Background: The prevalence of depression is much higher in people with chronic disease than in the general population. Depression exacerbates existing physical conditions, resulting in a higher-than-expected death rate from the physical condition itself. In our aging society, the prevalence of multimorbid patients is expected to increase; the resulting mental problems, especially depression, should be considered. Using a large-scale cohort from the Korean Longitudinal Study of Aging (KLoSA), we analyzed the combined effects of depression and chronic disease on all-cause mortality. Methods: We analyzed 10-year (2006–2016) longitudinal data of 9,819 individuals who took part in the KLoSA, a nationwide survey of people aged 45–79 years. We examined the association between multimorbidity and depression using chi-square test and logistic regression. We used the Cox proportional hazard model to determine the combined effects of multimorbidity and depression on the all-cause mortality risk. Results: During the 10-year follow up, 1,574 people (16.0%) died. The hazard ratio associated with mild depression increased from 1.35 (95% confidence interval [CI], 1.05–1.73) for no chronic disease to 1.25 (95% CI, 0.98–1.60) for 1 chronic disease, and to 2.00 (95% CI, 1.58–2.52) for multimorbidity. The hazard ratio associated with severe depression increased from 1.73 (95% CI, 1.33–2.24) for no chronic disease, to 2.03 (95% CI, 1.60–2.57) for 1 chronic disease, and to 2.94 (95% CI, 2.37–3.65) for multimorbidity. Conclusion Patients with coexisting multimorbidity and depression are at an increased risk of all-cause mortality than those with chronic disease or depression alone.

Background: The prevalence of depression is much higher in people with chronic disease than in the general population. Depression exacerbates existing physical conditions, resulting in a higher-than-expected death rate from the physical condition itself. In our aging society, the prevalence of multimorbid patients is expected to increase; the resulting mental problems, especially depression, should be considered. Using a large-scale cohort from the Korean Longitudinal Study of Aging (KLoSA), we analyzed the combined effects of depression and chronic disease on all-cause mortality. Methods: We analyzed 10-year (2006–2016) longitudinal data of 9,819 individuals who took part in the KLoSA, a nationwide survey of people aged 45–79 years. We examined the association between multimorbidity and depression using chi-square test and logistic regression. We used the Cox proportional hazard model to determine the combined effects of multimorbidity and depression on the all-cause mortality risk. Results: During the 10-year follow up, 1,574 people (16.0%) died. The hazard ratio associated with mild depression increased from 1.35 (95% confidence interval [CI], 1.05–1.73) for no chronic disease to 1.25 (95% CI, 0.98–1.60) for 1 chronic disease, and to 2.00 (95% CI, 1.58–2.52) for multimorbidity. The hazard ratio associated with severe depression increased from 1.73 (95% CI, 1.33–2.24) for no chronic disease, to 2.03 (95% CI, 1.60–2.57) for 1 chronic disease, and to 2.94 (95% CI, 2.37–3.65) for multimorbidity. Conclusion Patients with coexisting multimorbidity and depression are at an increased risk of all-cause mortality than those with chronic disease or depression alone.

BACKGROUND: Several studies have shown that negative mental health increases risky health behavior and mortality risk. We investigated the relationship between mental health and health behavior, and the causal association between mental health and mortality risk. METHODS: We used data from the 8-year (2006–2014) Korean Longitudinal Study of Aging with a cohort of 10,247 individuals (whom we divided into a younger group aged <65 years and an older group aged ≥65 years). Mental health was assessed with the following factors: depression, social engagement, and satisfaction of life. Health behavior was assessed with smoking, alcohol use, and regular exercise. Mortality risk was calculated using survival status and survival months as of 2014. Multiple logistic regression and Cox proportional hazard analysis were performed. RESULTS: Negative mental health was associated with current smoking and sedentary life style, but not with alcohol consumption. In addition, it was associated with an increase in all-cause mortality risk. The increase in mortality risk in the highest quartile (vs. lowest) was 1.71 times (hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.12–2.62) and 2.07 times (HR, 2.07; 95% CI, 1.60–2.67) for the younger and older group, respectively. CONCLUSION: Our results show that mental health affects health behavior and mortality risk. A key inference from this study is that improving mental health can lead to positive changes in health behavior and reduce the risk of mortality.
Aging ; Alcohol Drinking ; Cohort Studies ; Depression ; Health Behavior ; Life Style ; Logistic Models ; Longitudinal Studies ; Mental Health ; Mortality ; Smoke ; Smoking

OBJECTIVESTo investigate the hair growth-promoting effect of Miscanthus sinensis var. purpurascens (MSP) flower extracton on in vitro and in vivo models.

METHODSMSP flower extract was extracted in 99.9% methanol and applied to examine the proliferation of human dermal papilla cells (hDPCs) in vitro at the dose of 3.92-62.50 μg/mL and hair growth of C57BL/6 mice in vivo at the dose of 1000 μg/mL. The expression of transforming growth factor β1 (TGF-β1), hepatocyte growth factor (HGF), β-catenin, substance P was measured by relative quantitative realtime polymerase chain reaction. Histopathological and immunohistochemical analysis were performed.

RESULTSMSP (7.81 μg/mL) down-regulated TGF-β1 and up-regulated HGF and β-catenin in hDPCs (P<0.01). MSP (1000 μg/mL)-treated mice showed the earlier transition of hair follicles from the telogen to the anagen phase. The number of mast cells was lower in the MSP-treated mice than in other groups (P<0.05 vs. NCS group). Substance P and TGF-β1 were expressed in hair follicles and skin of the MSP group lower than that in negative control. Stem cell factor in hair follicles was up-regulated in the MSP-treated mice (P<0.01).

CONCLUSIONSThe MSP flower extract may have hair growth-promotion activities.

Animals ; Antioxidants ; pharmacology ; Cell Count ; Cell Proliferation ; drug effects ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Female ; Flowers ; chemistry ; Hair Follicle ; cytology ; drug effects ; growth & development ; Hepatocyte Growth Factor ; metabolism ; Humans ; Mast Cells ; cytology ; Mice, Inbred C57BL ; Phosphorylation ; drug effects ; Plant Extracts ; pharmacology ; Poaceae ; chemistry ; RNA, Messenger ; genetics ; metabolism ; Skin ; metabolism ; Stem Cell Factor ; metabolism ; Stress, Psychological ; pathology ; Substance P ; metabolism ; Transforming Growth Factor beta ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; beta Catenin ; metabolism

Familial Parkinson's disease (PD) has been linked to point mutations and duplication of the α-synuclein (α-syn) gene. Mutant α-syn expression increases the vulnerability of neurons to exogenous insults. In this study, we developed a new PD model in the transgenic mice expressing mutant hemizygous (hemi) or homozygous (homo) A53T α-synuclein (α-syn Tg) and their wildtype (WT) littermates by treatment with sub-toxic (10 mg/kg, i.p., daily for 5 days) or toxic (30 mg/kg, i.p., daily for 5 days) dose of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Tyrosine hydroxylase and Bcl-2 levels were reduced in the α-syn Tg but not WT mice by sub-toxic MPTP injection. In the adhesive removal test, time to remove paper was significantly increased only in the homo α-syn Tg mice. In the challenging beam test, the hemi and homo α-syn Tg mice spent significantly longer time to traverse as compared to that of WT group. In order to find out responsible proteins related with vulnerability of mutant α-syn expressed neurons, DJ-1 and ubiquitin enzyme expressions were examined. In the SN, DJ-1 and ubiquitin conjugating enzyme, UBE2N, levels were significantly decreased in the α-syn Tg mice. Moreover, A53T α-syn overexpression decreased DJ-1 expression in SH-SY5Y cells. These findings suggest that the vulnerability to oxidative injury such as MPTP of A53T α-syn mice can be explained by downregulation of DJ-1.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Adhesives ; Animals ; Apoptosis ; Dopamine* ; Dopaminergic Neurons* ; Down-Regulation* ; Hominidae ; Humans ; Mice* ; Mice, Transgenic ; Neurons ; Parkinson Disease ; Point Mutation ; Synucleins ; Tyrosine 3-Monooxygenase ; Ubiquitin

OBJECTIVE: Appropriate gestational weight gain (GWG) is important in diabetic women. Current GWG guideline is for US general population, but not specific for diabetic women. We compared the effect of GWG on perinatal outcomes between diabetic and non-diabetic women. METHODS: Fifty two hundred and twelve women who delivered live singleton infants at Korea University Medical Center from January 2009 to December 2013 were included. One hundred twenty-nine overt diabetes women and 322 gestational diabetes women were categorized as diabetic women, and the others were categorized as none-diabetic women. 5,212 women were categorized by GWG (low 1,081; adequate 2,102; or high 2,029; according to the 2009 Institute of Medicine guidelines), and each of the 3 GWG groups was categorized into 2 groups; diabetic or non-diabetic women. And then, we compared perinatal outcomes between diabetic and non-diabetic groups. RESULTS: In each 3 GWG groups, primary cesarean section delivery, high birth weight, and large for gestational age rates were significantly higher in diabetic women than non-diabetic women. Only in adequate GWG group, preterm birth rate was significantly higher in diabetic women than non-diabetic women. CONCLUSION: Our study shows that diabetic women had higher rates of adverse perinatal outcomes than non-diabetic women, although they achieved same GWG. It suggests that current GWG guideline may not be adequate for diabetic women, and that diabetic women may need more strict GWG control than normal population.
Academic Medical Centers ; Birth Weight ; Cesarean Section ; Diabetes, Gestational ; Female ; Gestational Age ; Humans ; Infant ; Institute of Medicine (U.S.) ; Korea ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Weight Gain*

BACKGROUND: This study aimed to investigate the relationship between leisure time physical activities (LTPA) and metabolic syndrome (MS). METHODS: Five thousand seven hundred and thirty two adults 40 years old or older were enrolled in the study from April 2009 to December 2010. National Cholesterol Education Program's Adult Treatment Panel III was used for the criteria of MS, and Minnesota Leisure Time Physical Activity Questionnaire was used to measure LTPA. After adjusted covariates (age, hypertension, smoking, drinking, education level, household income level, work time physical activities, and menopause for females), the relationship between LTPA and MS was analyzed using logistic regression analysis. RESULTS: The prevalence of MS was 22.8% in men, and 14.1% in women. Average LTPA was 1,498 kcal/wk in men, and 1,308 kcal/wk in women. After adjustment for covariates, the odds ratios of middle and low LTPA compared with high LTPA were 1.06 (0.87-1.34), 1.54 (1.08-1.75), for women, this same association was not seen in men. The prevalence of MS was 22.8% in men and 14.1% in women, and their LTPA burned 1,498 and 1,308 kcal/wk, respectively. When the odds ratio of MS for the high LTPA group was set at 1.0, the odds ratio of MS was 1.06 (0.87-1.34) in the middle LTPA group and 1.54 (1.08-1.75) in the low LTPA group in women, which showed that the MS risk increased when the LTPA was lower. This same association was not seen in men. CONCLUSION: LTPA was independently associated with metabolic syndrome, but only for women.
Adult ; Burns ; Cholesterol ; Drinking ; Education ; Family Characteristics ; Female ; Health Behavior ; Humans ; Hypertension ; Leisure Activities* ; Logistic Models ; Male ; Menopause ; Minnesota ; Motor Activity* ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Smoke ; Smoking

BACKGROUND: The objective of this study was to investigate the relationship between smoking and metabolic syndrome in men. METHODS: This cross-sectional study included 1,852 men over age 40 who underwent health screening from April 2009 to December 2010. We classified them into three smoking levels as non-, intermediate-, and heavy-smoker, considering their smoking status (non, ex, current) and amount (0, 1-29, > or =30 pack year [PYR]). The relationship between smoking level and metabolic syndrome was analyzed by logistic regression analysis, after covariates (age, body mass index, education, house income, alcohol intake, and physical activity) were controlled. RESULTS: The proportions of non-, intermediate-, and heavy-smokers were 31.8%, 56.2%, and 12.0%, respectively. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome were 1.0, 1.58 (1.09-2.23), 1.92 (1.29-2.81) in non-, intermediate-, and heavy-smokers, respectively. For heavy-smokers compared with non-smokers, ORs and 95% CIs of a lower high density lipoprotein cholesterol, higher triglyceride, and higher fasting glucose were 2.47 (1.63-3.74), 1.71 (1.17-2.52), and 1.43 (1.02-2.00), respectively. In current-smokers, we divided into three subgroups according to PYR, and compared with 1-19 PYR, ORs and 95% CIs of 20-29 PYR and > or =30 PYR for metabolic syndrome were 2.07 (1.14-3.74) and 3.06 (1.66-5.62), respectively. CONCLUSION: This study showed a positive dose-response relationship between smoking level and metabolic syndrome in men.
Body Mass Index ; Cholesterol, HDL ; Cross-Sectional Studies ; Education ; Fasting ; Glucose ; Humans ; Logistic Models ; Male ; Mass Screening ; Metabolic Syndrome X ; Odds Ratio ; Smoke* ; Smoking* ; Triglycerides

OBJECTIVE: Our aim was to figure out whether volumetric gray-scale histogram difference between anterior and posterior cervix can indicate the extent of cervical consistency. METHODS: We collected data of 95 patients who were appropriate for vaginal delivery with 36th to 37th weeks of gestational age from September 2010 to October 2011 in the Department of Obstetrics and Gynecology, Korea University Ansan Hospital. Patients were excluded who had one of the followings: Cesarean section, labor induction, premature rupture of membrane. Thirty-four patients were finally enrolled. The patients underwent evaluation of the cervix through Bishop score, cervical length, cervical volume, three-dimensional (3D) cervical volumetric gray-scale histogram. The interval days from the cervix evaluation to the delivery day were counted. We compared to 3D cervical volumetric gray-scale histogram, Bishop score, cervical length, cervical volume with interval days from the evaluation of the cervix to the delivery. RESULTS: Gray-scale histogram difference between anterior and posterior cervix was significantly correlated to days to delivery. Its correlation coefficient (R) was 0.500 (P = 0.003). The cervical length was significantly related to the days to delivery. The correlation coefficient (R) and P-value between them were 0.421 and 0.013. However, anterior lip histogram, posterior lip histogram, total cervical volume, Bishop score were not associated with days to delivery (P >0.05). CONCLUSION: By using gray-scale histogram difference between anterior and posterior cervix and cervical length correlated with the days to delivery. These methods can be utilized to better help predict a cervical consistency.
Cervix Uteri ; Cesarean Section ; Female ; Gestational Age ; Gynecology ; Humans ; Korea ; Lip ; Lipids ; Membranes ; Obstetrics ; Pregnancy ; Quaternary Ammonium Compounds ; Rupture

Amebic liver abscess (ALA) has been diagnosed in travelers to endemic areas or in patients with immunosuppression secondary to human immunodeficiency virus infection since the late 1990s. Further, it is a rare disease in Korea. ALA should be considered in patients present with fever and right upper quadrant pain along with a risk of exposure to amebiasis. We report an 82-year-old man with symptoms of fever, gross hematuria and severe renal impairment as having amebic liver abscess complicated with the obstruction of the inferior vena cava. Amebic liver abscess was successfully treated with antibiotics alone. Also, hematuria disappeared and renal dysfunction improved after treatment.
Aged, 80 and over ; Amebiasis ; Anti-Bacterial Agents ; Fever ; Hematuria ; HIV ; Humans ; Immunosuppression ; Korea ; Liver Abscess, Amebic* ; Rare Diseases ; Renal Insufficiency ; Vena Cava, Inferior*