Factors related to adolescent obesity and changes: a cross-sectional study based on the Korea Youth Risk Behavior Survey / 대한지역사회영양학회지

Objectives@# The objective of this study was to identify factors associated with adolescent obesity, as well as any new factors that correlated with a change in the rate of obesity over time. @*Methods@# The study used 5-yearly data collected by the Korea Youth Risk Behavior Survey starting from the year 2006 up until 2021 (data from 2nd, 7th, 11th, and 17th surveys were analyzed). Factors such as demographics, dietary factors, health behavioral factors, and mental health factors were studied. All data were analyzed using IBM SPSS 27.0, employing chi-square tests and multiple logistic regression analysis. @*Results@# This study included data from a total of 255,200 participants. Factors contributing to obesity varied with time. Over the survey duration of 15 years, low academic achievement, parents with low levels of education, low frequency of fruit consumption, low frequency of fast food intake, long periods of being seated, and high levels of stress were significantly associated with a high rate of obesity. Factors that showed a new correlation with an increase in obesity rates included living with single parents, low frequency of muscle strengthening exercises, and experiencing intense sadness and despair in the past year. Factors that were correlated with a change in obesity rates over time included household economic status, frequency of carbonated beverage consumption, frequency of intense physical activity, and frequency of alcohol consumption. Breakfast intake and smoking were not significantly associated with obesity rates in the 15-year period. @*Conclusions@# While several factors associated with obesity remained consistent over time, several new factors have emerged in response to social, economic, and environmental changes contributed to a change in obesity rate over time. Therefore, to prevent and manage adolescent obesity, continuous research into the new emergent factors contributing to obesity is needed.

Association between drinking behaviors and components of metabolic syndrome in subjects in their 20s and 30s: data obtained from the Korea National Health and Nutrition Examination Survey (2016–2018)

BACKGROUND/OBJECTIVES@#Numerous studies have examined the relationship between drinking behaviors and metabolic syndrome (MetS) for adults, but these include very few studies for young adults. This study therefore undertook to investigate the association between drinking behaviors and components of MetS among adult drinkers aged 20–30 years. @*SUBJECTS/METHODS@#Using the 2016–2018 Korea National Health and Nutrition Examination Survey data, drinking behaviors of adults in the age group 20–30 years were divided into 4 groups: 1) group A, good drinking habits; 2) group B, frequent binge drinking but not frequent drinking; 3) group C, frequent drinking but not frequent binge drinking; 4) group D, frequent drinking and binge drinking. The association between MetS components and drinking behaviors was analyzed by applying multiple logistic regression analysis. @*RESULTS@#We determined the prevalence risk compared to group A. In men, the prevalence risk of high triglyceride (TG) increased 2.051-fold in group C and 1.965-fold in group D.Moreover, in group D, the prevalence risk of low high density lipoprotein cholesterol (HDL-C) increased 0.668-fold, high blood pressure (BP) increased 2.147-fold, and MetS increased 1.567-fold. In women, there was an increased prevalence risk of low HDL-C (0.353-fold) and MetS (3.438-fold) in group C, whereas group D showed increased prevalence risk of abdominal obesity (2.959-fold), high TG (1.824-fold, and low HDL-C (0.424-fold). @*CONCLUSIONS@#Our study indicates that frequent drinking increases the risk of high TG, whereas frequent and binge drinking increases the risk of high TG, low HDL-C, high BP, and prevalence of MetS in men. In women, frequent drinking without binge drinking increases the risk of low HDL-C and MetS, whereas frequent and binge drinking increases the risk of abdominal obesity, high TG, and low HDL-C. We propose that improvements in the drinking behaviors can reduce the prevalence of MetS.

Status of Iodine Intake and Comparison of Characteristics according to Iodine-sourced Food Intake Patterns of Chinese Adults: A Study Encompassing Three Regions with Different Iodine Nutritional Statuses / 대한지역사회영양학회지

Objectives@#This study examines the status of iodine intake and compares the characteristics (region and thyroid disease prevalence) according to the iodine-sourced food intake pattern in Chinese adults. @*Methods@#An online survey was conducted by enrolling 437 Chinese adults aged 18-65 years, living in three regions with different iodine nutritional statuses: Sichuan, Chongqing, and Guangdong. @*Results@#The prevalence of thyroid diseases in Sichuan, Chongqing, and Guangdong were 12.5%, 8.5%, and 2.8%, respectively. Conversely, the proportion of people who received thyroid disease-related examinations was a mere 37.5%. Among the subjects who underwent thyroid examination, the prevalence of thyroid disease in the three regions was 32.2%, 21.8%, and 8.0%, respectively. No differences were obtained in the total iodine intake by region, but the type of iodine source foods differed. Regardless of the region, the highest iodine content was obtained from seaweed. However, the iodine content from iodized salt and other foods differed significantly by region. Factor analysis revealed three food intake patterns according to the iodine food source. The study further determined regional differences and differences in the prevalence of thyroid disease according to food intake patterns. @*Conclusions@#High salt intake can also increase iodine intake, which is thought to have an effect on the occurrence of iodine-excess thyroid disease. Hence, efforts focused on improving salty eating habits need to be implemented.

Clinical Reliability of IOL Master 700 in Measurement of Pupil Diameter and Corneal Curvature

Purpose@#To compare IOL Master 700 with autokeratometer and video pupillometer in measurement of pupil diameter and corneal curvature. @*Methods@#Pupil diameter were measured with IOL Master 700 and video pupilometer, horizontal keratometry and vertical keratometry were measured with IOL Master 700 and autokeratometer in 100 eyes of 50 children. Paired t-test and Pearson's correlation analysis were used to compare the differences among the devices. Agreement between measurement was analyzed using Bland Altman plot and intraclass correlation coefficient. @*Results@#Comparing IOL Master 700 and video pupilometer for pupil diameter, there was no significant difference (p > 0.05). There was also no significant difference between IOL Master 700 and autokeratometer in measurement of vertical keratometry (p > 0.05). However, regarding horizontal keratometry there was significant difference between IOL Master 700 and autokeratometer, horizontal keratometry measured with IOL Master 700 was steeper than with auto keratometer, +0.105 diopters (D) in right eye and +0.130 D in left eye (p < 0.05). @*Conclusions@#There was good agreement between IOL Master 700 and comparator instruments in regards to pupil diameter and corneal curvature. IOL Master 700 can be helpful in uncooperative children for measuring pupil diameter and corneal curvature at the same time.

Juvenile Dermatomyositis Presenting with Erythematous Swelling of the Upper Eyelid

Purpose@#To report a case of juvenile dermatomyositis that presented with erythematous swelling on the upper eyelid as the first clinical sign.Case summary: An 11-year-old female patient presented with erythematous swelling of both upper eye lids that persisted for 3 weeks prior to examination. She also had an erythematous rash over both cheeks but no pain or hyperemia in either eye. During anti-inflammatory eye drop treatment under suspicion of blepharitis, a reddish-purple heliotrope rash appeared around the eyelid margin. She also developed fever, arthralgia, multiple oral ulcers, an erythematous scaly rash behind the ear, and erythematous firm papules on the metacarpal (MCP) joint and around the elbow. On evaluation, aspartate aminotransferase was elevated to 184 IU/L, alanine aminotransferase to 352 IU/L, and alkaline phosphatase to 266 IU/L. We performed a skin biopsy. Based on histopathological examination, the eyelid lesion was diagnosed as dermatomyositis and the MCP joint lesion as Gottron’s papule. From the above findings, we diagnosed the patient with juvenile dermatomyositis based on the European League Against Rheumatism/American College of Rheumatology classification. The patient was treated with prednisolone. Three months after diagnosis, she died from rapidly progressive interstitial pneumonia, a complication of juvenile dermatomyositis. @*Conclusions@#Heliotrope rash should be considered in the differential diagnosis of patients presenting with eyelid swelling, for early diagnosis and better prognosis of juvenile dermatomyositis.

Clinical Reliability of IOL Master 700 in Measurement of Pupil Diameter and Corneal Curvature

Purpose@#To compare IOL Master 700 with autokeratometer and video pupillometer in measurement of pupil diameter and corneal curvature. @*Methods@#Pupil diameter were measured with IOL Master 700 and video pupilometer, horizontal keratometry and vertical keratometry were measured with IOL Master 700 and autokeratometer in 100 eyes of 50 children. Paired t-test and Pearson's correlation analysis were used to compare the differences among the devices. Agreement between measurement was analyzed using Bland Altman plot and intraclass correlation coefficient. @*Results@#Comparing IOL Master 700 and video pupilometer for pupil diameter, there was no significant difference (p > 0.05). There was also no significant difference between IOL Master 700 and autokeratometer in measurement of vertical keratometry (p > 0.05). However, regarding horizontal keratometry there was significant difference between IOL Master 700 and autokeratometer, horizontal keratometry measured with IOL Master 700 was steeper than with auto keratometer, +0.105 diopters (D) in right eye and +0.130 D in left eye (p < 0.05). @*Conclusions@#There was good agreement between IOL Master 700 and comparator instruments in regards to pupil diameter and corneal curvature. IOL Master 700 can be helpful in uncooperative children for measuring pupil diameter and corneal curvature at the same time.

Juvenile Dermatomyositis Presenting with Erythematous Swelling of the Upper Eyelid

Purpose@#To report a case of juvenile dermatomyositis that presented with erythematous swelling on the upper eyelid as the first clinical sign.Case summary: An 11-year-old female patient presented with erythematous swelling of both upper eye lids that persisted for 3 weeks prior to examination. She also had an erythematous rash over both cheeks but no pain or hyperemia in either eye. During anti-inflammatory eye drop treatment under suspicion of blepharitis, a reddish-purple heliotrope rash appeared around the eyelid margin. She also developed fever, arthralgia, multiple oral ulcers, an erythematous scaly rash behind the ear, and erythematous firm papules on the metacarpal (MCP) joint and around the elbow. On evaluation, aspartate aminotransferase was elevated to 184 IU/L, alanine aminotransferase to 352 IU/L, and alkaline phosphatase to 266 IU/L. We performed a skin biopsy. Based on histopathological examination, the eyelid lesion was diagnosed as dermatomyositis and the MCP joint lesion as Gottron’s papule. From the above findings, we diagnosed the patient with juvenile dermatomyositis based on the European League Against Rheumatism/American College of Rheumatology classification. The patient was treated with prednisolone. Three months after diagnosis, she died from rapidly progressive interstitial pneumonia, a complication of juvenile dermatomyositis. @*Conclusions@#Heliotrope rash should be considered in the differential diagnosis of patients presenting with eyelid swelling, for early diagnosis and better prognosis of juvenile dermatomyositis.

Validation of Sanitation Management Standards for Vegetable Preparation with No-Cook Step Based on Microbiological Analysis

This study evaluated the sanitation management standards for vegetable preparation processes without a cooking stage. The aerobic plate counts (APC), coliform counts, and Escherichia coli of the samples at each production step were analyzed, and microbial growth of the samples stored at different temperatures was measured. The validation was judged in accordance with the microbial criteria stipulated by the British PHLS.After washing and disinfection, the APCs of the two samples decreased to 3∼4 log CFU/g in both seasons. Compared to the purchasing stage, the decrease in coliform counts was approximately 0∼3 log CFU/g in both seasons; E. coli was not detected. The initial APC and coliform levels of two vegetable samples were 4∼ 5 log CFU/g in both seasons, with an increase of 1 log CFU/g taking more than 6 h at 25°C and 2 h at 35°C. More than 10 h at 25°C and 6 h at 35°C were required to increase the E. coli O157:H7 count by 1∼2 log CFU/g for two seasoned samples. In conclusion, washing and disinfection effects and changes in microbial growth during room temperature storage were similar in the two vegetables. Despite the low sanitizing effect of the two vegetables, when cut vegetables were stored under the critical limit within 2 h at two different room temperatures, seasoned lettuce and chicory were at the ‘satisfactory’ or ‘acceptable’ levels of PHLS regardless of the storage temperatures. The validation of sanitation management standards applied to vegetable preparation with the no-cook step was approved.

Analysis of Factors Affecting Breakfast Eating Behavior of Children in Indonesia: An Application of the Health Belief Model / 대한지역사회영양학회지

OBJECTIVES: This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior.METHODS: The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR).RESULTS: The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R²=0.200) and perceived sensitivity (β=0.373, R²=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children.CONCLUSIONS: In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.

Job Satisfaction of Nutritionist: Effect on Organizational Commitment and Turnover Intention in Public Health Center

This study examined the job satisfaction of nutritionists, and its effect on organizational commitment andturnover intention in public health centers. The response data of 174 nutritionists were analyzed. The overallaverage of job satisfaction was 3.94 out of 7 points, which was determined to be below ‘normal’; however, thejob suitability of sub-factors scored 5.26, which was more than ‘normal’. The variables affecting job satisfactionthat were provided by the respondents included job-related licenses (P＜0.01) and co-nutritionists (P＜0.01).Organizational commitment ranked ‘normal’ with a score of 4.35. Normative commitment (4.90) of thesub-factors was ‘normal’ or more, and differed when considering ‘age’ (P＜0.01), ‘employment status’ (P＜0.01),‘salary per year’ (P＜0.05), and ‘working area’ (P＜0.05). The turnover intention was analyzed to be below‘normal’ with 3.88 points, and the variables affecting turnover were significantly higher for subjects in their20s (P＜0.01), less than two job-related licenses (P＜0.05), and less than two co-nutritionists (P＜0.01). Thefour variables of job satisfaction, ‘business discretion’ (P＜0.05), ‘work environment’ (P＜0.01), ‘job suitability’(P＜0.01), and ‘reward’ (P＜0.01), positively affected the organizational commitment. Moreover, organizationalcommitment had a mediating effect (P＜0.01) on job satisfaction and turnover intention. Taken together, ourresults suggest that public health centers need to develop improvement plans for business discretion, workenvironment, job suitability and reward.

Association of Low Hand Grip Strength with Protein Intake in Korean Female Elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018 / 대한지역사회영양학회지

Objectives@#Decreasing muscle strength in old age has become a significant health problem because it increases the risk of falls or fractures and transfers to other diseases. The precise role of dietary protein intake in preventing or reducing muscle weakness is unclear. This study examined the relationship between handgrip strength and protein intake in Korean female elderly. @*Methods@#This was a cross-sectional study that used data from the Seventh Korean National Health and Nutrition Examination Surveys (KNHANES) on female subjects aged 65 years and older. Low handgrip strength (LHGS) was defined as a handgrip strength below than 18 kg. Dietary intake data were obtained using the 1-day 24-hour recall method. Multiple regression was performed to test whether there is an independent relationship between the grip strength and protein intake, and the association between protein intake and LHGS was confirmed through multiple logistic regression. @*Results@#The mean age of the 2,083 elderly females was 73.3 ± 0.1 years, and the prevalence of LHGS was 35% (n=734). Elderly women with an LHGS consumed less energy, total protein, and animal-based protein than those in the normal group. A multiple regression analysis after adjusting for covariate revealed a significant positive association between the handgrip strength and energy, protein, and animal-based protein intake. Multiple logistic regression analysis showed that the odds ratio (OR) of LHGS in female elderly with the highest quartiles of consumption of energy [OR, 0.65; 95% confidence interval (CI), 0.43- 0.82; P for trend=0.004], and animal-based protein [OR, 0.59; CI, 0.40-0.87; P for trend= 0.037] were significantly lower than those in the lowest quartiles. @*Conclusions@#The energy intake and animal-based protein intake were negatively associated with the LHGS. These results suggest that adequate energy intake and protein intake, particularly those from animal-based sources, for elderly women in Korea are beneficial in lowering the risk of LHGS.

Effect of Emotional Coaching Program for Clinical Nurses on Resilience, Emotional Labor, and Self-efficacy

Purpose@#This study aimed to assess the effect of the emotional coaching program for hospital nurses. @*Methods@#The study used anon-equivalent control group pretest-posttest design, and participants included 60 nurses (30 in the experimental group and 30 in thecontrol group) who worked at a general hospital. The experimental group attended four sessions, one per week, with each session lastingtwo and a half hours. Collected data were analyzed using descriptive statistics, Fisher’s exact test, x2 test, t-test, paired t-test, and repeatedmeasures ANOVA using SPSS WIN 23.0 program. @*Results@#Significant differences were shown between the experimental and the controlgroups regarding emotional labor (F=68.40, p<.001), resilience (F=48.77, p<.001), and self-efficacy (F=15.31, p<.001). @*Conclusion@#Theemotional coaching program for nurses is useful for enhancing nurses’ emotional labor management, resilience, and self-efficacy. In addition,this program may serve as a basis for providing emotional coaching to nurses in the future.

Factors affecting preference of vegetable in elementary school students: based on social cognitive theory / 한국영양학회지

PURPOSE: This study was conducted to identify the factors affecting vegetable preferences of children based on the social cognitive theory to reduce imbalances in vegetable consumption. METHODS: The survey investigated 177 elementary school students in Yangsan, Gyeongsangnam-do, in June of 2018. The subjects consisted of 44 fifth graders (27.7%) and 128 (72.3%) sixth graders. RESULTS: Among personal factors of the Social Cognitive Theory, positive outcome expectation and self-efficacy of the vegetable preference group were significantly higher than those of the non-preference group. Negative barrier scores of the non-preference group were significantly higher than those of the preference group, and the biggest barrier was that vegetables were tasteless. Among behavioral factors, the nutritional knowledge of vegetables was high, but the degree of practice was low. Practice score of the vegetable preference group was significantly higher than that of the non-preference group. Among environmental factors, the vegetable preference group was more likely to accept advice from people around them than the non-preference group and the most influential people were doctors and parents. In the vegetable intake environment, children in the vegetable preference group had high accessibility to vegetables. Correlation analysis and regression analysis of the social cognitive factors and vegetable preferences revealed all factors except nutritional knowledge showed significant correlation with vegetable preference. And surrounding people (p < 0.01), practice (p < 0.01), and self-efficacy (p < 0.05) had positive effects on vegetable preference. CONCLUSION: These results suggest that providing the health benefits from eating vegetables and educating children for improving their self-confidence are necessary for increasing the preference for vegetables and their intake by children.

Comparison of clinical severity between single- and coinfections of respiratory syncytial virus and influenza virus with common respiratory viruses

PURPOSE: Multiple virus infections may affect clinical severity. We investigated the effect of coinfection of respiratory syncytial virus (RSV) and influenza virus with other respiratory viruses on clinical severity. METHODS: Data from 634 samples of a single tertiary hospital between September 2014 and April 2015 were analyzed for clinical characteristics (fever duration and O2 need, steroid use, and ICU care) between single infection and coinfection of RSV (n=290) and influenza virus (n=74) with 16 common respiratory viruses from hospitalized children. RESULTS: The RSV coinfection group (n=109) (3.1±2.7 days) showed significantly longer fever duration than the RSV single infection group (n=181) (2.6±2.6 days) (P=0.04), while there was no difference in O2 need, steroid use or ICU care in the 2 groups. The influenza coinfection group (n=38) showed significantly higher O2 need than the influenza single infection group (n=36) (21.1% vs. 5.6%, P=0.05), while there was no difference in fever duration between the 2 groups. CONCLUSION: The results indicate that RSV and Influenza coinfections can increase clinical severity and that the severity may be influenced by the nature of coinfecting viruses.

Microbial Quality Analysis of Foods from Daycare Centers Supported by the Center for Children's Foodservice Management in Daegu

This study examined the microbiological quality of daycare center meals. Six menu items from five daycare centers in Daegu included uncooked processed foods (seasoned cucumber and lettuce salad), post-preparation after cooking processed foods (rolled omelet and seasoned soybean sprout), and cooking processed foods (panbroiled beef with oyster sauce and seasoned pork roast). Microbiological analyses were performed for the aerobic plate counts (APC), coliforms, and Escherichia coli. The analyses were conducted in July and November 2017. The mean APC and coliform count of seasoned cucumber decreased significantly from 4.71 log colony forming units (CFU)/g and 2.50 log CFU/g in July to 4.07 log CFU/g and 1.78 log CFU/g in November, respectively (P < 0.01 and P < 0.001). The APC of panbroiled beef with oyster sauce and seasoned pork roast were significantly lower in July (1.84 and 1.79 log CFU/g) than in November (2.41 and 2.28 log CFU/g) (P < 0.001). The coliform counts of panbroiled beef with oyster sauce and seasoned pork roast were significantly greater in November (2.11 and 1.62 log CFU/g) (P < 0.001). E. coli was not detected. Among the foods prepared using the three preparation processes, the post-preparation after cooking processed foods had the lowest microbial quality. The APC and coliform counts of cooking processed foods were satisfactory in July, with an acceptable rating for pan-broiled beef with oyster sauce in November. Time-temperature control and the prevention of cross-contamination are essential during meal production for food safety, regardless of the season.

Effect of carbonated water manufactured by a soda carbonator on etched or sealed enamel / 대한치과교정학회지

OBJECTIVE@#The purpose of this study was to determine the effects of carbonated water on etched or sealed enamel according to the carbonation level and the presence of calcium ions.@*METHODS@#Carbonated water with different carbonation levels was manufactured by a soda carbonator. Seventy-five premolar teeth were randomly divided into a control group and 4 experimental groups in accordance with the carbonation level and the presence of calcium ions in the test solutions. After specimen preparation of the Unexposed, Etched, and Sealed enamel subgroups, all the specimens were submerged in each test solution for 15 minutes three times a day during 7 days. Microhardness tests on the Unexposed and Etched enamel subgroups were performed with 10 specimens from each group. Scanning electron microscopy (SEM) tests on the Unexposed, Etched, and Sealed enamel subgroups were performed with 5 specimens from each group. Microhardness changes in different groups were statistically compared using paired t-tests, the Wilcoxon signed rank test, and the Kruskal-Wallis test.@*RESULTS@#The microhardness changes were significantly different between the groups (p = 0.000). The microhardness changes in all experimental groups except Group 3 (low-level carbonated water with calcium ions) were significantly greater than those in the Control group. SEM showed that etched areas of the specimen were affected by carbonated water and the magnitude of destruction varied between groups. Adhesive material was partially removed in groups exposed to carbonated water.@*CONCLUSIONS@#Carbonated water has negative effects on etched or sealed enamel, resulting in decreased microhardness and removal of the adhesive material.

Relationship between dietary intakes and the double burden of malnutrition in adults of Malang, Indonesia: An exploratory study

BACKGROUND/OBJECTIVES: Urbanization and lifestyle changes have resulted in nutrition transition. Over-nutrition causes obesity increase, although malnutrition still exists. This phenomenon is called a double burden of malnutrition (DBM). This study was conducted to confirm the existence of DBM and to investigate the dietary factors related to DBM in Indonesian adults. SUBJECTS/METHODS: Data for the subjects (51 men and 89 women) who are the adults resided in Malang, Indonesia were collected between July 17 and August 14, 2017, by using questionnaire. Height, weight, waist and hip circumference, blood pressure, blood glucose, total cholesterol, and hemoglobin were also measured for the subjects. RESULTS: The average age of the subjects was 47.2 years. The average height, weight, and body mass index for men were 160.08 cm, 62.6 kg and 25.45 kg/m², respectively, and those for women were 148.74 cm, 58.09 kg, and 26.21 kg/m², respectively. Of the subjects, 3.6% were underweight, 24.3% were normal or healthy weight, while 72.2% were overweight and obese. Analysis of the dietary intakes revealed high for cereal (7.73 points), but very low for milk (0.25 points) and fruits (0.51 points). Dietary diversity was very few overall (< 5). The occurrence of both anemia (23.6%) and chronic diseases such as hypertension (57.1%), diabetes (12.1%), and hypercholesterolemia (3.6%) was considerably high. The existence of DBM was confirmed by 16.4% of the subjects. DBM was observed significantly higher in women than in men. Dietary diversity and DBM occurrence were inversely correlated. On average, the number of chronic diseases was 1.08 in men and 1.79 in women. Dietary diversity inversely affected systolic blood pressure. CONCLUSIONS: DBM existed in adults in Malang, Indonesia due to inadequate dietary intakes, and a high rate of chronic diseases.

CRISPR/Cas9-mediated knockout of CD47 causes hemolytic anemia with splenomegaly in C57BL/6 mice / 한국실험동물학회지

CD47 (integrin-associated protein), a multi-spanning transmembrane protein expressed in all cells including red blood cells (RBCs) and leukocytes, interacts with signal regulatory protein α (SIRPα) on macrophages and thereby inhibits phagocytosis of RBCs. Recently, we generated a novel C57BL/6J CD47 knockout (CD47(−/−) hereafter) mouse line by employing a CRISPR/Cas9 system at Center for Mouse Models of Human Disease, and here report their hematological phenotypes. On monitoring their birth and development, CD47(−/−) mice were born viable with a natural male-to-female sex ratio and normally developed from birth through puberty to adulthood without noticeable changes in growth, food/water intake compared to their age and sex-matched wild-type littermates up to 26 weeks. Hematological analysis revealed a mild but significant reduction of RBC counts and hemoglobin in 16 week-old male CD47(−/−) mice which were aggravated at the age of 26 weeks with increased reticulocyte counts and mean corpuscular volume (MCV), suggesting hemolytic anemia. Interestingly, anemia in female CD47(−/−) mice became evident at 26 weeks, but splenomegaly was identified in both genders of CD47(−/−) mice from the age of 16 weeks, consistent with development of hemolytic anemia. Additionally, helper and cytotoxic T cell populations were considerably reduced in the spleen, but not in thymus, of CD47(−/−) mice, suggesting a crucial role of CD47 in proliferation of T cells. Collectively, these findings indicate that our CD47(−/−) mice have progressive hemolytic anemia and splenic depletion of mature T cell populations and therefore may be useful as an in vivo model to study the function of CD47.

CRISPR/Cas9-mediated knockout of Rag-2 causes systemic lymphopenia with hypoplastic lymphoid organs in FVB mice / 한국실험동물학회지

Recombination activating gene-2 (RAG-2) plays a crucial role in the development of lymphocytes by mediating recombination of T cell receptors and immunoglobulins, and loss of RAG-2 causes severe combined immunodeficiency (SCID) in humans. RAG-2 knockout mice created using homologous recombination in ES cells have served as a valuable immunodeficient platform, but concerns have persisted on the specificity of RAG-2-related phenotypes in these animals due to the limitations associated with the genome engineering method used. To precisely investigate the function of RAG-2, we recently established a new RAG-2 knockout FVB mouse line (RAG-2(−/−)) manifesting lymphopenia by employing a CRISPR/Cas9 system at Center for Mouse Models of Human Disease. In this study, we further characterized their phenotypes focusing on histopathological analysis of lymphoid organs. RAG-2(−/−) mice showed no abnormality in development compared to their WT littermates for 26 weeks. At necropsy, gross examination revealed significantly smaller spleens and thymuses in RAG-2(−/−) mice, while histopathological investigation revealed hypoplastic white pulps with intact red pulps in the spleen, severe atrophy of the thymic cortex and disappearance of follicles in lymph nodes. However, no perceivable change was observed in the bone marrow. Moreover, our analyses showed a specific reduction of lymphocytes with a complete loss of mature T cells and B cells in the lymphoid organs, while natural killer cells and splenic megakaryocytes were increased in RAG-2(−/−) mice. These findings indicate that our RAG-2(−/−) mice show systemic lymphopenia with the relevant histopathological changes in the lymphoid organs, suggesting them as an improved Rag-2-related immunodeficient model.

Related factors for and changes in clinical manifestations in mycoplasma pneumonia nonresponsive to macrolide treatment

PURPOSE: Mycoplasma pneumonia is known to be a major cause of community-acquired pneumonia in children. Macrolide has been the first-line treatment for mycoplasma pneumonia, but recently there has been an increasing tendency of macrolide-resistant Mycoplasma pneumoniae (MRMP). Therefore, this study aimed to investigate the clinical tendency and the therapeutic responsibility of mycoplasma pneumonia in terms of the fever duration after treatment and its associated factors. METHODS: A total of 346 children admitted with mycoplasma pneumonia during 3 recent periods (2008–2009, 2011–2012, and 2015–2016) were investigated with clinical manifestations, laboratory test results and chest x-ray findings. Patients were grouped according to fever duration and analyzed for differences in clinical features. RESULTS: There was no statistically significant difference in age or sex between the 3 periods (P=0.284 and P=0.559, respectively). Total fever duration during mycoplasma pneumonia was increased with time (P for trend < 0.001). The patients with a longer fever duration (≥3 days) after macrolide treatment presented with a higher CRP (P < 0.001) and with lobar-type pneumonia (P=0.020) compared to those with a shorter fever duration. Fever duration after steroid treatment became longer in the longer fever group in 2011 (P=0.015) and 2015 (P < 0.001), but not in 2008 (P=0.536). CONCLUSION: This study showed that the therapeutic effect of macrolide or steroid for mycoplasma pneumonia is recently attenuating and that high CRP, lobar-type pneumonia and presence of pleural effusion were the associated factors. Therefore, efforts to decrease MRMP and to develop better treatment guidelines for mycoplasma pneumonia are needed in the future.