Objective: This study evaluated a novel trivalent inactivated FAdV vaccine containing antigens from FAdV-4, 8b, and 11. Methods: An SD1356-like FAdV-8b strain, representing newly emerging variants in Asia and the Middle East, was included as an immunogen. Prior to vaccination-challenge trials, pathogenicity of FAdV-4, 8b, and 11 was assessed in chickens via oral, intramuscular, and intravenous routes. These models were used to determine the minimum protective dose.Cross-neutralization assays were performed using sera from monovalent vaccinations for each serotype. Duration of immunity was evaluated in specific pathogen-free chickens following a single vaccine dose. Results: Intravenous challenge produced the highest mortality across all serotypes, including the relatively low-pathogenic FAdV-11. A vaccine dose of 107.0TCID50 /bird induced strong neutralizing antibody responses and provided complete protection against virulent strains.Sera showed no cross-neutralization between heterologous serotypes, emphasizing the necessity of multivalent formulations. Protective antibody titers were maintained up to 78 weeks of age. Conclusions and Relevance: The trivalent vaccine provides effective protection against predominant FAdV-4, 8b, and 11 strains. These findings support the use of multivalent vaccines to achieve broad and sustained immunity against emerging FAdV infections in poultry.

Women undergo various physical changes because of hormonal changes occurring after menopause. Some representative changes caused by the reduction in estrogen levels in these women are dyslipidemia, abnormal lipoprotein levels, obesity, weight gain, and changes in body fat distribution. A characteristic of women approaching menopause is the shift of fat from their hips and thighs to their abdomen. Notably, fat accumulation is common in internal organs, resulting in male-pattern obesity among women approaching menopause; therefore, these women require more exercise therapy than premenopausal women to prevent and treat obesity. To the best of our knowledge, no effective exercise therapy guidelines have been established for postmenopausal women; therefore, I aimed to suggest more effective diet and exercise therapies for postmenopausal women with obesity. For this purpose, I organized the diet and exercise protocol by collaborating with an obstetrician and a researcher specializing in sports medicine; further, this protocol was actually applied to all participants. The results indicated that the protocol is effective in reducing weight; however, joint pain was commonly noted in participants who dropped out of the program. Based on the evaluation of joint pain, this study found that it is necessary to perform exercise therapy by avoiding weight-bearing activities and reinforcing personalized joint strengthening exercises because reduced estrogen level is an important factor exacerbating arthritis in postmenopausal women.

Objective: To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients. Methods: Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS). Results: The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%. Conclusion There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

OBJECTIVE: To develop guidelines and recommendations to prevent and treat glucocorticoid-induced osteoporosis (GIOP) in Korea. METHODS: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology developed this guideline based on Guidance for the Development of Clinical Practice Guidelines version 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously-published guidelines, and a systematic review and quality assessment were conducted. RESULTS: This guideline applies to adults aged 19 years or older who are using or plan to use glucocorticoids (GCs), but does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using FRAX (Fracture Risk Assessment Tool) with adjustments for GC dose, previous osteoporotic fracture history, and bone mineral density (BMD) results. All patients taking more than 2.5 mg/day prednisolone or equivalent for more than 3 months are recommended to take adequate calcium and vitamin D. Patients at moderate to high fracture risk should be treated with additional osteoporosis medication. All patients continuing GC therapy should receive an annual BMD measurement, vertebral X-ray, and fracture risk assessment using FRAX. When a treatment failure is suspected, switching to another drug should be considered. CONCLUSION: This guideline is intended to provide guidance for clinicians in prevention and treatment of GIOP.
Adolescent ; Adult ; Bone Density ; Calcium ; Child ; Denosumab ; Diphosphonates ; Evidence-Based Practice ; Glucocorticoids ; Humans ; Korea ; Miners ; Osteoporosis* ; Osteoporotic Fractures ; Prednisolone ; Rheumatology ; Risk Assessment ; Teriparatide ; Treatment Failure ; Vitamin D

BACKGROUND: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. METHODS: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. RESULTS: This guideline applies to adults aged ≥19 years who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ≥2.5 mg/day for ≥3 months are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. CONCLUSIONS: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.
Adolescent ; Adult ; Bone Density ; Calcium ; Child ; Denosumab ; Evidence-Based Practice ; Glucocorticoids ; Humans ; Korea ; Miners ; Osteoporosis* ; Osteoporotic Fractures ; Prednisolone ; Rheumatology ; Risk Assessment ; Teriparatide ; Treatment Failure ; Vitamin D

Diffuse alveolar hemorrhage (DAH) is a life-threatening condition associated with many disorders. Here, we report a case of 59-year-old female who had diffuse alveolar hemorrhage associated with methimazole. She had been treated with methimazole for two weeks due to the recurrence of Grave's disease, before visiting the emergency room. She had to be intubated on the 3rd day of hospitalization because of unabated massive hemoptysis and rapid progression of diffuse alveolar infiltration on chest radiographs. Since her clinical condition improved substantially after cessation of methimazole and steroid pulse therapy, she was extubated on the 9th day of hospitalization and then discharged. After discharge, DAH did not recur with cessation of steroid and she had radioactive iodine therapy for her Grave's disease. This was a rare and interesting case of life-threatening DAH associated with cytoplasmic-antineutrophil cytoplasmic antibody and methimazole.
Antibodies, Antineutrophil Cytoplasmic* ; Cytoplasm* ; Emergency Service, Hospital ; Female ; Hemoptysis ; Hemorrhage* ; Hospitalization ; Humans ; Iodine ; Methimazole* ; Middle Aged ; Radiography, Thoracic ; Recurrence

Remission is a primary end point of in clinical practice and trials of treatments for rheumatoid arthritis (RA). The 2011 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria were developed to provide a consensus definition of remission. This study aimed to assess the concordance between the new remission criteria and the physician’s clinical judgment of remission and also to identify factors that affect the discordance between these two approaches. A total of 3,209 patients with RA were included from the KORean Observational Study Network for Arthritis (KORONA) database. The frequency of remission was evaluated based on each approach. The agreement between the results was estimated by Cohen's kappa (κ). Patients with remission according to the 2011 ACR/EULAR criteria (i.e. the Boolean criteria) and/or physician judgment (n = 855) were divided into three groups: concordant remission, the Boolean criteria only, and physician judgment only. Multinomial logistic regression analysis was used to identify factors responsible for the assignment of patients with remission to one of the discordant groups rather than the concordant group. The remission rates using the Boolean criteria and physician judgment were 10.5% and 19.9%, respectively. The agreement between two approaches for remission was low (κ = 0.226) and the concordant remission rate was only 5.5% (n = 177). Pain affected classification in both discordant groups, whereas fatigue was associated with remission only by physician clinical judgment. The Boolean criteria were more stringent than clinical judgment. Patient subjective symptoms such as pain and fatigue were associated with discordance between the two approaches.
Arthritis ; Arthritis, Rheumatoid* ; Classification ; Consensus ; Fatigue ; Humans ; Judgment* ; Logistic Models ; Observational Study ; Rheumatic Diseases

BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

Granulocytic sarcoma is an extramedullary tumor composed of granulocytic precursor cells. It usually presents as a nodular mass in the course of acute myelogenous leukemia. Rarely, the tumor develops in non-hematological conditions or in a patient with complete remission from the acute myelogenous leukemia. In such cases, aleukemic granulocytic sarcoma can be a preceding sign of systemic leukemia or a first sign of hematologic relapse of leukemia. We present an unusual case of multiple granulocytic sarcomas developed in a patient with longstanding complete remission of acute myelogenous leukemia, who has not had bone marrow and peripheral blood involvement for a long time.
Bone Marrow ; Granulocyte Precursor Cells ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Recurrence ; Sarcoma, Myeloid

BACKGROUND: The expression of adhesion molecules contribute to development of systemic diseases. Vascular cell adhesion molecule-l(VCAM-1) is an endothelial cell membrane glycoprotein that has been implicated in leukocyte/endothelial cell interactions in inflammation. OBJECTIVE: The aim of this study was to characterize the surface expression and regulation of VCAM-1 on two different endothelial cells. METHOD: We examined the effects of the expression of VCAM-1 in two different endothelial cells, isolated from human umbilical cords and human glomerulus. Expression of VCAM-1 was measured by enzyme-linked immunosorbent assay(ELISA) and flow cytometry. RESULTS: In human umbilical cord endothelial cells(HUVECs), both interleukin-l B(IL-lB) and tumor necrosis factor-a (TNF-a) increased VCAM-1 expression. VCAM-1 expression increased by TNF-a was higher than that increased by IL-lB. In human glomerular endothelial cells(HGECs), IL-lB and TNF-a markedly increased VCAM-1 expression. Conclusion. The regulation of VCAM-1 appears to be somewhat different in HGECs compared with HUVECs. These differences between the responsiveness of the two cells may possibly indicate inherent differences in endothelial cell derived from different vascular beds.
Cell Adhesion ; Cell Communication ; Cytokines* ; Endothelial Cells* ; Flow Cytometry ; Humans* ; Inflammation ; Membrane Glycoproteins ; Necrosis ; Umbilical Cord ; Vascular Cell Adhesion Molecule-1*