1.Self-screening questionnaire for perianal fistulizing disease in patients with Crohn’s disease
O Seong KWEON ; Ben KANG ; Yoo Jin LEE ; Eun Soo KIM ; Sung Kook KIM ; Hyun Seok LEE ; Yun Jin CHUNG ; Kyeong Ok KIM ; Byung Ik JANG ;
The Korean Journal of Internal Medicine 2024;39(3):430-438
		                        		
		                        			 Background/Aims:
		                        			A poor prognostic factor for Crohn’s disease (CD) includes perianal fistulizing disease, including perianal fistula and/or perianal abscess. Currently, a tool to assess perianal symptoms in patients with CD remains nonexistent. This study aimed to develop a perianal fistulizing disease self-screening questionnaire for patients with CD. 
		                        		
		                        			Methods:
		                        			This prospective pilot study was conducted at three tertiary referral centers between January 2019 and May 2020. We formulated questions on perianal symptoms, including tenesmus, anal discharge, bleeding, pain, and heat. A 4-point Likert scale was used to rate each question. Patients with CD completed a questionnaire and underwent pelvic magnetic resonance imaging (MRI). 
		                        		
		                        			Results:
		                        			Overall, 93 patients were enrolled, with 51 (54.8%) diagnosed with perianal fistulizing disease, as determined by pelvic MRI. The Spearman correlation findings demonstrated that anal pain (p = 0.450, p < 0.001) and anal discharge (p = 0.556, p < 0.001) were the symptoms that most significantly correlated with perianal disease. For anal pain and discharge, the area under the receiver operating characteristic curve of the scores was significantly higher than that of the combined score for all five symptoms (0.855 vs. 0.794, DeLong’s test p = 0.04). For the two symptoms combined, the sensitivity, specificity, and positive predictive and negative predictive values were 88.2, 73.8, 80.4, and 83.8%, respectively, with 81.7% accuracy for detecting perianal fistulizing disease. 
		                        		
		                        			Conclusions
		                        			This study indicates that simple questions regarding anal pain and discharge can help accurately identify the presence of perianal fistulizing disease in patients with CD. 
		                        		
		                        		
		                        		
		                        	
2.Causal Association Between Alcohol Consumption and Atrial Fibrillation: A Mendelian Randomization Study
Jung-Ho YANG ; Ji-An JEONG ; Sun-Seog KWEON ; Young-Hoon LEE ; Seong-Woo CHOI ; So-Yeon RYU ; Hae-Sung NAM ; Kyeong-Soo PARK ; Hye-Yeon KIM ; Min-Ho SHIN
Korean Circulation Journal 2022;52(3):220-230
		                        		
		                        			 Background and Objectives:
		                        			Previous observational studies presented a positive association between alcohol and atrial fibrillation (AF). However, previous studies using genetic polymorphisms on the causal relationship between alcohol consumption and AF have reported conflicting results. This study aimed to evaluate the causality between alcohol consumption and AF using the aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism, which is the genetic variant with the most potent effect on drinking behavior. 
		                        		
		                        			Methods:
		                        			A total of 8,964 participants from the Dong-gu Study were included in the present study. The causal association between alcohol consumption and AF was evaluated through a Mendelian randomization (MR) analysis using the ALDH2 rs671 polymorphism as an instrumental variable. 
		                        		
		                        			Results:
		                        			No significant relationship between alcohol consumption and AF was found in the observational analysis. However, the genetic analysis using the ALDH2 polymorphism showed a significant association in men. In the MR analysis, genetically predicted daily alcohol consumption was positively related to AF. 
		                        		
		                        			Conclusions
		                        			MR analysis revealed a significant association between the amount of alcohol consumption and AF, which suggests that the association may be causal. 
		                        		
		                        		
		                        		
		                        	
3.Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
Kyungwon OH ; Yoonjung KIM ; Sanghui KWEON ; Soyeon KIM ; Sungha YUN ; Suyeon PARK ; Yeon-Kyeng LEE ; Youngtaek KIM ; Ok PARK ; Eun Kyeong JEONG
Epidemiology and Health 2021;43(1):e2021025-
		                        		
		                        			
		                        			The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
		                        		
		                        		
		                        		
		                        	
4.Association between Alcohol Consumption and Serum Cortisol Levels:a Mendelian Randomization Study
Jung-Ho YANG ; Sun-Seog KWEON ; Young-Hoon LEE ; Seong-Woo CHOI ; So-Yeon RYU ; Hae-Sung NAM ; Kyeong-Soo PARK ; Hye-Yeon KIM ; Min-Ho SHIN
Journal of Korean Medical Science 2021;36(30):e195-
		                        		
		                        			Background:
		                        			Several studies have reported conflicting results regarding the relationship between alcohol consumption and cortisol levels. However, the causality between alcohol consumption and cortisol levels has not been evaluated. 
		                        		
		                        			Methods:
		                        			This study examined 8,922 participants from the Dong-gu Study. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol consumption. The association between the genetically predicted alcohol consumption and cortisol level was evaluated with Mendelian randomization (MR) using two-stage least squares regression. 
		                        		
		                        			Results:
		                        			Alcohol consumption was positively associated with the serum cortisol level in both sexes in the observational analysis. In the MR analysis, the genetically predicted alcohol consumption was positively related to the cortisol level in men, with cortisol levels increasing by 0.18 µg/dL per drink per day. However, there was no relationship in women in the MR analysis. 
		                        		
		                        			Conclusion
		                        			The predicted alcohol consumption according to the ALDH2 rs671 polymorphism was positively related to the cortisol levels, suggesting a causal relationship between alcohol consumption and cortisol levels.
		                        		
		                        		
		                        		
		                        	
5.Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
Kyungwon OH ; Yoonjung KIM ; Sanghui KWEON ; Soyeon KIM ; Sungha YUN ; Suyeon PARK ; Yeon-Kyeng LEE ; Youngtaek KIM ; Ok PARK ; Eun Kyeong JEONG
Epidemiology and Health 2021;43(1):e2021025-
		                        		
		                        			
		                        			The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
		                        		
		                        		
		                        		
		                        	
6.Association between Alcohol Consumption and Serum Cortisol Levels:a Mendelian Randomization Study
Jung-Ho YANG ; Sun-Seog KWEON ; Young-Hoon LEE ; Seong-Woo CHOI ; So-Yeon RYU ; Hae-Sung NAM ; Kyeong-Soo PARK ; Hye-Yeon KIM ; Min-Ho SHIN
Journal of Korean Medical Science 2021;36(30):e195-
		                        		
		                        			Background:
		                        			Several studies have reported conflicting results regarding the relationship between alcohol consumption and cortisol levels. However, the causality between alcohol consumption and cortisol levels has not been evaluated. 
		                        		
		                        			Methods:
		                        			This study examined 8,922 participants from the Dong-gu Study. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol consumption. The association between the genetically predicted alcohol consumption and cortisol level was evaluated with Mendelian randomization (MR) using two-stage least squares regression. 
		                        		
		                        			Results:
		                        			Alcohol consumption was positively associated with the serum cortisol level in both sexes in the observational analysis. In the MR analysis, the genetically predicted alcohol consumption was positively related to the cortisol level in men, with cortisol levels increasing by 0.18 µg/dL per drink per day. However, there was no relationship in women in the MR analysis. 
		                        		
		                        			Conclusion
		                        			The predicted alcohol consumption according to the ALDH2 rs671 polymorphism was positively related to the cortisol levels, suggesting a causal relationship between alcohol consumption and cortisol levels.
		                        		
		                        		
		                        		
		                        	
7.Effect Modification of Acetaldehyde Dehydrogenase 2 rs671 Polymorphism on the Association between Alcohol Intake and Blood Pressure: the Dong-gu Study
Hye Yeon KIM ; Chang Kyun CHOI ; Sun Seog KWEON ; Young Hoon LEE ; Hae Sung NAM ; Kyeong Soo PARK ; So Yeon RYU ; Seong Woo CHOI ; Min Ho SHIN
Journal of Korean Medical Science 2020;35(9):14-
		                        		
		                        			
		                        			BACKGROUND: Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes.METHODS: This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed.RESULTS: In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91–1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15–1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women.CONCLUSION: ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers.
		                        		
		                        		
		                        		
		                        			Acetaldehyde
		                        			;
		                        		
		                        			Alcohol Drinking
		                        			;
		                        		
		                        			Aldehyde Dehydrogenase
		                        			;
		                        		
		                        			Asian Continental Ancestry Group
		                        			;
		                        		
		                        			Blood Pressure
		                        			;
		                        		
		                        			Cardiovascular Diseases
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypertension
		                        			;
		                        		
		                        			Linear Models
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Oxidoreductases
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
8.Efficacy of Preliminary Magnetic Resonance Imaging Measurement in Ultrasonography-Guided L4 Selective Nerve Root Block
Dae Moo SHIM ; Seok Hyun KWEON ; Hyung Gyu CHO ; Hyun Kyu YU ; Kyeong Hoon LIM
The Journal of the Korean Orthopaedic Association 2020;55(3):229-236
		                        		
		                        			 Purpose:
		                        			This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. 
		                        		
		                        			Materials and Methods:
		                        			As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. 
		                        		
		                        			Results:
		                        			At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). 
		                        		
		                        			Conclusion
		                        			A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure. 
		                        		
		                        		
		                        		
		                        	
9.Effect Modification of Acetaldehyde Dehydrogenase 2 rs671 Polymorphism on the Association between Alcohol Intake and Blood Pressure: the Dong-gu Study
Hye Yeon KIM ; Chang Kyun CHOI ; Sun Seog KWEON ; Young Hoon LEE ; Hae Sung NAM ; Kyeong Soo PARK ; So Yeon RYU ; Seong Woo CHOI ; Min Ho SHIN
Journal of Korean Medical Science 2020;35(9):e14-
		                        		
		                        			 BACKGROUND:
		                        			Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes.
		                        		
		                        			METHODS:
		                        			This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed.
		                        		
		                        			RESULTS:
		                        			In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91–1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15–1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women.
		                        		
		                        			CONCLUSION
		                        			ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers. 
		                        		
		                        		
		                        		
		                        	
10.Frozen-thawed gelatin-induced osteogenic cell sheets of canine adipose-derived mesenchymal stromal cells improved fracture healing in canine model
Yongseok YOON ; Taeseong JUNG ; Muhammad AFAN SHAHID ; Imdad Ullah KHAN ; Wan Hee KIM ; Oh Kyeong KWEON
Journal of Veterinary Science 2019;20(6):e63-
		                        		
		                        			
		                        			We assessed the efficacy of frozen-thawed gelatin-induced osteogenic cell sheet (FT-GCS) compared to that of fresh gelatin-induced osteogenic cell sheet (F-GCS) with adipose-derived mesenchymal stromal cells (Ad-MSCs) used as the control. The bone differentiation capacity of GCS has already been studied. On that basis, the experiment was conducted to determine ease of use of GCS in the clinic. In vitro evaluation of F-GCS showed 3–4 layers with an abundant extracellular matrix (ECM) formation; however, cryopreservation resulted in a reduction of FT-GCS layers to 2–3 layers. Cellular viabilities of F-GCS and FT-GCS did not vary significantly. Moreover, there was no significant difference in mRNA expressions of Runx2, β-catenin, OPN, and BMP-7 between F-GCS and FT-GCS. In an in vivo experiment, both legs of six dogs with transverse radial fractures were randomly assigned to one of three groups: F-GCS, FT-GCS, or control. Fracture sites were wrapped with the respective cell sheets and fixed with 2.7 mm locking plates and six screws. At 8 weeks after the operations, bone samples were collected and subjected to micro computed tomography and histopathological examination. External volumes of callus as a portion of the total bone volume in control, F-GCS, and FT-GCS groups were 49.6%, 45.3%, and 41.9%, respectively. The histopathological assessment showed that both F-GCS and FT-GCS groups exhibited significantly (p < 0.05) well-organized, mature bone with peripheral cartilage at the fracture site compared to that of the control group. Based on our results, we infer that the cryopreservation process did not significantly affect the osteogenic ability of gelatin-induced cell sheets.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Bone Morphogenetic Protein 7
		                        			;
		                        		
		                        			Bony Callus
		                        			;
		                        		
		                        			Cartilage
		                        			;
		                        		
		                        			Cryopreservation
		                        			;
		                        		
		                        			Dogs
		                        			;
		                        		
		                        			Extracellular Matrix
		                        			;
		                        		
		                        			Fracture Healing
		                        			;
		                        		
		                        			In Vitro Techniques
		                        			;
		                        		
		                        			Leg
		                        			;
		                        		
		                        			Mesenchymal Stromal Cells
		                        			;
		                        		
		                        			RNA, Messenger
		                        			
		                        		
		                        	
            
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