Thyroid Isthmus Length and Iodine Turnover as Predictors of Successful Radioactive Iodine Therapy in Patients with Graves’ Disease

Radioactive iodine (RAI) therapy is an effective treatment option for Graves’ disease. However, predicting treatment failures after RAI therapy remains controversial. The objective of this study was to investigate the factors associated with the success rate of RAI therapy for treatment of Graves’ hyperthyroidism. Thyroid functional outcome, pre-RAI ultrasonographic features, and clinical parameters were evaluated retrospectively in 98 patients followed up for at least 12 months after RAI (mean RAI dose was 11.7 ± 1.8 mCi). Hypothyroidism was achieved in 59 patients (60.2%), and euthyroidism in 16 patients (16.3%), while 23 patients (23.5%) remained hyperthyroid. Age, sex, body mass index, pre-RAI thyroid function, or thyroid-stimulating immunoglobulin levels were not associated with treatment outcome. Length of thyroid isthmus (p=0.028) and 2- to 24-hour iodine uptake ratios (p=0.002) were significantly associated with treatment failure, which was defined as a persistent hyperthyroid status after RAI therapy. Patients with a longer isthmus had a higher risk of remaining hyperthyroid, with a threshold for isthmus length of 5.2 mm, with a sensitivity of 69.6% and specificity of 70.3% for treatment success. Measuring the length of the thyroid isthmus can be a simple and useful way to predict RAI treatment outcome

Nearly 100% Horizontal Dipole Orientation and Upconversion Efficiency in Blue Thermally Activated Delayed Fluorescent Emitters

The relationship between anisotropic orientation and molecular structure of thermally activated delayed fluorescent (TADF)‐based organic light emitting devices (OLEDs) is studied using TADF emitters with carbazole, biscarbazole, and triscarbazole donor units. The bicarbazole and triscarbazole donors are more effective than the carbazole donor in driving the anisotropic orientation of the TADF molecules. A near‐perfect in‐plane orientation of the TADF dipole moment is demonstrated using the triscarbazole donor. In addition, the triscarbazole donor based OLED shows high photoluminescence quantum yield and an upconversion efficiency close to 100%. As a consequence, an external quantum efficiency >30% is obtained.A systematic study correlating donor structure with horizontal dipole orientation of blue triscarbazole thermally activated delayed fluorescent (TADF) emitters shows an exceptionally high horizontal dipole orientation of 95%. The dipole orientation and high photoluminescence quantum yield result in an external quantum efficiency >30% in organic light‐emitting diodes employing these TADF emitters.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145231/1/adom201701340.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145231/2/adom201701340_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145231/3/adom201701340-sup-0001-S1.pd

Spontaneous Non-Traumatic Stress Fractures in Bilateral Femoral Shafts in a Patient Treated with Bisphosphonates

Bisphosphonates are potent inhibitors of bone resorption and widely used to treat osteoporosis. Extensive studies have shown that therapy with bisphosphonates improves bone density and decreases fracture risk. However, concerns have been raised about potential over-suppression of bone turnover during long-term use of bisphosphonates, resulting in increased susceptibility to and delayed healing of non-spinal fractures. We report a patient who sustained non-traumatic stress fractures in bilateral femoral shafts with delayed healing after long-term bisphosphonate therapy. She underwent open reduction and surgical internal fixation. Although bisphosphonates effectively prevent vertebral fractures, and their safety has been tested in randomized trials, we must emphasize the need for awareness of the possibility that long-term suppression of bone turnover with bisphosphonates may eventually lead to an accumulation of fatigue-induced damage and adverse skeletal effects such as delayed fracture healing

Ion-selective and chemical-protective elastic block copolymer interphase for durable zinc metal anode

Aqueous rechargeable batteries based on zinc anodes are among the most promising systems to replace conventional lithium-ion batteries owing to their intrinsic safety, high ionic conductivity, and economic benefits. However, inferior reversibility of zinc anode resulting from zinc dendrites and surface side reactions limits the practical realization of zinc-ion batteries. Herein, we develop a thin but robust polymeric artificial interphase to enhance reversibility of zinc anode. The grafted maleic anhydride groups in the polymer structure restrain the detrimental reactions through selective zinc-ion penetration and homogenize ion distribution, leading to a smooth electrode surface after plating-stripping processes. Consequently, the coated zinc anode shows excellent stability with a long-term symmetric cell lifespan (>3,000 h at 3 mA??cm???2) and maintains capacity retention of 80% after 2,500 cycles, paired with a manganese oxide cathode. This study provides a facile fabrication process and accessible analysis methods to rationalize the development of high-performance zinc-ion batteries

Comparison of the Effectiveness of Interventional Endoscopy in Bleeding Peptic Ulcer Disease according to the Timing of Endoscopy

Background/Aims: The optimal timing for interventional endoscopy in bleeding peptic ulcer disease is controversial. This study compared the outcomes between early endoscopy and delayed endoscopy in patients with bleeding peptic ulcer disease. Methods: We conducted a prospective analysis of data from 90 patients with bleeding peptic ulcer disease who visited the emergency room between May 2006 and September 2007. Patients were categorized into two groups: the early-endoscopy group (admitted during the daytime or at night with prompt endoscopic management) and the delayed-endoscopy group (admitted at night or during weekends, with endoscopic management delayed until the next day). We compared the clinical outcomes of endoscopy between the two groups. Results: There were 49 patients in the early-endoscopy group and 41 patients in the delayed-endoscopy group. Patient demographics, clinical characteristics, bleeding control modality, and Rockall score did not differ between the two groups. There were also no significant differences between the early- and delayed-encloscopy groups 'in the re-bleeding rate (3/49 vs 5/41, p=0.313), the duration of hospital stay (10.7 vs 9.3 days, p=0.437), and the total amount of blood transfused (3.4 vs 2.7 units, p=0.240). Conclusions: The effectiveness of interventional endoscopy for patients with bleeding peptic ulcer disease is not significantly affected by the timing of endoscopy. (Gut and Liver 2009;3:266-270)This work was supported by the research fund of Hanyang University Industrial Digital Park (200700000005845)

Body mass index and mortality in patients with cardiovascular disease: An umbrella review of meta-analyses

OBJECTIVE: Although many previous meta-analyses of epidemiological studies have demonstrated a relationship between body mass index (BMI) and mortality, inconsistent findings among cardiovascular disease patients have been observed. Thus, we performed an umbrella review to understand the strength of evidence and validity of claimed associations between BMI and mortality in patients with cardiovascular diseases. MATERIALS AND METHODS: We comprehensively re-analyzed the data of meta-analyses of observational studies and randomized controlled trials on associations between BMI and mortality among patients with cardiovascular diseases. We also assessed the strength of evidence of the re-analyzed outcomes, which were determined from the criteria including statistical significance of the p-value of random-effects, as well as fixed-effects meta-analyses, small-study effects, between-study heterogeneity, and a 95% prediction interval. RESULTS: We ran comprehensive re-analysis of the data from the 21 selected studies, which contained a total of 108 meta-analyses; 23 were graded as convincing evidence and 12 were suggestive, 42 were weak, and 23 were non-significant. CONCLUSIONS: Underweight increased mortality in acute coronary syndrome (ACS), heart failure, and after therapeutic intervention for patients with cardiovascular diseases. Overweight, on the other hand decreased mortality in patient’s ACS, atrial fibrillation, and heart failure with convincing evidence

Genome-Wide Association Study in East Asians Identifies Novel Susceptibility Loci for Breast Cancer

Genetic factors play an important role in the etiology of both sporadic and familial breast cancer. We aimed to discover novel genetic susceptibility loci for breast cancer. We conducted a four-stage genome-wide association study (GWAS) in 19,091 cases and 20,606 controls of East-Asian descent including Chinese, Korean, and Japanese women. After analyzing 690,947 SNPs in 2,918 cases and 2,324 controls, we evaluated 5,365 SNPs for replication in 3,972 cases and 3,852 controls. Ninety-four SNPs were further evaluated in 5,203 cases and 5,138 controls, and finally the top 22 SNPs were investigated in up to 17,423 additional subjects (7,489 cases and 9,934 controls). SNP rs9485372, near the TGF-β activated kinase (TAB2) gene in chromosome 6q25.1, showed a consistent association with breast cancer risk across all four stages, with a P-value of 3.8×10−12 in the combined analysis of all samples. Adjusted odds ratios (95% confidence intervals) were 0.89 (0.85–0.94) and 0.80 (0.75–0.86) for the A/G and A/A genotypes, respectively, compared with the genotype G/G. SNP rs9383951 (P = 1.9×10−6 from the combined analysis of all samples), located in intron 5 of the ESR1 gene, and SNP rs7107217 (P = 4.6×10−7), located at 11q24.3, also showed a consistent association in each of the four stages. This study provides strong evidence for a novel breast cancer susceptibility locus represented by rs9485372, near the TAB2 gene (6q25.1), and identifies two possible susceptibility loci located in the ESR1 gene and 11q24.3, respectively

Empirical assessment of biases in cerebrospinal fluid biomarkers of Alzheimer's disease: an umbrella review and re-analysis of data from meta-analyses

OBJECTIVE: Alzheimer’s disease (AD) is a leading cause of years lived with disability in older age, and several cerebrospinal fluid (CSF) markers have been proposed in individual meta-analyses to be associated with AD but field-wide evaluation and scrutiny of the literature is not available. MATERIALS AND METHODS: We performed an umbrella review for the reported associations between CSF biomarkers and AD. Data from available meta-analyses were reanalyzed using both random and fixed effects models. We also estimated between-study heterogeneity, small-study effects, excess significance, and prediction interval. RESULTS: A total of 38 meta-analyses on CSF markers from 11 eligible articles were identified and reanalyzed. In 14 (36%) of the meta-analyses, the summary estimate and the results of the largest study showed non-concordant results in terms of statistical significance. Large heterogeneity (I2≥75%) was observed in 73% and small-study effects under Egger’s test were shown in 28% of CSF biomarkers. CONCLUSIONS: Our results suggest that there is an excess of statistically significant results and significant biases in the literature of CSF biomarkers for AD. Therefore, the results of CSF biomarkers should be interpreted with caution

Suicide associated with COVID-19 infection: an immunological point of view

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a pandemic and leading cause of death. Beyond the deaths directly caused by the virus and the suicides related to the psychological response to the dramatic changes as socioeconomic related to the pandemic, there might also be suicides related to the inflammatory responses of the infection. Infection induces inflammation as a cytokine storm, and there is an increasing number of studies that report a relationship between infection and suicide. MATERIALS AND METHODS: We searched the World Health Organization status report and the PubMed database for keywords (COVID-19, suicide, infection, inflammation, cytokines), and reviewed five cytokine pathways between suicide and inflammation using two meta-analyses and two observational studies starting from November 31, 2020, focusing on the relationship between suicide and inflammation by infection. First, we discussed existing evidence explaining the relationship between suicidal behaviors and inflammation. Second, we summarized the inflammatory features found in COVID-19 patients. Finally, we highlight the potential for these factors to affect the risk of suicide in COVID-19 patients. RESULTS: Patients infected with COVID-19 have high amounts of IL-1β, IFN-γ, IP10, and MCP1, which may lead to Th1 cell response activation. Also, Th2 cytokines (e.g., IL-4 and IL-10) were increased in COVID-19 infection. In COVID-19 patients, neurological conditions, like headache, dizziness, ataxia, seizures, and others have been observed. CONCLUSIONS: COVID-19 pandemic can serve as a significant environmental factor contributing directly to increased suicide risk; the role of inflammation by an infection should not be overlooked