL (B’toLi-Pg) depth, and angle, as tools for assessing lip curvature. The aim of this study was to assess whether new parameters demonstrated more pronounced flattening of the upper and lower lips in the extraction group compared to the non-extraction group. Methods: A total of sixty-two patients diagnosed with skeletal Class I malocclusion and treated with extraction or non-extraction orthodontic treatment were included and compared. Cephalometric measurements were analyzed and compared between the initial and final stages of treatment. Results: The difference in SAL (1.99°) and PBL (4.41°) angles and other soft tissue measurements between the groups was not statistically significant. Multiple regression analysis yielded the equation: ΔSAL = 0.66ΔU1 tip – 0.98ΔL1 tip – 1.58. Conclusions: Flattening of the upper lip was not significantly displayed on moderate anchorage. Consequently, orthodontic treatment accompanying the retraction of the upper incisors does not always result in obtuse lip profiles

    Psychological Distress and Influencing Factors in Newly Diagnosed Patients with Breast Cancer: A Cross-Sectional Study

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    Purpose: Cancer diagnosis is associated with psychological distress, which often leads to a significant reduction in adaptation and quality of life. This study aimed to identify the prevalence and related factors of psychological distress in newly diagnosed breast cancer patients. Methods: The study included 138 women scheduled for surgery or neoadjuvant chemotherapy following a recent breast cancer diagnosis at a university hospital in Korea. Psychological distress was assessed using the National Comprehensive Cancer Network Distress Thermometer and problem lists. Data collection occurred from November 1, 2021, to November 30, 2022. Descriptive statistics and logistic regression analysis were utilized for data analysis. Results: The average age of the participants was 51.72 years. Among the 138 participants, 67.4% (n=93) reported moderate to severe levels of psychological distress. Multivariate logistic regression analysis identified financial burden (Odds Ratio [OR]=4.32), fears (OR=5.35), and nervousness (OR=5.50) as predictors of moderate to severe psychological distress. Conclusion: Approximately two-thirds of newly diagnosed breast cancer patients experienced significant psychological distress. Nervousness, fears, and financial burden were significant factors influencing this distress. Therefore, management of psychological distress should be implemented for patients experiencing financial burdens or emotional problems, such as nervousness and fear, from the time of diagnosis

    Efficacy and safety of dapagliflozin in children with kidney disease: real-world data

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    Background: Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, has shown results in slowing estimated glomerular filtration rate (eGFR) decline and reducing proteinuria in adult patients with chronic kidney disease. This retrospective study examines dapagliflozin’s effects in 22 children with kidney disease and proteinuria. Methods: Children with a median age of 15.6 years were treated with dapagliflozin for > 3 months between July 2022 and December 2023. All children had been treated with either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker for at least 1 month before starting dapagliflozin. Results: The most common kidney disease diagnoses in this study included Alport syndrome (n = 7) and medication-resistant nephrotic syndrome or focal segmental glomerulosclerosis (n = 7). After 6.1 months of treatment, dapagliflozin treatment did not result in significant changes in eGFR or proteinuria. However, at the latest follow-up, a statistically significant decrease in eGFR was noted (65.5 compared to the baseline 71.1 mL/min/1.73 m2, P = 0.003). Proteinuria remained stable between baseline and the last follow-up (final spot urine protein/creatinine ratio (uPCR) 0.7 vs. baseline uPCR 0.6 mg/mg, P = 0.489). In the subgroup analysis of children treated for > 8 months, the eGFR decline post-treatment changed from − 0.5 to − 0.2 ml/min/1.73 m2 per month (P = 0.634). Only two children discontinued dapagliflozin due to suspected adverse events. Conclusions: Dapagliflozin has not been associated with serious side effects. Further prospective clinical trials are needed to confirm the efficacy and safety of dapagliflozin in children with kidney disease. Graphical abstract: (Figure presented.

    Kidney replacement therapy trends in end-stage kidney disease patients in South Korea during the COVID-19 pandemic

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    Background/Aims: The corona virus disease 2019 posed a major risk for end-stage kidney disease (ESKD) cases. Our study aimed to assess changes in kidney replacement therapy (KRT) trends and healthcare access for these patients during the pandemic. Methods: We retrospectively analyzed nationwide data from July 2017 to June 2022 to assess changes in KRT and ESKD incidence. KRT modalities included peritoneal dialysis (PD), hemodialysis (HD), and kidney transplantation (KT). We utilized the interrupted time series (ITS) method to compare changes in KRT modality before and after the incidence of the COVID-19 pandemic. Results: ESKD incidence remained stable from 2018 to April 2022. The ITS analysis confirmed that the pandemic did not significant impact overall KRT incidence. PD cases decreased (5.7% to 1.3%), while HD cases increased (81.6% to 85%), and KT recipient remained relatively stable (12.7% to 17.3%). The hospitalization and hospital stay decreased in nursing hospital (165.01 days to 147.77 days) and general hospital (61.34 days to 55.58 days) during the pandemic, however, remained un-changed for PD and KT. Conclusions: Our findings indicate no significant changes in ESKD incidence in South Korea during the pandemic. However, there were shifts in modality distribution, with decreased PD and increased HD cases. Notably, HD cases showed a significant reduction in hospital admissions and length of stay. The healthcare system demonstrated stability during the pandemic, with minimal disruptions in ESKD care

    Safety of the Herbal Medicine SH003 in Patients With Solid Cancer: A Multi-Center, Single-Arm, Open-Label, Dose-Escalation Phase I Study

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    Background: SH003, a novel herbal medicine comprising Huang-Qi, Dang-Gui, and Gua-Lou-Gen, has historical roots in traditional medicine with reported anticancer properties. The need to explore safe and effective treatments in oncology underlines the importance of this study. Methods: This phase I trial, conducted at Ajou University Hospital and Gachon University Gil Medical Center in Korea, adopted a single-arm, open-label, dose-escalation design. It aimed to evaluate the safety of escalated doses of SH003 in patients with various solid cancers, focusing on determining its maximum tolerated dose. Participants with confirmed solid cancers, unresponsive to standard treatments, were enrolled. The dosage of SH003 was escalated from 4800 to 9600 mg per day, using a 3 + 3 design. Safety was assessed based on the Common Terminology Criteria for Adverse Events ver. 5.0. Results: The study established that the maximum tolerated dose of SH003 is 9600 mg/day. Most adverse events were mild, primarily including dizziness and nausea, indicating the tolerability of SH003 at this dosage. Conclusions: SH003 demonstrates safety and promises as an anticancer treatment at doses up to 9600 mg/day. This research supports further investigation into its efficacy for cancer therapy, emphasizing the significance of natural products in oncology, particularly concerning patient safety and tolerance

    Development and Validation of Deep Learning-Based Infectivity Prediction in Pulmonary Tuberculosis Through Chest Radiography: Retrospective Study

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    Background: Pulmonary tuberculosis (PTB) poses a global health challenge owing to the time-intensive nature of traditional diagnostic tests such as smear and culture tests, which can require hours to weeks to yield results. Objective: This study aimed to use artificial intelligence (AI)-based chest radiography (CXR) to evaluate the infectivity of patients with PTB more quickly and accurately compared with traditional methods such as smear and culture tests. Methods: We used DenseNet121 and visualization techniques such as gradient-weighted class activation mapping and local interpretable model-agnostic explanations to demonstrate the decision-making process of the model. We analyzed 36,142 CXR images of 4492 patients with PTB obtained from Severance Hospital, focusing specifically on the lung region through segmentation and cropping with TransUNet. We used data from 2004 to 2020 to train the model, data from 2021 for testing, and data from 2022 to 2023 for internal validation. In addition, we used 1978 CXR images of 299 patients with PTB obtained from Yongin Severance Hospital for external validation. Results: In the internal validation, the model achieved an accuracy of 73.27%, an area under the receiver operating characteristic curve of 0.79, and an area under the precision-recall curve of 0.77. In the external validation, it exhibited an accuracy of 70.29%, an area under the receiver operating characteristic curve of 0.77, and an area under the precision-recall curve of 0.8. In addition, gradient-weighted class activation mapping and local interpretable model-agnostic explanations provided insights into the decision-making process of the AI model. Conclusions: This proposed AI tool offers a rapid and accurate alternative for evaluating PTB infectivity through CXR, with significant implications for enhancing screening efficiency by evaluating infectivity before sputum test results in clinical settings, compared with traditional smear and culture tests

    Automated Diagnosis of Knee Osteoarthritis Using ResNet101 on a DEEP:PHI: Leveraging a No-Code AI Platform for Efficient and Accurate Medical Image Analysis

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    Background: Knee osteoarthritis (OA) is a prevalent degenerative joint disease significantly impacting global health. Early and accurate diagnosis is crucial for effective management, but traditional methods often rely on subjective assessments. This study evaluates the efficacy of a deep learning model implemented through a no-code AI platform for diagnosing and grading knee OA from plain radiographs. Methods: We utilized the Osteoarthritis Initiative (OAI) dataset, comprising knee X-ray data from 1526 patients. The data were split into training (47.0%), validation (26.5%), and test (26.5%) sets. We employed a ResNet101 model on the DEEP:PHI no-code AI platform for image analysis. The model was trained to classify knee OA into five grades (0–4) based on the Kellgren–Lawrence scale. Results: Our AI model demonstrated high accuracy in distinguishing between different OA grades, with particular strength in early-stage detection. The model achieved optimal performance at 20 epochs, suggesting efficient learning dynamics. Grad-CAM visualizations were used to enhance the interpretability of the model’s decision-making process. Conclusions: This study demonstrates the potential of AI, implemented through a no-code platform, to accurately diagnose and grade knee OA from radiographs. The use of a no-code AI platform such as DEEP:PHI represents a step towards democratizing AI in healthcare, enabling the rapid development and deployment of sophisticated medical AI applications without extensive coding expertise. This approach could significantly enhance the early detection and management of knee OA, potentially improving patient outcomes and streamlining clinical workflows

    Effects of grit, calling, and resilience on the retention intention of general hospital nurses

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    Aim: This study aimed to determine the influence of personal factors such as grit, calling, and resilience on nurses’ retention intention in South Korean general hospitals. Background: The global shortage and high turnover rate of nurses have become significant concerns with no clear solutions for increasing retention. Introduction: Determining the factors related to the f general hospital nurses and retention intention is important for solving the problem of inadequate nursing personnel and improving the quality of nursing services. Methods: This study was a descriptive survey of 221 nurses working at a general hospital in South Korea from July 2021 to February 2022. Data were collected using self-reported online questionnaires, with measurement tools focusing on grit, calling, resilience, and retention intention. The STROBE checklist was used for reporting this study. Results: The average retention intention score was 5.35 ± 1.52 out of 8 points. Significant correlations were found between retention intention and grit, calling, and resilience. The factors influencing retention intention were job satisfaction, calling, marital status, and total career length, explaining 31.9% of the variance. Conclusions: To enhance nurses’ intention to remain at general hospitals, their job satisfaction and sense of a calling should be improved. Further research should be conducted to identify factors that influence retention intention, particularly among groups with low job retention, with consideration of individual characteristics that might affect retention intention. Implications for nursing and health policy: Increasing nurses’ retention intention would alleviate the nursing shortage, help hospitals retain competent nurses, reduce turnover-related costs, and improve organizational efficiency. Resolving the nursing shortage is critical for improving patient safety and nursing service quality at general hospitals

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