BACKGROUND: Lipids of horny layer forming multiple lamellar structure in the intercellular space acts as a skin barrier having a primary protective function and keeps softness and flexibility of the skin by absorbing and maintaining moistures. Among the intercellular lipids, ceramides mainly contribute to this important role. In xerotic eczema, atopic dermatitis, psoriasis, ichthyosis, and experimentally induced scaly lesion showing dryness and scales, the amount of ceramides is decreased or distribution of ceramide is changed. In addition to lipids, free amino acids, a component of NMFs, serve as a water retainer and are decreased in ichthyosis or experimentally induced scaly lesion. Hand eczema has dry and scaly lesion showing impaired skin barrier and low water content. So, changes of ceramides or free amino acids can be considered in the lesion of hand eczema. OBJECTIVE: The purpose of this study was to confirm the relationship between the development of hand eczema and changes of ceramides or free amino acids. METHOD: The lipids and free amino acids in scales from lesion of hand eczema were analyzed by using high performance thin layer chromatography and amino acid analyzer. RESULTS: Amounts of total lipids extracted were 0.63+/-0.33 microgram/cm2 in hand eczema and 0.44+/-0.26 microgram/cm2 in control. There was no difference between the two groups. Cholesterol sulfate, glucosyl ceramide, cholesterol, triglyceride, sterol ester, and n-alkane showed no difference between hand eczema and control. But ceramides were significantly decreased in hand eczema(11.0+/-5.5%) compared with control(21.4+/-8.0%)(p<0.05). Especially, ceramide type IV was significantly decreased in hand eczema (6.6+/-5.3%) compared with control(15.6+/-6.2%)(p<0.05) but ceramide type III in hand eczema did not differ from control. Amounts of total free amino acids in 10mg of scale were 10.4+/-3.1nmol in hand eczema and 9.5+/-3.0nmol in control. There was no significant difference between the two groups. CONCLUSION: Dry skin and scales in hand eczema are related to the decrease of total amount of ceramides and ceramide type IV than amino acids in horny layer. To clarify the exact pathogenesis of hand eczema, further investigations on all types of ceramides and their defect in the process on biosynthesis of ceramides will be necessary.
Amino Acids* ; Ceramides* ; Cholesterol ; Chromatography, Thin Layer ; Dermatitis ; Dermatitis, Atopic ; Eczema* ; Extracellular Space ; Hand* ; Ichthyosis ; Pliability ; Psoriasis ; Skin ; Triglycerides ; Water ; Weights and Measures

BACKGROUND: Lipids of horny layer forming multiple lamellar structure in the intercellular space acts as a skin barrier having a primary protective function and keeps softness and flexibility of the skin by absorbing and maintaining moistures. Among the intercellular lipids, ceramides mainly contribute to this important role. In xerotic eczema, atopic dermatitis, psoriasis, ichthyosis, and experimentally induced scaly lesion showing dryness and scales, the amount of ceramides is decreased or distribution of ceramide is changed. In addition to lipids, free amino acids, a component of NMFs, serve as a water retainer and are decreased in ichthyosis or experimentally induced scaly lesion. Hand eczema has dry and scaly lesion showing impaired skin barrier and low water content. So, changes of ceramides or free amino acids can be considered in the lesion of hand eczema. OBJECTIVE: The purpose of this study was to confirm the relationship between the development of hand eczema and changes of ceramides or free amino acids. METHOD: The lipids and free amino acids in scales from lesion of hand eczema were analyzed by using high performance thin layer chromatography and amino acid analyzer. RESULTS: Amounts of total lipids extracted were 0.63+/-0.33 microgram/cm2 in hand eczema and 0.44+/-0.26 microgram/cm2 in control. There was no difference between the two groups. Cholesterol sulfate, glucosyl ceramide, cholesterol, triglyceride, sterol ester, and n-alkane showed no difference between hand eczema and control. But ceramides were significantly decreased in hand eczema(11.0+/-5.5%) compared with control(21.4+/-8.0%)(p<0.05). Especially, ceramide type IV was significantly decreased in hand eczema (6.6+/-5.3%) compared with control(15.6+/-6.2%)(p<0.05) but ceramide type III in hand eczema did not differ from control. Amounts of total free amino acids in 10mg of scale were 10.4+/-3.1nmol in hand eczema and 9.5+/-3.0nmol in control. There was no significant difference between the two groups. CONCLUSION: Dry skin and scales in hand eczema are related to the decrease of total amount of ceramides and ceramide type IV than amino acids in horny layer. To clarify the exact pathogenesis of hand eczema, further investigations on all types of ceramides and their defect in the process on biosynthesis of ceramides will be necessary.
Amino Acids* ; Ceramides* ; Cholesterol ; Chromatography, Thin Layer ; Dermatitis ; Dermatitis, Atopic ; Eczema* ; Extracellular Space ; Hand* ; Ichthyosis ; Pliability ; Psoriasis ; Skin ; Triglycerides ; Water ; Weights and Measures

Objectives: This study examined the changes in anxiety and depressive symptoms in the parents of Korean adults with autism spectrum disorder (ASD) after participating in the Korean version of the Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS ® -YA-K). Methods: Forty-six parents were enrolled (mean age 54.7 years; 22 fathers and 24 mothers), of whom 27 participated in the PEERS ® -YA-K as social coaches. Participants completed self-report scales, including the Test of Young Adult Social Skills Knowledge (TYASSK), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Symptom Check-List-90-R (SCL-90-R). The scales were administered three times: before and after the 16-week program and 4 months after the program ended. Differences between participant variables at pretreatment, post-treatment, and follow-up were analyzed using paired-sample t-tests. Results: Participants showed a significant improvement in their social skills knowledge (TYASSK) (:p<0.01). There was a significant improvement in the BAI and BDI scores of parents with severe depressive and anxiety symptoms at the baseline (p<0.05). Paternal paranoia and maternal hostility results also significantly improved on the SCL-90-R. Conclusion This study suggests that PEERS ® -YA-K can reduce parental anxiety and depressive symptoms. To the best of our knowledge, this is the first to compare the degree of depression and anxiety after PEERS ® -YA-K in parents of adults with ASD.

Mitochondrial dysfunction is considered one of the pathophysiological mechanisms of autism spectrum disorder (ASD). However, previous studies of biomarkers associated with mitochondrial dysfunction in ASD have revealed inconsistent results. The objective of this study was to evaluate biochemical markers associated with mitochondrial dysfunction in subjects with ASD and their unaffected family members. Lactate and pyruvate levels, as well as the lactate-to-pyruvate ratio, were examined in the peripheral blood of probands with ASD (Affected Group, AG) and their unaffected family members (biological parents and unaffected siblings, Unaffected Group, UG). Lactate ≥22 mg/dl, pyruvate ≥1.4 mg/dl, and lactate-topyruvate ratio >25 were defined as abnormal. The clinical variables were compared between subjects with higher (>25) and lower (≤25) lactate-topyruvate ratios within the AG. The AG (n=59) had a significantly higher lactate and lactate-to-pyruvate ratio than the UG (n=136). The frequency of subjects with abnormally high lactate levels and lactate-to-pyruvate ratio was significantly higher in the AG (lactate 31.0% vs. 9.5%, ratio 25.9% vs. 7.3%, p<0.01). The relationship between lactate level and the repetitive behavior domain of the Autism Diagnostic Interview-Revised was statistically significant. These results suggest that biochemical markers related to mitochondrial dysfunction, especially higher lactate levels and lactateto-pyruvate ratio, might be associated with the pathophysiology of ASD. Further larger studies using unrelated individuals are needed to control for the possible effects of age and sex on chemical biomarker levels.

Objective: Previous research on autism spectrum disorder (ASD) in Koreans has primarily focused on genetic diversity because of its high heritability. However, the emerging recognition of transgenerational epigenetic changes has recently shifted research attention towards epigenetic perspectives. Methods: This study investigated the DNA methylation patterns of the promoter regions of candidate genes such asNR3C1, ASCL1, and FOXO3 in blood samples from ASD probands and their unaffected siblings. The analysis included 54 families (ASD proband group: 54; unaffected biological sibling group: 63). The diagnostic process involved screening the probands and their siblings for ASD based on the Diagnostic and Statistical Manual of Mental Disorders 5th edition.Intelligence, social ability, and medical history were thoroughly assessed using various scales and questionnaires.Genomic DNA from blood samples was analyzed using a methylation-sensitive quantitative polymerase chain reaction to examine the DNA methylation status of candidate genes. Results: Methylation levels in candidate gene promoter regions differed significantly between the proband and sibling groups for all candidate genes. Correlation analysis between the proband and sibling groups revealed strong and significant correlations in NR3C1 and ASCL1 methylation. Additionally, in the analysis of the relationship between DNA and ASD phenotypes, FOXO3 methylation correlated with social quotient in probands, and ASCL1 methylation was associated with nonverbal communication, and daily living skills as measured by the Korean Vineland Adaptive Behavior Scale. Notably, ASCL1 methylation was significantly associated with parental age at pregnancy. Conclusion This study proposes DNA methylation of NR3C1, ASCL1, and FOXO3 in peripheral blood samples is a potential epigenetic biomarker of ASD.

Objective: Previous research on autism spectrum disorder (ASD) in Koreans has primarily focused on genetic diversity because of its high heritability. However, the emerging recognition of transgenerational epigenetic changes has recently shifted research attention towards epigenetic perspectives. Methods: This study investigated the DNA methylation patterns of the promoter regions of candidate genes such asNR3C1, ASCL1, and FOXO3 in blood samples from ASD probands and their unaffected siblings. The analysis included 54 families (ASD proband group: 54; unaffected biological sibling group: 63). The diagnostic process involved screening the probands and their siblings for ASD based on the Diagnostic and Statistical Manual of Mental Disorders 5th edition.Intelligence, social ability, and medical history were thoroughly assessed using various scales and questionnaires.Genomic DNA from blood samples was analyzed using a methylation-sensitive quantitative polymerase chain reaction to examine the DNA methylation status of candidate genes. Results: Methylation levels in candidate gene promoter regions differed significantly between the proband and sibling groups for all candidate genes. Correlation analysis between the proband and sibling groups revealed strong and significant correlations in NR3C1 and ASCL1 methylation. Additionally, in the analysis of the relationship between DNA and ASD phenotypes, FOXO3 methylation correlated with social quotient in probands, and ASCL1 methylation was associated with nonverbal communication, and daily living skills as measured by the Korean Vineland Adaptive Behavior Scale. Notably, ASCL1 methylation was significantly associated with parental age at pregnancy. Conclusion This study proposes DNA methylation of NR3C1, ASCL1, and FOXO3 in peripheral blood samples is a potential epigenetic biomarker of ASD.

Objective: Previous research on autism spectrum disorder (ASD) in Koreans has primarily focused on genetic diversity because of its high heritability. However, the emerging recognition of transgenerational epigenetic changes has recently shifted research attention towards epigenetic perspectives. Methods: This study investigated the DNA methylation patterns of the promoter regions of candidate genes such asNR3C1, ASCL1, and FOXO3 in blood samples from ASD probands and their unaffected siblings. The analysis included 54 families (ASD proband group: 54; unaffected biological sibling group: 63). The diagnostic process involved screening the probands and their siblings for ASD based on the Diagnostic and Statistical Manual of Mental Disorders 5th edition.Intelligence, social ability, and medical history were thoroughly assessed using various scales and questionnaires.Genomic DNA from blood samples was analyzed using a methylation-sensitive quantitative polymerase chain reaction to examine the DNA methylation status of candidate genes. Results: Methylation levels in candidate gene promoter regions differed significantly between the proband and sibling groups for all candidate genes. Correlation analysis between the proband and sibling groups revealed strong and significant correlations in NR3C1 and ASCL1 methylation. Additionally, in the analysis of the relationship between DNA and ASD phenotypes, FOXO3 methylation correlated with social quotient in probands, and ASCL1 methylation was associated with nonverbal communication, and daily living skills as measured by the Korean Vineland Adaptive Behavior Scale. Notably, ASCL1 methylation was significantly associated with parental age at pregnancy. Conclusion This study proposes DNA methylation of NR3C1, ASCL1, and FOXO3 in peripheral blood samples is a potential epigenetic biomarker of ASD.

Objective: Previous research on autism spectrum disorder (ASD) in Koreans has primarily focused on genetic diversity because of its high heritability. However, the emerging recognition of transgenerational epigenetic changes has recently shifted research attention towards epigenetic perspectives. Methods: This study investigated the DNA methylation patterns of the promoter regions of candidate genes such asNR3C1, ASCL1, and FOXO3 in blood samples from ASD probands and their unaffected siblings. The analysis included 54 families (ASD proband group: 54; unaffected biological sibling group: 63). The diagnostic process involved screening the probands and their siblings for ASD based on the Diagnostic and Statistical Manual of Mental Disorders 5th edition.Intelligence, social ability, and medical history were thoroughly assessed using various scales and questionnaires.Genomic DNA from blood samples was analyzed using a methylation-sensitive quantitative polymerase chain reaction to examine the DNA methylation status of candidate genes. Results: Methylation levels in candidate gene promoter regions differed significantly between the proband and sibling groups for all candidate genes. Correlation analysis between the proband and sibling groups revealed strong and significant correlations in NR3C1 and ASCL1 methylation. Additionally, in the analysis of the relationship between DNA and ASD phenotypes, FOXO3 methylation correlated with social quotient in probands, and ASCL1 methylation was associated with nonverbal communication, and daily living skills as measured by the Korean Vineland Adaptive Behavior Scale. Notably, ASCL1 methylation was significantly associated with parental age at pregnancy. Conclusion This study proposes DNA methylation of NR3C1, ASCL1, and FOXO3 in peripheral blood samples is a potential epigenetic biomarker of ASD.

Post-tonsillectomy hemorrhage (PTH) is the most frequent complication of tonsillectomy, and occasionally results in a lethal outcome. A 21-year-old man (height 180 cm, weight 95 kg) was scheduled for a bilateral tonsillectomy and uvulopalatopharyngoplasty for treatment of obstructive sleep apnea. He required 5 rounds of general anesthesia due to recurrent PTH. The anesthesiologist used sugammadex a total of 3 times to achieve the successful reversal of the deep neuromuscular blockade (NMB) induced by rocuronium. After sugammadex 2 mg/kg was administered, the NMB was reversed in 2 minutes each time. Re-administration of rocuronium within a short time interval after sugammadex may result in unpredictable effects of neuromuscular blocking agents. Sugammadex made it possible to perform a rapid, complete reverse when the residual block was maintained by an incomplete reversal of anticholinesterase.
Anesthesia, General ; Hemorrhage* ; Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Postoperative Hemorrhage ; Sleep Apnea, Obstructive ; Tonsillectomy ; Young Adult

Objective: This cross-cultural study aims to examine the psychometric properties of the Social Responsiveness Scale (SRS) and to determine the best-estimate-cut-off scores for the diagnosis of autism spectrum disorder (ASD) in Korean preschool children. Methods: A total of 563 children was recruited from multiple sources, including Seoul National University Bundang Hospital. Participants were assessed by a multidisciplinary research team using multiple diagnostic tools based on DSM-5 diagnostic criteria. Discriminative validity was tested by comparing the difference in SRS scores between ASD and non-ASD groups. Convergent validity was tested by examining correlations between SRS scores with other diagnostic instruments. A receiver operation characteristic curve analysis was conducted to test the sensitivity and specificity of SRS and to determine the best-estimate-cut-off scores for screening ASD in Korean preschool children. Results: There were significant differences in the total SRS scores between the ASD (n=242) and non-ASD group (n=321) (p<0.01, 95% confidence interval [CI]: 14.08–17.24). The differences were significant even after adjusting for age. SRS scores were significantly correlated with other prescreening diagnostic tools for ASD. The best-estimate cut-off score to screen ASD was 55 (area under curve=0.88, sensitivity 78.1%, specificity 86.6%). Conclusion The SRS is a valid and reliable instrument to screen and aid in the diagnosis of ASD in Korean preschool children. The adjusted cut-off scores, notably lower than in the original U.S. version, may yield a more accurate diagnosis by reflecting transcultural differences.