Objectives: Changes in the autonomic nervous system have been observed in patients with depressive disorders by measuring their heart rate variability (HRV). However, whether HRV associates with depressive events in healthy people remains unknown. Methods: Four healthy people participated in the present study. Their HRVs were measured routinely for 6 to 13 months. During this time, two participants reported experiencing two and three bouts of depression, respectively. This approach allowed us to examine changes in the participants’ HRVs by comparing their HRVs from before and after the unexpected depressive events. Changes in HRV were compared against those of two participants who did not report any depressive event. Results: Participants’ low frequency/high frequency (LF/HF) ratios of HRV were lower after the event of depression than before. Their LF/HF ratios increased after recovery from the depressive events. In contrast, two participants who did not report any depressive event showed relatively smaller changes in their LF/HF ratios across measurements. Conclusions These results suggest that the LF/HF ratio may provide an objective measure of subjective experiences of depression and help identify potential cases of clinical depression.

Objectives: Changes in the autonomic nervous system have been observed in patients with depressive disorders by measuring their heart rate variability (HRV). However, whether HRV associates with depressive events in healthy people remains unknown. Methods: Four healthy people participated in the present study. Their HRVs were measured routinely for 6 to 13 months. During this time, two participants reported experiencing two and three bouts of depression, respectively. This approach allowed us to examine changes in the participants’ HRVs by comparing their HRVs from before and after the unexpected depressive events. Changes in HRV were compared against those of two participants who did not report any depressive event. Results: Participants’ low frequency/high frequency (LF/HF) ratios of HRV were lower after the event of depression than before. Their LF/HF ratios increased after recovery from the depressive events. In contrast, two participants who did not report any depressive event showed relatively smaller changes in their LF/HF ratios across measurements. Conclusions These results suggest that the LF/HF ratio may provide an objective measure of subjective experiences of depression and help identify potential cases of clinical depression.

BACKGROUND/AIMS: We analyzed chronological changes in hemoglobin according to renal function changes over a 5-year follow-up period. METHODS: We enrolled 5,266 adults with a glomerular filtration rate (GFR) > or = 60 mL/min/1.73 m2 at an initial examination at a routine health check-up; a follow-up examination was conducted 5 years later. We categorized the subjects according to GFR ratio (groups 1, 2, and 3, defined as GFRratio > or = 1.00, 0.75 to 0.99, and < 0.75, respectively). RESULTS: The mean hemoglobin level in subjects with a GFR of 60 to 74 was higher than in those with a GFR of 75 to 89 or > or = 90 mL/min/1.73 m2 at the initial examination (all p < 0.001). Among females and males, the frequencies of increased hemoglobin were 46.8% and 40.6% in the GFRratio group 1, 52.4% and 46.1% in group 2, and 59.6% and 52.5% in group 3 over the 5-year period, respectively (all p < 0.001). With multiple logistic regression, group 3 showed 1.594-fold (95% confidence interval [CI], 1.127 to 2.225) and 1.353-fold (95% CI, 1.000 to 1.830) higher likelihoods of increased hemoglobin over the 5-year follow-up period in females and males, respectively. The estimated difference in hemoglobin level was highest in group 3 in both genders. These findings were more evident in subgroups without metabolic syndrome, diabetes mellitus, hypertension, or GFR less than 90 mL/min/1.73 m2. CONCLUSIONS: Among a population with GFR > or = 60 mL/min/1.73 m2, a mild decrease in GFR over a 5-year follow-up period was associated with an increase in hemoglobin levels.
Adult ; Aged ; Biological Markers/blood ; Chi-Square Distribution ; Disease Progression ; Female ; Follow-Up Studies ; *Glomerular Filtration Rate ; Hemoglobins/*metabolism ; Humans ; Kidney/*physiopathology ; Kidney Diseases/blood/diagnosis/*physiopathology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Republic of Korea ; Time Factors ; Up-Regulation

BACKGROUND: Periodontitis and chronic kidney disease (CKD) are important health issues; however,the association between periodontitis and CKD markers, especially in Korean adults,remains elusive. METHODS: Data on 15,729 Korean adults were obtained from the Korean National Health and Nutritional Examination Surveys IV and V. The CKD markers included a decreased estimated glomerular filtration rate (eGFR;<60 mL/min/1.73m2), proteinuria, and hematuria. Odds ratios (ORs) and 95% confidence intervals were measured using stepwise multivariate logistic regression analyses for CKD markers based on the presence of periodontitis. RESULTS: Patients with periodontitis had greater unadjusted ORs for CKD markers compared to those without periodontitis, as follows: decreased eGFR,4.07(3.11-5.33); proteinuria, 2.12(1.48-3.05); and hematuria, 1.25 (1.13-1.39, all P<0.001). Periodontitis was a significant predictor of decreased eGFR independent of allcovariates [1.39 (1.03-1.89), P=0.034]. However, the effect of periodontitis on decreased eGFR seemed to be affected by hypertension and diabetes mellitus. Periodontitis was not an independent predictor of proteinuria; the significance disappeared after adjusting for hypertension and diabetes mellitus. Periodontitis was significantly correlated with hematuria, leading to similar ORs regardless of the adjustment for covariates[1.29 (1.15-1.46), P<0.001]. CONCLUSION: This study confirms the correlation between periodontitis and CKD markers, including decreased eGFR, proteinuria, and hematuria in Korean adults.
Adult* ; Diabetes Mellitus ; Glomerular Filtration Rate ; Hematuria ; Humans ; Hypertension ; Logistic Models ; Odds Ratio ; Periodontal Diseases ; Periodontitis* ; Proteinuria ; Renal Insufficiency, Chronic*

PURPOSE: This study was to examine the pedagogical validity for a the six-years curriculum in pharmacy education in Korea. METHODS: The focus group, composed of 5 specialists, analyzed the pedagogical validity for a six-years curriculum from the perspective of administrative policies of higher education, educational sociology, curriculum composition, and educational economy. In addition, 3 consultants advised on the main issues related to the reformation of the school system in pharmacy education. RESULTS: It is not clear that the reformation of the school system in pharmacy education is aimed at undergraduate or graduate education in view of specialization of a higher education institute. The reformation of the school system is likely to cause educational inequality since a student who lacks financial support and cultural resources might give up entering pharmacy school. It also may ignite a struggle for power between pharmacists and physicians. The six- years curriculum is supposed to offer integrated experiences with a balance of theory and practice, representing characteristics such as consistency, clarity, reliability, and legitimacy. From the educational economy view, the validity of reformation of the school system can only be secured on the premise the expected income exceeds the total costs if the age-earning profile is constant in the current situation. CONCLUSION: Prior to discussions on the reformation of the school system in pharmacy education, the quality of pharmacy education should be improved first through multifarious efforts such as curriculum development, improvement to teaching and learning, introduction to an accreditation system, revision of the license examination, and graduate and continued pharmacy education and so on.
Accreditation ; Consultants ; Curriculum* ; Education ; Education, Graduate ; Education, Pharmacy* ; Financial Support ; Focus Groups ; Humans ; Illegitimacy ; Korea ; Learning ; Licensure ; Pharmacists ; Pharmacy* ; Schools, Pharmacy ; Socioeconomic Factors ; Sociology ; Specialization

OBJECTIVES: Current treatments for osteoporosis were prevention of progression, yet it has been questionable in the stimulation of bone growth. The mesenchymal stem cells (MSCs) treatment for osteoporosis aims to induce differentiation of bone progenitor cells into bone-forming osteoblasts. We investigate whether human umbilical cord blood (hUCB)-MSCs transplantation may induce bone regeneration for osteoporotic rat model induced by ovariectomy. METHODS: The ovariectomized (OVX) group (n = 10) and OVX-MSCs group (n = 10) underwent bilateral ovariectomy to induce osteoporosis, while the Sham group (n = 10) underwent sham operation at aged 12 weeks. After a femoral defect was made at 9 months, Sham group and OVX group were injected with Hartmann solution, while the OVX-MSCs group was injected with Hartmann solution containing 1 × 107 hUCB-MSCs. The volume of regenerated bone was evaluated using micro-computed tomography at 4 and 8 weeks postoperation. RESULTS: At 4- and 8-week postoperation, the OVX group (5.0% ± 1.5%; 6.1% ± 0.7%) had a significantly lower regenerated bone volume than the Sham group (8.6% ± 1.3%; 12.0% ± 1.8%, P < 0.01), respectively. However, there was no significant difference between the OVX-MSCs and Sham groups. The OVX-MSCs group resulted in about 53% and 65% significantly higher new bone formation than the OVX group (7.7% ± 1.9%; 10.0% ± 2.9%, P < 0.05). CONCLUSIONS: hUCB-MSCs in bone defects may enhance bone regeneration in osteoporotic rat model similar to nonosteoporotic bone regeneration. hUCB-MSCs may be a promising alternative stem cell therapy for osteoporosis.
Animals ; Bone Development ; Bone Regeneration ; Female ; Fetal Blood ; Humans ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Models, Animal ; Osteoblasts ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats ; Stem Cells ; Umbilical Cord

No abstract available.
Aluminum* ; Onychomycosis* ; Yttrium*

The aim of this study is to determine whether the 65 competencies, defined in “the role of Korean doctor, 2014”, are suitable for basic medical education phase in Korea. It seeks to analyze the gap among the educational reality and expectation, assessment situation of the competencies above. We also try to define issues of the development, application and assessment phases of competency-based medical education (CBME) at individual medical schools. We designed survey tools based on the Miller's assessment pyramid (knowledge, explanation, demonstration, and performance) for each of the 65 competencies. The survey distributed to 41 medical schools in April 2015 and 38 replies were received (92.7%). Competencies that matched both the educational reality and expectation were numbers 1 (patient care), 33 (social accountability), and 49 (professionalism). However, all the other competencies ranked lower in current status than that of desirable level. 54 out of 65 competencies (83.07%) remained at the knowledge and explanation level when each competence were assessed. In the development, application, and assessment phases of CBME, common issues that medical schools commonly noted were difficulty linking competencies to curriculum preparation and student assessment, the lack of faculty's understanding, difficulty to reach consensus among faculties, and absence of teaching and learning methods and assessment tools that fits CBME. For the successful settle down of CBME, there is a need for efforts to develop the model of graduate outcomes, to share information and experience, and to operate faculty development program by the medical education communities.
Consensus ; Curriculum ; Education, Medical ; Humans ; Korea ; Learning ; Mental Competency ; Needs Assessment ; Schools, Medical

Academic Medical Centers ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Prostheses and Implants ; Survival Rate ; Titanium

BACKGROUND: Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent. OBJECTIVE: To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment. METHODS: Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated. RESULTS: One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients. CONCLUSION Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.