Although chronic obstructive pulmonary disease (COPD) is regarded as a chronic inflammatory lung disease, the disease mechanism is still not known. Intriguingly, aging lungs are quite similar to COPD-affected lungs in many ways, and COPD has been viewed as a disease of accelerated premature aging of the lungs. In this paper, based on a literature review, we would like to propose immunosenescence, age-associated decline in immunity, as a critical mechanism for the development of COPD. Immunosenescence can cause a low-grade, systemic inflammation described as inflammaging. This inflammaging may be directly involved in the COPD pathogenesis. The potential contributors to the development of inflammaging in the lungs possibly leading to COPD are discussed in the review paper. A notable fact about COPD is that only 15% to 20% of smokers develop clinically significant COPD. Given that there is a substantial inter-individual variation in inflammaging susceptibility, which is genetically determined and significantly affected by the history of the individual's exposure to pathogens, immunosenescence and inflammaging may also provide the answer for this unexpectedly low susceptibility of smokers to clinically significant COPD.
Aging ; Aging, Premature ; Immunosenescence ; Inflammation ; Lung ; Lung Diseases ; Pulmonary Disease, Chronic Obstructive

BACKGROUND: Decreased physical performance, such as weakened handgrip strength and cognitive decline, is associated with disability and premature death in old age. We investigated the association between handgrip strength and cognitive impairment in Korean elderly adults with normal cognitive function. METHODS: This prospective study used the database from the Korean Longitudinal Study of Ageing. The participants included 2,378 adults aged 65 years or older with normal cognitive function (Korean Mini-Mental Status Evaluation [K-MMSE] score ≥21). Using a mixed-effects model, we examined the associations at baseline and over an 8-year follow-up period between handgrip strength and K-MMSE score. We investigated handgrip strength as a predictor of change in cognitive function. RESULTS: This study included 1,138 women (mean maximum handgrip strength 19.2 kg, mean K-MMSE score 25.1) and 1,240 men (mean maximum handgrip strength 30.7 kg, mean MMSE score 26.2). The baseline handgrip strength was positively associated with the baseline K-MMSE score (β=0.18, P < 0.001). Using a mixed-effects model, we found that higher handgrip strength at baseline can predict MMSE scores positively over time (β=0.14, P < 0.001) and the change of handgrip strength over time was a predictor of high MMSE scores over the study period (β=0.01, P < 0.01). CONCLUSION: We observed significant associations between baseline handgrip strength and baseline and change of cognition, as well as the longitudinal influence of handgrip strength on the change of cognitive function in elderly Korean adults with normal cognitive function.
Adult ; Aged* ; Aging ; Cognition Disorders ; Cognition* ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Longitudinal Studies* ; Male ; Mortality, Premature ; Prospective Studies*

BACKGROUND: As the aging society progresses, the average age of mothers is also increasing. Advanced maternal age has been known to be associated with perinatal outcomes, as well as birth weight (BW). In this study, we aimed to investigate the perinatal factors associated with low birth weight infants (LBWIs) using birth statistics of the Korean population. METHODS: Birth statistics between 1993 and 2016 from the Korean Statistical Information Service were reviewed. We investigated 12,856,614 data points, which included the number of births, BWs, percentage of preterm births and LBWIs, multiple pregnancies, and maternal age. RESULTS: The proportion of LBWIs delivered by mothers of advanced maternal age has gradually increased since 1993. In addition, the proportion of older mothers (≥ 35 years old) giving birth to LBWIs has increased over the years. Average BW has a negative correlation with the ratio of preterm births, LBW, multiple births, and advanced maternal age. The mean BW also has a negative correlation with maternal age. CONCLUSION: This study shows that the average BW continues to decline, and the incidence of LBWIs is increasing in Korea since 1993. This study also revealed that several perinatal factors, including percentage of preterm births, LBWIs, multiple births, and maternal age influence the mean BW. Although this study did not investigate the effects of decreasing mean BW on perinatal health, future research is worth discussing.
Aging ; Birth Weight* ; Female ; Humans ; Incidence* ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Information Services ; Korea* ; Maternal Age* ; Mothers ; Multiple Birth Offspring ; Parturition* ; Pregnancy ; Pregnancy, Multiple ; Premature Birth

A better understanding of the underlying mechanisms by which signals from the fetus initiate human parturition is required. Our recent findings support the core hypothesis that oxidative stress (OS) and cellular senescence of the fetal membranes (amnion and chorion) trigger human parturition. Fetal membrane cell senescence at term is a natural physiological response to OS that occurs as a result of increased metabolic demands by the maturing fetus. Fetal membrane senescence is affected by the activation of the p38 mitogen activated kinase-mediated pathway. Similarly, various risk factors of preterm labor and premature rupture of the membranes also cause OS-induced senescence. Data suggest that fetal cell senescence causes inflammatory senescence-associated secretory phenotype (SASP) release. Besides SASP, high mobility group box 1 and cell-free fetal telomere fragments translocate from the nucleus to the cytosol in senescent cells, where they represent damage-associated molecular pattern markers (DAMPs). In fetal membranes, both SASPs and DAMPs augment fetal cell senescence and an associated ‘sterile’ inflammatory reaction. In senescent cells, DAMPs are encapsulated in extracellular vesicles, specifically exosomes, which are 30–150 nm particles, and propagated to distant sites. Exosomes traffic from the fetus to the maternal side and cause labor-associated inflammatory changes in maternal uterine tissues. Thus, fetal membrane senescence and the inflammation generated from this process functions as a paracrine signaling system during parturition. A better understanding of the premature activation of these signals can provide insights into the mechanisms by which fetal signals initiate preterm parturition.
Aging ; Cell Aging ; Cytosol ; Exosomes ; Extracellular Vesicles ; Extraembryonic Membranes ; Female ; Fetus ; Humans ; Inflammation ; Membranes ; Obstetric Labor, Premature ; Oxidative Stress ; Paracrine Communication ; Parturition ; Phenotype ; Pregnancy ; Premature Birth ; Risk Factors ; Rupture ; Telomere

BACKGROUND: Ambient fine particulate matter (PM2.5) is the major environmental health risk factor in Korea. Exposure to PM2.5 has been a growing public concern nationwide. With the rapid aging of the Korean population, the health effects attributable to long-term exposure to PM2.5 were expected to increase further in the future. We aimed to estimate premature deaths attributable to long-term exposure to ambient PM(2.5) in Korea. METHODS: A modelled estimation of long-term exposure to PM2.5 was used to calculate the nationwide exposure level. Hazard ratios of long-term exposure to PM2.5 were obtained from a large prospective cohort study in North America. Modified cause of death (CoD) data, which applied the garbage code reclassification algorithm, were used to calculate premature deaths attributable to long-term exposure to PM2.5. RESULTS: From 1990 to 2013, the average population-weighted PM2.5 concentration in Korea was 30.2 μg/m3. The estimated number of premature deaths was 17,203 (95% confidence interval [CI], 11,056–22,772). The most common CoD was ischemic stroke (5,382; 3,101–7,403), followed by cancer of trachea, bronchus, and lung (4,958; 2,857–6,820), hemorrhagic stroke (3,452; 1,989–4,748), and ischemic heart disease (3,432; 1,383–5,358). CONCLUSION: Premature deaths due to long-term exposure to PM2.5 accounted for 6.4% of all deaths in Korea. However, individual efforts alone cannot prevent the effects of air pollution. This disease burden study can serve as a basis for the establishment of government policies and budgets and can be used to assess the effectiveness of environmental health policies.
Aging ; Air Pollution ; Bronchi ; Budgets ; Cause of Death ; Cohort Studies ; Environmental Health ; Garbage ; Korea ; Lung ; Mortality ; Mortality, Premature* ; Myocardial Ischemia ; North America ; Particulate Matter* ; Prospective Studies ; Republic of Korea* ; Risk Factors ; Stroke ; Trachea

PURPOSE: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. METHODS: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (≤7 days, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. RESULTS: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. CONCLUSION: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.
Birth Weight ; Blood Cell Count ; Erythrocyte Aging ; Erythrocyte Transfusion ; Erythrocytes* ; Hematologic Tests ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal* ; Medical Records ; Premature Birth ; Retrospective Studies ; Ventilators, Mechanical

The premature ejaculation diagnostic tool (PEDT) is a brief diagnostic measure to assess premature ejaculation (PE). However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE (LPE)/acquired PE (APE) according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores (14.28 ± 3.05) and lower IIEF-15 (41.26 ± 8.20) than men without PE (PEDT: 5.32 ± 3.42, IIEF-15: 52.66 ± 6.86, P < 0.001 for both). It was suggested that a score of ≥9 indicated PE in both LPE and APE by sensitivity and specificity analyses (sensitivity: 0.875, 0.913; specificity: 0.865, 0.865, respectively). In addition, IIEF-15 were higher in men with LPE (42.64 ± 8.11) than APE (39.43 ± 7.84, P < 0.001). After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE (adjust r = -0.225, P < 0.001) and APE (adjust r = -0.378, P < 0.001). In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.
Adult ; Aging ; Asian People ; Erectile Dysfunction/diagnosis* ; Evidence-Based Medicine ; Female ; Humans ; Male ; Premature Ejaculation/diagnosis* ; Reference Values ; Reproducibility of Results ; Sensitivity and Specificity ; Socioeconomic Factors ; Surveys and Questionnaires ; Young Adult

In almost all human tissues and organs, adult stem cells or tissue stem cells are present in a unique location, the so-called stem cell niche or its equivalent, continuously replenishing functional differentiated cells. Those endogenous stem cells can be expanded for cell therapeutics using ex vivo cell culture or recalled for tissue repair in situ through cell trafficking and homing. In the aging process, inefficiency in the endogenous stem cell-mediated healing mechanism can emerge from a variety of impairments that accumulate in the processes of stem cell self-renewal, function, differentiation capacity, and trafficking through cell autonomous intrinsic pathways (such as epigenetic alterations) or systemic extrinsic pathways. This review examines the homeostasis of endogenous stem cells, particularly bone marrow stem cells, and their dysregulation in disease and aging and discusses possible intervention strategies. Several systemic pro-aging and rejuvenating factors, recognized in heterochronic parabiosis or premature aging progeroid animal models, are reviewed as possible anti-aging pharmaceutical targets from the perspective of a healthy environment for endogenous stem cells. A variety of epigenetic modifications and chromosome architectures are reviewed as an intrinsic cellular pathway for aging and senescence. A gradual increase in inflammatory burden during aging is also reviewed. Finally, the tissue repair and anti-aging effects of Substance-P, a peptide stimulating stem cell trafficking from the bone marrow and modifying the inflammatory response, are discussed as a future anti-aging target.
Adult Stem Cells ; Aging* ; Aging, Premature ; Bone Marrow ; Cell Culture Techniques ; Cell Self Renewal ; Epigenomics ; Hematopoietic Stem Cells ; Homeostasis* ; Humans ; Models, Animal ; Parabiosis ; Rejuvenation ; Stem Cell Niche ; Stem Cells*

Throughout the past several decades in Korea, the field of neonatology has developed enormously along with the advancement of modern neonatal intensive care units, which has resulted in significant improvement of treatment effectiveness for high-risk newborn and premature infants. Since the deaths of newborn infants are closely related to the infant death rate - one of the most important indicators of national health - neonatal intensive care is significant as a major element of the basic infrastructure of the national healthcare system. In Korea, where a noteworthy decrease in birth rates and an aging population has serious consequences for the future, interest at the national level and policy support for neonatal intensive care as well as for the effective continuous and systematic organization of perinatal care is strongly needed. Important topics for future exploration in the field of neonatology in Korea include the establishment of regionalization and organization of an effective perinatal care system, active quality improvement in neonatal care, and the improvement of evidence-based neonatal medicine through active multicenter clinical trials and the development of new research subjects for unresolved problems in the neonatal field. In addition, suggestions for multidisciplinary treatment and interest in family-oriented and developmental care for newborn infants as well as long-term follow-up research after discharge from the neonatal intensive care unit will also be discussed.
Aging ; Birth Rate ; Critical Care ; Delivery of Health Care ; Follow-Up Studies ; Forecasting ; Humans ; Infant Death ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Korea* ; Neonatology* ; Perinatal Care ; Quality Improvement ; Research Subjects ; Treatment Outcome

Although some mutations are beneficial and are the driving force behind evolution, it is important to maintain DNA integrity and stability because it contains genetic information. However, in the oxygen-rich environment we live in, the DNA molecule is under constant threat from endogenous or exogenous insults. DNA damage could trigger the DNA damage response (DDR), which involves DNA repair, the regulation of cell cycle checkpoints, and the induction of programmed cell death or senescence. Dysregulation of these physiological responses to DNA damage causes developmental defects, neurological defects, premature aging, infertility, immune system defects, and tumors in humans. Some human syndromes are characterized by unique neurological phenotypes including microcephaly, mental retardation, ataxia, neurodegeneration, and neuropathy, suggesting a direct link between genomic instability resulting from defective DDR and neuropathology. In this review, rare human genetic disorders related to abnormal DDR and damage repair with neural defects will be discussed.
Aging ; Aging, Premature ; Ataxia ; Cell Cycle Checkpoints ; Cell Death ; Central Nervous System Diseases ; DNA Breaks, Double-Stranded ; DNA Breaks, Single-Stranded ; DNA Damage* ; DNA Repair ; DNA* ; Genomic Instability ; Humans* ; Immune System ; Infertility ; Intellectual Disability ; Microcephaly ; Neuropathology ; Phenotype