Objective: This study examined the volume of choroid plexus across AD without delusion (AD-D), AD with paranoid delusion (AD+PD), and AD with misidentification delusion (AD+MD). Methods: This is a hospital based cross-sectional study of patients with AD. The main outcome measure is the volume of choroid plexus that were measured as regions of interest with magnetic resonance imaging and the FreeSurfer analysis at baseline. Analysis of covariance (ANCOVA) was conducted to compare the differences on the volume of choroid plexus across AD-D, AD+PD, and AD+MD after controlling demographics. Results: There was no volume difference in the both choroid plexus between AD-D and AD+D. However, the volumes of both cho-roid plexus were significantly reduced in AD+MD compared to AD+PD. Conclusion Our study demonstrates that AD+MD has significantly reduced volumes of choroid plexus compared to AD+PD. These findings suggest that AD+MD and AD+PD may have different pathophysiological mechanisms related to neuroimmune re-sponses in the choroid plexus.

Purpose: The current drain tubes for preventing surgically biliary anastomotic stricture are not naturally and easily removed. If a drain tube using biodegradable material is easily available and the degradation time of the tube is well controlled, surgical anastomotic stricture and fibrosis could be prevented. The aim of this animal study was to evaluate the preventive effect of novel biodegradable stents (BS) on biliary stricture and fibrosis after duct-to-duct (DD) biliary anastomosis. Methods: Ten mini-pigs were allocated to the control group (n = 5) and or the stent group (n = 5). The common bile duct was exposed through surgical laparotomy and then resected transversely. In the stent group, a 4-mm or 6-mm polydioxanone/ magnesium sheath-core BS was inserted according to the width of the bile duct, followed by DD biliary anastomosis. In the control group, DD biliary anastomosis was performed without BS insertion. Results: In the stent group, stents were observed without deformity for up to 4 weeks in all animals. Eight weeks later, histopathologic examination revealed that the common bile duct of the anastomosis site was relatively narrower in circumference in the control group compared to the stent group. The degree of fibrosis in the control group was more marked than in the stent group (3.84 mm vs. 0.68 mm, respectively; P < 0.05). Conclusion Our study showed that novel BS maintained their original shape and radial force for an adequate time and then disappeared without adverse events. The BS could prevent postoperative complications and strictures after DD biliary anastomosis.

Background and Objectives: Little is known about the outcomes of outpatient clinic-based elective external cardioversion (OPC-ECV) for persistent atrial fibrillation (PeAF). We investigated the acute, short-term, and long-term elective external cardioversion (ECV) outcomes. Methods: We included 1,718 patients who underwent OPC-ECV (74% male, 61.1±11.0 years old, 90.9% long-standing PeAF, 9.1% after atrial fibrillation [AF] ablation) after excluding patients with atrial tachycardia or inappropriate antiarrhythmic drug medication, and in-patient ECV. Biphasic shocks were delivered sequentially until successful cardioversion was achieved (70-100-150-200-250 J). If ECV failed at 150 J, we administered intravenous amiodarone 150 mg and delivered 200 J. Results: ECV failed in 11.4%, and the complication rate was 0.47%. Within 3 months, AF recurred in 55.5% (44.7% as sustaining AF, 10.8% as paroxysmal AF), and the AF duration was independently associated (odds ratio [OR], 1.01 [1.00–1.02]; p=0.006), but amiodarone was independently protective (OR, 0.46 [0.27–0.76]; p=0.002, Log rank p<0.001) against an early recurrence. Regarding the long-term recurrence, pre-ECV heart failure was protective against an AF recurrence (hazard ratio, 0.63 [0.41–0.96], p=0.033) over 32 (9–66) months of follow-up. ECV energy (p<0.001) and early recurrence rate within 3 months (p=0.007, Log rank p=0.006) were significantly lower in post-ablation patients than in those with long-standing persistent AF. Conclusions The success rate of OPC-ECV was 88.6%, and the complication rate was low. However, AF recurred in 55.5% within 3 months. Amiodarone was protective against short-term AF recurrences, and long-term AF recurrences were less in patients with baseline heart failure.

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate

OBJECTIVE: The aim of this study was to estimate the prevalence and correlates of mental disorders in Korean adults. METHODS: Door to door household surveys were conducted with community residents aged 18-74 years from July 19, 2011, to November 16, 2011 (n=6,022, response rate 78.7%). The sample was drawn from 12 catchment areas using a multistage cluster method. Each subject was assessed using the Korean version of the World Health Organization Composite International Diagnostic Interview (CIDI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS: Lifetime and 12-month prevalence estimates were as follows: alcohol use disorders, 13.4% and 4.4%, respectively; nicotine use disorders, 7.2% and 4.0%, respectively; anxiety disorders, 8.7% and 6.8%, respectively; and mood disorders, 7.5% and 3.6%, respectively. The prevalence rates of all types of DSM-IV mental disorders were 27.6% and 16.0%, respectively. Being female; young; divorced, separated, or widowed; and in a low-income group were associated with mood and anxiety disorders after adjustment for various demographic variables, whereas being male and young were associated with alcohol use disorders. Higher income was not correlated with alcohol use disorder as it had been in the 2001 survey. CONCLUSION: The rate of depressive disorders has increased since 2001 (the first national survey), whereas that of anxiety disorders has been relatively stable. The prevalence of nicotine and alcohol use disorders has decreased, and the male-to-female ratio of those with this diagnosis has also decreased.
Adult* ; Anxiety Disorders ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders* ; Divorce ; Family Characteristics ; Female ; Humans ; Male ; Mental Disorders* ; Mood Disorders ; Nicotine ; Prevalence* ; Tobacco Use Disorder ; Widowhood ; World Health Organization

OBJECTIVES: This study examined the moderating effects of stress coping strategies on the relationship between occupational stress of national statistical office workers and mental health. METHODS: Subjects were 133 workers at a regional statistics office. Occupational stress, stress coping strategies, and mental health were examined using the Korean Occupational Stress Scale (KOSS), Ways of Coping Checklist, and The Symptom Check-List-90-R. Stress coping strategies were composed of problem-focused coping, social support coping, emotion-focused coping, and wishful thinking coping. RESULTS: Moderated regression indicated that the social support coping and emotion-focused coping style positively moderated the relationship between occupational stress and mental health in national statistical office workers. The social support coping style positively moderated the relationship between interpersonal conflict (KOSS subscale) and mental health in national statistical office workers. The emotion-focused coping style positively moderated the relationship between job insecurity (KOSS subscale) and mental health in national statistical office workers. The emotion-focused coping style negatively moderated the relationship between job demand (KOSS subscale) and mental health in national statistical office workers. CONCLUSION: The implications of this study included that negative results due to high occupational stress can be varied by use of suitable stress coping strategies.
Checklist ; Mental Health* ; Thinking

Bloodstain pattern analysis is a forensic discipline that reconstruct events of a crime scene by analyzing sizes, shapes, distributions, positions of bloodstains. Bloodstain pattern can be classified into the low velocity, medium velocity, and high velocity system. Velocities in this system represent the velocity of the wounding agent (the force applied) and not to the velocity of the blood in flight. Thus there is no reference system about the velocity of the blood in flight in the existing bloodstain classification system. Applying bloodstain pattern analysis to the real crime case, we needed to have the reference system of velocities of impact spatter, cast-off spatter, and expectorate spatter. Therefore we measured the velocities of these spatters using high speed camera and we analyzed the results. In this experiments the average velocity of impact spatter that generated by swinging a hammer with all experimenter's strength at the pool of blood is about 4.7 times faster than that of swing cast-off spatter that generated by swinging a red-wat hammer with all experimenter's strength, and about 3.9 times faster than that of expectorate spatter that generated by emitting blood from the mouth with all experimenter's strength. The velocities of cast-off spatter and expectorate spatter, however, showed similar distributions. Our experiments that measure the velocities of droplets of blood spatters in flight under the specific conditions that generated at fastest speed can give some reference to the classification system of velocities of bloodstains which is not distinct up to now, as well as some real bloodshed crime cases.
Crime ; Enzyme Multiplied Immunoassay Technique ; Mouth

OBJECTIVES: In South Korea, there is limited information on nicotine dependence (ND) and its correlation with psychiatric disorders. Based on the National Epidemiologic Survey of Psychiatric Disorders in South Korea in 2006, we examined the relationship between the severity of tobacco smoking and mental disorders, paying specific attention to suicidal ideas, plans, and attempts. METHODS: A total of 6,510 adults underwent face-to-face interviews. The Korean version of the Composite International Diagnostic Interview (K-CIDI) was used to evaluate lifetime prevalence and correlates of mental disorders. According to the the severity of tobacco smoking, participants were grouped into never-smokers, ever-smokers, and ND. The frequencies of mental disorders and suicidal tendencies were analyzed among ND/ever-smokers. Multivariate logistic regression analysis was used to predict the odds ratios and significance levels among groups. RESULTS: Associations of ND with alcohol use disorder, mood disorder, anxiety disorder, pathological gambling, and suicidal tendencies were significant, even after controlling for demographic characteristics. Associations of most psychiatric disorders with smoking were stronger in females than in males. CONCLUSION: ND is highly associated with alcohol use disorder, mood and anxiety disorders, pathological gambling, and suicidal tendencies. Interventions are needed in order to prevent the development of ND from regular smoking.
Adult ; Anxiety Disorders ; Female ; Gambling ; Humans ; Logistic Models ; Mental Disorders ; Mood Disorders ; Odds Ratio ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicide ; Tobacco ; Tobacco Use Disorder

OBJECTIVES : The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. METHODS : The Korean Epidemiologic Catchment Area study Replication (KECA-R) was conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target population included all eligible residents aged 18 to 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). RESULTS : A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nictotine use disorder, 9.0% and 6.0%;3) specific phobia, 3.8% and 3.4%;4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. CONCLUSION : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.
Adult ; Aged ; Anxiety Disorders ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Health Services Needs and Demand ; Humans ; Male ; Mental Disorders ; Mood Disorders ; Nicotine ; Phobic Disorders ; Prevalence

Odontoblasts are responsible for the formation and maintenance of dentin which is a mineralized part in dentin-pulp complex of tooth. OD314 was obtained by subtractive hybridization between odontoblasts and osteoblast/dental papilla cells, and differentiatially expressed in the odontoblasts but not in osteoblasts and dental papilla cells. In this study, to better understand the biological function of new odontoblast-enriched gene, OD314, we examined expression of OD314 in cultured MDPC-23 cells and intracellular localization of OD314 protein. We also evaluate the effect of OD314 over-expression and inactivation on the cells by northern analysis. When MDPC-23 cells are cultured in the differentiation and mineralization medium for 28 days, OD314 mRNA expression was gradually increased from the beginning to day 21 and remained relatively high on day 28. Immunofluorescent staining of cultured MDPC-23 revealed localization of OD314 on the cytoplasm, especially near the nuclear membrane. However, a small amount of fluorescence was also observed in the nucleus. Inactivation of OD314 by RNA interference up-regulated the expression of DSPP, whereas over-expression of OD314 by CMV-OD314 plasmid down-regulated the expression of ON. These results suggest that OD314, a odontoblat-enriched gene, may play important roles in the odontoblast differentiation and dentin mineralization.
Cytoplasm ; Dental Papilla ; Dentin ; Fluorescence ; Nuclear Envelope ; Odontoblasts* ; Osteoblasts ; Plasmids ; RNA Interference ; RNA, Messenger ; Tooth