OBJECTIVES: This study was conducted to examine the length of exposure to smartphone and its association with dietary behavior toward snacks, lifestyle, and nutrition knowledge in elementary school students. METHODS: Subjects were 372 5th and 6th grade schoolchildren in Cheongju, Korea, and data was collected by a self-administered questionnaire. They were divided into two groups by the time spent using smartphone: moderate (< 2 hours/day) and overexposure (≥ 2 hours/day). Data was analyzed using frequency analysis, χ²-test, and independent t-test as well as analysis of covariance when necessary. RESULTS: Approximately half of subjects (41.4%) reported spending ≥ 2 hours/day using smartphone. That habit was more frequent among students in the 6th grade, those who received more monthly allowance, and who has a working mother. 63.4% of the subjects reported that they consumed snacks while watching television, using a computer and/or a smartphone and 48.1% said that they consumed snacks while they use a smartphone. Both situations were most prevalent among those with overexposure to smartphone (≥ 2 hours/day). We also observed that a higher percentage of subjects from the overexposure group spent more money on snack foods with the preference for ice cream, fast food, and carbonated drinks. Further, those in the overexposure group consumed more ice cream, cookies, and carbonated drinks. In addition, they had less desirable dietary behavior and health-related lifestyle (sleep duration and frequency of regular exercise) compared to those with moderate smartphone usage (< 2 hours/day). However, there was no statistical difference in nutrition knowledge among children with different degrees of smartphone usage. CONCLUSIONS: Our results showed that longer smartphone use was associated with less desirable snack preference/consumption and other dietary behavior in elementary school students. Thus interest and positive attitudes towards healthy snacks and diet should be reinforced in nutrition education programs, especially for those who are prone to use smartphones.
Carbonated Beverages ; Child ; Chungcheongbuk-do* ; Diet ; Education ; Fast Foods ; Humans ; Ice Cream ; Korea ; Life Style* ; Mothers ; Smartphone* ; Snacks* ; Television

Granulomatous reaction associated with clear cell renal cell carcinoma (CCRCC) is a rare finding, and only a few cases have been described in the literature. It is postulated to occur due to cancer-related antigenic factors such as cancer cells themselves or soluble tumor antigens shed into the blood. Herein, we describe a case of a 56-year-old male patient diagnosed with CCRCC with intratumoral granulomatous inflammation.
Antigens, Neoplasm ; Carcinoma, Renal Cell* ; Humans ; Inflammation ; Kidney Neoplasms ; Male ; Middle Aged

Objective: There is a growing interest in the safe use of medications in pregnant and breastfeeding women. Therefore, the purpose of this study is to find ways to improve education about safe medication use by investigating the status of medication use of pregnant and breastfeeding women, and by evaluating their knowledge, attitudes, and practices toward safe medication use. Methods: In this study, a self-report questionnaire was conducted on pregnant or breastfeeding women in Seoul and Gyeonggi Province. The questionnaire consisted of the following four sections; 1) sociodemographic characteristics of participants, 2) experience of medication use, 3) experience of being educated on safe medication use, and 4) knowledge, attitudes, and practices about medication use during pregnancy/breastfeeding. Results: A total of 203 participants were included in the analysis. Of these, 38.4% reported to take prescription medications during pregnancy and breastfeeding. Regarding education on safe medication use, nearly 90% of the participants answered that they were not educated or were unsure whether they had it. In the knowledge-attitude-practice evaluation on safe medication use, the knowledge level was the highest (mean, 4.45), followed by the attitude level (mean, 3.58) and the practice level (mean, 3.33). The preferred education method of the participants was online education using a computer or mobile phone application, etc. Conclusions This study suggests that there is a need for systematic and effective education that can link knowledge of safe medication use with attitudes and practices in pregnant and breastfeeding women.

PURPOSE: The aim of this study was to clarify the relationship between the autonomic nervous system and attention deficit hyperactivity disorder (ADHD) rating scales and to evaluate the usefulness of heart rate variability (HRV) as a psychophysiological biomarker for ADHD. MATERIALS AND METHODS: Subjects were recruited from outpatients in the Department of Child and Adolescent Psychiatry at the Korea University Medical Center from August 2007 to December 2010. Subjects received methylphenidate. Time- and frequency-domain analyses of HRV, the Korean ADHD rating scale (K-ARS), and computerized ADHD diagnostic system were evaluated before treatment. After a 12-week period of medication administration, we repeated the HRV measurements and K-ARS rating. RESULTS: Eighty-six subjects were initially enrolled and 37 participants completed the 12-week treatment and HRV measurements subsequent to the treatment. Significant correlations were found between the K-ARS inattention score and some HRV parameters. All of the HRV parameters, except the standard deviations of the normal-to-normal interval, very low frequency, and low frequency to high frequency, showed a significant positive correlation between baseline and endpoint measures in completers. High frequency (HF) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), which are related to parasympathetic vagal tone, showed significant decreases from baseline to endpoint. CONCLUSION: The HRV test was shown to be reproducible. The decrease in HF and RMSSD suggests that parasympathetic dominance in ADHD can be altered by methylphenidate treatment. It also shows the possibility that HRV parameters can be used as psychophysiological markers in the treatment of ADHD.
Adolescent ; Attention/drug effects/*physiology ; Attention Deficit Disorder with Hyperactivity/diagnosis/*drug therapy ; Autonomic Nervous System/physiopathology ; Biomarkers ; Central Nervous System Stimulants/pharmacology/*therapeutic use ; Child ; Female ; Heart Rate/*drug effects/physiology ; Humans ; Male ; Methylphenidate/pharmacology/*therapeutic use ; Prospective Studies ; Republic of Korea ; Treatment Outcome

Objectives: Cardiovascular disease is a major cause of death in the elderly in Korea. Increased arterial stiffness is linked to risk of cardiovascular disease and mortality. The purpose of this study was to investigate the relationship between arterial stiffness and physical activity in the elderly. Methods: A total of 209 older adults (110 men and 99 women) participated in this study. Arterial stiffness of subjects such as brachial–ankle pulse wave velocity (baPWV) and ankle brachial pressure index (ABI) was measured using a non-invasive vascular screening device (VP-1000 Plus, Omron, Kyoto, Japan). The interviewed Korean version of the international physical activity questionnaire short form (IPAQ-SF) was used to evaluate subject’s physical activity level and classify subjects as active or inactive group based on the time spent doing moderate to vigorous physical activity (MVPA). Results: The mean age of total subjects was 75.3 ± 5.6 years. There was no significant difference in sex distribution between the active group (39.7%) and inactive group (60.3%). The baPWV (1,758.1 ± 375.2cm /sec) of the active group was significantly lower than that (1,969.7 ± 372.3 cm/sec) of the inactive group (P < 0.05). There was a significant inverse association between time spent in MVPA and baPWV (r = -0.245, P < 0.01). Conclusions This study suggests that physical activity programs for older adults are needed to prevent arteriosclerosis.

Background/Aims: Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP-1RA) and thiazolidinedione (TZD) can improve nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH). However, comprehensive research comparing the effects of GLP-1RA and TZD is limited. Thus, this study aimed to compare the effects of GLP-1RA and TZD on NAFLD or NASH through a network meta-analysis. Methods: The PubMed, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCTs) that explored the efficacy of GLP-1RAs or TZDs in adult patients with NAFLD or NASH. The outcomes were liver biopsy-based (NAFLD activity score [NAS], fibrosis stage, and NASH resolution), noninvasive technique-based (liver fat content on proton magnetic resonance spectroscopy [1H-MRS] and controlled attenuation parameter [CAP]), biological, and anthropometric indicators. A random effects model was used to calculate the mean difference (MD) and relative risk with 95% confidence interval (CI). Results: Twenty-five RCTs with 2,237 overweight or obese patients were included. GLP-1RA was significantly superior in reducing liver fat content evaluated using 1H-MRS (MD –2.42, 95% CI –3.84 to –1.00), body mass index (MD –1.60, 95% CI –2.41 to –0.80), and waist circumference (MD –4.89, 95% CI –8.17 to –1.61) than TZD. In liver biopsy-based evaluation and liver fat content assessment using CAP, GLP-1RA tended to surpass TZD, albeit not significantly. Sensitivity analysis showed consistent results with the main results. Conclusions Compared with TZD, GLP-1RA had better effects on liver fat content, body mass index, and waist circumference in overweight or obese patients with NAFLD or NASH.

Dyslipidemia is a major cause of cardiovascular diseases which represent a leading cause of death in humans. Diverse immune cells are known to be involved in the pathogenesis of cardiovascular diseases such as atherosclerosis. Conversely, dyslipidemia is known to be tightly associated with immune disorders in humans, as evidenced by a higher incidence of atherosclerosis in patients with autoimmune diseases including psoriasis, rheumatoid arthritis, and systemic lupus erythematosus. Given that the dyslipidemia-related autoimmune diseases are caused by autoreactive T cells and B cells, dyslipidemia seems to directly or indirectly regulate the adaptive immunity. Indeed, accumulating evidence has unveiled that proatherogenic factors can impact the differentiation and function of CD4+ T cells, CD8+ T cells, and B cells. This review discusses an updated overview on the regulation of adaptive immunity by dyslipidemia and proposes a potential therapeutic strategy for immune disorders by targeting lipid metabolism.

Dyslipidemia is a major cause of cardiovascular diseases which represent a leading cause of death in humans. Diverse immune cells are known to be involved in the pathogenesis of cardiovascular diseases such as atherosclerosis. Conversely, dyslipidemia is known to be tightly associated with immune disorders in humans, as evidenced by a higher incidence of atherosclerosis in patients with autoimmune diseases including psoriasis, rheumatoid arthritis, and systemic lupus erythematosus. Given that the dyslipidemia-related autoimmune diseases are caused by autoreactive T cells and B cells, dyslipidemia seems to directly or indirectly regulate the adaptive immunity. Indeed, accumulating evidence has unveiled that proatherogenic factors can impact the differentiation and function of CD4+ T cells, CD8+ T cells, and B cells. This review discusses an updated overview on the regulation of adaptive immunity by dyslipidemia and proposes a potential therapeutic strategy for immune disorders by targeting lipid metabolism.

Vanishing bile duct syndrome (VBDS) is a rare disease characterized by ductopenia and cholestasis, and is linked to immunological damage to the bile duct system. VBDS can be triggered by infection, ischemia, autoimmune diseases, adverse drug reactions, and humoral factors associated with malignancy. A few cases of VBDS associated with nonsteroidal anti-inflammatory drug-related drug-induced liver injury (DILI) have been reported. Here, we report a case of a 29-year-old patient who developed DILI that progressed to VBDS after the administration of pelubiprofen.

A single exposure to stress can induce functional changes in neurons, potentially leading to acute stress disorder or post-traumatic stress disorder.In this study, we used in vivo wide-field optical mapping to simultaneously measure neural calcium signals and hemodynamic responses over the whole cortical area. We found that cortical mapping to whisker stimuli was altered under acute stress conditions. In particular, callosal projections in the anterior cortex (primary/secondary motor, somatosensory forelimb cortex) relative to barrel field (S1BF) of somatosensory cortex were weakened. On the contrary, the projections in posterior cortex relative to S1BF were mostly unchanged or were only occasionally strengthened. In addition, changes in intra-cortical connection were opposite to those in inter-cortical connection. Thus, the S1BF connections to the anterior cortex were strengthened while those to the posterior cortex were weakened. This suggests that the well-known barrel cortex projection route was enhanced. In summary, our in vivo wide-field optical mapping study indicates that a single acute stress can impact whole-brain networks, affecting both neural and hemodynamic responses.