BACKGROUND: Over the past decade, considerable evidence has been accumulated showing that social networks influence health. However few valid and reliable instruments exist for assessing social networks among elderly population. Therefore, we translated the Lubben social network scales (LSNS) and tested the validity and reliability of Korean version. METHODS: Ten items, self-administered questionnaires were translated by multidisciplinary committee members. Also they were reverse translated by bilingual and modified from pretest procedure. Reliability was tested by 4 weeks testretest reliability and internal consistency (Cronbach's alpha). Validity was tested by factor analysis and construct validity comparison with the Korean version of Duke-UNC and Korean Health Related Quality of Life Scale (KQOLS) were tested for validity testing. RESULTS: Cronbach's alpha was 0.75. Four weeks test-retest Pearson coefficient was 0.78 (P < 0.0001). Correlation coefficient with the Korean version of Duke-UNC was 0.58 (P < 0.0001). Correlation coefficient with social function domain of KQOLS was 0.40 (P < 0.0001). Principal components analysis identified 3 factors. Three contents areas are family and friends networks, interdependent social support and living arrangements. CONCLUSION: Korean version of LSNS is both valid and reliable instrument, but fine refinements will be needed to adapt for use in practical settings.
Aged ; Committee Membership ; Friends ; Humans ; Quality of Life ; Reproducibility of Results ; Residence Characteristics ; Weights and Measures ; Surveys and Questionnaires

BACKGROUND: Recently, there has been an increase of emerging concerns between dietary fiber and diabetics. Increasing intake of dietary fiber leads to delaying absorption of glucose, and lowering of serum insulin levels. In the past studies, there were inconsistent glycemic control effect of beta-glucan. Our purpose was to assess the glycemic control effect of beta-glucan in adults. METHODS: Electronic searches (Cochrane, PubMed, EMBase), hand-searching and review of reference were done. The search term for beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw], with no language restriction were used. All RCT that included available data of beta-glucan or that could impute dose of beta-glucan, at least one relevant outcome of glycemic control, run-in period more than 2 weeks, and intervention period of more than 2 weeks or greater were selected. A fixed-effect model was used to assess the summary effect of studies. RESULTS: A total of 43 articles were identified, 4 studies met our inclusion criteria and then analyzed. In pooled analysis, the effect size of fasting glucose level was 0.13 (95%CI: -1.25 to 1.51), and serum insulin level was -0.95 (95%CI, -2.37 to 0.47). It was impossible to adjust for sex and age owing to the lack of raw data. CONCLUSION: In this review, the results suggested that there were negative impacts of beta-glucan on fasting glucose and serum insulin level in adults, but we concluded that there was insufficient evidence to confirm about glycemic control effect. More powerful and well-designed RCT were required to confirm about glycemic control effect of beta-glucan.
Absorption ; Adult ; Avena ; beta-Glucans ; Diabetes Mellitus ; Dietary Fiber ; Electronics ; Electrons ; Fasting ; Glucose ; Hordeum ; Humans ; Insulin

BACKGROUND/AIMS: To determine the efficacies of entecavir (ETV) in nucleos(t)ide analogue (NA)-naive chronic hepatitis B (CHB) patients and in those with prior lamivudine (LAM) use who did not develop resistance. METHODS: We retrospectively enrolled 337 patients with CHB who were treated with ETV (0.5 mg daily) for at least 30 months. The study included 270 (80.1%) NA-naive patients and 67 (19.9%) LAM-use patients. Ten of the LAM-use patients were refractory to LAM therapy without developing resistance. RESULTS: Genotypic resistance to ETV developed more frequently in the LAM-use group (13.1%) than in the NA-naive group (2.6%) at 60 months (P=0.009). In subgroup analysis, after excluding the 10 patients who were refractory to LAM therapy, the cumulative probability of ETV resistance did not differ significantly between the two groups (P=0.149). Prior LAM refractoriness and a higher hepatitis B virus DNA level at month 12 were independent predictive factors for the development of ETV resistance. CONCLUSIONS: ETV resistance developed more frequently in LAM-use patients with CHB. However, prior LAM use without refractoriness did not affect the development of ETV resistance. The serum hepatitis B virus DNA level at month 12 was a major predictor for the development of ETV resistance.
Adolescent ; Adult ; Aged ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; *Drug Resistance, Viral/genetics ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Remission Induction ; Retrospective Studies ; Young Adult

Early post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) prediction may allow safe same-day outpatients discharge after ERCP and earlier proper management. This study aimed to assess the usefulness of the 4-hour post-ERCP serum amylase and lipase levels for PEP early prediction and to investigate predictive cut-off values for 4-hour post-ERCP serum amylase and lipase levels for safe discharge and urgent initiation of resuscitation. The data of 516 consecutive patients with native papilla who underwent ERCP between January 2013 and August 2014 were retrospectively reviewed. Serum amylase and lipase levels were measured before, and 4 and 24 hours after ERCP. PEP occurred in 16 (3.1%) patients. The receiver-operator characteristic curve for 4-hour post-ERCP serum amylase and lipase levels showed that the areas under the curve were 0.919 and 0.933, respectively, demonstrating good test performances as predictors for PEP (both P values < 0.001). The amylase level > 1.5 × the upper limit of reference (ULR) was found useful for PEP exclusion with a sensitivity of 93.8%, while 4 × ULR was found useful to guide preventive therapy with the best specificity of 93.2%. Similarly, the lipase level 2 × ULR showed best sensitivity, while 8 × ULR had the best specificity. Logistic regression analysis showed that 4-hour post-ERCP amylase level > 4 × ULR, lipase level > 8 × ULR, precut sphincterotomy, and pancreatic sphincterotomy were significant predictors for PEP. In conclusion, 4-hour post-ERCP amylase and lipase levels are useful early predictors of PEP that can ensure safe discharge or prompt resuscitation after ERCP.
Amylases* ; Cholangiopancreatography, Endoscopic Retrograde ; Humans ; Lipase* ; Logistic Models ; Outpatients ; Pancreatitis* ; Resuscitation ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: To analyse and compare high-resolution CT findings of pulmonary tuberculosis with consolidation and mycoplasma pneumonia. MATERIALS AND METHODS: Twenty patients with pulmonary tuberculosis [confirmed by sputum culture (n=9) and bronchoscopic biopsy (n=11)] and airspace consolidation on high-resolution CT and 17 patientswith mycoplasma pneumonia, confirmed by serologic test, were included in this study. High-resolution CT findings were analyzed in terms of ground-glass opacities, distribution of consolidation, type of nodules, cavities, interlobular septal thickening, bronchial dilatations, bronchial wall thickening and pleural effusion. RESULTS: In patients with tuberculsis, average age was 33.5 years (range, 20-67) ; in those with mycoplasma pneumonia it was 32.5 years (range, 17-74). Segmental and subsegmental distributions were most common in both diseases ; the preferred site of consolidation was different, however ; for tuberculosis it was the upper lobes (13 cases, 65% ; bilateral involvement, 7 cases) ; for mycoplasma pneumonia it was the lower lobes (11 cases, 64.7%). Non-segmental (diffuse and random) distribution of ground-glass opacities were seen in two patients(11.8%) with mycoplasma pneumonia. Centrilobular nodules, branching linear opacities and alveolar nodules were not different in both diseases, but there were nodules above 10mm in 14 cases of tuberculosis and in only one case of mycoplasma pneumonia. Tree-in-bud appearances were seen in five cases of tuberculosis. Cavities without air-fluid level were noted in ten cases of tuberculosis. Other interlobular septal thickening, bronchial wall thickening, bronchial dilatation and pleural effusion were not different in both diseases. CONCLUSION: There was considerable overlap between high resolution CT findings of tuberculosis with airspace consolidation and those of mycoplasma pneumonia. The location of consolidation, type of nodules, and the presence of tree-in-bud appearance and cavities help in the differentiation of the two diseases, however.
Adult* ; Biopsy ; Dilatation ; Humans ; Mycoplasma* ; Pleural Effusion ; Pneumonia, Mycoplasma* ; Serologic Tests ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

In an effort to investigate the molecular basis of growth discordance in embryos that experience the same uterine environment, we compared telomerase activity and apoptosis in placental trophoblasts obtained from growth discordant twins. Between January 2003 and February 2005, placental tissue from twenty pairs of twins was obtained within thirty minutes of delivery. Eleven cases were classified as growth discordant, with birth weight discordance greater than 20%. Nine cases comprised the control group, with less than 20% discordance. Telomerase and apoptotic activities in placental trophoblasts were analyzed by ELISA and immunoblot. Statistical significance was analyzed by a paired t-test, chi- squared test, and ANOVA (SPSS ver 11.0). The average growth discordance was 26.8% in the growth discordant group and 14.4% in the control group. There were no significant differences in maternal age, week of gestation at delivery, parity, or chorionisity between the two groups. In the growth discordant group, the larger twin showed significantly higher telomerase activity (p < 0.01), whereas no significant difference was observed in the control group (p = 0.36). In addition, there was no definitive correlation between telomerase activity and the degree of growth discordance in the larger or smaller twins (R = -0.521 and -0.399, p = 0.15 and 0.25, respectively). The apoptosis proteins Bax and Bcl 2 were detected in both the larger and smaller twins in the growth discordant and control groups. There was no statistically significant difference in Bax expression between the larger and smaller twins (p = 0.25 and 0.92, respectively) for either the growth discordant or the control groups. Bcl 2 expression also showed no significant difference between groups. In Conclusion, A tendency toward reduced telomerase activity and increased apoptosis was discovered in placental trophoblasts of the smaller growth- discordant twin, possibility resulting in delayed fetal growth.
bcl-2-Associated X Protein/metabolism ; Trophoblasts/*enzymology/pathology ; Telomerase/*metabolism ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Immunoblotting ; Humans ; Fetal Growth Retardation/*enzymology/metabolism/*pathology ; Fetal Development/physiology ; Enzyme-Linked Immunosorbent Assay ; Diseases in Twins/*enzymology/metabolism/*pathology ; *Apoptosis

Objective: This study aimed to investigate the biochemical, histologic, and immunologic effects of post-treatment administration of fluvastatin in a hemorrhagic shock (HS) rat model. Methods: Experimental rats were randomly divided into four groups: control group: no drugs and did not undergo HS; control statin group: fluvastatin 1 mg/kg (no HS); HS group: normal saline after HS; HS+statin group: fluvastatin 1 mg/kg+normal saline after HS. Briefly, HS was induced by femoral arterial catheter blood extraction of 30% of the total blood volume. The mean arterial pressure and heart rate were monitored for 2 hours after starting blood withdrawal. Arterial blood gas, complete blood count, and serum cytokine levels were measured at baseline, 2 hours after HS, and 48 hours after resuscitation. The kidneys, lungs, and small intestines were removed for pathological examination 48 hours after HS. Results: At the end of the resuscitation period, the HS and HS+statin groups showed reduced bicarbonate, base excess, and platelet counts, all of which differed significantly from values in the control and control+statin groups. Compared to the control group, the HS+statin group exhibited significantly elevated serum interleukin-10 (IL-10) at 2 hours after resuscitation (P<0.05). Except for IL-10, the group-time interaction was not significant for other cytokine profiles. Conclusion This study demonstrates that post-treatment with fluvastatin after HS increases the production of the anti-inflammatory cytokine IL-10 and affects the cytokine profiles in rats.

BACKGROUND/AIMS: Barcelona Clinic Liver Cancer (BCLC) C stage demonstrates considerable heterogeneity because it includes patients with either symptomatic tumors (performance status [PS], 1–2) or with an invasive tumoral pattern reflected by the presence of vascular invasion (VI) or extrahepatic spread (EHS). This study aimed to derive a more relevant staging system by modification of the BCLC system considering the prognostic implication of PS. METHODS: A total of 7,501 subjects who were registered in the Korean multicenter hepatocellular carcinoma (HCC) registry database from 2008 to 2013 were analyzed. The relative goodness-of-fit between staging systems was compared using the Akaike information criterion (AIC) and integrated area under the curve (IAUC). Three modified BCLC (m-BCLC) systems (#1, #2, and #3) were devised by reducing the role of PS. RESULTS: As a result, the BCLC C stage, which includes patients with PS 1–2 without VI/EHS, was reassigned to stage 0, A, or B according to their tumor burden in the m-BCLC #2 model. This model was identified as the most explanatory and desirable model for HCC staging by demonstrating the smallest AIC (AIC=70,088.01) and the largest IAUC (IAUC=0.722), while the original BCLC showed the largest AIC (AIC=70,697.17) and the smallest IAUC (IAUC=0.705). The m-BCLC #2 stage C was further subclassified into C1, C2, C3, and C4 according to the Child-Pugh score, PS, presence of EHS, and tumor extent. The C1 to C4 subgroups showed significantly different overall survival distribution between groups (p<0.001). CONCLUSIONS: An accurate and relevant staging system for patients with HCC was derived though modification of the BCLC system based on PS.
Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms ; Liver ; Population Characteristics ; Tumor Burden