Association between Alcohol Drinking Status and Depressive Symptoms in Korean Adults / 전남의대학술지

We investigated the association between alcohol drinking status and depressive symptoms in a representative sample of South Korean adults using data from the 2017 Korea Community Health Survey (KCHS), which included 216,771 participants (99,845 men and 116,926 women). Depression was defined as a Patient Health Questionnaire-9 score of ≥10. Multivariate logistic regression using sampling weights was used to assess the relationship between alcohol drinking status and depression after adjusting for potential confounders. Alcohol intake was nonlinearly associated with depression; the risk of depression was the lowest in men who were moderate drinkers and women who were light drinkers. In men, heavy drinkers (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.19-1.67), light drinkers (OR 1.13, 95% CI 0.94-1.36), infrequent drinkers (OR 1.31, 95% CI 1.00-1.73), and lifetime abstainers (OR 1.38, 95% CI 1.09-1.75) were at a higher risk of depression than moderate drinkers. In women, moderate drinkers (OR 1.19, 95% CI 1.02-1.40) and heavy drinkers (OR 1.56, 95% CI 1.33-1.84) were at a higher risk of depression than light drinkers; however, infrequent drinkers and lifetime abstainers were not at a high risk of depression. In both men and women, former drinkers were at a higher risk of depression (OR 1.61, 95% CI 1.34-1.93 and OR 1.25, 95% CI 1.09-1.43, respectively). In conclusion, the association between alcohol drinking status and depression was nonlinear in both sexes. Further investigation of age- and sex-specific factors related to the association between alcohol use and depression is needed.

Screening for Atrial Fibrillation Using a Smartphone-Based Electrocardiogram in Korean Elderly / 전남의대학술지

Atrial fibrillation (AF) is responsible for 10–20% of cerebral infarctions. Several mobile devices have been developed to screen for AF and studies of AF screening have been conducted in several countries to evaluate the applicability of these mobile devices. In this tradition, we conducted a community-based AF screening using an automated single-lead electrocardiogram (SL-ECG). This survey examined 2,422 participants in a community dementia screening program who were aged 60 years or older in the preliminary study, and 5,366 participants at 9 Senior Welfare Centers aged 60 years or older in the expanded study. AF screening was conducted using an automated SL-ECG (Kardia Mobile, AliveCor, Mountain View, CA, USA). AF was confirmed with a 12-lead electrocardiogram in subjects classified as having AF on the SL-ECG. In the preliminary study, of the 2,422 subjects, 124 had AF on the SL-ECG. The prevalence of AF was 3.0% (95% confidence interval [CI]: 2.4–3.8). The positive predictive value (PPV) of SL-ECG was 58.9% (95% CI: 50.1–67.1). Of the subjects diagnosed with AF, 65.8% (95% CI: 54.3–75.6) were newly diagnosed. In an expanded study, of the 5,366 subjects, 289 had AF on SL-ECG. The prevalence was 2.6% (95% CI: 2.2–3.1) and PPV of SL-ECG was 48.8% (95% CI: 43.1–54.5). In this community-based AF screening, we found that AF is underdiagnosed and undertreated. These results suggest that the early detection of AF using mobile devices is needed in Korea.

The Association between Phase Angle of Bioelectrical Impedance Analysis and Survival Time in Advanced Cancer Patients: Preliminary Study / 가정의학회지

BACKGROUND: A frequent manifestation of advanced cancer patients is malnutrition, which is correlated with poor prognosis and high mortality. Bioelectrical impedance analysis (BIA) is an easy-to-use and non-invasive technique to evaluate changes in body composition and nutritional status. We investigated BIA-derived phase angle as a prognostic indicator for survival in advanced cancer patients. METHODS: Twenty-eight patients treated at the hospice center of Seoul St. Mary's Hospital underwent BIA measurements from January, 2013 to May, 2013. We also evaluated palliative prognostic index (PPI) and palliative performance scale to compare with the prognostic value of phase angle. Cox's proportional hazard models were constructed to evaluate the prognostic effect of phase angle. The Kaplan Meier method was used to calculate survival. RESULTS: Using univariate Cox analysis, phase angle (hazard ratio [HR], 0.61/per degree increase; 95% confidence interval [CI], 0.42 to 0.89; P = 0.010), PPI (HR, 1.21; 95% CI, 1.00 to 1.47; P = 0.048) were found to be significantly associated with survival. Adjusting age, PPI, body mass index, phase angle significantly showed association with survival in multivariate analysis (HR, 0.64/per degree increase; 95% CI, 0.42 to 0.95; P = 0.028). Survival time of patients with phase angle > or = 4.4degrees was longer than patients with phase angle < 4.4degrees (log rank, 6.208; P-value = 0.013). CONCLUSION: Our data suggest BIA-derived phase angle may serve as an independent prognostic indicator in advanced cancer patients.

Sasa borealis leaves extract improves insulin resistance by modulating inflammatory cytokine secretion in high fat diet-induced obese C57/BL6J mice

Obesity is considered a mild inflammatory state, and the secretion of inflammation-related cytokines rises as adipose tissue expands. Inflammatory cytokines, including tumor necrosis factor-alpha (TNF-alpha), interlukin 6 (IL-6) and monocyte-chemoattractant protein 1 (MCP-1), are modulated by adipose tissue and known to play an important role in insulin resistance which is the common characteristics of obesity related disorders. In this study we analyzed the effects of Sasa borealis leaves extract on inflammatory cytokines and insulin resistance in diet induced obese C57/BL6J mice. The obese state was induced by a high fat diet for 20 weeks and then the mice were divided into two groups; obese control group (OBC, n = 7) and experimental group (OB-SBE, n = 7). The OBC group was fed a high fat diet and the OB-SBE group was fed a high fat diet containing 5% Sasa borealis leaves extract (SBE) for 12 weeks. We also used mice fed a standard diet as a normal control (NC, n = 7). The body weight and adipose tissue weight in the OB group were significantly higher than those in the NC group. The effects of the high fat diet were reduced by SBE treatments, and the body weight and adipose tissue deposition in the OB-SBE group were significantly decreased compared to the OBC group. The OBC group showed higher serum glucose and insulin levels which resulted in a significant increase of incremental area under the curve (IAUC) and HOMA-IR than the NC group. Also, serum leptin, TNF-alpha, and IL-6 levels were significantly higher in the OBC group than in the NC group. In contrast, the OB-SBE group showed a reversal in the metabolic defects, including a decrease in glucose, insulin, IAUC, HOMA-IR, TNF-alpha, IL-6 and leptin levels. These results suggest that BSE can suppress increased weight gain and/or fat deposition induced by a high fat diet and theses effects are accompanied by modulation of the inflammatory cytokines, TNF-alpha and IL-6 secretion resulting in improved insulin resistance.

The Effect of Fentanyl or Epinephrine Addition to Ropivacaine in Brachial Plexus Block / 대한마취과학회지

BACKGROUND: The administration of adjuncts to local anesthetics in brachial plexus block affects the onset of sensory or motor block and the duration of analgesia. But, the effect of opioid with ropivacaine is controversial, and epinephrine addition does not significantly affect the duration of analgesia. So, we evaluated the effects of fentanyl or epinephrine added to ropivacaine for brachial plexus block. METHODS: Forty-five patients scheduled for upper extremity surgery (ASA 1, 2) were randomly divided into 3 groups: Group 1 received 0.5% ropivacaine 52 ml, Group 2 received 0.5% ropivacaine 52 ml with 1:200,000 epinephrine, and Group 3 received 0.5% ropivacaine 50 ml with fentanyl 100microgram. At 1-min intervals after injecting local anesthetic, sensory block was assessed in the C5-6 dermatome by pinprick testing and motor block was assessed at the shoulder by asking the patient to elevate the affected arm while keeping the elbow straight. Duration of analgesia (the time between injection and the onset of pain) and the duration of motor block (the time between injection and the restoration of shoulder mobility) were recorded. RESULTS: No significant difference was observed in the onset of sensory or motor block, or in the duration of analgesia or motor block between the three groups. CONCLUSIONS: The addition of fentanyl or epinephrine to ropivacaine in brachial plexus block does not affect the onset of sensory or motor block, or the duration of analgesia or motor block.

Effective Production and Clinical Application of Anti-Interleukin-6 Monoclonal Antibodies / 대한면역학회지

Highly specific and sensitive immunoassay method for soluble human recombinant interleukin-6 (hu rlL-6) was established by two different immunization methods. One is conventional method by Freund's adjuvant method and the other is special method which is directly injected to mouse spleen. Among seven established monoclonal antibodies (mAbs), two typical monoclonal antibodies, designated YB3 (IgG1) and NY2 (IgM), were further characterized. These mAbs highly bound to IL-6, however did not show cross reactivity with IL-1B and IL-2. As the results of ELISA inhibition assay and western blotting method, it was further identified that YB3 and NY2 had high binding specificity with IL-6. And the limiting detection amount of rlL-6 for YB3 was 5 ng/ml and for NY2 was 0.5 ng/ml. Furthermore, N-glycosylated human rlL-6 was also bound to YB3 on ELISA. On the other hand YB-3 furtherly recognized N-glycosylated human rlL-6 by sandwich ELISA method. These mAbs may be of use to diagnose the gynecopathy which contains abortion and preterm labor.

Anesthesia Induction with Propofol Using a Target Controlled Infusion (TCI) / 대한마취과학회지

BACKGROUND: Target Controlled Infusion (TCI) is designed to achieve a predicted target blood concentration based on population pharmacokinetics and it provides the closest approximation for any individual patients. This study determined which target is appropriate for propofol induction using a TCI in korean adullt patients premedicated with midazolam. METHODS: Sixty six patients (ASA I or II, 18~55 years) premedicated with midazolam were allocated randomly to receive an infusion to achieve and maintain a target blood concentration of 3, 4, 5 and 6 microgram/ml using a TCI. Induction time was measured as the interval from the start of the infusion to loss of verbal contact and induction within 3 min was considered as successful. Calculated concentration, induction dose, context sensitive decrement time, vital signs, pain score and side effects were checked and compared each other during induction period. RESULTS: The success rate when the target was 3 microgram/ml was 25%, 58.8%, 77.8% and 100% when targets were 4 microgram/ml, 5 microgram/ml and 6 microgram/ml respectively. EC50 for induction was 3.87 microgram/ml and EC95 was 5.71 microgram/ml. Calculated concentration, induction dose, context sensitive decrement time in 3, 4, 5 microgram/ml group showed no differences among groups, but 6 microgram/ml group showed statistically significant differences compared with other groups. Vital signs, pain score and side effects showed no differences among groups. CONCLUSIONS: Target concentration of 5~6 microgram/ml would successfully induce anesthesia in the majority of patients premedicated with midazolam without major hemodynamic changes.

Effect of Speed of Injection on Vital Signs, Dose Requirement and Induction Time for Induction of Anesthesia using Propofol / 대한마취과학회지

BACKGROUND: Induction of anesthesia with propofol commonly associated with reduction in systemic arterial pressure, especially in elderly and high risk patients. This reduction is influenced by the dose and rate of propofol injection. The aim of this study was to examine the effect of different injection rate of propofol on vital signs, dose requirement and induction time during induction period. METHODS: Unpremedicated one hundred and twenty ASA physical status I and II patients aged 20~60 years scheduled for elective surgery were randomly allocated into one of four (150, 300, 600, 1200 ml/hr) groups according to speed of injection of propofol during induction period. Loss of verbal contact was taken as the end-point of induction. Vital signs, SpO2, dose requirement of propofol and induction time were checked. RESULTS: As the injection rate of propofol became slower, there were significant reduction in induction dose and increase in induction time (p<0.05). For example, induction dose and time were 1.82 mg/kg, 223 +/- 58 sec in 150 ml/hr group and 3.14 mg/kg, 50 +/- 11 sec in 1200 ml/hr group, respectively. Also, decrease in systolic and diastolic pressure were less marked at lower injection rates. CONCLUSIONS: Slower injection of propofol produces less vital sign changes and dose requirement for the induction of anesthesia.