The Relationship between Thyroid Nodules Detected through Ultrasonography and Thyroid Function Test Results in Healthy Individuals

BACKGROUND: The detection of thyroid nodules through ultrasonography (US) has improved with the development of imaging technologies and thyroid cancer screening in Korea. We evaluated the relationship between the presence of thyroid nodules on US and thyroid function test (TFT) results in healthy individuals.METHODS: We performed a retrospective review of data from 449 adults (313 men and 136 women) who underwent tests to evaluate serum thyrotropin (TSH) and free thyroxine levels, thyroid US, and if needed, fine needle aspiration cytology (FNAC).RESULTS: Of the 449 subjects, 144 subjects (32.1%) had thyroid nodules. Among the 144 with thyroid nodules, 24 (16.7%) were advised to undergo FNAC, and all of them showed normal serum TSH levels. Logistic regression analysis showed that the presence of thyroid nodules was not related to abnormalities noted on TFTs after adjusting for age, sex, smoking status, and presence of risky drinking behavior and hypertension (P=0.647).CONCLUSION: The presence of thyroid nodules on US in healthy adults was not associated with abnormal TFT results. Serum TSH check-ups during the evaluation of thyroid nodules discovered through US in asymptomatic individuals living in areas with a low prevalence of autonomous functioning thyroid nodules might not be necessary from the perspective of cost-effectiveness and subject convenience.

Health Literacy and Its Related Factors in North Korean Refugees

BACKGROUND: In September 2016, the number of North Korean refugees living in South Korea was 29,688. They have been struggling with health problems due to their poor health status and the differences in medical system and terminology between South and North Korea. We aimed to investigate the level of health literacy and its related factors in North Korean refugees. METHODS: This study was conducted with 142 patients who visited North Korean refugees' counseling center at Seoul Medical Center and National Central Medical Center and 100 South Korean patients who visited outpatient clinics or Health Promotion Center of Seoul Medical Center. General and health-related characteristics were surveyed through a questionnaire and health literacy was measured by using ‘Korean Adult Health Literacy Scale’. RESULTS: The average age of North Korean refugees was 48.92±11.49 years old. Almost 95% reported that their monthly income was less than 2 million KRW. The survey showed that North Korean refugees obtain health information mainly through TV, radio, and acquaintances and more than half (54.9%) said their health was bad or very bad. The mean score of North Korean refugees' health literacy was much lower than that of South Koreans (12.42±7.58 vs. 25.3±5.7, P<0.001). This discrepancy was maintained after adjusting related factors such as age, sex, and socioeconomic status with stratified analysis. CONCLUSIONS: It suggest the urgent need for policies which support for futher researches and development of education system, which may lead to the improvememt of the health literacy of North Korean regugees.

Ctbp2-mediated β-catenin regulation is required for exit from pluripotency

The canonical Wnt pathway is critical for embryonic stem cell (ESC) pluripotency and aberrant control of β-catenin leads to failure of exit from pluripotency and lineage commitments. Hence, maintaining the appropriate level of β-catenin is important for the decision to commit to the appropriate lineage. However, how β-catenin links to core transcription factors in ESCs remains elusive. C-terminal-binding protein (CtBP) in Drosophila is essential for Wnt-mediated target gene expression. In addition, Ctbp acts as an antagonist of β-catenin/TCF activation in mammals. Recently, Ctbp2, a core Oct4-binding protein in ESCs, has been reported to play a key role in ESC pluripotency. However, the significance of the connection between Ctbp2 and β-catenin with regard to ESC pluripotency remains elusive. Here, we demonstrate that C-terminal-binding protein 2 (Ctbp2) associates with major components of the β-catenin destruction complex and limits the accessibility of β-catenin to core transcription factors in undifferentiated ESCs. Ctbp2 knockdown leads to stabilization of β-catenin, which then interacts with core pluripotency-maintaining factors that are occupied by Ctbp2, leading to incomplete exit from pluripotency. These findings suggest a suppressive function for Ctbp2 in reducing the protein level of β-catenin, along with priming its position on core pluripotency genes to hinder β-catenin deposition, which is central to commitment to the appropriate lineage.

Protective Effects of Cinnamic Acid Derivatives on Gastric Lesion

P-methoxycinnamic acid and 3,4,5-trimethoxycinnamic acid are the compounds found in Polygalae Radix, the root of Polygala tenuifolia Willdenow, and have been reported to have hepatoprotective and anti-neurodegenerative effects. On the other hand, there are no reports of their effects on gastric lesions. This study examined the inhibitory effects of cinnamic acids, including p-methoxycinnamic acid, 3,4,5-trimethoxycinnamic acid, and 8 compounds (cinnamic acid, 2-(trifluoromethyl) cinnamic acid, 3-(trifluoromethyl) cinnamic acid, trans-4-(trifluoromethyl) cinnamic acid, 4-(dimethylamino) cinnamic acid, 3,4-(methylenedioxy) cinnamic acid and 3,4-dihydroxycinnamic acid), which were selected based on their presence in medicinal herbs and molecular weight, against gastric lesions. Animal models were used to confirm the protective effects on acute gastritis caused by the administration of HCl/EtOH. Gastric acid inhibition was examined by an acid-neutralizing test and the proton pump (H⁺/K⁺-ATPase) inhibiting activity. In addition, antioxidant tests were performed and the gastric emptying rate was determined. The results showed that cinnamic acid, p-methoxycinnamic acid, and 3,4,5-trimethoxycinnamic acid had an inhibitory effect on gastric lesions.

Expression of Nestin on Endothelial Cells and Pericytes During Retinal Vascular Development in Mouse

PURPOSE: Nestin, a marker of neural stem cells, is expressed in Müller cells during retinal development. However, the role of nestin in retinal vascular development is not well established. Thus, we investigated the expression of nestin in developmental mouse retina and identified which retinal cells are related to the expression of nestin during the retinal vascular development. METHODS: Eyes were enucleated from C57BL/6 mice on postnatal day (P) 4, P8, P12, P16 and P26. Immunofluorescence was used to evaluate nestin expression in relation to endothelial cells (isolectin B4), pericytes (neural/glial antigen 2) and astrocytes (glial fibrillary acidic protein). RESULTS: Nestin was strongly expressed from the ganglion cell layer to retinoblast layer at P4. At P8, P12 and P16, the expression of nestin was observed from the upper border of the ganglion cell layer, and vertically penetrating to outer nuclear layer. At P26, the expression of nestin was decreased and confined to the ganglion cell layer and inner nuclear layer. Interestingly, there was strong vascular shape expression of nestin at all stages. The superficial, deep and intermediate vascular plexus was completely merged with nestin expression at P4, P8, P12 and P16. In addition, the nestin expression merged with pericytes but not with astrocytes. CONCLUSIONS: Nestin was expressed in endothelial cells and pericytes during retinal vascular development in the retina. These results suggest that nestin could play an important role in developmental angiogenesis via interplay with endothelial cells and pericytes.

Protective Effect of Liriodendrin Isolated from Kalopanax pictus against Gastric Injury

In this study, we investigated the inhibitory activities on gastritis and gastric ulcer using liriodendrin which is a constituent isolated from Kalopanax pictus. To elucidate its abilities to prevent gastric injury, we measured the quantity of prostaglandin E2 (PGE2) as the protective factor, and we assessed inhibition of activities related to excessive gastric acid be notorious for aggressive factor and inhibition of Helicobacter pylori (H. pylori) colonization known as a cause of chronic gastritis, gastric ulcer, and gastric cancer. Liriodendrin exhibited higher PGE2 level than rebamipide used as a positive control group at the dose of 500 microM. It was also exhibited acid-neutralizing capacity (10.3%) and H+/K+-ATPase inhibition of 42.6% (500 microM). In pylorus-ligated rats, liriodendrin showed lower volume of gastric juice (4.38 +/- 2.14 ml), slightly higher pH (1.53 +/- 0.41), and smaller total acid output (0.47 +/- 0.3 mEq/4 hrs) than the control group. Furthermore liriodendrin inhibited colonization of H. pylori effectively. In vivo test, liriodendrin significantly inhibited both of HCl/EtOH-induced gastritis (46.9 %) and indomethacin-induced gastric ulcer (46.1%). From these results, we suggest that liriodendrin could be utilized for the treatment and/or protection of gastritis and gastric ulcer.

Gastroprotective Activities of Sennoside A and Sennoside B via the Up-Regulation of Prostaglandin E2 and the Inhibition of H+/K+-ATPase

Sennoside A (erythro) and sennoside B (threo) are dianthrone glycosides and diastereomers. We investigated their abilities to prevent the gastric lesions associated with diseases, such as, gastritis and gastric ulcer. To elucidate their gastroprotective effects, the inhibitions of HCl*EtOH-induced gastritis and indomethacin-induced gastric ulcers were assessed in rats. It was observed that both sennoside A and sennoside B increased prostaglandin E2 (PGE2) levels and inhibited H+/K+-ATPase (proton pump). In a rat model, both compounds reduced gastric juice, total acidity and increased pH, indicating that proton pump inhibition reduces gastric acid secretion. Furthermore, sennoside A and B increased PGE2 in a concentration-dependent manner. In a gastric emptying and intestinal transporting rate experiment, both sennoside A and sennoside B accelerated motility. Our results thus suggest that sennoside A and sennoside B possess significant gastroprotective activities and they might be useful for the treatment of gastric disease.

Relationship among Sense of Humor, Self-esteem, and Performance in Nurses / 한국직업건강간호학회지

PURPOSE: The study was done to identify relations among sense of humor, self-esteem, and performance in nurses. METHODS: Data were collected by questionnaires from 198 nurses in Seoul and Gyeonggi province. Measures were sense of humor, self-esteem, and performance. Data were analyzed using Pearson correlation coefficients, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 13.0 version. RESULTS: This study shows that performance of nurses has significant difference according to age, marriage, education level, income and clinical experience. The performance of nurses has positive correlation with their sense of humor and self-esteem. The higher clinical experience, sense of humor, and self-esteem they have, the better performance they make. The factors that affect performance of nurses are clinical experience, sense of humor and self-esteem. The degree of explanation is 36.5%. CONCLUSION: Knowing that sense of humor and self-esteem of nurse are significant factors which can cause nurses' better performance, we suggest an education program that can help nurses to develop and manage their sense of humor.

The Effects of an Overweight Control Exercise Program in Elementary School Students

PURPOSE: The purpose of this study was to identify the effects of an overweight control exercise program on body composition and blood lipids. METHOD: This comparative study was conducted at an elementary school in Seoul, Korea. Pre and post body weight, BMI, PBF, and obesity degree as body composition and TC, HDL-C, LDL-C, and TG as blood lipids were tested. The aerobic exercise lasted 12 weeks from April to July, 2006. A total of 168 overweight 3rd grade to 5th grade school children attended and were divided into a walking exercise group (n=68) and a rope jumping exercise group (n=38). Data were analysed using SAS 8.12. RESULT: At the end of the program, the participation rate was higher in the rope jumping exercise group than in the walking exercise group. Body weight, BMI, PBF, obesity degree, TC, and LDL-C were lower than those before the program, and HDL-C was higher than before the program. CONCLUSION: The school-based overweight control exercise program was effective. Because of the participation rate was higher in the rope jumping exercise group than in the walking exercise group, rope jumping exercise is recommended for low grade children.

The Effects of Group Walking Exercise Program on Body Composition, Blood Lipids and Psychological Factors

PURPOSE: The purpose of this study was to examine the effects of a group walking exercise program on body composition, blood lipids and psychological factors at a community. METHOD: The subjects were 200 women(29 groups) who agreed to participate in group walking exercise for three months. Their ages ranged between 30 to 77 years. A simple walking exercise protocol was given to the participants, which was to do walking over three times a week and over thirty minutes each time. We compared the participants' body composition (BMI, PBF, BFM, FFM, WHR and VFA), blood lipids (HDL C, LDL C, total cholesterol, triglyceride) and exercise-self efficacy, self esteem, and quality of life before and after group walking. Collected data were analyzed through paired t test using the SAS program. RESULT: BMI. PBF, BFM, WHR, and VFA were significantly reduced (p<.01). However. FFM did not increase significantly (p=.416). There were significant changes in TC and TG (p<.01) but not in LDL C (P=.340). HDL C decreased but within the normal range. Exercise-self efficacy and quality of life did not increase significantly. Only self esteem increased significantly (p<.0001). CONCLUSION: Group walking exercise had positive effects on body composition, blood lipid and self esteem in community women.

Interobserver Variability in Interpretation of Mammogram

PURPOSE: The purpose of this study was to evaluate the performance of radiologists for mammographic screening, and to analyze interobserver agreement in the interpretation of mammograms. MATERIALS AND METHODS: 50 women were selected as subjects from the patients who were screened with mammograms at two university hospitals. The images were analyzed by five radiologists working independently and without their having any knowledge of the final diagnosis. The interobserver variation was analyzed by using the kappa statistic. RESULTS: There were moderate agreements for the findings of the parenchymal pattern (k=0.44; 95% CI 0.39-0.49), calcification type (k=0.66; 95% CI 0.60-0.72) and calcification distribution (k=0.43; 95% CI 0.38-0.48). The mean kappa values ranged from 0.66 to 0.42 for the mass findings. The mean kappa value for the final conclusion was 0.44 (95% CI 0.38-0.51). In general, moderate agreement was evident for all the categories that were evaluated. CONCLUSION: The general agreement was moderate, but there was wide variability in some findings. To improve the accuracy and reduce variability among physicians in interpretation, proper training of radiologists and standardization of criteria are essential for breast screening.

Comparison of Histopathologic Stages of Asymptomatic and Symptomatic Cervical Neoplasm Patients / 예방의학회지

Screening is for the early detection and treatment of diseases in prior to development of symptoms, so that more favourable prognosis could be obtained. To evaluate efficiency of screening test for cervical neoplasms, we compared the histopathologic stages of asymptomatic cervical neoplasm patients diagnosed by screening test, with those of symptomatic patients confirmed by pathology. Total 1,120 cases of cervical neoplasm patient, diagnosed at Kang-nam St. Mary's hospital from Jan. 1990 to Dec. 1996, were reviewed by chart, and classified as asymptomatic and symptomatic group based on the presence of subjective symptoms on their hospital visit. Their histopathologic stages were analysed. The results were as follows, 1. From the total of 1,120 patient, asymptomatic group comprised 264 cases (25.5%). Asymptomatic proportion increased 15.3% in 1991 to 34.7% in 1996. 2. Mean age for the occurrence of cervical neoplasm was 44.3 +/- 10.4 years for the asymptomatic group, and 49.3+/-13.2 years for the symptomatic group, showing statistically significant differences(p=0.001). 3. Among the study subjects, 465 cases(45.0%) had CIS(carcinoma in situ), and 569 cases(55.0%) had invasive cancers. 4. Percentage of cervical neoplasm patient diagnosed at asymptomatic stages were 45.8% in twenties, 32.0% in thirties, 27.7 % in forties, 21.7% in fifties, 18.7% in sixties and 1.8% in above seventies, showing statistically significant differences according to age group(p=0.001). 5. In thirties, 87.2% of the asymptomatic patients were diagnosed as CIS and 45.0% of symptomatic patient were diagnosed as CIS. With increment of ages, CIS proportion were markedly decreased. 6. 76.9% of asymptomatic patients were diagnosed as CIS, and 34.0 % of symptomatic patients were diagnosed as CIS, suggesting screening test at asymptomatic stage can increase CIS proportion. 7. CIS proportion of asymptomatic patient was highest in thirties(40.4%) and 2nd highest in forties(34.0%). Screening test for cervical neoplasm should be actively carried out from the thirties.