Objective: We aimed to explore the influence of public workers’ distress or viral anxiety on their level of depression and work engagement during the coronavirus disease (COVID-19) pandemic. Additionally, we ascertain the mediation effect of resilience and public service motivation on this association. Methods: A total of 300 public workers participated in this online survey. Their demographic characteristics and responses to survey items were collected using the Stress and Anxiety to Viral Epidemics–6 items Scale, the Patient Health Questionnaire–9 items Scale, the Public Service Motivation (PSM) Scale, the Nine-item Utrecht Work Engagement Scale, the Korean Occupational Stress Scale–Short Form, and the Brief Resilience Scale. Results: Work engagement of public workers was expected by PSM (β=0.28, p<0.001), resilience (β=0.30, p<0.001), and work-related stress (β=-0.40, p<0.001) (F=57.4, p<0.001). Depression was expected by fewer years of employment (β=-0.12, p=0.02), viral anxiety (β= 0.21, p<0.001), and low resilience (β=-0.42, p<0.001) (F=22.1, p<0.001). Resilience and PSM partially mediated the effects of work-related stress on work engagement. Depression was influenced by COVID-19–induced viral anxiety, and their resilience—but not PSM—mediated the association. Conclusion Public workers’ resilience and PSM partially mediated the effects of work-related stress on work engagement. The influence of viral anxiety on public workers’ depression was mediated by their resilience but not PSM.

OBJECTIVE: This study aimed to examine the usefulness of each subscale score of the Clinical Dementia Rating (CDR) for predicting Alzheimer's disease (AD) dementia progression in amnestic mild cognitive impairment (MCI) elderly subjects. METHODS: Fifty-nine elderly MCI individuals were recruited from a university dementia and memory disorder clinic. Standardized clinical and neuropsychological tests were performed both at baseline and at the time of 2 years follow-up. Logistic regression analyses were conducted to examine the ability of various clinical measures or their combinations to predict progression to AD dementia in MCI individuals. RESULTS: MCIp individuals showed significantly higher CDR Orientation subscale and CDR sum-of-boxes (SOB) score than MCInp ones, while there were no significant differences in other CDR subscale scores between the two. MCIp individuals also showed marginally higher MMSE scores than MCInp ones. A series of logistic regression analyses demonstrated that the model including CDR Orientation subscale had better AD dementia prediction accuracy than either the model with either MMSE or CDR-SOB. CONCLUSION: Our findings suggest that CDR Orientation subscale score, a simple and easily available clinical measure, could provide very useful information to predict AD dementia progression in amnestic MCI individuals in real clinical settings.
Aged ; Alzheimer Disease* ; Dementia* ; Follow-Up Studies ; Humans ; Logistic Models ; Memory Disorders ; Mild Cognitive Impairment* ; Neuropsychological Tests

OBJECTIVE: The Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's disease (KBASE) aimed to recruit 650 individuals, aged from 20 to 90 years, to search for new biomarkers of Alzheimer's disease (AD) and to investigate how multi-faceted lifetime experiences and bodily changes contribute to the brain changes or brain pathologies related to the AD process. METHODS: All participants received comprehensive clinical and neuropsychological evaluations, multi-modal brain imaging, including magnetic resonance imaging, magnetic resonance angiography, [11C]Pittsburgh compound B-positron emission tomography (PET), and [18F]fluorodeoxyglucose-PET, blood and genetic marker analyses at baseline, and a subset of participants underwent actigraph monitoring and completed a sleep diary. Participants are to be followed annually with clinical and neuropsychological assessments, and biannually with the full KBASE assessment, including neuroimaging and laboratory tests. RESULTS: As of March 2017, in total, 758 individuals had volunteered for this study. Among them, in total, 591 participants–291 cognitively normal (CN) old-aged individuals, 74 CN young- and middle-aged individuals, 139 individuals with mild cognitive impairment (MCI), and 87 individuals with AD dementia (ADD)–were enrolled at baseline, after excluding 162 individuals. A subset of participants (n=275) underwent actigraph monitoring. CONCLUSION: The KBASE cohort is a prospective, longitudinal cohort study that recruited participants with a wide age range and a wide distribution of cognitive status (CN, MCI, and ADD) and it has several strengths in its design and methodologies. Details of the recruitment, study methodology, and baseline sample characteristics are described in this paper.
Aging* ; Alzheimer Disease* ; Biomarkers ; Brain* ; Cohort Studies ; Dementia ; Early Diagnosis* ; Genetic Markers ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Mild Cognitive Impairment ; Neuroimaging ; Pathology ; Prospective Studies

We compared the predictive ability of the various neuroimaging tools and determined the most cost-effective, non-invasive Alzheimer's disease (AD) prediction model in mild cognitive impairment (MCI) individuals. Thirty-two MCI subjects were evaluated at baseline with [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, diffusion tensor imaging (DTI), and neuropsychological tests, and then followed up for 2 yr. After a follow up period, 12 MCI subjects converted to AD (MCIc) and 20 did not (MCInc). Of the voxel-based statistical comparisons of baseline neuroimaging data, the MCIc showed reduced cerebral glucose metabolism (CMgl) in the temporo-parietal, posterior cingulate, precuneus, and frontal regions, and gray matter (GM) density in multiple cortical areas including the frontal, temporal and parietal regions compared to the MCInc, whereas regional fractional anisotropy derived from DTI were not significantly different between the two groups. The MCIc also had lower Mini-Mental State Examination (MMSE) score than the MCInc. Through a series of model selection steps, the MMSE combined with CMgl model was selected as a final model (classification accuracy 93.8%). In conclusion, the combination of MMSE with regional CMgl measurement based on FDG-PET is probably the most efficient, non-invasive method to predict AD in MCI individuals after a two-year follow-up period.
Aged ; Alzheimer Disease/complications/*diagnosis ; Atrophy/pathology ; Biomarkers/blood ; Brain/*pathology ; Diffusion Tensor Imaging/methods ; Female ; Glucose/*metabolism ; Gray Matter/*pathology ; Humans ; Male ; Mild Cognitive Impairment/*diagnosis/etiology ; Neuroimaging/methods ; Positron-Emission Tomography/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Severity of Illness Index ; White Matter/*pathology

OBJECTIVE: The purpose of this study was to explore the effect of demographic variables on Digit Span test (DS) performance in an educationally diverse elderly population and to provide normative information. METHODS: The DS was administered to 784 community-dwelling volunteers aged 60-90 years with an educational history of from zero to 25 years of full-time education. People with serious neurological, medical and psychiatric disorders (including dementia) were excluded. RESULTS: Age, education and gender were found to be significantly associated with performance on the DS. Based on the results obtained, DS norms were stratified by age (2 strata), education (3 strata), and gender (2 strata). CONCLUSION: Our results on DS performance suggest that both attention and working memory are influenced by age, education and gender. The present study provides reasonably comprehensive normative information on the DS for an educationally diverse elderly population.
Age Factors ; Aged* ; Asian Continental Ancestry Group ; Education* ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Volunteers

OBJECTIVE: We developed a Revised Korean version of the Geriatric Depression Scale (GDS-KR) and examined its reliability, validity, and factor structures. We also estimated its optimal cutoff scores for major depressive disorder (MDD) and minor depressive disorder (MnDD) stratified by age and education. METHODS: The GDS-KR was administered to 888 subjects (61 MDD patients, 45 MnDD patients, and 782 normal elders). Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) and Hamilton Depression Rating Scale (HAM-D). The mean GDS-KR scores of the MDD patients, MnDD patients and normal elders were compared to evaluate its discriminant validity. To evaluate its construct validity, a principal component analysis with varimax rotation was performed. Receiver operator characteristic (ROC) curve analyses were performed to evaluate its diagnostic ability. RESULTS: Chronbach's coefficient alpha for the GDS-KR was 0.90 and the test-retest reliability was 0.91 (p<0.01). The Pearson correlation coefficients of the GDS-KR scores with the CES-D-K and HAM-D scores were 0.63 (p<0.01) and 0.56 (p<0.01), respectively. The GDS-KR consisted of 5 factors. The optimal cut-off scores of the GDS-KR were 16/17 for MDD only and 15/16 for both MDD and MnDD. The optimal cutoff scores of the GDS-KR were higher in the less educated and younger subjects. The diagnostic accuracy for MDD of the GDS-KR was higher than that of the CES-D. CONCLUSION: The GDS-KR was found to be a reliable and valid questionnaire for screening MDD and MnDD in late life.
Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Education ; Epidemiologic Studies ; Factor Analysis, Statistical ; Humans ; Mass Screening ; Principal Component Analysis ; Surveys and Questionnaires

OBJECTIVE: We investigated the influence of social support on health, quality of life (QOL), and the risk of depression in elderly Korean people. METHODS: This study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA). A total of 787 nondemented community-dwelling elderly aged 65 years or older were recruited and underwent clinical evaluations for dementia and psychiatric disorders conformed to Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Clinical Assessment Battery (CERAD-K) and the Korean version of the Mini-International Neuropsychiatric Interview (MINI), respectively. Social support was assessed using the Medical Outcome Study Social Support Survey (MOS-SSS). Poor social support (PSS) was defined as having a MOS-SSS score below the 25th percentile of the entire sample. General health status was comprehensively evaluated using the modified Cumulative Illness Rating Scale (CIRS), the Korean version of the Geriatric Depression Scale (GDS-K), Mini-Mental Status Examination (MMSE-KC), Korean Activities of Daily Living (KADL), and Korean Instrumental Activities of Daily Living (KIADL). Health-related QOL was evaluated using the Short Form 36 (SF-36). RESULTS: Low educational attainment and living alone were associated with PSS. Geriatric depression was more prevalent in the PSS group (OR=3.05, 95% CI=1.77-5.27) than in the normal social support (NSS) group. Among the various forms of social support, positive social interaction was significantly associated with risk of geriatric depression (OR=2.25, 95% CI=1.07-4.73). Although health-related QOL was lower in the PSS group than in the NSS group, the ADL and IADL scores of the subjects in the PSS group were better than those of the subjects in the NSS group. In the subjects with geriatric depression, PSS was associated with more severe depression, higher medical morbidity, and poor QOL. CONCLUSION: PSS had a negative influence on the general health status and QOL among community-dwelling elderly and was an independent risk factor of geriatric depression.
Activities of Daily Living ; Aged* ; Aging* ; Alzheimer Disease ; Dementia ; Depression ; Humans ; Interpersonal Relations ; Longitudinal Studies* ; Outcome Assessment (Health Care) ; Quality of Life ; Risk Factors

OBJECTIVE: To determine whether the presence of Y-chromosome microdeletion affects the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) program. METHODS: Fourteen couples with microdeletion in azoospermic factor (AZF)c region who attempted IVF/ICSI or cryopreserved and thawed embryo transfer cycles were enrolled. All of the men showed severe oligoasthenoteratoazoospermia (OATS) or azoospermia. As a control, 12 couples with OATS or azoospermia and having normal Y-chromosome were included. Both groups were divided into two subgroups by sperm source used in ICSI such as those who underwent testicular sperm extraction (TESE) and those used ejaculate sperm. We retrospectively analyzed our database in respect to the IVF outcomes. The outcome measures were mean number of good quality embryos, fertilization rates, implantation rates, beta-hCG positive rates, early pregnancy loss and live birth rates. RESULTS: Mean number of good quality embryos, implantation rates, beta-hCG positive rates, early pregnancy loss rates and live birth rates were not significantly different between Y-chromosome microdeletion and control groups. But, fertilization rates in the Y-chromosome microdeletion group (61.1%) was significantly lower than that of control group (79.8%, p=0.003). Also, the subgroup underwent TESE and having AZFc microdeletion showed significantly lower fertilization rates (52.9%) than the subgroup underwent TESE and having normal Y-chromosome (79.5%, p=0.008). Otherwise, in the subgroups used ejaculate sperm, fertilization rates were showed tendency toward lower in couples having Y-chromosome microdeletion than couples with normal Y-chromosome. (65.5% versus 79.9%, p=0.082). But, there was no significance statistically. CONCLUSIONS: In IVF/ICSI cycles using TESE sperm, presence of Y-chromosome microdeletion may adversely affect to fertilization ability of injected sperm. But, in cases of ejaculate sperm available for ICSI, IVF outcome was not affected by presence of Y-chromosome AZFc microdeletion. However, more larger scaled prospective study was needed to support our results.
Avena ; Azoospermia ; Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Male ; Outcome Assessment (Health Care) ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Y Chromosome*

Ornithine transcarbamylase (OTC) deficiency is an X-linked co-dominant disorder. A couple, with a previous history of a neonatal death and a therapeutical termination due to OTC deficiency, was referred to our center for preimplantation genetic diagnosis (PGD). The female partner has a nonsense mutation in the exon 9 of the OTC gene (R320X). We carried out nested polymerase chain reaction (PCR) for R320X mutation and fluorescence in situ hybridization (FISH) for aneuploidy screening. Among a total of 11 embryos, two blastomeres per embryo from 9 embryos were biopsied and analyzed by duplex-nested PCR and FISH, and one blastomere per embryo from 2 embryos by only duplex-nested PCR. As a result of PCR and restriction fragment length polymorphism analysis, four embryos were diagnosed as unaffected embryos having the normal OTC gene. Among these embryos, only one embryo was confirmed as euploidy for chromosome X, Y and 18 by FISH analysis. A single normal embryo was transferred to the mother, yielding an unaffected pregnancy and birth of a healthy boy. Based on our results, PCR for mutation loci and FISH for aneuploidy screening with two blastomeres from an embryo could provide higher accuracy for the selection of genetically and chromosomally normal embryos in the PGD for single gene defects.
Adult ; Aneuploidy ; Codon, Nonsense ; DNA Primers ; Exons ; Female ; Humans ; In Situ Hybridization, Fluorescence/*methods ; Infant, Newborn ; Male ; Ornithine Carbamoyltransferase/*deficiency ; Polymerase Chain Reaction/*methods ; Pregnancy ; Pregnancy Outcome ; Preimplantation Diagnosis/*methods

BACKGROUND: Essential hyperhidrosis is a pathologic condition caused by excessive secretion of the eccrine sweat glands. This is an embarrassing condition, which severely reduces the quality of life and may result in psychological disturbance. Our purpose was to determine the therapeutic efficacy of oral glycopyrrolate in term of its strength, safety, and side effects. METHODS: Oral glycopyrrolate was given to 104 patients, 53 men and 51 women with a mean age of 24 years. Patients controlled the dosage of glycopyrrolate for a week. Attention was focused on patient satisfaction, onset time, duration, degree of reducing perspiration and side effects. RESULTS: Ninety eight of 104 patients (94%) were satisfied with their improved condition. The most common maximum dose/day was 2 mg. The overall mean onset time was 2.3 hours and the duration of the effect was 7.4 hours. Dry mouth occurred in 40 patients. Sixty eight of patients (65%) experienced reduced excessive sweating caused by oral glycopyrrolate. CONCLUSIONS: The administration of oral glycopyrrolate is a safe and effective method of treating essential hyperhidrosis, and appears to be an acceptable therapeutic option in any form of hyperhidrosis.
Female ; Glycopyrrolate* ; Humans ; Hyperhidrosis* ; Male ; Mouth ; Patient Satisfaction ; Quality of Life ; Sweat ; Sweat Glands ; Sweating