OBJECTIVES: Bedtime procrastination is defined as going to bed later than intended, without having external reasons for doing so. Despite various studies investigating the new concept of bedtime procrastination, there have been no studies that have validated the Bedtime Procrastination Scale (BPS). Thus, this study aims to validate the BPS in Korean. METHODS: Two hundred twenty seven participants (mean age 22±2.39 years, 81.1% female) participated in the study. All participants completed the BPS, Insomnia Severity Index, Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, Depressive Symptom Inventory-Suicidality Subscale, and General Procrastination Scale (GPS). Exploratory factor analysis was used to determine number of factors. RESULTS: Exploratory factor analysis revealed support for one factor, which was consistent with the original study. Goodness of fit was adequate for the one factor model [χ²=59.369(df=27, p<0.001), Comparative Fit Index=0.963, Tucker-Lewis Index=0.951, Root Mean Square Error of Approximation= 0.073, Standardized Root Mean Square Residual=0.042]. Internal consistency was also adequate (Cronbach's alpha=0.86). Convergent validity was also high with the GPS (p<0.001, r=0.411). Correlations were also high with other questionnaires (p<0.05). CONCLUSIONS: The BPS is a reliable and valid measure for bedtime procrastination, and may have important clinical implications for sleep disorders.
Depression ; Epidemiologic Studies ; Factor Analysis, Statistical ; Humans ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders ; Young Adult

Cerulein-induced pancreatitis is similar to human edematous pancreatitis, characterized by the dysregulation of digestive enzyme production, edema formation, and an infiltration of inflammatory cells into the pancreas. We previously showed that the Janus kinase 2 (JAK2)/STAT3 pathway mediates inflammatory signaling in cerulein-stimulated pancreatic acinar cells. PPAR-γ has been implicated in the regulation of inflammatory responses in several cells. In the present study, we investigated the role of PPAR-γ in cerulein-induced activation of JAK2/STAT3 in pancreatic acinar cells. Treatment with cerulein induced the activation of JAK2/STAT3 and PPAR-γ expression in AR42J cells. Cerulein-induced PPAR-γ expression was inhibited by AG490, a JAK2/STAT3 inhibitor, in AR42J cells. An immunoprecipitation analysis showed that PPAR-γ binds to STAT3 in cerulein-stimulated AR42J cells. Down-regulation of PPAR-γ by siRNA increased STAT3 phosphorylation in AR42J cells stimulated with cerulein. These results show that PPAR-γ inactivates STAT3 by directly interacting with STAT3 in cerulein-stimulated pancreatic acinar cells. Overexpression of PPAR-γ may be beneficial for preventing pancreatitis by suppressing the activation of STAT3 in pancreatic acinar cells.
Acinar Cells* ; Ceruletide ; Down-Regulation ; Edema ; Humans ; Immunoprecipitation ; Janus Kinase 2 ; Pancreas ; Pancreatitis ; Peroxisomes* ; Phosphorylation ; RNA, Small Interfering

PURPOSE: Peramivir is the first intravenously administered neuramidase inhibitor for immediate delivery of an effective single-dose treatment in patients with influenza. However, limited data are available on intravenous (IV) peramivir treatment compared to oral oseltamivir for these patients. MATERIALS AND METHODS: With a systematic review and meta-analysis, we compared the efficacy of IV peramivir with oral oseltamivir for treatment of patients with seasonal influenza. MEDLINE, EMBASE, and Cochrane Central Register were searched for relevant clinical trials. RESULTS: A total of seven trials [two randomized controlled trials (RCTs) and five non-randomized observational trials] involving 1676 patients were finally analyzed. The total number of peramivir- and oseltamivir-treated patients was 956 and 720, respectively. Overall, the time to alleviation of fever was lower in the peramivir-treated group compared with the oseltamivir-treated group [mean difference (MD), −7.17 hours; 95% confidence interval (CI) −11.00 to −3.34]. Especially, pooled analysis of observational studies (n=4) and studies of outpatients (n=4) demonstrated the superiority of the peramivir-treated group (MD, -7.83 hours; 95% CI −11.81 to −3.84 and MD, −7.71 hours; 95% CI −11.61 to −3.80, respectively). Mortality, length of hospital stay, change in virus titer 48 hours after admission, and the incidence of adverse events in these patients were not significantly different between the two groups. CONCLUSION: IV peramivir therapy might reduce the time to alleviation of fever in comparison with oral oseltamivir therapy in patients with influenza; however, we could not draw clear conclusions from a meta-analysis because of the few RCTs available and methodological limitations.
Fever ; Humans ; Incidence ; Influenza, Human* ; Length of Stay ; Mortality ; Oseltamivir* ; Outpatients ; Seasons ; Viral Load

BACKGROUND/OBJECTIVES: Although some juices affect subjective sleep quality, there is a lack of information on the effect of a specific juice on objective sleep quality and heart rate variability (HRV) during sleep; thus the present study investigated whether a blended juice made from natural extracts influenced sleep quality and HRV during sleep in adults with disturbed sleep. SUBJECTS/METHODS: A randomized, crossover study was conducted on twenty-five adults (15/10, female/male) complaining of difficulty initiating or maintaining nighttime sleep (Pittsburgh sleep quality index [PSQI] ≥ 5). During feeding sessions (FS), subjects received sleep-inducing juice made of natural ingredients (250 mL/trial) twice a day for 8 weeks or non-FS (N-FS) for 8 weeks while maintaining normal activities. Sleep quality and parameters were recorded via wearable actigraph for 7 consecutive days, and PSQI scores were assessed before and after the intervention. HRV was also monitored at rest and during sleep. RESULTS: After receiving the sleep-inducing juice intervention (FS), PSQI scores were significantly decreased (P < 0.001) and correlated with a significant decline in fatigue severity scale and visual analogue scale levels (P < 0.05; both). HRV indices of vagal activity were significantly improved during FS (P < 0.05), and no significant differences in N-FS were observed. Sleep efficiency and total sleep time increased significantly (P < 0.05) and sleep latency, total counts, sleep fragmentation index, and movement index, decreased significantly (P < 0.05, all 4) during FS, with no significant differences-observed during N-FS. CONCLUSIONS This study results demonstrated that an 8-week course of sleep-inducing juice has led to improve sleep quality, suggesting an enhanced cardiac vagal tone during sleep. Thus, it could be a well-tolerated option for adults with disturbed sleep.

Parry Romberg Syndrome (PRS), also known as idiopathic progressive hemifacial atrophy, is a rare neurocutaneous disorder characterized by loss of skin and subcutaneous fat of face, muscles, and bones causing unilateral atrophy. Most patients require only soft tissue augmentation although syndrome has varying grades of severity. In the majority of reported cases, it has been treated with surgical flap or autologous fat transplantation. However, these treatments need complicated surgical skills which take a lot of time and cost. Herein we report the first case of PRS augmented by hyaluronic acid (HA) filler in a 42-year-old female patient to suggest that HA filler could be a safe, simple, and even rational economic alternative to surgical treatment.
Adult ; Atrophy ; Facial Hemiatrophy* ; Female ; Humans ; Hyaluronic Acid* ; Muscles ; Neurocutaneous Syndromes ; Skin ; Subcutaneous Fat ; Surgical Flaps

PURPOSE: Bone markers can be useful for the diagnosis and treatment of skeletal diseases in children and adolescents. Owing to high skeletal growth velocity and rapid bone turnover, children and adolescents have higher bone marker levels than adults. Thus, a valid age- and sex-specific reference should be established for pediatric populations living in similar environments. We aimed to assess the associations of procollagen type I N-terminal propeptide (P1NP) and osteocalcin with age and sex in a group of healthy Korean children and adolescents. MATERIALS AND METHODS: The participants (290 boys and 290 girls, age range 0–18 years) were Korean outpatients. Serum P1NP and osteocalcin levels were measured in control materials and patient samples by electrochemiluminescence immunoassay using an automated Cobas e411 analyzer. RESULTS: Significant age-dependent variations in bone marker levels were observed in both sexes (p<0.001). The highest P1NP levels were observed during the first year of life; thereafter, levels decreased until puberty. There was no postnatal peak for osteocalcin; however, its levels remained higher than the adult reference range throughout childhood. Significant differences were observed between boys and girls (p<0.05), especially between the ages of 12 and 17 years. Cobas e411 results for P1NP showed satisfactory precision and linearity. CONCLUSION: We established reference data for P1NP and osteocalcin levels in healthy Korean children and adolescents, as the first and only study of these parameters in pre-adulthood in Korea. Cobas e411-quantified bone markers may be useful for determining bone metabolism indices.
Adolescent ; Adult ; Bone Remodeling ; Child ; Collagen Type I ; Diagnosis ; Female ; Humans ; Immunoassay ; Korea ; Metabolism ; Osteocalcin ; Outpatients ; Procollagen ; Puberty ; Reference Values

Background/Aims: Bariatric intervention has been reported to be an effective way to improve metabolic dysfunction-associated steatotic liver disease (MASLD) in obese individuals. The current systemic review aimed to assess the changes in MRI-determined hepatic proton density fat fraction (MRI-PDFF) and nonalcoholic fatty liver disease activity score (NAS) after bariatric surgery or intragastric balloon/gastric banding in MASLD patients with obesity. Methods: We searched various databases including PubMed, OVID Medline, EMBASE, and Cochrane Library. Primary outcomes were the changes in intrahepatic fat on MRI-PDFF and histologic features of metabolic dysfunction-associated steatohepatitis (MASH). Results: Thirty studies with a total of 3,134 patients were selected for meta-analysis. Bariatric intervention significantly reduced BMI (ratio of means, 0.79) and showed 72% reduction of intrahepatic fat on MRI-PDFF at 6 months after bariatric intervention (ratio of means, 0.28). Eight studies revealed that NAS was reduced by 60% at 3–6 months compared to baseline, 40% at 12–24 months, and 50% at 36–60 months. Nineteen studies revealed that the proportion of patients with steatosis decreased by 44% at 3–6 months, 37% at 12–24 months, and 29% at 36–60 months; lobular inflammation by 36% at 12–24 months and 51% at 36–60 months; ballooning degeneration by 38% at 12–24 months; significant fibrosis (≥F2) by 18% at 12–24 months and by 17% at 36–60 months after intervention. Conclusions Bariatric intervention significantly improved MRI-PDFF and histologic features of MASH in patients with obesity. Bariatric intervention might be the effective alternative treatment option for patients with MASLD who do not respond to lifestyle modification or medical treatment.

BACKGROUND/AIMS: The most commonly used immunosuppressant therapy after liver transplantation (LT) is a combination of tacrolimus and steroid. Basiliximab induction has recently been introduced; however, the most appropriate immunosuppression for hepatocellular carcinoma (HCC) patients after LT is still debated. METHODS: Ninety-three LT recipients with HCC who took tacrolimus and steroids as major immunosuppressants were included. Induction with basiliximab was implemented in 43 patients (46.2%). Mycophenolate mofetil (MMF) was added to reduce the tacrolimus dosage (n=28, 30.1%). The 1-year tacrolimus exposure level was 7.2 +/- 1.3 ng/mL (mean +/- SD). RESULTS: The 1- and 3-year recurrence rates of HCC were 12.9% and 19.4%, respectively. Tacrolimus exposure, cumulative steroid dosages, and MMF dosages had no impact on HCC recurrence. Induction therapy with basiliximab, high alpha fetoprotein (AFP; >400 ng/mL) and protein induced by vitamin K absence/antagonist-II (PIVKA-II; >100 mAU/mL) levels, and microvascular invasion were significant risk factors for 1-year recurrence (P<0.05). High AFP and PIVKA-II levels, and positive 18fluoro-2-deoxy-d-glucose positron-emission tomography findings were significantly associated with 3-year recurrence (P<0.05). CONCLUSIONS: Induction therapy with basiliximab, a strong immunosuppressant, may have a negative impact with respect to early HCC recurrence (i.e., within 1 year) in high-risk patients.
Adult ; Aged ; Biological Markers/analysis ; Carcinoma, Hepatocellular/mortality/pathology/*therapy ; Female ; Humans ; Immunosuppressive Agents/*therapeutic use ; Liver Neoplasms/mortality/pathology/*therapy ; *Liver Transplantation ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Positron-Emission Tomography ; Protein Precursors/analysis ; Prothrombin/analysis ; Regression Analysis ; Risk Factors ; Severity of Illness Index ; Survival Rate ; alpha-Fetoproteins/analysis

The diagnosis of hepatocellular carcinoma (HCC) is based on imaging studies particularly in high-risk patients without histologic confirmation. This study evaluated the prevalence and characteristics of false-positively diagnosed HCC in a liver resection cohort for HCC. A retrospective review was performed of 837 liver resection cases for clinically diagnosed HCC between 2005 and 2010 at our institute. High-risk patients with tumors > 1 cm with one or two image findings consistent with HCC and tumors < 1 cm with two or more image findings consistent with HCC with persistently increased serum alpha-fetoprotein (AFP) levels above the normal range with underlying inhibited hepatitis activity underwent liver resection. The false-positive rate was 2.2% (n = 18). Of the 18 patients, 7 patients (0.8%) were diagnosed with benign conditions (one each of hemangioma, inflammation, cortical adenoma, dysplastic nodule, angiomyolipoma, bile duct adenoma, and non-neoplastic liver parenchyme) and 11 patients (1.3%) were diagnosed with malignancies (cholangiocarcinoma [n = 6], hepatoblastoma [n = 2], and one each of lymphoepithelioma-like carcinoma, ovarian cystadenocarcinoma, and nasopharynx carcinoma metastasis). The clinical characteristics of pathologically diagnosed HCC patients were similar (P > 0.05) compared to non-HCC patients except for higher rate of history of alcoholism (P < 0.05) observed in non-HCC patients. Four of 18 non-HCC patients (22.2%) showed diagnostic discordance on the dynamic imaging study. Despite the recent progression in diagnostic imaging techniques, 2.2% of cases were false-positively diagnosed as HCC in a liver resection patient cohort; and the final diagnosis was benign disease in 0.8% of liver resection patients clinically diagnosed with HCC.
Adenoma ; Adenoma, Bile Duct ; Alcoholism ; alpha-Fetoproteins ; Angiomyolipoma ; Carcinoma, Hepatocellular* ; Cohort Studies ; Cystadenocarcinoma ; Diagnosis* ; Diagnostic Imaging ; Hemangioma ; Hepatitis ; Hepatoblastoma ; Humans ; Inflammation ; Liver* ; Nasopharynx ; Prevalence ; Reference Values ; Retrospective Studies

Epidemic keratoconjunctivitis (EKC) and acute hemorrhagic conjunctivitis (AHC) are common diseases caused by human adenoviruses (HAdV) and enteroviruses, respectively, in South Korea. However, there are limited studies on the molecular epidemiology of viral conjunctivitis in South Korea. The main objective of this study was to characterize the genotypes of adenoviruses and enteroviruses causing viral conjunctivitis in the southwest region of South Korea. We collected conjunctival swabs from 492 patients with suspected cases of viral conjunctivitis from 6 ophthalmic hospitals in Gwangju Metropolitan City, in South Korea, between 2012 and 2016. Of the 492 samples tested, HAdVs and enteroviruses were detected in 249 samples (50.6%) and 19 samples (3.9%), respectively. The genotype analysis detected HAdV-8 in 183 samples (73.5%), HAdV-37 in 14 samples (5.6%), and HAdV-3, and HAdV-4 in 9 samples (3.6%) each. We detected coxsackievirus A24 (CVA24) and coxsackievirus B1 (CVB1) in 8 samples (42.0%) and 4 samples (21.0%), respectively. We also reported for the first time HAdV-56-infected cases of EKC in South Korea. Furthermore, we found three cases of coinfection with HAdV and enterovirus genotypes in our samples. HAdV-8 and CVA24, the main causes of EKC and AHC, respectively, worldwide, were also found to be the predominant genotypes in our study.
Adenoviridae ; Adenoviruses, Human ; Coinfection ; Conjunctivitis, Acute Hemorrhagic ; Conjunctivitis, Viral* ; Enterovirus ; Genotype ; Gwangju ; Humans ; Keratoconjunctivitis ; Korea* ; Molecular Epidemiology*