Objective: Although several previous studies have examined the association between late-life depression and blood adipokine levels, a marker of chronic inflammation, no studies have comprehensively considered the effects of metabolic syndrome, which is known to affect blood adipokine levels. This study examined blood adipokine levels in geriatric depression after adjusting for the effects of metabolic syndrome. Methods: Participants were selected from the Ansan Geriatric Study (depression group [n = 76] and control group [n = 76]). Blood concentrations of four adipokines (adiponectin, resistin, neutrophil-gelatinase-associated lipocalin [NGAL], and plasminogen activator inhibitor-1 [PAI-1]) were measured using immunoassays. The effects of blood adipokine concentration on the diagnosis of depression were analyzed using multivariate logistic regression to adjust for the effects of metabolic syndrome and potential confounding factors. Results: When the effects of metabolic syndrome and potential confounding factors were adjusted, only PAI-1 could explain the diagnosis of depression among all the adipokines. The depression group showed a lower blood PAI-1 level than the control group. Adiponectin, resistin, and NGAL could not explain the diagnosis of depression when the effects of metabolic syndrome and potential confounding factors were adjusted. Conclusion This study suggests the possibility that the blood PAI-1 levels in clinically pathological late-life depression may show contrasting results to those with subclinical depressive symptoms. Additionally, considering that most previous studies have been conducted with pre-geriatric populations, the study suggests the possibility that geriatric depression may show inflammatory changes with patterns that are different from those of depression in the pre-geriatric population.

Background: Guselkumab is a monoclonal antibody that selectively blocks the p19 subunit of interleukin-23. It has shown good efficacy and safety profile in several clinical trials of plaque psoriasis. However, studies on the efficacy of guselkumab in patients treated with other biologics are lacking. Objective: We aimed to investigate the efficacy and safety profile of guselkumab in patients with moderate-to-severe plaque psoriasis. We also compared the efficacy of guselkumab between biologic-naïve (Bio-Naïve) and biologicexperienced (Bio-Ex) patients. Methods: This multicenter, retrospective study included 72 patients treated with guselkumab. The patients’ clinical characteristics and psoriasis area and severity index (PASI) scores were recorded at each visit. The PASI90 and PASI100 responses and mean PASI scores were compared between the Bio-Naïve and Bio-Ex groups. Results: Fifty-five Bio-Naïve patients and 17 Bio-Ex patients were included in the study. At week 20, there were no significant differences in the PASI90 (64.2% vs. 53.8%) and PASI100 (28.3% vs. 15.4%) responses between the groups. However, at weeks 36 and 44, the PASI90 response (week 36: 89.2% vs. 36.4% and week 44: 97.8% vs. 63.6%) and the PASI100 response (week 36: 64.9% vs. 18.2% and week 44: 68.9% vs. 27.3%) were significantly higher in the Bio-Naïve group (p＜0.05). There were no differences in PASI90 and PASI100 responses between the groups in terms of other clinical characteristics and comorbidities at week 20. Conclusion The efficacy of guselkumab remained consistent among patients in whom other biologics had failed. However, the efficacy was slightly lower in the Bio-Ex group than in the Bio-Naïve group.

Background: Biologics-experienced patients are more likely to show a lower response to biologics than that of biologic-naïve patients. However, no consensus on switching biologics exists. Objective: We aimed to investigate the switching patterns and efficacy of the switched biologics in patients with moderate-to-severe psoriasis in actual clinical practice. Methods: This multicenter retrospective study included 37 patients with a history of switching biologics. We analyzed the reasons for switching, the switching patterns, and psoriasis area and severity index (PASI) 75 response rates after switching biologics. We also analyzed the factors affecting the PASI75 response rate to the second biologic. Results: The reasons for switching baseline biologics were primary failure in five patients (13.5%), secondary failure in 28 patients (75.7%), and adverse events in four patients (10.8%). The second biologics prescribed mostly include interleukin (IL)-23 inhibitor in twenty-four patients (64.9%), IL-17 inhibitor in eight patients (21.6%), tumor necrosis factor-α inhibitor in three patients (8.1%), and IL-12/23 inhibitor in two patients (5.4%). A total of 46% of patients (17/37) switched biologics from IL-12/23 inhibitors to IL-23 inhibitors. The PASI75 response rates at the primary endpoint of the second and third biologics were 89.2% and 88.8%, respectively. Our study found that female sex and obesity were associated with the primary failure of the second biologic. Conclusion Secondary failure was the most common reason for switching baseline biologics. Korean dermatologists prefer different classes of biologics while switching. The PASI75 response rates at the primary endpoints of the second and third biologics were relatively satisfactory.

The phosphorylated 43-kDa transactive response DNA-binding protein (TDP-43) was identified as a major disease protein in sporadic amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration. We present a case with progressive muscle weakness who was diagnosed with sporadic ALS. On postmortem examination, TDP-43 immunoreactive neuronal cytoplasmic inclusions were noted in motor cortex, hippocampus and anterior horns of spinal cord, which was compatible with ALS-TDP, stage 4. This is the first documented autopsy-confirmed ALS case with ALS-TDP pathology in Korea.

Background: Multiple system atrophy (MSA) is a sporadic neurodegenerative disease characterized by various combinations of parkinsonism, cerebellar ataxia, autonomic dysfunction and pyramidal signs. Two clinical subtypes are recognized: MSA with predominant cerebellar ataxia (MSA-C) and MSA with predominant parkinsonism (MSA-P). The aim of this study was to compare pathological features between MSA-C and MSA-P. Methods: Two autopsy confirmed cases with MSA were included from the Pusan National University Hospital Brain Bank. Case 1 had been clinically diagnosed as MSA-C and case 2 as MSA-P. The severity of neuronal loss and gliosis as well as the glial and neuronal cytoplasmic inclusions were semiquantitatively assessed in both striatonigral and olivopontocerebellar regions. Based on the grading system, pathological phenotypes of MSA were classified as striatonigral degeneration (SND) predominant (SND type), olivopontocerebellar degeneration (OPC) predominant (OPC type), or equivalent SND and OPC pathology (SND=OPC type). Results: Both cases showed widespread and abundant α-synuclein positive glial cytoplasmic inclusions in association with neurodegenerative changes in striatonigral or olivopontocerebellar structures, leading to the primary pathological diagnosis of MSA. Primary age-related tauopathy was incidentally found but Lewy bodies were not in both cases. The pathological phenotypes of MSA were MSA-OPC type in case 1 and MSA-SND=OPC type in case 2. Conclusions Our data suggest that clinical phenotypes of MSA reflect the pathological characteristics.

BACKGROUND: Phlebotomy performed for laboratory testing has the potential to cause anemia in newborns and infants. This study investigated the minimum specimen volume required for an automated immunohematology analyzer DAYmate S. METHODS: Three combinations of tubes were evaluated: I. 6 mL EDTA tube, II. 0.5 mL microtainer (on top of 3 mL EDTA tube), and III. 1 mL sample cup (on top of 6 mL EDTA tube). ABO/RhD cell typing was done using centrifuged red cells; unexpected antibody screening was carried out using plasma, and Type & Screening was conducted using whole blood samples. The lowest specimen volume capable of performing 10 repetitive tests without errors was investigated. RESULTS: ABO/RhD cell typing could be performed from I. 30 μL, II. 25 μL, and III. 25 μL. Unexpected antibody screening could be performed from I. 170 μL, II. 150 μL, and III. 140 μL. According to the hematocrit levels, Type & Screening could be performed from 30%, I&III 650 μL, II. 800 μL; 40%, I&III 650 μL, II. 900 μL; and 50%, I&III 1,000 μL, II. Testing using specimen volumes below 1,000 μL was difficult. CONCLUSION: By separating red cells and plasma, pre-transfusion testing of ABO/RhD cell typing and unexpected antibody screening could be conducted with very small specimen volumes using DAYmate S compared to Type & Screening using whole blood. The application of small-sized sample tubes was more competitive and this is expected to be very useful for preventing iatrogenic anemia in neonates and infants less than 4 months old.
Anemia ; Edetic Acid ; Hematocrit ; Humans ; Infant ; Infant, Newborn ; Mass Screening* ; Phlebotomy ; Plasma

PURPOSE: In the present study, the dependence of intraocular pressure (IOP) on body position was compared between pseudophakic and phakic eyes after cataract surgery performed at least 3 months prior. METHODS: IOP was measured in 214 patients over 40 years of age who received cataract surgery at least 3 months prior. The present study included 104 patients who did not have any other ocular disease which could influence visual acuity or IOP. The IOP was measured in 4 different positions, sitting, supine, right decubitus, and left decubitus by a single skilled researcher using Icare tonometer. In addition, IOP was compared between the phakic and pseudophakic eyes, specifically, the dependent eye in the decubitus position. RESULTS: The comparison between the phakic and pseudophakic eyes in patients after cataract surgery in a single eye showed IOP was not different between the sitting and supine positions; however, in the decubitus position, IOP in the dependent eye was significantly higher than the non-dependent eye (p = 0.001). Additionally, regardless of lens status, IOP was significantly higher in the dependent eye than non-dependent eye. CONCLUSIONS: Both body position and lens status can affect IOP. After cataract surgery, regardless of lens status, IOP was higher in the dependent eye than non-dependent eye of patients in the decubitus position.
Cataract* ; Glaucoma ; Humans ; Intraocular Pressure* ; Iron-Dextran Complex ; Supine Position ; Visual Acuity

PURPOSE: To determine the long-term repeatability of diurnal intraocular pressure (IOP) patterns in healthy Asian subjects without glaucoma. METHODS: Twenty-three eyes in 23 healthy Asian subjects without glaucoma underwent diurnal IOP measurements using Goldmann applanation tonometry every 2 hours from 9 AM to 11 PM during two visits that were 8 weeks apart. To validate repeatability between visits, we calculated intra-class correlation coefficients (ICCs) mean IOP, peak IOP, minimum IOP, and IOP fluctuation at each time point and expressed the results as the difference between peak IOP and minimum IOP or as the standard deviation of all diurnal IOP values in the diurnal IOP curve. RESULTS: IOP repeatability was excellent at all time points, with ICCs ranging from 0.812 to 0.946 (p < 0.001). The 9 AM IOP showed the best repeatability between visits (ICCs, 0.946). Repeatability of mean IOP, peak IOP, and minimum IOP was also excellent (ICCs ranging from 0.899 to 0.929). However, IOP fluctuations showed poor repeatability, with an ICC lower than 0.15. CONCLUSIONS: Long-term repeatability of diurnal IOP patterns in healthy Asian subjects was excellent. These findings suggest that IOP measurements at standardized times of the day will be useful for assessing the effectiveness of glaucoma therapy.
Asian Continental Ancestry Group* ; Circadian Rhythm ; Glaucoma ; Humans ; Intraocular Pressure* ; Manometry

No abstract available.
Carcinoma, Endometrioid* ; Uterus*

PURPOSE: To report peripheral vascular retinal leakage findings of asymptomatic eyes based on fluorescein angiography, and investigate the associated factors. METHODS: Data were collected retrospectively from 47 subjects (94 eyes) and the peripheral leakage results based on fluorescein angiography were analyzed. The relationship between peripheral leakage findings and other factors including-arm-retinal circulation time (ARCT) and venous filling time (VFT), refractive error, age, hypertension, and diabetes- was evaluated. RESULTS: Ten eyes had peripheral leakage (21.3%). The mean age was 34.7 +/- 7.86 years in the non-leakage group and 44.3 +/- 9.63 years in the leakage group; the difference between the groups was statistically significant (p = 0.001). The mean spherical equivalent was -2.85 +/- 2.71 diopter in the non-leakage group and -3.46 +/- 3.62 diopter in the leakage group; the difference between the groups were not significant (p = 0.471). The mean ARCT was 10.50 +/- 2.06 seconds in the non-leakage group and 11.76 +/- 2.47 seconds in the leakage group; the difference between the groups was statistically significant (p = 0.041). The mean VFT was 9.70 +/- 1.91 seconds in the non-leakage group and 10.75 +/- 1.40 seconds in the leakage group; the difference between the groups was statistically significant (p = 0.048). CONCLUSIONS: Peripheral leakage can be found in asymptomatic eyes. Age, VFT, and ARCT were correlated to peripheral leakage findings based on angiography. These leakage findings were thought to be related with histological properties and physiological changes in peripheral retina.
Angiography ; Fluorescein Angiography* ; Hypertension ; Refractive Errors ; Retina ; Retinaldehyde ; Retrospective Studies