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Objective@#Although maintenance treatment for mood disorders is important, the treatment discontinuation rate is reported to be high. This study aimed to investigate the dropout rates and associated factors in mood disorders. @*Methods@#The patients in a mood disorder clinic (n = 535) were examined. Demographic and clinical factors, scores of psychometric scales, time to dropout from initial treatment in patients with bipolar disorder (BP) (n = 288) and depressive disorder (DD) (n = 143) were evaluated based on database of the mood disorder clinic. @*Results@#Among the studied patients with BP and DD, 50% showed dropout in 4.05 and 2.17 years, respectively. The mean survival times were 8.90 years in bipolar disorder I (BP-I), 5.19 years in bipolar II disorder, 3.22 years in bipolar disorder not otherwise specified, 4.24 years in major depressive disorder, and 4.03 years in other depressive disorders.In the multivariate Cox proportional hazards regression model in the BP group, diagnosis BP-I was found to be significantly related to the decrease in dropout rate (hazard ratio [HR] = 0.22, p = 0.001); however, increased past suicide attempt number was significantly related to the increase in dropout rate (HR = 1.13, p = 0.017). In the DD group, none of anxiety disorders as comorbidity, increased scores of openness, and extraversion personality were related to the increase in dropout rate. @*Conclusion@#Patients with BP, especially BP-I, showed a lower dropout rate as compared to patients with other mood disorders.
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Objective@#Apolipoprotein E (APOE) genotype is associated with risk of Alzheimer’s disease (AD), but the association ofAPOE ε4 allele with longitudinal medial temporal lobe atrophy (MTA) has been controversial. This study aims to evaluate the effect of APOE genotype on longitudinal MTA over a 2-year period in cognitively impaired patients with amyloid deposition. @*Methods@#This retrospective longitudinal study included 65 cognitively impaired subjects with amyloid deposition (subjective memory impairment, mild cognitive impairment, and mild AD). Participants were divided into carriers (n=27) and non-carriers (n=38) of the ε4 allele. The main outcome is longitudinal reduction of medial temporal lobe (hippocampus, entorhinal cortex, and parahippocampal gyrus) over 2 years. Analysis of covariance was conducted to compare the differences in longitudinal MTA between groups, controlling for covariates. @*Results@#At baseline, hippocampal volume was 4.6% smaller (6.38±1.13 vs. 6.69±0.83, p=0.026) and entorhinal thickness was6.4% thinner (3.51±0.57 vs. 3.75±0.52, p=0.033) in APOE ε4 carriers than non-carriers. Furthermore, APOE ε4 carriers had significantly 72% greater longitudinal hippocampal atrophy compared to non-carriers (-0.43±0.30 vs. -0.25±0.31, p=0.041). @*Conclusion@#Our findings of baseline or longitudinal MTA in APOE ε4 carriers suggest that APOE ε4 genotype may contrib-ute to underlying pathophysiology of medial temporal lobe in AD.
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Objective@#Mental health promotion programs using virtual reality (VR) technology have been developed in various forms. This study aimed to investigate the subjective experience of a VR-assisted mental health promotion program for the community population, which was provided in the form of VR experience on a bus to increase accessibility. @*Methods@#Ninety-six people participated in this study. The relationship between the subjective experience and mental health states such as depression, anxiety, perceived stress, and quality of life was explored. The subjective experience on depression and stress before and after VR program treatment was compared using the Wilcoxon signed-rank test. The satisfaction with the VR-assisted mental health promotion program was examined after using the VR program. @*Results@#The VR-assisted mental health promotion program on a bus significantly improved subjective symptoms such as depression (p=0.036) and perceived stress (p=0.010) among all the participants. Among the high-risk group, this VR program significantly relieved subjective depressive feeling score (p=0.033), and subjective stressful feeling score (p=0.035). In contrast, there were no significant changes in subjective depressive feelings (p=0.182) and subjective stressful feelings (p=0.058) among the healthy group. Seventy-two percent of the participants reported a high level of satisfaction, scoring 80 points or more. @*Conclusion@#The findings of this study suggest that the VR-assisted mental health promotion program may effectively improve the subjective depressive and stressful feelings. The use of VR programs on buses to increase of accessibility for the community could be a useful approach for promoting mental health among the population.
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Background@#Computer-assisted surgery, including robotic and navigational total knee arthroplasty (TKA), has been proposed as a technique used to improve alignment of implants. The purpose of this study was to compare the clinical and radiological outcomes during a minimum follow-up period of 10 years among robotic, navigational, and conventional TKA. @*Methods@#A total of 855 knees (robotic group, 194; conventional group, 270; and navigational group, 391) were available for physical and radiological examinations over a mean follow-up period of 10 years. The survival rate was analyzed using the KaplanMeier method based on the survival endpoint. The Hospital for Special Surgery score, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Society Score, and range of motion were used for clinical evaluation. The hip-knee-ankle (HKA) axis angle, the coronal inclination of femoral and tibial components, and the presence of radiolucent lines were also assessed at the final follow-up. @*Results@#All clinical assessments at the final follow-up revealed improvements in the three groups without any significant difference among the groups (p> 0.05). The cumulative 10-year survival rate was 97.4% in the robotic group, 96.6% in the conventional group, and 98.2% in the navigational group, with no significant difference (p = 0.447). The rates of complication-associated surgery were not significantly different among the groups (p = 0.907). Only the proportion of outliers in the HKA axis angle showed a significant difference (p = 0.001), but other radiological outcomes were not significantly different among the three groups. @*Conclusions@#Our study demonstrated satisfactory survival rates for robotic, navigational, and conventional TKAs and similar clinical outcomes during the long-term follow-up. Larger studies with continuous serial data are needed to confirm these findings.
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We report a case of subacute psychotic symptoms in a patient with germ cell tumor (GCT). The 32-year-old male patient showed progressive psychotic symptoms with diagnosis of GCT. His psychotic symptoms included delusions of reference and persecution. Brain magnetic resonance imaging, electroencephalography, and laboratory examinations were performed to evaluate any other causes. The clinical, neuroimaging, and laboratory review in this case suggested that the progressively developed psychotic symptoms that led to chronic deterioration were caused by the GCT. This is the case report in which subacute atypical psychotic symptoms in his thirties could develop from a GCT based on previous basic research findings showing the correlations of psychotic symptoms with GCT although it has the limitation of so early speculation.
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Objectives@#Schizophrenia (SPR) is the most devastating mental illness that causes severe deterioration in social and occupational functioning, but, the aetiology remains unknown. The aim was to identify patterns of association and segregation for genetic variants and to identify the genes and signalling pathways that determine the risk of developing SPR, through a family-based Genome-wide association study. @*Methods@#We have recruited 27 probands(with SPR) with their parents and siblings whenever possible. DNA was extracted from blood sampling of 58 individuals in 27 families and analysed in an Illumina core exome single nucleotide polymorphism (SNP) array. A family-based association test was used to derive SNP association values across all chromosomes. @*Results@#Although none of the final 800,000 SNPs reached the genome-wide significant threshold of 5×10-8 , the most significant 3 SNPs were within the 10-5 -10-7 . @*Conclusions@#This confirms that SPR is not monogenic but results as a consequence of interactions between multiple host genes and possibly also environmental factors. The present approach provides novel insights into the mechanisms underlying SPR and raises the possibility of identifying individuals at risk of acquiring this condition. In this study, several possible susceptibility genes have been identified that are linked to a range of different pathways, which could reflect the mind-body interaction that is included in the psychiatric genomics consortium.
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Objective@#The purpose of this study is to investigate the association of the apolipoprotein E (APOE) e4 genotype with cognition, brain volume, glucose metabolism, and amyloid deposition in patients with Alzheimer disease (AD). @*Methods@#This is cross-sectional study of 69 subjects with AD. All subjects were divided into carriers and non-carriers of the e4 allele. Forty APOE e4 carriers and 29 APOE e4 non-carriers underwent neuropsychological, structural magnetic resonance imaging, [18F]fluorodeoxyglucose positron emission tomography scans (PET) and [18F]florbetaben amyloid PET. Analysis of co-variance was conducted to compare the differences on cognition, brain volume, glucose metabolism and amyloid deposition between APOE e4 carriers and non-carriers after controlling demographics. @*Results@#APOE e4 carriers had 50% lower scores of Seoul Verbal Learning Test (delayed recall) compared to non-carriers (0.88±1.65 vs. 1.76±1.75, p<0.05). However, APOE e4 carriers performed better on other cognitive tests than non-carriers (Korean version of Boston Naming Test [11.04±2.55 vs. 9.66±2.82, p<0.05], Rey Complex Figure Test [25.73±8.56 vs. 20.15±10.82, p<0.05], and Stroop test [color response] [48.28±26.33 vs. 31.56±27.03, p<0.05]). APOE e4 carriers had slightly smaller hippocampal volume than non-carriers (3.09±0.38 vs. 3.32±0.38, p<0.05), but greater total brain cortical thickness (1.45±1.55 vs. 1.37±1.24, p<0.05). Amyloid deposition did not differ significantly between APOE e4 carriers and non-carriers, and no signifi-cant difference in glucose metabolism was found between groups. @*Conclusion@#We found that APOE e4 genotype is associated with cognition, brain volume in AD, suggesting that APOE e4 genotype could play an important role in the underlying pathogenesis of AD.
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BACKGROUND/OBJECTIVES@#The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. @*SUBJECTS/METHODS@#A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. @*RESULTS@#This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2 ; 95% confidence interval [CI], 1.59–2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2 ; 95% CI, 1.13–1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2 ; 95% CI, 0.1–1.51; P < 0.05; I2 = 95%). @*CONCLUSIONS@#Quantitative synthesis of the systematic reviews has shown that crosssectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.
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Objective@#Face-to-face evaluation is the most important in psychiatric evaluation, but smart healthcare, including non-face-to-face evaluation, can be beneficial considering the situation in which face-to-face evaluation is limited or the preventive aspect of mental illness. In this paper, we aimed to check whether mental health screening tests have the same significance as paper-based tests even when collected through mobile applications. @*Methods@#A smart mental healthcare screening test was conducted on the 1,327 community subjects. We measured two indicators of depression (Patient Health Questionnaire 9-item scale, PHQ-9) and anxiety (Generalized Anxiety Disorder 7-item scale, GAD-7) to check mental health conditions. @*Results@#The average Cronbach’s alpha value of the PHQ-9 questionnaire was good at 0.870. As a result of PHQ-9’s principal component analysis, one component with an eigenvalue of 1 or more was identified, which is suitable to be described as a single factor. The average Cronbach’s alpha value of the GAD-7 was 0.919. The structural validity of the GAD-7 was confirmed through principal component analysis. @*Conclusion@#Our results show that PHQ-9 and GAD-7 scales performed through mobile applications can have the same meaning as paper-based tests. Surveys using a tablet PC, or smartphone application can monitor residents’ mental health and accumulate data. Based on these data, smart mental health management can check the mental health of residents and treat mental illness in connection with medical services.
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Background@#Examining anger coping styles in patients with mood disorders is essential for a comprehensive understanding of them. This study aims to compare anger coping styles between patients with mood disorders and healthy individuals. @*Methods@#This study involved 237 patients diagnosed with bipolar and depressive disorders and 310 healthy controls. The Anger Coping Scale, specifically developed to assess anger coping characteristics in the Korean population, was used to measure anger coping styles. A comparison was made between patients with mood disorders and healthy individuals. @*Results@#Patients with mood disorders exhibited higher levels of behavioral aggression (p<0.001), verbal aggression (p<0.001), and anger suppression (p=0.001) styles and lower levels of problem-solving (p<0.001) and tensionreleasing (p<0.001) styles when experiencing anger, in comparison to healthy individuals. Furthermore, patients with bipolar disorders demonstrated higher problem-solving (p=0.024) and tension-releasing (p=0.001) coping styles when dealing with anger than patients with depressive disorders. @*Conclusion@#These results suggest that patients with mood disorders may possess more vulnerable anger coping characteristics compared to healthy controls. Additionally, patients with bipolar and depressive disorders exhibit different anger coping styles. Future study should focus on developing anger coping styles in patients with mood disorders.
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Background@#Stress assessment is a crucial aspect of mental health monitoring. The Perceived Stress Scale (PSS), a self-report inventory, assesses the level of stress individuals perceive in their daily lives. This study aimed to evaluate the reliability and validity of PSS shared via a mobile application. @*Methods@#The study included 1,327 residents. All participants completed the PSS, the nine-item Patient Health Questionnaire, and the seven-item Generalized Anxiety Disorder (GAD-7) scale. @*Results@#The average Cronbach’s alpha value for the PSS was 0.938, which is satisfactory. PSS (r=0.631, p<0.01) and GAD-7 (r=0.622, p<0.01) exhibited significant positive correlations. Factor analysis yielded two factors with eigenvalues of 7.855 and 1.463, accounting for 66.56% of the variance. Factor 1 represented “positive” while Factor 2 denoted “negative.” @*Conclusion@#The PSS is an appropriate measurement tool for perceived stress level and maintains its reliability and validity when administered through a tablet PC or smartphone application. Using a mobile application to evaluate PSS in the community would be beneficial.
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Fungi act as important decomposers in the forest environment. They recycle essential nutrients, promote plant growth through mycorrhizal relationships, and act as food for small animals. Samples of 265 indigenous fungal species were collected from Mudeungsan National Park in 2020. These species were identified based on morphological, molecular, and phylogenetic analyses using the internal transcribed spacer (ITS), nuclear large subunit rRNA (LSU), and RNA polymerase II second largest subunit (rpb2) regions. Subsequently, seven species were identified as unrecorded species in Korea: Cordyceps cicadae, Dentocorticium bicolor, Hymenochaete nanospora, Physisporinus crataegi, Rigidoporus piceicola, Russula raoultii, and Scutellinia crinita. This study reveals their detailed macro- and microscopic morphological characteristics with phylogenetic trees to report them as unrecorded species in Korea.
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Although Apiospora Sacc. has previously been considered a sexual morph of Arthrinium species on the basis of phylogenetic, morphological, and ecological diagnoses, a recent study delimited these as different species. Recently, 14 species, including eight new species, of marine Arthrinium have been reported from Korea. Six known species have previously been renamed as species in the genus Apiospora (A. arundinis, A. marii, A. piptatheri, A. rasikravindrae, A. sacchari, and A. saccharicola). However, the eight new species of marine Arthrinium (Ar. agari, Ar. arctoscopi, Ar. fermenti, Ar. koreanum, Ar. marinum, Ar. pusillispermum, Ar. sargassi, and Ar. taeanense) are yet to be studied, and thus the taxonomic status of these species remains to be clarified. In this study, we conducted phylogenetic analyses using the internal transcribed spacer, 28S large subunit ribosomal RNA gene, translation elongation factor 1-alpha, and beta-tubulin regions to confirm the phylogenetic position of these eight species. Based on these analyses, we re-identified the eight Arthrinium species as new combinations in Apiospora. Additionally, among the six known Apiospora species, two (A. piptatheriand A. rasikravindrae) have not previously been recorded in Korea. On the basis of morphological and molecular analyses, we report these as new species in Korea. Herein, we present scanning electron micrographs detailing the morphologies of these species, along with phylogenetic trees and detailed descriptions.
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Many Apiospora species have been isolated from bamboo plants – to date, 34 bambusicolous Apiospora species have been recorded. They are known as saprophytes, endophytes, and plant pathogens. In this study, 242 bambusicolous Apiospora were isolated from various bamboo materials (branches, culms, leaves, roots, and shoots) and examined using DNA sequence similarity based on the internal transcribed spacer, 28S large subunit ribosomal RNA gene, translation elongation factor 1-alpha, and beta-tubulin regions. Nine Apiospora species (Ap. arundinis, Ap. camelliae-sinensis, Ap. hysterina, Ap. lageniformis sp. nov., Ap. paraphaeosperma, Ap. pseudohyphopodii sp. nov., Ap. rasikravindrae, Ap. saccharicola, and Ap. sargassi) were identified via molecular analysis. Moreover, the highest diversity of Apiospora was found in culms, and the most abundant species was Ap. arundinis. Among the nine Apiospora species, two (Ap. hysterina and Ap. paraphaeosperma) were unrecorded in Korea, and the other two species (Ap. lageniformis sp. nov. and Ap. pseudohyphopodii
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Objective@#This study examined the volume of choroid plexus across AD without delusion (AD-D), AD with paranoid delusion (AD+PD), and AD with misidentification delusion (AD+MD). @*Methods@#This is a hospital based cross-sectional study of patients with AD. The main outcome measure is the volume of choroid plexus that were measured as regions of interest with magnetic resonance imaging and the FreeSurfer analysis at baseline. Analysis of covariance (ANCOVA) was conducted to compare the differences on the volume of choroid plexus across AD-D, AD+PD, and AD+MD after controlling demographics. @*Results@#There was no volume difference in the both choroid plexus between AD-D and AD+D. However, the volumes of both cho-roid plexus were significantly reduced in AD+MD compared to AD+PD. @*Conclusion@#Our study demonstrates that AD+MD has significantly reduced volumes of choroid plexus compared to AD+PD. These findings suggest that AD+MD and AD+PD may have different pathophysiological mechanisms related to neuroimmune re-sponses in the choroid plexus.
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Objective@#Although previous studies have shown association between anterior corpus callosum (ACC) and various psychotic disorder, the effect of ACC on development on psychotic symptoms in Alzheimer’s disease (AD) is still unclear. The purpose of this study is to investigate the association of ACC with the development of psychosis in patients with AD. @*Methods@#This is a hospital based cross-sectional study of 241 AD patients. The main outcome measure is the volume of ACC that were measured as regions of interest with magnetic resonance imaging and the FreeSurfer analysis at baseline. Analysis of covariance and Logistic regression analysis conducted to assess the association between the volume of ACC and the presence of psychosis in AD, adjusting for age, education, Clinical Dementia Rating-Sum of Boxes, and total intracranial volume. @*Results@#We found that the volume of ACC is significantly reduced in AD with psychosis (AD+P) compared to AD without psychosis (AD-P) (774.27±142.96 vs. 833.09±142.04, p=0.005). The volume of ACC associated with the presence of psychosis in AD (odds ratio=0.995; 95% confidence interval=0.993-0.997; p=0.006). @*Conclusion@#We have found that reduced volume of ACC in AD+P, suggesting that ACC might play an important role in the underlying pathogenesis of development of psychotic symptoms in AD.
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The phosphorylated 43-kDa transactive response DNA-binding protein (TDP-43) was identified as a major disease protein in sporadic amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration. We present a case with progressive muscle weakness who was diagnosed with sporadic ALS. On postmortem examination, TDP-43 immunoreactive neuronal cytoplasmic inclusions were noted in motor cortex, hippocampus and anterior horns of spinal cord, which was compatible with ALS-TDP, stage 4. This is the first documented autopsy-confirmed ALS case with ALS-TDP pathology in Korea.
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Objectives@#：This study was aimed to investigate whether 1) sexual dimorphism in subcortical gray matter volumes (GMV) and the length ratio between the second and fourth digits (2D:4D) would be found and 2) 2D:4D would have associated with subcortical GMV in healthy elderly people. @*Methods@#：Sixty-two females aged 70.3±6.3 (mean±SD) years and 23 males aged 70.4±4.9 years were recruited from the Dementia Clinic in the Pusan National University Hospital. The subjects with the clinical dementia rating scale-sum of boxes (CDR-SB) total score greater than 2.0, any psychiatric or neurological disease, or any pathologic lesion on brain MRI other than micro-angiopathy were excluded. The 2D:4D of the left and right hands were measured 3 times each. Volumetric segmentation of T1-weighted MRI scans was done by Freesurfer software (v7.1.1.1). @*Results@#：2D:4Ds of males were smaller than those of females significantly on repeated measures ANOVA. The males’ thalamus, putamen, hippocampus in both hemispheres and the right amygdala were larger than females’. These differences were not significant after controlling for age, education and total intracranial volume (ICV). In the females, the left 2D:4D was negatively correlated with the left hippocampal volume. In the males, 2D:4D was positively correlated with the volumes of ipsilateral or contralateral thalamus, hippocampus, amygdala and accumbens. These correlations were not significant after Bonferroni’s correction, except for the right accumbens. @*Conclusions@#：Sexual dimorphism of 2D:4D is preserved in healthy elderly people. There is a significant correlation between the right 2D:4D and GMV of the accumbens in males.
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BACKGROUND/OBJECTIVES@#It is difficult to consistently demonstrate the health effects of soy isoflavones owing to the multitude of factors contributing to their bioavailability. To accurately verify these health effects, dietary isoflavone intake should be measured using a biologically active dose rather than an intake dose. This concept has been expanded to the development of new exposure biomarkers in nutrition research. This review aims to provide an overview of the development of exposure biomarkers and suggest a novel research strategy for identifying the health effects of soy isoflavone intake.MATERIALS/METHODS: We cover recent studies on the health effects of soy isoflavones focusing on isoflavone metabolites as exposure biomarkers. @*RESULTS@#Compared to non-fermented soy foods, fermented soy foods cause an increased concentration of isoflavones in the biofluid immediately following ingestion. The correlation between exposure biomarkers in blood and urine and the food frequency questionnaire was slightly lower than that of corresponding 24-h dietary recalls. Urinary and blood isoflavone levels did not show a consistent association with chronic disease and cancer risk. @*CONCLUSION@#It is crucial to understand the variable bioavailabilities of soy isoflavones, which may affect evaluations of soy isoflavone intake in health and disease. Further studies on the development of valid exposure biomarkers are needed to thoroughly investigate the health effects of isoflavone.
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Objective@#Even though the importance of stress-coping, there is no reliable and valid scale to measure the stress-coping behavior yet. The purpose of this study is to explore the psychometric properties of Behavioral Checklist for Coping with Stress (BCCS). @*Methods@#A total of 458 subjects including healthy subjects and patients with bipolar or depressive disorders were analyzed. The reliability and validity of BCCS were examined by Chronbach’s alpha and exploratory factor analysis using Principal Component Analysis. In order to evaluate criterion-related validity, the Pearson’s correlation analyses between factors of BCCS and relevant scales were performed. @*Results@#BCCS showed good Chronobach’s alpha (0.695–0.833) and had acceptable validity. Factor 1 and factor 4 of BCCS were negatively correlated with depression, anxiety and positivity correlated with task and problem-solving, avoidance, tension-releasing copings in common. Factor 2 and 3 were positively correlated with impulsivity, emotionality, avoidance, behavioral and verbal aggression and tension-releasing copings in common. Different from factor 2, factor 3 was positively correlated with depression, anxiety and anger-suppression. @*Conclusion@#The results of this study suggest that this BCCS might be a reliable and valid scale for measuring stress-coping behaviors. This scale could facilitate research to investigate clinical implications related to behavioral stress-coping.