DNA profiling with sets of short tandem repeat (STR) markers is the most popular method for identifying human DNA in forensics. Identification by STR typing might fail when DNA is degraded or is present in low amounts, such as in disaster victim identification (DVI) samples. In such cases, more information might be obtained by using additional markers such as single nucleotide polymorphisms (SNPs). Multiplex PCR and microarray are convenient techniques to analyze SNP markers. We used an AccuID(TM) Chip, SNP-based DNA chip manufactured by DNA Link Corporation, to confirm genetic relationship between two human bone samples that had been buried for more than 50 years and blood samples from the alleged descendants of the sources of the bone fragments. The chip combines an Affymetrix resequencing array with a multiplex PCR technology and can genotype hundreds of SNP markers in a single experiment. Genotyping the two bone samples yielded 90.5 and 77 SNP markers. The commonly genotyped markers (61 and 47 SNP loci) in each bone-family pair provided high paternity indices to support the genetic relationships in both cases.
Disasters ; DNA Fingerprinting ; DNA* ; Forensic Anthropology* ; Genotype ; Humans* ; Microsatellite Repeats ; Multiplex Polymerase Chain Reaction ; Oligonucleotide Array Sequence Analysis* ; Paternity ; Polymorphism, Single Nucleotide

Serum is free of cellular components. Because DNA is located in the nuclei or mitochondria of cells, serum could be assumed DNA free. Few previously published case reports to date have used serum for DNA typing. Here, we report on human genotyping via short tandem repeat (STR) analysis using serum as a sample, and discuss problems involved in the process.
DNA Fingerprinting* ; DNA* ; Humans ; Microsatellite Repeats* ; Mitochondria

Recently, studies on mitochondrial DNA (mtDNA) have increased rapidly. Conventional parameters, such as diversity index, pairwise comparison, are used to interpret and validate data on autosomal DNA; however, the use of these parameters to validate data from mitochondrial DNA databases (mtDNA DBs) needs to be verified because of the different transmission patterns of mtDNA. This study was done to verify the use of these conventional parameters and to test the "coverage concept" for a new parameter. The mtDNA DB is not very big; however, it is necessary to check how the change in parameters corresponds to the DB size. For this, we artificially rearranged a Korean DB into several small sub-DBs of variable sizes. The results show that the diversity in nucleotide variations and the different haplotype numbers do not vary as the size of DB increases. However, the "coverage" changed a lot. The coverage increased from 0.113 in a DB of 100 people to 0.260 in a DB of 653 people. Additionally, using the "coverage concept", we predicted how the total number of haplotypes changed with variations in the sub-DB size and compared the predicted result with final result. In conclusion, "coverage", in addition to conventional statistical parameters, can be used to check the usability of an mtDNA DB. Finally, we tried to predict the size of the whole mtDNA number in Korea using "saturation concept".
DNA ; DNA, Mitochondrial* ; Haplotypes ; Korea ; Phylogeny

Objectives: This study was aimed to assess the usefulness of the quantitative assessment of clock drawing test (CDT) combined with the Mini-Mental State Examination (MMSE) compared to that of the Montreal Cognitive Assessment (MoCA) or the MMSE alone for screening of dementia in Parkinson disease (PD) in patients with a low educational level. Methods: A representative sample of 91 PD patients was administered MMSE, MoCA and CDT. The discriminative validity of the MMSE, MoCA, and a MMSE+CDT combination for dementia screening was determined by estimating the sensitivity and specificity of each test and by testing integrated discrimination improvement (IDI). Results: The mean age and educational years were 69.0 (years) and 7.3 in the study population. The best screening cut-off points for the MMSE, MoCA, and MMSE+CDT were 25/26, 21/22 and 41/42. In a group of patients with educational years ≤6,
Dementia

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient’s various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32–0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57– 0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05–1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30–2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34–2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19–2.11); people having diabetes (OR, 1.81; 95% CI, 1.41–2.32);or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28–8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension.Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

In order to determine paternity by genetic testing, the Paternity Index (PI) and probability of paternity are calculated using likelihood ratio method. However, when it is necessary, additional testing can be performed to validate the genetic relationship. This research demonstrates autosomal short tandem repeat (STR) results of Jeju Island population in order to determine genetic relationship. Two notable cases showed that despite the acceptable PI value obtained from STR testing, average of 12 mismatches were found in total of 169 autosomal single nucleotide polymorphism typing. Such cases imply that cautious statistical approach is necessary when determining genetic relationship, especially within an isolated population group. Moreover, this would suggest that a further research and investigation are needed in order to understand the population structure of Korea.
Genetic Testing ; Humans ; Korea ; Microsatellite Repeats ; Oligonucleotide Array Sequence Analysis ; Paternity* ; Polymorphism, Single Nucleotide ; Population Groups

Robotic thyroidectomy has been a good option in the treatment of benign and early stage differentiated thyroid cancers, with several functional benefits. In the last few years, many surgeons have established their own robotic thyroidectomy techniques, and published many reports on the feasibility, safety and benefits of their robotic procedures. Although there are many different surgical techniques, robotic thyroidectomy can be classified according to the different means of remote access to the thyroid gland. Each method has advantages and disadvantages, and surgeons have modified each procedure in an effort to eliminate its shortcomings. With the remarkable innovation of robotic instruments and patient selection based on the appropriate indications, robotic thyroidectomy may usher a paradigm shift for thyroid surgery in the near future.
Patient Selection ; Thyroid Gland ; Thyroidectomy*

Purpose: This study aimed to confirm the mediating effect of social responsibility on the relationship between nurses' stress and burnout from coronavirus disease (COVID-19) in tertiary general hospitals. Methods: For this descriptive cross-sectional study, online survey data from 193 nurses in three tertiary general hospitals were analyzed. Data were collected from March 30 to April 4, 2021. The following statistical analysis were conducted: t-test, ANOVA, Scheffé test, Pearson's correlation coefficient analysis, and Hayes Process Macro Model 4 (to test the mediating effect). Results: COVID-19 stress was positively associated with burnout (r=.28, p<.001) and social responsibility (r=.22, p=.002). Social responsibility was negatively associated with burnout (r=-.31, p<.001). Furthermore, the mediation analysis indicated that social responsibility mediated the relationship between COVID-19 stress and burnout. Conclusion According to the results, the impact of COVID-19 stress on the burnout was mediated by social responsibility. Therefore, to prevent the burnout from COVID-19 of nurses, developing educational programs to enhance social responsibility are recommended.

Background: There have been many studies on the associations between body mass index (BMI) and cognitive function. However, no study has ever compared the associations across the methods of categorizing BMI. In this study, we aimed to fill the gap in the previous studies and examine whether the obesity paradox is valid in the risk of cognitive function. Methods: Of the 10,254 people aged 45 and older from the Korean Longitudinal Study of Ageing from 2006 to 2016, 8,970 people were finalized as the study population. The dependent variable was whether a person has a normal cognitive function or not, and the independent variables of interest were BMI categorized by the World Health Organization Western Pacific Regional Office (WHO-WPRO) method, the WHO method, and a 10-group method. Covariates included sociodemographic factors, health behavior factors, and health status factors. A generalized linear mixed model analysis with a logit link was used. Results: In the adjusted model with all covariates, first, in the case of BMI categories of the WHO-WPRO method, underweight (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.15–1.17), overweight (OR, 1.36; 95% CI, 1.35–1.36), and obese (OR, 1.34; 95% CI, 1.33–1.34) groups were more likely to have a normal cognitive function than a normal-weight group. Next, in the case of BMI categories of the WHO method, compared to a normal-weight group, underweight (OR, 1.15; 95% CI, 1.14–1.16) and overweight (OR, 1.06; 95% CI, 1.06–1.07) groups were more likely to have a normal cognitive function; however, obese (OR, 0.62; 95% CI, 0.61–0.63) group was less likely to have it. Lastly, in the case of the 10-group method, as BMI increased, the likelihood to have a normal cognitive function changed like a wave, reaching a global top at group-7 (26.5 kg/㎡ ≤ BMI <28.0 kg/㎡ ). Conclusion The associations between BMI and cognitive function differed according to how BMI was categorized among people aged 45 and older in Korea, which suggests that cognitive function may be positively associated with BMI in some categories of BMI but negatively in its other categories. Health policies to reduce cognitive impairment need to consider this association between BMI and cognitive function.

Short tandem repeats (STRs) are the most popular markers for human identification in forensics. These markers can be easily analyzed through a multiplex polymerase chain reaction and electrophoresis and provide high discrimination power. However, in STR analysis, several atypical phenomena can be observed such as allelic dropouts, drop-ins, or imbalance, which may be due to DNA polymerase slippage or DNA degradation effects. The observed atypical STR profiles can also provide information for mixed DNA samples or chromosomal abnormalities. In this study, we report a case of mosaicism detected in routine casework of paternity testing. Hair samples from a phenotypically normal male were tested, and the result presented a typical STR profile of a female for the amelogenin gene (XX). Through chromosome analysis using peripheral blood, it was found that 45,X/46,XY mosaicism resulted in the discrepancy between the genotype and the phenotype. In addition, the amount of Y chromosome detected was particularly low in hair compared to that in blood. This study shows that mosaicism can make interpretation difficult during STR analysis and suggests that sample types and repeated analysis should be considered even for routine STR testing.