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Orbital currents have recently emerged as a promising tool to achieve electrical control of the magnetization in thin-film ferromagnets. Efficient orbital-to-spin conversion is required in order to torque the magnetization. Here, we show that the injection of an orbital current in a ferrimagnetic Gd_{y}Co_{100-y} alloy generates strong orbital torques whose sign and magnitude can be tuned by changing the Gd content and temperature. The effective spin-orbital Hall angle reaches up to -0.25 in a Gd_{y}Co_{100-y}/CuO_{x} bilayer compared to +0.03 in Co/CuO_{x} and +0.13 in Gd_{y}Co_{100-y}/Pt. This behavior is attributed to the local orbital-to-spin conversion taking place at the Gd sites, which is about 5 times stronger and of the opposite sign relative to Co. Furthermore, we observe a manyfold increase in the net orbital torque at low temperature, which we attribute to the improved conversion efficiency following the magnetic ordering of the Gd and Co sublattices.
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Spinal and bulbar muscular atrophy, namely Kennedy disease, is a rare progressive neurodegenerative disorder caused by the expansion of a CAG repeat in the first exon of the androgen receptor gene on the X chromosome. We assessed the clinical history, laboratory findings, functional scales and electrophysiological data, as well as the levels of luteinizing hormone, follicle-stimulating hormone and testosterone, in 157 Korean patients with genetically confirmed spinal and bulbar muscular atrophy (mean age at data collection = 56.9 years; range = 33-83 years). Hand tremor was the first symptom noticed by patients at a median age of 35 years, followed by gynaecomastia, orofacial fasciculation, cramps and fatigability in ascending order. Clinical symptoms such as paraesthesia and dysphagia appeared during the later stages of the disease. Cane use during ambulation began at a median age of 62 years. There were statistically significant differences between patients and controls in the results of sensory nerve studies, motor conduction velocity, and distal latencies. Furthermore, among the hormone markers analysed, the level of luteinizing hormone exhibited a negative correlation with the spinal and bulbar muscular atrophy functional rating scale, Korean version. However, among the patients with a disease duration of ≤5 years, the levels of luteinizing hormone showed a significant correlation with assessments using the amyotrophic lateral sclerosis functional rating scale-revised, spinal and bulbar muscular atrophy functional rating scale, Korean version and the 6-minute walk test. In conclusion, our findings provide clinical information from a substantial number of patients with spinal and bulbar muscular atrophy in Korea that accorded with that of patients with this disease worldwide but with updated clinical features.
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Atrofia Bulboespinal Ligada ao X , Atrofia Muscular Espinal , Humanos , Adulto , Pessoa de Meia-Idade , Atrofia Bulboespinal Ligada ao X/diagnóstico , Atrofia Bulboespinal Ligada ao X/genética , Estudos Transversais , Tremor , Atrofia Muscular , Hormônio Luteinizante , Atrofia Muscular Espinal/genética , Receptores Androgênicos/genéticaRESUMO
OBJECTIVE: This study aimed to investigate the long-term effects and functional outcomes of androgen suppression therapy using leuprorelin among Korean patients with spinal and bulbar muscular atrophy (SBMA). METHODS: This observational study enrolled patients with genetically confirmed SBMA who provided informed consent. Leuprorelin was administered via subcutaneous injection every 12 weeks. The primary outcome measure was the change in total Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) scores. RESULTS: A total of 48 SBMA patients were evaluated in this study. Among them, 39 patients underwent androgen suppression therapy over a 3-year period. The total SBMAFRS score decreased from 41.72 ± 5.55 to 36.74 ± 7.74 (p < 0.001) in patients who completed their treatment. The subgroup with a baseline SBMAFRS score of ≥ 42 had a significantly lower decline in SBMAFRS score than did those with a baseline SBMAFRS score of ≤ 41. We determined that at a baseline, SBMAFRS cutoff value of 41.5 could predict good prognosis, with a corresponding area under the curve of 0.689. CONCLUSION: Despite androgen suppression therapy, all enrolled participants exhibited a decrease in the overall SBMAFRS score. However, those with a baseline SBMAFRS of ≥ 42 showed a mild decrease in scores, indicating a more favorable prognosis. These findings suggest that a higher baseline motor function was a key prognostic indicator in SBMA treatment and that initiating early leuprorelin treatment in patients with high baseline function may lead to good clinical outcomes.
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Leuprolida , Humanos , Leuprolida/uso terapêutico , Leuprolida/administração & dosagem , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Feminino , Idoso , Adulto , Antagonistas de Androgênios/uso terapêutico , Atrofia Muscular Espinal/tratamento farmacológico , Atrofia Bulboespinal Ligada ao X/tratamento farmacológico , Índice de Gravidade de DoençaRESUMO
While it is often assumed that the orbital response is suppressed and short ranged due to strong crystal field potential and orbital quenching, we show that the orbital response can be remarkably long ranged in ferromagnets. In a bilayer consisting of a nonmagnet and a ferromagnet, spin injection from the interface results in spin accumulation and torque in the ferromagnet, which rapidly oscillate and decay by spin dephasing. In contrast, even when an external electric field is applied only on the nonmagnet, we find substantially long-ranged induced orbital angular momentum in the ferromagnet, which can go far beyond the spin dephasing length. This unusual feature is attributed to nearly degenerate orbital characters imposed by the crystal symmetry, which form hotspots for the intrinsic orbital response. Because only the states near the hotspots contribute dominantly, the induced orbital angular momentum does not exhibit destructive interference among states with different momentum as in the case of the spin dephasing. This gives rise to a distinct type of orbital torque on the magnetization, increasing with the thickness of the ferromagnet. Such behavior may serve as critical long-sought evidence of orbital transport to be directly tested in experiments. Our findings open the possibility of using long-range orbital response in orbitronic device applications.
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Eletricidade , Torque , Movimento (Física)RESUMO
This study aimed to delineate overlapping and distinctive functional connectivity in visual motor imagery, kinesthetic motor imagery, and motor execution of target-oriented grasping action of the right hand. Functional magnetic resonance imaging data were obtained from 18 right-handed healthy individuals during each condition. Seed-based connectivity and multi-voxel pattern analyses were employed after selecting seed regions with the left primary motor cortex and supplementary motor area. There was equivalent seed-based connectivity during the three conditions in the bilateral frontoparietal and temporal areas. When the seed region was the left primary motor cortex, increased connectivity was observed in the left cuneus and superior frontal area during visual and kinesthetic motor imageries, respectively, compared with that during motor execution. Multi-voxel pattern analyses revealed that each condition was differentiated by spatially distributed connectivity patterns of the left primary motor cortex within the right cerebellum VI, cerebellum crus II, and left lingual area. When the seed region was the left supplementary motor area, the connectivity patterns within the right putamen, thalamus, cerebellar areas IV-V, and left superior parietal lobule were significantly classified above chance level across the three conditions. The present findings improve our understanding of the spatial representation of functional connectivity and its specific patterns among motor imagery and motor execution. The strength and fine-grained connectivity patterns of the brain areas can discriminate between motor imagery and motor execution.
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Mapeamento Encefálico , Encéfalo , Humanos , Mapeamento Encefálico/métodos , Encéfalo/diagnóstico por imagem , Cerebelo , Mãos , Lobo Parietal , Imageamento por Ressonância MagnéticaRESUMO
AIM: The incidence of fungal sinusitis is increasing; however, its pathophysiology has not been investigated previously. We investigate the effect of periodontitis on the incidence of fungal sinusitis over a 12-year follow-up period using nationwide population-based data. MATERIALS AND METHODS: The periodontitis group was randomly selected from the National Health Insurance Service database. The non-periodontitis group was obtained by propensity score matching considering several variables. The primary end point was the diagnosis of sinonasal fungal balls (SFBs) and invasive fungal sinusitis (IFS). RESULTS: The periodontitis and non-periodontitis groups included 12,442 and 12,442 individuals, respectively. The overall adjusted hazard ratio (aHR) for SFBs in the periodontitis group was 1.46 (p = .002). In subgroup analysis, the aHR for SFBs was 1.59 (p = 0.008) for those with underlying chronic kidney disease (CKD), 1.58 (p = .022) for those with underlying atopic dermatitis, 1.48 (p = .019) for those with chronic obstructive pulmonary disease (COPD), and 1.36 (p = .030) for those with diabetes mellitus (DM), but these values are applicable only when considering the relationship between periodontitis and SFB. The aHR for IFS in the periodontitis group was higher than in the non-periodontitis group (2.80; p = .004). CONCLUSIONS: The risk of SFBs and IFS increased after diagnosis of periodontitis. This trend is often more severe in patients with DM, COPD, or CKD, but this association with underlying diseases is applicable only when considering the association between periodontitis and fungal sinusitis.
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Diabetes Mellitus , Micoses , Periodontite , Insuficiência Renal Crônica , Sinusite , Humanos , Seguimentos , Sinusite/complicações , Sinusite/microbiologia , Micoses/complicações , Micoses/epidemiologia , Diabetes Mellitus/epidemiologia , Periodontite/complicações , Insuficiência Renal Crônica/complicações , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND: We aimed to evaluate the nationwide trend of the prevalence of frailty in older adults in Korea from 2008 to 2020 to inform future geriatric healthcare policies. METHODS: The study used data of individuals aged 65 years and older from the Korea National Health and Nutrition Examination Survey, a nationwide repeated cross-sectional survey. Frailty was defined using frailty index, classified as non-frail (frailty index ≤ 0.15), pre-frail (0.15 < frailty index ≤ 0.25), or frail (frailty index > 0.25). RESULTS: The study included 17,784 individuals, with the mean age of 72.4 and mean frailty index of 0.2. The prevalence of frailty in older adults in South Korea decreased significantly from 2008 (41.1%) to 2020 (23.1%). The decrease in the frailty index was observed in all age groups (all P < 0.05). As components of frailty index, we found that certain comorbidities, such as dyslipidemia, diabetes mellitus, and cardiovascular disease, have increased over time, while factors such as chewing difficulty, activity limitation, and smoking, have decreased. CONCLUSION: The prevalence of frailty in older adults in South Korea has decreased significantly during the study period. Historical improvements in healthcare access and preventive measures may have contributed to this trend.
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Fragilidade , Humanos , Idoso , Estudos Transversais , Inquéritos Nutricionais , Prevalência , República da CoreiaRESUMO
BACKGROUND: Subjects with chronic obstructive pulmonary disease (COPD) have a higher risk of ischemic heart disease (IHD) than individuals without COPD; however, longitudinal evidence is lacking. Therefore, we aimed to estimate the risk of IHD between COPD and control cohorts using a longitudinal nationwide database. METHODS: We used 2009-2017 data from the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC). Adult participants at least 20 years of age who underwent health examinations and without a history of COPD or IHD were included (n = 540,976). Participants were followed from January 1, 2009, until death, development of IHD, or December 31, 2019, whichever came first. RESULTS: At baseline, there were 3,421 participants with incident COPD and 537,555 participants without COPD. During a median of 8.0 years (5.3-9.1 years) of follow-up, 2.51% of the participants with COPD (n = 86) and 0.77% of the participants without COPD (n = 4,128) developed IHD, with an incidence of 52.24 and 10.91 per 10,000 person-years, respectively. Participants with COPD had a higher risk of IHD (adjusted hazard ratio, 1.55; 95% confidence interval, 1.25-1.93) than subjects without COPD. Demographics such as age, sex, body mass index, and personal health behaviors including smoking status and physical activity did not show significant interaction with the relationship between COPD and IHD (P for interaction > 0.05 for all). CONCLUSION: The results indicate that COPD is associated with the development of IHD independent of demographic characteristics and health-related behaviors. Based on these results, clinicians should closely monitor the onset of IHD in subjects with COPD.
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Isquemia Miocárdica , Doença Pulmonar Obstrutiva Crônica , Adulto , Humanos , Estudos de Coortes , Isquemia Miocárdica/complicações , Isquemia Miocárdica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Incidência , Modelos de Riscos Proporcionais , Fatores de RiscoRESUMO
Oriental melon (Cucumis melo L.) is a popular Korean, Japanese, and Chinese fruit (Shin et al. 2017). In April 2022, abnormal fruit (n=20) that were collected in Sangju in Gyeongbuk Province (36°27'54.6"N, 128°10'49.7"E), Korea showed approximately 5% disease incidence with severity of 10-15%. Initial symptoms included shriveling, soaking, softening, dark discoloration, and sunken lesions. Internally, a rot extended to flesh, darkening from brown to black, and producing black mycelial masses. Two fungal strains (OM-rot-01 and OM-rot-02) were isolated and exhibited similar culture characteristics: aerial mycelium that was flat and pale grey to olivaceous on potato dextrose (PDA), malt extract (MEA), and oatmeal agar (OA) after seven days at 25°C and produced abundant buff-colored pycnidial ascomata on OA. Asci were bitunicate, clavate to cylindrical, 48.4 to 69.0 × 6.1 to 6.9 µm (n=10), and ascospores were biseriate, sparse, ellipsoidal, straight to slightly curved, hyaline, smooth, apex obtuse, 1-septate, 11.1 to 14.9 × 3.8 to 5.4 µm (n=20). Conidiomata were pycnidial, mostly solitary, irregular, pale brown to black, semi-immersed, 150 to 220 × 120 to 200 µm. Conidia were oblong or ovoid, smooth, thin-walled, hyaline, aseptate, 4.4 to 6.7 × 2.0 to 2.8 µm (n=35), with 1-3 guttules per conidium. The morphological characteristics corresponded to those of Stagonosporopsis cucumeris (Hou et al. 2020). For molecular identification, genomic DNA was extracted from strains (OM-rot-01 and OM-rot-02), and the ITS regions, partial 28S rDNA (LSU), beta-tubulin (TUB2), and RNA polymerase II second largest subunit (RPB2) genes were amplified and sequenced (White et al. 1990; Woudenberg et al. 2009; Vilgalys & Hester 1990; Liu et al. 1999). The obtained sequences revealed 99-100% homology with S. cucumeris accessions (MH858625, MH870265, MT005554, and MT018021). The sequences were deposited in GenBank with accession nos. for ITS regions (OP788058, OP788059), 28S rDNA (OP788094, OP788095), TUB2 (OP810568, OP810569), and RPB2 (OP810570, OP810571). Phylogenetic analysis combined with ITS, LSU, TUB2, and RPB2 concatenated sequences using neighbor-joining method revealed that the strains were S. cucumeris. To confirm pathogenicity, OM-rot-01 was inoculated onto ripe, asymptomatic Oriental melon fruit (n=6). After they were surface sterilized with 70% alcohol, fruit were wounded using a sterilized needle and corkborer, and 5-mm-diameter mycelial plugs were attached to the wound sites, followed by covering of the fruit with aluminum foil and maintenance in a plastic box (>90% relative humidity) at 25°C. Non-wounded fruit were inoculated and incubated in a similar manner, and fruit that were inoculated with PDA plugs served as controls (n=3). The aluminum foil was removed after three days of inoculation, and other conditions were kept constant. After six days, typical internal fruit rot symptoms were observed in both wounded and non-wounded fruit; brown to black rot extended into flesh, whereas control fruit remained asymptomatic. Fungi reisolated from lesions were morphologically identical to OM-rot-01; identity was confirmed by molecular analysis, fulfilling Koch's postulates, and the pathogenicity test was conducted three times. S. cucumeris was found as a canker on Cucumis sativus in the Netherlands (Hou et al. 2020), but has not been reported elsewhere as a pathogen on Cucumis spp. To our knowledge, this is the first report of S. cucumeris causing internal fruit rot on Oriental melon in Korea. This disease poses a threat to melon production, so accurate identification of the pathogen is a key starting point for development of sustainable management practices.
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BACKGROUND: Gait speed measurements are widely used in clinical practice, as slow gait is a major predictor of frailty and a diagnostic criterion for sarcopenia. With the development of wearable devices, it is possible to estimate the gait speed in daily life by simply wearing the device. OBJECTIVE: This study aims to accurately determine the characteristics of daily life gait speed and analyze their association with sarcopenia. METHODS: We invited community-dwelling men aged >50 years who had visited the outpatient clinic at a tertiary university hospital to participate in the study. Daily life gait speed was assessed using a wearable smart belt (WELT) for a period of 4 weeks. Data from participants who wore the smart belt for at least 10 days during this period were included. After 4 weeks, data from a survey about medical and social history, usual gait speed measurements, handgrip strength measurements, and dual-energy x-ray absorptiometry were analyzed. RESULTS: A total of 217,578 daily life gait speed measurements from 106 participants (mean age 71.1, SD 7.6 years) were analyzed. The mean daily life gait speed was 1.23 (SD 0.26) m/s. The daily life gait speed of the participants varied according to the time of the day and day of the week. Daily life gait speed significantly slowed down with age (P<.001). Participants with sarcopenia had significantly lower mean daily life gait speed (mean 1.12, SD 0.11 m/s) than participants without sarcopenia (mean 1.23, SD 0.08 m/s; P<.001). Analysis of factors related to mean daily life gait speed showed that age and skeletal muscle mass of the lower limbs were significantly associated characteristics. CONCLUSIONS: More diverse and accurate information about gait speed can be obtained by measuring daily life gait speed using a wearable device over an appropriate period, compared with one-time measurements performed in a laboratory setting. Importantly, in addition to age, daily life gait speed is significantly associated with skeletal muscle mass of the lower limbs.
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Sarcopenia , Dispositivos Eletrônicos Vestíveis , Idoso , Marcha , Força da Mão , Humanos , Masculino , Sarcopenia/diagnóstico , Velocidade de CaminhadaRESUMO
BACKGROUND: Postoperative delirium (POD) is a common clinical syndrome with significant negative outcomes. Thus, we aimed to evaluate the feasibility and effectiveness of a delirium screening tool and multidisciplinary delirium prevention project. METHODS: A retrospective cohort study was conducted at a single teaching center in Korea. A cohort of patients who underwent a delirium prevention program using a simple delirium screening tool from December 2018 to February 2019 (intervention group, N = 275) was compared with the cohort from the year before implementation of the delirium prevention program (December 2017 to February 2018) (control group, N = 274). Patients aged ≥65 years who were admitted to orthopedic wards and underwent surgery were included. The incidence rates of delirium before and after implementation of the delirium prevention program, effectiveness of the delirium screening tool, change in the knowledge score of nurses, and length of hospital stay were assessed. RESULTS: The sensitivity and specificity of the screening tool for the incidence of POD were 94.1 and 72.7%, respectively. The incidence rates of POD were 10.2% (control group) and 6.2% (intervention group). The odds ratio for the risk reduction effect of the project related to the incidence of POD was 0.316 (95% confidence interval: 0.125-0.800, p = 0.015) after adjustment for possible confounders. The delirium knowledge test score increased from 40.52 to 43.24 out of 49 total points (p < 0.001). The median length of hospital stay in the intervention and control groups was 6.0 (interquartile range, 4-9) and 7.0 (interquartile range, 4-10) days, respectively (p = 0.062). CONCLUSION: The screening tool successfully identified patients at a high risk of POD at admission. The POD prevention project was feasible to implement, effective in preventing delirium, and improved knowledge regarding delirium among the medical staff. TRIAL REGISTRATION: None.
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Delírio/epidemiologia , Delírio/prevenção & controle , Hospitalização/tendências , Procedimentos Ortopédicos/tendências , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Idoso , Estudos de Coortes , Delírio/diagnóstico , Feminino , Humanos , Tempo de Internação/tendências , Masculino , Procedimentos Ortopédicos/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , República da Coreia/epidemiologia , Estudos RetrospectivosRESUMO
Despite its wide use as a first-line therapeutic agent, gemcitabine has shown limited efficacy in advanced pancreatic cancer due to chemoresistance by as yet unidentified mechanisms. Our goal here was to identify molecular features involved in gemcitabine chemoresistance. Pyruvate kinase M2 (PKM2), a key enzyme of aerobic glycolysis, has recently emerged as an important therapeutic target for cancer treatment. It is involved in the metabolic reprogramming of cancer cells and has previously unexpected non-metabolic functions that are heavily involved in tumor growth and survival. Herein, we report that the chemoresistance of pancreatic cancer to gemcitabine was dependent on PKM2 expression and its non-metabolic function. Knocking-down of PKM2 significantly enhanced gemcitabine-induced cell apoptosis through the activation of caspase 3/7 and PARP cleavage, and this inhibitory activity was associated with p38-mediated activation of p53 phosphorylation at serine 46. Our findings support the potential of PKM2 as a novel target for gemcitabine chemoresistance and suggest the feasibility of combining gemcitabine and PKM2 inhibition for the improved chemotherapy of pancreatic cancer.
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Antimetabólitos Antineoplásicos/farmacologia , Proteínas de Transporte/metabolismo , Desoxicitidina/análogos & derivados , Resistencia a Medicamentos Antineoplásicos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Proteínas de Membrana/metabolismo , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/patologia , Hormônios Tireóideos/metabolismo , Apoptose , Western Blotting , Proteínas de Transporte/antagonistas & inibidores , Proteínas de Transporte/genética , Proliferação de Células , Desoxicitidina/farmacologia , Humanos , Proteínas de Membrana/antagonistas & inibidores , Proteínas de Membrana/genética , Neoplasias Pancreáticas/enzimologia , Fosforilação/efeitos dos fármacos , RNA Mensageiro/genética , RNA Interferente Pequeno/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Hormônios Tireóideos/genética , Células Tumorais Cultivadas , Gencitabina , Proteínas de Ligação a Hormônio da TireoideRESUMO
BACKGROUND: Mutations in genes that are part of the splicing machinery for myelodysplastic syndromes (MDS), including MDS without ring sideroblasts (RS), have been widely investigated. The effects of these mutations on clinical outcomes have been diverse and contrasting. METHODS: We examined a cohort of 129 de novo MDS patients, who did not harbor RS, for mutations affecting three spliceosomal genes (SF3B1, U2AF1, and SRSF2). RESULTS: The mutation rates of SF3B1, U2AF1, and SRSF2 were 7.0 %, 7.8 %, and 10.1 %, respectively. Compared with previously reported results, these rates were relatively infrequent. The SRSF2 mutation strongly correlated with old age (P < 0.001), while the mutation status of SF3B1 did not affect overall survival (OS), progression-free survival (PFS), or acute myeloid leukemia (AML) transformation. In contrast, MDS patients with mutations in U2AF1 or SRSF2 exhibited inferior PFS. The U2AF1 mutation was associated with inferior OS in low-risk MDS patients (P = 0.035). The SRSF2 mutation was somewhat associated with AML transformation (P = 0.083). CONCLUSION: Our findings suggest that the frequencies of the SF3B1, U2AF1, and SRSF2 splicing gene mutations in MDS without RS were relatively low. We also demonstrated that the U2AF1 and SRSF2 mutations were associated with an unfavorable prognostic impact in MDS patients without RS.
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Mutação , Síndromes Mielodisplásicas/genética , Síndromes Mielodisplásicas/mortalidade , Spliceossomos/genética , Idoso , Idoso de 80 Anos ou mais , Transformação Celular Neoplásica , Análise Mutacional de DNA , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/diagnóstico , Proteínas Nucleares/genética , Fosfoproteínas/genética , Prognóstico , Fatores de Processamento de RNA , Ribonucleoproteína Nuclear Pequena U2/genética , Ribonucleoproteínas/genética , Fatores de Processamento de Serina-Arginina , Fator de Processamento U2AFRESUMO
BACKGROUND: Urine is an important source for the detection of infections caused by CMV in stem cell transplant patients. Currently, there is no agreement about the type of urine specimen. In order to investigate which is the better specimen type for quantitative detection of CMV, we compared the results from urine supernatant and sediment from the same patients. METHODS: Seventy urine specimens were collected from patients with hematological disorders or solid tumors. After performing shell vial culture, residual urine specimens were centrifuged. Then, 10 mL of each urine supernatant and sediment were taken and immediately frozen at -70 degrees C. Afterwards, archived urine specimens were thawed at room temperature and CMV-quantitative PCR was performed on both the supernatant and sediment fraction of urine. The results from each patient were reviewed for CMV antigenemia, blood shell vial culture, CMV-IgM or IgG, and clinical symptoms. RESULTS: CMV-qPCR results for the urine sediment fraction revealed a significant difference (p = 0.012) between the active CMV infection group and the latent CMV infection group. In addition, receiver operating characteristic curves for active CMV infection revealed that CMV-qPCR using urine sediment produced more accurate results than urine supernatant. CONCLUSIONS: These findings suggest that the sediment fraction of urine is a more suitable specimen in CMV-qPCR testing.
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Infecções por Citomegalovirus/urina , Citomegalovirus/isolamento & purificação , Transplante de Células-Tronco/efeitos adversos , Urinálise/métodos , Viremia/urina , Adolescente , Adulto , Anticorpos Antivirais/urina , Antígenos Virais/urina , Criança , Pré-Escolar , Citomegalovirus/genética , Feminino , Neoplasias Hematológicas/terapia , Neoplasias Hematológicas/urina , Humanos , Imunoglobulina G/urina , Imunoglobulina M/urina , Lactente , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Neoplasias/urina , Reação em Cadeia da Polimerase em Tempo Real , Manejo de Espécimes , Adulto JovemRESUMO
Background/Aims: Despite the possible role of systemic low-grade inflammation on frailty, the majority of previous studies have focused solely on the phenotypic frailty with limited participant numbers, thereby weakening the evidence supporting the notion that circulating C-reactive protein (CRP) could be a potential frailty biomarker. Methods: This study is a nationally representative, population-based, cross-sectional analysis from the Korea National Health and Nutrition Examination Survey, involving 5,359 participants aged 65 and older. We generated a deficit accumulation frailty index (FI) based on 38 items, encompassing physical, cognitive, psychological, and social status. Frailty was classified as non-frail (FI ≤ 0.15), pre-frail (0.15 < FI ≤ 0.25), or frail (FI > 0.25). Serum high-sensitivity CRP (hsCRP) levels were measured by immunoturbidometric method. Results: After adjusting for confounders including age, sex, income, education, smoking, hypertension, diabetes, dyslipidemia, stroke, cardiovascular diseases, and body mass index, serum hsCRP levels were 29.4% higher in frail participants compared to their non-frail counterparts (p = 0.001). Additionally, circulating hsCRP concentrations positively correlated with the FI (p = 0.003), and the odds ratio for frailty per standard deviation increase in serum hsCRP was 1.18 (p = 0.001). Moreover, older adults in the highest hsCRP quartile exhibited a significant higher FI with a 1.59-fold increased odds ratio for frailty than those in the lowest quartile (p = 0.002 and 0.001, respectively). Conclusions: These findings validate the impact of age-related systemic low-grade inflammation on frailty and support the utility of serum hsCRP as a potential biomarker for detecting frailty in older adults.
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Since obstructive sleep apnea (OSA) affects various parts of the body, there has been little interest about the effect of OSA on voice. The objective of this study was to evaluate the risk of benign vocal fold lesions (BVFL) in OSA patients. This study used data from the National Health Insurance Service (NHIS) database. The study group was defined as the group diagnosed with OSA between 2008 and 2011. Non-OSA groups were selected based on propensity score (PS) matching. Incidence of BVFL among participants during the follow-up was analyzed. Cox proportional hazard regression analyses were performed to evaluate the association between OSA and incident BVFL. The HR value of the OSA group calculated by considering 8 variables indicates that the risk of developing BVFL is 79% higher than that of the control group. Further, among OSA patients, patients with a history of OP had a 35% lower risk of developing BVFL. The relationships between BVFL and 7 individual variables considered were as follows: For age, HR for the 40 to 59 years group was 1.20 (95%CI, 1.09-1.32). For sex, the HR in the female group was 1.22 (95%CI, 1.10-1.35). For residential areas, the HR values for "Seoul" 1.39 (95%CI, 1.23-1.59). In the high economic status group, the HR was 1.10 (95%CI, 1.01-1.21). This observational study indicated that OSA is associated with an increased incidence of BVFL. The incidence of BVFL increased with older age, female sex, and high SES.
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Apneia Obstrutiva do Sono , Prega Vocal , Humanos , Masculino , Feminino , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/complicações , Pessoa de Meia-Idade , Adulto , Seguimentos , Prega Vocal/fisiopatologia , Incidência , Fatores de Risco , República da Coreia/epidemiologia , Idoso , Modelos de Riscos Proporcionais , Doenças da Laringe/epidemiologia , Doenças da Laringe/etiologia , Pontuação de Propensão , Fatores Sexuais , Fatores EtáriosRESUMO
BACKGROUND: Uric acid (UA), the terminal breakdown product of purine metabolism, possesses contradictory roles, functioning both as an inflammatory mediator and as an antioxidant. Its clinical relevance, particularly in geriatric populations, remains a topic of ongoing debate. Aiming to elucidate whether circulating UA is detrimental or beneficial to human health, we investigate the association between serum UA concentrations and the frailty index-a comprehensive measure of biological aging in a nationally representative cohort of community-dwelling older adults. METHODS: We conducted a population-based, cross-sectional study utilizing data from the Korea National Health and Nutrition Examination Survey. The sample included 4268 participants aged 65 years and above. A deficit accumulation frailty index (FI) was constructed using 38 items that assess physical, cognitive, psychological, and social domains. Based on the FI, participants were categorized into non-frail (FI ≤ 0.15), pre-frail (0.15 < FI ≤ 0.25), or frail (FI > 0.25). Serum UA levels were quantified through a colorimetric enzymatic assay. RESULTS: After controlling for confounders such as age, sex, socioeconomic status (including income and education level), lifestyle factors (smoking status), and medical history (hypertension, diabetes, dyslipidemia, stroke, cardiovascular diseases), and body mass index, serum UA levels were observed to be significantly higher in frail participants compared with their non-frail counterparts (P < 0.001). Furthermore, serum UA concentrations demonstrated a positive correlation with the FI (P < 0.001), and the odds ratio for frailty per 1 mg/dL increase in serum UA was 1.22 (P < 0.001). Additionally, older adults in the highest quartile of UA levels exhibited a significantly higher FI and 1.66-fold increased odds of frailty compared with those in the lowest quartile (P = 0.011 and P = 0.005, respectively). CONCLUSIONS: These findings suggest that elevated circulating UA levels may act as a pro-aging factor rather than an anti-aging one in older adults, highlighting its potential role in accelerating biological aging. The data further support the utility of serum UA as a potential blood-based biomarker for frailty in this demographic, contributing to the expanding evidence on its significance in geriatric health assessments.
RESUMO
BACKGROUND: Although epilepsy is an uncommon comorbidity of Parkinson's disease (PD), the exact incidence of PD among the patients with epilepsy is not clarified yet. OBJECTIVES: We aimed to estimate the incidence of PD in patients with epilepsy and explore the association between epilepsy and PD. METHODS: Epilepsy patients enrolled in the National Health Insurance Service Health Screening Cohort (NHIS-HealS) (2002-2013) between 2003 and 2007 were set up as the experimental group. The major outcome was the occurrence of PD. Non-epilepsy patients were obtained through Propensity Score Matching of 'greedy nearest neighbor' algorithm in 1:1 ratio. The Cox Proportional Hazards model was used to calculate PD incidence and hazard ratio (HR). RESULTS: A total of 10,510 patients were finally included in the study, which contained 5255 patients in epilepsy and non-epilepsy groups, respectively. During the follow-up period, 85 patients with Parkinson's disease among 5255 patients with epilepsy and 57 patients with Parkinson's disease among 5255 patients without epilepsy occurred. The 10,000 Person-Year (PY), representing the number of PD patients per 10,000 per year, was 21.38 in the epilepsy group and 11.18 in the non-epilepsy group. When all variables were adjusted, it was found that the epilepsy group had a 2.19 times significantly higher risk of developing Parkinson's disease than the control group (The adjusted HR: 2.19 (95% CI, 1.55-3.12)). CONCLUSION: This study indicates an increased risk of PD in patients with epilepsy. However, further research is needed to prove an exact causal relationship between these two brain disorders.
Assuntos
Epilepsia , Doença de Parkinson , Humanos , Estudos de Coortes , Incidência , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Comorbidade , Epilepsia/epidemiologia , Epilepsia/complicações , Fatores de RiscoRESUMO
BACKGROUND: Several studies have investigated the relationship between ursodeoxycholic acid (UDCA) and coronavirus disease 2019 (COVID-19). However, complex and conflicting results have generated confusion in the application of these results. OBJECTIVE: We aimed to investigate whether the association between UDCA and COVID can also be demonstrated through the analysis of a large-scale cohort. METHODS: This retrospective study used local and nationwide cohorts, namely the Jeonbuk common data model cohort (JBUH CDM) and the Korean National Health Insurance claim-based database (NHIS). We investigated UDCA intake and its relationship with COVID-19 susceptibility and severity using validated propensity score (PS) matching. RESULTS: Regarding the COVID-19 susceptibility, the adjusted hazard ratio (aHR) value of the UDCA intake was significantly lowered to 0.71 in the case of JBUH CDM (95% confidence interval (CI): 0.52-0.98), and was significantly lowered to 0.93 (95% CI: 0.90-0.96) in the NHIS. Regarding the COVID-19 severity, the UDCA intake was found to be significantly lowered to 0.21 (95% CI: 0.09-0.46) in the case of JBUH CDM. It was also found that the aHR value was significantly lowered to 0.77 in the case of the NHIS (95% CI: 0.62-0.95). CONCLUSIONS: Using a large-scale local and nationwide cohort, we confirmed that UDCA intake was significantly associated with the reduction of COVID-19 susceptibility and severity. These trends remained consistent regardless of the UDCA dosage. This suggests the potential of UDCA as a preventive and therapeutic agent for COVID-19.