Background/Aims: Shifts in the gut microbiota and metabolites are interrelated with liver cirrhosis progression and complications. However, causal relationships have not been evaluated comprehensively. Here, we identified complication-dependent gut microbiota and metabolic signatures in patients with liver cirrhosis. Methods: Microbiome taxonomic profiling was performed on 194 stool samples (52 controls and 142 cirrhosis patients) via V3-V4 16S rRNA sequencing. Next, 51 samples (17 controls and 34 cirrhosis patients) were selected for fecal metabolite profiling via gas chromatography mass spectrometry and liquid chromatography coupled to timeof-flight mass spectrometry. Correlation analyses were performed targeting the gut-microbiota, metabolites, clinical parameters, and presence of complications (varices, ascites, peritonitis, encephalopathy, hepatorenal syndrome, hepatocellular carcinoma, and deceased). Results: Veillonella bacteria, Ruminococcus gnavus, and Streptococcus pneumoniae are cirrhosis-related microbiotas compared with control group. Bacteroides ovatus, Clostridium symbiosum, Emergencia timonensis, Fusobacterium varium, and Hungatella_uc were associated with complications in the cirrhosis group. The areas under the receiver operating characteristic curve (AUROCs) for the diagnosis of cirrhosis, encephalopathy, hepatorenal syndrome, and deceased were 0.863, 0.733, 0.71, and 0.69, respectively. The AUROCs of mixed microbial species for the diagnosis of cirrhosis and complication were 0.808 and 0.847, respectively. According to the metabolic profile, 5 increased fecal metabolites in patients with cirrhosis were biomarkers (AUROC >0.880) for the diagnosis of cirrhosis and complications. Clinical markers were significantly correlated with the gut microbiota and metabolites. Conclusions Cirrhosis-dependent gut microbiota and metabolites present unique signatures that can be used as noninvasive biomarkers for the diagnosis of cirrhosis and its complications.

Objectives: This study examines the foodservice status of kindergartens attached to elementary schools in Seoul. We further determine the perception of elementary school principals and kindergarten assistant principals on the foodservice management for kindergartens. Methods: This survey was conducted from July 17 to 23, 2019, enrolling 207 kindergartens attached to elementary schools in Seoul. Questionnaires were sent to principals of elementary schools and assistant principals of kindergartens, and the data obtained from 89 kindergartens were included in the analysis. The questionnaire consisted of four parts: general information on subjects, foodservice management status, foodservice management status during elementary school vacations, and the perception of principals of elementary schools and assistant principals of kindergartens on foodservice management. Data are presented as frequency and percentage or mean and standard deviation. Statistical comparison between principals of elementary schools and assistant principals of kindergartens was conducted by paired t-test, chi-square test, and Pearson's correlation analysis. Results: A separate menu (10.1%) or recipe (20.2%) that considers preschooler characteristics was rarely used for foodservice at kindergartens attached to elementary schools. Most kindergartens did not have a separate dining space (3.4%) or a dedicated cook (93.3%). Although most kindergartens (92.1%) had operational foodservice during elementary school vacations, non-professional staff and non-nutrition teacher were mainly in charge of organizing the menu and purchasing ingredients (34.1% and 41.5%, respectively). The rate of using a contract catering company (28.0%, 23.2%) was also high. Both elementary school principals and assistant principals of kindergartens showed a high perception of the necessity for providing responsibility allowances for nutrition teachers and improving the cooking environment for kindergartens during elementary school vacations. Conclusions There is a need for policies and administrative support measures to improve the quality of foodservices for kindergartens attached to elementary schools.

Recently, the number of patients with coronavirus disease 2019 (COVID-19) who have tested positive for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), via the reverse transcription polymerase chain reaction (RT-PCR) test, after recovery has increased; this has caused a dilemma regarding the medical measures and policies. We evaluated the dynamics of viral load and anti-SARSCoV-2 antibodies in four patients with positive RT-PCR results after recovery. In all patients, the highest levels of immunoglobulin G (IgG) and IgM antibodies were reached after about a month of the onset of the initial symptoms. Then, the IgG titers plateaued, and the IgM titers decreased, regardless of RT-PCR results.The IgG and IgM levels did not increase after the post-negative positive RT-PCR results in any of the patients. Our results reinforced that the post-negative positive RT-PCR results may be due to the detection of RNA particles rather than reinfection in individuals who have recovered from COVID-19.

Objective: This study evaluated the usefulness, as a risk factor of 30-day mortality, in patients residing in nursing-homes (NHs) or long-term care facilities with the diagnosis of pneumonia. Methods: We conducted a retrospective study in a public hospital between January 2017 and December 2017. The subjects included elderly patients residing in NHs and diagnosed with pneumonia in the emergency room. Data on age, gender, comorbidities, laboratory findings, pneumonia severity index score (PSI), and CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, and Age 65 or older) were entered into an electronic database. Results: A total of 439 patients were enrolled during the study period. The mean age was 82.1±8.0 years; 195 (44.4%) were men, and 30-day mortality was 21.8%. On multivariate Cox proportional hazard analysis, cerebrovascular accidents (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.33-0.87; P=0.012), chronic renal disease (HR, 2.28; 95% CI, 1.11-4.67; P=0.024), malignancy (HR, 1.69; 95% CI, 1.04-2.76; P=0.034), lactate (HR, 1.02; 95% CI, 1.01-1.03; P<0.001), albumin (HR, 0.52; 95% CI, 0.36-0.73; P<0.001), and red cell distribution width (RDW; HR, 1.11; 95% CI, 1.03- 1.19; P=0.007) were independently associated with 30-day mortality. Areas under the curve of PSI, RDW, albumin, lactate, and PSI+RDW+albumin+lactate were 0.690 (95% CI, 0.629-0.751), 0.721 (95% CI, 0.666-0.775), 0.668 (95% CI, 0.607-0.728), 0.661 (95% CI, 0.597-0.726), and 0.801 (95% CI, 0.750-0.852), respectively. Conclusion RDW, albumin, lactate and especially the combination of PSI and these factors appear to be major determinants of 30-day mortality in NH residents with pneumonia.

BACKGROUND: Recently, the number of nationwide medical researches on psoriasis using the National Health Insurance Service database has been on the rise. However, identification of psoriasis using diagnostic codes alone can lead to misclassification. Accuracy of the diagnostic codes and their concordance with medical records should be validated first to identify psoriasis patients correctly. OBJECTIVE: To validate the diagnostic codes of psoriasis (International Classification of Diseases, 10th Revision L40) and to find the algorithm for the identification of psoriasis. METHODS: We collected medical records of patients who received their first diagnostic codes of psoriasis during 5 years from five hospitals. Fifteen percent of psoriasis patients were randomly selected from each hospital. We performed a validation by reviewing medical records and compared 5 algorithms to identify the best algorithm. RESULTS: Total of 538 cases were reviewed and classified as psoriasis (n=368), not psoriasis (n=159), and questionable (n=11). The most accurate algorithm was including patients with ≥1 visits with psoriasis as primary diagnostic codes and prescription of vitamin D derivatives. Its positive predictive value was 96.5% (95% confidence interval [CI], 93.9%~98.1%), which was significantly higher than those of the algorithm, including patients with ≥1 visits with psoriasis as primary diagnostic codes or including ≥1 visits with diagnostic codes of psoriasis (primary or additional) (91.0% and 69.8%). Sensitivity was 90.8% (95% CI, 87.2%~93.4%) and specificity was 92.5% (95% CI, 86.9%~95.9%). CONCLUSION Our study demonstrates a validated algorithm to identify psoriasis, which will be useful for the nationwide population-based study of psoriasis in Korea.

OBJECTIVES: The present study investigated the association between long working hours and serum gamma-glutamyltransferase (GGT) levels, a factor influencing the incidence of cardiovascular disease. METHODS: Data from the fifth Korean National Health and Nutrition Examination Survey (2010-2011) were used to analyze 1,809 women. Subjects were divided into three groups based on the number of weekly working hours: < or =29, 30-51, and > or =52 hours per week. Complex samples logistic regression was performed after adjusting for general and occupational factors to determine the association between long working hours and high serum GGT levels. RESULTS: The prevalence of high serum GGT levels in groups with < or =29, 30-51, and > or =52 working hours per week was 22.0%, 16.9%, and 26.6%, respectively. Even after adjusting for general and occupational factors, those working 30-51 hours per week had the lowest prevalence of high serum GGT levels. Compared to those working 30-51 hours per week, the odds ratios (OR) of having high serum GGT levels in the groups with > or =52 and < or =29 working hours per week were 1.56 (95% confidence interval [CI], 1.10-2.23) and 1.53 (95% CI, 1.05-2.24), respectively. CONCLUSIONS: Long working hours were significantly associated with high serum GGT levels in Korean women.
Cardiovascular Diseases ; Female* ; gamma-Glutamyltransferase* ; Humans ; Incidence ; Logistic Models ; Nutrition Surveys* ; Odds Ratio ; Prevalence

Norovirus and rotavirus are important causes of acute nonbacterial gastroenteritis in communities worldwide. Genotypes of norovirus and rotavirus in stool samples, which were collected from patients, was determined by RT-PCR and ELISA. A total 4,484 stool samples (461 outbreak cases) collected during January 2010-April 2013 were analyzed. Four hundred thirty eight of samples were positive for norovirus. Twelve samples were positive for Rotavirus. Norovirus genotypes identified were nine kinds of G I genotype (G I -1, G I -2, G I -3, G I -4, G I -6, G I -7, G I -9, G I -12, G I -13) and nine kinds of G II genotype(G II -2, G II -4, G II -5, G II -6, G II -7, G II -11, G II -12, G II -15, G II -16). Rotavirus genotypes were G2P[4]. The results might be useful information for evaluating the epidemiological status of viral diarrhea in Seoul, and providing a strategy to prevent human norovirus, rotavirus and other threats to public health in Korea.
Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Gastroenteritis* ; Genotype ; Humans ; Korea ; Norovirus* ; Public Health ; Rotavirus* ; Seoul*

OBJECTIVE: Activation of one or more serotonin (5-HT) receptors may play a role in mediating the antidepressant effects of serotonergic antidepressants. The serotonin 2C (5HT 2C) receptor is known to be associated with antidepressant action and weight gain. We sought to determine whether the 5-HTR 2C receptor -759C/T polymorphism was associated with weight gain and treatment response to mirtazapine in major depressive disorder (MDD) patients. METHODS: The 5-HT 2C receptor -759C/T polymorphism was analyzed in 323 MDD patients. All patients were evaluated using the 21-item Hamilton Depression Rating Scale at the beginning of the study and at 1, 2, 4, and 8 weeks of mirtazapine treatment. RESULTS: There was no significant difference in the 5-HT 2C receptor -759C/T genotype distribution between responder and non-responder groups. The 5-HT 2C receptor -759C/T polymorphism was not associated with weight change over time after mirtazapine administration. CONCLUSION: The 5-HT 2C receptor -759C/T polymorphism does not appear to be a predictor of treatment response to mirtazapine. This polymorphism was not associated with weight change after 8 weeks of mirtazapine treatment. Further investigation on other polymorphisms of the 5-HT 2C gene is required to determine whether the 5-HT 2C gene influences treatment response and weight change after mirtazapine administration in patients with major depressive disorder.
Antidepressive Agents ; Depression ; Depressive Disorder, Major ; Genotype ; Humans ; Mianserin ; Negotiating ; Receptor, Serotonin, 5-HT2C ; Serotonin ; Weight Gain

OBJECTIVES: The purpose of this study is to identify the level of psychosocial stress of residents near asbestos mines, and to investigate the relationship between psychosocial stress and asbestos exposure history as well as, asbestos exposure awareness. METHODS: The survey was conducted in 297 individuals, by one-on-one interviews with a standard questionnaire including demographic characteristics, health status, asbestos exposure history, and awareness of asbestos exposure. The levels of psychosocial stress were measured through the Psychosocial Wellbeing Index-Short Form(PWI-SF). Multivariate logistic regression was conducted using psychosocial stress as a dependent variable. Demographic characteristics, health status, asbestos exposure history, and asbestos exposure awareness were examined as independent variable. RESULTS: The average PWI-SF score was 17.5 +/- 8.0, with 40 people (13.5%) in the high-risk stress group (PWI-SF 27 points or more). The group having an asbestos-related occupational history had a 2.53 times higher proportion of psychosocial stress (95% CI: 1.03~6.21). The group recognizing asbestos exposure had an even higher proportion of high psychosocial stress group (4.84 times, 95% CI: 1.41~16.55). CONCLUSIONS: The incidence of psychosocial stress is significantly higher in residents near asbestos mines having an asbestos-related occupational history who recognize their frequent asbestos exposure. Therefore, mental health is affected by the awareness of environmental asbestos exposure as well as an occupational exposure to asbestos.
Asbestos ; Incidence ; Logistic Models ; Mental Health ; Occupational Exposure ; Questionnaires

The aim of this study was to investigate the acute oral toxicity of fermented Scutellariae Radix (JKTMHGu-100) in rats and dogs. JKTM-HGu-100 was orally administered at a dose of 2,000 mg/kg in Sprague-Dawley rats. An escalating single-dose oral toxicity test in beagle dogs was performed at doses of 500, 1000, and 2000 mg/kg with 4-day intervals. Clinical signs, changes in body weight, mortality, and necropsy findings were examined for 2 weeks following oral administration. No toxicological changes related to the test substance nor mortality was observed after administration of a single oral dose of JKTM-HGu-100 in rats or dogs. Therefore, the approximate lethal dose (LD) for oral administration of JKTMHGu-100 in rats was considered to be over 2,000 mg/kg, and the maximum tolerance doses (MTDs) in rats and dogs were also estimated to be over 2,000 mg/kg. These results indicate that JKTM-HGu-100 shows no toxicity in rodents or non-rodents at doses of 2,000 mg/kg or less.
Administration, Oral ; Animals ; Body Weight ; Dogs ; Rats ; Rats, Sprague-Dawley ; Rodentia ; Scutellaria ; Scutellaria baicalensis ; Toxicity Tests