Background: Sutureless valves are widely used in aortic valve replacement surgery, with Perceval valves and Intuity valves being particularly prominent. However, concerns have been raised about postoperative thrombocytopenia with Perceval valves (Corcym, UK). We conducted a comparative analysis with the Intuity valve (Edwards Lifesciences, USA), and assessed how thrombocytopenia affected patient and transfusion outcomes. Methods: Among 595 patients who underwent aortic valve replacement from June 2016 to March 2023, sutureless valves were used in 53 (Perceval: n=23; Intuity: n=30). Platelet counts were monitored during hospitalization and outpatient visits. Daily platelet count changes were compared between groups, and the results from patients who underwent procedures using Carpentier Edwards Perimount Magna valves were used as a reference group. Results: Compared to the Intuity group, the Perceval group showed a significantly higher amount of platelet transfusion (5.48±1.64 packs vs. 0.60±0.44 packs, p=0.008). During the postoperative period, severe thrombocytopenia (<50,000/μL) was significantly more prevalent in the Perceval group (56.5%, n=13) than in the Intuity group (6.7%, n=2). After initial postoperative depletion, daily platelet counts increased, with significant differences observed in the extent of improvement between the Perceval and Intuity groups (p<0.001).However, there was no significant difference in early mortality or the incidence of neurological complications between the 2 groups. Conclusion The severity of postoperative thrombocytopenia differed significantly between the Perceval and Intuity valves. The Perceval group showed a significantly higher prevalence of severe thrombocytopenia and higher platelet transfusion volumes. However, thrombocytopenia gradually recovered during the postoperative period in both groups, and the early outcomes were similar in both groups.

BACKGROUND AND OBJECTIVES: Cochlear dead region (CDR) is a region in the cochlear where hearing loss has occurred due to damage to the inner hair cells and/or neurons. Recently, a subjective test involving a pure-tone test in the presence of threshold-equalizing noise (TEN) was introduced to identify CDR. However, for uncooperative patients, such a subjective method would be unsuitable and objective methods would be needed instead to detect CDR. The acoustic change complex (ACC) is an evoked potential elicited by changes in the ongoing sound. In this study, we developed an objective method of identifying CDR by combining ACC response with a TEN test, namely the TEN-ACC test, and investigated its feasibility in normal-hearing listeners. SUBJECTS AND METHOD: Ten normal-hearing subjects participated in this study. All subjects underwent both behavioral TEN test and electrophysiological TEN-ACC test. The stimuli for the TEN-ACC test consisted of TEN and embedded pure tones with different frequencies/signals to noise ratios (SNRs). To identify the thresholds, the range SNR of stimulation was varied from 0 to 20 dB, in stages of 4 dB. RESULTS: The ACC responses of all subjects who participated in this study were well elicited by stimuli developed for the TEN-ACC test. We confirm that the pure-tones embedded in TEN elicited the objective ACC response. CONCLUSION: The results of this study suggest that the novel TEN-ACC test can be applied to evoke ACC in normal-hearing listeners. Future research should incorporate hearing-impaired listeners to determine the feasibility of the TEN-ACC test as an objective method to identify CDR.
Acoustics* ; Evoked Potentials ; Hair Cells, Auditory, Inner ; Hearing Loss ; Humans ; Methods ; Neurons ; Noise

Chylomicronemia is a severe type of hypertriglyceridemia characterized by chylomicron accumulation that arises from a genetic defect in intravascular lipolysis. It requires urgent and proper management, because serious cases can be accompanied by pancreatic necrosis or persistent multiple organ failure. We present the case of a 1-month-old infant with chylomicronemia treated by plasmapheresis. His chylomicronemia was discovered incidentally when lactescent plasma was noticed during routine blood sampling during a hospital admission for fever and irritability. Laboratory investigation revealed marked triglyceridemia (>5,000 mg/dL) with high chylomicron levels. We therefore decided to perform a therapeutic plasmapheresis to prevent acute pancreatitis. Sequence analysis revealed a homozygous novel mutation in exon 4 of GPIHBP1: c.476delG (p.Gly159Alafs). Glycosylphosphatidylinositol-anchored high density lipoprotein-binding protein 1 (GPIHBP1) stabilizes the binding of chylomicrons near lipoprotein lipase and supports lipolysis. Mutations of GPIHBP1, the most recently discovered gene, can lead to severe hyperlipidemia and are known to make up only 2% of the monogenic mutations associated with chylomicronemia. The patient maintains mild hypertriglyceridemia without rebound after single plasmapheresis and maintenance fibrate medication so far. Here, we report an infant with chylomicronemia due to GPIHBP1 mutation, successfully treated by plasmapheresis.
Chylomicrons ; Exons ; Fever ; Humans ; Hyperlipidemias ; Hypertriglyceridemia ; Infant* ; Infant, Newborn* ; Lipolysis ; Lipoprotein Lipase ; Multiple Organ Failure ; Necrosis ; Pancreatitis ; Plasma ; Plasmapheresis* ; Sequence Analysis

BACKGROUND: This study was conducted to check whether self-resilience, one of the characteristics known to affect the occurrence of post-traumatic stress disorder (PTSD) symptoms after experiencing traumatic events, could serve as a protective factor for police officers whose occupational factors are corrected. METHODS: We conducted a cross-sectional study in which 112 male police officers in Gangwon Province participated. They visited the Wonju Severance Christian Hospital Occupational Environment Center for medical check-ups from June to December 2015. Their general characteristics were identified using structured questionnaires, and they were asked to fill in the Korean Occupational Stress Scale-Short Form (KOSS-SF). Further, the Center for Epidemiologic Studies-Depression Scale (CES-D), Connor–Davidson Resilience Scale-Korean (CD-RI-K), and Impact of Event Scale-Revised-Korean version (IES-R-K) were used to evaluate their job stress, depression, self-resilience, and PTSD symptoms. Logistic regression analysis was conducted to correct their personal, occupational, and psychological factors to analyze the relationship between self-resilience and PTSD symptoms. RESULTS: Among 112 respondents who experienced a traumatic event, those with low self-resilience had significantly higher rate of PTSD symptoms than those with high self-resilience even after correcting for the covariate of general, occupational, and psychological characteristics (odds ratio [OR] 3.51; 95 % CI: 1.06–19.23). CONCLUSIONS: Despite several limitations, these results suggest that a high degree of self-resilience may protect police officers from critical incident-related PTSD symptoms.
Cross-Sectional Studies ; Depression ; Gangwon-do ; Humans ; Logistic Models ; Male ; Police* ; Protective Factors* ; Psychology ; Stress Disorders, Post-Traumatic* ; Surveys and Questionnaires

Neuronal senescence caused by diabetic neuropathy is considered a common complication of diabetes mellitus. Neuronal senescence leads to the secretion of pro-inflammatory cytokines, the production of reactive oxygen species, and the alteration of cellular homeostasis. Agmatine, which is biosynthesized by arginine decarboxylation, has been reported in previous in vitro to exert a protective effect against various stresses. In present study, agmatine attenuated the cell death and the expression of pro-inflammatory cytokines such as IL-6, TNF-alpha and CCL2 in high glucose in vitro conditions. Moreover, the senescence associated-beta-galatosidase's activity in high glucose exposed neuronal cells was reduced by agmatine. Increased p21 and reduced p53 in high glucose conditioned cells were changed by agmatine. Ultimately, agmatine inhibits the neuronal cell senescence through the activation of p53 and the inhibition of p21. Here, we propose that agmatine may ameliorate neuronal cell senescence in hyperglycemia.
Aging ; Agmatine* ; Arginine ; Cell Aging* ; Cell Death ; Cytokines ; Decarboxylation ; Diabetes Mellitus ; Diabetic Neuropathies ; Glucose ; Homeostasis ; Hyperglycemia ; Interleukin-6 ; Neurons* ; Reactive Oxygen Species ; Tumor Necrosis Factor-alpha

OBJECTIVES: This study was conducted to investigate the relationship between night work and cardiovascular diseases among wage workers in Korea. METHODS: The study was based on the 3rd Korean Working Conditions Survey (KWCS; 2011). This study included 29,711 wage workers. We used the chi-squared test and logistic regression to examine the association between cardiovascular diseases and night work and cumulative night work. RESULTS: Among all of the paid workers, 12.5% reported doing night work > or = 1 day per month. Night work was significantly associated with an increased risk of cardiovascular diseases (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.11-2.25). Also, compared to the group that did not do night works, the group with higher cumulative night work demonstrated an increased risk for cardiovascular diseases (OR 1.81, 95% CI 1.19-2.74). CONCLUSIONS: This study suggests that night work is significantly associated with cardiovascular diseases.
Cardiovascular Diseases* ; Korea ; Logistic Models ; Salaries and Fringe Benefits

Using the Korean public health insurance database, we analyzed patients diagnosed as benign prostatic hyperplasia (BPH) from 2004 to 2008. Age and year-specific amount and seasonal variation of hospital visits (HV), duration of treatment (DT), the total and per capita amount of insurance payment (TAIP, PCIP) were evaluated. A total of 12,088,995 HV were studied. Total HV increased 1.7 times and DT almost doubled in 2008 compared to those in 2004. HV, DT, and TAIP showed linearly increasing patterns year by year. In a time series analysis, HV increased in winter and demonstrated seasonality in a 12-month cycle. In a Poisson regression analysis, the annual variations of HV, DT, TAIP, and PCIP were different by age groups. In patients older than 40 yr, HV significantly increased 1.10-1.16 times compared to that of the previous year. DT markedly increased in their 60s and 80s patients. The rate of increase in PCIP was steeper in patients 50 yr and older than in the others.Health care utilization due to BPH was rapidly increasing in Korea and it was remarkable in the elderly population. Seasonal variation of HV demonstrated that health care utilization increased in winter.
Adult ; Aged ; Aged, 80 and over ; Cost of Illness ; Health Care Costs ; Humans ; Insurance, Health/*economics/statistics & numerical data ; Male ; Middle Aged ; Patient Acceptance of Health Care/*statistics & numerical data ; Prostatic Hyperplasia/*economics/*epidemiology/therapy ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Young Adult

Using the Korean public health insurance database, we analyzed patients diagnosed as benign prostatic hyperplasia (BPH) from 2004 to 2008. Age and year-specific amount and seasonal variation of hospital visits (HV), duration of treatment (DT), the total and per capita amount of insurance payment (TAIP, PCIP) were evaluated. A total of 12,088,995 HV were studied. Total HV increased 1.7 times and DT almost doubled in 2008 compared to those in 2004. HV, DT, and TAIP showed linearly increasing patterns year by year. In a time series analysis, HV increased in winter and demonstrated seasonality in a 12-month cycle. In a Poisson regression analysis, the annual variations of HV, DT, TAIP, and PCIP were different by age groups. In patients older than 40 yr, HV significantly increased 1.10-1.16 times compared to that of the previous year. DT markedly increased in their 60s and 80s patients. The rate of increase in PCIP was steeper in patients 50 yr and older than in the others.Health care utilization due to BPH was rapidly increasing in Korea and it was remarkable in the elderly population. Seasonal variation of HV demonstrated that health care utilization increased in winter.
Adult ; Aged ; Aged, 80 and over ; Cost of Illness ; Health Care Costs ; Humans ; Insurance, Health/*economics/statistics & numerical data ; Male ; Middle Aged ; Patient Acceptance of Health Care/*statistics & numerical data ; Prostatic Hyperplasia/*economics/*epidemiology/therapy ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Young Adult

Glutathione (GSH) protects cells against oxidative stress by playing an antioxidant role. Protecting brain endothelial cells under oxidative stress is key to treating cerebrovascular diseases and neurodegenerative diseases including Alzheimer's disease and Huntington's disease. In present study, we investigated the protective effect of GSH on brain endothelial cells against hydrogen peroxide (H2O2). We showed that GSH attenuates H2O2-induced production of nitric oxide (NO), reactive oxygen species (ROS), and 8-Oxo-2'-deoxyguanosine (8-OHdG), an oxidized form of deoxiguanosine. GSH also prevents H2O2-induced reduction of tight junction proteins. Finally, GSH increases the level of nuclear factor erythroid 2-related factor 2 (Nrf2) and activates Nrf2-mediated signaling pathways. Thus, GSH is a promising target to protect brain endothelial cells in conditions of brain injury and disease.
Alzheimer Disease ; Apoptosis ; Brain Injuries ; Brain* ; Endothelial Cells* ; Glutathione* ; Huntington Disease ; Hydrogen Peroxide ; Hydrogen* ; Neurodegenerative Diseases ; Nitric Oxide ; Oxidative Stress* ; Reactive Oxygen Species ; Tight Junction Proteins

Differentiation of neural progenitor cells (NPCs) is important for protecting neural cells and brain tissue during inflammation. Interleukin-1 beta (IL-1beta) is the most common pro- inflammatory cytokine in brain inflammation, and increased IL-1beta levels can decrease the proliferation of NPCs. We aimed to investigate whether agmatine (Agm), a primary polyamine that protects neural cells, could trigger differentiation of NPCs by activating IL-1beta in vitro. The cortex of ICR mouse embryos (E14) was dissociated to culture NPCs. NPCs were stimulated by lipopolysaccharide (LPS). After 6 days, protein expression of stem cell markers and differentiation signal factors was confirmed by using western blot analysis. Also, immunocytochemistry was used to confirm the cell fate. Agm treatment activated NPC differentiation significantly more than in the control group, which was evident by the increased expression of a neuronal marker, MAP2, in the LPS-induced, Agm-treated group. Differentiation of LPS-induced, Agm-treated NPCs was regulated by the MAPK pathway and is thought to be related to IL-1beta activation and decreased expression of TLX, a transcription factor that regulates NPC differentiation. Our results reveal that Agm can promote NPC differentiation to neural stem cells by modulating IL-1beta expression under inflammatory condition, and they suggest that Agm may be a novel therapeutic strategy for neuroinflammatory diseases.
Agmatine* ; Animals ; Blotting, Western ; Brain ; Embryonic Structures ; Encephalitis ; Immunohistochemistry ; Inflammation ; Interleukin-1beta ; Mice ; Mice, Inbred ICR ; Neural Stem Cells ; Neurons* ; Stem Cells ; Transcription Factors