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© Copyright © 2020 Kim, Meng, Perez de Acha, Mustapic, Cheng, Eren, Kundu, Piao, Munk, Wood, De, Noh, Delannoy, Cheng, Abdelmohsen, Kapogiannis and Gorospe. Alzheimer’s disease (AD) is the most common type of dementia. Amyloid β (Aβ) plaques, tau-containing neurofibrillary tangles, and neuronal loss leading to brain atrophy are pathologic hallmarks of AD. Given the importance of early diagnosis, extensive efforts have been undertaken to identify diagnostic and prognostic biomarkers for AD. Circulating extracellular vesicles (EVs) provide a platform for “liquid biopsy” biomarkers for AD. Here, we characterized the RNA contents of plasma EVs of age-matched individuals who were cognitively normal (healthy controls (HC)) or had mild cognitive impairment (MCI) due to AD or had mild AD dementia (AD). Using RNA sequencing analysis, we found that mitochondrial (mt)-RNAs, including MT-ND1-6 mRNAs and other protein-coding and non-coding mt-RNAs, were strikingly elevated in plasma EVs of MCI and AD individuals compared with HC. EVs secreted from cultured astrocytes, microglia, and neurons after exposure to toxic conditions relevant to AD pathogenesis (Aβ aggregates and H2O2), contained mitochondrial structures (detected by electron microscopy) and mitochondrial RNA and protein. We propose that in the AD brain, toxicity-causing mitochondrial damage results in the packaging of mitochondrial components for export in EVs and further propose that mt-RNAs in plasma EVs can be diagnostic and prognostic biomarkers for MCI and AD.

This research was conducted for the purpose of developing a high-fidelity simulation education program, applying it to clinical field and analyzing this program's effect on nursing college students in order to solve problems being caused from the gap between the adult nursing theoretical class and practical education. As the analysis method, this study developed a scenario including an algorithm for caring hyperkalemia patients, the evaluation check list, and debriefing according to the adult nursing theoretical class's learning goal and measured the high-fidelity simulation program's effect in using the non-equivalent control group pre-test and post-test design. As the results from the analysis, there secured the simulation education program's general properties and dependent variable's homogeneity in the experimental group and the control group. The nursing simulation practice program for hyperkalemia patients showed slight effect on the experimental group compared to the control group in fields such as nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. (t=-83.313, p

Thirteen diary cows were diagnosed as bovine tuberculosis (BTB) based on pathological findings and PCR method from 74 diary cows slaughtered in Incheon city. BTB was outbreaked 9 times in the farm from March 2010 to June 2013. The BTB confirmed cows were all negatives by intradermal test with PPD at 3 times. Recently, disagreement between BTB outbreak and intradermal test has been raised as a big problem. This phenomenon suggest that a new control programs are necessary at farm level as well as diagnostic level.

†,*,** Korea Ocean Research & Development Institute/KORDI, Daejeon, 305-343, Korea *** Maritime Safety Research Center/KST, Incheon, 406-840, Korea요 약 :최근 IMO에서는 산적화물선 및 유조선, 대형여객선에 이어 ‘일반화물선의 안전(general cargo ships safety)’에 대한 논의의 필요성이 제기(IMO, 2006a)되고 있으며, 본격적인 논의를 위한 준비 작업으로 국제선급협회(IACS)를 통한 공식안전성평가(Formal Safety Assessment, 이하 FSA) 작업이 수행되고 있다. FSA란 위험도(risk)분석과 비용-효과 평가(cost-benefit assessment)를 바탕으로 인명, 해양환경 및 재산의 보호를 포함한 해사안전의 향상을 목적으로 한 구조화되고 체계적인 방법론으로서 새로운 법규의 평가, 기존법규와 새로운(제안) 법규와의 비교, 그리고 여러 이해관계자의 공감대 형성을 통해 법규 변경/개발을 용이하게 하는 수단이다(IMO, 2007). 본 연구는 국적일반화물선의 안전성 평가를 위한 수단으로서 IMO FSA방법론의 유용성을 확인하고, 향후 IMO에서의 ‘일반화물선 안전’에 대한 논의에 대응하기 위한 기초자료의 확보를 목적으로 하고 있다. 본 논문에서는 국적일반화물선에 대한 FSA의 1, 2 단계에 해당하는 위험요소 식별(Hazard identification) 및 사고시나리오에 대한 위험도 분석(Risk analysis) 결과를 중심으로 소개하였다.핵심용어 : 공식안전성평가, 일반화물선, 위험요소 식별, 위험도 분석, 위험도 허용기준Abstract :Following the application of Formal Safety Assessment(FSA) to bulk carriers, crude oil tankers and large passenger ships, an urgent need to consider the safety of general cargo ships has recently been raised through the International Maritime Organization(IMO)(IMO, 2006a), and related FSA studies are being carried out by International Association of Classification Societies(IACS) as a preparatory work for the discussion on the issue of general cargo ship safety in the IMO committee. FSA is a structured and systematic methodology which is based on the techniques of risk analysis and cost benefit assessment to assist in the decision-making process, and aims at enhancing maritime safety, including protection of life, health, the marine environment and property. FSA can be used as a tool to facilitate the development of regulatory changes equitable to the various parties, with a view to aiding the achievement of consensus, and to help in the evaluation of new regulations and in making a comparison between existing and possibly improved regulations(IMO, 2007). This study aims at verifying the usefulness of FSA methods as a tool to conduct a safety assessment of general cargo ships flying the Korean flag, and providing useful information on 'the safety of general cargo ships' for IMO committee's discussion on the matter at a future session. FSA comprises five steps, however, steps 1(Hazard identification) and 2 (Risk analysis) from the FSA study for the Korean-flagged general cargo ships are discussed in this paper.Key words :FSA, general cargo ship safety, Hazard identification(HAZID), risk analysis, risk acceptance criteria †교신저자 : 정회원, jklee@moeri.re.kr 042)866-3411 * 대표저자 : 정회원, ras4002@moeri.re.kr 042)866-3658 ** 종신회원, kht@moeri.re.kr 042)866-3643 *** 정회원, jeagni77@kst.or.kr 032)260-2267

To assess the association between hyperuricemia and risk of stroke incidence and mortality because hyperuricemia is hypothesized to be a risk factor for stroke and other cardiovascular disease, but, to date, results from observational studies are conflicting.A systematic review and meta-analysis were conducted. Studies were identified by searching major electronic databases using the Medical Subject Headings and keywords without restriction in languages. Prospective cohort studies were included only if they contained data on stroke incidences or mortalities related to serum uric acid levels in adults. Pooled risk ratios (RRs) for the association of stroke incidence and mortality with serum uric acid levels were calculated.A total of 16 studies including 238,449 adults were eligible and abstracted. Hyperuricemia was associated with a significantly higher risk of both stroke incidence (6 studies; RR 1.41, 95% confidence interval [95% CI] 1.05, 1.76) and mortality (6 studies; RR 1.36, 95% CI 1.03, 1.69) in our meta-analyses of unadjusted study estimates. Subgroup analyses of studies adjusting for known risk factors such as age, hypertension, diabetes mellitus, and cholesterol still showed that hyperuricemia was significantly associated with both stroke incidence (4 studies; RR 1.47, 95% CI 1.19, 1.76) and mortality (6 studies; RR 1.26, 95% CI 1.12, 1.39). The pooled estimate of multivariate RRs did not differ significantly by sex.Hyperuricemia may modestly increase the risks of both stroke incidence and mortality. Future research is needed to determine whether lowering uric acid level has any beneficial effects on stroke.

The healthy condition of living donors makes their tolerance to pain particularly low, and clinicians are often challenged to come up with an analgesic technique that is effective yet ensures donor safety. This study compared, in donor right hepatectomy, the efficacy and safety of preoperative intrathecal morphine (ITM) combined with intravenous patient-controlled analgesia (IV-PCA) with IV-PCA alone. Forty adult patients were randomly allocated into 2 groups: ITM+IV-PCA group (n = 20) and IV-PCA-only group (n = 20). Patients in the ITM+IV-PCA group received morphine sulfate (400 microg). The visual analog scale (VAS) at rest and when coughing and supplementary meperidine and IV-PCA (fentanyl) consumption were assessed at 2, 4, 6, 8, 10, 12, 18, 24, 30, 36, 42, 48 56, 64, and 72 hours after surgery. Also, side effects such as sedation, dizziness, nausea, vomiting, pruritus, and respiratory depression were evaluated. The ITM+IV-PCA group showed significantly less pain at rest and when coughing for up to 30 hours and 24 hours, respectively. Cumulative postoperative consumption of meperidine and IV-PCA (fentanyl) were significantly less in the ITM+IV-PCA group. The incidence of side effects were comparable between the 2 groups except for pruritus; its incidence was significantly higher in the ITM+IV-PCA group during the first 24 hours, but no treatment was required due to its mild severity. The results of our study suggest that preoperative ITM combined with IV-PCA may be considered as an effective and safe pain management regimen in living liver donors who have characteristics of low tolerance to pain and postoperative coagulation derangement.

The role of serum uric acid as an independent risk factor for cardiovascular disease remains unclear, although hyperuricemia is associated with cardiovascular disease such as coronary heart disease (CHD), stroke, and hypertension.A systematic review and meta-analysis using a random-effects model was conducted to determine the risk of CHD associated with hyperuricemia in adults. Studies of hyperuricemia and CHD were identified by searching major electronic databases using the medical subject headings and keywords without language restriction (through February 2009). Only prospective cohort studies were included if they had data on CHD incidences or mortalities related to serum uric acid levels in adults.Twenty-six eligible studies of 402,997 adults were identified. Hyperuricemia was associated with an increased risk of CHD incidence (unadjusted risk ratio [RR] 1.34, 95% confidence interval [95% CI] 1.19-1.49) and mortality (unadjusted RR 1.46, 95% CI 1.20-1.73). When adjusted for potential confounding, the pooled RR was 1.09 (95% CI 1.03-1.16) for CHD incidence and 1.16 (95% CI 1.01-1.30) for CHD mortality. For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR for CHD mortality was 1.12 (95% CI 1.05-1.19). Subgroup analyses showed no significant association between hyperuricemia and CHD incidence/mortality in men, but an increased risk for CHD mortality in women (RR 1.67, 95% CI 1.30-2.04).Hyperuricemia may marginally increase the risk of CHD events, independently of traditional CHD risk factors. A more pronounced increased risk for CHD mortality in women should be investigated in future research.

Factors Affecting Prostate Cancer Screening Behavior Lee, Eun Nam · Park, Jin Hee · Kang, Sung Gum · Yun, Seonyoung · Sin, Kyung Mi · Kim Kyoung Mi Department of Nursing, Dong-A University, Busan; Department of Nursing, Gimhae College, Gimhae; Department of Nursing, Youngsan University, Yangsan; Department of Nursing, Chunhae College of Health Sciences, Ulsan; Department of Nursing, Kosin University, Busan, Korea

The accurate diagnosis of a pelvic mass is a challenge to a gynecologist before the pelvic cavity is explored by laparotomy or laparoscopy, because of pelvic masses' bizarre and atypical behavior. Pelvic masses are one of the most common clinical presentations. These masses represent a number of benign and malignant conditions. Treatment can be optimally planned if it is known beforehand whether an ovarian neoplasm is benign or malignant. The prognosis for ISSN 1226-8704 http://dx.doi.org/10.6118/jksm.2013.19.1.18 J Korean Soc Menopause 2013;19:18-25

Copyright © 2012. Korean Society of Obstetrics and Gynecology Due to its bizarre and atypical behavior, accurate diagnosis of a pelvic mass prior to exploration of the pelvic cavity by laparotomy or laparoscopy is a challenge to the gynecologist. Pelvic mass is one of the most common clinical presentations, representing a number of benign and malignant conditions. Beforehand knowledge of whether an ovarian neoplasm is benign or malignant can allow for planning of optimal treatment. Appropriate firstline therapy may have a significant influence on the prognosis for women with ovarian cancer [1-6]. Performance of aggressive cytoreductive surgery demands specific skills and experience, which is often beyond the skill of general gynecologists [7,8]. Adoption of a method for better preoperative discrimination of a pelvic mass would result in more women receiving first-line therapy from adequately trained and experienced personnel. For such referrals to be efficient, specific and sensitive improved methods for diagnosis of ovarian cancer are needed. ORIGINAL ARTICLE Korean J Obstet Gynecol 2012;55(9):636-643 http://dx.doi.org/10.5468/KJOG.2012.55.9.636 pISSN 2233-5188 · eISSN 2233-5196

349 THE CORRELATION OF CERVICAL INTRAEPITHELIAL NEOPLASIA 3 DETECTED BY CERVICAL PUNCH BIOPSIES WITH THE PATHOLOGIC RESULTS OF CONIZATION AND HYSTERECTOMY Ki-Won Kim, MD, Kyoung-Mi Kim, MD, Jung-Woo Park, MD, Hyun-Jae Jung, MD, Jee-Young Han, MD, Joon-Mee Kim, MD, Jee-Hyun Park, MD, Sung-Ook Hwang, MD, Woo-Young Lee, MD, Eunseop Song, MD Departments of Obstetrics and Gynecology, Pathology, Inha University College of Medicine, Incheon, Korea

Clonic movement is a rare complication that occurs after neuraxial blockade. We report our experience with an 18-year-old man developing myoclonic movement on his both upper extremities following intrathecal injection of 0.5% hyperbaric bupivacaine for varicocelectomy. One and half hour after spinal anesthesia, he developed bilateral, rhythmic myoclonic movements on upper extremities. Two days after surgery, neck flexion was observed. Symptoms sustained for about one month but frequency and severity of clonic movement had been reduced by anticonvulsants and muscle relaxant therapy. Four weeks later, he recovered without any complication. (Korean J Anesthesiol 2008; 55: 107～10)

Background: Perioperative fluid deficits is known to induce the intestinal ischemia and release the emetogenic factors like serotonin. Many studies have reported that there is a close association between the amount of perioperative fluid administration and the incidence of postoperative nausea and vomiting (PONV). In this study, we examined whether amounts of intraoperative intravenous fluid administration would be related with the incidence of PONV in patients scheduled for gynecological surgery. Methods: One hundred twenty gynecological patients with ASA I-II were randomized to receive either large (18 ml/kg/hr) or small (6 ml/kg/hr) volume infusion of lactated Ringer’s solution intraoperatively. The incidence of PONV, severity of pain, and need for supplemental antiemetic and analgesic therapy were assessed by a blinded investigator at 0−2, 2−6, and 6−24 h postoperatively. Results: There were no significant differences between the two groups in the severity of pain and amounts of rescue antiemetics and rescue analgesics administration at any given time. There were no differences between the two groups regarding the incidence of PONV at 0−2, 2−6, and 6−24 h, postoperatively. Conclusions: Intraoperative large volume infusion of lactated Ringer’s solution was ineffective in reducing the incidence of PONV in patients scheduled for gynecological surgery during the postoperative period. (Korean J Anesthesiol 2008; 55: 166∼70)

Background: Activation of G-protein coupled-somatostatin receptors induces the release of calcium from inositol 1, 4, 5-trisphosphate-sensitive intracelluar stores. G-protein-coupled receptor signaling decreases with prolonged exposure to an agonist. Subjects and Methods: Fura-2-based digital Ca 2+ imaging was used to study the effects of prolonged

Purpose: The expression of matrix metalloproteinase-2 (MMP-2) by cancer cells has been implicated in metastasis through cancer cell invasion of the basement membranes mediated by a degradation of collagen IV. However, the MMP-2 pro-enzyme requires proteolytic activation for its physiologic or pathologic role. We tried to 1) compare expression and activation of MMP-2 in breast cancers with benign tumors, 2) determine the correlation between the actviation of MMP-2 in breast cancer and established prognostic factors, 3) observe whether MMP-2 is expressed and activated in axillary lymph nodes as well, and 4) determine the degree of correlation between MMP-2 activity in lymph nodes and metastatic status, if MMP-2 is expressed in lymph node. Methods: The specimens came from 11 fibroadenomas, 32 invasive ductal carcinoma and 129 axillary lymph nodes from cancer cases. Pro-MMP-2 cDNA transfected MDA-MB-231 cells were cultured and the conditioned media from them was used for a control. Zymography was used to monitor MMP-2 activation through the detection of the inactive proenzyme form (72 kDa) and the active form (62 kDa). Immunohistochemical staining was also performed for the localization of MMP-2 expression in tissues. Results: 1) 72 kDa was expressed in all fibroadenomas and cancers, while 62 kDa was expressed in only 10 cases of fibroadenomas and all cancers. MMP-2 activity (62 kDa/72 kDa + 62 kDa) was significantly higher in cancers than in fibroadenomas (P=0.014). 2) MMP-2 activity in cancers was significantly correlated with nodal metastasis (P=0.040). 3) The expression of MMP-2 in lymph nodes was very low and MMP-2 activity was not correlated with metastatic status. However, the immunohistochemical staining showed different staining patterns between the metastatic and non-metastatic nodes. Conclusion: We suggest that a measurement of the activation of MMP-2 could be useful as a prognostic marker representing metastatic potential in breast cancer. However, the low expression of MMP-2 in lymph nodes is an interesting subject for further study.