Objectives: This study examined the influence of adult attention-deficit/hyperactivity disorder (ADHD) and insomnia on the risk of unintentional minor musculoskeletal injuries (UMMI). Methods: A prospective observational study was carried out in a single unit of the army in South Korea. One hundred and seventy-seven subjects participated in the study. The Adult ADHD SelfReport Scale (ASRS-v1.1) and Insomnia Severity Index (ISI) was used to screen. The risk of UMMI during one-week winter ranger training was investigated. Results: All subjects were male and aged 21.75 (standard deviation 1.5). Approximately 9.6% of subjects had clinically relevant adult ADHD symptoms. Subjects with ADHD had a higher stress index and higher rates of insomnia than those without symptoms. After adjusting for age, rank, service months, obesity, history of UMMI, sleep time, and risk of the task, the ADHD group was 4.90 times more likely to have UMMI than the control group. Insomnia increased the risk of UMMI 8.14 fold. Conclusion These results suggest that an evaluation and intervention for adult ADHD and insomnia should be made in people engaged in other tasks that may result in UMMI.

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Purpose: Several studies have been conducted on the relationship between green tea intake and metabolic syndrome. However, compared to the studies carried out internationally, there is inadequate research on the relationship between domestic green tea consumption and metabolic syndrome. Therefore, in this study, the general characteristics of Koreans according to their green tea intake and its association with metabolic syndrome were examined. Methods: A total of 44,611 subjects were included in the study, and analysis was carried out using data from the Korean Genome and Epidemiology Study (KoGES) for Korean adults aged 40 or older. Green tea consumption was estimated using 106 verified food frequency questionnaires (FFQ). Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) parameters. After adjusting for confounding variables by performing a Cox regression analysis, the association between green tea consumption and metabolic syndrome was confirmed through the hazard ratio (HR) and 95% confidence interval (CI). Results: The average incidence of metabolic syndrome was 18.7% (20.8% in men and 17.8% in women). Compared to those who drank almost no green tea, in subject groups consuming more than one cup of green tea a day, the metabolic syndrome incidence was significantly reduced by 15% (HR, 0.85; 95% CI, 0.74–0.96; p trend = 0.0200) among men and by 19% (HR, 0.81; 95% CI, 0.73–0.90; p trend < 0.0001) among women. In addition, the biomarkers related to metabolic syndrome also tended to decrease overall in these groups. Conclusion This study concluded that as the intake of green tea increased, the incidence of metabolic syndrome and related indicators decreased. Therefore, green tea intake is believed to have a positive effect on the prevention and management of the metabolic syndrome.

Background: Nonsteroidal anti-inflammatory drugs (NSAID) are currently among the most prescribed medications worldwide to relieve pain and reduce inflammation, especially in patients suffering osteoarthritis (OA). However, NSAIDs are known to have adverse effects on the gastrointestinal system. If a gastric ulcer occurs, planned OA treatment needs to be changed, incurring additional treatment costs and causing discomfort for both patients and clinicians. Therefore, it is necessary to create a gastric ulcer prediction model that can reflect the detailed health status of each individual and to use it when making treatment plans. Methods: Using sample cohort data from 2008 to 2013 from the National Health Insurance Service in South Korea, we developed a prediction model for NSAID-induced gastric ulcers using machine-learning algorithms and investigated new risk factors associated with medication and comorbidities. Results: The population of the study consisted of 30,808 patients with OA who were treated with NSAIDs between 2008 and 2013. After a 2-year follow-up, these patients were divided into two groups: without gastric ulcer (n=29,579) and with gastric ulcer (n=1,229). Five machine-learning algorithms were used to develop the prediction model, and a gradient boosting machine (GBM) was selected as the model with the best performance (area under the curve, 0.896; 95% confidence interval, 0.883–0.909). The GBM identified 5 medications (loxoprofen, aceclofenac, talniflumate, meloxicam, and dexibuprofen) and 2 comorbidities (acute upper respiratory tract infection [AURI] and gastroesophageal reflux disease) as important features. AURI did not have a dose-response relationship, so it could not be interpreted as a significant risk factor even though it was initially detected as an important feature and improved the prediction performance. Conclusions We obtained a prediction model for NSAID-induced gastric ulcers using the GBM method. Since personal prescription period and the severity of comorbidities were considered numerically, individual patients’ risk could be well reflected. The prediction model showed high performance and interpretability, so it is meaningful to both clinicians and NSAID users.

No abstract available.
Kidney Pelvis*

PURPOSE: Dual-specificity protein phosphatase 4 (DUSP4), also known as mitogen-activated protein kinase phosphatase (MKP) 2 is a member of the inducible nuclear MKP group. The role of DUSP4 in cancer development and progression appears to vary with the type of malignancy. The purpose of this study was to investigate DUSP4 expression in a case series of invasive ductal carcinoma of the breast. METHODS: We constructed tissue microarrays consisting of 16, 14, 47, and 266 cases of normal breast tissue, usual ductal hyperplasia, ductal carcinoma in situ, and invasive ductal carcinoma, respectively. DUSP4 expression was investigated by immunohistochemistry. RESULTS: Cytoplasmic DUSP4 expression was observed. DUSP4 was more frequently expressed in malignant than in benign cases (p=0.024). The mean DUSP4 expression score was significantly higher in malignant tumors than in benign lesions (p=0.019). DUSP4 expression was significantly correlated with a larger tumor size (>2 cm, p=0.015). There was no significant correlation between overall survival or disease-free survival and DUSP4 expression in all 266 patients. We evaluated the impact of DUSP4 expression on the survival of 120 patients with T1-stage tumors. Interestingly, Kaplan-Meier survival curves revealed that DUSP4 expression had a significant effect on both overall patient survival (p=0.034, log-rank test) and disease-free survival (p=0.045, log-rank test). In early T-stage breast cancer, DUSP4 expression was associated with a worse prognosis. CONCLUSION: DUSP4 is frequently upregulated in breast malignancy, and may play an important role in cancer development and progression. In addition, it may be a marker of adverse prognosis, especially in patients with early T1-stage cancer.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Cytoplasm ; Disease-Free Survival ; Humans ; Hyperplasia ; Immunohistochemistry ; Kaplan-Meier Estimate ; Prognosis ; Protein Kinases

PURPOSE: To evaluate the therapeutic effect of human embryonic stem cell (hESC)-derived multipotent mesenchymal stem cells (M-MSCs) on ketamine-induced cystitis (KC) in rats. METHODS: To induce KC, 10-week-old female rats were injected with 25-mg/kg ketamine hydrochloride twice weekly for 12 weeks. In the sham group, phosphate buffered saline (PBS) was injected instead of ketamine. One week after the final injection of ketamine, the indicated doses (0.25, 0.5, and 1×106 cells) of M-MSCs (KC+M-MSC group) or PBS vehicle (KC group) were directly injected into the bladder wall. One week after M-MSC injection, the therapeutic outcomes were evaluated via cystometry, histological analyses, and measurement of gene expression. Next, we compared the efficacy of M-MSCs at a low dose (1×105 cells) to that of an identical dose of adult bone marrow (BM)-derived MSCs. RESULTS: Rats in the KC group exhibited increased voiding frequency and reduced bladder capacity compared to rats of the sham group. However, these parameters recovered after transplantation of M-MSCs at all doses tested. KC bladders exhibited markedly increased mast cell infiltration, apoptosis, and tissue fibrosis. Administration of M-MSCs significantly reversed these characteristic histological alterations. Gene expression analyses indicated that several genes associated with tissue fibrosis were markedly upregulated in KC bladders. However the expression of these genes was significantly suppressed by the administration of M-MSCs. Importantly, M-MSCs ameliorated bladder deterioration in KC rats after injection of a low dose (1×105) of cells, at which point BM-derived MSCs did not substantially improve bladder function. CONCLUSIONS: This study demonstrates for the first time the therapeutic efficacy of hESC-derived M-MSCs on KC in rats. M-MSCs restored bladder function more effectively than did BM-derived MSCs, protecting against abnormal changes including mast cell infiltration, apoptosis and fibrotic damage.
Adult ; Animals ; Apoptosis ; Bone Marrow ; Cystitis ; Female ; Fibrosis ; Gene Expression ; Human Embryonic Stem Cells ; Humans ; Ketamine ; Mast Cells ; Mesenchymal Stromal Cells ; Multipotent Stem Cells ; Pelvic Pain ; Rats ; Urinary Bladder

BACKGROUND AND OBJECTIVES: Patients with Kawasaki disease (KD) are clinically heterogeneous because its diagnosis is based solely on clinical observation and there are no definitive biomarkers. We dissected the clinical heterogeneity of KD patients using the KD-associated genetic variants. METHODS: We performed a genetic association analysis in several KD subgroups categorized by clinical characteristics using the KD-associated variants of the B lymphoid tyrosine kinase (BLK; rs6993775) and Fc gamma receptor II a (FCGR2A; rs1801274) in a large number of case (n=1,011) and control (n=4,533) samples. RESULTS: BLK and FCGR2A were very significantly associated with KD in Korean KD patients (odds ratio [OR],1.48; p=4.63×10⁻¹¹ for BLK, and OR, 1.26; p=1.42×10⁻⁴ for FCGR2A). However, in KD subgroup analysis, we found that neither BLK nor FCGR2A were associated with either incomplete Kawasaki disease (iKD) type patients or those older than 5 years of age (p>0.2), suggesting that patients with iKD or those older than 5 years of age are a unique subgroup of KD. In genetic association analysis after excluding iKD patients and those older than 5 years old, we found that BLK was associated with all KD subgroups, whereas FCGR2A was specifically associated with male KD patients younger than 1 year of age (OR, 2.22; p=2.35×10⁻⁵). CONCLUSIONS KD is a clinically and genetically heterogeneous disease. These findings will provide new insights into the clinical and genetic heterogeneity of KD.