Support from superiors reduces depression in Republic of Korea military officers.

BACKGROUND: The prevalence of depression is relatively high in the Korean military. Social support is a protective factor against depression and is classified into four categories: emotional support-having the sense of feeling loved; instrumental support-receiving material assistance; informational support-receiving advice; appraisal support-feeling valued and respected for one's abilities. OBJECTIVE: To investigate the effect of support from one's superior on depression among Republic of Korea (ROK) military officers. METHODS: 2047 participants from the 2015 Military Health Survey were included in the study. The Korean version of the Beck Depression Inventory was used to measure depression, and a self-reported questionnaire was used to assess support from one's superior. A chi-squared test and multiple logistic regression were used to analyse the data. RESULTS: Of the 2047 participants, 177 (8.6%) had depression. Military officers who did not receive support from their superior were more likely to have depression than than those who did receive support (OR=2.09, 95% CI 1.30 to 3.36). Additionally, military personnel who did not receive emotional or appraisal support were more likely to have depression (emotional support: OR=2.37, 95% CI 1.31 to 4.29; appraisal support: OR=1.56, 95% CI 1.48 to 2.75). CONCLUSIONS: Our study found that depression in military officers was associated with lack of support from superiors. In particular, emotional support and appraisal support had a statistically significant effect. Therefore, we suggest that the ROK armed forces consider early intervention and management for high-risk groups. A social support programme and organisational atmosphere are also needed to improve supportive ability and skills of superiors.

Assessment of myocardial perfusion in the empty beating porcine heart with laser Doppler flowmetry.

Laser Doppler flowmetry was applied to the empty beating heart of six pigs. Cardiopulmonary bypass was instituted and the preparation allowed continuous and simultaneous measurement of coronary sinus blood flow and local tissue perfusion. An epicardial and an intramuscular probe were used. Significant linear correlation coefficients were obtained between changes of laser Doppler signal and coronary sinus blood flow changes in all seven experiments in four animals (r from 0.71 to 0.94, p less than 0.005) and between laser Doppler signal and changes of extracorporeal bypass in five out of six experiments in four animals (r from 0.82 to 0.99, p less than 0.001). The correlation between coronary sinus flow and bypass flow of four pigs was significant (r from 0.81 to 0.98, p less than 0.001), the coronary flow being about 10% of bypass flow. Muscular activity of the heart contributed to the laser Doppler signal, the magnitude of this "noise level" varying between different experiments even in the same animal. A key question for the applicability of laser Doppler flowmetry to the beating heart is whether it will become possible to discriminate between flow and muscular contribution to the laser Doppler output.

Structural study of novel antimicrobial peptides, nigrocins, isolated from Rana nigromaculata.

Novel cationic antimicrobial peptides, named nigrocin 1 and 2, were isolated from the skin of Rana nigromaculata and their amino acid sequences were determined. These peptides manifested a broad spectrum of antimicrobial activity against various microorganisms with different specificity. By primary structural analysis, it was revealed that nigrocin 1 has high sequence homology with brevinin 2 but nigrocin 2 has low sequence homology with any other known antimicrobial peptides. To investigate the structure-activity relationship of nigrocin 2, which has a unique primary structure, circular dichroism (CD) and homonuclear nuclear magnetic resonance spectroscopy (NMR) studies were performed. CD investigation revealed that nigrocin 2 adopts mainly an alpha-helical structure in trifluoroethanol (TFE)/H(2)O solution, sodium dodecyl sulfate (SDS) micelles, and dodecylphosphocholine micelles. The solution structures of nigrocin 2 in TFE/H(2)O (1:1, v/v) solution and in SDS micelles were determined by homonuclear NMR. Nigrocin 2 consists of a typical amphipathic alpha-helix spanning residues 3-18 in both 50% TFE solution and SDS micelles. From the structural comparison of nigrocin 2 with other known antimicrobial peptides, nigrocin 2 could be classified into the family of antimicrobial peptides containing a single linear amphipathic alpha-helix that potentially disrupts membrane integrity, which would result in cell death.

Adverse effects of hyperoxemia during cardiopulmonary bypass.

OBJECTIVE: Aiming at elucidating the effects on capillary blood flow and tissue oxygenation of hyperoxemia during cardiopulmonary bypass, we studied skeletal muscle surface oxygen tensions in 10 patients undergoing elective cardiac operations. METHODS: In a prospective investigation each patient was exposed to normoxemia (arterial oxygen tension 75 to 115 mm Hg) and hyperoxemia (arterial oxygen tension > 185 mm Hg, inspired oxygen fraction = 1.00) during normal anesthetized conditions before and after cardiopulmonary bypass, as well as during normothermic and hypothermic continuous-flow bypass. In each state hemodynamic variables and arterial and mixed venous blood gas and acid base values were measured. From these data oxygen transport variables were calculated. Tissue oxygenation was studied with the use of a multiple-point polarographic oxygen microelectrode, known to provide measures of oxygen tensions at the capillary level. The oxygen distribution profile of such a sample is also indicative of capillary blood flow distribution changes. RESULTS: In all patients and at each occasion of the investigation markedly low mean surface oxygen tensions in skeletal muscle were registered. When hyperoxemia was instituted, a significant decrease in these surface oxygen tensions together with an increase in distribution heterogeneity was seen during all stages. Contrary to prebypass, postbypass, and hypothermic bypass, where vascular resistance, oxygen delivery, and oxygen consumption remained similar during hyperoxemia and normoxemia, a significant (p < 0.05) increase in vascular resistance together with a decline in oxygen consumption was seen during hyperoxemic normothermic (35 degrees to 36 degrees C) cardiopulmonary bypass. CONCLUSION: These findings show that the microcirculatory response to hyperoxemia, seen under other circumstances, persists during continuous-flow cardiopulmonary bypass, normothermic as well as hypothermic. If these adverse effects on tissue oxygenation by hyperoxemia can be further verified and shown to be valid for other organs than skeletal muscle, we would suggest that hyperoxemia should be avoided, especially during normothermic cardiopulmonary bypass.

Binding aspects of baicalein to HIV-1 integrase.

Human immunodeficiency virus type 1 (HIV-1) integrase is an essential enzyme in the life cycle of the virus. It is responsible for catalyzing the insertion of the viral genome into the host cell chromosome. This integrase is an attractive target for the design of a HIV antiviral drug, because integrase has no human counterpart. In order to know the interaction mode of HIV-1 integrase with its inhibitor, we investigated the effect of the inhibitor, baicalein, on the conformation of the HIV-1 integrase catalytic domain [IN-(50-212/F185K)] using fluorescence and circular dichroism (CD) spectroscopy. We found that baicalein binds to the hydrophobic region of the HIV-1 integrase catalytic core domain. This binding of baicalein induces the conformational change of the enzyme. We also found that the binding ratio of baicalein to the HIV-1 integrase catalytic domain is 2:1.

Revascularization of the ischemic colon transplant using the internal mammary vessels.

We describe a successful reconstruction of the esophagus with the isoperistaltic right colon and terminal ileum, which had very poor continuity of the marginal artery. The stomach and the left colon were not available because of corrosive injury and intraabdominal adhesions. The blood supply of the ischemic transplant was augmented by anastomosis of the internal mammary vessels to the iliocolic vessels.

The clearance of theophylline is increased during the initial period of tuberculosis treatment.

OBJECTIVE: To evaluate the effects of combined anti-tuberculosis treatment including isoniazid (INH), rifampicin (RMP), ethambutol (EMB) and pyrazinamide (PZA), on the pharmacokinetics of theophylline during the initial phase of treatment. DESIGN: Prospective, controlled clinical study. PATIENTS AND METHODS: Twenty patients with pulmonary tuberculosis received 7.35 mg/kg/day of aminophylline intravenously combined with anti-tuberculosis agents. The first theophylline serum concentration was measured before administration of INH, RMP, EMB and PZA, and samples were obtained once daily for 6 consecutive days after initiation of treatment. All patients in this study were non-smokers with normal hepatic and renal function, and they were not given any other drugs that could affect the clearance of theophylline. RESULTS: The concentration and half-life of theophylline was decreased and its clearance was increased significantly at days 5-7 after administration of antituberculosis agents compared to before the therapy was started. CONCLUSIONS: These results suggest that patients with asthma or chronic obstructive pulmonary disease administered combinations of anti-tuberculosis agents and theophylline during the initial phase of tuberculosis treatment should be monitored closely for changes in theophylline concentration, and that the dose of theophylline should be adjusted accordingly.

Effect of combined therapy of oral anti-tubercular agents on theophylline pharmacokinetics.

To evaluate the effects of combined therapy of anti-tubercular agents with theophylline during treatment of concurrent pulmonary tuberculosis and chronic obstructive pulmonary disease or asthma, the clearance and half life of theophylline was estimated in a control group not treated with anti-tubercular agents, a group treated with isoniazid (INH), rifampicin (RMP), ethambutol (EMB) and pyrazinamide (PZA), and a group treated with INH, RMP and EMB. Clearances of theophylline in the treated groups were significantly lower than in the control group, and the half-life of theophylline was longer than in the control. These results suggest that patients administered combinations of anti-tubercular agents with theophylline require lower doses of theophylline.

Americans With Disabilities Act.

The Americans with Disabilities Act gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. This act prohibits discrimination on the basis of disabilities in employment, public services, privately operated public accommodations, services, and telecommunications. The Americans with Disabilities Act is divided into five titles. Title I of the act pertains to discrimination against the disabled in the workplace. Title II prevents discrimination against persons with a disability in state and local government services. Title III prohibits discrimination against persons with disabilities in places of public accommodations and commercial facilities. Title IV ensures that companies offering telephone services to the general public provide special services for individuals with hearing and speech impairments. Under the enforcement provisions of the Americans with Disabilities Act, stringent penalties will be implemented for failure to comply with its provisions.

Architectural barriers to persons with disabilities in businesses in an urban community.

It is the purpose of this study to determine the frequency of architectural barriers to persons with disabilities in businesses in a small urban community in central Virginia. The survey was conducted by a trained volunteer using a one-page checklist. Only 27% of the businesses had no architectural barriers to individuals with disabilities. The most common architectural barrier for individuals with disabilities was the interference with parking and entrance into the business (65%). Faced with these architectural barriers, all individuals are encouraged to identify the architectural barriers in businesses and to file letters of complaints to the Department of Justice requesting their removal.

Assessment of myocardial perfusion with laser Doppler flowmetry. An experimental study on porcine heart.

Laser Doppler flowmetry was applied to the arrested heart of four pigs and to the fibrillating heart of three pigs during cardiopulmonary bypass. The coronary blood flow was maintained during cardiac arrest by infusion of hyperkalemic blood into the aortic root. A significant correlation (r = 0.88, n = 52, p less than 0.001) between laser Doppler signal and coronary blood flow was found during cardiac arrest. During ventricular fibrillation after release of the aortic cross-clamp there was significant correlation (0.84, n = 38, p less than 0.01) between laser Doppler signal and extracorporeal blood flow. A residual laser Doppler signal of about 60% of the maximal value was recorded even after the bypass flow was discontinued. Laser Doppler flowmetry is concluded to permit measurement of myocardial perfusion in the arrested porcine heart. Muscular activity of the heart contributes to the output signal during ventricular fibrillation.

Laser Doppler flowmetry estimating myocardial perfusion after internal mammary artery grafting.

Myocardial perfusion in the anteroapical part of the left ventricle was monitored intraoperatively with laser Doppler flowmetry in ten patients after grafting of the internal mammary artery to the left anterior descending artery. The myocardial perfusion after declamping of only the mammary artery averaged 61% of the perfusion found after declamping also the aorta. Laser Doppler flowmetry is proposed to offer a means of monitoring regional myocardial perfusion in the phase immediately after internal mammary artery grafting.

A system for on-line laser Doppler monitoring of ECG-traced myocardial perfusion.

Laser Doppler perfusion monitoring (LDPM) is an established method for microvascular measurements. When applied to the beating heart, however, movement artifact contributions will result in an overestimation of the perfusion. In order to overcome this problem, the perfusion signal may be processed in relation to intervals in the cardiac cycle with minimal tissue motion, e.g., in late systole and late diastole. The aim of this study was to develop an electrocardiogram (ECG) tracing algorithm for R, T and P wave detection and to use these peaks to process the perfusion in intervals with minimal motion. The algorithm, evaluated in three subjects, detected the peaks correctly to 99.9% under ideal conditions. Used on a heart patient in postoperative care this was reduced to 93.2%. However, since the overall goal is to monitor changes in the myocardial perfusion over hours or even days, it is not necessary to capture perfusion values in every single heartbeat. Time traces of perfusion captured in relation to the T and P waves showed a periodical behavior. In order to tune the processing and presentation of the perfusion signal, future studies will focus on long term monitoring of myocardial perfusion during heart surgery and in the postoperative care.

Prevalence of arthropod antibodies in Korean patients with allergic rhinitis.

Arthropod antigens are main causative agents which induce allergic responses in humans. However, little information is known about the prevalence of specific arthropod allergens in Koreans with allergic diseases. The current study was designed to determine the positive rates of arthropod antibodies by the Korean inhalant panel of MAST-CLA. One hundred sixty patients, who were diagnosed with allergic rhinitis from an out-patient center at the Soonchunhyang University Chunan Hospital, were studied between August 1998 to July 2000. The overall positive rate, at least more than one specific antibody of arthropods such as Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and cockroach mix (Cm), was 46.9%. Each positive rate of Df, Dp, and Cm was 45.0%, 43.1%, and 8.8%, respectively. A significant agreement among arthropod allergens was observed (Df and Dp: 95.6%, Kappa = 0.911, P < 0.001). Our data supported the fact that arthropods were the most common allergens in Korean patients with allergic rhinitis; however, the MAST-CLA should be modified to increase specificity of arthropod allergens.

Knowledge representation forms for data mining methodologies as applied in thoracic surgery.

Typical ways of disseminating and using results of clinical research are scientific journals and reports. Presentation forms are condensed and comprehensible mainly to the experts following the specific topics. A vast amount of information remains unutilized due to the complex form of presenting the knowledge. Subject of this research is to explore possibilities of representation and also visualization of the results obtained using data mining methodologies. The intention is to formulate more than scientific ways to communicate facts that are of interest for the clinicians, medical students and even patients. Internet technologies as already widely established media support knowledge representation forms such as hypertext documents and structured knowledge components. The "Assist Me" decision support system for surgical treatment of cardiac patients integrates several forms of data mining and representation methodologies. We are showing a feasibility study in which scientific outcomes were forwarded to a broad group of potential users.