Associated Factors of Ischemic Heart Disease Identified Among Post-Menopausal Women

OBJECTIVES: This study identifies associated factors of ischemic heart disease (IHD) among post-menopausal Korean women at the biomedical (age, family history of hypertension, dyslipidemia, type 2 diabetes mellitus, or cerebro-cardiovascular disease, body mass index, and metabolic syndrome), biosocial (socioeconomic status and educational level), and psychosocial levels (stress, depression, smoking, binge alcohol consumption, and physical activity). METHODS: This study used a cross-sectional design with secondary data analysis of the 2013–2016 Korean National Health and Nutrition Examination Survey. Data from 3,636 women were analyzed by logistic regression analysis using a complex sample procedure. RESULTS: Of the biomedical factors, older age [odds ratio (OR): 2.99, 95% confidence interval (CI): 1.87–4.80, p < 0.001], family history (OR: 2.29, 95% CI: 1.44–3.65, p = 0.001), and metabolic syndrome (OR: 1.93, 95% CI: 1.27–2.95, p = 0.002) were associated with IHD in post-menopausal women. Of the psychosocial factors, depression (OR: 2.56, 95% CI: 1.66–3.96, p < 0.001) and smoking (OR: 1.92, CI: 1.04–3.55, p = 0.038) were associated with IHD in post-menopausal women. CONCLUSION: These findings suggest that healthcare providers need to consider the contributing adverse effects of older age, family history, metabolic syndrome, depression and smoking when evaluating risk factors for IHD in post-menopausal women.

Comparison of Sit and Reach Test, Straight Leg Raise Test and Visual Analogue Scale When Applying Static Stretching and Mulligan's Two Leg Rotation in Young Adults with Hamstring Shortness

PURPOSE: This study compared the effects of Static stretching and Mulligan's Two-leg rotation about the Hamstring flexibility, Hip range of motion, and pain.METHODS: The subjects were allocated randomly into two groups: Static stretching group (n=13) and Mulligan's two leg rotation group (n=14). The study was designed with stretching protocols for four minutes and thirty seconds per day five times a week for three weeks in total. Measurements, including the Sit and reach test, Active/Passive Straight leg raise, and Visual analogue scale, were conducted before and after the intervention. The data were analyzed using a paired t-test and independent t-test.RESULTS: The flexibility of the two leg rotation group was higher than the static stretching group after the intervention. The post-sit and reach test value of the two leg rotation group was significantly higher than the pre-sit and reach test value of the static stretching group. In addition, the variance of the sit and reach test of the two leg rotation group was significantly higher than that of the static stretching group.CONCLUSION: These results showed that two leg rotation techniques have a positive effect on the changes in the sit and reach test and active straight leg raise test. Two leg rotation techniques can be recommended as a self-stretching and easier way to stabilize the lumbopelvic rhythm, reduce the stiffness of the muscle and relieve pain. This is effective in preventing muscle damage, enabling muscle relaxation and reducing the risk of injury to the spine during daily lives and in sports activities.

Methyl-CpG Binding Protein 2 in Alzheimer Dementia / 대한배뇨장애요실금학회지

Despite decades of research on Alzheimer disease, understanding the complexity of the genetic and molecular interactions involved in its pathogenesis remains far from our grasp. Methyl-CpG Binding Protein 2 (MeCP2) is an important epigenetic regulator enriched in the brain, and recent findings have implicated MeCP2 as a crucial player in Alzheimer disease. Here, we provide comprehensive insights into the pathophysiological roles of MeCP2 in Alzheimer disease. In particular, we focus on how the alteration of MeCP2 expression can impact Alzheimer disease through risk genes, amyloid-β and tau pathology, cell death and neurodegeneration, and cellular senescence. We suggest that Alzheimer disease can be adversely affected by upregulated MeCP2-dependent repression of risk genes (MEF2C, ADAM10, and PM20D1), increased tau accumulation, and neurodegeneration through neuronal cell death (excitotoxicity and apoptosis). In addition, we propose that the progression of Alzheimer disease could be caused by reduced MeCP2-mediated enhancement of astrocytic and microglial senescence and consequent glial SASP (senescence-associated secretory phenotype)-dependent neuroinflammation. We surmise that any imbalance in MeCP2 function would accelerate or cause Alzheimer disease pathogenesis, implying that MeCP2 may be a potential drug target for the treatment and prevention of Alzheimer disease.

Factors associated with Intermittent and Light Smoking among Korean High School Students: Intermittent and Light Smoking among Korean Adolescents

PURPOSE: The purpose of this study was to identify factors associated with intermittent and light smoking among Korean high school students. METHODS: In this cross-sectional study, we employed secondary data from the 2015 Korea Youth Risk Behavior Web-Based Survey, and used the biopsychosocial model as a framework. The analysis was performed using the data of 2,851 high school students who smoked. We defined intermittent and light smoking as smoking on 1 to 29 days in a 30-day period and no more than 10 cigarettes per day. A logistic regression analysis using the complex samples procedure was conducted. RESULTS: Among all the participants, 1,231 (43.2%) were intermittent and light smokers. Factors significantly predicting intermittent and light smoking were gender and grade (biological factors); subjective stress (psychological factor); and mother's smoking, sibling's smoking and academic achievement (sociocultural factors). CONCLUSION: In smoking cessation programs, health care providers both at school and in the community should consider the unique biological, psychological, and sociocultural characteristics of intermittent and light smoking behavior among high school students.

Sex-based Association between Depression and Metabolic Syndrome in Korean Middle-aged and Older Adults

OBJECTIVES: This study aimed to identify the sex-based association between depression and the development of metabolic syndrome (Mets) among middle-aged and older Korean adults. METHODS: A cross-sectional design was used for the secondary analysis of the 2010–2014 Korean National Health and Nutrition Examination Survey. Data from 1,938 men and 2,404 women were analyzed. Mets was defined in accordance with the criteria used for clinical diagnosis. Depression was assessed with a question about having clinical depression. The association between depression and the development of Mets with or without adjustment for covariates was identified by conducting logistic regression analysis on weighted data using a complex sample procedure. RESULTS: More women than men had depression. Before covariate adjustment, depression was significantly associated with the development of Mets among women (odds ratio [OR], 1.586; 95% confidence interval [CI], 1.152–2.183) and with a higher triglyceride level among men (OR, 1.679; 95% CI, 1.001–2.818). After covariate adjustment; depression was significantly associated with higher waist circumference among women (adjusted OR [AOR], 1.532; 95% CI, 1.046–2.245) and higher triglyceride level (AOR, 1.511; 95% CI, 1.029–2.219) than was Mets. Conversely, depression did not have significant effects on the development of Mets among men. CONCLUSION: Depression was associated with the development of Mets among middle-aged and older Korean women. Healthcare providers in communities should assess women with depression for the presence of Mets components. Interventions for relieving depressive symptoms should also be provided to women at risk for Mets.

Augmentative Effects of Working Memory Training on Behavioral Problems and Parental Stress in Medicated Children and Adolescents with Attention-Deficit Hyperactivity Disorder

OBJECTIVES: Executive dysfunctions including working memory deficit have been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of working memory training on the behavioral problems, quality of life, and parental stress of medicated children with ADHD. METHODS: Twenty-five children with ADHD, aged 9 to 19 years, who were being treated with ADHD medication, were included. The participants were trained with a commercially available and computerized working memory program (Cogmed®) for 5 weeks without any alteration of their medication. The Child Behavior Checklist (CBCL), KIDSCREEN-52 quality of life measure, and Parenting Stress Index-Short Form (PSI-SF) were administered before training, and 4 weeks and 7 months after training, respectively. RESULTS: After completing the training, the anxiety/depression, social problems, thought problems, attention problems, aggressive behavior, and externalizing problems scores in the CBCL were significantly reduced. The score on the Parent-child dysfunctional interaction in the PSI-SF was also decreased. However, the scores related to the quality of life were not changed. These changes were still observed 7 months after the training. CONCLUSION: Cogmed working memory training can be a promising training option for the additional improvement of behavioral problems and parental stress in medicated children with ADHD.

Augmentative Effects of Working Memory Training on Clinical Symptoms and Neuropsychology in Medicated Children and Adolescents with Attention-Deficit Hyperactivity Disorder

OBJECTIVES: Executive dysfunction including working memory deficit has been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of Cogmed working memory training on the symptoms and neurocognitive functions in medicated children and adolescents with ADHD. METHODS: Twenty-five children with ADHD, aged 7 to 19 years, taking ADHD medication participated in this study. The participants were trained for 5 weeks with a commercially available and computerized working memory program (Cogmed®) without any changes to their medication. The Korean version of the ADHD Rating Scale, Clinical Global Impression Scale, and Comprehensive Attention Test were administered before training and 4 weeks and 7 months after training, respectively. RESULTS: After completing the training, the clinical symptoms and function, rated by the parents and clinician, were improved. In addition, the level of commission errors was significantly reduced in the selective attention (visual/auditory) task, sustained attention to response task, and flanker task. The untrained visuospatial short-term memory and working memory were also improved. These effects were still observed 7 months after the training. CONCLUSION: Cogmed working memory training can be a promising training option for the additional improvement of the symptoms and deficits in working memory and response inhibition in medicated children with ADHD.

Gender Differences in the Effects of Weight, Weight Perception, and Weight Satisfaction on Depression in Adolescents

PURPOSE: This study aims to investigate gender differences in the association between depressive symptoms and weight, weight perception, and body satisfaction among Korean adolescents. METHODS: A secondary data analysis was performed on data from 33,374 adolescents who participated in the 2015 Adolescent Health Behavior Online Survey. They were classified as underweight, normal weight, or overweight/obese; weight perception was classified into perception of being underweight, normal weight, or overweight/obese; and weight satisfaction into desire to gain weight, satisfied, and desire to lose weight. RESULTS: Among boys, perception of being underweight (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.07~1.35) and desire to gain weight (AOR: 1.45, 95% CI: 1.30~1.62) were associated with depression. Among girls, perception of being overweight or obese (AOR: 1.18, 95% CI: 1.07~1.29) and a desire to lose weight (AOR: 1.30, 95% CI: 1.18~1.42) were associated with depression. CONCLUSION: Gender differences were observed in the association between weight perception and depression in adolescents. The perception of being underweight among boys and the perception of being overweight/overweight among girls were associated with depression. Thus, gender-specific intervention programs to correct weight perception and weight satisfaction are needed in order to relieve depressive symptoms in adolescents.

Pediatric anaphylaxis at a university hospital including the rate of prescribing epinephrine auto-injectors

PURPOSE: Anaphylaxis is an acute, life-threatening systemic reaction which should be treated by epinephrine, and patients should be prescribed epinephrine auto-injector after the event. The purpose of this study was to investigate the clinical features of pediatric anaphylaxis, including the rate of using epinephrine at hospital and prescribing epinephrine auto-injector. METHODS: We performed a retrospective study of 68 anaphylactic patients at in-hospital, out-hospital, and Emergency Department of Soonchunhyang University Cheonan Hospital, Cheonan, Korea, who were under 15 years of age, from January 2013 through December 2014. We reviewed their clinical features, doctor's treatment methods, rate of follow-up and prescribing epinephrine auto-injectors. RESULTS: Causes of anaphylaxis were food (76.5%), drug (10.3%), and idiopathic (13.2%). The involved organs were the skin (86.8%), respiratory tract (80.9%), cardiovascular system (23.5%), and gastrointestinal tract (17.7%). Patients were treated with systemic steroids (91.2%), antihistamines (88.2%), and epinephrine (75.0%). Fifty-three patients (77.9%) revisited our pediatric allergy clinic and epinephrine auto-injectors were prescribed for 25 patients (36.8%). CONCLUSION: Physicians should make an effort to use epinephrine as an initial treatment of anaphylaxis, to prescribe epinephrine auto-injectors, and to give proper information about disease.

Associations between sexually transmitted infections, high-risk human papillomavirus infection, and abnormal cervical Pap smear results in OB/GYN outpatients / 부인종양

OBJECTIVE: This study aimed to examine the meaning and usefulness of sexually transmitted infection (STI) test when caring for patients who have abnormal cervical cytology and/or positive high-risk human papillomavirus (HPV) DNA test results. METHODS: Among patients who underwent liquid-based cervical cytology and HPV DNA tests at the Obstetrics and Gynecology outpatient clinic, 800 patients who showed abnormal cervical cytology were compared with 200 patients in the control group. Both groups were simultaneously tested via multiplex real-time polymerase chain reaction for seven types of STI-causative microorganisms. RESULTS: The positive rate of high-risk HPV infection in total STIs positive group was 1.47 times higher than that of total STIs negative group. The probability of a cytological diagnosis of a grade equal to or higher than atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H) was significantly higher in patients testing positive for total STIs (1.46 times), Chlamydia trachomatis (3.21 times), or Mycoplasma genitalicum (3.58 times) than in those testing negative. The total STIs positive rate was significantly higher for those having a cytological diagnosis of a grade equal to or higher than atypical squamous cells of undetermined significance (ASC-US) when high-risk HPV test result was negative. CONCLUSION: Correlations were present not only between STIs and high-risk HPV infection but also between abnormal cervical cytology and STIs. Therefore, additional evaluation of STIs will be helpful to appropriately diagnose and treat patients with abnormal cervical cytology, positive results on high-risk HPV DNA test, or a cytological diagnosis of ASC-US despite negative high-risk HPV DNA test result.

Serum adipokine concentrations in dogs with diabetes mellitus: a pilot study

This study was conducted to determine whether serum adipokine concentrations differed between healthy dogs and dogs with diabetes mellitus (DM). To accomplish this, 19 dogs with newly diagnosed DM were compared to 20 otherwise healthy dogs. The serum concentrations of visfatin, leptin, IL-1beta, IL-6, IL-18, and TNF-alpha were significantly higher in diabetic dogs than in healthy dogs, whereas the serum adiponectin concentrations were lower in diabetic dogs. However, there were no significant differences in the IL-10 and resistin levels between groups. The serum leptin concentrations in diabetic dogs with and without concurrent disorders differed significantly. Treatment with insulin induced a significant decrease in IL-6 in diabetic dogs without concurrent disorders. These results show that the clinical diabetic state of dogs could modulate the circulating visfatin and adiponectin concentrations directly, while upregulation of leptin was probably a result of concurrent disorders rather than an effect of persistent hyperglycemia as a result of DM.

Human coagulation factor VIII domain-specific recombinant polypeptide expression

BACKGROUND: Hemophilia A is caused by heterogeneous mutations in F8. Coagulation factor VIII (FVIII), the product of F8, is composed of multiple domains designated A1-A2-B-A3-C1-C2. FVIII is known to interact with diverse proteins, and this characteristic may be important for hemostasis. However, little is known about domain-specific functions or their specific binding partners. METHODS: To determine F8 domain-specific functions during blood coagulation, the FVIII domains A1, A2, A3, and C were cloned from Hep3B hepatocytes. Domain-specific recombinant polypeptides were glutathione S-transferase (GST)- or polyhistidine (His)-tagged, over-expressed in bacteria, and purified by specific affinity chromatography. RESULTS: Recombinant polypeptides of predicted sizes were obtained. The GST-tagged A2 polypeptide interacted with coagulation factor IX, which is known to bind the A2 domain of activated FVIII. CONCLUSION: Recombinant, domain-specific polypeptides are useful tools to study the domain-specific functions of FVIII during the coagulation process, and they may be used for production of domain-specific antibodies.

Pigmented Choroidal Metastases Masquerading as Choroidal Melanoma

PURPOSE: To report the first case of pigmented choroidal metastases without enucleation diagnosed with fine-needle aspiration biopsy. CASE SUMMARY: A 47-year-old male was referred to our clinic with a suspected diagnosis of choroidal melanoma in his left eye. Positron emission tomography-computer tomography used to evaluate systemic metastases revealed lung cancer. Pathology of the detected lung mass was primary lung neuroendocrine tumor. To differentiate choroidal metastasis and primary choroidal melanoma, we performed a fine-needle aspiration biopsy for choroidal tumors. The cytology showed results favoring metastatic atypical carcinoid and the patient was started on systemic chemotherapy. CONCLUSIONS: All pigmented choroidal tumors are not choroidal melanomas and choroidal metastases may be pigmented. The present case suggests that proper systemic evaluation and biopsy for suspected choroidal tumor could be helpful in diagnosis.

Dehydroevodiamine.HCl Improves Stress-Induced Memory Impairments and Depression Like Behavior in Rats

Dehydroevodiamine.HCl (DHED) has been reported to prevent memory impairment and neuronal cell loss in a rat model with cognitive disturbance. We investigated the effect of DHED on memory impairment and behavioral abnormality caused by stress. We demonstrated that DHED can improve stress-induced memory impairments and depression-like behaviors by using open-field test, Y-maze test and forced swimming test. DHED treatment significantly recovered the decreases in the levels of neural cell adhesion molecule (NCAM) proteins caused by stress and the decreases in cell viability. Our results suggested that DHED is a potential drug candidate for neuronal death, memory impairment and depression induced by stress.

Practice guidelines for the early detection of cervical cancer in Korea: Korean Society of Gynecologic Oncology and the Korean Society for Cytopathology 2012 edition / 부인종양

The consensus guideline development committee of Korean Society of Gynecologic Oncology was reconvened in March 2012. The committee consisted of 36 experts representing 12 university hospitals and professional organizations. The objective of this committee was to develop standardized guidelines for cervical cancer screening tests for Korean women and to distribute these guidelines to every clinician, eventually improving the quality of medical care. Since the establishment of the consensus guideline development committee, evidence-based guidelines have either been developed de novo considering specific Korean situations or by adaptation of preexisting consensus guidelines from other countries. Recommendations for cervical cancer screening tests, management of atypical squamous and glandular cells, and management of low-grade and high-grade squamous intraepithelial lesions were developed. Additionally, recommendations for human papillomavirus DNA testing and recommendations for adolescent and pregnant women with abnormal cervical screening test results were also included.

Protective Effect of Fisetin (3,7,3',4'-Tetrahydroxyflavone) against gamma-Irradiation-Induced Oxidative Stress and Cell Damage

Ionizing radiation can induce cellular oxidative stress through the generation of reactive oxygen species, resulting in cell damage and cell death. The aim of this study was to determine whether the antioxidant effects of the flavonoid fisetin (3,7,3',4'-tetrahydroxyflavone) included the radioprotection of cells exposed to gamma-irradiation. Fisetin reduced the levels of intracellular reactive oxygen species generated by gamma-irradiation and thereby protected cells against gamma-irradiation-induced membrane lipid peroxidation, DNA damage, and protein carbonylation. In addition, fisetin maintained the viability of irradiated cells by partially inhibiting gamma-irradiation-induced apoptosis and restoring mitochondrial membrane potential. These effects suggest that the cellular protective effects of fisetin against gamma-irradiation are mainly due to its inhibition of reactive oxygen species generation.

Fucoxanthin Protects Cultured Human Keratinocytes against Oxidative Stress by Blocking Free Radicals and Inhibiting Apoptosis

Fucoxanthin is an important carotenoid derived from edible brown seaweeds and is used in indigenous herbal medicines. The aim of the present study was to examine the cytoprotective effects of fucoxanthin against hydrogen peroxide-induced cell damage. Fucoxanthin decreased the level of intracellular reactive oxygen species, as assessed by fluorescence spectrometry performed after staining cultured human HaCaT keratinocytes with 2',7'-dichlorodihydrofl uorescein diacetate. In addition, electron spin resonance spectrometry showed that fucoxanthin scavenged hydroxyl radical generated by the Fenton reaction in a cell-free system. Fucoxanthin also inhibited comet tail formation and phospho-histone H2A.X expression, suggesting that it prevents hydrogen peroxide-induced cellular DNA damage. Furthermore, the compound reduced the number of apoptotic bodies stained with Hoechst 33342, indicating that it protected keratinocytes against hydrogen peroxide-induced apoptotic cell death. Finally, fucoxanthin prevented the loss of mitochondrial membrane potential. These protective actions were accompanied by the down-regulation of apoptosis-promoting mediators (i.e., B-cell lymphoma-2-associated x protein, caspase-9, and caspase-3) and the up-regulation of an apoptosis inhibitor (B-cell lymphoma-2). Taken together, the results of this study suggest that fucoxanthin defends keratinocytes against oxidative damage by scavenging ROS and inhibiting apoptosis.

Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases

Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.

Use of the pedicled buccal fat pad in the reconstruction of intraoral defects: a report of five cases

The buccal fat pad is specialized fat tissue located anterior to the masseter muscle and deep to the buccinator muscle. Possessing a central body and four processes it provides separation allowing gliding motion between muscles, protects the neurovascular bundles from injuries, and maintains facial convexity. Because of its many advantageous functions, the use of the buccal fat pad during oral and maxillofacial procedures is promoted for the reconstruction of defects secondary to tumor resection, and those defects resulting from oroantral fistula caused by dento-alveolar surgery or trauma. We used the pedicled buccal fat pad in the reconstruction of intraoral defects such as oroantral fistula, maxillary posterior bone loss, or defects resulting from tumor resection. Epithelization of the fat tissue began 1 week after the surgery and demonstrated stable healing without complications over a long-term period. Thus, we highly recommend the use of this procedure.

Characteristics and Prognostic Factors of Open-Globe Injuries in Korea

PURPOSE: To characterize epidemiologically open-globe injuries and to identify prognostic factors for visual outcomes after open-globe injuries in Korea. METHODS: The medical records of 138 patients with open-globe injuries presenting to the Severance Hospital between January 2005 and June 2011 were retrospectively reviewed. RESULTS: Out of 138 patients, 85.5% were men. The types of injury included penetrating injury (44.2%), intraocular foreign body (15.9%), blunt injury (35.5%), and perforating injury (3.6%). The most common cause of injury was accidents at work (49.3%) and 60.9% of these injuries were a penetrating wound in zone I limited to the cornea. Predictors of poor visual outcome using univariate analysis included wound extended to posterior sclera, wound length of 10 mm or more, poor initial visual acuity of hand motion or less, and presence of associated ocular injuries at presentation including hyphema, lens injury, vitreous hemorrhage, and retinal detachment. Initial visual acuity and wound size were independent prognostic factors of visual outcome. CONCLUSIONS: Accidents at work are the most important cause of open-globe injuries in Korea. Accordingly, protective measures such as appropriate eyewear and safety education at work are warranted. Initial visual acuity and wound size predicted favorable visual outcome.