BACKGROUND AND PURPOSE: There have been a few national population-based epidemiological studies of myasthenia gravis (MG) with wide variation of incidence and prevalence rates worldwide. Herein we report the first nationwide population-based epidemiological study of MG in Korea. METHODS: We attempted to estimate the incidence and prevalence rates of MG using the Korean National Health Insurance claims database for 2010 to 2013. Cases with MG were defined as those having claim records with a principal diagnosis of MG and the prescription of acetylcholinesterase inhibitors or immunosuppressive agents including corticosteroids and azathioprine within 2 years after the diagnosis. The year 2010 was set as a washout period, such that patients were defined as incident cases if their first records of MG were observed in 2011. RESULTS: In 2011 there were 1,236 incident cases, and the standardized incidence rate was 2.44 per 100,000 person-years. The standardized prevalence rates were 9.67 and 10.66 per 100,000 persons in 2010 and 2011, respectively. The incidence and prevalence rates peaked in the elderly population aged 60 to 69 years for both sexes. CONCLUSIONS: This is one of the largest national population-based epidemiological studies of MG, and it has confirmed the high incidence and prevalence rates of MG in the elderly population of South Korea.
Adrenal Cortex Hormones ; Aged ; Azathioprine ; Cholinesterase Inhibitors ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Humans ; Immunosuppressive Agents ; Incidence* ; Korea* ; Myasthenia Gravis* ; National Health Programs* ; Prescriptions ; Prevalence*

OBJECTIVES: An outbreak of food poisoning occurred among the baseball club students at a high school in Ulsan city in 2014. An epidemiological investigation was carried out to examine the infection source and the transmission route of pathogen, and to prevent a recurrence. METHODS: A questionnaire survey was conducted for 26 male students and 2 food handlers. Rectal swabs were examined in 7 students and the 2 food handlers, and an environmental investigation was performed. A retrospective cohort study was used to evaluate the association between risk factors and disease. RESULTS: The attack rate was 35.7% (10 persons/28 persons) from June 9 to 14, and Enterotoxigenic E. coli ST/LT was isolated from 7 among 28 persons. The study revealed that no food was a significant risk factor for the outbreak. There were no connection between environmental factors and the outbreak. CONCLUSIONS: The major risk factors for this outbreak were presumed to be the contaminated ice cube and ice making machines and eating ice cube from the machines. More strict personal and environmental hygiene need to be enforced to prevent such outbreaks.
Baseball* ; Cohort Studies ; Disease Outbreaks ; Eating ; Enterotoxigenic Escherichia coli* ; Food Contamination ; Foodborne Diseases ; Humans ; Hygiene ; Ice ; Male ; Recurrence ; Retrospective Studies ; Risk Factors ; Ulsan ; Surveys and Questionnaires

The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P < 0.001). Beneficiaries of Medical Aid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were more likely to receive inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.
Abortion, Induced/*statistics & numerical data ; Adult ; Cesarean Section/*statistics & numerical data ; Delivery, Obstetric/*statistics & numerical data ; Disabled Persons/*statistics & numerical data ; Female ; Humans ; Mothers/statistics & numerical data ; Pregnancy ; Pregnancy Complications ; Prenatal Care/*statistics & numerical data ; Republic of Korea ; Young Adult

The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P < 0.001). Beneficiaries of Medical Aid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were more likely to receive inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.
Abortion, Induced/*statistics & numerical data ; Adult ; Cesarean Section/*statistics & numerical data ; Delivery, Obstetric/*statistics & numerical data ; Disabled Persons/*statistics & numerical data ; Female ; Humans ; Mothers/statistics & numerical data ; Pregnancy ; Pregnancy Complications ; Prenatal Care/*statistics & numerical data ; Republic of Korea ; Young Adult

BACKGROUND/OBJECTIVE: Myocardial cell death due to occlusion of the coronary arteries leads to myocardial infarction, a subset of coronary heart disease (CHD). Dietary fiber is known to be associated with a reduced risk of CHD, the underlying mechanisms of which were suggested to delay the onset of occlusion by ameliorating risk factors. In this study, we tested a hypothesis that a beneficial role of dietary fiber could arise from protection of myocardial cells against ischemic injury, manifested after occlusion of the arteries. MATERIALS/METHODS: Three days after rats were fed apple pectin (AP) (with 10, 40, 100, and 400 mg/kg/day), myocardial ischemic injury was induced by 30 min-ligation of the left anterior descending coronary artery, followed by 3 hr-reperfusion. The area at risk and infarct area were evaluated using Evans blue dye and 2,3,5-triphenyltetrazolium chloride (TTC) staining, respectively. DNA nicks reflecting the extent of myocardial apoptosis were assessed by TUNEL assay. Levels of cleaved caspase-3, Bcl-2, and Bax were assessed by immunohistochemistry. RESULTS: Supplementation of AP (with 100 and 400 mg/kg/day) resulted in significantly attenuated infarct size (IS) (ratio of infarct area to area at risk) by 21.9 and 22.4%, respectively, in the AP-treated group, compared with that in the control group. This attenuation in IS showed correlation with improvement in biomarkers involved in the apoptotic cascades: reduction of apoptotic cells, inhibition of conversion of procaspase-3 to caspase-3, and increase of Bcl-2/Bax ratio, a determinant of cell fate. CONCLUSIONS: The findings indicate that supplementation of AP results in amelioration of myocardial infarction by inhibition of apoptosis. Thus, the current study suggests that intake of dietary fiber reduces the risk of CHD, not only by blocking steps leading to occlusion, but also by protecting against ischemic injury caused by occlusion of the arteries.
Animals ; Apoptosis* ; Arteries ; Biomarkers ; Caspase 3 ; Cell Death ; Coronary Disease ; Coronary Vessels ; Dietary Fiber* ; DNA Breaks, Single-Stranded ; Evans Blue ; Immunohistochemistry ; In Situ Nick-End Labeling ; Ischemia ; Models, Animal* ; Myocardial Infarction ; Rats ; Risk Factors

BACKGROUND/OBJECTIVE: Myocardial cell death due to occlusion of the coronary arteries leads to myocardial infarction, a subset of coronary heart disease (CHD). Dietary fiber is known to be associated with a reduced risk of CHD, the underlying mechanisms of which were suggested to delay the onset of occlusion by ameliorating risk factors. In this study, we tested a hypothesis that a beneficial role of dietary fiber could arise from protection of myocardial cells against ischemic injury, manifested after occlusion of the arteries. MATERIALS/METHODS: Three days after rats were fed apple pectin (AP) (with 10, 40, 100, and 400 mg/kg/day), myocardial ischemic injury was induced by 30 min-ligation of the left anterior descending coronary artery, followed by 3 hr-reperfusion. The area at risk and infarct area were evaluated using Evans blue dye and 2,3,5-triphenyltetrazolium chloride (TTC) staining, respectively. DNA nicks reflecting the extent of myocardial apoptosis were assessed by TUNEL assay. Levels of cleaved caspase-3, Bcl-2, and Bax were assessed by immunohistochemistry. RESULTS: Supplementation of AP (with 100 and 400 mg/kg/day) resulted in significantly attenuated infarct size (IS) (ratio of infarct area to area at risk) by 21.9 and 22.4%, respectively, in the AP-treated group, compared with that in the control group. This attenuation in IS showed correlation with improvement in biomarkers involved in the apoptotic cascades: reduction of apoptotic cells, inhibition of conversion of procaspase-3 to caspase-3, and increase of Bcl-2/Bax ratio, a determinant of cell fate. CONCLUSIONS: The findings indicate that supplementation of AP results in amelioration of myocardial infarction by inhibition of apoptosis. Thus, the current study suggests that intake of dietary fiber reduces the risk of CHD, not only by blocking steps leading to occlusion, but also by protecting against ischemic injury caused by occlusion of the arteries.
Animals ; Apoptosis* ; Arteries ; Biomarkers ; Caspase 3 ; Cell Death ; Coronary Disease ; Coronary Vessels ; Dietary Fiber* ; DNA Breaks, Single-Stranded ; Evans Blue ; Immunohistochemistry ; In Situ Nick-End Labeling ; Ischemia ; Models, Animal* ; Myocardial Infarction ; Rats ; Risk Factors

BACKGROUND/OBJECTIVES: Vascular dementia (VaD) caused by reduced blood supply to the brain manifests as white matter lesions accompanying demyelination and glial activation. We previously showed that arabinoxylan consisting of arabinose and xylose, and arabinose itself attenuated white matter injury in a rat model of VaD. Here, we investigated whether larch arabinogalactan (LAG) consisting of arabinose and galactose could also reduce white matter injury. MATERIALS/METHODS: We used a rat model of bilateral common carotid artery occlusion (BCCAO), in which the bilateral common carotid arteries were exposed and ligated permanently with silk sutures. The rats were fed a modified AIN-93G diet supplemented with LAG (100 mg/kg/day) for 5 days before and 4 weeks after being subjected to BCCAO. Four weeks after BCCAO, the pupillary light reflex (PLR) was measured to assess functional consequences of injury in the corpus callosum (cc). Additionally, Luxol fast blue staining and immunohistochemical staining were conducted to assess white matter injury, and astrocytic and microglial activation, respectively. RESULTS: We showed that white matter injury in the the cc and optic tract (opt) was attenuated in rats fed diet supplemented with LAG. Functional consequences of injury reduction in the opt manifested as improved PLR. Overall, these findings indicate that LAG intake protects against white matter injury through inhibition of glial activation. CONCLUSIONS: The results of this study support our hypothesis that cell wall polysaccharides consisting of arabinose are effective at protecting white matter injury, regardless of their origin. Moreover, LAG has the potential for development as a functional food to prevent vascular dementia.
Animals ; Anoxia ; Arabinose ; Brain* ; Carotid Arteries ; Carotid Artery, Common ; Cell Wall ; Corpus Callosum ; Dementia, Vascular* ; Demyelinating Diseases ; Diet ; Functional Food ; Galactose ; Larix* ; Models, Animal* ; Optic Tract ; Polysaccharides ; Rats* ; Reflex ; Silk ; Sutures ; White Matter ; Xylose

MHC class II has long been known to play a classical role in antigen presentation and to act as a signal transducer capable of inducing the adaptive immunity needed to produce pathogen specific antibodies. However, it has recently been revealed that MHC class II can also promote the activation of Toll-like receptor mediated signaling by functioning as an adapter. This means that in addition to its classical function of adaptive immunity, MHC class II also plays an intriguing role in the mechanisms that regulate innate immunity. That being the case, queries inevitably arise regarding the fact that many pathogens have tried to control the induction of MHC class II so as to escape the host immune response. Liu et al (Nat Immunol 2011;12:416-424) demonstrated that intracellular MHC class II interacted with Btk, and that this activated Btk promoted TLR signaling via Myd88 and TRIF. The results of this study provide insight regarding the possibility of a novel role for MHC class II, which was heretofore regarded solely as a classical molecule involved in adaptive immune responses, as a regulator of innate immune responses.
Adaptive Immunity ; Antibodies ; Antigen Presentation ; Immunity, Innate ; Toll-Like Receptors ; Transducers ; United Nations

The objectives of this study were to develop optimal analytic methods for detecting urinary 2-thiothiazolidine-4-carboxylic acid (TTCA) and thiocarbamide simultaneously and to evaluate the usefulness of these metabolites to a biological exposure index (BEI) for carbon disulfide (CS2) exposure. For this experiment, synthesized TTCA and thiocarbamide were used. The synthesized TTCA was identified by infrared spectrophotometer, nuclear magnetic resonance spectrometer and thin layer chromatography. The recovery rates of both metabolites were calculated to find the optimum analytical method. The amounts of urinary TTCA and thiocarbamide were measured by using an ultraviolet detector connected to high performance liquid chromatography (HPLC) after the administration of CS2 (350, 700 mg/kg) into Sprague-Dawley rats intraperitoneally. The maximum absorbance wave lengths for TTCA and thiocarbamide were 272 and 236 nm, respectively. Ethyl acetate extraction with NaCl as a salting-out reagent was used as a simultaneous extraction method for these metabolites. HPLC conditions for these metabolites included using a NH2 column, 50 mM KH2PO4: acetonitrile (85:15) and pH 3. Excreted amounts of urinary TTCA and thiocarbamide were increased significantly following CS2 administration. TTCA, which was already adopted as a BEI for CS2 by the American Conference of Governmental Industrial Hygienists (ACGIH), seems to be a more useful BEI for CS2 exposure than thiocarbamide. However further studies are needed to increase analytical efficiency before thiocarbamide can be adopted as a BEI and to apply this analytic method for simultaneous analysis of these metabolites in workers exposed to CS2.
Animal ; Carbon Disulfide/pharmacology* ; Environmental Exposure* ; Rats ; Rats, Sprague-Dawley ; Thiazoles/urine* ; Thiourea/urine* ; Urea/urine*

BACKGROUND: Restoring orbital volume in large blowout fractures is still a technically challenge to the orbital surgeon. In this study, we restored the orbital wall using the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses, and we compared the surgical outcome to that of a conventional transorbital method. METHODS: A retrospective review of all patients with pure unilateral blowout fractures between March 2007 and March 2013 was conducted. 150 patients were classified into two groups according to the surgical method: conventional transorbital method (group A, 75 patients, control group), and the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses (group B, 75 patients, experimental group). Each group was subdivided depending on fracture location: group I (inferior wall), group IM (inferomedial wall), and group M (medial wall). The surgical results were assessed by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. RESULTS: In the volumetric analysis, the OVR decreased more by the experimental groups than each corresponding control groups (P<0.05). Upon ophthalmic examination, neither the differences among the groups in the perioperative Hertel scale nor the preoperative and postoperative Hertel scales were statistically significant (P>0.05). CONCLUSIONS: Our surgical results suggest that orbital volume was more effectively restored by the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses than the conventional method, regardless of the type of fracture.
Enophthalmos ; Humans ; Orbit* ; Orbital Fractures ; Paranasal Sinuses ; Retrospective Studies ; Weights and Measures