The most common aging-related neurodegenerative disorder is Alzheimer’s disease (AD), of which the main symptom is memory disturbance. Though the mechanism of AD pathogenesis is not fully defined, abnormal aggregation of amyloid beta (Aβ ) plaques and tau have been considered as key factors and main histological hallmarks of the disease. Astrocyte is responsible for the control of cells and the environment around brain and spinal cord cells. Astrocytes have been implicated with AD. However, the exact function of astrocytes in AD has not been established. In this study, we investigated the regulation of astrocytes in the AD model using primary cultures. We have demonstrated that oligomerized Aβ is toxic to neurons and can induce cell death in primary cultures. In the primary cultures containing neurons and astrocytes, amyloid beta uptake was observed in both neurons and astrocytes. To verify if the uptake of amyloid beta in astrocytes is dependent on neurons, we separated and cultured primary astrocytes with no neurons. Amyloid uptake was still observed in this pure astrocyte culture, suggesting that the uptake of amyloid beta is a neuron-independent function of astrocytes. Astrocyte activation was observed in both pure and mixed cultures. Taken together, our data suggest that astrocyte is activated by oligomerized Aβ and uptakes it, which is independent of neurons.

Growing evidence suggests that environmental air pollution adversely affects kidney health. To date, the association between carbon monoxide (CO) and mortality in patients with end-stage renal disease (ESRD) has not been examined. Methods: Among 134,478 dialysis patients in the Korean ESRD cohort between 2001 and 2014, 8,130 deceased hemodialysis patients were enrolled, and data were analyzed using bidirectional, unidirectional, and time-stratified case-crossover design. We examined the association between short-term CO concentration and mortality in patients with ESRD. We used a two-pollutant model, adjusted for temperature as a climate factor and for nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter less than 10 μm in diameter as air pollution variables other than CO. Results: Characteristics of the study population included age (66.2 ± 12.1 years), sex (male, 59.1%; female, 40.9%), and comorbidities (diabetes, 55.6%; hypertension, 14.4%). Concentration of CO was significantly associated with all-cause mortality in the three case-crossover designs using the two-pollutant model adjusted for SO2. Patients with diabetes or age older than 75 years had a higher risk of mortality than patients without diabetes or those younger than 75 years. Conclusion: Findings presented here suggest that higher CO concentration is correlated with increased all-cause mortality in hemodialysis patients, especially in older high-risk patients.

Purpose: We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea. Materials and Methods: We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients). Results: Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance. Conclusion The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

Background: The problem with current dental hygienist education is that it operates as an education system based on the national examination rather than on a practical basis; thus, graduates have difficulties in practice after obtaining their license. This study aimed to propose a job-oriented curriculum by analyzing the links between the task analysis of Korean dental hygienists and dental hygiene learning goals. Methods: This study performed a relationship analysis based on a second job analysis study of dental hygienists conducted by the Korea Health Personnel Licensing Examination Institute and the learning goals of the Korean Dental Hygiene Faculty Association. Results: Based on the links between the task and learning goals of the dental hygienist, they were classified into six types: 1) tasks listed in the license exam and learning goal, 2) tasks not listed in the license exam but listed in learning goals, 3) tasks not listed in learning goals, 4) learning goals not related to tasks, 5) learning goals listed in a few tasks, and 6) tasks related to several learning goals. The results showed that most of them correspond to the 5th classification, followed by the 3rd and 4th categories, which are mostly basic science learning goals. Tasks without learning goals are not included in the curriculum; thus, the curriculum needs to be supplemented. The overlapping learning goals of several subjects for one job skill must be reduced in job-oriented education. Conclusion We suggest that the dental hygiene curriculum be developed based on task analysis and reflected in the national dental hygienist exam. The clinical practice performance of dental hygienists will take further leap forward through task-oriented education.

Background/Aims: Although proton pump inhibitors (PPIs) remain a mainstay for the suppression of gastric acid secretion, long-term PPI use is associated with side effects. However, the genotoxicity associated with long-term PPI use is unclear. Materials and Methods: This prospective observational pilot study enrolled patients who had been on PPIs for >1 year and healthy controls from July 2015 to August 2016. The subjects completed self-report questionnaires pertaining to their drug and medical history, and only those with no medical history and a ≥2-year wash-out period (for drugs other than PPIs) were included. We collected peripheral-blood lymphocytes from long-term PPI users and healthy controls and analyzed the genotoxicity by using the cytokinesis-block micronucleus cytome assay; we also determined the fasting serum levels of pyridoxine, folate, cobalamin, and homocysteine. Results: Ten long-term PPI users and 40 healthy control subjects were enrolled. The median serum pyridoxine, folate, cobalamin, and homocysteine levels were not significantly different between the groups. The median frequencies of micronuclei (MNi), nucleoplasmic bridges (NPBs), and nuclear buds (Nbuds) per 1,000 binucleated cells, in long-term PPI users and healthy controls, were 30.3 and 16.3 (P<0.005), 2.5 and 1.8 (P<0.005), and 9.3 and 5.0 (P<0.005), respectively. Even after adjustment for confounding factors, the OR of the MNi, NPBs, and Nbuds for long-term PPI users compared with healthy control subjects were 14.1 (P<0.001), 2.0 (P=0.001), and 1.3 (P=0.3), respectively. Conclusions Long-term PPI use was significantly associated with an increased risk of genotoxicity after adjustment for age, sex, body mass index, medical history, drug history, and the serum levels of vitamins.

BACKGROUND: This study aimed to analyze correlations between depression, cognitive function, oral health state, ability to perform activities of daily living, oral dryness symptoms, and oral health-related quality of life, and determine factors influencing the latter.METHODS: This was a cross-sectional study based on questionnaires completed by 260 participants with suspected dementia, residing in South Korea. Psychiatrists, psychiatric nurses, and dental hygienists visited clinics in the participating regions for examination and questionnaire administration. General characteristics, the geriatric depression scale, ability to perform activities of daily living, cognitive function, oral health state, and oral health-related quality of life were analyzed. Independent t-tests, one-way analysis of variance (ANOVA), correlation analysis and multiple regression analysis were conducted, identifying factors affecting oral health-related quality of life. Data analysis was performed using SPSS ver. 20.0 (IBM Corp., USA), and the significance was set at p<0.05.RESULTS: Approximately 65.0% of participants were female, 63.5% were in their 70s, and 90.0% had health insurance. About 21.5%, 42.0%, and 36.5% were normal, slightly impaired, and had dementia, respectively. High cognitive impairment was associated with poor oral health. Sex, education levels, marital status, and living arrangements influenced oral health-related quality of life. According to the regression analysis, geriatric depression and oral dryness affected the Geriatric Oral Health Assessment Index scores.CONCLUSION: In conclusion, oral dryness and depression levels among elders influenced oral health-related quality of life. The results showed that to enhance elders' oral health-related quality of life, it is essential to not only improve their oral health state, but also relieve oral health problems, especially oral dryness, and take into consideration their psychological aspects.
Activities of Daily Living ; Aged ; Cognition ; Cognition Disorders ; Cross-Sectional Studies ; Dementia ; Dental Hygienists ; Depression ; Education ; Female ; Humans ; Insurance, Health ; Korea ; Marital Status ; Oral Health ; Psychiatry ; Quality of Life ; Residence Characteristics ; Statistics as Topic

OBJECTIVETo investigate the anti-oxidative stress and preventive effect of modified Gongjin-dan (WSY-1075) in a detrusor underactivity rat model.

METHODSRats were randomly allocated to three groups: shamoperated (control), bladder outlet obstruction-induced detrusor underactivity (BOO-DU), and BOO-DU with WSY-1075 (WSY) groups. WSY-1075 was orally administrated to rats 200 mg daily for 2 weeks prior to the operation and 4 weeks after the operation. Bladder outlet obstruction was surgically induced in rats by ligation around the urethra avoiding total obstruction. Cystometrography was conducted on rats in each group for examination of bladders.

RESULTSCompared with the control group, bladder outlet obstruction led to a significant increase in oxidative stress with consequent changes to molecular composition, and decrease in maximal detrusor pressure (P<0.05). WSY-1075 treatment significantly suppressed oxidative stress and prevented degenerative and dysfunctional changes in bladder, as compared with BOO-DU group (P<0.05).

CONCLUSIONWSY-1075 had beneficial effect on prevention of BOO-DU.

Betula platyphylla var. japonica (Betulaceae), also known as Asian white birch, is an endemic medicinal tree, the bark of which has been used in Chinese traditional medicine for the treatment of various inflammatory diseases. In our continuing search for bioactive compounds from Korean natural resources, a phytochemical investigation of the bark of B. platyphylla var. japonica led to the isolation of 7-oxo-β-sitosterol (1) and soyacerebroside I (2) from its ethanol extract as main components by liquid chromatography (LC)/mass spectrometry (MS)-based analysis. The structures of isolates were identified by comparison of ¹H and ¹³C nuclear magnetic resonance spectroscopic data and physical data with the previously reported values and LC/MS analyses. To the best of our knowledge, this is the first study to demonstrate that the isolated compounds, 7-oxo-β-sitosterol and soyacerebroside I, were isolated in B. platyphylla var. japonica. We examined the effects of the isolates on the regulation of adipocytes and osteoblast differentiation. These isolates (1 and 2) produced fewer lipid droplets compared to the untreated negative control in Oil Red O staining of the mouse mesenchymal stem cell line without altering the amount of alkaline phosphatase staining. The results demonstrated that both compounds showed marginal inhibitory effects on adipocyte differentiation but did not affect osteoblast differentiation.
Adipocytes ; Alkaline Phosphatase ; Animals ; Asian Continental Ancestry Group ; Betula ; Chromatography, Liquid ; Ethanol ; Humans ; Lipid Droplets ; Magnetic Resonance Spectroscopy ; Medicine, Chinese Traditional ; Mesenchymal Stromal Cells ; Mice ; Natural Resources ; Osteoblasts ; Spectrum Analysis ; Trees

Iatrogenic postintubation tracheal injury is a rare but potentially fatal complication associated with anesthesia. However, as signs of tracheal injury including subcutaneous emphysema, pneumomediastinum, pneumothorax, and respiratory distress may also be related to surgical technique, diagnosis may be confused and treatment of tracheal injury can be delayed. We report a case of postintubation tracheal laceration, whose diagnosis was delayed because of symptoms were confused with subcutaneous emphysema after septorhinoplasty including osteotomy. As symptoms deteriorated in spite of conventional management, patient underwent evaluation to determine other causes and eventually postintubation tracheal injury was detected. Therefore, even if there is no problem during tracheal intubation, it is necessary to consider postintubation tracheal injury in patients with subcutaneous emphysema that worsens despite appropriate treatment after septorhinoplasty including osteotomy.
Anesthesia ; Delayed Diagnosis ; Diagnosis ; Humans ; Intubation ; Intubation, Intratracheal ; Lacerations ; Mediastinal Emphysema ; Osteotomy ; Pneumothorax ; Subcutaneous Emphysema