PREDICTION OF NONDIAGNOSTIC RESULTS IN FINE-NEEDLE ASPIRATION OF THYROID NODULES: UTILITY OF ON-SITE GROSS VISUAL ASSESSMENT OF SPECIMENS FOR LIQUID-BASED CYTOLOGY.

OBJECTIVE: To explore a comprehensive approach for on-site gross visual assessments of liquid-based cytology (LBC) specimens of thyroid nodules and determine morphologic criteria that help predict nondiagnostic rates. METHODS: Two-hundred nodules from 165 patients who underwent fine-needle aspiration (FNA) at our hospital were included in this prospectively designed, retrospective analysis. Specimens were visually assessed on-site for three morphologic categories (specimen color, specimen volume, and particle count) using a 5-point grading. RESULTS: Twenty-two nodules (11%) showed nondiagnostic results. Regarding specimen color, nondiagnostic rates tended to be higher in grades 1 (75%) and 5 (100%) than in grades 2 (18%), 3 (8%), or 4 (17%), with a significant difference between grade 1 and grade 3 ( P = .003). For specimen volume, nondiagnostic results were significantly more common in grade 1 (33%) and 5 (33%) than in grades 3 (5%) or 4 (1%) ( P<.005). There was a significant negative correlation between the grading of the particle count and the nondiagnostic rate (Spearman ρ = -1.000; P<.001). The sensitivity and specificity in the prediction of nondiagnostic results were 77% and 76%, respectively, at the optimal cutoff value of 2 (grade 2 or lower). CONCLUSION: Particle count was an important morphologic criterion that helped predict nondiagnostic rates in LBC specimens of thyroid nodules, and the specimen color and volume were also useful adjuncts. In routine practice, on-site gross visual assessment followed by resampling (if necessary) may potentially help reduce the rates of nondiagnostic results, repeat FNAs, and the number of unnecessary needle passes. ABBREVIATIONS: FNA = fine-needle aspiration; LBC = liquid-based cytology; ROC = receiver operating characteristic; US = ultrasonography.

Gender- and age-group-specific associations between physical performance and bone mineral density, falls, and osteoporotic fractures in Koreans: the Chungju Metabolic Disease Cohort study.

Several factors increase the risk of fragility fracture, including low bone mineral density, falls, and poor physical performance. The associations among these factors have been investigated; however, most of the subjects of previous studies were either elderly men or elderly women, and the associations were controversial. The aim of this study was to evaluate the associations between physical performance and bone mineral density, and the history of falls and fractures, stratified by gender and age group. We analyzed 5368 subjects who were aged 50 years or older, including 1288 younger men (younger than 70 years), 1615 younger women (younger than 70 years), 1087 older men (70 years or older), and 1378 older women (70 years or older). We used the one-leg standing time (OLST) for assessing static balance and the timed up-and-go test (TUGT) for assessing dynamic balance. The subjects in the worst performance quartile for the OLST were more likely to have osteoporosis than those in the best performance quartile. Additionally, women who had experienced a fracture during the past 2 years were 1.68 times more likely to be in the worst performance quartile for the OLST than women without a previous fracture. Although the TUGT time was not associated with either the incidence of osteoporosis or the fracture history, the odds ratios for falling were 1.51 and 1.28 as the TUGT time increased by one standard deviation in younger men and younger women, respectively. The findings of the present study show that the OLST was associated with the incidence of osteoporosis and previous fracture and that the TUGT time was associated with the incidence of falling.

Higher adherence to a Mediterranean-type diet is associated with reduced psychosocial stress levels in baby boomers: a cross-sectional study.

BACKGROUND/OBJECTIVES: This study investigated the relationship between adherence to the Mediterranean diet among Korean baby boomers and their levels of psychosocial stress. SUBJECTS/METHODS: The study included 1,656 adults (889 men and 797 women) born between 1955 and 1963 who participated in the 2005-2006 survey of the community-based Korean Genome and Epidemiology Study (KoGES). The Mediterranean-type diet score (MTDS) was calculated from the semi-quantitative food frequency questionnaire (SQFFQ) data. The psychosocial stress levels were calculated using the psychosocial well-being index-short form (PWI-SF). Logistic regression analyses were performed to analyze the association between the MTDS (tertiles) and the prevalence of high psychosocial stress by gender. RESULTS: The ranges of the MTDS tertile groups were T1 (20-33 points), T2 (34-37 points), and T3 (38-39 points) for men, T1 (20-33 points), T2 (34-37 points), and T3 (38-48 points) for women. In both men and women, the consumption of whole grains, potatoes, fruits, vegetables, legumes, and fish increased with higher MTDS, while the consumption of red meat and dairy products decreased (P for trend < 0.05). As MTDS score increased the intake of energy, fiber, vitamins, and minerals (P for trend < 0.05). Men in the highest MTDS tertile had a 41% lower odds ratio (OR) of high psychosocial stress compared with those in the lowest tertile (OR, 0.59; 95% confidence interval [CI], 0.38-0.91). Similarly, women in the highest tertile of the MTDS had a 39% lower OR of high psychosocial stress compared with those in the lowest tertile (OR, 0.61; 95% CI, 0.40-0.95). CONCLUSION: Promoting adherence to the Mediterranean diet among baby boomers may have a positive impact on reducing their levels of psychosocial stress.

Nursing practice readiness improvement program tailored for newly graduated registered nurses: A quasi-experimental study.

BACKGROUND: Helping newly graduated registered nurses successfully adapt to clinical practice, evaluating work capabilities, identifying deficiencies, and continuously providing educational support to improve deficiencies are reported to be of paramount importance. OBJECTIVES: To develop a tailored nursing practice preparation improvement program for newly graduated registered nurses and assess its impact on the successful adaptation of nurses. DESIGN: A quasi-experimental study. SETTINGS: The study was performed at a tertiary general hospital in South Korea. PARTICIPANT: A total of 53 newly graduated registered nurses (experimental group = 28; comparison group = 25) participated. METHODS: The newly graduated registered nurses were recruited using purposive sampling to one of two groups. The study was conducted between February and May 2022. The experimental group underwent a 4-week education program that integrated various methods, whereas the control group underwent preceptor training in their department. Data were collected through a questionnaire survey and analyzed using the chi-square test, independent t-test, and analysis of covariance with the SPSS 26.0 program. RESULTS: The nursing practice readiness improvement program tailored for newly graduated registered nurses was effective in reducing the transition shock (F = 9.18, p = 0.004) of newly graduated registered nurses and improving nursing practice readiness (F = 19.90, p < 0.001), job satisfaction (F = 4.09, p = 0.049), and retention intention (F = 6.20, p = 0.016). CONCLUSIONS: This study presented an evidence based approach on the use of a nursing practice readiness improvement program for the successful adaptation of newly graduated registered nurses and the establishment of a nurse education system.

Endocrinopathies in transfusion-associated iron overload.

BACKGROUND: Transfusional iron overload primarily results in reticuloendothelial iron accumulation, which is considered to be less harmful than parenchymal iron accumulation. However, systematic and comprehensive data on endocrine function in transfusion-associated haemochromatosis are limited. METHODS: We examined 25 aplastic anaemia patients (11 men and 14 women) diagnosed with transfusion-associated haemochromatosis at a single institution. Pituitary function was determined with a combined pituitary function test. On a different day, a 75-g oral glucose tolerance test was performed. The bone mineral density (BMD) of the lumbar spine and total hip was assessed with dual-energy X-ray absorptiometry. RESULTS: Twenty-two (88%) of these 25 patients had at least one endocrine abnormality, and 12 had more than one abnormality. The most common pituitary hormonal deficiency involved the pituitary-gonadal axis; 54% of the total subjects had hypogonadotropic hypogonadism. Two patients had an insufficient cortisol response to corticotrophin-releasing hormone stimulation. No patient had a deficiency of growth hormone or thyroid-stimulating hormone. Twelve (48%) had diabetes mellitus, and these patients tended to have higher concentrations of ferritin, alanine aminotransferase and γ-glutamyl transferase. Osteoporosis (T-score <-2·5 SD) was observed in 48% of patients. The reduction in BMD was more pronounced in the lumbar spine than in the total hip. The patients with osteoporosis were accompanied by hypogonadism, which predominantly affected the trabecular bone. CONCLUSIONS: Our observations suggest that endocrinopathies are common in transfusion-associated haemochromatosis.

Sodium intake trend and current intake level by meal provision place among the citizens of Seoul.

BACKGROUND/OBJECTIVES: The diversity of meal provision places has increased in recent years and sodium intake can vary depending on where meals are eaten, particularly in large cities. In this study, an analysis of the recent trends in sodium intake was performed and a comparison of sodium intake level according to meal provision place among citizens of Seoul was performed. SUBJECTS/METHODS: Data from a 24-h recall dietary intake survey from the 2010-2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used in order to determine the trends in sodium intake among citizens of Seoul, aged 3-74 years old. (n = 11,811). The trend of daily sodium intake was presented in absolute amount and proportion compared to the chronic disease risk reduction intake (CDRR) for each selected characteristic. A comparison of sodium intake level according to meal provision place by sex and age groups as a total amount per meal (mg), density per meal (mg/1,000 kcal), and proportion of the daily sodium intake was performed using the 2016-2019 KNHANES. RESULTS: Sodium intake levels showed a downward trend from 2010-2019. The highest level of sodium intake was observed for subjects aged 30-49, and the level for males aged 30-49 was 202.8% higher than the CDRR. Results of the analysis of sodium intake per meal according to meal provision place showed that the highest sodium intake was in the order of restaurant meal (RM) > institutional foodservice (IF) > home meal (HM) > convenience food (CF). A higher sodium density (mg/1,000 kcal) was observed for IF compared with RM in most adults. Adults aged over 50 years old consumed more than half of the daily sodium in HM. CONCLUSION: Significant variation in the level of sodium intake was observed according to sex and age groups, therefore, different approaches and nutrition policies based on meal provision place are needed.

Potential role of urinary angiotensinogen in predicting antiproteinuric effects of angiotensin receptor blocker in non-diabetic chronic kidney disease patients: a preliminary report.

OBJECTIVES: Many chronic kidney disease (CKD) patients have persistent overt proteinuria despite angiotensin receptor blocker (ARB) treatment. This study investigated whether the initial difference in intrarenal renin-angiotensin system activity measured with urinary angiotensinogen would affect the antiproteinuric effects of ARB. METHODS: Between September 2005 and September 2008, in 50 non-diabetic proteinuric CKD patients not taking renin-angiotensin system inhibitors, the urinary protein/creatinine ratio (P/Cr), angiotensinogen/creatinine ratio (AGT/Cr), plasma renin and aldosterone were measured before starting valsartan, and were followed for 18 months. RESULTS: Patients were divided into three groups according to their initial urinary AGT/Cr. The urinary P/Cr was lower in the low angiotensinogen group, but similar in the high and extremely high angiotensinogen groups (1.3±0.38 vs 2.0±0.92 vs 2.2±0.78). In all groups, the urinary P/Cr was decreased most for the first 6 months. The urinary P/Cr reduction at 6 months was greatest in the high angiotensinogen group (-24.2% vs -46.2% vs -16.4%). The urinary AGT/Cr was decreased most in the high angiotensinogen group. Renal functional deterioration was attenuated in the high angiotensinogen group compared with the extremely high angiotensinogen group. CONCLUSIONS: The antiproteinuric effects of ARB were different according to the initial urinary angiotensinogen levels. These results suggest the potential value of the initial urinary AGT/Cr for predicting the therapeutic effect of ARB in proteinuric non-diabetic CKD patients.

Relationship between vitamin D, parathyroid hormone, and bone mineral density in elderly Koreans.

There is controversy regarding definition of vitamin D inadequacy. We analyzed threshold 25-hydroxyvitamin D (25[OH]D) below which intact parathyroid hormone (iPTH) increases, and examined age- and sex-specific changes of 25(OH)D and iPTH, and association of 25(OH)D and iPTH with bone mineral density (BMD) in elderly Koreans. Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women. Femur neck BMD above and below threshold differed when threshold 25(OH)D concentrations were set at 15-27.5 ng/mL in men, and 12.5-20 ng/mL in postmenopausal women. Vitamin D-inadequate individuals older than 75 yr had higher iPTH than those aged ≤ 65 yr. In winter, age-associated iPTH increase in women was steeper than in summer. In conclusion, vitamin D inadequacy threshold cannot be estimated based on iPTH alone, and but other factors concerning bone health should also be considered. Older people seemingly need higher 25(OH)D levels to offset age-associated hyperparathyroidism. Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.

Comparison of physicochemical characteristics and consumer perception of rice samples with different countries of origin and prices.

BACKGROUND: Rice is the only food item which is not liberalized in Korea. To prepare for future liberalization of the rice market in Korea, the physicochemical characteristics and consumer perception of four domestic rice samples were compared with those of 11 foreign rice samples. Additionally, the influences of country of origin (CO) and price on purchase intent (PI) and willingness to pay (WTP) were investigated. RESULTS: Consumer acceptance of rice samples from Japan was generally higher than that of rice samples from other countries. In an informed test, PI was affected by price and CO, while WTP was affected mostly by price. The PI decreased with the price provided while the WTP increased. In a blind test, consumers evaluated PI and WTP according to sensory liking. The PI was higher in the informed test than in the blind test in all domestic samples. Generally, consumer acceptance was highly correlated with fat acidity (r = - 0.76), protein content (r = - 0.72), and b value (r = - 0.64) of the rice samples. CONCLUSION: Further efforts to increase the quality of rice are recommended for survival in the global market after liberalization of rice, even though consumers showed loyalty for PI of domestic samples.

Association between Diet Quality and Sarcopenia in Older Adults: Systematic Review of Prospective Cohort Studies.

(1) Background: Nutrition is a key determinant of sarcopenia in later life. (2) Methods: A systematic review of prospective cohort studies examining association of diet quality with muscle mass (MM), muscle strength (MS) or physical performance (PP) among older adults was conducted. A total of 22,885 results were obtained from a literature search in MEDLINE via PubMed and EMBASE up to November 2020. Inclusion criteria included diet quality assessment via dietary indices or statistical approaches, a sample of adults aged 45 years and over at baseline in a longitudinal study design. (3) Results: Of the 22,885 cohort studies, 14 studies were eligible. Meaningful results were obtained for the Mediterranean diet and Nordic diet regarding the decrease of sarcopenia risk, however results from non-European countries were inconsistent. In addition, due to the insufficient number of studies on Japanese Food Guide Spinning Top (JFG-ST), dietary variety score (DVS), and dietary quality index-international (DQI-I), effectiveness was difficult to prove. Studies using factor analysis to examine dietary patterns suggested that the risk of sarcopenia is increased with a high in saturated fat diet such as westernized pattern etc. (4) Conclusion: In this systematic review it was found that various diet qualities are meaningful to a decreased risk of sarcopenia.

Stages of menopause and abnormal lung function: a cross-sectional study of middle-aged women.

OBJECTIVE: Whether hormonal changes during menopausal transition postmenopause stages influence pulmonary function is not clearly understood. We evaluated the association between each stage of menopause and the prevalence of abnormal lung function in healthy middle-aged women. We hypothesized that the prevalence of abnormal lung function would increase from the late menopausal transition stage during menopausal transition postmenopause stages. METHODS: The study population included women 40 to 65 years of age who underwent comprehensive health screening examination at the Kangbuk Samsung Hospital Total Healthcare Centers from January 2015 to December 2017. Stages of menopause (premenopausal, early menopausal transition, late menopausal transition, and postmenopausal) were defined using the 2011 Stages of Reproductive Aging Workshop (STRAW + 10) criteria. Abnormal lung function was defined based on spirometry as forced expiratory volume in 1 second/forced vital capacity less than70% or forced vital capacity less than 80% predicted. Prevalence ratios (PRs) for abnormal lung function by stages of menopause were estimated from logistic regression models adjusted for age, anthropometric measurements, lifestyle factors, medical history, lipid and inflammatory biomarkers, and reproductive factors. RESULTS: Among 43,822 participants, there were 4,615 participants (10.5%) with restrictive ventilatory disorder and 653 participants (1.5%) with obstructive ventilatory disorder. The fully adjusted PRs (95% confidence interval) for abnormal ventilatory disorder comparing early menopausal transition, late menopausal transition, and postmenopausal stage to premenopausal stage were 1.01 (0.94-1.08), 1.13 (1.03-1.22), and 1.10 (0.98-1.22), respectively. The fully adjusted PRs for restrictive ventilatory disorder comparing early menopausal transition, late menopausal transition, and postmenopausal stages to premenopausal stage were 1.02 (0.94-1.11), 1.18 (1.06-1.30), and 1.15 (1.00-1.31), respectively. There was, however, no clear association between stages of menopause and obstructive ventilatory disorder. CONCLUSIONS: In this large study of middle-aged women, the fully adjusted prevalence of abnormal lung function, particularly that of restrictive ventilatory disorder, was higher in women in late menopausal transition and menopausal stages compared to women in premenopausal stage.

Improvement of mechanical properties of orodispersible hyaluronic acid film by carboxymethyl cellulose addition.

Orodispersible films (ODF) were prepared with mixtures of hyaluronic acid (HA) and carboxymethyl cellulose (CMC), and the effect of CMC addition on the disintegration and mechanical properties of the composite films were examined. Low molecular weight HA (10 kDa) appeared more acceptable for ODF than high molecular weight HA (800 kDa) because of its rapid disintegration in the oral cavity. The composite films appeared similar to pullulan film with excellent transparency and surface smoothness. The disintegration time as well as mechanical properties of the films such as tensile strength and elongation at break were increased by the addition of CMC. Overall, the CMC addition, up to 35%, improved the mechanical properties of low molecular weight HA film within a proper range of disintegration time for ODF.

Evaluation of New Octacalcium Phosphate-Coated Xenograft in Rats Calvarial Defect Model on Bone Regeneration.

Bone graft material is essential for satisfactory and sufficient bone growth which leads to a successful implant procedure. It is classified into autogenous bone, allobone, xenobone and alloplastic materials. Among them, it has been reported that heterogeneous bone graft material has a porous microstructure that increases blood vessels and bone formation, and shows faster bone formation than other types of bone graft materials. We observed new bone tissue formation and bone remodeling using Ti-oss® (Chiyewon Co., Ltd., Guri, Korea), a heterologous bone graft material. Using a Sprague-Dawley rat calvarial defect model to evaluate the bone healing effect of biomaterials, the efficacy of the newly developed xenograft Ti-oss® and Bio-Oss® (Geistilch Pharma AG, Wolhusen, Switzerland). The experimental animals were sacrificed at 8 and 12 weeks after surgery for each group and the experimental site was extracted. The average new bone area for the Ti-oss® experimental group at 8 weeks was 17.6%. The remaining graft material was 22.7% for the experimental group. The average new bone area for the Ti-oss® group was 24.3% at 12 weeks. The remaining graft material was 22.8% for the experimental group. It can be evaluated that the new bone-forming ability of Ti-oss® with octacalcium phosphate (OCP) has the bone-forming ability corresponding to the conventional products.

The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter's Therapy for Insomnia and Nightmares) Study.

Background: Firefighters are vulnerable to irregular sleep patterns and sleep disturbance due to work characteristics such as shift work and frequent dispatch. However, there are few studies investigating intervention targeting sleep for firefighters. This preliminary study aimed to develop and test a sleep intervention, namely FIT-IN (Firefighter's Therapy for Insomnia and Nightmares), which was based on existing evidence-based treatment tailored to firefighters in consideration of their occupational characteristics. Methods: This study implemented a single-group pre-post study design, utilizing an intervention developed based on brief behavior therapy for insomnia with imagery rehearsal therapy components. FIT-IN consisted of a total of three sessions (two face-to-face group sessions and one telephone session). Participants were recruited from Korean fire stations, and a total of 39 firefighters participated. Participants completed a sleep diary for two weeks, as well as the following questionnaires to assess their sleep and psychological factors: insomnia severity index (ISI), disturbing dream and nightmare severity index (DDNSI), Epworth sleepiness scale (ESS), depressive symptom inventory-suicidality subscale (DSI), and Patient Health Questionnaire-9 (PHQ-9). These questionnaires were administered before the first session and at the end of the second session. Results: The FIT-IN program produced improvements in sleep indices. There was a significant increase in sleep efficiency (p < 0.01), and a decrease in sleep onset latency, number of awakenings, and time in bed (p < 0.05), as derived from weekly sleep diaries. In addition, significant decreases were shown for insomnia (p < 0.001) and nightmare severity (p < 0.01). Conclusion: There were significant improvements in sleep and other clinical indices (depression, PTSD scores) when comparing pre-and post-intervention scores. FIT-IN may be a feasible and practical option in alleviating sleep disturbance in this population. Further studies will be needed to ascertain FIT-IN's effectiveness.

Cardiovascular Health Metrics in the Development and Regression of Nonalcoholic Fatty Liver Disease: A Cohort Study.

Cardiovascular Health (CVH) metrics scores are associated with cardiovascular disease but whether CVH scores are associated with nonalcoholic fatty liver disease (NAFLD) is uncertain. Our aim was to investigate associations between CVH scores and development or regression of NAFLD. A cohort study was performed in Korean adults who underwent a comprehensive health examination. The CVH metrics were defined according to the American Heart Association Life's Simple 7 metrics, ranging from 0 (all metrics considered unhealthy) to 7 (all metrics considered healthy). Fatty liver was diagnosed by ultrasound, and liver fibrosis assessed using NAFLD fibrosis score (NFS). Among 93,500 participants without NAFLD or fibrosis at baseline, 15,899 developed NAFLD, and 998 developed NAFLD plus intermediate/high NFS. Healthy CVH metrics were inversely associated with NAFLD and also NAFLD with fibrosis. In time-dependent models after updating the CVH score and confounders as time-varying covariate, the multivariable-adjusted hazard ratio (95% confidence intervals) for incident NAFLD plus intermediate/high NFS participants with CVH metrics score 2, 3, 4, 5, or 6-7 to those with score 0-1 were 0.86 (0.59-1.25), 0.51 (0.36-0.73), 0.44 (0.31-0.62), 0.20 (0.14-0.29) and 0.09 (0.05-0.14), respectively. Regression of NAFLD occurred in 9742/37,517 participants who had NAFLD at baseline with positive association with CVH metrics. Higher CVH scores were significantly associated with both (a) decreased incidence of NAFLD, and (b) regression of existing NAFLD. Promoting adherence to ideal CVH metrics can be expected to reduce the burden of NAFLD as well as cardiovascular disease.

Association between changes in N-terminal pro-brain natriuretic peptide levels and changes in left ventricular mass index in stable hemodialysis patients.

BACKGROUND/AIMS: Left ventricular (LV) hypertrophy is a powerful predictor of mortality in dialysis patients. Serial measurements of LV mass provide prognostic information. We evaluated the association between changes in biomarkers and changes in LV mass index (LVMI) in hemodialysis (HD) patients. METHODS: This was a prospective study of 21 stable HD patients with preserved LV ejection fraction (> or =50%). Echocardiography and measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP), brain natriuretic peptide (BNP) and cardiac troponin T were performed on the same day and repeated 6 and 12 months later. RESULTS: At baseline, the NT-proBNP and BNP levels correlated with LVMI. Percent changes in LVMI were positively associated with those in log-transformed NT-proBNP levels during both the first (baseline vs. month 6, r = 0.78, p < 0.001) and the second 6 months (months 6 vs. 12, r = 0.73, p < 0.001). Among the 3 biomarkers, NT-proBNP was the only one that was related to changes in LVMI by multivariate correlation analysis, including age, sex, blood pressure, predialysis weight and use of angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. CONCLUSION: Our results show that changes in LVMI are closely correlated with variation in NT-proBNP levels in HD patients. These data have significant implications for the application of NT-proBNP as a biomarker for assessing changes in LVMI in HD patients.

Excessive nitric oxide attenuates leptin-mediated signal transducer and activator of transcription 3 activation.

The mechanisms of leptin resistance observed in most cases of human obesity are poorly understood. Therefore, we evaluated the effects of nitric oxide (NO) on the leptin-induced activation of Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) pathways and on the leptin receptor (LEPR) expression using SH-SY5Y cells. Here, we show that the NO donor spermine/NONOate inhibited leptin-induced activation of STAT3 in vitro. The inhibition of leptin-mediated STAT3 phosphorylation caused by excessive NO was partially prevented by a sulfhydryl reducing agent, ascorbic acid. Cellular experiments show that reduced expression of long form leptin receptor (LEPR-b) and STAT3 protein instability induced by NO may be mechanisms of the NO-mediated inhibition of leptin-STAT3 signaling. We also present data showing that the hypothalamic NO content of high-fat (HF)-diet-induced obese mice was higher than that of control mice; this is likely caused by decreased caveolin-1 expression and increased nNOS expression induced by HF diet over 19 weeks. Concurrently with the overproduction of NO, the decrease of hypothalamic LEPR-b in obese mice also supports these in vitro data. Combined results suggest that excess of NO can induce the attenuation of leptin-mediated STAT3 activation through reduced expression of LEPR-b mRNA and instability of STAT3 protein at least in part. Furthermore, our in vivo data indicate that long-term HF diet induces hypothalamic overproduction of NO, which may be related with leptin insensitivity. However, further study is required to warrant direct in vivo evidence of a causal relationship between endogenous excess of hypothalamic NO and central leptin resistance.

[The study on predictors of depression for Korean female adolescents].

PURPOSE: The purposes of this study were 1) to compare the contribution of demographic-behavioral variables and psychological variables in explaining the variance of depression, 2) identify the most important predictors of depression for Korean female adolescents. METHOD: The participants were 840 female adolescents. Data was collected through self-report questionnaires, which were constructed to include demographicbehavioral factors, self-esteem, hostility, hopelessness, and depression. Data was analyzed using the SPSS program. RESULT: Female adolescents' demographicbehavioral variables explained 17% of the variance in depression, and perceived physical health status, history of physical abuse, smoking, satisfaction of body weight, parental alcohol abuse, parental divorce, and history of suicidal attempt were the significant predictors of depression for female adolescents. Psychological variables explained 50% of the variance in depression, and self-esteem, hostility, and hopelessness were the significant predictors of depression for female adolescents. The significant predictors of depression among female adolescents' demographicbehavioral variables and psychological variables were self-esteem, hostility, hopelessness, perceived physical health status, parental alcohol problem, and history of physical abuse, explaining 52% of the variance in depression. CONCLUSION: In order to reduce depression in female adolescents, it is necessary to design an intervention program that emphasizes improving self-esteem while reducing hostility and hopelessness.

Predictors of suicidal ideation among high school students by gender in South Korea.

The purpose of this study was to examine the evidence to determine if there are gender differences in suicidal ideation of adolescents. This study examined the main effect of risk factors from 5 domains and protective factors from 1 domain in relation to suicidal ideation by gender and identified the most important predictors of suicidal ideation for males (N = 654) and females (N = 658). This study was a cross-sectional survey, and data were collected through self-report questionnaires. In the univariate analysis, especially, risk factors from behavioral variables and psychosocial-environmental variables appeared to be gender skewed. For males, all behavioral variables were predictive of suicidal ideation. For the females, unlike the males, Wang-tta or victim of bullying behavior and sexual orientation as behavioral variables were predictive of suicidal ideation. For males, parental divorce and parental alcohol abuse as psychosocial-environmental variables were predictive of suicidal ideation. For the females, again unlike for the males, all the psychosocial-environmental variables were not predictive of suicidal ideation. The most important predictors of suicidal ideation for males as a result of the multivariate analysis were history of suicidal attempt, depression, hostility, smoking, parental alcohol abuse, communication with friends, and self-esteem. The most important predictors of suicidal ideation for females as a result of the multivariate analysis were depression, hostility, sexual orientation, and self-esteem. These results would indicate that an effective suicide screening and prevention program for adolescents should consider gender differences.

[Satisfaction with life and it's predictors of Korean adolescents].

PURPOSE: This study was done to investigate the satisfaction with life in adolescents, and to identify factors affecting satisfaction with life for them. METHOD: The participants were 1,057 adolescents. Data was collected through self-report questionnaires which were constructed to include satisfaction with life, self-esteem, hostility and hopelessness. The data was analyzed using the SPSS program. RESULT: Satisfaction with life for adolescents was significantly different according to school type, grade, scholastic achievement, religion, monthly income of family, conversation with parents and conversation with friends. Satisfaction with life in adolescents correlated with self-esteem, hostility and hopelessness. Significant predictors influencing satisfaction with life in adolescents were self-esteem, hopelessness, school type, conversation with parents, monthly income of family and religion, and these predictors accounted for 37.8% of the variance in satisfaction with life. CONCLUSION: The above findings indicate that satisfaction with life in adolescents is influenced by self-esteem, hostility and hopelessness. Therefore when nursing interventions are developed to improve satisfaction with life in adolescents, these factors need to be considered.