The Association Between Depression and Death Anxiety Among Older Adults: Moderating Effect of Ego-Integrity.

This study verifies the relationship between depression and death anxiety in older adults and the moderating effect of ego-integrity on this relationship. The survey was conducted with 236 participants aged 65 years and older through a combination of online and offline surveys. The final data were analyzed using the PROCESS macro for SPSS 2.16. The main findings of this study are as follows: First, depression in old age was positively related to anxiety about death. Second, the moderating effect of ego-integrity was observed on the relationship between depression and death anxiety. Third, on examining the moderating effect of each sub-variable of ego-integrity, the moderating effect of satisfaction with one's life was observed to be significant. Conversely, the moderating effect of attitude toward life and acceptance of old age was not significant. The results of this study are meaningful in examining the moderating effect of ego-integrity on the relationship between depression and death anxiety. Furthermore, the results of this study can provide basic data for the development and application of psychological intervention programs for older adults experiencing psychological problems due to depression and death anxiety in old age.

Influence of Health-Related Status and Social Activities on Depressive Symptoms in Korean Older Adults Who Live Alone.

The current study aimed to explore predictors of depressive symptoms in Korean older adults who live alone using data from the 2017 National Survey of Older Koreans. Participants were 2,258 adults (females, n = 1,838 [81.4%]; males, n = 420 [18.6%]) aged ≥65 years (mean = 75.9, SD = 6.8 years). Multiple hierarchical regression analysis indicated that perceived health status, instrumental activities of daily living (IADL), social gatherings, interaction frequency with children living separately, income quintile, religion, and education were significant predictors of depressive symptoms. In particular, perceived health status, IADL, and interaction frequency with children living separately were the most powerful predictors of depressive symptoms in older adults living alone. The result of the current study was to verify the relationship between social activity and depression of older adults who live alone. This study suggests that contact with children and social gatherings may help prevent depression in older adults who live alone. [Journal of Psychosocial Nursing and Mental Health Services, 59(2), 25-30.].

Impact of different running distances on muscle and lymphocyte DNA damage in amateur marathon runners.

[Purpose] The aim of this study was to investigate the impact of different marathon running distances (10 km, 21 km, and 42.195 km) on muscle and lymphocyte DNA damage in amateur marathon runners. [Subjects and Methods] Thirty male amateur runners were randomly assigned to 10 km, 21 km, and 42 km groups, with 10 subjects in each group. Blood samples were collected before and after the races and on the 3rd day of recovery to examine levels of muscle damage (creatine kinase and lactate dehydrogenase) and lymphocyte DNA damage (DNA in the tail, tail length, and tail moment). [Results] Serum creatine kinase, serum lactate dehydrogenase, and tail moment were significantly higher after the races compared with before the races in all groups. In addition, the 42 km group showed significantly higher levels of creatine kinase, lactate dehydrogenase, and tail moment than the 10 km and 21 km groups after the races. [Conclusion] Strenuous endurance exercise can cause muscle and lymphocyte DNA damage, and the extent of such damage can increase as running distance increases.

Effects of treadmill exercise on skeletal muscle†mTOR signaling pathway in high-fat diet-induced obese mice.

[Purpose] The aim of this study was to investigate the effects of regular treadmill exercise on skeletal muscle Rictor-Akt and mTOR-Raptor-S6K1 signaling pathway in high-fat diet-induced obese mice. [Subjects and Methods] Four- week-old C57BL/6 mice were adopted and classified into normal diet group (ND, n = 10), normal diet and training group (NDT, n = 10), high-fat diet group (HF, n = 10), and high-fat diet and training group (HFT, n = 10). The exercise program consisted of a treadmill exercise provided at low intensity for 1-4 weeks, and moderate intensity for 5-8 weeks. [Results] The Western blot method was used to measure the expression of mTOR, Raptor, S6K1, Rictor, and Akt proteins in the soleus muscle. mTOR levels were significantly higher in the HF group than in the ND and NDT groups. Raptor/mTORC1 and S6K1 levels were significantly higher in the HF group than in all the other groups. Akt levels were significantly lower in the HF group than in the NDT group. The risk of obesity may be associated with the overactivation of the mTOR-Raptor-S6K1 signaling pathway and a decrease in Akt levels. [Conclusion] This study also indicates that performing aerobic exercise may be associated with the downregulation of the mTOR-Raptor-S6K1 pathway.

The Effects of 12 Weeks Regular Aerobic Exercise on Brain-derived Neurotrophic Factor and Inflammatory Factors in Juvenile Obesity and Type 2 Diabetes Mellitus.

[Purpose] The purpose of this study was to investigate the effects of 12 weeks regular aerobic exercise on brain-derived neurotrophic factor (BDNF) and inflammatory factors in juvenile obesity and type 2 diabetes mellitus (T2DM). Obesity and T2DM, typically common among adults, have recently become more prevalent in the Korean juvenile population, affecting not only their lipid profiles and oxidant stress levels, but also their BDNF and inflammatory factor levels. [Subjects] This study enrolled 26 juveniles (boys = 15, girls = 9) who were assigned to a control group (CG, n = 11), obesity group (OG, n = 8), or T2DM group (TG, n = 7). [Methods] The outcome of a 40-60-minute aerobic exercise session that took place three times per week for 12 weeks at a maximum oxygen intake (VO2max) of 50~60% was investigated. [Results] The exercise resulted in a significant reduction in the resting serum BDNF and TrkB levels (baseline) among juveniles in the OG and TG as compared to those in the CG. Additionally, the 12 weeks of regular aerobic exercise led to significant reductions in body weight, body fat percentage, and body mass index in the OG and a significant increase of VO2max in the OG and TG. However, no significant differences in serum NGF or inflammatory factors were found among the three groups. There was a significant increase in resting serum BDNF levels following the 12 weeks regular exercise only in the OG. [Conclusion] While 12 weeks of regular aerobic exercise had a positive effect on body composition, and increased BDNF levels of juveniles in the OG, it did not affect the inflammatory factor levels and had no effect on the TG.

Anastomosis by use of compression anastomosis ring (CAR™ 27) in laparoscopic surgery for left-sided colonic tumor.

PURPOSE: The safety and efficacy of the compression anastomosis ring (CAR™ 27) had been demonstrated by animal studies. This study was designed to evaluate clinical validity of the CAR™ 27 anastomosis in laparoscopic surgery for patients with left-sided colonic neoplasm. METHODS: Intracorporeal anastomosis using the CAR™ 27 (CAR group) was performed in 66 patients (male 35; median age, 64.5 years), and short-term results were compared with consecutive 116 patients (male 70; median age, 64 years) where the anastomosis was constructed by double stapling technique using a circular stapler for the same indications (stapled group). RESULTS: There were no statistically significant differences between the two groups in terms of gender, age, and distribution of pathologic lesion. The laparoscopic procedures, pathologic diagnosis/stage, and length of operation time and postoperative hospital stay were comparable between the two groups. Conversion rate in the CAR and stapled group was 3% and 6%, respectively. There was no surgical mortality in either group. No intraoperative complications associated with the CAR™ 27 anastomosis were encountered. One patient in the CAR group was complicated by anastomotic leakage and none in the stapled group (p = 0.36). There was intestinal obstruction in two patients, in whom one required re-operation for entrapped small bowel adhesions within pelvis. No patient in either group showed symptomatic anastomotic stricture. CONCLUSIONS: The anastomosis using the CAR™ 27 is an innovative technique. The CAR™ 27 anastomosis in patients undergoing laparoscopic colectomy for left-sided colonic tumor proved to be a safe and efficacious alternative to the standard double stapling technique.

The effect of training type on oxidative DNA damage and antioxidant capacity during three-dimensional space exercise.

OBJECTIVE: Orbotron training is a popular training method for fighter pilots because it replicates a high-acceleration environment with excessive G-force. The purpose of this study was to investigate the effects of 9 weeks of orbotron training on oxidative DNA damage and antioxidant capacity in humans during 3-dimensional space exercise. SUBJECTS AND METHODS: The subjects comprised 15 senior cadets from the Korea Air Force Academy who had no record of medical disorders and who participated in a regular exercise program (3 times per week). They were randomly divided into three groups consisting of 5 subjects each: a weight training group (21.97 +/- 1.12 years), a running training group (21.53 +/- 0.18 years) and an orbotron training group (21.48 +/- 0.29 years). Three-dimensional exercise tests were performed before and after training, and blood samples were taken to measure the concentration of plasma lactate, malondialdehyde (MDA), erythrocyte superoxide dismutase (SOD) activity, and leukocyte DNA damage. RESULTS: Plasma lactate concentrations decreased in all three groups when measured after training and after 30 min of recovery compared to before training (p < 0.05). The concentration of plasma MDA also decreased after training in all blood samples compared to the values obtained before training although there was no significant difference in the weight training and orbotron training groups. In contrast, the activity of erythrocyte SOD increased for all three groups compared to before training (p < 0.05). In the comet assay results, the greatest lymphocyte DNA damage was demonstrated at the end of exercise compared to the other three samples under all conditions, and these aspects were commonly observed in all three parameters of lymphocyte DNA damage (tail DNA, tail length and tail moment) (p < 0.05). CONCLUSION: It can be concluded that the three types of exercise training reduced plasma lactate concentration, improved antioxidant enzyme activity, and further protected the body against oxidative stress (lipid peroxidation and DNA damage). Although we have identified an effect of exercise training on the levels of antioxidants and oxidants, our cohort was small, so further studies are needed to evaluate the different types of exercise training.

Circuit resistance exercise improves glycemic control and adipokines in females with type 2 diabetes mellitus.

The aim of study was to evaluate whether circuit resistance exercise (CE) improves glycemic control and adipokine levels in comparison with walking exercise (WE) in 15 adult postmenopausal Korean females with type 2 diabetes mellitus (T2DM). The participants were randomly assigned to either the CE or WE group. Subjects exercised for 1 h, three times per week for 12 weeks. The parameters measured were body composition, respiratory rate, blood glucose, insulin and adipokines. The body composition of the CE group showed a significant reduction (all p < 0.05) in body weight, body mass index (BMI), and percentage of body fat and a significant increase in muscle mass. Respiratory function was also significantly increased in the CE group. Additionally, hemoglobin A1c (HbA1c) changed favorably in the CE group, as were the concentrations of adipokines such as retinol binding protein 4 (RBP-4) (p < 0.05), adiponectin (p < 0.01), and monocyte chemoattractant protein-1 (MCP-1) (p < 0.01). In addition, significant correlations with CE were evident for homeostatic model assessment insulin resistance (HOMA-IR) and glucose (r = 0.69, p < 0.001), muscle mass and glucose (r = 0.45, p < 0.05), and muscle mass and HbA1c (r = 0.39, p < 0.05). The beneficial effects of CE include the development of muscle mass, which effectively increases glucose use and reduces the amount of insulin required. Thus, our results suggest that CE improves glycemic control and adipokines resulting from incrementally increased muscle mass and reductions of body weight, BMI and percentage of body fat for T2DM postmenopausal Korean women. Key pointsCE-induced weight loss and muscle mass increment increases the level of adiponectin secreted by adipocytes due to heightened glucose utilization and fat oxidation.Aerobic exercise decreases body weight, fat and adipokines in high intensity and frequency, while resistance exercise decreases these parameters in low intensity, time and frequency.CE can improves glycemic control and adipokines resulting from reduction of body fat postmenopausal Korean women with T2DM.

The SNP276G>T polymorphism in the adiponectin (ACDC) gene is more strongly associated with insulin resistance and cardiovascular disease risk than SNP45T>G in nonobese/nondiabetic Korean men independent of abdominal adiposity and circulating plasma adiponectin.

This study aimed to determine whether polymorphisms of the adiponectin (ACDC) gene independently contribute to insulin resistance (IR) and other cardiovascular disease (CVD) risk factors in nonobese, nondiabetic Korean men after adjusting for major environmental factors that influence IR. Among the 7 ACDC single-nucleotide polymorphisms (SNPs;C-11377G, T45G, G276T, H241P, Y111H, G90S, and R221S) prescreened in 48 subjects, we genotyped 333 subjects for SNP45 and SNP276, both of which showed an allele frequency of more than 2%. In Pearson correlation and multiple stepwise regression analyses, we found that waist circumference was the most important influencing factor (beta = .369, P < .001) in homeostasis model assessment (HOMA)-IR, whereas plasma adiponectin was the second most important (beta = -.217, P = .023). At position 276, T/T subjects showed significantly lower glucose concentrations (P = .043) and higher low-density lipoprotein particle sizes (P = .033) than the G/G and G/T subjects. The subjects also had lower serum triglycerides and HOMA-IR; however, these results were not statistically significant. After adjusting for waist circumference and plasma adiponectin, T/T subjects showed a significantly lower HOMA-IR than G/G or G/T subjects (P = .048). On the other hand, at position 45, only glucose concentrations were significantly lower in G carriers (P = .005). In the SNP45-SNP276 haplotype test, TT/TT subjects (having T/T at both SNP45 and SNP276) showed significantly lower IR before and after adjusting for waist circumference and adiponectin levels than did other carriers. In conclusion, we suggest that SNP276G>T, rather than SNP45T>G, is more strongly associated (both directly and indirectly) than with several components of metabolic syndrome and CVD risk, including IR, triglyceride concentration, and low-density lipoprotein particle size, in nonobese, nondiabetic men.

Intestinal Anastomosis by Use of a Memory-shaped Compression Anastomosis Clip (Hand CAC 30): Early Clinical Experience.

PURPOSE: The safety and the efficacy of the compression anastomosis clip (Hand CAC 30) have been demonstrated by animal studies. This study was designed to evaluate the clinical validity of the Hand CAC 30 in enterocolic side-to-side anastomosis after colonic or enteric resections. METHODS: A non-randomized prospective data collection was performed for patients undergoing a side-to-side anastomosis using the Hand CAC 30. Eligibility criteria for the use of the Hand CAC 30 were for anastomoses between the colon and the ileum or between two small bowels. The primary short-term endpoint was the rate of anastomotic leakage. Other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the clip elimination time were recorded. RESULTS: A total of 63 patients (male, 36) underwent an enteric or right-sided colonic resection followed by a side-to-side anastomosis using the Hand CAC 30. Laparoscopic surgery was performed in 36 patients, in whom one patient who underwent a laparoscopic right hemicolectomy was converted to an open procedure (1/32, 3.1%). One patient with ascending colon cancer showed postoperative anastomotic leakage and died of co-morbid ischemic heart disease. There were no other surgical mortalities. The exact date of expulsion of the clip could not be recorded because most patients were not aware of clip elimination. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the Hand CAC 30 anastomosis in patients undergoing enterocolic surgery proved it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

Adjuvant Chemotherapy Using the FOLFOX Regimen in Colon Cancer.

PURPOSE: Great progress has been made in the adjuvant treatment of colon cancer. The aim of this study was to evaluate the efficacy of postoperative adjuvant chemotherapy using the FOLFOX regimen in patients with stage III and high-risk stage II colon cancer. METHODS: Eighty-two patients who underwent a potentially curative resection for stage III or high-risk stage II colon cancer were enrolled in this retrospective study. They received FOLFOX4 or modified FOLFOX6. The primary endpoint was disease-free survival. RESULTS: During the median follow-up of 37 months (range, 21 to 61 months), 14 patients experienced disease relapse. The disease-free survival rate at 3 years was 82.9%: 84.6% for stage II and 82.6% for stage III. At the time of the analysis, 8 patients were dead from recurrence. The probability of overall survival at 5 years was 74.5%: 90% for stage II and 74.6% for stage III. Grade 3 or 4 hematologic adverse events included neutropenia (40.2%), anemia (2.4%), and thrombocytopenia (1.2%). Gastrointestinal toxicities included grade 3 or 4 nausea (4.9%) and stomatitis (2.4%). Peripheral sensory neuropathy was observed in 81.7% of the patients during treatment. Of the 11 patients (13.4%) who had grade 3 peripheral sensory neuropathy during treatment, grade 3 symptoms were persistent in 3 patients with gait disturbance at the time of analysis. No treatment-related deaths were recorded. CONCLUSION: Postoperative chemotherapy using the FOLFOX regimen, oxaliplatin in combination with 5-fluorouracil and leucovorin, is effective and tolerable in patients with stage III and high-risk stage II colon cancer.

Early experience of the compression anastomosis ring (CAR™ 27) in left-sided colon resection.

AIM: To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. METHODS: A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. RESULTS: A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.