PURPOSE: In an effort to determine the characteristics of suicide, which is a serious social problem, we analyzed the relationship with gender, age, educational level, occupation, and suicidal attempt and completed suicide. The results of this study could serve as fundamental material for suicide preventive education and improvement of health. METHODS: General characteristics of completed suicide, attempted suicide, and total injured according to gender, age, educational level, and occupation were compared using the injury surveillance dataset, the material from in-depth investigation of patients in the emergency room. All injuries from suicidal attempts and completed suicide of suicidal attempts were analyzed by logistic regression. RESULTS: The rate of injury by attempted suicide was higher in women than in men; however, completed suicide showed more male dominance, in comparison with other injuries. And, for age, the highest was observed for 30-40s. The lower educational attainment subgroup showed the highest level of attempt, and for the occupation, unemployed, skilled agriculture or fishery workers, soldiers, students, and housewives showed the highest value. CONCLUSION: Vulnerable demographic and socioeconomic groups, including women, low level of education, unemployed, skilled agriculture or fishery workers, soldiers, students, and housewives are weaken to attempted suicide, and intensive management, education, and supportive policy are necessary to those groups.
Agriculture ; Dataset ; Education ; Emergency Service, Hospital ; Female ; Fisheries ; Humans ; Logistic Models ; Male ; Military Personnel ; Occupations* ; Social Problems ; Socioeconomic Factors ; Suicide* ; Suicide, Attempted

PURPOSE: This study assessed the association between the ratio of leukotriene E4 (LTE4) to fractional exhaled nitric oxide (FENO) in the response of children with exercise-induced bronchoconstriction (EIB) enrolled in a therapeutic trial with montelukast or inhaled corticosteroid (fluticasone propionate [FP]). METHODS: Children aged 6 to 18 years with EIB were randomized in a 4-week, placebo-controlled, double-blinded trial with montelukast or FP. Before and after treatment, treadmill exercise challenges were performed. The LTE4 levels in the induced sputum and urine and the FENO levels were measured in subjects before and 30 minutes after the exercise challenges. The same tests were conducted after treatment. RESULTS: A total of 24 patients completed the study: 12 in the montelukast group and 12 in FP group. Both study groups displayed a similar postexercise maximum decrease in forced expiratory volume in one second (FEV1) before treatment as well as after treatment. However, there were significant differences in the magnitude of change between the two (Delta; -18.38+/-14.53% vs. -4.67+/-8.12% for the montelukast and FP groups, respectively; P=0.021). The Delta logarithmic sputum baseline and postexercise LTE4/FENO ratio were significantly lower in the montelukast group than in the FP group (baseline; -0.09+/-0.21 vs. -0.024+/-0.03, P=0.045; postexercise, -0.61+/-0.33 vs. -0.11+/-0.28, P=0.023). CONCLUSIONS: These data indicate that the efficacy of montelukast for preventing a maximum decrease in FEV1 after exercise is significantly higher than that of FP, and the high LTE4/FENO ratio is associated with a greater response to montelukast than to FP for EIB therapy. These results suggest that LTE4 may play an important role in EIB.
Acetates ; Aged ; Bronchoconstriction ; Child ; Diethylpropion ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Nitric Oxide ; Quinolines ; Sputum

OBJECTIVES: The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients’ prior history of allergic diseases. METHODS: Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [NO₂], ozone [O₃], sulfur dioxide [SO₂], and particulate matter with an aerodynamic diameter <10 μm [PM₁₀]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. RESULTS: A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in O₃ concentration. IQR changes in NO₂ and PM₁₀ concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in PM₁₀ concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. CONCLUSIONS: Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.
Air Pollutants ; Air Pollution* ; Asthma* ; Dermatitis, Atopic ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Insurance, Health ; Korea ; Nitrogen Dioxide ; Ozone ; Particulate Matter ; Rhinitis, Allergic ; Seasons ; Seoul ; Sulfur Dioxide

OBJECTIVES: This study aimed to collect information that will help enhance the social networks and improve the quality of life among elderly people by observing the relationship between their social network and health-related quality of life (HRQoL) and by analyzing social network factors affecting HRQoL. METHODS: This study was based on the 2008 Community Health Survey in Yeoncheon County. Three hundred elders were included in the study population. We compared the revised Lubben Social Network Scale (LSNS-R) score and Euro quality of life-5 dimensions health status index by demographic characteristics and chronic disease prevalence. We analyzed the data using multiple regression and tobit regression by setting the HRQoL as the dependent variable and social network and other characteristics as the independent variables. We analyzed social network factors by using factor analysis. RESULTS: The LSNS-R score differed significantly according to age and existence of a spouse. According to the results from the hierarchical multiple regression analysis, the LSNS-R explained 0.10 of the variance and LSNS-R friends factor explained 0.10 of the variance. The tobit regression indicated that the contribution of the LSNS-R family size factor to the regression coefficient of the independent variable that affected the HRQoL was BT=2.96, that of the LSNS-R family frequency factor was BT=3.60, and that of LSNS-R friends factor was BT=5.41. CONCLUSIONS: Social networks among elderly people had a significant effect on HRQoL and their networks of friends had a relatively higher effect than those of family members.
Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Chronic Disease ; Demography ; Female ; Health Status ; Humans ; Income ; Interviews as Topic ; Male ; *Quality of Life ; Questionnaires ; Regression Analysis ; Republic of Korea ; Social Support

Background: Diabetic kidney disease (DKD) is a risk factor for hospitalization for heart failure (HHF). DKD could be classified into four phenotypes by estimated glomerular filtration rate (eGFR, normal vs. low) and proteinuria (PU, negative vs. positive). Also, the phenotype often changes dynamically. This study examined HHF risk according to the DKD phenotype changes across 2-year assessments. Methods: The study included 1,343,116 patients with type 2 diabetes mellitus (T2DM) from the Korean National Health Insurance Service database after excluding a very high-risk phenotype (eGFR <30 mL/min/1.73 m2) at baseline, who underwent two cycles of medical checkups between 2009 and 2014. From the baseline and 2-year eGFR and PU results, participants were divided into 10 DKD phenotypic change categories. Results: During an average of 6.5 years of follow-up, 7,874 subjects developed HHF. The cumulative incidence of HHF from index date was highest in the eGFRlowPU– phenotype, followed by eGFRnorPU+ and eGFRnorPU–. Changes in DKD phenotype differently affect HHF risk. When the persistent eGFRnorPU– category was the reference, hazard ratios for HHF were 3.10 (95% confidence interval [CI], 2.73 to 3.52) in persistent eGFRnorPU+ and 1.86 (95% CI, 1.73 to 1.99) in persistent eGFRlowPU–. Among altered phenotypes, the category converted to eGFRlowPU+ showed the highest risk. In the normal eGFR category at the second examination, those who converted from PU– to PU+ showed a higher risk of HHF than those who converted from PU+ to PU–. Conclusion Changes in DKD phenotype, particularly with the presence of PU, are more likely to reflect the risk of HHF, compared with DKD phenotype based on a single time point in patients with T2DM.

Background: Diabetic kidney disease (DKD) is associated with an elevated risk of fractures. However, little is known about the association between proteinuric or non-proteinuric DKD and the risk of hip fracture. Thus, we investigated the incidence of hip fractures among Korean adults with type 2 diabetes mellitus (T2DM) stratified by DKD phenotype. Methods: In this retrospective cohort study using the Korean National Health Insurance Service database, patients with T2DM who received at least one general health checkup between 2009 and 2012 were followed until the date of hip fracture, death, or December 31, 2018. We classified the DKD phenotype by proteinuria and estimated glomerular filtration rate (eGFR), as follows: no DKD (PU−GFR−), proteinuric DKD with normal eGFR (PU+GFR−), non-proteinuric DKD with reduced eGFR (PU−GFR+), and proteinuric DKD with reduced eGFR (PU+GFR+) Results: The cumulative incidence of hip fractures was highest in the PU+GFR+ group, followed by the PU−GFR+ group and the PU+GFR− group. After adjustment for confounding factors, the hazard ratio (HR) for hip fracture was still highest in the PU+GFR+ group. However, the PU+GFR− group had a higher HR for hip fracture than the PU−GFR+ group (PU+GFR+ : HR, 1.69; 95% confidence interval [CI], 1.57 to 1.81; PU+GFR− : HR, 1.37; 95% CI, 1.30 to 1.46; PU−GFR+ : HR, 1.20; 95% CI, 1.16 to 1.24 using the PU−GFR− group as the reference category). Conclusion The present study demonstrated that DKD was significantly associated with a higher risk of hip fracture, with proteinuria as a major determinant.

Intermediate filaments, including nestin and glial fibrillary acidic protein (GFAP), are important for the brain to accommodate neural activities and changes during development. The present study examined the temporal changes of nestin and GFAP protein levels in the postnatal development of the mouse hippocampus. Mouse hippocampi were sampled on postnatal day (PND) 1, 3, 6, 18, and 48. Western blot analysis showed that nestin expression was high at PND 1 and markedly decreased until PND 18. Conversely, GFAP expression was acutely increased in the early phase of postnatal development. Nestin immunoreactivity was localized mainly in the processes of ramified cells at PND 1, but expression subsequently decreased. In contrast, GFAP was evident mainly in the marginal cells of the hippocampus at PND 1, but immunoreactivity revealed satellite, radial, or ramified shapes of the cells from PND 6-48. This study demonstrates that the opposing pattern of nestin and GFAP expressions in mouse hippocampus during postnatal development occur in the early development stage (PND 1-18), suggesting that the opposing change of nestin and GFAP in early postnatal development is important for neural differentiation and positioning in the mouse hippocampus.
*Aging ; Animals ; Blotting, Western ; Brain/cytology/growth & development ; Female ; *Gene Expression Regulation, Developmental ; Glial Fibrillary Acidic Protein/genetics/*metabolism ; Hippocampus/cytology/*growth & development/*metabolism ; Immunohistochemistry ; Intermediate Filament Proteins/genetics/*metabolism ; Male ; Mice ; Mice, Inbred ICR ; Nerve Tissue Proteins/genetics/*metabolism ; Neurons/metabolism

Object recognition memory and contextual fear conditioning task performance in adult C57BL/6 mice exposed to cranial fast neutron irradiation (0.8 Gy) were examined to evaluate hippocampus-related behavioral dysfunction following acute exposure to relatively low doses of fast neutrons. In addition, hippocampal neurogenesis changes in adult murine brain after cranial irradiation were analyzed using the neurogenesis immunohistochemical markers Ki-67 and doublecortin (DCX). In the object recognition memory test and contextual fear conditioning, mice trained 1 and 7 days after irradiation displayed significant memory deficits compared to the sham-irradiated controls. The number of Ki-67- and DCX-positive cells decreased significantly 24 h post-irradiation. These results indicate that acute exposure of the adult mouse brain to a relatively low dose of fast neutrons interrupts hippocampal functions, including learning and memory, possibly by inhibiting neurogenesis.
Animals ; Cranial Irradiation ; *Fast Neutrons ; Hippocampus/metabolism/physiology/*radiation effects ; Immunohistochemistry ; Ki-67 Antigen/metabolism ; Male ; Memory/physiology/*radiation effects ; Mice ; Mice, Inbred C57BL ; Microtubule-Associated Proteins/metabolism ; Neurogenesis/physiology/*radiation effects ; Neuropeptides/metabolism

Pure red cell aplasia (PRCA) in adults is usually idiopathic, although some underlying conditions can cause PRCA. Immunosuppressive therapy (IST) is used to treat PRCA, but IST has side effects and may fail. The anti-CD52 monoclonal antibody alemtuzumab (ALM) was recently used to successfully treat therapy-resistant PRCA. We herein report successful treatment of secondary PRCA after erythropoietin therapy using ALM and cyclosporin A (CsA) in one patient. The total dose of ALM was 60 mg over 3 days (10, 20, and 30 mg, respectively) plus CsA for at least 6 months. The patient achieved a complete response 18 months after ALM-CsA treatment and his treatment could be changed to a different erythropoietin-stimulating agent.
Adult ; Antibodies, Monoclonal, Humanized ; Cyclosporine ; Erythropoietin ; Humans ; Red-Cell Aplasia, Pure

BACKGROUND AND OBJECTIVES: Joint National Committee guidelines attempt to vary treatment recommendations for patients based on considerations of their comorbidities. The aim of the present study is to estimate the age-standardized prevalence of common comorbidities among Korean hypertension patients. SUBJECTS AND METHODS: We analyzed the Korea National Health and Nutrition Examination Survey from 2007 to 2013. Among the 58423 participants, 30092 adults, aged ≥30 yrs who completed a health examination and interview survey, were selected. The survey procedures were used to estimate weighted prevalence and odds ratios for 8 comorbidities, including obesity, diabetes mellitus, dyslipidemia, cardiovascular disease, chronic kidney disease, and thyroid disease. RESULTS: Most chronic conditions were more prevalent in adults with hypertension than in those without hypertension. Common comorbidities were obesity (60.1%), dyslipidemia (57.6%), and impaired fasting glucose (45.1%). Hypertensive patients with two or more comorbid diseases were 42.2% and those with three or more diseases were 17.7%. The age- and sex-specific prevalence of three or more comorbid diseases among male hypertension patients was significantly higher than those patients in the 30-59 (p<0.05) age group. CONCLUSION: Comorbidity is highly prevalent in Korean patients with hypertension.
Adult ; Cardiovascular Diseases ; Chronic Disease ; Comorbidity* ; Diabetes Mellitus ; Dyslipidemias ; Epidemiology ; Fasting ; Glucose ; Humans ; Hypertension* ; Joints ; Korea* ; Male ; Nutrition Surveys* ; Obesity ; Odds Ratio ; Prevalence* ; Renal Insufficiency, Chronic ; Thyroid Diseases