Design of a Self-Measuring Device Based on Bioelectrical Impedance Analysis for Regular Monitoring of Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a chronic disease, in which permanent joint deformation is largely preventable with the timely introduction of appropriate treatment strategies. However, there is no consensus for patients with RA to monitor their progress and communicate it to the rheumatologist till the condition progresses to remission. In response to this unmet need, we proposed the design of a self-measuring device based on bioelectrical impedance analysis (BIA) for regular monitoring of inflammation levels. Twenty joints of both hands were measured to monitor trends in inflammation levels. Three electrodes were used to measure two joints of each finger. A central electrode was used for two consecutive measurements. A suitable form factor for the device was proposed for the vertical placement of the hand. To ensure the stability of measurements, an air cushion was incorporated into the back of the hand, hand containers were designed on both sides, and a mobile application was designed. We conducted a convergence-assessment experiment with five air pressures to validate the consistency and convergence of bioimpedance measurements. A heuristic evaluation of the usability around the product and mobile application was conducted in parallel by six subject matter experts and validated the design. This study underscores the significance of considering patients' disease activity during intervals between hospital visits and introduces a novel approach to self-RA care.

Pharmacological Treatment for Neuroinflammation in Stress-Related Disorder.

Stress is an organism's response to a biological or psychological stressor, a method of responding to threats. The autonomic nervous system and hypothalamic-pituitary-adrenal axis (HPA axis) regulate adaptation to acute stress and secrete hormones and excitatory amino acids. This process can induce excessive inflammatory reactions to the central nervous system (CNS) by HPA axis, glutamate, renin-angiotensin system (RAS) etc., under persistent stress conditions, resulting in neuroinflammation. Therefore, in order to treat stress-related neuroinflammation, the improvement effects of several mechanisms of receptor antagonist and pharmacological anti-inflammation treatment were studied. The N-methyl-D-aspartate (NMDA) receptor antagonist, peroxisome proliferator-activated receptor agonist, angiotensin-converting enzyme inhibitor etc., effectively improved neuroinflammation. The interesting fact is that not only can direct anti-inflammation treatment improve neuroinflammation, but so can stress reduction or pharmacological antidepressants. The antidepressant treatments, including selective serotonin reuptake inhibitors (SSRI), also helped improve stress-related neuroinflammation. It presents the direction of future development of stress-related neuroinflammation drugs. Therefore, in this review, the mechanism of stress-related neuroinflammation and pharmacological treatment candidates for it were reviewed. In addition, treatment candidates that have not yet been verified but indicate possibilities were also reviewed.

Relationship between Brain Metabolic Disorders and Cognitive Impairment: LDL Receptor Defect.

The low-density-lipoprotein receptor (LDLr) removes low-density lipoprotein (LDL), an endovascular transporter that carries cholesterol from the bloodstream to peripheral tissues. The maintenance of cholesterol content in the brain, which is important to protect brain function, is affected by LDLr. LDLr co-localizes with the insulin receptor and complements the internalization of LDL. In LDLr deficiency, LDL blood levels and insulin resistance increase, leading to abnormal cholesterol control and cognitive deficits in atherosclerosis. Defects in brain cholesterol metabolism lead to neuroinflammation and blood-brain-barrier (BBB) degradation. Moreover, interactions between endoplasmic reticulum stress (ER stress) and mitochondria are induced by ox-LDL accumulation, apolipoprotein E (ApoE) regulates the levels of amyloid beta (Aß) in the brain, and hypoxia is induced by apoptosis induced by the LDLr defect. This review summarizes the association between neurodegenerative brain disease and typical cognitive deficits.

Neuroinflammation in Post-Traumatic Stress Disorder.

Post-traumatic stress disorder (PTSD) is a well-known mental illness, which is caused by various stressors, including memories of past physical assaults and psychological pressure. It is diagnosed as a mental and behavioral disorder, but increasing evidence is linking it to the immune system and inflammatory response. Studies on the relationship between inflammation and PTSD revealed that patients with PTSD had increased levels of inflammatory cytokine biomarkers, such as interleukin-1, interleukin-6, tumor necrosis factor-α, nuclear factor-κB, and C-reactive protein, compared with healthy controls. In addition, animal model experiments imitating PTSD patients suggested the role of inflammation in the pathogenesis and pathophysiology of PTSD. In this review, we summarize the definition of PTSD and its association with increased inflammation, its mechanisms, and future predictable diseases and treatment possibilities. We also discuss anti-inflammatory treatments to address inflammation in PTSD.

Effects of feeding starch sugar by-products on in situ rumen disappearance rate, growth performance, and carcass characteristics of late finishing Hanwoo steers.

OBJECTIVE: The aim of this study was to determine the effects of feeding starch sugar by-products (SSBs) on in situ disappearance rate, performance, and carcass characteristics of Hanwoo steers in the late finishing stage. METHODS: To determine the in situ disappearance rate, nylon bags filled with 5 g of SSB were inserted into the ventral sac of two cannulated Holsteins cows and incubated for 0, 2, 4, 8, 16, 24, and 48 h. A total of 30 Hanwoo steers were fed the experimental diets, which were basal diet (control) and 7% SSB on an as-fed basis (4.35% dry matter [DM]), formulated according to requirements of the Korean Feeding Standard for Hanwoo. The experiment was conducted over 80 days using a completely randomized block design. RESULTS: Soluble fraction a of DM and organic matter (OM) was 44.20% and 64.60% DM, fraction b was 23.00% and 19.40% DM, and c values (the rate of degradation of fraction b) were 0.04 and 0.04/h, respectively. The effective degradability of DM at rumen solid outflow rates of 0.02, 0.05, and 0.08/h was 59.83, 54.75, and 52.16, respectively, and for OM was 77.78, 73.52, and 71.34, respectively. Initial and final body weight, average daily gain, DM intake, and gain:feed did not differ significantly between control and SSB groups during the entire experimental period. Carcass traits of Hanwoo steers with SSB supplementation were not significantly different between treatments except for dressing percentage, which was greater with SSB treatment. The content of saturated fatty acid (SFA) was greater and that of unsaturated fatty acids (UFA) was lower in the SSB group than in the control group. The ratio of UFA to SFA was significantly lower in the SSB group than in the control group. CONCLUSION: A total mixed ration containing less than 4.0% DM of SSBs can be used in Hanwoo steers without a decrease in productivity and carcass traits.

Risk of fracture in antidepressant users with concurrent use of benzodiazepines: A self-controlled case-series analysis.

OBJECTIVE: Despite the fracture risk associated with both antidepressant (AD) medication and benzodiazepines (BDZs), they are commonly prescribed simultaneously. However, studies elucidating the effects of concurrent use of BDZs and ADs on the risk fracture are scant. The objective of this study was to evaluate the risk of fracture associated with concurrent use of BDZs in AD users, using a self-controlled case-series analysis. METHODS: A self-controlled case-series analysis, in which the participants act as their own control, was conducted using the Korean National Health Insurance Service-National Sample Cohort database (2002-2015). We studied AD users who were prescribed BDZs and diagnosed with a fracture. The risk periods were subdivided into consecutive periods (1-30, 31-60, and > 60 days) after receiving a BDZ. A 2-week pre-exposure period and a 2-week post-exposure period were also included. The incidence rate ratio (IRR) was estimated after adjusting for age and use of co-medications. RESULTS: A total of 3020 patients were identified during the study period. There was an increased fracture risk in the first 30 days following BDZ use (IRR: 1.88, 95% confidence interval [CI] 1.66-2.12), in the 31-60-day period (1.73, 95% CI 1.48-2.02), and beyond the 60-day period (IRR: 1.68, 95% CI 1.47-1.91). The risks of fracture were greater in men and older patients. CONCLUSION: The concomitant use of BDZs and ADs was related to a significant increase in fracture risk. AD users should be aware of the fracture risk with concomitant BDZ use, especially for first-time BDZ users and for elderly patients.

Pediococcus spp.-fermented chicken meat for dogs.

An experiment was conducted to evaluate Pediococcus spp.-fermented chicken meat as a snack for dogs. The fermented or non-fermented snacks used in this study were prepared through the following process; meat mixtures containing 52.8% MDCM, 35.2% chicken breast meat (CBM) and 9.7% corn starch were inoculated with or without Pediococcus spp., incubated at 37°C for 24 h and then sterilized at 121°C for 20 min. During the 24-h fermentation, the pH of fermented chicken snack dropped rapidly with concomitant increase in number of lactic acid bacteria. The nutritional composition was not altered by fermentation. In vitro pepsin nitrogen digestibility was higher (p < 0.05) in the fermented snack compared with the non-fermented snack. Upon storage at room temperature for 14 days, bacteria grew slowly in fermented vs. non-fermented snack samples. In a palatability trial, dogs preferred non-fermented over fermented snack food. In 12-d-long feeding trial, fecal ammonia content was lowered, but fecal lactic acid content was increased in dogs fed the fermented vs. non-fermented snack food. Our study shows that the fermented MDCM-based snack exhibited good preservability upon storage, and improved in vitro nitrogen digestibility and fecal characteristics in dogs.

Effects of transport stress on physiological responses and milk production in lactating dairy cows.

OBJECTIVE: This study was conducted to investigate the effect of transport stress on physiological and hematological responses and milk performance in lactating dairy cows. METHODS: Ten lactating dairy cows were randomly divided into 2 groups. The treatment group (TG) was transported 200 km for 4 h by truck, and the control group (NTG) was restrained by stanchion for 4 h in Konkuk University farm. Blood and milk samples were collected at 24 h pre-transport; 1, 2, and 4 h during transport; and 2, 24, and 48 h post-transport. Milk yields were measured at 24 h pre-transport, 0 h during transport, and 24, 48, and 72 h post-transport. RESULTS: Leukocyte, neutrophil, and monocyte numbers in the TG were significantly higher than those of the NTG at each experimental time point. Lymphocyte numbers in the TG were significantly (p<0.05) higher than those of the NTG at 48 h post-transport. Additionally, the neutrophil:lymphocyte ratio of the TG was 45% and 46% higher than that of the NTG at 4 h during transport and 2 h post-transport, respectively. There were no significant differences in erythrocyte numbers, hemoglobin concentrations, platelet numbers, and hematocrit percentages between two groups. Cortisol levels in the TG were significantly (p<0.05) higher than those in the NTG. Milk yields in the TG were lower than those in the NTG. The somatic cell count (SCC) of the TG was significantly (p<0.05) higher than that of the NTG at 1 and 2 h during transport; that of the TG increased dramatically at 1 h during transport and gradually decreased subsequently. CONCLUSION: Transport stress increased blood parameters including leucocyte, neutrophil, and monocyte numbers by increased cortisol levels, but did not affect erythrocytes, hemoglobin and hematocrit levels. Additionally, transport resulted in a decrease in milk yield and reduced milk quality owing to an increase in milk SCC.

Is the Location of White Matter Lesions Important in the Swallowing Function of Older Patients with Mild Stroke?

Older patients with stroke have poor functional prognosis compared to younger patients. Patients with stroke who have severe white matter (WM) lesions have been reported to have swallowing problems. The aim of this study was to determine whether the location of WM lesions affects swallowing function in older patients with mild stroke. We conducted a retrospective analysis of 88 patients aged > 65 years who had a National Institutes of Health Stroke Scale score of ≤ 5 and who underwent videofluoroscopic swallowing examination after their first stroke. Participants were divided into three groups according to the involvement of corticobulbar tract (CBT) as follows: group I, no involvement of CBT; group II, involvement of CBT in one hemisphere; and group III, involvement of CBT in both hemispheres. Linear regression analysis showed that pharyngeal transit time tended to increase according to the involvement of CBT in WM lesion (p = 0.043). In addition, inadequate laryngeal elevation was related to the involvement of CBT (p = 0.016). Early spillage, inadequate laryngeal elevation, and penetration could also be predicted by Fazekas grade. Accordingly, the location of WM lesions can be regarded as a potential predictive factor for dysphagia. Moreover, in patients with WM lesions involving CBT, detailed evaluation of dysphagia is required.

Hematologic and serologic status of military working dogs given standard diet containing natural botanical supplements.

The health of military working dogs (MWDs) deployed with Korean troops is of prime importance. The aim of our study was to investigate the hematologic and serologic status of Korean MWDs given natural botanical supplements. To do this, 11 natural botanicals were selected based on relevant references and combined to supplement MWDs. Throughout the 16-week experimental periods, there was no significant difference in body weights of individual dogs. The Hemoglobin (HGB), hematocrit (HCT), Mean Corpuscular Volume (MCV), and Mean Corpuscular Hemoglobin (MCH) values were slightly higher in the group given the supplement. On the other hand, the Mean Corpuscular Hemoglobin Concentration (MCHC) values were slightly lower. Changes in platelet, lymphocyte, and basophil counts were observed in the supplemented group. The median serum IL-6 level did not differ significantly between the supplemented and control groups. However, the mean serum C-reactive protein (CRP) value increased significantly from the start of supplementation to 8 weeks, and then decreased at 16 weeks. Taken together, our result suggests that the health condition of most MWDs supplemented with natural botanicals was gradually improved. Thus, this study may provide support for the development of a feed supplement for MWDs using natural botanicals.

Associations between Alpha Angle and Herniation Pit on MRI Revisited in 185 Asymptomatic Hip Joints.

OBJECTIVE: To evaluate the association between alpha angle and herniation pit on MRI in asymptomatic hip joints and their associations with demographic variables. MATERIALS AND METHODS: Hip MRI of 185 asymptomatic hip joints of 105 adults (age 18 to 80 years) from September 2011 through December 2012 were retrospectively studied. Alpha angles were measured on oblique axial MR images by 2 observers. Herniation pit was determined by 1 observer. Size measures, prevalence, and statistical analyses were conducted regarding its association with age, gender, laterality (right or left hip). Intra- and inter-observer agreements were determined by intra-class correlation coefficient. RESULTS: The prevalence of herniation pit in asymptomatic hips was 21.6%. The range of alpha angle was 27.6-65.0 degrees. Seventeen and 16 out of 185 (9.1% and 8.6%) hip joints showed alpha angle of ≥ 55 degrees in first and second measurement sessions, respectively. There was no association between alpha angle ≥ 55 and presence of herniation pit. There was no association between alpha angle ≥ 55 and the size of herniation pit. Inter-observer agreement of alpha angle was 0.485 between first measurements of first vs. second observer, respectively. Intra-observer agreement of alpha angle was 0.654, respectively. Forty (21.6%) of 185 hip joints (35 of 105 patients, 33.3%) had herniation pit, with no difference according to age, gender, or laterality of hip joint. CONCLUSION: There is no association between alpha angle ≥ 55 degrees and presence of herniation pit or demographic variables.

Imaging findings of mimickers of hepatocellular carcinoma.

Radiological imaging plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC) as the noninvasive diagnosis of HCC in high-risk patients by typical imaging findings alone is widely adopted in major practice guidelines for HCC. While imaging techniques have markedly improved in detecting small liver lesions, they often detect incidental benign liver lesions and non-hepatocellular malignancy that can be misdiagnosed as HCC. The most common mimicker of HCC in cirrhotic liver is nontumorous arterioportal shunts that are seen as focal hypervascular liver lesions on dynamic contrast-enhanced cross-sectional imaging. Rapidly enhancing hemangiomas can be easily misdiagnosed as HCC especially on MR imaging with liver-specific contrast agent. Focal inflammatory liver lesions mimic HCC by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging. It is important to recognize the suggestive imaging findings for intrahepatic cholangiocarcinoma (CC) as the management of CC is largely different from that of HCC. There are other benign mimickers of HCC such as angiomyolipomas and focal nodular hyperplasia-like nodules. Recognition of their typical imaging findings can reduce false-positive HCC diagnosis.