BACKGROUND: Mental health issues such as stress and depression have been regarded as major social problems in Korea. We investigated the relationship between stress and depression with unmet medical needs (UMN). METHODS: Using the nationwide database of 2010 Korea National Health and Nutritional Examination Survey (K-NHANES), subjects aged 19 years or above were selected (n=6,055). In the K-NHANES questionnaire, subjects were asked about their UMN experience, severity of stress, and perceived depression lasting at least 2 weeks over the past year. The effects of stress and depression on UMN were analyzed in 4 models established by adding predisposing, enabling and need factors in a step-wise fashion. The risks for UMN were also assessed according to the causes of UMN. RESULTS: Individuals who felt stress ‘very often’ (odds ratio (OR) 3.28, 95% CI=2.23-4.86) and ‘often’ (OR 2.53, 95% CI=1.93-3.31) and who experienced depression (OR 1.68, 95% CI=1.35-2.10) reported significantly elevated UMN rates, and these effects were substantial especially for the individuals who had UMN due to economic constraint. Females, lower education level, lower income, unemployed status, and negative perceptions about health status were found to be additional risk factors for UMN. CONCLUSION: Our results confirmed the risks of stress and depression on UMN. It is strongly advisable to create initiatives to improve mental health, particularly stress and depression, and to fulfill individuals' medical utilization needs.
Depression* ; Education ; Female ; Humans ; Korea ; Mental Health ; Risk Factors ; Social Problems

A patient with a complete right ureteral triplication presented with recurrent pyelonephritis and flank pain that was refractory to medical management. Evaluation showed that the atrophic upper-most renal moiety had been chronically obstructed and was associated with a dilated ureter. Intraureteral and intravenous indocyanine green (ICG) were used as real-time contrast agents intraoperatively to facilitate right robotic partial nephroureterectomy of the diseased system. Intraureteral ICG was used to accurately distinguish the pathologic ureter and associated renal pelvis from its normal counterparts. Intravenous ICG was used to assess perfusion in the right kidney and delineate the margins of diseased renal parenchyma.
Administration, Topical ; Adult ; Coloring Agents/administration & dosage ; Female ; Humans ; Indocyanine Green/*administration & dosage ; Infusions, Intravenous ; Nephrectomy/*methods ; Pyelonephritis/surgery ; Robotic Surgical Procedures/*methods ; Tomography, X-Ray Computed ; Ureter/*abnormalities/radiography/*surgery

BACKGROUND: Tosufloxacin is one of the fluoroquinolones with higher antibacterial activity against many organisms than other fluoroquinolones developed previously. However, the antimicrobial susceptibilities of tosufloxacin against uropathogens are not well known. The objective of this study was to compare minimum inhibitory concentrations (MICs) of tosufloxacin with those of levofloxacin and ofloxacin for uropathogens cultured from the urine of female outpatients with acute uncomplicated cystitis. MATERIALS AND METHODS: We collected and cultured urine samples from four metropolitan hospitals between August 2006 and November 2006. The MICs of tosufloxacin, levofloxacin and ofloxacin were determined for 89 isolates using an agar dilution method. RESULTS: The most prevalent causative organism was Escherichia coli (70.8%). The MIC distribution of tosufloxacin and levofloxacin showed a bimodal distribution for E. coli. The two modes for E. coli were 0.03 and 32 microgram/mL for tosufloxacin and 0.03 and 16 microgram/mL for levofloxacin. However, ofloxacin had one more peak at MIC 0.5 microgram/mL. MIC50s of tosufloxacin, levofloxacin and ofloxacin for E. coli were 0.03 microgram/mL, 0.06 microgram/mL and 0.125 microgram/mL, respectively. Tosufloxacin, the newer fluoroquinolone, was more active than levofloxacin and ofloxacin against both E. coli and Gram-positive bacteria. CONCLUSION: Of the studied fluoroquinolones tosufloxacin had the lowest MICs against uropathogens and could be considered a promising alternative fluoroquinolone agent for the treatment of urinary tract infection.
Agar ; Cystitis* ; Escherichia coli ; Female* ; Fluoroquinolones ; Gram-Positive Bacteria ; Hospitals, Urban ; Humans ; Levofloxacin* ; Microbial Sensitivity Tests ; Ofloxacin* ; Outpatients* ; Urinary Tract Infections

BACKGROUND: Tosufloxacin is one of the fluoroquinolones with higher antibacterial activity against many organisms than other fluoroquinolones developed previously. However, the antimicrobial susceptibilities of tosufloxacin against uropathogens are not well known. The objective of this study was to compare minimum inhibitory concentrations (MICs) of tosufloxacin with those of levofloxacin and ofloxacin for uropathogens cultured from the urine of female outpatients with acute uncomplicated cystitis. MATERIALS AND METHODS: We collected and cultured urine samples from four metropolitan hospitals between August 2006 and November 2006. The MICs of tosufloxacin, levofloxacin and ofloxacin were determined for 89 isolates using an agar dilution method. RESULTS: The most prevalent causative organism was Escherichia coli (70.8%). The MIC distribution of tosufloxacin and levofloxacin showed a bimodal distribution for E. coli. The two modes for E. coli were 0.03 and 32 microgram/mL for tosufloxacin and 0.03 and 16 microgram/mL for levofloxacin. However, ofloxacin had one more peak at MIC 0.5 microgram/mL. MIC50s of tosufloxacin, levofloxacin and ofloxacin for E. coli were 0.03 microgram/mL, 0.06 microgram/mL and 0.125 microgram/mL, respectively. Tosufloxacin, the newer fluoroquinolone, was more active than levofloxacin and ofloxacin against both E. coli and Gram-positive bacteria. CONCLUSION: Of the studied fluoroquinolones tosufloxacin had the lowest MICs against uropathogens and could be considered a promising alternative fluoroquinolone agent for the treatment of urinary tract infection.
Agar ; Cystitis* ; Escherichia coli ; Female* ; Fluoroquinolones ; Gram-Positive Bacteria ; Hospitals, Urban ; Humans ; Levofloxacin* ; Microbial Sensitivity Tests ; Ofloxacin* ; Outpatients* ; Urinary Tract Infections

BACKGROUND: One of the characteristics of spinal stenosis is elastin degradation and fibrosis of the extracellular matrix of the ligamentum flavum. However, there have been no investigations to determine which biochemical factors cause these histologic changes. So we performed the current study to investigate the hypothesis that matrix metalloproteinases (MMPs), which possess the ability to cause extracellular matrix remodeling, may play a role as a mediator for this malady in the ligamentum flavum. METHODS: The ligamentum flavum specimens were surgically obtained from thirty patients with spinal stenosis, as well as from 30 control patients with a disc herniation. The extents of ligamentum flavum elastin degradation and fibrosis were graded (grade 0-4) with performing hematoxylin-eosin staining and Masson's trichrome staining, respectively. The localization of MMP-2 (gelatinase), MMP-3 (stromelysin) and MMP-13 (collagenase) within the ligamentum flavum tissue was determined by immunohistochemistry. The expressions of the active forms of MMP-2, MMP-3 and MMP-13 were determined by western blot analysis, and the blots were quantified using an imaging densitometer. The histologic and biochemical results were compared between the two conditions. RESULTS: Elastin degradation and fibrosis of the ligamentum flavum were significantly more severe in the spinal stenosis samples than that in the disc herniation samples (3.14 +/- 0.50 vs. 0.55 +/- 0.60, p < 0.001; 3.10 +/- 0.57 vs. 0.76 +/- 0.52, p < 0.001, respectively). The expressions of the active form of MMPs were identified in all the ligamentum flavums of the spinal stenosis and disc herniation patients. The expressions of active MMP-2 and MMP-13 were significantly higher in the spinal stenosis samples than that in the disc herniation samples (both p < 0.05). The expression of active MMP-3 was slightly higher in the spinal stenosis samples than that in the disc herniation samples, but the difference was not statistically significant (p = 0.131). MMP-2, -3, and -13 were positively stained on the ligamentum flavum fibroblasts. CONCLUSIONS: The current results suggest that the increased expression of active MMPs by the ligamentum flavum fibroblasts might be related to the elastin degradation and fibrosis of the ligamentum flavum in the patients who suffer with lumbar spinal stenosis.
Aged ; Blotting, Western ; Elastin/*metabolism ; Extracellular Matrix/metabolism/pathology ; Female ; Fibrosis ; Humans ; Immunohistochemistry ; Ligamentum Flavum/*metabolism/pathology ; *Lumbar Vertebrae ; Male ; Matrix Metalloproteinase 13/metabolism ; Matrix Metalloproteinase 2/metabolism ; Matrix Metalloproteinase 3/metabolism ; Matrix Metalloproteinases/*metabolism ; Middle Aged ; Spinal Stenosis/*metabolism/pathology

PURPOSE: To demonstrate our technical approach for robot-assisted ureteroneocystostomy (R-UNC) for benign and malignant distal ureteral pathologies. MATERIALS AND METHODS: Between January 2009 and January 2013, a total of 10 patients underwent R-UNC in the distal ureter by a single surgeon. Indications for R-UNC were as follows: idiopathic (3), fistula (2), iatrogenic (2), malignancy (2), and chronic vesicoureteral reflux (1). RESULTS: Tension-free anastomosis was attained in all 10 R-UNC procedures. A psoas hitch was performed in 6/10 cases (60%). Intravesical and extravesical reimplantations were completed in 5/10 (50%) and 5/10 cases (50%), respectively. A nonrefluxing ureter was constructed in 2/10 cases (20%). The patients' mean age was 52.9+/-16.6 years, their mean body mass index was 30.8+/-6.3 kg/m2, the mean operative time was 211.7+/-69.3 minutes, mean estimated blood loss was 102.5+/-110.8 mL, and mean length of stay was 2.8+/-2.3 days. There were no intraoperative complications. There was one Clavien-Dindo grade I and one Clavien-Dindo grade II postoperative complication. The mean postoperative follow-up duration was 28.5+/-15.5 months. Two patients had recurrence of ureteral strictures at 3 months postoperatively and were managed successfully with balloon dilation. CONCLUSIONS: Our technique for R-UNC demonstrates good perioperative outcomes. However, underlying periureteral inflammation and pelvic adhesions may predispose patients for stricture recurrence after R-UNC.
Adult ; Body Mass Index ; Constriction, Pathologic ; Fistula ; Follow-Up Studies ; Humans ; Inflammation ; Intraoperative Complications ; Length of Stay ; Operative Time ; Postoperative Complications ; Reconstructive Surgical Procedures ; Recurrence ; Replantation ; Surgical Procedures, Minimally Invasive ; Ureter ; Vesico-Ureteral Reflux

Various vaccines have been developed to fight severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 pandemic.However, new variants of SARS-CoV-2 undermine the effort to fight SARS-CoV-2. Here, we produced S proteins harboring the receptor-binding domain (RBD) of the Omicron variant in plants. Plant-produced S proteins together with adjuvant CIA09A triggered strong immune responses in mice. Antibodies in serum inhibited interaction of recombinant human angiotensinconverting enzyme 2 with RBD of the Omicron variant, but not RBD of other variants. These results suggest that antibodies induced by RBD of the Omicron variant are highly specific for the Omicron RBD, but not for that of other variants.

BACKGROUND: Although the lung is a common site of metastasis, endobronchial metastases (EBM) from extrathoracic malignancies are rare. Previous studies were retrospective reviews of the cases from each single institute, and the last one was performed between 1992 and 2002. We evaluated the characteristics of patients with EBM who had been diagnosed in recent 10 years in our hospital. METHODS: We retrospectively reviewed 1,275 patients who had undergone diagnostic bronchoscopic procedures between 2001 and 2011. An EBM was defined as bronchoscopically notable lesion, which was histopathologically identical to the primary tumor. RESULTS: A total of 18 cases of EBM were identified. The mean age was 53 years, and 12 cases of the 18 patients were female. The most common primary malignancies were colorectal cancer and breast cancer (4 cases each), followed by cervix cancer (3 cases) and renal cell carcinoma (2 cases). Cough was the most common symptom. The most common radiologic finding was atelectasis, which was identified in 27.7% of the cases. The median interval from the diagnosis of primary malignancy to the diagnosis of EBM was 14 months (range, 0-112 months). The median survival time from the diagnosis of EBM was 10 months (range, 1-39 months). CONCLUSION: EBM from extrathoracic malignancies were rare. Colorectal cancer and breast cancer were common as primary malignancies. Fiberoptic bronchoscopy should be performed in all patients, who are suspected of having EBM. If atypical clinical and pathological features are present, appropriate diagnostic studies should be undertaken.
Breast Neoplasms ; Bronchi ; Bronchoscopy ; Carcinoma, Renal Cell ; Colorectal Neoplasms ; Cough ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Pulmonary Atelectasis ; Retrospective Studies ; Uterine Cervical Neoplasms

A total of 18 Newcastle disease virus (NDV) isolates that were recovered from 1949 through 1997 were characterized and pathotyped. All viruses were highly virulent as determined by intracerebral pathogenicity indices > or = 1.81 in day-old. These pathotypes are typical for viscerotropic velogenic NDV (VVNDV) pathotype viruses. Some differences were observed for the chicken red blood cell elution rate and thermostability of the hemagglutinin at 56degrees C. Three antigenic groups were identified by a hemagglutination-inhibition assay using NDV monoclonal antibodies. And the predominant gross lesions were as follows: discharge from the nasal cavity, tracheal mucus, petechial hemorrhage in the heart fat, kidney urates and hemorrhage with or without necrosis in the gastrointestinal tract. Severe hemorrhagic or necrotic lesions were also noted in the lymphoid organs and were localized primarily in the spleen and cecal tonsil. However, differences in the occurrence and frequency of the gross lesions were observed between the virus strains. Among them, NDV strains that induced neurological symptoms belonged only to genotype VI. This strain had spread throughout Korea during the late 1980s to the 1990s, which suggests that specific VVNDVs genotypes might result in neurological symptoms.
Animals ; Antibodies, Monoclonal ; Avulavirus ; Chickens ; Erythrocytes ; Gastrointestinal Tract ; Genotype ; Heart ; Hemagglutinins ; Hemorrhage ; Kidney ; Korea ; Mucus ; Nasal Cavity ; Necrosis ; Newcastle Disease ; Newcastle disease virus ; Palatine Tonsil ; Spleen ; Sprains and Strains ; Viruses

Objective: To address the gap in timely diagnosis of dementia due to limited screening tools, we investigated the validity and reliability of the Hellocog, computerized neuropsychological test based on tablets for screening dementia. The higher the probability score on the Hellocog, the higher the likelihood of dementia. Methods: This study included 100 patients with dementia and 100 individuals with normal cognition who were aged 60 years or older and free of other major psychiatric, neurological, or medical conditions. They administered the Hellocog on a tablet under the supervision of a neuropsychologist. To determine test-retest reliability, 20 took the Hellocog again after 4 weeks. Diagnostic performance was assessed using the receiver operator characteristics (ROC) analysis. Results: The Hellocog showed adequate internal consistency (Cronbach’s alpha=0.69) and good test-retest reliability (intraclass correlation coefficient=0.86, p<0.001). Participants with dementia scored higher on the Hellocog than those with normal cognition (p<0.001), confirming its high criterion validity. Strong correlations with the Mini-Mental Status Examination (MMSE) score and the total score of the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Assessment Battery (CERAD-TS) highlight the concurrent validity of the Hellocog. The area under the ROC curve for dementia of the Hellocog was excellent (0.971) and comparable to that of the MMSE and CERAD-TS. The sensitivity and specificity for dementia were 0.945 and 0.872%, respectively, which were slightly better than those of the MMSE and CERAD-TS. Conclusion Hellocog stands out as a valid and reliable tool for self-administered dementia screening, with promise for improving early detection of dementia.