Purpose: Neuroinflammation is considered an important pathway associated with several diseases that result in cognitive decline. 18F-THK5351 positron emission tomography (PET) signals might indicate the presence of neuroinflammation, as well as Alzheimer’s disease-type tau aggregates. β-amyloid (Aβ)-negative (Aβ–) amnestic mild cognitive impairment (aMCI) may be associated with non-Alzheimer’s disease pathophysiology. Accordingly, we investigated associations between 18F-THK5351 PET positivity and cognitive decline among Aβ– aMCI patients. Materials and Methods: The present study included 25 amyloid PET negative aMCI patients who underwent a minimum of two follow-up neuropsychological evaluations, including clinical dementia rating-sum of boxes (CDR-SOB). The patients were classified into two groups: 18F-THK5351-positive and -negative groups. The present study used a linear mixed effects model to estimate the effects of 18F-THK5351 PET positivity on cognitive prognosis among Aβ– aMCI patients. Results: Among the 25 Aβ– aMCI patients, 10 (40.0%) were 18F-THK5351 positive. The patients in the 18F-THK5351-positive group were older than those in the 18F-THK5351-negative group (77.4±2.2 years vs. 70.0±5.5 years; p<0.001). There was no difference between the two groups with regard to the proportion of apolipoprotein E ε4 carriers. Interestingly, however, the CDR-SOB scores of the 18F-THK5351-positive group deteriorated at a faster rate than those of the 18F-THK5351-negative group (B=0.003, p=0.033). Conclusion The results of the present study suggest that increased 18F-THK5351 uptake might be a useful predictor of poor prognosis among Aβ– aMCI patients, which might be associated with increased neuroinflammation (ClinicalTrials.gov NCT02656498).

Background: This study was conducted to examine the effect of adverse childhood experiences on depressive symptoms in university students and to verify whether positive psychological resources act as a protective factor for depression. Methods: Data from 1,317 young adults aged 18-29 years who took part in the university-based cross-sectional survey were analyzed. All participants completed self-report questionnaires that included demographic variables, the Adverse Childhood Experience (ACE) Scale, the Patient Health Questionnaire-9, and the Positive Resources Test. Results: The incidence of depression was 33.3% and was higher in women than in men. Based on the 10 ACE categories, 32.7% of the students reported one or more adverse childhood experiences, and 14.4% reported two or more forms of adverse childhood experiences. Students with depressive symptoms were likely to report more traumatic experiences in childhood and fewer positive psychological resources than those without depressive symptoms. Hierarchical regression analysis indicated that positive psychological resources moderated the relationship between adverse childhood experiences and depression. Conclusion Based on these results, professionals should consider identifying adverse childhood experiences early and provide active mental health service support, including positive psychological and social resources for individuals who have adverse experiences during childhood.

Objectives: Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. Methods: A total of 156 mothers with children aged 13–18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. Results: Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). Conclusion Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Objectives: Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. Methods: A total of 156 mothers with children aged 13–18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. Results: Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). Conclusion Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.

Background: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. Results: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. Conclusion This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

OBJECTIVES: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. METHODS: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. RESULTS: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. CONCLUSION: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.
Academies and Institutes ; Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Diagnosis ; Education ; Education, Special ; Humans ; Korea* ; Running ; Seoul ; Specialization

OBJECTIVES: 'Taegyo,' prenatal education, is steeped into Korean culture. Although there has been a traditional focus on providing education and care for the fetus in Korea, there is a lack of medical evidence for its effectiveness. METHODS: The authors assessed the scientific basis for 'Taegyo' by reviewing the evidences. RESULTS: 'Taegyo' in Korea began with the spread of Buddhist culture from China, and transmitted by word-of-mouth. The first 'Taegyo' book, the Tae-gyo-shin-gi, was published on 1803. Modern prenatal education is very diverse. However, only a few studies on its effect have been conducted. Development of medicine, especially obstetrics, fetology, pediatrics, psychiatry, and etc., has learned that many factors, including bad environmental conditions and maternal stress, influenced against the fetus and mother. As for the paternal side, occupation, smoking, and stress were also revealed to have consequences for the development of the fetus. On the contrary, adequate maternal nutrition, exercise, and music stimulation positively impact the fetal development and healthy birth. CONCLUSION: Traditional contents of 'Taegyo' were proved to have effectiveness from evidence-based medicine and animal experiments. We need further studies to explore the impact of prenatal education for the fetal development and maternal health.
Animal Experimentation ; China ; Education ; Evidence-Based Medicine ; Female ; Fetal Development ; Fetus ; Humans ; Korea ; Maternal Health ; Mothers ; Music ; Obstetrics ; Occupations ; Parturition ; Pediatrics ; Pregnant Women ; Prenatal Care ; Prenatal Education* ; Smoke ; Smoking ; Stress, Psychological

BACKGROUND/AIMS: Advances in endoscopic technology seek to improve the accuracy of neoplastic tumor detection. Recently developed endoscopy devices such as narrow-band imaging (NBI) nevertheless have limitations in morphologic diagnosis. The purpose of this study was to investigate whether a novel imaging technique-near-infrared fluorescence (NIRF) imaging using a protease-activatable nanoprobe-could provide more accurate neoplastic tumor detection, compared to NBI. METHODS: Images of the intestines of Apc(Min/+) mice were obtained by NIRF using a matrix metalloproteinase (MMP)-sensing probe, which was based on a nanoparticle platform. Immediately after imaging, endoscopy with NBI capability was performed on the same excised intestine. Macroscopic and microscopic findings in the intestines were assessed, and MMP expression was analyzed by Western blotting and real-time polymerase chain reaction. RESULTS: Numerous tiny polypoid lesions were present in the intestines of aged Apc(Min/+) mice. These lesions included adenomas, lymphoid follicles, and protruding normal tissues. When using NIRF imaging with an MMP-activatable nanoprobe, adenomatous polyps showed higher fluorescence, compared to lymphoid follicles or adjacent normal tissues. The expression of MMP was higher in the adenomatous tissue than in the other tissues. The sensitivity and specificity for adenoma detection were 88.9% and 82.2%, respectively, when using NIRF imaging with a MMP-nanoprobe, compared to 77.8% and 66.7%, respectively, when using NBI (P<0.05). CONCLUSIONS: Near-infrared fluorescence imaging with a protease-activatable nanoprobe could aid in the differentiation of tumor characteristics. Clinical application of this approach may improve the endoscopic detection of neoplastic tumors.
Adenoma ; Adenomatous Polyps ; Animals ; Blotting, Western ; Endoscopy ; Fluorescence* ; Intestines ; Mice ; Molecular Imaging ; Nanoparticles ; Narrow Band Imaging ; Optical Imaging* ; Sensitivity and Specificity