OBJECTIVE: In Korea, online board games, such as “flower cards,” are played using virtual money. In contrast, Internet-based gambling (ibGambling) concerns the use of real money to gamble online. We hypothesized that online board gamers using virtual money show less risky behaviors than do gamblers who use real money, and that, in regard to psychological aspects, online board gamers are less depressed and more introverted than online gamblers are. METHODS: For this study, 100 online board gamers, 100 ibGamblers, 100 offline gamblers (offGamblers), and 100 age- and sex-matched healthy controls were recruited by an online research company. Gambling behavior and self-efficacy were assessed using the Korean Gambling Behavior Scale-high/low factors (KGBS-H/L) and the Gambling Abstinence Self-efficacy Scale (GASS). Additionally, introversion, depression, and mania tendency were assessed. RESULTS: Online board gamers had good intentions gaming, as evidenced by their higher KGBS-L scores than ibGamblers and offGamblers, and they showed less risky behaviors, as evidenced by their lower KGBS-H scores than offGamblers. Additionally, online board gamers were less introverted than ibGamblers and less depressed than offGamblers. CONCLUSION: Online board gaming could be a gateway to the world of gambling (ibGambling or OffGambling). However, the higher tendency of online board gamers to engage in good intentioned gaming could help prevent online board gaming from progressing to online or offline gambling.
Bipolar Disorder ; Depression ; Gambling ; Intention ; Introversion (Psychology) ; Korea

OBJECTIVE: To assess the current practice patterns of radiologists who perform transthoracic needle biopsy (TNB). MATERIALS AND METHODS: An email survey of 71 questions on TNB was sent to 240 members of the Korean Society of Thoracic Radiology. The answers to multiple-choice questions (n = 56) were analyzed. RESULTS: Of 60 respondents, 45% had 10 or more years of experience in chest radiology, and 70% had 5 or more years of experience in TNB. For the question on the most frequently used diagnostic method for lesions with high probability of being resectable-stage lung cancer, 70% of respondents answered that TNB is initially used, with or without bronchoscopy. In patients at high-risk of TNB-related complications, the proportion of the respondents who consistently declined TNB was only 5%. The number of rebiopsies was said to be increased; molecular analysis for an established target therapy (43.6%) and clinical trial of a new drug (28.2%) were the two most common reasons for it. The most popular needle type was the coaxial cutting needle (55%), and the popular guiding modality was conventional computed tomography (CT) (56.7%). In addition, 15% of respondents have encountered air embolism. CONCLUSION: Despite high variation in how TNB is being performed in Korea, some patterns were noted. It is common for patients with resectable-stage lung cancer to undergo TNB prior to surgery. Rebiopsy is now more common than before, with personalized medicine as the most important reason for it. The most popular type of needle is the coaxial system; the most popular modality for guidance is still CT.
Biopsy, Needle* ; Bronchoscopy ; Electronic Mail ; Embolism, Air ; Humans ; Korea ; Lung Neoplasms ; Methods ; Needles* ; Precision Medicine ; Surveys and Questionnaires ; Thorax

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic disease and a potentially life‐threatening systemic necrotizing vasculitis predominantly affecting small vessels. Herein, we describe a 47-year-old man with EGPA misdiagnosed as non-ST-segment elevation myocardial infarction. He presented to the Emergency Department with indigestion and diarrhea. He had been diagnosed with asthma and chronic rhinosinusitis 3 years earlier and was taking antibiotics due to worsening sinusitis. In laboratory tests, peripheral blood eosinophils, serum creatinine, and serum troponin were elevated to 4,641 cells/μL, 13.40 ng/mL, and 1.26 ng/ mL, respectively. Electrocardiography showed ST-segment depression on the inferior wall, and echocardiography indicated an ischemic insult in the right coronary artery territory. A non-ST-segment elevation myocardial infarction as well as antibiotic-associated diarrhea, eosinophilia and acute kidney injury was initially suspected. However, fever persisted and eosinophilia worsened despite cessation of antibiotics after admission. There was no significant stenosis of the coronary arteries on coronary angiography. Meanwhile, abdominal computed tomography suggested medical renal disease, and magnetic resonance imaging showed late gadolinium enhancement at the mid wall and the subepicardial area in the left ventricle of the heart. As a workup for eosinophilia, serum anti-MPO was measured and turned out to be positive. A kidney biopsy was performed, which yielded membranous nephropathy superimposed on antineutrophil cytoplasmic antibodies-mediated crescent formation. He was diagnosed as EGPA with cardiac and renal involvement, and received systemic steroid, cyclophosphamide, and plasmapheresis. Then, peripheral eosinophil counts and renal function were normalized. He is now in clinical remission even after stopping the use of steroids and immunosuppressive agents.

BACKGROUND/AIMS: Several studies have reported on the clinical aspects of adverse drug reactions (ADRs). To date, no study has evaluated serious adverse drug reactions (SADRs) in Korea. The current study evaluates the clinical expression of SADRs in a Korean hospital. METHODS: We reviewed a total of 3,386 cases of SADR occurring between March 2012 and November 2015 in a single tertiary care institution (Regional Pharmacovigilance Center). RESULTS: When classified by organ system, the most common SADRs were white cell and reticuloendothelial system disorders (n = 511). Skin/appendage (n = 296) and gastrointestinal (n = 216) disorders were the fourth- and eighth-most common SADRs, respectively. The three most common single symptoms were leukopenia (n = 499 events), hypotension (n = 444) and anaphylaxis (n = 215). Leukopenia was mainly caused by anti-tumor drugs, followed by piperacilin/tazobactam (n = 28), vancomycin (n = 10) and methimazole (n = 6). Hypotension was most often caused by propacetamol injection (n = 145), while anaphylaxis was mainly caused by cefaclor (n = 19), ranitidine (n = 12), iopamidol (n = 10) and multi-vitamin infusion (n = 9). CONCLUSIONS: Significant differences were noted in the clinical aspects of ADRs and SADRs. Additional studies are warranted to further assess SADRs in response to frequently used causative drugs.
Anaphylaxis ; Cefaclor ; Drug Hypersensitivity ; Drug-Related Side Effects and Adverse Reactions* ; Hypotension ; Iopamidol ; Korea* ; Leukopenia ; Methimazole ; Mononuclear Phagocyte System ; Pharmacovigilance ; Ranitidine ; Tertiary Healthcare* ; Vancomycin

Simultaneous myofibril and mitochondrial development is crucial for the cardiac differentiation of pluripotent stem cells (PSCs). Specifically, mitochondrial energy metabolism (MEM) development in cardiomyocytes is essential for the beating function. Although previous studies have reported that MEM is correlated with cardiac differentiation, the process and timing of MEM regulation for cardiac differentiation remain poorly understood. Here, we performed transcriptome analysis of cells at specific stages of cardiac differentiation from mouse embryonic stem cells (mESCs) and human induced PSCs (hiPSCs). We selected MEM genes strongly upregulated at cardiac lineage commitment and in a time-dependent manner during cardiac maturation and identified the protein-protein interaction networks. Notably, MEM proteins were found to interact closely with cardiac maturation-related proteins rather than with cardiac lineage commitment-related proteins. Furthermore, MEM proteins were found to primarily interact with cardiac muscle contractile proteins rather than with cardiac transcription factors. We identified several candidate MEM regulatory genes involved in cardiac lineage commitment (Cck, Bdnf, Fabp4, Cebpα, and Cdkn2a in mESC-derived cells, and CCK and NOS3 in hiPSC-derived cells) and cardiac maturation (Ppargc1α, Pgam2, Cox6a2, and Fabp3 in mESC-derived cells, and PGAM2 and SLC25A4 in hiPSC-derived cells). Therefore, our findings show the importance of MEM in cardiac maturation.

Two Domestic Korean Shorthair cats presented with dyschezia and vomiting. Computed tomography revealed a colonic mass with calcification and lymph node metastasis in case 1, and a small intestinal mass with disseminated mesenteric metastasis and calcification in case 2. Histopathology revealed intestinal adenocarcinoma with osseous metaplasia. Case 1 died two months after surgery from distant metastasis; and case 2 showed no metastasis for five months but presented with anorexia, euthanized seven months after diagnosis. Metastatic intestinal adenocarcinoma with bone formation should be considered as differential diagnosis for calcification on imaging, and lymph node metastasis at diagnosis may indicate poor prognosis.

Our objective was to investigate whether inflammatory microenvironment induced by Trichomonas vaginalis infection can stimulate proliferation of prostate cancer (PCa) cells in vitro and in vivo mouse experiments. The production of CXCL1 and CCL2 increased when cells of the mouse PCa cells (TRAMP-C2 cell line) were infected with live T. vaginalis. T. vaginalis-conditioned medium (TCM) prepared from co-culture of PCa cells and T. vaginalis increased PCa cells migration, proliferation and invasion. The cytokine receptors (CXCR2, CCR2, gp130) were expressed higher on the PCa cells treated with TCM. Pretreatment of PCa cells with antibodies to these cytokine receptors significantly reduced the proliferation, mobility and invasiveness of PCa cells, indicating that TCM has its effect through cytokine-cytokine receptor signaling. In C57BL/6 mice, the prostates injected with T. vaginalis mixed PCa cells were larger than those injected with PCa cells alone after 4 weeks. Expression of epithelial-mesenchymal transition markers and cyclin D1 in the prostate tissue injected with T. vaginalis mixed PCa cells increased than those of PCa cells alone. Collectively, it was suggested that inflammatory reactions by T. vaginalis-stimulated PCa cells increase the proliferation and invasion of PCa cells through cytokine-cytokine receptor signaling pathways.

Ginsenosides from Panax ginseng are well known for their diverse pharmacological effects including antithrombotic activity. Since adventitious roots of mountain ginseng (ARMG) also contain various ginsenosides, blood flow-improving effects of the dried powder and extract of ARMG were investigated. Rats were orally administered with dried powder (PARMG) or ethanol extract (EARMG) of ARMG (125, 250 or 500 mg/kg) or aspirin (30 mg/kg, a reference control) for 3 weeks. Forty min after the final administration, carotid arterial thrombosis was induced by applying a 70% FeCl₃-soaked filter paper outside the arterial wall for 5 min, and the blood flow was monitored with a laser Doppler probe. Both PARMG and EARMG delayed the FeCl₃-induced arterial occlusion in a dose-dependent manner, doubling the occlusion time at high doses. In mechanism studies, a high concentration of EARMG inhibited platelet aggregation induced by collagen in vitro. In addition, EARMG improved the blood lipid profiles, decreasing triglyceride and cholesterol levels. Although additional action mechanisms remain to be clarified, it is suggested that ARMG containing high amount of ginsenosides such as Rg₃ improves blood flow not only by inhibiting oxidative thrombosis, but also by modifying blood lipid profiles.
Animals ; Aspirin ; Cholesterol ; Collagen ; Ethanol ; Ginsenosides ; In Vitro Techniques ; Panax* ; Platelet Aggregation ; Rats ; Thrombosis ; Triglycerides

In this article, So-Young Park is inadvertently omitted from the listed author names. In the Acknowledgement section, funding source is incorrectly cited and has been changed upon request of authors.

BACKGROUND: While various screening tools are available for depression, they are not feasible in clinical practice because of their excessive number of questions. The Patient Health Questionnaire-2 (PHQ-2) consists of two questions gauging the frequency of depressed mood and anhedonia over the past two weeks. This study aimed to assess the usefulness of the PHQ-2 as a brief screening tool for depression.METHODS: This study used Korean National Health and Nutrition Examination Survey data from 2014, and the study population consisted of 4,946 individuals. We analyzed the validity of the PHQ-2 compared with ‘depression by PHQ-9,’ and obtained the optimal cut point for screening depression. The agreement between PHQ-2 and depression by PHQ-9 and the agreement between PHQ-2 and ‘currently diagnosed as depression’ were analyzed using Cohen's kappa. The correlation between EuroQol-5D (EQ-5D) index scores and PHQ-2 scores was analyzed using Student's t-test.RESULTS: Using ‘depression by PHQ-9’ as the criterion standard, PHQ-2 scores ≥2 had a sensitivity of 89% and a specificity of 87%, and a receiver operating characteristic analysis identified PHQ-2≥2 as the optimal cut point for screening. The agreement between PHQ-2 and depression by PHQ-9 was 0.430 when PHQ-2 ≥2 was used as a cut point. The agreement between PHQ-2 and ‘depression by questionnaire’ was poor. The EQ-5D index score of the depressive group was significantly lower than that of the normal group.CONCLUSION: The PHQ-2 is an effective measure for screening depression and is expected to be useful in busy clinical settings.
Anhedonia ; Depression ; Humans ; Mass Screening ; Nutrition Surveys ; ROC Curve ; Sensitivity and Specificity ; Surveys and Questionnaires