OBJECTIVES: This study was performed to investigate the association between hopelessness, social support and community integration, and depression. METHODS: We analyzed data from a questionnaire administered to subjects aged 65 years or older living alone for a 2015 community mental health project in Gyeongnam S city. We used a correlation analysis and a hierarchical regression analysis to identify factors that affect depression. RESULTS: When controlling for socio-demographic factors, hopelessness and community integration had significant effects on depression. That is, the higher the hopelessness (B=0.768, p<.001) and the lower the community integration (B=-0.163, p=.012), the higher the depression in elderly living alone . CONCLUSIONS: There is a need for approaches at both the individual and social levels that consider and improve measures to prevent and reduce depression. Moreover, it is especially necessary to enhance community integration.
Aged* ; Community Integration* ; Depression* ; Humans ; Mental Health

PURPOSE: All-trans retinoic acid (ATRA) modulates immune responses by affecting T cells. Several studies have revealed that allergic inflammation of the lower airways is negatively associated with the vitamin A concentration. However, the role of ATRA in allergic inflammation of the upper airways is unclear. We investigated the effects of ATRA in an allergic rhinitis mouse model. METHODS: BALB/c mice except control groups (CON group) were sensitized with and challenged intra-nasally with Dermatophagoides farina (AR group). The ATRA groups were administered ATRA intraperitoneally. The steroid groups were administered steroid intranasally (ST group). Allergic symptoms and the average eosinophil number were counted. Cytokines and transcription factors were measured by Real-Time PCR and Western blotting. Der f-specific immunoglobulin E (IgE) was measured. Flow cytometry results of CD4+CD25+Foxp3+ T cells were analyzed. RESULTS: The symptom scores were lower in the ATRA group than in the AR group and higher than in the CON group. The levels of IgE were lower in the ATRA group than in the AR group and higher than in the CON and ST groups. The levels of Foxp3, TGF-beta, and IL-10 mRNA, as well as the percentage of CD4+CD25+Foxp3+ T cells, were higher in the ATRA group than in theAR group. In the ATRA group the levels of IFN-gamma mRNA were higher, and the levels of GATA-3 and IL-4 mRNA, and ROR-gammat were lower. In Western blotting analyses, the expression patterns of all factors, except Foxp3, showed similar to those of mRNA expression. CONCLUSIONS: ATRA has anti-allergic effects in an allergic rhinitis model, and its underlying mechanisms mainly include the induction of regulatory T cells and the inhibition of Th2 responses.
Animals ; Blotting, Western ; Cytokines ; Eosinophils ; Flow Cytometry ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Interleukin-10 ; Interleukin-4 ; Mice* ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; Pyroglyphidae ; Real-Time Polymerase Chain Reaction ; Rhinitis* ; RNA, Messenger ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Th17 Cells ; Th2 Cells ; Transcription Factors ; Transforming Growth Factor beta ; Tretinoin* ; Vitamin A

BACKGROUND: In Korea, the prevalence, complications, and mortality rate of diabetes are rapidly increasing. However, investigations on the actual condition of diabetes management are very limited due to lack of nation-wide research or multicenter study. Hence, we have minutely inquired the current status of diabetes management and achievement of glucose target goal in general hospital offering education program. That way, we are able to furnish data for policy making of diabetes education and draw up guideline which may allow us to reduce the morbidity and mortality of diabetes. METHODS: The subjects consisted of 2,610 patients with type 2 diabetes who visited the 13 general hospital in Seoul or Gyeonggi region from March 19 to May 29, 2013. General characteristics, associated diseases, complications, and management status were investigated. RESULTS: The mean age was 61.0+/-11.6 years, body mass index was 25.0+/-3.3 kg/m2, and family history of diabetes was 50.5%. The mean duration of diabetes was 10.7+/-7.9 years and 53% received education about diabetes. The prevalence of hypertension and dyslipidemia were 59.2% and 65.5%, respectively, and 18.3% of the subjects were accompanied by liver disease. Diabetic retinopathy appeared in 31.6%, nephropathy in 28.1%, and neuropathy in 19.9% of the subjects. The mean glycosylated hemoglobin (HbA1c) level was 7.3%+/-1.3% and the achieving rate based on Korean Diabetes Association guideline (HbA1c <6.5%) was 24.8%, blood pressure (130/80 mm Hg or less) was 49.4%, and low density lipoprotein cholesterol (<100 mg/dL) was 63.6%. The reaching rate to the target level in four parameters (blood glucose, blood pressure, lipids, and body weight) was 7.8%. CONCLUSION: The blood glucose control rate was lower than other parameters, and the implementation rate of diabetes education was only 53%. Thus more appropriate glucose control and systematic diabetes education are imperative.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol, LDL ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy ; Dyslipidemias ; Education ; Glucose ; Gyeonggi-do ; Hemoglobin A, Glycosylated ; Hospitals, General* ; Humans ; Hypertension ; Korea* ; Liver Diseases ; Mortality ; Policy Making ; Prevalence ; Seoul

PURPOSE: Serine protease inhibitors are involved in immune development, anti-inflammatory mechanisms, and tissue repair. In the present study, the serine protease inhibitor 4-(2-aminoethyl) benzene sulfonyl fluoride hydrochloride (AEBSF) was evaluated for its prophylactic and therapeutic applications in a mouse model of allergic rhinitis (AR). METHODS: BALB/c mice were divided into 5 groups: contol (CON), Dermatophagoides farinae (Derf), AR mice treated with AEBSF before sensitization (S), AR mice treated with AEBSF after challenge (C), and steroid groups. Derf was used as an allergen. AEBSF was administered before S or after C. Allergic symptom scores, eosinophil counts, proteolytic activity, interferon-gamma, interleukin (IL)-10 levels and serum Derf-specific IgE levels were measured. T-bet, GATA-3, Foxp3, IL-13, and transforming growth factor (TGF)-beta mRNA levels were determined using real-time polymerase chain reaction. CD4+CD25+Foxp3+ T cells were assessed using flow cytometry. RESULTS: Symptom scores, serum Derf-specific IgE levels, GATA-3 mRNA levels, IL-13 mRNA levels, and tissue eosinophil counts decreased in both the S and C groups (P<0.05). Additionally, the percentage of CD4+CD25+Foxp3+ T cells, IL-10 levels, and Foxp3 mRNA levels increased in the S and C groups compared with those in the Derf group (P<0.05). AEBSF treatment decreased the proteolytic activity in the S and C groups (P<0.05). CONCLUSIONS: Prophylactic and therapeutic treatment with AEBSF significantly reduces allergic airway inflammation and can induce regulatory T cells in a murine model of AR.
Animals ; Benzene* ; Dermatophagoides farinae ; Eosinophils ; Flow Cytometry ; Fluorides* ; Immunoglobulin E ; Inflammation* ; Interferon-gamma ; Interleukin-10 ; Interleukin-13 ; Interleukins ; Mice* ; Models, Animal ; Pyroglyphidae* ; Real-Time Polymerase Chain Reaction ; Rhinitis* ; RNA, Messenger ; Serine Proteases* ; Serine Proteinase Inhibitors ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Transforming Growth Factors

BACKGROUND/AIMS: We aimed to evaluate the efficacy and safety of peginterferon plus ribavirin for chronic hepatitis C (CHC) patients under real life setting in Korea. METHODS: We retrospectively analyzed the medical records of 758 CHC patients treated with peginterferon plus ribavirin between 2000 and 2008 from 14 university hospitals in the Gyeonggi-Incheon area in Korea. RESULTS: Hepatitis C virus (HCV) genotype 1 was detected in 61.2% of patients, while genotype 2 was detected in 35.5%. Baseline HCV RNA level was > or =6x10(5) IU/mL in 51.6% of patients. The sustained virological response (SVR) rate was 59.6% regardless of genotype; 53.6% in genotype 1 and 71.4% in genotype 2/3. On multivariate analysis, male gender (p=0.011), early virological response (p<0.001), genotype 2/3 (p<0.001), HCV RNA <6x10(5) IU/mL (p=0.005) and adherence to the drug >80% of the planned dose (p<0.001) were associated with SVR. The rate of premature discontinuation was 35.7%. The main reason for withdrawal was intolerance to the drug due to common adverse events or cytopenia (48.2%). CONCLUSIONS: Our data suggest that the efficacy of peginterferon and ribavirin therapy in Koreans is better in Koreans than in Caucasians for the treatment of CHC, corroborating previous studies that have shown the superior therapeutic efficacy of this regimen in Asians.
Asian Continental Ancestry Group ; Genotype ; Hepacivirus ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Hospitals, University ; Humans ; Male ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; Ribavirin ; RNA

Selenoprotein S (SelS) is widely expressed in diverse tissues where it localizes in the plasma membrane and endoplasmic reticulum. We studied the potential function of SelS in erythrocyte differentiation using K562 cells stably overexpressing SelS wild-type (WT) or one of two SelS point mutants, U188S or U188C. We found that in the K562 cells treated with 1 microM Ara-C, SelS gradually declined over five days of treatment. On day 4, intracellular ROS levels were higher in cells expressing SelS-WT than in those expressing a SelS mutant. Moreover, the cell cycle patterns in cells expressing SelS-WT or U188C were similar to the controls. The expression and activation of SIRT1 were also reduced during K562 differentiation. Cells expressing SelS-WT showed elevated SIRT1 expression and activation (phosphorylation), as well as higher levels of FoxO3a expression. SIRT1 activation was diminished slightly in cells expressing SelS-WT after treatment with the ROS scavenger NAC (12mM), but not in those expressing a SelS mutant. After four days of Ara-C treatment, SelS-WT-expressing cells showed elevated transcription of beta-globin, gamma-globin, epsilon-globin, GATA-1 and zfpm-1, whereas cells expressing a SelS mutant did not. These results suggest that the suppression of SelS acts as a trigger for proerythrocyte differentiation via the ROS-mediated downregulation of SIRT1.
beta-Globins ; Cell Cycle ; Cell Membrane ; Cytarabine ; Down-Regulation ; Endoplasmic Reticulum ; epsilon-Globins ; Erythrocytes ; gamma-Globins ; K562 Cells ; Selenoproteins

The hypothalamic-pituitary-adrenal (HPA) axis is the primary endocrine system to respond to stress. The HPA axis may be affected by increased level of corticotrophin-releasing factors under chronic stress and by chronic administration of monosodium glutamate (MSG). The purpose of this study was to investigate whether chronic MSG administration aggravates chronic variable stress (CVS)-induced behavioral and hormonal changes. Twenty-four adult male Sprague-Dawley rats, weighing 200~220 g, were divided into 4 groups as follows: water administration (CON), MSG (3 g/kg) administration (MSG), CVS, and CVS with MSG (3 g/kg) administration (CVS+MSG). In addition, for the purpose of comparing the effect on plasma corticosterone levels between chronic stress and daily care or acute stress, 2 groups were added at the end of the experiment; the 2 new groups were as follows: naive mice (n=7) and mice exposed to restraint stress for 2 h just before decapitation (A-Str, n=7). In an open field test performed after the experiment, the CVS+MSG group significant decrease in activity. The increase in relative adrenal weights in the CVS and CVS+MSG group was significantly greater than those in the CON and/or MSG groups. In spite of the increase in the relative adrenal weight, there was a significant decrease in the plasma corticosterone levels in the CVS+MSG group as compared to all other groups, except the naive group. These results suggest that impaired HPA axis function as well as the decrease in the behavioral activity in adult rats can be induced by chronic MSG administration under CVS rather than CVS alone.
Adult ; Animals ; Axis, Cervical Vertebra ; Corticosterone ; Decapitation ; Endocrine System ; Humans ; Male ; Mice ; Plasma ; Rats ; Rats, Sprague-Dawley ; Sodium Glutamate ; Water ; Weights and Measures

PURPOSE: The purpose of this study was to examine the relationships among knowledge, attitudes, and the use of negative control maintenance techniques toward older adults among nurses working in geriatric hospitals (n=86). METHODS: Data were collected from April 4th to May 30th in 2006 by using questionnaires of Fact on Aging Quiz Part I, Aging Semantic Differential Scaling, and Control Maintenance Techniques. RESULTS: The findings showed that the nurses displayed lack of knowledge concerning older adults and their average rate of correct answer was 45.6%. They also hold some negative bias and attitudes, especially in psychological and social aspects. The level of using negative control maintenance techniques in managing older patients' problematic behaviors was reported as the mean of 5.65 with a possible range of 0-40. Nurse's knowledge of older adults was positively associated with their attitudes toward older adults, but their knowledge and attitudes were not associated with the use of negative control maintenance techniques. CONCLUSION: It is necessary to provide educational programs for nurses that focus on a comprehensive understanding of aging with lifetime developmental perspectives. Further studies are needed to understand the factors associated with using negative control maintenance techniques and to evaluate the intervention programs in reducing the use of negative control maintenance techniques.
Adult* ; Aging ; Bias (Epidemiology) ; Humans ; Semantic Differential ; Surveys and Questionnaires

BACKGROUND/AIMS: Elevated transaminase levels are often detected during pregnancy. Causes are variable and difficult to differentiate. Furthermore, there is no practical guideline for abnormal transaminase levels in pregnancy. The aim of this study was to suggest a strategy for managing elevated transaminase level during pregnancy. METHODS: One hundred and fiftyfive women with elevated transaminase level were included from an antenatal care center between January 1, 2003 and December 31, 2004. Another 221 women with normal transaminase levels were enrolled as control group. We analyzed documented causes, changes in laboratory tests, and pregnancy outcomes. RESULTS: Two groups showed no difference in baseline characteristics except the duration of pregnancy, parity, and albumin level. Of abnormal results, 39.4% occurred between 30 and 40 gestational weeks while 29% occurred between 10 and 20 gestational weeks. Common causes were hyperemesis gravidarum followed by pre-eclampsia, viral hepatitis, and HELLP syndrome. Excluding viral hepatitis, 69 patients showed abnormal results in the first two trimesters and the results were normalized during the follow-up period. AST and ALT levels were 52.9 (+/-49.6) IU/L and 83.3 (+/-77.0) IU/L during the first two trimesters in the patient group. Abnormal results during the third trimester were associated with shorter duration of pregnancy. CONCLUSIONS: Elevated transaminase levels up to 3 to 4 times of the upper normal limit during the first two trimesters could be safely observed with careful history taking and hepatitis viral antigen tests. However, abnormal results in the third trimester were associated with a shorter duration of pregnancy and should be managed carefully.
Adult ; Alanine Transaminase/*blood ; Aspartate Aminotransferases/*blood ; Data Interpretation, Statistical ; Female ; Humans ; Liver Function Tests ; Pregnancy ; Pregnancy Complications/diagnosis/*epidemiology ; Pregnancy Trimesters ; Retrospective Studies

In colon, smooth muscle tumors are extremely rare and represent only 3% of digestive tract leiomyomas. A 51-year- old women was admitted with complaints of epigastric pain and weight loss. Colonoscopy revealed a large pedunculated polyp covered with almost normal mucosa in the proximal transverse colon. After clipping of the stalk, we performed polypectomy successfully by colonoscopic snare electrocoagualtion. We report a case of endoscopic removal of colonic pedunculated leiomyoma with a review of literature.
Colon* ; Colon, Transverse ; Colonoscopy ; Female ; Gastrointestinal Tract ; Humans ; Leiomyoma ; Mucous Membrane ; Polyps ; Smooth Muscle Tumor ; SNARE Proteins ; Weight Loss