Bone mineral density among Korean females aged 20-50 years: influence of age at menarche (The Korea National Health and Nutrition Examination Survey 2008-2011).

To evaluate a possible correlation between bone mineral density (BMD) and age at menarche, the present study used the BMD dataset of the Korea National Health and Nutrition Examination Survey IV-V (KNHANES IV-V). Age at menarche had a small but significant association with BMD of the lumbar spine in premenopausal Korean females, aged 20-50 years. INTRODUCTION: To investigate any correlation between bone mineral density (BMD) and age at menarche in Korean females using data from the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-V; 2008-2011). METHODS: In total, 37,753 individuals participated in health examination surveys between 2008 and 2011. A total of 5032 premenopausal females aged 20-50 years were eligible. Age, height, weight, and age at menarche were assessed. RESULTS: Results from the univariate linear regression and analysis of covariance (ANCOVA) indicated that age (per 1 year), height (per 1 cm), weight (per 1 kg), exercise (per 1 day/week), familial osteoporosis history (yes), parity (n = 0 to ≥4), and menarche age distribution were associated with BMD of the total femur, femur neck, and lumbar spine. After stratifying the bone area and adjusting for age, parity, alcohol intake, smoking, exercise, and familial osteoporosis history, no effect was seen for the total femur or femur neck. Age at menarche 16~17 and ≥18 years groups were associated with BMD of the lumbar spine only. CONCLUSIONS: Age at menarche had a small but significant association with BMD of the lumbar spine in premenopausal Korean females, aged 20-50 years. Females with late menarche may achieve lower peak bone mass at some skeletal sites, which may put them at greater risk for osteoporosis in later life.

Ectopic pregnancy occurring in the remnant tube of a previous adnexectomy: a case report.

Ectopic pregnancy occurring in the same region is a comparatively rare disease, but sometimes it is very serious to patients if it is delayed. The authors present a case of spontaneous ectopic pregnancy occurring in the ipsilateral salpingectomy stump of a previous adnexectomy that was successfully removed via laparoscopic surgery without complication. This case may support the idea of intrauterine transmigration of a fertilized egg as an etiology of spontaneous ectopic pregnancy. Thus, the potential for ectopic pregnancy in the tubal remnant in cases of previous salpingectomy or adnexectomy needs to be carefully considered.

Effects of ß-Glucan on the Release of Nitric Oxide by Macrophages Stimulated with Lipopolysaccharide.

This research analyzed the effect of ß-glucan that is expected to alleviate the production of the inflammatory mediator in macrophagocytes, which are processed by the lipopolysaccharide (LPS) of Escherichia. The incubated layer was used for a nitric oxide (NO) analysis. The DNA-binding activation of the small unit of nuclear factor-κB was measured using the enzyme-linked immunosorbent assay-based kit. In the RAW264.7 cells that were vitalized by Escherichia coli (E. coli) LPS, the ß-glucan inhibited both the combatant and rendering phases of the inducible NO synthase (iNOS)-derived NO. ß-Glucan increased the expression of the heme oxygenase-1 (HO-1) in the cells that were stimulated by E. coli LPS, and the HO-1 activation was inhibited by the tin protoporphyrin IX (SnPP). This shows that the NO production induced by LPS is related to the inhibition effect of ß-glucan. The phosphorylation of c-Jun N-terminal kinases (JNK) and the p38 induced by the LPS were not influenced by the ß-glucan, and the inhibitory κB-α (IκB-α) decomposition was not influenced either. Instead, ß-glucan remarkably inhibited the phosphorylation of the signal transducer and activator of transcription-1 (STAT1) that was induced by the E. coli LPS. Overall, the ß-glucan inhibited the production of NO in macrophagocytes that was vitalized by the E .coli LPS through the HO-1 induction and the STAT1 pathways inhibition in this research. As the host immune response control by ß-glucan weakens the progress of the inflammatory disease, ß-glucan can be used as an effective immunomodulator.

Decreased Bcl-6 and increased Blimp-1 in the peritoneal cavity of patients with endometriosis.

PURPOSE OF INVESTIGATION: The authors investigated the expression patterns of interleukin (IL)-lß and tumor necrosis factor (TNF)-α, cytokines associated with peritoneal inflammatory reactions, and of B cell leukemia lymphoma (Bcl)-6 and B lymphocyte inducer of maturation program (Blimp)-1, transcriptional factors associated with immunoglobulin (Ig) production; the concentrations of Igs, and their correlation, in patients with and without endometriosis. MATERIALS AND METHODS: The authors analyzed the peritoneal fluid of 98 patients, 46 with endometriosis, and 52 with benign tumors. RESULTS: IL-1 and TNF-α mRNAs and IgG and IgA concentrations were higher in the endometriosis group, but the differences were not statistically significant. However, Bcl-6 mRNA level was significantly lower and Blimp-1 mRNA level was significantly higher in the endometriosis group with significant correlations among transcriptional factors, Igs, and cytokines (p < 0.05). CONCLUSION: Peritoneal immune responses in patients with endometriosis may be due to increased IgG and IgA concentrations, as well as to changes in expression of proinflammatory cytokines and transcriptional factors.

Paraneoplastic arthritis mimicking rheumatoid arthritis in cervical cancer.

Paraneoplastic arthritis, a subcategory ofparaneoplastic syndrome, presents in a similar manner to rheumatic disorder and usually precedes the detection of the primary tumor by years. Herein, the authors report a case of a patient who was diagnosed with parane- oplastic rheumatoid arthritis (RA)-like arthritis with synchronous cervical cancer. A 38-year-old nulligravida woman was admitted to the gynecology department with a three-month history of irregular vaginal spotting accompanied by severe multiple joint pain. She had a one-year history of RA, for which she had been receiving treatment. During the early stage of treatment, her symptoms were slightly improved by RA treatment; however, after eight months of treatment, she showed absolute resistance to RA treatments and complained of a profuse vaginal discharge with severe foul odor. After colposcopy-directed punch biopsy, she was diagnosed with Stage IIA2 squamous cell carcinoma of the cervix. She underwent radical hysterectomy with lymphadenectomy without complications. After treatment, the multiple joint pain associated with paraneoplastic arthritis spontaneously disappeared. There was no evidence of malignancy according to the follow-up cervical cytology report, magnetic resonance imaging, and positron emission tomography-computed tomography.

Attitudes and practices of Korean gynecologists towards hormone replacement therapy in endometrial cancer survivors.

PURPOSE: To investigate the attitudes of Korean gynecologists towards prescribing hormone replacement therapy (HRT) after treatment for endometrial cancer. MATERIALS AND METHODS: A questionnaire, addressing attitudes towards HRT and treatment strategies for patients previously treated for endometrial cancer, was distributed to 163 Korean gynecologists. RESULTS: Of the 163 gynecologists that were sent this questionnaire, 98 (60.1%) responded. Among the respondents, 81 (82.7%) had previously prescribed HRT to patients with endometrial cancer. Of the latter, 75 (92.6%) had prescribed HRT to patients with Stage I, and more than half to patients with Stage II, endometrial cancer. Of the respondents who had prescribed HRT, 33 (40.7%) did so without regard for cancer-cell type and 33 (40.7%) began patients on HRT more than two years after endometrial cancer treatment. Tibolone was the most commonly prescribed drug (61.9%). The most common reason not to prescribe HRT was fear of cancer recurrence (38.1%). CONCLUSION: Most of the Korean gynecologists surveyed had experience prescribing HRT to endometrial cancer patients. Although HRT is not actively recommended, HRT given post-therapy to endometrial cancer patients is considered acceptable.

The relationship between overweight and otitis media with effusion in children.

OBJECTIVE: To assess the relationship between pediatric otitis media with effusion (OME) and body mass index (BMI). METHODS: We assessed 140 children aged 2-7 years who underwent unilateral or bilateral ventilation tube insertion for treatment of OME (experimental group) and 190 children with no history of OME who underwent operations for conditions other than ear diseases during the same period. Each group was divided into four subgroups based on BMI by age and gender: underweight (BMI below normal limits; BMI ≤ 5 th percentile), normal (BMI within normal limits; 5th < BMI < 85th percentile), overweight (BMI over normal limits; 85 th ≤ BMI < 95th percentile) and obese ( BMI ≥ 95 th percentile). We explored differences in BMI, and serum triglycerides (TG) and total cholesterol (TC), between the experimental and control group, in comparison with values from those of standard body weight. RESULTS: The prevalence of obesity was significantly higher in the experimental than in the control group (P<0.05). BMI, TG and TC did not, however, differ significantly between groups, according to standard body weight. CONCLUSION: Pediatric obesity may have an effect on the development of OME, but pediatric overweight may be not associated with occurrence of OME.

Aggressive angiomyxoma of the vulva treated by using a gonadotropin-releasing hormone agonist: a case report.

A rare case of a 38-year-old woman with progesterone receptor-positive aggressive angiomyxoma is presented. She underwent local excision and was treated with a gonadotropin-releasing hormone agonist as adjuvant therapy, and is free of disease 20 months after.

A multilocus sequence analysis of the genus Xanthomonas.

A multilocus sequence analysis (MLSA) of strains representing all validly published Xanthomonas spp. (119 strains) was conducted using four genes; dnaK, fyuA, gyrB and rpoD, a total of 440 sequences. Xanthomonas spp. were divided into two groups similar to those indicated in earlier 16S rDNA comparative analyses, and they possibly represent distinct genera. The analysis clearly differentiated most species that have been established by DNA-DNA reassociation. A similarity matrix of the data indicated clear numerical differences that could form the basis for species differentiation in the future, as an alternative to DNA-DNA reassociation. Some species, X. cynarae, X. gardneri and X. hortorum, formed a single heterogeneous group that is in need of further investigation. X. gardneri appeared to be a synonym of X. cynarae. Recently proposed new species, X. alfalfae, X. citri, X. euvesicatoria, X. fuscans and X. perforans, were not clearly differentiated as species from X. axonopodis, and X. euvesicatoria and X. perforans are very probably synonyms. MLSA offers a powerful tool for further investigation of the classification of Xanthomonas. Based on the dataset produced, the method also offers a relatively simple way of identifying strains as members of known species, or of indicating their status as members of new species.

Relationships of plant pathogenic enterobacteria based on partial atpD, carA, and recA as individual and concatenated nucleotide and peptide sequences.

Relationships of the genera in the Enterobacteriaceae containing plant pathogenic species: Brenneria, Dickeya, Enterobacter, Erwinia, Pantoea, Pectobacterium, and Samsonia, were investigated by comparison of their nucleotide and peptide sequences of atpD, carA, recA, and the concatenated sequences. Erwinia spp. and Pantoea spp., with Pectobacterium cypripedii, formed a group distinct from other pathogenic taxa. Pectobacterium, Brenneria, Dickeya, and Samsonia formed a contiguous clade. Samsonia was usually concurrent with Pectobacterium. Most Brenneria were also close to Pectobacterium, suggesting that these three taxa might be better represented as a single genus. Brenneria quercina was not closely associated with other members of this genus and may represent a separate genus. The sequences representing Dickeya were distinct, further supporting the generic status of the taxon. Plant pathogenic Enterobacter spp. display such sequence variability that few definite conclusions as to their specific placement could be made. These data highlight the difficulty of drawing reliable and robust taxonomic conclusions based on comparative analysis of sequence data without some independent criterion to calibrate a scale for diversity.

Molecular and morphological characterization of Pyricularia and allied genera.

The phylogenetic relationships of Pyricularia species and species from related genera were established from sequences of the internal transcribed spacer ribosomal RNA gene. Phylogenetic analysis disclosed a consistent correlation with spore morphology. Most Pyricularia species studied, and two species of Dactylaria that have obpyriform conidia, fell within the Magnaporthaceae cluster with high bootstrap support. Pyricularia variabilis was more related to Dactylaria, Tumularia or Ochroconis species than to the Magnaporthaceae. Dactylaria and species of Nakataea, Ochroconis, Pyriculariopsis and Tumularia were distinct from the Magnaporthaceae, and the genus Dactylaria is polyphyletic. The combination of morphological and molecular characters, such as spore morphology and ITS ribosomal DNA sequences data, suggested that conidial shape could be a primary character to distinguish Pyricularia from related genera.

Medication adherence in rheumatoid arthritis patients: older is wiser.

OBJECTIVES: To create a profile of individuals nonadherent to their medications in an age-stratified sample (ages 34-84) of community-dwelling rheumatoid arthritis patients. The relative contributions of age, cognitive function, disability, emotional state, lifestyle, and beliefs about illness to nonadherence were assessed. DESIGN: A direct observation approach was used in conjunction with structural equation modeling. All participants were administered a preliminary assessment battery. Medications were then transferred to vials with microelectronic caps that recorded medication events for all medications for the next 4 weeks. PARTICIPANTS AND SETTING: A volunteer sample of 121 community-dwelling rheumatoid arthritis (RA) patients were recruited from newspaper ads, posters, and via informal physician contact from private rheumatology practices in Atlanta and Athens, Georgia. Written verification of the RA diagnosis and a disease severity rating were obtained from personal physicians before patients were enrolled in the study. Patients were tested in a private physician's office, and their medication adherence was monitored electronically for a month in their every-day work and home settings. MEASUREMENTS AND RESULTS: Structural equation modeling techniques were used to develop a model of adherence behavior. Cognitive and psychosocial measures were used to construct latent variables to predict adherence errors. The model of medication adherence explained 39% of the variance in adherence errors. The model demonstrated that older adults made the fewest adherence errors, and middle-aged adults made the most. A busy lifestyle, age, and cognitive deficits predicted nonadherence, whereas coping with arthritis-related moods predicted adherence. Illness severity, medication load, and physical function did not predict adherence errors. Omission of medication accounted for nearly all errors. CONCLUSION: Despite strong evidence for normal, age-related cognitive decline in this sample, older adults had sufficient cognitive function to manage medications. A busy lifestyle and middle age were more determinant of who was at risk of nonadherence than beliefs about medication or illness. Thus, practicing physicians should not assume that older adults have insufficient cognitive resources to manage medications and that they will be the most likely to make adherence errors. Very busy middle-aged adults seem to be at the greatest risk of managing medications improperly.

Processing of visually presented clock times.

The encoding and representation of visually presented clock times was investigated in three experiments utilizing a comparative judgment task. Experiment 1 explored the effects of comparing times presented in different formats (clock face, digit, or word), and Experiment 2 examined angular distance effects created by varying positions of the hands on clock faces. In Experiment 3, encoding and processing differences between clock faces and digitally presented times were directly measured. Same/different reactions to digitally presented times were faster than to times presented on a clock face, and this format effect was found to be a result of differences in processing that occurred after encoding. Angular separation also had a limited effect on processing. The findings are interpreted within the framework of theories that refer to the importance of representational codes. The applicability to the data of Bank's semantic-coding theory, Paivio's dual-coding theory, and the levels-of-processing view of memory are discussed.

Individual difference and contextual variables influence spatial memory in younger and older adults.

This study examined the influence of individual difference and contextual variables on the magnitude of age differences in memory for spatial location. Younger adults and 2 samples of older adults that differed in educational attainment, verbal intelligence, and working memory ability were compared. Ss studied and later recreated an arrangement of small objects that were placed on a plain map or a visually distinctive model. The objects were either unrelated or categorically related items. The results indicated that distinctive context enhanced spatial memory, and the magnitude of the benefit was generally comparable across age groups and stimulus sets. Hierarchical regression analyses confirmed that working memory resources accounted for a sizable proportion of age-related variance in memory for spatial location. The implications of these results for current views on age-related differences in memory for spatial location are discussed.

Effect of environmental support on implicit and explicit memory in younger and older adults.

The study addressed 2 major issues: whether there are age differences on an implicit word-stem-completion task and whether age differences on both implicit and explicit memory would decrease with increased environmental support. A total of 287 Ss were presented with words in an incidental learning task with structural or semantic processing. Following 2 filler tasks, Ss received an implicit or an explicit word-stem-completion task. The number of letters in the stem varied from 2 to 4. Results yielded an Age x Memory Task dissociation such that there were large age differences on the explicit task and no age difference on the implicit task, regardless of whether Ss aware of the memory test were included or excluded. There was no evidence that environmental support improved older adults' performance more than that of younger adults on either memory task.

The effects of age, illustrations, and task variables on the performance of procedural assembly tasks.

Older adults may be disadvantaged in the performance of procedural assembly tasks because of age-related declines in working memory operations. It was hypothesized that adding illustrations to instructional text may lessen age-related performance differences by minimizing processing demands on working memory in the elderly. In the present study, younger and older adults constructed a series of 3-dimensional objects from 3 types of instructions (text only, illustration only, or text and illustrations). Results indicated that instructions consisting of text and illustrations reduced errors in construction for both age groups compared with the other formats. Younger adults, however, outperformed older adults under all instructional format conditions. Measures of spatial and verbal working memory and text comprehension ability accounted for substantial age-related variance across the different format conditions but did not fully account for the age differences observed.

Memory for news in young and old adults.

Memory for news stories was studied in 48 young and 48 old adults (20-40 and 60-80 years of age, respectively). Three stories selected from actual news programs were presented in print, audio, and TV formats for study. Young adults recalled a higher proportion of news content than old adults and performed better on source recognition tests. Presentation of the information in a TV format led to better performance than in an audio format for both young and old adults. Hierarchical regression analysis revealed that approximately 86% of the age-related variance in news recall was mediated by measures of sensory acuity and processing speed, and commonality analysis revealed that 75% of the age-related variance was mediated jointly by acuity and speed. Findings support common-cause and generalized slowing views of memory impairment in old age.

Judgments about estrogen replacement therapy: the role of age, cognitive abilities, and beliefs.

This study investigated age, cognitive abilities, health beliefs, and other factors in women's judgments about effective treatments for menopause. Women (N = 102) ranging in age from 20 to 79 read a vignette about a woman facing a decision about Estrogen Replacement Therapy (ERT) and then made judgments about what should be done. Participants also completed a battery of questions pertaining to ERT and cognitive abilities. Path-analytic techniques were used to determine the role of specific cognitive abilities and the representation of menopause and its treatment in making judgments about ERT treatments. Cognitive abilities had direct effects on treatment decisions. Education affected the number of perceived options for treatment. Age and education indirectly affected treatment decisions, operating through cognitive abilities. Factors related to the mental representation of menopause had no direct effects and few indirect effects on treatment decisions. Potential mechanisms that can help older adults compensate for declines in cognitive abilities in medical decisions are discussed.

Forgetting of pictures over a long retention interval in young and older adults.

Young and older adults were presented with pictures for study. Their recognition of the information was tested at five retention intervals: immediately, and 48 hr, 1 week, 2 weeks, and 4 weeks later. The main finding of interest was that picture recognition did not show an age-related decline until the 1-week retention interval.

Memory for pictures: does an age-related decline exist?

In the present experiments, the effects of varying detail on memory were examined. In Experiment 1, pictorial embellishment was varied by presenting old and young adults with normal photographs, high-contrast photographs, or line drawings, and testing their memory immediately and 4 weeks later. All of the subjects did best with the most elaborate pictures (normal photographs), and old subjects remembered as well as young at the immediate but not at the delayed interval. In Experiment 2, detail was varied by adding background to line drawings of a central object. Subjects of both ages profited from enhanced background detail, and there were no differences in memory as a function of age. Experiment 3 replicated Experiment 2, except that subjects studied the pictures under divided attention conditions. Again, subjects of both age recognized elaborate pictures best, and no significant age differences emerged. The studies suggest that old and young adults profit from visual embellishment and that memory for meaningful pictures remains relatively intact with age.