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Aims and objectives This study aimed to establish and test a predictive model for explaining the health-related quality of life of young adult patients with stroke. Background Individual characteristics, biological and physiological variables, social support, emotional and cognitive symptoms, physical function disability and general health perception may be interrelated and may directly or indirectly affect the health-related quality of life of young adult patients with stroke. Design A cross-sectional study. Methods 237 young outpatients with stroke were recruited and surveyed. Data collection used a structured questionnaire from July-November 2018. The collected data were analysed using SPSS version 25.0® and AMOS 23.0. This study is based on STROBE guidelines. Results The hypothetical model's fit indices were adequate. Stroke severity, social support, fear of stroke recurrence, physical function disability and general health perceptions directly affected the health-related quality of life. Additionally, stroke severity, depression and fear of stroke recurrence also indirectly affected it. These variables explained 60.3% of the variance in this quality. Conclusions Variables such as severity of stroke, depression, fear of stroke recurrence, social support, physical function disability and general health perception were found to be related to the HRQoL of young adult patients with stroke. Relevance to clinical practice A variety of physical, psychological, functional and social factors related to health-related quality of life should be systematically monitored. Furthermore, nurses need to develop and apply detailed nursing interventions that take into account all these variables.

The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) is a scale that measures quality of life (QoL) based on the characteristics of older adults. This study aimed to evaluate the reliability and validity of the Korean version of the WHOQOL-OLD. It was administered to 273 older adults by convenience sampling in Jeonbuk, South Korea. The six-factor model was validated by confirmatory factor analysis (χ2=462.52 [p

Background/Aims Coronary endothelial and microvascular function play important roles in cardiovascular disease. We aimed to evaluate the effect of ticagrelor on coronary artery function and tested the antiplatelet effect of low dose ticagrelor in East-Asian patients. Methods Sixty-one consecutive patients with non-significant coronary disease were included in the study. Initially, patients were randomized in 1:1:1 ratio to receive drugs: ticagrelor 90 mg twice a day (bid; n = 22), ticagrelor 45 mg bid (n = 19) or clopidogrel 75 mg once a day (qd; n = 20) and then divided into two groups (ticagrelor vs clopidogrel) for evaluation of coronary artery function, and three groups for evaluation of antiplatelet function. Endothelial dysfunction was measured by coronary flow reserve (CFR), and changes in the levels of asymmetric dimethylarginine (ADMA), cluster of differentiation (CD) 40 ligand, and P-selectin. Microvascular function was evaluated as index of microvascular resistance (IMR). Platelet reactivity was assessed by VerifyNow P2Y12 assay. Results The levels of CFR, ADMA, and CD 40 ligand were not different between the two groups. However, P-selectin was lower in the ticagrelor group compared with clopidogrel group. IMR was significantly lower in the ticagrelor group compared with clopidogrel group (median, 15.0 [interquartile range, 12.0 to 21.0] vs. 47.5 [23.0 to 67.5], p = 0.014). There was significant difference in platelet inhibition among the three groups (ticagrelor 90 mg bid vs. ticagrelor 45 mg bid vs. clopidogrel 75 mg qd; 85.57 ± 47.63 vs. 120.33 ± 51.09 vs. 256.42 ± 55.10, p < 0.001) Conclusions It is hypothesized that ticagrelor might ameliorate the coronary microvascular function. When compared with clopidogrel, low dose ticagrelor exhibited satisfactory antiplatelet effect in the present study.

PURPOSE: Foot reflexology has become popular for sustainable health management because it is free from side effects, easy to learn and perform. The purpose of this study was to investigate the effects of foot reflexology on the physical symptoms of cancer patients.METHODS: The systematic review and meta-analysis was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Data were pooled using fixed- or random-effects models. Pain, sleep, fatigue, and nausea and vomiting were analyzed for the main effects. Eighteen studies were included, representing 931 participants.RESULTS: Foot reflexology was effective in alleviating pain (d=-1.05; 95% CI: -1.52, -0.59), promoting sleep (d=1.15; 95% CI: 0.45, 1.85), and relieving fatigue (d=-1.46; 95% CI: -1.79, -1.14), but it was not significantly effective in reducing nausea and vomiting (d=-0.53; 95% CI: -1.29, 0.22).CONCLUSIONS: Based on these findings, there is clear evidence that foot reflexology has significant positive effects on the physical symptoms of cancer patients. Further study is needed, however, to perform subgroup analysis using the frequency of sessions as predictors.

Background Verrucous carcinoma, a rare low-grade well-differentiated squamous cell carcinoma, is known for its favorable biological behavior and lack of metastatic potential. However, aggressive resection is problematic in terms of compromised function and aesthetics. Hence, more conservative treatments are needed. Methods: To identify the up-to-date general biological behavior, diagnosis, and treatment trends, we searched PubMed using the keyword “penile verrucous carcinoma” without restrictions on publication date. Results: Current treatments for penile verrucous carcinoma include wide surgical excision, seldom preventive lymphadenectomy, and conservative chemotherapy without surgery or local excision with safe margins. Despite the advent of partial penectomy to minimally impact function and aesthetics, affected patients experience psychosexual problems. Local excision can be used to save the penile shaft and glans penis without preventive lymphadenectomy or adjuvant therapy and can achieve good clinical prognosis with rare recurrence. Conclusions: To preserve the functional and cosmetic aspects, we recommend local excision, especially for tumors measuring

Aims and objectives This study aimed to develop a fall risk perception questionnaire for patients admitted to acute care hospitals and to establish its reliability and validity. Background To prevent falls during patients' hospitalisation, it is essential for them to accurately perceive their risk of falling. Design This methodological study was performed to develop a fall risk perception questionnaire. Methods After generating a preliminary questionnaire, two rounds of content validity testing were performed with nine experts. Following a pilot test, a convenience sample of 236 participants was recruited from an acute care hospital between 2 May 2018 and 15 December 2019. Construct, convergent and known-group validity of the questionnaire was evaluated, and reliability was estimated by calculating the internal consistency reliability coefficients. The study adhered to STROBE guidelines. Results Exploratory factor analysis yielded a three-factor solution with 27 items. The questionnaire showed statistically significant positive correlation with the Korean Falls Efficacy Scale-International and the Morse Fall Scale, thus establishing convergent validity. For known-group comparison, Morse Fall Scale scores were categorised into two groups by cut-off score. The risk for falls group had a significantly higher perceived fall risk than the no risk for falls group, thus establishing known-group validity. Cronbach's alpha values indicated good to excellent reliability for the overall questionnaire with 27 items and for each of the three subfactors. Conclusions The fall risk perception questionnaire demonstrated satisfactory reliability and validity in an acute care hospital setting. Relevance to clinical practice Because understanding patients' perceptions of their fall risk is essential for preventing falls, it is necessary to regularly assess patients' fall risk perception using tools with established reliability and validity.

Purpose This study was conducted to investigate the effects of an education program using a high-fidelity simulator of labor and delivery on nursing knowledge, critical thinking, and clinical performance among nursing students who had not yet experienced clinical practicum. Methods The development of a 5-week maternity nursing education programs using high-fidelity simulators included modules containing case-oriented scenarios, knowledge, and skills required for maternity care. A randomized controlled study was conducted to verify the effects of the developed program. Data were collected from October 21 to December 9, 2019. The experimental group (n=36) participated in a 5-week high-fidelity simulation program on care for the woman in labor, whereas the control group (n=36) received standard education as lecture and practice with delivery model. The collected data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation), the Chi-square test, Fisher exact test, and t-test. Results For participants who received education using the high-fidelity simulation program, nursing knowledge (t=2.33, p=.011), critical thinking (t=3.73, p

Introduction Globally, pneumococcal disease represents a significant burden. South Korea implemented the 7-valent pneumococcal conjugate vaccine (PCV7) in 2003, replaced with the 10-valent (PCV10) and 13-valent (PCV13) vaccine in 2010. In 2014, both vaccines were introduced in the national immunization program (NIP) for infants with 3 primary doses and one booster dose We performed a cost-effectiveness evaluation to elucidate which vaccine may be expected to provide greater impact if included in a NIP. Methodology Using an established model, we estimated the impact of introducing either PCV13 or PCV10 into the South Korean NIP in 2015. Vaccine impact was based on historic observed impact of PCV13 from 2010 to 2015 in Korea given high uptake of PCV13, and PCV10 impact was estimated based on experiences in countries using PCV10. Incidence and costs for all ages and including invasive pneumococcal disease, pneumonia, and acute otitis media were derived from the literature and Health Insurance Review and Assessment database. Results In the base-case, over 5-years PCV13 was estimated to avert 550,000 more cases of pneumococcal disease compared to PCV10, driven by broader serotype coverage and less replacement due to serotypes 3 and 19A. This translated to a cost-savings of $47.4 million USD despite PCV13’s higher cost. Sensitivity analysis found incremental cost-effectiveness ratios (ICERs) ranged from cost-saving to $7,300 USD per quality-adjusted life year (QALY). Conclusion A NIP using PCV13 was estimated to have a more substantial public health impact and be cost-saving compared to a program with PCV10 due to broader serotype coverage.

Although previous studies have shown that the administration of fibroblast growth factor 21 (FGF21) reverses hepatic steatosis, the mechanism by which FGF21 exerts a therapeutic effect on nonalcoholic fatty liver disease (NAFLD) is not yet entirely understood. We previously demonstrated that hepatic six transmembrane protein of prostate 2 (STAMP2) may represent a suitable target for NAFLD. We investigated the mechanism underlying the therapeutic effect of recombinant FGF21 on NAFLD, focusing on the involvement of hepatic STAMP2. In this study, we used human nonalcoholic steatosis patient pathology samples, C57BL/6 mice for a high-fat diet (HFD)-induced in vivo NAFLD model, and used human primary hepatocytes and HepG2 cells for oleic acid (OA)-induced in vitro NAFLD model. We observed that recombinant FGF21 treatment ameliorated hepatic steatosis and insulin resistance through the upregulation of STAMP2 expression. We further observed hepatic iron overload (HIO) and reduced iron exporter, ferroportin expression in the liver samples obtained from human NAFLD patients, and HFD-induced NAFLD mice and in OA-treated HepG2 cells. Importantly, recombinant FGF21 improved HIO through the hepatic STAMP2-mediated upregulation of ferroportin expression. Our data suggest that hepatic STAMP2 may represent a suitable therapeutic intervention target for FGF21-induced improvement of NAFLD accompanying HIO.

Purpose: The purpose of this study was to investigate the effects of anxiety and smartphone dependency on sleep quality in pregnant women with preterm labor. Methods: The participants of this study were 111 pregnant women who were between 20 and 37 weeks of gestation and experienced preterm labor. The data were collected from October 1, 2018 to October 25, 2019. The collected data were analyzed using descriptive statistics (frequency, percentage, and standard deviation), as well as the t-test, Pearson correlation coefficients, and hierarchical multiple regression. Results: Significant negative correlations were found between anxiety and sleep quality and between smartphone dependency and sleep quality. Participants’ history of preterm birth, pregnancy method, bowel movements, anxiety, and smartphone dependency significantly affected sleep quality, with an explanatory power of 18%.Conclusion: In order to improve the quality of sleep, which is an important health-related factor for pregnant women experiencing preterm labor, it will be necessary to identify a history of premature birth, pregnancies achieved using artificial reproductive technology, bowel problems, and smartphone dependency in advance and to provide nursing interventions accordingly.

Familial hypophosphatemic rickets (FHR) is a disorder characterized by phosphate wasting and hypophosphatemia due to defects in renal phosphate transport regulation. There are 4 known inherited forms of FHR that differ in their molecular causes. Very few studies have been conducted that focused on the molecular analysis of FHR in Koreans. Eighteen mutations of the PHEX gene have been identified to this date in Korea. Herein, we report the clinical case of a 24-month-old boy presenting with bowed legs and short stature. The biochemical profile showed hypophosphatemia with decreased tubular reabsorption of phosphate. Several family members were identified with short stature and genu varum. Therefore, he was diagnosed with FHR. To identify the molecular causes of FHR, we performed targeted gene panel sequencing and found a novel hemizygous missense variant, c.1949T>C (p.Leu650Pro), in the PHEX gene. This variant was also detected in the boy’s mother who exhibited genu varum and short stature.

Background Isolated superior mesenteric artery dissection (ISMAD) was previously considered a rare disorder; however, this condition has been increasingly diagnosed as time progressed. Although treatment regimen and treatment outcomes have become clearer, the optimal treatment strategy has not yet been well established. Materials and Methods This study included 54 patients diagnosed with ISMAD by computed tomography (CT) between November 2004 and December 2017. Thirteen patients were excluded from the analysis of natural course as 6 were lost to follow-up, and 7 underwent endovascular therapy. Results Of the 54 patients included in the study, 50 were male, and 4 were female. The mean age of the patients was 52.3 years (range 40–74). The mean follow-up duration was 18.5 months (range 1.0–131.0). Thirty-eight patients were symptomatic, and 16 were asymptomatic. All aneurysmal changes observed on follow-up CT scans were initially classified as type III or IV. Of these patients, 7 underwent endovascular therapy. The failure rate of conservative treatment was 13%. Conclusions Conservative treatment is safe and effective if bowel necrosis or arterial rupture is not present. Symptomatic patients classified as type III or IV on the initial CT scan should be followed up. If there is recurrent pain or aneurysmal progression, endovascular therapy should be performed.

As another wave of COVID-19 outbreak has approached in July 2020, a larger scale COVID-19 pediatric Asian cohort summarizing the clinical observations is warranted. Children confirmed with COVID-19 infection from the Republic of Korea, the Hong Kong Special Administrative Region (HKSAR) and Wuhan, China, during their first waves of local outbreaks were included. Their clinical characteristics and the temporal sequences of the first waves of local paediatric outbreaks were compared. Four hundred and twenty three children with COVID-19 were analyzed. Wuhan had the earliest peak, followed by Korea and HKSAR. Compared with Korea and Wuhan, patients in HKSAR were significantly older (mean age: 12.9 vs. 10.8 vs. 6.6 years, p

Aims and objectives To test a hypothetical path model estimating the influence of resilience and gratitude disposition on well-being in Korean clinical nurses and to verify the mediating effects of burnout, compassion satisfaction and job satisfaction using a multi-mediation model. Background To improve the well-being of nurses, it is necessary to consider their personal and work-related characteristics comprehensively. Design A descriptive cross-sectional design was used. Methods A total of 310 clinical nurses participated in this study. A structured questionnaire was used to collect data. A path analysis using a multi-mediation model was performed using AMOS 23.0 to test the hypothetical path model. This study adhered to the STROBE guideline. Results The model's fit indices were adequate. Resilience and gratitude disposition both had significant direct effects on well-being. Resilience and gratitude disposition had significant indirect effects on well-being through the effect of burnout, compassion satisfaction and job satisfaction. Resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction explained 68.3% of the total variance of well-being. Conclusions Intervention programmes considering these factors may be useful to improve nurses' well-being. Relevance to clinical practice Nurses' well-being should be assessed along with resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction. To improve the well-being of clinical nurses, systematic and integrated intervention programmes need to be developed and applied, with consideration for a variety of factors related to well-being.

We investigated the functional role of miR-892b as a novel inhibitor of chondrocyte hypertrophy during TGF-β-mediated chondrogenesis of human mesenchymal stem cells (hMSCs). The expression of miR-892b during TGF-β-mediated chondrogenesis of hMSCs and the effects of miR-892b overexpression on chondrogenic and hypertrophic marker genes in the chondrogenesis of hMSCs were investigated. Targets of miR-892b were identified and verified by overexpression of synthetic miRNA mimics and luciferase assays. Cross-talk between Kruppel-like factor 10 (KLF10) and Indian hedgehog (Ihh) was investigated using KLF10 knockdown (KD). miR-892b enhanced chondrogenic makers and suppressed hypertrophy in hMSC chondrogenesis, mimicking parathyroid hormone-related peptide (PTHrP). KLF10, a transcription factor and miR-892b target, directly regulated Ihh promoter activity. Like miR-892b, KLF10 KD enhanced hMSC chondrogenesis and inhibited hypertrophy. Our findings suggest a key role of miR-892b in targeting the KLF10-Ihh axis as a regulator of hypertrophy in TGF-β-mediated chondrogenesis of hMSCs and provide a novel strategy for preventing hypertrophy in chondrogenesis from MSCs. Keywords: chondrogenesis, mesenchymal stem cells, hypertrophy, miR-892b, KLF10

Purpose: Magnetic resonance imaging (MRI) of the brain can provide valuable information about structural abnormalities in strabismus. The aim of this study was to evaluate the utility of MRI in this regard and to identify risk factors for abnormal MRI results in children with strabismus. Methods: A retrospective analysis of children Results: A total of 90 patients (47 [52.2%] male, 43 [47.8%] female; mean age, 2.19 ± 0.53 years) were enrolled. Of those, 64 (71.1%) presented with normal and 26 (28.9%) with abnormal MRI results. The age at presentation was lower and abnormal findings on fundus examination were more common in the abnormal MRI group ( P = .002 and P = .008, respectively). Among the patients, 46 (51.1%) had infantile strabismus and 44 (48.9%) had childhood strabismus. Global developmental delays, speech delays, and MRI abnormalities were more common in patients with infantile than in those with childhood strabismus. Ptosis and headaches were more common in patients with childhood strabismus ( P = .025, P = .025, respectively). Conclusion: Brain MRI was helpful for accurate diagnosis and treatment of strabismus in younger children, those with abnormal findings on fundus examination, and infants with developmental, especially speech, delays.

Background: The aims of this study were to construct and verify a model that explains the quality of life in patients with recurrent coronary artery disease. Methods: Participants were 212 patients with recurrent coronary artery disease undergoing percutaneous coronary intervention. Data were collected through structured questionnaires from 21 December 2016–30 April 2017, and were analyzed using SPSS 23.0 and AMOS 23.0. Results: The model’s fit indices were adequate. Type D personality, symptom experience, and resilience had a direct effect on quality of life, while type D personality, cardiac function status, social support, and resilience had an indirect effect on quality of life. Type D personality, cardiac function status, social support, symptom experience, and resilience explained 55% of the total variance in quality of life. Thus, type D personality, cardiac function status, social support, symptom experience, and resilience affected the quality of life in patients with recurrent coronary artery disease. Conclusions: Systematic and integrated intervention programs considering factors related to quality of life may be useful for improving quality of life for patients with recurrent coronary artery disease.

Anti-GQ1b antibody syndrome encompasses Miller Fisher syndrome and its related disorders. We retrospectively identified 11 pediatric patients (5.4–18 years old) with anti-GQ1b antibody syndrome. Diagnoses of patients included acute ophthalmoparesis (n = 6), classical Miller Fisher syndrome (n = 2), Miller Fisher syndrome/Guillain-Barre syndrome (n = 1), acute ataxic neuropathy (n = 1), and pharyngeal-cervical-brachial weakness (n = 1). Nine patients (81.8%) fully recovered. Maturational change in GQ1b antigen expression and the accessibility of anti-GQ1b antibodies might be the cause of the difference of clinical manifestations in children with anti-GQ1b antibody syndrome.

Background Thus far, human leukocyte antigen (HLA)-B∗58:01 has been recognized as the most important risk factor for allopurinol induced severe cutaneous adverse reactions (SCARs). Objective To determine the usefulness of prospective screening for the HLA-B∗58:01 allele to identify Korean individuals at risk for SCARs induced by allopurinol treatment. Methods We prospectively enrolled 542 patients with chronic renal insufficiency (CRI) from 10 hospitals nationwide and performed DNA genotyping to determine whether they carried the HLA-B∗58:01 allele. Of these, 503 HLA-B∗58:01-negative patients (92.8% of total) were treated with allopurinol, and 39 HLA-B∗58:01-positive patients (7.2%) were treated with febuxostat, an alternative drug. The patients then were followed up biweekly for 90 days using a telephone survey to monitor symptoms of adverse drug reactions, including SCARs. As a control, we used the historical incidence rate of allopurinol-induced SCARs in 4002 patients with CRI from the same hospitals who were enrolled retrospectively. Results Nineteen patients in the prospective cohort developed mild and transient adverse reactions but none showed allopurinol-induced SCARs. By contrast, we identified 38 patients with allopurinol-induced SCARs (0.95%) in the historical control. The difference in the incidence of allopurinol-induced SCARs between the prospective cohort and historical control was statistically significant (0% vs 0.95%, respectively; P = .029). Conclusions The present study demonstrated the clinical usefulness of the HLA-B∗58:01 screening test before allopurinol administration to prevent allopurinol-induced SCARs in patients with CRI.

Low-income middle-aged women (LMW) who are vulnerable have various physical and psychosocial problems. They need lifestyle interventions to actively cope with these risk factors. This study used a randomized control group pretest-posttest design. LMW aged from 40 to 60 years were recruited and randomly assigned to an experimental group (n = 31) and a control group (n = 32). The lifestyle interventions for this study, which were implemented for eight weeks, included nutritional management, physical activity, stress management and cognitive function improvement based on King’s goal attainment theory. The measured outcomes were health-promoting behaviors, Type D personality, cognitive function and body composition. The experimental group scored significantly higher than the control group for health-promoting behaviors (effect size (ES) = 0.68~1.27, p &lt, 0.001~0.014) and cognitive function (ES = 0.79~1.31, p &lt, 0.001~0.005). The negative affectivity (ES = 0.70, p = 0.012) and the prevalence of a Type D personality (x2 = 4.39, p = 0.047) and the systolic blood pressure (ES = 0.65, p = 0.019) decreased significantly in the experimental group compared with the control group. Lifestyle interventions for LMW were effective in improving health-promoting behavior, Type D personality traits and cognitive function.

Importance There is limited information describing the full spectrum of coronavirus disease 2019 (COVID-19) and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in children. Objective To analyze the full clinical course and the duration of SARS-CoV-2 RNA detectability in children confirmed with COVID-19 in the Republic of Korea, where rigorous public health interventions have been implemented. Design, Setting, and Participants This case series of children with COVID-19 was conducted in 20 hospitals and 2 nonhospital isolation facilities across the country from February 18, 2020, to March 31, 2020. Children younger than 19 years who had COVID-19 were included. Exposures Confirmed COVID-19, detected via SARS-CoV-2 RNA in a combined nasopharyngeal and oropharyngeal swab or sputum by real-time reverse transcription–polymerase chain reaction. Main Outcomes and Measures Clinical manifestations during the observation period, including the time and duration of symptom occurrence. The duration of SARS-CoV-2 RNA detection was also analyzed. Results A total of 91 children with COVID-19 were included (median [range] age, 11 [0-18] years; 53 boys [58%]). Twenty children (22%) were asymptomatic during the entire observation period. Among 71 symptomatic cases, 47 children (66%) had unrecognized symptoms before diagnosis, 18 (25%) developed symptoms after diagnosis, and only 6 (9%) were diagnosed at the time of symptom onset. Twenty-two children (24%) had lower respiratory tract infections. The mean (SD) duration of the presence of SARS-CoV-2 RNA in upper respiratory samples was 17.6 (6.7) days. Virus RNA was detected for a mean (SD) of 14.1 (7.7) days in asymptomatic individuals. There was no difference in the duration of virus RNA detection between children with upper respiratory tract infections and lower respiratory tract infections (mean [SD], 18.7 [5.8] days vs 19.9 [5.6] days;P = .54). Fourteen children (15%) were treated with lopinavir-ritonavir and/or hydroxychloroquine. All recovered, without any fatal cases. Conclusions and Relevance In this case series study, inapparent infections in children may have been associated with silent COVID-19 transmission in the community. Heightened surveillance using laboratory screening will allow detection in children with unrecognized SARS-CoV-2 infection.

Aims and objectives The purpose of this study was to examine the magnitude of cancer stigma, social support, coping strategies and psychosocial adjustment among breast cancer survivors and to identify the factors associated with patients' psychosocial adjustment. Background Few studies have examined the association between cancer stigma and adaptation outcomes, which are considered interpersonal stressors for breast cancer survivors. Design A correlational, cross-sectional research design was used. Methods This study was designed based on the stress-coping theory of Lazarus and Folkman. This descriptive cross-sectional study included 158 breast cancer survivors who visited a Korean tertiary hospital. Data collection was performed using a structured questionnaire and electronic medical records between March-May 2018. Data analyses included descriptive statistics, independent t test, one-way ANOVA, Kruskal-Wallis test, partial correlation analysis and hierarchical regression analysis and were performed with the SPSS WIN 25.0 program. This study adheres to STROBE guidelines. Results Cancer stigma had the strongest association with psychosocial adjustment among Korean breast cancer survivors, followed by social support and coping strategies. These variables accounted for approximately 44% of the variance in psychosocial adjustment. Conclusion Cancer stigma had the strongest association with psychosocial adjustment. Healthcare professionals should assess patients' cancer stigma to develop patient-tailored stigma management programmes. Relevance to clinical practice Interventions to alleviate cancer stigma should be developed, and social support and coping strategies for breast cancer survivors should be considered in clinical oncology settings.

Studies have been conducted on the development of healthcare programs for older adults in rural areas, not only in Asia but also in Europe and the United States. However, these reports have been limited by largely non-comprehensive results, lack of demand surveys, or programs with no systematic development. The purpose of this study was to develop an integrated healthcare program for rural older adults and investigate the effects of the program. A nonequivalent control group pretest&ndash, posttest design was used. Subjects were aged over 65 and lived in the rural community. The integrated healthcare program involved 12 three-hour sessions over 12 weeks. Compared with the control group, the experimental group demonstrated significant differences in both upper extremities strengths (t = 2.74, p = 0.008, t = 2.03, p = 0.047), static balance (z = &minus, 2.38, p = 0.017), dynamic balance (t = &minus, 4.82, p &lt, 0.001), loneliness (t = &minus, 3.02, p = 0.003), and role self-efficacy (t = 2.39, p = 0.020), but no differences for ego integration (t = 1.51, p = 0.137). To improve physical, mental, and social health of the rural older adults, we developed an integrated healthcare program. The program improved physical functions, loneliness, and role self-efficiency of the rural older adults. Therefore, it is recommended that healthcare professionals actively apply this program in primary healthcare institutes and elsewhere.

OBJECTIVE To investigate the influence of type-D personality on quality of life (QoL) in patients with primary brain tumours. METHODS We performed descriptive cross-sectional study between July 2018 and March 2019. A convenience sample of 293 patients was recruited from an outpatient neurosurgery clinic. RESULTS Type-D personality was identified in 34.1% of subjects. Type-D patients had poorer QoL and experienced more severe symptoms and interference with life. Poor QoL was associated with lower education, no spouse and lower family income. Symptoms were the most significant factor affecting QoL, followed by type-D personality, income and education. CONCLUSION Symptoms, type-D personality and demographic factors should be considered when assessing QoL in patients with primary brain tumours. Interventions that reflect these characteristics, including type-D personality, may help improve QoL for patients with primary brain tumours.

The extracellular sulfatases (Sulfs), sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2), have an important role in cell signaling by modulating the 6-O-sulfation of heparan sulfate proteoglycans (HSPGs) on the cell surface. Gene expression and enzyme activity of Sulfs are elevated in hypertensive vascular smooth muscle cells (VSMCs) compared to those in normotensive VSMCs. CXC-chemokine ligand (CXCL) 8 has a pathogenic role in the development and progression of hypertension. In this study, we investigated the effect of Sulfs on the expression of CXCL8-induced endothelin (ET)-1, a hypertensive mediator, in VSMCs from spontaneously hypertensive rats (SHR). Expression of ET-1 and elevation of angiotensin (Ang) II-induced ET-1 expression by CXCL8 were reduced in Sulf2 small interfering RNA (siRNA)-transfected SHR VSMCs. But, downregulation of Sulf1 did not affect the expression of CXCL8-induced ET-1 and additive effect of CXCL8 on Ang II-induced ET-1 expression in SHR VSMCs. CXCL8-induced ET-1 expression and the additive effect of CXCL8 on Ang II-induced ET-1 expression were dependent on the Ang II type 1 receptor (AT1 R) pathway, not the Ang II type 2 receptor (AT2 R) pathway. In addition, downregulation of Sulf2 reduced the expression of CXCL8-induced AT1 R and abrogated the additive effect of CXCL8 on Ang II-induced AT1 R expression in SHR VSMCs. Sulf2 mediated, partially, the expression of ET-1 and the additive expression of Ang II-induced ET-1 mRNA by CXCL8 via the AT1 R pathway in SHR VSMCs. These findings suggest that Sulf2 is an up-regulatory factor in the additive action of CXCL8 via the AT1 R pathway on Ang II-induced ET-1 expression in VSMCs under hypertension environment.

Background Proximal femoral fracture (PFF), such as intertrochanteric femoral fracture or femur neck fracture, and its management are crucial issues to surgeons. PFF has been dramatically is becoming exponentially prevalent, and it is at high risk of complication and mortality because it is frequently associated with serious trauma and advanced age, especially in patients treated with anticoagulants or antiplatelet agents. Surgical management is essential for the treatment of PFF. Unfortunately, current surgical procedures have been related to accompanied by vascular complications, including laceration, hemorrhage, thrombosis, embolism, intimal flap tear and pseudoaneurysm. Furthermore, these vascular injuries following surgical management of PFF are potentially limb- and life-threatening. Of the complications after operation of PFF, femoral arteriovenous fistula (AVF) is rare, but remains a challenging problem because it is frequently associated with significantly high mortality and morbidity and is very difficult to treat. Methods A systematic literature review was conducted using the PRISMA guidelines with no language restriction. We searched scientific publications via PubMed, Embase, Cochrane central register of controlled trial, Google Scholar, the KoreaMed and the Research Information Sharing Service database. The goal of this study was to report on the incidence, clinical presentation, diagnosis, treatment, associated complications, morbidity and mortality of femoral AVF caused by PFF and to draw special attention to its prevention and management. Results A total of 7 case reports on femoral AVF associated with operation of PFF were identified, and one our case was added to the systematic analysis. Of the 8 cases, 4 were male and 4 were female under the age of 67.87±18.44; 6 (75.0%) survived without any events, 1 (12.5%) survived with a sequela of peroneal nerve impairment, and 1 (12.5%) died of multi-organ failure and hypovolemia. Conclusions The incidence of femoral AVF associated with PFF is extremely low, though it appears to increase with the rising frequency of PFF. With a very few exceptions, complications following internal fixation are potentially limb- and life-threatening. There is still no definite consensus on the standardized diagnostic or therapeutic modalities. Therefore, surgeons should keep in mind that this serious complication requires early diagnosis and prompt treatment, which should not be underestimated. Femoral AVF following operation of PFF should be meticulously managed, because untreated fistulae result in serious unexpected complications including renin-mediated hypertension, high-output heart failure and venous and/or arterial insufficiency. Surgical treatment is still the gold standard for such cases, but in limited cases endovascular procedures using embolization and closure device can be a good treatment option.

Purpose The aim of this study was to assess the reliability and validity of the Korean short version of the Stroke-Specific Quality of Life Scale (SS-QoL-12K). Design A descriptive, cross-sectional design was used. Methods We recruited 233 outpatients with ischemic stroke. Findings The Cronbach's alpha coefficients for internal consistency was .93, and the test-retest reliability value was .98. Confirmatory factor analysis identified two dimensions for the SS-QoL-12K. The SS-QoL-12K was correlated positively with the 36-Item Short Form Health Survey score and Instrumental Activities of Daily Living and negatively with the modified Rankin Scale score. The SS-QoL scores in the National Institutes of Health Stroke Scale mild group were higher than those in the National Institutes of Health Stroke Scale moderate and severe groups. Conclusions This study shows that the SS-QoL-12K has a satisfactory level of reliability and validity in patients with ischemic stroke. Clinical relevance This instrument will be helpful in advancing research and clinical care for stroke patients.

Transient ischemia in the whole brain leads to neuronal loss/death in vulnerable brain regions. The striatum, neocortex and hippocampus selectively loose specific neurons after transient ischemia. Just 5 minutes of transient ischemia can cause pyramidal neuronal death in the hippocampal cornu ammonis (CA) 1 field at 4 days after transient ischemia. In this study, we investigated the effects of 5-minute (mild), 15-minute (severe), and 20-minute (lethal) transient ischemia by bilateral common carotid artery occlusion (BCCAO) on behavioral change and neuronal death and gliosis (astrocytosis and microgliosis) in gerbil hippocampal subregions (CA1–3 region and dentate gyrus). We performed spontaneous motor activity test to evaluate gerbil locomotor activity, cresyl violet staining to detect cellular distribution, neuronal nuclei immunohistochemistry to detect neuronal distribution, and Fluoro-Jade B histofluorescence to evaluate neuronal death. We also conducted immunohistochemical staining for glial fibrillary acidic protein and ionized calcium-binding adapter molecule 1 (Iba1) to evaluate astrocytosis and microgliosis, respectively. Animals subjected to 20-minute BCCAO died in at least 2 days. BCCAO for 15 minutes led to pyramidal cell death in hippocampal CA1–3 region 2 days later and granule cell death in hippocampal dentate gyrus 5 days later. Similar results were not found in animals subjected to 5-minute BCCAO. Gliosis was much more rapidly and severely progressed in animals subjected to 15-minute BCCAO than in those subjected to 5-minute BCCAO. Our results indicate that neuronal loss in the hippocampal formation following transient ischemia is significantly different according to regions and severity of transient ischemia. The experimental protocol was approved by Institutional Animal Care and Use Committee (AICUC) of Kangwon National University (approval No. KW-180124-1) on May 22, 2018.

The extracellular sulfatases (exSulfs) sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2) are well-known regulators of cell signaling and metabolism. In addition, exSulfs mediate the up- or downregulatory effects of cytokines on angiotensin II (Ang II)-induced expression of hypertensive mediators in vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHRs). Previously, we demonstrated that interleukin-10 (IL-10)-induced dimethylarginine dimethylaminohydrolase-1 (DDAH-1) expression was mediated by Ang II subtype 2 receptor (AT2 R) and AMP-activated protein kinase (AMPK) activation, and that IL-10-mediated inhibition of Ang II-induced proliferation of SHRs VSMC was partially associated with DDAH-1. In this study, we examined the effects of exSulfs on IL-10-induced DDAH-1 expression, abrogation of Ang II-induced DDAH-1 downregulation, and inhibition of Ang II-induced proliferation of SHRs VSMC. IL-10-induced DDAH-1 expression and abrogation of Ang II-induced DDAH-1 downregulation were attenuated in Sulf1 siRNA-transfected SHRs VSMC. However, Sulf2 did not affect IL-10-induced DDAH-1 expression and abrogation of Ang II-induced DDAH-1 downregulation. Downregulation of Sulf1 inhibited IL-10-induced AT2 R expression and the synergistic effects of IL-10 on Ang II-induced AT2 R expression. Additionally, Sulf1 downregulation inhibited IL-10-induced AMPK activity and abrogation of Ang II-induced decrease in AMPK activity. Moreover, the IL-10-mediated inhibition of Ang II-induced proliferation was not detected in Sulf1 siRNA-transfected SHRs VSMC; IL-10-mediated inhibition of Ang II-induced VSMC proliferation was mediated via the AT2 R pathway and AMPK activation. Specifically, IL-10-induced DDAH-1 expression, abrogation of Ang II-induced DDAH-1 downregulation, and inhibition of Ang II-induced proliferation, which is mediated by the AT2 R pathway and AMPK activation, are mainly mediated by Sulf1 activity in SHRs VSMC. These results suggest that Sulf1, and not Sulf2, mediates the IL-10-induced inhibition of Ang II-induced hypertensive effects in SHRs VSMC.

3′-Sialyllactose (3′-SL), a natural prebiotic, maintains immune homeostasis and exerts anti-inflammatory and anti-arthritic effects. Although regulatory T cells (Tregs) prevent excessive inflammation and maintain immune tolerance, the effect of 3′-SL on Treg regulation is unclear. This study aimed to investigate the effect of 3′-SL on Treg responses in atopic dermatitis (AD) pathogenesis. Oral administration of 3′-SL reduced AD-like symptoms such as ear, epidermal, and dermal thickness in repeated topical application of house dust mites (HDM) and 2,4-dinitrochlorobenzene (DNCB). 3′-SL inhibited IgE, IL-1β, IL-6, and TNF-α secretion and markedly downregulated AD-related cytokines including IL-4, IL-5, IL-6, IL-13, IL-17, IFN-γ, TNF-α, and Tslp through regulation of NF-κB in ear tissue. Additionally, in vitro assessment of Treg differentiation revealed that 3′-SL directly induced TGF-β-mediated Treg differentiation. Furthermore, 3′-SL administration also ameliorated sensitization and elicitation of AD pathogenesis by suppressing mast cell infiltration and production of IgE and pro-inflammatory cytokines in mouse serum by mediating the Treg response. Furthermore, Bifidobacterium population was also increased by 3′-SL administration as prebiotics. Our data collectively show that 3′-SL has therapeutic effects against AD progression by inducing Treg differentiation, downregulating AD-related cytokines, and increasing the Bifidobacterium population.

Purpose This study aims to identify demographic, clinical, and nutritional factors related to malnutrition in community-dwelling patients with schizophrenia. Design and methods We used a descriptive cross-sectional design. Between June and July 2016, 188 community-dwelling patients with schizophrenia were included in this study. Findings Of the 188 participants, 4.3% were classified as malnourished, and 40.4% were at risk of malnutrition. Living status, body weight, and appetite were significant factors related to malnutrition in community-dwelling patients with schizophrenia. Practice implication Assessment of nutritional status should be considered along with demographic and nutritional factors in community-dwelling patients with schizophrenia.

Reproductive health includes responsible, satisfying, and safe sex as well as reproductive well-being. This study aimed to examine relationships between sexual knowledge, sexual attitudes, and reproductive health behaviour among female college students.Cross-sectional survey.Female undergraduate students (N = 407) from 4 universities completed a series of self-report questionnaires consisted of sexual knowledge, sexual attitudes, and reproductive health behaviour.Reproductive health behaviour was significantly influenced by sexual knowledge (β = .67) and sexual attitudes (β = .20). Structural equation modelling indicated that sexual knowledge directly and indirectly affected reproductive health behaviour with sexual attitudes acting as a mediator.The findings indicate that it is necessary to consider sexual attitudes as well as sexual knowledge in promoting young women's reproductive health behaviour. The results may guide the development of sexual education programmes for young women. Impact Statement: Sexual attitude is an important factor influencing relationship between sexual knowledge and reproductive health behaviour among young female.

Nonalcoholic fatty liver disease (NAFLD) is an increasingly studied condition that can progress to end-stage liver disease. Although NAFLD was first described in 1980, a complete understanding of the mechanism and causes of this disease is still lacking. Six-transmembrane protein of prostate 2 (STAMP2) plays a role in integrating inflammatory and nutritional signals with metabolism. Our previous study suggested that STAMP2 may be a suitable target for treating NAFLD. In the current study, we performed a focused drug-screening and found that cilostazol could be a potential STAMP2 enhancer. Thus, we examined whether cilostazol alleviates NAFLD through STAMP2. The in vivo and in vitro pharmacological efficacies of cilostazol on STAMP2 expression and lipid accumulation were analyzed in NAFLD mice induced by high-fat diet (HFD) and in HepG2 cell lines treated by oleic acid (OA), respectively. Cilostazol increased the expression of STAMP2 through transcriptional regulation in vivo and in vitro. Cilostazol also dampened the STAMP2 downregulation caused by the HFD and by OA in vivo and in vitro, respectively. Cilostazol activated AMP-activated protein kinase (AMPK) in vivo and in vitro, and AMPK functions upstream of STAMP2, and reversed downregulation of STAMP2 expression through AMPK in the NAFLD model. Cilostazol ameliorates hepatic steatosis by enhancing hepatic STAMP2 expression through AMPK. Enhancing STAMP2 expression with cilostazol represents a potential therapeutic avenue for treatment of NAFLD.

Purpose Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results One hundred patients were included. Mean age at presentation was 7.4±5.62 years. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.

The purpose of this research was to propose a method to acquire the three-dimensional movement of a roller skiing athlete utilizing a global positioning system (GPS), an atmospheric pressure sensor (APS), and an inertial measurement unit (IMU) to distinguish between diagonal skiing and double poling techniques. In this study, we developed a lightweight wearable sensor that was composed of a GPS, APS, and IMU. For the data collection, two national level athletes roller skied a 1700 m long course where the maximum difference in elevation was 5.3 m. The planar positions of the athletes were based on the longitudinal and latitudinal data provided by the GPS, and the altitude was calculated by the International barometric formula and Laplace transform from the APS. The longitudinal and latitudinal data acquired through GPS had errors within 2 m range at each point. The altitude of Laplace transform from the APS showed errors of less than 1 m at each point. The range of motion of pelvis from the IMU was 34.0 ± 3.8° for diagonal skiing, which is wider than the 21.2 ± 6.9° for double poling.

Background Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease associated with hyperreactivity to environmental triggers. Among those, outdoor air pollutants such as particulate matter (PM) have been reported to aggravate pre-existing AD. However, underlying mechanisms of air pollution-induced aggravation of AD have hardly been studied. Objective To investigate the molecular mechanisms by which glyoxal, a PM-forming organic compound, exacerbates the symptoms of AD induced by neonatal capsaicin treatment. Methods Naive and AD rats had been exposed to either fresh air or vaporized glyoxal for 5 weeks (2 h/day and 5 days/week) since one week of age. Pruritus and dermatitis were measured every week. The skin and blood were collected and immunological traits such as Staphylococcus aureus skin colonization, production of antimicrobial peptides and immunoglobulin, and mRNA expression of inflammatory cytokines were analyzed. Results Exposure to glyoxal aggravated pruritus and dermatitis in AD rats, but did not induce any symptoms in naive rats. Staphylococcus aureus skin colonization was increased in the skin of both naive and AD rats. Expression of antimicrobial peptides such as LL-37 and β-defensin-2 was also increased by exposure to glyoxal in the skin of both naive and AD rats. The mRNA expression of Th1-related cytokines was elevated on exposure to glyoxal. However, serum immunoglobulin production was not significantly changed by exposure to glyoxal. Conclusion In AD rats, exposure to glyoxal exacerbated pruritus and cutaneous inflammation, which was associated with increased colonization of S. aureus and subsequent immunological alterations in the skin.

Objectives: This study examined the effects of job autonomy and job satisfaction on burnout among careworkers in Japan and South Korea. Careworker is defined as a direct care worker in long-term ca...

Background Although the cause of adenotonsillar hypertrophy remains unknown, some studies have shown that allergy may be a risk factor. Purpose This study determined the levels of allergen-specific immunoglobulin E (sIgE) in the adenotonsillar tissues of children with adenotonsillar hypertrophy and evaluated the clinical significance of local atopy in adenotonsillar tissues. Methods We measured 21 types of specific immunoglobulin E in the serum and adenotonsillar tissues of 102 children with adenotonsillar hypertrophy and compared the sensitization patterns of the serum and local tissues. The patients were divided into three groups—atopy, local atopy, and nonatopy—according to the sensitization of serum and adenotonsillar tissues, and the clinical symptoms among the groups were analyzed. Results Seventy-two (70.6%) children with adenotonsillar hypertrophy were sensitized to more than one allergen in the serum and/or adenotonsillar tissue. Thirty (29.4%) children had no IgE positivity to any allergen in both serum and adenotonsillar tissues. Fifty-five (53.9%) were sensitized to at least one allergen in the serum. Seventy (68.6%) were sensitized to at least one allergen in the adenotonsillar tissue. Seventeen (36.2%) of 47 children with specific immunoglobulin E-negative serum had specific immunoglobulin E-positive adenotonsillar tissues. The rate of specific immunoglobulin E was significantly higher in local tissues than in serum. The rate of inhalant allergen specific immunoglobulin E was significantly higher in the adenoids than in the tonsils. However, the rate of food allergen specific immunoglobulin E was significantly higher in the tonsils than adenoids. The lifetime prevalence of asthma and allergic rhinitis, recent symptoms or treatment of allergic rhinitis, and severity of nasal symptoms (rhinorrhea, sneezing, and nasal itching) were significantly higher in children with local atopy than with nonatopy. Conclusions These results confirm that allergic response may be a risk factor for adenotonsillar hypertrophy. Local allergic inflammation may play an important role in childhood adenotonsillar hypertrophy, and local atopy in adenotonsillar tissues can cause respiratory allergic symptoms in children.

Background: Nuclear hormone receptor gene, NR2F1, plays a key role in brain and eye development. Bosch-Boonstra-Schaaf optic atrophy syndrome (BBSOAS, MIM #615772) is an autosomal dominant ...

Purpose: The purpose of this descriptive survey study was to characterize the relationship between clinical decision-making and job satisfaction among pediatric nurses and to elucidate the mediating effects of the nurse-parent partnership on that relationship. Methods: The subjects of the study were 174 nurses who had worked in a pediatric ward in a university hospital, general hospital, or children's hospital. Data were collected from June 20, 2016 to August 10, 2016 and analysed using descriptive statistics, the t-test, analysis of variance, the Pearson correlation coefficient, and three-step mediated regression analysis in SPSS version 22.0 for Windows. Results: The nurse-parent partnership had significant effects on clinical decision-making and job satisfaction, with an explanatory power of 19% and 26%, respectively. The nurse-parent partnership had a partial mediating effect on the relationship between clinical decision-making and job satisfaction (Sobel test: Z=4.31, p

Background: Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. Methods: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. Results: Respiratory syncytial virus (RSV), the main cause of infection in children aged

PURPOSE To identify the NANDA-I–NOC–NIC (NNN) linkages for inpatients of the obstetrics nursing unit using electronic nursing records. METHODS In this retrospective, descriptive survey, the electronic nursing records for 220 adult patients aged ≥18 years who were discharged after obstetrics nursing unit were analyzed. FINDINGS The 7 most frequent nursing diagnoses were found to be associated with 9 nursing outcomes and 26 nursing interventions. CONCLUSIONS Herein, the list of nursing diagnoses was observed to comprise the safety/protection domain, the list of nursing outcomes the physiological health domain, and the list of nursing interventions the physiological: complex domain. IMPLICATIONS FOR NURSING PRACTICE This result can contribute to improving the nursing quality and will help continuing education and documentation system refinement.

PURPOSE: The aims of the study were to develop mobile application for postpartum care of first-time mothers and to validate it's effect. METHODS: Using a nonequivalent control group pretest-posttest design, 52 first-time mothers were recruited (26 each in experimental and control) and the experimental group used the mobile application for 6 weeks after delivery. Postpartum self-care knowledge and confidence, infant care knowledge and confidence, and postpartum depressive mood (Edinburgh Postnatal Depression Scale) were measured before discharge from the hospital and 6 weeks later. RESULTS: Women who have used the postpartum care mobile application reported higher levels of postpartum self-care knowledge (p=.030) and confidence (p=.023) infant care knowledge (p=.001) and confidence (p=.004), while scores of postpartum depression (p=.021) were lower than those in the control group. CONCLUSION: The postpartum-care mobile application developed in this research may be effective in reinforcing knowledge and confidence for postpartum self-care and infant care and in reducing postpartum depressive mood.

Aster pseudoglehni (Asteraceae) (AP) is a perennial plant from the Asteraceae family that is indigenous to Korea, and has traditionally been used as famine relief food in Korea. However, the effect of AP on food intake has not been characterized scientifically. The present study aimed to investigate the effect of the aqueous ethanolic extract of AP (AEE-AP) on food intake-related parameters in vitro and in vivo . AEE-AP stimulated cholecystokinin (CCK) secretion in enteroendocrine STC-1 cells, and serotonin (5-HT) secretion in RIN14B cells, an enteroendocrine cell model. Furthermore, AEE-AP affected physiological processes related to food intake in rats. Single oral administration of AEE-AP activated c-Fos in the dorsal vagal complex (DVC) and the arcuate nucleus of the hypothalamus (ARC), and delayed gastric emptying in rats. Our results demonstrated that AEE-AP regulated food intake-related parameters in the enteroendocrine system and gastrointestinal motility that affect food intake and eventually obesity.

The mesenchymal-to-epithelial transition (MET) is an intrinsically mechanical process describing a multi-step progression where autonomous mesenchymal cells gradually become tightly linked, polarized epithelial cells. METs are fundamental to a wide range of biological processes, including the evolution of multicellular organisms, generation of primary and secondary epithelia during development and organogenesis, and the progression of diseases including cancer. In these cases, there is an interplay between the establishment of cell polarity and the mechanics of neighboring cells and microenvironment. In this review, we highlight a spectrum of METs found in normal development as well as in pathological lesions, and provide insight into the critical role mechanics play at each step. We define MET as an independent process, distinct from a reverse-EMT, and propose questions to further explore the cellular and physical mechanisms of MET.

Background: Extracellular sulfatases (Sulfs), sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2), play a pivotal role in cell signaling by remodeling the 6-O-sulfation of heparan sulfate proteoglycans on the cell surface. The present study examined the effects of Sulfs on angiotensin II (Ang II)-induced hypertensive mediator expre-ssion and vascular smooth muscle cells (VSMCs) proliferation in spontaneously hypertensive rats (SHR). Methods: Ang II receptors, 12-lipoxygenase (12-LO), and endothelin-1 (ET-1) messenger RNA (mRNA) ex-pressions in SHR VSMCs were analyzed by real-time polymerase chain reaction and Western blotting. VSMCs proliferation was determined by [ 3 H]-thymidine incorporation. Results: Basal Sulfs mRNAs expression and enzyme activity were elevated in SHR VSMCs. However, Sulfs had no effect on the basal or Ang II-induced 12-LO and ET-1 mRNA expression in SHR VSMCs. The inhibition of Ang II-induced 12-LO and ET-1 expression by blockade of the Ang II type 2 receptor (AT 2 R) pathway was not observed in Sulf1 siRNA-transfected SHR VSMCs. However, Sulf2 did not affect the action of AT 2 R inhibitor on Ang II-induced 12-LO and ET-1 expression in SHR VSMCs. The down-regulation of Sulf1 induced a reduction of AT 2 R mRNA expression in SHR VSMCs. In addition, the inhibition of Ang II-induced VSMCs proliferation by blockade of the AT 2 R pathway was mediated by Sulf1 in SHR VSMCs. Conclusion: These findings suggest that extracellular sulfatase Sulf1 plays a modulatory role in the AT 2 R pathway that leads to an Ang II-induced hypertensive effects in SHR VSMCs.

During early cardiogenesis, bilateral fields of mesenchymal heart progenitor cells (HPCs) move from the anterior lateral plate mesoderm to the ventral midline, undergoing a mesenchymal-to-epithelial transition (MET) en route to forming a single epithelial sheet. Through tracking of tissue-level deformations in the heart-forming region (HFR) as well as movement trajectories and traction generation of individual HPCs, we find that the onset of MET correlates with a peak in mechanical stress within the HFR and changes in HPC migratory behaviors. Small-molecule inhibitors targeting actomyosin contractility reveal a temporally specific requirement of bulk tissue compliance to regulate heart development and MET. Targeting mutant constructs to modulate contractility and compliance in the underlying endoderm, we find that MET in HPCs can be accelerated in response to microenvironmental stiffening and can be inhibited by softening. To test whether MET in HPCs was responsive to purely physical mechanical cues, we mimicked a high-stress state by injecting an inert oil droplet to generate high strain in the HFR, demonstrating that exogenously applied stress was sufficient to drive MET. MET-induced defects in anatomy result in defined functional lesions in the larval heart, implicating mechanical signaling and MET in the etiology of congenital heart defects. From this integrated analysis of HPC polarity and mechanics, we propose that normal heart development requires bilateral HPCs to undergo a critical behavioral and phenotypic transition on their way to the ventral midline, and that this transition is driven in response to the changing mechanical properties of their endoderm substrate.

Cellular deposition of destabilized proteins and their aggregates is considered one of the most indisputable factors implicated in protein conformational diseases. Here, we report an innovative high-throughput screening method for discovering anti-aggregation reagents out of numerous potential candidates by using gold nanoplasmonic particles. In our method, nanoparticles act as catalytic activators to accelerate protein aggregation and simultaneously exhibit a colorimetric response according to their embedded shape on the protein aggregates. Using this principle, we observed the colorimetric response to the anti-aggregation effect of amyloid β (Aβ) with the naked eye within a few minutes. Investigation of the anti-aggregation effects of select candidates under three different protein aggregation stages showed that the anti-aggregation efficiency could relate to disease progression. Finally, results obtained with spiked samples in cerebrospinal fluid as well as under various denaturation conditions and different Aβ compositions show the feasibility of future personalized medicine considering individual patient's disease progression.