BACKGROUND: Enhancement and maintenance of the stemness of mesenchymal stem cells (MSCs) is one of the most important factors contributing to the successful in vivo therapeutic application of these cells. In this regard, three-dimensional (3D) spheroid formation has been developed as reliable method for increasing the pluripotency of MSCs. Moreover, using a new protocol, we have previously shown that dental tissues of extracted wisdom teeth can be effectively cryopreserved for subsequent use as a source of autologous stem cells. The main purpose of this study is to analyze the stemness and in vitro osteogenic differentiation potential of 3D spheroid dental MSCs compared with conventional monolayer cultured MSCs. METHODS: In this study, MSC-characterized stem cells were isolated and cultured from long-term cryopreserved dental follicles (hDFSCs), and then 2D hDFSCs were cultured under 3D spheroid-forming conditions using a newly designed microchip dish. The spheroids (3D hDFSCs) thus produced were investigated and characterized with respect to stemness, MSC marker expression, apoptosis, cell cycle analysis, extracellular matrix (ECM) production, and osteogenic and adipogenic differentiation properties. RESULTS: In terms of MSC and senescence markers, spheroid cells showed no difference when compared with 2D hDFSCs; however, 3D hDFSCs were observed to have a higher proportion of cell cycle arrest and a larger number of apoptotic cells. Moreover, spheroids showed substantially increased levels of pluripotency marker (early transcription factors) and ECM protein expression. Compared with 2D hDFSCs, there was also a notable enhancement in the osteogenic induction potential of spheroids, although no differences were observed with respect to in vitro adipogenesis. CONCLUSION: To the best of our knowledge, this is the first study to demonstrate the application of a spheroid culture system for dental follicle-derived stem cells using a microchip dish. Although further studies are needed, including in vivo transplantation, the results obtained in this study indicate that spheroid hDFSCs derived from cryopreserved dental follicle tissues could be used as a valuable source of autologous stem cells for bone tissue regeneration.
Adipogenesis ; Aging ; Apoptosis ; Bone and Bones ; Cell Cycle ; Cell Cycle Checkpoints ; Dental Sac ; Extracellular Matrix ; Humans ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Methods ; Molar, Third ; Osteogenesis ; Regeneration ; Stem Cells

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of mirtazapine treatment in multicenter population consisting of Korean patients suffering from moderate-to-severe depression. METHODS: Total 163 of in and outpatients with a diagnosis of major depressive disorder (DSM-IV) and 18 or over scores of 17-items Hamilton Rating Scale for Depression (HAMD) received treatment with mirtazapine (15-45 mg/day) for 6 weeks. Efficacy was assessed by HAMD, Montgomery and Asberg Depression Rating Scale (MADRS), Beck's Depression Inventory (BDI), and Clinical Global Impression (CGI) scales and statistical analyses were performed on the intent-to-treat sample (143 patients) using the last-observation-carried-forward method. In addition, reported adverse events, routine laboratory parameters, and vital signs were investigated to evaluate the safety of mirtazapine. RESULTS: Mean daily dose of mirtazapine was 28.4 mg. At the end of the study, the response rate (50% or more reduction from baseline in HAMD scores) was 75.5% and the remission rate (7 or less in HAMD score) was 42.7%. Mirtazapine treatment induced significant reduction in depressive symptoms at the 4(th) day and substantial reduction along the treatment period, as assessed by changes in HAMD, MADRS, BDI, and CGI scales. At the 4(th) day and first week of mirtazapine treatment, the mean HAMD-17 total score was significantly reduced compared that of the baseline and the response rates were 11.9% and 28.7%, respectively. Mirtazapine was well tolerated in general, and somnolence and sedation were the most common adverse events reported. In addition, there were no clinically relevant changes in laboratory parameters and vital signs, although body weight was increased. CONCLUSION: Although this trial had many limitations of open non-comparative study, mirtazapine was demonstrated to an effective treatment for moderate to severe major depressive disorder and was well tolerated. A potentially rapid onset of overall therapeutic efficacy of mirtazapine was suggested by significant changes in all major variables of efficacy after 4(th) day of treatment.
Body Weight ; Depression ; Depressive Disorder, Major ; Diagnosis ; Humans ; Outpatients ; Vital Signs ; Weights and Measures

Background: The purpose of this study was to evaluate the applicability of the Korean Brief Comprehensive Geriatric Assessment Questionnaire through testing the reliability and validity of it. Methods: Questionnaire consisted of items on medical, functional, mental, socioeconomic status and lifestyle was administered as test-retest on 78 elderly outpatients at 6 university hospitals in Seoul, Korea. Weighted kappa value, kappa value, Pearson correlation coefficients and overall percent agreement were calculated to measure reliability. Validity coefficient was estimated by using reliability coefficient. Results: Reliability coefficients and validity coefficients were higher than 0.50 (fair or good) for 28 items (87.5%) among 32. For test- retest reliability, median was 1.00 (range, 0.87-1.00) for overall percent agreement, 0.66 (range, 0.27~1.00) for kappa value, and 0.83 (range, 0.65~1.00) for Pearson's correlation coefficients. Differences of reliability and validity were identified by gender for 19 items (59.4%), and by age group for 12 items (37.5%). Conclusion: The Korean Brief Comprehensive Geriatric Assessment Questionnaire appears to be a reliable and valid screening tool. After additional study is performed, this instrument can be used as a useful tool for comprehensive outpatient geriatric assessment.
Aged ; Geriatric Assessment* ; Hospitals, University ; Humans ; Korea ; Life Style ; Mass Screening ; Outpatients ; Surveys and Questionnaires* ; Reproducibility of Results* ; Seoul ; Social Class

BACKGROUND: One method for achieving medical practice to be more evident, especially in the field of primary care, is to encourage the use of clinical guidelines. If development of guidelines is difficult because of time and cost, an evidence based foreign guidelines can be selected and translated into Korean for application. METHODS: A team was formed, consisting of 11 family physician experts on evidence based medicine and clinical practice guidelines. We selected six respiratory diseases requiring clinical guidelines because of variability in practice. We searched several clinical practice guideline databases and selected one guideline according to currency, scope of guideline, whether it was evidence based, and its feasibility in the field of primay care. We translated selected guideline's full-texts or summaries which were done by authorized organization into Korean. RESULTS: The selected respiratory diseases were chronic obstructive pulmonary disease, asthma, pneumonia, sinusitis, rhinitis, and influenza. According to criterion, we selected GOLD (Global Initiative for Chronic Obstructive Lung Disease) for chronic obstructive lung disease, GINA (Global initiative for asthma) for asthma, CDC (Center for disease control) guideline for influenza, IDSA (Infectious Diseases Society of America) guideline for pneumonia, AAP (American Academy of Pediatrics) guideline for sinusitis, and JCAAI (Joint Council of Allergy, Asthma and Immunology) for rhinitis. CONCLUSION: We selected six common respiratory diseases and the most appropriate evidence based guidelines for those particular diseases.
Asthma ; Centers for Disease Control and Prevention (U.S.) ; Evidence-Based Medicine ; Humans ; Hypersensitivity ; Influenza, Human ; Lung ; Physicians, Family ; Physicians, Primary Care* ; Pneumonia ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive ; Rhinitis ; Sinusitis

BACKGROUND: The functional status of elerly has been measured by mamy measures including Karz ADL index, Karz ADL index and physical self-maintenace scale. Amon them, Karz ADL index has been widely used in many countries because of easiness to scoring and adminstration. So we translated Karz ADL index and tested the translation validity, psychometric properties(validity and reliability) of Korean version of Karz ADL index. METHODS: The Karz ADL index was translated by multidisciplinary committee members. The quality of translation was rated by committee members using three criteria(clarity, use of common language, conceptual equivalence). Reliability was tested by internal consistency(Cronbach's alpha), two weeks test-retest reliability, intraobserver agreement. Clinical validity and construct validity comparison with brain disability grade were tested for validity testing. RESULTS: Cronbach's alpha was 0.90. 2 weeks test-retest correlations coefficient was 0.94(p=0.00). Interrator agreements were high in all 10 items( =0.79 0.96). Normal control group had lower scores than patients group(p=0.000). Correlation coefficients between Korean version of Karz ADL index score and brain-disability grade was -0.68(p=0.000). CONCLUSION: Korean version of Karz ADL index is a valid and reliable instrument for measuring functional status of elderly.
Activities of Daily Living* ; Aged ; Brain ; Committee Membership ; Humans ; Psychometrics ; Reproducibility of Results*

BACKGROUND: The functional status of elderly has been measured by many different methods including Karz ADL index, Bathel ADL index and physical self- maintenance scale. Among them, Bathel ADL index has been widely used in many countries because of easiness to scoring and administration. Therefore, we translated the Bathel ADL index and tested the translation validity and psychometric properties (validity and reliability) of Korean version of Bathel ADL index. METHODS: The Bathel ADL index was translated by multidisciplinary committee members. The quality of translation was rated by committee members using three criteria (clarity, use of common language, conceptual equivalence). Reliability was tested by internal consistency (Cronbach's alpha), two weeks test-retest reliability, and intraobserver agreement. Clinical validity and construct validity comparison with brain disability grade were tested for validity testing. RESULTS: Cronbach's alpha was 0.97. Two weeks test-retest correlations coefficient was 0.95 (P=0.00). Interrator agreements were high in all 10 items (kappa=0.82~1.0). Normal control group had lower scores than the patient group (P=0.000). Correlation coefficients between the Korean version of Bathel ADL index score and brain- disability grade was -0.58 (P=0.000). CONCLUSION: The Korean version of Bathel ADL index is a valid and reliable instrument for measuring functional status of the elderly.
Activities of Daily Living* ; Aged ; Brain ; Committee Membership ; Humans ; Psychometrics ; Reproducibility of Results*

BACKGROUNDS: Katz index of ADL and Barthel index of ADL have been used to evaluate the function of disabled elderly in Korea. But no ADL scale reflecting Korean's own language expression and culture has been developed and verified yet. METHODS: Descriptions of basic activities which needed others' help were collected from 190 Korean disabled elderly. The collected results were categorized into basic activities of daily living and instrumental activities of daily living, and then in each domain such as bathing, shopping, etc. Preliminary instrument items were selected by the judgement of the expert committee, considering the frequency of the responses and the importance of each item. A preliminary questionnaire was developed based on the selected items. The preliminary questionnaire was pretested twice, and corrected by the results. Finally a scholar on Korean literature verified the questionnaire on the grammar and context. RESULTS: A total of 408 basic activities of daily living and 242 instrumental activities of daily living were collected. The activities were categorized into 7 domains of ADL(dressing, washing face and hand, bathing, eating, transfer, toileting, continence) and 10 domains of IADL(decorating, housework, preparing meals, laundry, outgoing for a short distance, using transportation, shopping, handling money, using telephone, taking medicine) CONCLUSIONS: We developed a Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale reflecting Korean elderly's own language expression and culture.
Activities of Daily Living ; Aged ; Baths ; Eating ; Hand ; Housekeeping ; Humans ; Korea ; Meals ; Surveys and Questionnaires ; Telephone ; Transportation

BACKGROUNDS: Korean Activities of Daily Living(K-ADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of Korean Activities of Daily Living(K-ADL) scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach's alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach's alpha was 0.937. 2 weeks test-retest correlations in all 7 items were higher than 7.0. Interrator agreements were high in all 7 items(h=0.86~1.0). Nonnal control group had lower scores than patients group in all 7 items(p=0.000). Correlation coefficients between K-ADL score and braindisability grade was between -0.465(eating) and -0.696(bathing)(p=0.000). CONCLUSIONS: Korean Activities of Daily Living(K-ADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-ADL and mortality, prognosis are needed.
Activities of Daily Living ; Aged ; Humans ; Korea ; Mortality ; Prognosis ; Reproducibility of Results*

BACKGROUND: Korean Instrumental Activities of Daily Living(K-IADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of K-IADL scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach`s alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach`s alpha was 0.938. 2 weeks test-retest correlations in all 10 items were higher than 0.674. Interrator agreements were high in all 10 items(H=0.808~0.947). Normal control group had lower scores than patients group in all 10 items(p=0.000). Correlation coefficient between K-IADL score and brain-disability grade was between -0.336(laundry) and -0.663(using transportation)(p=0.000). CONCLUSIONS: Korean Instrumental Activities of Daily Living(K-IADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-IADL and mortality, prognosis are needed.
Aged ; Humans ; Mortality ; Prognosis ; Reproducibility of Results*

No abstract available.
Tuberculosis*