Glial cell line-derived neurotrophic factor (GDNF) has been reported to be involved in negatively regulating the effects of addictive disorders. The objective of this study was to investigate alterations in the levels of GDNF in patients with Internet gaming disorder (IGD) and to assess the relationship between GDNF levels and the severity of IGD indices. Nineteen male patients with IGD and 19 sexmatched control subjects were evaluated for alteration of plasma GDNF levels and for relationship between GDNF levels and clinical characteristics of Internet gaming, including the Young's Internet Addiction Test (Y-IAT). The GDNF levels were found to be significantly low in patients with IGD (103.2±62.0 pg/mL) compared with the levels of controls (245.2±101.6 pg/mL, p<0.001). GDNF levels were negatively correlated with Y-IAT scores (Spearman's rho=-0.645, p=<0.001) and this negative correlation remained even after controlling for multiple variables (r=-0.370, p=0.048). These findings support the assumed role of GDNF in the regulation of IGD.
Case-Control Studies ; Glial Cell Line-Derived Neurotrophic Factor ; Humans ; Immunoglobulin D ; Internet ; Male ; Neuroglia ; Pilot Projects ; Plasma

OBJECTIVES: Internet gaming disorder (IGD) is associated with attention deficit/hyperactivity disorder (ADHD) or depression etc. We tried to examine the mediating effects of depression in the relationship between ADHD and IGD.METHODS: This study was conducted on 2000 people who participated in on-line survey among 14–39 year-old men and women in 2017. And we clarified the relationship among IGD, ADHD, and depression and tested the mediation model. The mean and standard deviation of the main variables were calculated and correlation analysis was performed to confirm the relationship among the main variables. In order to test the mediating effect of depression on the relationship between ADHD and IGD, the structural equation model was implemented using AMOS 21 (IBM).RESULTS: There were significant correlations among the variables; IGD, ADHD and depression. Depression had a mediating effect 0.23 (95% confidence interval : 0.17–0.28) in the relationship between IGD and ADHD.CONCLUSIONS: This study showed that depression can mediate ADHD and IGD. Therefore, the evaluation and management of depression and ADHD should be included in the diagnosis and treatment of IGD.
Depression ; Diagnosis ; Female ; Humans ; Immunoglobulin D ; Internet ; Male ; Negotiating

BackgroundGlehnia littoralis has been used for traditional Asian medicine, which has diverse therapeutic activities. However, studies regarding neurogenic effects of G. littoralis have not yet been considered. Therefore, in this study, we examined effects of G. littoralis extract on cell proliferation, neuroblast differentiation, and the maturation of newborn neurons in the hippocampus of adult mice.

MethodsA total of 39 male ICR mice (12 weeks old) were randomly assigned to vehicle-treated and 100 and 200 mg/kg G. littoralis extract-treated groups (n = 13 in each group). Vehicle and G. littoralis extract were orally administrated for 28 days. To examine neurogenic effects of G. littoralis extract, we performed immunohistochemistry for 5-bromo-2-deoxyuridine (BrdU, an indicator for cell proliferation) and doublecortin (DCX, an immature neuronal marker) and double immunofluorescence staining for BrdU and neuronal nuclear antigen (NeuN, a mature neuronal marker). In addition, we examined expressional changes of brain-derived neurotrophic factor (BDNF) and its major receptor tropomyosin-related kinase B (TrkB) using Western blotting analysis.

ResultsTreatment with 200 mg/kg, not 100 mg/kg, significantly increased number of BrdU-immunoreactive () and DCX cells (48.0 ± 3.1 and 72.0 ± 3.8 cells/section, respectively) in the subgranular zone (SGZ) of the dentate gyrus (DG) and BrdU/NeuN cells (17.0 ± 1.5 cells/section) in the granule cell layer as well as in the SGZ. In addition, protein levels of BDNF and TrkB (about 232% and 244% of the vehicle-treated group, respectively) were significantly increased in the DG of the mice treated with 200 mg/kg of G. littoralis extract.

ConclusionG. littoralis extract promots cell proliferation, neuroblast differentiation, and neuronal maturation in the hippocampal DG, and neurogenic effects might be closely related to increases of BDNF and TrkB proteins by G. littoralis extract treatment.

Animals ; Apiaceae ; chemistry ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; metabolism ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Dentate Gyrus ; cytology ; drug effects ; Hippocampus ; cytology ; drug effects ; Immunohistochemistry ; Male ; Mice ; Microtubule-Associated Proteins ; metabolism ; Neurogenesis ; drug effects ; Neuropeptides ; metabolism ; Plant Extracts ; pharmacology ; Receptor, trkB ; metabolism

Fanconi syndrome is a dysfunction of the proximal renal tubules that results in impaired reabsorption and increased urinary loss of phosphate and other solutes. The pathophysiology of drug-induced Fanconi syndrome is unclear. Here we report the case of a 36-year-old woman who presented with pain in multiple bones and proteinuria. She had a 7-year history of taking adefovir at 10 mg/day for chronic hepatitis B. Three years previously she had received surgery for a nontraumatic right femur neck fracture, after which she continued to complain of pain in multiple bones, and proteinuria, glycosuria, and phosphaturia were noted. The findings of a light-microscope examination of a renal biopsy sample were normal, but mitochondrial damage of the proximal tubules was evident in electron microscopy. Western blot analysis revealed that the level of serum fibroblast growth factor 23 (FGF23) was lower than in normal controls. After 2 months of treatment, hypophosphatemia and proximal tubular dysfunction were reversed, and serum FGF23 had normalized. This case suggests that direct mitochondrial damage in proximal tubules can cause drug-induced Fanconi syndrome associated with osteomalacia.
Adult ; Biopsy ; Blotting, Western ; Fanconi Syndrome* ; Female ; Femoral Neck Fractures ; Fibroblast Growth Factors ; Glycosuria ; Hepatitis B, Chronic ; Humans ; Hypophosphatemia ; Hypophosphatemia, Familial ; Kidney Tubules, Proximal ; Microscopy, Electron ; Mitochondria ; Osteomalacia* ; Proteinuria

OBJECTIVES: Internet gaming disorder (IGD) is known to be related to stress and the serotonin-transporter-linked polymorphic region (5-HTTLPR) that is known to be associated with stress and has been studied to affect various psychiatric illness outbreaks. We tried to examine the relationship between stress, 5-HTTLPR and IGD. METHODS: A total of 59 participants with IGD, diagnosed according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and 67 normal controls (NC) were enrolled. The IGD group and the NC were compared using chisquare test and independent sample t-test, and logistic regression analysis was used to examine the relationship between stress, the 5-HTTLPR, and IGD. RESULTS: The mean scores for anxiety, impulsivity and stress were significantly higher in the IGD group than in the NC. In addition, there was a significant association between stress and IGD [odds ratio (OR) = 1.172, 95% confidence interval (CI) = 1.008–1.362]. CONCLUSIONS: This study showed that stress would affect IGD. Therefore, the evaluation and management of stress should be included in the diagnosis and treatment of IGD.
Adult* ; Anxiety ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Disease Outbreaks ; Humans ; Immunoglobulin D ; Impulsive Behavior ; Internet* ; Logistic Models

An epidemiological study was performed to know the recent infection status of Paragonimus westermani metacercariae (PwMc) in freshwater crayfish, Cambaroides similis, from 2 streams in Jeollanam-do, Republic of Korea. Crayfish were collected from creeks in Bogil-do (Island), Wando-gun, and in a creek near Daeheung Temple in Haenam-gun. The infection rate of crayfish with PwMc in Bogil-do was 89.8%, and the metacercarial burden was 37 PwMc per the infected crayfish. Crayfish in a creek near Daeheung Temple were larger and twice heavier than those in Bogil-do. Of them, 96.5% were infected with PwMc. An average of 140 metacercariae was found in the infected crayfish, almost quadruple to those of Bogil-do. There was a strong correlation between the number of PwMc and body weight of the crayfish. These results suggest that P. westermani metacercariae are still prevalent in crayfish of the 2 regions in Jeollanam-do, Korea.
Astacoidea* ; Body Weight ; Epidemiologic Studies ; Fresh Water* ; Incidence* ; Jeollanam-do* ; Korea* ; Metacercariae* ; Paragonimus westermani* ; Paragonimus* ; Republic of Korea ; Rivers

BACKGROUND: Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution. METHODS: The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA. RESULTS: Of the 111 neonates with a diagnosis of PDA, 26 (23%) underwent PDA ligation. PDAs were ligated within 28 days of birth (mean, 14.5±7.8 days), and the mean gestational age of these patients was 30.3±4.6 weeks (range, 26 to 40 weeks) with a mean birth weight of 1,292.5±703.5 g (range, 480 to 3,020 g). No residual shunts through the PDA were found on postoperative echocardiography. There was 1 case of 30-day mortality (3.8%) due to pneumonia, and 6 cases of in-hospital mortality (23.1%) after 30 days, which is comparable to results from other centers with congenital cardiac surgery programs. CONCLUSION: Although our outcomes may not be generalizable to all hospital settings without a congenital cardiac surgery program, in select centers, PDA ligations can be performed safely by adult cardiac surgeons if no congenital cardiac surgery program is available.
Adult* ; Birth Weight ; Cardiac Surgical Procedures ; Diagnosis ; Ductus Arteriosus, Patent* ; Echocardiography ; Electronic Health Records ; Gestational Age ; Heart Defects, Congenital ; Heart Diseases ; Hospital Mortality ; Humans ; Infant, Newborn ; Korea ; Ligation* ; Mortality ; Parturition ; Pneumonia ; Seoul ; Surgeons* ; Thoracic Surgery

PURPOSE: To investigate and document a disaster medical response during the collapse of the Gyeongju Mauna Ocean Resort gymnasium, which occurred on February 17, 2014. METHODS: The official records of each institution were verified to select the study population. All the medical records and emergency medical service records were reviewed by an emergency physician. Personal or telephonic interviews were conducted without a separate questionnaire if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. RESULTS: One hundred fifty-five accident victims, who were treated at 12 hospitals mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of the collapse was disseminated in 4 minutes, it took at lease 69 minutes for a dispatch of 4 disaster medical assistance teams to take action; 4.5% of patients were treated on-site, 56.7% were transferred to 2 nearest hospitals, and 42.6% were transferred to hospitals with poor preparation to handle disaster victims. CONCLUSION: In the collapse of the Gyeongju Mauna Ocean Resort gymnasium, the initial triage and distribution of patients were inefficient, with delayed arrival of medical assistance teams. These problems had also been noted in prior mass casualty incidents. Government agencies are implementing improvements, and this study could aid the implementation process.
Disaster Victims ; Disasters* ; Emergencies ; Emergency Medical Services ; Government Agencies ; Gyeongsangbuk-do ; Health Resorts* ; Humans ; Mass Casualty Incidents ; Medical Assistance ; Medical Records ; Social Networking ; Triage ; Wounds and Injuries

OBJECTIVES: This study was conducted to examine the mediating effect of depression on the relationship between behavior inhibition system (BIS) and smart-phone addiction (SA) in Korea. METHODS: An online survey was conducted including 5003 adult participants. Except for people without a smartphone, participants consisted of 2573 men and 2281 women, including a 20s group, 1611, 30s group, 2133, and 40s group, 1110. For evaluation of psychiatric symptoms and personal characteristics, participants were asked to complete self-reports, including BIS scale, depression scale of SCL-90-R (Dep), and SA scale. RESULTS: The BIS predicted both variance of depression and SA (BIS→Dep : β=0.374, p<0.001 ; BIS→SA : β=0.268, p<0.001), and depression predicted SA (β=0.386, p<0.001). The result of hierarchial regression analysis showed that depression mediated the relationship between behavior inhibition system and SA. Thus the effects between behavior inhibition system and smartphone decreased (β=0.268→0.144). CONCLUSION: Depression mediates the influence of behavior inhibition system on SA. This result indicates that biological traits and negative emotions, such as depression, have an important influence on behavioral addiction.
Adult ; Depression* ; Female ; Humans ; Korea ; Male ; Negotiating* ; Smartphone

A growing body of evidence supports that Internet gaming disorder (IGD) is considered as ‘behavioral addiction’ with neurobiological alterations. We have reviewed previous research into the clinical and neurobiological features of IGD, and suggest a flowchart for the comprehensive evaluation of IGD. Several self-rating screening tests based on Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) IGD criteria were developed. IGD is often comorbid with depressive disorder, social anxiety disorder, attention deficit/hyperactivity disorder (ADHD), and smartphone addiction. Individuals with IGD are prone to act impulsively and make risky decisions, especially in response to game-related cues. Functional neuroimaging results have shown altered functional activities in prefrontal cortex, cingulate cortex, superior temporal gyrus and nucleus accumbens (NAc). Structural neuroimaging demonstrated gray matter volume changes in prefrontal cortex and NAc, while showing white matter integrity disruption in thalamus and posterior cingulate cortex. There are few evidences on the attribution of specific genes to IGD. To evaluate IGD comprehensively, self-rating scales based on DSM-5 are useful, but a diagnostic interview by a clinician is more helpful to assess functional impairments of IGD. Presence of psychiatric comorbidities such as depressive disorder, social anxiety disorder, ADHD, and smartphone addiction should be evaluated. Neurocognitive tests that assess impulsivity, decision-making under risk, and cue-reactivity are helpful when planning individualized IGD treatment.
Anxiety Disorders ; Comorbidity ; Cues ; Depressive Disorder ; Functional Neuroimaging ; Gray Matter ; Gyrus Cinguli ; Immunoglobulin D ; Impulsive Behavior ; Internet* ; Mass Screening ; Mental Disorders ; Neuroimaging ; Nucleus Accumbens ; Prefrontal Cortex ; Smartphone ; Software Design ; Temporal Lobe ; Thalamus ; Weights and Measures ; White Matter