Background: The medial temporal region is the earliest affected structure in patients with Alzheimer’s disease (AD), and its atrophy is known as the hallmark of AD. This study aimed to investigate the value of medial temporal atrophy (MTA) for detecting 18F-florbetaben positron emission tomography (PET)-proven AD pathology. Methods: We retrospectively enrolled 265 subjects complaining of cognitive decline at a dementia outpatient clinic from March 2015 to December 2017. All subjects underwent brain magnetic resonance imaging, 18F-fluorodeoxyglucose PET, and 18F-florbetaben PET at baseline. We performed multivariable logistic regression analyses on variables including age, sex, years of education, white matter hyperintensities, apolipoprotein E (APOE) genotype, and memory composite scores in various combinations to investigate whether MTA was indicative of underlying AD pathology. Results: Our sample population of 265 patients comprised 121 with AD-related cognitive impairment, 42 with Lewy bodies-related cognitive impairment, 32 with vascular cognitive impairment, and 70 with other or undetermined pathologies. In the multivariable logistic regression analyses, MTA was not an independent predictor of underlying AD pathology (P>0.200). The predictive power of underlying AD-related cognitive impairment significantly increased when multiple variables including APOE genotype and memory composite scores were considered together (area under the curve >0.750). Conclusion Our results suggest that MTA alone may be insufficient to accurately predict the presence of AD pathology. It is necessary to comprehensively consider various other factors such as APOE genotype and a detailed memory function to determine whether the patient is at high risk of AD.

Purpose: This cross-sectional study aimed to identify factors affecting coronavirus disease 2019 (COVID-19) vaccination intention. Methods: For an anonymous online survey, recruitment notices were posted on an anonymous community by each university, and an online survey was conducted through online form from June to July 2021. COVID-19 knowledge and health-protective behavior were measured using a questionnaire based on previous literature and reflecting the Korea Centers for Disease Control and Prevention’s COVID-19 Response Guidelines. The psychological antecedents of vaccination were measured by 5C scale. Results: Two-hundred and ninety-four college students (women 67.3%) answered the survey; 179 (60.9%) reported that they would accept a COVID-19 vaccine. The mean scores for COVID-19 knowledge and health-protective behavior were 22.97 ± 5.33 (out of 35) and 9.92 ± 2.22 (out of 12), respectively. For the psychological antecedents of vaccination, the mean scores for confidence, collective responsibility, calculation, complacency, and constraints were 4.45 ( ± 1.24), 5.61 ( ± 1.09), 5.09 ( ± 1.18), 2.42 ( ± 1.11), and 2.37 ( ± 1.19) out of 5 points, respectively. The confidence, calculation, and collective responsibility were associated with vaccination intention. Additionally, the top reason for those who were less prone to accept vaccination against COVID-19 was concern about vaccine safety. Conclusion The higher the confidence in the vaccine and the higher the collective responsibility, the higher the vaccination intention. As it is a factor related to an individual’s perception of COVID-19 information, it is necessary to increase confidence in the vaccines through obtaining accurate information on the safety, effectiveness, and side effects of the COVID-19 vaccines and vaccination.

PURPOSE: Candidiasis is an important morbidity among very low birth weight infants (VLBWI). There is a little data on the risk factors in VLBWI. This study was done to describe the incidence, treatment, and risk factors of candidiasis in VLBWI. METHODS: From September 2008 to December 2011, medical records of 130 infants with VLBWI in Inje University Ilsan Paik hospital neonatal intensive care unit (NICU) were reviewed retrospectively. Seventeen infants were diagnosed with candidiasis and treated with antifungal agent. Patients were divided into the candidiasis group (CAN, n=17), the bacterial sepsis group (BAC, n=34), and the non-sepsis group (Non-SEP, n=74). Demographic findings and factors associated with candidiasis were compared between these groups. RESULTS: The mean gestational age was significantly low in the CAN group, but birth weight was not significantly different between the groups. The maternal demographic findings were not significantly different between the groups. The incidence of respiratory distress syndrome (RDS) is higher in the CAN group compared to these groups (P<0.05). The durations of intubation and central venous line were significantly longer in the CAN group than in the other groups (P<0.05). In the logistic regression analysis, the duration of central venous line is the significant factor for candidiasis (P=0.003, odd ratio: 1.56, 95% confidence interval: 1.39-1.68). CONCLUSION: The incidence of candidiasis in VLBWI was 13.1 % and the risk factor for candidiasis was longer duration of central venous line in our study.
Birth Weight ; Candidiasis* ; Gestational Age ; Humans ; Incidence* ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Intubation ; Logistic Models ; Medical Records ; Retrospective Studies ; Risk Factors* ; Sepsis

A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and expresses CD117, a c-kit proto-oncogene, which can be detected immunohistochemically. We reported a GIST of the rectum of a 61-year-old-woman who had visited emergency room complaining of constipation over one week. Upon rectal examination, a round hard mass was palpated. Colonoscopy showed a 7x5 cm sized protruded lesion with surface ulceration on a rectum, adjacent the anus. And abdomen computed tomography revealed the soft tissue mass compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST. The patient had been treated with a ultra anorectal anastomosis with loop ileostomy. Immunohistochemical studies on the surgically resected specimen showed c-kit (+) and CD34 (+). The final diagnosis was a GIST of the rectum. She was grouped into high risk and she has been given adjuvant chemotherapy with Imatinib.
Abdomen ; Anal Canal ; Benzamides ; Chemotherapy, Adjuvant ; Colonoscopy ; Constipation ; Emergencies ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Ileostomy ; Piperazines ; Proto-Oncogenes ; Pyrimidines ; Rectum ; Ulcer ; Imatinib Mesylate

BACKGROUND: It is well-known that patients with chronic fatigue or frequent pain seek complementary and alternative medicine therapies (CAT) in Western countries. We conducted this study to determine the pattern of CAT use and the factors related to CAT use in patients with chronic fatigue or pain in Korea. METHODS: This was a cross-sectional study. The participants (n = 143) with chronic fatigue or pain completed a self-reported questionnaire including demographic characteristics and lifestyle as well as disease-related and CAT-related items. RESULTS: The frequency of CAT use was 51.0& and 39.2& over the past 10 years and 1 year, respectively. The most common type of CAT used was herbal medicine. The therapeutic effects of the CAT were similar to physicians' prescriptions. CAT were most often used in combination with conventional medicine rather than alone. More than 70.0& of subjects did not consult their physicians for the use of CAT. The duration of illness, severity of fatigue and pain was signifi cantly related to the use of CAT. CONCLUSION: Many patients with chronic fatigue or pain use CAT. Most of these patients do not consult their physicians regarding CAT use.
Animals ; Cats ; Complementary Therapies ; Cross-Sectional Studies ; Fatigue ; Herbal Medicine ; Humans ; Korea ; Life Style ; Prescriptions

Tight junctions (TJs) form continuous intercellular contacts in intercellular junctions. TJs involve integral proteins such as occludin (OCLN) and claudins (CLDNs) as well as peripheral proteins such as zona occludens-1 (ZO-1) and junctional adhesion molecules (JAMs). TJs control paracellular transportation across cell-to-cell junctions. Although TJs have been studied for several decades, comparison of the transcriptional-translational levels of these molecules in canine organs has not yet been performed. In this study, we examined uterine expression of CLDNs, OCLN, junction adhesion molecule-A, and ZO-1 in canine. Expression levels of canine uterine TJ proteins, including CLDN1, 2, 4, 5, JAM-A, ZO-1, and OCLN, were measured using reverse transcription PCR, real-time PCR, and Western blotting, whereas TJs distribution was determined by immunohistochemistry. The mRNA and protein expression levels of OCLN, CLDN-1, 4, JAM-1, and ZO-1 were identified in the uterus. Immunohistochemistry demonstrated that TJs were localized to the endometrium and/or myometrium of the uterus. Our results show that canine TJ proteins, including CLDNs, OCLN, JAM-A, and ZO-1, were expressed in the canine uterus. Taken together, these proteins may perform unique physiological roles in the uterus. Therefore, these findings may serve as a basis for further studies on TJ proteins and their roles in the physiological or pathological condition of the canine uterus.
Animals ; Blotting, Western ; Claudins ; Dogs ; Endometrium ; Female ; Herpes Zoster ; Immunohistochemistry ; Intercellular Junctions ; Junctional Adhesion Molecules ; Mice ; Myometrium ; Occludin ; Physiology ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; Tight Junctions* ; Transportation ; Uterus*

AA amyloidosis is one of the most significant complications of rheumatoid arthritis characterized by the deposition of amyloid A (AA) in multiple organs and tissues in the body. This disorder displays variable clinical symptoms depending upon the involved organ and a diagnosis is rendered through a biopsy of the affected organ, followed by staining using Congo-red which reveals an apple-green birefringence. Fundamental disease control is critical in the treatment of AA amyloidosis. Anti-tumor necrosis factor alpha (anti TNF-alpha) agents are promising in inducing clinical remission by suppressing systemic inflammation in AA amyloidosis. We report a case of AA amyloidosis in a 71 year old woman with rheumatoid arthritis that responded well to infliximab therapy.
Amyloid ; Amyloidosis ; Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Biopsy ; Birefringence ; Female ; Humans ; Inflammation ; Necrosis ; Infliximab

PURPOSE: The impulse oscillometry (IOS) is applicable to young children because it requires minimal cooperation and a non-invasive method to measure the mechanics of respiratory system. This study aimed to develop the reference values in school-aged children in Korea, using IOS which is a modification of forced oscillation technique (FOT). METHODS: Measurements were performed in 92 previously untrained healthy children, aged 7 to 12 years old, using IOS. We analyzed the relationships between the data about their age, height, weight, body surface area (BSA), body mass index (BMI) and the result of IOS using the linear regression test. RESULTS: The success rate of IOS was 92.4%. Stepwise multiple regression of resistance of respiratory system (Rrs) and reactance of respiratory system (Xrs) in natural form for age, height, weight, BSA, BMI showed that height was the most significant predictor and altogether of 5 variables explained the Rrs and Xrs most. Our regression equations at multiple frequencys were comparable to published reference values, especially about the Rrs obtained at 5 Hz. CONCLUSION: IOS is a feasible method to measure the respiratory resistance in untrained children. We got the reference values using IOS and it seems to be useful to diagnose a variety of respiratory diseases.
Airway Resistance ; Body Mass Index ; Body Weight ; Child* ; Electric Impedance* ; Humans ; Korea* ; Linear Models ; Mechanics ; Oscillometry* ; Reference Values* ; Respiratory Function Tests ; Respiratory System*

OBJECTIVES: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. MATERIALS AND METHODS: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. RESULTS: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. CONCLUSION: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.
Amnesia ; Blood Pressure ; Body Mass Index ; Case-Control Studies ; Conscious Sedation* ; Dental Anxiety ; Drug Dosage Calculations ; Heart Rate ; Humans ; Midazolam* ; Molar, Third* ; Oxygen ; Patient Satisfaction ; Retrospective Studies ; Risk Factors* ; Surgery, Oral

Little is known about how the interaction between red blood cell distribution width (RDW) and vascular calcification (VC) affects cardiovascular (CV) events and mortality in end-stage kidney disease (ESKD) patients. This study investigated the combined prognostic effect of RDW and VC in ESKD patients starting dialysis. Methods: A retrospective single-center study of 582 ESKD patients was conducted. VC was assessed by calculating the aortic calcification index (ACI) using computed tomography. Patients were divided into low ACI-low RDW, low ACI-high RDW, high ACI-low RDW, and high ACI-high RDW groups based on median ACI (17.12) and RDW (14.3) values. The association between RDW and VC and the composite endpoint of CV events and death was analyzed. Results: During a median follow-up of 3.1 years (range, 1.5–5.5 years), 165 CV events (28.4%) and 124 deaths (21.4%) occurred. Cox regression showed that the low ACI-high RDW (adjusted hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.04–2.66; p = 0.03) and high ACI-low RDW (adjusted HR, 1.95; 95% CI, 1.21–3.14; p = 0.006) groups had a greater risk of CV events and death than the low ACI-low RDW group. The high ACI-high RDW group had the greatest risk (adjusted HR, 2.23; 95% CI, 1.42–3.52; p = 0.001). The effect of the interaction between ACI and RDW on CV events and mortality was statistically significant (p = 0.005). Conclusion: High RDW and VC interact to increase the risk of CV events and death in ESKD patients.