Lower socioeconomic status associated with higher tuberculosis rate in South Korea.

BACKGROUND: Tuberculosis is an infectious disease influenced by social factors rather than a simple infectious disease. In this study, we investigated the relationship between tuberculosis rates and socioeconomic status. METHODS: This study was conducted using data of the 49,483 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) VI-VIII (2013-2021). The relationships between tuberculosis rates and the quartiles of monthly household income and education level were examined using a multivariate logistic regression analysis. RESULTS: The KNHANES data revealed that the prevalence of tuberculosis as substantially related to monthly household income (odds ratio [OR], 6.0; 95% confidence interval [CI], 1.1-32.0 for lowest vs. highest incomes) and education level (OR, 3.8; 95% CI, 1.2-12.0 for 10-12 years vs. ≥13 years; OR, 4.1; 95% CI, 1.2-14.8 for ≤ 6 years vs. ≥13 years). Furthermore, current tuberculosis treatment was significantly related to monthly household income and education level. CONCLUSION: There were substantial correlations between tuberculosis rates and socioeconomic status in South Korea.

Re-initiation of bottom water formation in the East Sea (Japan Sea) in a warming world.

The East Sea (Japan Sea), a small marginal sea in the northwestern Pacific, is ventilated deeply down to the bottom and sensitive to changing surface conditions. Addressing the response of this marginal sea to the hydrological cycle and atmospheric forcing would be helpful for better understanding present and future environmental changes in oceans at the global and regional scales. Here, we present an analysis of observations revealing a slowdown of the long-term deepening in water boundaries associated with changes of water formation rate. Our results indicate that bottom (central) water formation has been enhanced (reduced) with more (less) oxygen supply to the bottom (central) layer since the 2000s. This paper presents a new projection that allows a three-layered deep structure, which retains bottom water, at least until 2040, contrasting previous results. This projection considers recent increase of slope convections mainly due to the salt supply via air-sea freshwater exchange and sea ice formation and decrease of open-ocean convections evidenced by reduced mixed layer depth in the northern East Sea, resulting in more bottom water and less central water formations. Such vigorous changes in water formation and ventilation provide certain implications on future climate changes.

Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women.

PURPOSE: Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. METHODS: This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. RESULTS: The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. CONCLUSIONS: Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly.

Factors that Affect Medication Adherence in Elderly Patients with Diabetes Mellitus.

BACKGROUND: This study was conducted to evaluate the factors affecting medication adherence in geriatric diabetic patients treated at private clinics and tertiary hospitals. We compared the factors affecting medication adherence between these two patient groups. METHODS: We included 108 diabetic patients older than 65 years treated at one tertiary hospital and 157 patients older than 65 years treated at two private clinics. We conducted an interview survey based on the Health Belief Model, and used a questionnaire that included the self-efficacy variable. For the medication adherence, Morisky's self-report was used. RESULTS: The medication adherence based on Morisky's self-report was significantly higher in tertiary hospital patients (61.1%) compared to private clinic patients (43.2%) (P < 0.01). The results showed that drug storage and self-efficacy were factors affecting adherence to medication in tertiary hospital patients (P < 0.05). The adherence was high in cases of proper drug storage (odds ratio [OR], 5.401) and in cases with high self-efficacy (OR, 13.114). In private clinic patients, financial level (P < 0.05), recognition of the seriousness of diabetes complications (P < 0.05) and self-efficacy (P < 0.01) were associated with medication adherence. The medication adherence was significantly lower in patients whose financial state were moderate than those with lower (OR, 0.410), and medication adherence was significantly higher in patients who had higher perceived severity (OR, 2.936) and in patients with higher self-efficacy (OR, 4.040). CONCLUSION: Different strategies should be used to increase medication adherence in geriatric diabetic patients, depending on institutions whether they are treated.

Comparison of dietary compliance and dietary knowledge between older and younger Korean hemodialysis patients.

OBJECTIVE: The numbers of older hemodialysis patients (OHPs) are increasing very rapidly worldwide, but few studies have focused on the compliance of OHPs. This study compared the compliance with, and the knowledge of, dietary restriction regimens between OHPs and younger hemodialysis patients (YHPs). Mortality was also compared between these two groups. PATIENTS AND SETTING: A total of 160 patients who were registered at the Asan Medical Center (Seoul, Korea) participated in the study, 64 of whom were classified as OHPs (age >or=65 years), and 96 as YHPs (age <65 years). MAIN OUTCOME MEASURES: Data were collected between September 2003 and February 2004. General characteristics and dietary knowledge of potassium, phosphorus, and sodium and fluid restrictions were assessed by personal interview. Dietary compliance was determined by measuring serum levels of these nutrients and interdialytic weight gain. Subjective global assessments were used to evaluate nutritional status. Both OHPs and YHPs were followed until May 2007 for mortality analysis. The data were analyzed with descriptive statistics, Student's t test, chi(2) test, and Spearman correlation using the SPSS statistical package (SPSS, Inc., Chicago, IL). RESULTS: The OHPs had a lower appetite, lower physical activity, and lower educational level compared with the YHPs. Dietary compliance with phosphorus restriction and with sodium and fluid restriction was higher in the OHPs than in the YHPs (P < .01 and P < .05, respectively), whereas compliance with potassium restriction did not differ between groups. The knowledge scores concerning potassium (P < .05) and phosphorus (P < .01) restriction diets were lower in OHPs than in YHPs, whereas no differences were found for knowledge scores concerning sodium and fluid restriction diets. Mortality was higher in the OHPs than in the YHPs (P < .001). The OHPs with higher mortality had higher dietary compliance with sodium and fluid restriction (r = 0.248, P < .05), and lower nutritional status (r = -0.342, P < .05). CONCLUSIONS: The OHPs were generally less knowledgeable and more compliant, and had a lower appetite and a higher mortality than the YHPs. Therefore, the current application of the same dietary education to both OHPs and YHPs may be problematic. Instead, developing age-specific strategies to increase dietary knowledge and nutritional intake is urgently needed to increase the survival rate of Korean hemodialysis patients.

Expression of Cu/Zn SOD protein is suppressed in hsp 70.1 knockout mice.

Heat shock proteins (HSPs) are known to protect cells from oxidative stress and other types of injuries. We previously reported the neuroprotective effect of HSP70 following cerebral ischemia and reperfusion using hsp 70.1 knockout (KO) mice. However, the precise role of HSP70 in neuroprotection has not been established yet. The purpose of this study was to investigate the relationship between HSP70 and antioxidant enzymes using hsp 70.1 KO mice. The activities of both SOD-1 and SOD-2 were significantly decreased in hsp 70.1 KO mice than in the wild type (WT) littermates. SOD-1 protein level in the hsp 70.1 KO mice was lower than that of WT. We speculate that HSP70 might be involved in regulation of expression of SOD-1 at the level of transcription or by post-transcriptional modification.

Factors affecting the quality of life after ischemic stroke: young versus old patients.

BACKGROUND: Factors affecting the quality of life (QOL) may be different between young and old stroke patients. However, these issues have not yet been properly investigated. METHODS: We identified 170 young-onset stroke patients (onset between 15 and 45 years of age) who were admitted to the Asan Medical Center. Three hundred and forty follow-up period matched, old-onset stroke patients (onset >45 years of age) were chosen as a control group. A follow-up interview was performed 1~5 years after the onset of stroke in 96 young patients and 160 old patients. With the use of standardized questionnaire, we assessed physical disabilities, activity of daily living (Barthel Index Score, modified Rankin scale), the presence of depression (using DSM IV criteria and Beck Depression Inventory) and socio-economic/job status. The QOL was assessed using the Stroke Specific QOL developed by Williams et al. RESULTS: The QOL scores were significantly higher in young patients than in old ones. Univariate analysis showed that factors related to low QOL included unemployment, motor impairment, aphasia, dysarthria, dysaphagia and severe modified Rankin score in young patients while poor economic status, unemployment, supratentorial (vs. infratentorial) stroke, anterior (vs. posterior) circulation stroke, the presence of diabetes mellitus, motor impairment, aphasia, dysarthria, dysphagia, visual field defect, severe modified Rankin score, the presence of post-stroke seizures and depression were related to the low QOL in old patients. Cigarette smoking (in old patients) and alcohol drinking (in both young and old patients) were related to high QOL. Multiple regression analysis showed that modified Rankin score was the most important factor explaining low QOL in both groups, while other important factors included depression, visual field defect and anterior circulation stroke in old patients, and the motor dysfunction and dysarthria in young patients. CONCLUSIONS: We conclude that aside from modified Rankin scale, factors affecting the quality of life are different between these two groups. Recognition of these differences may allow us to develop different strategies to improve the quality of life in stroke patients.

Temporal changes in cerebral antioxidant enzyme activities after ischemia and reperfusion in a rat focal brain ischemia model: effect of dietary fish oil.

This study investigated the neuroprotective effects of dietary supplementation of fish oil on both brain infarction and the activities of antioxidant enzymes. Male Sprague-Dawley rats (4-weeks old) were divided into two groups and received either a regular diet (RD) or a fish-oil-supplemented diet (FOD) for 6 weeks prior to middle cerebral artery (MCA) occlusion. The infarction volume of the brain was calculated using image analysis after staining. Antioxidant enzymes were measured before ischemia (BI), after 2 h of ischemia (AI) and after 24 h (24hR), 48 h (48hR) and after 7 days (7dR) of reperfusion. The infarction volume of the brain was significantly smaller in the FOD group than in the RD group after 24 h of reperfusion (p<0.05). Before ischemia, the levels of lipid peroxide and the glutathione peroxidase (GPx) activity were higher in the FOD group than in the RD group. During reperfusion, the catalase (CAT) activity in the FOD group remained at the preischemia level until after 48 h of reperfusion, while those in the RD group did not. The Mn-superoxide dismutase (SOD) activity and GPx activity were higher in the FOD group than in the RD group only after 2 h of ischemia. In the fatty acid analysis, the ratio of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were higher in the FOD group than in the RD group (p<0.05). Our results demonstrate that supplementing the diet with fish oil could decrease the cerebral infarction volume following ischemia and reperfusion (I/R) partly by working directly as an antioxidant and partly by modulating antioxidant enzyme activities.

Chemopreventive effect of garlic powder diet in diethylnitrosamine-induced rat hepatocarcinogenesis.

This study was conducted to examine the effects of dietary garlic powder at the different levels on preneoplastic foci formation and glutathione (GSH)-dependent detoxifying enzyme activities in rat hepatocarcinogenesis. Male Sprague-Dawley rats were fed with garlic powder supplemented diets (0, 0.5, 2.0 or 5.0%) for 11 weeks, and induced hepatocarcinogenesis by diethylnitrosamine (DEN) and two-thirds partial hepatectomy in medium-term bioassay system. The 2.0 and 5.0% garlic powder diets suppressed the formation of placental GSH S-transferase positive (GST-P(+)) foci in number (49.7 and 63.1% of DEN-treated control group, respectively) and area (44.2 and 63.9% of DEN-treated control group, respectively). Total GSH content in 2.0% garlic powder diet group was 1.2 fold higher than that in DEN-treated control group. GSH S-transferase activity of 2.0% garlic powder diet group was lower than that in DEN-treated control group, and GSH peroxidase (GPx) activity was significantly increased by garlic powder diets (83 and 164% of DEN-treated control group, respectively). GSH reductase activity, however, did not show a noticeable difference among groups. Therefore, the suppression of GST-P(+) foci formation by garlic powder diets could be partly affected by the increase of total GSH content and GPx activity.

Anticarcinogenic effect and modification of cytochrome P450 2E1 by dietary garlic powder in diethylnitrosamine-initiated rat hepatocarcinogenesis.

The purpose of this study was to determine the effects of dietary garlic powder on diethylnitrosamine (DEN)- induced hepatocarcinogenesis and cytochrome P450 (CYP) enzymes in weaning male Sprague-Dawley rats by using the medium-term bioassay system of Ito et al. The rats were fed diets that contained 0, 0.5, 2.0 or 5.0% garlic powder for 8 weeks, beginning the diets with the intraperitoneal (i.p.) injection of DEN. The areas of placental glutathione S-transferase (GST-P) positive foci, an effective marker for DEN-initiated lesions, were significantly decreased in the rats that were fed garlic powder diets; the numbers were significantly decreased only in the 2.0 and 5.0% garlic-powder diets. The p-Nitrophenol hydroxylase (PNPH) activities and protein levels of CYP 2E1 in the hepatic microsomes of the rats that were fed the 2.0 and 5.0% garlic powder diet were much lower than those of the basal-diet groups. Pentoxyresorufin O-dealkylase (PROD) activity and CYP 2B1 protein level were not influenced by the garlic-powder diets and carcinogen treatment. Therefore, the suppression of CYP 2E1 by garlic in the diet might influence the formation of preneoplastic foci during hepatocarcinogenesis in rats that are initiated with DEN.