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Background: The fall prevention activities of nursing staff are emphasized more in order to reduce the incidence of falls in elderly people in long-term care hospitals. Objectives: To examine the extent of knowledge and attitude about falls and the degree of fall prevention activities among nursing staff in long-term care hospitals, and to identify the effect of knowledge and attitude about falls on prevention activities. Design: The data collection was, in the period between July 10th, 2017 and August 10th, 2017, accumulated by constructive questionnaires targeting 138 nurses and nurse aids who are employed within five long-term care hospitals. Methods: The statistical processing was as follows: the frequency, percentage, mean and standard deviation, independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and hierarchical regression analysis. Results: The fall prevention activities showed a significant difference statistically in the fields of age (F = 5.33, p = 0.002), working career (F = 3.98, p = 0.014), positions (t = 2.71, p = 0.008), subject’s experience with patient falls (t = 2.15, p = 0.033), fall prevention education (t = 3.32, p = 0.001). As for the correlation between knowledge and attitude towards falls and fall prevention activities, knowledge and attitude towards fall (r = 0.45, p < 0.001), knowledge and fall prevention activities (r = 0.27, p < 0.002), attitude towards falls and fall prevention activities (r = 0.42, p < 0.001) had significantly positive correlations. As for the fall prevention activities of nursing staff in long-term care hospitals, their attitude towards falls (β = 0.32, p < 0.001) had an effect on fall prevention activities. Conclusion: In order to increase fall prevention activities in long-term care hospitals, nursing staff’ attitude towards falls is important. Therefore, we need to explore diverse strategies to promote fall prevention activities of nursing.

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

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions, most commonly triggered by medications, characterized by extensive necrosis and detachment of the epidermis.We investigated the differences in clinical characteristics of drug-induced SJS/TEN depending on the type of drug in a single center.The relevance of sex, age, culprit drugs, clinical features, courses, treatment options, and follow-up results were retrospectively evaluated in patients diagnosed with drug-induced SJS/TEN at Pusan National University Hospital between 2008 and 2019.Ninety-two patients with a mean age of 58.7 ± 20.2 years (range, 10-93 years) were included in the study. Those aged 60-80 years accounted for the largest number of patients (42.4%). Patients with drug-induced SJS/TEN comprised 40 women (43.5%) and 52 men (56.5%). We categorized drug-induced SJS/TEN cases by culprit drugs into 6 groups: antibiotics, allopurinol, antiepileptic (AED), nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and other drugs. The rate of NSAID-induced disease significantly increased from SJS to TEN (This study showed that the clinical characteristics of each causative drug group may be different in drug-induced SJS/TEN. Our findings may help clinicians better understand drug-induced SJS/TEN.

Purpose: The prevalence of osteoporosis in postmenopausal women is increasing, and diabetes patients have decreased bone density. Their health-related quality of life (HRQoL) is diminished by the resultant physical dysfunction and depression. The purpose of this study was to identify factors influencing HRQoL in postmenopausal women with diabetes and osteoporosis.Methods: This was a secondary data analysis of the Seventh Korea Health and Nutrition Examination Survey (2016–2018), which utilized a complex, multistage probability sample design. The participants in the study were 237 women with diabetes and osteoporosis. To evaluate the factors that influenced HRQoL, a complex-samples general linear model was constructed, and the Bonferroni correction was performed.Results: In this sample of women aged 45 to 80 years (mean±standard deviation, 71.12±7.21 years), the average HRQoL score was 0.83±0.18 out of 1.0. Factors influencing HRQoL were age (70s: t=–3.74, p

It is necessary to comprehensively consider the personal and environmental factors of women who experience overweight or obesity and low-income households (WOOL) to improve their quality of life (QoL).The aim of this study was to test a hypothetical path model to estimate the effects of self-efficacy, psychological distress, social support, and health-promoting behaviors (HPB) on QoL and verify the mediating effects of HPB among WOOL.A total of 151 women with a monthly household income less than 50% of the national median income at eight welfare centers in South Korea participated in this study. Data were collected from January to December 2019 and analyzed using SPSS 25.0 and Amos 23.0.The fit indices of the model were adequate (χIntegrated nursing interventions that consider self-efficacy, psychological distress, social stress, and HPB can be useful for improving the QoL of WOOL.

When epithelial cells are exposed to potentially threatening external stimuli such as allergens, bacteria, viruses, and helminths, they instantly produce "alarmin" cytokines, namely, IL-33, IL-25, and TSLP. These alarmins alert the immune system about these threats, thereby mobilizing host immune defense mechanisms. Specifically, the alarmins strongly stimulate type-2 immune cells, including eosinophils, mast cells, dendritic cells, type-2 helper T cells, and type-2 innate lymphoid cells. Given that the alarm-raising role of IL-33, IL-25, and TSLP was first detected in allergic and infectious diseases, most studies on alarmins focus on their role in these diseases. However, recent studies suggest that alarmins also have a broad range of effector functions in other pathological conditions, including psoriasis, multiple sclerosis, and cancer. Therefore, this review provides an update on the epithelium-derived cytokines in both allergic and non-allergic diseases. We also review the progress of clinical trials on biological agents that target the alarmins and discuss the therapeutic potential of these agents in non-allergic diseases.

Immigrants in Korea face numerous difficulties in seeking medical services due to language and cultural differences. Providing medical services to them could be beyond the institutional capacity of the host country owing to factors such as, physical and psychological problems, social unrest, language barriers, and problems adapting to unfamiliar environments. According to Andersen’s health service use behavioral model, we used a multifaceted approach to explore the factors influencing the unmet healthcare needs of immigrants in Korea from the Korean health system. This cross-sectional secondary analysis study used data from the 2019 Korea Community Health Survey of 3524 immigrants. Their unmet healthcare needs were calculated using a complex, weighted sample design. Group differences in categorical variables were analyzed using the Rao-Scott chi-square test. Logistic regression analysis was used to analyze the association between unmet healthcare needs and ageing factors. Overall, 262 (7.4%) of surveyed immigrants experienced unmet healthcare needs. Factors influencing unmet healthcare needs were being a woman (OR = 1.41, 95% CI = 1.03-1.94), national primary livelihood security receiver (OR = 1.44, 95% CI = 1.29-1.68), stress (OR = 1.34, 95% CI = 1.26-1.45), perceived health status (poor: OR = 2.35, 95% CI = 1.58-3.52), and perceived health status (moderate: OR = 1.62, 95% CI = 1.18-2.20). Policymakers could focus on these predictors when formulating policy strategies to reduce unmet health care needs. In addition, by effectively delivering services that meet the unmet healthcare needs of immigrants, their right to health is protected.

BTT-105 (1-O-hexyl-2,3,5-trimethylhydroquinone), a hydroquinone derivative, is a potent anti-oxidant that was safe and tolerable in phase I clinical trial. This study examined the anti-fibrotic effect of BTT-105 in a mouse model of non-alcoholic fatty liver disease (NAFLD) along with the underlying mechanisms. In vivo, efficacy of BTT-105 evaluated from three kinds of NAFLD models (methionine/choline deficient diet (MCD), high fat diet (HF) and western diet (WD)). Metabolomics and transcriptomics profiling analysis in liver tissues were conducted. In vitro, anti-fibrotic effect of BTT-105 assessed in human hepatic stellated cells (HSCs) and primary mouse HSCs. BTT-105 improved NAFLD activity score in three kinds of NAFLD animal models (MCD, HF, and WD). BTT-105 also decreased levels of hepatic pro-collagen and collagen fibers deposition in liver tissue. Metabolome and transcriptome analysis revealed that BTT-105 decreased lipid metabolites and increased antioxidants in NAFLD mice. In HepG2 cells, BTT-105 enhanced Nrf2-ARE reporter activity in a dose-dependent manner and increased the levels of antioxidant gene expression. BTT-105 showed inhibition of HSCs activation and migration. Gene expression profiling and protein expression showed that BTT-105 increased Nrf2 activation as well as decreased PI3K-Akt pathway in activated HSCs. BTT-105 attenuated ameliorates steatohepatitis and hepatic fibrosis.

Several clinical studies have suggested a strong correlation between cholecystectomy and the incidence of non-alcoholic fatty liver disease (NAFLD) although the exact correlation and causal relationship are unclear. This study aimed to investigate whether cholecystectomy increases the incidence of NAFLD or aggravates pre-existing NAFLD.Standard diet-fed and high-fat (HF) diet-fed mice were subjected to sham operation and cholecystectomy. In study 1, 20 standard diet-fed C57BL/6N mice were sacrificed at months 1, 2, and 4 post-surgery. Meanwhile, in study 2, 25 HF diet-induced NAFLD C57BL/6N mice were biopsied at months 2 and 3 post-surgery and sacrificed at month 6 post-surgery. The hepatic fatty acid and bile acid metabolic pathways and the hepatic bile composition were evaluated.The bodyweight and biochemical parameters (hepatic enzyme, triglyceride, and cholesterol levels) were not significantly different between the standard diet-fed sham and cholecystectomy groups. The NAFLD activity score and the levels of hepatocyte apoptosis markers (Krt18 expression and DNA fragmentation) and de novo lipid synthesis genes were not significantly different between the standard diet-fed sham and cholecystectomy groups. Cholecystectomy did not exacerbate hepatic steatosis, inflammation, and ballooning in the HF diet-fed mice. Hepatic bile acid composition was not markedly different in the sham and cholecystectomy groups fed on standard or HF diet. Cholecystectomy significantly downregulatedCholecystectomy did not increase the incidence of NAFLD in standard diet-fed mice. Additionally, NAFLD incidence was not significantly different between the HF diet-fed sham and cholecystectomy groups. Furthermore, the histological parameters were not markedly different between the sham and cholecystectomy groups fed on standard or HF diet. These findings suggest that cholecystectomy does not induce NAFLD.

Although lung macrophages are directly exposed to external stimuli, their exact immunologic roles in asthma are still largely unknown. The aim of this study was to investigate the anti-asthmatic effect of Acinetobacter lwoffii in terms of lung macrophage modulation.Six-week-old female BALB/c mice were sensitized and challenged with ovalbumin (OVA) with or without intranasal administration of A. lwoffii during the sensitization period. Airway hyperresponsiveness and inflammation were evaluated. Using flow cytometry, macrophages were subclassified according to their activation status. In the in vitro study, a murine alveolar macrophage cell line (MH-S) treated with or without A. lwoffii before IL-13 stimulation were analysed by quantitative RT-PCR.In a murine asthma model, the number of inflammatory cells, including macrophages and eosinophils, decreased in mice treated with A. lwoffii (A. lwoffii/OVA group) compared with untreated mice (OVA group). The enhanced expression of MHCII in macrophages in the OVA group was decreased by A. lwoffii treatment. M2 macrophage subtypes were significantly altered. A. lwoffii treatment decreased CD11bIntranasal A. lwoffii exposure suppresses asthma development by suppressing the type 2 response via modulating lung macrophage activation, shifting M2a and M2c macrophages to M2b macrophages.

In this paper, we present TESS photometry and high-resolution spectra of the short-period Algol EW Boo. We obtained double-lined radial velocities (RVs) from the time-series spectra and measured the effective temperature of the primary star as $T_{\rm{eff,1}}$ = 8560 $\pm$ 118 K. For the orbital period study, we collected all times of minima available for over the last 30 years. It was found that the eclipse timing variation of the system could be represented by a periodic oscillation of 17.6 $\pm$ 0.3 years with a semi-amplitude of 0.0041 $\pm$ 0.0001 d. The orbital and physical parameters were derived by simultaneously analyzing the TESS light and RV curves using the Wilson-Devinney (WD) binary star modeling code. The component masses and radii were showed over 3% precision: $M_{1}$ = 2.67 $\pm $ 0.08 M$_{\odot}$, $M_{2}$ = 0.43 $\pm $ 0.01 M$_{\odot}$, $R_{1}$ = 2.01 $\pm $ 0.02 R$_{\odot}$, and $R_{2}$ = 1.35 $\pm $ 0.01 R$_{\odot}$. Furthermore, multiple frequency analyses were performed for the light-curve residuals from the WD model. As a result, we detected 17 pressure-mode pulsations in the region of 40.15 - 52.37 d$^{-1}$. The absolute dimensions and pulsation characteristics showed that the $δ$ Sct pulsator was the more massive and hotter primary star of the EW Boo., 27 pages, 8 figures, Accepted for publication in AJ

Despite numerous previous studies, the full action mechanism of the pathogenesis of asthma remains undiscovered, and the need for further investigation is increasing in order to identify more effective target molecules. Recent attempts to develop more efficacious treatments for asthma have incorporated mesenchymal stem cell (MSC)-based cell therapies. This study aimed to evaluate the anti-asthmatic effects of MSCs primed with Liproxstatin-1, a potent ferroptosis inhibitor. In addition, we sought to examine the changes within macrophage populations and their characteristics in asthmatic conditions. Seven-week-old transgenic mice, constitutively overexpressing lung-specific interleukin (IL)-13, were used to simulate chronic asthma. Human umbilical cord-derived MSCs (hUC-MSCs) primed with Liproxstatin-1 were intratracheally administered four days prior to sampling. IL-13 transgenic mice demonstrated phenotypes of chronic asthma, including severe inflammation, goblet cell hyperplasia, and subepithelial fibrosis. Ly6C+M2 macrophages, found within the pro-inflammatory CD11c+CD11b+ macrophages, were upregulated and showed a strong correlation with lung eosinophil counts. Liproxstatin-1-primed hUC-MSCs showed enhanced ability to downregulate the activation of T helper type 2 cells compared to naïve MSCs in vitro and reduced airway inflammation, particularly Ly6C+M2 macrophages population, and fibrosis in vivo. In conclusion, intratracheal administration is an effective method of MSC delivery, and macrophages hold great potential as an additional therapeutic target for asthma.

We present new BVRI light curves of UY UMa with no O’Connell effect and a flat bottom secondary eclipse. Light curve synthesis with the Wilson-Devinney code gives a new solution, which is quite different from the previous study: UY UMa is an A-subtype over-contact binary with a small mass ratio of q = 0.21, a high inclination of 81°.4, a small temperature difference of ΔT = 18°, a large fill-out factor of f = 0.61, and a third light of approximately 10% of the total systemic light. The absolute dimensions were newly determined. Seventeen new times of minimum light have been calculated from our observations. The period study indicates that the orbital period has intricately varied in a secular period increase in which two cyclical terms with periods of 12y.0 and 46y.3 are superposed. The secular period increase was interpreted to be due to a conservative mass transfer of 2.68 × 10–8 M⊙/yr from the less massive to the more massive star. The cyclical components are discussed in terms of double-light time contributions from two additional bound stars. The statistical relations of Yang & Qian (2015) among the physical parameters of 45 deep, low mass ratio contact binaries were revisited by using the physical parameters of UY UMa and 25 Kepler contact binaries provided by Şenavci et al. (2016).

This study developed and tested a conceptual model delineating the interrelationships among hedonic shopping orientation, consumer need for mobile app atmospherics, entertainment gratification, mobile irritation, and intention to reuse mobile apps for apparel shopping. A total of 216 U.S. mobile shoppers in the age range of 18–34 participated in the study. Consumers with a higher need for mobile app atmospherics tended to experience increased entertainment gratification and reduced irritation in using mobile apps. Hedonic shopping orientation was found to be an antecedent of consumer need for mobile app atmospherics. However, hedonic shoppers’ mixed emotions toward mobile apps were confirmed through the positive influences of hedonic shopping orientation on both entertainment gratification and irritation. Consumer need for mobile app atmospherics played a significant role in predicting the intention to reuse mobile apps for apparel shopping, along with entertainment gratification and mobile irritation. This study extended the research scope of mobile shopping behavior and provided implications for mobile app retailing.

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

Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR). T2DM is correlated with obesity and most T2DM medications have been developed for enhancing insulin sensitivity. Silk protein fibroin (SPF) from spiders has been suggested as an attractive biomaterial for medical purposes. We generated transgenic rice (TR) expressing SPF and fed it to diabetic BKS.Cg-m+/+Leprdb mice to monitor the changes in blood glucose levels and adipose tissue proteins associated with energy metabolism and insulin signaling. In the present study, the adipocyte size in abdominal fat in TR-SPF-fed mice was remarkably smaller than that of the control. Whereas the adenosine monophosphate-activated protein kinase (AMPK)-activated protein kinase and insulin receptor substrate 1 (IRS1) protein levels were increased in abdominal adipose tissues after TR-SPF feeding, levels of six-transmembrane protein of prostate 2 (STAMP2) proteins decreased. Phosphorylation of AMPK at threonine 172 and IRS1 at serine 307 and tyrosine 632 were both increased in adipose tissues from TR-SPF-fed mice. Increased expression and phosphorylation of IRS1 at both serine 307 and tyrosine 632 in adipose tissues indicated that adipocytes obtained from abdominal fat in TR-SPF-fed mice were more susceptible to insulin signaling than that of the control. STAMP2 protein levels decreased in adipose tissues from TR-SPF-fed mice, indicating that STAMP2 proteins were reducing adipocytes that were undergoing lipolysis. Taken together, this study showed that TR-SPF was effective in reducing blood glucose levels in diabetic mice and that concurrent lipolysis in abdominal adipocytes was associated with alterations of AMPK, IRS1, and STAMP2. Increased IRS1 expression and its phosphorylation by TR-SFP were considered to be particularly important in the induction of lipolysis in adipocytes, as well as in reducing blood glucose levels in this animal model.

PURPOSE: The purpose of this study is to identify knowledge, awareness, and risk of occurrence of venous thromboembolism among pregnant women. METHODS: Subjects were 106 pregnant women treated as inpatients and outpatients at a women's health hospital in a metropolitan city February 19–March 22, 2018. Instruments consisted of questionnaires that included knowledge, awareness, and risk of occurrence of venous thromboembolism queries. Collected data were analyzed by t-test, one-way analysis of variance, Mann-Whitney U test and Kruskal-Wallis test. RESULTS: Mean score of subjects' knowledge of venous thromboembolism was 4.47 (0–15), mean score of subjects' awareness of venous thromboembolism was 66.98 (25–100), and mean score of subjects' risk factor of venous thromboembolism was 0.98 (0–44). CONCLUSIONS: Pregnant women's level of knowledge and awareness of prevention and risk factors on venous thromboembolism, is significantly low. To raise their awareness of risk symptoms and prevent occurrence of the disease, it is essential for nurses as well as medical staffs to: 1) provide an educational program on venous thromboembolism for patients; 2) assess and monitor pregnant women with a risk factor of venous thromboembolism; and 3) implement proper prophylaxis for patients.

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.

The development of technology-mediated media has enabled marketers and advertisers to use personalization when interacting with customers. In this article, we explore two boundary conditions (i.e. ...

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.

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.

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.